Tag Archives: CEO Robert Forster

THE NUMBER ONE REASON TO STRETCH

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BY CEO ROBERT FORSTER, PT

We know stretching is good for us, so why do we avoid it like the plague? Maybe you just don’t know that stretching is its own workout, and provides performance benefits way beyond your sport. Maybe you’ve convinced yourself that you don’t have time to stretch, and you would rather grab a cup of coffee instead. Bad Idea.

Stretching is valuable; it’s essential, and delivers benefits beyond simply preparing your body for exercise or addressing issues of safety and performance. Here is the number one reason you need to stretch: It keeps you young.

It’s critical to prioritize muscle length as much as strength, so exercising to build muscle, improve posture, eliminate joint pain, or to increase your metabolism is only half the battle.

To lengthen muscles that have been shortened over time through a breakdown in posture, immobility, injury, disease, and the constant pull of gravity you must concentrate on connective tissues called fascia.

Fascia is fibrous connective tissue that wraps and supports muscles, bones, tendons, ligaments, organs, nerves.

When we get injured or engage in repetitive actions that don’t have much variety in range of motion, our body may over time develop excess fascia between muscle tissue.

This fascia wraps healthy tissue much like a spider wraps it’s prey in a web. The result is compromised range of motion, cross-linkages, and fascial adhesions. Adhesions restrict our movement and create tension that is unnecessary and dangerous to our joints and muscles. Adhesions increase the likelihood for fascial restrictions which have the capacity of creating up to 2,000 pounds of pressure per square inch. This intense pressure compromises our youthful physiology and results in chronic pain, and joint dysfunction, and imminent injury.

Many stretching therapies address the elastin fibers of connective tissue; but what we have found by working with elite athletes is that those therapies must also address fascia at deeper levels to alter the fascia substance and construction.

To melt or break apart the adhesions that age the connective tissue, stretching and massage are critical.

For this reason foam rolling, self massage, AND stretching techniques together, lead to lengthier muscles, pain relief, and a more permanent change within the fascia for younger healthier pain free movement. Forster Training System Pro Self Massage Roller was designed to not only massage muscles before and after exercise, it was developed with special gears, much like a therapist’s fingers to work across fascia, breaking apart scar tissue to repair muscles and increase circulation. Purchase your FTS massage stick, or find one sold exclusively at Forster Physical Therapy or the PHASE IV center in Santa Monica.

Next time you are tempted to skip your stretching for that cup of coffee, think twice and always choose stretching first!

For more personalized stretching, get STRETCHED at PHASE IV, call for your appointment and ask for the

PHASE IV (3) PAC STRETCH LAB

STRETCH LAB INCLUDES:

A head to toe Postural and Structural Analysis with a Physical Therapist, and 2 Training Sessions to learn advanced stretching and foam rolling techniques to keep your connective tissue and your joints pain free, heathy, young, strong, and flexible at any age! $199 (for a limited time)

Call 310-582-8212 or visit PHASE IV Santa Monica 1544 20th Street Santa Monica, CA 90404

WHAT IS A SPORTS HERNIA

This week’s client testimonial is from one of our Forster PT clients. He is a middle aged competitive power lifter who suffered a catastrophic groin injury, some times called a sports hernia. He was told his condition would require surgery to heal and allow him to return to weight lifting at his previous performance level. By directing treatment to the exact location of the injured muscles and providing some immediate pain relief without surgery we convinced him that his injury was 100% fixable with a smart PT program. For me and my staff Paul became the model client who follows all our rehab directives and proves our treatment paradigm works. Read of his triumphant return to power lifting below.

What did Paul hurt? There is a relatively new name for groin pain in the sportsmedicine lexicon: sports hernia. It seems the necessity to create a new name for a common athletic injury speaks to a current lack of understanding among clinicians for this difficult-to-treat injury. The confusion starts with the name. This newly popularized term “sports hernia” does not fit the common definition of a “hernia,” where an organ or soft tissue is poking through a break in the abdominal muscle wall.

The new trend is to lump all of the injuries that present pain in the lower abdominal area and/or the top of the inner thigh, together and and mislabel it a hernia.

These injuries are common in sports where sudden starts, stops, change of direction, or traumatic falls and accidents occur. The injury is sustained in one muscle; but when left unchecked, it leads to the break down of surrounding structures.

The key to resolving this mislabeled condition is to find, through careful physical examination, the exact location of the muscle injury, and treat it before there is a more extensive weakening and break down of the surrounding injuries. If the damage has already spread to surrounding muscles because the athlete continued to participate in the sport while their injury was misdiagnosed and/or mistreated, then treatment must include all damaged tissues.

The approach to treating these injuries is really no different than any other muscle injury; and I suspect it is only mistreated because clinicians lack the palpation skills, patience, or knowledge to find the exact injury site. After careful testing and palpation the inflamed area is located and treated for inflammation, then for scar tissue, and advanced through stretching exercises and re-strengthening. The critical path to resolving these injuries and preventing reoccurrence is to treat the whole athlete by correcting muscle imbalances, leg length discrepancies, and alignment issues for a successful return to sport, better than they were before!

If you have a tough injury give us a call and we will sort it out. 310-656-8600

LATERAL KNEE PAIN AND THE ILLIOTIBIAL BAND

By CEO Robert Forster, PT Author: Healthy Running Step by Step, The Complete WaterPower Workout Book

Pain on the outside of the knee is one of the most common complaints from marathoners we see as they build up the mileage in training.

The usual culprit is excessive friction between the thick band of fascia on the outside of the thigh called the Illiotibial band, and the bump at the end of the thighbone (femur).

In most cases, the pain is in one knee and not the other. This begs the question: why would only one knee hurt if both legs ran the same mileage? The answer, as in all one sided “asymmetric” marathon overuse injuries, a mechanical deviation in the pelvis on the injured or non injured side of the body.

Most often, the cause of IT band syndrome is a pelvic misalignment, causing a functional leg length discrepancy. When the pelvis is unbalanced, the joints of the “short” or “long” leg will make adjustments to compensate in an attempt to level the pelvis.

Typically, the foot on the long leg side will over-pronate as a strategy to flatten the arch and functionally shorten that leg while the foot on the short side will typically supinate in an attempt to hold that arch up and functionally elongate that leg. Either of these subtle but significant compensations will cause aberrant forces to bear down on the vulnerable tissues on the outside of your knee.

An effective rehabilitation program must not only treat the painful area, but also address the cause of injury by exposing and correcting the mechanical imbalance at the pelvis.

Anatomy and Function

The Illiotibial Band is a thick band of fascia that extends from the pelvis down along the outside of the thigh to attach below the knee on the outside of the lower leg bone called the tibia. The IT Band functions to stabilize the thighbone and knee during the weight bearing “stance” phase of the running or walking gait; and helps guide the lower leg as it swings forward through the air in the swing phase.

Just before foot strike, the illiotibial band slides over a bony prominence on the outside of the knee called the Lateral Epicondyle. This irritates a structure called a bursa (a fluid filled sac much like an internal blister that is supposed to be there) which is designed to prevent friction between the bony prominence and the illiotibial band.

Pain Presentation

Illiotibial Band problems may also present at the top end of this broad band of fascia running along the outside of the thigh. Either at the top, where it originates on the outside of the pelvis; or much more commonly, at the lower end at the site of the bursa on the outside of the knee. This lower IT Band pain tends to appear suddenly on a run and it often becomes so severe you have to limp or stop the workout and walk home.

While it does not represent a high degree of damage to the bursa or the IT band, it can be one of the most painful conditions runners suffer and it will stop you in your tracks.

If you ignore the pain and continue to run, the pain will progress to daily activities including stairs, squatting and pivoting. At the top of the IT Band, where it attaches to the outside of the pelvis bone; the pain can come on more gradually and is typically much less intense, but can be equally as persistent. Pain in either the top or the bottom should never be ignored because they can be very stubborn and difficult to resolve if you run through the pain for any period of time.

The pain typically limits your workouts rather quickly before it can cause significant damage to the bursa or the illiotibial pain. However, if pain causes you to limp or alter your gait in an effort to limit the pain, you are likely to cause excessive stress on other structures and cause additional, potentially more damaging injuries.

Rehabilitation

Alleviating marathon-training injuries requires the right treatment to the right structures. The first step in any sports rehabilitation program is to first get an accurate diagnosis. Most often, lateral knee pain in marathoners is an IT Band syndrome, but it is critical to rule out a meniscus cartilage tear and tendon injury before settling on a diagnosis.

The primary approach to all IT Band syndromes is to address the inflammation and pain at the injury site while simultaneously working to limit the amount of pronation in the foot when you run. Ultimately, this involves correcting leg length inequality with stretching and strengthening exercises. This takes some time but improving running gait mechanics can immediately start to reduce the pain.

Summary

Lateral knee pain needs to be evaluated immediately to rule out problems in the joint itself. Local icing and PT treatment at the painful site will help, but ultimately we need to address the leg length discrepancy for total resolution of the problem. We will teach you stretching and strengthen exercises to correct your alignment and work with you to improve your running mechanics.

Call Forster Physical Therapy for your free evaluation: 310-656-8600

Remember, California law allows you to go directly to Forster PT without first seeing a doctor for a referral.

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