Portland-area running coach Brian (Ziggy) Gillespie and I have worked together for over 20 years. I love his coaching system of mixing speed work, long runs and plenty of recovery time.

One of his female athletes was having issues with her lower back when she started to increase her distance and speed for racing. She has the mental stamina and physique for running middle to long distances. She knew she could be competitive in her age group.

Her job required her to sit at her computer for hours at a time. This combination of sitting and only running created a chronic, low-grade back pain without sciatica (pain traveling down the leg).

Our examination found her to be very fit, with muscle spasm and reduced range of motion in her sacroiliac joint and left lower back.

X-rays of her low back revealed a birth defect in her lumbar joints. One side of her spine was shaped differently than the other. We also pointed out a stone in her gallbladder.

She is a very compliant and motivated patient. A plan of action included manipulation of her pelvis and spine with exercise to do before and after her runs. She did a series of massage and consulted with David Knop, PT at Livevital in Portland, for core exercises.

Cross training, including cycling, which she resisted and now loves, along with yoga were encouraged. Her competitive nature was satisfied when she took up tennis.

She is able to run, but racing is no longer an option. She now knows participating in multiple sports will allow her to continue her exercise program, maintaining her health and fitness.

Racket sports can create the same overuse issue if done exclusively. The former tennis pro at Prout’s Neck Country Club referred a player to my office.

He was a college squash player ranked number two in the nation, and a competitive tennis and paddle tennis player.

Do you think he may suffer from overuse of his right side? His pain was on the right side of his middle back and shoulder blade. It had been going on for a number of years, gradually getting more uncomfortable.

Examination revealed a muscle spasm between his spine and shoulder blade. He had no pain radiating down his arm.

X-rays showed a vertebra in his middle back was compressed on one side, causing a slight curve in his spine. This structural weakness along with the overuse of his right arm was causing the spasm and pain.

Because stopping squash and tennis was out of the question, we had to develop a plan that would allow him to compete at the highest level without aggravating his spine.

Exercises to balance the muscles were prescribed along with chiropractic adjustments. He had to do an extensive stretching program to avoid arthritis from developing later in the spine. Much of this was done with a fitness ball and hot room yoga.

Cross training included golf, swimming and cycling. While he still has minor issues with his spine, he can still compete in racket sports.

Both of these athletes were trying to compete at the highest level. They had limited themselves to a specific sport that resulted in overuse of specific muscles. They each had a structural defect that created instability in their spine. They used their competitiveness to overcome these shortcomings.

Do you have an achilles heel injury? This article Dr Lynch wrote for his column “Staying in the Game”, for the Portland Press Herald, may be helpful. If you are looking for relief from sports injuries, back pain or other issues, contact Dr Lynch at 207 799 2263 from the info on our contact page.

That pain in the back of your heel may be Achilles tendonitis. It may have come on gradually or suddenly after a quick movement or jump.

The Achilles tendon has an important job. It attaches the two large calf muscles to the back of your heel. Pain can be from inflammation resulting from running and jumping. Overuse also can cause a slight tear in the tendon.

Rupture of the tendon is when there is a complete tear of the tendon. This is rare, and a consultation with an orthopedic surgeon is recommended to determine if surgery is required to repair the damaged tissue.

Symptoms of Achilles tendonitis are pain and stiffness, especially in the morning. You may even notice a bump on the back of your heel. I have had patients say they can hear a crackling noise in their heel. This is from fluid buildup or the formation of scar tissue on the tendon.

Causes of the pain include running too far, too fast, too soon or wearing the wrong or worn-out shoes. Weak or tight calf muscles are also a major contributing factor. Flat feet or foot pronation and inflexible ankles will put stress on the tendon as you exercise.

Activities such as running, jumping and climbing stairs will aggravate your pain.

One of my patients in her late 30s decided to sign up for a women’s triathlon. She thought it would be a fun way to improve her fitness and lose weight. She hired a coach to help her, especially with the swimming portion of the triathlon.

This young woman began to feel pain, and stiffness started in the back of her heel during her training. She had a case of Achilles tendonitis.

I worked with her coach to modify her training to include more cycling and swimming and less running, which would maintain her cardio endurance.

My staff and I taught her how to stretch the Achilles with a straight and bent leg. We had her doing toes raises on stairs to increase her calf and tendon strength. She used ice therapy at home for the first two weeks.

Manipulation of her ankle was used to increase her flexibility, along with ultrasound and deep friction massage to increase circulation and reduce scar tissue. Her shoes were fine.

She responded beautifully and her family and friends were at the triathlon when she crossed the finish line.

A man in his late 70s visiting from Annapolis, Md., was limping off the golf course. His brother and playing partner introduced me to him.

We chatted on the veranda of the golf club and I asked why he was limping. He said two weeks ago while playing squash he felt a pain in his ankle. He was told he had a sprained ankle.

He proceeded to take his shoe and sock off. He wanted my opinion. I examined his ankle and asked him to remove his other shoe and sock. My suspicion was confirmed. He had ruptured his Achilles tendon while playing squash.

He returned home from his vacation the next day and I instructed him to contact his physician for a referral to an orthopedic surgeon. His brother reported to me his surgery was a success and that he was expected to make a full recovery.

To prevent Achilles tendonitis, start your workouts slowly and gradually increase the intensity. Always stretch after a workout. Using a roller can work as a massage to your calf muscles.

Cross training is also helpful in preventing injuries. And remember to replace your training shoes every six months.

Are you suffering from neck pain? This article Dr Lynch wrote for his column “Staying in the Game”, for the Portland Press Herald, may be helpful. If you are looking for relief from neck pain or other issues, contact Dr Lynch at 207 799 2263 from the info on our contact page.

Neck injuries have recently been in the news when Tiger Woods withdrew for a golf tournament with neck pain and tingling down his right arm. He thought he may have a bulged disc in his neck but an MRI proved that his neck pain was a result of an inflamed joint in his neck. The media is speculating his neck injury may be associated to the November auto accident at his home.

The neck is made up of seven vertebras that are separated by discs and held together by ligaments. Muscles allow for movement of the head and neck.

What makes the neck so vulnerable to injuries is how the neck works. It holds your head, weighs 10-14 pounds. The neck is also highly flexible so you can look up, down and rotate your head.

Collision-type sports like football and hockey have substantial neck injuries. Contact sports like basketball, field hockey, soccer also have a number of neck injuries. Sports where you can fall such as skiing, biking and gymnastics also produce injuries to the neck that are similar to the injuries you would experience in a whiplash-type injury for an auto accident.

The symptoms from a neck injury can be limited to just pain and discomfort in the neck and upper back or more significant symptoms such as pain radiating down your arm. Football players may feel pain shooting down both arms at once which is known as a stinger. Over half of the catastrophic sports injuries occur to the neck and these can result in a fracture to a vertebra and paralysis as a result of an injury to the spinal cord.

Prevention I believe is the key to avoiding long-term damage to your neck. If your sport requires equipment such as a helmet, make sure it fits properly. The same thing applies to a bicycle; it needs to be fitted to you. You also need proper coaching to ensure your technique is correct. Do not lead with your head when making plays. Maintaining flexibility and strength also is essential.

Sometimes neck injuries are unavoidable. The athletic trainer for the Portland Pirates sent me a player who took a hard check into the boards that he was not expecting. He had suffered a whiplash-type injury to his neck. The trainer did an excellent job evaluating and doing initial treatment of ice, heat and massage. After his evaluation we took X-rays to rule out any serious injuries such as fractures. What we did find on the X-ray study was signs of arthritis in his neck. This is very unusual for a fit young man in his 20s. Obviously this is not his first injury of this nature to his neck. Fortunately he responded well to a series of spinal manipulation combined with the fine work of the trainer. This player was instructed on the seriousness of his injury and to avoid this arthritis from advancing he would have to maintain a program of neck strengthening and flexibility long after his hockey career is over.

A fit mother of three woke up with acute neck pain. She denied any recent neck injuries. Following my exam and X-ray study we asked her when she had a whiplash injury. This jogged her memory that she was involved in a car accident 20 years ago and had a sore neck following the accident. The X-rays showed she had a severe degenerating disc. She had no symptoms for years but her neck still suffered from the accident. Today she is managing her neck issues with exercise and stretching with periodic spinal manipulation.

Neck injuries, no matter how minor, should be evaluated by a health care provider to ensure you do not have issues years later.

Dr. Robert Lynch is a former president of the Maine Chiropractic Association and head of the Lynch Chiropractic Center in South Portland. “Staying in the Game” appears every other Thursday in the Press Herald.

Are you suffering from a ribcaage injury? This  article Dr Lynch wrote for his column “Staying in the Game”, for the Portland Press Herald, may be helpful. If you are looking for relief from a ribcage injury or other issues, contact Dr Lynch from the info on this contact page.

The rib cage is made up of 12 pairs of ribs and supports the upper body while protecting the body’s vital organs, including the heart, lungs and blood vessels. The ribs attach to the spine and curve around to the front: seven pairs attach to the breast bone, three pairs attach to cartilage and two sets are called floating ribs.

Injuries to your rib cage are more common than you may believe. The most common injury is caused by a blunt force from a fall, tackle or an object like a ball. The elderly are very prone to rib-cage injuries because the bones and cartilage tend to become more fragile and brittle as we age.

The types of rib injuries you may experience can be a bruise, torn cartilage or fracture. Severe trauma to the rib cage can be life threatening, such as a punctured lung and torn blood vessel. This happened to Drew Bledsoe, the former quarterback of the New England Patriots. He was tackled in a game, causing a tear to a major blood vessel in the chest. This gave Tom Brady a chance to start as quarterback, leading the Patriots to a Super Bowl victory.

The symptom most athletes experience is pain at the site of the injury. Movement of the ribs will increase the pain, as well as laughing, coughing and sneezing. Taking a deep breath can also aggravate the pain. There also can be a grinding or crunching noise.

To properly evaluate the ribs, a thorough history of how the injury happened is essential. This will give the health care provider an idea of the severity of the injury. A physical examination also is required and X-rays may be needed if a fracture is suspected.

Not too long ago I was having lunch with a friend who is an attorney. He and I play tennis, and he is also an avid skier. He started telling me about his daughter, a teenager and an excellent athlete who has been in a ski racing program. He told me she had a fall racing the previous year and had another fall three months ago, landing very hard on her right-upper back.

Her parents brought her to my office for evaluation. She is having chronic pain in the middle of her back and into her right shoulder blade area, with some discomfort in her chest. She also has tingling down her right arm and her last two fingers. Her pain is aggravated when she is bent over studying. Her treatment to date only provided temporary relief.

Our examination found a healthy, fit female athlete. There was muscle spasm and tenderness to the touch in the space between her spine and shoulder blade where her ribs attach to her spine. There also was muscle spasm in her neck. She also had soreness along her breast bone where her rib connects.

I told her parents she had a rib strain and misalignment of the ribs at the attachment of the spine and breast bone and her neck. This made sense to her parents, and I recommended manual manipulation and adjustments to her spine and rib attachments. She was given specific stretching to do at home to enhance the care she was getting at our office. She was very compliant.

This young lady responded remarkable well to our care. Within two weeks she was able to resume her training and sit comfortably in school.

This is an article that Dr Lynch wrote for his column “Staying in the Game”, for the Portland Press Herald. We hope you find it informative. If you are looking for relief for tennis elbow or other issues, you can contact Dr Lynch from the info on this contact page.

The nets are up on the tennis courts. It is now time to get out and play. On a sunny day you will find these courts busy with players enjoying the game they love.

Unlike many team sports, tennis is a game you can play for a lifetime. Plus the whole family can enjoy it together. All you need is a pair of tennis shoes, a racket, a can of balls and someone to hit with.

But remember that tennis players, like athletes of other sports, are susceptible to injuries specific to the nature of the sport. Because you hold the tennis racket in one hand for most of your shots, the elbow is vulnerable to injury.

Tennis elbow is inflammation, soreness and pain on the outside of the elbow region. There can also be a partial tear of the tendons and ligaments of the forearm. Symptoms may include a gradual increase in pain in your elbow, especially when you hit the ball. You may notice pain running down your forearm toward your wrist, or a loss of grip strength.

You might think that hitting a lot of balls would cause the injury, but Jeff Barrett, a teaching tennis pro at Foreside Fitness in Falmouth, notes this is not necessarily true. Pros hit far more balls than recreational players and rarely suffer the injury.

Barrett says the proper alignment of the racket head to the shoulder; elbow, forearm and wrist defuse the force of the impact. Professional players also play with a heavier racket to absorb the impact.

When I am presented with a tennis player with elbow pain, there are many issues that I need to evaluate. Last summer, I saw a high-level female tennis player with elbow pain.

She had the typical signs and symptoms, including pain when hitting the ball. The pain was gradually getting worse but she continued to have good grip strength. The diagnosis was classic tennis elbow. When she noticed the pain coming on, she started to wear a forearm support which offered some relief.

Our treatment plan included ice therapy, stretching, cross friction massage and ultrasound with manipulation to the elbow. She was given specific stretching exercises for her forearm and elbow to do at home. These exercises are designed to lengthen and strengthen the muscles, tendons and ligaments.

We also asked her to bring in her racket, which we found to have too big of a grip. Most professional players are now playing with a smaller grip, which allows the player to generate more spin on the ball while also reducing stress to the forearm.

This patient improved beautifully, but she was still having some issues when she played. One day, I happened to see her playing doubles. I noticed she was constantly hitting the ball late, which puts more pressure on the arm.

On her follow-up visit I told her what I thought was a flaw in her ball striking and suggested she take a lesson from the club teaching pro. She did so, and the stroke flaw was corrected. The remaining issues of her elbow were quickly resolved.