Wednesday, 23 August 2017

Sports Massage and the Runner

On April 23rd between 30,000 and 40,000 people lined up at the start of the London Marathon. Around 50% will have finished inside 4 hours. By the time they’ve completed their training and the 26 miles (and the extra few hundred yards) they will probably have gone through at least 4 pairs of trainers. 
Throughout all the training some will have spent time on the treatment table getting regular massages and treatment. So what can massage do for the runner?
Sports massage has a number of physical benefits from improving the permeability of soft tissue to allow for faster delivery of nutrients and faster removal of waste products, to helping increase flexibility in muscles and other soft tissue structures that it turn can help you become a more efficient runner. 
Sports massage also involves a number of techniques that help breakdown scar tissue that arises from muscle injury, improving the tone of muscles. Add to that improving circulation, relieving relief and relaxation, and you have a growing number of reasons why a massage is not just a luxury to be enjoyed once in a while but might actually be a benefit on a more regular basis.
What, when and how often
Everyone is different, but if you’ve been inspired by the marathon, actually running the marathon or just taking up jogging or running, then consider making a regular massage part of your training plan. If you’re just starting out, then a good massage can help identify areas where the muscles are tight or short, or maybe weak and not working as well as they could. If you’re deep into training, then massage can help keep you healthy, reducing the potential for injury.
A massage once a week might be too difficult to work into your diary but once a month or every six weeks can be a good pattern to adopt. A massage in the final week before the marathon is a good idea, and don’t forget to book an appointment for a post-event session too! After running 26 miles your muscles will need a bit of attention!
And if you’re not running the marathon? Well Sports Massage can be of great benefit to everyone whatever exercise you do, and even if you don’t!
Try it and see.
10 odd facts from the London Marathon
The London Marathon is the Guinness World Record's largest annual fundraising event in the world. The event itself holds a Guinness World Record for one-day charity fundraising, a record it has broken each year for the past nine years.
The millionth runner crossed the finish line in 2016.
The London Marathon is shown on television in nearly 200 countries around the world.
The fastest MP to date was Matthew Parris, who ran a crowd-pleasing 2:32:57 in 1985.
The speediest female celebrity was Nell McAndrew, clocking an impressive 2:54:39 in 2012.
The hottest marathon day was in 2007 when temperatures peaked at 21.7°C.
The coldest race day was a chilly 7.6°C in 1994.
The most common occupation for people running the marathon is teaching.
250 tubs of petroleum jelly, 200 bottles of baby oil, 2,000 plasters and 50,000 Lucozade Sport gels were available on the route last year.
At mile 10.5, the route passes within 300 yards of the Mayflower, the pub where the Pilgrim Fathers met for a quick pint before they sailed to America.
How much do you stretch before and after a run?
Go on, be honest now, how much stretching do you actually do? Many of us, even those committed to exercise, probably don’t stretch as much as we need to. It almost feels like time wasted when what we really want to do is getting out there and run or ride the bike or just get through our workout at the gym. We simply don’t have the time to stretch for 15 or 20 minutes before or after our exertions.
But the older we get the more we begin to understand that stretching is vital if we’re going to maintain flexibility and recovery from exercise.
So how do you make the most of your time spent stretching? Well, before exercise it’s best to warm up and do some dynamic stretches. After exercise, a few simple static stretches can help reduce muscle soreness and stiffness and help maintain flexibility.
It doesn’t have to be complicated or time consuming. For example, a good dynamic warm up stretch that engages large groups of muscles in a single movement would be a lunge with upper body rotation and arm raises. That just about engages every major muscle in your body and doing 10 or 12 of these takes very little time.
After exercise, a few simple static stretches of the muscles that have been most used can help keep them healthy. Hamstrings and calf muscles can be stretched in one move by flexing at the waist, rotating the pelvis forward. You will probably feel a stretch going all the way up the backs of your legs if you perform this move properly.
So, make sure to add some simple stretching to your exercise or training programme. You will definitely feel the benefit.

Wednesday, 16 August 2017

Tight or Toned?

New to the gym or an old hand, eventually you’ll become aware that some muscles might feel a bit “tighter” than they used to. You might be tempted to put this down to getting more toned, but that might not be the whole story.

Muscles are meant to operate at a certain length. In fact they are at their optimum power just short of what is called their normal resting length. When a muscle is overworked it can become shortened and tight. This has a knock-on effect throughout the body. Muscles work in pairs or groups and tight, shortened muscles can stress their partner muscles and are themselves under stress.

At the most basic level muscles work in pairs. When one muscle contracts the muscle that performs the opposite motion relaxes so that movement can occur. They need to be balanced in order to work at their most efficient. Any tightness on one side will upset this balance. But it’s not only the opposing muscle that can be affected. That pain you sometimes feel in the back of your shoulder when you’ve been running for a while-well it might just be that it’s related to a problem with the opposite hip, or even the ankle.

Tight muscles on one side can lead to weak muscles on the opposing side. For example, if your job means that you spend a lot of time sitting down, then it’s possible that the muscles that flex the hip can become shortened and tight. This in turn can lead to the muscles that extend the hip becoming weak. Typically in the hip that means the big gluteal muscles become weak and the knock-on effect of that is that your hamstring muscles have to compensate for the the weak gluteal muscles and they in turn become stressed and overworked!

So, what’s the solution? The first thing you need to understand is that there is no point trying to strengthen a weak muscle until you’ve got the shortened muscle back to its proper resting length. In fact strengthening the weak muscle will probably make the problem worse because now you will have tightness on both sides of the joint, reducing flexibility and preventing fluid movement. Manual therapy like massage and manipulation can help relax the stressed muscles and restore length. Simple, regular stretching can help maintain the new length and begin to restore range of motion and flexibility. Left untreated, shortened muscles can lead to tendonitis, a condition that causes inflammation and pain in the tendons.

There are a few simple things you can do to help yourself as you train. Firstly, always make sure you have good posture when you exercise. Shoulder back, round and down, was a phrase my PT always used to repeat as we did various circuits. Don’t just use the mirrors in the gym to admire your biceps, use them to check your posture! You can support your posture too by making sure you include exercises that work the muscles groups you can’t see in the mirror. You could even ask someone to do a simple posture check by looking at the alignment of your ear, shoulder, hip and ankle. Most postural problems lead to a forward head position.

Secondly, make sure you are doing some work on flexibility and that you are stretching regularly. We all know that stretching can be the tedious part of any exercise routine, but we can’t ignore its importance.

Thirdly, build rest and recovery into your training plan. Vary your training load and intensity so that your body gets to recover. And last, but not least, stay hydrated. A 2% fall in hydration can lead to up to 20% loss of function, so keep drinking plenty of water as you train.

Wednesday, 9 August 2017

Rest & Recovery

This is a short piece I wrote for our summer newsletter at the gym where I run a weekly clinic.

How is your fitness plan going now we’ve landed in the summer holidays? Are you still putting in the miles, hitting PB’s, upping the intensity, or are you taking a break, relaxing, making the most of time away from the treadmill? You might, if you've opted for the latter approach, be feeling a twinge of guilt. You might feel that if you don’t get out and do something you’ll suffer for it when you get started again, or maybe you worry you’ll never get started again.

Perhaps you’ve just joined the gym, having decided it’s time to get fitter, lose some weight or simply get active. You’re hitting the cross-trainer, looking at classes and are all pumped-up about the new you waiting to be revealed!

Whenever you start a new exercise or fitness routine one of the sometimes overlooked aspects of the plan is rest and recovery. Along with all those stretches we’re supposed to do pre- and post- training, but never quite find the time to actually do, taking rest and recovery seriously simmers away on the back burner of our training schedules. Someone somewhere once mentioned periodisation, but we can’t remember what it is and why it’s important. And anyway, we’re too busy training to take time off.

But here’s the thing, over-training can create chronic conditions that can be hard to treat and can even lead to not being able to participate in training the way you want to. Typical over-use injuries include things like tennis elbow, runner’s or jumper’s knee, tendonitis, joint and muscle pain. As their name implies, they come on slowly over a period of time rather than suddenly, although some show up suddenly with an acute pain, the symptoms have probably been developing over weeks and months. Some seem to cure themselves, usually because our technique improves, but others simply persist.

The good news is that if you factor in proper rest and recovery, you can reduce the risk of suffering a chronic injury. Soft tissue therapy can also play an important role in helping keep tissue healthy and helping in rehabilitating injuries when they occur.

Periodisation doesn’t have to be complicated and it isn’t just for competitive athletes. Everyone can develop a simple approach to keep themselves motivated and energised about their training. A simple plan might be set out over three months and broken down into three four-week cycles. Weeks 1-3 might be you’re most intense training patterns and the fourth week would be a light, rest and recovery week. You could even schedule a Sports Massage for week 4!

Thursday, 4 May 2017

Stretching and the role of fascia

I'm working my way through Fascia in Sport and Movement, edited by Robert Schleip, reading the chapter on fascia as sensory organ. Fascia is a fascinating subject. It is an intricate and historically overlooked anatomical and physiological feature. These days there is more and more research being undertaken to explore the nature and function of what appears to be the largest sensory organ of the body (p31). I'm just reflecting on this paragraph:
Stimulation of the Golgi receptors tends to trigger a relaxation response in skeletal muscle fibres that are directly linked with the respectively tensioned collagen fibres. However, if tendinous extramuscular are stretched in a condition in which they are arranged in series with relaxed muscle fibres, then most of the elongation will be 'swallowed' by the more compliant myofibres. In this way, the respective stretching impulse may not provide sufficient stimulation for eliciting any muscular tonus change (Jami, 1992). A practical conclusion may be that a stretching impulse, aimed at reaching the tendinous tissues, may profit from including some moments in which the lengthened muscle fibres are actively contracting or temporarily resisting their overall elongation. (p33)
My first thought was isn't this what we do when we apply MET or PNF? In both those approaches to stretching we use the Golgi Tendon Organs to elicit a relaxation phase in the target muscle by contracting it against a resistance and 'turning off' the muscle spindles. But maybe this also explains why, having stretched a muscle it can quickly return to its shortened state. Perhaps it is simply not enough to target the compliant fibres, needing in addition to target those less compliant fibres. I don't know, and it definitely needs more thought. There are many other possible reasons why, after applying all our techniques and skills, some tissue simply refuses to respond as we would like. But it does look like a deeper understanding of an appreciation for the role of fascia could open up a whole new world of possibilities!

One of those possibilities that came to mind was to experiment with stretching by adding a small degree of stretch during the contraction phase. It's just a wild idea at the moment, and may prove totally fruitless. Even as I think about it, I wonder how you could do this in practice-stretch an already contracting muscle. I shall have to experiment on myself!

Saturday, 22 April 2017

A germ of an idea

Okay, so as you know I'm off to the London Marathon tomorrow (Sunday 23rd April). It's my second year working with Against Breast Cancer, and as I said in the previous post, it's quite a small group of runners. And that got me thinking.

How many smaller charities have runners, maybe only one or two, raising money for them at this year's event? I don't know the answer to that question, I'm guessing someone, somewhere does, but it's not me. I'm pretty sure that although there might be a welcoming committee to cheer these runners home, I'm not sure how many will get the good bags and an offer of a post-event massage at the end of their 26 mile run.

So what if we got together and provided that service for a group of charities? Under some sort of collective banner a small team of 6 or 8 therapists could probably treat 100+ runners that might otherwise not get the opportunity.

I'm not sure how to organise something like that, but if a group of charities worked together I'm sure we could get a big enough marquee sorted. It's worth some thought.

Saturday, 15 April 2017

Why I work for nothing

On the 23rd April 2017 I will once again be dragging my massage couch through St James Park to set up in a gazebo and prepare to treat a group of charity runners at the London Marathon. I've done this for the last 5 years and always as an unpaid volunteer.

Each year I see offers of 'paid work' but for me it's become somehow important that I give up my time for free. Each runner I treat has put themselves through some sort of training programme that has resulted in them just having run 26 miles. It might have taken them anything from 4 to 6 hours to complete the course. They've done it to raise money, often for a cause close to their hearts because of family loss or circumstances or experience.

Don't get me wrong, I don't have a problem with people getting paid to do what I choose to do for free. It is, after all, my choice. It doesn't make me or them better. It's a choice. I do get a bit annoyed when I discover that having volunteered some pull out of the volunteer role because a paid role has come along. That leaves the charity looking for volunteers in the difficult position of casting around for last minute replacements, and quite frankly I find that unacceptable.

This year I'm working with Against Breast Cancer again. We'll be somewhere in St James Park and I'm not sure how many runners they have in this year's event and how many will come for a post-event massage, but we'll be there, ready and waiting.

And if your chosen charity hasn't got post-event massage available and you fancy a 10 minute rub-down, then why not come and find me and I'll see what I can do.