Category — Soft Tissue Techniques

Anterior pelvic tilt is a posture characterized by increased tightness of the hip flexors/lumbar erectors and weakened hip extensors/abdominals. This pelvic position is what Dr. Vladimir Janda classified as “lower-crossed syndrome”.

In this video, I offer two techniques for addressing the erector spinae musculature (which act as a force couple with the hip flexors in an anterior tilt). These techniques require the client to be active during the treatment process, which helps them to learn what it feels like to move their pelvis between both anterior and posterior pelvic tilts.

Being able to both anteriorly and posteriorly tilt the pelvis is an essential component of the golf swing and is tested during the “pelvic tilt test” in the Titleist Performance Institute Golf Fitness Assessment.  You may observe many clients who are unable to move out of anterior pelvic tilt, or if they are they do so with what Dr. Greg Rose refers to as a “shake and bake”, where you see their body actually shake as the muscles try and allow this movement to happen.

Hopefully you find these techniques useful!

Patrick
patrick@optimumsportsperformance.com

Over the last few articles we have talked about stress, quantifying stress, and Heart Rate Variability (HRV).  In the HRV article I hinted at massage and the potential effect is can have on HRV and helping the athlete/client get into a more parasympathetic state.  While science continues to exam what is happening under the skin when soft tissue therapy is being applied, one thing is for certain, people tend to feel better after getting some bodywork.  Athletes report less delayed onset of muscle soreness (DOMS) and tend to feel more relaxed and rested following massage therapy.

As I stated in previous articles, as coaches we have become very good at applying the stress.  We can take the athlete out and run them, make them lift heavy, throw medicine balls, do circuits, do intervals, etc., however, we often overlook the restorative aspect in our training programs.  No program is a good program if you cannot recover from it.  One of the ways that I have found soft tissue therapy to be of extreme value is its use in restoration and recovery.  It is one way in which we can help the athlete relax and calm down following intense bouts of work and stress (training, competition, etc).

Some athletes will require more recovery between intense periods of training/competition than others, making it important to understand your athletes and how they respond to these situations so that you can adjust training accordingly.  Using some form of soft tissue therapy/bodywork is one method that can be helpful in bringing the athlete back to a parasympathetic state.  A number of papers have looked at changes in HRV following a few different types of massage techniques – trigger point therapy, rolfing, joint manipulation, and thai massage.  In all instances, massage helped to increase HRV, indicating a move towards a parasympathetic state.

While the changes in HRV, enhanced parasypathetic state, and overall psychological well-being are impressive, many of these studies are not conducted in conjunction with exercise.  However, one study conducted by Arroyo-Morales et al, looked at the effects of 40min. of myofascial release work compared to placebo (sham ultrasound) following three 30-second Wingate tests (high intensity exercise).  Interestingly enough, those in the massage/myofascial release group actually had better recovery in HRV and blood pressure compared to the placebo group.  Those in the massage group recovered their HRV and blood pressure back to baseline/pre-exercise levels.

Practical Application

As noted above, knowing your athletes and when they need a “recovery day” is important for enhancing their development and avoiding overtraining.  One thing that I have noticed in athletes that are in a more sympathetic or under-recovered state is that their skin is a little more tight/taught when I try and move it, compress it, or roll it.  Additionally, there are other changes in the skin and muscle that may be interpreted as an increased sympathetic state:

• Goosebumps when skin rolling techniques or pressure is applied

 

• Inability to relax when pressure is applied (often times going into an upper chest breathing pattern or being very guarded)

 

• Some have suggested that being ticklish is a sign of an overly sympathetic state (especially if it happens on one side of the body and not the other)

 

• Extreme soreness or tenderness with light pressure

From a practical standpoint, when athletes are in this sort of sympathetic state, it is necessary to be patient with your soft tissue therapy and be aware of how the athlete is responding to the treatment.  Being to aggressive in times like this or trying to ”work deep” to quickly (not patiently waiting for their body to make the changes that allow you to work into deeper layers) may lead to a less than desirable result, as it is important to keep in mind that soft tissue therapy can also be thought of as a stress that ones needs to recover from.

Trying to get the athlete to relax and get comfortable is an important goal to have in these times, as these circumstances differ slightly from doing soft tissue therapy for a specific injury or painful movement pattern.  I often think of it as successful if I can get the athlete to nod-off a little bit on the table and get “sleepy”.  Because the parasympathetic nervous system is thought of as the “rest and digest” portion of our autonomic nervous system, eliciting a more rest-full/sleepy state is a good goal to have.  My colleague, physiotherapist Willem Kramer, has stated before that “a little bit of pain can be a gateway into the parasypathetic nervous system”.  What Willem means by this is a little bit of the good pain – you know, the “it hurts so good” stuff – can help to fatigue the athlete or make them a little bit tired (sort of like what happens when you sit in the sun all day and get sleepy).  Willem states that a goal is to try and get the athlete to fall asleep on your table, as he interprets this as helping push them into a parasypathetic state and increasing healing (Willem, is talking about more “treatment” based soft tissue/manual therapy here, where you are dealing with a specific injury).

Acknowledging the recovery aspect of your training program and being aware of your athlete’s physical and mental state is an important part of a well-rounded training program.  Massage therapy is one type of modality that can be used to help improve recovery and increase heart rate variability.

Patrick
patrick@optimumsportsperformance.com

The splenii musculature helps to extend the head/neck, as well as perform ipsilateral (same side) rotation and lateral flexion.  Addressing these muscles as well as the tissue in the cervical-thoracic region in people who are limited in cervical spine range of motion can be extremely helpful and can have an impact on the movement of the entire body.

Here are three ways to address this musculature.

Patrick
patrick@optimumsportsperformance.com

I just wanted to let everyone know that my latest research review is up at Fitness Research Review Service on the topic of precompetition massage sprint performance (Fletcher IM., The Effects of Precompetition Massage on the Kinematic Parameters of 20-M Sprint Performance. Journal of Strength & Conditioning Research 2010; 24(5): 1179-1183.).  Here is a little information that I talk about in the review:

Intro

Proper warm up is important to training and competition and with so many differing opinions on appropriate warm up protocol, it makes this topic a highly debated one. Stretching and foam rolling have found their way into the warm up of many athletes despite the potential for these modalities to lower power output and performance (1,2,4). Decreased neurological output is one of the reasons cited as a factor of strength and power attenuation following a stretching or massage protocol during the warm up period (1-4). However, a few recent studies have indicated that this negative effect may be mitigated when stretching or massage are followed by a more neurologically active dynamic warm up (1,3). This study sought to test the result of three different warm up strategies – pre-event massage, traditional warm up, or pre-event massage combined with traditional warm up – on 20-m sprint times in college athletes.

Key Findings

• All subjects performed their slowest sprint times following the pre-event massage only condition.

 

• Traditional warm up alone led to a 2.74% decrease in sprint times compared to pre-event massage. This finding was significant.

 

• Compared to pre-event massage only group, there was a significant (2.44%) decrease in sprint time for the pre-event massage combined with warm up group.

 

• The difference between the warm up group and the pre-event massage combined with warm up group was not significant.

To read more of my review and the practical applications that I give, please log onto Fitness Research Review Service.

Patrick
patrick@optimumsportsperformance.com

In past blogs I have referred to soft tissue therapy as a “dance” between doing something, assessing (assessing tissue quality, movement, mobility, etc), and then doing something else or something different.

This concept has become even more apparent as I have been working with the Anatomy Links thought process over the past few months.  I find myself working on one thing much less as I am constantly moving to check other areas that are part of the “link” that I am trying to treat/affect.  This is in stark contrast to what is taught in massage therapy school where if something feels “tight” or the client says that it is “tender” you just keep working on it until something happens (that elusive something).  Unfortunately, that something doesn’t always happen and you typically find yourself wasting treatment time on one structure or, at worst, irritating things more and getting a negative outcome.

Following the assessment process, I try and key in on areas that I think are important to work on or at least areas that I want to have an affect on.  From there, I put together a plan of attack, thinking about other things that affect those areas (bones, muscles, fascia, skin, nerves, etc).  Those “key” areas serve as a standard for me to check my work against to make sure I am moving in the right direction – Is tissue quality improving? Does the client report less pain/tenderness? Can we get better range of motion?

Rather than beating an area to death.  I make contact with it, work on it for a minute or two, and then start to move on to some of the “links” that interact with it.  Again, I work for a little bit, go back and check the key area, work a little more, move to another link, etc.  This “dance” goes on for the entire treatment period.  In doing this, I find that I have much faster results and positive outcomes.

Instead of just banging away on one area for 20 minutes hoping to make something happen, try and connect the dots to other areas and see what sort of result can be achieved when they are treated.  Or, as Willem says,

If you do not get the answer you are looking for in a short amount of time, rephrase your question and ask again.

Patrick
patrick@optimumsportsperformance.com