Regaining Thoracic Mobility

Alright, let's do a quick recap of where we have been...

I began this series with a post titled "The Aging Golfer".  My intent was to educate my fellow aging athlete golfers on the importance of maintaining adequate mobility within the hips and spine, as this would not only improve their performance on the links, but possibly stave off the degenerative spine disease that so many golfers suffer from later in life.

As we have learned along the way however, this information pertains to other aging athletes as well...and even non-athletes.  This is the kind of information that everyone needs to have.  In fact, this is the kind of knowledge that our doctors  need to know, but unfortunately...most don't.

"The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” 

                                    ― Thomas A. Edison

 The quote above reflects some pretty forward thinking...especially for someone living in the early 1900's.  It is time for more importance to be placed on the care of the human frame...by all, not just athletes.  

Ok, I'm beginning to rant.  I shall dismount my soapbox and get back on track.

So...what can we do about our decreased mobility?  Over the next couple of posts within this series, I plan to take you through some mobility exercises that are used by Physical Therapists to regain flexibility and range of motion.  You don't have to be a Physical Therapist to do these exercises, but you will need to have some specific equipment.

I would expect that by now you have clicked on the Trigger Point advertisement on this blog, and purchased your very own, life-changing Trigger Point Therapy kit...yes?  What?  You didn't think it was necessary?  Alright, there's still time.  You can always click on that banner right now, and then come back to this post once you have received your 'tools' and learn the exercises.

Before we dive into fun stuff however, we need to do a little more education.  I know, I know, you've had enough teaching, and you want to get on with the fun stuff.  Believe me, I've heard it before...but trust me, because this information is important, and will help bring it all together.  Really.

We need to talk about the Cumulative Injury Cycle (CIC).

"What is the Cumulative Injury Cycle?" you ask.  Great question!

 The CIC is a process that occurs within the human body, and disrupts the human movement system (HMS) through the development of muscle imbalance, altered neuromuscular control, etc.

The National Academy of Sports Medicine (NASM) describes the CIC as "A cycle whereby an injury will induce inflammation, muscle spasm, adhesion, altered neuromuscular control, and muscle imbalances."

But you're not injured, so this doesn't pertain to you...right?

Wrong.

The term injury is used to describe both acute traumatic injury, as well as chronic overuse injury patterns.  Every time we engage in physical activity, we create micro trauma to our muscles and connective tissues. This small amount of injury is enough to trigger the CIC.

I want you to have a solid understanding, so let's dive in a little deeper and go through each step of the CIC.

Step 1: Tissue Trauma

Tissue trauma can result from an injury such as a strain, or it can simply refer to the micro-tears and contractive tension in a muscle which are normal results of strength training. The body treats this stress on the tissue as an injury and initiates the repair process. The only way muscles get bigger and stronger is when the body undertakes this healthy, normal repair process on these micro-tears. Excessive tension, however, is NOT normal and healthy. It interferes with the healthy growth of the muscles by allowing them to remain in a shortened, contracted state.

Step 2: Inflammation

Any trauma to tissues leads to inflammation of the traumatized area. Inflammation triggers the body’s pain response system, which activates protective mechanisms meant to prevent further damage. At the microscopic level, we are talking about activation of tiny receptor sites called muscle spindles that sense the level of tension in the muscle and attempt to protect it by initiating contraction.

Step 3: Muscle Spasm

When the muscle spindles are stimulated, microspasms begin to occur throughout the muscle, creating further tension and shortening.

Step 4: Adhesions

Also known as “knots”, adhesions are the result of the microspasms in step 3. These adhesions can be described as tight nodules within the soft muscle tissues. They reshape the muscle itself, creating an inelastic matrix of roadblocks which prevent the muscle from contracting and releasing as it should. Untreated adhesions can become permanent features of the soft tissue as the tissue repairs itself to cope with the demands of strength training. Inflexible tissue causes postural compensations as the body attempts to find ways to move itself in spite of its new limitations.  Remember...life will find a way!

Step 5: Altered Neuromuscular Control

These permanent adhesions cause compensatory movement patterns to occur . The body wants to move, and it will find a way to do so even if it means using muscles and joints in suboptimal ways which deviate from their intended functions.

Step 6: Muscle Imbalance

Repeated patterns of movement model the body in their image. If the body moves in a suboptimal manner over time, the faulty patterns will be built into the muscles and joints themselves.  Remember...the body adapts!

And Then the Vicious Cycle Repeats and Reinforces Itself

The CIC is a process that feeds on itself.  As the cycle draws to a close, the muscles are left in sub-optimal states.  This reinforces each of the previous steps within the CIC, and essentially causes the cycle to repeat...over and over again, until a severe acute injury occurs.  At this time, most people simply write it off as just another injury, when in fact it was caused by a failure to recognize and mitigate the CIC from the outset.

Pattern Overload and the Cumulative Injury Cycle

The cumulative injury cycle is directly tied to the concept of pattern overload, which means placing repeated stress on the body through performing the same motions. Poor posture combined with pattern overload is the recipe for repetitive stress injuries.

Alright, now that you are familiar with the cumulative injury cycle, let's talk about what we are going to do to restore some movement in your thoracic spine.

There are two corrective techniques that we are going to employ...corrective flexibility, and self myofascial release (SMR).

Corrective Flexibility training involves a variety of different stretching techniques that can be used to re-lengthen over-stressed, shortened muscles.  The goal is to return those muscles to their normal resting length.

SMR techniques will be used to attack the adhesions (described in Step 4 above) that are reducing the elasticity of the muscles.  These exercises are carried out with the use of SMR tools, such as those produced by Trigger Point...hence my reminder to click on the ad banner and purchase yourself a set.

In my next post, we will learn how to use these tools, and get down to the business of Self Myofascial Release!

Until then...

Yours in Health and Performance,

John

 

Jurassic Mobility?

We left off yesterday talking about the low back (the lumbar spine) 'taking over' for the thoracic spine.  What I mean by this, is that movement must occur in the spine to allow for the human body to ambulate.

Add to normal ambulation, the loads and demands of sport...and well, you get the picture...right? 

Many athletes generate power through the rotation, or twisting of their spine.  The golfer, the tennis player, quarterback, pitcher, bowler, track and field...must I go on?

In his book Low Back Disorders, Dr. Stuart McGill presents research regarding repetitive twisting of the spine, and it's effects on the vertebral discs.  Dr. McGill states that repetitive twisting causes the annulus (ring-like portion of the disc) to slowly delaminate.  Once this happens, the nucleus of the disc begins to migrate outward, placing pressure on nerve roots, and destroying the disc itself.

Armed with this knowledge, it is in our best interest to do whatever we can to keep our spine working properly...thereby reducing the effects of rotational torsion (twisting) on the vertebral bodies and discs.

So...back to the lumbar spine taking over for the thoracic spine.  

The body is amazing...I've said it before, and I'll say it again.  God did a superb job when he created us.  He gave our bodies the ability to adapt to a plethora of both internal and external stimuli.

How many of you remember the movie Jurassic Park?  In the movie, Ian Malcolm (played by Jeff Goldlbum) is speaking to Ellie Satler (Laura Dern) about life...and the ability to adapt.  It goes something like this...

“Because the history of evolution is that life escapes all barriers. Life breaks free. Life expands to new territories. Painfully, perhaps even dangerously. But life finds a way.”

The concept is relatively similar...the thoracic spine becomes dysfunctional...life still requires mobility...so the body adapts, and uses a different part of the spine to create movement.

Life will find a way.

Interestingly and in alignment with what Ian Malcolm states, this adaption...or as we call it in the world of human movement: compensation...occurs, it too can be painful, and it too can be dangerous.

"How so?" you ask.

When the lumbar spine takes over for the dysfunctional thoracic spine, it begins to move in a manner that it was not designed for.  Over time, the compensatory movement creates stress on both the vertebral bodies and the discs.  The body may opt to respond by engaging a protective mechanism called calcification.  

Yeah, most of us have heard the term calcification...but how many of really know what it means.  Quite simply...and I mean quite simply...the body begins to fuse the vertebrae of the lumbar spine together by way of calcifying the vertebrae together.  This is a protective mechanism that serves to prevent the movement compensation from occurring, thereby preventing further damage to either the vertebral body and the all important, shock absorbing disc.

The picture below shows the onset of this protective process.  The arrow points to an area of calcification that is serving to limit the amount of movement that occurs between the two vertebral bodies.  I suspect that the disc between the two vertebrae has become damaged, and this is why the body has enlisted this protective mechanism.

Life will find a way.

In my next post I will provide valuable, evidence-based information about how you can regain much, if not all, of your lost Jurassic...I mean thoracic mobility.

Until next time,

Yours in Health and Performance,

John

Oh My Aching Back!!!

In my last post, I introduced you to the human spine, and how dysfunction within the spine can affect sports performance - specifically the game of golf.  I closed out my last post with a statement about back pain, and how the majority of it presents in the low back.

Today we talk about why that is.

There are numerous culprits when it comes to low back pain...trauma, vertebral degeneration, bulging and herniated discs...the list goes on and on.  In this post however, we will discuss the issue of low back pain as a result of poor thoracic mobility.

Yep, that's right...poor mobility in your thoracic spine can actually cause your low back to hurt!  

Before moving forward, let me say that if you have not read my previous post, The Aging Golfer, please read it first.

Now where were we?  Oh yeah thoracic mobility...or lack thereof.

In my previous post I introduced you to the concept that each region of the spine is comprised of vertebrae that are built for a specific purpose.  You also learned about the alternation of mobility and stability within the regions of the spine.  

So...as a golfer, why are you experiencing low back pain?  

One of the reasons could be due movement dysfunction in the thoracic spine.  "What in the world does that mean?" you ask.  Simply stated...you have lost mobility in your thoracic spine.

Your next question is probably "How does that happen?"

Remember my post on muscle imbalance?  Much of what we do, creates an imbalance between the muscles on the front of our torso, or chest (anterior) and the muscles of our back (posterior).  This anterior/posterior imbalance is often the result of chronic poor posture...what I like to call computer posture.  

Many of us (including me) spend a great deal of time in front of a computer.  Sitting in front of a computer does not promote the best posture.  Many individuals look just like the picture below...

When in fact, we should look more like this...

 An ergonomically correct computer workstation looks like this...

There is a great deal of truth to this picture...if you believe in the theory  of evolution.

So let's get back to what happens here....

When we repetitively place our bodies into poor posture, our muscles begin to adapt.  Remember the term adaptive shortening?  This means that muscles that are frequently shortened, will adapt to that shortened length.  Muscles that are put 'on stretch' or lengthened for long periods of time, will also adapt to that length.  The body's response is to make those shortened and lengthened states, the new resting lengths of the affected muscles.

A good example of this concept is the muscles that control and stabilize the shoulder capsule...the chest (pectorals), anterior deltoids, and the back muscles (upper, mid, and lower trapezius, rhomboids, and posterior deltoids, and a few others.  As we sit, hunched over the computer, the mid and upper back round (kyphosis), the shoulders roll forward (protract), and the head juts forward.  Sitting in this position for hours, day after day, causes the muscles of the chest and anterior deltoids to adapt to this shortened position, and become overactive.  On the back side, the antagonist muscles (remember that term?) which control the position of the shoulder blades, and the alignment of the spine, become lengthened, weakened, and underactive.  

This has now become the new normal for you!

As a result, the muscles that stabilize and control the alignment of the thoracic spine become weak, and turned off...much like that of turning on and off lights in your house.

Soon these muscles become 'fixed' in their positions...and as a result, do not allow for proper movement within the thoracic spine.  

What region of the spine is located just south of the thoracic spine?  That's right!  The lumbar spine.  Is the lumbar spine supposed to provide mobility or stability?  Right again!  You guys are good!  The lumbar spine is built for stability.  One of it's primary jobs is to provide a stable base from which the thoracic spine can move.

So...if the thoracic spine is 'locked up' and unable to provide good quality movement, what do you think takes over?  That's right...the lumbar spine...but wait!  The lumbar spine is not designed to be highly mobile...that could be a problem.

Well...that's enough for one day.  We'll finish this up in the next day or so.

Yours in Health and Performance

John

The Aging Golfer

A couple of days ago, I decided to go golfing with my brother-in-law.  I love the the game of golf, and there was a time in my life when I could actually play the game pretty well.  I'm not talking about "Hey, I'm thinking about retiring and going on the Senior Tour" good...but I was a consistent 80's golfer.

No...I'm not talking mullets and parachute pants 80's (although I do miss my mullet!) I'm talking about scoring in the 80's.  No, not that kind of scoring...never mind.

Let's just say I was slightly above average.  How's that?

Ok...moving on.

My brother-in-law said it just right the other day.  He said "You and I have some of the best looking swings for two guys who don't really play that well anymore."  Truth be told...he's a heck of a lot better than I am, and he was merely being nice.  Here's what's funny about that...when I was around fourteen or fifteen years of age, I picked up a golf club and swung it with near perfect form.  I'm not bragging...it's just the way it was.  

You see, my dad was a tremendous golfer.  He shot his first score of 59 at age fourteen!  I often heard from family friends and relatives, that he was easily good enough to play at the pro level.  He played one year of golf at Stanford before deciding to pursue his passion of aerospace engineering, and abandon his pursuit of the PGA.

Anyway...suffice it to say that he knew a good, natural swing when he saw one.  His was beautiful.  

So, back to my swing...my Dad saw me swing a club one day...just playing around in the back yard...and knew right then and there, that I had some potential for the game.  Unfortunately however, golf wasn't one of the cool sports back then, so I had little interest, if any, in learning to play.  I did enjoy going to the driving range and watching my Dad hit balls.  It really was a thing of beauty.  Occasionally, I'd pick up a club and attempt to hit some balls...without much success, I might add.

My Dad used to tell me "Son, you have such a pure swing.  Anyone out here watching you swing that club would automatically think you were an 80's golfer" (sans mullet).  "Right up until I actually try to hit the ball" was usually my reply.  My Dad would just smile, and start hitting again.  He never pushed me into playing the game.  I wish he would have.

I've been told I have my Dad's swing.

I play golf three or four times a year.  That's not much.  I am considered a 'bogey golfer' which means that on average, I shoot 1-over par per 18 holes.  Which, I might add, is actually not bad for someone who plays as infrequently as I do.

The other day however, proved to be one of the most humbling days I have ever spent on the links.  As I always do, I arrived early to hit some balls on the range, and get my body warmed up.  

It never happened.

I felt like I was 80-years old.  Every joint in my body was stiff, and my muscles were tight...for all eighteen holes.  It was a long day. 

You see, I had ridden 51-miles on my road bike the day before, a combination of 15 road miles and 10 mountain bike miles the day before that, and 35-miles on the road bike the day prior to that...I was tired, sore...and I just couldn't move.  

Not only was I physically sore, I was facing the harsh reality of truly being an aging athlete.  It hurt...literally and figuratively.

My inability to move correctly created in an inability to consistently create a smooth, powerful, and well-timed swing.  I was not a high-performer that day.

Has this ever happened to you?  Have you ever felt so tight you just couldn't get in the groove?  If you've been golfing for any amount of time (young or old), and you did not answer yes to that question...well, let's face it...you're being dishonest.  It happens to all golfers.

So let's take a look at some common issues that golfers face.  Issues that can decrease performance.

First and foremost is mobility.  The ability to move, and move freely is paramount in the sport of golf.  No...golfers are rarely seen sprinting down fairways, or performing other feats of phenomenal or heroic athleticism, but believe me...they must be able to move freely to perform well.

Let's start at the ground...where our body makes contact with the earth.  As a golfer 'addresses' the ball, flexion occurs at the ankle, knee, and hip joints.  The degree of flexion varies with each golfer, but without it...the golf swing just wont happen.  In order to flex the body at these joints, the muscles controlling the joints must be supple enough to allow for freedom of movement at the joint.  If your calf muscles, or your hamstring muscles are tight, your ability to flex properly, is severely reduced.  Additionally, tightness in your hamstring musculature will place undue stress on your lumbar spine (lower back) and create acute and/or chronic low back pain.

Another important factor in the ability to swing a golf club is that of rotation.  Specifically rotation of the thoracic spine.  This can be a huge problem for many of us...especially those of us who are reaching our mid-lives.  You see, our lifestyle choices such as lack of exercise, prolonged sitting, computer posture (the list goes on an on) takes its toll on our ability to move the way we were designed...thoracic rotation being one of the most affected.

Our spine is made up of individual vertebrae.  Each of those vertebrae belong to a group, or region of the spine.  There are three primary regions, and one secondary region.  The primary regions are the cervical spine, the thoracic spine, and the lumbar spine.  These three primary spinal regions sit atop the sacrum and coccyx...which are fused vertebrae, and make up the 'secondary' spinal region.

The vertebrae in each of the primary regions are built slightly different than one another.  Some are shorter, some taller, some thinner, and some thicker.  Some are built to move freely, while others are built more for stability than mobility.  That's the way God created us, yet we have done our best to mess up His perfection.

When teaching my athletes and firefighters about the spine, I prefer to divide it into alternating regions of stability and mobility.  Here's what I mean...

Starting with the neck (cervical spine) - the seven vertebrae that make up the cervical spine are shaped in a manner that allows for tremendous freedom of movement.  This freedom of movement is what allows us to look up, down, side to side, tip our head sideways, diagonally, etc.  The cervical spine is meant to be highly mobile.

The thoracic spine is the light colored area

The thoracic spine is comprised of twelve vertebrae which are shaped slightly different than their cervical 'relatives'.  Looking at the picture above, you will notice that the thoracic vertebral bodies are much 'beefier' than their cervical counterparts (light colored area).  These vertebrae are built to withstand greater forces, and as a result, they are less mobile.  The upper region of the thoracic spine is aligned with our scapulae (shoulder blades).  The point where the scapulae 'rest' against the thoracic spine is referred to as the Scapulothoracic (SC) Joint, and is designed to provide stability to the highly mobile c-spine.

Moving downward...the remaining vertebrae in the thoracic spine are designed to be mobile, albeit less mobile than the C-spine.  Mobility within this region of the spine can be described as forward bending (flexion), backward bending or arching (extension), twisting to the left and right (rotation), and side-bending (lateral flexion).  Thoracic spine mobility is what allows golfers to achieve rotational power in their swing.

An example of great thoracic mobility

The lumbar spine is comprised of five vertebrae, and is designed to provide stability for the thoracic spine.  Interestingly, the majority of back pain occurs in the lumbar spine.  

Why do you think that is?

Check back tomorrow to find out the answer!  

Don't worry...we'll be making our way back to the knee pain series soon enough!

Yours in Health and Performance,

John 

The Mighty, Mighty Mushroom

I know some of you have been waiting patiently for part three of the Knee Pain series...and you will need to wait a little bit longer, because today we learn about one formidable fungus!

There was a time when I despised mushrooms.  I think it was around the same time that I couldn't stomach spinach, Brussels sprouts, peas...pretty much all veggies.  Those days however, are long gone my friend.  I am a vegetable eatin' son of a gun these days!

As an athlete - sorry, yes...an aging athlete, it is in my best interest to eat the most beneficial, nutrient dense, power-foods I can get my hands on.  My days of eating Jack-In-The-Box tacos are far behind me...well, maybe not that far come to think of it.

Before we dive into the marvelous mushroom, I have to tell you a quick story.  I am a little ashamed of it, but I think it proves that, while I try to eat very healthy, nutrient dense foods...I falter.  Hey...I'm only human for cryin' out loud.

Recently, the guys at the firehouse decided they wanted to have 'taco night' for dinner.  This is not out of the ordinary, and often times we create fairly healthy tacos...but not this time.  You see, one of the guys on my truck suggested we buy Jack-In-The-Box tacos for dinner...yep, those same tacos that you and I used to eat after a night of partying!  I truly cannot remember the last time I had a Jack-In-The-Box taco!  What I do remember however, is just how TASTY they were.

What?  You mean the real tacos don't look like the ones on the left?

We ordered up 60 tacos.  Yes you read that right...60 tacos!  Before you judge us, it is important to understand that there are 11 guys at my fire station.  That's only 5.45 tacos per person!  Just for the record, I only ate three...and they sure don't taste like they used to.  Well...they probably taste exactly the same, but they sure don't taste good to me anymore!

Stop judging.

So let's move on to the magic mushroom.  No...not that magic mushroom!

The mushroom is a superfood.  Did you know that?  Those little fungi are packed full of nutrients and vitamins.  In fact, take a look at how these fungi stack up...

• Mushrooms manufacture their own Vitamin-D...just like humans!
• Mushrooms are naturally low in sodium, and their earthy flavor (umami) counterbalances saltiness, and can lead to lower salt usage per meal.
• Mushrooms are immunity boosters thanks to their abundance of a powerful antioxidant known as ergothioneine.
• The cap of a Portabella Mushroom has more potassium per 100-gram serving than bananas, therefore mushrooms can help lower blood pressure, as potassium plays a key role in the control of blood pressure.
• Mushrooms provide B-vitamins including riboflavin, niacin, and pantothenic acid-which help in the breaking down of the macro-nutrients (carbohydrate, protein, and fat).
• The mushroom is low in calories, while high in nutrients.

Pretty cool for a funny little fungus huh?

Have some fun with your formidable fungi!

What is even better is that recent research has found mushrooms to play a role in the prevention and treatment of various forms of cancer!  That's right, that funny little toadstool may actually be able to fight cancer.

Current research has identified phytochemicals in mushrooms that block the enzyme aromatase from producing estrogen. Controlling aromatase activity can help decrease estrogen levels, which controls and kills hormone-dependent breast cancers. In addition, mushrooms also demonstrate the ability to inhibit cancer cell activity and slow tumor growth.  More research is necessary however,  Promoters claim that shiitake mushrooms contain several compounds with health benefits. A compound called lentinan is believed to stop or slow tumor growth. Another component, activated hexose-containing compound (also known as 1,3-beta glucan), is also said to reduce tumor activity and lessen the side effects of cancer treatment. The mushrooms also contain the compound eritadenine, which is thought to lower cholesterol by blocking the way cholesterol is absorbed into the bloodstream. 

Click here to be taken to Google Scholar, and a list of peer-reviewed, journal published studies regarding these purported cancer fighting benefits.

By the way...if you are not familiar with Google Scholar, and you like to research stuff, I highly recommend that you use this site.  Google Scholar only contains research that is both peer reviewed and journal published.  Therefore, you can be assured that the information is evidence-based rather than just one individual's opinion...such as those found on sites like Wikipedia.

Now that you know...enjoy mushrooms with your meals.  There are many ways to prepare mushrooms...some healthy, some...not so much!  I prefer to eat them raw...I even put a couple mushrooms in my morning fruit/veggie smoothies!  I know, I know...it sounds horrible, but trust me on this - you cannot taste them!  I promise.

Peein' in the Firehouse

As I lay here in bed, laptop propped up against bent knees, I feel relieved.  It would be even better if I could go back to sleep, but given the situation...I'll take relieved.

As I press the small button on my Timex Ironman digital watch, the soft Indiglo blue light reveals that it is 0445 hours...that's a quarter 'till five in the morning.  In all honesty, I'd rather be somewhere else...almost anywhere else right now.  Some place free from the impending computer generated voice that is sure to be emanating, any moment, from the dispatch system within the firehouse, telling me it's time to make the donuts...so to speak.

Yep, that's right...I'm at work.

What in the world does this have to do with aging athletes?  Very little, if anything.  I did set out on this literary journey however, clearly stating that there would be random thoughts thrown about here and there.  This is one of those times.

I was sleeping soundly...well, as soundly as possible in a firehouse...when the red LED panel in my bunk-room lit up, and the soft, computer-generated female voice entered into my dream...

"Ladder 131, channel K-6, injured person, 10601 West Something, Something Drive, Ladder 131, K6."

In an instant, I was awake - realizing that the voice in my head...wasn't really in my head.  It was coming from the overhead speaker in my room.  It was time to get up...again.

The need to urinate became quite apparent.  In a matter of seconds, I had an hour long debate with myself as to whether or not I should take the time to go pee before heading out to the truck.  I've had this debate many, many times over the last twenty-three years.  It's always the same outcome.  I never stop to go pee.

Why?

Someone is having an emergency.  They called 911, expecting us to show up at their house and take care of business...and they want us there ten-minutes ago.  In my line of work, the time it takes to go pee could, quite literally, mean the difference between life and death.  Especially if we're talking about an aging athlete like me.  There, I made the correlation.

You see, at age forty-eight...I just don't pee like I'm nineteen anymore. It's one of those things that happens to aging athletes like us...it's part of life I suppose.  

So...what that means is that many a night, I can be found bouncing down the road in the middle of the night, in a firetruck...desperately needing to go pee.  

It's a glorious job - someone's gotta do it.

Here's the interesting thing.  I do this multiple times throughout a typical night at the firehouse.  I don't drink water between emergency calls...yet I have to pee upon returning from every call.  It's not just me either...we all do it.  

I have a theory that all firefighters have weak bladders.  Maybe weak isn't the right term.  Pavlovian comes to mind here.  It seems as though we have trained our bodies to urinate frequently over the years...some sort of protective mechanism, I suppose.  Interesting.

As I mentioned earlier - I do feel relieved.  We took care of business, made Mrs. Smith feel better...then rushed home so we could all go pee.

Like I said...it's a glorious job, and someone's gotta do it!

Knee Pain - Part 2

In my last post, I introduced you to a condition known as patellar tendonitis, also known as jumper's knee.  Patellar tendonitis can cause a great deal of pain as well as limit our ability to participate or compete in our favorite sport or physical activity, and if you remember, it is not limited solely to those athletes who jump as a requirement of their chosen sport.

I mentioned that overuse causes micro tears in the tendon tissue, and that this trauma triggers the body's inflammatory response system.  While I would like to be able to keep these posts relatively simple and easy to understand...it does become necessary to dive a little deeper to gain a complete understanding of one concept prior to moving on to the next.

So...grab yourself a shot of espresso, give yourself a couple of slaps on the face, and let's get to it!

One of the contributing factors in the development of patellar tendonitis is muscle imbalance.  I introduced this concept a few posts back, and now it's time to dig into this concept a little deeper.

Patellar tendonitis is often the result of repetitive stress place on the knee joint.  You see, during running and jumping, the body must decelerate and stabilize a great deal of energy...energy that is developed as a result of our body weight being accelerated upward and forward.  Muscles contract eccentrically in an attempt to decelerate and stabilize our bodies when in motion.

Let's back up for a moment.

There are three types of muscle contractions that occur; concentric, eccentric, and isometric.  A concentric contraction of muscle tissue is generally associated with the working phase of a given action.  Let's take the biceps curl exercise for instance. During this exercise, the biceps muscle, concentrically contracts...which means it shortens in length...to create flexion, or bending of the elbow joint.  During this action, the antagonist muscle (remember that term?) - the triceps - eccentrically contracts, which means it lengthens.  The eccentric contraction is a type of braking mechanism, which helps to control both the rate and distance of the joint action - in this case, the bending or flexing of the elbow.  An isometric contraction is one in which the agonist and antagonist muscles reach a state of contraction in which there is nearly equal shortening and lengthening.  Confused?  Try this...

Flex your biceps muscle...you know, the way you do in the mirror when you are getting ready in the morning.  Oh, you don't do that?  I do.

Anyway, flex that thing, and then reach over with your other hand and feel the tension within both the biceps and triceps muscles.  Those are isometric contractions, and they are stabilizing the elbow joint.  Now imagine that you are jumping down from a small ladder.  Why would you do that?  Good question.  Let's say the ladder was breaking while you were standing on it, and in an attempt not to fall to the ground, you decided to leap from it, and land on your own two feet.  Ok?  Good.  Let's move on.

Now think about what occurs within the muscles of your legs and hips when you land.  That's right...eccentric contractions occur.  Your quadriceps (thigh muscles) lengthen as you flex your knees to absorb the energy of the landing.  Simultaneously, your hamstrings concentrically contract (shorten).  Without thought, these muscle groups work synergistically to control the rate and distance that your body travels toward the ground, stabilizing the knee joint, and preventing you from crashing into the ground.  That's a very simple explanation of what happens, but it's enough to understand the basic concept. 

Alright, lets get back to the muscle imbalance issue.  

A large number of people are what physical therapists refer to as quad-dominant.  What this means is that their quadriceps muscles (thigh muscles) have taken over as the dominant muscle group during various functions such as walking, running, squatting, lunging, etc.  Each of these tasks relies on the synergistic effect of multiple muscle groups to function together...hence the term synergistic.  Unfortunately, our society spends significantly more time sitting than we do moving.  

Over time, our muscles adapt to the length that they spend the most time in.  Remember...our bodies are amazing at adapting.  When we sit for prolonged periods of time, our hip flexor muscles (the quads are part of this group) become shortened, and overactive.  Conversely, our hip extensor muscles (glutes) become lengthened and relatively weak.  To make things even worse, our hamstrings have to take over for the weakened and lengthened glutes, and as a result, end up shortened and overactive as well.

Wow...there's a lot going on there.  Are you still with me? 

Now let's look at the basic function of squatting.   I'm not talking about squatting with hundreds of pounds loaded onto a bar...nope, I'm simply referring to the functional movement pattern that occurs when we sit into a chair...or better yet, onto the toilet!

Alright, we're going to do a little experiment here...and I want everyone of you to post a comment with your results.  If you have a full length mirror, I would like you to stand in front of it.  Now, I want you to perform a squat and watch yourself in the mirror.  Do a couple facing the mirror, then turn 90-degrees from the mirror so that you can look over and see yourself from the side.  Perform a couple additional squats.

Make note of what you see when you squat.  While facing the mirror, you may notice that your knees collapse inward, or that you bend over severely at the waist, which causes you to have to bend your neck, as if looking upward, just to see yourself in the mirror.  While looking from the side, you may notice your heels rise off the ground, and your knees travel forward (resulting in your knees being out in front of your toes).

We wont tackle each of these issues today, but rest assured that we will eventually discuss each and every one of them!  

Today we are just looking at your knees.  Do you remember the picture below?  I am using it again to show perfect squat mechanics.  Take a look at this little guy's knees, and note their position in relation to his toes.  His weight is back slightly on his heels, and his knees have not 'traveled' forward, out in front of his toes.

Now compare YOUR squat to this picture...specifically the position of the knees.  If your knees are forward of the toes, and your weight is shifted forward rather than back and into your glutes...then you my friend, are quad dominant!

Quad dominance can result in greater than normal amounts of tension to be placed on the patellar tendon.  Think about it this way...the quad muscles are in a constant state of contraction above and beyond normal.  They are in this state 24-7-365.  Wouldn't that be classified as overuse?  Absolutely!

What is the result of this muscle imbalance?  Knee pain.  The kind of knee pain that most people write off as either genetic or age related, when in fact...it has noting to do with either.  Possibly the best exercise known to man, is the squat.  There is a caveat to that statement however.  Anyone care to hazard a guess?  You got it...proper squat mechanics.

Unfortunately, many people experience knee pain when they squat (I used to be one of those guys...which is why my legs are so small!)  So what do they do?  They don't squat.  Those who still want to train their legs, usually end up on the leg extension machine, and work their overactive quads even more...compounding the problem!

Before you squat like this....

You should be able to squat like THIS!

Once again, I have written to much for one post.  I am sure you all want to know what we can do to fix this quad dominance, and how it can affect your overall performance...so you'll just have to check back for part three!

Yours in health and performance...

John