The Chainlink

New Blog: Ouch, That's Going To Leave A Mark!

Sick of riding hurt, or worse yet, being sidelined by injuries? Well, your friendly P.T., Laura Cooper, is hanging out at the Chainlink with a little advice and some tips to help you ride without those nagging aches and pains. I am here to share a little knowledge and offer my two cents worth if you have any queries or questions. This first post is a little long, but my philosophy of treatment is not one dimensional. Future posts will be sleeker, like your dream road bike. Scroll down if something seems familiar take a read. Treatment hints are at the end

I am an orthopedic physical therapist. I deal with just about everything injury under the sun if it is related to muscles, tendons, ligaments, bones, discs, cartilage or nerves. This time of year, most of my patients have overuse injuries either from triathlon or marathon training. On a positive note, I rarely see athletes that are primarily cyclists, but they do pop in the clinic once in a while. The main complaints I get are listed below. The good news is most of it is pretty easy to treat if you are willing to take just the tiniest bit of time to negate some of the repeated strains on your body as a biker.

“Ouch! That’s gonna leave a mark” is going to be part of a blog series and will be all about injury and recovery. I will touch quickly on some of these nagging issues today and maybe go into more depth if the masses demand it every other month or so.


IT (ilio-tibial) band : Firstly, it is not a muscle and no matter what you read, you can’t stretch this bad boy. It is a type of tissue called fascia, fibrous collagen that surrounds muscles and creates boundaries. The ITB, is basically a line of demarcation between your quads and your hamstrings. How do you make it feel better? The answer is two fold; usually massage, whether it is by a person, a foam roll or a stick. Secondly you have to make it stop working so hard. It is not a muscle, but it acts like one when you are weak in your hip abductors, pelvic and hip stabilizers. (This theme of stability is going to start to repeat itself, just so you know. )

Knee pain or patello-femoral syndrome: This is sort of a garbage or catch all term. You have to ask yourself “where is the knee pain?” Is it under the knee cap? Is it the tendon just under the knee cap that goes to the tibia? Is it deep? Is there crunching? Does your knee get locked into a position? Does it burn? Does it move around? All of these questions help me figure out what the real source of your pain is. Most of the time surgery is not needed.

Low back pain: We all get it!! Saddle and stem adjustments are out of my realm of expertise. Bike fit is always a good place to start, but I do know that a weak core and a stiff spine along with hamstring and hip flexor tightness can add fuel to the fire. It becomes a bigger deal when you start to have pain that radiates to your butt and legs. Like the knee there are several types of tissue that can cause pain. We have to figure out which it is, disc, joint, nerve, before we can get you better.

Middle back pain: As we get older, our spine starts to tighten up, especially the thoracic spine. It is the spine between the collar of your shirt and the bottom of the ribs. It tends to stay in a sort of rounded or flexed posture. It needs to extend, to move, to breathe. Speaking of breathing, if your spine moves better, so do your lungs and diaphragm. Better breath = better performance and recovery  When you can’t breath nothing else matters.

Neck pain: Biking is hard on the neck especially our racing friends. Keeping your neck and scapular (shoulder blade) stabilizers strong is integral along with good mobility in the spine.

Numbness and tingling in the hands: Nerve pain is a bear. If you have ever had something that just doesn’t seem like any other pain you have had (I don’t know about child birth yet ) it could be nerve pain. Gnawing, burning, numbness and tingling = yucky. Sometimes the cause can be central, from the spine, or peripheral, from the nerve, like when you hit your funny bone.

Now how about some help?

Solutions 101!!!!! Yay. It really boils down to a few key concepts.

The first one will elicit groans, but it makes sense. Cross train. Try something your body isn’t used to, to give it a rest. Your tissue adapts to familiarity, although this can initially make things easier it is a great way to develop overuse syndromes. We can talk about pilates, functional training, etc down the line.

Foam roll: This is a great multi-purpose tool. We can address posture issues in the middle and lower back. We can massage with it and we can also hit the next magic bullet!!!

Core strengthening!!! Everyone knows about the core. Abs right? Yes but doing the right type of ab ex is important and what else does the core consist of and why does it matter? Let me climb up on my soap box for a minute. Ok!!!

The missing link in my practice for years was the hip. I would treat patients forever and not get anywhere. I would make the quads stronger, work on the abs, yet their pain would persist. Well the Holy Grail for me was discovering the importance of the hip stabilizers, primarily the glut medius. It is a muscle deep in the butt that helps bring your leg out to the side. BUT more importantly, when working together with your deep abs, if you are doing a one legged weight bearing activity (drum roll please) it helps stabilize your pelvis, and everything down the leg into the ankle.

Cycling can be a (very) one legged activity. Think about being out of the saddle and big climbing. In a one leg stance your hip (and core) should be helping to assist in stabilizing the pelvis above and the knee and foot below. If you don’t have a good platform of core stability, things start to get tweaked up and down the chain, i.e. the back, the knee and even the foot.

Why does it matter? Simple, balance and power. As cyclists you understand both of those words. Your core can facilitate balance, which increases efficiency and output. Also, balance allows for the tissue to be in its optimal position, which allows more power and more fun with less pain. One to two times a week exploring some core and strengthening activities will improve your cycling ability and prevent a lot of unnecessary injuries.

Check out the link below, some great pics for foam roll exercises and massage techniques.

If you have any questions hit me up here in the forum or shoot me an email. Let me know if there are topics you want to hear about. Got exercise ideas or what has worked for you? I am a big believer in the concept of team rehab. One philosophy does not encompass it all!!!! Ride safely and see ya on the streets and trails.


http://sportsmedicine.about.com/od/flexibilityandstretching/ss/FoamRoller.htm


Coops





** These posts are part of the Chainlink Blog Series. CBS are themed blogs that highlight chainlink members, their talents, interests and expertise, and how they apply it to biking. If you would like to contribute to a CBS or start your own, please submit an idea to blogideas@thechainlink.org.**

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Tags: coops, injury, physical therapy, recovery

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Comment by Julie Hochstadter on May 2, 2012 at 12:50pm

bump!

Comment by coops on September 17, 2008 at 9:08pm
stretching the itb is like stretching burlap. you need to pony up and get one of these bad boys....

the itb is fascia. it responds to compression or massage because the increased bloodflow to the tissue helps warm the tissue up. so the stick or your foam roll is the best bet. in general i am not a huge proponent of stretching. more often that not tight muscles are protectively guarding, because the body is trying to prevent pain/dysfunction. when you stretch a muscle that is in this state, you ellicit a reflex that, gasp, makes the muscle tighter. if you needed an excuse for massage....here it is. so warm ups, massage, stick, foam roll that is going to increase flexibility without creating more dysfunction. isn't p.t. funno?
Comment by Leah on September 16, 2008 at 11:19pm
So all my "stretching" my IT band is for naught?? :(

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