self-massage for runners

In honor of my niece who incorporated a lot of running into her training, I offer these self-massage tips for runners and other athletes. Using self-massage as part of a warm-up routine can help improve performance and reduce the chance of injury. Muscles pumped full of blood have more oxygen at their disposal and therefore more power and endurance. Tendons and ligaments that have been warmed up are less brittle and better able to flex when needed. This simple routine addresses both of these goals.

Sit on a chair or on the floor. Begin by jostling the muscles of the upper and lower legs. Allow your muscles to be loose and think of jostling them around the bones at the center of the leg. (Easier when seated on a chair.)

Next make your hands into loose fists and rhythmically, gently pound the muscles of the upper leg. (Pretend you’re a  drummer finally getting your turn at a solo.) Keep the tempo fairly vigorous, not slow and meditative. In a pre-workout session you want to get the blood pumping. You can alternate left and right fists or clasp hands and strike the muscles together. (no picture for this one)

Target the inside and outside of the upper leg by leaning into the muscles with the heel of your hands. Inside and outside muscles help with balance and equilibrium. They benefit from being warmed up too. Keep the pressure light to medium and the rhythm fairly quick. You’re pumping blood into these muscles.

Target tendons and ligaments of the ankles and knees: We want our tendons and ligaments to be warmed up before taking the load of running or other sports. Tendons and ligaments are made of a substance that responds really well to heat or heat generated by friction. Should one twist or roll an ankle, a brittle ligament is more likely to tear than a warmed-up one.

Vigorously rub the area all around the knee (top, bottom, front and sides of knee). You can use the heel of your hands, the palms, or backs of knuckles – whatever is comfortable. You can do this through clothing, right on the skin, or by throwing a towel over the knee. You can also throw a hot water bottle or hot pack onto the knees before you run. Both of these strategies work well.

Proceed to the ankles. Ankles have many tendons and ligaments. They help provide stability for the variety of motions we ask of our bodies: bend, flex, point, brake, sprint, turn on a dime, etc. With the heel of your hand, vigorously rub all around both ankles. Get the tops of the feet, all around the ankle bones on the insides and outsides of the feet, the heels, the Achilles tendons in the back. Take a moment to move each ankle through a complete range of motion passively or actively. Be sure to rub the bottom of the foot where the important plantar fascia lies. You can do with with a tennis ball instead of your hand if you stand up and roll your foot over the ball.

Lastly, if you have a tool like The Stick, use this to roll out any muscles that were hard to reach. This can be great for the hips. A tennis ball up against the wall can also get the hips pretty well. The gluteus maximus is a very important muscle in running.

Now do some stretching and you should be ready to tackle your run or other exercise. Share in the comments if you have a favorite pre-run/pre-exercise warm-up everyone should know about.

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Forearms 101

Daydreaming in jr. high social studies class I used to admire my forearms, thinking I would make a pretty good body builder. At the time I thought I had some nice muscle definition. Clearly I was just a dorky jr. high kid. Right after this phase I wanted to be an accountant and look where I am now – the burly forearms won!?

In honor of well-defined forearm muscles everywhere and my former daydreaming days, I humbly submit to you, dear reader, this primer on the forearms. Forearms house the bulk of muscles that work our hands and fingers. If all of our hand muscles were in our hands, each hand would be about the size of a catcher’s mitt. Although there are some fancy specialized muscles, the forearms are pretty straight forward. The flexors on one side flex the fingers and wrist (think curling in the fingers and wrist). The extensors on the other side extend the fingers and wrist (think of a police officer directing traffic showing “STOP” with her outstretched hand) (Or think of the Supremes’ hit “Stop in the Name of Love” and feel the Motown wave washing over you!).

There are other muscles that help us perform all the exact motions that make our arms and hands so amazing, but I’m just going to focus on flexors and extensors today.

Why even write about the forearms? Don’t they kind of take care of themselves? When people come in for massage they want to focus time on massage for the weary back and neck. But wait! When I get to the forearms I often hear, “I didn’t realize my arms were so sore.” Yes, they work hard for us and we want to take care of them.

Muscle mapquest: see the photos above. The Trail Guide to the Body by Andrew Biel (Books of Discovery 2005) describes the forearms this way: “As a group [the extensors of the wrist and hand] are smaller and more sinewy than the forearm flexors.” p. 143 “…the flexors are thicker and more pliable than the extensors.” p. 148 It may be obvious, but these muscle groups are antagonists to each other. When one side is working, the other side is not. Ideally there should be balance in the strength between the 2 groups.

Why should I care, Susan? I argue that many of us use these forearm muscles more than we realize. And we often overburden them without realizing it. Further we pay them no heed unless they really complain, which is often a little late for their health. Tasks like typing & mousing use these muscles repetitively. Activities like playing piano, drums, violin, guitar and many other instruments tax them.  Racquet sports like tennis & racquetball give them quite a workout. Any activities where you are gripping an object repetitively or with a lot of exertion will use these muscles. Rock climbing comes to mind too! Ever heard of carpal tunnel syndrome? Well that has a lot to do with how we use these muscles because the tendons to these muscles dive under the flexor retinaculm and can cause inflammation in that carpel tunnel. See the quote at the end for more information.

Here are 3 strategies for taking care of these workhorses of daily living. They can be used together or separately.

Ice bath: On days when you are really giving your forearm muscles a challenge, you can treat them to an ice bath. To do so, fill up your kitchen sink with cold water. Add a couple trays of ice cubes. Dip your arms into the water up to and including the elbows. Keep your arms in for as long as you can tolerate the cold. Raise your arms out of the water and let them warm up or dry them off. Dip again several times. This takes down inflammation caused by repetitive use. It also flushes blood through the muscles by alternately constricting and dilating the blood vessels in the area.

Self massage: These muscles are fairly easy to massage oneself. Lay 1 arm flat on a counter, desktop or tabletop. Apply a small amount of lotion so you can glide over the muscles. With your other hand shaped like a fist, apply pressure with the back of the knuckles as you slide from wrist to elbow. For extra benefit alternate between making a fist and stretching the wrist and fingers back of the arm being massaged while you slide up with the working hand. Start on the more fleshy flexor side and then change to the extensor side. You’ll find it’s a little more bony on the extensor side, but feels fabulous.

Helpful tools: There are several helpful tools on the market that can help you take care of your arms. Here are 3 of my favorites: Roleo, Armaid, The Stick. If you want to purchase the Roleo through Gaiam or The Stick, click on my affiliate link first over at Foothill Health Dialogues. I’ll get a little kick-back that helps pay for maintaining that site. (Thanks!)

Here’s what one of my favorite authors has to say on the topic:

Median nerve entrapment, especially in the carpel tunnel, is one of the most common upper-extremity injuries. While the carpal tunnel is the likely site for median nerve entrapment, there are at least half a dozen potential sites of nerve entrapment between the neck and hand. In many cases, a carpal tunnel syndrome becomes more symptomatic than it normally would because there is at least one additional location of nerve compromise along the median nerve’s path. Even a partial nerve entrapment can complicate the condition.

Traditional treatments for carpal tunnel syndrome often only focus attention on the carpal tunnel itself at the base of the hand. The contribution of nerve entrapments in other locations can be overlooked. An advantage of massage therapy treatment is the amount of time the practitioner spends with the client and the subsequent thoroughness of soft-tissue treatment that can be applied throughout the entire upper extremity. Extensive massage treatment along the entire path of the median nerve helps make sure any of these potential sites of nerve entrapment are properly neutralized. Orthopedic Massage Theory and Technique by Whitney Lowe (Mosby Elsevier 2009) page 270.

Incidentally I think my 8 year old son would think I’m extra cool if I told him I was “neutralizing” the enemy of carpal tunnel syndrome. What do you think?

Lastly, please remember I’m not a doctor and this is not medical advice to you personally. Especially if you believe you have some forearms challenges, please get them checked out by a physician, physical therapist or another healthcare professional.

the end of the line: suboccipitals

In my last post I confessed that I have some tight muscles trying to get my attention. One of these groups of muscles is called the suboccipitals. As I’ve massaged hundreds of people’s suboccipital muscles, I’ve nicknamed them the end of the line. If all other muscles get tired and fatigued, these little workhorses will keep your head up.

They are tiny, but mighty. The 8 individual muscles form a triangle of sorts at the base of the skull (4 on each side).

Muscle Mapquest: take your hands and place them behind your head at the base (where head meets neck). Deep under layers of skin and muscle, your suboccipitals are hard at work. They connect the base of the head (the occiput bone) to the first & second vertebrae, and the first vertebra to the second vertebra. If you are lying down, it’s easier to sink your fingers in deep enough to feel them. If you’re sitting or standing, it’s hard to penetrate the more superficial muscles to feel these muscles distinctly because all the muscles are engaged and active.

Little muscles, big names: What they lack in size, they make up for in their super long names: rectus capitis posterior major (extends & rotates head), rectus capitis posterior minor (extends head), obliquus capitis inferior (rotates first vertebra), oliquus capitis superior (extends & bends head laterally).

Why they hurt: One can argue that the muscles that extend the head (this means to tip the head back), also must eccentrically contract to hold the head in place when we are bending forward or flexing the head. I would argue that this is why they get fatigued, sore and cranky! Our heads are heavy and often forward of where they should be. Because the suboccipitals are postural muscles they tend to become hypertonic (super tight) when they are overused or fatigued (Orthopedic Massage, Lowe 2009 p. 222). “Suboccipital trigger points cause pain that feels like it’s inside the head, extending from the back of the head to the eye and forehead.” (The Trigger Point Therapy Handbook, Davies 2004 p. 62)

Massage care and self-care: If you’re due for a massage and you think these are tight, ask your therapist (hopefully that’s me!) to devote some extra time to these workhorses. Here are some tips to self-massage them. Lie down on your back without a pillow. If you can heat the muscles first with some kind of heating pad, that will enhance your efforts. After heating them for about 5 minutes, scoop your hands under your head. You can press into the muscle bundle right at the base of the skull. You can tilt the head so that pressure is applied to one side for 30 seconds and then the other side for 30 seconds. Take a break and simply rest your head on the bed or floor. If you need a small support under your neck, use a rolled up hand towel. Resume massaging by gliding fingers from the base of the skull towards the neck. Glide up and down with a satisfying amount of pressure applied. You can push your fingers into the muscles from both left and right sides toward the vertebrae in the center. Rest. Tuck your chin, rotate your head side to side. Finish with more heat or try a few minutes resting on a flexible ice pack. Ice can be very soothing to muscles. These are great muscles, so let’s take good care of them! Let me know if you have any questions. 626-660-6856

receiving the advice I give, a trip to the dentist

It all started with a tooth ache. Which subsided, thankfully. I headed into the dentist to explore the subsided pain. After some careful investigation, the very nice dentist, gently, suggested I might be experiencing something else. Pain. Hypertoned muscles in the neck, head and face. And perhaps I clench my teeth when I’m working hard to help other people relax.

True confession. I could hide this little story; I’m sure none of you would know. But I think it’s really instructive of what I see quite often. With me as the “patient” I can offer you insights of what I’ll be doing to help decrease my pain and muscle tension. Hopefully there might be something that you can glean from my confession.

  • Use heat & ice. Heat the neck & shoulders to bring fresh blood to these fatigued muscles. If I massage the muscles, using heat is a great first step. A muscle pumped full of blood through dilated blood vessels is much more receptive to massage. Ice constricts blood vessels and soothes muscles, especially after deep massage. Used together heat & cold can manually flush lots of blood through a troublesome muscle group.
  • Get massage – quick! I had a session scheduled last week that had to move to next week. I scheduled another one on Friday with a friend I trade with. 2 in 1 week! Yes, when things get really tight you can gain more from frequent massage, even if it’s 2 shorter sessions. Sounds decadent, but to me it’s just smart. If I can get back on top of this tension, I can go back to my regularly scheduled massages. Sometimes a quick chair massage at Whole Foods can do wonders.
  • Self-massage. I have lots of tricks to get at the muscles that are complaining. For the average person, having a visual picture of where the muscle is can help you massage it more accurately. Short and frequent self-massage is a good strategy. The muscles I’ll be targeting are: suboccipitals, temporalis, masseter, SCMs and trapezius. It’s hard to describe self-massage techniques in writing. It’s very easy to show. If you’re curious, please ask me and I’ll be more than happy to show you some neat (and free!) tricks.
  • Ease up at work. Although I often joke that I should be magically immune from muscle tension, I’m not. With a job where I bend over people for an hour at a time, I have the particular challenge of combating a forward-head posture. I’ve recently heard that for every inch you carry your head forward of mid-line, you need to exert an extra 5 lbs. of strength. This work falls to the muscles on the back of the head, neck and upper back. So…I think a lighter workload for a couple of weeks would be a good idea.
  • Pay attention! The dentist asked if I grind my teeth while I sleep. I don’t believe I do. He than asked if I might clench my teeth while I work – working hard to muscle into someone else’s tight muscles. Now that’s something to consider. Since his suggestion, I have been paying attention while I work to how tight my jaw feels. I think this might be an area where I could improve. As I have noticed tightness in my jaw or face, I have closed my eyes, opened my jaw wide like in a yawn, and moved my jaw side to side. At each of these 3 steps I feel tension drain out of my face. Then I can draw my attention to my shoulders or other areas that are “trying to hard.”

Sometimes it can be hard to receive the same advice you give. But in this case, I was more amused than anything else. How ironic! And kudos to Dr. Kanda for delivering the news in such a gentle, easy-to-respond kind of way.