Friday, June 29, 2012

Fascia Fitness Friday: Break Out of Your Pattern

Most athletes tend to gravitate to a particular type of training.  Runners run, swimmers swim, bikers bike and lifters lift.  Some even combine them and call it "cross training."

What you have is a pattern.  Pattern is important to develop, we call this movement memory, or muscle memory.  Athletes train for decades to hone their movement.  To make it effortless.  To know that it takes them 42 strides to run a 100 meter.  To carry a 95rpm cadence on the bike, hour after hour.   Pattern.

The cost of this efficiency can be the fascial health of their body.  Fascia likes big movements that allow all the muscular chains to be involved.  It doesn't like repetitive activity.  It likes variation in tempo, duration and intensity.  Right now as I type, sitting in a chair, my fascial health is not improving.

Runners should do bear crawls, swimmers should trail run, lifters should play soccer, bikers should play some beach volleyball.  They should all jump, climb, crawl and throw things.  Their fascia will be healthier and in the end they may have found that the pattern they have worked all these years to develop actually improves.  That is some "cross training."

Tuesday, June 26, 2012

Small Overlooked Muscles: Pyramidalis for Adductor and Abdominal Pain

The Pyramidalis is a very small triangular shaped muscle that originates off the pubic crest.  Its function is to tense the linea alba.  The line alba is the line in the rectus abdominis.

Fascially, this muscle I believe holds important tension relationships between the adductor fascia and the abdominal fascia.

It is essentially a crossroads between the opposite adductor and the opposite oblique muscles.  This is sometimes referred as the anterior oblique system.

Find your belly button.  Slowly palpate lower until you hit bone.  You will be on the pubic crest.  Slowly rub back and forth.  One side is usually more tender.  This would be the one to target.  This muscle can play a contributing factor to pubic area pain, abdominal pain and groin pain.  Hockey and soccer players will often present with this.

I usually have the patient or athlete do this on their own as it's in a pretty sensitive area.

Friday, June 22, 2012

Fascia Fitness Friday: The Recipe for Healthy Movement

Here is the recipe I use.  Pinch of this, pinch of that.  I do believe in the order.  The quantity of each ingredient is up to you.  (I do use chiropractic adjustments, but that wouldn't work for home care.)

1.  Muscle Release Work.  I use A.R.T.   Any soft tissue work will do.  You can use a foam roller for self use.  The principle here is tissue quality.

2.  Long Myofascial Chain Stretches.  For example, if you just did work with the quads, I suggest you stretch the whole frontal chain on that side.  A little anatomy trains knowledge is helpful.  (see Thomas Meyers)  The principle is length.

3.  Activation.  I use M.A.T.  Essentially, Muscle Activation Technique uses low grade isometrics to make sure a muscle can contract fast.  The principle is facilitation.

4.  Strength/Power.  Bodyweight movements.  Squat, lunges, push ups, chin ups ect.  This doesn't have to be bodyweight either.  Just easier patient homework to give.  This is tempo driven.  Beginners would start with a slower tempo.  4 second eccentric, pause, 2 second concentric as an example.  A more advance athlete may be given a fast tempo.  The principle is Strength Expression.

There you go.  Play around.   Train Out Pain Chiropractic Myofascial Health Recipe.

Thursday, June 21, 2012

Random Thoughts and Readings this Week

I get the question asked of me frequently of what side I fall on the barefoot or "normal" running shoe debate.  I find this way of thinking fascinating.  First, it makes an assumption there is a correct answer.  I don't think there is one.  If you have wore an orthotic and a reinforced brick on your feet for 20 years, only occasionally jog,  common sense says, don't go buy a minimalist shoe and run.  Perhaps walk.  For many months.  You are unique.  I personally use an orthotic and wear "minimalist shoes." (not together)

(why if they are minimalist, and they really do have nothing to them, do they cost the same or more then other shoes?)

Here is an article talking about perhaps the same concept that not everyone is supposed to run with a forefoot strike.  Journal of Ankle Research.    This dives into energy efficiency, hind strike is more energy efficient.  Forefoot is faster.

For the record, I hate the Merrill version.  I feel like I'm walking on my heels.  When I'm barefoot, I do not.

This pretty much sums up the basics of "Philosophy of Sprint."  Simple, but the meanings behind each takes years of study and dedication to master.

I like Charlie Weingroffs idea of Boyles joint by joint approach where he sees stable segments moving on top of mobile segments.  This makes sense to me.  Muscles have main jobs, brakes and gas pedals.  The ones that propel and the ones that stabilize.  Nothing new here, just more clarity.

I've continued to use the diaphragmatic breath at end ranges of motion, either with A.R.T. in office or with specific exercises I give my patients/athletes.  I'm liking the results.

If I had to sum up the fascial chains for runners.  Keep the back side strong, calves, hamstrings, butt muscles (all).  Keep the front side loose.  Tib Anterior, quad group, psoas(all hip flexors).  You will run more efficiently and have much less chance to get injured.

Tuesday, June 19, 2012

Small Overlooked Muscles: Popliteus for Knee Pain

This weeks continuation of small but important muscles that can create unusual pain is the Popliteus.  This small muscle is a triangular shape that is on the back of the knee.  From the picture you can see it has attachments on the tibia, the fibula and also onto the lateral meniscus.  Fascially it sends strips into the arcuate popliteal ligament.

Functionally, its action is to "unlock" the knee.  When the foot is on the ground as in walking and running, it laterally rotates the femur to allow flexion to happen.  It's a very weak flexor.  With the thigh fixed, leg free to move, it rotates the tibia medially.  (think sitting)  It's also a big player in keeping the femur from tracking over the tibial plateau when weight bearing.

I have found a lot of knee pain can occur when this muscle is tight that will mimic a lateral meniscus sprain.  It is usually more present with running downhill or going downstairs.  It's also a player when a patient/athlete can't quite achieve full leg extension.  They usually don't even realize they have lost this last 5-10 degrees of motion.

We are born with lots of muscle spindles in this muscle.  This means the brain is using this muscle to let it know what the knee joint is doing in space.   I believe if it's tight, we lose some of this kinesthesia for the joint.

Females need to get out of high heels when this is tight.  Essentially you are walking downhill with each step.  This will just aggregate symptoms.

If you back of the knee pain that gets worse with downhill type activities think Popliteus.

Thursday, June 14, 2012

Great Idea: Impact Kids Class

We always hear about how the kids today are getting fatter and weaker. Here is a great looking program that is actually doing something about it. Come to think of it, how many of us as adults, have done something even close to this lately?

Tuesday, June 12, 2012

Small Overlooked Muscles: Anconeus for Elbow Pain

Once a week, for the next few weeks, I am going to highlight one small muscle that is often overlooked in treatment for pain and body dysfunction. I have found, through clinical practice, these muscles can have big dividends in return to play/life pain free.

I guess my definition of small and overlooked is a muscle you don't target to train in the weight room. The first muscle I'm targeting is the Anconeus. Whens last time you've heard, "I'm training my Anconeus today."

I call this muscle the triceps little helper. It has attachments on the lateral epicondyle and the olecrenon of the ulna. Like the triceps, it helps to extend the elbow, but I believe this is a very minor roll.

It, along with the medial triceps head and supinator, helps stabilize the elbow in pronation and supination. It accomplishes this by abducting the ulna in pronation. EMG has revealed that it contracts with all index finger movement.

Another crucial role, with elbow extension, it pulls on the joint capsule to keep it from getting pinched. (Things that can alter joint capsules, I'm starting to believe have more important roll in pain management. Muscles that stabilize, as other things move, I think also have a vital roll.)

If you are dealing with lateral elbow pain as therapist or athlete, don't forget this muscle. Small, but important.

-train out pain and train in performance!

Thursday, June 7, 2012

Simple Explanation of Morton's Neuroma

I recently had the chance to have a few long conversations with a podiatrist that is pretty famous in my area of Grand Rapids, MI.  He long ago quit doing surgeries in favor of adjusting the bones of the feet to provide "long lasting relief."

He said it came from doing "to many surgeries for a bunion or neuroma and seeing it come back a few years later."

His explanation for how he thinks a neuroma develops is one of the best I've heard.  My personal understanding was that the common neuroma between the 3rd and 4th digit of the metatarsal was from the compression that happened from a tight toe box in a shoe.  He extrapolated on this concept.

When the cuboid bone becomes misaligned, the foot on impact can no longer lock the lateral line of the foot for stability on impact.  This allows for the foot to actually increase the degree of pronation that occurs.  Now, because of this the metatarsal bones rotate.  The lateral 2 rotate laterally, the medial three rotate medially.  With this the plantar nerve is put under quite a stretch, thus irritating it.

Your body has an ingenious way of protecting itself.  It grows a protective coating.  Picture, scraping your hand every day.  What happens?  A callous forms.  Irritate the plantar nerve with each step, a callous will start to form around that structure.  You get a Morton's Neuroma.

Tuesday, June 5, 2012

Monday, June 4, 2012

Monday Motivation: Marco and Paulo from Cirque du Soleil

I had a chance to see Cirque De Soleil: Quidam this past Saturday. The two strongman never fail to leave me in awe. The movement at around 3:50 till the end is mind blowing!