I can't help but emphasis the importance of massage as a diagnostic tool for the trainer or the physio. It enables a better understanding of your client's muscle tension and his readiness for the level of workout intensity required. An experienced trainer/physio will be able to find out if the client is on his way to getting a strain or a pull just by palpating the muscle.
Manytrainers/ physios i have observed try to stay away from massaging their clients because of the hard work required . They would rather put their clients immediately in a machine or on a foam roller to ease the tension. Regrettably, this takes away one of the most effective ways to improve client rapport and a valuable tool in injury prediction and prevention.
Tuesday, August 2, 2011
Wednesday, April 6, 2011
3 reminders this week and it is only Wednesday
1) When working with female clients, don't treat them as if they are the weaker sex. They should be able to do normal push ups and pull up progressions. Granted that their upper body is weaker than that of a male, but normal teaching progressions should be adhered to.
2) Just been reminded that focusing on hip stability when warming up and doing plyos is more important for females than males because of the inherent disposition to knee valgus that can cause knee problems.
3) When a client has fainting spells, please check for vertebral artery occlusion! Carl has a client who gets fainting spells when he gets up from prone or supine position. Did the vertebral artery occlusion test and it was a positive. Did ART on the superior oliques, orbitals, rectus capitis and temporalis. Cleared up the fainting spells significantly but will need to do this on a wekly basis for the client at this point of time. phew!
2) Just been reminded that focusing on hip stability when warming up and doing plyos is more important for females than males because of the inherent disposition to knee valgus that can cause knee problems.
3) When a client has fainting spells, please check for vertebral artery occlusion! Carl has a client who gets fainting spells when he gets up from prone or supine position. Did the vertebral artery occlusion test and it was a positive. Did ART on the superior oliques, orbitals, rectus capitis and temporalis. Cleared up the fainting spells significantly but will need to do this on a wekly basis for the client at this point of time. phew!
Thursday, March 31, 2011
Three things I learnt over the past week
1) The nutritional value of organic fruits and commercial fruits are the same. The issue is that commercial fruits have pesticides and hormones which can cause lots of health problems including cancer.
2) Barefoot running is great. It is a self-limiting exercise as your feet will hurt after awhile. It will hurt sooner if you run with wrong mechanics. Running with shoes allow you to run longer without pain and with wrong mechanics which results in the overuse injuries due to heel strike and repetitive stress.
3)Farmers knew centuries ago that to make cattle fat, put them on a low fat, low protein and high carbohydrate diet. Isn't that what we are told to get healthy and lean?
2) Barefoot running is great. It is a self-limiting exercise as your feet will hurt after awhile. It will hurt sooner if you run with wrong mechanics. Running with shoes allow you to run longer without pain and with wrong mechanics which results in the overuse injuries due to heel strike and repetitive stress.
3)Farmers knew centuries ago that to make cattle fat, put them on a low fat, low protein and high carbohydrate diet. Isn't that what we are told to get healthy and lean?
Tuesday, March 29, 2011
In every action, there is a postive and a negative reaction
I have been preparing for my King Sports International Level 1 and have come across this wonderful and enlightening statement. " In every action, there is a postive and negative reaction".
To give an illustration, imagine the training program of an endurance runner. He runs longer distances to create that "aerobic base" (if there is such a thing). He increases the volume of his training rather than the intensity as he believes that running longer and not faster is the key to winning in an endurance event. The positive effect is that he can run longer distances but the negative effect is that there will be increased injury risk due to repetitive stress.
Another illustration would be the footwear issue. You buy a running shoe with excellent padding. However, due to the increase in padding, you run with your heels rather than the balls of your feet. This repetitive impact causes plantar fascitis, IT band and patella femoral issues.
In order to reduce the negative impact of training, focus on injury prevention. I.e. get a coach to advise you on running mechanics. Focus on increasing intensity rather than volume as endurance is a function of recovery ability.
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To give an illustration, imagine the training program of an endurance runner. He runs longer distances to create that "aerobic base" (if there is such a thing). He increases the volume of his training rather than the intensity as he believes that running longer and not faster is the key to winning in an endurance event. The positive effect is that he can run longer distances but the negative effect is that there will be increased injury risk due to repetitive stress.
Another illustration would be the footwear issue. You buy a running shoe with excellent padding. However, due to the increase in padding, you run with your heels rather than the balls of your feet. This repetitive impact causes plantar fascitis, IT band and patella femoral issues.
In order to reduce the negative impact of training, focus on injury prevention. I.e. get a coach to advise you on running mechanics. Focus on increasing intensity rather than volume as endurance is a function of recovery ability.
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Wednesday, March 23, 2011
The smoke alarm syndrome
If you are suffering from injuries due to cumulative stress / repetitive stress, i.e. patella femoral, plantar fascitis, non acute back and neck pains etc, going to see a doctor to seek symptomatic pain relief is only a temporary solution. As in my previous articles, pain site is hardly the source of the pain. Consuming painkillers and panadols will only help you relieve the pain temporarily. Resting it may not work as well as the trigger points and fascial adhesions are still present and requires manual soft tissue intervention.
Seeking symptomatic relieve is like removing the batteries from the smoke alarm. There is a fire in the house but the alarm is not working because the batteries are taken out. Without a doubt, removing the batteries from the smoke alarm is a foolish thing. So is seeking symptomatic relieve for pain which is clearly cumulative in nature.
If you are suffering from cumulative injuries, go get soft tissue treatment and get advise on proper corrective exercises to prevent it from happening again. This will help you enjoy your sport for longer without performing it in pain or on medication.
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Seeking symptomatic relieve is like removing the batteries from the smoke alarm. There is a fire in the house but the alarm is not working because the batteries are taken out. Without a doubt, removing the batteries from the smoke alarm is a foolish thing. So is seeking symptomatic relieve for pain which is clearly cumulative in nature.
If you are suffering from cumulative injuries, go get soft tissue treatment and get advise on proper corrective exercises to prevent it from happening again. This will help you enjoy your sport for longer without performing it in pain or on medication.
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Simple ways of adding variety and injury resistance to an endurance athlete's training program
Endurance athletes should add in some variety to their training by including the following;
1) Hill Sprints
2) Jumps and skipping
3) Interval training on a slide board for lateral work
Sprinting and jumping help to open up joints in the chest, shoulder, hip and ankles as it promotes greater extension and rotation of the joints. This will help lubricate the joints and improve range of motion. In sprinting and jumping you get more hip involvement as you are required to go into greater hip extension and flexion which will work to fire your gluts and psoas which are primary hip extensors and flexors. In jogging, your hips rarely go into extension and flexion and this results in a greater development of the secondary hip extensors and flexors namely the hamstrings and quads respectively.
Working on the gluts and hamstrings in the sprint and jump will go a long way in preventing synergistic dominance of the secondary muscle groups which will usually result in cumulative injuries (TFL pain, hamstring pulls, groin strains, IT band syndrome etc) if not properly looked after.
As in sprinting, jumps and skipping forces you to be in the chin tuck, chest out and neutral spine position. In jogging, you can still maintain the head forward slouched position similar to your deskjob posture. Getting out of the deskjob posture is vital in promoting spinal health.
Lateral work is a good change from your usual linear jogs as it puts more demand on the glut medius which is an important hip and knee stabilizer. At the same time, you get a good cardio workout which is what you are after anyway
1) Hill Sprints
2) Jumps and skipping
3) Interval training on a slide board for lateral work
Sprinting and jumping help to open up joints in the chest, shoulder, hip and ankles as it promotes greater extension and rotation of the joints. This will help lubricate the joints and improve range of motion. In sprinting and jumping you get more hip involvement as you are required to go into greater hip extension and flexion which will work to fire your gluts and psoas which are primary hip extensors and flexors. In jogging, your hips rarely go into extension and flexion and this results in a greater development of the secondary hip extensors and flexors namely the hamstrings and quads respectively.
Working on the gluts and hamstrings in the sprint and jump will go a long way in preventing synergistic dominance of the secondary muscle groups which will usually result in cumulative injuries (TFL pain, hamstring pulls, groin strains, IT band syndrome etc) if not properly looked after.
As in sprinting, jumps and skipping forces you to be in the chin tuck, chest out and neutral spine position. In jogging, you can still maintain the head forward slouched position similar to your deskjob posture. Getting out of the deskjob posture is vital in promoting spinal health.
Lateral work is a good change from your usual linear jogs as it puts more demand on the glut medius which is an important hip and knee stabilizer. At the same time, you get a good cardio workout which is what you are after anyway
Monday, March 21, 2011
Should clients with shoulder injuries continue with overhead activities?
Recently, i have been getting a number of 'shoulder problem' clients. almost 90% of them had to do with an inhibited subscapularis which resulted in an elevation of the glenohumeral joint therefore causing the acromium to impinge the supraspinatus. It doesn't help that tight pec minor causes an anterior tilit of the scapular which reduces the sub-acromial space. In such cases, foam rolling the external rotators and anterior serratus will not help one bit since the subscap is right under the ribs behind the scapular.
I suggest doing some stretches followed by light activation work of the subscapularis using light dumbell prone internal rotation and anterior serratus (AS) wall slides to activate both the subscap and AS before going into your weight routine. This may help alleviate the pain.
If it is an unstable AC joint, you might want to get some taping done to stabilize the joint and do elevated or basic side bridges to strengthen the joint.
However, if it still hurts, refer out. Get a qualified soft tissue therapist to help you release trigger points and adhesions in the subscap, pec minor and infraspinatus. Mulligans technique and taping are great for resolving instability in the AC joint but proper corrective work is still required to strengthen the ligaments in the joint.
Once you are better, i would suggest redesigning your workout program to have at least a 3 : 1 pull to push ratio i.e. do more deadlifts, pull ups and rows to push ups and shoulder presses. Shoulder and bench presses should be done in neutral grip at least until the shoulder pain has been eliminated. It is good practice to deload one week of the month with neutral grip presses to give your shoulder joint a 'break".
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I suggest doing some stretches followed by light activation work of the subscapularis using light dumbell prone internal rotation and anterior serratus (AS) wall slides to activate both the subscap and AS before going into your weight routine. This may help alleviate the pain.
If it is an unstable AC joint, you might want to get some taping done to stabilize the joint and do elevated or basic side bridges to strengthen the joint.
However, if it still hurts, refer out. Get a qualified soft tissue therapist to help you release trigger points and adhesions in the subscap, pec minor and infraspinatus. Mulligans technique and taping are great for resolving instability in the AC joint but proper corrective work is still required to strengthen the ligaments in the joint.
Once you are better, i would suggest redesigning your workout program to have at least a 3 : 1 pull to push ratio i.e. do more deadlifts, pull ups and rows to push ups and shoulder presses. Shoulder and bench presses should be done in neutral grip at least until the shoulder pain has been eliminated. It is good practice to deload one week of the month with neutral grip presses to give your shoulder joint a 'break".
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