How To Loosen Up Stubborn Areas

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Today we kick off our weekly Q&A session with the most common question I get:

“I have been working on _______ EVERY day and it will not loosen up. What do I do?”

We have all been there on this one. For some of you it may be the calves or hamstrings, and for others maybe it’s a hip or a persistent shoulder issue that just won’t let up. Whatever the area, the problem just won’t go away despite consistent work with the roller or massage ball. So what’s going on and why won’t it go away??

The first thing to realize is that our bodies are not like cars. If something breaks down, we can’t just swap that part out and carry on our merry way like it never happened. This is even more true when it comes to overuse injuries. For most of us, the start of symptoms and the start of the injury are not one and the same. There is a gap between the two and that gap is where we learn how to compensate around the problem so that we can continue training , racing, competing, etc.

This means we need to step back and stop focusing our efforts just on the area that hurts. Instead, we need to think about what other areas are contributing to the problem. Here’s an example:

Shoulder Pain (front of the shoulder to be more specific):

  • You start your self treatment using the Anterior (Front of) Shoulder Basics Course. This will take you through a progression of treatments targeting that area over the course of a few days. You want that time to see what works and to allow recovery between treatment sessions. However, at the end of that program, your shoulder still hurts. Now what?
  • My next step would be to include work on the opposite side of the shoulder. Why? Muscle groups work in pairs. These pairs allow controlled movement of a joint in opposite directions.  If the front side is having problems, then its safe to assume that the back side is as well. Head over to the body map and pull up the back of the shoulder. Add those techniques into your self treatment and reassess how things are feeling.
  • If working both sides doesn’t help, then it’s time to expand the areas we are working on. Why? Most major muscle groups work to move more than one joint. If there are problems at one joint, that muscle group will likely be compromised in how it moves the other joint. This is why the next step is to move up one joint and move down one joint. Using the shoulder as an example, this means that it is time to see how the neck and upper arm (biceps/triceps) are feeling. Back to the body map and pull up those basics courses to learn those techniques.

To put it more simply:

  1. Start with the problem area.
  2. Expand the area you are working on to include the opposite side as well.
  3. Add in the areas directly above and below the problem area.

Sound complicated? It’s not at all! This is where the interactive body map comes in. It doesn’t require you to know muscle groups or names. Simply start with your problem area and then flip the map over to find the area on the other side (this option is on the left hand side of the map). If you are moving up or below, use your mouse to select the areas directly above and directly below.

ATA Turns 6 (and gets a big makeover!)

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It’s hard to believe that this past January the ATA website turned six years old! For those of you who have been along for the ride from the beginning, you have seen a few different versions of the site now. What started as a little clinic wordpress blog has grown into a virtual warehouse of pictures, videos and content. In fact, managing all of that content and keeping it organized, user friendly, and time efficient has been my biggest challenge so far! Thankfully, you have all been a wonderful feedback loop over the years.
That’s why when I sat down to plan out the next phase for ATA, it was with your suggestions and feedback in mind.
  • Problem #1: Site Navigation. Let’s be honest, there is A LOT of information on the site. The body map was a great start in terms of organizing all of it by region, but it still made for large amounts of clicking around to find stuff. Despite my attempts to organize and reorganize, I never really could find a good fix for this until now. The new site is truly an educational site, complete with “courses”. These courses allow me to not only deliver the content in a streamlined way, they allow me to keep everything all in one place, on one screen. The new site is essentially an “app”. It’s simple and incredibly easy to use.
  • Problem #2: Information Overload. The new course setup allows me to keep things short and to the point. Even the videos have a whole new look. There are little timers built in and directions so that you can literally watch and let the video do the rest. Each treatment will take you less than 10 minutes from start to finish.
  • Problem #3: Not mobile device friendly. The new site is more mobile friendly than it is desktop friendly. Why? Because I want you to be able to pull this stuff up on your phone or tablet while you’re on your family room floor using the treatment techniques.

 

Here’s a video to show you how it all works:

So what does all of that mean for you as the user??

To access the courses, you will need to create an account and sign up for a membership plan. 🙂

Here’s what you can expect with your membership:

  • Access to all of the courses. As of today, there are 18 courses currently on the site. This number is only going to grow over the next few weeks as I start loading up the injury specific courses. Once those are done, you can expect 1-2 courses per month on average. My plan is to have three types of courses per region:
    • Basic- these courses are region specific and focus on how to use the different self treatment techniques on that area only.
    • Intermediate- these courses are more in depth and take a more total body approach by working on areas above and below the symptom area.
    • Advanced – these are injury specific courses. Like the intermediate courses, these are more in depth and designed to not only cure your symptoms, but also help you identify the cause behind them.
  • Access to monthly webinars and Q&A’s. These will be announced on the blog and also through member emails. Each will be recorded so if you miss one? No problem. You will be able to download it when you have the time.
  • Access to me for questions, feed back etc. As things get rolling I will be posting “office hours” for you to reach me on skype.

In addition to individual plans, the new site layout also gives me the ability to create custom courses for teams and groups. Coaches? Need an offseason maintenance plan for your athletes or a post workout recovery routine? This is the option for you. Simply use the contact page to tell me what you are looking for!

Sounds pretty good doesn’t it?

 

 

Strengthening

What:

Muscles and joints that have been stuck in a tight/short position lose the ability to function normally over time. This is a fact. Remember, the body is phenomenal at being able to adapt when something breaks down. It will find a way to keep moving forward even if it has to call in every muscle it can to compensate. This is why need to restore strength and balance to the entire functional chain.

How:

The ATA system uses a total body strengthening approach that works from the proximal joints out. This means that we want to create stability where it is required and power/strength that can use that stability. In other words, we want to restore balance to the entire functional chain so that each muscle is working to its potential, when it should be working. We also want it to be resting when it should be resting.

What You Need To Get Started:

Equipment will vary based on the area you are working on. Examples include: hand/ankle weights, resistance band/tubing, and a stability ball. Wherever possible options will be given for both home and gym routines.

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Kinesiology Tape

What:

Kinesiology tape is a specially made elastic tape that can be applied to your muscles or joints to decrease pain and swelling, correct faulty motion, and assist weak or injured muscles. It can also be used as a proprioceptive tool for muscle re-education for sport specific movements such as running, cycling, and swimming. In short, these $20 rolls of tape are a must have addition to your training bag and can be used in several different ways throughout the healing cycle.

How:

The ATA system uses the tape in four different ways:

  • For symptom control to decrease pain and swelling.
  • To restore normal muscle position and joint alignment (blocking faulty motion as needed; providing negative feedback to inhibit faulty motion).
  • To assist weak and injured muscles to promote recovery.
  • As a proprioceptive tool to re-educate muscles to improve form and athletic performance through sport specific movement patterns.

What Do You Need To Get Started:

A roll of tape and the sharpest scissors you can find. Seriously. Cheap scissors will fray the tape and cause it to roll up.

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Stretching

What:

In the ATA System, we use self massage and mobilizations to break up restrictions and restore mobility. The next step is to stretch those muscle fibers and joints out so that the body can register that a change has occurred and adapt accordingly. You see muscles have what is known as a resting length and tension. This means that at rest, a muscle has an ideal length and tension that allow it to function at full capacity in terms of the force it can generate and the velocity at which it can move the joint it supports. Changes to that resting length and tension, whether it’s loss of mobility or increased tension in the form of knots, spasms, etc, will limit the muscles performance. The bigger the change, the more significant the loss of function. Stretching is a great way to help the muscle reset and restore how the brain and nervous system utilize that muscle.

How:

The key to success with stretching is frequency, frequency, frequency. In sports, we literally perform the same actions millions of times whether its steps, pedal rpms, or swim strokes. It’s going to take more than a few massage sessions to get things back to normal on the mobility front.

What you need to get started:

In most cases, nothing at all. Nice to haves include a long strap or belt that you can hold onto.

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Peroneal/shin mobilizations

In this post I’m going to show you how to use the tennis ball to mobilize the muscles along the shin bone and down the outside of the lower leg . This includes the anterior tibialis, extensor digitorum, and peroneal muscles. The goal with this mobilization is to anchor one end of the muscle down and then actively stretch out the rest of the muscle against it.

Key Points

1) Go back and read the massage post specifically on the hand itself to review the body landmarks and muscles in this region. There is one bony landmark that you will need to be able to find to as your point of reference- the fibular head. This is where the peroneal muscles attach and if you move forward towards the shin from this landmark, where the anterior tib and EDL muscles are.

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The fibular head is actually located slightly below the knee. To find it, while sitting with your knee bent, wrap your hand around the upper part of your calf so that the space between your thumb and index finger are directly behind the knee and your fingers are wrapped around towards the front of your knee. The fibular head will be the large, bony bump under your index finger.

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2) To perform these mobilizations, you’re going to need a tennis ball and some floor space. The basic idea is to apply pressure with the tennis ball to one of the three yellow x’s (picture below) and to then move the foot/ankle to stretch out the muscle against it. Remember, only go as far as you can comfortably. You’re not trying to force these! If this is too much or the spot is too tender ease up on the pressure or go back to the foam roller. See the video below for full details and demonstration of the mobilizations.

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3) Repeat for 10 reps.

4) Same warm up rules apply. Try to do this either following a workout or warm up the area with the foam roller first. Especially if you’re coming back from an injury or this is a problem area.

Video

Lower Back

backmuscle1This region is home to the large muscles of the low back including the paraspinals (erector spinae and multifidus), as well as, the quadratus lumborum and larger overlapping latissimus dorsi muscles. In this section you will find our available treatment plans as well as the different self treatment techniques on this site.

Injury Treatment Plans for this area:

(* note. each treatment plan includes a free downloadable PDF. Here’s a post on how to use them.)

1) Low back strain. Click here.

These plans are part of our “Injury of the Week” blog series. Each post will talk about what the injury is and how it can happen. It will then take you through all five steps of the ATA self treatment system including self massage, mobilizations, kinesiology taping, stretching and strengthening.

Individual Parts of Self Treatment System:

Part 1. Self Muscle Massage.

  1. Blog post with anatomy review, video and picture demonstration of self muscle release techniques for the low back using a foam roller and tennis ball. Click here.
  2. Blog post on additional treatment tools for use in the back, including the RAD Roller, Rumble Roller, and Knobber. Click here.

Part 2. Mobilizations

  1. Blog post on how to perform a tennis ball mobilization/active release of the low back. click here.

Part 3. Stretching.

  1. Blog post on how to stretch out the muscles of the low back. Click here.

Part 4. Kinesiology tape.

  1. Blog post on how to apply tape following a low back strain/sprain. Click here.

Part 5. Strengthening. 

Right now our strength advice is specific to our “injury of the week” blog series (see top of this page for injuries affecting this area). However, all of our strenghtening videos can be found on our youtube channel (link at top of website).

Low Back Pain

As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

  1. Immediately after injury  (for swelling and pain)
  2. During the healing process (correction techniques to restore normal position and allow for healing)
  3. Techniques to help improve strength + function

In this post, we’ re going to be talking about a taping application designed to decrease the amount of pull along the muscles that run parallel to the lumbar spine. This is perfect following a muscle strain to provide support and allow for rest so that the injured muscle/tendon can heal.

Anatomy

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The large muscles that make the lumbar spine move are actually organized into three separate layers. The first layer is the deepest (closest to the bone) and the third layer is the most superficial. As you can see from the pictures above, some of the muscles within these layers move in a vertical direction, parallel to the spine while others travel diagonally to or away from the spine. For this taping application we are focusing on the muscles that run in the vertical direction. They all share a common insertion point at the base of the spine on the PSIS (aka the posterior superior iliac spine, aka the “dimples” at the bottom or spine where the vertebrae attach to the pelvic bones).

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Before we get to the application itself, it is important that you can locate the PSIS on yourself. To find it, you’re going to start with your hands on top of your hip bones so that your thumb is pointing towards your back and your fingers are pointing forwards towards your stomach. As you reach behind with your thumbs, you’re looking for two small bumps on either side of your spine. Visually, you can see them. They are the two “dimples” at the small of your back.

You can read more about the anatomy in this area and find palpation tips here.

What you will need:

1) Roll of kinesiology tape.

2) Sharpest scissors in the house.

Prep work:

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated.

Taping Techniques

1) Low back application with correction strip.

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Key Points:

  • Prep the skin first. For this application you will want to put the back extensor muscles on stretch. To do this, start in a seated position with your feet on the floor. Then simply bend forward in your seat as far as you can comfortably.
  • There will be two primary strips that run up the back parallel to the spine. Each will be anchored at or just below the PSIS where the muscles share a common insertion point. From here, move into the stretch position and then apply the tape. The tape works by pulling on itself and you have already put the muscle on stretch to do the work for you. If you are unable to move the muscle into this position, you may add a small amount of stretch to the tape.
  • A secondary correction strip can be applied horizontally across the low back. If you have a sore area in the low back, you want this strip to cover it! Cut the tape so that it is long enough to cover both vertical strips with 1-2″ of tape on either side (these are your anchors and must be applied without stretch). Round the edges, apply 50-75% stretch and place the tape. Then remove the paper backing and lay down the ends. Don’t sweat the 50-75%. Think medium stretch versus maximum “how far can I pull this tape” kind of stretch.
  • When the tape application is complete you will have three strips of tape, 2 vertical and 1 horizontal.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.

Stretching pt 10- Low Back

In the introduction post to this series, we reviewed and answered some common questions regarding stretching, including why, when, how, etc. Click here to review it.

In this post we will be talking about stretches specifically for the low back. This includes the long back extensors (erector spinae), the QL and where the large hip flexor (the psoas) sneaks through to insert on the front of the lumbar spine.

The Rules:

1) Stretching should NEVER hurt. The goal is to only go until you feel a pull in the muscle. It should not be to go until it hurts in one of those “no pain, no gain” efforts. It should be comfortable and repeatable, allowing you to move a little further with each repetition.2) Perform stretches when the muscles are warmed up. This can be following a workout or following work with the foam roller. Click here to review the self massage post for the low back (this includes pictures and video using a foam roller and tennis ball to review 3 self muscle release techniques).

2) Hold for 20-30 seconds and repeat 3-4 times. You can hold longer than the 20 seconds, but the reps are key. You will always get more out of stretching frequently versus one killer session a week.

3) If hurt, make sure you are using a firm surface where the back is fully supported. A saggy bed mattress for example will make these far more difficult than they need to be. Also, start with the easier stretches in the progression and work your way up.

The Progression:

#1. Double knee to chest

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This is always a good one to start with as it brings both knees up at the same time to stretch out the lower lumbar muscles. Start laying flat on your back and bring both knees up to waist height. From here let your arms do the rest. Gently pull your knees up until a stretch is felt in the low back. If this is too uncomfortable, start by laying on a pillow and wrap a belt/strap behind your knees. Pull up using your arms versus your legs. Hold 20-30 seconds and repeat 4 times.

#2 Single knee to chest

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This is a continuation from the stretch above. Start by bringing both knees to your chest and then drop one back down towards the floor. Just let the leg fall as far as it can comfortably can. It may not go all the way down at first. If you’re looking to increase this stretch, try to use a surface where you can drop the lower leg down further. For example, I have people sit on the edge of the table and then lean back with both knees to their chest. As they let one leg go, the leg can come down into full hip extension and the knee can bend freely. Be careful when trying this one. It can be a big stretch! Start by laying flat on the floor and work from there. Hold 20-30 seconds and repeat 4 times each side.

#3 Lower trunk rotation

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Like the stretch above, this stretch allows for a few modifications to make it more challenging as you go. Start by laying flat on the floor with both knees and feet together. From here, drop your knees down to one side. You should feel a stretch in the low back and possibly even wrapping around the hip depending on how tight things are. Hold 20-30 seconds and repeat 4 times to each side.

How to modify this??

1) As you drop both legs to one side, straighten the top knee and keep the bottom one bent. the stretch will also be increased by how high you keep that leg (i.e. waist height and above versus lower).

2) Using the modification above, pull the lower leg back so that your legs are in more of a scissor position. Remember- shoulders must stay flat when you do this. Do what you can to start and work your way up from there.

#4 Quadratus Lumborum Stretch

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To target the QL muscle, we need to use both the upper and lower body. for this you’ll need surface where you can literally hang off the side (this means bed, coffee table, etc). Start by laying on your side. Bring the bottom knee up a little and then keep the top leg straight and bring it back. From here let it drop down. The last part is to add the arms in. Twisting your upper body, reach overhead with you top arm. Bottom arm stays relaxed. This should result in a stretch from your hip to your rib cage. Hold 20-30 seconds and repeat 4 times. Go slow setting it up to make sure both the upper and lower portions are set up correctly.

#4 Hip flexor stretch

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For this stretch, start in a lunge position kneeling on the side you want to stretch with the other leg out in front. From here you’re going to want to lunge forward onto the front leg (aka push your hips forward with your back STRAIGHT- no leaning forward). Keep the side you are stretching completely relaxed. You should feel a stretch right in the front of your hip and may even feel it in the top of your quad (thigh muscle). Hold for 20-30 seconds and switch legs. Repeat 4 times.

Click here for ways to modify this stretch.

Tennis ball mobilization- low back

In this post we’re going to use a tennis ball to try and break up soft tissue restrictions in the low back. The goal is to anchor down one end and then to slowly stretch the muscle out against it.

Key Points:

1) Go back and read the massage post specifically on the back itself to review the body landmarks and muscles in the lumbar region. The main area you will want to be able to locate for this mobilization is the PSIS (aka the posterior superior iliac spine). This is the common insertion point of the long back extensors and you will need to be able to find it so that you can accurately position the tennis ball.

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2) This is a two part move. The first part is moving into a pelvic tilt. The goal of this is to engage the lower abdominals and stabilize the lumbar spine. See the video below for full details.

3) When performing a rep, lay flat on your back with your legs straight and the tennis ball in position. Then move into the pelvic tilt. From here, slowly try to bring your knee up towards your chest. Do not force the movement. You may not be able to bring the knee all the way on the first few tries. Go as far as you can comfortably and then return back to the start. Try to hold the tilt throughout all of the repetitions. If you can not, stop, rest, and then reset before continuing.

4) Try to perform 10 reps.

5) Same warm up rules apply. Try to do this either following a workout or warm up the area with the foam roller first. Especially if you’re coming back from an injury or this is a problem area

Video