Suzie Trains Maui BLOG

Our knees can take quite a toll. Imagine simply walking downhill and all of the force on the joint of the knee is basically your weight times three! If you’re experiencing knee discomfort, grinding under the knee cap often referred to as creptius; nagging pain, or unusual sensations near or underneath the knee cap, read this informative article provided by Cas Soma, MD. from North Shore Orthopedics.

Runners, cyclists and others who report the above can benefit from knowing more about the anatomy of the knee compartment; the muscles, bones ligaments and tendons that stabilize and support the knee itself.  Learn more about the symptoms, preventive measures such as staying in shape and keeping nicely stretched out, to fine tuning your equipment and gear.

I recently had a private road bike, fitting specialist in my studio from Boulder, Colorado and Maui local physical therapist, Laura Dunn, PT share their knowledge for a few privileged folks, to fine tune their pedals, seat height and handlebar stems.  Micro adjustments to the height of the seat and to the stem made all the difference for one rider. His knee pain vanished and he was able to ride pain free.

Here is a simple diagram that illustrates where the Patella lies. As you can see the attachments of the connecting tendons and ligaments also attach to bone like structures protruding from the tibia and fibula.

An excerpt from Cas Soma’s resource: AAOS  : click here to read the entire article provided to his patients

..Causes

The knee is a complex structure and is very sensitive. A number of factors can contribute to runner’s knee, including:

• Malalignment of the kneecap
• Complete or partial dislocation
• Injury
• Excessive training or overuse
• Tightness, imbalance, or weakness of thigh muscles
• Flat feet

Patellofemoral pain may be the result of irritation of the soft tissues around the front of the knee. Strained tendons are fairly common in athletes. Other contributing factors to patellofemoral pain include overuse, muscle imbalance and inadequate stretching. Pain that begins in another part of the body, such as the back or hip, may cause pain in the knee (referred pain).

In some people with runner’s knee, the kneecap is out of alignment. If so, vigorous activities can cause excessive stress and wear on the cartilage of the kneecap. This can lead to softening and breakdown of the cartilage on the patella (chondromalacia patella) and cause pain in the underlying bone and irritation of the joint lining…

Click here to read the entire article and learn more about prevention, diagnosis, and different treatment options.

If my clients complain about any knee discomfort you can be sure that I’ll refer them to Dr. Soma for an examination and full work up. I want to see my clients enjoy their activities and take care of their bodies. Getting back to play or to the simple things you enjoy to stay healthy and fit are very important.

Thanks Dr. Soma for being a valued resource and partner!   To contact Dr. Soma go to:

http://orthodoc.aaos.org/casomamdmaui/

Stayed tuned for more information and helpful tips to keep you in play!  You CAN be healthy and fit.

If I can help you achieve your fitness goals, learn a new sport or be part of your health team, call me today at 808-283-2121

Or, go to my website at http://www.suzietrainsmaui.com

Suzie Cooney, CPT  Suzie Trains Maui

I’ve asked Marc Hartung, professional massage therapist on Maui, to share his experience, as the lead massage director at the recent Naish Paddle Board and SUP Championships on Maui, July 18, 2010. All the tables were full as his team provided over 50 of the competitors a soothing post-event massage.  Also read his special note on pre event massage.

Getting a sports massage can make a huge difference post event or race!

Stand up paddling does have its own over use and injury list. Common among them are strains to the shoulder complex and rotator cuff muscles. I too suffer from a worn out supraspinatus and infraspinatus weakness that I had Marc attend to for me the next day after the muscles calmed down a bit. I had pain and numbness radiating down my shoulder like Marc describes in other competitors that checked in.

As a stand up paddler himself, his knowledge of the muscle groups that function together that allow for normal paddling efficiencies is very key in addressing one’s complaints and soreness.

Read more from Marc and learn more about how his tips and information may help you.

Marc writes:

This past Sunday I supervised a group of students from The Maui School of Therapeutic Massage, providing post event massage for competitors in the 2010 Naish standup paddleboard race.  I personal only worked on two people, while I managed and screened the crowd of competitors waiting for massage, making sure they were rinsed off and well hydrated before they got on the table. 

The two competitors I had the pleasure of working with were brought to my attention by some of the students.  One complained of a burning sensation radiating from his elbow up to his shoulder and down to his hand, and the other, with numbness radiating down from his shoulder through his pinky finger.  These can be common nerve entrapment injuries with chronic tension and overuse of certain muscle groups.   When addressed early they can often be quickly relieved and eliminated with massage. 

 Stand up paddling works a lot of muscles and is well known for being a great core workout. It also requires a lot of work from stabilizers of the shoulder girdle. The paddle stroke is a combination of medial rotation and abduction (of the top hand).  This requires the work of subscapularis, latissimus dorsi, pec. minor, pec. major, and teres major along with deltoid and supraspinatus to lift the arm up. The bottom hand is mostly stabilizing to transfer the rotation of the trunk to the paddle the muscles used to stabilize are mainly latissimus dorsi rhomboids, triceps, and middle fibers of the traps.  (For more information on the anatomy of the shoulder click here:) http://www.eorthopod.com/content/shoulder-anatomy

Muscles of the rotator cuff

I have found with my clients that massage is crucial in preventing nerve entrapment or overuse injuries, as well as speeding recovery from training and competing.  The sooner you address tension or injuries the easier and faster they respond, allowing you to build strength with out developing tension or muscle imbalance.

A special note about “pre race” massage:

Pre event massage can happen as soon as 24 hours before the event to as close as during or following your warm up for the event. 

 Athletes are all particular about there preparation, some like to be relaxed some prefer a level of mental stress or “psych”, along with warming up some athletes like to keep there muscles tight and some like to stretch out and be real loose, and sometimes a bit of both in varying muscle groups.  It can change drastically with different activities and especially between athletes.

With all that in consideration there are many benefits to pre race massage.  A massage can help reduce anxiety (anxiety and stress alone can ruin performance).  Massage can also help warm muscles and be included in your warm up routine to help prevent injury.  Massage can either help to stretch and lengthen muscles or not depending on preference.  Massage can can also stimulate increased motor neuron activity for faster and stronger contraction of muscles. Just make sure your massage therapist is aware of your goals and needs. 

Clay Everline, M.D. of Waves of Health writes:

Rotator Cuff Strain and Impingement

A rotator cuff injury is a strain or tear in the group of tendons and muscles that hold your shoulder joint together and help move your shoulder. It is exacerbated by use of your shoulder in sports with a repetitive overhead movement, such as swimming, baseball (mainly pitchers), football, tennis and SUP, which gradually strains the tendon. Poor shoulder posture compounds this problem. Avoid flexing the shoulder overhead when initiating the SUP stroke. Make sure to be even and symmtric through the strokes.

Ice massage and perform these exercises to rehab the shoulder:  For more helpful information on tips on how to strengthen your rotator cuff muscles from Clay.. click here:   http://www.everlinemd.com/SUP_Medicine.html

      Suzie Cooney, CPT   Suzie Trains Maui