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Is Swimming Low-Impact?

If you have back pain or a history of back pain, which sport listed below is the least likely to cause more damage?:

  • Baseball
  • Kendo
  • Running
  • Soccer
  • Swimming

Swimming seems like the obvious answer, since that is usually the go-to sport for people with pain. Surprisingly, a recent research article didn’t find this to be the case (1).

Researchers used MRIs to image the lower backs of 306 well-trained university athletes and compared them to 71 non-athlete university students and found that swimmers and baseball players had the highest amount of low back degeneration (1).

With baseball players, it makes sense because of the forces that are involved with swinging a bat. But how does swimming cause so much degeneration? (The rest of this article is a hypothesis on why an increase in degeneration occurs in swimmers.)

Kicking during swimming is a very large part of propulsion. The main muscle that fires during kicking movements is the psoas major (hip flexor). Looking at the green highlighted portion of the picture below, you can see that it attaches to the side/front of the lumbar spine (lower back) and travels down to attach to the femur (upper leg bone).

Every time you kick your leg, the psoas contracts, pulling on your low back. This causes the muscles in the back of your lumbar spine to contract to counteract the pulling force from the psoas. The end result is stabilization of your low back. This happens everywhere throughout your body. When one muscle contracts, other muscles contract to stabilize the area and prevent motion. In this case, the repetitive contraction to stabilize your spine during kicking causes increased compression on your lower back discs. The end result is increased disk degeneration.

This doesn’t mean swimming is a bad thing, but it is something to take into consideration. If you have back pain or have a history of back pain, then you may want to reconsider the structure of your swimming workouts. Many workouts will include kickboard drills or kicking with fins (fins will increase the strength of the psoas contraction, leading to more disc compression). These drills will greatly increase stress on your low back. If you know you have degeneration in your low back and still want to swim, it may be a good idea to limit kicking or use a pull buoy to avoid any extra kicking stress. In addition, many people will turn to swimming when they have back pain because it is the only physical activity they can do with minimal pain. I would strongly advise against this because it may only prolong the length of time that you are in pain. It is important to note that if you are experiencing pain, then you should be properly evaluated to determine the cause.

1) Hangai M, Kaneoka K, Hinotsu S, et al. Lumbar intervertebral disk degeneration in

athletes. Am J Sports Med 2009; 37:149-155.

Muscle adhesion is the most common source of pain and stiffness and the most underdiagnosed. If you are experiencing pain or stiffness, please click the button below.

 

 

Stretching: The Solution to Muscle Pain… or Is It?

Do you have tight, stiff, or painful muscles? You obviously need to stretch more, right?

If something is tight, stiff or painful, we immediately assume it needs to be stretched. Stretching may provide temporary relief for some, but the majority of people do not get results. Unfortunately, stretching is not the answer to all of your problems. In this article, we will talk about two of the major contributors to your tight, stiff, and painful muscles. Read more

Top 5 Foam Rolling Mistakes

1. Only foam rolling AFTER exercise.

Foam rolling is a great way to warm up your body BEFORE exercise.  Foam rolling followed by a quick dynamic warm-up is a great way to prepare your body for movement. To learn how to foam roll and perform a dynamic warm-up click the following link: The 6 Characteristics of a Good Dynamic Warm-up by Eric Cressey. 

2. Rolling over the greater trochanter.

The greater trochanter is a bony prominence of the femur.  If you google it, you can see pictures of it.  If you run your hand down the side of your thigh, you will feel a bony bump at the top.  When you are rolling the side of your leg avoid rolling over that bump.  It can irritate the bursa that is over top of it.

3. Hyperextending low back.

The foam roller is a great way to mobilize your mid back (thoracic spine) into extension.  If you go to the 1:35 mark in the following video (Foam rolling Series) you can see how to perform this.  You will notice that he doesn’t go near the low back (lumbar spine) when performing this movement.  The low back and mid back work differently and hyperextending the low back can irritate it.

4. Using the foam roller on every muscle.

The foam roller works great for most muscles but it doesn’t work that great in the calf area. Try using a massage stick (The stick) instead.  Make sure the calf is relaxed in order to get the deep calf muscles as well.  Sit down lifting your knee straight toward the ceiling let your foot relax so it points toward the floor and relax as much as possible as you roll/massage your leg.

5. Using the foam roller to treat pain.

Foam rolling shouldn’t be used to treat pain. Foam rolling may reduce or eliminate your pain temporarily but ultimately it only delays you from getting the proper treatment.  Proper treatment involves removing adhesion, which the foam roller cannot do. To learn more about this topic click the following link: Can foam rolling remove adhesion?

If you are experiencing pain or have any questions regarding your pain, please click the button below.

Are you ready for the running season?

In the northeast many runners cross-train over the winter.  This is a good time to recover from injuries, strengthen weak areas, and get ready for the next season.  But how do you know if you are ready for the running season?  Two simple tests below will give you a quick insight into the health status of your muscular tissues.

Standing toe touch

Stand with feet shoulder width apart, keep your knees straight and reach toward the floor.  You should be able to touch the floor and only feel minor stretching equally in both hamstrings.  This should  be done WITHOUT warming-up.  A passing test is touching the tips of your fingers to the ground. A failed test occurs if any of the below findings occur.

  • Can’t touch the floor
  • Stretching in calves
  • Stretching in back
  • Focal spot of tension in hamstrings
  • Unequal stretching in hamstring
  • Pain

Forward lunge

Lunge forward with one leg and then push back with the same leg to the start position. Then repeat with other leg.  A passing test is a lunge that is balanced and effortless.  The left and right leg should feel stable and pain free. A failed test occurs if any of the below findings occur.

  • Body leaning forward
  • Unstable
  • Painful
  • Front knee dives in
  • Fatigue quickly (should be able to do 10 reps on each leg without much effort)

If you fail either of these tests, then you are at a higher risk of injury while running.  Stretching, foam rolling, and strengthening will not make a sustained improvement on these tests.  The first step is to see if adhesion is causing the failed test.  Adhesions can cause all of the failed findings above.  To learn more about adhesions click the link below:

Adhesion

If you suffer with the same injuries every season and/or you failed a test, then click the button below to schedule an initial exam.  Let us get to the root of your problem.

Sport Injuries: Consequences of Pushing Through the Pain

An article from the New York Times titled, “Sport Injures: When to Tough It Out“, recently caught my attention.  The main point of the article was to answer the question of whether you should go to the doctor or tough it out?  A quote from one of the doctors in the article is below:

“I think most folks should not go (to the doctors), because most general doctors don’t know a lot about running injuries,” he said, adding, “Most docs, often even the good sports docs, then will just tell you to stop running anyway, so the first thing is to stop running yourself.”

This quote brings about two very important points.

1. Your primary care physician, emergency room physician, and urgent care physician do not have a reason to know a lot about overuse injuries.  Most of the time they will prescribe rest, anti-inflammatories, ice and/or muscle relaxors. This will cover up the pain so you feel better but it will not fix the problem and most likely you will experience similar symptoms down the road.

2.  I do not like the advice to stop running or stop doing whatever activity aggravates your condition.  This may be good advice at first because it will allow your body to recover and reduce the pain but it didn’t fix the problem.  There is a reason why you have shin, hip or knee pain with running.  I recommend that you try to figure out why you are experiencing the pain.

I believe if you are experiencing any joint pain with activity then your first step should be a chiropractor that specializes in soft tissue treatment.  In my office,  screening procedures and motion assessments are used to diagnose the source of the pain.

It is impossible to write an article that would cover every scenario of when to see a doctor and when to tough it out. It is a good idea to have any pain checked out but below are some general guidelines of when to go see a chiropractor:

  • Shin pain-if you push through it, it can progress to stress fractures
  • Elbow pain (tennis or golfers elbow)-left untreated it can progress to tendinosis which is degeneration of the tendon.
  • Achilles tendon pain-can lead to degeneration of the tendon and possibly rupture.
  • Heel pain/ plantar fasciitis-pushing through this will lead to further degeneration of the tissue causing pain even with sitting.
  • IT band tendonitis-will cause chronic knee pain but the problem is usually at the hip.
  • Pain in the same area with activity that gets better with rest but returns once you start the activity again.

If you get a random ache in a joint that only last a few minutes, then this is most likely not a reason to go see a doctor.  Aches that increase in duration and frequency should be checked out.

If you are experiencing pain, then feel free to email a general outline of your symptoms to me.  Then I can help you determine what your next step should be.

Knee Surgery May Not be the Answer

A recent article in the NY times (Common Knee Surgery Does Very Little for Some, Study Suggests) suggests that many people may be undergoing unnecessary knee surgery.

The studies they referenced in the article showed that people undergoing knee surgery for degeneration did no better than people that underwent sham surgery, physical therapy, or who took medication.  This research suggests that jumping into surgery may not be the answer and it is costing our healthcare system billions of dollars.

Meniscus (shock absorbing cartilage in the knee) tears are very common.  They can occur from trauma or degeneration.   The degenerative type occur without trauma and accumulate from the stress and strain of life.  MRI’s allow us to visualize degenerative changes in the mensicus which have many doctors rushing to surgery.  The research is showing that we shouldn’t be so quick to rush into surgery in these cases.

If you have knee pain or have an MRI showing degenerative changes in the mensicus or other tissue, then conservative care should be your first priority.  Adhesions can accumulate in the tissue surrounding the knee.  This can occur without any previous history of trauma.  Adhesions will act like glue and not allow the knee to move properly.  To see if you have limitations in your knee.  Perform the test Read more

The Gift of Pain

Why is pain a gift?

Pain is the bodies warning system that something is wrong.  If we didn’t have pain, we would slowly destroy our bodies and not even know it.

Unfortunately, we are trained to cover up pain.  Americans consume billions of dollars of pain medicine every year.  Pain medicine allows us to function when we shouldn’t.  It seems like the answer to shoulder, knee, back, elbow, neck, and foot pain is ibuprofen or some other type of pain medicine.  This may help in the short term but it sets you up for disaster down the road.  Many times pain medicine will allow you to irritated the bad tissue until it tears.  This may be why we see such a large number of rotator cuff tears and disc herniations.

Rest, ice, or pain medicine is not the answer to reducing your pain.  Muscle adhesion is the most common source of pain and stiffness and the most underdiagnosed. To determine the cause of your pain, click the button below to schedule an appointment.

Triathlon Training and Recovery

One of the most crucial pieces left out of a beginner’s triathlon training program is recovery. If you don’t allow your body to recover, then overtraining can occur.  Training for a triathlon can put a lot of stress on your body because you have to train for 3 sports at once.  Learning to balance swimming, biking, and running in the right ratios takes time.  Common warning signs of overtraining include:

  • Sudden drop in performance
  • Changes in your sleep pattern
  • Loss of enthusiasm for training
  • Change in appetite
  • Increased incidence of illness
  • Feeling tired even after easy workouts
  • Moody and unpleasant to be around

Beginner athletes always assume more is better.  This may work for a year or so but eventually you will stop seeing improvements and realize that you have to train smarter, not harder.  The best way to do that is to get a triathlon coach.  Find someone in your area that has a good reputation and listen to everything they say.  If hiring a trainer is not in your budget, then read the Triathlete’s Training Bible.  This book will give you the basics to design your own training program. Everyone responds differently to training and listening to your body is very important.  Your training program will change over the years as you learn what works and what doesn’t work. Most programs will have at least one complete rest day a week and then every 4th week will be an easy week.  It is also important to take a break from training completely at the end of the triathlon season. Learning to train smarter will allow you to perform pain free for many years.

 

No pain, no gain…..right?

Have you ever heard the saying, no pain, no gain?  This saying can be a good thing or a really bad thing.  For example, if a triathlete starts swimming after a long break, it is probably going to be a painful experience.  It’s hard to get oxygen, your arms are sore, and you are trying your hardest not to let your legs become a 60 pound anchor.  At first you have to push through the pain, and eventually it becomes easier. Pain in this case is a part of becoming better, stronger, and faster.  If that same triathlete has shoulder pain on his right side during the recovery portion of his stroke, then that’s a different story.  This is bad pain and indicates that the joint is not working correctly.  This pain would most likely be caused from adhesion in the rotator cuff muscles.  This will cause the joint to move incorrectly and create pain in the shoulder and down the arm.  Bad pain is your body’s way of saying STOP.  If you try to work though the pain and take anti-inflammatory medicine, it will only get worse.  The medicine will allow you to continue to move the joint wrong until something tears.  I like the saying, “No GOOD pain, no gain”.   If you are unsure if your pain is good or bad, please schedule an exam to find out.

Spinal decompression with no machine?

The goal of spinal decompression is to take the load off of the discs in your low back or neck.  This can help take away neck pain, low back pain, and numbness/tingling in your hands and feet.  At Muscle and Joint Chiropractic, we treat the adhesions to naturally decompress the spine.  Any muscle that crosses a joint will stabilize and compress it.  In the neck and low back there are many muscles that cross these joints.  If you have adhesion in these muscles, they will increased load and pressure on your discs because the joints are not moving correctly.  Breaking down adhesion with ART, MAR, and IAR, will naturally decompress the spine.