Are You at Risk for Shin Splints?


English: DEERWOOD, Md. (Feb. 7, 2009) Lt. j.g....

English: DEERWOOD, Md. (Feb. 7, 2009) Lt. j.g. Gina Shaw treats shin splints by wrapping her leg in ice after her 8 Kilometer run after competing in the 2009 Armed Forces Cross Country Championship. The women’s cross-country team finished second behind the Air Force. (U.S. Navy photo by Mass Communication Specialist 2nd Class Jhi L. Scott/Released) (Photo credit: Wikipedia)

A common complaint among runners is Shin Splints.  In all honesty, this type of injury happens to more than just runners.  Anyone who has a mild to major increase in activity level is susceptible to shin splints. Shin splints (medically known as Medial Tibial Distress Syndrome) can limit the amount of activity a person can do.  If you have ever had shin splints before, you know exactly what I am talking about.  The pain is excruciating!  So now that the summer is coming to an end, maybe you are trying to increase your amount of activity before the clouds and storms come in representing the change in seasons.

Some factors that increase your risk to shin splints are:

  • Improper footwear
  • Overpronation of the foot/ankle
  • Muscular weakness
  • Muscular tightness
  • Decrease joint mobility
  • Poor training quality/form
  • High foot arches

I am sure that everyone can fit into this list in at least one category.  I know that I fit into at least two fo them.  Does that mean you will get shin splints?  No!  Does it mean you should address pain in the front of your lower leg (shin) if you have it?  Yes, of course!  Here are a few tips to help avoid shin splints

  • Try to stay on softer surfaces for running
  • Replace running shoes around 300-400 miles
  • Limit distance increases to 10% or less each week
  • Include lower impact activities (cycling, elliptical, rowing, swimming, etc.)
  • Stretch the calf muscles (gastrocnemius and soleus)

If you do get shin splints, Advantage PT therapists can help get you back to full training faster!!  Email us with any questions (


Back to School

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Hey everyone.  School is starting up, and that means that summer is slowly coming to an end!  Fall sports are starting and everyone is returning to the grind. Did you know that one of the riskiest things for children at school is a backpack?  A backpack that is overloaded or worn improperly can cause damage to the spine and the surrounding musculature.  It is extremely important to watch for the risks of backpacks. Our website has some wonderful advice from the APTA on how to wear a backpack.  Here is a list of some of the more important considerations:

  • Wear both straps.  This distributes the weight more evenly across the back and promotes symmetrical posture
  • Make sure the backpack fits. The pack should sit evenly in the middle of the back and not sag.

Left: Improper wearing of a backpack. Right: Proper wearing of a backpack.

When looking to make a new purchase, some features that are beneficial are a padded back, a waist belt, compression straps, and reflective material.

It seems that today, many children are burdened with heavy packs.  Here is how you can tell if a backpack is too heavy:

  • Pain with use
  • Tingling or numbness down the arms
  • Red marks on the shoulders


One of the new “fads” is to have roller bags for school gear.  This can cut on the wear and tear to a childs back.  The drawback to this is that the pack is heavier itself and can cause injury when carrying it over unever surfaces. It is also important to not the size of the roller.  If you or your child have to lean to reach the handle, this can lead to some assymytry in the spine due to extra bending to one side (lateral flexion).

If you feel that you may want a backpack assessment or are having pain due to a backpack or a purse, call your physical therapist.

Prevent and Treat IT Band Symptoms

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Many people who are active feel sore knees either during or after participation in exercise and sports.  Unsure if they did anything to cause injury, most people just rest and then resume activity.  The IT (iliotibial) band can be a major culprit in some of these injuries.  The IT Band runs down the side of your leg from just above your hip all the way to your knee.  A tight IT band can pull the patella to the outside and cause some havoc with patellofemoral gliding.  At the same time, a tight IT Band can increase pressure over the greater trochanter and its bursa causing trochanteric bursitis.  Being able to keep the IT Band supple can help to stop both knee pain and some hip pain.

How do you keep the IT Band supple?  There are really two ways that work, and it is best if you perform both of them together. A strong hip will help create better alignment of the leg reducing the load on the ITB.  A majority of my patients demonstrate strength deficits in the gluteus medius muscle with is a strong supporter of pelvic alignment during ambulation.  Other hip dysfunctions due to weakness may result in walking or running with your leg rotated away from midline and the toes pointing more outward than forward.  Remember, strong and stable hips will help keep the IT Band from getting to tight.

Sometimes people are really tender along the IT band.  You can check yourself by applying gentle pressure along the side of your leg between your hip and knee.  If this is the case, the strengthening exercises below will help you out, but you will need to perform some “stretching” type of exercises as well.  I have found that even with a tight IT Band, it is a difficult muscle to perform a stretch to, but it is possible for some people.  What I find to be most effective to loosen the tissue is a self massage with a foam roller or a self roller.

Here are two exercises to help you on your way to stronger hips!

Side Lying Leg Raise



You can always use a foam roller to help massage out the ITB.  If this is not progressing the way you would like, please call us at Advantage Physical Therapy and schedule an appointment


Knee Pain

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Upon returning to exercise, it is common to feel pain in the front of the knee just below the knee cap (patella).  This is a very common complaint among my friends and in my practice.  In physical therapy and orthopedics, this type of pain is generally referred to as patellofemoral pain.  It is related to the way the patella tracks in the femoral groove.  There are many reasons for this to occur:

English: Right knee.

English: Right knee. (Photo credit: Wikipedia)

  • Weakness of the hip abductors
  • Tightness of the illiotibial band (IT Band)
  • Poor foot control
  • Tightness of the lower extremity musculature (hamstring, quadriceps, and gastroc-soleus complex)
  • Poor form in exercise

Because there are many causes for this anterior knee pain, it is important to get a proper and correct diagnosis from a physical therapist.  If you have pain in the front of your knee, your physical therapist can design a program to help you beat the pain and return to your exercise program.

This month’s Sports Health: A Multidisciplinary Approach has an article that talks about how exercise (done properly) is the best intervention for patellofemoral pain. (Read the Abstract here)

In my practice, I find that a majority of patients require training of the gluteus medius, which is the major hip abductor muscle.  This muscle can become weak due to positioning of the leg during exercise.  If you look at your feet when they move, are they turned outward?  If so, this is the body’s way of compensating for a weak gluteus medius, and forces the tensor fascia latae (TFL) and ITB to do a lot of the work, thus changing the position and angle of the knee bending during gait and squatting/lunging movements.

Here are a few exercises that can be performed to target and strengthen the gluteus medius:


Sidelying Hip Abduction:


Bridging with Band:


Single Leg Balance:


Wall Slides/Squats:


It is important to remember that, although these exercises may help your knee symptoms, a physical therapist can help treat the cause and individualize a program for you.  Please contact Advantage Physical Therapy to set up an appointment!!!


Low Back Pain Statistics


Many of my friends and family, and even myself, have experienced some sort of low back pain.  As a PT, they all ask me “What can you do to fix my back?”  This is always a tough question.  Sure, there are some exercises that will usually help the majority of the population, but each back issue has a root cause that needs to be addressed.  Finding the cause of the back pain by using a thorough history and examination is how physical therapists can design a treatment plan for each INDIVIDUAL.

The vertebral column - Anatomy Français : La c...

The vertebral column - Anatomy Français : La colonne vertébrale - Anatomie (Photo credit: Wikipedia)

Earlier this year, the American Physical Therapy Association (APTA) performed a survey about low back pain.  The results of this survey were very telling.  Here are a few of the key points:

  • 61% of Americans experience some form of low back pain
  • 69% of people with low back pain say it affects some part of their lives (exercise, sleep, and work lead these answers)
  • Men are more likely than women to say back pain affects their ability to work
  • 72% of people with back pain use pain medication to relieve symptoms
  • 55% of low back pain sufferers use heat and/or cold packs for relief

If you are interested in looking more into these numbers from the survey, here is an infographic produced from the APTA

You may or may not know, that most states allow you to see a physical therapist without a prescription.  In Washington State, most insurance companies do allow for and cover direct access to physical therapy services.  Physical therapy can provide exercises for both increased range of motion and spinal stabilization, manual therapy to increase joint mobility and release soft tissue tightness, electric stimulation to help with the pain, ultrasound to help with inflammation, and ice or heat to help treat your symptoms.

It is IMPORTANT to note that proper exercises and stretching can help to prevent lower back pain.  We at Advantage Physical Therapy are always happy to help diagnose and treat your back problems.


The Importance of Good Posture


Advantage Physical Therapy has two clinics; Mercer Island, WA and Redmond, WA.  Also in these communities are Amazon, Google, Microsoft, AT&T, and T-Mobile.  In this area, a lot of people work in the tech industry and are therefore sitting at a computer for most of the day.  Add to this today’s instant news cycle and we can expect a lot of problems.  Almost everyone I know has a cell phone, tablets are becoming more common, and a majority of people communicate with email at work.

This means a lot of people spend a lot of time with poor posture staring at misaligned screens that might be too small for what they are doing.  They may be squinting to read small writing on the latest iPhone or Android device.  All of this can result in postural deficits.  Anyone with a posture issue may have some of the following issues:

  • Low Back Pain
  • Neck Pain
  • Temporomandibular Dysfunction (Jaw)
  • Tension Headaches
  • Carpal Tunnel Syndrome
  • Illiotibial Band Syndrome
  • Piriformis Syndrome


    POSITION OF SKELETON IN GOOD AND POOR POSTURE - NARA - 515194 (Photo credit: Wikipedia)

With the rising use of mobile devices and computers, it is important to maintain good posture.  As a species, we are not meant to be hunched over a desk.  Follow these tips to help maintain your posture and prevent posture related injuries.

  • Take a break:  Get up from your desk at least one time every hour, even if it is just to get up and get some water.
  • Position your monitor:  The top of your computer monitor should be at eye level when you are sitting up straight.
  • Lumbar support:  Prevent decreased lumbar curvature by adding support in your chair for your low back.
  • Standing work stations:  By standing, we can alleviate some pressure on the spine and increase our posture

It is good to know that your physical therapist can correct most of these problems with some manual therapy, stability and strengthening regimens, and an ergonomic evaluation.


Ankle Support: Taping or Bracing


English: Sprained Ankle

Image via Wikipedia

As a Physical Therapist, people often turn to me for advice.  Since there is a basketball court across the hall from my office, I get a lot of questions regarding ankle stability and support.  Athletic trainers from high school to pros tape athlete’s ankles to help stability.  Most people have difficulty taping themselves and/or finding another person capable of doing the taping.  I am often asked if a brace is as good as tape to stabilize the ankle and either prevent or deal with an ankle sprain.

Let’s start with some facts.

  • The National Institute of Health states that there are more than 25,000 ankle sprains on a given day in the United States.
  • Inversion sprains are the most common sprain (straining the outside of the ankle)
  • Inversion sprains can be linked to the anterior talofibular ligament (ATFL) and/or the calcaneofibular ligament (2 most common ligaments affected)
  • Garrick and Requa found lace-up ankle braces were more effective than taping on football players
  • Sitler et al. found that taping resulted in 5.2 sprains per 1000 athletes and bracing resulted in 1.6 sprains per 1000 athletes
  • Taping allows for individualization
  • Tape can loosen up between 10-30 minutes after application due to sweat

Ankle sprains are common maladies in athletic endeavors.  The research shows that braces are definitely more effective in prevention.  Taping may be more beneficial in the acute stage of an ankle sprain due to the fact that a therapist or trainer can individualize the taping to position each individual foot/ankle complex depending on which ankle ligament is most affected by the injury.  If the injury is still in the acute phase, it is recommended to see a physical therapist to diagnose and treat the primary effects of inflammation and have a successful and quick return to participation.

If you are susceptible to ankle injuries, I recommend purchasing a quality brace that laces up the front and has figure 8 straps for added support.  This is usually called an ASO Brace (Ankle Stabilizing Orthosis) and there are many different companies that make them. If the injury occurred recently, physical therapy can help speed the healing process and decrease the inflammation in the region.


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