Addressing Tension and Tissue Quality - Part 3

For the third and final installment of addressing tension and tissue quality I want to quickly review and consolidate the previous posts and then touch on one last issue: muscle adhesions.

Foam rolling is one of the most common forms of myofascial release and can work wonders for ones movement and tissue quality. Similar to stretching, we can see lasting benefits from regular rolling. It can also help address muscular imbalances caused by today’s sedentary lifestyle. We often forget that our bodies will adapt to any situation presented to it meaning we are essentially always training our bodies regardless of whether we frequent the gym or not.

As noted in part 1, sitting can cause a host of problems most commonly displayed as adaptively short and tight hip flexors. This leads to what Dr. Vladimir Janda, a leading thinker regarding muscle imbalances and faulty posture and their relationship with chronic pain syndromes, coined the lower crossed syndrome. If we spend an exorbitant amount of time in a seated position the body will adapt and the hip flexors become short and tight while the antagonist muscles do the opposite and become long and weak. In the case of the lower crossed syndrome, the iliopsoas and rectus femoris become short and tight as do the spinal erectors. In conjunction with this the abdominals, glutes and hamstrings become lengthened and weak. The following graphic shows how this causes an anterior pelvic tilt, which can lead lower back pain and faulty movement patterns. The good news is that regular foam rolling and stretching of the hip flexors and quads can help prevent this. However, one should not forget that strengthening the weak muscles is also important.

Lower crossed syndrome. The pelvis is allowed to tilt anteriorly because the antagonist muscles (glutes, hamstrings, and abdominals) have become weak and no longer balance out the pull of the muscles shown.

And now the last part of this topic: muscle adhesions. Adhesions are basically scar tissue that builds up in the muscle due to trauma. This trauma does not need to be major for this to occur.

Scar tissue build up between the muscle fibers

Think back to the last time you exerted yourself physically and woke up the next morning experiencing soreness. That soreness is the result of micro-trauma to the muscle tissue which is enough to create adhesions over time. Obviously with resistance training soreness is accepted as somewhat of a norm, though it shouldn't be the goal. 

Now you may be wondering why we would want to subject our bodies to this relatively avoidable trauma. Remember how we were talking about our bodies adapting to every situation thrown at it? Well when we challenge ourselves physically our bodies adapt by becoming stronger, faster, more flexible, more endurance tolerant and lets not forget healthier and more disease resistant. So there is a huge upside to pushing ourselves physically as long as we train in a balanced way and address tissue quality. Foam rolling is the easiest way to do this. It can alleviate trigger points, reduce overall muscle tension and help keep our muscles functioning at their best. It doesn't really matter when you roll be it before exercise, after exercise, or on off days as long as you do it regularly.

-KO

Addressing Tension and Tissue Quality - Part 2

For the second installment of addressing tension and tissue quality we are going to take a look at trigger points. The inception of a trigger point is very much debatable, but we do know they are tight areas (knots) of muscle that are tender to touch and often refer pain to other areas upon palpation. Regardless of their genesis they exist and can cause a host of problems.

Trigger points can be active or latent so just because you aren’t experiencing any pain doesn’t mean all is well. A latent trigger point will only hurt when touched, however, it can still create movement dysfunction. Think of driving your car with the e-brake slightly on, you may not feel it but there is a definite drag that will affect the performance of your car. A similar thing happens in the body when part of a muscle is consistently “on”. Let's take the shoulder for example; generally speaking, the muscles on the backside of the shoulder are responsible for slowing the arm down when we throw. If one of the posterior shoulder muscles has a latent trigger point we may not feel it, but when we throw that muscle creates drag on the forward movement of the arm. While we want the shoulder muscles to slow the arm down at some point, this braking action is happening through the entire range of motion, which is not optimal.

This leads us to active trigger points. Active points not only create movement dysfunction but they flat out hurt. The traps are an area commonly loaded with trigger points. If you’ve ever had discomfort or tension in the upper shoulders and found the pain became worse or referred to other areas of the body when touched then you’ve found a trigger point.

Addressing trigger points can be done in a number of ways. When you go to a massage therapist they usually use their hands to work tension out of the muscles. For those that can’t afford massage on a regular basis there are many inexpensive ways to get a similar effect. I have had great success using a lacrosse ball, though many massage tools can do the trick as well. 

Lacrosse balls come in an assortment of colors and resemble a super hard racquet ball.

And now some common trouble spots; the "X" illustrates the trigger point itself while the red highlights the areas of referred pain. In other words, when these trigger points are depressed there will often be discomfort in the areas highlighted in red also.

 Trapezius - A common area of tension that can cause headaches due it's origin at the occipital bone of the skull. Using a lacross ball and running it straight up the back on either side of the spine can be a good way to address multiple trouble spots. Another easy and inexpensive way to hit this area is by using a "peanut"; two tennis balls taped together with athletic tape.

The "peanut"

Rhomboids - The rhomboids sit deep to the trapezius and can often be addressed at the same time. 

Levator Scapulae - Also deep to the trapezius, the levator scapulae contribute to that familiar tension in the upper back and neck that many experience.

Supraspinatus - Another muscle that is deep to the trapezius as well as the deltoid. The supraspinatus is one of four muscles that comprise the rotator cuff. This grouping of muscles affects the movement of the arm and stability of the shoulder so when dysfunction appears there can be far reaching consequences. 

 Infraspinatus - Another of the rotator cuff muscles that can affect the arm and shoulder similarly to the supraspinatus.

Teres Minor - A third rotator cuff muscle that can be palpated at the posterior shoulder. 

Teres Major - While not part of the rotator cuff, this muscle sits very close to the shoulder and helps make part of the arm pit. It can be palpated on both the anterior and posterior sides of the body as seen in the graphic.

Pectoralis Minor - Sitting deep to the pec major, the pec minor can cause a host of problems due to it's attachment on the scapula. This means that when it becomes tight, or in chronic cases adaptively short, it encourages anterior rounding of the shoulder. Hunchback anyone?

Gluteus Medius - The glute medius, as seen in the graphic, can cause all kinds of discomfort. This is most easily addressed by pinning a lacrosse ball between this muscle and a wall.

Piriformis - The piriformis sits deep to the gluteus maximus and is part of a group of hip external rotators. If you recall from part 1 this muscle can create sciatic like pain if chronically tight as well as adding to an externally rotated standing posture and gait pattern.

Iliopsoas - The iliacus and psoas major are two main hip flexors and can become chronically tight due to extended periods of sitting. In the graphic you can see that the psoas major has a direct attachment to the spine so when these muscles become tight they often cause low back pain. If you suffer from low back pain, releasing tension in these muscles would be a good starting point due to ease and low cost.

Rectus Femoris - The only thigh muscle that crosses both the hip and knee. Excess tension in this muscle can cause knee pain, however, since there is also an attachement on the pelvis it can add to an anterior pelvic tilt, along with a tight iliopsoas, and contribute to low back pain.

Vastus Medialis - Another contributor to knee pain and often addressed with foam rolling.

Vastus Lateralis - Also a contributor to knee pain but found on the outside of the thigh. This muscle is easily targeted with a foam roller.

  

You are now well on your way to addressing a lot of the discomfort you may be experiencing. Feel free to comment and share success stories.

-KO

Graphics courtesy of MyoRehab

Addressing Tension and Tissue Quality - Part 1

  For my first real post I want to introduce (or re-introduce for some) a technique that has improved how my muscles feel in many ways: self-myofascial release. Myofascial release comes in many forms but the most common is foam rolling.

A little background before I go further; foam rolling, as with other forms of myofascial release, utilizes what is called autogenic inhibition to reduce muscle tension. Our muscles have many types of sensory receptors in them, some of which detect the level of tension placed on the tissue. These receptors will relax the muscle to prevent injury if enough tension is detected, which is autogenic inhibition.

With foam rolling we want to start with common problem areas and then work our way around seeking out other hot spots that may not seem troublesome at the time. As an example, I began with the iliotibial band (IT Band) due to some nagging knee pain that never seemed to fully go away with stretching. The muscles of the outer hip feed into this long fascial track that eventually attaches just below the knee. When upstream tissues become tight the IT Band gets pulled creating symptoms that include lateral knee pain and a palpable “clicking”. From this point it’s a good idea to work around the entire hip complex as this entire area tends to be problematic due to the amount of time many spend sitting. 

Foam rolling can be used on just about any part of the body so if you have chronic tightness and can get the roller on it, try it out. For the first couple of times you should shoot for about 10 rolls on each area, especially if it's painful. As the procedure becomes less tender proceed to between 20 and 30 seconds per area. This can be done before or after exercise depending on ones needs.

A quick side note, rolling can be a bit uncomfortable in certain areas when you first start so proceed slowly, however, remember the reason it’s uncomfortable is that the muscles are tight. We want to work this tension out which means we need to roll, stretch, massage, or what have you to loosen the tissues up. Below are some common problem areas and how to address them.

IT Band – This is generally one of the most tender areas to foam roll, though it can also be one of the most beneficial. Keep in mind that many of the outer hip muscles feed into this band so rolling all the way into the high hip is a good idea. The low point of the roll should be just above the knee.

 

Piriformis and hip external rotators – Located on the outer hip and deep to the glute max, this grouping of muscles can be responsible for externally rotated feet. Take some time and watch people walk and you’ll be amazed at how many exhibit a waddle of sorts because their feet are chronically externally rotated. In cases of extreme tension the piriformis muscle can put pressure on the sciatic nerve creating what is known as piriformis syndrome, which causes discomfort similar to sciatica including pain that runs down the leg.

Hip Flexors and Quadraceps – An area that can become chronically tight due to long periods of time sitting on a regular basis. That would basically include all desk jockeys out there. For this one you need to start high on the hip by the ASIS (anterior superior iliac spine), which is the portion of the pelvis that can be felt near the waistline above your front pockets. From there move all the way down and finish just above the knee. If this is difficult then rolling from the ASIS to the mid thigh would be one roll and then mid thigh to just above the knee would be another.

 Adductors – The adductor group is a little tough to get at and therefore is overlooked more often than other muscles. As with the calves, this group can be so tight that just putting pressure on the area is enough.

 Gastrocnemius and Soleus (Calves) – Controlling much of what happens in the foot and ankle these muscles get used constantly and therefore require some attention. Sometimes just elevating yourself off the floor is enough to cause discomfort, if this is the case, just flex and extent the ankle rather than trying to roll.

 

Back – Obviously this is a large area and how you position your body makes a big difference. Rolling straight can address the thoracolumbar fascia just above the waistline all the way up to the Rhomboids and Traps at the shoulders. Rotate a bit and the Lats and posterior shoulder become more of the focus. This area usually feels the best to roll because it’s similar to a back massage.

A few options out there:

Low Density Foam Roller

Medium  Density Foam Roller

High Density Foam Roller

Foam Roller Plus with PVC core making it harder

Rumble Roller - nothing but fun right here!

           Remember that certain areas can be challenging at first but stick with it and you will likely experience a reduction in tension. I was amazed by how much better I felt after just a couple weeks of consistent rolling. If your gym doesn't have foam rollers they can be found at places such as power systems and perform better. Feel free to post comments or questions.

-KO

Pictures courtesy of bodybuilding.com.