Sometimes I just have to take my own advice! Believe it or not, this does not always happen.
I’ve been nursing a very sore area right in front of my right heel, even self-treating it with dermaneuromodulation techniques (fantastic pain relief to treat inflamed and tethered nerves through gentle traction on the skin). The pain keeps coming back. So I ignored it and jumped some more. Or warmed it with a heating pad. Or rested it. No go.
Lately I have been doing more jumping in my self training, and went to ballet class last night which really flared this up. Suddenly I had the ‘Doh!” moment”: this feels more like a tendinitis/tendinosis issue, so why not try treating it as such the same way I would a client’s tennis elbow or achilles tendinitis: slow and targeted exercise that works through deceleration with loading, aka ‘loading while stretching’ or eccentric contraction.
I prefer 2-1, working into the concentric phase of a movement with two feet or two hands, then decelerating through the eccentric contraction with one foot or hand. Two feet to rise over the stair step on straight legs, one foot to descend slowly and smoothly. A jerky descent tells me I have lost coordination through that movement and need to work on it a bit. If it is really bad, I do one to one, as in, use the unaffected side, then decelerate through the sore one. That method got e through the worst of my tennis elbow times, when I could barely use my right arm.
So..I will need to baby this foot a little bit, jump wise, but am confidant that this targeted exercise plus my own peripheral nerve self treatment plus an upcoming visit to an Advanced Rolfer™ in Fort Collins next week to help me sort out why I am shortening so much on my right side further up the chain of fascia, joint action, sacro/pelvic mobility, organ restriction, cranial bone restriction or whatever. But I can do this self-care part, and am excited!!
In a recent class with Osteopath Ron Murray, we were taught that the initial rhythms an embryo is exposed to are the beating of its own tiny heart going pitter pat very fast, contrasted to the mother’s relatively much slower heart beat. The embryological movements are of an enveloping of the arms around the developing heart, back supported, lengthening and anchoring in the uterine wall, coupled the reaching down of the legs to the mother beat in the umbilical cord. It occured to me how many times we use this movement. In Chi Gong for instance soft legs reach down into mother earth as we create a circle in front of our torso, cycling energy from/to all of the internal organs, the spine lengthened in two directions, the breath omnidirectional. In ballet, there is constant reference to the “gate” of first position of the arms, not just for use in pirouettes, but for every “preparation” movement at the barre or centre. It’s a gathering of energy, whether it’s a settling, as in the preparations, or a prelude to an explosion into space, as in jetes tournants or tours jetes.The idea, as best I understand it, is that every movement we accomplish in life has an antecedent in the womb. We wouldn’t be able to do them otherwise. The expansion of embryological arm or leg buds out to fully developed limbs presage every bending, twisting, spiraling, lengthening, compressing, pulling movements that we explore later. I just find that so cool!
I’m working on an article in my mind and several times daily practice: relieving sore feet by allowing movement through them. One common kind of foot pain emanates from the instep on the inside edge of the foot, close to the heel. In anatomical terms, the flexor hallucis longus, brevis and tibialis posterior tendons there get inflamed and sore. So, the inflamed tendons and associated nerves are directly causing pain; what’s causing the tendons to be at issue? Now since this was about my own foot, I had a really strong incentive to figure it out, or at least figure out how to make it better.
In essence, while I did need to figure ways to relieve the tendons strain directly (non-weight bearing ankle rotations that allow eversion of the ankle and toe flaring) and then get my feet/ankle to better feel into the rotations and full range of motion available; standing and rocking and rolling the feet/ankles, first both going the same direction, then in opposition) ultimately the best resolution has been through movement that shows me how to allow motion through the bones of the feet; figure 8s at the ankle, then knee and then hip, working first to pull far enough into the 8 motion so that my feet naturally roll off the floor in response, then teaching them to stay with the floor in response to the same level of swaying. The bones have to glide naturally to maintain contact between the bottom of the foot and the floor in response to the body movement. This gives the foot the chance to recover it’s natural articulation and responsiveness. The result: fabulous! Immediately I want to move and walk forward, and those tendons are at ease!
How much emphasis on tight abs restricts a athlete’s ease of movement. Would Michael Jordan have had such a tense abdomen as recently featured in a pic of Dwayne Wade? (There’s no need to talk about Larry Bird, or Magic Johnson.) Is there a disconnect between the look and true functionality here? We’ll see. It was interesting to me that last year, when the a/c went out in San Antonio, it wasn’t the oldest and most supposedly out of shape players who went out of the game; it was the in-his-prime Lebron James who could not take the heat. The biggest engine was the least efficient and adaptable. Teamwork and intelligence probably helped the Spurs stay cool too! Food for thought. To me, it is tragic how many players fall to injury every year. Some of that is the playing schedule, but how many injuries could be avoided with a more kinesiologically -correct approach to training that adequately prepares, and regimens that help maintain responsiveness and coordination, not just muscle mass.
If I sit meditation on a very low wood platform ( maybe 4 inches off ground) with palms up on my thighs, I can enjoy breathing through the back of my armpits and sides of my ribs. Palms are up up to avoid the reflexive down-pushing that results when the palms are down. This is calming and very supportive to release, for me. As I inhale, I allow extension up through my spine, even as the organs in my abdomen get massaged by the upside-down plunger pressure of my diaphragm. As I exhale, I enjoy the sense of stability and grounding feeling from the base of my pelvis. I enjoy the feeling and shape of my Ischial tuberosities and perceive the shape of my Illia and Pubic bones as they give me containment and strength, passing effortless support up through sacrum to the spine, torso and effortlessly supporting my head. Often I need to recover this sense, and I enjoy doing so each time. It’s part of my meditation, the weight rocking subtly forward and back, and happier when the shift is smaller around an easy center line.
This is the home made fitness device using a dowel rod, a length of rope and a weight.
My own tennis elbow condition got so bad in 2012 that I could not pour milk from a gallon container without a lot of pain. I had learned some new Rolfing® techniques and in my eagerness I lost good coordination, self-awareness and self-care. I also learned that, like for me, it is common for such an injury to move from not feeling especially painful to total debilitation in a day.
Any injury like this is a complex affair of missed opportunities for coordinative action – in this case, lack of support in the back, ribs and shoulder girdle through the rhomboids, middle trapezius, serratus anterior (the magic muscle), and good sensing in all the affected joints: fingers, hand, wrist, elbow, glenohumeral and all of the physiological mechanisms that allow supported gliding of the scapula on the ribs. AND…when it’s messed up, it’s messed up and needs to be treated. Otherwise, ain’t no way just helping the coordinative pattern is really going to work. Now that my elbow is over %95 better, I am really enjoying re-patterning my use of the arm while I work, dance and drink milk (actually not drinking dairy right now. Hmmmm…hoist the large laundry detergent bottle, then.)
From what I understand, a tendinosis condition means that there are actual tiny tears in the tendon that will not heal without concentrated work. A lot of pain ensues when people try to strengthen this area when there is a tendinosis. An injured muscle or tendon needs good blood flow and actual loading (work) to heal. Unfortunately the body resists doing any work through that tendon, to protect the tears in the tissue, and will divert movement around it in any concentric contraction (curling the weight up). It was Sam Ianetta of Functional Fitness in Boulder CO who taught me that a tendon put into eccentric contraction (lowering the weight) must fire, even if there are tendinosis tears. It cannot help it. Because of this, it re-activates tissue growth and repair in the tendon! He taught me a few eccentric contraction-type exercises. Once I had figured it out, I made up my own, and figured out how that could work inside of a manual therapy treatment or home self-care session.
The area of tendinosis feels like it collects little globular areas on and around it. They feel to me like the tiny balls of tapioca in that tea drink so favored by the smart tea drinking set around Boulder CO. This is probably the body’s attempt to buttress the injured tension with dense connective tissue. It’s effect, though, is to impede the muscles gliding on its adjacent muscle synergists or antagonists.
In order to get free and supported movement (and by supported I mean the tensional support from adjacent muscles, as well as the leveraging of support from more distant muscles and joints, these globules need to soften. Like a lot of Rolfing SI work, the method for breaking up these impeding globules involves active client movement: I ask them to supply a light resistance as I treat the area with one hand using the other hand to put it into stretch. This “resisted stretch” – putting load on the targeted muscles and tendons while they are elongating – is an eccentric contraction!
I believe that the level of success I had, for myself, was persistent effort. The success I have had with clients has had to do with combining the soft-tissue manipulation and active eccentric contraction movements in session with homework exercises with clients combined with their persistent effort! (This is not something, in my opinion, that just ‘gets better on its own’.) It takes a while for an area to re-grow muscle. This will be longer or shorter depending on your background. Basically, first you get a neurological stimulation, then later actual tissue re-growth that is required for healing the tears in the tendon.
Here’s a little tour of self-care exercises for tennis elbow. Working through the pain doesn’t work: concentric contractions (curling the weight up) hurt, felt weaker afterwards and made no improvement in my tennis elbow pain or post-exercise functionality (it still hurt to lift and pour the gallon of milk). Eccentric-oriented exercises (doing a negative curl only or rolling down the weight) relieved pain in the elbow and gradually gave me fuller use of the elbow, to the point where now I consider it 95% healed.
I use this idea in treating tendinosis anywhere in the body, making up movements for table work, and self-care exercises to suit. Right now, I have used this to good effect on Achilles tendon problems and bicep tendon issues, and am working on solutions for issues in the hip joint. Being a Rolfer means figuring out new solutions for every client every session in a sort of structured improvisation. We use a basic strategy then modify it based on its success with that particular client with that particular issue (and often, on that particular day).
Rolling down the weight: One of my favorites from Sam Ianetta: unrolling the weight down to the ground. For this you need a short thick piece of wooden dowel rod and about 6-8 feet of rope (depending on how tall you are). Fasten the rope to dowel and a weight. Start very light and go for high number of repetitions. The trick to this one: only roll the weight down to the floor. Roll the rope up on the dowel with the weights on the floor; lift it up with the unaffected side; unroll the weight down to the floor with only the affected side. Do not curl it back up until the tennis elbow is mostly healed. This has a lovely lengthening effect on the forearm extensors, supinators as well as somewhat in the anconeus/triceps at the elbow. It also helps re-coordinate the synergist and antagonist muscles in the area, as in flexors and pronators of the forearm, brachialis, biceps and brachioradialis.
I teach clients how to give themselves a resistance stretch in flexion and extension of the whole arm. This is really easy. Use the affected arm to resist in one direction while the other arm pulls it the other way. As in: try to bring wrist to shoulder and push the arm down, straight. This is an eccentric contraction for the flexors at the elbow: brachialis, biceps, and brachioradialis if you alter the angle of the thumb so that it faces straight in front of you instead of to the side.
Once you start to really improve, you need to work to get the whole chain working in sensitive concert, from finger tip to sliding action of scapula on the ribs, connecting to the spine, connecting to the pelvis, connecting to the sitzbones (if seated) or feet (if standing). I will leave that for a later post!
My own tennis elbow condition got so bad in 2012 that I could not pour milk from a gallon container without a lot of pain. I had learned some new Rolfing® techniques and in my eagerness I lost good coordination, self-awareness and self-care. I also learned that, like for me, it is common for such an injury to move from not feeling especially painful to total debilitation in a day.
Any injury like this is a complex affair of missed opportunities for coordinative action – in this case, lack of support in the back, ribs and shoulder girdle through the rhomboids, middle trapezius, serratus anterior (the magic muscle), and good sensing in all the affected joints: fingers, hand, wrist, elbow, glenohumeral and all of the physiological mechanisms that allow supported gliding of the scapula on the ribs. AND…when it’s messed up, it’s messed up and needs to be treated. Otherwise, ain’t no way just helping the coordinative pattern is really going to work. Now that my elbow is over %95 better, I am really enjoying re-patterning my use of the arm while I work, dance and drink milk (actually not drinking dairy right now. Hmmmm…hoist the large laundry detergent bottle, then.)
From what I understand, a tendinosis condition means that there are actual tiny tears in the tendon that will not heal without concentrated work. A lot of pain ensues when people try to strengthen this area when there is a tendinosis. An injured muscle or tendon needs good blood flow and actual loading (work) to heal. Unfortunately the body resists doing any work through that tendon, to protect the tears in the tissue, and will divert movement around it in any concentric contraction (curling the weight up). It was Sam Ianetta of Functional Fitness in Boulder CO who taught me that a tendon put into eccentric contraction (lowering the weight) must fire, even if there are tendinosis tears. It cannot help it. Because of this, it re-activates tissue growth and repair in the tendon! He taught me a few eccentric contraction-type exercises. Once I had figured it out, I made up my own, and figured out how that could work inside of a manual therapy treatment or home self-care session.
The area of tendinosis feels like it collects little globular areas on and around it. They feel to me like the tiny balls of tapioca in that tea drink so favored by the smart tea drinking set around Boulder CO. This is probably the body’s attempt to buttress the injured tension with dense connective tissue. It’s effect, though, is to impede the muscles gliding on its adjacent muscle synergists or antagonists.
In order to get free and supported movement (and by supported I mean the tensional support from adjacent muscles, as well as the leveraging of support from more distant muscles and joints, these globules need to soften. Like a lot of Rolfing SI work, the method for breaking up these impeding globules involves active client movement: I ask them to supply a light resistance as I treat the area with one hand using the other hand to put it into stretch. This “resisted stretch” – putting load on the targeted muscles and tendons while they are elongating – is an eccentric contraction!
I believe that the level of success I had, for myself, was persistent effort. The success I have had with clients has had to do with combining the soft-tissue manipulation and active eccentric contraction movements in session with homework exercises with clients combined with their persistent effort! (This is not something, in my opinion, that just ‘gets better on its own’.) It takes a while for an area to re-grow muscle. This will be longer or shorter depending on your background. Basically, first you get a neurological stimulation, then later actual tissue re-growth that is required for healing the tears in the tendon.
Here’s a little tour of self-care exercises for tennis elbow. Working through the pain doesn’t work: concentric contractions (curling the weight up) hurt, felt weaker afterwards and made no improvement in my tennis elbow pain or post-exercise functionality (it still hurt to lift and pour the gallon of milk). Eccentric-oriented exercises (doing a negative curl only or rolling down the weight) relieved pain in the elbow and gradually gave me fuller use of the elbow, to the point where now I consider it 95% healed.
I use this idea in treating tendinosis anywhere in the body, making up movements for table work, and self-care exercises to suit. Right now, I have used this to good effect on Achilles tendon problems and bicep tendon issues, and am working on solutions for issues in the hip joint. Being a Rolfer means figuring out new solutions for every client every session in a sort of structured improvisation. We use a basic strategy then modify it based on its success with that particular client with that particular issue (and often, on that particular day).
Rolling down the weight: One of my favorites from Sam Ianetta: unrolling the weight down to the ground. For this you need a short thick piece of wooden dowel rod and about 6-8 feet of rope (depending on how tall you are). Fasten the rope to dowel and a weight. Start very light and go for high number of repetitions. The trick to this one: only roll the weight down to the floor. Roll the rope up on the dowel with the weights on the floor; lift it up with the unaffected side; unroll the weight down to the floor with only the affected side. Do not curl it back up until the tennis elbow is mostly healed. This has a lovely lengthening effect on the forearm extensors, supinators as well as somewhat in the anconeus/triceps at the elbow. It also helps re-coordinate the synergist and antagonist muscles in the area, as in flexors and pronators of the forearm, brachialis, biceps and brachioradialis.
I teach clients how to give themselves a resistance stretch in flexion and extension of the whole arm. This is really easy. Use the affected arm to resist in one direction while the other arm pulls it the other way. As in: try to bring wrist to shoulder and push the arm down, straight. This is an eccentric contraction for the flexors at the elbow: brachialis, biceps, and brachioradialis if you alter the angle of the thumb so that it faces straight in front of you instead of to the side.
Once you start to really improve, you need to work to get the whole chain working in sensitive concert, from finger tip to sliding action of scapula on the ribs, connecting to the spine, connecting to the pelvis, connecting to the sitzbones (if seated) or feet (if standing). I will leave that for a later post!
My own tennis elbow condition got so bad in 2012 that I could not pour milk from a gallon container without a lot of pain. I had learned some new Rolfing® techniques and in my eagerness I lost good coordination, self-awareness and self-care. I also learned that, like for me, it is common for such an injury to move from not feeling especially painful to total debilitation in a day.
Any injury like this is a complex affair of missed opportunities for coordinative action – in this case, lack of support in the back, ribs and shoulder girdle through the rhomboids, middle trapezius, serratus anterior (the magic muscle), and good sensing in all the affected joints: fingers, hand, wrist, elbow, glenohumeral and all of the physiological mechanisms that allow supported gliding of the scapula on the ribs. AND…when it’s messed up, it’s messed up and needs to be treated. Otherwise, ain’t no way just helping the coordinative pattern is really going to work. Now that my elbow is over %95 better, I am really enjoying re-patterning my use of the arm while I work, dance and drink milk (actually not drinking dairy right now. Hmmmm…hoist the large laundry detergent bottle, then.)
From what I understand, a tendinosis condition means that there are actual tiny tears in the tendon that will not heal without concentrated work. A lot of pain ensues when people try to strengthen this area when there is a tendinosis. An injured muscle or tendon needs good blood flow and actual loading (work) to heal. Unfortunately the body resists doing any work through that tendon, to protect the tears in the tissue, and will divert movement around it in any concentric contraction (curling the weight up). It was Sam Ianetta of Functional Fitness in Boulder CO who taught me that a tendon put into eccentric contraction (lowering the weight) must fire, even if there are tendinosis tears. It cannot help it. Because of this, it re-activates tissue growth and repair in the tendon! He taught me a few eccentric contraction-type exercises. Once I had figured it out, I made up my own, and figured out how that could work inside of a manual therapy treatment or home self-care session.
The area of tendinosis feels like it collects little globular areas on and around it. They feel to me like the tiny balls of tapioca in that tea drink so favored by the smart tea drinking set around Boulder CO. This is probably the body’s attempt to buttress the injured tension with dense connective tissue. It’s effect, though, is to impede the muscles gliding on its adjacent muscle synergists or antagonists.
In order to get free and supported movement (and by supported I mean the tensional support from adjacent muscles, as well as the leveraging of support from more distant muscles and joints, these globules need to soften. Like a lot of Rolfing SI work, the method for breaking up these impeding globules involves active client movement: I ask them to supply a light resistance as I treat the area with one hand using the other hand to put it into stretch. This “resisted stretch” – putting load on the targeted muscles and tendons while they are elongating – is an eccentric contraction!
I believe that the level of success I had, for myself, was persistent effort. The success I have had with clients has had to do with combining the soft-tissue manipulation and active eccentric contraction movements in session with homework exercises with clients combined with their persistent effort! (This is not something, in my opinion, that just ‘gets better on its own’.) It takes a while for an area to re-grow muscle. This will be longer or shorter depending on your background. Basically, first you get a neurological stimulation, then later actual tissue re-growth that is required for healing the tears in the tendon.
Here’s a little tour of self-care exercises for tennis elbow. Working through the pain doesn’t work: concentric contractions (curling the weight up) hurt, felt weaker afterwards and made no improvement in my tennis elbow pain or post-exercise functionality (it still hurt to lift and pour the gallon of milk). Eccentric-oriented exercises (doing a negative curl only or rolling down the weight) relieved pain in the elbow and gradually gave me fuller use of the elbow, to the point where now I consider it 95% healed.
I use this idea in treating tendinosis anywhere in the body, making up movements for table work, and self-care exercises to suit. Right now, I have used this to good effect on Achilles tendon problems and bicep tendon issues, and am working on solutions for issues in the hip joint. Being a Rolfer means figuring out new solutions for every client every session in a sort of structured improvisation. We use a basic strategy then modify it based on its success with that particular client with that particular issue (and often, on that particular day).
Rolling down the weight: One of my favorites from Sam Ianetta: unrolling the weight down to the ground. For this you need a short thick piece of wooden dowel rod and about 6-8 feet of rope (depending on how tall you are). Fasten the rope to dowel and a weight. Start very light and go for high number of repetitions. The trick to this one: only roll the weight down to the floor. Roll the rope up on the dowel with the weights on the floor; lift it up with the unaffected side; unroll the weight down to the floor with only the affected side. Do not curl it back up until the tennis elbow is mostly healed. This has a lovely lengthening effect on the forearm extensors, supinators as well as somewhat in the anconeus/triceps at the elbow. It also helps re-coordinate the synergist and antagonist muscles in the area, as in flexors and pronators of the forearm, brachialis, biceps and brachioradialis.
I teach clients how to give themselves a resistance stretch in flexion and extension of the whole arm. This is really easy. Use the affected arm to resist in one direction while the other arm pulls it the other way. As in: try to bring wrist to shoulder and push the arm down, straight. This is an eccentric contraction for the flexors at the elbow: brachialis, biceps, and brachioradialis if you alter the angle of the thumb so that it faces straight in front of you instead of to the side.
Once you start to really improve, you need to work to get the whole chain working in sensitive concert, from finger tip to sliding action of scapula on the ribs, connecting to the spine, connecting to the pelvis, connecting to the sitzbones (if seated) or feet (if standing). I will leave that for a later post!
My own tennis elbow condition got so bad in 2012 that I could not pour milk from a gallon container without a lot of pain. I had learned some new Rolfing® techniques and in my eagerness I lost good coordination, self-awareness and self-care. I also learned that, like for me, it is common for such an injury to move from not feeling especially painful to total debilitation in a day.
Any injury like this is a complex affair of missed opportunities for coordinative action – in this case, lack of support in the back, ribs and shoulder girdle through the rhomboids, middle trapezius, serratus anterior (the magic muscle), and good sensing in all the affected joints: fingers, hand, wrist, elbow, glenohumeral and all of the physiological mechanisms that allow supported gliding of the scapula on the ribs. AND…when it’s messed up, it’s messed up and needs to be treated. Otherwise, ain’t no way just helping the coordinative pattern is really going to work. Now that my elbow is over %95 better, I am really enjoying re-patterning my use of the arm while I work, dance and drink milk (actually not drinking dairy right now. Hmmmm…hoist the large laundry detergent bottle, then.)
From what I understand, a tendinosis condition means that there are actual tiny tears in the tendon that will not heal without concentrated work. A lot of pain ensues when people try to strengthen this area when there is a tendinosis. An injured muscle or tendon needs good blood flow and actual loading (work) to heal. Unfortunately the body resists doing any work through that tendon, to protect the tears in the tissue, and will divert movement around it in any concentric contraction (curling the weight up). It was Sam Ianetta of Functional Fitness in Boulder CO who taught me that a tendon put into eccentric contraction (lowering the weight) must fire, even if there are tendinosis tears. It cannot help it. Because of this, it re-activates tissue growth and repair in the tendon! He taught me a few eccentric contraction-type exercises. Once I had figured it out, I made up my own, and figured out how that could work inside of a manual therapy treatment or home self-care session.
The area of tendinosis feels like it collects little globular areas on and around it. They feel to me like the tiny balls of tapioca in that tea drink so favored by the smart tea drinking set around Boulder CO. This is probably the body’s attempt to buttress the injured tension with dense connective tissue. It’s effect, though, is to impede the muscles gliding on its adjacent muscle synergists or antagonists.
In order to get free and supported movement (and by supported I mean the tensional support from adjacent muscles, as well as the leveraging of support from more distant muscles and joints, these globules need to soften. Like a lot of Rolfing SI work, the method for breaking up these impeding globules involves active client movement: I ask them to supply a light resistance as I treat the area with one hand using the other hand to put it into stretch. This “resisted stretch” – putting load on the targeted muscles and tendons while they are elongating – is an eccentric contraction!
I believe that the level of success I had, for myself, was persistent effort. The success I have had with clients has had to do with combining the soft-tissue manipulation and active eccentric contraction movements in session with homework exercises with clients combined with their persistent effort! (This is not something, in my opinion, that just ‘gets better on its own’.) It takes a while for an area to re-grow muscle. This will be longer or shorter depending on your background. Basically, first you get a neurological stimulation, then later actual tissue re-growth that is required for healing the tears in the tendon.
Here’s a little tour of self-care exercises for tennis elbow. Working through the pain doesn’t work: concentric contractions (curling the weight up) hurt, felt weaker afterwards and made no improvement in my tennis elbow pain or post-exercise functionality (it still hurt to lift and pour the gallon of milk). Eccentric-oriented exercises (doing a negative curl only or rolling down the weight) relieved pain in the elbow and gradually gave me fuller use of the elbow, to the point where now I consider it 95% healed.
I use this idea in treating tendinosis anywhere in the body, making up movements for table work, and self-care exercises to suit. Right now, I have used this to good effect on Achilles tendon problems and bicep tendon issues, and am working on solutions for issues in the hip joint. Being a Rolfer means figuring out new solutions for every client every session in a sort of structured improvisation. We use a basic strategy then modify it based on its success with that particular client with that particular issue (and often, on that particular day).
Rolling down the weight: One of my favorites from Sam Ianetta: unrolling the weight down to the ground. For this you need a short thick piece of wooden dowel rod and about 6-8 feet of rope (depending on how tall you are). Fasten the rope to dowel and a weight. Start very light and go for high number of repetitions. The trick to this one: only roll the weight down to the floor. Roll the rope up on the dowel with the weights on the floor; lift it up with the unaffected side; unroll the weight down to the floor with only the affected side. Do not curl it back up until the tennis elbow is mostly healed. This has a lovely lengthening effect on the forearm extensors, supinators as well as somewhat in the anconeus/triceps at the elbow. It also helps re-coordinate the synergist and antagonist muscles in the area, as in flexors and pronators of the forearm, brachialis, biceps and brachioradialis.
I teach clients how to give themselves a resistance stretch in flexion and extension of the whole arm. This is really easy. Use the affected arm to resist in one direction while the other arm pulls it the other way. As in: try to bring wrist to shoulder and push the arm down, straight. This is an eccentric contraction for the flexors at the elbow: brachialis, biceps, and brachioradialis if you alter the angle of the thumb so that it faces straight in front of you instead of to the side.
Once you start to really improve, you need to work to get the whole chain working in sensitive concert, from finger tip to sliding action of scapula on the ribs, connecting to the spine, connecting to the pelvis, connecting to the sitzbones (if seated) or feet (if standing). I will leave that for a later post!
My own tennis elbow condition got so bad in 2012 that I could not pour milk from a gallon container without a lot of pain. I had learned some new Rolfing® techniques and in my eagerness I lost good coordination, self-awareness and self-care. I also learned that, like for me, it is common for such an injury to move from not feeling especially painful to total debilitation in a day.
Any injury like this is a complex affair of missed opportunities for coordinative action – in this case, lack of support in the back, ribs and shoulder girdle through the rhomboids, middle trapezius, serratus anterior (the magic muscle), and good sensing in all the affected joints: fingers, hand, wrist, elbow, glenohumeral and all of the physiological mechanisms that allow supported gliding of the scapula on the ribs. AND…when it’s messed up, it’s messed up and needs to be treated. Otherwise, ain’t no way just helping the coordinative pattern is really going to work. Now that my elbow is over %95 better, I am really enjoying re-patterning my use of the arm while I work, dance and drink milk (actually not drinking dairy right now. Hmmmm…hoist the large laundry detergent bottle, then.)
From what I understand, a tendinosis condition means that there are actual tiny tears in the tendon that will not heal without concentrated work. A lot of pain ensues when people try to strengthen this area when there is a tendinosis. An injured muscle or tendon needs good blood flow and actual loading (work) to heal. Unfortunately the body resists doing any work through that tendon, to protect the tears in the tissue, and will divert movement around it in any concentric contraction (curling the weight up). It was Sam Ianetta of Functional Fitness in Boulder CO who taught me that a tendon put into eccentric contraction (lowering the weight) must fire, even if there are tendinosis tears. It cannot help it. Because of this, it re-activates tissue growth and repair in the tendon! He taught me a few eccentric contraction-type exercises. Once I had figured it out, I made up my own, and figured out how that could work inside of a manual therapy treatment or home self-care session.
The area of tendinosis feels like it collects little globular areas on and around it. They feel to me like the tiny balls of tapioca in that tea drink so favored by the smart tea drinking set around Boulder CO. This is probably the body’s attempt to buttress the injured tension with dense connective tissue. It’s effect, though, is to impede the muscles gliding on its adjacent muscle synergists or antagonists.
In order to get free and supported movement (and by supported I mean the tensional support from adjacent muscles, as well as the leveraging of support from more distant muscles and joints, these globules need to soften. Like a lot of Rolfing SI work, the method for breaking up these impeding globules involves active client movement: I ask them to supply a light resistance as I treat the area with one hand using the other hand to put it into stretch. This “resisted stretch” – putting load on the targeted muscles and tendons while they are elongating – is an eccentric contraction!
I believe that the level of success I had, for myself, was persistent effort. The success I have had with clients has had to do with combining the soft-tissue manipulation and active eccentric contraction movements in session with homework exercises with clients combined with their persistent effort! (This is not something, in my opinion, that just ‘gets better on its own’.) It takes a while for an area to re-grow muscle. This will be longer or shorter depending on your background. Basically, first you get a neurological stimulation, then later actual tissue re-growth that is required for healing the tears in the tendon.
Here’s a little tour of self-care exercises for tennis elbow. Working through the pain doesn’t work: concentric contractions (curling the weight up) hurt, felt weaker afterwards and made no improvement in my tennis elbow pain or post-exercise functionality (it still hurt to lift and pour the gallon of milk). Eccentric-oriented exercises (doing a negative curl only or rolling down the weight) relieved pain in the elbow and gradually gave me fuller use of the elbow, to the point where now I consider it 95% healed.
I use this idea in treating tendinosis anywhere in the body, making up movements for table work, and self-care exercises to suit. Right now, I have used this to good effect on Achilles tendon problems and bicep tendon issues, and am working on solutions for issues in the hip joint. Being a Rolfer means figuring out new solutions for every client every session in a sort of structured improvisation. We use a basic strategy then modify it based on its success with that particular client with that particular issue (and often, on that particular day).
Rolling down the weight: One of my favorites from Sam Ianetta: unrolling the weight down to the ground. For this you need a short thick piece of wooden dowel rod and about 6-8 feet of rope (depending on how tall you are). Fasten the rope to dowel and a weight. Start very light and go for high number of repetitions. The trick to this one: only roll the weight down to the floor. Roll the rope up on the dowel with the weights on the floor; lift it up with the unaffected side; unroll the weight down to the floor with only the affected side. Do not curl it back up until the tennis elbow is mostly healed. This has a lovely lengthening effect on the forearm extensors, supinators as well as somewhat in the anconeus/triceps at the elbow. It also helps re-coordinate the synergist and antagonist muscles in the area, as in flexors and pronators of the forearm, brachialis, biceps and brachioradialis.
I teach clients how to give themselves a resistance stretch in flexion and extension of the whole arm. This is really easy. Use the affected arm to resist in one direction while the other arm pulls it the other way. As in: try to bring wrist to shoulder and push the arm down, straight. This is an eccentric contraction for the flexors at the elbow: brachialis, biceps, and brachioradialis if you alter the angle of the thumb so that it faces straight in front of you instead of to the side.
Once you start to really improve, you need to work to get the whole chain working in sensitive concert, from finger tip to sliding action of scapula on the ribs, connecting to the spine, connecting to the pelvis, connecting to the sitzbones (if seated) or feet (if standing). I will leave that for a later post!
