Core3 Massage

These past few weeks I have been reading through a book that was recently published – Running Injuries: Treatment and Prevention by Jeff Galloway and David Hannaford DPM. I found it quite thorough- possibly useful and accessible to the regular runner – once I got over Galloway’s stretching paranoia and his walk/run obsession. 

The sections are grouped by body part (Foot and Toes, The Ankle, The Knee….) and the descriptions of injuries include terminology that runners might use, such as: Outside of the Ankle Mostly – But Can Be on the Inside, Various Pains in the Calf Muscle, or Outside of the Thigh from the Bony Knob on the Outside of the Hip, Going Down…..and so on.

The book was given to me by a client who has been dealing with calf issues for a long time.  Her calf issues (perhaps defined as “Various Pains in the Calf Muscles “) had stopped her from running at all for long periods of time. So, they were frustrating for her.

She is now, thankfully, slowly getting back into running, with her calves feeling good. She saw a podiatrist (discovering that yes she does need to wear her orthotics), as well as came in for regular calf focused massages.  But she also started regularly to do calf raises (as the above book suggests, for those runners with persistent calf issues) to strengthen her calves.

The book, like the New York Times article that I mentioned in my last post http://well.blogs.nytimes.com/2009/12/01/phys-ed-how-to-prevent-stress-fractures/  suggested calf raises as treatment for calf problems. They have you start with working up to 25 regular calf raises, and then progress to doing calf raises with your toes pointed in, and then toes pointed out. The goal is 25 of each (toes in, toes out) to give you a total of 50 calf raises.

Not only do calf raises (and overall calf strength) help to prevent tibial stress fractures (as suggested in the NY Times article), but they also help with overall lower leg health.

And as you may remember, the article also suggested decreasing your stride length as well to help prevent tibial stress fractures.  Likewise, the authors of Running Injuries also suggest: “The most efficient and gentle running form is a “shuffle”: the feet stay close to the ground, touching lightly and with a relatively short stride. When running at the most relaxed range of the shuffling motion, the ankle mechanism does a great deal of the work, and little effort is required  from the calf muscle. But when the foot pushes harder and bounces more, and the stride increase, there are often more aches, pains and injuries.”

So, another plug for shorter stride length. And, as some of you may be out running in the snow and ice, shorter quicker strides help you negotiate the messy stuff – and minimizes your foot slipping.

In my many years of running, I have had 2 stress fractures. One in my tibia and one in my upper femur. Stress fractures are not uncommon in runners, and can be a real drag. Once diagnosed, one has to take 6-8 weeks off  from running to let it heal. Runners don’t like not running. It makes us grumpy and miserable.  (It is at this time that we usually discover the pool or the bike to get our exercise fix, and a few triathletes are born)

As dreaded as stress fractures are, at least once the 6-8 weeks is over, the injury is healed. Then you can gradually start running again, and happiness returns to the runner.

Tibial stress fractures were recently addressed in a NY Times article http://well.blogs.nytimes.com/2009/12/01/phys-ed-how-to-prevent-stress-fractures/  , which is what got me thinking about stress fractures again.  Although it has been over 10 years since my tibial stress fracture, I still fear them.  So any tips on decreasing my, or my client’s, possibility of a stress fracture, grabs my attention.

First of all, the tibia is one of the 2 lower leg bones (http://adam.about.com/encyclopedia/Leg-skeletal-anatomy.htm).  In the article, tibial stress fracture prevention was focused on 2 possibilities: 1) strengthening the calves ( primarily found to help women)  and 2) decreasing your stride length.

Strengthening the calves can be as easy as just adding some calf raises to your strength or stretching routine (I know you all have one). As the article states “…rising up on to your toes and sinking back to the floor 10 or 12 times every day, might be enough.”  So , if you are a female runner, this might be something that you want to add into your daily routine.

The other suggestion is to reduce your stride length.  Back when I was the Assistant XC and Track coach at Bowdoin, this was something that all the runners were taught.  Head Coach Peter Slovenski had all his runner count their strides on a regular basis (I will call 1 stride every time your right or left foot - pick a foot - strikes the ground).  The goal was 90 strikes or more per minute. ( You can also try for 30 or more strides per 20 sec – if you can’t focus for that full minute).

As Peter told me, he based this on work  Jack Daniels, a respected running coach, had done.  He noticed that in the Olympics the runners all had a stride rate of 90-110.  So, these are the fast guy/gals – and they all had a short fast stride.

As the article states “The researchers determined that reducing stride length by about 10 percent seemed to reduce the stress on the tibia enough to lower the risk of a stress fracture. “  So, I am guessing that by counting your foot strikes and trying to increase them, one is on their way to decreasing their stride length by 10%.

Certainly more can be said about stress fractures, but in general they are an injury to respect.  They are usually first identified as a very specific area of pain found when pushing down on the bone.  You will feel it when you run, and can be so painful that it alters your stride, or even so that you just can’t put any weight on the bone. Have it checked out ASAP.  And a reminder – the tibia is only one bone where you can get a stress fracture.  The femur, the bones of the foot, and the spine are other examples of areas where stress fractures can occur – and not only with runners.

With all this said, I hope none of you ever have to suffer from a stress fracture ever – or ever again.

Now that Spring is almost here (perhaps?) no more musings on winter running for me.  Enough of the snow! I am thinking ahead to long bike rides along the ocean, trail running in the woods and lots more light!

The approaching season of Spring also leads me to reflect on Springboard Pilates, the place where I take my Pilates classes. Pilates is a set movements based on exercises developed by Joseph Pilates. These exercises “…strengthen your core (torso)  muscles and work out from there to stretch and strengthen every muscle in your body.” , as is written on their website (www.springboardpilates.com). 

One can start with Mat classes, where most of the exercises are done lying down or while sitting. You learn a set of exercises and build on them each week.  In private sessions, one works on equipment instead.  With springs and leather straps, these machines look sort of scary, but they are actually pretty cool. They help add resistance to the movements, as well as support you (if needed) as you become stronger.

I love Pilates for what it does to my body. Having a strong core during movement (running, massaging….) makes me feel more effient . And working from a strong core makes me feel stronger overall.

I enjoy the structure of the workouts (Meredith telling me what to do) and the fact that the exercises progress as one gets stronger. The Springboard Pilates studio is also a very beautiful space. It is in an old townhouse (on Spring St.) with high ceilings, wood floors and great art work on the walls.

I encourage you to contact them (the lovely Meredith or Momma To Be Bethany) if you are at all interested in Pilates.  15 min consultations are free.  Right now they are having a New Client Special: 30 min Private session for $10 or a 50 min Private session for $20 – great deals!

If Pilates is not your thing at the moment, check out the Tri-Maine (www.tri-maine.com) races for the year. Along with perhaps giving you a reason to work-out this spring/summer, these races are always fun events. One might even say they are “epic”.

I  believe in the importance of core strength.  I have certainly read a lot about it’s importance, but have also felt how important it is in my own body.  When I have a strong core I am a stronger runner, cyclist, swimmer and massage therapist. 

For most of my adult life I have done some sort of core work.  I certainly have had my lazy periods when I don’t bother with it.  But after several months of being  lazy, I can feel it in my body.  Overall I am not as strong.  

These past 8 months I have made an effort to really focus on my core (and overall) strength, after a few years of haphazard strength training.  This past June I started working with Erica (efitess08@yahoo.com) which has made a huge difference in my  strength.  I do overall strength work with her, incuding lots of core stuff – and not your grandmother’s sit-ups (sorry for the reference Mom). She has me work on all the muscles around my core  incuding movements with the upper and lower body.  Really good functional strength stuff.

Then this past fall I started Pilates with Meredith @ Springboard Pilates (www.springboardpilates.com) . Not only am I now addicted to Pilates (more on this addiction at a later time), but I have seen my core strength improve even more.  Pilates includes a number of excerises (with and without machines) that help you focus intensely on all your core muscles (there are a lot of them - believe me! More than just Rectus abdominis).  I have had sore muscles that I knew existed, but never new they could be worked in this way.

The work I have done with both Meredith and Erica has helped me tremendously in my  running and in my work as a massage therapist. The increased strength of my core (“power house” in Pilates)  helps me in all of my movements. My body is more efficient as well as stronger. 

I recently found out that triathlete and blogger (you HAVE to check out her and her hubbie’s blog (http://maukamakai.wordpress.com/) if you love the bizarre side of nature) Kelsey Abbott (kelseyabbott@gmail.com) also leads Core Conditioning classes. I thought it was just for her swim girls. No no – she leads classes at The Sanctuary in Yarmouth on Mondays @ 7pm, as well as classes at the Freeport YMCA.

One last work on core strength. I have noticed that many of my clients with low back pain have a weak core.  So, if nothing else – core work can prevent one of the most common complaints – low back pain.

Ever since I was a senior in high school, I have done some sort of strength training.  As a runner, the focus was primarily on maintaining my upper body strength, a little leg work and core work using the “traditional”  exercises (such as bicep curls, hamstring extensions, sit ups…).  Over the years it was basically the same stuff, until I started triathlon training. 

The last few years doing triathlons, I have grown a little lazy with the strength work.  I figured that I am strengthening my body with swimming (arms) and biking (legs).  The only “strength” stuff I did on my own was core work.  Then this spring I met Erica.

Erica is a personal trainer who works with athletes, helping them train for their sport/activities of choice.  I was thinking at the time that I met her, that my swimming form and speed wasn’t improving because I didn’t feel strong enough in my arms and obliques.  So, I decided to see what she could do for me.

After an initial assessment, she was able to identify the areas that needed to be addressed on me – the specific muscles/areas that were weak or tight.  She not only took into consideration what activities I do, but also what I do for work. And as many of you know, what you spend 8 hrs a day doing, is going to have an impact on your body – such as driving a lot, standing a lot or sitting at a computer all day.

After the assessment we started the fun stuff – working on all those weak/tight areas, and not in the traditional way.  All sort of cool exercises (monster steps, inch worm….) that help to strengthen not just the major muscle groups, but those smaller muscles that assist when the big muscles get tired.  Lots of lateral strengthening  too, since most of our activities are linear in motion, and not side to side, leaving you vulnerable when you: step wrong off the sidewalk, try to play pick-up basketball after doing nothing but running for 20 years, or other activities that involve lateral motion.

After 4 months with Erica, I have found a great improvement in my overall strength. I can feel it in all my activities – even when I massage. It makes me feel so much more efficient and less prone to injury. I am able to do those trail runs without worrying about twisting my ankle.  I feel stronger on the bike, due to the single leg strengthening exercise.  And the increased core strength has helped me maintain form and speed in swimming. I could go on and on, but why not check her out yourself. 

Her business is called Evolution Fitness and is based out of Health Coaches on 17 Free St. in Portland. She can be reached at efitness08@yahoo.com or (207) 329-7528.  If getting a personal trainer is not possible, doing some research to find exercises (or a trainer in your area) that would help you in your sport/activity — or just to balance out your body, is well worth it. That strength can mean less pain and injury in the long run. Fall/Winter/Spring are great months to work on strength, because unfortunately in Maine, we can’t get outside as much to play.