Don’t Be Distracted By the Water on the Floor

by | November 16, 2012, 9:31am 0

The following blog post is contributed by Anna Bucher, Doctorate of Physical Therapy and outpatient clinician.

Front of knees hurt; Quads are tight; Cannot get hammies warm; Achilles is angry;  Constantly having to foam roll IT band.  Whether just temporary or chronic nagging issues, these are all things that most ultimate players have experienced in their career at one point or another.  As we proceed into being a more intelligent and trained population, we not only need to look at ways to make us faster, jump higher, and improve our sprint endurance, but also how to address and reduce the incidence of these problems. What I mean to address in this piece, is that just because you feel something somewhere, doesn’t mean that’s the source of the problem.

Our bodies consist of muscles that act as “stabilizers” and “movers.”  The stabilizers are typically smaller muscles, i.e. glute medius/maximus, deeper abdominal/intraspinal muscles, scapular stabilizers, that have greater motor control and precision over movements.  They are the ones that are setting the stable foundation for the movers to function on and create power off of.  The movers, i.e. quads, hip flexors, hamstrings, calves, are ones that produce the force to drive your movement.  If the stabilizers are not doing their job, then the movers are not provided with a solid foundation to pull from, contracting from both ends, and end up doing more work than they are meant to do.  Eventually this results in muscle strains, tendonitis, and a chronic sense of tightness in the muscles.

We can further assess movement dysfunction with the “joint by joint” approach.  The general idea is that each joint in the body requires a balance of both mobility and stability with the joints alternating between needing more mobility or more stability.  From the ground up: the ankle needs mobility, the knee stability, the hip mobility, the low back stability, the thoracic spine/mid back mobility, the scapula stability, the shoulder mobility, the lower cervical spine/neck stability, and finally the upper cervical spine/neck mobility.  If a joint is not fulfilling its role, the body will  find the movement or stability by other means, causing overuse at the joint above or below, and resulting in injuries insidious in nature.

Mobility is controlled by the joint capsule and the soft tissue surrounding the joint.  Proper mobility allows for good range of motion, providing the joint optimal feedback of its movements in space, and allowing the muscles to respond to stabilize and control dynamic activity.  If your hips lack mobility for a squat or lunge, your body will find the movement from somewhere else.  Typically, increased movement will occur at the low back and knee, adding movements and extra stress to joints that primarily need stability.

In turn, proper stability creates a good foundation for your body’s movement.  Without creating  stability from the proper muscles at that joint, your body will not have a good foundation.  Your body will create tightness in your long muscles/movers, also including IT band and paraspinals, to provide a false stability through stiffness and limit movement at the joint above and below.  Now you have limited your much needed mobility and put extra work on your movers.  For example here, if your knee lacks stability then your body will tighten your hamstrings, IT band, and hip flexors that attach up at the hip to try to stabilize through stiffness, resulting in decreased hip mobility, excess strain on the long muscles, and once again; overuse injuries. Without this fine balance of mobility and stability throughout the body, compensatory movement patterns occur, cause extra stress on structures and tissue, and contribute to chronic tight muscles, muscles strains, and tendonitis.

What all of this means, more often than not, is that the location of a muscle or tendon injury is not typically the source of the problem.  When we look at injuries, we need to not only look at the location of the injury, but also how things are working above and below the joint.  Typically, it is further up the chain where the true problem exists, thus causing an overload of soft tissues resulting in strains and inflammation. Often when people have a muscle strain or tendonitis, they are under the impression that that individual muscle needs to be stretched, massaged, ultrasounded, e-stimmed, iced, heated, needled, given a cortisone injection, or strengthened.  These techniques may get rid of your symptoms temporarily and can be useful in helping to address tissue changes/quality of the affected tissues, but it needs to be accompanied with proper stretching and strengthening of the entire body in functional movement patterns to enable normal movement.   You must address the full movement dysfunction, rewire the mechanics, and reset the foundation.  If not then your body will go back to old habits and you will find yourself constantly dealing with tendonitis, strains, and tight muscles.  It is like mopping up the floor, but not fixing the leak. This whole body treatment approach can lead to full recovery and an end to chronic pain and injuries.

Feature photo by Brandon Wu –

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