Archive for injury

Coach Al: No Ice After Injury or Hard Training? That Fad Advice is Bad Advice

Coach Al Lyman, CSCS, FMS, HKS

I’ve received a few questions about icing, especially on the heels of some recent information which has come out debunking the benefits of using ice after a long or hard workout, and even after an acute injury.

The current argument goes something like this: when an injury occurs, your body creates inflammation as a healing response. So if inflammation is the body’s natural way to heal an injury, why would you want to block this inflammatory process with ice? Let me share some thoughts on this, for your clarification.

Ice does not completely reduce swelling from inflammation, but it can prevent excessive swelling from happening for a long period after the initial injury occurs. Some swelling does assist important healing aspects such as white blood cells and other chemicals involved in the healing process to migrate into damaged tissues through increased vascular permeability. Swelling also physically protects an injured area through decreasing it’s potential range of motion. There is, however, no physiological reason to allow swelling to freely progress for hours or days after an injury occurs, especially if you have access to ice or cold water.

  1. Prevention of excessive swelling is important because fluid that has escaped into the tissues from excessive swelling can, among other things, create a low oxygen environment that can lead to additional tissue damage and delayed healing. In addition, swelling can cause distention in joint capsules and other tissues, and excitation of nervous system components (those darn mechanoreceptors), which can lead to more pain. Ice reduces this by shrinking blood vessels surrounding an injury.

  2. The cold temperature of ice can slow down nerve conduction speed and shut down the activation of your proprioceptors (muscle spindles), making it an effective pain reliever and muscle relaxant. If a muscle is in less pain and is more relaxed, mobilization and movement become easier, and a return to movement and, ultimately, training can occur much more quickly, which can limit any loss of fitness and keep you happier!
  3. Ice also reduces metabolic activity in the tissues that you ice, making them better able to resist the damaging effects of the impending loss of oxygen from inflammatory swelling pressure. In other words, lower tissue temperatures from icing means less oxygen is required by your muscles to sustain their integrity.
  4. And lastly, at least for now, ice causes vasoconstriction, or shrinking of blood vessels. Unless you are in extreme circumstances where you must shuttle blood to your brain to survive, your body will avoid tissue death by not allowing the body part you are icing to cool excessively. Through a process called “reactive vasodilation” (aka Hunting reflex or Lewis reflex), your vessels, while being exposed to cold, create a negative pressure in the capillaries. This negative pressure causes a pumping of inflammatory byproducts out of an injured spot, while allowing additional healing components such as white blood cells to cascade into the area. When combined with pressure and elevation, this pumping action of ice can be an effective rehab tool. Ever wonder why, when you jump into cold water and “ice”, your skin turns red? This is why! Reactive vasodilation.

All in all, icing and cold have very therapeutic effects and can be a very important part of optimizing recovery and healing. Limit your exposure to five to 10 minutes, in most instances.

Next up, and explanation of what I am about to do here at home– jump into a COLD SHOWER. Why on earth would I do this, you might ask? Well, all the typical jokes aside , enough of my athletes have asked, so a post about the benefits of that coming up!

~Coach Al

I Have NO PAIN After My Ironman! Why?

Coach Al Lyman, CSCS, FMS, HKS

Great story for you today!

One of our clients, and a triathlete I coach, had a terrific day at Ironman Coeur d’Alene on June 24. Her super finish is all the more sweet when you consider that she came to us last winter a seriously BROKEN athlete. For the previous few years she had followed a training plan that focuses on daily intensity, actively discourages athletes from strength work, and promotes a “just train more” philosophy. Like most athletes, our triathlete did OK for a while on this kind of plan, putting up gains and getting faster.

But then the inevitable kicked in.

Without proper strength, stability, mobility, flexibility to support ANY kind of training–much less the kind of program she was on–our athlete fell apart. She could not absorb the training, she was not recovering, and her times got slower. End result? Injury. (Unfortunately, we see this scenario in our Gait Analysis Lab every day.)

Our triathlete came to us for a gait analysis last winter. Through our findings, we went to work to rebuild her, and then train her hard, but sensibly, for her Ironman. She took our work together seriously. As the months passed her body became functionally strong, durable, and resilient. She was able to train with appropriate intensity, absorb the training, and recover. She made serious gains in power and speed. And as we said, she had a great Ironman race day.

But take a look at how she feels now, only a few days out from the race:

I have to say that this has been my must amazing post race ever. I was walking and sitting yesterday like it was 2 or 3 days post marathon. Unbelievable. It’s strange, every time I sit or stand I brace myself for pain but it isn’t there. I guess this is what being healthy, balanced, and functionally strong is all about! Essentially pain free post IM. Un-frickin-believable!”

This athlete emailed me to ask WHY she felt so good? Here the reasons, all of which are very obvious to me.

1. She was not remotely injured going into the race.

2. She was and is stronger than she has ever been. Hence, her body was able to deal with the stress of race day much more easily.

3. She was more balanced and more “fit” in a holistic sense, than ever before.

4. For the first time, she went into a race with a training plan that was designed to bring her fitness along smartly, rather than destroy her into injury and poor health submission.

My partner, Dr. Kurt Strecker, and I are thrilled for this client. We know how far she has come from the broken athlete that walked into our Gait Analysis Lab last winter. As her coach, I am thrilled at where she is at this point in time. Now, FOR THE VERY FIRST TIME, she can now unleash and get faster. Why?

Strength, stability, muscular balance, and good health are the basis for a training program designed to get you fast. That’s right, it’s not punishing intensity or the latest-and-greatest secret-sauce training. Movement quality FIRST is the only way to get fast, stay fast, and get faster over time.

It’s like we tell athletes all the time, when your body is working as it should, it will race well AND also recover quickly and completely. It’s how our athletes race again and again, year after year.

We wish every competitor, from Ironman to 5K runner, the same sense of accomplishment and good health our triathlete here is experiencing. She has a heck of a post-Ironman glow, and we are so happy for her

Coach Al

PLEASE STOP THE MADNESS!!!! STOP RUNNING THROUGH PAIN!

Dr. Kurt Strecker, DC, CCSP

Dr. Kurt Strecker here. My blog post today has a direct, lay-it-on-the-line tone. The urgency comes from a deep caring and concern for the athletes we see every day in the lab and in the clinic. Serious injuries are often created when small aches and pains are ignored. Athletes frequently exacerbate problems because they are obsessed with exercise. Creating serious trauma in the name of fitness just makes no sense, yet we see it every day. The real crime is, most of these injuries are actually preventable.

Over the last three weeks, three different runners have come into the lab with knee pain. Here’s the scenario:

  • All of them continued to run after the initial onset of pain
  • Not only did they finish the run they were doing when pain first presented, but they ran on subsequent days!

With all three runners, I had clinical suspicion of meniscus tear. Unfortunately, I was correct in all cases:

  • MRI revealed torn medial menisci in the first two runners
  • The MRI for the third runner revealed not only a torn medial meniscus, but also included a completely ruptured Anterior Cruciate Ligament (ACL)

What did all three runners have in common?

  • An obsessive desire to run
  • Very poor stability in the frontal plane

THE MADNESS HAS GOT TO STOP!

Exercise is for the benefit of the body, not its detriment! There is no sense whatsoever in building great cardiovascular fitness if it means you may, eventually, lose your ability to simply WALK.

In the case of each of these three runners, their severe injuries were totally PREVENTABLE. What got in the way? Here’s what we heard:

  • “I have to keep going. I HAVE to run.”
  • “I signed up for a race. I HAVE to train.”

Really, people? Why are so many of you willing to risk serious and possible long-term damage to your body, AND possibly lose the ability to participate in the sports you profess to love? Actually, what each of these runners signed up for is surgery, rehabilitation, the possibility of no running ever again, and early-onset osteoarthritis.

70% of all runners are injured in a calendar year. 70%! If you are a runner reading this, it is likely you have been one of them. Is it hopeless? Absolutely NOT!

  • What it will take is a commitment from YOU to become educated about how to become a stronger, more stable, and durable athlete. And that does not mean “just train more.”
  • You need to be to be proactive and build a solid frame BEFORE you rev the motor.
  • You must take preventative measures to develop muscular balance in your chassis to avoid injury.
  • You must develop proper functional strength, stability, and mobility in order to protect your body to then be able to train effectively.
  • Finally, you need to continue these productive practices over the long term so that you can train, race, and recover with resiliency year in and year out. It CAN be done!

So how do you do what I’ve outlined above? You can begin your re-education about what true athleticism entails right here by reading our blog and our website. We also invite you to get in touch with us–we can help you put it all together.

My final takeaway is this:

STOP RUNNING THROUGH PAIN! Pain is a signal that something is wrong. LISTEN TO YOUR BODY. You cannot accomplish any goal or fulfill any dream with a body that is unstable, unbalanced, weak, and broken.