2 min read


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Strengthen Your Ankle Tendons

If you’ve ever rolled your ankle, you have felt that pain along the outside of the foot – it’s sharp, swells up, and makes walking incredibly difficult.

But sometimes pain occurs at the outside ankle area, and you have no idea where it came from. You’ll ask yourself “what did I do to cause that? I didn’t trip, I didn’t fall, and I didn’t roll it.” If you’re experiencing mysterious ankle pain, the peroneal tendons may be to blame.

What Is Ankle Tendon Pain Called?
A peroneal tendinopathy is dysfunction of the peroneal tendon. These tendons connect the peroneal muscles to the outside and base of the foot. They’re responsible for plantar flexion and eversion movements of the foot.

When there’s increased load to the tendon from an increase in running, training, or sports that require significant amounts of sharp movements, function of the peroneal tendon group will be disrupted. Depending on the severity of the tendon irritation, an injury can manifest as inflammation, pain with movement, weakness, and range of motion restriction. This makes getting back to your sport and everyday activities difficult to participate in.

Strong Ankle Tendons

Who Gets It?
This injury is typically seen if you’re a high volume and intense training athlete. It’s also common if you have chronically rolled your ankle(s). Having a history of rolled ankles weakens the supportive ligaments, and stresses the peroneal muscles and tendons that provide structure and protection. This ultimately increases the demand on the peroneal tendons, furthering risk of injury.

The pain tends to be gradual at first, and most people ignore the pain until it becomes chronic and aggravated with common activities like running.

Ankle Tendons

What Can You Do About It?
Education – Don’t Go At It Alone

Like all tendon injuries, it’s important to seek education on load management from your therapist. Your tendons need sufficient time to heal, but this doesn’t mean a full stop in using your muscles. You’ll want a progressive plan focused on regaining full range of motion of the ankle, strength, and stability. That often means knowing what your limits are, respecting limitations, and having a goal specific approach to regaining function.

Manual Therapy

People with a peroneal tendinopathy typically show reduced movement in the joints responsible for eversion of the foot. Your therapist at Myodetox can work on any restrictive muscle and joint that may be contributing to movement restriction and pain.

Exercise Management

Your therapist will work with you and provide the correct exercises to regain your ankle movements. If you’re unable to access a therapist immediately, give some of these exercises a try.

Ankle CARs: Click here to watch the video

Foam Rolling: Click here to watch the video

Strength Training: Click here to watch the video

Stability Training: Click here to watch the video

Ready to take the next step?

Book your session today!

2 min read

Dr. Aimee Anagnostos

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What is Pelvic Floor Physical Therapy?

The less we know about something, the easier it is to ignore. The pelvic floor is a group of muscles with attachments to your pubic bone, tailbone, and pelvis. However, it isn’t something we see everyday (or ever), so many people don’t understand its role in relation to the rest of our bodies.

Before we get into Pelvic Floor Therapy, let’s first understand…

What Is The Pelvic Floor?
The pelvic floor is a general term used to describe a group of muscles, ligaments, and fascia that creates a natural ‘hammock’ for the pelvis.

The functions of the pelvic floor include:

  • Supporting abdominal organs
  • Stabilizing the low back and “core”
  • Controlling bladder and stool function
  • Maintaining positive sexual stimulation

    Pelvic floor issues can include pelvic pain or bowel/ bladder issues. The pain can be described as burning, stinging, painful sitting, and more. Bowel/ bladder dysfunctions include leaking, dribbling, constipation, urgency, and frequency- to name a few.

    Pelvic Floor Physical Therapy

    How Does Pelvic Floor Physical Therapy Help?
    At Myodetox, our Pelvic Floor Physical Therapist will evaluate the extent to which the muscle, nerves, and fascia affect the issue.

    Pelvic Floor Therapy can include;

  • Trigger point release
  • Neural/visceral/ myofascial release
  • Digital biofeedback
  • Soft tissue mobilizations
  • Education
  • Therapeutic exercises, and more.

    This conversation can be difficult to have, but our trained staff empowers you to seek the proper care for pelvic floor dysfunctions.

    Pelvic Floor

    What To Expect At Your First Session
    Seeking pelvic floor therapy can be intimidating. Our hope is that this blog can help you navigate your first Pelvic Floor Physical Therapy Session and make your visit as comfortable as possible.

    Our pelvic physical therapist will gather as much information regarding your condition. Too often we hear that pelvic pain is dismissed. Therefore, it is important to us to create the time and space to understand your pelvic pain. That is why our initial evaluation is 60-minutes long and conducted in a private treatment room for patient privacy.

    Depending on your history and symptoms, our pelvic therapist can perform an external evaluation of the spine, hips, pelvis, and abdomen- an exam which is very similar to an orthopedic physical therapy exam.

    You will then have the option to proceed with an internal pelvic exam. (No spectrum is used, only one gloved finger.) Our pelvic therapist is certified to treat both female pelvic floor and male pelvic floor dysfunctions internally. If consent is given, the therapist may evaluate vaginally or rectally, while explaining the procedure every step of the way.

    After the assessment is complete, the pelvic therapist will explain their findings and what is needed in your future treatments. Your treatment may include visceral mobilization, soft tissue mobilization, trigger point release, stretches, strengthening, breathework, and more.

    We hope this serves to put any hesitancy at ease. If you have further questions you can contact Myodetox Brentwood at (925) 430-6630.

    Interested in trying Pelvic Floor Physical Therapy?

    Book your Complimentary Virtual Consultation

  • 3 min read


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    How to come back from runner’s knee

    Rafael Nadal is a legend in the tennis community. With 22 Grand Slam wins (to date) and many other tennis accolades, Nadal has solidified himself as one of the greatest tennis players of all time (in fact, he was No.1 for 209 weeks!).

    Unfortunately, in 2005 during the Wimbledon final, he suffered a knee injury. This injury wasn’t a tear or dislocation, but it was enough to interfere with his play. His knee troubles continued for years, even forcing him to withdraw from the 2012 US Open. Rafael Nadal has since been able to recover and continue his astonishing career, but it hasn’t been without hard work.

    So what is this knee injury that set him back?

    What Is Runner’s Knee?
    If you’re a runner of any level, you’re likely familiar with “Runner’s Knee.” This condition, medically known as patellofemoral pain syndrome (PFPS), is pain at the front of the knee caused by dysfunctional movement patterns of the patella (i.e. kneecap) and femur (i.e. your thigh bone) that can lead to pain at the patellar tendon (i.e. the thick tendon at the bottom of your knee cap). As you can tell from Rafael Nadal’s injury , PFPS doesn’t only affect runners.

    There are a number of reasons for knee pain, but patellofemoral pain syndrome is the most common. This injury, though common in running, is also seen in sports associated with running, jumping, and other high load demands. People with PFPS are able to reproduce their pain with squats, going up stairs, jumps, and of course – running.

    Runner's Knee

    What Are The Main Causes?
    Everyone’s experience with PFPS is different, but the most common causes are:

  • Overuse injury: this can be an increase in volume, or introducing a challenge to the knee that it may not be ready for (e.g. under training for a challenging run, or hiking for the first time in years)
  • Muscle: deficits like weakness at the quadriceps and hips can contribute to PFPS
  • Injury: previous injuries (e.g. dislocations) can contribute to PFPS
  • Movement Coordination: the joint angle to the knee may stress the tendon, leading to pain.
  • Mobility Impairment: you can be excessive movement or lack flexibility of certain muscle groups, which further contributes to PFPS

    Knee pain

    What Are The Main Signs and Symptoms?
    The signs and symptoms of patellofemoral pain syndrome may not all be applicable to you, but be mindful of the following:

  • Pain with lower leg exercises e.g. cycling, running, weight lifting.
  • Pain with walking, stairs, kneeling, and squatting.
  • Pain at the knee with sitting too long e.g. watching a movie or sitting on a plane.
  • Aggravated pain with increased use e.g. walking or cycling longer distances.

    Who’s At Risk?
    Age can play a big factor when it comes to PFPS. This is typically seen in teenagers and young adults. When we age, problems with the knee tend to be more joint related e.g. arthritis

    Sex differences are also present with PFPS. Unfortunately, women are twice as likely as men to experience PFPS. The common causes of PFPS are often related to women more than men e.g. joint alignment with the hip and muscle imbalances.

    Activity specific – as said before, runner’s knee is commonly seen in sports that involve running, jumping, cutting, and any other sport that stresses the knee.

    What Can Be Done?
    There are a number of things you can do to alleviate pain at the knee. Try these below:

    Foam Rolling helps release your muscles from any myofascial tension caused by poor flexibility, overuse, or muscle weakness. Though temporary in affect, it can be a very helpful tool to use in the rehab arsenal.

    Taping at the knee can temporarily help alleviate pain, especially with movements like getting up and down a chair or a set of stairs.

    Mobility is key to addressing knee pain. This can include dynamic whole body movements, as well as specific stretches to alleviate tension at the knee. Here are some examples of movements that alleviate tension of the quadriceps, hamstrings, hip flexors, glute muscles, and calf.

    Strength training has the highest level of evidence for alleviating “runner’s knee.” This should be incorporated into a rehabilitation and maintenance routine. The research supports exercises that target the quadriceps and hips to facilitate the proper mechanics for the knee. Here are some examples you can try at home: glute bridge, stork, and squat.

    It’s important to note that mobility and strength exercises will serve you best under guidance from a healthcare professional. Even professional athletes and therapists alike benefit from coaching, cues, and progressions for the knee exercises under safe conditions.

    Ready to start managing your Runner’s Knee?
    Though there are many things you can do to immediately help your pain, seeing a healthcare professional sooner rather than later can offset any gaps in treatment. Your therapist will provide the needed guidance for pain management, progressions, and ultimately working with you to help reach your goals.

    Therapists have other tools up their sleeve – manual therapy, gait/movement retraining (biomechanics), blood flow restriction therapy, taping, education Alternate

    It is important to see a licensed healthcare professional if you’re experiencing PFPS. It’s not uncommon for people to push through the pain. Unfortunately, this ends up lengthening your recovery time. By seeing a healthcare provider sooner rather than later, you can prevent any further damage ensure that you’re given the tools to address the causes of your pain and FutureProof your body.

    Find your nearest location

  • 3 min read

    All You Need To Know About Knee Bursitis

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    All You Need To Know About Knee Bursitis

    Knee pain can be the cause of much concern and confusion, especially if you have no idea what’s going on! To help give you a better understanding of pain and swelling in the knee, let’s explain a common condition affecting the area called: knee bursitis.

    So what is bursitis exactly? Often, any swelling of the knee joint is called ‘water on the knee.’ However, there is a difference between fluid accumulation within a bursa specifically, and within the knee joint as a whole.


    A bursa is a thin sac of synovial fluid (the body’s natural lubrication fluid) that is found between muscles, tendons, and skin, and allows these tissues to slide over one another without causing friction. These bursa are found throughout the body, particularly at interfaces where a lot is going on (think shoulders, hips, knees).

    Unfortunately, bursa can sometimes become inflamed and irritated – a condition known as bursitis. As opposed to generalized knee joint swelling, there is a more localized swelling and tenderness with pressure applied in bursitis. Furthermore, as there are up to eleven bursa around the knee, depending on which one is inflamed the location and feeling of pain can vary.

    Bursitis in the knee occurs mostly from overuse injuries and is less frequent due to trauma. The mechanism of injury influences which bursa is affected, with the most common ones being the: pre-patellar, infrapatellar, suprapatellar and pes anserinus bursa (anatomy fun fact: the ‘patella’ is the kneecap).


    Prepatellar bursitis is common in those who kneel a lot (think gardener, roofer, carpet layer), and results in superficial swelling on the front of the knee.

    Infrapatellar Bursitis often occurs in conjunction with ‘jumper’s knee’ (you guessed it, in jumping activities) from repetitive strain and irritation to the tendon just below the patella. This form can cause anterior knee pain that mimics a patellar tendinopathy and can be harder to treat.

    Suprapatellar bursitis causes pain above the patella, under the quadriceps tendon; it is seen following an injury such as a fall to the knee or repetitive microtrauma – think running on soft/uneven surfaces or jobs that require crawling.


    The pes anserinus bursa at the lower inside of the knee is more commonly irritated in middle-aged women and overweight people. Regardless of location, bursitis often results in a knee that is painful to move, has a limited range of motion, and may be swollen/red/warm around the affected area. Symptoms are often worsened with kneeling, crouching or repetitive bending/squatting, and relieved when sitting still and resting.


    To summarize, bursitis in the knee can be caused by direct trauma, biomechanical changes, frequent falls, repeated pressure or repetitive microtrauma to the knee.

    Treatment for mild cases of knee bursitis involves rest and lifestyle management strategies such as weight loss, protection for your knees during work, and changing positions of movement to vary the load from just being on your knee. The use of non-steroidal anti-inflammatory drugs may further assist in decreasing inflammation. Severe cases might require aspiration (removal of fluid via a needle/syringe), the use of a corticosteroid and local anesthetic with appropriate treatment of the surrounding tissue if necessary, as advised a professional.

    As you can imagine, by not treating knee bursitis as soon as possible, this will lead to further irritation. With that, to prevent bursitis of the knee from re-occurring, the cause of inflammation must be found. This involves determining if it is a muscle tightness, leg length discrepancy, training error, or something else that is aggravating the bursa. This might require assessment by a professional to determine the best plan of action to prevent this annoying pain from coming back!

    2 min read

    What Is A Shin Splint?

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    What Is A Shin Splint?

    This article will walk you through some of the causes and symptoms of shin splints, as well as how to recover from it in order to battle this Summer buzz kill!

    Now that the end of Summer is just around the corner (for us Canadians that is), you’ll probably have overused your Summer kicks from all the physical activities this Summer had to offer, especially running activities! It is not uncommon for a lot of beginners to feel pain along the front of their shins. This annoying pain is called shin splints, or medial tibial stress syndrome (MTSS).

    What is a shin splint/Medial Tibial Stress Syndrome (MTSS)?
    Shin splints/MTSS refers to a nagging and dull ache that runs along the inner shin – with potential swelling. Although, often not serious, shin splints can lead to more serious conditions (like stress fractures) if not treated properly – or, by doing too much too soon! This is the reason why a lot of beginner runners tend to “run” into this problem.

    The impact from running creates a lot of repeated stress on our body, and the muscles and bones require time to adapt and rebuild to become stronger. When runners increase their training too quickly, it can cause the muscle and bone to be mechanically overstressed leading to injury.


    Although shin splints are common in runners, it is also frequently found in many who engage in sports activities such as: soccer, basketball, long jump, or tennis. Make sure you progress the frequency, duration, and intensity of your activities gradually to avoid shin splints.

    Causes of Shin splints/Medial Tibial Stress Syndrome (MTSS)


    • Increased foot pronation
    • An abrupt increase in training intensity
    • Hard or inclined running surfaces (or both)
    • Inappropriate or old/inadequate footwear
    • Previous injury
    • Greater internal and external hip ROM

    Sometimes, no matter how hard you try to avoid some injuries, you can’t always run away from those problems.


    Treatments for Shin Splints/ Medial Tibial Stress Syndrome (MTSS)
    There are various treatment options that can be prescribed by your therapist, including:

    • Ice
    • Stretching
    • Strengthening exercises for the legs
    • Graded running program

    How Long Does It Take For Shin Splints To Heal?
    Shin splints is a tricky condition that may linger for weeks or months. Be patient, it can take anywhere between a couple of weeks to 6 months to heal. If you have pain, stop the activity — do not ignore the symptoms because the earlier you receive treatment the faster your shin splints heal!