Apr 172012

I encounter many clients and swimmers with shoulder problems. In many cases, the pain can be resolved simply by icing and reducing activity for a period of time and then following up with exercises that facilitate proper alignment and movement in the shoulder girdle. Consult with a physical therapist if you are unsure how to rehabilitate a shoulder injry. If your shoulders are in good shape or have been recently rehabilitated, you can keep them that way by practicing a few safety tips:

1) Never carry a purse or backpack over one shoulder. This puts undue stress on the tissues around the shoulder girdle. Carry the purse or bag over both shoulders or in the hand. Even better, remove some items you don’t absolutely need to carry around with you.

2) When walking your dog, hold the leash in the hand opposite of the side where your dog is walking. When your dog stops suddenly, your shoulder will internally rotate and be more “anchored” than it will be if you are holding the leash with the opposite hand where the tug may pull your elbow and shoulder away from your trunk and hurt your shoulder.

3) Never yank an item from the back seat of the car. This jerky and unsupported movement places a tremendous amount of stress on the shoulders.

4) Stretch the pectoral muscles after you spend time in front of the computer to restore balance in your posture. When you are hunched over, muscles and connective tissue is unable to move properly without “collisions.”

5) When picking up objects, try to get “underneath” them by using a step stool or ladder and use both arms. More stress is placed on the shoulder when you lift a heavy object that is above shoulder height. In general, avoid “heaving” objects such as suitcases. Ask for help or have someone assist you when getting a bag off of a carousel. Sudden jerky movements are most likely to tear tissues.

6) Be aware of anything causing aggravation and try to avoid or modify it. For example, if you are a swimmer who also plays tennis and racquetball, you may want to cut back on one or two of those sports and pursue an activity such as running or biking that is more lower body dominant to avoid putting so much stress on your shoulders.

Jan 172012

Just like your car, when you driving your body hard, it needs some maintenance and tune-ups. Many athletes and fitness buffs are very diligent about making sure they swim, bike or run a certain number of miles ever week, but devote little attention to pre- and post-workout stretching, massage, and recovery.

In reality, the body maintenance is as important as the workout itself. Proper care for your body can reduce the incidence of injuries, reduce pain and inflammation and improve performance. Below are some tips to help you establish a preventative maintenance schedule for your body:

1 – Schedule massages regularly. Massage is necessary to keep muscles and the connective tissue that sheaths muscles healthy (long and pliable rather than lumpy and thickened). Massage also often alleviates muscle discomfort. If you can afford it, schedule one twice a month. Otherwise, learn how to do self-massage work with balls and foam rollers.

2 – Stretch major muscles worked after every workout. Stretching releases toxins that build up during exercise, improves circulation, restores length to tissues and incites a relaxation response. Always take nice deep breaths while stretching and hold stretches for 30-60 seconds per muscle stretched. Do not bounce the stretches.

3 – Identify overtight parts of your body and give them extra attention. Stretch these muscles more frequently or even do 2 to four sets of 30-60 seconds for these areas. For example, many people have tight psoas muscles (upper part of front of thighs) from sitting so much. This can tip the pelvis forward and place undue stress on the low back. You can stretch the psoas after work by getting down on your knees and taking a giant step forward with the right foot, resting your hands on the front thigh and then pressing forward with hips in the back, getting that lengthening stretch in the psoas. Then you can change sides. Sitting also tightens the chest muscles, which can be loosened by lying on top of a foam roller with the arms out to sides, palms up at shoulder level and letting gravity passively lengthen the muscles.

4 – Rest. Sleep sufficient hours nightly and take at least one day off from training every week. Never work the same muscle groups in strength training two days in a row.

Your body works very hard for you and you should give something back by nurturing it with some care and recovery.

Mar 012011

I read a bulletin this morning on rotator cuff injuries by Chris Mallio, the head of sports medicine at Bath Rugby in Queensland, Australia. As a trainer and competitive swimmer, I devour any article on the subject. One of the points he reiterates is that a major contributor to rotator cuff injuries is when a “space problem” occurs in the shoulder girdle. Basically, when your muscles and posture are in balance, the muscles, tendons and ligaments in the shoulder are able to move around without brushing up against bony structures as long as there is no inherent abnormality in the shape of the acromonian (or no bone spurs are present). However, most of us have imbalances in posture and musculature. This leads to a shortage of space for fluid movement in the shoulder. When repetitive abrasion occurs, so does inflammation and injury.

A common postural issue in our society of computer users is a forward slump, which leads to a protracted and downwardly rotated scapula. Sitting with a forward lean in front of the computer tightens the chest and weakens the back of the body. If you go to the gym and emphasize chest flies, bench press, and pushups and neglect the back muscles, this will further exacerbate the imbalance. Stretching the chest for 30-60 seconds daily (I prefer laying on the foam roller with arms out to let gravity do the work) and strengthening the rhomboids and upper trapezius can go a long way to remediate this imbalance. Activities such as rows (with a shoulder blade “squeeze” at the back) and scapular retraction are effective exercises to strengthen the back of the body.

Unhealthy “thickening” of connective tissue around the muscles that can inhibit movements may be remediated through regular massage or rolling under tissues with a ball or foam roller. Be sure to have a physical therapist teach you proper technique and to evaluate your condtion to ensure that what you are doing is safe and applicable to your situation.

Feb 212011

Personal Best Stretch: Move Better Than Ever

Susan Dawson-Cook and Jennifer Rischard in Personal Best Stretch

I am attaching a link to a short segment from my DVD for your viewing pleasure. To order Personal Best Stretch, please go to www.susandawson-cook.com You can also post comments or send me an e-mail at susan@corazondeloro.com

http://www.youtube.com/watch?v=ZEYvsG-1IK4&feature=player_detailpage

Jun 082010

Running elevates heart rate, improves bone density, and keeps us feeling positive. In addition, running demands no inflation of tires, no special equipment and can be done almost anywhere. The only downside of running is the trauma on our bodies.

The impact of striking the ground repeatedly places a lot of stress on the feet, shins, knees, and hips. Runners can reduce the incidence of common injuries such as Iliotibial Band Syndrome, Sacroiliac Joint Dysfunction, achilles tendonitis, knee problems, and hamstring and other muscle strains by taking a few simple precautions.

1) Wear footwear appropriate for your arch height and runnng style (its best to get fitted at a running store by someone who can do a proper evaluation) and replace shoes when cushioning has broken down (shoes are usually rated for X amount of miles).

2) Gradually increase intensity during each workout. Be sure not to start out too fast.

3) Increase intensity and distance gradually. Beginners might start by alternating between walking for a minute and jogging for a minute for a total of 15 minutes the first week. Fitter individuals could start with a mile jog, gradually increasing distance by a half mile to a mile per week. Listen to your body! It will tell you if you are doing too much too soon.

4) Avoid running on shoulders and other banked surfaces, which will put undue stress on the hips and knees on one side of the body. I ran on a shoulder in a half marathon once and my knee hurt very badly for two weeks afterward.

5) Integrate cross training into your program. Low or non-impact activities such as swimming or cycling are ideal.

6) Stretch and use a foam roller to lengthen the IT band post-run. It tends to shorten and contract during and after running and cycling. When this band of connective tissue gets too tight, it causes pain on the outside of the knee and hip. To stretch, lay on back, legs extended. Place yoga strap under right foot, extending leg up and gently stretching over body toward the left. To roll, position yourself on your side over foam roller and roll up and down the outside of the thigh. Avoid rolling over the knee joint or the hip bone. A soft roller will work best. I purchases a green one from OTPT that works very well.

7) Stretch hip flexors, hamstrings, quadriceps, IT band, and low back after every workout.

8) If your running style is awkward, hire a running coach or pick up a copy of Danny Dreyer’s Chi Running. His book offers great suggestions on how to adjust your posture, foot strike and running style so it is less traumatic on the body.

Are you ready to get out there and enjoy your workout? I know I am. I’ve got to don my running shoes now, too, before it gets too hot. Tucson in June is hot, hot, hot!!

Apr 192010

Far too often, my more senior clients arrive at the gym in open-toed or street shoes. I typically ask them, “Why aren’t you wearing the right shoes?” Often the response is “These shoes are really comfortable.” I empathize with them. Comfort matters. And these people grew up in an era when comfortable exercise shoes were hard to come by and the idea of wearing them might strike them as unpleasant (as does the idea of me listening to my teenagers’ hip-hop music in the car instead of my favorite and familiar 70s and 80s tunes). Believe it or not, “gym shoes” really can feel great on your feet if you select the right pair. Not to mention the fact that proper footwear protects you in more ways than one.

Wearing a closed-toe shoe in the gym is imperative because bare toes are very vulnerable to the drop of a dumbbell (by you or someone else) or the end of a piece of equipment (surely I’m not the only one who has broken a toe more than once at home in bare feet)? A shoe with proper cushioning and support minimizes trauma on muscles and joints and reduces post-exercise discomfort.

A shoe worn for lifting weights need not be as “high tech” as one worn for impact activities such as walking, jogging or step aerobics. A weight lifting shoe should cover the entire foot, enable comfortable movement in all directions, and offer enough cushioning and support so the floor doesn’t feel too hard beneath your feet (low back and lower extremity joint discomfort often indicate inadequate cushioning).

If you run or engage in other high-impact activities regularly, you should buy very high quality (expensive) exercise shoes. Also buy the best footwear if you wear your shoe soles unevenly. A reputable sporting goods or running store won’t recommend a shoe without first having someone observe you walking or jogging on a treadmill, measure your arch height, and study your posture. Try on the shoe to make sure you get the proper fit (sizes vary from brand to brand), wearing your normal socks and orthotics.

Shoes worn for activities that include lateral movements, such as step aerobics and tennis, should provide lateral support so they don’t “roll over” when you move side-to-side. Running shoes are a poor choice because they are designed exclusively for forward movement. I prefer owning two pairs of shoes—a pair for running and a separate one for aerobics—over buying a once-size-fits-all “cross-training” shoe which doesn’t work optimally for either activity.

Exercise shoes should be replaced regularly. Once the cushioning in a shoe is broken down, it fails to do its job of protecting you. Get in the habit of replacing shoes every six months or about every 350 to 400 running miles to avoid unnecessary injury and pain.

There is a comfortable shoe out there waiting to be found. So when the shoe fits…buy it (and then wear it)!

Mar 022010

The author and SammySometimes we let our goals and our bull-headedness keep us from using good judgement when it comes to training and exercise. A knee is swollen and hurting but we still go out for a morning run. Our rotator cuff muscles hurt long after we stop swimming, but we dive in the water and workout as if the shoulder pain didn’t exist. Before long, we end up in rehab. If only we had listened to our bodies sooner, we could have avoided weeks of physical therapy and rehabilitation later!

I have had more nagging injuries than I’d care to mention, only one of which escalated to a point where it required physical therapy. In the case of my recent shoulder tendinosis, which took three months to rehabilitate, I knew I should back off, but I was in the middle of a 2 day swim meet and I just kept on going, despite what my better judgement was telling me to do. In the cases where the injury mended within days, I adjusted the way I taught my classes so I wouldn’t overly stress the tender area and adjusted my workouts so the muscles had time to recover. Often figuring out the root of the injury was beneficial.

In 2008, I pulled an adductor muscle on my left leg 3 weeks before the USMS Long Course swimming nationals. Despite the fact that breast stroke was my main event, I had to stop swimming that stroke altogether for nearly two weeks and also iced the muscles three times a day and took anti-inflammatories to reduce swelling. I determined that I was tighter in the glutes and piriformis on the left leg and, which resulted in too much strain on the adductors when swimming breaststroke. When I resumed swimming breast stroke again (a week before the championship), I always stretched the piriformis first. I have never had a problem with my adductors since.

My point? Listen to your body. If something is hurting, something about your training needs to change. Determine why the injury is happening, reduce your training and ice, and pursue training that is non-traumatic on the injured site. When my shoulder was at its worst, I increased my running and often got into the pool and did long kick sets with a board. I was able to stay in shape without hurting my shoulder. This morning, once I take my kids to school, I will swim rather than do my normal Tuesday run because my knees ache after wading nearly 8 miles up Sabino Canyon in my bare feet. Every day, I think about what kind of training will work best for my body given its current circumstances.

Here’s some more tips on how you can prevent injuries”
- always warm up before and cool down after high intensity exercise
- find different modes of exercise (crosstraining) to avoid putting the same stress on the body day after day
- stretch after every workout
- adjust training whenever something starts to hurt and ice inflammed areas regularly
- strength train appropriately for the activities you pursue
- assess the source of the injury and aim to remediate the problem. A common problem is too much strength or tightness on the dominant side of the body. Strength train and stretch to minimize these imbalances.

Follow these principles and you’re likely to enjoy many more enjoyable and injury-free workouts. Well, I gotta go – the pool is calling my name right now!