Category Archives: Injuries

Correcting some movement impairments

http://youtu.be/0TXZX1_ILeA

I've been having a bunch of uncomfortable muscle pain recently: a tight spot mid-spine; some numbness still in my arms; and occasionally my hip flexors are SO over worked that standing up causes serious muscle spasms in my butt. Or my hip flexor along the front of my pelvis hurts so badly I don't want to sit or lie down with my legs bent.

I look a little bit like Frankenstein.

Remarkably, I took the course to learn all about this several years: NASM's Corrective Exercise Training course. Haven't used what I learned in a while, so I pulled out the book to put myself through the assessment.

It's not very complicated: photograph your regular standing posture, looking to see if everything is line. Then video overhead squats from the front, side and back to see how my body moves. I linked to a movement assessment I did a few years ago as an example. (pre-hip replacement).

The theory here is that because of likely injury or overuse, I developed poor (compensating) movement habits:

-spend a lot of time on computers, knitting, walking dogs… anything that requires the arms to be forward of the body will make the pecs tight and the latts lazy.

Stop doing the rehab exercises on the replacement hip and weaknesses set back in.

My Assessment:

STATIC POSTURE: My left shoulder and right hip are slightly high giving me a slightly wonky appearance. My back arches slightly and arms are falling slightly forward.

DYNAMIC POSTURE: My right leg moves out -my left leg does too only less. And my arms fall forward during the movement. My hips don't break when they should so my arms fall forward. From the back, there is a slight shift of my weight to the right.

WHAT THIS MEANS: The arms falling forward indicate tight pecs and underactive latts. The slight shift to the right means the muscles on the right side are compensating for weakness on the left.

Likely overactive muscles: The piriformis (left side), TFL/Glute Min on the left side, pecs. These muscles need slow steady foam rolling and probably some lacrosse ball work every day for about a month.

Underactive Muscles: Adductors, Hamstring, Glute Max, Anterior Tibialis, Erector Spinae, Lattimus Dorsi. These muscles need to be stretched and strengthened with a planned program about 5 times a week for the same month. Then the movement assessment repeated and compared to the assessment from today.

So I know what I'll be doing work-out wise for the next few weeks.

 

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DOMS:That “ouch I exercised” ache…


image from http://www.flickr.com/people/missahomespun_naturesdaughter/

Yesterday you changed up your routine – adding some weight and some new exercises to your routine- and this morning you’re body you’re definitely feeling it.  The muscles you worked are sore; even muscles you didn’t think you HAD are sore.

Welcome to the wonderful world of DOMS.

DOMS – or Delayed Onset Muscle Soreness- is that pain you feel one to three days after you’ve exercised.  It normally occurs when:

  1. you’ve just begun an exercise routine;
  2. you’ve increased the intensity;
  3. you’ve added new exercises;
  4. you overlooked a proper warm up or cool down.

While traditionally DOMS was explained as an excess building of lactic acid causing the discomfort,  recently it’s been discovered that the same micro-tears that occur to make a muscle stronger cause DOMS. 

Let me explain:

When we begin a new exercise routine -either new  all together or simply switch up what we’ve been doing- the increased demand causes tiny micro tears in the muscle fibers.  These tears- when repaired-make the muscle stronger.  But while they are in the process of repair, we feel the pain.

First a chemical is released into the blood stream that draws white blood cells to the damaged area.  These blood cells clean out each damaged muscle cell, creating free radicals while they do, which add to the destruction of the cells.  This creates swelling and inflammation on a cellular level that we perceive as pain. 

This pain will continue until the tears are completely healed – a process that can take 24-72 hours to accomplish depending on the quality of our sleep and the amount of rest we get during the day.

It’s interesting to note that most DOMS seems to be caused by the eccentric (negative) movement.  So slowly lowering weight against the force of gravity is a move that will more frequently create this delayed pain. 

This will be an important consideration when I look at  ways to cope with DOMS or to limit its impact all together.

March in like a Lionness

… Perhaps not really marching, but looking at the calendar, I couldn’t resist using the phrase.

I woke up this morning eager to be moving.  However, my achy hip is still limiting my ability to move much.  But this morning I had plan.  I headed to the gym about 8:15 am, walked past all the cardio machines (each one taken), headed downstairs to the locker room.  Once there, I stripped off my street clothes, down to the swim suit I had pulled on at home.  Then I padded my way to the pool.

The pool wasn’t quite as crowded as the cardio section upstairs.  I quietly eased myself down into the heated water (though not THAT heated) and started walking.  I kept on walking for the next 20 minutes. Something I have rarely been able to do since the middle of December.

I wouldn’t call it a highly aerobic workout.  Not that I could have moved any faster – when you’re neck deep in water the resistance is significant.  Not to mention that I was bouyant!  Most of the length, my toes were the only thing touching the bottom.

I will have to remember that this is a legitimate rehab option to keep in my bag of tricks.

Foam Rolling-Part One:What’s It All About?

Man foam rollingFoam rolling is professionally known as Self-Myofacial Release.  It’s designed to allow your fascia to work without impairment.  But what exactly are fascia? The easiest way I can explain it is to have you imagine that each muscle comes with it’s own condom.  You want this condom to contain, not be too tight, and slide appropriately when its muscle moves.  THAT is the role of the fascia.

Self-Myofacial Release -foam rolling-is a technique to keep this “muscle condom” working in perfect order.  A simple explanation: using a tool to massage the fascia covering a muscle group.  Often that tool is a 6″ round foam tube, though PVC piping, balls, rolling pins, water bottles, and specialized tools can be used too.

This fascial massage:

  • Improves ROM by removing adhesions, reducing tension / tightness and neurological inefficiencies, and passively lengthening the muscle.
  • Used in conjunction with stretching protocols can improve muscle length, flexibility and mobility
  • Improves recovery and helps relieve the effect of DOMS

First point: It increases RANGE OF MOTION.

While we’re inactive- sleeping or spending too many hours working at a computer- our fascia relaxes, and small fibers of “fuzz” grows between them.  If we stretch completely when we get back up, this fuzz can easily be broken down again.  However, if we don’t move our muscles through their full range of motion, that fuzz remains.  And grows.

Eventually these fuzzy fibers stick together making a small “knot” of fuzz.  This knot may make a movement painful- restricting your range of movement.  Now think about when you’ve seen a wool sweater that has been thrown in the washing machine.  The fibers tangle among themselves becoming tighter and smaller.  The sweater shrinks and eventually -if enough heat and cold and agitation is present-becomes felt.

The same thing happens to the fuzz that grows between myofascia.

If we attack this fuzz when it’s light and thin, it’s easy to get rid of.  A thorough stretch before we get out of bed will help.  And foam rolling once a day will go even further to break down some of the “felted” knots we’ve developed over the years.

Like wool fibers, fascia runs in one direction: the direction in which the muscle moves.  Slightly injure a spot on a muscle and the fibers in that spot will realign themselves in different directions to protect those muscle fibers while they heal much like a patch on bicycle tube.  Afterward, we must work to break down this patch -by stretching to the point of tightness, relaxing and working for greater range of motion.  Foam rolling helps things along by encouraging the fascial fibers to realign themselves- once again moving in the direction of muscle fiber movement.

Oh, if only we could do the same thing with our ruined sweaters!

Recovering

I’ve been really quiet lately with several things on my plate that kept me from posting much.

  1. I came home from BlogHer in early August with a hella head cold.  Took a lot out of me for a couple weeks.  About the time I was starting to feel better,
  2. I flew to Denver for my brother’s wedding.  Nothing happened, but it pulled my attention in a different direction.  And I still had a “throat tickle” cough left over from the cold.
  3. Now I’m figuring that the cough was more allergy than anything.  And my doctor agreed when I saw her for a
  4. Pre-Op visit.  Because a week ago I finally had some simple repair done on my damaged shoulder.  It was a simple surgery -short and sweet- where they cleaned up some bone spurs to make things slide a bit more easily in the shoulder.
  5. Then several days of pain meds (hello tylenol and codeine) that left me barely able to communicate well.

I’m healing now and hope to get back on the blogging horse right quickly.  In about a month to 6 weeks I should get the OK to start lifting again and then my mojo will definitely kick in. (crosses fingers)

Learning about the Rotator Cuff.

Last week, I finally decided to schedule my surgery.  Hopefully the end of October I will have my shoulder repaired.  Week by week it’s been getting more painful; I’ve been taking more pain meds.  I can’t ignore it any longer.

Last December, while flying home from Vegas, a kind gentleman helped me put my suitcase in the overhead bin.  But when he assisted me by taking the case out of my right arm, I tore several tendons.  From the latest MRI, I have a full thickness tear (a hole) in the labrum tendon, a partial thickness to full thickness tear (pinhole) of the superspinitus, and a partial tear of the bicep tendon.

As explained here:

The labrum is a rim of soft tissue that makes the socket more like a cup. The labrum turns the flat surface of the glenoid into a deeper socket that molds to fit the head of the humerus.

The soft labral tissue can be caught between the glenoid and the humerus. When this happens, the labrum may start to tear. If the tear gets worse, it may become a flap of tissue that can move in and out of the joint, getting caught between the head of the humerus and the glenoid. The flap can cause pain and catching when you move your shoulder. Several tendons and ligaments attach to the labrum that help maintain the stability of the shoulder. So when the labrum tears, the shoulder often becomes much less stable.

In the image above, you can see that the bicep tendon lies directly above the common location of a labrum tear.  And just above that point lies the supraspinitus tendon.  Three tendons- one place.  This is why this is such a bad place to get injured.

I definitely started experiencing that catching within hours of the injury.  It continues to this day, with me never knowing exactly when it will happen.

We’re hoping on a debridement only surgery – the ortho will clean up any bone spurs in the joint that might be irritating and tearing the tendons, plus cleaning up all the frayed edges in the tendons.  A two week recovery at home, limited movements afterward (nothing overhead) and 70% back in 4 months.

If I’m unlucky, he will get in there (arthroscopically) and need to tie the tendons to the bone beneath them.  Longer recovery but no chance of the tendons tearing further.

Until that time, I’m being careful, not doing much exercise and generally feeling the tension from the pain and lack of exercise.  Yes, I can still do some things- leg machines, cardio, some ab work.  Nothing that I particularly like, but I’d probably be homicidal if I couldn’t at least do this much.  I’m living on Aleve and the occasional vicodin…

October can’t come soon enough.