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One of the main keys to full functional rehabilitation is the removal/reduction of scar tissue from the soft tissues of the body.  We provide expert manual therapy to clients during rehabilitation to speed the process and obtain more lasting results.  Understanding the different ways scar tissue affects your body is important.

The body moves when muscles get longer and shorter.  To do this they slide past other muscles, nerves, blood vessels, and other connective tissues.  When this happens the joints are controlled correctly in their axis of rotation.  However, scar tissue can form:

• IN a Muscle -
  • Preventing the muscle from getting as long or short as it needs
  • Symptoms: Weakness, Reduced range of motion
• BETWEEN two Muscles
  • Preventing the muscles from sliding past each other
  • Symptoms: Weakness, Reduced range of motion
• BETWEEN Muscles and Nerves
  • Preventing the nerve from sliding easily
  • Symptoms: Numbness, Tingling, Burning, or Aching
• BETWEEN Muscles and Blood Vessels
  • Preventing proper blood flow into the muscle or to other tissues beyond the area of restriction
  • Symptoms: Muscle fatigue or exhaustion, Swelling
• IN Joint Structures -
  • Preventing proper movement of a joint
  • Symptoms: Pinching, Catching, Fullness, Swelling, or “Giving way” of a joint.

By using our hands we can feel the restricted tissue.  By using the movements of your body and pinning the scar tissue we can break the tissues free so that muscles get longer and shorter, slide past other muscles, nerves and blood vessels slide freely, and the joint is properly controlled.  This results in reduced symptoms and greater strength/movement control.

This video is an explanation of what soft-tissue restriction looks like in a real body and a great explanation of what happens when we “rest” an injury too much.  The speaker is an Anatomy professor and educator of many great manual therapists.

Healthy tissue and a functional movement system require a few things: 1) Healthy movement 2) Rest from that movement 3) Nutritional quality, quantity, and type that maximizes your body’s hormonal responses.

I title this as a Recommendation/Requirement because I cannot change one’s dietary choices.  Only the individual can.  You will make progress on your health, injury rehabilitation, and fitness without dietary change however to maximize your progress under my program, I require you follow the guidelines I lay out below.

There are specific qualities of food, quantities of food, and types of food for your body to:

• Maximize tissue healing
• Rebuild muscle, tendon, ligament, and cartilege
• Burn body fat
• Optimize energy levels
• Recover from workouts

The specifics shift from person to person, and may vary through the rehabilitation process.  For this, I offer individual counseling.  However, I lay out the basics below for anyone to begin to apply.

• Eat real, whole, local food
  • We are not meant to eat food products manufactured in a factory and packaged to be sat on a shelf and picked up weeks to months later for consumption.  Eat foods that exist naturally in the environment and were grown ideally within 100 miles of you.  Find your local farmer’s market and this will ensure freshness and maximize its ability to heal you.
• Balanced proportions of meat, nuts, seeds, oils, veggies
  • There can be too much of a good thing.  Again, proportions may vary by individual but a rule of thumb follows: Have a meat at each meal that is the size of your palm.  Put this on a bed of varied vegetables and top the dish with nuts, seeds, or the cold pressed oils of them.
• Monitor fruits and roots
  • Fruits and root vegetables (potatoes, carrots, beets, parsnips, etc) can cause an increase in the hormone insulin.  Insulin will cause your body to store fat and sugar, thus not allowing you to remove body fat.  Reserve fruits and roots for certain situations and find counseling for when to add them to your diet.
• Remove grains
  • Grains have an anti-nutrient capacity.  Similar to exposure to poison ivy, your body will have an inflammatory reaction in the gut when exposed to these anti-nutrients.  Levels of inflammation differ by person in severity and frequency, but are inevitably a stress to your system.
• Keep quantity to sustain energy
  • A good diet should provide consistent balanced energy.  Waxing and waning of energy levels through the day and from week to week are evidence of poor diet.  Eating too much or too little can slow down your system.  Monitor amount of intake along with quality, type, and proportion to maximize energy.

The basics are as follows: Eat meat, veggies, nuts and seeds.  Monitor fruits and roots.  Avoid grains.  Below I offer a day of menu choices.  Menu is taken from “The Paleo Solution” by Robb Wolf.  He is a fantastic speaker and author and I highly recommend you purchase his book for your collection.

Breakfast: Ginger Eggs

• 1 tsp chili oil
• 1/2 cup green beans
• 1 tbsp minced ginger
• 1 small clove garlic, minced
• 3 eggs
• 1 tbsp chopped chives or green onions
• 1/4 tsp coriander
• pepper to taste

Heat the oil in a small skillet.  Add the green beans, saute’ for 2 minutes.  Add the ginger and garlic, cook 3 minutes more.  Meanwhile, crack the eggs into a bowl, whip well.  Add the beans, ginger, and garlic, plus the chives and coriander.  Mix well, then return to the skillet.  Cook until the eggs set.  Serve topped with fresh ground pepper.

Lunch: Smoked Turkey Salad

• 10 oz smoked turkey
• pile of mixed greens from local market
• 1/4 cup pine nuts

Mix and eat.

Snack: Hickory Nut Gap beef jerky with macadamia nuts

Dinner: Chicken and cauliflower

• 1 tbsp olive oil
• 1 1/2 lbs chicken breast or thighs
• 1 head of cauliflower
• 8 oz tomato sauce (check for Earth Fare Organic for no additives, if you make your own, even better)
• 1 red bell pepper
• 1 tsp cumin
• 1 tsp thyme
• 1/2 tsp garlic powder

Heat the olive oil over medium heat in either a large skillet or soup pot.  Brown the chicken on all sides.  Meanwhile, chop the cauliflower into small pieces and add to the pot.  Add all of the remaining ingredients to the pot, then reduce to medium-low.  Cover and cook for 45 minutes, stirring occasionally.  Makes 5 servings.

Feel free to ask any questions in person or through email.

Steak salad w/nuts, seeds, tomato, okra & leeks coated w/egg&almond meal, golden kiwi and salsa

As fall and winter approach, some runners tend to choose the indoor comfort of treadmills over toughing out the weather.  However, consistent treadmill running will ruin your stride.

First, the history of treadmills:  They were designed for cardiac rehab patients to be able to move slowly in the close safety of monitors and medical personnel to monitor their progress.  These patients could walk on the treadmill for distances but not move anywhere, allowing their ECG machine to stay in place and watch their progress.

Running vs. Walking: Running and walking are two different movements for two different purposes.  Walking was designed to carry us for long distances sparing lots of energy in order to be efficient.  When walking the lead foot grabs the ground, pulls the body forward, pushes out the back and the next foot repeats the process by grabbing the ground.  Running was meant to take us less total distance but at a much faster pace.  It does this by sparing impact on the bones and joints and loading the musculature as a shock absorber.  Instead of the feet grabbing the ground and then pulling and pushing the body, it absorbs the downward force of a fall repeatedly.  Running is a forward lean where the center of gravity moves in front of the foot and we fall forward; the leg absorbs the impact of the fall.  If we are still leaning forward we repeat the process with the other foot.

"Putting a child on a treadmill should be considered abuse"

When walking becomes running:  This process is known as jogging.  Distance running is meant to be a slowed down sprint, not a sped up walk.  Jogging is when the mechanics of walking are sped up to a “running” speed.  This is not a safe movement because the musculature is not loaded enough to absorb impact.

No running on a treadmill: No matter how “fast” the belt is spinning on a treadmill, it is impossible to run.  This is due to the forward lean necessary for a run.  If we lean forward on a treadmill we run into the monitor.  As such, we stay upright and move our legs to the timing of the belt known as jogging.  These mechanics are nothing more than the mechanics of walking.

Training benefit of a treadmill: Your heart rate will rise because you are working to move your muscles and you need blood flow to increase energy supply.  However, you will not improve your running significantly.  Muscles and movements are only improved when done correctly; running on a treadmill correctly is a mechanical impossibility.

In summary, treadmills were designed for cardiac rehab patients to walk and increase heart rate safely.  Running, and improving your running, is not possible.  This winter, brave the weather to improve your running, but don’t expect a treadmill to help.

This is part two of an educational series about active and passive connective tissues and their ability to move: your flexibility.  In Part I we addressed WHY flexibility was important, and the two factors limiting your flexibility.  Today we will address one of those limits in depth, how it occurs, why it occurs, and how to deal with it.

Neurological restriction is a term given to the amount of tension in the muscle that can be released reflexively and immediately. The way a muscle creates tension (in essence, shortens) is by a signal from your brain telling it to shorten or lengthen.  This can be something controlled by the conscious mind or can be automatic like a reflex.  When this tension limits your range of motion, it is termed neurological restriction.

“I’m so stiff from those squats on Friday.”  Ever notice that after a good workout you feel stiff and maybe a bit sore?  That is neurological tension and it is an example of your nervous system’s limit to your flexibility.  In a workout your body creates a small amount of damage to the muscle tissue.  In order to deal with this, your nervous system tightens down the surrounding muscles to aid the healing process and prevent further damage.  This increase in tension “protects” the muscles, and as suchneurological tension can be termed protective tension.

The stiffness and soreness of your muscles after a workout is termed delayed-onset muscle soreness (DOMS).  However, DOMS is only one mechanism of protective tension.  There are actually three methods to develop protective tension:

1)      Protecting weakened muscles – Not only does the tension that occurs in the days following your workout protect your muscles, it can do so DURING a workout.  Ever feel like you’re unable to squat any deeper and the coach is saying “ALL THE WAY DOWN”?  That is because your muscles are tiring and neurological tension is stopping your range.  At this point, you must rest the tired muscles, if even for a brief moment, and then return to the activity.  Continuing exercise through a shorter range will not improve your strength through the full range.

2)      Protecting damaged joints – Either when a joint is not sitting properly at the center of its axis of rotation, or part of the joint is injured, your body will tighten the muscles to limit joint range of motion.  This is also termed “splinting”.  This is less applicable to your daily training, but if you ever notice an injury to a joint, you will also notice the increase in tension of the muscles around the joint.  Now you can be aware.

3)      Protect nerve tissue – Nerves need to slide between muscles throughout a movement.  Sometimes they can become adhered or scarred to the surrounding connective tissue and do not slide.  As such, when the movement creates a pull on the nerve your muscles will contract to limit the movement and therefore limit the pull.  If you continue to pull on the nerve it can result in neurological symptoms like numbness, tingling, weakness, or sharp/burning pain.  This can also be the cause of injuries like sciatica and carpal tunnel syndrome.

These are the ways that protective tension develops.  Now you need to know how to deal with it on a daily basis.

1)      Warm-ups are a way to reduce some of that neurological tension.  Especially with day to day training, a warm-up is imperative to alleviate a lot of tension and soreness.  By warming up you increase blood flow and reduce a small amount of the protective tension and your body is able to get into certain positions easier and without compensation.  If the warm-up for your workout does NOT alleviate the tension, you either need another day to recover or you have more serious joint/nerve damage and should consult a professional.

2)      You should not “get tight” in the middle of a workout.  This is a serious warning sign that more serious damage is about to occur.  If an area is tight during a workout, be sure to seek help from a professional.  If you are a CrossFit Asheville member, this is a definite time to inform the coach of the situation and then set up a CFA Triage appointment with the Stay Active Clinic.

3)      Decreases in ANY stress will decrease overall tension.  If you’re not eating/sleeping/thinking well you will increase and prolong daily protective tension from training.  This means you need to eat/sleep/think better.

4)      Hold yourself to functional Range Of Motion standards.  We, as coaches at CFA, spend much of our time ensuring you reach full ranges and you must do the same.  Muscles only get strong through the range they are used.  A more shallow squat does not strengthen that deeper squat.

5)      Foam rolling, lacrosse ball work, and mobility drills (as done in many of our warm-ups) are excellent at reducing protective tension on a daily basis.  Use these as tools for recovery.  Basically, a tangential force (pushing into the muscle from outside) will cause a reflexive relaxation of that muscle… this is the function of the foam rollers and lacrosse balls.  A relaxing spa massage will do the same thing, but that is far more expensive and difficult to fit into your schedule.

You will battle the first type of protective tension on a daily basis when training.  This is simply a physiological fact and must be obeyed to achieve optimal success.  Doing so will limit your acquisition of certain mechanical tensions (adhesions, scarring).  A more in depth look at mechanical tensions and the relationship to protective tensions is to come.

For Part III click here.

In addition to running the Stay Active Clinic, I am the beginner program director of CrossFit Asheville.  The following post and the follow-ups to come were originally written for CrossFit Asheville.  Follow the link to see questions/answers/comments related to the article:

I am often asked, “What should I do for workouts?”  My basic answer is “something that achieves your goals”.

I write workouts for specialized athletes as well as general fitness athletes.  For specialized athletes my objective is based on what movements they need for their competition and other movements they need for health is supplemental.  For a White-water kayaker he needs explosive pulling with the arms and shoulders with a well timed propulsion of the hips.  Dynamic pullups are a fantastic way to achieve this.  Though a kayaker does not push I program some pushing activities to avoid overuse injury.

The general fitness individual however is looking to improve their lives… make their everyday activity easier.  For this I typically do not need to focus on certain movements, but instead need to take a broad scope understanding of what their daily activities are.  This equates to a few necessary ideals that each individual should take into account for their movement health.

1) You must lift, squat, push, pull, run and jump.  These are the basics of human movement and you MUST engage all of these to be healthy.  No amount of “machine” workouts will give you the health incurred by these movements.  Has someone told you not to squat or jump because they are bad for you?  Not true… you just need to do them correctly.

2) Move slowly for long periods of time.  This is something I cannot help you with and is just something you need to do.  Whether swimming, biking, or hiking it needs to be slow, easy, and of significant distance.  Notice I did not say “jog”.  In another post I will discuss why jogging is terrible for you.

2) Move heavy things.  You MUST move heavy things.  When something is heavy, we use a greater percentage of muscle tissue.  This is NOT possible lifting something light a lot of times.  ONLY lifting heavy will allow you access that portion of muscle.

3) Move fast for short periods.  This goes along with lifting heavy things.  By moving fast we access more muscle tissue which is not the same as moving slowly for long periods.

4) Do the above through your fully accessible joint ranges along multiple planes.  This is VERY important.  By avoiding your normally available ranges you tighten joints and muscles.  Now, when your life NEEDS that further range your body has to find a compensatory way to move which leads to injury.

5) Do this correctly.  Old injuries, sustained postures, and repetitive movements will lead to restictions and compensations in movement.  Any of the above causing you discomfort is NOT reason to stop them, but instead reason to do them BETTER.

To summarize: Lift, squat, push, pull, jump and run; move slowly for long periods; move heavy things; move fast for short periods; do this through full ranges along multiple planes.  If you are not doing all of this, or any of it causes you pain, your movement is not healthy.

I was inspired for this blog post because I bought a pair of socks.  Why would my new Fruit of the Loom Sport Crew socks inspire a post about arch support?  I was disgusted to see a new feature of the socks: Arch support.  What about socks could possibly lead to support of the entire weight and control of your body?  Nothing.  However the marketing department at Fruit of the Loom has decided to jump on the band wagon of products that propose to aid your arches.

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Sigh...

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A commonly diagnosed problem is “low arches” “flat arches” or “pes planus”.  This is the assumed cause of foot pain, back pain, knee pain, and other conditions in many individuals.  The solution?  Push it up with a piece of fabric, foam or plastic called an orthotic.  The question is never asked “why has that arch fallen?”

Your foot is a series of arches (not just the one on the inside of your foot) that work as shock absorbers.  This is done with the help of your lower leg, thigh, and hip muscles.  The arches are supported like a marionette by muscles around the calf with tendons that run down under each arch like a sling to control it.  Being small muscles they can only work well when put in the proper position.  Muscles of the hip control the rotation and placement of the foot which allow proper contraction of the arch supporting muscles.  Weakness, poor control, and tight areas can influence the middle arch to fall and the outside arch to tighten up.  As a result, when the leg moves with walking, running, or jumping the middle arch drops more than necessary and changes the mechanics of the entire foot, knee, and hip.

Why has that arch fallen? It is NOT the lack of an orthotic.  It is poor movement control of the hip, knee, ankle and foot.  When people tell me they have poor arches they don’t need better shoes.

They need better arches. How do you achieve this?

• You need myofascial release methods to loosen the areas of muscle and ligament that have become restricted.
• You then need to re-examine the way you move (lift, run, jump) to re-establish your natural arch support.

When you attempt to mask the muscle tensions and poor movement patterns with an orthotic or different shoe you simply mask the problem and set up an environment to further weaken the situation.  In my opinion, effective strength/conditioning programs with myofascial release methods are your most effective way to regain control of your arches.

A description of how movement abnormality leads to IT band pain and how our clinic identifies and removes it.

IT band syndrome in distance runners

The basic mechanics of tendinosis are applied to all the common areas: Patellar, Achilles, Plantar fascia (bottom of heel), Proximal hamstring (sitting bone), Shoulder, and Elbow.  Our analysis, treatment, and rehab can help all of these areas and others.

Patellar Tendinosis in a Distance Runner

Chiropractic theory is based around healing the whole body.  This article is a brief description of wellness and how our clinic approaches this in a unique manner.

Chiropractic was started over 100 years ago in Iowa by DD Palmer. The original premise was that the human body had the ability for health and could heal itself with the building blocks to do so. Wellness is care that supports the optimal capacity for health; To thrive instead of survive! Toxic environmental factors like processed foods, sedentary lifestyle, and negative thoughts limit the healing capacity. The chiropractor serves as an assistant to optimal health.  Reduction of a toxic environment (physical, chemical, and emotional) prevents sickness before it develops and this is Wellness Care.  Since that time there have been many diverging beliefs on how a chiropractor can assist a patient.

My definition of health is your ability to do anything life requires, anything you desire, and survive without issue.  Ever wonder why some people can go on long hikes with no effects and others get worn down just walking a mile or two?  Health.  Ever wonder why some individuals can be in a room full of sick people and never get sick?  Health.  Ever wonder why some people can play with their kids and not have an issue but others wind up injured?  Health.  In my practice I watch hundreds of people improve their ability to do anything:

• Mother’s with a history of spinal surgery and inability to play with their children improve strength and safety and play with them again!
• 60 yr old men who can’t get both feet off the ground at the same time can now jump on an 8″ box repetitively.
• People get off medications for diabetes, cholesterol, osteoporosis, and auto-immune disorders.

Health, that was once declining, is now rocketing towards their genetic potential!!

At The Stay Active Clinic we believe wellness is simple, just not always convenient. One must follow the three premises below which are basic, but not the easy route in today’s culture.

• You must be active in many different ways. When something is alive we say it is animated, animation is movement, movement is life. You must move slowly for long periods of time, lift heavy things, and move quickly for short periods of time while frequently utilizing a full range of motion.
• Your diet must consist of real, whole foods. Both animal products and plants are necessary for a balanced diet. They will provide you with all the macro nutrients (proteins, fats, carbohydrates) and vital micro nutrients (vitamins, minerals, phytochemicals) for sufficient energy, a strong immune system, mental peace and happiness.
• Mental balance and stress reduction requires a change in perspective. Mental stress is not what happens to you but your reaction to the event. Short-term stress is not a problem. Sustained “worrying” over things you cannot change creates a chronic, measurable physiological event that depresses the immune system and increases your risk for diseases like cancer, heart disease, stroke, Type – II Diabetes, and a litany of auto-immune disorders. The following statement best describes how to control your mental stress: Have the courage to change things you can, the discipline to let alone things you cannot, and the wisdom to know the difference.

The nervous system is a primary component in health.  It is the system that has control over other systems.  Many chiropractors choose to focus on it and have great success that way.  My belief, however, is that we must address the entire movement system, not specifically the spine.  I’ve found that spinal health is as much dependent on the strength and range of motion of your arms and legs as it is of your spine itself. Playing with your children, helping a friend move, and getting off the toilet at 80 years of age are closely related to not just spinal strength, but full body functional strength.  That is why my program incorporates ALL of the body parts and seems a bit different from other chiropractors.

At The Stay Active Clinic we encourage our patients to follow the three premises above and take an active role in their own health. The original meaning of “doctor” was “teacher”. Our job is to teach you how to care for yourself in the long-term.

Your success is largely dependent on your ability to learn about your own body, and we can teach you that. Our services help to keep you out of pain and moving efficiently so premise #1 is maximally effective, but without utilizing the other two you will not be well. Through the course of care you will develop the knowledge and resources to keep yourself healthy for years to come.