I just got done treating a new patient who was very angry with another provider.
You see, this person advertises that she is an Active Release provider. So when the patient went to see her, the provider said, “well, I’m not really certified, but I do the same things.”
This particular patient has been seeing ART providers all over the country (she travels a lot for work). She knows Active Release. And she knows that the Denver provider she saw was not a Denver Active Release Techniques provider, regardless of the advertising.
After her bad experience, she called the ART office and asked who are the most credentialed ART providers in town. There are 2 of them, myself, and my good friend Dr. Michelle Clark. In my humble opinion, the two of us are your best options. (We practice separately.)
Regardless, before you make an appointment with someone who advertises that they do Active Release, go to www.activerelease.com, click on find a provider, and enter that provider’s name in the box. If the provider’s name doesn’t come up, he or she probably isn’t certified (you can also call their toll free number to verify, it’s on the site).
You can also search by zip code. The locator will pull up certified providers. Then look for the little squares which indicate which ART certifications each provider has completed. The ones with the most squares are the ones who have done the most work to improve their ART skills. In this world of internet advertising, anyone can say anything they want. Make sure you get what you’re paying for by doing your homework up front.
Active Release is great, and we hope you find a provider who can help you.
/wp-content/uploads/2016/10/denverback-logo2016.png00Glenn Hyman/wp-content/uploads/2016/10/denverback-logo2016.pngGlenn Hyman2011-09-02 10:19:042019-04-02 11:29:34Denver Active Release Techniques providers- make sure you get what you pay for!
“Thousands of tired, nerve-shaken, over-civilized people are beginning to find out that going to the mountains is going home: that wildness is a necessity; that mountain parks and reservations are useful not only as fountains of timber and irrigating rivers, but as fountains of life.”
– John Muir
After my run last night, the pain in my lower leg is not feeling too bad. I am still experiencing ‘tibial stress syndrome’ or shin splints but it is nothing to prevent climbing Mt Quandry tommorrow. Shin Splints are most often caused by overuse, increasing intensity/duration of training, and activities that require sudden stops and starts. Shin splints happen when muscle fibers in the muscles that stabalize and move the ankle/foot tear from their periosteal attachment. After the initial injury, these muscles become fibrotic during the healing phase which can exacerbate the pain with increased activity.
The best thing that can be done for shin splints is Active Release Technique (ART). ART will break up the fibrotic tissues, scar tissue, and adhesions that limit range of motion and cause pain. Icing can also be used to relieve pain and inflammation, using a styrofoam cup filled with frozen water, tear off the top edge of cup so the ice is exposed and gripping the covered bottum, massage painful areas for 8-10 minutes. Rest for 30 min and repeat for another 8-10 min.
Stretching and strengthening are also great ways to decrease the amount of discomfort you feel and to prevent recurring shin splints. One stretch that I use is get into a forward lunge position and plantar flex your back foot (so the top side of foot is on the ground), you should feel a stretch on the front side of your lower leg. Hold for 15 sec and repeat 5 times on each leg. There are many exercises to do prevent shin splints, one exercise is the 4 way range of motion exercise. Move your foot/ankle into dorsiflexion (toes pointing up), plantar flexion (toes pointing down), eversion, and inversion. Complete all 4 movements 10x each on both legs.
To prevent shin splints from overuse, it is a good idea to only increase your milage 10% each week. This will allow the shin muscles (tibialis anterior, extensor hallicus longus, extensor digitorum longus) to strengthen without creating microtears in the tissue. Shin splints are not something that you “just have to put up with,” come in the office and we will get you back to living/training without pain. DONT PUT UP WITH PAIN!
Here is a basic progression we’ve developed to correct low scores on the Active Straight Leg Raise. The general idea is to progress from isolation exercises to integration exercises to functional exercises.
Of course, the first step to improving poor performance on the Active Straight Leg Raise is releasing any scar tissue in the hamstrings and hip flexors with Active Release (Dr. Glenn is standing by). Then add in the following therapeutic exercises.
In reality, a corrective exercise program is tailored to you, based on your personal condition and your score on the Functional Movement Screen, from which the ASLR was extracted.
Single Leg Contract-Relax Stretch (isolation). Start on your back. Your right leg is the one doing the stretching, so with a slight bend at the knee, bring it up until you feel a bit of a stretch in the hamstring. Grab a hold of the leg as shown and push the leg into your hands for about as long as it takes you to take 3 slow deep breaths (this is the contract part). When you exhale that third breath, relax the hamstring and slowly stretch further by bringing your leg closer to chest. This takes advantage of 2 types of reflexes, the relaxation that comes with a deep exhale and the relaxation that comes after a prolonged contraction. Together, these two activities help your nervous system learn a new resting length for the hamstring. Repeat 3-5 times on each side.
Single leg stretch with opposite terminal extension (isolation/integration). While we would normally use an isolated leg stretch for a few days, for our purposes here we’ll move right into an integration exercise. Here, we’re basically combining a the contract-relax hamstring stretch above with active hip extension on the other side. So start with your left leg flattened out leg onto the ground while gently pulling the other one into the stretch. As you start to feel the right leg reach a stretch, actively push the left leg into the ground. Pay attention to what each leg is doing and hold the extension during the stretch on that third exhale. Do 3 reps on each side. Same picture as above.
Combining hip extension with hip flexion on the opposite side is a pattern that’s fundamental to many sports. This rehab activity helps restore and reinforce the fundamental pattern. It’s a stepping stone to the more complicated activities below.
Quadruped hip extension with opposite flexion (integration). Taking the idea of combining opposing hip flexion and extension farther, we have this excellent little move. Get down on all 4’s. Extend your right leg straight behind you making sure you fully engage the right glute.
While maintaining the extension of the right hip, drop your left hip further into flexion- moving your whole body toward the floor. You must keep that right glute contracted and that right leg straight. Watch what happens with my left (bent) leg below. It’s tougher than it looks.
This exercise lets you improve your neuromuscular control and directly improves or maintains your Active Straight Leg Raise score and helps protect your back, your hips, and your knees. Remember to work both sides, 3-5 reps.
Stiff-Leg Deadlift with stick (functional pattern). After a couple of weeks of training in the above rehab exercises, it’s time to up the complexity. Now you’ll combine the opposing hip flexion and extension with a whole body balance challenge. Hold a stick in your right hand to help with balance (if needed). First, you’ll tilt slightly forward, arch your back slightly and kick your right leg back into full extension.
Continue moving forward toward the floor by flexing forward at the hip joint. The end range is when your body is almost parallel to the ground.
It’s once again important to maintain hip extension in that right hip. And of course, switch legs. Do 3 sets of 5 reps.
As you can see, we’ve progressed the basic pattern of opposing hip extension and hip flexion and created a greater demand on both legs. This is the essence of the progressive rehab that we’ve added to our treatment plans at Denver Chiropractic Center. Once again, we’ve moved beyond simply treating symptoms, like pain.
We’re looking to correct the underlying dysfunctional patterns that are the underlying cause of pain. This is what keeps problems from coming back over and over. If something’s been hurting you, or if you just feel like certain movements feel restricted or “wrong,” give us a call and come on in. 303.300.0424. Or simply reply to this email.
(BTW-Why am I holding a crutch? Well, it’s Meredith’s after her recent major knee surgery, but that’s a topic for a future email.)
/wp-content/uploads/2016/10/denverback-logo2016.png00Glenn Hyman/wp-content/uploads/2016/10/denverback-logo2016.pngGlenn Hyman2011-01-25 14:06:002019-04-02 11:29:354 Steps to improving hamstring strength and flexibility (beyond mere stretches).
/wp-content/uploads/2016/10/denverback-logo2016.png00Glenn Hyman/wp-content/uploads/2016/10/denverback-logo2016.pngGlenn Hyman2010-09-10 11:37:042019-04-02 11:29:35The very popular barefoot running article is now online
Well, after three seasons of training for Xterra triathlons by myself, I’ve decided I don’t really know what the hell I’m doing. So I’ve begged my friends at Mile High Multisport (www.milehighmultisport.com) to coach me.
Lucky for me, Pete and Kathy Alfino agreed. So Kathy Alfino is going to serve as my coach. I can’t describe how excited I am.
After 3 years of finishing at the back of the pack (yes, I know that finishing is an accomplishment) it’s time to start moving up. So I’ll keep you posted in the ol’ blog about my progress. I’m planning on training through the off season so I can get better. I’m going to keep swimming, biking, and running all winter long.
Kathy Alfino qualified for the Ironman World Championships in Kona, and she’s one of the main reasons my family and I have decided to go out there for the big race. As an official ART Ironman Provider (one of 2 in Denver) I’m looking forward to working on the athletes on the Big Island.
How will Meredith and I survive a 6-hour flight with the boys (ages 5,3,1)? That’s a damn good question.
I’ve been doing a little lifting in the interlude here. Did the P90x Shoulders and Arms workout today. I went kind light on the weights as I’ve been incredibly busy at work. Thanks for reading!!
By the way- Happy 3rd birthday to Jason!
L to R- Zachary, Meredith, Jason, Me, Andrew
/wp-content/uploads/2016/10/denverback-logo2016.png00Glenn Hyman/wp-content/uploads/2016/10/denverback-logo2016.pngGlenn Hyman2010-09-02 20:39:082019-04-02 11:29:35Getting ready for next season