This two-day seminar (14 contact hours) will focus on the muscles and common conditions of the upper body. Techniques will incorporate movement and stretching to quickly and effectively address sports-related problems, as well as orthopedic assessment techniques to quickly identify root causes of injury.

Assist Scapular Motion

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While the results showed a significant increase from both types of stretching, they found the PNF/MET stretching provided an better increase in range of motion (ROM).  The static stretch resulted in an average of 7.53 degree increase in ROM, while the single bout of 6-second PNF stretching resulted in an increase of 11.80 degrees.

One thing to note is they did not specify how much effort was used by the participants during the PNF technique.  There is a wide-range of thought on the effort of PNF stretching, from 10% of maximum contraction, up to a full 100% effort.

Take this study into account as you are working with athletes.  I have found similar results in my practice, and utilize PNF/MET stretching often to release muscles before and/or after any hands-on massage techniques.

O’Hora, J, Cartwright, A, Wade, CD, Hough, AD, and Shum, GLK.  Efficacy of static stretching and proprioceptive neuromuscular facilitation stretch on hamstrings length after a single session.  J Strength Cond Res 25(6): 1586-1591, 2011

Now that The Running Institute is going well, I have decided to reduce my time commitment to this venture and return to my private massage practice and plan some Muscle Wisdom courses.

In the next few weeks, I plan to update the fall schedule with some courses in November and December.  Thank you to everyone for your patience this past year.  I am excited to bring what I’ve learned to future courses.

Levator Scapula

They attached cadavers and skeletons to machines that would take the arms through an overhand throwing motion, allowing them to look at the stresses on the shoulder joint when different movement dysfunctions were introduced.

So, when presented with a shoulder impingement, check the scapular motion!

This new business is part of Michigan Rehabilitation Specialists (MRS) in Hamburg, Michigan.  The facility includes physical therapy and a fitness & performance training center.  The focus of our work is on prevention and rehabilitation of running injuries as well as performance improvement.  We have some pretty cool equipment at our disposal, including an AlterG “antigravity” treadmill.  It’s pretty fun to try, if you ever get the chance.

With this new business, I am now able to utilize more of my educational and work experience.  I lead the video gait (running) analysis, generating reports on distance runners of all levels, working with Ron to provide feedback and recommendations on corrective stretches and exercises.  For those of you who have taken one of my courses, you know how much I enjoy looking at the mechanics of movement to identify potential problems!

On top of this, there is a small group of elite, post-collegiate distance runners who are coached by Ron, preparing for the 2012 London Olympics (called Team Michigan Elite).  I am the massage therapist and strength & conditioning coach to this group, working to maintain muscle balance, reduce the chance of injury, and strengthen key muscles to help them with their performance.

The best part of this new position is the opportunity for me to learn from some incredibly experienced professionals in rehabilitation, running, and performance coaching.  I hope to bring the added insight I have gained into the future workshops!

Subjects were reassessed after 1, 24, 48, 72, and 96 hours of the initial plyometric exercise for:  perceived soreness, creatine kinase activity, isokinetic muscle strength, and jump performance.

The results of the study showed that the compression group and the combined group both reduced the loss of strength after the plyometric exercise, when compared to the control group.  The addition of sports massage to compression did not improve recovery compared to the compression group, but the combined massage and compression group did show significant improvement in perceived muscle soreness.

Jakeman, JR, Byrne, C, and Eston, RG.  Efficacy of lower limb compression and combined treatment of manual massage and lower limb compression on symptoms of exercise-induced muscle damage in women.  Journal of Strength and Conditioning Research 24(11): 3157-3165, 2010

Huang, SY, Di Santo, M, Wadden, KP, Cappa, DF, Alkanani, T, and Behm, DG, Short duration massage at the hamstrings musculotendinous junction induces greater range of motion. J Strength Cond Res 24(7): 1917-1924, 2010.

The massage technique performed was slow, circular friction at a pace of 1 repetition per second.  The subjects were supine, with their knee straight, and massage was performed to the distal hamstrings with the fingertips wrapped around the thigh.

Before and after the massage, they measured the EMG activity of the hamstrings as well as the passive muscle tension.  Tension was measured as the torque force produced at the posterior knee at the point of discomfort during stretching.

There were a few interesting results from this study.  First, the massage was performed only to the musculotendinous junction, targeting the golgi tendon organs, and not the muscle belly and attachments.

Next, the increased range of motion did not create an increase in either muscle tension or EMG muscle activity.  The investigators suggest the massage increased the range of motion through a modified stretch perception or increased compliance of the hamstrings.

The suggested practical application of this research is to use slow, circular friction massage to the musculotendinous junction of a muscle either before stretching or after activity to improve range of motion.  This work can be applied to a sports massage therapist’s toolbox, or to teach an athlete for self-care of a chronically tight muscle.

The technique that I most often turn to in this situation is Muscle Energy Technique (MET).  With gentle activation of the guarding muscles, you can utilize the post-isometric relaxation (PIR) response to “turn off” the guarding muscles and increase the client’s ROM.

I usually start with the client in the mid-rage of their ROM and instruct them to use very gentle force (about 10% of their maximum) against my resistance for about 10 seconds.  At the very end of the 10 seconds, I will slowly decrease my resistance while the client is still pressing against my hand, allowing the client to move their joint further.  After a brief, 5-second hold in the new position, I have the client move against my resistance in the opposite direction following the same steps and repeat this back-and-forth MET for about 10 repetitions.

For example, a client with guarding in shoulder external rotation will attempt to externally rotate their shoulder against my gentle resistance for 10 seconds.  After 8 seconds, I will decrease my resistance slightly, allowing the client to overcome my force and take the arm into a few more degrees of external rotation.  I then repeat these steps against internal rotation to activate the antagonistic muscle groups.

By allowing the client to slightly move the joint at the end of the resistance, they begin to overcome the fear of movement, all the while working within their pain tolerance.

Streepey, JW, Mock, MJ, Riskowski, JL, VanWye, WR, Vitvitskiy, BM, and Mikesky, AE.  Effects of Quadriceps and Hamstrings Proprioceptive Neuromuscular Facilitation Stretching on Knee Movement Sensation.  J Strenth Cond Res 24(4): 1037-1042, 2010.

I found this to be a very interesting study, as most previous studies on the effects of stretching focused on its effect on the muscle’s ability to contract or generate power.  As this study shows a decrease in the proprioception of the knee position, it shows a potentially dangerous effect of static stretching before sports involving rapid start and stop or lateral movements, as the muscles must be able to sense and control the joint position to prevent damage to the joint structures.

However, the authors of the study do note that the proprioception was tested with the subject’s leg hanging in a non-weight bearing position, where in a weight-bearing situation, the quadriceps and hamstrings would be actively contracting and not completely relaxed.

So, further testing needs to be performed to identify a true risk, but the study did show a slowed response of the body to identify a change in position of the joint angle following a contract-relax PNF stretch, and shows another reason to avoid holding a stretch for long periods before athletic activity.