Hip pointer injuries: what they are and what to do about them

Understanding Hip Pointer Injuries: Causes, Symptoms, and Recovery Tips for Active Lifestyles

If you’ve ever taken a hard fall while snowboarding or collided during a soccer game, you know how painful hip injuries can be. A hip pointer injury, caused by a direct blow to the iliac crest (the bony part of your pelvis), is one such injury that can derail your active lifestyle. This blog will help you understand what a hip pointer injury is, how to recover, and why seeking professional care like chiropractic and physiotherapy is essential for a full recovery.

What is a Hip Pointer Injury?
A hip pointer injury is essentially a deep bruise or contusion to the iliac crest. It occurs when trauma compresses soft tissues against the bone. This type of injury is especially common in high-impact sports like soccer, football, and snowboarding, where falls and collisions are frequent.

Snowboarding and Hip Pointer Injuries
Snowboarders are particularly vulnerable to hip pointers. Hard falls onto icy slopes or misjudged landings can lead to significant trauma to the hip. Protective gear like padded shorts can reduce the risk, but accidents happen, and knowing how to manage this injury is key.

Symptoms to Watch For:

• Sharp, localized pain over the hipbone.

• Bruising and swelling at the site of impact.

• Difficulty walking, twisting, or bending without pain.

• Muscle spasms in nearby hip or abdominal muscles.

Why Proper Diagnosis Matters:
While hip pointer injuries are often straightforward, it’s important to rule out more severe conditions like fractures or hip joint damage. Chiropractors and physiotherapists are well-equipped to assess the injury, identify underlying issues, and create a recovery plan tailored to your needs.

Treatment Options:
Many hip pointer injuries respond well to conservative care, but not all treatments are created equal.

1. Rest and Activity Modification: Avoid activities that put stress on the injured area.

2. Ice for Pain Relief: Ice can help numb the area and reduce pain, but it does not reduce inflammation. Pain relief allows you to focus on effective treatments like manual therapy and rehab exercises.

3. Chiropractic and Physiotherapy: These therapies are essential for restoring mobility, addressing soft tissue damage, and preventing compensatory movement patterns that could lead to future injuries.

   • Manual therapy to reduce muscle tension and improve alignment.

   • Guided exercises to rebuild strength and flexibility.

4. Compression and Support: Use wraps or padding to protect the area while healing.

Rehabilitation: Moving from Pain to Performance
Chiropractors and physiotherapists don’t just treat the injury—they guide you through recovery. A typical rehab plan for a hip pointer injury might include:

• Gentle mobility exercises to restore movement.

• Strengthening the hip flexors, glutes, and core to stabilize the pelvis.

• Gradual return to activities like snowboarding or running with proper movement mechanics.

When to Seek Professional Care:
If pain persists for more than a few days, or you notice severe swelling, numbness, or weakness in your leg, seek care immediately. Chiropractors and physiotherapists can identify hidden issues and help you avoid setbacks in your recovery.

Preventing Hip Pointer Injuries:

• For Snowboarders: Wear padded shorts and practice falls to reduce impact.

• Build core and hip strength to better absorb trauma.

• Warm up and stretch before activities to improve flexibility.

Conclusion:
A hip pointer injury might slow you down, but with proper care, including chiropractic and physiotherapy, you can recover fully and return to your favourite activities—whether it's snowboarding, soccer, or just staying active. By addressing the root cause and focusing on functional recovery, you’ll not only heal faster but also prevent future injuries.

If you’re dealing with hip pain or need guidance for recovery, don’t hesitate to reach out to a professional who can help you navigate the process.

Flexor Hallucis Muscle Strains: Causes, Recovery, and Treatment Options

Flexor hallucis muscle strains, while not as commonly discussed as hamstring or calf strains, can significantly impact movement and quality of life—especially for runners, dancers, and other active individuals. Let’s break down what this injury entails, how it happens, and the steps you can take to recover effectively.

What is the Flexor Hallucis Muscle?

The flexor hallucis longus (FHL) is a muscle in the lower leg that plays a key role in controlling your big toe. It allows you to push off during walking, running, or jumping and stabilizes your foot during movement. Despite its small size, the FHL is critical for activities requiring balance and power.

A strain in this muscle happens when the fibers are overstretched or torn, which can range from a mild pull to a more significant tear.

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How Do Flexor Hallucis Strains Happen?

The most common causes include:

- **Overuse:** Repetitive motion, such as running or jumping, can lead to microtrauma in the muscle.

- **Biomechanics:** Issues like overpronation (rolling your foot inward) or tight calves can put extra strain on the FHL.

- **Acute injury:** A sudden, forceful movement can overstretch the muscle, leading to a strain.

Athletes, particularly runners, dancers, and those involved in sports requiring rapid direction changes, are most at risk for this type of injury.

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Symptoms to Watch For

- Pain or tenderness along the inner side of the lower leg or ankle.

- Swelling or inflammation in the area.

- Difficulty pushing off the ground or pointing your toes.

- Pain that increases with activity but may lessen with rest.

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Diagnosis and Imaging

Diagnosing a flexor hallucis muscle strain often starts with a physical examination. A healthcare provider will assess your pain, range of motion, and strength.

In some cases, imaging can help:

- **Ultrasound:** Useful for detecting tears or inflammation in the muscle.

- **MRI:** Provides a detailed look at soft tissues, which can help confirm the diagnosis if the strain is severe.

For most mild-to-moderate strains, imaging isn’t necessary unless symptoms persist or worsen despite treatment.

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Treatment and Recovery Options

1. Conservative Care: The Foundation of Recovery

Most flexor hallucis strains respond well to conservative care. This includes:

- Rest: Allow the muscle to heal by avoiding activities that exacerbate pain.

- Compression and elevation: Support the area and reduce inflammation.

2. Rehabilitation and Exercise

Rehabilitation is essential to restore strength, flexibility, and function. A well-rounded rehab plan might include:

- **Stretching:** Gentle stretches to improve calf and ankle flexibility, reducing strain on the FHL.

- **Strengthening exercises:** Targeting not only the FHL but also the surrounding muscles to improve overall foot and leg stability.

- **Gradual return to activity:** Slowly reintroducing movements like running or jumping to build tolerance.

Working with a rehab professional ensures exercises are tailored to your injury and activity goals.

3. Manual Therapy

Techniques like soft tissue mobilization or dry needling can reduce muscle tension, improve circulation, and support recovery.

4. Footwear Adjustments

Wearing supportive shoes or orthotics can offload the strain on the FHL, especially if poor biomechanics contributed to the injury.

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How Long Does Recovery Take?

Recovery times vary depending on the severity of the strain:

- Mild strain: 2-4 weeks with consistent rehab and rest.

- Moderate strain: 4-8 weeks, requiring a more structured rehab program.

- Severe strain: Several months, especially if a significant tear occurred.

The key to recovery is patience and consistency with your rehab plan. While it’s tempting to return to full activity quickly, rushing can lead to setbacks.

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Why Conservative Care is the Best Starting Point

For most flexor hallucis strains, conservative care is highly effective. Surgery is rarely needed unless there’s a complete tear, which is uncommon. By focusing on rest, rehabilitation, and proper biomechanics, you can not only recover but also prevent future injuries.

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Optimistic Outcomes: Get Back to Doing What You Love

While flexor hallucis muscle strains can be frustrating, they don’t have to sideline you permanently. With the right care and guidance, you can make a full recovery and return to your favorite activities stronger than before.

If you’re experiencing pain or suspect an injury, don’t hesitate to seek help. A thorough assessment and personalized rehab plan can set you on the path to recovery and long-term success.

Ready to take the next step?

Reach out today to start your recovery journey.

Understanding Triangular Fibrocartilage Complex (TFCC) Injuries: Causes, Rehab, and Recovery

The Triangular Fibrocartilage Complex (TFCC) is a critical structure in your wrist that acts like a cushion and stabilizer. Located on the pinky side of the wrist, it connects your forearm bones (radius and ulna) and plays a vital role in wrist stability, especially during twisting, gripping, or weight-bearing activities.

If you've been diagnosed with a TFCC injury—or suspect one—you might feel concerned about your wrist’s future. This post will break down what you need to know, focusing on how injuries happen, rehabilitation options, and imaging choices. While TFCC injuries can be tricky, with the right approach, recovery is very achievable.

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What Is the TFCC and How Do Injuries Happen?

The TFCC is a complex structure made up of cartilage and ligaments. Think of it as the "shock absorber" on the outer side of your wrist. It stabilizes your wrist during motions like:

- Rotation (turning a doorknob).

- Weight-bearing (pushing up from a chair).

- Grip-intensive tasks (carrying groceries or using tools).

How TFCC Injuries Happen:

1. Trauma:

Sudden injuries, such as falling on an outstretched hand, can tear the TFCC.

2. Repetitive Stress:

Activities like racquet sports, weightlifting, or even prolonged typing can gradually wear down the TFCC.

3. Degeneration:

Over time, natural wear and tear (often starting after age 30) can weaken the TFCC, making it more susceptible to injury.

Common Symptoms:

- Pain on the pinky side of your wrist.

- Clicking or catching sensations when moving your wrist.

- Weakness during gripping or twisting motions.

- Swelling or tenderness near the wrist.

Imaging Options for Diagnosing TFCC Injuries

If a healthcare provider suspects a TFCC injury, imaging can confirm the diagnosis:

1. X-rays:

While they won’t show the TFCC directly, they can rule out fractures or joint alignment issues.

2. MRI:

This is the gold standard for viewing soft tissue injuries, including the TFCC. Adding contrast dye (an MRI arthrogram) can improve the accuracy of the diagnosis.

3. Ultrasound:

A less expensive and accessible option to visualize certain TFCC tears, especially in skilled hands.

Your provider will decide which imaging is appropriate based on your symptoms and physical exam findings.

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Rehabilitation: The Cornerstone of Recovery

Rehabilitation focuses on restoring strength, mobility, and function while minimizing pain. Here’s how the process typically works:

1. Protect and Calm

- In the early stages, you’ll focus on protecting the wrist. This may include wearing a brace or splint to limit motion and allow healing.

- Manual therapy and specific exercises can help calm pain and reduce inflammation.

2. Restore Strength and Mobility

- Gentle range-of-motion exercises will help maintain flexibility without stressing the TFCC.

- Gradually, strengthening exercises are introduced to rebuild support in the wrist and forearm.

3. Reload the Wrist

- Once pain decreases, you’ll work on loading the wrist with functional movements that mimic your daily activities or sports.

- Balance between progression and avoiding aggravation is critical.

**Sample Exercises**:

- **Wrist curls and extensions** using light resistance bands.

- **Supination/pronation drills** to improve rotation strength.

- **Grip strength training** with tools like putty or hand grippers.

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Conservative Care: The First Line of Defense

For most TFCC injuries, surgery isn’t the first step. Conservative care is often highly effective, especially if you catch the injury early.

Why Conservative Care Works:

- Tissue Healing: The outer part of the TFCC has better blood supply, making it more responsive to rest and rehab.

- Rehabilitation: Proper strengthening and mobility exercises can restore function and reduce strain on the TFCC.

- Avoiding Surgery Risks: Rehabilitation allows you to avoid the potential complications of surgery, such as stiffness or prolonged downtime.

When Surgery Might Be Considered: If conservative care hasn’t improved symptoms after several months, or if the TFCC is completely torn in a way that causes instability, your provider may discuss surgical options.

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Be Realistic, But Stay Optimistic

Recovery from a TFCC injury depends on several factors, including:

- Severity of the injury: Partial tears or wear-and-tear injuries generally heal better than complete tears.

- How quickly you start treatment**: The earlier you address the injury, the better your chances of avoiding long-term issues.

- Consistency in rehab: Following a structured plan is key to success.

Most people with TFCC injuries can return to their favourite activities with time and effort. While the process might take several weeks to months, the goal is always to restore pain-free function without needing surgery.

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Key Takeaways

1. Understand the TFCC: It’s a crucial stabilizer in your wrist, and injuries often happen due to trauma, repetitive strain, or aging.

2. Don’t Skip Rehab: Conservative care, including targeted exercises and protection, is your best shot at recovery.

3. Be Patient: Healing takes time, but with the right approach, you can regain strength and mobility.

If you’re struggling with wrist pain that’s holding you back, seek help from a professional trained in conservative care and rehabilitation. The path to recovery might feel long, but each step brings you closer to doing what you love without limitations.

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For more guidance or support, reach out to schedule a consultation—we’re here to help!

-Dr Mark Murdoch, Chiropractor, MS Sports Medicine

Which running shoes do I need?

How to Choose the Best Running Shoes for Injury Prevention and Performance

With so many options on the market, finding the best running shoes can be a challenge. Whether you’re looking for shoes to prevent injury or boost your performance, the key is to think of your footwear as a tool that supports your body—allowing your feet to function as they’re designed to.

In this post, we’ll explore some key factors to consider when choosing the right running shoes for your needs and highlight some popular brands that offer options for every type of runner.

What Makes a Good Running Shoe?

Here are the essential principles to keep in mind when selecting your next pair of running shoes:

1. Let Your Feet Function Naturally
   Your feet are designed to move, flex, and absorb impact. The best running shoes will allow your feet to do this without unnecessary restriction. Minimalist shoes, like those from brands such as Altra and Vivobarefoot, offer a more natural running experience, allowing your foot to move freely with each stride. These types of shoes can be especially beneficial for runners who prioritize foot strength and natural movement.

2. Offer Protection Without Over-Engineering
   Running shoes should provide protection from the repetitive stress of modern surfaces, but it’s important not to overdo it. Too much cushioning or support can interfere with your foot’s natural mechanics, leading to inefficient movement and potential injuries. Shoes like the Hoka One One Clifton or the Brooks Ghost strike a balance between cushioning and support, offering comfort without completely taking over your foot’s function. These shoes are great for runners who want some extra protection while still maintaining a natural gait.

3. Pay Attention to Your Everyday Footwear
   What you wear when you’re not running is just as important as your running shoes. Tight, rigid, or poorly designed shoes worn throughout the day can cause long-term damage to your feet and affect your performance. Brands like New Balance and Merrell offer everyday footwear options that prioritize foot health, with wide toe boxes and flexible designs that support your foot’s natural movement.

4. Trust Your Body—Self-Selection Works Best
   Ultimately, the best shoe for you is the one that feels right. Studies have shown that self-selected shoes tend to reduce injury risk because your body knows what’s comfortable. Whether you prefer the zero-drop design of Altra or the plush cushioning of Asics Gel-Nimbus, trust your feet to guide you toward the right choice. Trying on different brands and running in them before making a decision can help you find what works best for your unique running style.

So… what are the key takeaways?

Choosing the best running shoes is about finding the right balance between natural foot function, protection, and comfort. Whether you’re a trail runner, road runner, or someone looking for everyday comfort, brands like Altra, Brooks, Hoka, and New Balance offer a variety of options designed to meet your needs.

Remember, your running shoes are a tool to help you perform your best. By focusing on shoes that let your feet function naturally and provide just the right amount of protection, you’ll be setting yourself up for better performance and fewer injuries.

- Dr Mark Murdoch
Chiropractor, MS Sports Medicine

Exercising During Wildfire season

understand the risks and when to move your training inside

We bailed on our run on the Rockwall Trail (58k) last week due to smoke from nearby wildfires. After months of training and prep, it was a heartbreaking decision, but Mark and I looked at each other and chose not to risk it. As someone who falls in the higher risk category, it didn’t make sense to put my body through this type of damage.

We all want to enjoy summer on the trails, but poor air quality during wildfire season can cause significant health risks that can overshadow the benefits.

But how significant is the risk?

Wildfires release a complex mixture of gases, fine particulate matter (PM), and volatile organic compounds(VOCs) into the air, seriously affecting respiratory and cardiovascular health. Exposure to these compounds can lead to irritation, inflammation and long-term damage to the respiratory system.

What do we know so far?

Research has shown that exposure to wildfire smoke can exacerbate respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). A study published in BMC reports exposure to PM, with most evidence derived from studies of wildfire smoke PM, is a risk factor for adverse cardiovascular effects, especially among susceptible populations. The tiny particles can penetrate deep into the lungs, causing systemic inflammation and reduced lung function, which can be particularly dangerous during physical exertion when the oxygen demand is higher. 

Can I train at a lower intensity to decrease my risk?

According to Dr. Michael Koehle, the director of the Environmental Physiology Laboratory at the University of British Columbia, there is no good evidence at this time that supports the idea that, at a given duration, higher-intensity exercise is more harmful than lower-intensity exercise during times of poor air quality.

How can I determine my risk?

Monitoring air quality is essential for those who wish to exercise outdoors during wildfire season. The Air Quality Index (AQI) is a valuable tool that provides real-time information about air pollution levels. Health experts recommend limiting outdoor activities when the AQI exceeds 100, particularly for sensitive groups. When air quality is poor, consider alternative indoor exercises such as using a treadmill, stationary bike, or yoga and strength training. You should choose strength training, cough, cough. Air purifiers can also help improve indoor air quality, making exercising safer.

When to move your training inside?

Running in poor air quality stresses the body, leading to injury or delayed recovery even if you don’t fall within the sensitive populations category. If the AQI is greater than 100 or you fall within the sensitive populations category, the risk is much higher. However, young and healthy athletes also struggle with the physiological demands of training in these conditions. Running a little less this week won’t set you back as far as the symptoms you may experience running at times of high wildfire smoke. Talk to your coach about options to cross-train.

While staying active is essential for overall health, it is crucial to prioritize safety during wildfire season by being aware of the air quality and the associated health risks. Taking appropriate precautions while staying informed can maintain your fitness routine without compromising your health.

References:

Chen H, Samet JM, Bromberg PA, Tong H. Cardiovascular health impacts of wildfire smoke exposure. Part Fibre Toxicol. 2021 Jan 7;18(1):2. doi: 10.1186/s12989-020-00394-8. PMID: 33413506; PMCID: PMC7791832.

Rundell KW, Sue-Chu M. Air quality and exercise-induced bronchoconstriction in elite athletes. Immunol Allergy Clin North Am. 2013 Aug;33(3):409-21, ix. doi: 10.1016/j.iac.2013.02.009. Epub 2013 Mar 27. PMID: 23830133.

https://sportsustainabilityresource.ubc.ca/digital-museums/exercise-and-air-pollution

Training during bad forest fire season | Uphill Athlete. https://uphillathlete.com/forums/topic/training-during-bad-forest-fire-season/

Battling Wildfire Air Pollution: Strategies for a Safer Future | Dryad. https://www.dryad.net/post/battling-wildfire-air-pollution-impacts-and-strategies-for-a-safer-future