Dr. Clark was published in this month’s Colorado Runner Magazine. The full text is below. Enjoy!
After many long hard months of training, recovery prior to that awe-inspiring long distance race is essential. Many runners follow the recommendations of rest, lighter workouts, proper nutrition, ice, stretching and massages, but all too frequently some minor aches and pains just don’t go away. Serious runners and triathletes are always tempted to “work through” that pesky knee pain, that stabbing foot pain, or that calf pain on those arduous hills. I am a victim of that very concept. Although tempting, this runner’s attitude far too often delays recovery and promotes more serious repetitive overuse types of injury.
So when should you stop training and start healing?
For starters, a good clue is when “working through the pain” doesn’t work, if the problem worsens with more mileage or faster paces, or if intermittent periods of rest isn’t providing adequate relief. When pain perpetually increases, scar tissue begins to build up in muscles, tendons, ligaments, and fascia. Scar tissue acts as the “glue” to repair and mend together micro-tearing that naturally occurs in tissues during the strength and endurance building phases.
During the healing process, the presence of scar tissue essentially renders the area of “glued” tissue less elastic and thus inefficient. It only makes sense that when we continue to “work through the pain” in order to achieve our customary pace and speed, the functional muscles surrounding the scarred area have to work harder. As this occurs, blood flow to the injured tissue begins to decrease as does the essential nutrient input and removal of cellular debris.
The body doesn’t know what to do with the sudden build-up of debris and thus it lays down more scar tissue to protect the muscle.
Until the process is stopped, the efficiency of the entire muscle will continue to degrade and the cycle will exponentially increase. If you are training for a goal race and you have symptoms that don’t fade or resolve as expected with rest, don’t throw in the towel just yet; the ART® of recovery is at your finger tips.
What is Active Release?
Active Release Technique® (ART®), a non-invasive soft tissue technique, is a patented, state-of-the-art technique specifically designed to break up scar tissue in repetitively overused muscles. Many Ironman triathletes have already discovered the technique that relieves their aches and pains, helps them recover faster, and enhances their athletic performance.
How does it work?
It works by aggressively massaging out the scar tissue that causes your tendonitis, plantar fasciitis, IT band syndrome, or shin splints. All of these conditions are a result of repetition and can be caused by something as simple as scar tissue. The technique itself is diagnosis and treatment in one step, continually asking the athlete to aggravate the symptoms in-house followed by treatment and re-testing to determine if the site of pain is being affected. If you are not a candidate for ART®, it is apparent to the practitioner within the first few sessions.
It is especially convenient for the eager runner who doesn’t want to take time off to heal an injury. Athletes under care are often encouraged to continue training, with instructions to stop once the pain sets in. Frequently, athletes can measure their own progress by charting an increase in pain-free distances obtained, as well as a decrease in pain intensity.
What does it feels like?
In order to effectively reduce scar tissue, ART® has to be an aggressive procedure. But, most people describe the non-invasive technique as a “good hurt.” There is a large amount of digital pressure that has to be applied to the injury to affect scar tissue. Since we are speaking about muscles and tissue that are deep relative to the skin, you can compare it to a deep tissue massage with motion. The athlete is an active part of the treatment, which serves to improve the efficacy of the treatment and to mitigate the discomfort involved in receiving ART®.
It is definitely worth the “good hurt” to overcome the pain of training in order to reach the finish line. Don’t get frustrated with how your body is feeling and certainly don’t ignore what your body is telling you. Try the most conservative treatments first, and if that doesn’t work then consider an alternative treatment. ART® may be the answer to your training roadblock. Additionally, it may provide insight on “how” you were hurt, so that you can prevent future injuries and run longer.
As most of you know, I specialize in sports-related injuries. But as most of you may not know, I treat pregnant women too. Here is what one mother-to-be had to say about me in her blog. (She has given me consent to share this with you.)
Lot’s of things happen physiologically in the body during pregnancy. One major change is a hormone that is released into the bloodstream that causes the ligaments to stretch to allow the hips to expand for childbirth. This stretching can sometimes lead to pain. Not to mention all of the extra weight that these women begin to carry around in the second trimester… this too will cause stress on the body. Muscle and joint pain is very common in pregnancy, but you don’t have to live with the pain.
People often approach me with their ailments in a social setting. I would have to say that one condition I get asked about a lot is Plantar Fasciitis. Almost immediately after they bring up the topic the next question that ensues is “Can you help me with it? I mean, you work on joints.”
Besides being a chiropractor, I specialize in a soft tissue technique that was designed to treat conditions like Plantar Fasciitis. You can read about it on the home page or on the ART section of this site.
First of all what is plantar fasciitis?
There is a piece of connective tissue on the bottom of the arch of the foot that connects the front of the heel bone (calcaneus) to the base of the toes (metatarsal heads) and it’s purpose is to help maintain the arch and absorb shock with every step you take. Sometimes when your arches fall (overpronation) this fascia or connective tissue becomes overstretched and inflammed, which in turn results in pain especially the first step you take in the morning. When this happens scar tissue forms to protect the foot arch and less blood can reach these structures, which results in more pain.
I have had numerous patients that claim they cannot run, bike, hike, or ski because of this exact kind of pain.
I just want you to know. This is very treatable and if uncomplicated, it resolves fairly quickly with Active Release Technique.
Be aware that all types of heel pain or foot pain are not necessarily plantar fasciitis, it is important to be properly diagnosed.Heel pain can be caused by nerve, tendons, muscles, or bones.
There is a huge correlation between chronic low back pain and a lack of core strength. Here is a video showing some tips on how to relieve, correct, and possibly prevent low back pain with a few simple exercises. Please be aware that if you back pain persists for more that a few weeks, you should probably see a doctor.
I know this sounds crazy, but I agree with the information contained in this BBC article when referencing the back. I urge my patients to avoiding sitting really close to their computers, but it is hard for people accomplish if they have a hard time looking at their computer screens. When was the last time you had your eyes checked?
Slouching over a desk is certainly not recommended.
Sitting up straight is not the best position for office workers, a study has suggested.
Scottish and Canadian researchers used a new form of magnetic resonance imaging (MRI) to show it places an unnecessary strain on your back.
They told the Radiological Society of North America that the best position in which to sit at your desk is leaning back, at about 135 degrees.
Experts said sitting was known to contribute to lower back pain.
Data from the British Chiropractic Association says 32% of the population spends more than 10 hours a day seated.
Half do not leave their desks, even to have lunch.
Two thirds of people also sit down at home when they get home from work.
Spinal angles
The research was carried out at Woodend Hospital in Aberdeen, Scotland.
Twenty two volunteers with healthy backs were scanned using a positional MRI machine, which allows patients the freedom to move - so they can sit or stand - during the test.
Our bodies are not designed to be so sedentary
Rishi Loatey, British Chiropractic Association
Traditional scanners mean patients have to lie flat, which may mask causes of pain that stem from different movements or postures.
In this study, the patients assumed three different sitting positions: a slouching position, in which the body is hunched forward as if they were leaning over a desk or a video game console, an upright 90-degree sitting position; and a “relaxed” position where they leaned back at 135 degrees while their feet remained on the floor.
The researchers then took measurements of spinal angles and spinal disk height and movement across the different positions.
Spinal disk movement occurs when weight-bearing strain is placed on the spine, causing the disk to move out of place.
Disk movement was found to be most pronounced with a 90-degree upright sitting posture.
It was least pronounced with the 135-degree posture, suggesting less strain is placed on the spinal disks and associated muscles and tendons in a more relaxed sitting position.
The “slouch” position revealed a reduction in spinal disk height, signifying a high rate of wear and tear on the lowest two spinal levels.
When they looked at all test results, the researchers said the 135-degree position was the best for backs, and say this is how people should sit.
‘Tendency to slide’
Dr Waseem Bashir of the Department of Radiology and Diagnostic Imaging at the University of Alberta Hospital, Canada, who led the study, said: “Sitting in a sound anatomic position is essential, since the strain put on the spine and its associated ligaments over time can lead to pain, deformity and chronic illness.”
Rishi Loatey of the British Chiropractic Association said: “One in three people suffer from lower back pain and to sit for long periods of time certainly contributes to this, as our bodies are not designed to be so sedentary.”
Levent Caglar from the charity BackCare, added: “In general, opening up the angle between the trunk and the thighs in a seated posture is a good idea and it will improve the shape of the spine, making it more like the natural S-shape in a standing posture.
“As to what is the best angle between thigh and torso when seated, reclining at 135 degrees can make sitting more difficult as there is a tendency to slide off the seat: 120 degrees or less may be better.”
A patient of mine sent me this article on a vanity shoe that started helping women with their chronic low back pain. I have attached the article below and although it seems to have some research behind it, I was curious has anyone tried these out?
Everyone’s Flipping over the “Miracolous” FitFlop
Designed for women seeking toned legs without the gym, a humble sandal is now helping those with chronic back pain
By Ian Johnston Sunday, 18 May 2008
At £90 a pair, the latest range of flip-flops might seem an unlikely summer bestseller. But, according to an adviser on biomechanics to UK Athletics, this is not simply beachwear: the FitFlop appears to be capable of performing miracles.
Despite the product being originally designed and marketed as a “vanity shoe” that would help body-conscious women to tone their bottoms and legs, stories of how people crippled with arthritis or back pain are suddenly able to walk again are flooding in, according to the manufacturers.
On Friday, the FitFlop gained influential public support from Oprah Winfrey when she named it as one of her summer favourites on her television talkshow in the US, while other celebrities including Hilary Swank, Heidi Klum, Jennifer Garner and Jessica Biel, have a pair. Jade Johnson, the Olympic long jumper who suffers from a painful foot condition, found she gained the same benefit from wearing them as exercises recommended by her physiotherapist.
The FitFlop is said to produce a similar effect to walking barefoot, but with a degree of shock absorption. This makes the muscles work harder, creating the toning effect.
But Dr Phil Graham-Smith, head of the directorate of sport at Salford University and a consultant biomechanist for UK Athletics, also believes they may make the body adjust its walk to ensure the knee is correctly aligned.
“We carried out some independent tests and they came out quite favourably,” he said.
Dr Graham-Smith, who works with Britain’s jumping athletics team, said Johnson had benefited from wearing FitFlops. “She suffers from plantar fasciitis, which causes pain in the heel. Her physio gives her drills like walking through sand to help strengthen the arch of the foot,” he said.
“When she tries these on, she gets the same benefit as walking through sand and prefers using the FitFlops because, of all things, she has an allergy to sand.”
Marcia Kilgore, founder of the FitFlop company, admitted they were initially designed for their cosmetic effect on the body.
“They were originally launched as a vanity shoe – you could walk and help tone your legs. But over and over again, we’d hear things like ‘I’ve had a degenerative spine disease, haven’t been off morphine, and all I have to do is put on a pair of FitFlops and suddenly I don’t feel pain any more’,” she said. “A lot of people with severe and chronic back pain have reported a vast improvement, an almost miraculous improvement on putting these things on.”
The FitFlop was launched in May last year and has sold more than a million pairs, mostly in the US and UK. The basic style costs £36, but in keeping with this summer’s trend, Roman sandal-style versions costing £90 have been introduced.
GREELEY, Colo. — MichelleClark, D.C., of Denver, Colo.,participated on the Practice Analysis Advisory Committee held on April 3-5, 2008, at the headquarters of the National Board of Chiropractic Examiners (NBCE) in Greeley.Dr. Clark was one of 24 individuals who participated on the advisory committee.
Doctors in full-time chiropractic practice from across the United States came to the NBCE to develop a list concerning critical tasks they perform as part of their professional roles. These critical tasks will become part of a survey instrument that will be mailed to chiropractors throughout the United States.The meeting was facilitated by Ray Talke, president of Minds in Action Inc., who has worked with over 100 occupational groups in the development of professional task analysis descriptions.
This will be the fourth time the National Board has surveyed practitioners from all 50 states and the District of Columbia in order to document chiropractic practice, with the first survey conducted in 1991.The practice analysis is the foundation of the Part III and Part IV clinical and practical skills assessments administered by the NBCE to ensure that exam content directly pertains to the practice of chiropractic.
Additionally, the published report of the practice analysis is a tool for educators as well as legislators, state licensing boards, insurance companies, practitioners and others who need a reference concerning the practice of chiropractic.
The practice analysis also includes an extensive survey of research in the profession that has proven useful in understanding the importance of chiropractic in the health care system.
Headquartered in Greeley, Colo., the NBCE is the international testing organization for the chiropractic profession. Established in 1963, the NBCE develops, administers and scores legally defensible, standardized written and practical examinations for candidates seeking chiropractic licensure throughout the United States and in many foreign countries.
I joined a running group last November to train for a half marathon. I knew that I could reach my goal, but I wanted to do it in an environment that offered coaching, encouragement, and other people who were striving for the same goal. When one of my patients told me about Runner’s Edge of the Rockies I was psyched. The first Saturday group run was so much fun. I felt like part of the family from day one. What I didn’t realize is that a lot of the people in my pace group were first-time half-marathoners AND doing my same race! I chose the Phoenix Rock and Roll half marathon ( I am no dummy, I wanted my first half-marathon to be flat, low in elevation, and warmer than Denver in January).
I started training and followed a pretty rigid training schedule that was provided by Coach David Manthy. He was there via email for all questions and concerns, but after the group runs on Saturday he was there to chit chat. He was always checking in to make sure the training was going well. We trained from Thansgiving to mid January. At the time for signing up the race I thought that training for a half marathon would be the perfect way to prevent the holiday weight gain however, that meant training in ice and snow and getting up in the pitch black to get a morning run in before the sun came up.
But it all paid off…. On a Sunday morning in January, I successfully completed my first half-marathon! And I did it with the help of Runner’s Edge and Coach Manthy.
If you are thinking about training with a group for a race goal, I highly encourage it. It is fun, exciting, and worth every step.
Now an in-network provider with Pacificare. Pacificare was added to the American Chiropractic Network (ACN) as of January 2008. I now accept and am in-network with United Healthcare, Great West, and Pacificare. If you have these insurances, call our offices today an initial consultation. It is never too late to take responsibility for your health.
Our bodies are not designed to be so sedentary 
