Monday 17 November 2014

KINESIO TAPING FOR PERFORMANCE


KINESIOLOGY TAPING BLOG
The concept of Kinesiology or 'Movement' taping has been in existence since the 1960's but has shot to popularity in the last few years with many famous sportsman seen using it to enhance performance.

Initially regarded as a FAD and placebo, studies are now starting to provide evidence that supports the use of kinesiology taping.
A recent paper I read on Patella-Femoral (knee) pain suggested that correct application of this taping strategy had a positive effect in reducing an individual's pain and elicited an improvement in performance. Depending on your sport and what level you compete, the  margins for victory can be small, wouldn't you like to try something that is affordable and could make the difference between winning and losing.

THE SKIN
Within the layers of the skin and encompassing the joints there are specialist receptors that identify stretch, strain, pain, hot, cold, vibration, pressure.
All of these receptors provide the brain with a picture to inform it of what is going on around the body, allowing it to transmit its positional sense, this is also known as Sensory input.
The brain then uses this information to coordinate subsequent movements, also known as Motor output.
By placing the target tissue on a comfortable stretch you are in fact exposing these receptors deep within the skin. The tape is then applied to alter the message being sent to the brain.
 
AN EXAMPLE OF HOW THIS CAN BECOME A PROBLEM
Following injury the central nervous system in the brain starts to receive an incorrect SENSORY INPUT (Picture) from the injured tissue this can be attributed to any of the factors listed below:
  • Offloading the injured limb (possibly with crutches to protect form further damage)
  • Pain due to swelling & cell death
  • Loss of flexibility through not using the muscles around the joint
  • Loss of joint range of motion due to reduced use through pain
  • Loss of strength (1% for every day of immobilization)
  • Ligament damage
  • Joint damage
The body will always adapt to the environment in which it is exposed to, leading to changes in its movement patterns. The result of a poor picture going in to the brain, is a faulty MOTOR OUTPUT (order) in this case could be an individual displaying a limp without noticing and or using the good leg more to compensate for the weaker ankle)

Depending on the application of the tape, the aim of the clinician is to place the tissue in a position to illicit the correct sensory input (message in), in turn ensuring the movement coordinated by the brain promotes a correct motor output.


RIGID TAPING
As demonstrated here in taping the ankle for stability of the lateral ligament complex. Rigid taping only provides feedback and support to a joint for around 10 minutes before becoming loose and ineffective.
It is non-elastic, restricts full range of the joint and is compressive affecting the blood supply.
Not that I am knocking an age old taping strategy but in my experience it is far more useful when trying to limit someone post injury to prevent further damage & support the PRICED protocol
WHY KINESIOLOGY TAPING?
In contrast to rigid taping, Kinesiology tape is waterproof, elastic, light, allows full range of motion & is cost effective lasting up-to 3-5 days depending on how it is applied. I have  tried to Rigid tape Football players  before matches but it either stops them putting their boots  on or affects the blood flow and is uncomfortable.

DOES THE COLOUR MATTER?
I hear people talking about the various colours of the tape and how more effective one is compared to the other or stickier.....

In truth all tapes are the same however there is some cognitive reasoning behind the colours which is as follows:
  • Blue- Applied to provide a cooling effect (cognitively) to areas of injured soft tissue suffering from increased blood flow, swelling, inflammation
  • Black- Absorbs the sunlight better when playing outside which activates the adhesive far  more effectively
  • Red- Provides a warming effect to weak or inhibited muscles to (cognitively) allow an individual to 'feel' the area working
  • White- Used in clinical backgrounds such as hospitals
  • Beige- Used in some sports due to its similarity to skin colour

 WHAT CAN IT TREAT?
The answer to this is virtually anything from the following lists and much more:
  • Shoulder joint pain
  • Knee Pain
  • Headaches
  • Swelling
  • Patella tendon pain
  • Shin splints
  • ITB Friction syndrome

5 MAIN ROLES OF KINESIOLOGY TAPING 

1- MUSCLE IMBALANCE
The tape is elastic and has a natural recoil at 50% tension, this essentially means that if you apply the tape (one square) to the body (also known as an anchor strip) with no stretch, then take the tension up-to 50% the tape will always recoil back towards the original anchor. This is a significant factor when applying to the muscles to achieve a particular effect (explained below)
 
Inhibiting muscles- Applying the tape from the point where the muscle inserts to the point where it originates to effectively 'lengthen the tissue' and help to 'switch it off' should it be overworking. the example to the right demonstrates an inhibition application to the Gastrocnemius and Soleus of the Triceps Surae muscle Group. This could therefore be useful for someone presenting with tight overused calf. Individuals who are in a running program, mid season sports or suffering muscle pain

Facilitating muscles- Applying the tape from the point where it originates to the point where is finishes or inserts will help to 'switch on' and shorten to activate the tissue. Facilitation is useful for people who present with weakness in postural muscles, it can help individuals to activate muscles that help stop the back from hunching or shoulder blades from rounding and tipping forwards.

2- POSTURAL INEFFICIENCY
If individuals are suffering from poor posture such as a rounded upper back from too much sitting or driving the tape can be used to facilitate a change to body position and help maintain awareness of keeping correct posture. In my experience it works well at helping maintain a neutral pelvis and shoulder position, limiting pain in the lower back and neck.


3- CIRCULATORY AND LYMPHATIC DRAINAGE
Following injury such as a direct impact through a tackle in football or intense exercise such as long distance running, the body goes through a process of removing dead cells and commences the laying down new ones also known as repair and regeneration. This is completely normal and part of the tissue healing process however if it not managed correctly then your tissue will remain weak, exposing you to long-term chronic problems


 As a remedial masseur I would not be keen to 'touch' or 'massage' tissue post injury (up-to 48 hrs) instead I could help to support the healing process with a Lymphatic application in conjunction with ice intermittently, every ten minutes for the first 8 hours (anything after the first 8 hrs is generally for pain relief).
The body has lots of specialized cells called lymph nodes that help to remove any waste products and damaged cells through 'The Lymphatic System'
The two pictures show how the tape can help to 'draw' the lymph towards the nodes in conjunction with the circulatory system. 
Following tissue damage, pain is normally present due to swelling which irritates free nerve endings leading to a feeling of pain
This application will help to 'lift' the tissue and promote fluid flow/ circulation and reduction of pressure in turn limiting pain.

4- LIGAMENT, TENDON, JOINT INJURIES
LIGAMENTS:
The tape can be used to support strained ligaments such as those found in the ankles (following an inversion, trip or fall), knees or even to support dislocated shoulders following excessive loss of control at a joint. A simple joint ligament application could be all you need to complete a run or event with peace of mind

TENDONS: 
The most commonly injured tendons in the body are the Achilles and patella which are tasked with transmitting huge amounts of force from the quadriceps and triceps surae group
Kinesiology tape can be applied to help offload Tendons and reduce pain, stiffness... essential if you suffer from problem injuries such as tendonitis or partial tears due to overuse.
This is vitally important when you consider how the quality of tendon fibrils reduces when most individuals pass the age of thirty. The image to the right shows a really effective achilles tendon offload, I prefer this for long distance runners, triathletes.

5- FASCIA ADHESION'S
The tape can also be applied to ensure the CORRECT movement of connective tissue known as FASCIA. If fascia is restricted the body will very quickly develop relative flexibility and cheat to produce a movement. A full explanation of FASCIA can be found below

MUSCLE& FASCIA HOW DOES IT WORK
 Fascia is like a giant web, it is a connective tissue that lines the bones, the organs, it separates muscles into working compartments, functional chains & lines every cubic centimeter of the body.
Fascia is so important in movement, when there are muscular dysfunctions present such as poor gluteal activation the fascial connections to other muscles compensate to stabilize the pelvis. Unlike a muscle that has a start & finish point, fascia actually pulls against itself to provide stability a term known as tensegrity. Interestingly it is also now believed that if you strip all the muscle off the skeleton the remaining fascia is strong enough to maintain the shape of the body. Fascia is now believed to be responsible for attaching up-to 80% of a muscle to bone in contrast to tendons which account for the other 20%  

HOW SHOULD FASCIA MOVE
Imagine throwing a pebble into a pond, you would expect the wave like ripples to flow away, this is the same concept with fascia, it supports effortless movement of the body.
Overuse, tissue trauma & injury affect the composition of the fascial connection which leads to changes in the way your muscles & body move.

If you think this type of therapy could help you in one of the five different ways discussed please get in contact for advice or to book an application. 

Enjoy my blogs & even if you found this useful, please share my work and help me to promote Primal Movement Solutions to the masses


Friday 15 August 2014

Self Myo-fascial Release (Foam roller) common errors & useful tips

The application of a foam roller to support the recovery & performance of muscles has been steadily on the increase over the last five years or so. Applied correctly it can be a very useful tool, however in most cases poor understanding of what you are trying to achieve physiologically leads to misuse

Problem
I continue to see (almost daily), token efforts (rolling too quickly or not along the path of a muscle) on the Foam Rollers supplemented by incorrect use. This will in fact have a damaging effect on performance & potentially promotes injury.

So where does the term SMFR originate: 
Self- Your providing the therapy
Myo- Latin term for muscle
Fascia- Connective tissue

Muscle & Fascia how does it work

Fascia is like a giant web, it is a connective tissue that lines the bones, the organs, it separates muscles into working compartments, functional chains & lines every cubic centimeter of the body.
Fascia is so important in movement, when there are muscular dysfunctions present such as poor gluteal activation the fascial connections to other muscles compensate to stabilize the pelvis. Unlike a muscle that has a start & finish point, fascia actually pulls against itself to provide stability a term known as tensegrity. Interestingly it is also now believed that if you strip all the muscle off the skeleton the remaining fascia is strong enough to maintain the shape of the body. Fascia is now believed to be responsible for attaching up-to 80% of a muscle to bone in contrast to tendons which account for the other 20%  

How should fascia move

Imagine throwing a pebble into a pond, you would expect the wave like ripples to flow away, this is the same concept with fascia, it supports effortless movement of the body.
Overuse, tissue trauma & injury affect the composition of the fascial connection which leads to changes in the way your muscles & body move.

Test your fascial movement
1- If you place your hand lightly on your forearm, try moving the skin in all direction & observe how it is highly mobile and there are no restrictions,
2- Now do the same placing the hand lightly on the ITB running down the side of the thigh, there will be a significant difference,

  Fascia can be described like an orange, 
Skin- The orange skin can be likened to our skin,
Superficial Fascia- The white pyth lying between the orange skin & the segments can be likened to  our superficial (closest to the surface of the skin) layer of fascia
Deep Fascia- Once inside the orange you'll notice it is broken into large triangular segments, further broken into compartments housing the pips. This is known as the deep fascia

Why use a foam roller?
Daily living activities, posture & exercise force your body to regenerate & progressively adapt to the stress placed upon it. In response, the body lays down scar tissue, this must be realigned for it to function correctly, imagine ironing the crease out of a shirt.
You will also find that during 'rolling' you may find 'knots' also known as trigger points (excitable band of tissue), these are like roadblocks that sit in the muscle & considerably reduce muscle function/ movement.

Correct application of SMFR will
- Re-align scar tissue
- Remove Trigger Points
- Improve flexibility
- Reduce over activity in dominant muscles
- Improve circulation & delivery of nutrients
- Remove waste products

Do not
- Roll over varicose veins
- Roll over Joints
- Roll over inflamed areas

Techniques
The concept of foam rolling or fascial release is an aggressive & intrusive technique, in simple terms you are giving the muscle a deep tissue massage.
Deep tissue massage will inevitably cause bleeding & inflammation within the tissue that leads to pain on function or during movement, this may sound bad, but it supports all the positive aspects listed above.
Foam rolling every single day will however, reduce the ability for a muscle to recover & could incite further injury as individual continue to train whilst working deep into tissue.

Fascia re-alignment
Muscles & Fascia are surrounded by a substance that is similar to hard jelly, as you roll slowly through the muscle the jelly changes into a liquid which exposes the fascia and scar tissue. this takes 60-90 seconds of slow focused through the tissue. Be wary not to wade into the muscle to prematurely, treat the muscle like a good woman, romance it, get it in the mood and then go deep! Your more likely to get what you want at the end of the process :)


Trigger pointing as a foam roller technique
Imagine tying a knot into a rubber band, you can pull it tight but the knot will not go anywhere, reducing the stretch. Therefore prior to rolling through a muscle it is useful to trigger point (applying direct pressure by hand or with the roller/ Hockey/Tennis Ball) first to remove these knots to allow full dynamic flexibility of the muscles.
If your hip flexors have knots present you will lose the ability to extend the hip, compromising glute activation, it would therefore make sense to release the hip flexors first, to improve contraction of the glutes.
How to identify a trigger point When slowly rolling the muscle if you come across a localized painful area of tissue, apply no more than a 8/10 pressure to the area for up-to 60 secs 3 x times if needed, until the pain reduces to a 2/10 or you feel a release. The reason we are only applying 60 secs of pressure and not longer is due to the reduction in oxygen flow to the cells. If the hold is applied for too long you can have a negative effect on the tissue causing it to die.


Recommendations
1- Alter the depth of the roller so that you target the superficial layer of tissue to promote general movement of the 'connective web'
2- Only target the deep fascia a day or so after exercise or during prolonged bouts of inactivity to improve circulation & reduce scar tissue build-up. Deep tissue rolling can reduce muscle soreness after heavy training by upto 40%
3- Trigger pointing is safe prior to exercise or competition,
4- Do not foam roller deep 24hrs before an event or training, you will have a terrible session

I hope you enjoyed the blog, if you learned something please take the time to like and share with your friends and colleagues, I am also on Facebook 'Primal Movement Solutions'.








Friday 8 August 2014

Suffering from re-occuring injuries & cant work out why? Best take a read

My favorite analogy in rehabilitation is that "people treat their bodies like cars and only get them fixed once they have broken down". 
Over the years I have met all sorts of people from sportsman to gym goers and office workers, they all complain to me about re-occurring injuries. Some of the most common examples of these 're-occurring issues' are listed below;

  • Ankle inversions when running or playing sports such as football
  • Lower Back pain
  • Calf Strains
  • Shin Splints
  • Knee pain
  • Neck & Shoulder pain
Regardless of what type of symptoms people suffer from, in most cases they are not willing to invest in getting their injuries rectified. Poor understanding & lack of knowledge prevents individual's from realizing the importance of getting these problems solved immediately, most punters believe that time is a great healer & the body will get better....but will it? of course it won't,

It does frustrate me when I see people complain and grumble to me about their injuries, requesting my advice yet in most cases they are not willing to take ownership for themselves and are happy to go and spend £60-80 on a pair of fashionable non functional trainers or go out for a expensive night on the town rather than seek rehabilitation.

Its time to wake up
If your car breaks down & starts to fall apart or becomes too expensive to run you exchange it or buy a new one. You cannot do this to your body, it suffers day in day out and in most cases you are not  maintaining it.

The aim of this BLOG is to support the last few paragraphs & to do this i will use a model known as the Cumulative Injury Cycle.

Tissue Trauma
Occurs when force or load is applied to the tissues of the body (muscles, ligaments, tendons), which they cannot withstand.
Trauma can be caused;
Progressively-  Raging from weeks, months to years through poor posture such as hunching whilst sitting at a desk, or training the same muscles without rest, repetitive movements (the list is endless).
or
Traumatically- via a direct impact such as a hard tackle in sport, a twist of the ankle while running or a fall.
Following trauma or general exercise the tissues break down under stress & the body commences a repair process. Using protein in your diet the tissue progressively grows back stronger (hence the need for rest, In marathon running the cardiac tissue can break down by up to 15 percent).

Inflammation
When tissue is damaged the body goes into a alarm phase, a release of histamines stimulates nerve endings to tell the brain that there is a problem. The sub-acute inflammatory response generally lasts up-to 72 hours, within this period you can expect to see the following;
  •  Swelling  (caused by chemical release)
  •  Redness/ bruising (caused by bleeding)
  •  Heat (caused by increased blood flow)
  •  Pain on Function (Tissue is damaged & the pressure caused by pressure from fluid release
The Cardinal Sin 
Once the pain on function settles, people believe the problem has been solved when in fact the damaged ligaments & muscle are only at 30% their potential strength 3 weeks post injury. The people that suffer regular injuries tend to sneak back to sport within a week or two, quickly breaking down again and yet wander why they can't stop suffering the 'same injury'

Muscle Spasm 
Inflammation triggers a muscle to spasm as a protective response to prevent further damage. It can last a few days to a week but will restrict the ability to move the muscle through range which leads to a loss of flexibility & joint range of motion. You will start to move differently to produce a movement by way of compensation placing 'STRESS' on other structures.

Adhesion


The image to the right shows how adhesion's or 'knots', 'trigger points' are formed. These act like roadblocks within the tissue preventing it from stretching fully during functional movements. It is essential that these are addressed immediately to regain normal muscle firing patterns. Stretching will only improve the length of the surrounding tissues, the knots are left unaffected & will remain until they are treated accordingly. 
A knot can be formed within 7 minutes of holding a poor posture

Scar Tissue
Scar tissue is also laid down to help re-enforce the strength in the weak/baby tissue. Scar tissue does not get aligned like other tissue it is rather haphazard & does not give to stretch which can lead to further issues with flexibility & movement patterns.

Altered Control & Muscle Imbalance
The pain you feel causes changes to the way in which your brain interprets the position & movement of the joints & muscles affected by injury which leads to altered control.
Relative flexibility occurs which is how your body tries its hardest to achieve movements by any means necessary, an example being; someone who suffers with tight calves has to lift their heels to do a full squat or has to pivot more from the hip to alleviate for the loss of range at the ankle, putting strain on the lower back.

In summary
The injury cycle continues in a vicious circle leading to chronic problems that starts to affect other parts of the body.
I am a Remedial Masseur/ Rehabilitation specialist with years of experience following the exposure to hundreds of progressive/ acute injuries. I can work with injured tissue & apply contemporary techniques/rehabilitation to regain full function & prevent injuries from coming back;

Please inbox me for further advice or to book in.