Core3 Massage

Several weeks ago I went to a massage class that focused on the lower leg and foot called “Neuromuscular Therapy and The Dynamic Foot”. Seemed appropriate, since I recently have been working with several clients on calf  issues, and often am working on someone with foot/lower leg problems.

In general I think that I know a lot about the legs, but there is always more to learn (I learned that the Plantaris muscle  – in the calf – has the longest tendon in the body. See  http://www.criticalbench.com/calve-muscles.htm - the muscle is red and the tendon is white) , or to be reminded of.  This class reminded me of the deep calf muscles that are so hard to palpate. The Soleus is one of these, as is the Tibialis Posterior.

One can palpate the Soleus a bit at the lateral and medial sides (around the larger and more superficial Gastrocnemius).   (You can check this pic to see some of the muscles I am refering too – and in this instance, how the Soleus sort of peaks out at the edges of the Gastrocnemius and the Achilles Tendon  http://www.best-leg-exercises.com/calfmuscle.html )   Also, when one massages deep into the Gastrocnemius, one is indirectly working on the Soleus below it. Sort of like a 2 for 1 massage.

The Tibialis Posterior is even more difficult to access. It can really only be worked on by working on the muscles that lay on top it – the Gastrocnemius and the Soleus.

 The calf, as with other areas of the body, has many layers of muscles. Some muscles are superficial, some deep, and some even deeper.  When I am massaging I am usually working on several different muscles, and not just one.

During a massage I think about all the individual muscles I am working on. I actuallysort of imagine what they look like in my head (I really needed to take a cadaver class – where one dissects a cadaver – so I can get a better idea of what all the muscles really look like). I think about the superficial muscles immediately beneath my hands, as well as the muscles that are even deeper below. Toss in the tendons (which attach muscle to bone) that I palate and the overlying fascia that surround all muscles, and there is a lot to think about.

So when I am massaging you, it is never just one muscle that I am working on. And it is usually not just one muscle that is the problem when you have pain. There is lots going on, and hence lots for me to think about when I am giving you your massage.

In my many years as a runner, I have used Ibuprofen to help me deal with occasional pain and soreness. I have been known to pop a pill after a long run to prevent that post “long run soreness”. I’ve even downed a few before a workout when dealing with some persistent discomfort.

 Of course, I have regular massages to help prevent and reduce any of the soreness and pain from hard training…..but you know how it goes – there are just those days when you want to get out there and you don’t want that stubborn soreness to stop you.

I just read an article that leads me to think that I wasn’t doing myself any favors. http://well.blogs.nytimes.com/2009/09/01/phys-ed-does-ibuprofen-help-or-hurt-during-exercise/  According to the article, researchers found more inflammation in athletes that used Ibuprofen before/during activity….. actually inhibiting recovery. And, compared to athletes not taking Ibuprofen, their legs were just as sore post-activity.

Something to think about, and more reason to not use pills to mask your pain.  Keeping those muscles loose and healthy with massage, stretching and proper hydration and nutrition is best in the “long run” anyway.

Back in the 80’s, when I was runner @ Northfield Mount Hermon, I learned something that has stayed with me since. Relaxing your jaw helps relax your whole body.

It is hard to tense up your shoulders and other muscles, if  your jaw is relaxed. This works with cycling as well as running….and I am guessing with other activities as well as work situations.

Try it: if your jaw is relaxed, it is hard to tense up your shoulders. And tense shoulders can make you tight all over. Shoulder tightness, if left untreated, can spread up (into the jaw) and/or down (to the low back and pelvis) the body. (This is not based on scientific studies, but on my own massage experience and knowledge of how the body is connected…this said just to cover my butt.)

So, instead of wasting your energy clenching your jaw (and hence tightening your shoulders….etc), you could spend it actually running or riding  faster. All this in the spirit of relaxing all those tight shoulders out there.

The illiotibial band (ITB) is a fibrous band of fascia that runs down the outside of your upper leg.  More specifically, it goes from the junction of the tensor fasciae latae (TFL-otherwise know as the hip flexor) and gluteus maximus (the big butt muscle), down the outside of your leg and attaches just below the knee to the lateral condyle of the tibia (that bump just below the outside of the knee).

(FYI – As mentioned above, the ITB is fascia  not muscle.  Fascia is a type of connective tissue that also takes the form of ligaments (attaches bone to bone) and tendons (attaches muscle to bone).  And like other types of connective tissue, fascia binds structures together, provides pathways for blood vessels and such, and serves as a framework.  Perhaps more on fascia in a later post. But together with the TFL, the ITB helps with hip flexion, abduction and medial rotation.)

One often first becomes aware of their ITB when they feel pain on the outside of their knee.  This pain could be from the increased friction of the ITB rubbing over the bony lateral condyle of the tibia, with every running stride or pedal stroke. If left untreated, the ITB gets tighter and tighter with use, and movement at the knee becomes more painful, eventually causing so much pain that one has to stop running/cycling because it is so painful to do.

But it doesn’t have to be this way!!! All it takes are some preventative measures — and some time.  Believe me, severe ITB pain is not something you want to have, unless you are looking for an excuse not to exercise.

I have worked on so many endurance athletes with ITB tightness/pain,  that I  almost assume that it will be a problem area on all endurance athletes that I work on.  I actually work on the ITBs of every single client I have, since ITB tightness/pain is so prevalent overall. 

Therefore, as you might have guessed, I strongly believe that one should use preventative measures regarding the ITB. If caught and dealt with early enough, it doesn’t have to be an area of concern.

Regular massage is a great preventative measure, since most massage therapist will massage the ITB to help keep it loose. However, even better is to do self-massage on a regular basis by using the foam roller.

Foam rollers can be purchased online (www.performbetter.com) or locally @Peak Performance (www.mypeakmultisport.com). I suggest the black ones (3′ long 6″round). They are firmer and last longer than the white ones. There are other foam roller options, but regardless you can’t go wrong.

If you are totally new to these rollers, you might have someone at the store show you how to use them.  Basically you lie down on the floor on your side. Support your upper body with your arms, place the foam roller under the outside of the leg lowest to the floor.  Using your arms and top leg, release as much of your body weight as you can handle (pain-wise) onto the roller and roll from your hip down to your knee and back. Roll up and down for a few minutes, pausing and focusing on the most painful/tight areas.

This is great to do daily after your run, ride, walk. Lots of people use the time at the end of the day while they are watching TV to roll. You can roll not only your ITBs, but also calves, hamstrings, adductors, glutes, and quads.  You can be pretty creative with it. You may not “have fun”, but if it is painful, you need it. It is a lot better than having me use my forearm or elbow  on your ITBs.

As I have mentioned to a number of you already – I am moving, and I am excited about it.  My move is due to Tri-Me’s  office consolidation. (BTW – they put on really great races right here in Maine – triathlons and well as running races.  Check them out at http://www.tri-maine.com/  .) 

I share my current space with Will (epic leader of the Tri-Me gang) – who is consolidating all his offices to 164 Middle St, Suite 3 (instead of being in Suite 1 (with me) and Suite 4). Just in case you want to be blown away – check out Will’s successful journey to become an EpicMan (kayak from Peak’s Island to Portland/bike from Portland to Boston/run the Boston Marathon – all in under 24 hours!!), along with his fearless friend Seth the Red Bull Guy http://theepicmancometh.blogspot.com/.

I will really miss my yellow office here on Market St., and being right next to Tri-Me.  Although they are a busy group, I like to bug them now and then. Friendly guys and gals, who share Red Bull and chocolate treats.  I have a feeling that I will continue to bug them, always remembering the day they had brownies.

So where am I going?  To another wonderful place – Health Coaches @ 17 Free St in Portland,  not far at all from my current office. The parking situation should be better (a parking garage next door and parking lot across the street help), and I hope to be able to validate parking.

Health Coaches (http://www.health-coaches.com/ ) is a cool place. Especially because my friend Erica works there. It is primarily a facility for personal training.  However, they also providing massage and corporate health programs.  The Pres. of Health Coaches, Mark Holmes, has graciously offered me use (@ a good price) of one of their massage rooms to continue my Core3 Massage work.

Looking forward to it all very much.

These last few months I have been thinking a lot about what we do (or “should do”) before we start working out. I haven’t been much for stretching before exercise, although I definitely include a lot of stretching in my post-workout regimen (along with regular self-massage).  There are numerous articles about whether stretching actually helps you or not. I won’t go there right now, but I will address what we probably should be doing before we go out for that walk/ride/run/swim.

My first inspiration, in my rethinking the pre-excersice warm-up, was a New York Times article http://www.nytimes.com/2008/11/02/sports/playmagazine/112pewarm.html?_r=1&scp=1&sq=stretching&st=cse  that one of you out there brought it to my attention.  It talks about why dynamic stretching, as opposed to static stretching, should be what we are doing before we workout.  According to the article, static stretching (holding a stretch) does nothing to warm up our muscles/tendons and improve their ability to preform. But dynamic stretching does. The article gives 3 examples of dymanic stretches, and in the last month I have been trying them out before I go out for my daily run. Actually 2 of the exercises I was already familiar with (scorpion and handwalks) having been introduced to them by my trainer Erica Napuli (efitness08@yahoo.com) of Evolution Fitness.

My feedback: they are fun to do, and they really do seem to help warm up my muscles. However, I also use the stick before I run. So that nice loose feeling in my legs at the beginning of my run, might be due to the stick, the dynamic stretches or both. But regarless, I probably will continue with these dymanic stretches.

The second experience that is helping shape my pre-exercise thinking, is my exposure to Resistance Stretching. Gary Gurney (Certified Rolfer at Rolfing Structural Integration www.mainerolfing.com ) was generous enough to introduce this form of pre-exercise stretching to me.  Resistance Stretching is basically contracting a muscle as it is being stretched. Dana Torres used this method of stretching in her Olympic training. After the Olympics Gary became interested in this type of stretching, has been trained in preforming and teaching of Resistance Stretching, and he is now using it to help athletes here in Portland. He recently has introduced Resistance Stretching to the Bowdoin Swim team with great success, and continues to spread the word. 

Being curious to see if this really works, I have been stretching my persistent tight left hamstring using this method.  I’ll use Resistance Stretching before or during a run if/when my hamstring feels tight.  And amazingly, it has really helped.  Check out http://www.innovativebodysolutions.com/olympic-athletes/dara-torres-stretching/stretch-like-dara.html if you are interested. 

This is just the beginning of my quest to discover the best way to warm-up for events/workouts.  So, more later on Resistance Stretching, as well as other pre-workout warm-up info. All just to keep you as healthy as possible, and preforming your best.