


Children and adolescents have soft “growth plates,” which are areas where their bone is still growing. In children, this growth plate is much weaker than in adults. This means that children are more likely to suffer growth plate injuries than adults, especially during periods of rapid growth.
Osgood Schlatter’s disease, also called tibial epiphysitis, is a painful irritation of the growth plate near the insertion of your quadriceps muscle on your knee. The powerful thigh muscles attach onto your knee through the patellar tendon. When your thigh muscle contracts- like during running or jumping, they place a sheer force on the growth plate of your knee.
Osgood Schlatter’s disease is more common in athletes, particularly those who participate in soccer, gymnastics, basketball, running or track. It is most common between the ages of 10 and 15 and is relatively equally common between boys and girls. Excessively tight thigh or calf muscles may contribute to this problem.
You may experience pain with activity that requires running or jumping. You will often feel tenderness or even bony enlargement of your “tibial tuberosity”, just below your knee. Kneeling or prolonged squatting may be painful.
Some athletes with mild cases may continue activity as long as it does not increase your symptoms. Most cases may require a period of rest to allow the condition to heal. Depending on the severity of your condition, you may need to limit activities that require running and jumping for a while, usually two to eight weeks. You can often cross train in the pool or on a stationary bike.
You should avoid running with a narrow stride “on a line,” as this may increase your symptoms. Our office may recommend use of a patellar tendon strap to assist with your healing. Osgood Schlatter’s disease can temporarily limit your activity, but most of the time, it can be successfully managed, allowing your return to pain-free activity in a relatively short period of time.

The normal walking or running cycle begins with your heel striking the ground. As you transfer your body weight onto the front part of your foot, the arch of your foot naturally flattens slightly. This is called pronation.
The tissues that help maintain the arch of your foot are exposed to tremendous stress and may eventually break down. The loss of the normal arch of your foot results in a condition called “overpronation” or flat feet. This condition most commonly develops over a long period of time from repetitive stress.
Overpronation by itself is not painful, but the problem often leads to secondary problems, which may be painful. Plantar fasciitis, foot pain, shin splints and problems in the knee, hip or lower back are all related to overpronation. Patients who carry excess weight are more likely to develop this condition.
To help support your foot, you should wear shoes with good arch supports consistently. In some cases, specially molded orthotics may be needed to help support your arch.
Your posture plays an important role in your overall health. Poor posture leads to chronic strain and discomfort. “Upper crossed syndrome” describes poor posture that results from excessive tightness in your shoulders and chest with weakness in your neck and mid-back. This combination forces your shoulders to roll inward and your head to project forward.

To help understand how upper crossed syndrome causes trouble, think of your spine as a telephone pole and your head as a bowling ball that sits on top. When the bowling ball is positioned directly over the top of the upright post, very little effort is required to keep it in place. If you tip the post forward and the ball begins to roll over the edge of the post, significantly more effort would be required from the muscles trying to hold it there. This effort results in chronic strain of the muscles of your neck and upper back.
The chronic strain is uncomfortable and may also lead to neck pain, upper back pain, headaches, TMJ pain, and ultimately- arthritis. This postural problem is exceptionally common in computer workstation users. Correction of this problem is accomplished by stretching the tight muscles, strengthening weak muscles, and modifying your workstation.
The gluteus medius muscle plays an important role in hip and pelvic stability. It originates on the gluteal surface of the ilium, deep to the gluteus Maximus. It inserts on the greater trochanter of the femur. It’s main actions are to abduct the hip and to assist in internal rotation of the hip. It also maintains pelvic stability during walking and running. Trigger points in this muscle will refer pain into the sacrum, the iliac crest, and down the lateral hip and into the thigh. This muscle is often a cause of lower pack pain.
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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. |
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Here is a brief description of the treatments we may use to help manage your problem. ![]() Joint Manipulation
Your chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints.
![]() Therapy Modalities
We may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed.
![]() Myofascial Release
Overworked muscles often become tight and develop knots or “trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility.
![]() Therapeutic Exercise
Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury.
![]() Elastic Therapeutic Tape
Your chiropractor may apply a special elastic therapeutic tape in order to support injured areas or encourage better movement. This tape is thought to decrease pain and swelling, improve circulation and limit muscle soreness.
![]() Foot Evaluation
Fallen arches and faulty foot mechanics are common problems that can perpetuate your condition. Our office will carefully evaluate your feet and consider the need for a change in shoe style, arch supports or even custom orthotics.
![]() Ankle Brace
Our office may recommend using a support brace to protect your ankle from further injury. Your doctor will discuss the specific type of brace and provide instructions for use.
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After this initial course of treatment we will reassess your progress. We will determine the need for any additional care after your reassessment.
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![]() Sleep Posture
Your mattress and the position you sleep in may affect your condition.
✓ Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses. ✓ Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach. ✓ Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms. ![]() RICE
The acronym RICE can help you remember what to do after a new injury:
✓ Rest – Limit stress to the injured area for at least the first 48 hours. ✓ Ice – Apply for 10-15 minutes. Break for 30 minutes. Reapply. (Alternatives to the ice pack include Ziploc bags filled with ice, or a bag of frozen vegetables.) ✓ Compression – Wrap the injured area with an elastic ACE bandage if possible. ✓ Elevation – Elevate the injured area to limit swelling. ![]() Standing
To avoid extra stress on your spine while standing:
✓ Avoid high-heeled shoes or boots ✓ Use a footrest ✓ If excessive standing can’t be avoided, consider shock absorbent shoes or an anti-fatigue mat. ![]() Footwear
Improperly supported feet can affect the alignment of all of the structures above. To improve your overall comfort:
✓ Choose shoes with good arch support. ✓ Avoid going barefoot or wearing shoes that lack support (i.e. flip-flops). The following brands of sandals provide better than average arch support: Naot, Fit Flops, Orthoheels, Abeo, Vionic and Yellow box. ✓ Avoid high-heeled shoes or boots (keep heels to a maximum of 1½ inches, especially if you are going to be doing a lot of walking). ✓ “Cross-trainer” athletic shoes tend to provide the best all around support and shock absorption for daily activities. ✓ Patients with fallen arches should consider adding arch supports or orthotics. ✓ Repair or replace shoes with worn soles or heels. ![]() Running Shoes
Running shoes need to be replaced every 250 miles. There are three basic options:
✓ Motion Control Shoes – Designed for people with low or no arches, these shoes are for runners who strike the ground on the outer edge of their foot. Avoid overly stiff shoes as these decrease you perception of ground strike and lead to new injuries. ✓ Stability or Neutral Shoes – Designed for people with normal or average arches and running mechanics. The shoe contains some cushioning to absorb shock and prevent injuries and some rigidity to avoid pronation. ✓ Cushioned Shoes – Designed for people with high arched feet. Their footprint will typically leave a thin band along the foot’s edge. As they run weight is distributed from heel strike to the outer edge of the foot and small toes that bear the brunt of “lift off.” This shoe is more flexible and absorbs the shock created by the lack or rotation (under-pronation) created by their running style. |
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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 bones in your knee have a slick protective covering called “cartilage” on the joint surfaces that touch each other. This cartilage serves as a friction reducer and shock absorber, thereby helping to extend the life of your joints. “Arthritis” means that your cartilage has begun to thin or crack and may eventually wear away, leading to a painful “bone on bone” situation.

Knee arthritis is very common, affecting more than 1/3 of adults over age 65. People who are overweight or have a history of knee injury or surgery are more likely to develop arthritis. Jobs and activities that require repetitive squatting, kneeling, pivoting or stair climbing may cause increased wear. Contrary to popular opinion, runners have no increased risk of developing knee arthritis. Women are two to three times more likely to develop knee arthritis as compared to men.
The pain of knee arthritis is often described as a “deep ache” that is aggravated by activity and relieved by rest. You probably notice morning stiffness that goes away after a short period of activity, but returns after sitting for long periods of time. Some patients have difficulty squatting, bending and walking stairs. You may notice that your knees pop and crack. Eventually, knee arthritis can cause you to walk slower, lose your balance and even fall more often. Many patients notice that their symptoms increase with weather changes.
Although there is no cure for the irreversible wearing associated with arthritis, there is help for your symptoms. Performing your home exercises is very important. The way that your knee is aligned (and wears) is largely based upon how your hip and foot function, so many of your home exercises will target those regions. Our office may prescribe arch supports or orthotics, since people with flat feet are almost twice as likely to suffer from knee arthritis.
Overweight patients should begin or increase low-impact aerobic exercises like walking, stationary cycling, elliptical exercising, water walking or swimming. Be sure to take frequent breaks from prolonged sitting and avoid overly painful activities.
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.