This statement, which I tell most patients, holds true so often. Why does your knee start to hurt one day on a run? Did you run wrong that day? Did you stand up wrong? Most likely not. There’s a good reason for your injury, and it’s not because you’re lacking ibuprofen or you haven’t used enough ice.
Aside from trauma, injuries primarily occur from being too anaerobic. Your body will be in anaerobic excess if you are exercising too much, not recovering properly, eating the wrong type of diet, lacking proper nutrition, or under too much emotional stress. Injuries don’t just pop up one day while you are out for a run or playing tennis. There are almost always warning signs of too much stress and overtraining, just check out the other articles under Natural Fitness. You will not become injured from a lack of anti-inflammatory medication. You may become injured from a diet that cannot fight inflammation to the degree you are creating it though. Basically, you will never be deficient in aspirin, but you may be deficient in the “good” anti-inflammatory fats. As you will see and have perhaps learned if you already read the other sections of the drgangemi.com site, the hormonal system, primarily the adrenal glands and the pancreas, have to deal with the burden of too much anaerobic exercise, and too much everyday stress. Most injuries have an adrenal gland component to them. Properly addressing the hormonal dysfunctions, dealing with inflammation, and balancing the muscles around and involved with the injury leads to success – not in months or years, but in weeks, and often days.
Common Athletic Injuries
|Plantar fasciitis is a type of foot pain that occurs in the heel and sometimes in or around the arch of the foot as your plantar fascia is the thick connective tissue on the bottom of your foot. Symptoms are usually worse in the morning, and tend to ease off or go away as you walk throughout the day. The pain can be sharp over one specific point, or more diffuse throughout the fascia (sheath of muscle) of the foot. Today this is treated conventionally with “night splints” to help stretch the fascia, and reduce muscle contracture. It is not a very comfortable way to sleep and the therapy is about as beneficial and primitive as a caveman making a square wheel. As with most pain, anti-inflammatories are prescribed as are orthotics, which only support the dysfunction and weaken foot muscles.|
Plantar fasciitis occurs most often from the fatigue of the tibialis posterior muscle. This muscle is behind your lower leg bone and supports the main arch of your foot. Problems arise from injury, lower leg dysfunction, and/or adrenal gland (hormonal) stress. Pretty much if you have plantar fasciitis you are under more stress than you can handle – whether that be from overtraining (too much anaerobic activity, or lack of an aerobic base), working too hard, dietary stress (too much sugar, not enough protein or nutrient-dense foods), emotional stress, or other physical trauma/stress – ANYWHERE in the body, not just in the foot. Even a poor fitting pair of shoes can cause this problem. The calf muscles are often involved as often are other leg muscles in the thigh and hip. The imbalance in the muscles causes the plantar fascia to tighten and spasm as it tries to support the foot. Addressing the reason for the muscle imbalances will address the plantar fasciitis problem, and the reason is not because you need to stretch it more, or didn’t stretch it enough. Often treatment involves dietary modifications, nutrient supplementation such as natural anti-inflammatories, exercise & training adjustments (more aerobic, less anaerobic), and local muscle therapies.
Here’s What You Should Do Instead if You Have Plantar Fasciitis: Rub out any muscle trigger points behind the shin bone all the way down to the Achilles tendon. Strengthen your foot muscles by walking barefoot as much as possible and trying to pick up small objects (like marbles) by crunching your toes. Wear minimalist-type shoes with a wide toe box, low to zero-drop, and little support.
–You may need to ease into these if you’ve been in thick-heeled supportive shoes for a long time
– Do not stretch your calves, since this will only lengthen the injured muscle.
– Check out my plantar fasciitis video here at Sock Doc!
|Just about anyone who has ever played high school sports has rubbed a Dixie cup of ice up and down their shins to deal with the painful shin splints. This is still being prescribed today. I think that the Dixie cup is just as effective in treating this as the actual ice (haha). There are two types of shin splints – anterior (front of the leg), and posterior (back of the leg). In either case, the shin splints occur from a muscle imbalance between the two. If the tibialis anterior (front muscle) is neurologically inhibited (weak), the muscle will easily fatigue when walking or running, causing pain and therefore the “splints.” But the weakness can also cause the muscle on the opposite side, the tibialis posterior, to work extra hard to support the foot, so this can cause shin splints in the back of the leg. The story is the same in a vice-versa situation if the muscle in the back of the shin is weak causing the front to work harder. Shin splints are an adrenal gland issue most of the time – which means there is too much physical, dietary, or emotional stress the body cannot adapt to. Overtraining can result in shin splints too. Sometimes the injury can be from something directly going on within the muscles or involved joints (knee/foot/ankle). Often the same stress will cause either shin splints or plantar fasciitis in a person; no rhyme or reason to it – maybe (un)lucky enough to get both. Gait imbalances are very often seen in athletes as they wear the wrong types of footwear, often over-supportive and motion-control shoes that don’t allow their foot muscles to behave naturally. Orthotics can also be the cause of shin splints – or later prescribed for the problem only to further alter body mechanics and cause a gait dysfunction. The foot, ankle, and lower leg muscles, tendons, and ligaments fatigue and muscle compensation begins when orthotics and non-minimalist shoes are worn. Some muscles work too hard to compensate, while others don’t work enough, so the pain begins. Don’t stretch those tender shins or calves, it won’t help. Rather, look for tender muscle points (“trigger points”) throughout the muscles and rub them out as I show in the video. Ice will rarely help, other than to numb the pain; keep your veggies in the freezer and off your legs. Check out the Sock Doc Shin Splints Video.|
|You have hundreds of bursa all over your body which can be thought of as little bags of oil that help reduce friction between two joints moving in opposite directions as well as where muscles and tendons slide over bone. Bursitis, or inflammation of a bursa, is often described as “hot & stabbing” pain, and has some degree of swelling. Bursitis can be caused by a local injury to a joint, such as the elbow or knee, as well as improper repetitive motion between muscles. For example, if your biceps muscle is not functioning properly (there is some muscle “weakness” – inhibition) then your triceps will work harder due to the opposing muscle inhibition of the biceps. This muscle imbalance will cause stress on the elbow and shoulder joints. If the bursa in the elbow were to become inflamed due to the chronic joint and muscular imbalances, you would have a diagnosis of olecranon bursitis. Trochanteric bursitis in the hip is also a very common spot for bursa problems. Swelling of the bursa behind the knee where the calf and hamstring muscles cross is also very common; this is called a Baker’s cyst. Similar local therapies which help treat tendonitis also help with bursitis, but the nutrition aspects of bursitis is a bit different. Nutritionally, bursitis has to do with calcium, fats, and the acidity of your tissues.|
Here’s the common bursitis “nutritional” scenario: When you’re under too much stress of any kind, your body requires additional protein. This protein comes from your diet as well as muscle breakdown and even from the area around your actual bursa. The robbing of protein from the tissue and bursa creates a more alkaline medium in that area. Calcium is then deposited in the bursa as a result of the alkaline environment to help protect the bursa. Unfortunately, this creates pain and inflammation – bursitis. Treating the bursitis involves not only dealing with the inflammation but also mobilizing the calcium out of the area by creating an acidic environment in the tissues. One of the best ways to acidify the tissues is to add 1-2 TB of vinegar to your diet every day, (many use apple cider vinegar), though sometimes more may be needed. In addition to acidifying the tissues to mobilize the calcium, sometimes essential fatty acids are needed to help fight the inflammation. Omega-3 fats such as flax oil and fish oil, and omega-6 fats such as black currant seed, borage, and especially unrefined sesame seed oil, can be of use here. Other anti-inflammatories such as quercetin and turmeric can help too.
|Tendonitis is inflammation of a tendon, which is how a muscle connects to a bone. This is probably the biggest complaint that athletes have in regards to injuries. It is also one of the most used diagnoses, and perhaps sometimes incorrectly. For example, many physicians now think of Achilles tendonitis as Achilles tendonosis (also spelled tendinosis) – which is a chronic degenerative condition with some micro-tearing of the tissues without inflammation. Resolving tendonitis (as well as a tendonosis) involves both local and global “systemic” treatment. Trigger point therapies, as I explain and demonstrate in the Sock Doc videos, and meridian (acupressure/acupuncture) therapies can help tremendously with pain and inflammation reduction as well as healing the involved tissues.|
Gait disturbances can cause tendonitis. Walking or running incorrectly due to muscle imbalances or joint dysfunctions caused by another injury or from wearing improper footwear can result in tendon problems. What you put on your feet will have a dramatic effect on your entire body – not just your feet. I have treated many people with shoulder tendonitis because of an improper gait – some because of poor shoes and some because of old injuries that were still unknowingly affecting them. Every swing forward of your arm when you walk or run must also be in sync with the muscles of your opposite-side leg. An old injury or surgery to your knee, for example, could still be affecting your gait causing an imbalance which results in the improper motion of your shoulder on the opposite side. Next thing you know, you have tendonitis in that shoulder.
Your adrenal glands, pancreas, and liver are the three major organs involved in tendonitis problems. The adrenal glands are your hormonal glands that deal with stress. They will secrete excess cortisol when there is too much dietary, physical, or emotional stress. Over time, the beneficial hormone DHEA, also made in the adrenal glands, will become depleted with persistent chronic stress, resulting in low sex hormone levels such as testosterone and estrogen, as those hormones are made from DHEA. This constant cortisol burden will tax the liver, which must detoxify the hormone, and much of this is done via a process known as sulfation. When your body uses up sulfur, it has less available to heal injured tendons as well as your cartilage (joints) where they attach to. So chronic stress leads to chronic cortisol leads to chronic inflammation and the inability to heal. The increased cortisol also plays off the pancreas, creating a constant tug-of-war between the two organs (the pancreas and the adrenals) as they try to keep blood sugar levels from swinging out of control all day long as you work, exercise, and sleep. This will create insulin and carbohydrate sensitivities, and in turn create even more inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed for many “itis” problems. Guess what? These will also deplete sulfur from your body because that’s how your liver detoxifies them, so overall healing is even further delayed. If you ever feel better from taking a NDAID it’s a sure sign that you have a fatty acid metabolism problem occurring in your body. If there was no fatty acid metabolism problem or imbalance, you’d see no benefit taking the drug. If there actually isn’t inflammation to be treated and you’re dealing with an “osis” rather than “itis” you may not see a NSAID benefit. However I’d say it’s very rare for a person to have a chronic injury that their body can’t heal and not have some degree of inflammation.
Using ice can sometimes help with the pain during the acute phase of the injury, but it should not be used for weeks and months. This may in fact just be numbing your pain temporarily during use but actually delaying the healing by constricting blood flow to the area and artificially reducing inflammation too much for the tendon to heal. You do need some inflammation to heal in the acute phase – not too much for too long, and not too little!
|Overpronation is not an injury but I put it under this section because many people are given this “diagnosis” and it’s treated like an injury via footwear support and orthotics. Overpronation does not occur because you’re wearing shoes that don’t have extra support or because you’re lacking orthotics, though changing the footwear is the remedy given by a lot of physicians and running “experts.” Pronation is the natural inward roll of your foot as you walk or run. This is how you absorb shock. If you overpronate, you roll inward too much. You’ll see excessive wear on the front inside and back outside (heel area) or your shoes. If you lay your shoes on a flat surface, they’ll (naturally) roll in if you’ve been wearing them for a while and overpronate. I always get a kick out of people at running stores who watch their customer run or walk. They want to try to fit them in a shoe that supports their gait – the way they walk or run. So if they overpronate, they want to put them in a shoe that stops that. If they are a heavy heal striker, then they’ll put them in a shoe with a lot of cushion. Yeah, that’s their job but ideally that person should be focusing on their gait and structure and walking correctly which is often best accomplished by going barefoot as much as possible. Shoes that have little to no support is the best way to go. Overpronation is a posterior tibialis muscle issue. Yes, the same muscled described above that can cause shin splints, plantar fasciitis, bunions, and neuromas. So as with all posterior tibialis involvements, there is the adrenal glands issue to investigate. The posterior tibialis can no longer support the major arch of the foot, so there is excessive inward motion. A shoe or orthotic that prevents the overpronation is not going to address the issue by a long shot. More on overpronation at Sock Doc.|
|ITB FRICTIONAL SYNDROME|
|If you’ve had Iliotibial Band (ITB) Frictional Syndrome, then you know how much it hurts, and how it feels like it’s never going to go away. I’ve had it more than once many, many years ago before I knew how to train and eat properly. It’s one of those pains in your knee or the outside of your leg where you go out for a run, and have to limp home. I was miserable – and taking high doses of NSAIDs didn’t help and rubbing DMSO only made me stink! (Runners reading this know the DMSO smell.) Many suffer with this injury for months. It’s like a knife digging into the side of your leg or knee. The ITB is an extension of a short muscle on the side of your hip called the tensor fascia lata (TFL) as well as your gluteus maximus muscle, (that’s your behind). The ITB extends from the TFL and glut max down to the outside of your knee. Pain occurs anywhere along the ITB, usually at the insertion (by the knee) or somewhere in the middle. You’ll have pain running, walking (usually down) stairs, and anytime you try to bend your leg, especially after keeping it straight for a while. Waking up in the morning will be like an ice-pick in your leg. If you’ve ever had ITB(F) syndrome, you probably went through a whole slew of treatments and still had it for 3-6 months; that is very common and no fun.|
Medical treatment is cortisone shots and NSAIDs for inflammation and if that doesn’t help, then surgery is recommended to cut and release the band. That sounds like fishing, but much more miserable because someone would actually be cutting into a thick sheath of tendon, leaving the leg much less stable than what it was before going under the knife. ITB syndrome occurs typically from the following reasons. Often there is an actual weakness of the TFL or glute max itself. 75% of the ITB is made up of the glute max – the major leg extensor powerhouse muscle you use to jump, climb, squat, run, ride your bike, and even just to get out of a chair. This weakness could be from a structural imbalance, an injury somewhere (anywhere in the body), an insulin issue from eating too many carbohydrates creating a gait disturbance, or even from a digestive problem, (gut inflammation can inflame the ITB). One or both of those muscles could have fatigued from wearing the wrong type of shoes or orthotics, or even from an old injury that is still haunting you, but you don’t know it because the pain is gone, but your body has compensated. ITB Syndrome can also occur from an imbalance between the inside and the outside of the leg. The muscles that support the inside of the knee are related to the adrenal glands. These are the sartorius, gracilis, as well as one of your hamstring muscles on the inside of the back of the leg that wraps around to the inner lower knee. If there is an adrenal involvement from overtraining and/or too much life stress, these muscles will weaken, causing an over-firing of the tissues on the outside of the leg/knee, which as you now know, is the ITB and TFL. Or the muscles on the inside of the leg could be working too hard so the outer leg muscles – the TFL and gluteus medius and minimus – are pulled inward, essentially torquing the leg. Treating the injury with this understanding usually corrects it very quickly, often within a couple of weeks, if not sooner. Check out the Sock Doc ITB video here!
|OSGOOD-SCHLATTER’S DISEASE (SYNDROME)|
|This “disease” most commonly occurs in boys aged 10-18, though girls can have it too. It occurs when the area where the patella (knee) tendon attaches to the tibia (lower leg) bone is under too much stress and becomes inflamed or it pulls so hard on the insertion at the bone that it actually ruptures. This pain, as common as it is especially during a child’s growth spurt, is very unnecessary. And the fact that conventional medicine takes the “do nothing but ice and rest” approach because it usually resolves within 1-2 years (!) makes it very frustrating for an active kid to participate in sports due to the pain. Physical therapists and the medial community understand that it is often due to an imbalance between the quadriceps and hamstrings muscles, but they still have this idea that a muscle that is “weaker” needs more exercise and a muscle that is working too hard (stronger) needs to be stretched. Well, those imbalances don’t improve at all with that perspective because the imbalance is neurological – those muscles surrounding the knee are out of balance front to back and sometimes inside to outside for various reasons; it’s different for each kid. It could be due to another injury in the leg, or opposite leg. It could be from improper footwear. It could be from a dietary condition as the quadriceps are related to the small intestine. Food allergies can and often cause this imbalance. Yes, I’m saying that eating something the child is allergic to can cause this syndrome; I’ve seen it plenty of times. I’ve helped kids resolve their Osgood-Schlatter “Disease” quickly, sometimes within one treatment by finding out exactly what their imbalance is. Kids are told to deal with it until they outgrow it. Although most will, it keeps them from performing as well as they should, and some kids can’t play the sports they want because of the pain. Some adults still have “weak knees” because of this syndrome. It’s unnecessary. I don’t think Dr. Osgood and Dr. Schlatter knew this way back in 1903.|
|I don’t have a good knee and a bad knee. I have two good ones! So many people have a “good knee” or a “bad knee.” Well, there’s lots of reasons for knee pain. Head right over to my article “No Need For Knee Pain” and get back to what you’d like to be doing but can’t because of that evil/bad knee.|
|GOLFER’S ELBOW & TENNIS ELBOW|
|Tennis elbow is pain on the outside of the elbow; golfer’s elbow is on the inside whether or not you participate in either sport. These injuries occur from overuse to the muscles and ligaments making up the elbow joint. There are usually a series of muscle imbalances present, not just around the elbow, but also at the shoulder and/or wrist/hand. One of the most common imbalances of tennis elbow is the triceps muscles. One or all three of the triceps can be an issue due to direct muscle injury from overuse, or nutritionally most often from carbohydrate intolerance as the triceps have a strong visceral (organ) relationship with the pancreas. The biceps is the common culprit of golfer’s elbow, as are the pronators and wrist flexors of the lower arm. The biceps can be out of balance with the triceps and either problem with the elbow can result. Either one is most often due to carbohydrate metabolism issues. Eating too much sugar and drinking soda or beer out on the golf course and all of a sudden your elbow hurts and, well, there you have it.|
|Whether the wrist and hand hurts because of “carpal tunnel syndrome” or not, it’s better to diagnoses what is going on rather than what you’re ultimately diagnosed with. More on carpal tunnel syndrome here.|
|Cramping can be due to a variety of issues. Rather than write them all here, you can read about them by reading my article “Cramping Your Style“.|
|SHOULDER PAIN & ROTATOR CUFF PROBLEMS|
|The shoulder is a complex joint. You’ve got four rotator cuff muscles in the back & side of your shoulder and then your actual deltoid muscles, which people generally call their shoulder. There’s the muscles of your upper arm, such as your biceps and chest (pectoralis muscles – 3 of them) which have a lot to do with forward motions, and you’ve got the muscles coming down from your neck and up your back and side to further support your shoulder joint. So with all these muscles, there’s a lot that can and will go wrong if there is a muscle imbalance. Shoulder pain is right up there with knee pain – a lot of people have it and “learn to live” with it everyday. There can be arthritis, tendonitis, and bursitis in the shoulder. There can be loss of mobility from elbow or neck involvement. Whatever the case, two people with the same exact shoulder pain many times have different reasons for their pain. Individualized treatments are most important here to figure out why the shoulder isn’t functioning as well as it should, especially when dealing with situations such as a frozen shoulder or chronic displacements. Sock Doc Shoulder Pain Video here.|
|It’s too much to discuss all the causes of back pain and all the treatment options, so I decided to talk about just two. That is, two of the most overlooked reasons for chronic back pain and frequent injuries. Both are structural with nutritional components.First involves the abdominal muscles. Many therapists mention the abdominal muscles when someone comes to them with an injured back, but they just tell the patient to do more exercises such as crunches. The abdominal weakness is often from some digestive issue or from dehydration. The digestive issue creates abdominal distension causing those muscles to fatigue and this spasms the lower back. You know your abdominals are involved if you have (back) pain when you are lying flat on your back and the pain goes away or gets better when you put your knees up (or under a pillow). You’ll also have more pain trying to get up from that lying position. After standing for sometime, the abdominals will no longer be able to support you, so you’ll also more than likely have some back pain standing for prolonged periods. Many times you’ll have a “sway” back posture. Figuring out what is causing the digestive problem is the goal to fix the lower back pain, or at least support it. This is especially true if the pain is aggravating any lumbar discs. The most common digestive issues are a food allergy, dysbiosis in the gut (which means lack of healthy gut flora and/or bad bacteria, fungus, or yeast), too much sugar or caffeine, and bad “trans” fats (hydrogenated fats). The psoas muscles are often involved as much as the abdominals. The psoas makes up part of your hip flexors and does just that (flexes your hip) bringing your thigh up towards your chest. Trouble lifting your leg in such a manner or more back pain bending forward to touch your knees or toes often means the psoas muscles are involved. The second most common type of low back pain involves the iliolumbar ligament. This short and strong ligament connects the fourth and fifth lumbar vertebrae to the iliac crest (pelvic bone). Irritation to this ligament often causes that one-sided lower back pain as it tries to stabilize the joint between your lumbar spine and the pelvis. The abdominal issue can cause these ligaments trouble as well. A disrupted gait is the number one reason for chronic iliolumbar ligament pain and inflammation. When this ligament loses its support, the stage is set for other injuries to occur, such as disc problems and spinal misalignment. Actually, the involvement of this ligament is a very common reason for a chiropractor to constantly need to adjust your lower back. The bone will never stay in place if the function of the ligament isn’t restored. Sometimes this involves direct ligament treatment. Nutritionally this is where carbohydrate intolerance/insulin resistance becomes important as having glucose/insulin issues will “wind you up” in one direction and throw off your gait – leading to an iliolumbar ligament sprain.|
|Achilles tendonitis is a pain in the Achilles tendon often where it attaches to the heel bone. Another name this injury goes by is Achilles tendinopathy as there is question to whether there is actually inflammation (the ‘itis’) in the injury. Retrocalcaneal bursitis is sometimes diagnosed too, signifying that the bursa sac under the Achilles is inflamed. Then you’ve got names like heel spur, bone spur, and my favorite – the “pump bump” when there is an obvious swelling on the back of the heel. Call it what you like, there’s a problem in the lower leg. The Achilles is the tendon attachment of the two calf muscles – the gastrocnemius and the soleus. These muscles provide your power when running (especially uphill) and jumping. They are very susceptible to stress as their function is closely related to the adrenal gland organs and cortisol (stress hormone) production. This is why if you’re exercising too much, too often, and too hard, you’ll most likely injure your foot or calf muscles resulting in names like Achilles tendonitis, plantar fasciitis, or shin splints. But remember, it’s more important to diagnose WHY you have a problem rather than exactly WHAT you have. So whether you’re told you have tendonitis, bursitis, or a good ol’ pump bump, it means your calf muscle(s) aren’t working well and you’re biting off more than you can chew. In the Achilles tendonitis video I show ways to find the trigger points in the calf muscles to help relieve the pain and start to heal the injury in the Achilles tendon. As with any injury, there is some local therapy that needs to take place as well as a resolution to WHY the injury occurred in the first place. Are you wearing the wrong type of shoes? Too high of a heel? Too much support? These types of shoes will weaken your feet and can result in an Achilles problem. Think minimalist footwear and stay barefoot as much as you can to strengthen your feet, lower legs, and entire body. Orthotics – not a good idea either. They support the foot and lower leg dysfunction. Excess anaerobic training will soon stress the adrenal glands too much and often result in an injury.|
Read about exercising aerobically and building a solid aerobic base on the Sock Doc site. Too much emotional stress can result in injury too. Do you work 60+ hrs a week and are under a lot of stress? Lastly, the nutritional component is often of utmost importance. Hydrogenated fats, refined sugars, MSG, and other processed foods can all wreak havoc on your health and cause so much stress you’ll end up with an injury. Nutritional problems often set the stage for physical injuries.
Remember, your Achilles tendonitis is an injury that is telling you you’ve overtrained – either on the bike, on the track, in the pool, at home, in the office, or in life.