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In the last decade there has been a boom in the fitness industry in the form of “mobility training.” Within the mobility movement, there is an ever-increasing amount of people who understand that muscles, fascia, ligaments, and tendons make up a joint complex and therefore any restriction within these structures can result in a decrease in movement resulting in performance deficits and even pain.

This understanding has lead to techniques, and products that include movement drills, self myofascial release, various types of roller balls, straps bands, PVC pipes, mats, etc, that are geared toward increasing improving mobility and performance within the individual. I have even come across extremely heavy solid metal structures that look like scuba tanks. They are supposed to be laid on top of you and are to compress these soft tissue structures. Yes, I did try it and some of the metal pipe looking stuff was approximately 90 pounds. I swear I could’ve went to a construction site and found similar piping and just painted it. Anyway, within this market specifically, foam rollers have generated big business. They are virtually in every sporting goods business, gyms, and are even found an electronic stores like Best Buy.

What is Foam Rolling?

From rolling is a technique designed to compress or even mash structures. This technique is done to help increase flexibility, and decrease scar tissue by using your own weight and a circular foam roller. It’s basically a way of doing self-massage or self trigger point work using a compressive technique.

How does it work?

Just like deep massage therapy; deep compression to muscles can help restore normal blood flow, which is vital for healthy tissue. By breaking down scar tissue, and loosening tight muscles, you can restore the blood flow and increase flexibility within the joint.

What should I do?

When doing foam rolling, you should compress an area from mild to moderate pressure depending on your own skill for pain tolerance. If you find an area that is tender, obviously you may want to use a little less pressure. Also, avoid rolling over a bone! You will definitely know if you did it the wrong way.

Typical compression time should occur from 5 to 30 seconds. If necessary you may need to work the course of that muscle or even repeat that area. Many people mistake pain for good, therefore, the harder you go, the better. This is not true, and the ultimate goal of foam rolling or any myofascial release or mobility work is to increase movement and flexibility to the area so that the muscles are now supple and soft, rather than tight and tender.

Knowing which muscle or muscle group is not always obvious. If this is a case or your discomfort is not improving, then a proper evaluation is likely necessary.

Why does it hurt?

It is likely for an area of the body to have sore, sensitive, or even painful spots. These spots can indicate areas of dysfunction. In most cases, if you had a sore or painful area, it is likely that something within that muscle needs to be worked out. Just as a warning, you may have some soreness the following day.

What does the research say?

All this stuff may seem practical but what does the research actually say. In one study, they tested the difference between foam rollers and planking before athletic tests in order to determine performance. The results indicated that foam rolling and planking showed that there were no differences in performance. The study also indicated that post exercise fatigue was less in the group who did foam rolling which indicates that individuals can likely increase their workout time and volume and may lead to enhancements in performance in the future.

In this study, the use foam rolling was to help with delayed onset muscle soreness. (DOMS). You guessed it, the results indicated that the group who use the rollers have less soreness.

Another study indicated that foam rolling can help increase range of motion for a period of time without negatively affecting performance.

Final Thoughts

Foam rolling should be part of your routine. The research shows that it can help with range of motion, recovery, and will not negatively affect performance. . It can be used prior to exercise or as a form of recovery from an activity. This is a great inexpensive tool/therapy that can go a long way. If you are new to it, give it a try and if you have some experience with it, go ahead and create a solid routine. Remember, if you don’t get the results you are looking for then you may need to take a step back and re-evaluate.

Do you have any numbness, tingling or shooting pain? Does it go into your hands or feet? While a “pinched nerve” may be an accurate description, the truth is that a pinched nerve is really not the best diagnosis because it is a general term. The real question is, where is the location of the pinched nerve?

Often times, patients come into the office with numbness or tingling into the extremities and they are often diagnosed with a disc bulge or disc herniation, but that is often times incorrect!

Disc Herniation and. Peripheral Nerve Entrapment

A disc bulge or herniation is when material of the disc (fibrocartilage in the spine) protrudes out or even leaks out of the spine. In this condition, there can be direct pressure onto the nerve or irritation of the nerve roots from inflammation. If severe enough, it can cause symptoms that include shooting pain, numbness, tingling, and even weakness. Compression from the spine is considered a nerve root impingement.

A Nerve Entrapment is when a nerve gets “caught up” or compressed within the path that it runs. Nerve entrapments can occur as a result of bone spurs, trauma, weight gain, fluid retention, inflammation, scar tissue buildup, overuse syndrome, tight muscles, etc. When structures surrounding a nerve no longer (soft tissue) glide and slide properly, it can cause compression to these structures.   Compression of a nerve within the extremities is called a peripheral nerve entrapment.

How to tell the difference?

Telling the difference between a pinched nerve from the back or a nerve entrapment can often be difficult since the symptoms may often be similar, that is one reason why you need an healthcare practitioner who is well versed in the diagnosis and treatment of it. The practitioner should test for nerve tension signs, weakness, as well as a host of other orthopedic testing prior to treatment. History of the injury is very important as well.

Typically (but not always), a pinched nerve that comes from the spine (herniation) may accompany pain in or around the spine. In both cases, patients may have radiating pain but in a nerve root impingement, the pain may extend from the spine and into the extremities (we call this peripheralization). There may also be a loss of range of motion within the spine and patients will have difficulty with sitting to standing as well as pain with abdominal core testing.

A peripheral nerve entrapment on the other hand, may exhibit localized pain and then show signs of peripheralization (radiation of the pain). Often times, the pain may come from a select area or region of the body and there may be an increase in symptoms after use of the joint or muscle. There are common locations (like the carpal tunnel, cubital tunnel, pronator teres syndrome, etc) in the body where nerves commonly become “trapped.” These areas should not be mistaken for a neck or spine injury.  Again, these are referred to as peripheral entrapment sites.

Treatment

Both treatments focus on taking pressure off of the nerve; however, a pinched nerve in the spine should focus more on the musculature around the spine and decompressing the spine itself. Peripheral nerve entrapments should focus on releasing the pinched nerve as well as the associated soft tissue structures along the kinetic chain.

What to look for?

If left untreated, both of these conditions can get worse and can possibly lead to weakness as well as muscle atrophy. If you see muscle atrophy and weakness, this should not be neglected and you should seek treatment sooner than later.

If this article grabbed your attention, chances are you sit very often. Now, I understand that sitting may be part of your job description, but does sitting too long lead to things like muscle imbalance, increased risks for chronic diseases, low back pain, hip pain, knee pain, and a whole host of other issues? So if sitting is the new smoking, how bad is it really?

The average American spends nearly 18-21 minutes commuting in one direction and they work approximately 40-45 hours per week. Additionally, the average American watches nearly 5 hours of television per day. Combine all this, and you total nearly 50 or more hours in the seated position (and yes, this is likely an underestimate). Keep in mind this does not include sitting down for breakfast, lunch, dinner, overtime, leisure, etc.

Sitting and Health Risks

If you trace back your ancestors, they obviously did not have computers, iPhones, and television. What they did have was a tremendous amount of functional movements. Our ancestors completed basic tasks that included picking up branches to build a shelter, hunting/gathering food, exploring nearby territory in search of new resources, and probably the most important thing with regard to health and social bonding, playtime.

Since our development, technology has advanced and we have gotten more and more used to sitting.   Chronic diseases and pain have become part of our culture worldwide but is there really a connection between them?

Not shockingly, YES, there is a connection between sedentary behavior and an increased risk for disease. It appears that study after study had indicated that the increased exposure to computers, television, and sitting is a major cause for the demise of societies health

Lower Crossed Syndrome

Functionally, your body really does take a beating when you sit too long! Over time, sitting weakness the core musculature and the glut muscles, while at the same time creating very tight hip flexors and tight low back muscles. Allow this posture to occur for a few weeks, months, or years and you will develop what is known as lower crossed syndrome.

Lower crossed syndrome simply put, is an improper muscle balance of the hips, core and spine.  With any muscle imbalance, it alters your posture and the way your body functions. Structure affects function and vice versa.  Therefore, sitting and whether or not you take care of your body can influence your pain and performance.

Eventually if this left unchecked you will likely develop chronic low back pain, pelvic pain, hip pain, knee pain, and/or leg pain. It can and will predispose you to injuries!

Take a look at some of the illustrations and you can easily see what sitting can do to your body.

Muscles that become weak include the following:

Rectus Abdominis (Core)

Transversus Abdominis (Core)

Obliques (Core)

Glut Maximus, Medius, and Minimus (Hip Stabilizers)

Quadricep muscles (thigh muscle group)

Tibialis anterior and posterior (leg muscle)

Personeus Longus (leg muscle)

Muscles that become too tight include the following:

Psoas (hip flexor)

Rectus Femoris (hip flexor)

Hamstring (hip and knee muscle)

Erector Spinae (Low Back)

Tensor Fascia Lata (Hip flexor)

Thigh Adductor (Hip/thigh muscle)

Piriformis muscle (hip rotaror)

Quadratus lumborum (low back muscle)

Gastroc/Soleus (Leg muscles)

Can it be fixed?

Yes, but you are going to have to work for it! Simply put, you need to take all the above muscles mentioned and strengthen the weak ones while stretching the tight ones. At first glance, it seems like a lot but the body works in synergy and by working one group of muscles correctly, you can be working others to facilitate a better outcome.

Okay, So What Can I Do?

• Strengthening the Core and Gluts
• Planks, Pelvic Tilts, Bridges, Hip Extensions, Bird-Dog Exercise

Stretch the Low Back and Hips

• Psoas/Hip Flexor Stretch, Quadricep Stretch
• Quadricep Stretch, QL and Erector Stretching

The good news

Lower crossed syndrome is mostly preventable and treatable with corrective exercises and good posture . A little can really go a long way and if you want to expedite your return to better posture, health, better performance, you have several options.  You can see a health care professional, increase the number of times you do your exercises, and decrease the amount time you sit and/or watch television. Research indicates that high levels of moderate physical activity (60-75 min per day) can eliminate the risk of death associated with prolonged sitting time. Unfortunately, adding exercises still seems to not help with regard to sitting time due to TV! So if anything, sitting while watching TV is the new smoking.

Whole body cryotherpapy is quickly gaining its name in the fitness industry and these fancy machines appear be very futuristic, but do they work? These machines have been generating big buzz with mega-athletes like Lebron James and Floyd Mayweather admitting to have used them. So is this new machine just big buzz or does it really work?

What is Whole Body Cryotherapy?

Cryotherapy in itself is cooling the body down in order to stimulate a therapeutic response. Whole Body Cryotherapy (WBC) is an alternative approach to traditional icing and ice baths. It subjects your body to an extremely cold temperature (usually around -200 degrees F) for nearly 3 minutes long. WBC uses liquid nitrogen to cool the surrounding air. Next, the individual walks into the chamber with minimal clothing using protective gear, which typically includes, gloves, socks, and ear protectors. The process is not painful and should be supervised.

What is it used for?

Currently, individuals use WBC for recovery purposes following exercise routines, intense trainings, and wellness care. The ultimate goal of WBC is to decrease the surface temperature. Decreasing the temperature to the surrounding tissues helps reduce inflammation and stimulate a flush of new blood flow.

With regard to tissue repair, controlling proper blood flow is critical and by controlling the blood flow, you can help with things like delayed onset muscle soreness (DOMS), pain, chronic and acute inflammation, skin health, and metabolism.

Whole Body Cryotherapy Research

Tissue Temperature

If you are really looking to lower the temperature of the tissues, you may not have guessed but the traditional ice pack had seemed to be the best method as opposed to WBC and cold water immersion.

Inflammatory Chemicals

A study done to compare a simulated trail run using high level athletes found that during the 4 day recovery, there inflammatory chemicals were fairly similar. There had been some lower inflammatory markers in the WBC group at the 24, 48, 72, and 96 hours post exercise. Overall, there seemed to not be a huge difference.

Muscle damage

Interestingly enough, there had been no evidence indicating that WBC had affected markers that signal muscle damage

Oxidative Stress

Using WBC had increased the number of anti-oxidants when comparing the untreated group, however, there was difficulty concluding the free radical production. Another crossover study was done with Olympic athletes and surprisingly, there had been anti-oxidants lower than the group that used cryotherapy.

Autonomic Nervous System

Following immediate use of cryotherapy, there had been larger numbers of nor-epinephrine concentrations. Also, the group using cryotherapy had indicated that the largest effect on parasympathetic reactivation.

Perceived and functional recovery

The research seemed to show that there is a better recovery and there had been improvements with regard to strength, pain, and subjective fatigue when individuals underwent cryotherapy 24 and 48 hours after training.

Study Conclusion

WBC does help with tissue temperature reduction that may be similar to cold-water immersion but seems to be less effective than an ice pack. There had been improvements in inflammatory chemicals, anti-oxidant, and autonomic effects. There seems to also be some improvement in soreness, pain, and functional recovery, however, the research study stated that these results are preliminary and if needed, the much less expensive and traditional cryotherapy offer comparable benefits.

Additionally, another study demonstrated that cold-water immersion was more beneficial in accelerating recovery and reducing muscle soreness as well as perceived recovery levels 24-48 hours post exercise.

Final Thoughts

Whole body cryotherapy likely does help with discomfort and pain and other areas of recovery. It is a quick and easy process to do if you have the available cash and really dislike the cold-water immersion baths or ice packs. I have no doubt that there will be more significant research showing the benefits.

Keep in mind that if you really do have some significant inflammation and pain, using the WBC may be at a disadvantage as it uses air, which is a poor conductor and will not significantly cool the tissues.

For more information about muscle recovery and ice, click here.

Had a wonderful opportunity to present at the PB library this weekend.  If you can, you should really check out all the services they offer the community.

Here is some footage/photos from last weeks events that took place at the annual Tri Rock Triathalon.  Congrats to all athletes and thanks for having me.

Tri