Achilles Tendon Maintenance

Posted on August 28, 2023 by drparenteau

Men in their forties are at risk of rupturing their Achilles’ Tendons. If you have been inactive for some time and want to get back into sports, or if you want to make sure you’re not at risk of injury, follow our basic protocol.

Perform this program 4 times per week.

1. Warm Up

Go for a 5 minute walk or climb a flight of stairs 3 times

2. Calf Raises

Use stairs to get deep stretch at bottom of movement, then perform calf raise

3 sets of 16, 14, 12

3. Seated Toes-to-Nose Raises

– sit on edge of bed/chair, heels on floor

– raise toes towards your nose and then relax foot

1 set of 30

4. Jogger’s Stretch

– hands on wall, stretching leg back

– keep knee straight and lean forward until stretch felt in calf

2 sets of 30 seconds for each leg

5. Soleus Stretch

– hands on wall, one leg back

– knee of back leg drives forward until stretch is felt lower than calf (try and keep heel on ground)

2 sets of 30 seconds each leg

6. Pike Stretch for Hamstrings

1 set of 60 seconds

Knee Stability Exercises – Level 2

Posted on November 17, 2017 by drparenteau

**Do not start this program without first being examined and prescribed a beginner program. This is NOT a beginner program.

Stabilizing the knee via exercises is an important injury prevention technique that most people do not incorporate enough into their routine. Many sports place strain on the knee and therefore can cause injury. You cannot strengthen ligaments or joint cartilage. It simply is what it is. However you can strengthen tendons and muscles and improve flexibility and co-ordination. There is no better injury prevention for the knee than a 2 to 3 times per week stability program.

Here are the goals with knee stability programs:

Increased flexibility of:
1. Hips (internal, external rotation)
2. Quadriceps
3. Hamstrings
4. Inner thigh muscles
5. Calves

Increased co-ordination of:
1. Ankles
2. Core
3. Hip & knee movements

Increased strength of:
1. inner thighs
2. hip muscles
3. hamstrings

We cannot ignore any aspect of the leg structure, from the core down to the ankles, as they all have an impact on the efficacy of knee movement. Please do these exercises after a proper warm up (e.g.: 5 minutes on the eliptical).

1. Foam Airplanes
– stand on foam board (without shoes)
– arms out in “T” formation (do not let arms drop throughout exercise)
– lift one leg off
– keeping chest over hips (straight back), bend one “wing tip” down to ground by moving hips NOT arms
– then reverse movement and bring other “wing tip” towards ground
2 sets of 8 on both sides

2. Balance & Pass Medicine Ball
– balance on an exercise ball with your knees (feet OFF ground)
– stand erect, chest over hips, arms out, one hand holding med ball
– pass ball back and forth (see video below)
2 sets of 10 passes (5 to each hand)

Advanced Core Control: balance while transfering ball in crucifix position. Go as long as you can. *this is a core coordination movement NOT a 6 pack builder. Body smarts not just body strength.

A post shared by Dr Emmanuel Parenteau (@drparenteau) on Dec 14, 2016 at 4:12pm PST

3. Face-the-wall Squats
– face wall, feet wide apart
– have chair behind you to catch you if you fall
– toes turned outward 45 degrees and toes one inch from the wall
– pull chest “back” by pinching shoulder blades together and keeping ears over shoulders (head back)
– hands between your legs (finger tips against wall)
– squat down as low as possible while maintaining proper technique
2 sets of 15

4. Hamstring “pops” on exercise ball
– lay on back, feet on ball
– arms at your sides, palms down for support
– lift buttocks off floor and lift on leg up in air
– simultaneously roll the ball towards your buttocks and elevate the leg towards ceiling (see video below)
2 sets of 8 each leg

Nurse performing body-hamstring proprioceptive strength rehab

A post shared by Dr Emmanuel Parenteau (@drparenteau) on Aug 17, 2016 at 8:57pm PDT

5. One-legged Quarter Squat with Ball and Foam Board
– pin ball between wall and buttocks (NOT low back)
– place both feet on foam board (NO shoes)
– chest out, arms out (do NOT lean forward)
– lift one leg in the air
– drop into a controlled, quarter squat (NO further, too much pressure on PCL)
– press back up and repeat (see video below)
– make sure foam pad is far enough away so that at bottom of quarter squat your knee is not shifting forward
2 sets of 8 each leg

Knee Stability Squats – only quarter squats or less (otherwise hard on PCL and knee in general) 2 sets of 8 each leg

A post shared by Dr Emmanuel Parenteau (@drparenteau) on Nov 15, 2017 at 5:18pm PST

6. Hip Circles
– Lie on your side.
– Bend bottom knee.
– Point toe of top leg.
– “Draw” as large a circle as you can by moving leg in a circle.
– Go as far UP and BACK as possible.
– reach forward lay forearm flat on ground to keep pelvis from leaning back during exercise
Do 2 sets of 10 on each side

7. Single Leg Pot Stirs on Exercise Ball
– lay on ground
– one leg on ball
– lift pelvis slightly off floor
– palms down on floor for support
– “stir the pot” with foot on ball
2 sets of 8 “stirs” for each leg

Level 2 Knee Stability Exercise: Single Leg Pot Stirs on Exercise Ball – one leg on ball – lift pelvis slightly off ground – "stir the pot" with foot on ball 2 sets of 8 each leg #drparenteau

A post shared by Dr Emmanuel Parenteau (@drparenteau) on Nov 17, 2017 at 11:57am PST

WHAT KIND OF HEADACHE DO YOU HAVE?

Posted on May 26, 2014 by drparenteau

photo by Petr Kratochvil (click image for more)

Many of my headache patients come to see me and describe their intense headaches as “migraines.” This self diagnosis is purely based on the high level of discomfort they are experiencing.

Fortunately, most headaches are not migraines, even the very intense ones. And knowing what type of headache you have is crucial in determining what course of action will cure you.

According to the American Headache Society, over 78% of people will suffer tension type headaches during their lifetime. A much smaller percentage will ever have a true migraine. Therefore, if you have intense headaches, instead of self diagnosing yourself, go see your chiropractor or family doctor for a professional opinion. Having treated headache patients for over 10 years and having taught a headache class at the University of Victoria, I am well aware of sufferers and their tendency towards self-diagnosis. If the self diagnosis is wrong it can stop them from getting to the pain free stages they so desire because they are doing the wrong things.

This post is not meant to replace diagnosis by a professional, but to help you see that you may have wrongly self diagnosed and therefore are on the wrong track.

WHAT CAUSES MIGRAINES AND TENSION TYPE HEADACHES?

If you were to drill a hole through each of your cheek bones (front to back) within about 2 inches you would hit a bundle of nerves known as the trigeminal ganglion. This is a squid-like branch of nerves that connect to the eyes, forehead, scalp, face, jaw and temple region and then relays them all back to the spinal chord. In the spinal chord the trigeminal nerves connect to the neck nerves via an area called the trigemino-cervical nucleus. The trigeminal ganglion is involved in both migraines and tension type headaches but only tension type headaches affect the trigemino-cervical nerves. The following information will teach you some basics to differentiate migraines from tension headaches.

MIGRAINES
Because the trigeminal nerves interact with blood vessels the foods we eat can trigger migraine headaches. Migraines are therefore different from tension type headaches because they can be triggered by wine, cheese, chocolate or caffeine. Migraines also don’t involve the neck or back of the head and are usually around the temple and eye area on one side only. The pain is typically a throbbing or pulsing sensation.

photo by Petr Kratochvil (click image for more)

Migraines typically occur only a couple of times per month and last minutes to hours but generally not days. Further, if just before you feel the headache you have visual disturbances or light and sound hypersensitivity, this points towards migraines. The typical migraine patient has migraines in their family history and has had migraines since adolescence. Typically, migraines do not respond much to ibuprofen, tylenol or aspirin. Women are more prone then men to migraines. See your chiropractor to determine if you are indeed suffering from migraines and receive the appropriate nutritional advice and treatments.

TENSION TYPE HEADACHES
The tension type headache patient usually has neck pain before their headaches. Classic tension headaches affect the rim of your scalp like a sweat band (i.e.: forehead, sides of the head and back of the head) and both sides are affected equally. Unlike migraines, tension headaches can last more than an hour and can even be constant for 2 or more days. Tylenol, ibuprofen and aspirin generally are quite helpful at reducing tension headaches. Tension headaches typically manifest several times per week and feel like constant pressure or pain — they do not pulse like migraines. No pre-headache visual or hearing issues occur with tension headaches.

Tension type headaches involve the cervical nerves and migraines do not. This is why neck injury from muscle or joint trauma or prolonged bad posture is usually the sole cause of tension headaches. They affect the neck nerves which communicate with the trigeminal ganglion which in turn sends nerves to the scalp and face, therefore causing the head pain associated with headaches. Sometimes tension type headaches are more severe than even true migraines, leading the sufferer to re-label it a “migraine.”

Because the neck causes all or most of the head and face symptoms for tension type headaches, treating the muscles and joints of the neck is usually the solution to years of suffering. People don’t know their neck is causing their debilitating headaches. At our clinic we’ve developed a series of treatments that are very effective at dealing with tension headaches.

Even long term, well entrenched tension type headaches can be cured. Our clinic also has designed a 10 week exercise rehabilitation and manual therapy program to solve even the longest term headaches. As an example, one of our headache patients let us do a documentary on her full recovery after 13 years of debilitating headaches. Please take the time to watch:

http://drparenteauimagebank.files.wordpress.com/2012/01/testimonial-mclennan.jpg

CLICK IMAGE TO SEE VIDEO

Some patients have symptoms of both tension headaches and migraines. Sometimes, these patients receive treatment for their tension headaches and their migraines disappear. This is because both types of headaches affect the trigeminal ganglion. Therefore, in some patients, tension headaches trigger the migraines. So if you remove the tension headache, you remove the migraine by default.

To recap the difference between tension headaches and migraines, see the diagram below for an easy comparison:

Please do not use this post as substitute for professional diagnosis. There are many other types of headaches such as cluster headaches, temporal arteritis, toxic headaches and others that mimic certain aspects of migraines and tension headaches. A clinician such as your chiropractor or family doctor will be able to differentiate from these and give you a sure diagnosis.