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Spine West Newsletter
August 2013
Spine West
Our Providers
Michelle Pepper, M.D.
Christopher Morelli, D.O.
Vaheed Sevvom, PA-C

tel:  303.494.7773
fax:  303.494.1104

Good News is Worth Sharing
Dr. John Tobey will be competing in an Ironman race in September.

Several staff at Spine West have passed MRI boards, passed nursing boards, applyied for medical school or physician assistant school. Congratulations Chrystal, Ana, Jackie, Aubrae, Stephanie and Erica!  
Spine West's reputation is built upon trust and "treating patients like family."  Please tell a friend about Spine West to help us promote high quality healthcare.  
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Our Mission

Spine West's mission is to promote health, hope and function, and to prevent injury. 


Don't Let Running Slow You Down

Running couple 




As "external medicine specialists," Physical Medicine and Rehabilitation (PM&R) physicians are uniquely suited to diagnose, treat, and prevent sports-related injuries. In addition to our general medicine education, physiatrists are trained in biomechanics. We evaluate the body as a whole, with all its connected moving parts, not just focusing on the injured area. We look at your unique biomechanics and try to identify the true source of the problem, helping to develop a safe training or rehabilitation program specifically for you.


Some of the most common running-related injuries are:

  • Runner's Knee - This is the most common running injury referred to as patello-femoral pain, and chondromalacia of the patella. It is essentially irritation of the cartilage of the kneecap. While running, various mechanical conditions may predispose runners to a poorly tracking kneecap. This can result in irritation and/or damage to the kneecap. Runners will notice pain near the kneecap, especially after sitting for extended periods of time with knees bent or while walking down stairs or downhill. Appropriate treatment involves eliminating or modifying activities that cause the pain; correcting improper biomechanics that allow the injury to arise; and avoiding positions that further irritate the condition, such as sitting for prolonged periods of time.


  • Iliotibial Band Syndrome - Symptoms of this syndrome include pain or aching on the outside of the knee, usually occurring in the middle or at the end of a run. When you flex and extend your knee, the iliotibial band, which runs along the outside of the thigh, can become irritated from repetitive rubbing over the outside of the knee. There are several causes of this syndrome, including weak butt muscles, bowed legs, over-pronation of the foot, leg length discrepancy, and running on uneven surfaces. Running on a circular track may also contribute to the problem. As with other running injuries, athletes should decrease their training regimen. In addition, they should also add stretches for the outside of their thigh to their warm-up program, avoid running on uneven or circular track surfaces, and some should wear motion control running shoes.


  • Shin Splints - Also called medial tibial stress syndrome, "shin splints" refers to pain occurring in either the front or inside portions of the lower leg. Tenderness extends along the length of the lower leg at either of the surfaces. Those most at risk for shin splints are beginning runners who are not yet used to the stresses of running or who have not stretched or strengthened properly. To care for shin splints, runners should decrease their training, and begin with ice and rest, later adding strengthening of their lower leg muscles. They may use swimming and biking as alternative forms of exercise. If symptoms persist, runners should consult their physicians.


  • Achilles Tendinitis - The Achilles tendon is the connection between the heel and the muscles of the lower leg. Several factors contribute to the development of Achilles tendinitis, including excessive hill running, sudden increases in training, and improper shoes. One of the major factors is excessive tightness of the posterior muscles of the leg, including the calf muscles and the hamstrings. Runners with this condition should reduce their running. They can use ice and gentle stretching to reduce pain and tightness. If not treated properly, Achilles tendinitis can develop into a chronic problem.


  • Heel Pain (Heel Spurs and Plantar Fasciitis) - The most common heel problems are caused by strain of the plantar fascia, which extends from the heel to the toes. Strain in this tissue can become very painful, especially with the first steps of the day. The condition can cause swelling at the origin of the plantar fascia at the heel. The pain is most noticeable when the foot flattens during weightbearing or when pushing off with the toes during walking or running, and it is usually located near the heel. The problems tend to occur in flat, flexible feet and in high arched, stiff feet. Left untreated, the pain can spread around the heel. Treatment should include a decrease in the intensity and duration of running workouts. Runners should also evaluate their running shoes for excessive wear and for proper fit. The wrong shoe for a foot type can worsen biomechanical flaws and cause plantar fasciitis.

Runners can take several precautions to prevent being sidelined because of an injury. They are a good way to keep you on the right track.

  • Prepare for exercise/activities - Understand what muscle groups will be used and slowly start conditioning them by strengthening them. Ensure adequate hydration and nutrition is available before, during, and after. Talk with a PM&R physician to determine the appropriate type of exercises.


  • Properly stretch muscles before running - Muscles and joints need to warm up before beginning a run. Also be sure to allow for a "cooling down" period afterward. Even hot water bottles or heating pads on leg muscles can increase blood flow prior to exercise and prevent injury.


  • Use an appropriate running shoe - There are several brands and models of running shoes. Make sure you are using the type best suited for your feet and your running style, especially if your foot has excess pronation (arch falls inwards). Running shoes should be replaced regularly. Consult a specialty running store to choose an appropriate shoe.


  • Incorporate hard days and easy days into your training program - Mileage should only be increased approximately 10 percent each week. Runners should make sure to decrease their mileage slightly every third week as a way to allow for recovery prior to additional mileage increases. Runners should also be patient with their development, being careful not to push themselves too far or too fast.

Information referenced form aapmr.com


Written by Christopher Morelli, MD


Spine West, PLLC
tel:  303. 494.7773  fax:  303.494.1104
5387 Manhattan Circle, Ste. 200
Boulder, Colorado   80303