Iliotibial band friction syndrome (IT Band Syndrome) is one of the most common injuries affecting long distance runners.  When iliotibial band syndrome occurs (also known as iliotibial band friction syndrome or “IT band syndrome”) a part of the band can get irritated as it rubs against the femur (thigh bone) just above the knee.  This can occur when certain biomechanical factors and tissue changes are subjected to repeated use, like that during endurance exercise.

IT Band Syndrome – Causes

There are many different opinions and ideas as to how and why iliotibial band syndrome occurs.  In general, the majority of the literature suggests that the iliotibial band tissue is “frictioning” on the femur because the iliotibial band is taut against it.  Given this, it is advisable to try and reduce the tension in the iliotibial band. Stretching is one option.  Foam rolling is also gaining popularity as a method to try and reduce tension in various soft-tissues, although to my knowledge this approach is lacking scientific evidence (perhaps because it is relatively new).  Unfortunately, stretching and foam-rolling as stand-alone remedies are unlikely to resolve iliotibial band syndrome. 

Treatment for IT Band Syndrome

To effectively treat iliotibial band syndrome our clinic combines some “homework” (as mentioned above) with targeted soft-tissue treatment such as active release technique and graston technique.  These techniques have the ability to separate the iliotibial band from the underlying and surrounding tissues that may be adhered.  Perhaps this is why stretching has limited effectiveness since it cannot adequately separate tissues or specifically target areas of adhesion.  At Burlington Sports Therapy, active release technique and graston technique are performed by our chiropractors.  We also have physiotherapists on staff who are able to treat iliotibial band syndrome.

Physiotherapy for ITBand Syndrome

According to the literature, weakness in certain hip flexor and gluteal muscles can be contributing factors in the development of iliotibial band friction syndrome.  When this weakness is identified, the appropriate strengthening exercises are an important aspect of recovery.  Consulting with a knowledgeable physiotherapist can assist you in this regard, providing you with the appropriate tools to prevent iliotibial band syndrome from recurring.  Our physiotherapists also treat iliotibial band syndrome using laser therapy, soft tissue therapy and strengthening.

Unsure what to do?  Give us a call, we can assist you.  905.220.7858.  info@burlingtonsportstherapy.com

References

Fredericson M, Wolf C. Iliotibial band syndrome in runners. Sports Medicine 2005; 35(5): 451-459.

Fredericson M, Cookingham CL, Chaudhari AM et al. Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sports Medicine 2000; 10(3): 169-175.

Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clinical Journal of Sports Medicine 2005; 15(1): 14-21.

Taunton JE, Ryan MB, Clement DB et al. A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine 2002; 36(2): 95-101.

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One of our first blogs on this site was entitled “where do you get your health information”?  The purpose of this entry was to address the difficulty in searching the internet for health information.  Often times, you don’t know who is writing the article and you don’t know what they are basing their opinion on.  We provide references at the end of our entries to help reassure our readers that we’re bringing them quality information derived from good quality scientific journals…not just our opinion, but advice and treatment methods that have some objective evidence behind them.  It often surprises me how many patients forget to challenge the recommendations they read on the internet.  The following will illustrate the point…

Stretches for Sciatica – Ill Advised?

Quite often, patients present to our clinic with evidence of lumbar disc herniation.  This herniation causes symptoms in the lower limb (numbness, tingling, weakness) which are often described as “sciatica”.  Prior to writing this blog, I did a google search for “stretches for sciatica”.  The following is a snap-shot of what the first website gave me…

Lower Back Pain Stretches…Helpful?

You’ve probably already seen the stretches pictured above.  More than likely, you’ve tried them before.  These stretches are frequently used for low back pain management yet to my knowledge there is no scientific evidence to validate their use.  When a patient presents to our clinic with low back pain and we have appropriately diagnosed them with lumbar disc herniation (“sciatica”) we usually start their care with eliminating these stretches.  We do this because there is no evidence supporting their use, and the balance of the evidence suggests that these stretches would more than likely aggravate or worsen lumbar disc herniation (sciatica).

Best Stretches for Sciatica

So what are the best stretches for sciatica?  What are the best stretches for low back pain?  As some exercises can be helpful for low back pain, some can be harmful.  To ensure that your condition is treated effectively it needs to be diagnosed properly.  Once diagnosed, the appropriate management strategy can be implemented.  Although you’re reading this online, Google isn’t a doctor!

Chiropractors for Lower Back Pain?

Chiropractors are qualified to diagnose your lower back pain and the numbness and tingling in your leg.  Your chiropractor should be able to give you good advice on the appropriate rehabilitation exercises for your specific case of low back pain or “sciatica”.  If you choose to search on the internet for your advice, beware…a website can’t diagnose your condition and if the author hasn’t provided references, you can’t necessarily be certain that the information you are reading is correct!

Treatment for Sciatica

If you’re experiencing back pain, sciatica, or numbness and tingling in your leg, feel free to call our clinic today and have your condition examined by one of our practitioners.  There are various treatment options.  Physiotherapy, Chiropractic, laser therapy, active release technique…we have lots of options.  What’s right for you depends on many factors such as how long you’ve had your condition, what you’ve already tried and of course, your comfort level.  If you’ve been to a chiropractor before and it worked, you might be best to try it again!  Regardless, give us a call or email us; we can help!  905.220.7858   info@burlingtonsportstherapy.com

Want to meet our Physiotherapists?  Click here.

Want to meet our Chiropractors?  Click here.

References

Hahne Aj, Ford JJ.  Functional restoration for a chronic lumbar disk extrusion with associated radiculopathy.  Physical Therapy  2006; 86(12): 1668-1680.

McGill S. Low Back Disorders. 2002 Human Kinetics.

McGill S. Ultimate Back Fitness and Performance 2nd Ed. 2006 Stuart McGill. 

Rhee JM, Schaufele M, Abdu WA.  Radiculopathy and the herniated lumbar disc.  The Journal of Bone and Joint Surgery 2006;  88-A: 2070-2080.

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Osteoarthritis (“arthritis”) is a very common condition, affecting 25% of the population over the age of 65. Weight bearing joints in the lower limb are particularly susceptible to arthritis as the weight of the body adds to the biomechanical stresses affecting the joints. Two very common areas for arthritis are the hip and the knee.

What is Arthritis?

There are different forms of arthritis. Some are inflammatory, like rheumatoid arthritis. These types of arthritis are usually genetic and have less to do with “wear and tear”. Your body has decided to “attack” its own joints and inflame them. The more common type of arthritis is not an inflammatory type of arthritis, but rather a “wear and tear” type. This is osteoarthritis…the type that usually affects knees, hips, the lower back and neck (to name a few areas).

Risk Factors for Arthritis

There are various risk factors for the development of arthritis. If everyone in your family has experienced arthritis, there’s a good chance you will too. If you’ve had multiple traumas to a joint and have endured a lifetime of strenuous activity (sports or employment) there’s a good chance you’ll develop arthritis in that joint. Interestingly, some research has uncovered some more interesting, less obvious risk factors…

Knee Arthritis and Hip Arthritis…Risk Factors?

A recent paper published in Foot and Ankle International found a correlation between certain foot-types and joints where arthritis occurred. The authors found those with limited dorsiflexion (the movement of bringing your toe toward your shin) and a high arch in the foot had a trend toward arthritis in the hip. For those with a normal range of motion in the ankle but flat feet there was a trend toward arthritis in the inside of the knee.

Diagnosing Arthritis

Thankfully, another recent study has provided a reliable way for practitioners to measure patients and determine if their foot type and ankle range of motion is abnormal. We can combine this information with other risk-factors for osteoarthritis and tailor a treatment plan accordingly. In other words, if your measurement scores are poor and you already have some risk-factors for the development of arthritis (elderly, female, obese, osteoporotic, history of trauma to the joint, genetics etc.) there’s a good chance you’ll experience some pain at some point. X-rays and blood tests can also sometimes be helpful for the diagnosis of arthritis.

Treatment for Arthritis

There are various treatment options for arthritis. At our clinic in Burlington, we offer treatment through our physiotherapists and our chiropractors. Both practitioners offer laser therapy, which is perhaps the fastest way to get pain relief. For some, the pain doesn’t return for quite some time. For others, strengthening and stretching are the best options, which can be taught to you by our physiotherapist.

If you think you may have arthritis or at risk of arthritis, give us a call.  We can offer you advice, direction and a plan for the future.  Laser Therapy, Chiropractic, Physiotherapy…we can help!    

To learn more about our chiropractors, click here.
To learn more about our physiotherapists, click here.

For further information please contact us…905.220.7858 info@burlingtonsportstherapy.com

References
Bosomworth NJ. Exercise and knee osteoarthritis: benefit or hazard? Canadian Family Physician 2009; 55: 871-878.
Reilly K, Barker K, Shamley D et al. The role of foot and ankle assessment of patients with lower limb osteoarthritis. Physiotherapy 2009; 164-169.
Reilly K, Barker K, Shamley D et al. Influence of foot characteristics on the site of lower limb osteoarthritis. Foot Ankle International 2006; 27: 206-211.
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Carpal tunnel syndrome occurs when a nerve in the wrist (the median nerve) gets compressed between some bones and soft tissues. The symptoms usually consist of pain, numbness, tingling, weakness and deficits in sensation. Typically, carpal tunnel syndrome is more common in women and often occurs in both hands.

Carpal Tunnel Syndrome Treatment

There are many different treatment approaches for carpal tunnel syndrome. For those individuals with significant changes in the hand musculature, an unrelenting symptom pattern and objective confirmation of carpal tunnel syndrome surgery is often indicated. For most people carpal tunnel syndrome can be easily controlled with conservative treatment.  At our chiropractic and physiotherapy clinic in Burlington we recommend a combination of soft tissue therapy (active release techniques and graston technique) with night splinting. The purpose of the soft tissue therapy is to break-down scar tissue that is impeding the proper function of the median nerve. The night splinting is used to “unload” the nerve and allow it to heal.

Wrist Brace for Carpal Tunnel Syndrome?

Although there is significant evidence supporting night splints for carpal tunnel syndrome, the results of a 2007 paper published in the Archives Physical Medicine Rehabilitation suggest that there may be a right and a wrong way to do this. In this study the authors compared two different approaches for splinting the wrist in patients with carpal tunnel syndrome. Their findings indicated that a splint which keeps a specific segment of the finger extended is more effective, as several studies have shown that this position keeps certain muscles out of the carpal tunnel. Shortening these muscles at night therefore allows the median nerve to have more room in the carpal tunnel without being compressed.

Physiotherapy for Carpal Tunnel Syndrome

The combination of active release technique, graston technique and night splinting is an effective and evidence based way to conservatively control carpal tunnel syndrome.  Our clinic has also found laser therapy to be effective for this condition.  What is right for you?  It depends on a variety of factors; how long you’ve had carpal tunnel syndrome and what else you’ve tried are two of the more important factors.  Keep in mind that there are numerous causes of numbness, tingling, pain and weakness in the wrist and hand. There are other potential entrapment sites of the median nerve and there are other nerves that can create similar symptoms to carpal tunnel syndrome. Ensure that your condition is properly diagnosed by a qualified practitioner; feel free to contact our clinic and schedule an appointment with one of our doctors to see if you truly have carpal tunnel syndrome.

For more information about our Chiropractors, click here.

Fore more information about our Physiotherapists, click here.

References

Brininger TL, Rogers JC, Holm MB et al. Efficacy of a fabricated customized splint and tendon nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch Phys Med Rehabil 2007; 88: 1429-1435.

Goodyear-Smith F, Arroll B. What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management. Ann Fam Med 2004; 2: 267-273.

Miedany YE, Ashour S, Youssef S, Mehanna A, Meky FA. Clinical diagnosis of carpal tunnel syndrome: old tests – new concepts. Joint Bone Spine 2008; 75: 451-457.

Ugbolue UC, Hsu WH et al. Tendon and nerve displacement at the wrist during finger movements. Clinical Biomechanics 2005; 20: 50-56.

A Burlington Ontario Physiotherapy Clinic on Low Back Pain Exercise

As mentioned in a previous blog, the transverses abdominis muscle has been shown in the literature to play an important role in controlling the spine and therefore has an impact on lower back pain.  Although it has yet to be determined whether this muscle can cause lower back pain or whether it changes as a result of low back pain, it is relatively safe to say that the literature supports retraining this muscle as a potentially helpful approach to rehabilitation of lower back pain for some patients.

Transversus Strengthening for Lower Back Pain

A 2010 study published in the Journal of Orthopaedic and Sports Physical Therapy had similar findings to a 2008 study in that athletes with lower back pain could not perform the muscle test for the transverses abdominis as well as those athletes who did not have lower back pain.  So what does a finding like this mean? 

The Most Important Muscle for the Lower Back?

The transverses abdominis is not necessarily the most important stabilizing muscle of the lumbar spine.  It is not the only muscle that needs to be trained for patients with lower back pain.  Training the transverses abdominis will not guarantee elimination or total prevention of lower back pain.  These findings suggest that for some patients with lower back pain, retraining of the transverses abdominis can be helpful in re-establishing control of the spine.  This may result in decreased low back pain.  Identifying weakness of the transverses abdominis is paramount to the effectiveness of this approach, since we cannot expect targeting this muscle to be helpful if a person already has normal function in this area.

Treatment for Low Back Pain

At Burlington sports therapy, our chiropractors and physiotherapists make every effort to keep abreast of the most current, proven and progressive approaches to the treatment of lower back pain.  We don’t just choose stretches and strengthening exercises that look creative or clever.  We choose the appropriate exercises for our patients as dictated by the scientific literature.  Live in the Burlington area and looking for treatment?  Give us a call!  905.220.7858   info@burlingtonsportstherapy.com

References
Hides JA, Boughen CL, Stanton WR et al. A magnetic resonance imaging investigation of the transverses abdominis muscle during drawing-in of the abdominal wall in elite Australian football league players with and without low back pain. Journal of Orthopaedic and Sports Physical Therapy 2010; 40: 4-10.
Hides JA, Stanton WR et al. MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. British Journal of Sports Medicine 2008; 42: 509-513.
Richardson CA, Snijders CJ, Hides JA et al. The relation between the transverses abdominis muscles, sacroiliac joint mechanics and low back pain. Spine 2002; 27: 399-405.

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