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221 N. 1st St., Suite 150, Minneapolis MN 55401
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What Does All This Sleep Mean?
Sleep plays a role in many of our bodies functions, such as our long-term memory, cognitive function, alertness and reaction time, hormone regulation and tissue regeneration to name a few. It also accounts for roughly a third of our lives. Many of us think of going to bed as the end of the day, when in reality it is the start of the following day. To assess whether or not you are getting enough restful sleep ask yourself “do I feel rested when I wake up in the morning or more rested before going to bed?” If you feel less rested in the morning you are likely not getting enough sleep or enough restful sleep and should consider implementing one of the following tips.
Researchers suggests that 7.5 to 9 hours of sleep per night allows the body to appropriately go through the proper sleep cycles for maximum restfulness. The first sleep cycle is known as the non-rapid eye movement. NREM lasts 70 to100 minutes, and accounts for majority of total sleep time. During NREM heart rate and blood pressure begin to drop and allows your heart to relax. During this cycle, motor skills that were learnt the previous day are engrained. Additionally, the body becomes disconnected and is able to achieve a true resting state. During which point, growth hormone (GH) is at its highest. The elevated levels of GH enable tissue maintenance and building soft tissue, immune system support and fat, cholesterol and carbohydrate metabolism. The final sleep cycle is the rapid eye movement (REM) cycle. The REM cycle occurs 4 to 6 times per night and lasts 10-16 minutes. Here, the body is twitchy and the mind races. Heart rate and blood flow to the brain is increased due to the increased brain function. As mentioned previously, this cycle allows absorption of complex thoughts, creativity, and perceptual skills acquisition. As you can see sleep is a complicated procedure that our body and mind must prepare for to allow for restful sleep.
Preparing to fall asleep is just as important as actually sleeping. It’s best to start preparing for bed when the sun goes down and it starts getting dark out. At this time, melatonin production increases. Melatonin is a (natural) hormone produced by the body, which stimulates the urge to fall asleep. Melatonin production can be decreased by blue light. Sources of this light include fluorescent and LED bulbs, and all electronic devices. Because blue lights decrease the production of melatonin it is important to limit the amount of exposure during the time you are preparing for bed; following sunset. Ways of avoiding blue light contact at night include the use of blue light blocking glasses, changing the setting on your phone to night shift or downloading a blue light filter app such as the one from justgetflux.com. Blue light is just one of the many reasons why you may have trouble falling and staying asleep. Here are a few ‘do’s’ and ‘don’ts’ to maximize your sleep.
DO
Get consistent – Creating a routine that promotes you falling asleep each night within a 30-minute window of going to bed and waking up consistently at the same time each morning. Creating consistency allows the body to maximize the production of melatonin, and have it peak at the same time each day. This will ultimately allow the body to maintain a stable circadian rhythm. The circadian rhythm is our bodies 24-hour clock that dictates when we wake up and fall asleep. Think about those times when you naturally wake up in the morning without your alarm. That is your internal clock that has become programmed to that time.
Get active – Vigorous physical activity during the day will help you sleep. Physical activity stresses the nervous system and the body. By doing so, this promotes the body’s desire to rest from the implied stress.
Clear your mind – If you spend hours thinking about all the things you need to get accomplished the next day this one is important. A simple fix for this is to create a to do list. By doing so this you promote a restful state for your mind, and allows your body to relax because you know longer have to worry about forgetting to do something. Or worrying about what all needs to be taken care of because it’s all written down.
Block out your surroundings – White noise machines are a great way to mask noises and avoid being startled when sleeping. They also can be soothing for individuals, which promotes relaxation for the body. All of which will contribute to a more restful sleep. If you don’t want to splurge on a machine, utilizing a fan is a great alternative.
Optimize your temperature – Prime sleeping temperature is between 65 to 68 degrees. A cool room is in important for restful sleep so that your body can appropriately dissipate heat and get into the rapid eye movement (REM) cycle. Getting enough time in the REM cycle is important because brain function is ramped up, allowing complex thoughts to be absorbed, perceptual skills acquired and creativity to be at work.
Turn your mind off – Reading before going to sleep is a very effective way of turning your mind off and separating yourself from all the events that happened throughout the day. Doing so allows your parasympathetic (rest and digest) system to kick in and aids in maintaining that 30-minute window of falling asleep that was talked about earlier. It is also a great alternative to spending time on social media, which will help reduce your exposure to blue lights prior to bed.
DON’T
Eat a large meal – Eating a large meal prior to bed turns your digestive system on and delays you from falling asleep. When your digestive system is turned on, it shifts your body’s focus from relaxing to processing what you just consumed. Additionally, avoid high volumes of fluids prior to sleep because the urge to urinate mid sleep cycle will inhibit a full night of uninterrupted sleep.
Consume caffeine – The half-life of caffeine is 6 hours, meaning that the increased heart rate, alertness and energy will take 6 hours to lose half of its effect and can prevent some individuals from falling asleep.
Spend time in front of a screen – As previously mentioned, blue light inhibits melatonin production and therefore it’s important to minimize your exposure prior to bed. It’s also important for our brains to slow down and enter a relaxation state as we get ready for bed. Watching TV is stimulating to the mind, so it is a good idea to avoid TV and your electronic devices for an hour before your established bed time.
If you feel you are not getting enough sleep and aren’t feeling rested in the morning consider implementing some of these strategies. However, while you are mastering your bedtime route and increasing your sleep productivity, napping make help to fill those hours you need. It has been shown that napping has a summative effect and can make up for lost sleep from the previous night. A quick power nap, of less than 30 minutes, is best for a ‘recharge of the battery’. If you are wanting to have a longer nap that fits into the sleep cycle, nap for at least an hour and a half. That length of nap includes both the NREM and REM cycle, so you will achieve the benefits of resting both the body and the mind. Keep in mind, it is important to consider the time you nap and whether it will inhibit your ability to fall asleep in the 30-minute window you have set out for bedtime. Naps should not take away from getting a good sleep at night.
If all else fails and you are still struggling, it’s recommended to seek the care of a trained professional.
Resources
Sleep: A Clinical Management Factor. Sleep Sciences and Research
The posterior chain muscles may be the most important group of muscles when it comes to daily performance as an athlete or an average Joe. The posterior chain of muscles in the hip include the glutes, hamstrings and the posterior core/para-spinals; and they are responsible for stabilizing and moving the hip and pelvis. They are often neglected in strength training causing muscular imbalance and anterior chain dominance, which can lead to low back pain and instability. So, if you have had some sort of low back pain, you are most likely not working your butt off as much as you thought.
When your hip joint and its muscles fail to function, your lumbar spine takes over movements that it shouldn’t which can cause low back pain. The glutes are often the most affected by the lack of hip mobility, often getting inhibited or unused. Posterior chain muscles are crucial to full functioning hips. Many Crossfit movements require powerful hips, which really means a powerful posterior chain. The power positions in the Olympic weightlifting movements, deadlifts, kettlebell swings, rowing, and even the push press all generate power from your hips. Without full functioning hip muscles, these movements will lack efficiency and cause pain.
Along with pain there are some postural signs that can be seen that can help us identify weaknesses. One of these signs are an anterior pelvic tilt or lower cross syndrome (LCS). LCS can be seen in individuals with a hyperlordotic curve in their lumbar spine, which is caused by tight/over used anterior muscles (rectus femoris, iliopsoas, and abdominals) and weak/inhibited posterior chain muscles (hamstrings, glutes).
Just like with UCS, we want to address the short muscles first then strengthen the weak. Stretching and mobilizing the rectus femoris and hip flexors (refer to Low Back Pain post). Next, we want to strengthen the posterior chain muscles. The main movement we want to get to activate all the posterior chain muscles is the hip hinge. This can be seen in exercises like the “Good Morning”, kettlebell swings and deadlifts. The combination of the stretching and strengthening will help take some tension off the anterior muscles, make the posterior muscles fire correctly and bring full mobility back into your hip joint and stability to your low back.
-Curtis Hoang
In the constant pursuit of the fad of the week we find ourselves chasing a mythical magic pill, the path of least resistance, one that will give you the desired aesthetic and performance that we see on Instagram, T.V., or in magazines. Or maybe you’re pursuing fitness because you love the way it makes you feel, you remember a time when you felt more alive and are desperate to get back there.
Sometimes this sparks something inside you, drives you to want to do more, achieve more, be the best version of yourself, you find your groove and don’t look back. Other times the promises of your well intentioned endeavor falls short and it’s back to the drawing board.
Fitness is a journey, one that is never mastered nor completed. It is an evolving part of your internal fabric driven by variables that change with the world around you. The worst thing you can do is give up on yourself and fill your subconscious with doubt on whether or not you’ll ever find something that suits you.
Sit down and define your ‘why’. Without an intrinsic drive to push you past the points of resistance you leave yourself vulnerable to failure. It has to come from you and it has to hold value with your current set of priorities, without that it is simply another short term solution to a long term dilemma. Align your drive with the intended stimulus and outcome of the given fitness program, if it initially makes you uncomfortable- good! Comfortable is what got you where you’re at, you have to trust yourself and your intuitive nature to what you know you want. Keep putting yourself out there and know that you can achieve what you may think just isn’t meant for you.
Once you’ve set yourself on this path be prepared to work hard and commit to the process as there is always work to do and areas of your fitness you can continue to improve upon. Be ready to reevaluate your ‘why’ as your circumstances and priorities change and adjust your approach accordingly.
Most of all remember to enjoy it. To steal a commonly used quote on happiness, fitness is the journey-not the destination.
-Dr. Crane
Photo by Alex Tubbs of Tubbs Photos
One of the latest trends in the health and fitness industry is to manage food intake by keeping track of macronutrients, i.e. the amounts of protein, carbohydrate and fats that are consumed in a day. While there are many benefits to precise measurement of food, it can also be time consuming and hard to implement long term. If you have been thinking about jumping on the bandwagon here are some questions to consider before making the jump to the next nutritional level.
While we are all human and not many of us are going to be accomplishing every single one of the tasks above, they are all individually great places to start dialing in our nutrition before beginning to count macronutrients. Once you have the majority of these habits in place, the next step then would be to consider weighing and measuring your food to help you achieve your nutrition goals.
Whether you are ready to take on macro counting or trying to just get the basics down a nutrition coach can be really helpful to guide you along the way. Take some time, think about your goals, and do some research on your options for nutrition coaching. Usually working one on one with a personalized coach is going to lead to the best results with least amount of frustration.
-Alye Deroma, Certified Precision Nutriton Coach
For inquires on our nutrition program please visit here or email alye@uptowncore.com
At one time or another, everyone has experienced the unwelcome, throbbing pain of a headache. Some headaches may blindside you; there seems to be no explanation for their occurrence. Others come on gradually over the span of hours or days. The number of headache presentations is outweighed only by the number of causes. Due to the numerous potential triggers, it can often be difficult to narrow it down to the true culprit. Doing so, however, is the key to resolving headaches for the long term. Below, you will find descriptions of various headache triggers, some common and some lesser known, in addition to ways to combat and prevent their occurrence.
Subluxation/Misalignment of the Spine
Headaches and mechanical neck pain are the bread and butter of chiropractic. So many people suffer from chronic headaches that can be easily fixed through a series of adjustments. Often, the cause of neck pain and headaches is stress on the nervous system due to misalignment of the cervical vertebrae. When vertebrae move improperly, the mechanics of the entire head and neck are disrupted. This results in compensations in head position and movement, as well as an increase in muscle tone. Headaches are the culmination of this mechanical and postural dysfunction.
The Fix: Have a chiropractor check your spine and adjust any subluxations in the body. They can also perform manual therapy to any hypertonic musculature of the head and neck. Your chiropractor may also refer you for other therapies, including acupuncture or massage, as they see fit.
Stress & Muscle Tension
When stressed, people tend to hold their shoulders high and clench their jaws. All of this is done unconsciously, of course. Right now, be mindful of your shoulders. Try to lower them. If you can relax your shoulders and they drop, you were likely holding up without even realizing it. The same goes for clenching the jaw. Many people do this while they sleep, resulting in sustained tension in the jaw and temples. All of this upper back, neck and jaw tension leads to trigger points and the radiation of pain into different areas of the body, namely, the head and neck.
Though your upper body muscle tension may not be due to psychological stress, it can be due to the physical stressors of daily activity. Many people who work in jobs which require repetitive upper extremity motion will experience tension type headaches. Athletes involved in impact sports or completing high repetition exercises can also succumb to tension headaches.
The Fix: Identify the source of stress and create a plan to remove or decrease it. If this isn’t feasible, a plan to manage or relieve yourself of stress throughout or at the end of the day can be helpful. This might include taking mini breaks at work, meditation, exercise, baths or scheduling time out for yourself. Also, be mindful of tensing the shoulders and jaw, aiming to keep them relaxed as possible.
Mobility and recovery is key for the athlete. Using a lacrosse ball or roller after a workout, in combination with stretching, will offset tightness. Exercise is a huge stress to the body, make sure you are recovering sufficiently with nutrient dense meals and good sleep.
Allergies, Low Blood Sugar & Dehydration
Food and environmental allergies trigger an immune response in the body. The result of this immune response is systemic inflammation. This inflammatory response can often cause a headache. The body uses the headache as a warning sign to the body, indicating that something is wrong and a larger issue needs to be addressed.
If you’re attempting the new intermittent fasting trend or just forgot to eat a meal or two, you may feel a headache coming on. Fasting too long, dieting too hard or not eating enough can cause the blood sugar to enter a hypoglycaemic range. When the blood sugar gets too low, a headache can ensue. Keep your body hydrated, too! Low hydration and electrolyte levels are notorious for triggering headaches.
The Fix: Discovering the food that sets the body awry is not always easy. It can often require an elimination diet, in which foods that are traditionally more allergenic are removed for a period time to determine the body’s response without them. Allergy tests or panels can also be done to determine food allergies. If low blood sugar or dehydration is the culprit, get some healthy, nutritious food & water in your body and see if the headache subsides once the values have returned to a normal range.
Seek Help
Regardless of the trigger, at the end of the day you are still experiencing the pain of a headache, and you just want to be rid of it! Research supports the use of chiropractic for headache reduction and elimination. Go see one! It is the safest, most effective course of treatment and should be the first line of defence against headache symptoms. Your DC will evaluate your symptoms and spine and provide you with appropriate treatment and advice. You have nothing to lose except your nagging headache.
Low back pain (LBP) is the most common musculoskeletal complaint in the US, and the condition most commonly treated in the chiropractic office. Though almost everyone has dealt with low back pain at some point in their lives, the cause of the pain, in each case, can be different. With the athlete, the causes are often predictable and can be narrowed down to a few diagnoses. This article will discuss some commonalities in low back pain & measures that can be taken to keep your back healthy.
Possibly the most troubling cause of low back pain is a disc herniation. This can cause crippling pain that may radiate to into the butt and down the leg. It may also cause muscle spasms and negatively effect your posture and range of motion. Anatomically, discs lie between each vertebrae and act primarily as shock absorbers. With repeated stress on the spinal column, these discs may become damaged. When the outer portion of the disc tears, the softer portion of the disc, the nucleus, may protrude out. Only the outer third of the disc has pain receptors, therefore you can have some herniation without pain. This means that there can be serious structural problems in your spine and you can have zero pain. It is so important to listen to your body and seek therapy before you have been incapacitated. Herniations do not discriminate based on your sport or activity level. Yogis may sustain herniations from sustained poses in hyper flexion or extension, weight lifters from poor form or repetitive flexion, and high impact athletes from trauma. These are just a few of the many examples.
Though herniations may cause numbness, tingling or shooting pain into the leg. It is not the only cause, as irritation of the sciatic nerve may also be the culprit. The sciatic nerve courses down the leg to the foot and enters the posterior leg just below the piriformis muscle. When this muscle becomes tight from overuse or increased strain, as it often does in athletes, it can irritate the sciatic nerve, resulting in this pattern of pain. Preventatively, this muscle can be tough to get at on your own, but using a mobility ball to release the glutes is helpful. Soft tissue work and manual release is the ideal course of treatment for an exacerbated issue.
A main flexor of the hip and trunk, the iliopsoas runs from the lower spine to the femur. This muscle is shortened and hypertonic in many individuals and can pull the pelvis forward, increasing the strain on the hamstrings and muscles of the low back. Chronic psoas tightness can cause a ‘sway-back’ appearance and decrease the stability of the spine, especially in overhead positions. Today, many people have tight, weak psoas muscles because of time spent seated. Sitting puts the psoas in a shortened position and, unfortunately, a short muscle is a weak muscle. Aside from decreasing time spent on your behind, the best way to combat psoas tightness is to release the psoas on a regular basis. This can be done on your own or by a professional. The latter may be a better option, as this muscle can be very tender and will put your mental toughness to the test if you decide to tackle it on your own.
Upper Cross Syndrome (UCS) is a group of symptoms that leads to muscle imbalances and pain the upper shoulders and neck. It is typically seen in people with poor, slumped posture and those who spend their days at desks or looking down at their phones. It also becoming an increasingly common presentation in the Crossfit athlete.
UCS occurs as a result of forward head carriage, an increased thoracic kyphosis (hunchback), and consistently elevated shoulders that round forward. A head that is forward and flexed puts strain on sub-occipital muscles and upper traps, tightening and shortening them. This lengthens, and subsequently weakens the deep neck flexors. When the shoulders are rounded and slumped, the pecs become tight and the rhomboids and lower traps weaken. In the athlete, weakness in the rhomboids and rotator cuff muscles means the upper traps must compensate and fire every time the shoulder moves. Trap dominance may be especially noticeable when performing high rep cleans or snatches, as the aggressive shrug is facilitated by the trapezius.
UCS may manifest as pain in the shoulders, headaches, instability in overhead positions, numbness or tingling in the hands and/or weakened grip. Over time, it will cause postural changes that can put the body, especially the shoulders, at risk for injury. Muscles that are not working synergistically cause the joints they act on to become unstable as the imbalance in musculature pulls the joint out of optimal position. A joint that is not being stabilized correctly or moving in the proper plane will cause repetitive strain on the tissues and lead to complications in the form of impingement, rotator cuff strains, ligament sprains or dislocation of the shoulder.
To treat UCS, the tight, shortened muscles must be addressed first. Stretching, mobilizing and having manual therapy applied through the pecs, upper traps and sub-occipital muscles is a necessary first step. Close attention to posture is also imperative. Many people hold tension through the shoulders and are unconsciously holding them in an elevated position. Throughout the day, make note of shoulder position, then relax and lower them if necessary. Also be sure to pull the shoulder blades back. If you need a cue, think about squeezing them together or pinching your shirt between them. You should always think about this when setting up for a lift. Be sure to also keep the head level on the shoulders, not flexed forward. Think about making a double chin. This is the motion needed to pull the head upright. The final step is to strengthen the weak muscles. The following exercises are ideal for this:
Though it is typically an issue that plagues the endurance athlete, Iliotibial (IT) band syndrome is becoming more common in those that Crossfit. The IT band runs down the lateral side of the leg, from the hip to just below the knee. Due to its insertion near the knee, many people mistake IT band issues for lateral knee pain. The IT band functions to stabilize the knee. It is a very strong band of fascia, but faulty body mechanics combined with high repetition or high mileage can be extremely taxing on the tissue. This can lead to inflammation and swelling on the lateral aspect of the knee, and pain that can be felt up the length of the tissue, spreading has high as the hip. It may even cause a snapping noise when the knee is bent beyond 45 degrees.
Mechanically, the culprit is instability at the pelvis, knee, and/or foot. If just one of these structures is out of alignment, the knee and lower leg will rotate inwards and put increased strain on the IT band, increasing its contact with the bony structures of the knee joint. A flat or pronated foot can cause the knees to cave in. An unbalanced pelvis creates a leg length discrepancy, increasing the stress on one leg as the majority of load is shifted to that side. This can be due to a structural misalignment, or a weak gluteus medius, a dynamic stabilizer of the lower extremity. There isn’t one cause of IT band issues, so there isn’t just one solution. The underlying cause needs to be found, and addressed appropriately. Running shoes may need to be replaced or be supplemented with arch supports if you are an over pronator. The foot should also be adjusted to ensure the various bones that comprise it are aligned and functioning synergistically. The hips should also be assessed by your chiropractor to ensure proper alignment. The glute med can be muscle tested to determine whether or not it is inhibited. If this is the case, proper strengthening of the muscle should be implemented.
Regardless of the cause, if you are experiencing IT band pain or discomfort, you should address the issue immediately. Resting from activity, applying ice and consulting with your chiropractor are all imperative to resolving the issue.
Walking into a crossfit gym for the first time can trigger a wide range of emotions. Excitement, anxiety and, potentially, mild regret as you stand there watching the current class splash in pools of their own sweat and release guttural noises while throwing heavy things in the air. You’re in too deep to leave, and so you make it through your first workout, exhausted yet invigorated. This is the typical story of the crossfit rookie. Regardless of fitness level, the beginner is new to many of the programmed movements and, in turn, will be adding many stresses to their body that have never been experienced before. Not only are the movements new, but so are the body aches and pains that accompany them. Wrist pain, shoulder impingement, IT band tightness, low back & upper trap pain are a few of the most common issues seen in the beginner WOD-er. In the following paragraphs, we will aim to explain more about the trials and tribulations of each of these issues and how you, a rookie or a seasoned vet, can work to prevent and treat them.
Wrist Pain
As a crossfit athlete, you are almost guaranteed an experience with some type of wrist pain. This could range from a mild ache post-workout to an uglier, chronic pain. Unfortunately, it’s the nature of the beast as the majority of functional movements performed in the crossfit setting require repetitive or prolonged wrist extension. Pushups, ring dips, front squats, cleans, thrusters, overhead squats, handstands. The list could go on. Performing these movements under load and in a fatigued state can push the joint into hyperextension and increase the potential for ligament sprains, muscle strains and cartilage tears. These are more of the severe injuries you could encounter, and they are actually located at the wrist joint. However, the type of pain that most people experience in their wrists is actually referred pain from the forearm. If you thought the list of exercises that put the wrist into loaded extension was long, start thinking of all the times you are required to grip something during a typical 60 minute crossfit class. Yeah. Almost the entire time. Holding on to a bar, a weight, a rope, a rowing handle. Cue Popeye forearms. Even if you don’t leave the box unable to grip your blender bottle and car keys, the repetitive use of these muscles class after class, without any stretching or treatment, is enough to elicit wrist pain. For the most part, people neglect caring for their forearms not because they’re lazy, but because they don’t even realize their forearm muscles are sore until a practitioner digs into them with a thumb or soft tissue tool. It’s pretty common to think that if a joint hurts, then the problem must be there! Often, it’s not, and this is especially true with wrist pain. At least once a week, be sure to show your forearms some love in at least one of the ways listed below.
Here are some ways to keep the forearms & wrists happy:
If you can relate to any of the following statements, your wrist pain may be due to a more serious issue. You should seek out a medical provider for an exam and diagnosis.
Shoulder Impingement
Crossfit is notorious for high-rep overhead movements such as push press, overhead squats and handstand pushups. This can be great for the guns, but not so great for a shoulder that isn’t being mobilized properly after class or outside of the gym. Repetitive overhead movements without preventative shoulder care can put you at risk for shoulder impingement syndrome, an issue that causes inflammation and micro-tearing of the rotator cuff muscles. The tendons in the shoulder can then be pinched under the acromion process of the scapula, causing pain and limiting range of motion. The first step in preventing this problem is to ensure you are properly warmed up and increasing the load on the shoulder at an appropriate pace. Addition of weight to movements should be done gradually, and when choosing a weight for the WOD, a load that is suitable to your skill level should be used. If you’re not sure what you should use, ask your coach. At the same time, listen to your body, and if you begin to lose proper form or if movement becomes unstable, take a quick rest before continuing. The second way to prevent shoulder pain is to take care of them after class! Stretch & use a lacrosse ball on the muscles of the upper back, pecs and arms. Tightness in any of these regions can pull the shoulder out of ideal alignment. You should also work to strengthen the muscles of the rotator cuff to create resilience. Finally, see your chiropractor at least once a month to ensure your body is moving properly and have any soft tissue issues addressed.
Anterior knee pain, often diagnosed as Patellofemoral Pain Syndrome (PFPS), is a common complaint in the chiropractic office. This complaint is typically from runners and other endurance athletes who are overtraining, but can also be due to increased load on joints and repetitive impact from running or jumping. The pain will be centralized to the front of the knee, feel achy, and get worse when moving up or down stairs. It may also ache while sitting for prolonged periods.
The knee is a hinge join connecting the femur to the tibia, and allowing for flexion and extension. The patella, or knee cap, is a bone that receives the quadriceps tendon and links it across the knee joint to the tibia via the patellar tendon. It also acts to protect the articular surface of the knee. As the knee moves through its range of motion, the patella moves in combination, tracking up and down, tilting and rotating to help facilitate proper body mechanics. Traditionally, anterior knee pain has been attributed to improper tracking of the patella. It is theorized that the muscles acting on the patella are weak or tight, pulling it off course. The issue with this theory, however, is that a clear definition of a proper tracking motion has not been established. In fact, many studies have found that every individual’s patellar tracking pattern may be distinct, and a normal movement path many not actually exist. A research study conducted in 2006 at Queen’s University in Canada discovered that there is no evidence to link aberrant patellar motion to knee pain. This means there is a good chance that if you assessed the patellar movement of healthy knees, you would see patterns similar to those in pathologic knees.
So, if the knee cap is not the culprit, then what is? Why has this pain occurred and where is it coming from? The answer is to look beyond the site of pain and assess the body as a whole. Currently, the gold standard treatment for this issue is to strengthen the vastus medialis, one of the muscles comprising the quadriceps. This is an effective treatment if weakness of this muscle is the legitimate cause of the pain. If it is not the cause, though, then improving the strength of it will do little to improve the situation. The practitioner should perform a comprehensive assessment of the lower limb; the foot, ankle, knee, and hip joints should all be assessed for subluxation and aberrant motion, and the muscles checked for hypertonicity and weakness. They should also be working to find which motions or regions of muscle reproduce, exacerbate, or relieve the knee pain. From here, a proper solution can be provided and an effective treatment plan can be developed. This may include initial reduced activity or a period of time away from sport, adjustments, stretching, instrument assisted soft tissue work (FAKTR, Graston), active release therapy, massage & resistance exercises.
The following are potential causes of PFPS:
By Taylor Meyers