Archive for Atheletes

When to Head to the Doctor for Muscle Pain and Discomfort


Clients come in with muscle pain all the time. My active clients come in with soreness and aches related to their exercise schedule or new activities. Sedentary clients come in with muscle pain from inactivity or from starting a new exercise or hobby. In either case, the discomfort of muscles is something massage can address. Often, resting the muscles for a few days, using ice and elevation, self-massage and slowing reintroducing a normal range of motion over the affected joint will be enough to get the healing going. But, the duration of the discomfort along with accompanying symptoms can signal something more serious that needs to be addressed by your primary care physician.

I turned to one of my favorite medical sites, to find some guidelines for you on when to take your muscle pain to the doctor.

Schedule an office visit if you have:

  • Muscle pain that lasts longer than a week
  • Signs of infection, such as redness and swelling, around a sore muscle
  • Poor circulation and muscle pain in your legs

via Muscle pain: When to see a doctor –

For more serious symptoms that might be signs of a more serious injury or a drug interaction, you’ll need to contact your doctor right away.

Call your doctor right away if you:

  • Have sudden, severe muscle pain that doesn’t go away or that recurs every time you exercise
  • Think you have a serious muscle strain or rupture
  • Have a tick bite or rash
  • Experience muscle pain after you start taking or increase the dosage of a medication — especially a statin

via Muscle pain: When to see a doctor –

And in combination with some very serious symptoms, muscle pain can be association with stroke or heart attack. In these cases, seek medical care immediately.

Get immediate medical care if you have muscle pain with:

  • Trouble breathing or dizziness
  • Extreme muscle weakness
  • A high fever and stiff neck

via Muscle pain: When to see a doctor –

Most of the time muscle pain can be healed without a trip to the doctor’s office, but knowing when to be concerned and when to get to the doctor right away can keep you and your family healthy. So keep these guidelines in mind and take some of the following information in when you see your primary care physician:

  • When did the pain start?
  • How long has it been bothering you?
  • Did it start after an injury?
  • Does any particular movement make it worse?
  • Does lack of movement (i.e. sitting or lying down) for long periods of time make it worse?
  • What is the most comfortable position for you?
  • What kinds of exercise/activity did you do the day of or the day before the injury?
  • Did you feel a pop or thump in your muscle or joint?
  • How has your daily activity been affected?
  • Have you noticed other areas of the body becoming sore, tight or tired because of injury?
  • Has it made a difference in your sleeping patterns? Is it worse at night?
  • Has this area of the body been compromised by an earlier injury or surgery?

Giving your medical practitioner this information can help the both of you figure out the underlying cause and how to treat the symptoms. For serious strains and pulls that don’t get better in a week or two, I always recommend clients go to a physician and ask if physical therapy might be a good treatment. In many cases of soft-tissue disorder, physical therapy is a great alternative to medication and surgery.

photo credit: CCL – User: a.drian


Massage “Fore” Golfers

golf club and ball

With better weather come the golfers – warming up their game from weeks or months off during the winter months, and coaxing the body into returning to the great form they had as they left off last year. Golf looks deceptively simple, but the mechanics of the swing, coupled with the physicality of walking long distances during each round impact the body, in some ways, negatively.

The biomechanics of the golf swing involve the whole body, from the stance of the feet, up through the balance of the knees, the stability and movement of the pelvis and platform for the swivel that occurs during the swing, up to the shoulders and the wrists and hands propelling the club down at a fast speed to set the ball in motion. As such, the body’s entire system of soft tissue (from ligaments and tendons to muscles and fascia) are affected. These soft tissues bear the brunt of the force of such a fast, but short-duration movement.

Injuries are common in golf as in many other sports, but in the case of golf specifically, there are common injury patterns and areas that massage can help with:

Not only can injuries surface from weak muscles, but poor technique and mechanics can wreak havoc on the golfer. The swing, requiring great rotation and compression, asks for the entire body’s cooperation, if not heeded, disaster can strike. Fortunately for veteran golfers like former PGA member Jerry Impellittiere, there is a way to fight back.

“I went for massage initially because I had very tight muscles which were affecting my game,” recalls the 53-year-old Impellittiere, who lives in Palm City, Fla., and plays golf almost every day, as well as takes part in tournaments like the recent Senior PGA. “The deep- tissue massage I got two to three times a week worked right away, elongating my muscles and really helping with my flexibility.” Impellittiere, who has been swinging his clubs since age 10 and been a pro for the past 30 years, adds, “I would recommend massage for all golfers, as they suffer from so many different injuries which can be relieved by this means.”

via Massage Helping Move Golfers “Fore”ward || Massage Therapy Articles.

The issues most common with golfers involve the neck, shoulders and the rotator cuff structure, the elbow (thus golfer’s elbow), and the lower back/glutes. The lower back issues can sometimes present as sciatica-like symptoms, or as pain in the lower lumbar area that is concentrated on one side.

Because golfers have a swing that is either right- or left-handed, one side of the muscles attaching the pelvis to the spine become tight, and sometimes refer pain down into the hips/glutes/legs.

When I massage golfers, I focus a lot of attention on the lower back and hips with deep tissue, neuromuscular therapy, myofascial release and some passive stretching. I also suggest clients work with physical therapists, personal trainers, or sports pros who specialize in golf to get an individualized set of stretches and strengthening exercises to improve their game and reduce their pain/discomfort level.

For more information, see the great link above (Massage Helping Move Golfers “Fore”ward) for more on golf, its effects on the body and how massage can assist golfers. Or, come see me for a massage in Louisville or Nashville and experience it first hand.

Photo credit: CCL user chispita 666

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Doctors’ New Advice for Joint Pain: Move It!

Swimmer in Pool

It’s official. Doctors now advise movement and strengthening exercises as treatment for the aching and sore joints of osteoarthritis rather than suggesting a reduction in activity and encouraging patients to keep off their feet to heal.

Aching and sore joints used to be treated by rest and reducing movement. (You know the joke: Patient: Doctor it hurts when I do X. Doctor: Then don’t do X.) Through more and more research, physicians have begun to understand that a careful approach of movement, stretching and strengthening delivers better results over the long term. From the Wall Street Journal:

The new treatment approach comes as osteoarthritis, a degenerative joint disease once considered a problem of old age, has begun showing up in more middle-aged and young adults as a result of obesity and sports injuries. Studies have shown that weight loss, combined with exercises aimed at improving joint function and building up muscles that support the joints, can significantly improve patients’ health and quality of life compared with medication alone.

via Doctors’ New Advice for Joint Pain: Get Moving –

While NSAIDs and over the counter medications treat general inflammation and do help with the pain of osteoarthritis, they are not necessarily a long-term solution due to their side-effects. The current suggestion by doctors includes education and exercise regimens to help patients strengthen and stabilize the tissues and support structures around a joint.  More from WSJ:

Self-management programs typically involve classes that instruct people on the best exercises for strengthening muscles that support the joints and for enhancing flexibility to keep joints from regularly seizing up. As important, patients are taught which exercises not to do to avoid exacerbating the problem. Even mild exercise can be painful for osteoarthritis patients. But with time, doctors say, the benefits accumulate as reduced pain and greater mobility.

Another fact I learned from the article is that osteoarthritis arising from injuries can happen as few as 10 years after an injury.  That means people injuring themselves in their teens or early 20s might have early onset osteoarthritis by 25 or 30. Our increasingly sedentary lifestyles coupled weight issues and obesity means joints have to work harder and support more weight when in motion, another factor contributing to the increase in osteoarthritis.

Coupled with an alarming Men’s Health article: The Scariest Thing You’ll Do All Day, this information puts movement and exercise at the top of the list of things to add to your day. For myself, I’m glad I have a job that requires movement and standing throughout the day after reading those two pieces.

I highly recommend reading the Wall Street Journal link if you have osteoarthritis (or think you do) or if you have family members with arthritis issues. Pass it along. And while you’re at it, get up and move around for a quick break.

Photo credit: creative commons, user jayhem

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Feet of Steel – Strengthen and Stretch Daily

Two feet against a sky

For my athletes, marathoners and runners, I’ve got a great link with some well-described stretches and strengthening exercises to prevent injury and keep your feet and ankles strong.  I’ve only listed two here, but click through to see the full list with illustrations.


Put 10 small objects on the floor–like marbles or Monopoly pieces–and place a small cup nearby. Using your toes, pick up the pieces one at a time and put them in the cup. Do two sets of 10 with each foot. Compete with your spouse or kids to see who can do 10 in the fastest time. “That’s just so you don’t get bored,” Schneider says. “Strengthening your feet can be only so exciting.”


Sit down barefoot and cross your right leg so that your ankle rests on your left thigh. Hold your toes and bend them back toward your shin, stretching the plantar fascia. A study showed that people suffering from plantar fasciitis had a 77 percent chance of returning to full activity within three to six months after performing this stretch. Researchers suggest that you do the stretch 10 times at least three times a day (once or twice a day doesn’t produce as strong of an effect).

via Runner’s Helps You Build Stronger Feet and Ankles.

Photo credit user thesaint.


Runners Knee: Iliotibial Band Syndrome

Runner against sunset

As the weather gets warmer, the runners and cyclist start their training. One of the most common injuries among runners and cyclists is IT Band Syndrome.  The article below explains IT Band Syndrome and describes some massage techniques that can be used to relieve the symptoms of it. Follow the link to view the full article.

Iliotibial band friction syndrome is recognized as one of the most common lower-extremity injuries in athletes, especially in long-distance runners and cyclists. Casually referred to as runner’s knee, massage therapists are likely to encounter this inflammatory condition.

Also known simply as iliotibial band (ITB) syndrome, physiologists debate the actual pathology involved. While some understand this overuse injury to be associated with excessive friction between the ITB tract and the lateral femoral epicondyle, others suspect that ITB syndrome is a consequence of impaired hip musculature. Whether or not tightened hip muscles or localized friction are behind ITB syndrome, several bodywork techniques can help resolve this problem.

via A Summary of Iliotibial Band Syndrome for Bodyworkers.

If you’re training up for marathons this spring, or just getting more active in the nice weather, be sure to add massage to your self-care routine to ease the aches and pains of training and to reduce injuries.  Louisville massage office appointments available March 22-26.  I work on many athletes and lots of runners and cyclists, so come on in!

Photo from CCL joshjanssen


The Dilemma: Heat or Ice for Injuries and Aches

Blue ice cubes

Right after an injury, our first instinct is to touch or hold the area.  After that, we start trying to figure out how to treat it.  In the case of muscle or tissue injury, one of the most basic questions is whether to use ice or heat on the injured area.

This article (see link at the bottom of the quote) walks you through determining if the injury has inflammation (meaning heat cannot be used and ice would be the preferable treatment) or not.  A quick quote from the article:

First determine whether your muscles have bruising or inflammation. If the muscle fibers are stretched too far, then your body responds in positive manner when the blood flow is increased.

If the inflammation is severe, it makes blood to become congested and restricts the oxygenated blood from reaching the muscles.

You must know whether it is to use ice or heat. Ice can be used more frequently than heat because of the risks associated with heat. Heat causes pain or burning if used incorrectly.

Don’t dare to keep ice or heat directly on your skin.  Always use a protective barrier.

via Ice and Heat Therapy for Your Muscles.

She discusses the benefits of ice therapy and heat therapy in the article as well.

To be safe, stick with ice for any initial trauma until you know whether or not there is any inflammation.  Check out her full article if you’ve got an injury and want to know if ice or heat would be a better course of treatment.  As always, check with your doctor or physician when you’ve injured yourself and need professional advice or consultation.


The Lactic Acid Legend

fluids in beakers

Since I started training as a massage therapist I’ve heard the same statement hundreds of times: “Massage reduces lactic acid in muscles. This reduces post-exercise soreness and removes the lactic acid toxin from the tissues.”

Not true. New understanding of lactic acid and its role in exercise and recovery points to a more complex role in the body’s systems. It turns out that lactic acid works itself out of the body within 30-60 minutes after exercise – whether or not massage is involved.

Lactic acid is more than just a byproduct of muscular contraction. It’s generated by muscles during periods of intense contraction and used as an energy source for muscle fibers and cells nearby. In cases of endurance training, lactic acid gets into the blood stream and provides an energy source for other parts of the body.

Lactic acid has also been found to fuel fibers in the heart cells and cells in the brain.  The liver prefers to use lactic acid to make glucose for the blood when exercise is prolonged. The production of lactic acid is stimulated, in part, by circulating adrenalin; the combination of adrenalin and lactic acid helps protect against the electrolyte imbalance across muscle membranes brought on by the loss of potassium.

Via Massage & Bodywork: The Lactic Acid Debate

If there’s a biological process for removing lactic acid without the intervention of massage, how is it that massage improves muscle soreness and post-exercise aches?

We now know that the soreness in muscles after exertion is not caused by lactic acid, but rather, by microtears and inflammation of the muscle fibers, fascia and other surrounding tissue.  Massage helps by reducing inflammation and supporting the body’s healing processes.  Specific physiological processes haven’t been identified via research, but there is research that points to an specific reduction in muscle soreness when massage is applied after higher than normal exertion levels.

What’s this mean for massage therapists and massage lovers? You can still point to the positive research that correlates massage and muscle recovery.  You just can’t say it’s because massage works lactic acid out of the muscles.  The body does that on its own.

Photo Credit Flickr CCL: Horia Varlan

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Warrior Dash: Adult Dream or ER Visit Waiting to Happen?

A friend of mine (in an incredible act of bravery, or, well, um, bravery) signed up for something called the Warrior Dash.  Imagine a big, 5K obstacle course for adults – crawling under wire, slogging through a mud pit, jumping over walls – and getting a cool viking with horns at the end (with beer!). Check out the name of the obstacles on Warrior Dash Website.

As a massage therapist watching the video montage below all I could think was, “Oh, no, that’s going to be ugly in the morning.”  But since I know plenty of weekend warriors who, as clients, would think this is the coolest thing ever, here’s the video.  Enjoy (just be sure to come see me for a massage in Louisville or Nashville while you’re training and the day after the race).

And yes, it does look like a lot of fun!


Tips to Avoid MRSA as You Hit the Gym

Make a resolution to become more fit in 2011?  Does that include more time at the gym?  If so, make sure you take a look at this article about MRSA infections (methicillin-resistant staphylococcus aureus) becoming more and more common at gyms.   MRSA’s danger is in its resistance to the most commonly used antibiotics.  This makes it hard to treat and hard to heal.

Here’s the link: Steer Clear of Staph Infections in Your Gym | TweakFit.

Quick summary (pictures also included in the link):

  • keep all wounds and abrasions clean and covered
  • clean equipment before and after you use it
  • wear flip flops or shower shoes in the changing areas
  • wash your hands often at the gym

Get fit, but stay healthy and use the tips mentioned in the article.


For my athletes: Avoiding the Bonk

An NPR Weekend Edition link to a story about a marathoner who decided to create a formula for how to avoid the bonk (aka hitting the wall) during marathons and other long duration athletic events.

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