Author Archives: Katie Dunn

Why am I so tight?

I often have clients ask me why they’re so “tight”. I place the term “tight” between quotations delicately; In some cases, it may be the correct term, but in many others, it is not. Regardless of terminology, the perception remains the same in the eye of the proprioceptor, and the bottom line is that they just want that tight muscles feeling to take a hike.

While there are always exceptions to any rule, it is often the case that the folks that complain of feeling tight in a particular area, their tissue doesn’t “feel” tight upon palpation and they often don’t exhibit restricted range of motion that would indicate tight musculature.

So let’s start with this:

What are tight muscles, anyway?

In a very unscientific survey of a random bunch of people I know, I sought out some descriptions of what people thought tight meant for them. I first asked if they had any areas of their body that they’d describe as being “tight”. If they responded affirmatively (and everyone did), I asked them to identify how they’d describe their tight muscles in that area using terminology other than “tight”. In some cases, I offered them a theraband and asked them to show me what they thought their muscles were doing in that area. In every case, they identified the muscles in their tight area as being significantly shorter. For many of us, this holds true; we believe that tight = short.

At the risk of oversimplifying to keep this palatable for a non-expert audience, I’m going to argue that shortened muscles are one variety of tight that we feel in the body, but that having physically shortened muscles is often not the case for the areas that people describe as tight.

What I think most people often perceive as being “tight” are actually areas where muscles are locked in an elongated position. It might be helpful to think of this as your muscle being long and taut, versus the short and tight that many of us think of. Our muscles can be either be positioned or locked long or short. Positioned would indicate that the shortening or lengthening of the muscle is postural, and that you could move yourself out of that particular position. Locked short or long would indicate that you’re stuck in that position and need a hand to try to change the muscle length.

The shoulders: A prime example

The shoulders offer a prime example of this perception of tightness in the body. The vast majority of clients who end up on my table complain of some variety of tightness in the neck/shoulder/upper back region – generally between the shoulder blades. Many even ask that their entire treatment focus on that area only. Put simply, they feel tight there and think that an hour of rubbing that area will lengthen the muscles and make them feel better.

In actuality, most people – symptomatic or not – don’t have shortened muscles in the shoulders and upper back. While there are a few muscles in the neck (upper trap, levator scapula) that are tight,  In fact, the bulk of the muscles in this region are generally overstretched and positioned or stuck in this lengthened position – something we might also call inhibited. That is, they can’t do their job because they’re just hanging on. We’d definitely want to do some work in that area to help the muscles contract a bit better, we would also want to spend time focusing on the muscles in the front of the body that are contributing to the tight muscles in the back being too long. This work would lengthen in the front and shorten in the back, or basically the exact opposite of what most people think they need.

If my muscles aren’t shortened, then why do I feel tight?

So in a case where the muscles in question are not actually tight or exhibiting decreased range of motion, why do they feel tight? I have a few different theories on this (some, all, or none of which may be heading in the right direction…)

  • Semantics: We’re saying tight, but we actually mean another sensation that we may not have the vocabulary for. The muscles aren’t doing their job, you feel that, but the only word you have to describe it is tight.
  • Simplistic Sensory Signaling: The muscle in question is feeling something isn’t right, and it is sending a signals to let you know. Perhaps the difference between tight and overstretched, overworked, irritated, or whatever isn’t something your brain can distinguish between. However you slice it, the body is perceiving a sensory input
  • Pain Begets Pain: It is pretty commonly understood in pain science that the longer (and more) we hurt, the more likely we are to become oversensitive to the sensory input causing the pain. While I have some hesitation equating a tight sensation to pain, it would make at least some sense that similar patterning could occur for other types of sensation.
  • Nerve Sensitization: Perhaps the sensation is more nerve related and less muscle related?

However you slice it, you’ll want to work with someone who understands the postural patterns and is able to help you balance them with some combination of manual therapy, exercises, stretching, and movement repatterning. Even if we don’t entirely understand why things are perceived as tight when they’re not physically shortened, we do have techniques to help achieve a normal daily life with less perceived pain and tightness.

Photo by Olenka Kotyk

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Stretching Hands, Wrists, and Forearms
Most of us are fairly hard on our wrists and hands without even knowing it. We spend a good portion of our days gripping things and typing on keyboards or mobile devices, neither of which are actions that make your hands, wrists, and forearms very happy. If you’re gripping and lifting heavy weights, you’re really asking them to do a lot, even if the focus of the exercise is elsewhere in the body. Whether you have pain in these areas or not, you can benefit from spending a little time giving them some love – you’ll help keep your grip strong, your hands and wrists free of pain and numbness, and ward off things like carpal tunnel syndrome and similar issues.
To address these areas, you’re going to focus on 4 main points: 1. The front of the chest (pectoralis/pectoralis minor), 2. The spot at the back of your armpit where it connects to your torso, 3. The forearm, and 4. The wrists.
*special thanks to Philip for modeling these stretches!

Stretching Hands Wrists and Forearms

Front of the Chest (Pec/Pec Minor)

 

Lie on your belly on the floor with enough room to extend at least one arm directly out from your shoulder (straight elbow). Roll over onto that side, like so:
Stretching Hands, Wrists, and Forearms
Use your opposite arm for stability, as this person is doing here. Bend your top leg and let the foot fall onto the floor (as seen here). If it doesn’t reach the floor, use a pillow or something to support it comfortably.  Do both sides.
THEN, you’ll do something similar on each side, except instead of having a straight arm coming directly from your shoulder, you’re going to bend the elbow of the arm on the floor 90° degrees, and slide the elbow up so that it about level with your eyes/top of your head, at about a 45° angle. This should feel like a much more intense stretch, and you’ll likely not be able to roll over as far as you were on the first one.
 Stretching Hands, Wrists, and Forearms
In this, you’re looking to relax the pec and the pec minor, which can often trap the brachial plexus, which is the nerve supply for the whole arm.  The muscle in the diagram below that is shown lying over the brachial plexus is the pec minor. You can imagine it roughly going from the divot near the shoulder to the nipple on the same side. It is generally fairly grumpy.
Stretching Hands, Wrists, and Forearms

The brachial plexus, seen beneath the pec minor.

Teres Major Release

This is another entrapment point for the brachial plexus. The muscle that we’re addressing here is called the Teres Major, and it plays a bigger role in shoulder mobility and rotation than you might think, given its relatively small size. Addressing this area will help to balance the tension in the shoulder which will help ease any tension patterns traveling down the arm.
To release teres major, you’re going to lean against a ball on the floor and put some pressure into it. Teres Major attaches on the outside edge of the bottom of your shoulder blade, so that’s the area you’re looking for. Raise your arm above your head, hold the ball in place with your opposite hand while you arrange yourself on the floor and start to put pressure into it. You may need to roll around slowly a bit until you find something cranky, and then lean on it. If you’re using the floor, you’ll want to use something to support your head. If lying on a ball on the floor is super painful, do this against a wall instead, you’ll have more control over how much of your body weight you’re putting into the ball.
Stretching Hands, Wrists, and Forearms

Forearms

 

The muscle responsible for most of forearm pronation lives here, up in the soft part of your inner forearm near the elbow. It is generally a cranky, bossy fellow. In the diagram below, the black X represents the rough location of the muscle, and the red dots indicate typical pain patterning when this little guy is angry.
Stretching Hands, Wrists, and Forearms
To get at this, you’ll come onto all fours to a tabletop position, with knees under hips and hands/elbows/wrists under shoulders.
From here, lay one forearm down with the back of your hand on the ground, palm facing up. Your elbow of this arm should still be below the same shoulder, and your hand on this side will be almost under your opposite shoulder (roughly). You’ll need to bend your opposite elbow, and you’ll feel like you’re a little bit in a crunched up, awkward position here. Soldier on, you’re doing it right.
Stretching Hands, Wrists, and Forearms
Walk the elbow of the “forearm flat” arm back towards your knee, and bring your knee onto your forearm and mush it around. (That’s a technical term.) When you do this, you’ll see that as you press your knee into various areas of the forearm, it will make your fingers curl. Stay towards the middle forearm and elbow – there isn’t a lot of muscle down near the wrist and broken wrists don’t feel good, especially when self-inflicted.
Then, rotate your hand so it faces your feet (rather than pointing up at your face) and use the knee to drag the forearm muscles gently away from the bone.

Wrists

Start in a tabletop position and from there, simply turn your fingers to point out toward the sides instead of forward. Slowly start to make circles with your whole body so that the pressure in the wrists changes as you move. Circle in both directions maybe about 10x each, and move relatively slowly.
From here, turn your fingers back to face your body, keeping the same tabletop position. Do the same circles in both directions. Once you’ve finished with the circles, you’ll do a static stretch with your hands in the same position – simply start to shift your bodyweight back so that your shoulders are behind your wrists instead of over them.
Feel free to shift back as far as you like. You can come back all the way to sit on your heels, and peel the heels of your hands up IF it feels good. Stick within a reasonable comfort zone. Hold 20-30 seconds.
Stretching Hands, Wrists, and Forearms
After that, sit in any comfortable position (cross legged, kneeling, whatever works). Clasp your hands in front of you and reach your arms straight out in front of you, rounding your back and pushing your knuckles as far away from you as you can.
Flip your hands around and push your hands out in front of you again, arching your back this time, and pressing the palms of your hands away from you, looking up.
Now, keep the same hand position (palms away) and reach arms up over your head, reaching high.
Repeat those same three a few more times.
Stretching Hands, Wrists, and Forearms

 

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Muscle Spotlight: The Hip Flexors

If I were asked to identify a part of the body that is widely misunderstood, the hip flexors immediately come to mind. This may be partly due to the fact that we colloquially use the term ‘hip flexors’, since that’s easier to say than naming the specific muscles in the group, and partly because a large portion of people I talk with think they know what “flex” means, and they don’t.

Hip Flexors: What they do

The easy answer to the question ‘what do your hip flexors do’ is ‘flex your hip. Well, what is flexing your hip? More times than not, when I ask someone to flex their hip, they don’t know what to do.

Hip flexion may be more easily understood as bringing your leg up towards your torso (or decreasing the angle between your torso and your leg). It doesn’t matter if your knee is bent or straight (though most will perform this action by bending their knee at the same time).

https://www.youtube.com/watch?v=31Y1kRAjVg4

 

What muscles are the “Hip Flexors”?

If you head in to see a bodyworker and tell them your hip flexors are tight, they’ll know what you mean. That said, the hip flexors aren’t a single muscle that has the common name of hip flexors, they are a group of muscles that work together to perform the action of flexing the hip. So what muscles are they?

The biggest and strongest muscle in this category is going to be the Psoas. I’ve explained a lot about the psoas in a previous post, so I’m going to direct you back to that post for more information. In short, it is the largest and strongest muscle of the hip flexor group, and lies deep under the abdominal contents along the back body near the spine. Psoas (major) hangs out with his friends Iliacus, which sits largely just inside the hip bone, and Psoas Minor, which a) is only present in ~40% of the population and is relatively weak, so we won’t worry too much about the psoas minor in particular.

Next up is rectus femoris, which is grouped in with the quadriceps (which most people know!) and aids in hip flexion because it crosses both the knee and the hip joint. It originates on the front of your hip bone (ASIS, or anterior superior iliac spine) and attaches down below the knee on your shin.

Also in the hip flexor group is sartorius, which holds the title of being the longest muscle in the human body. It runs from the front hip bone (ASIS), descends obliquely across the front of the thigh, and after joining in with the tendons of other muscles (gracilis + semitendinosis), inserts on the front, interior tibia. The sartorius is a pretty wimpy muscle, so think of it more as a helper than a powerful mover.

We also have the TFL, short for tensor fascia latae, which assists in hip abduction (moving your leg across your body) but also lends a hand in flexion, which often goes hand in hand with abduction. (Most of the time, you’ll bend your knee before trying to move it across your body, rather than trying to do so with a straight leg, which will offer a much smaller range of motion).

There are also a handful of small muscles on the medial (inner) thigh that also help with hip flexion. These are all minor players, so I’ll stick to just listing them for now, and we’ll talk about stretching them later. Here you’ll find pectineus, adductor longus, adductor brevis, and gracilis.

Many of these muscles also take part in other actions as well as stabilization, so keeping them happy will get you more than you might think.

Why are the Hip Flexors Relevant?

If your hip flexors are tight (and they probably are, because modern humans sit a LOT, keeping the hip flexors shortened, tight, and angry), there can be repercussions other than painful/tight hip flexors, though that can obviously be a symptom. Tight hip flexors can contribute to lower back pain (if the psoas is pulling either up or down too much on the pelvis, it will tilt it unfavorably in one direction or the other), knee pain, decreased hip mobility, lack of stabilization in the hips and core, balance issues, and more.

If you’re an athlete, the imbalance caused by too-tight hip flexors will cause you to lean forward in many motions (especially squats). Often times, your quads will be working harder than they should, and your glutes won’t be working hard enough if this is the case (there go those booty gains!).

Balancing the Hip Flexors

Stretch Em

Most people will fall into the category of having overly tight hip flexors. If this is you, you’ll want to do some stretching and mobility exercises to improve the range of motion. I’ll have a much more in-depth hip flexor stretching routine coming your way shortly, but here are a few basics:

1. Start in a low, static squat, like this. Spend a little bit of time wiggling about to get comfortable, and hold the static stretch for 2 minutes.

2. Next, move into a runner’s lunge. To get there, start in a downward facing dog. Bring one foot between your hands, while staying on the ball of the back foot with your back knee lifted. Wiggle your back toes back as far as you can. Ensure your front knee is bent at a 90 degree angle, and your front knee stays behind your toes. Press back through your back heel, and try to ensure your hips are even with one another. Spend about 2 minutes here once you find the static position.

From here, put your back knee down into a low lunge. Walk the back knee back if you need to, and double check that your front knee has not come past your toes. If it has, walk your front foot up a bit more. From here, go ahead and sink your pelvis down towards your front foot/the floor. When you find a spot where you feel a good stretch but don’t have the immediate urge to get the heck out of that position, hold for 2 minutes.

Repeat the runner’s lunge and low lunge on the other side.

Sit crosslegged on the floor, and sit up as straight as you can. From here, hinge forward at the hips and start to fold over your legs. In this crosslegged forward fold, you may not get very far down, and that’s ok! Your goal is to move to a place where you start to feel some stretch in the back and sides of your hips, and maybe your low back. The goal is NOT to get your head down – instead, imagine that your sternum could reach the floor before your head does – you want to keep a straight(ish) spine. Hold for about 2 minutes when you find the right spot. Re-cross your legs so the opposite leg is in front, and repeat on that side.

Sit up and place the soles of your feet together and bring them in towards your pelvis. This is often referred to as a butterfly. It is a-ok if your knees are high in the air – you’re going to spend a few minutes here and let gravity and the magical stretch reflex do their work for some gentle release.

Strengthen Em

If you find yourself on the other end of the spectrum and have weak hip flexors, you’ll need to do a little work to strengthen them. Mountain climbers are your friend here – IF you move slowly and ensure you’re using the hip flexors to move your knee in towards your chest and not just momentum and accessory muscles.

Lying straight leg raises will also give you a lot of bang for your buck. Lie on the floor on your back with both knees bent and your feet flat on the floor. Extend one leg long, and slowly lift it as high as you can, flexing your toes back towards your face as you do so. Slowly lower the leg back down. While you perform this movement, make sure that your low back is staying down on the ground and not arching up.

Finally, a simple looking yet deceivingly hard exercise – standing single leg raises with a hold. If you’re super weak here, you’re going to want to start with your back against the wall, which will help make sure you’re not bending forward to achieve the desired motion. You’ll stand up straight, bring your weight into one foot, and bend the opposite knee and lift the knee until it is even with your hip on the same side. Hold here, 30 seconds. To amp this up, you can move away from the wall, but be mindful that your hips are even and you’re not leaning forward or back, especially when you’re holding. If you still find this to be super easy, try with a straight leg.

 

 

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How does Voodoo Floss work?

As of late, I’ve seen a fair number of folks using voodoo floss. Admittedly, I hadn’t given it much thought, seeing as most of the folks using it would easily qualify as meatheads, and the first guy I saw using it told me he used it to make his arms puff up so he could “Look more swole, bro”.

Yeah, so anyway.

Off I went to do some research with my pal Dr. Google about Voodoo Floss. I wasn’t impressed. Especially given the choice of video tacked onto the bottom of the product listing, wherein big name mobility guy Kelly Starrett voodoo flosses someone’s elbow and jolts it around, nearly hyperextending it in the name of ‘increasing mobility’. I clicked off the page and moved on with my day. Not long after, I started thinking about why this dude was using voodoo floss to ‘look swole’, and my line of thinking brought me to the idea that maybe the voodoo floss wasn’t so much voodoo at all.

I borrowed one from a friend, and started experimenting on myself. I ‘flossed’ knees, elbows, ankles, shoulders and basically anything I could easily wrap on my own. I played around with different types of movement and different methods of wrapping. I had some pesky clicking in my knee during squats that cleared up each time I flossed my knee. I started doing it to my friends and family, and finally, with my clients.

Like many other things in massage therapy, there isn’t much in the way of evidence-based study on things like Voodoo Floss – everything I discuss below is based off my own experiences and the information my clients have passed on to me. While I’m always looking for data and studies that back up this subjective information, when I see excellent anecdotal evidence supporting the use of a tool like this, I’m happy to go with it. I’m sure we’ll be seeing more information on voodoo floss and other similar tools as they become more mainstream.

Ischemic Compression

It would make sense to me that tightening the voodoo floss would cause some type of ischemic compression (oft employed some massage modalities, like trigger point therapy) in the area in question. The concept is fairly simple: deliberately block the blood flow to a specific area. The body realizes this and attempts to send more blood to that area. Release the blockage, and all that blood flows back into the area in question. More blood flow = swole. But more importantly, we want increased blood flow! Increased blood flow means more oxygen, more nutrients getting to your cells, waste being easily transported out of your cells, easier body temperature regulation, and a slower time to reach fatigue, just to name a few. (As a side note, one of the awesome benefits of massage is increased blood flow).

Fascial Shear

Let’s start off with a couple of quick definitions, just to ensure everyone is on the same page:

Fascia:a thin sheath of fibrous tissue enclosing a muscle or other organ.

Shear: a strain in the structure of a substance produced by pressure, when its layers are laterally shifted in relation to each other.

Your muscles are essentially wrapped and layered in fascia. These layers of tissue should move and slide on each other to create movement. Lack of movement, injury, or overuse can cause adhesions in these tissues, which will cumulatively lead to difficulty of movement, among other potential things. (Sidenote: Gil Hedley gives an excellent overview of what he calls ‘fuzz’. Spend 5 minutes watching his video “The Fuzz Speech“. It will give you an excellent visual of fascia.) 

When we’re talking about fascia and the Voodoo Floss, we’re looking at a type of fascial shear. By wrapping the floss around the joint in question, we’re creating a compression of the tissues in the area. When we combine that compression with movement (either passive or active), we’re creating fascial shear, which breaks up the adhesion in the tissue.

 

 

Header image via

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Should I do Yoga?

I get this question quite often from both clients and friends, and while it may be formulated as a question, it usually isn’t really a question. Most of them mean something like “I know I should do yoga, right? Yoga will help me”.

This attitude should come as no surprise, given that yoga has grown drastically in popularity in the recent past. According to the 2012 statistics from Namasta, there are over 15 million practitioners in the US, and the industry sees about a 20% year over year increase. Over the last 5 years, there has been an 87% increase in the amount of money spent on yoga products. There has been a huge influx of yogis on social media, posting photos and videos of themselves in poses most people can’t even think of getting into. We’ve been cultured to believe that yoga is the panacea of all our ills – whether they’re caused by sitting at a desk for hours a day or too much running.

But is it? As someone who takes a fairly moderate approach to many things in life, I generally advise people (and often need to remind myself) that if something promises the world, or seems too ‘perfect’ it is probably too good to be true? We’ve come to believe that yoga can heal – and while I’d definitely argue that it can, I’d also argue that it isn’t all its cracked up to be, that not all yoga is for everyone, and that you need to approach it with some knowledge, care, and self-awareness.

yoga

Yoga Can Be Good

So you’re probably thinking that I’m mostly here to hate on yoga. Which is not the case – yoga, in many ways, completely changed my life. I’m a yoga teacher. I spend a good amount of time with my clients teaching them how to stretch and do certain yoga poses. So we’ll start with the good stuff. Most of this is probably stuff you’ve already heard about yoga, but its worth mentioning anyway:

  • Yoga will likely help improve your flexibility. Probably one of the more obvious attributes of practicing.
  • Yoga will help you to be more aware of your body. Buyer beware! This can sometimes get pretty annoying, especially if you’re an over-analyzer like me.
  • Yoga can help you prevent injuries from doing….well, all the other stuff you do.
  • Yoga can help you relax. The focus on breath in yoga is really good for us. Taking time to breathe and be present is pretty awesome, and something most of us need quite badly.
  • Yoga can be an excellent workout, depending on the style of yoga you choose to practice.
  • Yoga is awesomely adaptable. Whether you’re someone who can sit comfortably with both feet behind their head or can’t touch their toes, its ok – there’s yoga that you can do and that you can benefit from.

The list can go on and on – if you don’t believe me, head over to see what your pal Google has to say when you search for “benefits of yoga” or “why should I do yoga”. From hotter sex to better sleep to increased happiness and injury prevention, the list goes on and on.

Yoga Can Be Bad

Now that you know that yoga is totally awesome, we’re going to shine a little bit of light on the not so good stuff. There’s a lot of talk about how yoga can help prevent injuries, but not a lot of talk about how you can get injured doing yoga. And believe me, you can! I spent several years doing bodywork in a yoga studio, and lots of people get injured doing yoga.

Something that often gives me pause is that because yoga has exploded in popularity pretty recently, we don’t have a lot of long term data or studies showing what happens to people who do a lot of yoga for a long time. While it has been fairly well documented that stretching (within guidelines) is pretty good for you, what about repeatedly performing backbends, standing on your head or shoulders, or moving your neck in certain ways? A 2012 New York Times article addressed a number of ways yoga can be totally horrible for your body. Its a good read – take a few minutes to sift through it when you have a moment, but I’ll sum it up in a (majorly) oversimplified way: not all yoga is good for everyone. Further, what might feel great for you today might not feel great tomorrow, or next week. In order to benefit from yoga, we must move carefully, mindfully, and without ego. Oh yes, all those cliches that you didn’t want – you just wanted the workout, right?

What You Should Do

Whether you’re brand new to yoga or a seasoned practitioner, it is hugely important to move move carefully, mindfully, and without ego. If a teacher is leading the class through a sequence that includes a pose or two that say, hurts your lower back when you perform it, maybe you shouldn’t be doing that pose. If you’re doing something and it hurts, stop doing it!  Seems basic, right? But most of us will just keep performing the pose that hurts or doesn’t feel right without question. Either perform a different pose, a less intense version of the same pose, or skip it altogether. Ask the teacher for help with your technique on that pose and for modifications.

Don’t be afraid to move slow. Lots of people love power yoga, lots of vinyasa, classes that move and make you sweat. Don’t get me wrong – I love these classes too. Vinyasa flow is my preferred flavor of yoga, but especially when you’re first learning, moving quickly through a lot of poses can mean you’re doing a lot of stuff wrong. Which can lead to injury. I’ve been to more “All Levels Yoga” classes than I can count, and very very few work through the technique of the vinyasa – a series of movements that brings you firmly into the camp of those likely to incur a shoulder injury if you’re doing it wrong and often enough. We’re so hard-wired in our culture to need to do MORE and FASTER that slower, stretchier yoga is often shunned for the more ‘workouty’ types, but there’s a lot of benefit to be had in classes that do fewer poses, longer holds, and offer a lot of cues for technique.

We see so many uber-stretchy yogis online doing crazy poses, and we aspire to them. We want to do forearm stand and bring our foot to the back of our head in one-legged king pigeon. Leave your ego at the door: just because someone else is doing something doesn’t make it right for your body. I once watched my neck-injured mother in law craning her neck at a horrific angle in an attempt to bind in extended side angle pose– a pose which wasn’t accessible for her body at that time. The vision of it makes me cringe even now, but I remember looking around and seeing every other person in the class performing the bound version of the pose, even those for whom it looked extremely difficult and/or just plain wrong. When the teacher guides a class through a sequence, they likely offer several stages of poses. Take the easier one if you need to, even if the people next to you are going further. Don’t do handstands and weird binds and backbends and hand balancing because you see people on Instagram doing them.

Do your homework. Not all yoga teachers are equal (and are often a dime a dozen, so if you strike out, keep looking!). I’ll be frank: the basic requirements for certification by the Yoga Alliance (the certifying body for yoga instructors in the US) is only 200 hours, which breaks down to roughly three weeks of full time training. This doesn’t mean that if a teacher has only completed that level of training they’re not good or knowledgeable, my point is just that the bar is fairly low, and not everyone has additional training or outside knowledge of the body, injuries, and more. Ask around. Try a lot of different teachers. Ask the teachers a lot of questions. You may find twenty mediocre but totally acceptable teachers before you find a great one. You’ll know when you find the great ones. They’ll offer you movement cues and modifications you haven’t heard before. They’ll work into harder poses logically, opening and strengthening areas of the body in ways that make sense.

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Should I foam roll my IT band?

Foam rolling can be pretty awesome. I recommend it to many of my clients for a variety of issues, and as far as self-care methods go, it is one of the more versatile and easy to do. So I’m sure you can imagine that I enjoy seeing foam rollers making a rather widespread appearance. They’re in gyms, PT clinics, and lots of people are using them. But I cringe when I see people rolling up and down their IT bands at light speed.

I’m not entirely sure what’s up with the overabundance of foam rolling on the IT bands. It seems like everyone does it, though I’m not clear on where everyone learned their ‘technique’ and how they know that foam rolling the IT band is what their body needs. At one point, I sat in the gym I belonged to at the time and watched a number of people foam rolling. Every single one rolled up and down their IT bands, even the ones who didn’t roll any other areas at all.

Which bring us to the main question of this post: Should I be foam rolling my IT band?

What’s an IT band, anyway?

Your IT Band, otherwise known as the Iliotibial band or ITB, is a thick sheath of fascia (connective tissue) found on the outer thigh, roughly from the hip to the knee. It helps stabilize your knee, and the muscles that surround it (some even insert into it) play a role in extension, abudction, and lateral rotation of the hip.

You’re asking it to do a job when you’re walking, running, cycling, and doing just about anything else that involves your legs. You change the tension on it when you sit (which many of us do all day, at a desk). That’s a lot of different movements that it is involved in, so it should come as no surprise that it plays a huge role in may forms of hip and knee pain. A number of sources indicate that IT band syndrome is one of the leading causes of lateral knee pain.

itb

 

 

Should I foam roll my IT band?

The concept isn’t entirely ridiculous: If my IT Band is tight and causing problems, I should roll it to stretch it out, and then it won’t be tight anymore and I’ll get better. So where does this theory fail?

  • The IT band isn’t a muscle – it is connective tissue. Really, really thick connective tissue, that you can’t stretch much.
  • Rolling quickly up and down wouldn’t break up any adhesions in a muscle anyway (which is what most people seem to be doing)
  • The IT band may be playing a role in your pain, but there are a number of things that may put your IT band at greater risk for injury (such as gait abnormalities). You’ll need to get to the root of the problem, which may not be the IT band itself.
  • If you have inflammation in the area, you’ll likely just irritate it more by rolling up and down the IT band.

The idea that you can stretch out or ‘release’ your IT band is a nice visualization, but it doesn’t actually work that way. Furthermore, if you have pain in the area or have been diagnosed with IT band syndrome (inflammation/irritation of the IT band) and you roll the area, you’re likely to make it even more inflamed.  And more inflammation = no thanks.

What to do instead

So if foam rolling the IT band isn’t going to get you very far, then what should you be doing?

Stop Consulting Dr. Google

If you think you may be injured…..We all know we shouldn’t, but we do it anyway. We have pain, and we check with Dr. Google to see what it is. If you have persistent pain, go see a real doctor and use Google for cat videos instead.

Address the TFL

The tensor fasciae latae (TFL) is a small muscle that sits along the upper lateral hip, inserting down into the IT band, aiding in hip stabilization. It pulls upward on the IT band which increases tension.  You can help reduce tension on this muscle with static pressure on the muscle (either a foam roller that you’re not rolling on or a tennis/lacrosse ball will work well).

Should I foam roll my IT band

Take a look at both the TFL and the gluteus maximus in this photo

 

Glutes, glutes, glutes

Think about the location of your gluteus maximus (that’s the butt, for y’all that prefer the colloquial). It doesn’t ‘attach’ to the IT band technically, but it does share fascia, which means if it is tight and yanking your pelvis in an undesirable way, then it is likely affecting other structures in the area. Foam roll, use static pressure on sensitive spots, or stretch (try the figure 4 stretch below).

figure4

 

Foam roll your quads, adductors, and hamstrings: Many people think that the quads (front of the leg) and hamstrings (back of the leg) ‘attach’ to the IT band, which is incorrect. This is a very oversimplified description, but the IT band comes closer to lying next to/on top of the edges of some of these muscles rather than attaching to them. Slow foam rolling and/or static holds for the quadriceps, adductors, and hamstrings will help to balance tension in the leg overall, hopefully putting less load on the IT band.

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Good resources for learning about your body

When it comes to the body, there’s a lot to learn about. It is a pretty complicated and interesting machine, and the more I learn, the more I realize I have to learn about it. When I work with clients on their pain or mobility issues, I try to explain a bit of what’s happening and why, to help them understand what is going on in their body.  Many follow up by asking me for resources to check out so they can learn more. To keep everything all in one place with a handy list, I’ve listed some of my favorites below. Along with the few resources (at the top) that are great for almost everyone, I’m including some of my favorite massage and bodywork resources, too.

This list will be updated periodically, as I find new resources (and as I remember!)

  1. Netter’s Atlas of Human Anatomy
  2. Trail Guide to the Body
  3. Anatomy Trains
  4. Fascial Release for Structural Balance
  5. Yoga Anatomy
  6. Orthopedic Assessment in Massage Therapy
  7. Orthopedic Massage, Theory and Technique
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Muscle Spotlight: Psoas

When most people come in for a first session with me, they have some knowledge of their body. Most people know about quads, hamstrings, calves, biceps, and a handful of other muscles, but most people have less overall knowledge of the rest of the muscles – of which there are a lot! Today, we’re going to take a look at the psoas.

Where is it and what does it do?

The psoas is one of the muscles that most people don’t know much about. The psoas is the largest and strongest of the muscles that flex the hip (quite accurately referred to as the hip flexors, as a group). Psoas major and its friend, Iliacus may often be referred to together as “Iliopsoas”, because at their lower attachment, they are usually indistinguishable. Just to throw a little more fun into the mix, we’ll also consider the psoas minor, since it shares a half a name with psoas major.

The psoas major is the longest, strongest muscle of this group, and is found deep to the abdominal contents. It originates from the lumbar vertebrae and travels down to attach on the lesser trochanter, on the back (top) of the femur.

The iliacus is shorter and wider, located deep in the abdomen, originates in the iliac fossa (better understood as the area just inside your hip bone), and attaches at the same spot as the psoas major.

The psoas minor is less relevant, largely because it is only found in around 40% of the population. It originates from the lumbar vertebrae (along with the psoas major) and attaches on the superior ramus of the pubis (so, on the pelvis as opposed to on the femur bone in the leg). Interestingly, it does the opposite of the psoas major – when present, it assists in bringing a posterior tilt to the pelvis (upward rotation).

Because of its location connecting the torso and the legs, your psoas is involved in a lot of different movements – walking, running, sitting, twisting. Hip flexion is the psoas’ major job (bringing  your thigh towards your torso or vice versa depending on what position you’re in). In addition to hip flexion, it stabilizes your lumbar spine, and it assists in laterally rotating the hip and adducting it (rotating out and bringing the leg towards the midline).

Why is it relevant?

If you sit a lot (for example, you sit at a desk for work ~8 hours a day), your psoas is shortened while you sit. If you do this often and/or for extended periods of time, they can become short and tight. Short, tight psoas muscles may lead to low back pain (since the muscle originates on your lumbar vertebrae- remember?)

Untitled Infographic (1)

 

The photo above gives you a pretty good idea of one way the psoas can contribute to low back pain. When the psoas shortens, it gives a downward pull (blue arrow). Since you don’t want to go through life bent over, your body’s response is to right itself (white arrow), and this causes an increase in the lumbar curve (lordosis).

Short and tight isn’t the only problem the psoas can have. It can also become overstretched, which makes it weak. In this scenario, there is a flattening of the lower back, a posterior tilt to the pelvis, and resultant tightening in the hamstrings. The flattened lumbar curve makes one particularly susceptible to disc damage in that area.

Balancing tension in the psoas

Given modern human’s proclivity towards sitting (working at a desk, driving, watching tv, etc), the psoas is often tight, short, and needs to be stretched. But stretching the psoas shouldn’t be your go-to move: there are other considerations.

1. In the first scenario described above – where the psoas is shortened, tight, and yanking the lumbar spine into an increased curvature – the body is in a position where there is a strong pull downward on the psoas. Stretching a muscle that is already being pulled on isn’t the best idea. In this case, you’d be better off contracting the muscle and then relaxing it a few times instead of giving it a traditional stretch. (This contract-relax method is PNF stretching – there’s a good description here)

2. In the second scenario that we described above – where the psoas is overstretched, weak, and there is a flattening of the lumbar curve – the body is in a position where there is a strong upward pull on the psoas. This comes partly from overly tight glutes and hamstrings which are basically taking advantage of the weak psoas and pulling the tension posteriorly. If you stretch the psoas further, it will allow the glutes and hamstrings to pull even more, which puts an even greater load on the psoas – effectively making the problem worse. A better solution here would be to release the tension on the glutes and hamstrings, which will lighten the load on the psoas.

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What can kinesiotape do for me?

By now, you’ve probably seen people wearing it. Brightly colored or black tape standing in stark contrast to the skin, applied to various areas of the body in sometimes dramatic pattern. More often, you probably don’t see it – because it’s hiding beneath clothing or shoes. Regardless of where it is or what color it is, you may wonder exactly what it does? And what is it?

Most of us are familiar with athletic tape – stiff(ish) white stuff designed to stabilize joints during athletic activity. This stuff is different. It is softer, more flexible, and stretchy. Most often, it is called kinesio-tape (the name Dr. Kenzo Kase gave it way back in the 70’s), but there are a ton of different (brand) names out there today.

A little background

The ‘original’ Kinesio tape was designed back in the 70’s in Japan by a chiropractor and acupuncturist named Kenzo Kase. He developed the first tape of this kind with the goal of increasing the efficacy and achieving longer lasting results from manual therapy sessions. The tape was designed to have a similar elasticity to healthy human muscle, breathe well, stay in place for longer periods of time, and lift the skin microscopically.

What does the tape do?

When a muscle is injured, it loses some of its elasticity. The tape is designed to help augment the healing process and offer support for joints while not restricting any range of motion. At least in theory, the tape extends the benefits of manual therapy by providing extended soft tissue manipulation. When applied, the tape is supposed to activate certain types of mechanoreceptors (little receptors in the skin that respond to light touch, sustained pressure, texture, tension, etc) that alleviate pain. The microscopic lifting of the skin that I mentioned earlier creates interstitial space which allows for a decrease in inflammation in the taped area.

Does it work?

Lots of people I’ve talked to have relayed positive messages regarding their own use of kinesio tape, but I always like to take a look at any studies that have been done to see more objective analysis rather just than anecdotal support. There are more studies out there than I can count, but I’ve selected a few just to give you an idea of what’s out there. I’d encourage you to search Pubmed to see additional studies on therapeutic taping.

  • This meta analysis of 10 studies concerning sports injuries concluded that “there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries.”
  • This study that compared nonelastic sports tape with kinesio-type tape (elastic tape)showed that elastic tapes offered no effect on muscle activation
  • This study looked at basketball players with chronic ankle sprains, and though it determined that taping didnt have a positive effect for the players in their functional performance tests, it had no negative effects, either.
  • In a study of healthy college athletes, it was determined that taping did not have any positive effect on performance.
  • This study  shows that taping offered some increase in dynamic postural control in healthy individuals.
  • Another study looked at healthy young women performing squat exercises, and determined that tape application prior to this exercise didn’t effect muscle pain or short sprint performance, but did help maintain muscle flexibility at day 2 of recovery.
  • This study looked at the typical asymmetrical gait of stroke patients and found that the application of the tape to the paralyzed parts offered improvement in gait (ie, it made it less asymmetrical).
  • One last one explores the effect of taping on lumbar spine flexibility. The subjects in this study showed increased flexibility in the lumbar spine at 24 and 48 hours after tape removal.

In short: mixed results. That’s the worst – right? Things are much easier when there’s a clear conclusion and subsequent action items. The good news is that kinesiotape (regardless of brand, color, or whatever) isn’t going to break the bank and isn’t going to hurt you. So go ahead and give it a try.

 

 

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Welcome to the blog

Welcome to the blog portion of this site!

So, why does a bodyworker need a blog, you ask? Well, I probably don’t. You can learn about me and the type of work I do by clicking around on all the other parts of this site. But there’s a lot of stuff out there that I read about and hear about. As these things get my brain churning, I find things that I want to share with my clients and friends. A lot of people ask me questions that are relevant to health and fitness. Sometimes I know the answers and other times these questions send me on a research trip, seeking information to give educated, informed responses to the asker. The internet may bring a ton of information to our fingertips, but it also enables anyone to put information out there for our consumption whether or not they’re truly an expert. It often takes a bit of digging to find unbiased information. Think of  it as me doing the legwork for you. So here we are with a blog.

What you’ll find here will probably include discussions of common injuries and musculoskeletal syndromes, different types of bodywork and other treatments, exercise, current research on manual therapies, maybe some nutrition, and some personal musings along the way.

Questions? Comments? Something you want me to write about? Just ask! Click on the contact link and type away! (Don’t forget to be nice).

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