Disclaimer: This is mostly my opinion, I haven't done any research on this topic!
Since I'm studying kinesiology and my department is in the School of Public Health at Maryland, I spend a lot of time researching, thinking and talking about exercise and health. Because of a few conversations I've had lately, I've been thinking a lot about how to define health. Not surprisingly, different people think of health differently and I can't help but think this could contribute to the drastic differences in the health of our population. Our knowledge and beliefs shape our actions which in turn affect our health, and this is where the definition begins for me. The dictionary definition of health is: the absence of illness or injury, or a person's mental or physical condition. I'm not actually on board with that first part being THE definition of health, and I'll get into that in a moment. There are several factors that I think are important in defining health.
I hadn't though about health literacy at all until I did a quick search for "health" on google and the first website that popped up (that wasn't popular media crap) was the site for the Department of Health and Human Services. One of their main links is about health literacy, and I think this might actually be one of the most important factors contributing to health behaviors. Having knowledge or knowing how to find information about everything from how diet, exercise, sleep and stress affect your health to when and how to go to the doctor, and resources to help you make positive choices for all of these things are huge factors. Current knowledge in these areas must certainly affect individual behaviors. (How may people exercise because they know they should vs. really like it? Probably not enough...but I know there are a lot of people out there.)
The Absence of Illness or Injury
This one is also important, but here's why I think it is incorrect to consider this the only definition of health. Many diseases/disorders, particularly chronic ones (cardiovascular/circulatory diseases, diabetes, alzheimers, liver/kidney diseases, many cancers, etc.) develop over years and decades of poor dietary and/or exercise habits. One bad meal or missing one workout will not cause you to develop these diseases or even have much effect at all for that matter. However, years and years of poor diet, nutrition, excessive alcohol consumption and/or smoking will. Therefore, just because at a given moment in your life you are not diagnosed with a certain disease does not mean that your lifestyle is not negatively affecting your health in a very permanent but temporarily unmeasurable way. Once you have interruped your body's function enough to develop diabetes or have a heart attack, you may be able to reduce or eliminate the symptoms of these diseases, but these body systems will NEVER function completely normally again. Don't forget that EVERYTHING IS CONNECTED so one symptom can lead to many diseases/conditions. (diabetes=kidney problems, neurological dysfunction/limb loss, blindness; Chron's disease=osteoarthritis, cardiovascular disease)
Maintaining a Heathy Weight
I'm definitely on board with the current trend of accepting yourself for who you are, no matter what. I have to admit though I am a bit torn when it comes to obesity. I don't intend to body shame anyone, I don't think obese people should be ashamed of themselves, and I am extremely sympathetic to people struggling with obesity. I've read enough research on how obesity affects body system functions and have trained enough ridiculously hard-working obese clients to recognize that obese people who are working to lose weight are fighting an uphill battle and for many people has nothing to do with how much or little they are eating and exercising. That said, there are still risks involved in being overweight and obese and losing any amount of weight if you are in these categories will reduce your risk, and exercising and healthy eating will help even if you do not lose a substantial amount of weight. In a perfect world (as if) people would just not become obese because like all diseases prevention is "easier" than treatment. By the way, not being overweight or obese does not mean everyone walking around will be a Skinny Minnie. At my height, my weight could range from 124-158.4 lbs and still be considered within a healthy range (I'm usually around 138). At 158 I would definitely not be skinny, but according to disease statistics I would still not be at a measurable increased risk of disease.
Having a Basic Physical Aptitude
Can you walk up 3 flights of stairs without having to take a break? Can you carry several grocery bags in each hand? Can you reach to the top sheft in your kitchen cabinet? Can you bend down to tie your shoes or pick something up off the floor? If you had to run away from or run after something could you run for 5 minutes? Can you mow your yard with a push mover and shovel snow without being exhausted or injured? Good enough-you don't need to be in marathon shape to have basic physical aptitude.
This one is a little harder to define because different populations have different needs, and such a wide variety of foods could meet these needs. If you're meeting the daily value for vitamins and minerals and meeting the macronutrient recommendations from food rather than supplements that's a good start. Making sure you're added sugar intake is as low as possible as well as high fruit and vegetable intake is also helpful.
After thinking about this over the past several weeks, these are the factors that I think are most important to define health. If you think I missed anything or have any comments about what I described here I'd love to hear from you!
While I'm being buried under 2 feet of snow by winterstorm Jonas, I'm dreaming of the days when I lived in Miami and got to complain about how anything under 70 was cold. I'm also really missing my outdoor pool where I swam year round, even on those frigid 60-something degree days! I haven't done any triathlons or serious triathlon training since I moved north in August and I'm seriously missing it.
Considering the work I'll have cut out for me to get back into the training routine, I'm most concerned about the swim. It's my weakest event already and even though I'm still swimming here and there, nothing compares to the hard training I was doing even a year ago. The swim is the smallest portion of the entire race which is good for me, but I think the importance of swim performance is often downplayed. Yes, I can still perform very well overall although I am very middle-of-the-pack on the swim, but think about how much better I'd do if I was even in the top 25%! Lots of studies measured how cycling affects running, but not as much attention is paid to swimming. I came across an article that reviewed how the swim affects the cycle portion of tris, and some even looked at its effects on both the bike and run legs.
Here is a summary of some of the findings. I've put the major points in bold if you're a skimmer, and more details if you want the nitty-gritty. For you scientists, here's a link to the full article:
Longer swims affect cycling performance LESS than shorter swims.
The details: Triathletes completed a 3000m swim in an averge of 52.5 minutes, followed by a 3 hour cycle. There was no significant difference in the power output, heart rate response, or blood lactate buildup when compared to those who only cycled. This may or may not be good news for longer distance triathletes since the swim distance is smack in the middle of half- and full-ironman swim distances.
Swimming causes a decrease in cycling power output.
The details: Triathletes swam 800m (basically, sprint distance) in an average of 10min, 24sec. Then they cycled for 75 minutes at 70% of their maximum heart rate and compared it to a cycling only trial at the same intensity. Their power output after swimming was 17% lower, meaning that at the same relative intensity (HR) they would take longer to complete a set distance.
Swimming increases physiological difficulty of cycling.
The details: Triathletes swam 1500m in an average of 30 minutes followed by 30 minutes of cycling, compared to cycling only. Although their performance was not shown to be affected (distance covered in a given time or power output), other variables indicated that cycling was more physiologically taxing. Heart rate, blood lactate, and oxygen consumption were all higher after swimming-all of which could negatively affect subsequent running.
Swimming at 80-95% is better than swimming at 100% for race performance.
The details: Triathletes did three different test days where they swam at all three intensities (based on a 750m time trial), cycled 20k, and ran a 5k. Cycling power output was much lower after swimming at 100% (278W compared to 298W and 305W). Run time after the 100% intensity swim was an average of 1:45 longer when compared to 80-85% intensity. No 5k time difference was given for the "moderate" intensity and I would've liked to know it. I like this study the best because they used real triathlon distances (why WOULDN'T you?!) and compared to both biking and running.
Improve swim performance, learn how to draft, wear a wetsuit whenever possible!
These findings show us that swimming does affect cycling, especially in short distances, and if you go balls to the wall during the swim you are likely to negatively affect your overall race performance. Improving maximal swim ability can help you improve your speed at relatively lower intensities, but as anyone who does this knows that takes FOREVER. The study includes some information about how drafting, wetsuits, and speedsuits affect swimming performance but they don't compare it cycling which is why I'm not detailing it here. They tell you what you you probably already know-that all three of these things help you swim faster without wearing yourself out more, which will help everthing else.
Only one of the studies reviewed used actual triathlon distances. This is a pet peeve of mine in sports research because it makes it hard to translate the research to training when things don't match up, but it still helps you get an idea of what's going on. The athletes' performance level also probably vary quite a bit. Some of the reviewed studies used absolute time, some relative intensity-so it's hard to know exactly how you'd compare. But again, it still help you get an idea how your pacing strategy can affect your race.
When it comes to marketing and exposure there's no doubt that social media outlets including Facebook, Instagram and YouTube are invaluable to fitness professionals. You can reach an incredibly large and diverse market, and communicate all kinds of information quickly and effectively. Obviously I utilize these resources through my occasional blogging and Facebook posting and my recent YouTube adventures. It has been suggested to me by multiple that I should open an Instagram account but I just can't bring myself to do it, and here's why.
It seems to me that how many followers a person has on Instagram is being confused for credibility and knowledge as a fitness professional. Looking good and taking good pictures, posting the right motivational quote, snapping pics of your salad...I don't have a problem with trainers and fitness instructors doing this to demonstrate what it takes to live a healthy and fit lifestyle. I know as well as anyone that it takes a lot of work. But this is not the same things as being educated, knowledgeable, certified, and being able to teach safe class or train an individual on their specific needs and goals. Sure, you can have both a popular Instagram account and be well educated and good at your job, but unfortunately this is not always the case.
I work out with one of my clients in the gym in his building. A couple weeks ago there was a girl in there who I will admit had a pretty great looking body-slim, toned muscles, low body fat (I'm not into the fake boobs and her ass was also questionable...but that's Miami). Nothing she did in the gym explained in any way how she looks like that because in the 30 minutes that I saw her working out she didn't do a single exercise that was worth a damn. Then she spent the last 20 minutes of her time in the gym attempting to take the perfec selfie. This place is like a funhouse of mirrors and she tried all of them. I'm making an assumption that the pic was for Instagram and I could be wrong, but nonetheless she demonstrates a population of trainers that I see all the time. They look good, so whatever they're doing is working well for them, but when they get clients with extremely different capabilities and needs, they are doing things that are totally inappropriate for that person.
An example of how Instagram looks nice, but can be as real as reality TV, is a former student of mine who also has many Instagram followers. His page is covered with pictures and videos at the track at Flamingo Park, workouts on the beach, more stuff about the beach lifestyle, beach, beach, beach...the guy lives in Hialeah. For non-Miami people, Hialeah is nowhere near the beach. I will give the guy credit that he has his degree in Exercise Physiology, but let's just say he wasn't my top student. And a manager at a local training facility refused to hire him. So at least he's not completely clueless, but he's not that great, and his Instagram posts are BS.
Sure, everyone knows how to work a pair of scissors, but that doesn't make you a hairdresser. You have to go to school and obtain a license from the state before you can say that. So just because you can pick up a dumbbell, does that mean you know how to design a fitness program for someone? I don't think so. What happens if you give someone a terrible haircut? They're pissed, then their hair grows back. But what if you're an uneducated trainer and you push someone to the point of rhabdomyolosis? Best case scenario they go into kidney failure, worst case scenario they die. I realize that sounds a little workout apocolyptic, but it's happening more are more.
I'm not saying that I believe if someone is on Instagram and has a lot of followers that they automatically don't actually know anything. I just want to encourage people to be more aware of the true qualifications of the people they choose to get their information from. Does the person have formal education in an exercise related field? What certifications do they have and are they high quality? What kind of work experience do they have? In addition to being what many people consider a hobby, exercise is a burgeoning field of science with an increasing population of highly educated and effective people studying and working to improve the health and well-being of the general population. Wouldn't you rather get your tips from one of them?
This is how I have chosen to set myself apart. I don't do gimmicky short-term challenges, I don't sell myself out with cheezy pictures of every workout I do because honestly there are too many. I have spent years of my life, tens of thousands of dollars, blood, sweat, and tears to read, study, practice and teach as much of what I know as possible. So, thank you to those of you that have shown me how much you value me, my knowledge and my experience by being my real-life followers in class and in training. A picture may be worth a thousand words but in this case I'd rather help you in person.
They say you don’t learn as much from when things go right as when they go wrong. I can’t agree more. This was my second year competing in triathlons, and while I placed in 4/6 races last year and 2/5 this year, I feel so much more accomplished at the end of this season. Here’s what I learned in my training this year:
- Getting up is harder than falling down.
- Missing one opportunity sometimes opens up the time/space for a better one.
- Just because you don’t improve in the thing you planned to doesn’t mean you haven’t made improvements.
- Don’t run on a path you don’t know without water, your cell phone, and rescue flares!
- Triathlon is an endurance sport. Sometimes you just have to push through, even when you get discouraged, and make it to the end.
Let me elaborate…
1. The trouble really started in June when I attempted an Olympic distance race. I’d done a couple tune-ups earlier in the year and felt pretty good about my capabilities when I started training for this race. I trained really hard for 6 weeks, I had a new set of race wheels (early birthday + Christmas present from my parents) and I felt strong, confident and prepared on race day. Unfortunately, halfway through the race I made a wrong turn. To prevent hitting a chain blocking the way I slammed on my brakes and did a flip over the handlebars and onto my face that I’m pretty sure could’ve become a feature video on Ridiculousness. I either looked like a badass or a battered wife, depending on how judgemental you are. I was only scratched and bruised which was lucky, but that was the end of the race for me. I had been averaging around 22 mph on the bike up to that point and I was beyond disappointed in myself for making that mistake.
2. All the confidence I had in my abilities at this point was gone. I had planned on signing up for the Miami 70.3 immediately after the race but was so defeated that I hesitated and missed the registration deadline. I was disappointed in myself all over again, because the 70.3 is more popular and draws a more competitive field and I was really looking forward to the challenge. I conceded and signed up for the Miami Man, the same race I had done last year and completely fallen apart in the run. It ended being a good thing I had the extra time to train due to some upcoming poor training conditions. (See #4)
3. If you need any evidence that this stuff is addictive, my signing up for the Escape to Miami is all you need. I had begun my half-ironman training after taking a few weeks to nurse my physical and emotional wounds after the crash, but it was early and I really wasn’t prepared. I finished with a much slower time (~10 minutes) and lower placement so needless to say, this did not provide me with the post-race high I was seeking. To add insult to injury-literally, all anyone else had to say about my performance was, “At least you didn’t crash!” as opposed to last year, “Did you win?” My standards are a little higher than just not falling on my face, thanks. Really good things that came out of this race, though, were that the changes I’d made in my race nutrition and supplement plan paid off. I have a tendency to get an ab cramp on the run and that didn’t happen this time even though it was really hot. One small battle won!
4. Should I also mention the day I had a 3 hour brick workout that turned into a 5 hour tour of the Key Biscayne preservation, complete with no water for over an hour, climbing a barbed wire fence, and barely making it to the parking lot, where I had to ask someone to walk me to my car because I was so dehydrated I was on the verge of passing out? That was a fun day.
5. By the time I made it to the Miami Man race day, I had managed to get myself together and have over a month of really good workouts, so I felt like I might not die doing the race. I know that’s still lacking a bit of confidence, but I really just wanted to survive and better my time from last year if that was humanly possible. I ended up cutting 15 minutes off, mostly from the run. Finally, true race success-and very hard earned! I ended up in 4th place, compared to 3rd last year, but I'm still so happy about my improvement which was my goal.
Whether you're training for an event or just exercising to be healthier and look better, using the 4 basic training principles to plan your workout schedule is extremely helpful. The principles are specificity, progression, overload, and recovery. I'll explain them in general here and discuss each one in detail over the next couple weeks.
Specificity: This means that you should select exercises or training methods that are specific to your goals. For example, if you want to run a marathon your training program should consist primarily of running and exercises that will improve your running. If you want to improve strength, you should do strength training with weight sufficient to fatigue your muscles.
Progression: Progression means that as your body adapts to the workouts you are doing, you must either increase or change what you are doing in some way. This concept seems to have been replaced with "muscle confusion", a term I really hate. Motor learning is not the same as reaching a plateau and unfortunately the former is often discarded to prevent the latter. I'll get into a lot more detail about this later.
Overload: Simply put, you have to challenge your body with workloads that push the limits of your capabilities in order to see improvements. This doesn't necessarily mean that you should go all out, all the time, on every exercise but it brings to mind one of my favorite quotes, "If you always do what you've always done, you'll always get what you've always gotten". If you're not pushing yourself to get stronger, faster, leaner, or whatever you're going for, it's just not going to happen.
Recovery: This principle is just as important as the other three, if not more. If you do not give your body adequate time to rest and rebuild from all the demands you are placing on it, you run the risk off illness or injury. This one is the hardest for many people to incorporate into their training because it feels a lot like wasting time. Trust me, it's not.
Now that you know the basics idea of each training principle, I'll begin delving into each topic in greater detail over the next few weeks. Until then, keep training!
Last week when someone cut me off in the bike lane for no other reason than to cut me off (there was no turn he was going for, just me) I went to the police station to report him only to be told that unless he hit me or harmed me there is nothing they can do. Well karma came and got me because I was hit by a car on my bike yesterday on Jefferson Ave. and 16th Street in Miami Beach while riding in the bike lane. I flipped over my handlebars and landed on my shoulder and my head, but somehow I am completely fine and my bike was undamaged. I am very lucky, I know. The police were called, she was cited, and I rode off.
I am not satisfied with the officer's response when I tried to report the driver that tried but failed to hit me, and I certainly don't want to be hit again just so the police will respond. I could tell you many stories of all the close calls, near misses, and almost accidents as can anyone who rides around this city. While I enjoy critical mass and a big part of me relishes in the big F**K YOU message it sends to drivers, I have to agree with my urban planner friend that all it does is piss motorists off. If we want respect as cyclists we have to give it, and no amount of yelling, banging on trunks, and flipping off rude drivers will achieve that. (I am guilty of all of these things by the way.) In light of this, something needs to be done to make people aware of the bike lanes and the consequences of ignoring them without making them hate cycists.
Please join me next Saturday at 6pm in the bike lane on 16th Street in Miami Beach to create awareness of the rules of the lane. I cannot stress enough that this rally is meant to generate respect for cyclists (and skateboarders and rollerbladers for that matter) by showing respect for motorists as well. If you want to be belligerent towards drivers and block traffic, this event is not for you. I would like to create a single file human+bike barrier at the edge of the bike lane. Why single file? Because, as I said, I do not want to block traffic for motorists, and especially not cyclists. Cyclists and supporters are all welcome, bring your bike if you have one and come even if you don't. If you choose to attend, please adhere to the following guidelines:
respect traffic by not blocking intersections, driveways, or crosswalks
allow residents in and out of parking (it is a residential parking area)
be friendly to motorists
bring signs to create awareness (examples of what your sign could say: Share the road, respect bike lanes, RIP with name and birthday of a cyclist friend who has been killed by a motorist, We just want to be safe, etc. Please do not write anything accusatory towards drivers)
I personally will be at Jefferson and 16th where I was hit with a sign saying "This is where my head hit the pavement when a car hit me". Subtle, I know. I cannot stress it enough, I really want to shed a positive light on cyclists in Miami so please bring your good attitude. If we want respect we have to show it!
Myofascial Release Part 5
Now that we’ve reviewed so much research regarding the tissues affected by myofascial release and how, it’s time to get into how to actually perform self myofascial release (SMR) and when is the best time to do so. By the way, if you missed any of the other entries in the series just click on The Bio Mechanic above and it will link you to my blog history.
Since there’s no research on SMR and endurance sports and not much research in general on when is the best time to do SMR for most athletes, here’s my disclaimer about the recommendations I make. I’m considering what little research there is and making the best recommendations I can according to what we do know, combined with my and others’ experience using the foam roller and other SMR tools. As more research is done I may change my mind about some of this, but for now these are the best recommendations I can make.
The first step in SMR is tool selection. First of all, there are several different types of foam rollers, including eva foam, soft and hard molded foam, the grid, the rumble roller and the vibraroll. In addition to these rollers, you may also use Trigger Point Therapy tools (massage ball, quad roller, foot baller, baller block), cold roller, muscle trac massager, posture ball, and spikey ball. These items can be found in some sporting goods and running stores, and online at fitness product websites such as performbetter.com, power-systems.com, and spri.com. If you’re looking for a more economical option, SMR can easily be done with unopened 2 liter soda bottles as a substitute for the foam roller, frozen water bottles as a substitute for the cold roller, a rolling pin in place of the stick, tigertail, or muscle trac massager, and softball, baseball, tennis and golf balls instead of the myoball and foot baller. Since some SMR tools can be expensive, these alternatives are just as effective for a fraction of the price.
With all the options available, there are a couple things to consider when determining which tools will be most beneficial for you to use. One factor is to consider the area of the body on which you want to perform SMR. The size of the tool determines the surface area it will affect, and if you’re trying to release smaller muscles such as those in the lower leg, feet or shoulders it is best to use one of the smaller tools (myoball, tennis ball, etc.) Also, if you have tension deep within muscles, using one of the smaller tools can be more effective even on larger muscles. In general, the smaller the surface area the tool affects, the deeper the pressure and more effective the release will be. Another factor is the density of the tool you are using. Soft foam rollers have more give, which results in less pressure applied to the muscles. This could be good for people who are new to myofascial release and/or do not have high pain tolerance, or for use as something of a warm-up to help lightly release muscles before using a more aggressive form of release tool.
In my opinion, the best time to perform the roller can vary by the individual and the number of trigger points that are present. If you have muscles that are chronically tight or painful, I recommend at least doing SMR on these muscles on both sides of the body prior to training. For pre-training SMR, staying within the times used in the performance studies is probably best, so spending 1 minute per muscle group is sufficient. For athletes who are using SMR for treatment of tight muscles and for prevention of developing trigger points, I believe it would be beneficial to use the foam roller as a recovery tool. For recovery, you could use the roller after moderate workouts. I would be cautious rolling after really intense workouts that cause lots of soreness. In this case, there is a higher level of inflammation in the muscles (which causes the feelings of pain) and I’d be hesitant to apply too much pressure in this case. You could also use the roller in conjunction with your lower intensity or lower impact workouts such as swimming, yoga, or stretching, since there is less trauma to the muscles during these types of workouts. When using SMR as recovery, I would not hesitate to spend several minutes on areas that have lots of trigger points rather than limiting to one minute per muscle group.
There are already lots of resources for how to use the roller so rather than explain everything here I’m including links to some helpful videos to get you started. Once you get the idea of how it works, you will learn how to position your body to massage the muscles you want. As I mentioned before, for larger muscles you can try using smaller tools that will get deeper into the muscles. For example, I use a softball on my hamstrings.
You can use a golf ball for the SMR shown in this video. They mention rolling the forefoot but don’t demonstrate it. You can roll the ball between the bones in the ball of the foot, which is great relief for women who wear heels.
This video has good tips for using a small ball on the shoulders and other areas of the body. Although the video is described for seniors the tips are useful for anyone, especially if you’ve experienced tired shoulders while using the roller.
Enjoy your self massages!
One of the comments I got about the last post regarding the effects of self myofascial release (SMR) on performance was about how it affects recovery. As with studies on SMR and performance, the research on how it affects recovery are also quite limited. It also depends on what factors you consider when you think of recovery. Immediately after exercise, we have what you could consider general recovery when the heart rate, blood pressure, and internal body temperature are returning to resting levels. We also have muscle recovery, which can take much longer if you consider soreness, which occurs from high intensity or long duration exercise. Personally, I’m more concerned with if and how SMR can help my sore muscles after a week of intense training, but unfortunately I could find no research studies on this topic.
It’s not that there aren’t studies on SMR and pain, but the populations used in these studies have some kind of pathology-fibromyalgia, breast cancer, pelvic malalingments. At a glance, SMR seems to be helpful for these groups but as anyone in science knows we shouldn’t directly transfer results from one population to another. However, it would make sense that if SMR relieves pain in someone with a disease affecting their fascia, people with soreness due to exercise would likely experience some benefit too. So as I’m writing this, it gives me the idea to compare the study I reviewed earlier that measured inflammatory markers in muscles with painful trigger points and see how they compare to subjects with fibromyalgia. Fibromyalgia is a condition that causes generalized pain throughout the entire body because of its affects on myofascial tissue. Exploring this connection is not where I intended to go when I began writing this, but after reading a little bit it seems relevant so here we go. If you want a thorough refresher on what I discussed regarding inflammation in the muscles, review Myofascial Release Part 2. You can access previous entries by clicking on the blog title “The Biomechanic” at the top of the page.
One study on fibromyalgia measured several inflammatory markers, among other things. When I compared the results of this study to the previously mentioned study measuring biochemical markers in active trigger points I found a few similarities. Between the two studies, there were 3 inflammatory markers in common (cytokines IL-6, IL-8, and tumor necrosis factor alpha-don’t worry if you don’t know what these are, I just feel the need to specify for anyone who might). In both studies, the concentrations of these markers were compared to normal subjects and found that they were higher in subjects with both fibromyalgia and active trigger points. Although the causes are much different, this indicates that there could be some similarities in what causes pain in both conditions. If SMR helps relieve the symptoms of one it is possible to work for both. Considering the amount of research that is being done on fibromyalgia, this could potentially be helpful for research on myofascial release in athletic population.
Even without scientific research to explain how and why, athletes who use the foam roller and other SMR tools know they work. I’ll be getting into SMR tool selection and use next.
Bazzichi, L., Rossi, A., Massimetti, G., et al. Cytokine patterns in fibromyalgia and their correlation with clinical manifestations, Clinical and Experimental Rheumatology, 2007, 25: 225-230.
Shah, J.P., Danoff, J.V., Desai, M.J., et al. Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points. Arch Phys Med Rehabil, Vol 89, January 2008.
Myofascial Release Part 3
I got some feedback from readers that I’m writing a little too technically. Sorry everyone, when I get in science mode it’s hard to get out! This time around I’ll try my best to make things as understandable as possible, but feel free to comment with questions or requests for further explanation.
The next area I want to address regarding SMR is how it affects performance. After reading about what’s happening in the myofascial system to create painful trigger points it’s easy to see that doing SMR regularly is probably a good thing. However, as with any training method, it is important to know when and how to implement the foam roller to maximize the benefit.
In searching for scientific research on this topic I must admit there is little. I found only one study and one thesis that actually tested performance measures after using the foam roller. There were no studies to measure how it affects running or cycling, which I know is an area of interest for many of my readers. The studies that I did find measured multiple factors. In general, if I mention a difference occurring it means the effect of the foam roller was statistically significant, which means the effect was enough for us to care.
One study looked at quadriceps function without doing any SMR, and after doing 2 1-minute bouts of SMR on a PVC+foam roller. They measured isometric strength (strength of the muscle in a static position), range of motion, and other factors at 2 and 10 minutes after foam rolling. They found that the muscles were able to activate as well and produce similar amounts of force with and without performing SMR. When they measured range of motion, subjects’ ROM at the knee increased an average of 9 degrees after SMR. Another interesting result of the study was that for the control condition (no SMR) as range of motion increased, strength decreased. When the subjects performed SMR and were tested again, range of motion no longer affected strength. The researchers also noted that the increases in range of motion they measured were similar to studies measuring the effects of static stretching, with the difference that SMR did not decrease muscle strength production while static stretching did.
Another study compared a general warm-up only, general and dynamic warm-up, and general warm-up and SMR on plyometric power measured through jump height. The foam roller was done on the calves, hamstrings, quadriceps, and glutes for one minute per muscle group. Subjects were tested for performance after each type of warm-up on 3 different days with at least one day rest in-between. They were tested on three different jumps:
- squat jump-subjects held a 90 degree squat position for 2 seconds then jumped as high as possible
- countermovement jump-subjects squat down and immediately jump as high as possible with no pause
- depth jump-subjects stand on a .5m (~20 inch) box, step down to land on both feet and jump as high as possible upon landing
The analysis showed that the dynamic warm-up increased the height of the countermovement jump, but no other differences were found. In this study, the foam roller had no effect on power production.
For now, this is all we have to go on regarding foam rolling and performance. It’s not much, but what we can get from this is that range of motion is improved with no decrease in performance with the foam roller, at least in strength and power exercises. Although we cannot assume the outcome would be the same for endurance activities like running and cycling, we are at least one step closer in understanding how SMR affects muscle force production. In my next entry I’ll make my recommendations for what I believe is the best way to implement SMR into your training program, and how to do it. Thanks for reading!
MacDonald, G.Z., Penney, M.D.H., Mullaley, M.E., et al. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. The Journal of Strength and Conditioning Research, 27(3), 812-821.
Fama, B.J., Bueti, D.R. The Acute Effect Of Self-Myofascial Release On Lower Extremity Plyometric Performance. (2011). Theses and Dissertations, Sacred Heart University.
In Myofascial Release Part 1 I reviewed in general the structure and function of the connective tissue that surrounds the muscles, which is the target structure of myofascial release. Now that we have a basic understanding of what the fascia is and what it does, let’s review some of the issues that myofascial release is meant to alleviate.
First of all, I would like to offer clarification on a statement I made in Part I regarding the innervation and circulation supplied to myofascia. I said that “While fascia does not contract on its own the way muscles do, or have direct connection with the circulatory system…”. I realize this implies that fascia does not contract or have circulation at all, and this is not the case. Researchers found that within the collagen fibers of fascial tissue are embedded smooth muscle cells and capillary systems. Smooth muscle fibers are those found in our internal organs that we do not voluntarily control, such as the stomach and intestines. As a result of the existence of these muscle fibers, when connective tissue was subjected to prolonged stretch, the tension of the tissue increased, indicating “contraction” of the fascia. These studies show that fascia is an active rather than passive tissue, as previously thought, and it can be extremely responsive to forces on the body, whether due to muscle contraction or stretch.
The painful areas usually targeted through myofascial release are called trigger points. When using the foam roller these spots are typically easy to find. As you roll the pressure often feels like strong massage, and when pressure is applied on or near the trigger points it is usually quite painful. The goal is to “release” these trigger points to alleviate the pain and improve function of the area. But what causes these trigger points and the pain associated with them?
Although fascia may not have large vessels directly supplying flow of blood or fluid, there are many points in the fascia where an artery, vein and nerve traveling together pass through, or perforate, the fascia. It was found that the majority of the 361 Chinese acupuncture points corresponded with one of these perforation points. Patients experiencing pain at these sites showed additional collagen buildup around the perforation described as “strangling” the vessels and nerves. This collagen buildup and subsequent pain is what is creates these trigger points.
In addition to the physical buildup of collagen associated with trigger points, there are also chemical differences. A study measuring the concentrations of a variety of chemical markers associated with pain and inflammation (inflammatory mediators, catecholamines, neuropeptides, cytokines) took samples from trigger point areas in the trapezius muscle (upper back) and unaffected gastrocmenius (calf) muscles. These chemical markers specifically indicate a decrease in fluid circulation, decreased ability to utilize oxygen and increased acidity. The increase in acidity also inhibits acetylcholinesterase activity at the motor end plate. This means that after the muscle fiber is stimulated to contract, the chemical that subsequently allows the muscle to relax is not able to function properly, causing the muscle to stay in a state of partial contraction. The results of these things are increased metabolic demand, muscle fiber shortening and muscle tension. It is easy to see how with these things occurring, muscle function would be affected along with the pain associated with trigger points.
This study also found that many of these biochemical markers were elevated in the trigger point areas as well as in unaffected muscles when compared to subjects with no trigger points. This indicates that the inflammation that occurs in areas of pain can affect the chemical balance of the fascia system of the entire body. There is debate whether the increased inflammation markers are the cause or effect of trigger points and more research is needed to determine this.
Now we have a better idea what is happening physically and chemically at the trigger point sites. Based on what we know so far, I think it is fair to say that in addition to just feeling better after doing myofascial release, there is probably some measurable physical and chemical improvement to the muscles. As with any therapy or training technique, there are questions about when and for how long we should perform foam rolling and other SMR techniques in order to increase performance rather than decrease it. Keep reading, as I will address this next!
Schleip, R. Fascial plasticity-a new neurobiological explanation: Part 2. Journal of Bodywork and Movement Therapies, 2003. 7(1) 11-19.
Shah, J.P., Danoff, J.V., Desai, M.J., et al. Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points. Arch Phys Med Rehabil, Vol 89, January 2008.