Andrea Dowd at Precision Sports Therapy INC

05/21/2026

Hip Pain and Limited Hip Extension? Your Sacrum May Be the Problem

A ‘locked” or poorly moving sacrum can contribute to hip pain and reduced hip extension- especially during walking, running, lunges, deadlifts, hills or explosive movements.

The sacrum, Si joint, pelvis, hip capsule, glutes, psoas, and lumbar spine all work together. If one area stiffens, another area usually compensates.

Common Patterns: When hip extension is limited, people often compensate by:
• Extending through the low back
• Rotating the pelvis
• Overusing hamstrings
• Gripping with the hip flexors
• Compressing the SI joint
This can create:
• Deep buttock pain
• Front-of-hip pinching
• SI joint ache
• Groin tightness
• Low back stiffness
• Pain during the stride or push-off

Common causes:
• SI joint dysfunction: symptoms:
o One-sided low back or buttock pain
o Pain rolling in bed
o Pain standing on one leg
o Feeling “stuck” or asymmetrical

Hip Flexor/ Psoas Tightness
• A tight psoas can pull the pelvis forward and restrict extension

Glute Inhibition
• Weak or delayed glute max activation reduces hip extension power

Hip Capsule Restriction
• Especially anterior capsule tightness

Femoroacetabular Impingement (FAI)
• Can cause pinching at end-range extension or flexion

Lumbar Spine Compensation
If the hip lacks extension, the low back often extends excessively instead
Key Movement Relationship:
Hip extension comes from:
• Glute Max
• Posterior pelvic mobility
• Sacral nutation, counternutation mechanics
• Hip capsule mobility
• Thoracic rotation

If the pelvis and sacrum cannot move well, the hip often “runs out” of extension early.

https://youtu.be/LSprUYhsYD4?si=59xmJeOPdTvxb3lL
https://youtu.be/N0SItAVNIkQ?si=UD37AShKcIgSXD4H
https://youtu.be/o1C6fAGRDME?si=-dv02ubQ6EdsSKGp

05/06/2026

How Flat Feet (Overpronation) Cause Knee Pain — And How to Fix It | Calgary Athletic Therapy
I
f you’re dealing with persistent knee pain, the problem may not actually be your knee. One of the most overlooked causes is flat feet (overpronation)—a biomechanical issue that changes how force travels through your body.
At Precision Sports Therapy, we commonly see knee pain driven by poor foot mechanics, not just local joint dysfunction.

What Is Overpronation?
Overpronation occurs when the arch collapses excessively inwards during walking or running. While some pronation is normal, too much leads to:
• Arch collapse
• Heel rolling inward
• Loss of foot stability
This creates a chain reaction up the leg.

How Flat Feet Affect the Tibia, Fibula, and Knee
When your foot overpronates:
• The tibia internally rotates (inwards)
• The proximal tibiofibular joint (on the outside of the knee) loses optimal mechanics
• The fibular head may become stiff or irritated
This forces the knee into a valgus position (collapsing inward), increasing stress on:
• Patellofemoral joint (kneecap pain)
• Medial knee structures
• ACL (higher injury risk)

Signs Your Foot Mechanics Are Causing Knee Pain
• Knees collapse inward during squats or lunges
• Pain with running, stairs, or prolonged standing
• Flat or collapsing arches under load
• Tight calves or ankle stiffness
• Discomfort near the outside of the knee (fibular head)

Why Most Treatments Fail
If you only treat the knee:
• Symptoms may temporarily improve
• The root cause (foot mechanics) remains
• Pain often returns
Real recovery requires a full kinetic chain approach.
How to Fix Overpronation and Reduce Knee Pain

Effective rehab focuses on:
1. Foot Stability
• Short foot exercises
• Arch control training
• Toe coordination (intrinsics)- opposition toes ( yoga toes)
2. Tibial Control
• Managing internal rotation
• Strengthening lateral lower leg (fibularis muscles)
3. Knee Alignment
• Training the knee to track over the foot
• Reducing valgus collapse ( strengthen gluteus medius)
4. Full Movement Integration
• Squats, lunges, and single-leg control ( make sure foot/ankle doesn't collapse in and ensure glutes are engaged)
• Return to running and sport safely

When to Get Help
If your knee pain isn’t improving, or keeps coming back, it’s time to assess the root cause.
A proper movement assessment can identify:
• Foot instability
• Tibial rotation issues
• Knee tracking dysfunction

04/15/2026

Forward Head Posture, Elevated First Rib & Shoulder Pain: The Hidden Cause of Neck and Shoulder Dysfunction (And how to fix It)

Why This Matters:
If you're dealing with chronic shoulder pain, neck tightness, or poor posture, the root cause may not actually be your shoulder. A common but overlooked issue involves forward head posture, tight anterior scalenes, and an elevated first rib- a combination that disrupts normal movement and leads to persistent discomfort.

The Connection Between Posture, First Rib Dysfunction, and Shoulder Pain

1. Forward Head Posture (FHP)

Forward head posture is one of the most common postural imbalances today: often caused by:
• Prolonged sitting
• Computer and phone use
• Poor ergonomic setup

When the head shifts forward:
• Neck muscles become overactive
• Deep neck stabilizers weaken
• Stress increases on the shoulders and upper back

2. Tight Anterior Scalenes and Neck Muscle Dysfunction:

The anterior scalene muscles play a key role in both neck movement and breathing. When they become tight:
• They elevate the first rib
• Contribute to shallow chest breathing
• Can compress nerves (leading to tingling or numbness)

3. Elevated First Rib: A Hidden Driver of Shoulder Pain:

An elevated first rib can significantly affect shoulder mechanics:
• Restricts the proper movement of the clavicle and scapula
• Alters shoulder blade positioning
• Leads to impingement-like symptoms

4. Shoulder Pain Isn’t Always a Shoulder Problem

Many cases of chronic shoulder pain are caused by:
• Poor rib cage positioning
• Neck Dysfunction
• Altered breathing patterns

Common Symptoms of First Rib and Scalene Dysfunction:

• Pain in the front or top of the shoulder
• Tightness along the side of the neck
• Pain with overhead movements
• Tingling and numbness in the arm
• Difficulty taking a deep breath

How to fix Forward Head Posture, Elevated Rib, and Shoulder Pain

1. Restore First Rib Position
• First Rib mobilization exercises
• Scalene muscle release techniques
• Manual therapy or self-release work

2. Improve Breathing Mechanics:
• 90/90 breathing exercises
• Slow controlled exhales
• Rib cage positioning drills

3 Correct Posture and Strengthen Key Muscles:
• Chin tucks (deep neck flexors)
• Serratus anterior strengthening
• Lower Trapezius strength exercises

What not to do:
• Don’t just stretch your upper traps repeatedly
• Don’t ignore breathing mechanics
• Don’ t treat the shoulder without addressing the neck and ribcage

Daily Routine to Relieve Neck and Shoulder Pain (5-10 mins)
• Breathing reset (2-3 mins)
• Scalene and 1st Rib release (1-2 mins per side)
• Chin Tucks (10-15 reps
• Wall slides with reach (10 reps
Videos:

https://youtu.be/SCQexBR34Ig?si=lAhhELTR3fvvO1-Y
https://youtu.be/0Tt5Pu9yoUs?si=PWW6JhmdNH40L09_
https://youtu.be/iKQ_eWs6rr4?si=VqqEHyWpUonhIyse

04/08/2026

Thoracic Spine Mobility: Fix Poor Posture, Relieve Back Pain & Move Better

The thoracic spine (T-spine) is the middle portion of your spine, located between your neck and lower back. It plays a critical role in rotation, breathing, posture and overall movement efficiency.

Despite its importance, T-spine mobility is often overlooked- leading to back pain, poor posture, and shoulder dysfunction.

Key Functions of the Thoracic Spine:

1. Thoracic Spine Mobility and Rotation:
a. The thoracic spine is designed for rotational movement, which is essential for everyday activities like walking, reaching, as well as sports such as golf, hockey, and baseball.
b. When thoracic mobility is limited, the body compensates by overusing the lower back, increasing the risk of injury.

2. Reducing Lower Back Pain:
a. One of the most important roles of the thoracic spine is to protect the lumbar spine.
b. Poor thoracic mobility can lead to:
i. Chronic lower back pain
ii. Disc injuries
iii. Muscle strains

3. Improving Posture:
a. A stiff thoracic spine often results in:
i. Rounded shoulders
ii. Forward head posture
iii. Increased neck tension

4. Enhancing Shoulder Function:
a. The thoracic spine directly affects shoulder mobility and stability
b. Limited T-spine movement can cause:
i. Shoulder impingement
ii. Rotator Cuff Injuries
iii. Restricted overhead movement

5. Supporting Proper Breathing:
a. The ribs attach to the thoracic spine, making it essential for efficient breathing mechanics.
b. A stiff thoracic spine can:
i. Limit rib expansion
ii. Reduce lung capacity
iii. Lead to shallow breathing patterns

6. Boosting Athletic Performance:
a. The thoracic spines acts as a bridge between the upper and lower body, allowing for effective force transfer.
b. Important for:
i. Lifting
ii. Throwing
iii. Running

What are some signs of Poor Thoracic Spine Mobility:
• Persistent neck or shoulder pain
• Chronic lower back tightness
• Poor Posture (rounded upper back)
• Limited rotation or stiffness
• Difficulty reaching overhead

Exercises to Improve Thoracic Spine Mobility
• Thoracic Extensions over a foam roller
• Open book rotation
• Cat-Cow stretches
• Wall Rotations

Try these exercises:

youtube.com/watch?v=R0UwVZdqgTs&time_continue=4&source_ve_path=NzY3NTg&embeds_referring_euri=https%3A%2F%2Fprecisionst.ca%2F

03/26/2026

Tension Headaches Explained; common Causes, Key Muscles Involved, and Proven Rehab Strategies.

Tension headaches are the most common type of headache, often described as a dull, tight pressure around the head. If you’re dealing with recurring symptoms, understanding the root causes, muscle involvement and targeted rehab strategies is essential for long-term relief- not just temporary fixes.

What Causes Tension Headaches?

1. Stress and Anxiety:
a. Emotional stress increases muscle tone in the neck and shoulders
b. Leads to sustained contraction and reduced blood flow

2. Poor Posture:
a. Common in desk workers and phone users
b. Places a constant load on neck muscles

3. Prolonged Sitting and Screen Time
a. Static positions fatigue postural muscles
b. Reduced movement=increased stiffness

4. Sleep Issues:
a. Poor pillow support or sleep position leads to overnight muscle strain

Key Muscles Involved in Tension Headaches

Tension headaches are largely musculoskeletal in origin, especially involving the neck and upper shoulders

1. Upper Trapezius-
a. Elevates shoulders and stabilizes neck
b. Commonly overactive with stress and poor posture

2. Levator Scapulae
a. Connects neck to shoulder blade
b. Tightness creates stiffness and pain into the nek and head

3. Suboccipital Muscles:
a. Small Muscles at the base of the skull
b. Major contributor to base of skull headaches

4. Sternocleidomastoid (SCM); causes dizziness
a. Large neck muscle running from the collar bone to skull

b. Can refer pain into the forehead, temples and behind the eyes
5. Temporalis & Masseter (jaw)
a. Involved in chewing and clenching
b. Common source of temple headaches

Why Do These Muscles Cause Headaches

When these muscles become:
• Tight
• Overworked
• Fatigued
They develop trigger points that refer pain into the head, creating the classic tension headache pattern.

Best Rehab Strategies for Tension Headaches

To fix tension headaches, you need a 3-part approach:
• Reduce muscle tension
• Restore mobility
• Improve strength and posture

Mobility and Release Work

1. Suboccipital Release:
a. Use a lacrosse ball or a peanut at the base of the skull
b. Gently nod “yes” to release tension

2. Neck Extension over the bed
a. Lying on back, supporting head, with shoulders over bed- slowly lower head back as far as can go
b. Rotate head to the right and left 3x’s each side (make sure neck is relaxed)- then let the head extend further back- do this 3 sets each time extending head backward over the bed

3. Upper Trap Stretch w band; Hold 10 sec x 2
a. Band attached to something, grab onto the band and move away from the attachment site
b. Take the opposite ear to your shoulder- then take your hand and bring the ear closer to your shoulder

4. Levator Scapula Stretch w band:
a. Band attached to something, grab the band and move away from the attachment site
b. Turn your head 45 degrees and look down, place your head on your hand and slowly move your head further down

5. SCM Stretch w band:
a. Look up to the ceiling, rotate and then tilt the neck to the opposite shoulder

Postural Correction Exercises

1. Chin Tucks
a. On back, pull chin straight back- this will activate the deep neck flexors

2. Wall Posture Holds- helps with forward head posture
a. Back against the wall, shoulders against the wall
b. Retract your chin in and push your neck into the wall- reinforces proper alignment

Strengthening (Long Term Fix)
• Rows
• Banded pull-apart
• Y/T/W’s
• Neck retraction with a band- helps with forward head posture
• Scapula protraction and retraction

Bottom Line:
Tension headaches are usually caused by muscle overload, poor posture, and stress related tension. The key muscles- like the upper trapezius, suboccipital, and jaw muscles – can refer pain into the head when over worked.

Video Demonstration:

https://youtu.be/wDUGZ3sqCNA

03/18/2026

Sciatica Relief Guide: Causes, Symptoms, and Proven Exercises to Eliminate Nerve Pain Fast

What is Sciatica? (Complete Guide)

Sciatica refers to pain caused by irritation or compression of the sciatic nerve, which runs from your lower back through the hips and down each leg. It’s not a condition itself, but a symptom of an underlying issue or surrounding tissues

Sciatica Symptoms: How to Know if You Have it

Common signs of sciatica include:
• Sharp, burning, or shooting pain down one leg
• Pain starting in the lower back or glutes
• Tingling or numbness in the leg or foot
• Muscle weakness in more advanced cases
• A key indicator: the pain travels below the knee, often in a specific nerve-like pattern

What Causes Sciatica

• Lumbar disc herniation (most frequent)
• Spinal Stenosis
• Degenerative disc disease
• Piriformis syndrome
• Prolonged sitting and poor movement mechanics

Best Sciatica Treatments

1. Stay Active- Avoid Bed Rest: movement helps reduce nerve sensitivity and improve recovery
a. Short, frequent walks
b. Avoid sitting for longer than 30-45 mins

2. Find Your Directional Preference:
a. Extension (back bending) helpful for disc related sciatica- cobra/ McKenzie technique
b. Flexion (forward bending) helpful for stenosis

Goal is to move the pain out of the leg and back into the spine

Top Exercises for Sciatica Relief: Start with low-impact exercises

1. Prone Press up- McKenzie Extensions
2. Sciatic Nerve Glides (gentle sliders not stretches)
3. Glut Strengthening (bridges, clamshells)
4. Core stability (bird dogs, dead bugs)

What to Avoid:
• Aggressive Hamstring Stretches
• Prolonged sitting and slouched posture
• Heavy lifting with poor mechanics

Pain Relief Options:
• Heat or ice depending on the preference
• Anti-inflammatory medications (ibuprofen- if applicable)

When to See a Professional:
• Pain persists longer than 4-6 weeks
• Progressive weakness develops
• Symptoms worsen significantly
• You experience bowel or bladder changes (Cauda equina Syndrome)

Video Demonstration of Exercises:

https://youtube.com/shorts/Z-GrhAAeYgc?si=wWUUjrpoS7npTh0h

03/10/2026

The Hidden Link Between Your Big Toe and Glute Medius: Why Foot Function Matters for Hip Stability?

Many people think that hip pain and foot problems are separate issues, but the body doesn’t work that way. In reality, your big toe and glute medius are closely connected through the lower limb kinetic chain.

If the big toe is stiff, weak or painful, it can significantly affect hip stability, walking mechanics, and even lead to lateral hip pain.

Understanding this relationship is crucial for treating common conditions like hip pain, knee valgus and foot disorders.

How the Big Toe Influences Hip Stability

The glute medius is one of the most important muscles for pelvic stability and single-leg balance. It prevents the pelvis from dropping when you run, walk or stand on one leg.

However, the glute medius relies heavily on a stable foot, especially the big toe, to do its job effectively.

The big toe plays a critical role in the propulsive phase of GAIT, also known as toe-off.

When the big toe extends during walking;
• The plantar fascia tightens
• The arch lifts
• The foot becomes rigid for push off
• The leg stabilizes for efficient hip function

The above process is known as the Windlass Mechanism. When this mechanism works well, it creates a stable foundation that allows the glute medius to control the pelvis efficiently.

What Happens When the Big Toe doesn’t Move Well?

When the big toe mobility is limited or painful, the entire lower limb must compensate. Conditions such as Hallux Rigidus and Hallux Valgus can reduce the ability of the big toe to extend during walking and running. This leads to several biomechanical changes:
• Collapse of medial arch
• Increased tibial internal rotation
• Femoral internal rotation and knee valgus
• Reduced efficiency of the glute medius

As a result, the glute medius must work harder to stabilize the pelvis, which can contribute to:
• Lateral hip pain
• IT band irritation
• Knee pain
• Poor single-leg stability

The Reverse Relationship: Weak Glute Medius can affect the Big Toe

When the Gluteus Medius is weak or poorly coordinated:
• The femur moves into internal rotation and adduction
• The knee collapses inwards
• The foot overpronates
• Excess pressure shifts onto the big toe joint

Over time, this increased stress can contribute to conditions such as Hallux Rigidis and Hallux Valgus. This is why we need to address the foot and hip.

Clinical Signs of Big Toe- Glute Medius Dysfunction

We often see this in patients who have:
• Weak glute medius strength
• Poor big toe extension
• Difficulty maintaining foot tripod stability
• Knee collapse during squats or lunges
• Hip drop during walking or running

When these signs co-occur, addressing both foot mechanics and hip stability is essential.

Big Toe and Foot Strength:
• Big Toe extension mobility drills
• Short foot exercises
• Toe Yoga

Hip Stability Exercises:
• Side lying hip abduction
• Single-legged Romanian deadlifts
• Lateral step downs
• Single leg balance training

Video Link to Exercise Demonstrations:

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

03/03/2026

Big Toe Pain During Walking and Running

If you have big toe pain while walking, or pushing off during running, your GAIT mechanics may be altered. One of the most common causes of pain at the base of the big toe is Hallux rigidus (a stiff big toe). This condition affects the first metatarsophalangeal (1st MTP) joint, it changes toe off during GAIT.

Why Toe-Off Matters in Walking and Running:
During normal gait, the body needs:
• 50-60 degrees of big toe extension (Big toe bends backwards)
• Stable 1st ray loading
• Activation of the windlass mechanism
• Efficient push off through the hallux (big toe)
If the process is disrupted, you may experience:
• Foot pain when pushing off
• Transfer pain to the 2nd toe
• Plantar Fasciitis
• Achilles tightness
• Knee or hip pain
Toe off dysfunction doesn’t just affect the foot; it affects the entire kinetic chain

Hallux Rigidus: Stiff Big Toe and Loss of Propulsion

Hallux rigidus is a form of 1st MTP joint arthritis that limits toe extension.

What Happens During GAIT?
Because the big toe cannot bend properly:
• Early Heel rise occurs
• Push-off shifts to the lateral forefoot
• Step length shortens
• Propulsive power decreases
• You may develop calluses under the 2nd metatarsal
Patients often describe:
• Foot pain when walking uphill
• Sharp pain when pushing off
• Stiff big toe in the morning

Best Rehab for Hallux Rigidus (stiff big toe treatment)

1. Restore Mobility:
a. Focus on short foot exercises (medial bias)
i. Stand barefoot and establish 3 pts of contact- heel, big toe and little toe
ii. Now shift awareness to the big toe, and shorten the foot (without curling the toes)
iii. Gently draw the ball of the foot towards the heel
iv. Add medial activation by lightly pressing the big toe into the floor, think load the inside of the foot and slightly shift pressure towards the 1st ray
v. Progression- seated, standing, single legged, dynamic integration (squat, lunge etc.)
b. Resisted hallux press down
c. Controlled heel raises with big toe extension
d. Big toe abduction
e. Piano Keys
f. Shockwave the big toe extensor
2. Offload the joint
a. Use Rocker bottom shoes- these shoes are designed with a curved sole that allows the foot to ‘roll” forward during walking and running instead of bending at the forefoot
i. The big toe doesn’t need to extend 50-60 degrees during toe off, the curved sole help moves the body forward
ii. Example- HOKA Women speed goat 6, HOKA Men’s Challenger 8- these have a rocker type sole geometry- aids GAIT transition and smooths the roll from impact to toe-off. These are not the same as medical rocker-bottom shoe (which completely bypass big toe extension)
b. Metatarsal pads- place under the metatarsal head so that the big toe doesn’t have to extend fully to 50-6- degrees

Why Big Toe Dysfunction Causes Knee, Hip and Back Pain:

If the toe-off mechanics are altered, you may see.
• Increased tibial rotation stress
• Medial knee overload
• Hip flexor overuse
• Reduced Hip extension
• Low back strains

Video Demonstration:

https://youtube.com/shorts/R8rhRGUf5uM?feature=share

02/24/2026

Severe Back Pain for Constipation? Causes, Symptoms, Treatment for Lower Back Relief.

If you’re dealing with constipation and lower back pain at the same time, you’re not imagining the connection.

Constipation can absolutely cause severe low back pain, sacral pressure, hip discomfort, and even symptoms that mimic sciatica. Understanding how the gut and spine interact can help you identify the true source of your pain- and treat it effectively.

How Constipation Causes Severe Low Back Pain:
• It can cause:
o Deep aching in the lower back
o Sacral pressure
o Pain in the hips and glutes
o Pain that radiates down the back of the leg
o Increased back pain with straining
o In some cases, it can feel like a disc bulge or sciatica

Why Constipation Causes Low Back Pain:

1. Re**al Distension and Sacral Nerve Irritation:
a. Excess stool accumulation can irritate the sacral nerves S2-4, create deep aching across the sacrum, and refer pain into the hip and buttocks
b. The re**um and sigmoid colon share nerve pathways with the lower spine.

2. Increased Intra-Abdominal Pressure:
a. When constipated, people often:
i. Strain during bowel movements
ii. Hold their breath ( Valsalva maneuver)
iii. Brace their abdominal wall excessively

The above increases the intra- abdominal pressure, which:
o Compresses lumbar discs
o Loads facet joints
o Aggravates existing disc bulges

3. Psoas Tightness and Pelvic Floor Dysfunction:
o Compresses lumbar discs
o Loads facet joints
o Aggravates existing disc bulges

Chronic Constipation is frequently associated with:
o Pelvic Floor tightness
o Overactive hip flexors
o Abdominal Wall guarding

• The psoas attaches directly to the lumbar spine. When it becomes tight or overactive, it can:
o Increase lumbar compression
o Pull the spine into extension
o Cause one-sided low back pain
• Pelvic floor dysfunction can also create a closed pressure system in the pelvis, amplifying both constipation and low back pain

4. F***l Impaction and Nerve Compression:
a. In severe constipation, hardened stool can cause f***l impaction. This may:
i. Compress nearby nerves
ii. Cause radiating pain
iii. Produce numbness or tingling in the legs

Symptoms may resemble sciatica or lumbar nerve irritation

Symptoms That Suggest Constipation is Causing Your Back Pain, if you experience ny of the following:
• Pressure in the sacrum
• Difficulty passing stool
• Abdominal bloating
• Back pain that improves after a bowel movement
• Pain not clearly worsened by bending or lifting

How to relieve Constipation and Lower Back Pain:

1. Address the Constipation:
a. Increase fibre gradually
b. Improve Hydration
c. Stool Softener
d. Walk daily to stimulate the bowel
e. Avoid Excessive Straining
f. Use a proper toilet posture- hips flexed, feet elevated

2. Reduce Pelvic and Lumbar Tension:
a. Gentle diaphragmatic breathing
b. Pelvic Floor relaxation drills
c. Hip flexor mobility work
• Lumbar decompression positions

3. Restore Normal Abdominal Pressure;
a. Avoid chronic bracing
b. Train coordinated breathing during lifting
c. Improve core function without over-tightening

02/17/2026

Laura has completed her debut at the Olympics. It’s now time for Daniel to shine. This guy works hard, and pushes himself past the point of pain. Remember that name Daniel Hall over the next week, he races the 1500 m on thrus at 8:20 am and then the Mass start on Sat at 6:30 am. He has been enjoying time at the village, but also has been training hard prior to to his debut on Thrus. Go Daniel Hall- Go team 🇨🇦