Building Your Body Maintenance Routine Final

36

Transcript of Building Your Body Maintenance Routine Final

Page 1: Building Your Body Maintenance Routine Final
Page 2: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Building Your Body

Maintenance Routine

Created by Leigh Boyle DPT, CSCS

© 2010 Athletes Treating Athletes

Page 3: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Table Of ContentsAbout the Author -----------------------------------------------------------------------------------------

Introduction -------------------------------------------------------------------------------------------------------------------

Part One: What is a body maintenance routine and what will you need it for? ----------------

1. What will you need to get started -------------------------------------------------------------

2. What are the components ----------------------------------------------------------------------

1. muscle massage ------------------------------------------------------------------------

2. mobilization techniques --------------------------------------------------------------

3. stretching -------------------------------------------------------------------------------

Part Two: Actually building your body maintenance routine ----------------------------------

1. identifying your problem areas ---------------------------------------------------------------

2. identifying the common problem areas of your sport -------------------------------------

1. Running ---------------------------------------------------------------------------------

2. Cycling ----------------------------------------------------------------------------------

3. Swimming -------------------------------------------------------------------------------

4. Triathlon ---------------------------------------------------------------------------------

3. identifying the problem areas that come with your job -----------------------------------

1. seated work -----------------------------------------------------------------------------

2. standing work --------------------------------------------------------------------------

4. determining when to use your body maintenance routine --------------------------------

5. choosing the individual components of your routine --------------------------------------

6. sample maintenance routine + walk through ------------------------------------------------

Part Three: Your Back Up Plan -------------------------------------------------------------------------

1. Plan for the worst- building your pit crew ---------------------------------------------------

2. Immediate Injury Care --------------------------------------------------------------------------

3.TrainingmodificationChart-------------------------------------------------------------------

Part Four: Thank You -------------------------------------------------------------------------------------

Appendix

1. Chart (Links to massage, mobilization, stretch blog posts) -------------------------------

2. Maintenance Plan Work Sheet -----------------------------------------------------------------

4

5

7

7

8

8

10

11

12

12

14

15

16

17

18

19

20

21

22

24

26

30

30

31

33

34

35

36

Page 4: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

About The Author

Before we get started, I just wanted to take a few moments to introduce myself and Athletes Treating Athletes. My name is Leigh Boyle and I am aDoctorofPhysicalTherapy(DPT)andCertifiedStrengthandCondi-tioning Specialist (CSCS). By day I am the co-owner of a private physi-cal therapy practice in Southern New Hampshire. Our clinic specializes in sports medicine and orthopedic injuries and we see anything from ankle sprains to surgical reconstructions and most everything in between. In my free time, I am primarily a long distance triathlete (2011 will be my 9th season and will include my 6th Ironman distance race), cyclocross junkie, wannabe roadie, and sometimes road runner.

I founded Athletes Treating Athletes in January of 2010 with one goal in mind- to build the best one stop resource for endurance athletes working through or trying to prevent overuse injuries.Asanathlete,Iknowfirsthandhowdifficultitistotrainthroughpainorbesidelinedbyaninjury.Ialsoknowhowfrustratingitisforthefirstmedicaladviceyouheartoalwaysbe“stopdoingsportX”insteadofhere’swhatwecandotofixtheproblemandhere’swhatyou should do to modify your training until then. As a clinician, I see the injured athlete who wantsthequickfixsothattheycanmoveonandforgetiteverhappened.Asanathleteanda clinician, I can tell you that there is almost always a GAP between the start of an overuse injury and the point where you require professional treatment for it. With a little work and some dedication, YOU can catch problems in that gap and prevent symptoms/problems from becoming full injuries.

That is why over the past year I’ve developed The A-T-A Self Treatment System- my four part approach to self treatment. The primary goal is to bring you through the entire healing process of overuse injuries by using four different treatment techniques that you can literally do at home on your own. In fact, if you’ve been following along on the website, we’ve already com-pletedthefirstpartforeverymajormusclegroupinthebodyandarealmostdonewiththesecond. Here are the techniques:

1 Self muscle massage, active muscle/tendon mobilizations, and joint mobilization tech-niques to restore mobility and decrease muscle spasms/restrictions.

2 Stretching to improve and maintain this new mobility.

3 Kinesiotaping to provide support and neuromuscular feedback to the injured area.

4 Strengthening to restore normal muscle balance and function.

Inwritingthisguide,mygoalistotalkaboutthefifthandmostimportantpartoftheA-T-ASystem-BuildingYourBodyMaintenanceRoutine.Overthenext30+pagesI’mgoingtohelpyoumapoutaplanthatisefficient,specifictoyourinjuries,yoursport,yourlife,andyourtraining schedule

Page 5: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Introduction Chances are that if you’re reading this you’ve either been sidelined by an injury or participate in an endurance sport that comes with a good dose of aches and pains throughout your train-ing and racing. You probably already own a few recovery tools like a foam roller, stick or mas-sage ball. You may even break them out once in a while when things are stiff and sore or start-ing to impact your training and daily life. What about the other 95% of the time? If you’re like most of the athletes I know and treat, those same tools are on a shelf collecting dust or being used as toys by your children and pets. If we’re not actually injured, we don’t need them, right?

Wrong. :)

My clinic is full of masters athletes who ignored their bodies when they were younger and have now rusted in their golden years. My main goal in writing this is to help you NOT be one of them 10, 15, 20+ years down the road! You only get one body. Time to take care of it so that it can take care of you for the long haul.

Over the course of this guide I’m going to walk you through the process of building your very own body maintenance routine. This is an actual routine designed to keep your muscles and joints moving and you training and racing to your hearts content. I’ll walk you through how to maketheroutinespecifictoyou,yourinjuryhistory,yoursport(s),andyourschedule.Wantto hear the best part? I’m going to start by telling you what you DON’T have to do.

#1 You do NOT have to stretch, foam roll, trigger point, mobilize, etc before and after every workout.

Your maintenance routine should never replace your training or cut into it by tacking onextratimetothefrontandbackendofyourworkouts.Thatisoverkill,unnecessary,andmore importantly, completelyunrealistic for real life. It’s hard enough tofit theworkout in without worrying about squeezing in additional stuff.

#2 You do NOT have to do this stuff for hours on end or even everyday.

The goal of helping you create a body maintenance routine is to make it manageable, efficient,andmoreimportantlyrepeatable.Itshouldsupportyourtrainingnothinderit.

#3 You do NOT need to spend a lot of money.

While it would be nice to have your very own sports massage therapist/A.R.T. superstar on call or all of the latest miracle recovery gadgets, the truth is that you can accomplish all of the same things without them. It’s like dieting- at the end of the day,you and the decisions you make are the most important part of its success.

Why should it be important to you?

Page 6: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Think about our lives as endurance athletes and how the majority of our injuries occur. We aren’t typically the people pulling up in pain during the 100 yd dash with a torn hamstring or being loaded up into an emergency vehicle following crashes, falls,and other traumatic events. Can those types of things happen to us?? Absolutely. I was one of those crashes this pastyear(thankyoutextingwhiledrivinghighschoolkid!).Instead,ourinjuriestendtobemore gradual and somewhere on the overuse spectrum with an -itis at the end of the diagnosis (i.e. achilles, IT Band, rotator cuff, etc). This means that our injuries are sneakier and that our symptoms are more subtle in the early stages. With a traumatic injury, it’s obvious that treat-ment is required. With an overuse injury,things may just feel sore or tight, but you can still train and race without any real problems or discomfort. Most of the time you can associate these symptoms with periods of heavy or intense training and for that reason many athletes write off these symptoms as something to just get through for now and “deal with” later during the taper or on a post-race basis. If you’ve done that in the past, has it always worked out or were you one of the people struggling with a taper injury? Worse yet, did it hit after two weeks on the couch as you returned to training? What about those injuries that just won’t go away? Not with rest, treatment, cross training, or all the above.

Long story short, overuse injuries play by different rules. As we rack up miles and hours, our bodies are constantly in a state of break down and rebuild. They continually adapt to let us do all the crazy things we do to beat them up. In fact our body is so good at adapting that if the musclesandjointsthatarebreakingdownsuddenlycan’trebuild,itwillfindawaytocompen-sate and shift that load some place else to get the job done. Why is that a such a big problem? Moreoftenthatnot,whatfinallydoesbreak,wasn’ttheinitialproblem.Nowyouhavetwoproblemsandyouhavetobacktracktofindthefirstoneinadditiontohealingthesecondone.

That is why creating and having a body maintenance plan is important. By routinely monitor-ing your known problem areas or the areas that your chosen sport beats up the most:

1 You can prevent big injuries from sneaking up on you by catching the early signs and symptoms

2 You can make sure that your body is rebuilding the way that it should be.

3 You can prevent that shift from rebuild to compensate.

Sound like a good plan? Grab a pen and paper and let’s get started. :)

Page 7: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Part One

What is a body maintenance routine and what will you need for it?

Simply put, a maintenance routine is work that you can do at home and on your own to improve rangeofmotion(howfarajointcanmove),flexibility(howfaramusclecanstretch),andsofttissue mobility (how smoothly a muscle moves without knots,spasms, or other restrictions limitingit’smovement).Thiscanbeperformedwithstretchingexercises,selfmusclemassage/release work (using a foam roller and tennis/trigger point ball), joint mobilization, and in some cases strengthening to restore balance between the different muscle groups. Regardless of the individual components that make up your routine, the goal is always the same: to achieve and maintain normal mobility and function in your joints and muscles.

What will you need to get started?

#1 Foam Roller

This can be homemade or store bought, ranging anywhere from $10-50+ dollars. Rollers varybydensity(howsoftorfirmtheyare),length,circumference,andbypattern(somehave different grooves and shapes to better assist with deeper muscle release tech-niques). With this in mind, rollers are very individual and will depend on the problem areasyouwillbeworkingon.Forexample,whatfeelsgreatonthecalf/moresuperficial/bony areas, may be too soft for areas with bigger muscles like the back or hips where a firmrollermayworkbetter.Ifyouarenewtofoamrollers,startoffconservativelywithamid-size,softrollerasitwillhavethemostusesversusatopoftheline,firmrollerthatmaybetoohardtouseatfirst.

#2 Tennis Ball

A standard tennis ball is great to start with. As you progress and become better at the techniques you may choose something that is harder and able to generate more pressure orsomethingthatmoldswithuselikeaspecifictriggerpointballorsimilarproduct.

#3 Resistance Band

Resistance tubing/bands are very affordable and available online or in most sporting goodstores.Youwillwantabandthatisapproximately5-6feetinlength.Hereisanexampleofwhatyou’relookingfor-

http://www.amazon.com/Thera-band-20540-Single-Latex-Exercise/dp/B000FH0Q4S/ref=sr_1_8?ie=UTF8&qid=1293920003&sr=8-8

Page 8: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

What will you be doing with these tools?

Step #1: Thefirstpriorityofyourbodymaintenanceroutineistorestoremobilityinthemus-cles. As muscles become overworked and fatigued, they want to stiffen up and stay in a more protected position. If they are allowed to remain in this position, there rebuild process can stall and the body will switch gears to compensate by using something else. This is bad. We want to stop this from happening and work to get those muscles out of that closed up, tight position. To do that we are going to use self muscle mas-sage or release.

An easy way to look at self muscle massage is to break it down into the three different ways or directions that you can loosen up a muscle:

1 Youcanelongateorstretchoutthemusclefibers(inotherwords,workparallelorinthesame direction the muscle runs)

2 You can work perpendicular to the muscle (known as cross friction and used to break up specificadhesions).

3 You can apply sustained pressure to the muscle (known as trigger point and used tore-lieve muscle spasm).

Here is a video demonstration of the three basic techniques and the key points you’ll need to master them.

YouTube link: http://www.youtube.com/watch?v=9hK_VHPLIbg

Page 9: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Technique Tools Needed Used For What do do

Elongating/Lengthening Foam Roller Muscle release technique that

is used for increasing blood

flowtothemuscle,relieving

general tension,lengthening

themusclefromstarttofinish,

and locating deeper “problem

areas”.

The goal is to work in the same

directionasthemusclefibersfor

this technique,lengthening between

insertion points as you go. Typically,

2-3 minutes is a good starting point,

less if the muscle is tender, or more

if stiff vs. painful. Cap the effort at

5 minutes.

Cross friction (working

perpendicular to the muscle)

Tennis ball Deep muscle release technique

that works against the muscle

fiberstobreakuprestrictions/

adhesions. the movement

relies on sinking deep into the

muscle due to pressure;there is

actually very little side to side

movement (1-2 inches). this

prevents sliding over the skin as

you want the skin and muscle

to move together.

1)relaxthemuscleandletthetennis

ball sink in, 2) apply pressure(this is

key!), 3) slowly move from side to side

(remember1-2inchesmax).When

done correctly, you should be able to

feel the difference between healthy

muscle and restricted muscle. You may

even feel uneven,hard, or “crunchy”

sections. 2-3 minutes.

Trigger Point (sustained

pressure)

Tennis ball Deep muscle release technique

that works on trigger points/

muscles pasms/knots.

1) Once a knot/spasm is located,

positiontheballontopofitandrelax

the muscle so that the ball can sink

into it. Be careful not to move! If the

ball rolls off, it will hurt! 2) maintain

pressure and wait. You should feel the

musclestarttorelaxbeneathit,almost

like your easing up on the pressure. 2-3

minutes,5max.Ifthemusclehasn’t

released by then, go back later.

While the above techniques are a great starting point, it is possible for knots/spasms to become adhesions. In other words, the muscles and joints remain tight/stiff for so long that they actu-ally become stuck in that position. When this happens, the earlier techniques may not be enough to improve mobility. For these situations, we can then begin to use active mobiliza-tions and joint mobilizations. Both of these techniques use pressure to anchor down one end and then move/glide the other end. This allows them to break up restrictions/adhesions by stretching the muscle or joint against itself. The main difference between the two is that active mobilizations work on the muscle and their tendons and joint mobilizations work on the joint itself. These techniques are not held or worked on for time. Instead we use repetitions with the goal of slow,controlled movements for each.

Page 10: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Technique Tools Needed Used For What to do

Active mobilization (sustained pressure with active movement; aka tennis ball mobilizations)

Tennis ball This technique uses a tennis ball (and sometimes a different trigger point tool) to anchor down one end of the muscle while it is in a shortened/relaxedposition.Fromherethatpressure is maintained and the muscle is moved to a stretch position. By doing so adhesions/restrictions can be broken up by the combination of pressure and movement.

These mobilization techniques all use a tennis ball or similar trigger point device. 1) move the muscle intoarelaxed/shortenedposition.This will give us slack to work with. 2) apply pressure with tennis ball. 3) slowly move the muscle into a stretch position. Unlike the massage techniques above, joint mobs are done for repetitions. The goal is 10 smooth, controlled reps.

Joint mobilizations Resistance band/tubing

Eachjointismadeoftwobonesthatare held together by a joint capsule. The capsule is composed of thick fibrousmaterialandreinforcedbyligaments and the tendons of the large supporting muscles. If the muscles and joints remain in a tight position, the capsule will stiffen. Joint mobs (mobilizations) are designed to anchor one part of the joint (using a resistance band) and glide/move the other bone against it.

Eachjointmobilizationwilluseapiece of resistance band to anchor down one bone of the joint. From here,the second bone will be moved to try and stretch the capsule. Unlike the massage techniques above, joint mobs are done for repetitions. The goal is 10 smooth, controlled reps.

Step #2: Now that you have loosened or broken up any restrictions in the muscle itself, the second priority is to improve upon and maintain these changes. This is accomplished through stretching.

Breaking up restrictions is only part of the process. From here you need to stretch those mus-clefibersandjointsoutsothatthebodycanregisterthatachangehasoccurredandadaptaccordingly. You see muscles have what is known as a resting length and tension. This means that at rest, a muscle has an ideal length and tension that allows it to function at full capacity in terms of the force it can generate and the velocity at which it can move the joint it supports. Changes to that resting length and tension, whether it’s loss of mobility or increased tension in the form of knots/spasms,will limit the muscle’s performance. Think of it this way- the ear-lier techniques are working to change the things altering that length/tension, but stretching is what will reset and restore how the brain and nervous system use that muscle. The best way to do this is through frequency. Remember, in endurance sports we literally do things millions of times. Doesn’t it make sense then that to change those bad habits, we’ll need to do this stuff more than once or twice when things get out of whack?

Unlike all of the studies out there debating the effectiveness of stretching, our goals are not to decrease recovery times, decrease injury rates, or even to improve performance. They are much simpler than that. We’re trying to restore normal mobility and function so that the affected muscle and those that work with and against it can all work the way that they are supposed to. Below are some of the basic guidelines to keep in mind while stretching:

Page 11: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

1 Stretching should never hurt. The goal is to only go as far as you can comfortably. Once you feel a pull or “stretching sensation” stop there. This way you can build on each stretch without risking injury.

2 Shoot for 20 second holds and 3 repetitions. The key is frequency. Stick to the reps and avoid holding longer to get done faster. It’s worth it!

Over the past few pages I’ve given you a general overview of the individual components that youcanusetomakeupyourbodymaintenanceroutine.Tosumitallup,youhavefivedif-ferent techniques to loosen up the muscles, break up restrictions,and restore motion in your joints.Thesecondstepistomaximizethosegainsbyfollowingitupwithregularstretching.

Page 12: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Part Two

Actually Building Your Body Maintenance Routine

[**important: Inthebackofthisguideyouwillfindaplanningsheet.Irecommendprintingit out so that you can follow along.]

Therearefivestepstomapoutyourroutine.

1 Identifying your problem areas by looking at past injuries.

2 Identifying the potential problem areas that are typical of your sport.

3 Identifying the potential problems that may arise from your job.

4 Determining when you will perform your routine based on your training schedule and targeting two key training events.

5 Determiningwhatspecificcomponentswillmakeupyourroutine.Thiswill includeademoroutineasanexample.

Step 1- Identifying YOUR problem areas

The easiest way to start this process is to sit down and actually write out the injuries you’ve had over the past several seasons. Here’s what we’re looking for:

1 Type of injury or location. Was it a muscle or joint? tendon?

2 Was it a new injury or have you had it before?

3 Diditstartgraduallyandgetworseovertimeorwasitaspecificeventthatyoucanpinpoint?Arethereotherdetailsyoucanremembersuchaschangestobikefit,shoes,equip-ment, etc?

4 Did the injury change during your recovery? (meaning did it start in one place and move to another; did the other side become affected?)

5 Whataboutthejointsaboveandbelow?Forexample,iftheinjurywasatyourknee,howdid your hip and ankle feel?

What we are looking for in this list are patterns versus isolated injuries. Is it always one side thatseemstobetheproblem?Isitalwaysonespecificarea?Weretheinjuriesbacktobackorconsecutive? Did one start while you were on your come back from the previous injury despite a conservative increase in volume/intensity?

Page 13: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Onceyouhaveyourlist,thenextthingIwantyoutodoisnarrowthatlistdown.

1. Start by crossing off any “traumatic injuries”. This includes falls, bike crashes or any sudden movements you can identify (i.e. felt a pop in hamstring while doing a track workout, pulled back while moving furniture, etc). What we want on your list are inju-ries that snuck up on you and started either following a workout or during. If they startedwhilerunningforexample,we’relookingfortheinjuriesthatstartedaspain,butyou could still keep going until the symptoms stopped you (either later in the run or on a later date).

2. Nextcrossoffanycomebackinjuries.Thismeansthatfootpainyougotwhilerampingback up after a knee injury.

3. What you should have now are all gradual/overuse injuries. Those are what we want! From here we are looking for two things: 1) the most common side and 2) the most com-mon region (hip, knee, foot, back, shoulder, etc). Hold onto this, we’ll get back to it.

Let’susemeanasexampletoshowyouwhatImean:

1 ‘05Rightcalfstrain.Thisstartedgraduallyduringhalfironmanprepandwasmyfirstrealoveruse injury. Symptoms worsened until it became an audibly creaking calf with each step. Healed with PT + change in running shoes and bike cleats.

2 ‘06 IT Band syndrome on right side (down at the knee). Gradual onset during prep for NYC marathon. Worsened until unable to run and had to pull out of race.

3 ‘07 Stress fracture right foot (sesamoid). Gradual onset during ironman prep. Landed myself in a walking boot for 2 months with no land running for three. First real stand-down time in my endurance career. Plus side? Learned to love water running!

4 ‘09 Sesamoiditis left foot. Gradual onset during ironman prep. Caught early and healed quicklywithconservativetreatment,newbikeshoes,andtrainingmodifications.

5 ‘10 left elbow fracture following bike crash. Had to be a patient for this one.

Page 14: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Okay, so those are my endurance world injuries. Now let’s narrow it down.

Cross#5offthelistasthatfallsintothetraumaticcategory.Everythingelsecanstay.Noneof the injuries were comeback injuries as they were all spread out between different seasons. WhenIlookatthislist,thefirstthingthatjumpsoutatmeisthatthreeofthefouritemsareonthe right side. Two of those three things are from the ankle down and the third is only slightly upstream at the knee. This is important!

Whatisthebigtakeaway?Mymaintenanceroutinemustincludeworkonmyrightanklefirstand foremost.

Do you have a problem side or area? If so, mark it down on your planning sheet.

Step 2- Identifying the common problem areas of YOUR sport

Thenextpartofthisprocessistolookatyourspecificsportandtoidentifywhatthecommonproblem areas are for it. Ideally we are looking for areas of the body that are kept in a shortened position and stretched only when the opposing muscle group contracts.

Whyisthisimportant?Musclesworkinpairsthatcontractandrelaxinoppositiontoeachother.Forexample,whenyourglutemusclesextendyourhiptohelpyoupushoffwhilerun-ning,yourhipflexorscanrelaxandbestretched.Thisallowstheglutestocontractfullyandthehipflexorstorelaxfullyandviceversa.However,iftheglutesbecomefatiguedandareunabletocontractfully,thehipflexorisunabletorelaxfully.Instead,itisleftinthatshortenedposition where it can stiffen up. While this may not be problematic on any one run, if it hap-pens again and again, the front of the hip will stiffen and the back of the hip (the glutes) will have to work even harder. Over time this can result in muscle break down and injury.

Page 15: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

This means that we are looking for two things as we move through the different sports:

1 The muscles that are the most likely to fatigue and stop contracting fully.

2 The muscles that will stop being stretched when #1 happens and stiffen up/restrict motion as a result of that fatigue.

Let’sstartlookingatspecificsportstogiveyouabetterideaofwhatImean.

1. Running

The picture above shows good running form and what I call the Big Three. This means

1 fullhipextensionwiththehipstiltedforwardandupperbodystraight.

2 fullkneeextension.

3 normal ankle mobility for both shock absorption at heel strike and also push off during the back half of the stride.

As these components start to change due to muscle fatigue and tightness, your stride changes and you start to transfer the impact of each foot strike differently. Over time this can result in restricted joint motion and muscle mobility.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffenup and restrict joint and muscle mobility

Ankle Calf muscles (gastroc and soleus) AnteriorTibialis,LongToeExtensors

Knee Quadriceps Hamstrings

Hip GluteusMaximus HipFlexors

Page 16: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

2. Cycling

Inthepictureabovewehaveanaggressiveroadbikefit.Yoursmaynotlooklikethis,butitmakes it easier to point out what we’re looking for- areas that are stuck in that short position for long periods of time. If the muscles that contract to get you out of that short position tire out/fatigue, you spend more time there making it easier to remain stuck.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffen up and restrict joint and muscle mobility

Shoulder/Neck Back of neck and shoulder (upper + middle traps,rhomboids)

Pectoralis/chest muscles

Back Longbackextensorsincludingtheerectorspinae,multifidus,etc.

Abdominalsandhipflexors(theyinsertonthefrontofthe lower spine giving cyclists a double whammy with the hip position).

Hips Glutes Hipflexors(psoas)

Knee Quads+adductors Hamstrings + ITB

Ankle Calf (gastroc/soleus) Anterior Tibialis

Page 17: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

3. Swimming

I’m going to focus on freestyle technique as it will apply to both swimmers and tri athletes. Obviously the problem areas may vary between the different strokes. In the picture above thekeypointsarestraightknees,hip/backextension,aswellas,highelbowsandstrongpullthrough with the back of the shoulder and triceps.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffen up and restrict joint and muscle mobility

Elbow Triceps Biceps

Shoulder/Neck Back of neck and shoulder (upper + middle traps,rhomboids, and Lats)

Pectoralis/chest muscles

Back Longbackextensorsincludingtheerectorspinae,multifidus,etc.

Abdominalsandhipflexors(theyinsertonthefrontofthe lower spine)

Hip Glutes/Hipextensors HipFlexors

Knee Quads Hamstrings

Ankle Calf (gastroc + soleus) Anteriortibialisandlongtoeextensors

Page 18: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

4. Triathlon

Tokeepthisguidefrombeingabillionpageslong,I’mgoingtorelyontheabovesportspecificdescriptions. However, instead of saying that you will now need to work on all of the sports above (which would be mean!), I’m going to stream line it for you.

Start with the bike advice. It’s the longest leg of your sport and will take up the most training hours on a weekly basis. While cycling may not be painful or even uncomfortable, it is most definitelyacommonculpritbehindmulti-sportoveruseinjuries.Inparticular,trytothinkofit this way- there are three main contact points that connect you to your bike for long periods of time:

1 Handlebars. This will transmit impact from the road up your arm into your chest,upper back, and neck. Problems here can surely impact your swim, as well as,overall comfort in the aero position.

2 Seat. Sitting in an aero position requires a strong back/core to allow for proper hip angle and continued hip mobility. This is harder than it sounds when you stack run mileage on topofit.Sufficeittosay,yourhipsshoulddefinitelybeapointofinterest!

3 Pedals. This transmits impact up the entire leg chain. Problems here can result in calf, knee, and hip injuries upstream.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffen up and restrict joint and muscle mobility

Shoulder/Neck Back of neck and shoulder (upper + middle traps,rhomboids, and Lats)

Pectoralis/chest muscles

Hip GlutesandHipextensors(upperandinnerhamstrings)

Hipflexors(psoas)andadductors

Ankle Calf (gastroc and soleus) AnteriorTibialisandlongtoeextensors

Fromhere,finetuneyourproblemareasusingyourinjuryhistory.Forexample,haveahistoryofbackproblemsorkneeproblems?BesuretoputaXnexttothoseregionsaswell.

Page 19: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

5. Don’t see your sport?

Dropmeanemail,tweet,orfindusonfacebookandwe’llputsomethingtogetherforyoursport. My goal with this guide was to start with the most common things I see in the clinic and build from there. :)

Let’sgobacktomeasanexample.Wedeterminedbylookingatmyinjuryhistorythatmyrightsideistheproblemchildandthatspecificallymyinjuriestendtobebelowtheknee.Nextwestoppedtoconsidermyspecificsportandwhatproblemareascomewithit.I’mprimarilya long distance tri athlete. I like to play in the cycling world,love cyclo cross, and occasionally get talked into running events, but my major training focus is triathlon.

When I look at the common problem areas for tri athletes, my ankle issues are already on the list. Coincidence? Probably not. :) I’m also going to add the hip and shoulder/neck from the triathlon chart above.

Step 3- Identifying the common problem areas that come with your job.

Let’s face it. Our sports are our hobby. For most us, that means we have a day job that takes us away from that sport far more than we would like it to! It also means that our jobs unfortu-nately have the ability to impact our sport in ways we may not think about.

Justlikethesportspecificsectionabove,we’restilllookingforthesamethings.

1 The muscles that are working hard and likely to fatigue.

2 The muscles that will stop being stretched and stiffen up/restrict motion when number-one happens.

In the work world, the muscles are most likely to be affected by what position you are in for your hours on the job.

Page 20: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

1. Seated work

For most of the work force, the most common work position is sitting. Thanks to large improvementsinofficefurnitureergonomics,it’snoweasierthanevertomaintaingoodpos-turethroughouttheday.However,it’sjustlikethesportspecificsituationswediscussedabove.There are plenty of problem areas that can sneak up from being stuck in this position for hours on end.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffen up and restrict joint and muscle mobility

Ankle Calf (gastroc + soleus) AnteriorTibialis+LongToeextensors

Knee Quads Hamstrings

Hip Glutes+Hipextensors HipFlexors

Neck/Shoulder Back of neck and shoulder (upper + middle traps,rhomboids, lats)

Pectoral/chest muscles

Page 21: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

2. Standing work

While sitting at work all day may seem like the more problematic of the two,standing can also leadtoproblems.Goodstandingpostureisdefinedasalevelpelviswithoutarchingyourbackforward or leaning into your hips, knees should be straight but not locked, shoulder blades should be back together and chin level. In other words, try to look more like the picture above.

Region Muscle likely to tire out and stop contracting fully

Muscle likely to stiffen up and restrict joint and muscle mobility

Ankle Calf (gastroc + soleus) AnteriorTibialis+longtoeextensors

Low Back Longbackextensors Abdominals+hipflexors

Neck/Shoulder Back of neck and shoulder (upper + middle traps,rhomboids, lats)

Pectoral/chest muscles

Let’sgobacktomeasanexample.Iworkfulltimeasamanualphysicaltherapist.Thismeans7-8 hours a day are spent on my feet working on patients muscles, joints, etc, with occasional sitting and some climbing on tables for better body mechanics. My computer for writing notes is on a stand and lunches are on the run for the most part.

Page 22: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Howaboutyou?Ifyouhaveajobthatmixesboth,gowithwhatyouspendthemosttimedoing.

Step 4- Determining when to work on these area’s

Thenextpartofbuildingyourbodymaintenanceroutineistodeterminewhenyouaregoingtoactuallyuseit.LikeIsaidinthefirstfewpages,thisisnotstuffyouneedtodoaroundeveryworkout or even every day. The goal is to create a routine that is manageable and repeatable.

So let’s talk about your training. When are you most likely to overload your muscles? Will it be during that easy, volume workout or will it be during the intense interval sessions and long workouts? It will be the latter when the muscles will fatigue and stiffen and you will still have work left to do before the workout is over. These are the days you want to build your routine around.

Ideally you want to perform your maintenance workout after 1) intense workouts and 2) long workouts.

This does not mean the second your workout is over. Immediately following your workout, focus on what you normally do. Rehydrate, refuel, rest. In other words let everything calm down. If you’re an ice bath fan, ice away.

Instead of targeting this post workout window, lets use the recovery time that you already have built into your training schedule to determine when you do your maintenance routine. Most athletes do not schedule consecutive hard days back to back. In fact, most schedules have rest or active recovery days following harder sessions. This gives you a nice window to be able to fityourroutinein.Ideallyyouwanttoperformyourmaintenanceroutinebeforethefollowingworkout. This means that you will use the massage/mobilization techniques to break restrictions up,stretch,andthenusethateasier“recovery”workouttoflushthesystemout.Ifyoudosched-uleconsecutiveharddays,thenwaituntilyouhaveaneasydaycomingup.Forexample,it’snotuncommon for multi-sport athletes to schedule consecutive hard days in different sports. If this issimilartoyoursetup,finishuptheharddaysandthengettoworkbeforethateasyday.

Page 23: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Let’sgobacktomeasanexample.Hereismytypicaltrainingweek.Iliketostackupmyharddays into blocks. Tuesday through Thursday are my hard days on the bike, in the pool and out on the run. My long workouts are on the weekends when I have the most time. Monday and Friday are my easy recovery days. This means that I want to target Thursday night/Friday morning before that swim and Sunday night/Monday morning before that swim.

Monday Tuesday Weds. Thurs Fri Sat Sun

Swim (active recovery)

Hard Bike + Brick Run

Hard Swim + Run

Hard Run Swim (active recovery)

Long Bike+ brick run

Long Run

Mon Tue Wed Thu Fri Sat Sun

off/cross train Hill work short/easy (active recovery)

Speed work off/cross train short/easy Long Run

Here’sadifferentexample(weeklyscheduleofalongdistancerunner):

With this schedule there are three possibilities to target- Hill work, speed work and the long run. At a minimum you will want to schedule your routine for Sunday night/Monday morn-ing and Thursday night/Friday morning. If you have the time and are putting in lots of miles/volume, you can add in Tues night/Wed morning as well.

Page 24: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Step 5- Choosing the individual components of your routine.

If you’ve been playing along with your own copy of the planning sheet, you should have the topfourboxesallfilledoutbynow.Itshouldlooksomethinglikethis:

InthefirstthreestepsweidentifiedwhatspecificproblemareasIhadbasedonmyinjuryhis-tory, what my problem areas were from work, and what my problem areas were as a tri athlete. We also determined based on my training schedule that my goal was to perform the routine 2 times a week on Thursday and Sunday nights following my hard workouts and the long workoutsontheweekend.WiththisinformationIcannowstartfillingintherestofthechartto see what my routine will actually involve.

• ThefirstthingI’mgoingtodoisputabigXnexttotheanklebox.Basedonmyinjuryhistory, this is clearly my problem area, especially on the right side. If I’m pinched for time and can only get one thing in- it will be work on the right ankle.

• ThesecondthingthatI’mgoingtodoisputanXnexttotheproblemareasspecifictobeingatriathlete.ThismeansaddinganXnexttothehipandneck/shoulderboxes.Ialready have the ankle from my injury history.

• ThethirdthingI’mgoingtodoisputanXnexttotheproblemareasspecifictostandingalldayatwork.ThismeansaddinganXinthelowbackbox.Ialreadyhavetheankleandshoulder/neck on there.

This gives me four regions that I should be focused on. As I move down the planning sheet on tothewhitechart,I’mgoingtoputan“X”nexttoeachofthosefourregions.I’malsogoingtoputastarnexttotheankle.It’sprioritynumberoneforme.Ifyouhaveacommonproblem/injuryarea,putastarnexttoitonyoursheetaswell.

Once we have our regions picked, we can start moving to the right on the planning sheet. The firstthingyouwillseefollowingtheregionsaretheindividualmusclesyouwillbeworkingonfollowedbycolumnsforeachofthesixtechniqueswediscussedearlier.

Page 25: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

The Muscles

There are two columns of muscles on this chart. In the green column are the muscles that are most likely to get tired and stop functioning properly. When that happens, the muscles in the pink column are affected. Remember, muscles work in pairs. For each region, there will be a pair of muscles that you will need to work on.

The Individual Techniques

Earlier inthisguidewewentthroughthesixdifferenttechniqueswehavetochoosefrom.Technically we can break them down into three categories:

1 Self Muscle Massage (Foam Roller, Cross friction, Trigger Point)

2 Advanced techniques: Active muscle mobilization and Joint mobilization.

3 Stretching

Foreachregionthatyouhavean“X”nextto,youaregoingtoputanXinthefoamrollerandstretchingcolumns.Thesearemandatorycomponentsinyourroutine.Evenifthingsarefeeling great, you are always going to want to do these to monitor for problems and maintain normal mobility and function. This means that you will have to foam roll and stretch out both muscle columns.

This leaves the cross friction, trigger point, active mobilization and joint mobilization columns empty. If you have a priority area from prior injuries, I want you to put an X in each of those columnsforthatregiononly.Forexample,IhaveX’sallthewayacrossmysheetfortheankleregion.

What about the other regions? You can leave those columns empty. Since these are not your problem areas, you are going to monitor them versus attack with everything you have. At the minimum,youshouldalwaysfoamrollandstretchtheseregions.Ifyoufindsorespotsortheyare stiffer than normal, then you can use any additional techniques that you need to loosen them up. Some days, it might be an easy session. During periods of high volume/intensity, you mayfindthatmostregionsrequireadditionalwork.Playitbyear.Asyoubecomemoreintunewithyourbodyandlearnthesetechniques,you’llbeabletoeasilydecidewhatneedsextrawork and what doesn’t.

Page 26: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Here’swhatmysheetlookslikeallfilledout:

Sample Maintenance Routine:

Basic rules to remember

1 Always start with your #1 problem area. If you’re pinched for time and have to cut ther-outineshort,alwaysbesuretohitthisareafirstonyour problem side.

2 You want to do this stuff on BOTH sides, even if you only ever get hurt on one side and have never ever had any problems on the other side. That’s why we went through your sport and work histories.

3 Startwithoneregionandfinishitbeforemovingtothenext.Youwillalwaysneedtow-orkontwomusclegroupsforEACHregion.Iliketostartwiththemusclesinthepinkcolumn (the ones that have stiffened up) on both legs and then move to the muscles in the green column (the ones that caused the problem) on both legs. Once both muscle groupsaredone,youcanmoveontothenextregion.

4 At the bare minimum, you should be working your #1 problem area (this means using each technique in the chart) and then foam rolling + stretching the other areas using extratechniquesasneeded.

Page 27: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Walk through demo:

When doing my routine, I always start with the ankle region.

1 2-3minuteswiththefoamrollerontherightanteriortib+longtoeextensors(pinkcol-umn muscles). I’m looking for sore spots, knots and overall tension.

2 WhatdidIfindwiththefoamroller?Fromhere,Iwanttobreakoutthetennisballtodothe cross friction and trigger point techniques on the sore spots that I found. 2-3 minutes max.

3 From there I move onto the active and joint mobilizations. If things are under control and I’m feeling good, I may not need them, but because I know my ankle is a known problem, I’m going to try them anyway. 10 reps of each.

4 Once my soft tissue techniques are done, I follow it up with stretching. 3 × 20 second holds for pink column muscles (in this case, the front of my shin and top of foot).

5 Repeat steps 1-4 on the left side.

6 Once both legs are done, I can move on to the muscles in the green column- the large calf muscles (the gastroc and soleus). From here, I’m going to repeat steps 1-4 on both legs.

Oncetheankleregionisdonecompletely,Icanmoveontothenextregion.Thisiswheremyapproachchanges.Forthisexample,I’mgoingtomovetothehip.Remember,youwillneedto do this on both legs!!

1 2-3 minutes with the foam roller on muscles in the pink column (in this case the hip flexorsandadductors).ThereissomeinitialtendernessbutnospecificspotsthatIcanfind.

2 Since therewereno specific spots, I’m going to skip the cross friction, trigger point,active and joint mobilization techniques.

3 I want to follow up the foam roller work with stretching. 3 × 20 seconds for both muscles (adductors+hipflexors).

4 Once the pink column is done, I move to the muscles in the green column (the glutes andhipextensors).Firstup,2-3minuteswiththefoamroller.Turnsout,myupperham-strings are pretty tender even though I haven’t noticed any problems/stiffness in training.

5 I’m going to play it safe here. Break out the tennis ball and dig deeper with the cross fric-tion and trigger point techniques. That feels like it does the trick! Things loosen up and I’m going to skip the active and joint mobilizations.

6 Finish off the region with 3 × 20 second stretches.

Page 28: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Oncethehipregioniscomplete,Icanmoveontothenextregion.SinceI’mmovingupthechart,thatmeansthelowbackisnext.Remember,bothlegs!

1 2-3 minutes with the foam roller on the muscles in the pink column (the abs and hip flexorsinthiscase).Thingsfeelgoodandnotenderspotsfound.

2 No tender spots mean I can skip the deeper techniques.

3 Finish off the muscles in the pink column with stretching. 3 × 20 seconds.

4 2-3 minutes foam roller for the muscles in the green column. Turns out my back is sneaky sore and there are a few sore spots.

5 Break out the tennis ball and dig deeper with the cross friction and trigger point tech-niques. Still no luck.

6 From here I’m going to try out the active and joint mobilization techniques. For the low back, there are only active mobilizations so I’m going to use the tennis ball and perform 10 reps. That seems to do the trick!

7 Follow it up with stretching 3 × 20 seconds.

Last up is the shoulder region. This is the home stretch. Don’t get lazy-both sides!

1 2-3 minutes with the foam roller on the back of my neck and shoulder (muscles in the pink column). No sore spots and everything feels good.

2 No tender/sore spots mean I can skip the deeper techniques.

3 Finish off the muscles in the pink column with stretching. 3 × 20 seconds.

4 2-3 minutes with the foam roller for the pectoralis/chest (muscles in the green column). No sore spots and everything feels good.

5 Skip the deeper stuff.

6 Finish it all of by stretching out the muscles in the green column. 3 × 20 seconds.

[note*: if I found anything that was really sore and tender and I used all of the different tech-niques on it, I would try to follow up the session with ice on that area. 10 minutes is plenty.]

Sound like a long routine? It’s really not. The more you let this stuff get ahead of you, the more techniques you’ll need, and the longer it will take you to do. If you stay on top of it, the rou-tine, even with multiple joints and muscle groups, can be done in 20-30 minutes tops. If you arebattlinganinjuryorthingshavegottenthebetterofyou,expectittotakelongerthanthatand adjust accordingly to allow for healing!

Andthereyouhaveit,afivestepplantohelpyoumapoutyourveryownbodymaintenanceroutine.We’ve identified thewhat, thewhen,and thehow.We’veput itall together intoarepeatableplanthatisastimeefficientasyoucanget.Thereisonlyonepieceleftforyouto

Page 29: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

work on. You will need to learn how to perform the individual techniques. The good news is thatonceyoulearnthemandputthemtouse,theywillbecomesecondnature.Tofinddetailedinstructions simply go to the www.athletestreatingathletes.com website.

ClickontheIndex(BodyMap)tabatthetopandthenclickontheregionsyouwanttoaddtoyourroutine.Undereachregion,youwillfindablogpostwithpictures,instructionsandvideodetailing the three self massage techniques, as well as, videos for active release mobilizations, jointmobilizations,andstretching.Everythingyouneedisrightthereandreadytogo.Tohelpmake this process simpler, I’ve also included a cheat sheet in the back of this guide with the planningchartfilledinwithallofthelinksyou’llneed.

Please note, the Athletes Treating Athletes website is continually growing and adding new materialdaily.Thatbeingsaid,ifsomethingismissingasyouputthefinishingtouchesonyourroutine, stay tuned. It will be added.

Lastly, I want to include one additional and very important chapter in this guide.

Page 30: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Part Three

Your Backup Plan

Unfortunately,sometimeseventhebestexecutedplanscomeupshortintheinjuryworldandfor that reason, I wanted to give you some additional resources in the event that an injury does strike.ThefirstandmostimportantpieceofadvicethatIcangiveyouistoplanaheadandact quickly when stuff does happen. That doesn’t mean run to your PT/Chiro/orthopedic every time something hurts, it means don’t sit on an injury for weeks, train through it, and generally hope that it will go away on it’s own. You may luck out by doing that, but you’re more likely to shoot yourself in the foot and prolong your recovery.

Step One- Plan for the worst

Have you ever actually sat down and thought about where you would go if you blew a ham-string or snapped an a chilles?? Are there people that you already know and trust to treat you? Who do your training buddies see and recommend? Do you have an ame and contact info to reach them? Do you know how your insurance works and if these people are covered on your plan? Can you walk in off the street to see them or does your insurance require you to go through your primary care doctor? What is your plan if you don’t have insurance?

ThefirststepinhavingabackupplanistodoyourhomeworkandbuildwhatIcallmy“pitcrew”. These are the people I will go to if something goes wrong and I need treatment. It makes sense doesn’t it? If you spend weeks researching the car or bike you want to buy, why wouldn’t you do the same for the health care providers that will treat you? They are providing a service afterallandyouwanttobesuretheyaretherightfitforyoubeforeyouwastecopaymoneyandinsurancevisits.Thereareawidevarietyofskillsetsoutthereandtheonlywaytofindoutwhich ones are geared towards you as an athlete is to look. The nice part is that most health care practices now have websites listing the services they provide. If they don’t, call them or stop in to ask.

Here are the people in my pit crew and the phone numbers/contact info I have stuck to my fridge.

1 PCP (Primary Care Physician). In most insurance carriers, your PCP is typically the gate keeper to other healthcare specialists. They are able to evaluate and refer you to the appropriate professional. In the case of a sports related injury, you may be sent to an orthopedic for further treatment or to a physical therapist (PT) for treatment. They will be able to provide you with guidance for immediate symptom relief and any medica-tions/protective bracing/assistive device (i.e. ankle brace, crutches, etc). If diagnostics are required(x-rays,MRI,etc)theycanreferyouforthoseaswell.

2 Orthopedic. Anorthopedicwillspecificallyevaluatethesportsinjury.Theywillbeabletousediagnostics(x-ray,MRI,ultrasound)toassessformoreseriouspathologysuchas

Page 31: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

muscle/tendon tears, fractures, etc. An orthopedic will also be able to perform certain treatments such as cortisone injections, platelet-rich plasma treatment, etc. These treat-ments may vary from facility to facility.

3 Physical Therapist (PT). A PT will be able to restore mobility to an injured joint or mus-cle, perform modalities to decrease symptoms, assist with home treatment, and provide strengtheningandmobilityexercisestohelpyoureturntosports.Whatshouldyoulookfor in your therapist?? Make sure they are a manual therapist(meaning they do soft tis-sueworkversussimplyassigningexercises).LookforsomeonewhoiscertifiedinGras-ton or ASTYM. These are instrument assisted soft tissue techniques designed to break up muscle adhesions and restore normal mobility. They require that the therapist take classes and become credentialed to perform the. You should also look for someone who is credentialed to perform A.R.T. (active release therapy). This is another muscle release technique performed with movement to break up adhesions as the muscle is stretched. Eachtechniquehasawebsite(youcangooglethem)andatooltolocateprovidersinyour area.

4 Chiropractor. Contrary to popular belief, chiropractors are not all bone cracking and-manipulations. They are now specializing in sports injuries and most are also creden-tialedinGraston,ASTYM,ART,orcombinationsoftheabove.Eachtechniquehasaweb-sitefeaturing“providerfinders”.Besuretochecktoseewhoisinyourarea!Inadditiontosofttissuework,asportsspecificchiropractorwillbeabletoguideyouwithhomeexercisesyoucanperformbetweenappointments.

5 Massage Therapist. A licensed massage therapist will be able to help you dig out any tight muscles resulting from the injury. This is important as a PT and chiropractor may belimitedtoperformingspecifictechniquesthatarelocalizedtothesiteoftheinjury.Amassage therapist will be able to spend an hour working at the injury site and the rest of thelowerextremitywhereothermusclesmayneedworkduetoovercompensationdur-ing or from the injury. MT’s are also a great option for planned maintenance work follow-ing large blocks of training and on a pre/post race basis.

Step Two- Injury strikes. Now what?

When injurydoes strike, thefirst step is treat it on an acute (new injury) basis. For this,R.I.C.E.isstillthegotomethodforgradualonset/overusemuscleandjointinjuries.Ifyourinjury falls into the traumatic injury bracket, call your doctor. :)

1 Rest: This may sound obvious, but I’m going to say it anyway. An injured muscle/joint will require a decreased activity level to fully heal. The severity of the injury will deter-mine if this is a full rest or more of an active recovery.

2 Ice: while heat may feel better on stiff and sore muscles, ice only duringthefirst7daysfollowinginjury.Thiswillhelptodecreaseswelling,inflammationandpain.10-20minutesissufficientandyoucanperformeveryhourasneeded.Avoiddirecticetoskincontact.

Page 32: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

3 Compression: thankstotherecentexplosionofcompressionsleeves,tights,shorts,etc,you have several options in this department. Ideally you want something that is snug without being uncomfortably tight (think recovery tights if you’ve ever worn them).

4 Elevation: This is critical in the early days following acute injury where swelling may bepresent.Inthecaseofanankleinjuryforexample,elevatethelegsothatitisabovechest level. This can be accomplished by laying down and propping for your foot up on the arm of the couch with pillows.

Step Three- What about training?

Moreoftenthannot,thefirstquestionIgetisnot-whatdoIdotogetthisbetter?It’swhatcan IdoWHILEIget thisbetter?Toanswer thisquestion, Iput togetherachart thatwillhelp you grade the severity of your injury based on your symptoms, make appropriate train-ingmodifications,anddeterminewhatcourseofactionisbestintermsofmedicaltreatment.Think of it like a giant thermometer. The higher up you move on the chart, the more important action is and the more likely your training and racing will take a hit.

I can’t stress this enough- use common sense when using this chart. This is not all encompassing anditisnotdesignedtokeepyoufromyourhealthcareteam.Ifyouareexperiencingsymp-toms like numbness/tingling, swelling, scary dark/purple bruising,inability to stand/weight bear, lift your arm over your head, etc please call your Doctor. Not sure? Call your doctor. Better to be safe than sorry later when early treatment could have made a world of difference. That’s what your insurance is for.

Page 33: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Page 34: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Part Four

Thank you for reading!

We’venowreachedtheendofthisguide.Byreadingityou’vetakenthefirstandmostimpor-tant step towards protecting your muscles and joints and prolonging what will undoubtedly be a long and happy career in endurance sports.

Stick with it!! It will be very temping to fall off the bandwagon and forget about your body maintenance routine. The time it takes will become less as you do it and before you know it, the techniques and plans discussed here will be second nature. Taking the time to learn them and what feels normal in YOUR muscles and joints is the one of the best preventative things you can do for yourself.

Lastly, if you take away only one thing from this guide, let it be this-

You are in complete and total control of your body and how it works. Accept that and take care of it. You only get one.

Happy Training and see you out there!

Like what you’ve read here? Please. Share it with your friends and training partners.

Questions,feedback,orneedhelpfinetuningyourbodymaintenanceroutine???Feelfreetoemail me at [email protected] or join the discussion on Twitter or Facebook.

Athletes Treating Athletes is committed to building the one stop resource for athletes managing their current injuries and working to prevent future ones. This is a growing website composed of trained and licensed health care professionals. We hope you’ll join us for the journey to a healthier you.

Page 35: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Regions

Muscles likely to get tired + stop

working

Muscles that stiffen

up + restrict motion as a

result

Foam Roller, Cross Friction,

and Trigger Point Massage

Techniques

Active + Joint Mobilization Techniques

Stretching

Neck/Shoulder

•UpperTrap•MiddleTrap•LevatorScap•Lats•Rhomboids

•PecMajor•PecMinor•SerratusAnterior

Pink Column: Shoulder (anterior)

Green Column: 1) Shoulder (posterior) 2) Neck

Pink Column: Shoulder(Anterior/Front of)Green Column: 1) Shoulder(posterior/back of) 2) Neck

Pink Column: Front ofshoulderGreen Column: 1) Back of shoulder2) Neck

Elbow •Triceps •Biceps Pink Column + Green Column (same

blog post)

Same Blog Page:Upper Arm (Bicep/tricep)

Pink + Green Column (sameblog post)

Wrist/Hand •Wristextensors

•Wristflexors

Pink Column + Green Column (same

blog post)

Same Blog Page:Forearm/Wrist

Pink + Green Column (sameblog post)

Low Back •Longbackextensors

•Abs•Hipflexors

Pink Column: Anterior Hip

Green Column: Low Back

Pink Column: Hip (anterior/front of)Green Column: Low Back

Pink Column: Anterior HipGreen Column: Low Back

Hip •Glutes•Hipextensors

•Hipflexors•Adductors

Pink Column: 1) Anterior Hip 2) AdductorsGreen Column: 1) Posterior Hip 2) Posterior Thigh

Pink Column: 1) Hip (anterior/front) 2) Adductors/Inner Thigh/GroinGreen Column: 1) Hip (posterior/back of) 2) Hamstrings

Pink Column: 1) Anterior Hip 2) AdductorsGreen Column: 1) Posterior Hip 2) Posterior Thigh

Knee •Quads •Hamstrings Pink Column: Posterior Thigh

Green Column: Quads

Pink Column: HamstringsGreen Column: Quadriceps/Thigh/Knee

Pink Column: Posterior thighGreen Column: Quads

Ankle •Gastroc•Soleus

•AnteriorTib•Longtoe

ext.

Pink Column: Anterior/lateral lower leg

Green Column: Calf

Pink Column: Shin/outer lower legGreen Column: Calf

Pink Column: shin/outerankleGreen Column: calf

Foot •Toeextensors •Toeflexors•PFascia

Pink Column: Bottom of Foot

Green Column: Anterior/lateral lower leg

Pink Column: FootGreen Column: Shin/outer lower leg

Pink Column: Foot/PlantarfasciaGreen Column: shin/outerankle

Links to Massage, Mobilization and Stretching Blog Posts

Page 36: Building Your Body Maintenance Routine Final

Build

ing Y

our B

ody M

aintena

nce Routine

ww

w.A

thle

tesTre

atin

gAth

lete

s.c

om

Mus

cles

that

stiff

en u

p +

rest

rict m

otio

nas

a re

sult

Mus

cles

like

ly to

get t

ired

+ st

opw

orki

ng