Pes Anserine Bursitis, or "My knee hurts!"

Knee and back pain are kinda like a really good steak: everyone has experienced it, or at least knows someone who has. The types with flashy names like "runner's knee" (patellofemoral pain) or "lumbago" (lower back pain) get all sorts of attention, but what about poor old "hurt goose's foot"?! An awkward way of describing for anserine bursitis, it doesn't really tell you what's going with your knee, does it? Not to worry, that's what we're here for.

Because it often pops up right alongside other knee problems (MCL tear anyone?), this injury is often overlooked. The "goose's foot" refers to the pes anserinus, the conjoined leg tendons that connect to your tibia, just below your knee cap, on the inner side of your lower leg. They're most there to flex the knee, but also stabilize it side-to-side.

Guess it's not surprising then that pes anserine injuries are found most commonly in young individuals playing sports with lots of side-to-side movement. Risk is also increased in people with tight hamstrings, who overpronate when running, or who are obese. Pain normally creeps in when going from sitting to standing or climbing up stairs, but walking along a flat surface feels just fine. Especially when the injury is due to some feat of athletics, the pain can occur when stretching the hamstrings or reproduced with some stretches by your physiotherapist.

Not a young buck but still struggling with knee pain you think might fit that description? Pes anserine bursitis also occurs in older patients with articular cartilage damage. It often coincides with osteoarthritis of the knee, increasing the severity of pain and functional limitations.

So, hurty knees, what are you going to do? No matter the knee pain, it's important to have it diagnosed, since there are SO many different things that could be going on. If it is pes anserine bursitis the first thing you'll likely be prescribed is rest. Anti-inflammatory medications will help with swelling and pain, but won't fix the problem. Physiotherapy is what you'll need to correct the biomechanics that lead to your injury, and ultrasound or electrical stimulation will also help reduce inflammation.  Take action now and count your lucky stars: the need for surgical intervention is rare for this injury!

Plantar fasci-what-is?!

Lower back pain is something we can all imagine, but what does it mean if your plantar is fasciating (no, that's not actually a word)?! Today we're going to talk about plantar fasciitis, a common injury you have likely heard about in passing. Now you'll be able to do more than just steer the conversation towards the weather.

There's a band of connective tissue running along the sole of your foot, known as the plantar fascia.

Normally it just chills out supporting the arch of your foot, but if it gets stretched too far it can tear, causing inflammation. That inflammation leads to pain, and is referred  to as plantar fasciitis.

What causes plantar fasciitis? Good question. Sometimes physiological things like flat feet or high arches, if left to their own devices, can cause it to arise. Or a sudden change in how your feet need to support you, such as an increase in activity or increased weight gain might bring it on. It's a common injury in runners, especially after increasing training volume or switching from running on a soft surface to a harder one.

The pain is typically felt on the bottom of the foot, close to the heel. It might fade and reoccur in an unpredictable pattern, or disappear completely only to return after a single workout. So you've got some tenderness on your heel, how do you know if you've got plantar fasciitis? Ask yourself the following questions:

Does it hurt especially when you wake up in the morning?

Does the pain go into the rest of your heel or the arch of your foot?

Do you notice the pain when you've stood up after sitting/lying down for a long time?

Does the pain occur after/during activity?

If you answered yes to any of the above, you may very well have plantar fasciitis. Icing the site of inflammation, adding more rest into your daily routine or substituting your normal exercise with non-weight bearing activity (such as swimming) are all options to help reduce your pain. While some cases will be helped greatly just by stretching tight leg mucles, while others may need custom orthotics. So feel free to give us a call, and any of our physiotherapists can help diagnose the cause of your specific pain. Then we can recommend the course of action that you need to get moving again, pain free.

Run. Stretch. Repeat.

We see a lot of runners come into our clinics, for a couple of reasons. First off, it’s one of the most accessible sports, and has become ubiquitous. Some days it might feel like you talk to more people who have run marathons than haven’t. Secondly, it’s one of the most accessible sports, so people just pick up off the couch and head out for a run…which can often result in injury. One thing that has been said time and again to help prevent injuries is stretching. Yep, be honest, you know you should be stretching, but do you? Well, if you’re diligent enough to be reading our blog you just might, but most people don’t. It’s hard enough to squeeze in the time for 10K, never mind having to tack on a yoga class at the end. Nope, no time to stretch.

Hey now! Turns out you don’t need a yoga class at all. Yoga for runners is great, but if you’re just looking for THE stretches you need to be doing as a runner, we’ve got them for you right here, Mathew approved. Just remember you want to be stretching WARM muscles, so use these to help cool down after a run. Make sure to do both sides, remember to breathe and hold each for at least 30 seconds.

1. Hamstrings: if you run you've probably complained about tight hammies more than once. So, lay down on your back w/ legs extended. Starting with one leg at a time, bend your knee into your chest, and grab the back of it with both hands. Slowly straighten that leg until you feel a gentle stretch, pulling it towards you, while you keep your hips flat on the floor. If it feels too intense you can always bend your knee a little.
2. Quadriceps: the big beautiful muscles on the front of your legs, this is the stretch you'll catch most people doing. Standing with your back straight, pick up one foot behind you with the hand of the same side. Be sure to keep your hips level and thighs lined up.
3. Piriformis: piriwhat? Not as talked about as the quads, but just as important, these muscles control hip rotation. They tend to tighten up in runners (what doesn't?!) so start by laying on your back with legs out straight, hips level. Bend one knee, place your foot on the floor, and cross your other ankle over your bent knee. Put both hands behind your bent knee and draw it towards your chest.
4. Piriformis: again! That should tell you it's pretty important to stretch these muscles out. Start lying flat again, bend your right knee into your chest, and grab your knee with your left hand. Place your right hand out to the side, like you were making a "T" shape. Keeping your shoulders on the floor, guide your right knee across your body towards the floor, as far as is comfortable, on the left hand side.
5. Calves: your calves might be small, but they are certainly important to your ability to run - those of us who run in minimalist shoes are especially aware. To give 'em a good stretch, start by facing a wall, standing back about a foot. Place your hands on the wall at shoulder height, keeping your elbows slightly bent. Keeping both feet flat, slide one foot back and press into the wall until you feel the stretch in your calf. The stretch will increase as you move your foot further back.
6. IT Band: if you've picked up a running mag you've certainly heard about the illotibial or IT band. IT's kind of a big deal...okay, let's just get to the stretch. Stand with your left side facing a wall, an arms length away, with your left hand on the wall. Cross your right leg (far leg) in front of your left leg (leg beside wall) and place your right hand on your hip. Lean your left hip towards the wall, bend your left elbow, and remember to breathe. Be sure to keep your legs and back straight.

That's it! Be sure to do these after each run to help keep loose, limber and injury free. If you've got questions about any of these stretches, or have a running injury that needs individual attention, any of our physiotherapists would be happy to help you out.

OPTSC Presents: Nick!

With three busy clinics we’ve got quite a few physiotherapists kickin’ around OPTSC. Remember Andrew? Of course, how could you forget a face like that! Today we’re going to introduce you to another handsome member of our team: Nick Antaya.

That's nick!

 Nick decided to go into physiotherapy because he was inspired by his dad, but in a different way than you might imagine. His father wasn’t a physiotherapist, but a police officer. Unfortunately he was also the victim of a catastrophic accident; Nick’s father was hit by an 18-wheeler while standing next to his cop car. He broke every rib on the left, punctured a lung, and suffered head trauma as well as a multitude of other injuries. He spent 2 weeks in the intensive care unit where they didn't think he would make it. Don’t worry, this story has a happy ending! Nick’s father did intensive rehabilitation with physiotherapy. It was the impact physiotherapy had, not just on his father but the entire family, that led Nick towards life as a physiotherapist.

In 2007 Nick completed and undergraduate degree in Health Sciences (Honours) at the University of Ottawa. Instead of just froshing and keg stands, he also completed his personal training certifications. Yep, he’s ambitious, and completed his Masters Degree in Physiotherapy at the University of Ottawa in 2009. Even with all that training Nick didn’t slow down, and is currently one of the youngest physiotherapists in Ottawa to have competed his Level Three’s in manual therapy. Nick really knows his stuff.

What are his favourite injuries to treat with all that knowledge? He loves any injury to do with running! Whether it is a back, knee or ankle injury, running injuries are truly unique to each individual. Nick enjoys the challenge of running injuries, since you must look at many factors to determine what could be contributing to the issue. Oh, and runners will typically also run even if you tell them not too, so it always make things...interesting.

That's Nick...running!

How does Nick know runners so well? He’s an avid long distance runner himself. Nick recently completed a personal best at the most recent Ottawa Race Weekend half marathon, cracking the top 300 finishers! He’s hoping to qualify for the Boston Marathon in the next year. Want someone to empathize with your shin splints or your “NEED” to get your 50 kms in this week? Nick’s your guy.

He might be a runner, but Nick’s got all types of injuries and imbalances covered. Having seen the affect of intensive physiotherapy first hand, you better believe he truly understands the process. His biggest tip: follow the recommendations that are given to you by your physiotherapist, and yes, that means your exercises! Right from the man himself: “a large part of the rehabilitation process is the homework we give people for home. I can guarantee your progress will be much faster if you stick to our plan.” If you want to hear more of Nick’s great advice, be sure to tune into CTV’s “Ask The Expert” on July 8th. He’ll be stealing the limelight from Matthew and happy to answer any of your physiotherapy related questions.

Oh , and don’t fret, Nick’s not ALL business. He also loves to golf, fish, wakeboard and snowboard. Oh, and he’s got a 14 month old daughter, Mackenzie, if you want to talk about on/off sleep deprivation. “Thank goodness for coffee...and the occasional glass of wine.”

Nick works exclusively out of our Barrhaven location. To book your appointment with Nick, please give us a call at: 613-825-8548

Ottawa Race Weekend! The aftermath...

CONGRATULATIONS RUNNERS! Another Ottawa Race Weekend over, and we hope many of you hit some new PRs! Now that it’s been a few days we also hope you’ve taken some time to relax and let the soreness dissipate. Wish you would’ve stretched a bit better? Matthew made some stretching recommendations on Ask The Expert this week:

Still feeling sore? In might be more than just general after-race aches. Wondering if you should come in and see us? In this next segment Matthew talks a little bit about if you should be booking an appointment. Frustrated that you’re hurting despite all your training? Don’t sweat it – totally normal and Matthew outlines why:

Arthritis, doctor’s referrals, and did you know we have subsidized rates for people without insurance? All in this last segment:

That’s it for now. The next segment will be June 17^th, so be sure to jot your questions down!

Look Ma! We're on the TV!

Been watching TV recently? Then you might’ve seen the happy, smiling faces of our team in this delightful little clip:

Hmm, remember a little more than that? Don’t worry, you weren’t just dreaming about more of Jason’s face. You might’ve seen this full-length version:

Neat, huh? TV is a new thing for OPTSC this year, but Matthew’s especially enjoyed his little taste of show business.

So much so, in fact, that starting tomorrow he’ll be doing a series of segments for CTV’s “Ask the Experts.” It’s a segment that happens every Monday morning after 9:00AM where you have the chance to ask a particular expert your questions via e-mail, Facebook, Twitter or by calling in live to the show. This week Matthew will be talking about running evaluations, so all you Ottawa Race Weekend runners can get your last few questions in before the big day! That’s right, no appointment required.

Want to ask a question? Here’s how:
E-mail: Ottawa.morning@ctv.ca 

Facebook

Twitter
Phone: 613-789-6559 ext. 2803

Be sure to tune into to CTV Morning Live for the answers!

OPTSC Presents: Andrew!

Since we're all about the personal touch here at OPTSC, it's only appropriate that we help you get to know our team, personally. Our 6'2" physiotherapist Andrew Dings likes long walks on the beach...

That's Andrew!

C'mon, of course that's not what we meant. We are going to tell you a bit about Andrew though. First off, we're going to tell you why he decided to enter the world of physiotherapy. Funnily enough, it's because he wanted to teach. That might make you wonder why he didn't just become a teacher. Well, turns out the only class he really liked in high school was exercise science. Go figure.That led him to thinkin' he might want to teach it himself when he grew up.

Andrew aptly decided to start with an undergraduate degree in Human Kinetics at the University of Ottawa...where the only thing he liked was physio. So he decided to roll with it, figuring he could teach people about health and well being through physiotherapy. He enrolled in the Masters of Physiotherapy at UofO and was so keen on it he started working reception in the clinic before his Masters had even started. He's been a part of OPTSC ever since.

If you've ever had a treatment with Andrew, you'll realize he's a natural teacher. To make sure you're clear about his methods, he explains everything while he's doing it. You'll appreciate knowing what's going on, especially if he's doing manual therapy (one of his favourite types of treatment, where he helps to get joint surfaces moving against one another in the way they should be moving). He's super laid back, so don't be shy if you've got any questions; Andrew is straightforward and thorough with his answers. His favourite injuries to treat? Lower back. Good thing, since low back and neck pain are the things he treats most often.

Like to curl? Run? Volley? So does Andrew. In his youth he was quite the curler, although he doesn't do much of it now. He gets his sports fix through volleyball, and of course with those long legs he's a runner. A distance runner though, and he's training for his second 1/2 marathon this May. He also snowboards, cross country skis, plays soccer, plays ultimate frisbee...the list goes on. On top of sports, and helping old ladies cross the street, Andrew volunteers as a medical trainer with the Myers Jr. Riders of the Quebec Junior Football League. So he's obviously knowledgeable about MANY different injuries, but if you're looking for someone who won't judge you for dislocating your shoulder throwing a "biter," he's your guy.

Andrew diving in Honduras

If you want to talk about something other than injuries or sports during a treatment, try travel! Andrew loves it, and has been to: Ireland, France, Cuba, Australia, Belgium, Netherlands, Germany, Austria, and Honduras. Don't worry though, he won't brag all through your appointment. On top of everything else, Andrew's nothing other than professional.

Andrew Dings works primarily out of our Westboro location. To book an appointment with him, please call: 613-728-4160

Spring has spRUNg

 

Well, almost anyway. If you’re crazy brave enough to run out-of-doors you’ll notice the number of people joining you has increased. Maybe it's just 5 others running along the canal instead of 1, but there’s no doubt the slight rise in temperature means running season is just around the corner. 

Most people take to spring running to help shed the pounds gained from a winter of hibernating, but there are a multitude of other benefits. Increased cardiovascular health, decreased stress, increased energy, prevention of bone/muscle loss and the increased ability to survive during a zombie apocalypse are just a few. Oh, and stomping your time from last year’s Ottawa Race Weekend is a good reason to lace up the trainers sooner rather than later. So let’s get to it, shall we? 

No matter if your past running experience is 20 marathons or 20 minutes, the best thing you can do for yourself now is to START SLOW. After 4 months of sitting around (conveniently the span of the worst parts of an Ottawa winter), you’ve lost enough endurance to merit starting out at a beginner level. Don’t think all that snowboarding counts either – running is a different ball game, using different muscles in different ways. Your lungs and heart might be in good shape, but we want to keep your joints and tendons like that too. 

So how do you start running slowly? Try 20 to 30 minutes at low intensity, two or three times a week. Low intensity is different for everyone, so listen to your body. Once you’ve got 30 minutes down no problem, start increasing the time in 5 minute intervals, or increasing the intensity by about 5%. It might seem slow, but d’you know what else is slow? An injured runner. 

Will starting slowly guarantee you won’t be injured? Unfortunately not, but it’s a great place to start. Another great way to detour around injury town is to partake in a running evaluation. Performed at any of our three clinics, it’s spread over two sessions. The first is a clinical evaluation, which delves into your previous running/injury history, takes a good look at your current level/goals, and identifies any physical factors that may impact your running biomechanics. 

The second session is a running evaluation, where your technique is assessed on an outdoor track. Based on your movement patterns, recommendations are made to make you the best runner you can be, while minimizing injury. If this is the year you want to have your fastest time, the detailed training plan we’ll provide will certainly get you there. This isn’t a generic week-to-week program! Running is a highly technical sport and a personalized plan will definitely help bring out your best. 

Now go get running! Race Weekend is only 12 weeks away!