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A horrible event to wake up to.
My friends and I have spent countless hours on buses zigzagging from one small town to the next as part of Jr. hockey teams. This tragedy hits hard as a result. I can’t shake the image of a team full of guys, on their way to battle a rival in the playoffs, relaxing, shooting the shit, chirping each other about last game, talking girls and the NHL when the unthinkable happens.
These guys were and are hockey guys.
Hockey guys are a different breed. Tough, loyal, hardworking and a joy to be around. The men who have had the biggest influence on me are hockey guys. My Dad, Trigger, Pop, countless coaches and teammates. My son is a hockey guy, my best friends are hockey guys.
As hockey parents we imagine sending our sons away to ride these buses. Imagine them chasing their dreams as we did before them. We hope they’ll be safe, make life long friendships and become men along the way. That was taken from the Broncos last night and it breaks my heart.
These hockey guys need our help now. Their families, friends, billets and fans need our help. I don’t have a big following or a pulpit through which to bring attention to what happened. Many others do and are making the world aware of the tragedy that Humboldt and all of the hockey world woke up to. What I do have is a cheque book and I’ll use that to help how I can.
If you’re a prayer guy, please pray for these kids and all who know them. If not, save a spot to think of them today. If you’re able, please try and support them financially a little bit to help them through this unthinkable time in their lives.
The High Ankle Sprain (Don’t Let This Happen To You. These SUCK.)
Your lower leg bones (tibia and fibula) are held together at the ankle by a group of soft tissues and ligaments called the “syndesmosis”. This connection prevents excessive spreading of these bones during normal activity, but injuries can cause these ligaments to be stretched or torn. This problem is called a “syndesmotic ankle sprain” or “high ankle sprain”. High ankle sprains often occur during contact sports (like football, hockey, and soccer) when your foot is planted while the rest of your body shifts forward and turns inward. High ankle sprains are much less common than other types of ankle sprains.
The pain of a high ankle sprain starts just above your ankle and runs up your shin. Interestingly, the “length” of pain correlates very closely to your severity of injury. Standing and walking is usually uncomfortable and sometimes unbearable. Bringing your toes toward your shin or rotating your foot outward will likely increase your pain. Significant bruising or swelling is possible. Be sure to tell your doctor if you notice numbness, tingling, or coldness in your foot.
Ankles that have suffered a complete separation usually require surgery, since they will have lost the ability to push off, propel, and cut. Most other stable sprains will respond to conservative care, like the type provided in this office. It is important to recognize that high ankle sprains heal more slowly than other types of ankle sprains. The average recovery time for a syndesmotic sprain is between two and seven weeks but some injuries may require up to four months away from your sport. You may need to wear a boot or avoid weight bearing for a period of time. Ice may help to limit swelling initially, and the home exercises described below are an important part of your recovery.
Turf Toe? What Is That?
“Turf toe” means that the strong fibrous ligaments connecting your big toe to your foot have been stretched too far and have been “sprained.” This most commonly happens when your big toe is extended forcibly toward the top of your foot. This may happen abruptly from a fall or when something lands on the back of your calf while your toes are touching the ground. Turf toe commonly occurs from jamming your big toe into a hard surface. Occasionally, the injury happens over a long period of time from repetitive stress- like pushing off of the big toe each time you run or jump.
The term “turf toe” was coined because this injury became more common in athletes with the implementation of artificial turf fields. Turf toe injuries rank third after knee and ankle injuries among the most common cause for lost playing time in athletes.
A turf toe injury causes pain and swelling at the base of your big toe. You will notice your pain probably increases when your toe is straightened or bent backward toward the top of your foot. Sometimes you may notice bruising shortly after the injury. Gout, a type of arthritis that is more common in men, can sometimes act like turf toe. Be sure to tell your doctor if you or someone in your family has a history of gout.
Early treatment is focused on keeping your toe from moving too much. Depending upon the severity of the injury, turf toe usually requires a period of rest for proper healing. When directed, you may begin non-weight bearing activities, such as stationary cycling or swimming. You should take a close look at your shoes before returning to play. Wearing excessively flexible shoes on a turf field increases your chance of injury. Consider a stiff-soled shoe or hard carbon fiber insert during initial healing. When you are able to run and change directions without pain or loss of mobility, you will likely be allowed to return to play. Be sure to ice your toe for 10-15 minutes following any activity while your injury is healing.
My ankle hurts…….
The posterior tibialis muscle begins deep in your calf. The muscle is connected to the arch of your foot by a tendon that runs along the inside of your ankle, just behind the large bump called the medial malleolus. When you walk, the posterior tibialis muscle lifts the arch of your foot. 
Posterior tibial tendon dysfunction is one of the most common foot and ankle problems. The tendon may be damaged from an acute injury, like an accident or fall. More commonly, problems arise from overuse or repeated strain. Ongoing irritation slowly damages the tendon’s fibers and eventually leads to weakening and degeneration. This decreases the tendon’s ability to support your foot when you walk. As the tendon becomes less effective, the arch of your foot is allowed to collapse, which further increases the strain on the muscle and tendon.
The condition is often triggered from overuse and/or training on excessively hard surfaces. Other factors that can contribute to posterior tibial tendon dysfunction include: obesity, diabetes, hypertension, prior surgery or steroid injections.
Symptoms include pain or swelling along the course of the tendon, particularly behind your inner ankle bone. Symptoms often begin following an increase in training intensity or duration. Standing, walking, or running will likely increase your discomfort. Your pain may be aggravated by spending prolonged periods of time on your feet, especially, when standing tiptoe and walking stairs or uneven surfaces.
Early diagnosis and treatment is important to slow progression of the disorder. You may need to temporarily limit weight-bearing activity to allow your tendon to heal. Using a stationary cycle, elliptical machine, or swimming can be good alternatives to walking and running. Your doctor will likely prescribe arch supports or orthotics to help support your foot. You will be given exercises to strengthen the posterior tibialis muscle. These exercises should be performed while wearing shoes with good arch supports. In certain instances, a walking cast or boot may be needed to temporarily protect your foot.
What patients respond better to chiropractic manipulation versus physical therapy?
In discussions with physicians, we are often asked: “What patients respond better to chiropractic manipulation versus physical therapy?”. This is an excellent question as the emerging healthcare model demands that PCP’s select the most cost-efficient and clinically effective management for every case. Almost all musculoskeletal conditions have a defined “best practice” recipe and different conditions require a toolbox of different specialists.
Some neuromusculoskeletal conditions like a spinal cord injury or post-surgical rehab, are nearly always better managed by a therapist. Other conditions like uncomplicated ankle or knee sprains can typically be managed equivocally by either. But when dealing with mechanical LBP, neck pain, and cervicogenic headache, the research is clear – chiropractic spinal manipulation is the most effective option.
In fact, earlier this year the American College of Physicians published a clinical practice guideline (the ultimate synthesis of research) recommending that for acute or chronic LBP, physicians delay pharmacologic management and consider “spinal manipulation, heat, massage or acupuncture”- with no recommendation for therapy modalities. (1)
Furthermore, a new randomized clinical trial comparing outcomes for neck pain patients treated with manual joint mobilization vs. physical therapy demonstrated that the manual therapy group required significantly fewer treatment sessions (6.1 vs. 10.0 treatments at 52 weeks). (2)
Medical physicians, chiropractors, and physical therapists must work together to provide integrated “best practice” care. This means recognizing each other’s strengths and limitations while choosing the best possible option regardless of personal or professional bias.
Our providers understand who to treat and more importantly who not to treat. We strive to employ best practice management for every patient, every encounter. We are proud to co- manage our patients and will work hard to maintain your trust.
