Common Athletic Injuries

Plantar fasciitis occurs most often from the fatigue of the tibialis posterior muscle. This muscle is behind your lower leg bone and supports the main arch of your foot. Problems arise from injury, lower leg dysfunction, and/or adrenal gland (hormonal) stress. Pretty much if you have plantar fasciitis you are under more stress than you can handle – whether that be from overtraining (too much anaerobic activity, or lack of an aerobic base), working too hard, dietary stress (too much sugar, not enough protein or nutrient-dense foods), emotional stress, or other physical trauma/stress – ANYWHERE in the body, not just in the foot. Even a poor fitting pair of shoes can cause this problem. The calf muscles are often involved as often are other leg muscles in the thigh and hip. The imbalance in the muscles causes the plantar fascia to tighten and spasm as it tries to support the foot. Addressing the reason for the muscle imbalances will address the plantar fasciitis problem, and the reason is not because you need to stretch it more, or didn’t stretch it enough. Often treatment involves dietary modifications, nutrient supplementation such as natural anti-inflammatories, exercise & training adjustments (more aerobic, less anaerobic), and local muscle therapies.

Here’s What You Should Do Instead if You Have Plantar Fasciitis: Rub out any muscle trigger points behind the shin bone all the way down to the Achilles tendon. Strengthen your foot muscles by walking barefoot as much as possible and trying to pick up small objects (like marbles) by crunching your toes. Wear minimalist-type shoes with a wide toe box, low to zero-drop, and little support.

–You may need to ease into these if you’ve been in thick-heeled supportive shoes for a long time

– Do not stretch your calves, since this will only lengthen the injured muscle.

– Check out my plantar fasciitis video here at Sock Doc!

Here’s the common bursitis “nutritional” scenario: When you’re under too much stress of any kind, your body requires additional protein. This protein comes from your diet as well as muscle breakdown and even from the area around your actual bursa. The robbing of protein from the tissue and bursa creates a more alkaline medium in that area. Calcium is then deposited in the bursa as a result of the alkaline environment to help protect the bursa. Unfortunately, this creates pain and inflammation – bursitis. Treating the bursitis involves not only dealing with the inflammation but also mobilizing the calcium out of the area by creating an acidic environment in the tissues. One of the best ways to acidify the tissues is to add 1-2 TB of vinegar to your diet every day, (many use apple cider vinegar), though sometimes more may be needed. In addition to acidifying the tissues to mobilize the calcium, sometimes essential fatty acids are needed to help fight the inflammation. Omega-3 fats such as flax oil and fish oil, and omega-6 fats such as black currant seed, borage, and especially unrefined sesame seed oil, can be of use here. Other anti-inflammatories such as quercetin and turmeric can help too.

Gait disturbances can cause tendonitis. Walking or running incorrectly due to muscle imbalances or joint dysfunctions caused by another injury or from wearing improper footwear can result in tendon problems. What you put on your feet will have a dramatic effect on your entire body – not just your feet. I have treated many people with shoulder tendonitis because of an improper gait – some because of poor shoes and some because of old injuries that were still unknowingly affecting them. Every swing forward of your arm when you walk or run must also be in sync with the muscles of your opposite-side leg. An old injury or surgery to your knee, for example, could still be affecting your gait causing an imbalance which results in the improper motion of your shoulder on the opposite side. Next thing you know, you have tendonitis in that shoulder.

Your adrenal glands, pancreas, and liver are the three major organs involved in tendonitis problems. The adrenal glands are your hormonal glands that deal with stress. They will secrete excess cortisol when there is too much dietary, physical, or emotional stress. Over time, the beneficial hormone DHEA, also made in the adrenal glands, will become depleted with persistent chronic stress, resulting in low sex hormone levels such as testosterone and estrogen, as those hormones are made from DHEA. This constant cortisol burden will tax the liver, which must detoxify the hormone, and much of this is done via a process known as sulfation. When your body uses up sulfur, it has less available to heal injured tendons as well as your cartilage (joints) where they attach to. So chronic stress leads to chronic cortisol leads to chronic inflammation and the inability to heal. The increased cortisol also plays off the pancreas, creating a constant tug-of-war between the two organs (the pancreas and the adrenals) as they try to keep blood sugar levels from swinging out of control all day long as you work, exercise, and sleep. This will create insulin and carbohydrate sensitivities, and in turn create even more inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed for many “itis” problems. Guess what? These will also deplete sulfur from your body because that’s how your liver detoxifies them, so overall healing is even further delayed. If you ever feel better from taking a NDAID it’s a sure sign that you have a fatty acid metabolism problem occurring in your body. If there was no fatty acid metabolism problem or imbalance, you’d see no benefit taking the drug. If there actually isn’t inflammation to be treated and you’re dealing with an “osis” rather than “itis” you may not see a NSAID benefit. However I’d say it’s very rare for a person to have a chronic injury that their body can’t heal and not have some degree of inflammation.

Using ice can sometimes help with the pain during the acute phase of the injury, but it should not be used for weeks and months. This may in fact just be numbing your pain temporarily during use but actually delaying the healing by constricting blood flow to the area and artificially reducing inflammation too much for the tendon to heal. You do need some inflammation to heal in the acute phase – not too much for too long, and not too little!

Medical treatment is cortisone shots and NSAIDs for inflammation and if that doesn’t help, then surgery is recommended to cut and release the band. That sounds like fishing, but much more miserable because someone would actually be cutting into a thick sheath of tendon, leaving the leg much less stable than what it was before going under the knife. ITB syndrome occurs typically from the following reasons. Often there is an actual weakness of the TFL or glute max itself. 75% of the ITB is made up of  the glute max – the major leg extensor powerhouse muscle you use to jump, climb, squat, run, ride your bike, and even just to get out of a chair. This weakness could be from a structural imbalance, an injury somewhere (anywhere in the body), an insulin issue from eating too many carbohydrates creating a gait disturbance, or even from a digestive problem, (gut inflammation can inflame the ITB). One or both of those muscles could have fatigued from wearing the wrong type of shoes or orthotics, or even from an old injury that is still haunting you, but you don’t know it because the pain is gone, but your body has compensated. ITB Syndrome can also occur from an imbalance between the inside and the outside of the leg. The muscles that support the inside of the knee are related to the adrenal glands. These are the sartorius, gracilis, as well as one of your hamstring muscles on the inside of the back of the leg that wraps around to the inner lower knee. If there is an adrenal involvement from overtraining and/or too much life stress, these muscles will weaken, causing an over-firing of the tissues on the outside of the leg/knee, which as you now know, is the ITB and TFL. Or the muscles on the inside of the leg could be working too hard so the outer leg muscles – the TFL and gluteus medius and minimus – are pulled inward, essentially torquing the leg. Treating the injury with this understanding usually corrects it very quickly, often within a couple of weeks, if not sooner. Check out the Sock Doc ITB video here!

Read about exercising aerobically and building a solid aerobic base on the Sock Doc site. Too much emotional stress can result in injury too. Do you work 60+ hrs a week and are under a lot of stress? Lastly, the nutritional component is often of utmost importance. Hydrogenated fats, refined sugars, MSG, and other processed foods can all wreak havoc on your health and cause so much stress you’ll end up with an injury. Nutritional problems often set the stage for physical injuries.

Remember, your Achilles tendonitis is an injury that is telling you you’ve overtrained – either on the bike, on the track, in the pool, at home, in the office, or in life.