Trigger finger, also known as stenosing tenosynovitis, is a condition where you feel pain, stiffness and a sensation of clicking or locking when you try to bend or straighten your finger.  It can happen to any of your fingers, but it usually affects your thumb or ring finger.

So what exactly is going on?

Muscles move bones.  They are attached to the bones by cords called tendons.  In your hand, there are tendons that attach the muscles on the front of your forearm to your fingers.  When the muscles contract, the tendons pull your finger bones together to make a fist or grab an object.  Each of these tendons passes through a tunnel called a tendon sheath, which helps it glide smoothly when the muscles contract.  There are also bands of tissue called pulleys that hold the tendon and it’s sheath close to the bone.

Sometimes, one of the pulleys (usually the A1 pulley at the base of your finger) gets irritated.  It can become thickened and inflamed.  The tendon may also get irritated and develop a nodule on it’s surface.  When the nodule gets pulled under the thickened pulley, it can catch.  This can be painful, cause a “pop” or even make your finger lock up so that it gets stuck in a bent position.

The exact cause of Trigger Finger is unclear.  It has been suggested that repetitive forceful grasping may contribute to the condition.  It also appears to be more common in patients with certain medical conditions.

The Good News

Two of my colleagues, Drs. Anthony Lombardi and Joey Walker have developed an electro-acupuncture protocol for treating Trigger Finger.  They published it in the journal Acupuncture in Medicine.  I had the good fortune of learning the protocol from Dr. Lombardi a few months before it was published and have been using it to successfully reduce pain and improve function.

You’ve probably heard people talk about “TMJ.”  There’s a good chance that you even know someone who has a problem with theirs.  Or maybe you are suffering from “TMJ” yourself.  So what is it, exactly?

When people talk about the “TMJ”, they are talking about the Temporomandibular Joint.  It is the place where your jaw bone attaches to your skull.  You have two of them, one on each side.  They are basically a pair of sliding hinges that let your jaw open and close.  Normally, you should be able to open your mouth, chew, eat and talk without pain.  However, patients suffering from TMJ disorder often have difficulty with these activities and / or suffer from pain in their jaw, teeth or face.  It is estimated that ten million Americans suffer from TMJ disorder, with women being affected more often than men. 

SO WHAT ARE THE SYMPTOMS?

There is a wide variety of symptoms associated with the TMJ, and some are more serious than others.  For instance, many people report a “click” or other sounds coming from the joint.  If the clicking isn’t painful and doesn’t get in the way of chewing or other activities, it probably isn’t anything to worry about. 

Many TMJ patients cannot open their mouth all the way or their jaw “cocks” to one side when they try to open it.  Usually, I find that this happens because one or more of the muscles that opens or closes your jaw is tight.  There is also a good chance that you (or your dentist) will notice that your teeth don’t line up properly anymore.  There has been a fair amount of debate among scientists as to whether this is the cause – or the result – of altered function of the TMJ.

Pain is probably the most common TMJ symptom that brings patients into my office.  When the joint – or the muscles that move it – aren’t functioning properly, it can produce pain in the face, jaw, sinuses or teeth.  Since these muscles have a strong functional and neurological relationship to the neck muscles, there is also a good chance that you will also notice pain or stiffness in your neck.

SO WHAT CAUSES IT?

Many things can cause pain and dysfunction of the TMJ.  Most of the time, several interrelated factors are at play. 

There are several strong functional links between the neck and the jaw, and when one of them isn’t working properly, there is a good chance the other isn’t either.  For instance, when your neck and jaw are both working properly, your head actually tips backward when your jaw opens.  Think of a little kid being told to say, “aaaahh.”  Most likely, you’ll picture her tipping her head back when she opens all the way.  On the other hand, patients with TMJ pain usually tip their heads much less – and may not tip their heads at all.

Maybe you’ve heard of “tech neck” – that posture you get when you stare at screens or your phone all day.  This results in a posture where your head and shoulders lean forward.  When this happens, it puts tension on the muscles under your chin and on the front of your neck that pull your mouth open.  When these muscles are tight, the muscles that close your jaw have to work harder to keep you from walking around with your mouth hanging open.  Over time, this extra tension can lead these muscles to develop trigger points that restrict jaw opening, cause headaches, toothaches and other pain. 

Trigger points in the neck can also “refer” pain from the neck up into the jaw, temple jaw and forehead.  What’s more, they can also cause the muscles that move your jaw to tighten up, too.  I see this scenario in patient’s who have been in car accidents and also in people who have stressful jobs. 

Other common causes of TMJ pain include grinding your teeth at night, biting your nails, trauma, arthritis or other damage to the joint.

SO WHAT CAN I DO?

Often, TMJ-related pain is mild and goes away on its own.  However, if the pain or limited mobility interferes with chewing or talking, is extremely painful or is associated with other symptoms like dizziness or hearing loss, it is time to seek out a medical professional.  The good news is that TMJ pain and dysfunction usually responds to conservative treatment.  For instance, your dentist may give you a mouth guard. 

In our office, we take a sports medicine approach to treating patients with TMJ.  By “sports medicine approach,” I mean that we focus on assessing and improving the biomechanics of your neck, shoulder girdle and jaw.  Often, by improving function, pain and other symptoms will go away on their own.

On your first visit, we will discuss your treatment goals.  Then, we’ll assess your posture and how the muscles and joints of your neck, jaw and upper extremity are working.  We’ll also locate any Trigger Points that may be contributing to your pain and other symptoms.  Based on what we find, we will put together a treatment plan using dry needling, electroacupuncture and soft tissue techniques to help you improve your posture, correct muscle imbalances and help restore normal function of the neck and jaw.  Our goal is to help restore normal, pain-free movement, relieve pain and help improve your quality of life.

Thoracic outlet syndrome (TOS) has a wide range of symptoms, and can be confused with cervical radiculopathy – “a pinched nerve in your neck.”  Symptoms include pain or numbness, which may affect the pinky and outside of the hand, or may spread to the whole hand and arm.  Pain may also affect the area below your collar bone, your armpit or the area in between your shoulder blades. 

You may also find that one of your hands is swollen for no apparent reason.  The swelling is usually worse when you wake up in the morning.  You may also notice discoloration or coldness in the affected hand.  You may also notice that your hand or arm feels weak or uncoordinated.

So what is TOS?

Thoracic outlet syndrome happens when the nerves and / or blood vessels to the arm get compressed (“squished”, “pinched”) near where they leave the neck.  There is a little triangle in the side of your neck where the brachial plexus, a bundle of nerves that goes to your arm  and the subclavian artery that feeds your arm have to pass through.  The triangle is made up of two muscles, the anterior scalene and medial scalene.  The first rib is the bottom of the triangle. 

When the scalene muscles are tight, they can pull the first rib upward.  This makes the triangle smaller and can compress the nerves and the artery.  A small percentage of people also have an extra rib that makes the triangle smaller, too. 

After the nerves and artery go between the scalenes and the rib, they have to between the collar bone and the rib cage.  Unfortunately, they can get pinched here, too.  Lots of things can cause this.  If the scalenes are tight, they can lift the first rib up against the collar bone.  There is also a little muscle called the subclavius that stabilizes the collar bone.  When it is tight, it can also pull the collar bone against the rib and compress the nerves and blood vessels.  Poor posture with slumped, rounded shoulders can also contribute to nerve compression here.

What Can Cause Scalenes (and other muscles) to be Tight?

One of the most common causes that I see are whiplash injuries.  Whiplash is associated with sudden extension of the neck, like what happens when you are rear-ended in a car.  This puts a sudden strain on your neck muscles.  Other things, like stress, poor posture, chest breathing, excessive coughing and exercises like farmer carries can also cause your scalenes to tighten up.

What’s more, muscles in your neck and shoulder girdle can form trigger points that can mimic the symptoms of TOS.  What are trigger points?  Trigger points are sore spots in tight bands in your muscles. Normally, they shouldn’t be there. Injury, infections, stress, over training and about a hundred other things can cause them to form. They’re different from regular tight muscles. Trigger points are basically little inflammation factories. What’s even weirder, trigger points can cause pain and other symptoms in totally different parts of the body – away from where the real problem is.

The Good News

A careful physical exam and imaging will help determine if your symptoms are due to tight muscles or related trigger points and rule out structural issues, like disc bulges or an extra rib.  When symptoms of TOS are due to tight muscles or trigger points, they usually respond well to dry needling acupuncture.   

When you come in for your appointment, we will take a history, do a physical exam and help rule out more serious problems.  We’ll examine your posture to see what muscles might be weak and which other ones are tight.  We’ll also check for trigger points that could be referring pain to your arm or compressing nerves. The advanced Orthopedic Acupuncture & Dry Needling styles that we use are ideally suited to reset dysfunctional muscles, reduce neurogenic inflammation and help restore normal function.  We’ll create an individualized treatment plan for you to help reduce your pain level, improve your quality of life and help you get back to doing what you love.

Tennis elbow is a broad term that describes pain and tenderness on the outside part of your elbow.  Pain can also spread down the back of your forearm to the back of your hand and even your fingers.  Sometimes, you’ll notice that your grip is weaker than it used to be or you have trouble opening jars or turning door knobs.

Traditionally, tennis elbow was believed to be to an irritation of the tendon where the muscles that straighten your wrist and fingers attach to the bone near your elbow.  While this does happen, there are several other common, but often overlooked causes of pain on the outside of your elbow.

For one, trigger points in the muscles that attach to the outside of your arm can radiate pain to the outside of the elbow.  Two of the most common causes of elbow pain that I see in my patients are trigger points in the triceps (a muscle in the back of your upper arm that straightens your elbow) or in the supraspinatus (part of the rotator cuff that helps lift your arm and stabilize your shoulder joint).

So What Are Trigger Points?

Trigger points are sore spots in tight bands in your muscles. Normally, they shouldn’t be there. Injury, infections, stress, over training and about a hundred other things can cause them to form. They’re different from regular tight muscles. Trigger points are basically little inflammation factories. What’s even weirder, trigger points can cause pain and other symptoms in totally different parts of the body – away from where the real problem is.  In tennis elbow patients, I often see trigger points in the neck or rotator cuff muscles causing patients forearm muscles to keep tightening up (how weird is that!).

While almost anyone could be affected, I most often see tennis elbow pain in martial artists, construction workers, law enforcement, musicians and members of the dental profession. 

The good news is that a careful exam will usually reveal the source of your elbow pain. What’s more, most cases of lateral elbow pain respond well to dry needling acupuncture and tuina soft tissue techniques.

When you come in for your appointment, we will take a history, do a physical exam and help rule out more serious problems.  We’ll examine your posture to see what muscles might be weak and which other ones are tight.  We’ll also check for trigger points that could be referring pain to your elbow or triggering your forearm muscles to tighten up.

The advanced Orthopedic Acupuncture & Dry Needling styles that we use are ideally suited to reset dysfunctional muscles, reduce neurogenic inflammation and help restore normal function.  We’ll create an individualized treatment plan for you to help reduce your pain level, improve your quality of life and help you get back to doing what you love.

For many of us, the short answer is, “Yes.”  On average, Americans spend nearly half of their day interacting with digital media of various forms.  Think about your day.  How often do you find yourself bent over, absent mindedly looking at your phone to kill time.  I certainly know I’m guilty.  Then think of the amount of time you spend actually texting, searching for directions, sending emails or staring at your computer at work.  It all adds up.  While “killing” may be a bit of an over-statement, there are very real consequences to all of this screen time.   

Think of what happens when you look down at your phone or tablet.  Let’s be honest, very few of us hold our devices at eye level.  More often, we hold them in front of our chests near where our ribs come together or even down by our laps.  In order to look down, we have to bend our necks and upper backs forward and our shoulders roll inward.  Our head comes out in front of it’s normal center of gravity and tips downward.  Sitting at a computer isn’t all that much better.  When most of us sit at a desk, we end up slouching, with our chins leaning forward toward the screen.

Let’s take a look at what happens when you sit or stand with your head too far forward.  Normally, when you stand, your ears, shoulder joint and hip joints should basically line up with one another.  In that position, your head is balanced, and your spine and neck muscles only have to contend with holding up about 10-12 pounds.  Now, for every inch your head moves forward from it’s neutral balanced position, the muscles in the back of your neck have to do the work of holding an extra ten pounds.  So, if you’re staring at your phone with your head 4” farther forward than it should be, your neck is experiencing about 50 pounds instead of the normal 10.

Needless to say, all this extra work makes the muscles in the back of your neck tighten up and shorten, along with your chest muscles.  When this happens, muscles in your mid back and deep within the front of your neck have to relax and lengthen.  Over time, these muscles become weak.  The result is a forward-slumping posture, with your head too far forward, upper back hunched and shoulders rolled forward and inward – sort of like a gorilla.  Some writers have taken to calling this phenomenon “tech neck”.

So what’s so bad about that?

There are many reasons why tech neck isn’t good.  Some are worse than others.  When your muscles are chronically tight and overworked, they are prone to developing Trigger Points.  They’re different from regular tight muscles.  Trigger points are basically little inflammation factories.  What’s even weirder, trigger points can cause pain and other symptoms in totally different parts of the body – away from where the real problem is. 

Trigger points in your neck and shoulder girdle can produce headaches, neck, chest, back and arm pain.  It has even been suggested that trigger points in the neck can contribute to sensitization of a structure in your brain (the caudal trigeminal nucleus), and may contribute to migraines.  What’s more, if you’re an athlete, tech neck can affect your performance by restricting shoulder mobility.

Over time, tech neck may also contribute to wear and tear on your spine.  Vladimir Janda noted that certain segments of the spine in the neck and upper back wear more quickly due to added mechanical stress and altered curvature.  Pain from the joints in your spine can add to your headaches, back and shoulder blade pain.

So What Can I Do About It?

The most obvious thing is to limit how much time you spend on electronic devices.  Obviously, that’s easier said than done.  What you can do is keep screens closer to eye level so that you don’t have the same tendency to lean your head forward and down.  If you work on a computer at work, you may want to take frequent short breaks to stand up or simply look away from your screen.  A trainer at your gym may also be able to show you some exercises that can help, too.

If you are experiencing pain, headaches, TMJ, think you have a pinched nerve or your think your tech neck posture is affecting your athletic performance, it is time to see a qualified healthcare practitioner. 

At Orthopedic & Sports Acupuncture, we specialize in treating patients muscle imbalances like tech neck.  When you come in for your appointment, we will take a history, do a physical exam and help rule out more serious problems.  The advanced Orthopedic Acupuncture & Dry Needling styles that we use are ideally suited to reset dysfunctional muscles, reduce neurogenic inflammation and help restore normal function.  We’ll create an individualized treatment plan for you to help reduce your pain level, improve your quality of life and help you get back to doing what you love.

Shoulder pain is one of the most common complaints that brings patients to our office.  Many things can cause shoulder pain, including tendonitis, impingement syndrome, bursitis and problems with the joints.  Shoulder pain can also be referred from muscles in your neck, rotator cuff or arm.

The Glenohumeral Joint

Your shoulder is a special joint.  The main joint, the glenohumeral joint, is where the bone in your upper arm attaches to the shoulder blade.  It is a ball in socket joint, like your hip.  A ball in socked joint is exactly what it sounds like.  There is a ball on the end of one bone, the arm bone.  There is a cavity or “socket” on the other bone, the shoulder blade.  The ball on the end of the arm bone sits into the socket part of the shoulder blade.  This allows the arm to move and rotate in a bunch of directions.

Now, for what makes the shoulder special.  As I mentioned, the hip is also a ball in socket joint.  But the hip joint has a deep socket, called the acetabulum.  Imagine a softball sitting in a bowl – there is a bunch of the bowl that wraps around the softball.  This is stable and can support a bunch of weight.

The shoulder is different.  It has a very shallow socket, called the glenoid.  Think of a golf ball sitting on a tee.  This setup allows for a lot more mobility.  This lets us climb, throw, brush our teeth and about a million other things that make us who we are as humans.  Now, this mobility comes at a price – the joint is way less stable than the hip. 

The Rotator Cuff

Instead of having a deep, stable, bony socket, the glenohumeral joint has a group of muscles, called the rotator cuff, that hold it together and stabilize it during functional motions.  The rotator cuff consists of four muscles:  the supraspinatus on top, the subscapularis in front, and the infraspinatus and teres minor in the back.

Tendons are what attach muscles to bone.  The rotator cuff tendons attach to the top of the upper arm bone, near where the ball is.  The tendons – especially the supraspinatus tendon – have to pass under a part of the shoulder blade called the acromion.  Normally, there is about 9-10 millimeters of space for the tendon to pass through.  There is a little sac of fluid, called a bursa, that normally cushions the tendon as it passes under the bone.

Other Joints

There are two other joints that make up the shoulder joint.  One is the acromioclavicular (AC) joint.  It is where the collar bone attaches to your shoulder blade.  The other joint is the scapulothoracic (ST) joint.  This is where your shoulder blade slides over your rib cage.  It isn’t a “true” joint, because it isn’t surrounded by a fibrous capsule, but it is very important for athletes and everyone else who is suffering from shoulder pain. 

Causes of Pain

Shoulder pain is common in middle aged people, in people who work construction or similar professions.  It is also common in swimmers, throwing athletes, weight lifters and other people whose sporting activities involve spending a lot of time reaching overhead.

Some of the more common causes of shoulder pain include bursitis, tendonitis and impingement syndrome.  Bursitis is a condition where the bursa – the “water sack” that lubricates the tendon – gets irritated, swollen and inflamed.  Tendonitis of the rotator cuff tendons (or the biceps tendon) can also cause pain on the front or outside of your shoulder.

Impingement syndrome is a bit more complicated.  With impingement syndrome, the space between your arm bone and the acromion gets smaller – and the rotator cuff tendon can rub against the bottom of the acromion and get irritated. 

Digging a Little Deeper (muscle imbalances, etc)

Let’s take a closer look at what happens when you move your shoulder.  When you lift your arm, the ball at the head of your arm bone rotates.  It also slides upward and forward a little bit.  The infraspinatus and subscapularis muscles help control this movement and make sure that it isn’t excessive.

There are lots of interesting things that happen with the scapulothoracic joint, too.  When you raise your arm to the side, the shoulder blade has to rotate upward 1 degree for every 2 degrees that the GH joint moves.  This is called the “scapulohumeral rhythm”.  The shoulder blade also needs to slide around the rib cage in a controlled way.  Near the top of arm elevation, the shoulder blade has to be able to tip backward a a bit to low full range of motion.

So what happens when there are muscle imbalances?

Clearly, movements of shoulder are complex.  Imagine a symphony.  If one of the musicians is playing out of time, the whole thing ends up not sounding good.  That’s sort of how the shoulder works.  For instance, if the rotator cuff muscles are weak (or there is a problem with the joint capsule), the head of the humerus (the “ball”) can move upward too much. 

Lots of things can happen at the scapulothoracic joint.  For instances imbalances between the different portions of the trapezius muscle in your upper back or with the serratus anterior (the muscle between your shoulder blade and the rib cage) can keep our shoulder blade from rotating properly.  A tight pectoralis minor can keep your shoulder blade from tipping backward the way it is supposed to.  Any of these cases, can adversely affect the movement of your GH joint, leading to impingement or other painful conditions of the shoulder.

Other things can cause shoulder pain.  One of the more common ones is a “hooked acromion.”  This is where part of the acromion (the bone that the tendon passes under), bulges downward, making the subacromial space smaller.  Traditionally, this was thought to be genetic.  Some recent research has suggested that it might be something that develops secondarily to other shoulder pathology.  Either way, it is believed to increase the likelihood that your supraspinatus tendon will get irritated.

Any of these three conditions can produce shoulder pain.  The most common area of pain is the front and the outside of your shoulder.  It may also spread down the outside of your arm to your elbow and occasionally even to your wrist.  Pain may be worse with work or sports activities, or when you lift your arm or lower it from a lifted position.  Pain may be constant and aching, or it may be sudden and sharp with lifting overhead,  reaching behind your back or other specific movements.  It may interfere with sleeping.

Myofascial Pain

Myofascial pain is one of the most common causes of shoulder pain that I see in my clinic.  It is pain is pain referred from muscles and the fascia – the “shrink wrap” around your muscles.  Referred pain is pain that originates in one place, but is felt in another.  Referred pain is often coming from “Trigger Points.”

Trigger points are sore spots in tight bands in your muscles. Normally, they shouldn’t be there. Injury, infections, stress, over training and about a hundred other things can cause them to form. They’re different from regular tight muscles. Trigger points are basically little inflammation factories. What’s even weirder, trigger points can cause pain and other symptoms in totally different parts of the body – away from where the real problem is. 

Several studies have shown that the rotator cuff muscles have trigger points in the majority of patients with impingement syndrome.  The muscles can form trigger points in the absence of impingement, too.  What’s more, neck muscles like the scalenes, the pectoral muscles of the chest and the biceps muscle of the arm can also cause shoulder pain.

What Next?

If you’ve been suffering from shoulder pain, you may want to contact a qualified healthcare practitioner, like a sports acupuncturist.  The good news is that shoulder pain often responds well to conservative treatment. 

When you come in for your appointment, we’ll examine your your shoulder.  We’ll see how it is moving and see what muscles might not be working properly.  We’ll screen for more serious problems and look for trigger points that may be referring to your shoulder or causing muscles to “shut down”.

The techniques that we specialize in and teach are unique.  While most traditional acupuncture styles focus on balancing out the body’s organ systems, and focusing on overall health, modern Orthopedic Acupuncture specifically targets the muscles, joints, and the nerve pathways that affect them. The goal is to restore normal, pain-free movement and get you back to doing what you love!

The Trigger points and muscle imbalances that often underlie shoulder pain usually respond well to the dry needling, orthopedic acupuncture and tuina soft tissue therapies that we specialize in.  If you think you may be suffering from Give us a call at (315) 935-5700 to schedule your appointment today!

First off, I love treating runners.  There are about a hundred reasons for that.  For one, runners (like bodybuilders) tend to be very aware of what is going on in their bodies.  Secondly, I have first-hand experience suffering from many common running injuries that I see in clinic – so I can relate.  Let’s take a look at a few common running injuries.

Shin Splints

“Shin Splints” are one of the most common running injuries that I see in my clinic.  Shin splints can affect athletes of all ages.  While it is often thought of as a novice runner’s injury, experienced runners can also develop them, especially following a change in their training routine.

Patients usually report pain along the middle or lower 1/3 of the inside of their shin, either along the edge of the bone or just behind it.  When the pain starts, they usually only feel it after a run.  Then, as their condition gets worse, they start to feel pain while running and sometimes it ends up being all the time.  (ouch!)

The exact cause of shin splints (also called medial tibial stress syndrome) isn’t fully understood.  However, it appears to be due to an irritation of the tissue that attaches the muscles to the bone and / or tight, weak, over-worked muscles in the low leg. 

Clinically, when I see shin splints / medial tibial stress syndrome, it is usually the end result of faulty movement patterns and muscle imbalances.  Let’s take a look at a couple of these.

First off, I’d like to talk about the posterior tibialis muscle.  It’s a long, thin muscle that “lives” behind your shin bone.  It’s not a muscle that a lot of people talk about, because it’s hidden and doesn’t show up in bodybuilding poses.  But it’s very important for athletes.  This is because of how it stabilizes the ankle – and since the foot and ankle are our foundation – the whole body.

The posterior tibialis runs from the back of your two low leg bones (fibula and tibia) to the arch of your foot.  When it’s doing it’s job, it does several important things.  It helps spread your weight across the width of the arch of your foot.  It keeps you from over-pronating while walking or running.  It also helps prevent your knees from collapsing inward. 

So how does the posterior tibialis get overworked?

To answer this question, we need to look at what’s happening at the other end of the leg – at the hip.  Weak hip stabilizers, especially the gluteus medius, can wreak havoc on the ankle, knee, and the muscles that stabilize them.  When the gluteus medius muscle is weak, your low leg will collapse / rotate inward when your run, do lunges, etc. 

Your body doesn’t want to fall down or otherwise hurt itself, so your posterior tibialis has to work harder to keep your leg straight up-and-down when you stand, workout, walk or run.  Over time, this extra effort overworks the muscle and stresses the tissue that hooks it to your leg bones.  What’s more, two recent European studies by Verrelst and associates showed that a weak gluteus medius led to shin splints in athletes.  Clinically, I find that gluteus medius tests weak in at least 2/3 of runners with shin splints.

Trigger Points

Pain along the inside of your shin may also be “referred” from a problem somewhere else.  The most common cause of referred pain that I see is from “Trigger Points.”  Trigger points are sore spots in tight bands in your muscles. Normally, they shouldn’t be there. Injury, infections, stress, over training and about a hundred other things can cause them to form. In muscles, they usually form where the nerve attaches to the muscle.  Trigger points are different from regular tight muscles. Trigger points are basically little inflammation factories. What’s even weirder, trigger points can cause pain and other symptoms in totally different parts of the body – away from where the real problem is.

Occasionally, pain along the inside of the shin is coming from trigger points.  More often, I see referred pain from the posterior tibialis and other muscles causing additional pain in the foot, ankle, or Achilles tendon.

So what can I do?

When you come in for your appointment, we’ll check for muscle imbalances and examine how you move when your walk.  We’ll look for trigger points that may be mimicing shin splints and rule out other, more serious problems like stress fractures and vascular problems.

We can use orthopedic acupuncture to help correct muscle imbalances and restore proper movement patterns.  If trigger points are part of your problem, we will use dry needling acupuncture to deactivate them .  Tuina and other soft tissue mobilization techniques help  break up any adhesions that might be there.  The goal is to reduce inflammation, improve function and restore normal, pain-free movement.

Peroneal Tendonitis:

Peroneal Tendonitis (tendonosis, tendinopathy) is another common overuse injury I see in runners.  It is an irritation of a group of tendons that stabilize the ankle and “kick” the foot out to the side (pronation / everson) during toe-off.  Patients usually come to my office complaining of pain on the outside of their ankle, behind the the pointy bone on the side of the ankle (the lateral maleolus) or on the outside of their foot. 

The main causes of peroneal tendonitis are similar to shin splints.  The peroneal muscles “kick” the foot out to the side, and support the ankle and arch.  When the other muscles that stabilize the ankle, arch, knee and hip aren’t doing their jobs, the peroneal muscles  have to pick up the slack.  When they’re overworked, their tendons can get irritated.  The muscles, themselves, can also develop trigger points, which can also cause pain in the outside of your ankle.

When you come into our office, we’ll take a look at your gait and test for muscle imbalances and restricted range of motion.  Usually, I find that people have weak hip abductors / stabilizers, and an imbalace between peroneals and posterior tibialis / long toe flexors.  The soleus muscle  (a deep calf muscle) is also involved sometimes.

Now, for the good news!  Orthopedic electro-acupuncture and dry needling are two of the best tools to quickly restore strength and function, and improve overall sensorimotor integration in your lower extremity. What’s more is that tuina mobilizations and gua sha can help break up fascial adhesions and other issues that may be leading to sub-maximal performance.  This means that you can expect more strength, flexibility and stability.

IT Band Syndrome

Iliotibial Band Friction Syndrome (a.k.a. IT Band Syndrome) is another common overuse injury seen in runners and cyclists.  Usually, pain starts gradually on the outside of your knee, about an inch above the joint.  Over time, the pain may spread up the outside of your thigh or downward to the upper part of your calf.  There may also be localized redness and swelling, and the outside of your knee may be sore to the touch. 

So what is the “IT Band”?

The Iliotibial Band (a.k.a. IT Band) a band of fibrous tissue – basically a big, thick, wide tendon – that runs along the outside of your thigh.  It connects two muscles in your hip area, the TFL and Gluteus Maximus, to the main bone of your low leg and to the outside of your kneecap.

The IT Band helps slow down inward movement of thigh when your foot lands on the ground when running.  It’s important to mention that when the knee flexes from straight to being bent about 30 degrees, it gets pressed against a bump on the outside of your thigh bone.  When the muscles that pull on your IT band are tight (and often weak), the IT Band can get irritated as it gets dragged over the bone.  Repetitive tightening and relaxing of the band can also irritate the underlying tissue.  Over time, the IT band or underlying tissue can become inflamed.  Usually, the symptoms begin gradually.

There are many things that can cause IT Band Syndrome. As with many other running injuries abnormalities in your gate can make it more likely that you will develop it.   For instance, over-pronation and/or over-supination of the ankle, or weak hip stabilizers that allow the thigh and knee to collapse inward can over-stress the IT Band.  Bowed legs or having one leg longer than the other can also contribute. 

How you train can also cause your IT band to get irritated.  For instance, running downhill or on ground that slopes to one side (like the shoulder of the road) can increase the tension on the IT band where it crosses your thigh bone.  Cycling with your toes pointed inward also places extra tension on the IT band.  As mentioned earlier, over time the repetitive compression or friction can cause the IT band or underlying tissue to become irritated, causing pain.

Trigger points in your thigh muscles can also mimic IT band syndrome – causing pain along the outside of your leg, from the hip down to the middle calf.  Sports activities like squats, lunges, Olympic weightlifting, running and jumping can activate these trigger points.  They can also be set off by impacts (like getting tackled or getting beaned with a baseball), muscular imbalances or problems in your hip or low back.

The good news is that Dry Needling and orthopedic acupuncture can help.  When you come in for your appointment, we will assess for muscular imbalances, trigger points and anything else that may be contributing to your pain.  If you’re an athlete, we’ll also take a look at how move when you walk, squat or do other functional movements. 

We’ll most likely use orthopedic acupuncture help address the muscular imbalances in you’re low leg and any issues we find in you hip stabilizers.  If trigger points are to blame, we’ll use dry needling to help “deactivate” them – allow them to relax and reduce local inflammation. 

Treatment of IT band issues usually involves a fair amount of soft tissue mobilization, especially guasha.  As with treating other musculoskeletal conditions, the ultimate goal is to restore normal, pain-free movement.

Popliteus Tendonitis / Popliteal Tendinopathy

Popliteus Tendinopathy is an overuse injury that results in the irritation of the popliteus tendon near where it attaches to the outside of your knee.  Patients usually complain of pain on the outside of their knee, near where the muscle attaches.  The pain may also spread to the back of their knee.

The popliteus muscle is a little muscle on the back of the knee.  It wraps around the outside of your knee joint and attaches to a bump on the outside of the end of your thigh bone.  It helps unlock the knee when you first start to bend it and generally stabilizes the knee.  It also rotates your low leg so that your toes point toward the middle. 

Popliteus tendinopathy is relatively uncommon in the general population, but is more common among athletes.  Most often, I see it in cross country runners.  Usually, it happens because the muscle is working too hard because of muscle imbalances and / or instability of the knee joint. 

In my experience, the popliteus muscle responds well to dry needling.  When you come in for your appointment, we will also check for muscle imbalances and anything else that may be contributing to your condition.

Plantar Fasciitis

Plantar fasciitis is a common condition seen in runners that causes pain in the bottom of your heel. It is usually worse first thing in the morning, but may last all day. It can be excruciating and keep you from doing the things you love.

Scientists believe that it is due to unhealthy changes in the tissue that supports the arch of your foot. It can can be caused by many different things, including: trauma, standing on your feet all day, repetitive overuse (like running), tight calf muscles and unhealthy movement patterns. Referred pain from muscles farther up your leg can sometimes add to or even mimic the pain.

When you come in, we will check for muscular imbalances and trigger points that may be causing pain in your feet. Our goal is to restore normal functioning of your leg and foot. This allows your body to heal itself so that you can get back to doing what you love.

Peroneal Tendonitis (tendonosis, tendinopathy) is a common overuse injury I see in runners.  It is an irritation of a group of tendons that stabilize the ankle and “kick” the foot out to the side (pronation / everson) during toe-off.  Patients usually come to my office complaining of pain on the outside of their ankle, behind the the pointy bone on the side of the ankle (the lateral maleolus) or on the outside of their foot. 

The main causes of peroneal tendonitis are similar to shin splints.  The peroneal muscles “kick” the foot out to the side, and support the ankle and arch.  When the other muscles that stabilize the ankle, arch, knee and hip aren’t doing their jobs, the peroneal muscles  have to pick up the slack.  When they’re overworked, their tendons can get irritated.  The muscles, themselves, can also develop trigger points, which can also cause pain in the outside of your ankle.

When you come into our office, we’ll take a look at your gait and test for muscle imbalances and restricted range of motion.  Usually, I find that people have weak hip abductors / stabilizers, and an imbalace between peroneals and posterior tibialis / long toe flexors.  The soleus muscle  (a deep calf muscle) is also involved sometimes.

Now, for the good news!  Orthopedic electro-acupuncture and dry needling are two of the best tools to quickly restore strength and function, and improve overall sensorimotor integration in your lower extremity. What’s more is that tuina mobilizations and gua sha can help break up fascial adhesions and other issues that may be leading to sub-maximal performance.  This means that you can expect more strength, flexibility and stability.

It can be so frustrating: that nagging, aching pain in your neck. It keeps you up at night. You can’t turn to look over your shoulder when your driving. It’s starting to interfere with doing the things you love.

Maybe it’s from work: hours at a desk, looming deadlines or that boss that you can’t stand. Or maybe you’re an athlete who overdid it with shrugs or high pulls at the gym. Maybe you’ve been in a car accident or spent years wearing a heard hat or helmet.

There are many things that can cause neck pain. Chronic stress, poor posture from looking at screens every day, car accidents, over training and sports injuries are just a few of the things that can give you a “pain in the neck.” Regardless of the original cause, there is a good chance that we can help. At our Orthopedic & Sports Acupuncture Clinic in Syracuse, NY, we will treat your case individually to help restore normal functioning of your neck, reduce pain and inflammation, and help your body heal itself.You can link to Tech Neck Article

Iliotibial Band Syndrome (a.k.a. Iliotibial Band Friction Syndrome, IT Band Syndrome) is a common overuse injury seen in runners and cyclists.  Usually, pain starts gradually on the outside of your knee, about an inch above the joint.  Over time, the pain may spread up the outside of your thigh or downward to the upper part of your calf.  There may also be localized redness and swelling, and the outside of your knee may be sore to the touch. 

So what is the “IT Band”?

The Iliotibial Band (a.k.a. IT Band) a band of fibrous tissue – basically a big, thick, wide tendon – that runs along the outside of your thigh.  It connects two muscles in your hip area, the TFL and Gluteus Maximus, to the main bone of your low leg and to the outside of your kneecap.

The IT Band helps slow down inward movement of thigh when your foot lands on the ground when running.  It’s important to mention that when the knee flexes from straight to being bent about 30 degrees, it gets pressed against a bump on the outside of your thigh bone.  When the muscles that pull on your IT band are tight (and often weak), the IT Band can get irritated.

There is some debate among researchers.  Traditionally, it was believed that the IT band got irritated by being dragged across the bone.  Recent studies have suggested that most of the pain may actually be coming from an irritation of the underlying tissue due to repetitive tightening and relaxation of the band.  Either way, the IT band or underlying tissue can become inflamed and sore.  Like most overuse injuries, symptoms usually begin gradually. 

There are many things that can cause IT Band Syndrome. As with many other running injuries, abnormalities in your gate can increase your chances of developing it.   For instance, over-pronation or over-supination of the ankle and weak hip stabilizers that allow the thigh and knee to collapse inward can over-stress the IT Band.  Bowed legs or having one leg longer than the other can also contribute. 

How you train can also cause your IT band to get irritated.  For instance, running downhill or on ground that slopes to one side (like the shoulder of the road) can increase the tension on the IT band where it crosses your thigh bone.  Cycling with your toes pointed inward also places extra tension on the IT band.  As mentioned earlier, over time the repetitive compression or friction can cause the IT band or underlying tissue to become irritated, causing pain.

Trigger points in your thigh muscles can also mimic IT band syndrome – causing pain along the outside of your leg, from the hip down to the middle calf.  Sports activities like squats, lunges, Olympic weightlifting, running and jumping can activate these trigger points.  They can also be set off by impacts (like getting tackled or getting beaned with a baseball), muscular imbalances or problems in your hip or low back.

The good news is that Dry Needling and orthopedic acupuncture can help.  When you come in for your appointment, we will assess for muscular imbalances, trigger points and anything else that may be contributing to your pain.  If you’re an athlete, we’ll also take a look at how move when you walk, squat or do other functional movements. 

We’ll most likely use orthopedic acupuncture help address the muscular imbalances in your low leg and any issues we find in you hip stabilizers.  We’ll also use electroacupuncture to address the IT band, itself.  If trigger points are to blame, we’ll use dry needling to help “deactivate” them – allow them to relax and reduce local inflammation.  Treatment of IT band issues usually involves a fair amount of soft tissue mobilization, especially guasha.  As with treating other musculoskeletal conditions, the ultimate goal is to restore normal, pain-free movement

We’ll most likely use orthopedic acupuncture help address the muscular imbalances in your low leg and any issues we find in you hip stabilizers.  We’ll also use electroacupuncture to address the IT band, itself.  If trigger points are to blame, we’ll use dry needling to help “deactivate” them – allow them to relax and reduce local inflammation. 

Treatment of IT band issues usually involves a fair amount of soft tissue mobilization, especially guasha.  As with treating other musculoskeletal conditions, the ultimate goal is to restore normal, pain-free movement and get you back to doing what you love as quickly as possible.

Pain Points for IT BAND syndrome

Runners

  1. Pain getting in the way of your runs
  2. Hobbling to the finish line
  3. Is knee pain hurting your time