Sports Conditioning & Rehabilitation

Sometimes stretching isn’t enough improve muscle flexibility. Maybe you have a nagging ache during or after your runs. Or maybe you fatigue faster than you used to. These could be signs that you have a tight muscle or muscles that are inhibiting your performance. Simply stretching a tight or sore muscle isn’t always the cure for the problem. Muscles can develop regions of hypersensitivity or reactivity as a response to overload. The overload could be simply a hard training day, or it could be due to an accident such as an ankle sprain. When hypersensitive regions develop, the result is a small spasm within the muscle, causing the muscle to feel tight. Sometimes you are not aware to the tightness, but it is there nonetheless, negatively impacting your performance. This phenomenon is called myofascial dysfunction. You can identify myofascial dysfunction by applying light pressure to an area. If that area is tender to touch, myofascial dysfunction is present.

Not everyone can afford their own personal massage therapist, but self massage can be a powerful tool when applied correctly. A self-massage program is most effective when it is custom designed for you by a sports medicine professional such as a physical therapist or certified athletic trainer, or by a fitness professional such as a clinical exercise specialist. Call SCAR today to schedule your free consultation!

Here is one example of a common dysfunctional muscle pattern in runners and a self-massage prescription to correct it.

Problem: shin pain on the inside of the leg during or after running.

Possible cause: tightness in muscles on the outside of the lower leg and hip.

Self-massage treatment: treat muscles on the outside of the leg and hip as well as the bottom of the foot (where many lower leg muscles attach).

Tennis/golf ball foot massage

Roll bottom of foot on a tennis ball while seated in a chair. Roll ball from toes to back of the foot several times and make little circles over sore spots. Important: do not use very much pressure. This will only make your foot sore. Use light to moderate pressure the first time you do this until you know how your body responds to it later in the day and the following day. Follow this up with using a golf ball to apply light pressure to sore regions. Let your foot rest on the golf ball and breathe deeply, consciously relaxing as you wait for the tissue to soften under the ball. Hold this position for 30 -90 seconds. You can also wiggle your toes, and make quick small circles with the ball to gently manipulate the tissue under the ball.

Foam Roll

Peroneals (lower leg outside of the leg)

Iliotibial Band

Tensor Fasciae Latae

Biceps Femoris (outside of hamstring)

Foam Roll Instructions:

1) Slowly roll up and down over the region several times until pain subsides and the tissue softens.

2) Hold light to moderate pressure over tender spots 30-90 seconds as tolerated. Important: Use light to moderate pressure the first time you attempt until you know how your body responds to the massage. If you use too much pressure the tissue may respond by tightening up even more.

Calf Foam Roll Technique

Iliotibial Band Foam Roll Technique

Special instructions for Iliotibial band self massage: DO NOT use pressure over your hip joint or knee joint.

Email us today at info@scarfitness.com to receive your own FREE copy of a self-massage pictorial guide for runners.

Posted by: Nicole Anderson, MS, ATC

In today’s world many people spend the majority of their day sitting at a computer. This leads to chest and shoulder tightness that can cause neck, shoulder, back pain. If you are physically active with running or swimming and your chest and shoulders are tight, an injury or a drop in performance can result. The following is a stretch that opens up the chest and shoulders. You can do this stretch even while you sit at your desk. In fact, if you sit most of your day, doing this stretch a couple times a day is optimal for your health.

Standing Chest and Shoulder Stretch

1. Stand tall, clasp your hands behind you, interlacing your fingers together.

2. Reach back as far as you can, lifting your breastbone up slightly toward the ceiling as you take a deep slow breath in.

3. Keep taking slow deep breaths and hold the stretch for 30 seconds.

You should feel a stretch through the front of your chest, and you may feel a satisfying pop in your upper back.
Do not stretch through pain. For more stretches to relieve chest and shoulder tightness, and to prevent neck and back pain, click here.

Posted by: Nicole Anderson, MS, ATC

If you spend time sitting in front of a computer on a daily basis, you probably have tightness in your upper back, neck, and shoulders. This restricted range of motion can interfere with training, and and even cause chronic pain. There are many self-treatment techniques address tightness in the upper spine and shoulders. A few are listed below. If you are experiencing chronic pain, call SCAR today to request a consultation for a personalized plan for treatment.

The foam roll is a great tool for reducing neck and back pain. The following is the first part of a circuit that will gently mobilize your spine and stretch muscles in the front of your body that tend to get tight with activities of daily living. To get your complementary copy of the rest of the circuit, send an email to info@scarfitness.com or call SCAR today to schedule a consultation.

Foam Roll Circuit (part one)

Angels

Instructions: Head and tailbone should be on foam roll, head supported with pillow or towel roll if necessary. Knees bent and feet flat. Arms out to side with palms up. Move arms up and down slowly like making snow angels. Keep back of hands on floor. Stay in a pain free range.

Backstroke Arms

Instructions: Head and tailbone should be on foam roll, head supported with pillow or towel roll if necessary. Knees bent and feet flat. Alternate arms up and down like you are swimming the backstroke. Go slow.

Stay in pain free range.

Rope Climber

Instructions: Head and tailbone should be on foam roll, head supported with pillow or towel roll if necessary. Knees bent and feet flat. Raise one arm up toward ceiling at a time. Try to reach up and grab the air, then pull it back down. Go slow.

Posted by: Nicole Anderson, MS, ATC

If you have persistent tight hamstrings, shins, or calves, it is possible you are not warming up appropriately before you run. A pre-run warm-up should include dynamic flexibility and neuromuscular facilitation for the entire back side of the body, especially the low back, hamstrings, and calves. A dynamic stretch called the inch worm accomplishes all of this. The inch worm is challenging, causing some people to have a love-hate relationship with it, but the benefits gained make it well worth the effort. Use this stretch consistently before you run and in a few weeks you will have more flexibility through your hips and ankles, allowing you to generate better power as you run. To see more dynamic stretches click here.

Inch Worm

Goal: Increase shoulder, back, hamstring and gastrocnemius (calf) flexibility, while strengthening the core, shoulders, chest and hip flexors.

Directions: Keep the legs completely straight, reach down to the ground. Without moving the feet, walk the hands out as far as you can keeping the body tight and the legs straight. Once fully out stretched, hold for 1 second. Then slowly walk the feet in towards the hands, keeping the legs straight and raising the hips towards the sky creating an upside down V (Hold for 1 second). Without getting up, walk the hands out again and repeat the exercise.

Verbal Cues: “Keep elbows and knees straight. Don’t let your back or hips sag”

Exercise Duration: 30 seconds, approximately 10 yards.

Posted by: Nicole Anderson, MS, ATC

It is important to “wake up” your nervous system, and increase heart-rate and body temperature before you train. Dynamic stretching is the ideal warm-up activity for any physical activity because it is proven to improve flexibility and strength over time as well as improve performance. The following is a stretch that will awaken muscles of your low back and hips that are often stiff and tight. This stretch is especially beneficial if you spend a great deal of time sitting on a daily basis.

If you would like to learn more dynamic stretches, you can send us an email at info@scarfitness.com to request a complete dynamic stretching routine, or stop in at Sports Conditioning and Rehabilitation and ask to speak with one of our sports medicine experts.

Hip Flexor Rotation Dynamic Stretch

Do this stretch at the beginning of your workout. Start face down with your arms outstretched and legs together. Bend your left knee and bring your left heel toward your right hand. Hold one second, then return to the start position. Be conscious about using your core to move your leg. Alternate sides and repeat 10 times.

Posted by: Nicole Anderson, MS, ATC

If you want to improve your flexibility, the ideal time to stretch is right after your workout. You should hold the stretch for 30-90 seconds. The longer you can hold the stretch the better, because a gentle stretch over time allows the tissue to elongate optimally. To see results long term you should stretch this way at least 3 times a week, but daily is even better. If you are like most people, you are pressed for time and stretching often gets skipped. In as little as 4 minutes you can hit all the major muscle groups essential to runners, and this is time well worth the investment. Check out the program below to find out three essential stretches for runners.

*Important safety note: “White knuckling it” through pain or discomfort during these stretches can lead to injury. If you feel pain back off the stretch so that it is not painful. Be sure to consult a health care professional if these stretches cause pain.

Hip flexor stretch (click here to view instructions): 30 – 90 sec each leg

This stretch increases hip flexibility, which allows you to have a more powerful push off during running. Lack of hip flexibility in a runner can cause hamstring strains and even overuse injuries in the lower leg.

Hamstring stretch with rotation (see below): 30-90 sec each leg

(both directions)

This stretch specifically targets the hamstrings and the rotational element of the stretch targets hip muscles including the piriformis, glutes, hip flexor, and adductors.

Hamstring Stretch Toe In

Hamstring Stretch Toe Out

Calf stretch with rotation (see below): 30-90 sec each leg

Make it your goal to find the region of your calf that is most restricted and target that region during your stretching time. A restricted area will feel more tight and/or sore when you rotate your foot and lean into the stretch. If you have extra time you can stretch other regions of your calf

Calf Stretch Toe In

Calf Stretch Toe Out

Posted By: Nicole Anderson, MS, ATC

Hopefully you know that a technique called “dynamic stretching” is the best thing to do right before you go run. This type of stretching helps to prepare the muscles for high intensity activity by waking up the nervous system and increasing blood flow. Click here to view examples of dynamic stretching. If you want to improve or maintain flexibility with stretching, AFTER your workout while you are still “warm” is the time to do it. Long holds of 30-90 seconds called “static stretching” are the key.

How to stretch for flexibility gains:

1. Stretch while you are still warm. The soft tissue that makes up your muscles will elongate best when your body temperature is still elevated from exercise.

2. Ease into the stretch slowly. If you try to force it by pushing the muscle you are trying to stretch too hard at first, nerves that protect your muscles from overstretching will kick in, and you won’t be able to get the elongation you want. So ease into the stretch slowly, then after 20 seconds, try to move a little deeper into the stretch. Chances are you will find you have a little more play at that time.

3. Hold the stretch for 30-90 seconds. Longer holds in the neighborhood of 90 seconds or more engage myofascial restrictions that won’t release with short holds.

If you are consistent with stretching, you should notice a difference in flexibility within 3-6 weeks. The following is a great static stretch for your hip flexors, quadriceps, abdominals, and other muscles on the front of your body.

Hip Flexor Stretch

1. Kneel with your right leg in front.

2. Push your hips forward, keeping your back straight.

3. Rotate toward your front knee. You should feel a stretch in the front of your left hip and into your abdominals. Hold for 30-90 seconds.

Posted by: Nicole Anderson, MS, ATC

If you are a runner you have probably been told that if you want to prevent injuries, you should stretch. But research has shown that performing long slow stretches of 20 seconds or more right before exercise can decrease performance or even be harmful. A technique called “dynamic stretching” is the best thing to do right before you go run. Dynamic stretching involves taking the joints and muscles through a range of motion similar to what they will be expected to perform during exercise. The intensity is low and each hold should only last about one to two seconds. The goal is to prepare the muscles for high intensity activity by waking up the nervous system and increasing blood flow. Stretches involving long slow holds to improve flexibility should be done at the END of your workout. The following is an example of a great dynamic stretch for your hip flexors, quadriceps, abdominals, and other muscles on the front of your body.

Backward Lunge

The stretch should be held only one to two seconds and you should repeat the stretch on each side 5-10 times. Use small movements for the first few reps, and gradually increase the range of motion as you go. You should never push through a painful range of motion as you are warming up with this stretch.

Step 1

Lunge backward, driving your left knee as close to the ground as you can without resting it there. Rotate toward the right knee and lean slightly back until you feel a stretch in the front part of your left upper thigh and abdominals.

Step 2

Face forward again, then lunge backward. This time your left knee will be in front as you rotate.

If you are interested in learning more dynamic stretches to do before your workout, click here.

You can also send us an email at info@scarfitness.com to request a complete dynamic stretching routine designed specifically for runners, or stop in at Sports Conditioning and Rehabilitation and ask to speak with one of our sports medicine experts.

Posted by: Nicole Anderson, MS, ATC

If your hamstring feels tight during or after physical activity, it may be a warning sign that a strain is just around the corner. But stretching the hamstring might not solve the problem. The sensation of hamstring tightness can be the result of poor hip mobility due to tightness in other muscles, or a problem with a joint or structure above or below the hamstring. For example, a common muscle problem that causes hamstring tightness is hip flexor (iliopsoas muscle group) tightness. Tightness in the iliopsoas muscle group causes your pelvis to rotate forward, putting a stretch on the hamstrings. This causes the hamstrings to feel “tight,” and be susceptible to a strain injury, but the muscle that actually needs to be stretched to fix the problem is the iliopsoas. To see a iliopsoas muscle group stretch, click here.

Identifying the Problem.

If your hamstring feels tight, or if you have had recurring hamstring injuries, the best way to find a solution is to go see a sports medicine professional such as a physical therapist or a certified athletic trainer. There are many reasons a hamstring might feel tight during or after physical activity, including poor hip/pelvic mobility, core weakness, ankle problems, calf tightness, or back problems. A sports medicine professional will be able to tell you the cause of your hamstring pain or tightness and what to do about it.

Why Sport Specific Hamstring Strength is Crucial:

And How to Build it.

One common cause of hamstring strains is poor sport specific hamstring and hip strength. Running is not enough to build sufficient strength in the legs. Some strength training is essential. Double leg exercises such as squats or cleans are good for developing leg strength and power, but single limb exercises carry greater protection against injury. Most sports involve single limb stresses such as those encountered during sprinting, jumping, or leaping, and single limb strength exercises prepare the body for these activities. It is important to include some single limb exercises as a part of training for any sport, not only to guard against injury, but also to enhance performance. Some good single limb exercises for the hip and leg include: walking lunges, single leg bridges (pictured below), single leg squats (including TRX variations) and the cone reach (click here to watch), or TRX cone reach (click here to watch). If you are interested in learning other excellent single leg exercises ask the experts at SCAR next time you go in, or if you are not yet a member, schedule your FREE trial exercise session today.

The Key to Staying Injury Free:

Consistent Functional Training Pre-season and In-season.

Your strength training program should change in volume and intensity as the season progresses. But it is important to consistently include functional training such as single limb strength training and hip mobility exercises to maintain your performance edge and protect against injury. A great way to include quality flexibility and strength exercises with minimal time investment is to utilize a dynamic warm-up. Click here to see examples of some dynamic warm-up exercises. And if you want to find out some more dynamic warm-up exercises specific to improving hip and hamstring mobility, send us an email at info@scarfitness.com or stop by SCAR and ask one our sports medicine experts today.

Posted by: Nicole Anderson, MS, ATC

When an athlete arrives in our clinic with a shoulder injury, the most common cause of injury relates to what the athlete is and isn’t doing in training. The number one training error that we see involves neglecting to strengthen the supportive muscles in the back of the shoulder and inadequate core conditioning. The following three tips will help any athlete avoid shoulder injury and perform better than ever before.

1. In the weight room, perform three pulls for every one push

Many athletes are pushing a lot of weight, but they should be pulling much more often. It is the exercises that involve pulling (such as lat pulls, rows, flys, etc) that are most protective of the shoulder girdle. As athletic trainers and physical therapists we can’t tell you the number of times an athlete comes in with shoulder pain and tells us they regularly perform lots of pushing exercises (bench press, push ups, and military press), and are not doing much else. Once they have a few weeks of performing a program composed primarily of various exercises for the muscles in the back of the shoulder, that pain tends to go away.

2. If you aren’t getting in the weight room, start doing some band work

You can easily accomplish the essentials in 10 minutes or less two or three times a week. Add it to the beginning of practice, or do it at home. But if you play an overhead sport and you aren’t building up the strength and endurance of the supportive muscles in the back of your shoulder, it is only a matter of time before the shoulder will break down. If you are interested in receiving some free examples of excellent band exercises for overhead athletes, email us today at info@scarfitness.com.

3. Build up your functional core strength

The power for throwing or striking a ball comes from your hips, through your core, and out the shoulder. Overhead athletes with weak hips and a weak core consistently put their shoulder through unnecessary stress, and eventually it breaks down resulting in injury. Simply doing a bunch of sit-ups won’t cut it. The best type of core training for overhead athletes includes exercises that utilize the entire body, especially exercises in which the feet are planted on the ground and the core is challenged in multiple dimensions. If an overhead athlete performs a basic plank with a major sway back and can’t correct it, their shoulder is at risk. If they CAN do a plank properly, that is only a starting place. The alternate arm/leg plank (pictured right) is an example of an exercise that challenges the core in three dimensions and requires excellent core strength to perform properly. This plank is the final level of difficulty in a plank series. Click here to see examples of some  intermediate level planks.