Avoid Overuse Tendon Injuries:

As the weather heats up, we head outside to test our athletic prowess. We hit the road and trails on bike or foot without questioning that we may have lost some of our endurance since last fall. Tendon issues may arise during repetitive activity without proper training. Tendons attach muscle to bone and “tendonitis” or “tendonosis” is a degenerative, inflamed tendon. With tendon injury, the tendon tissues become disorganized bundles of collagen, rather than in parallel orientation and no longer function properly.  The most commonly injured tendons in the lower extremity are the patellar tendon, Achilles tendon, and the posterior tibial tendon.

The patellar tendon attaches the knee cap to the shin bone and can produce anterior knee pain with overuse. The Achilles tendon attaches the calf muscle to the heel and will cause pain along the tendon or at the heel. The posterior tibial tendon supports the foot arch and attaches the posterior tibial muscle to the bottom of the foot. Injury can weaken the foot arch causing collapse.

The best way to strengthen these areas, to prevent or recover from tendon pathology, is with ECCENTRIC strengthening. Eccentric means lengthening. By strengthening the tendon in a lengthened position the tendon properties are able to re-align in the parallel orientation making the tendon inherently stronger. The eccentric motion of these tendons is the functional position of where the tendons are at highest stress during repetitive motions. Strengthening in this position is most efficient.

Eccentric strengthening for tendon pathology has been proven is various studies to be effective. The protocol that has been used in research is performing 3 sets of 15 repetitions twice a day. The exercise varies based on which tendon you are attempting to load/strengthen in an eccentric position.

Patellar tendon = Perform single leg mini squats on an incline board. The heel should be raised, toe pointing towards the ground; keep the knee aligned over the first two toes. Only squat to 45 degrees of knee bend.

 Achilles tendon = Perform single leg heel raises off a step, focusing on slow controlled lowering motion, getting the heel lower than the step.

 Posterior tibial tendon = Perform seated with a resistance band over the ball of you foot and attached to a stable surface (band perpendicular to the outside of your leg).Resistance should be pulling your foot into an outward position. Pull the band so your foot/ankle turns inward. Again, focus on the slow controlled outward motion or back motion. Also, performing the Achilles exercise will help strengthen the tendon, since it functions in both actions.

 Before you get on your bike or lace up your running shoes to enjoy the spring sunshine, make sure your tendons are ready to handle the load. ECCENTRICALLY strengthen! Happy trails.

Lindsey Fitch is a doctor of physical therapy and running specialist at Vail Integrative Medical Group. She is an Avid competitive runner, most recently winning the Salt Lake City Marathon

Vax-D Decompression Therapy for Low Back Pain

Do you suffer from low back pain? Vail Integrative Medical Group may be able to help. Approximately 5.4 million Americans are disabled annually due to back pain and up to 85% of the U.S. population will have back pain at some time in their life. And did you know that spine surgery is the second leading surgical procedure in America, with the total number in the U.S. approaching 500,000 per year. Lastly, an estimated 93 million workdays are lost each year due to back pain. What, if anything, can be done about this growing epidemic? 

               

Common conservative treatment for low back pain includes chiropractic, physical therapy, massage therapy and acupuncture. Another form of treatment is Vax-D or vertebral axial decompression. What is Vax-D you ask? It is a patented non-surgical therapy proven to be as much as 88% successful at treating chronic low back pain. This pain may be caused by bulging, herniated or degenerative discs leading to sciatica. Even post-surgical patients and those suffering from stenosis (a narrowing of the spinal canal) have reported significant pain relief from Vax-D treatments.

How does Vax-D work? Vax-D lengthens and decompresses the spine, reversing high intradiscal pressures through the application of negative pressure via a patented “slow ramp-up” process. This reversal of pressure creates a vacuum inside the discs, which takes pressure off of pinched nerves and helps to reposition bulging discs and pull extruded disc material back into place. Nutrients, oxygen and fluids are simultaneously drawn into the disc to create a revitalized environment conducive to healing.

Vax-D stimulates the body’s repair mechanism, providing the building blocks needed to actually mend injured and degenerated discs. Vax-D’s process is the only patented treatment clinically proven to decrease disc pressures to the negative levels needed to facilitate healing.

A recently completed 2 ½ year study has demonstrated that Vax-D achieved a remarkable 88% success rate in the 283 chronic back pain patients studied. The patients selected for the study had failed at least two previous non-surgical treatments. The study also used pre and post MRI’s to determine the extent of the damage to the discs and showed actual reduction in disc herniation, rehydration of disc heights and improved lordotic curve after 6 weeks of 30 minute Vax-D treatments as well as their own tailor-made exercise program.

A typical Vax-D treatment regimen consists of approximately 20 sessions (5 days a week for 4 weeks). Some conditions require fewer visits, some require more.  Many patients report relief from their pain and other symptoms during the first few treatments sessions. Most experience dramatic pain relief after completion of their full treatment.

At VIMG, we specialize in treatment of chronic lower back pain and offer a comprehensive approach to treatment. Along with Vax-D, we offer chiropractic, physical therapy, massage therapy and medical neurology. During the month of May, we will be doing a 12 session trial of Vax-D for $900. This is a 50% discount! Give us a call today at (970) 926-4600 and reserve your appointment for Vax-D. Another day with back pain is another day you are not living life to the fullest.

  

Dave Blanchard MPT