Injuries in running

Dr. Marc Nimchuk

As a chiropractor in Kelowna, there is a tendency to see certain ailments or injuries more at a given time of year.  For me personally, since I tend to treat a lot of runners and triathletes as part of my practice, I notice a bump in the rate of running related injuries at this time of year.  Runners are abnormally prone to injury, in fact somewhere between 65-80% of runners will experience a significant injury during the course of a year.   Many people at this time of year increase their running distances either just for exercise or because they are training for some of the many races in the Okanagan.  Believe it or not, marathon and ½ marathon programs for the Okanagan Marathon are starting even though that race is not until October. 

Two of the most common injuries that I treat for runners are “shin splints” (properly termed MTSS) and disorders of the Achilles tendon and calf area.  These are both injuries which may start with relatively mild symptoms but can quickly progress to a point where an athlete has to take time away from running in order to recover.  Convincing a runner to take time off can be difficult as they are a stubborn bunch.

Shin splints is a common disorder and is really a misnomer.  In the vast majority of cases it is actually a soft tissue injury affecting the front muscles of the lower leg.  It often feels like a bony injury however, only in rare cases does it progress to something like a stress fracture.  Most often, the symptoms are felt hours or the day after activity. If they progress, symptoms can become more intense and actually affect running.  Initial treatment for this should include dedicated icing and strengthening of the calf muscles.  Manual therapy such as Active Release Technique® can be very helpful in breaking up adhesions in the muscles.  One newer self help technique that has become popular recently is the use of compression socks.  Many athletes are now using these before, during and after running to help reduce symptoms.  In my practice, I have sent several patients to local running stores and they have found a noticeable decrease in pain levels.  The compression socks that are available are surprisingly stylish as well!  If symptoms get to the point where they are affecting the actual activity, some time away and a consultation with a professional is required.

Achilles tendonitis and calf injuries are also quite common for runners.  This is often the result of hard running or rolling terrain.  Achilles injuries can be quite debilitating and, if not taken care of early, these injuries can progress into permanent tissue damage.  Strengthening exercises for the feet, stretching of the calf muscles and increasing ankle mobility is recommended.  With these injuries it is important to match your running style with proper shoes.  More expensive shoes are not necessarily the solution.  In fact, one study has shown that people with pricier footwear tend to get injured more!

Both of these injuries are manageable and with the right course of action, can be quickly resolved to keep you moving.

Dr. Nimchuk is a chiropractor practicing at KLO Chiropractic Centre in Kelowna.  He is also a full body Active Release Techniques® provider and fitness consultant.  When not in practice he can be found running, biking, swimming and spending time with his family.  He can be reached atwww.klochiropractic.ca

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Your neck and computer; not a happy couple

Dr. Marc Nimchuk

Ironically, as you are reading this column, I am contributing to the condition that is the topic of this column. In fairness however, the amount of time you spend on this page likely pales in comparison to the overall amount of time you spend in front of a computer or in a very similar position.

Depending on the source, the average teen and adult will spend anywhere from 60 minutes to several hours per day of leisure time on the computer. Keep in mind this does not include work time on the computer, which for sedentary office type work can add several hours per day. Being stuck in this position for hours on end is a source of chronic pain and worsened biomechanics for many people. This position of neck forward and rounded shoulders has recently been termed "Computer neck".

In reality, this position has been traditionally known as Upper Cross Syndrome and was first described by Valdimar Janda from the Czech Republic, a pioneer in rehabilitation medicine. Basically what upper cross syndrome describes is a weakening of rhomboid (mid-back) and deep neck flexor (front of neck) muscles along with a tightening of upper traps, levator scapulae (shoulders) and pectoralis (chest). These muscles when linked form a diagonal cross, hence the name upper cross. And yes, there is a lower cross syndrome as well, but that's for another time.

The effect of all this weakness and tightness is to alter your posture. Your shoulders round forward and is followed by your neck and head tilting forward as well. Your mid-back increases its kyphotic posture and becomes very stiff. Symptoms of this type of posture include:

• Cervicogenic/Migraine headaches
• Neck pain and immobility
• Rotator cuff (shoulder) pain
• Thoracic Outlet Syndrome
• Mid back pain

In order to treat this syndrome, a number of things have to happen, not the least of which is trying to spend less hours in front of your computer. If that can't be changed, then a review of your workstation should be completed to put you in the best possible position (tips found here.). Chiropractic treatment can be very effective at not only relieving the symptoms of this condition, but also to make the changes in your spinal mobility to improve your posture. Your chiropractor will treat the joint restrictions and soft tissue tightness. Exercises to strengthen the weak muscles and stretches to lengthen the tightened ones should also be provided. Implementing microbreak exercises at work to unravel yourself is also a great idea. An example of Brugger's Postural Relief Exercise is found here.

"Computer neck" is a progressive, chronic condition that sneaks up on people and can already be quite advanced before any noticeable symptoms arrive. At the beginning, it is easily fixable, however if left untouched for months or even years, permanent postural dysfunction can result.

Thanks and have a healthy day!


Dr. Nimchuk is a chiropractor practicing at KLO Chiropractic Centre in Kelowna. He is also a full body Active Release Techniques® provider and Certified Exercise Physiologist®. He treats active patients from 2 months to 90 years old.

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Exercise and Lung Health

James A. Peterson, Ph.D., FACSM

1. Deteriorating circumstances. Individuals who have lung disease often feel that it is impossible to exercise because they suffer from muscle weakness, fatigue, and shortness of breath. When they try to exercise, they get discouraged and stop working out when they get short of breath. In reality, their subsequent inactivity only makes their symptoms worse.

2. Confronting the challenged. Among the numerous health benefits of exercise is helping the heart and lungs work better. For example, exercising on a regular basis enables the muscles to become more efficient, which, in turn, allows them to perform the same amount of work with less oxygen.

3. Stepping out. Walking is an appropriate exercise activity for individuals with lung disease who want to initiate a physical activity program. It’s relatively easy, doesn’t require any special equipment, can be performed almost anywhere (indoor or outdoor), and doesn’t place undue stress on the exerciser’s musculoskeletal system.

4. Training the lungs. Individuals with lung disease should try to breathe deeply as they exercise. All factors considered, increasing the amount of oxygen taken into the lungs would enhance the training impact on the respiratory muscles. In fact, to the extent possible, they should attempt to breathe out twice as long as they breathe in. At no time should they hold their breath.

5. Keeping things in perspective. Being short of breath while working out should not be perceived as unduly harmful. More often than not, it is merely a signal that the lungs are working hard. On the other hand, individuals with lung disease should stop and relax for a few moments before continuing if they feel too tired or if they experience shortness of breath while exercising.

6. Being mindful. Individuals with lung disease who choose to exercise outdoors should be aware of the quality of the air they breathe (as anyone who exercises outdoor should), particularly on days when high levels of ozone ‘‘smog’’ are in the air. Ozone smog exacerbates the breathing problems of people with poor lung health.

7. Keeping a respectful distance. Individuals with lung disease should avoid exercising near congested highways because they are particularly susceptible to the adverse affects of air pollution. As a rule of thumb, they should try to stay 30 to 50 feet away from any car whose motor is running (stationary or in transit).

8. Lessening the difficulty. Individuals with inhaled allergies should try to reduce their exposure to allergy triggers (e.g., dust, dust mites, pollens, animal dander, air pollutants, etc.). Such triggers can make exercise more difficult for these people. For example, these individuals should avoid engaging in outdoor activities before midmorning, when pollen counts are typically at their highest.

9. Planning ahead. Asthma sufferers should consult with their doctor and determine if a preventive dose of medication should be taken before they engage in physical activity. As such, individuals with asthma should premedicate if their physician believes it is appropriate for them to do so.

10. Engaging the part of the brain that controls common sense. Like their healthy counterparts, the exercise-related advice for individuals with lung disease is fairly straightforward: use common sense, make a commitment to exercise on a regular basis, set and strive to attain reasonable goals, listen to the body, and always try to adhere to the ‘‘minimum effective dose’’ principle.

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Ways to Avoid Catching the Cold or the Flu

James A. Peterson, Ph.D., FACSM

1. Be ever vigilant. Be constantly on your guard against catching a cold or the flu. Keep in mind that each year the average American adult sneezes through three to five colds. Fortunately, once you've had a cold virus, your immune system will protect you from that particular strain for a long time. On the other hand, more that 200 different cold viruses exist.

2. Wash your hands. Prevent a cold or flu by washing your hands frequently and by keeping them away from your eyes, nose, and mouth. Viruses can live for one to three hours on the fingers of people who are already infected. You can pick up a cold from surfaces they touch (e.g., counters, telephones) when you touch your nose or rub your eye.

3. Don't spread the germs. Use tissues rather than cloth handkerchiefs that may harbor viruses for hours or days. Cover your mouth and nose when you cough or sneeze and encourage others to do the same.

4. Defend yourself. Have a flu vaccine. keep in mind that because children and the elderly are at higher risk for the flu, they have a particular need to be protected.

5. Don't share. Avoid sharing food, drinks, dishes, silverware, or straws with someone who has cold or flu symptoms.

6. Don't smoke. Cigarette smoke destroys protective cells in the airways and worsens the cough that often accompanies a cold or flu. Limit alcohol consumption, too, because alcohol depresses the level of white cells and also increases the risk of bacterial pneumonia in flu sufferers.

7. Fly smart. Because air circulation in an airplane is relatively low until take-off, delay boarding to limit your time in the plane while it's on the ground. Good air circulation can help disperse cold and flu viruses. Also, avoid dehydration of mucous membranes by drinking plenty of liquids (other than caffeine and alcohol, which increase dehydration).

8. Check out alternative cold remedies. Talk with your doctor or pharmacist about taking alternative cold remedies such as zinc lozenges at the first sign of a cold. Several clinic studies have shown that zinc may help diminish cold symptoms as well as reduce the length of a cold.

9. Don't stop exercising. Research has shown that exercise boosts the immune system. If you experience cold symptoms (above the neck), continue to exercise, but at a more moderate level of intensity than usual. Avoid exercising too hard since strenuous exercise may cause a cold to take a turn for the worse.

10. Don't sweat the small stuff. Finally, don't worry. All factors considered, the more stressed you are, the more susceptible you become to catching a cold or the flu. Undue stress may reduce the production of immunoglobulin A, a component of the immune system that helps defend the body against colds and flu.


James A. Peterson, Ph.D., FACSM, is a freelance writer and consultant in sports medicine. From 1990 until 1995, Dr. Peterson was director of sports medicine with StairMaster. Until that time, he was professor of physical education at the United States Military Academy.

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Get Healthy by Taking the Stairs

Gregory Minor, a middle-aged housekeeper at Duke University Medical Center, lost 80 lbs. and 10 inches simply by taking the stairs when he was at work. He's the latest success story in the Duke employee health program known as "Take the Stairs." The self-paced exercise program encourages employees to take the stairs and record how many stairs they climb. After certain milestones - climbing the equivalent of a mile, the equivalent of a 5k, and so forth - the employees get rewarded with small gifts. For Minor, the biggest gift of all was watching his waistline shrink. He reports in a YouTube video promoting the program that he now has more energy and feels better about himself.

Research Shows Climbing the Stairs Has Multiple Benefits

The Duke wellness program is based upon research that shows using the stairs over a period of months has significant health benefits. A study in European Heart Journal followed 69 hospital employees who ditched the elevator for the stairs for roughly 90 days. The employees reaped the following benefits:

• Body fat dropped 1.7%
• Waist circumference dropped 1.8%
• Blood pressure fell 2.3%
• LDL cholesterol fell 3.9%
• Lung capacity went up 8.6%

Given these statistics, it's not surprising that Gregory Minor lost 80 pounds after 18 months the stairs of Duke Universitdical Center.

Add Years to Your Life and to Your Years

The perks Minor experienced are one small glimpse at the benefits of stair climbing. People who are regular stair climbers generally live longer and have a lower risk of cardiovascular disease than those who take the elevator instead. A Harvard study estimated that 8 flights of stairs per day could reduce your death rate by as much as 32%. Furthermore, as Minor reported when he said he had more energy, stair climbers have better leg strength and aerobic capacity than those who take the elevator, leading to a greater quality of life. Most average, sedentary adults gain an average of two pounds per year. Over ten or fifteen years, this gradual increase in weight leads to an extra twenty or thirty pounds of body weight, resulting in numerous health complications. However, a mere two minutes of stair climbing per day over a one-year period can keep those annual twonds at bay.

Save Money on Medical Bill Medication

When you start losing weight, lowering your cholesterol level, lowering your blood pressure, and increasing your lung capacity by taking the stairs, you'll also spend less time feeling sick. When you spend less time feeling sick, you spend less time at the doctor. When you spend less time at the doctor, you'll have fewer prescriptions. When you spend less time at the doctor and have fewer medications, you'll save a lot of money on medical expenses. How expensive is it to fight your cholesterol and other conditions with regular medical solutions? Here are a few statistics to encourage you:

• Lipitor, the popular cholesterol drug, can cost as much as $470.69 when you buy it from an average retail pharmacy
• Even less expensive cholesterol medications still cost hundreds or thousands of dollars per year
• People with chronic conditions, such as heart disease, accrue an average of over $6,000 in medical expenses each year
• In 2003, a survey found that 63% of families who struggled to pay medical bills also struggled to pay for food, clothing, rent, and other necessities
• Since 1981, bankruptcies resulting from medical expenses has increased 30-fold
• Doctors are prescribing more medications than ever before - approximately 146 drug prescriptions for every 100 doctor visits

Given that the cost of medical care and prescription drugs continues to skyrocket, getting in shape isn't just a quality of life issue anymore. It's also a financial issue. When you keep off the extra pounds and get the other health benefits listed above by taking the stairs, you lower the likelihood of experiencing a number of chronic illnesses. Chronic health conditions related to obesity include:

• Diabetes
• Hypertension
• Heart disease
• Infertility and erectile dysfunction
• Acid reflux
• Breast cancer
• Osteoarthritis
• Back problems
• Acne and other skin disorders
• The list goes on...

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The 15 Best Fat Loss Tips

Submitted by brealz68,

Many individuals embark on a diet at some point in their life. While we are unable to accurately display a percentage of failed diets we can say that most efforts result in short-term weight loss due to calorie reduction and unfortunately lead to further weight gain. Just in case your diet has failed or is on the verge of failure read our tips for the best fat loss…

1. Between 5-15 minutes before a meal, drink an 8 oz. glass of water or another healthy choice beverage to fill your stomach up so you don't eat as much food.

2. Choose breads and other carbohydrates that are whole grains such as spelt, buckwheat, barley,

3. Replace all soft drinks and other sugary juices with water. If you need flavor in your water use a lime or lemon wedge mixed in your water.

4. Always eat breakfast. A balanced breakfast will include a protein (steak, chicken, fish or eggs); Fruit and some oatmeal to kick start your metabolism. A balanced breakfast will allow you to stabilize blood sugar and prevent over indulging later in the day.

5. Have an oral fixation that you normally correct with food? Try chewing flavored gum between meals. Most gum can be found in a variety of desert flavors and can have less than 10 calories per stick. Don’t overdo it with the gum and be careful of your dental health.

6. Cheat Days are acceptable. Allow your body to give into a craving once a week for one meal. Just don’t overdo it.

7. Replace your regular snack foods with raw almonds, cashews, pumpkin seeds that are high in protein and essential fats. Just be conservative as calories can add up fast.

10. Try to avoid milk as it is filled with unhealthy hormones. Leafy greens are rich in calcium and can replace the calcium lost from the reduction of milk.

11. Cook more often at home. This will allow you to know exactly what is in your food and help you reach your goals.

12. Avoid all fried foods. If you are craving fried foods cook them at home using coconut oil.

13. Try to avoid processed food. Processed foods have chemicals and additives that are unhealthy and contain a mass amount of calories.

14. Remember to keep working. All types of activities burn calories. Move around as much as possible. Park further in the lot when going to the store, take the stairs instead of an elevator and experiment in new types of physical fitness. If you have kids create activities that get you all outside to PLAY and just do what you enjoy!

15. Don’t judge weight loss by the scale alone. Find ways to judge your progress and don’t get discouraged if the scale fluctuates. Take before and after pictures of your progress and judge your goals by the way your clothes fit.

Desire, Dedication and Determination will be required to reach your goals. Diets are not a quick fix they are a life style change that must include physical activity. 

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