Our SLIR team will be providing pre- and post- run services at the GO! St.Louis All American 5K & Fun Run!  Please come see us at the finish line!  Hope to see you there!

This 5k race (3.1 miles) [...]]]>

Our SLIR team will be providing pre- and post- run services at the GO! St.Louis All American 5K & Fun Run!  Please come see us at the finish line!  Hope to see you there!

This 5k race (3.1 miles) & Fun Run (1-Mile) is a summer family tradition, so make plans to join us on Father’s Day. The GO! St. Louis All-American 5K & Fun Run, promises to be pure All-American fun, complete with Apple Pie and Ice Cream, and is open to all ages and fitness abilities. The flat-downhill 5k course will be ideal for those athletes looking for a new PR (personal record) on a scenic neighborhood course.

The addition of Dr. Morales and the Elite Chiropractic Office in Creve Coeur, is a [...]]]> Dr. Heather Morales and the office of Elite Chiropractic and Sports Medicine are joining the staff and offices of St. Louis Injury & Rehabilitation Center.

The addition of Dr. Morales and the Elite Chiropractic Office in Creve Coeur, is a significant merger between the two facilities.  St. Louis Injury & Rehabilitation Center, LLC and it’s chief medical director, Dr. Bill Cragg, have been providing services to the areas athletes and general public for the last 18 years.

Dr. Morales brings a great deal of clinical knowledge to the office having worked with MMA fighters and hockey players.  She will serve as Asst. Clinical Director of St. Louis Injury & Rehabilitation Center , located in Webster Groves .  She will continue treating patients at the Creve Coeur office as well.  Joining her at the Creve Coeur location will be experienced therapists from St. Louis Injury & Rehab., Jamal Carter and Adrian Ortiz, along with Dr. Cragg.  This more comprehensive staff means that a greater diversity of treatment and services will be available to patients.

About Dr. Heather Morales

Elite Chiropractic and Sports Medicine Center

Creve Couer Location Hours:

Webster Groves Office Hours:

SLIR staff will be at the EXPO on 4/5 and 4/6 from 11am-7pm on Friday and Saturday.  We will also be at the finish [...]]]> SLIR office will be closed on 4/5/2013 and you may find our staff at the EXPO.

SLIR staff will be at the EXPO on 4/5 and 4/6 from 11am-7pm on Friday and Saturday.  We will also be at the finish line on Sunday 4/7 for all your pre and post race needs!  Make sure you stop by and see us!

If you are a patient or friend of the office make sure to stop by and receive your VIP Sticker for the SLIR VIP post race recovery tent at the finish line!  See you at the Races!

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This page is having a slideshow that uses Javascript. Your browser either doesn't support Javascript or you have it turned off. To see this page as it is meant to appear please use a Javascript enabled browser.

SLIR Recent Blog Articles:

GO! St.Louis All American 5K & Fun Run

Our SLIR team will be providing pre- and post- run services at the GO! St.Louis All American 5K & Fun Run!  Please come see us at the finish line!  Hope to see you there! This 5k race (3.1 miles) & Fun Run (1-Mile) is a summer family tradition, so make plans to join us on Father’s Day

<< Read More >>

Snapping Hip Syndrome

Snapping hip syndrome (also referred to as coxa saltans, iliopsoas tendinitis, or dancer's hip) is characterized by a snapping sensation felt when the hip is flexed and extended or often externally rotated along with flexion. Runners will experience symptoms due to tightness of the muscles around th

<< Read More >>

Congrats 2013 gO St Louis Marathon Participants!

Congratulations to all the participants of the gO St Louis half and full marathons!  You braved the miles, the heat and the aches and pains and accomplish(ed) a great goal.  Now is the time to recover and prepare for future training and racing.  Click on the link to see how to improve your recove

<< Read More >>

Office Closed Friday, April 5th:

SLIR office will be closed on 4/5/2013 and you may find our staff at the EXPO. SLIR staff will be at the EXPO on 4/5 and 4/6 from 11am-7pm on Friday and Saturday.  We will also be at the finish line on Sunday 4/7 for all your pre and post race needs!  Make sure you stop by and see us! If you are

<< Read More >>

Welcoming Dr. Morales & Elite Chiropractic and Sports Rehab!

Dr. Heather Morales and the office of Elite Chiropractic and Sports Medicine are joining the staff and offices of St. Louis Injury & Rehabilitation Center. The addition of Dr. Morales and the Elite Chiropractic Office in Creve Coeur, is a significant merger between the two facilities.  St. Lou

<< Read More >>

Sports Chiropractors Prevent Runner's Injuries

Below is an article from Active.com, by Sabrina Grotewold.  She interviewed a Chiropractor from New York City, and he eloquently states the benefits of chiropractic care, not only post injury, but as a pre-injury regime for endurance athletes. -------- If you think chiropractors simply "crack" back

<< Read More >>

My Foot Pain Doesn’t Seem to Get Any Better

The Flexor Digitorum/Hallucis Longus Muscles May be The Answer Runner’s injuries are numerous when it comes to the foot and ankle.  Achilles tendinitis, plantar fasciitis, Morton’s neuromas, stress fractures and calf strains are the more common problems that runners experience.  Often overloo

<< Read More >>

Dehydration: As Temperatures Rise, Performance May Decline

It’s HOT out there runners!  If you live in Missouri (or anywhere else in the United States these days) you may dread walking outdoors for any reason.  Stepping out the front door may result in the soles of your running sneakers melting and sticking you to the driveway.  If you are considering

<< Read More >>

Iliotibial Band Syndrome

This is likely the most reported runner’s condition I see in our office, especially during this time of year when runners and walkers are getting more active. The typical complaint is that of knee pain on the lateral side that comes on “usually all of a sudden” during running or sometime after

<< Read More >>

Morning Lagging? Drink Some Water!

-- The skin on your lips is 200 times more sensitive than your fingertips. -- Pain occurs when sounds are above 130 db (decibels). -- Lack of water is the #1 trigger of daytime fatigue. -- Stress can result in more headaches as a result of the body rerouting blood flow to other parts of the body.

<< Read More >>

Applying adjustments to various joints of the spine results in specific and powerful effects to the nervous system. The adjustments are often accompanied by a program of physical therapy to enhance the recovery process. We also offer an array of therapies from massage, stretches, exercises, and modalities, to guide you on your path to pain-free health.

By employing a program of stretching and strengthening exercise, your back and neck can gain the flexibility needed to survive a lifetime of stress and strain.

Feel free to browse our our recent info (above) for current events, office updates, and notes from the doctors.

Did You Know …

You can find Dr. Cragg on the sidelines! At Ladue and SLUH that is.  Dr. Cragg has recently extended his expertise to assist with sideline pre and post performance care for some of our St. Louis area high school athletes. 

Wishing them all the best in health and wellness from the SLIR Staff!

You’ve made it through the Thanksgiving, Hanukah and Christmas dinners and have just recently finished the New Year’s celebration with more delicious meals, candies, baked goods and spirits. You may have even been lucky enough to [...]]]> by Dr. Bill Cragg

You’ve made it through the Thanksgiving, Hanukah and Christmas dinners and have just recently finished the New Year’s celebration with more delicious meals, candies, baked goods and spirits. You may have even been lucky enough to escape with only a couple pounds added to your running frame. I wasn’t so lucky. And now, you’re ready to go back to a steady diet of Cliff Bars, GU and some type of electrolyte replacement drink.

Song Writer, Sammy Cahn, wrote one of the most well known holiday songs. I am sure you’ll recognize the lyrics.

“Oh the weather outside is frightful,

And like the lyrics, you also recognize that winter has fallen upon the St. Louis area. You, undoubtedly, recognize the winter weather St. Louis is so well known for. Several weeks of warmer weather are typically followed by the reality of cold, wet, icy, and windy mess that we are so accustomed to. Nonetheless, like me, you may have awoken on New Year’s Day, put on your multiple layers of clothing recently gifted to you by your friends, family or Santa and headed out the door for your annual New Year’s Day run with your buddies.
The weather may be “frightful” but for runners there’s always a “place to go, Let it Snow, Let it Snow, Let it Snow!” While many of you would prefer the comfortable, constant, climate with no wind that our local health club or gym provides, there are some of you “crazy runners” (as I refer to them) thinking to yourself …”Bad weather? Snow? Cold? Cool …….. let’s hit the trails or Forest Park, it’s beautiful out there!”

If you do choose to head out there into the “bad elements” for a run, walk, hike or trail run, keep in mind that there are lots of hidden potentials for injury out there. Take the proper precautions before you go out so that your experience is a great one to reflect on or share with someone else. Otherwise, you could find yourself starting the “New Year” with a new injury. Remember this simple rule…if you’re uncomfortable running, you increase the risk for injury. Shivering in the cold, wet and cold running shoes and apparel, icy and slippery areas, high winds, uncomfortable clothing, running in the darkness as well as traffic all can make your workouts a little more unpleasant and can increase the risk for injury.

• Consider what you wear in the colder and wetter climates. Multiple layers are needed in colder climates. It’s easier to pull off layers than to wish you had put them on before you left the house. Uncomfortable clothing can lead to “tightening up” of the muscles leading to muscle fatigue, strain and or cramping.
• The proper shoes should always be worn. If you’re headed into the woods, the proper trail shoes and socks can help keep your footing. Yak Tracks are a great addition to your running apparel. They are like having chains on your feet during heavy snow and icy roads. Slips, falls and twisted ankles are increased when the running surface is slicker due to ice or snow. Consider running on gravel paths during the winter. These give you better footing. Calf cramps, an increase in plantar fascial pain or knee pain can result from running in cold, wet, slippery areas.
• Wear a headlamp if you running in the darker mornings during the winter months. It’s easier to see your footing. I see a lot of runners for ankle sprains they got from stepping in holes or on debris they didn’t see in the dark. Try to run during the later hours in the sun or daylight.
• Try to avoid the roads when the snow has accumulated. Plowed roads often take away the road’s shoulders we like to run along instead of sidewalks. Putting yourself into traffic is never a comfortable run but it gets much riskier when the roads are slick. If it’s snowing, it becomes much harder for drivers to see you on the road as well.
• Run later in the day when the temperatures may be warmer. I know that many people find the treadmill a welcomed relief from the cold. You could break your longer runs into a warm-up on the treadmill, outside for a few miles and then a cool down back on the treadmill.

Injuries are never welcomed. When they occur in the winter months they carry the potential for ruining your spring workouts as the warmer weather begins to return. So, “Let it Snow!” and enjoy the outdoors running safely. The parks are beautiful this time of year and the woods quiet and peaceful. Otherwise, grab your headphones, your shorts and t-shirts and enjoy the treadmill at a balmy 75 degrees all winter.

On behalf of myself and the staff at St. Louis Injury & Rehabilitation Center, we wish you a wonderful Holiday Season, a Happy New Year and a healthy, injury free 2013.

Train Smart, Train Healthy!
Dr. Bill Cragg

If [...]]]> Below is an article from Active.com, by Sabrina Grotewold.  She interviewed a Chiropractor from New York City, and he eloquently states the benefits of chiropractic care, not only post injury, but as a pre-injury regime for endurance athletes.

——–

If you think chiropractors simply “crack” backs, you’re not alone. Scott Duke, D.C., owner of Duke Chiropractic in New York City, is accustomed to hearing this misconception.

“Sports chiropractors who are trained in muscle work, such as Active Release Technique (ART) and Graston, are probably the best manual therapists for preventing injury and optimizing performance,” says Duke. “That’s why there’s always a sports chiropractor on Olympic and professional sports teams.”

For runners, chiropractic can be used for injury prevention because it emphasizes proper alignment of the spine and pelvis. The most common running-related injuries Duke sees in his patients, which range from recreational runners to Olympians and New York City Marathon winners, are plantar fasciitis, Achilles tendonitis, IT Band Syndrome, patella (knee) tracking problems and hip bursitis.

Duke’s first step in treating these injuries: Search for misalignment.

“Mal-alignment of the spine can cause unnecessary tension on one particular body part versus an equal distribution of pressure,” he says. “I can’t take care of anyone’s chronic IT band problem without making sure their pelvis is in as perfect alignment as it can be. Otherwise, it’ll continue to wear, tear, and put strain on that one particular body part.”

What Causes Improper Alignment?

Major causes of improper alignment include running in the same direction on the same course every day; running often slanted surfaces, such as a beach; and not replacing shoes every few hundred miles.

Fix these training errors that cause misalignment with a few simple tweaks:

• Vary your running surface—pavement, track, asphalt, grass, dirt, wood chips—a few times a week, and you’ll naturally run on different courses.

• Run as close to the water as possible when on the beach, as the sand tends to be more flat there.

• Buy two of the same type of running shoes, and switch between the pairs.

Runner’s injuries are numerous when it comes to the foot and ankle.  Achilles tendinitis, plantar fasciitis, Morton’s neuromas, stress fractures and calf strains are the more common problems that runners experience.  [...]]]> The Flexor Digitorum/Hallucis Longus Muscles May be The Answer

Runner’s injuries are numerous when it comes to the foot and ankle.  Achilles tendinitis, plantar fasciitis, Morton’s neuromas, stress fractures and calf strains are the more common problems that runners experience.  Often overlooked, however, are a couple important muscles that when strained or overstressed, can create significant pain in the foot and ankle, the flexor digitorum longus (FDL) and flexor hallucis longus (FHL).

The flexor digitorum longus is located on the lateral (or outside) side of the tibia in the back of the calf.  It attaches to the 2nd – 5th toes and acts on the foot by flexing those toes.  The flexor hallucis (“big toe”) longus is a deep calf muscle and is one of the stronger muscles of the deeper calf.  It is located on the fibular (the outside bone) side of the leg.  The FHL tendon attaches the muscle to the “big toe”.

Repetitive flexion of the foot and toes, such as with running, can place an enormous amount of stress on these muscles.  When the flexor hallucis longus (FHL) is involved it is often referred to as ballet dancer’s tendonitis because of the constant “tip toe-ing” that they do.  Similar injuries also occur in soccer, climbing and running.  Runners will experience pain and tenderness along with swelling just posterior to the medial malleolus (or inside ankle bone).  Pain can be felt along the underside of the foot along the big toe and is increased with continued irritation.  The flexor digitorum longus muscle assists in flexion of the big toe as well and makes it susceptible to injury.  The condition can often be confused with plantar fasciitis because the pain is felt in the inner ankle and heel where the tendon of the FHL passes and the plantar fascia inserts.  The pain may be felt at rest after activity rather than while during running.  Running uphill or on uneven surfaces may increase the pain and worsen the condition.  Runners may experience pain in the morning upon waking and then standing or walking.  This too is similar to plantar fasciitis.

Causes of FHL/FDL tendonitis in runners occur when a stress greater than the tendon can withstand is introduced to the tendon.  These forces can be accumulated by running too many miles, improper shoes, surface changes (usually to a harder surface like concrete or very soft surfaces like sand), or more commonly due to gradual wear and tear associated with overuse.   Additional factors that contribute to this condition include improper mechanics of the foot, improper foot wear, muscle weakness or imbalances, flatter feet and lack of flexibility.

Recovering from tendonitis in the flexor hallucis longus and flexor digitorum longus muscles is focused on reducing the aggravating activities, reduce swelling and improve flexibility in the muscle(s), and reduce imbalances in the foot.   Treatment may include soft tissue techniques, ultrasound therapy, anti-inflammatory considerations, stretching, ice, kinesio taping, a change in running shoes, strengthening of the muscles, balance exercises and much more.

If you are experiencing pain on the inner side of the ankle or plantar surface of the foot and it has not responded to treatment, it may be a tendonitis of the FHL or FDL.  You may have been diagnosed with plantar fascia or other problems of the foot and ankle and have had treatment (unsuccessfully) and become discouraged.  Perhaps you’ve even stopped running or other activities in hopes that the problem will go away or diminish.   Have the FDL and FHL evaluated along with your gait and running shoes.  With proper treatment most cases resolve within a few short weeks.

Happy and Healthy Running!

Dr. Bill Cragg

If you live in Missouri (or anywhere else in the United States these days) you may dread walking outdoors for any reason.  Stepping out the front door may result in the soles of your running [...]]]> It’s HOT out there runners! 

If you live in Missouri (or anywhere else in the United States these days) you may dread walking outdoors for any reason.  Stepping out the front door may result in the soles of your running sneakers melting and sticking you to the driveway.  If you are considering a run outdoors hydrating properly needs to be top priority.  According to the International Center for Sports Nutrition you are mostly water.  In fact, if you removed the water out of a 180-pound lean body, there would be about 55 pounds left.  Your muscles, your brain, your blood and sweat are mostly water.  If there’s not enough water in the body it simply doesn’t work as well.   Your endurance is compromised, performance is decreased, your judgment is altered and your heart works harder.

During these hot summer months thousands of athletes will suffer needlessly from the effects of dehydration.  Our perceptions, as athletes, are not always accurate when trying to balance our fluid intake.  Learn what your body needs during and away from exercise.

Dehydration results from an inadequate amount of fluid in the body.  For athletes who participate in endurance activities or train for long periods of time, dehydration may occur quicker.  A person is considered dehydrated when they have lost more than 2 percent of their body weight during exercise.  If you weigh 150 pounds, a loss of 3.0 pounds during training or racing may result in dehydration.

Symptoms of dehydration include the following:

Dry or sticky mouth

Low or no urine output

Very dark colored, concentrated urine

Not producing tears

Weakness

Dizziness

Skin may “tent” when pinched (doesn’t bounce back quickly when released).

The Gatorade Sports Science Institute did a study to determine the amount of fluids needed during a run or race.  To determine how much liquid to take, you need to know your sweat rate, and that can vary between 1 and 4 quarts per hour.  Weigh yourself nude before a training run, and then again after.  One pound of weight loss equals 1 pint of water loss.  Calculate sweat rate and use this to determine your fluid needs during a run or race.  Basically, if you lose 2 pounds during an hour run, that’s 2 pints or 32 ounces.  Thus, you need 8 ounces of water or sports beverage every 15 minutes.  If you’re like me, I usually don’t get enough fluids.

In an additional study, they also looked at how accurately athletes could estimate their sweat losses and fluid consumption during a 10 mile race.  Eighteen seasoned runners participated in the study.  The results showed that the runners drastically underestimated how much sweat they lost and consequently drank too little to stay well hydrated.  The runners underestimated their sweat losses by an average of 46 percent and their fluid intake by an average of 15 percent, resulting in the runners replacing only 30 percent of their fluids lost through sweat.  Going further into the study, they show results for these athletes are affected greatly when a 2 percent weight loss occurs.  In some cases, runners finishing times were over 2 minutes greater for a 10K race.

If seasoned athlete’s perceptions were this far off, it makes you wonder what the amateur’s results would be.  Runners will also have the wrong perceptions of heat outside by only considering the temperatures and not the humidity.  Here’s a chart making the comparisons between heat and humidity.

Runners need to take into consideration of humidity as well as heat.  If there is 70% relative humidity and the temperature is 90 degrees, the “what it feels like” temperature is 106 degrees.

 If you do go outside for that workout or race there are some things you should consider:

Dress appropriately.  Wear light colored clothing, preferably technical gear or wickening material.  If you are going outside shirtless make sure you have plenty of sunscreen on.

If running in the heat and humidity for the first time, acclimate to the warmer conditions.  This may take a couple weeks so take it slow and keep the distance of runs shorter.

Being thirsty is not the first indicator of being dehydrated.  If you are thirsty, you are already at risk for dehydration and low on beneficial fluids.  Drink before you go for that workout.

In general, drinking 4-8 ounces of water and/or some type of sports drink every 15-20 minutes will help avoid dehydration (see the hydration formula above).

Apply sunscreen of at least an SPF of #15 or greater.

Eating and snacking on saltier foods during the day can be of benefit in reducing your dehydration risks.  Pretzels, tomato juice, peanuts, etc. are healthy alternatives to the saltier diet.  If you are taking certain medications a saltier diet may be contraindicated.

Avoid running during the hot times of the day, noon – 4:00 pm are usually the hottest.  Run when your shadow is taller than you are.  Morning or later afternoon and early evening are better times.

Weigh yourself before and after your runs.  Try to drink 16 ounces of fluid for every pound of weight lost after your runs.

What have you done the rest of the day?  Did you work in the yard?  Did you play with the kids or sit in the sun at the soccer games?  Take your daily activities and lifestyle into consideration.

When eating use common sense.  Avoid hot foods, alcohol and heavy foods that increase your core temperature.

If you feel any headaches, fatigue or irritability or notice your exercise performance decreasing, stop exercising and cool off.

This is certainly not an exhaustive list.  There are many other factors to consider.  Obesity, smoking, injuries, lack of sleep, emotional stress and many other conditions may increase the risk of dehydration. Every runner accommodates to the heat differently.  As always, consult your doctor if you experience continued symptoms of dehydration or are concerned.  Remember, when your kids playing outside this summer they are also at risk.  Make sure you routinely speak with them about hydrating properly.

Enjoy your outdoors wisely and safely!