2.10.2010

Psychic Therapist Predicts Diagnoses

Step right up. Hear from a real live physical therapist who can see the future!

[Initiate wavy dream transition sequence.]

Oh yes. Yes, there it is. I see you there, my friend. You're on the sofa. I'm getting a strong sense that your muscles are not strained. You have some typical aches and pains, but nothing major to speak of right now.

I see you rising up off the sofa. Now you're signing your name and address on a piece of paper - it's a roster! You're outside enjoying the fresh spring air as you stretch. You're going easy at first, jogging a little, laughing with the guys, doing big arm circles and other random things you did back in the day.

Wait. What's this? Good news - I see that you hit a shot to right center field. It's a close game and you're going to stretch an easy double into a triple. You're rounding second in an all out sprint. Oh. Oh no.

You turned back. I see you standing on second base, right hand grabbing your butt, left hand motioning toward the bench. I hear it. The word designated runner comes to mind.

I see you back on the sofa.

- - - - -

Mark my words. The time is near when this prophecy will come to pass.

I just hope it's not me.

Every sports medicine/rehab guy gets asked what to do about strained muscles at least four times per year. Hamstrings groan, hip flexors scream, and achilles tendons rupture. With each new season comes a new wave of folks hobbling around because they didn't read up at wellduh.com.

Oh imagine that: you got hurt running as hard as you can. When was the last time you did anything as hard as you can? Did you shovel snow or vacuum or grill burgers with 100% all out physical effort? But now your tendons and muscles that have sat around most of the year or maybe did some bench pressing and (submaximal) cardio at the gym are magically supposed to hold up to extreme demands.
Aw, don't feel bad. A few of my best friends who are doctors and therapists and former pro ballplayers have recently fulfilled this prediction. One friend who (distance) runs competitively suffered a pretty severe strain when sprinting in flag football. And yes, this big mouth therapist has suffered with it too.

What can you do other than just stay on the couch? Before we get into treatment for strained muscles, lets talk about the best treatment strategy around: not straining them in the first place.

Stretching before activity does not prevent strained muscles (1). Neither does massage, E-stim, IcyHot, or anything that the guy at GNC tries to sell you (2). Warming up properly does help a little. The older you are and the more strains you've experienced in the past, the more likely your chances of fullfilling (something like) my vision of the future (3).


The ONLY thing that has been proven to prevent muscle strain is functional eccentric strength training(4). Sure, you do need to stretch your back, ankles, and hips against the tightness that develops from hours and hours...and hours of sitting. But you need more than stretching and jogging before the game.

I don't think we need hard data to support the idea that if you plan to run hard, you need to prepare your body to run hard. That means weight training and a gradual build up of form running with interval sprints. You don't need to sprint until you puke. A light warm up then 5 to 10 sprints is quicker, less boring, and pays far bigger dividends than going for a random jog.

Yes sprint. I don't want to hear about how old you are. You have to be smart about it. But if you want to keep living well after twenty, you're too old not to run hard.

Six to eight weeks of the right strength training and progressive sprinting, each done once every five days or so, is a realistic timetable if you want to escape from the wiles of the couch and survive church league softball.
And think of the implications of proving my psychic skills wrong. Think of being able to actually changing the future.

1. Anderson K, Strickland SM, Warrn R. Hip and groin injuries in athletes. Am J Sports Med 2001; 29:521-23.

2. Orchard, JW. Instrinsic and extrinsic risk factors for muscle strains in Australian football. Am J Sports Med. 2001;29:300-03.

3. Heiderscheit, BC, Sherry, MA, Silder, A, Chumanov, ES, and Thelen, DG. Hamstring strain injuries: Recomendations for diagnosis, rehabilitation, and injury prevention. J Orthopedic Sports Phys Ther. 2009;40:67-79.

4. Brooks JH, Fuller CW, Demp SP, Reddin DB. Incidence, risk, and prevention of hamstring injuries in professional rugby. Am J Sports Med. 2006; 34:1297-306.

1 comment:

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