Knee pain is a common complaint that affects people of all ages. A few reasons one may be experiencing knee pain include: a sudden increase in one’s training or activity schedule, the commencement of a new sport or activity, a change in footwear, improper training technique, or muscle imbalances and/or alignment issues.

Understanding what is causing your knee pain is the first step in treating it, and there are many possible causes of mechanical knee pain which include:

patello-femoral syndrome, patellar fracture, bursitis, Ilio-tibial band friction syndrome, patellar or quadriceps tendinopathy, ligament injuries/sprains, Meniscal injuries/tears, Osteoarthritis, Osgood-Schlatter’s disease,  Loose Bodies, etc…

 Knee pain is one of the most common cycling injuries. The most common cause of knee pain in cyclists in ilio-tibial band (IT band) syndrome. The IT band is a thick band of fibrous tissue that runs down the outside of the upper leg from the hip area to the knee. Pain usually results when the IT band becomes too tight and therefore rubs over the bony prominences of the knee. The IT band has direct attachments to the tensor fascia latae (TFL) muscle, which runs down along the outer front of the thigh/hip area and acts to help flex and abduct the hip. This muscle, which is used consistently in cycling, often becomes shortened and/or tight, thereby increasing tension on the IT band and contributing to knee and/or hip pain.

 As injury can often be a problem of overuse, or misuse, it is important to avoid the temptation to do too much (especially if just starting out with a new sport/activity, or commencing a training season). To avoid misuse of muscles, and prevent injury, it is important to ensure appropriate training technique and equipment fit (ie: bike fit).  With cycling, it is important to add in a stretching program for your lower extremities to help maintain a healthy and appropriate muscle length while training.

 In order to determine the cause of one’s knee pain, a comprehensive examination of the knee is completed and the appropriate treatment plan is outlined.

Treatment for knee pain can include:

1)    Electrotherapy such as ultrasound to decrease swelling, pain, speed up cell turn over and thus enhance healing and recovery.

2)    Interferential current may be used to decrease swelling or joint effusion, decrease pain, and speed up recovery.

3)    Heat may be used to decrease pain and increase range of motion

4)    Ice may be used to decrease inflammation and pain

5)    Soft tissue work to improve circulation, break up adhesions, decrease muscle tightness or tension, decrease pain

6)    Joint mobilizations to increase range of motion, decrease stiffness, increase circulation, and decrease pain

7)    Passive stretching to increase muscle length

8)    Taping to improve muscle function or joint alignment and decrease pain

9)    Comprehensive exercise program to correct for muscle imbalances, increase flexibility, improve strength / stability / proprioception.

 Below are a few exercises to help prevent knee injuries:

  1. Glute med strengthening – use theraband or stretchy tubing tied around ankles. In standing with legs straight and core contracted, side step (with straight legs) to left against the resistance of the band around the ankles. Continue for a minimum of 15 steps or until fatigue and then return to the starting point by side stepping to the right as above.
  2. Double leg or single leg squat, either on a BOSU or on the ground with a stability ball against the wall (your back leaning against the stability ball).
  3. Hamstring, Hip flexor stretching, and IT band rolling on foam roller

Remember to follow the PRICE principle if you believe you’ve sustained an acute knee injury, until you’ve been assessed from your health care practitioner.

P – Protect: Avoid anything that could cause further harm/injury or increase pain

R – Rest: Discontinue any and all physical activity as much as possible

I – Ice: Apply ice, 15-20 min max, 3-4 times/day

C – Compression: Wrap the injured area with a tensor bandage etc applying pressure around the area (to help decrease swelling and inflammation)

E – Elevation: Sit or lie with the limb or injured area elevated

Written by Jessica McCartie M.P.T.

The recent winner of a prestigious environmental prize, Mike Biddle and MBA Polymers are changing what we think of as recyclables.

When the Gothenburg Prize called Mike Biddle and told him he’d won this year, he didn’t understand the message at first. “I couldn’t get the Swedish accent. I thought they wanted me to be a judge,” he says. “When they said, ‘Oh no, we want to give you the prize,’ I was literally speechless.”

The Gothenburg, which focuses on sustainable development, isn’t the Nobel, but it’s prestigious enough (Kofi Annan and Al Gore are previous recipients). Biddle is bashful about why he was chosen, but thinks it may be because he’s “stuck with something for 20 years,” and achieved something “quite difficult.”

If my coffee maker or vacuum cleaner dies, you can take it to Goodwill, and that’s about it. They throw the rest away.

“That’s why you don’t see hundreds of companies like us out there, sorting plastics. We figured out how to do it, and took it to a commercial reality. That’s not something you always see with new technologies.”

MBA Polymers, the company Biddle founded 20 years ago, goes after the recyclables others don’t want, or don’t know how to deal with: plastics from coffee makers and toasters, TVs and cell phones, fittings from cars and trucks, and so on. These materials are actually more valuable, and more plentiful, than steel, Biddle says. But they don’t get recycled in high volumes, because they’re more difficult to separate from the waste stream.

You can use a magnet to extract metals, or sort them by hand: They have different colors and tell-tale densities. But plastics are much less distinguishable. They have infinite different colors, share similar densities, and have no electrical or magnetic properties that make sorting easier. Hence, metals are recycled at an estimated 90% rate, while plastics have only a 5% to 10% rate. The rest ends up in landfills, burned in incinerators, or shipped to dangerous and inefficient sorting plants in the developing world.

MBA Polymers takes waste from “shredders” that have already separated out metals, then isolates up to 40 plastic types in a multi-stage process. It produces virgin plastic pellets that can be reused in the same way as traditional plastic, but with an 80% savings in energy, and a lower cost. Biddle calls this “above the ground mining,” and thinks there is a huge potential, if only we could see used plastic as a resource, instead of as a disposable good.

MBA has three plants so far–in China, Austria, and the U.K. But it’s still only scratching the surface of what gets thrown out every year. In fact, the overall problem of un-recycled plastic is getting worse. While many developed countries now collect standard recyclables such as PET Coke bottles and milk jugs, the rates for other plastic types are pathetic. Computer and electronics waste is the fastest growing part of the world’s waste stream.

If you can get the collection right, the economics take care of the rest.

Biddle says the problem isn’t necessarily technological. Plants like his, while costly upfront, are economical. The issue is having reliable incoming waste streams, which means better collection in the first place. “Single-stream recycling has gone a long way to solving the problem of household waste. But if my coffee maker or vacuum cleaner dies, you can take it to Goodwill, and that’s about it. They throw the rest away.”

“But if you can get the collection right, the economics take care of the rest. The problem in developed countries is the first mile from the home to the recycling plant.”

The issue in developing countries is different, Biddle says. There are thousands of “pickers” who already sort through the trash looking for materials they can sell to make some extra money. There is no lack of willingness to sort the waste, or manpower to do it. The problem is that the work is often unsafe, and the economic opportunity and environmental benefits aren’t maximized. “Pickers can play a vital role if we can figure out how to get them to collect stuff and bring it to processing centers like ours,” he says.

Biddle’s currently looking at ideas for coordinating informal pickers into organized teams, possibly working in some kind of public-private partnership. And he thinks he can improve incomes, and health and safety standards, as a result.

“[The pickers] don’t necessarily get treated fairly in my experience. We’re trying to get around that and give them another option, and provide a more environmentally safe way to market,” he says.

Written by Ben Schiller

Ben Schiller is a staff writer for Co.Exist, and also contributes to the FT, and Yale e360.

What Triggers your Migraine |  health clinic victoria bcIn her book, The Women’s Migraine Survival Guide, Christina Peterson, M.D., offers some advice on an array of migraine triggers that women (and men too!) with chronic migraines should learn about and avoid. Here are the most common:

Stress -Stress may be a trigger, says Peterson. When you’re under stress, take periodic breaks from difficult activities, alternating tough tasks that require brainpower with other jobs that are more physically oriented. For example, switch from analyzing problems to picking up  office supplies or to another activity that’s a no-brainer.

Bright Lights – Bright lights and glare can cause migraines in some people. If you’re outside in bright sunlight, always wear a protective hat and sunglasses, or move to a shady area. If the sun is streaming into the room, and you’re susceptible to migraines, it’s best to put the blinds down to limit glare. You can always put on your sunglasses or slap a ball cap on your head! (Yes, even though you’re indoors.)

Odors – Some people are very sensitive to odors, particularly those from heavy perfume or some cleaning items. You may find that strong aromas can trigger a migraine within several hours. If someone at work drenches herself (or himself) in cologne, tell your colleague you’re hypersensitive to aromas. Consider saying that you’re allergic to strong perfume, which is more likely to obtain the reaction you want, less heavy-handedness with the spray bottle.

Cigarette and Cigar Smoke – The odor of cigarette smoke is also a migraine trigger for some people. Fortunately, few workplaces allow smoking, but people do smoke in other locations. If you eat out, always sit in the “non-smoking” section.

Loud Noises – Loud noises can trigger migraines in some people, and if you’re one of them, you may wish to carry earplugs with you.

Foods – Foods are a migraine trigger for some people, especially caffeine, chocolate, aged cheese, onions and garlic. Also, stay away from monosodium glutamate (MSG), a common food additive.

NOTE: Some people limit their migraines by using white noise machines at work. These devices make a “SSSSH” sound, and help block out noise chaos. Ongoing white noise will still enable you to hear your boss and other key sounds. If you avoid migraine triggers as best you can, but you still feel a migraine coming on, try icing the pain away. Also, give us a call; we will fit you in for an immediate appointment. Be sure to explain that it’s a migraine attack that’s coming on. Chiropractic adjustments may be able to stop a migraine “dead in its tracks.”

Finally, please remember, if you ever have any questions or concerns about your health, talk to us. We’re here to help, and enjoy  participating in your good health!

Diversified Health would like to welcome Carol Schwall as she blogs her way through the aches and pains, and her experiences as she trains for her first full marathon  in October, here in beautiful Victoria BC.

I’m a runner.

I love running, I never have to force myself to go for a run. Sometimes I will forget for a moment that I just went for a run, and feel ready for the next run already soon after. Running in the pelting rain is my favorite. I enjoy the solitary factor, with just Runkeeper and a playlist to keep me company. I say that I’m a runner, and yet, I still don’t feel like one. I guess it’s like people who have been overweight for a long time and then slim down a lot – they still identify as ‘fat’. Well, I still feel out of shape, even though I have shown myself that I can sustain bipedal forward motion for over 2 hours at a time. Go figure.

Diary of a Want-To-Be Marathoner! I’ve only been running for 21 months (that’s 1 3/4 years). Over the last year I ran 2 half marathons, a few 10k races and a handful of other, shorter races. It seems like the time has come for me to challenge myself to a full marathon. That’s right, 26 miles. 42.2 km in Canadian. Until now, sheer persistence and willpower have edged me past the 10k mark and into the 21.1 km races. No real training, just running a bit further each time. But I know that to be able to run 42.2 km sustainably, I will need real training. So on the spur of the moment I joined a 16-week running clinic. We meet to run twice a week – Wednesday after work and Saturday at 8:00 am – and there are 2 easy, short ‘homework’ runs. We will do hills, stairs, speedwork, and just plain distance running. See, that last one is the one I like best. No problem getting out there and just running. It’s the hard work that I balk at, so that’s why I’m training with a group led by experienced long distance runners.

This past Saturday we had our first small group long run. This time there were only 3 of us. We are the slowest marathon group in the clinic, but I don’t care. Our run leader, Silvia, has done several Ironman triathlons, and is a regular marathon and ultra trail runner. She goes on 5 hour trail runs for fun. She knows her stuff. As we ran for one hour, we chatted about pace and negative splits, about carrying water and what ‘recovery run’ means. We covered about 10 km, choosing our route as we went. We start these runs at 8 am, but I still think it may get too hot on the longer runs, as we inch closer toward the marathon in October.

This evening we did about 8 km, with 5 long sets of stairs smack dab in the middle. That’s the hard work part. But I didn’t whine, nope, I just trudged up and down with the rest of them. Mind you, I chose to do only 4 repetitions, because my lunch was long used up, and we still needed to run back. But I feel great, and certainly earned my dinner.

This is going to be fun! Heck, it already is! And the 42.2 km? I’ll get there in time.

Carol works for a local coffee roaster and compensates for her excess caffeine (and love of bacon) by running as far and as fast as she can in her free time, when she’s not singing in a choir or knitting a sweater. 

Running Clinic by Victoria Frontrunners