Breathe- Performance and Your Nervous System

Walk inside your story and own it. Breathe it in.

 

And then pause.

Breathe again.

Repair your world.

Continue.

 

We have told you before and will tell you again: We want you to train hard and train smart. This will lead to you getting stronger and more powerful.  We want to build up your tolerance, endurance, and capacity.

We want you to be able to produce strength in all ranges. We want your joints to be able to do everything they are made to do.

We want your story as an athlete to be full of adventure.

But one part of the system that is often ignored: the breath. Breathing is the most fundamental movement pattern we have. Your story is built upon it, driven by it, and affected by it.

How we breathe and how we feel are intimately connected. Slow, rhythmic breathing can quiet your inner storms.  Paying attention to your breath can allow space for clarity. It can allow room to calm your heart and listen to what lives deep down.

So this month, remember what you carry inside of you. Be still enough to hear it.

Sit down and observe your inhale and exhale. Normal breathing, also known as diaphragmatic breathing, involves synchronized motion of the upper rib cage, lower rib cage, and abdomen. It requires the diaphragm muscles to work adequately.  Abnormal breathing, known as thoracic breathing, involves breathing from the upper chest. You would see greater upper rib cage motion, compared to the lower rib cage. Abnormal breathing can also be only “belly breathing” where you don’t use your ribs and diaphragm much, and only use your lower belly.

Athletes have this ability to function with a pattern that is “abnormal” or “dysfunctional.” You may be able to perform well enough without paying attention to breathing/range of motion/recovery...the list goes on.

But what if you did pay attention? What if you could improve your breathing mechanics?

We are not suggesting that you may have “bad” breathing techniques, but what we are saying is that you may be able to improve your awareness of your breath, and work on your breathing as you would any other exercise.

Big change can lie in the detail.

And if it did make a difference, think about what this could do for your state of mind.  Think about what this could do for your performance. Breathing patterns influence hip, shoulder, and spinal position.  It is a huge leak of potential to not be able to fix your spine. When you are biking, or skiing, or running, or climbing, you need to be able to move fluidly, and then brace your trunk. This needs to happen over and over. You need to quickly move from fluid to fixed.

So, if you wanted to pay attention to the breath, what would you look for?

 

In general, the innermost layers of the abdominal wall consisting of the transverse abdominis and internal obliques play a very important role. They create what is called the Zone of Apposition with the diaphragm. This zone acts as a traction area allowing the dome position required of the diaphragm so it can exert its force on the rib cage for breathing instead of the spine. This ZOA is required for efficient breath. When the belly is left to “fall out,” there is no resistance against which the diaphragm can act to properly change the form of the chest wall. The ZOA is also supported by other muscles like the hamstrings and hip adductors.

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An ideal breathing pattern should involve the diaphragm descending in the caudal direction (towards your tailbone), with elastic recoil promoting an upward motion upon exhalation. As a result, the organs shift down as well, and the abdominal wall expands in all directions. Your diaphragm and pelvic floor work together during every breath. If the diaphragm is not working properly, then the pelvic floor can suffer. This means that awareness of the breath is extremely important for any new mom, or anyone with a pelvic floor issue.

 

Characteristics of optimal breathing (at rest):  are that it is diaphragmatic, nasal (inhalation and exhalation), smooth, deep, even, quiet and free of pauses.

 

From a muscular perspective, we see an alternating dance of muscle activity. Inspiration requires concentric diaphragm and pelvic floor activity, which compresses the abdominal cylinder to establish intra-abdominal pressure.  Ab wall expansion occurs through eccentric activity of the abdominal muscles, quadratus lumborum, spinal extensors, and hip external rotators. Your belly does not simply fall out; you are eccentrically contracting muscles, making room for the diaphragm that is moving downwards. When we exhale, the reverse occurs: the diaphragm and pelvic floor eccentrically return to their starting position and the ab wall concentrically tightens up.

 

The diaphragm’s mechanical action and respiratory advantage depends on its relationship and anatomic arrangement with the rib cage. Remember, the zone of apposition has anatomic importance because it is controlled by the abdominal and oblique muscles and directs diaphragmatic tension.

 

The alignment of the rib cage should ideally correspond to the position of the pelvis. When the thoracic spine is erect, the rib cage is positioned parallel to the pelvis. This alignment of the thorax allows for the diaphragm to act in a caudal (towards the tailbone) direction, as a piston against the pelvic floor. This relationship is very important.

 

The lungs occupy a 3-dimensional space in the thoracic cavity, and when this space changes shape to cause air movement, it changes shape 3-dimensionally. An inhalation involves the chest cavity increasing its volume from top-to-bottom, from side-to-side and from front-to-back, and an exhale involves a reduction of volume in those same three dimensions.

 

If you have a suboptimal ZOA, this could lead to:  increased extension, or back bending, through the lower spine. This is accompanied by a front chest that is opened up in a state of hyperinflation, a mid back that is flattened, and an excessively rounded upper back near the base of the neck.  If you have a suboptimal ZOA, you may be breathing more with your thoracic area, which is produced by the accessory muscles of respiration (including sternocleidomastoid, upper trapezius, and scalene muscles), dominating over your lower rib cage and abdominal motion.

 

If these patterns continue, it can lead to an inability to create stiffness in the trunk. Do you feel like you have a hard time bracing?  Can you create a stiffness in your lumbar spine?

 

Remember, being able to move from fluid to fixed is an ability that every athlete should have. If this is something you struggle with, it is worth looking to the breathe. Your story as an athlete can change just with a bit of awareness in this area.

Find a bit of stillness. Practice your breathing.

 

Normal respiration should occur through the nose.  Breathing through the nose has many benefits: The hairs in the nose filter the air to keep the lungs free of particles.  The turbinates in the nose warm the air prior to entering the lungs.  There are receptors in the nose that relax the body and tells it that it’s OK to run your immune system, digestive system, and hormonal system.

 

Slow, controlled breathing is not only relaxing, it's been scientifically proven to affect the heart, the brain, digestion, the immune system.  Slow breathing means different things to different people. For many, they think they need to breathe very deeply. However, deep breathing can actually be over-breathing, and it can quickly cause hyperventilation. This is an excessive rate or depth of breathing that causes abnormally low carbon dioxide levels in the body. It is more about the timing of the breathe. Slow breathing is what is most calming.

Start with 10 minutes a day. Stay conscious and aware of how you are breathing. Breath through the nose. Let yourself be inside your own story.

 

Most people breathe twice the optimal volume of air. Many people think that healthy breathing means a high volume of air filling the lungs, emptying the lungs with huge exhales, and a lot of movement. At rest, including during sleep, a normal and healthy breath size is only one-eighth to one-tenth of total lung capacity.

Physiologically normal, healthy breathing at rest is 8 to 12 breaths per minute, and very small, soft and gentle breathing, with small movement of the upper abdominal area and lower ribs, with no sound to it. Of course, the breath will need to be deeper during exercise, but it will happen naturally. Your body just increases breathing volume and rate. You don’t have to go, ‘I’m going for a run, so now I’m going to breathe more.’

So next time you feel yourself becoming anxious, instead of taking a few deep breaths, try a few slow, steady, gentle ones.

  • When you stop mouth breathing and learn to bring your breathing volume toward normal, you have better oxygenation of your tissues and organs, including your brain

  • You breathe to remove excess Co2, but it’s still important that your breathing volume is normal, to maintain ideal Co2 levels in your lungs. Lack of Co2 constricts your blood vessels and detrimentally affects your heart function

  • The heavier you breathe, the less oxygen that’s actually delivered throughout your body due to lack of carbon dioxide, which causes your blood vessels to constrict (When blood Co2 drops, at least two major changes occur in the body. First, certain blood vessels constrict causing less oxygen to reach the brain, heart and extremities. Secondly, the blood acidity changes, causing less oxygen to reach the tissues and certain ions to flood body tissues. These changes account for a wide array of symptoms that are virtually identical to the symptoms of anxiety. The change in blood acidity is thought to play a role in sensitizing the nerves.

  • Hyperventilation, or overbreathing, means that you expel carbon dioxide (Co2) faster than your body is producing it. This usually occurs with rapid, shallow "chest" breathing, but can also occur with deep breathing.

  • Slow, diaphragmatic, 360 degree breathing is the goal

 

 

Breathing and the nervous system:

 

The sympathetic nervous system is mainly activated by stress and pre­pares the body for a fight. It is a survival mechanism that increases heart rate, blood pressure, and blood sugar. If the sym­pathetic nervous system becomes overburdened by prolonged stress, it will wear on your body. The parasympathetic nervous system, however, has a calming influ­ence. It lowers the heart rate and blood pressure and simultaneously promotes digestion and the uptake of nutrients. It is primarily during rest, eating and sleeping that the parasympathetic nervous system dominates and coordinates the body’s repose and regeneration.

 

Often our sympathetic nervous systems get too ramped up, and we don’t activate our parasympathetic systems enough.

Let’s consider one of the most fundamentally important ele­ments in the parasympathetic nervous system, the vagus nerve, which is the most complex of all of our nerves. In Latin, Vagus means “wander­ing”. It is termed so because from its origin in the brain stem it spreads nerve fibers to the throat and upper body, and through these nerve fib­ers signals wander to and from the body and the brain. In short, the vagus nerve connects the brain to everything from the tongue, pharynx, vocal chords, lungs, heart, stomach and intestines to different glands that produce enzymes and hormones, influencing digestion, me­tabolism, and much more.

The key to managing your state of mind and stress level lies in being able to activate the calming parasympathetic pathways of your nervous system. By actively focusing on your breath and the movements of your diaphragm, you can influence the system enormously through the vagus nerve that spreads from your brain to your lungs, heart and other or­gans. Try to activate your own vagus nerve. Simply try to calm your breath down. Breathe in and out through your nose in a quiet, controlled way . Can you feel how your heart rate drops and your mind relaxes instantly?

 

Retraining your breath:

 

 

So, the goals of breathing retraining include relaxing and stabilizing the breathing pattern with the intention of:

  • Moving toward restoration of proper function of the nervous system

  • Leaving fight-or-flight mode if it's not appropriate

  • Reducing heart and breathing rates

  • Relaxing muscles

  • Mitigating anxiousness, hyperventilation and stress

 

Tips for Breathing Retraining:

 

  • If you can, breathe through your nose, which increases resistance and helps to slow breathing. If you can’t, breathe through pursed lips.

  • Don’t be too concerned with technique. Just be aware of your breathing and attempt to breathe in a way that is restful for you. Simple awareness of how you’re breathing is often all that is needed to slow down and to encourage healthy breathing.

  • While fist practicing, use a mirror to check for tension or movement in the face, jaw, shoulders or chest.

  • Hold a normal breath for a count of five, breathe out slowly, hold to five, then resume easy breathing. (This can help increase your tolerance to Co2. You always need a certain amount of Co2 for normal functioning. If you have normal Co2, you will have a good tolerance to it, which translates into a higher breath-hold time).

  • Practice this when speaking. Relax your muscles. Go more slowly and smoothly. Use short sentences with gentle breathing through your nose; no gasping or gulping air. Seek natural pausing places to breathe gently.

  • As this becomes more natural, you will automatically use these techniques during exercise

  • Remember that we are not saying that you are correct or incorrect with your breathing habits, but rather, attention to your breath is the important part

 

Breathing during exercise:

 

 

Let’s talk about your tolerance to carbon dioxide. When your body and brain have a normal tolerance of Co2, your breathing will be light and smooth as your body is not constantly trying to get rid of too much Co2. Contrary to popular belief, the primary stimulant signaling your body to take a breath is not lack of oxygen, rather it is an excess Co2.

You always need a certain amount of Co2 for normal functioning. If you have normal Co2, you will have a good tolerance to it, which translates into a higher breath-hold time. Also, when you exercise, your body generates more carbon dioxide, and if you have good tolerance to Co2, your breathing will remain much lower than someone who has a poor tolerance to Co2.

 

A higher Co2 tolerance will equate to a more regulated breathing pattern while under stress. It will allow us to preserve the power output of our breathing musculature for longer periods. Improved Co2 tolerance will also allow us to regulate our breathing so that our bodies have more Co2 available during exertion to buffer elevated acid levels. One of the greatest benefits of improved Co2 tolerance is the reduction of breathlessness while we train. It opens the door for us to train harder and longer without that sense that we have to stop to get a breath.

 

Again, you can increase your ability to tolerate Co2 with breathing retraining. If you can slow down your breathing to about 8-12 breaths per minute, you will begin to increase your tolerance to Co2. After you have tried at rest to calm and slow down your breath, in and out of your nose, then try to engage in moderate exercise in the same manner.

Breathing influences our movement.  

 

The diaphragm has a dual function as both a respiratory and postural muscle. The dual role of the diaphragm is essential for spinal stability and all resultant movements, especially for the complex tasks that comprise athletic performance.  

You don’t own a movement unless you can breathe at the pinnacle of the movement, when max mobility and/or stability is needed.  Practice breathing over a brace. Practice getting into bird dog or plank or the bottom of a push up and hold it and try to perform diaphragmatic breaths. You will feel that you cannot only breathe into your belly, because then you will not be able to fix your lumbar spine. You will also feel that if you only breathe with your upper chest, then the same will happen. Practice 360 degree expansion of the diaphragm. This will allow for a static position of the spine.

 

If you forget your story, slow down. Your breath will find it’s way in. And it’s way out.

To not pause and think about what it is you love, would be a life that is very much missing the point.

Breathe. Stand still for a minute. Remember what you are looking for.

-Laurel Lippard

 

 

References:

Bonaz B, Sinniger V, Pellissier S.  Vagal tone: effects on sensitivity, motility, and inflammation. Neurogastroenterol Motil. 2016 Apr;28(4):455-62.

 

 

 

 

Bradley H, Dr. Esformes J. BREATHING PATTERN DISORDERS AND FUNCTIONAL MOVEMENT. International Journal of Sports Physical Therapy. 2014;9(1):28-39.

 

 

Chaitow, L., Bradley, D., Gilbert, C. Recognizing and treating breathing disorders.

 

 

Frank C, Kobesova A, Kolar P. DYNAMIC NEUROMUSCULAR STABILIZATION & SPORTS REHABILITATION. International Journal of Sports Physical Therapy. 2013;8(1):62-73.

 

 

J. B. Frøkjaer, S. Bergmann, C. Brock, A. Madzak, A. D. Farmer, J. Ellrich, A. M. Drewes. Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. Neurogastroenterol Motil. 2016 Apr; 28(4): 592–598. Published online 2016 Jan 4. doi: 10.1111/nmo.12760

 

 

 

 

 

 

 

 

Pain and the Complex Athlete

The complex athlete and the biopsychosocial approach to pain.

Our lives as athletes are beautifully complex. Our souls know defeat as well as strength. Our faces are marred by sweat and dust. Our insides are fierce, and there is a whole galaxy of neural networks active in our bodies. These networks are designed to get information from the outside world. All this information is travelling from the outer reaches of the body to the brain, sometimes at speeds of 268 miles per hour! As the brain processes this information, it creates a kind of mysterious sway. It orchestrates the flow of information in a way that we still do not fully understand.

Part of the intricate orchestra is how we experience pain. When it comes to pain, our brain is always trying to decide what is important for us, and it takes into account many different factors.  Pain is multidimensional.  

Understanding your pain is important, because it can change how much things hurt.

This month we want to give you insight as to what we think about when you are in pain, and the steps we take to helping you. Knowing about pain is a massive way to help mitigate it. So, get ready folks, because pain is not simple. It is vastly complex, and we are going to dive in deep.

The biopsychosocial approach

There is still some mystery to pain, but we have made huge leaps in understanding it, and pain scientists now know that many factors are involved with pain:

Biological: joint pathology, inflammation, genetics

Psychological: mood/emotion, catastrophizing, coping, stress, expectations, past experiences, beliefs, attitude,

Sociological: occupation, education, income, social support

These together make the biopsychosocial approach...showing you that pain is not just caused by tissue damage, but rather a whole slew of factors. And because pain is so complex, it doesn’t end there. Many other factors contribute….sleep, diet, exercise, substance use, and the list goes on.

pain.jpg

 If you have a brain, you will experience pain

Pain is a construct of the brain. The brain and the nervous system are very adaptable.

As humans and athletes, adaptability is our greatest gift, but can also be the thing that causes problems. The very same mechanisms that cause us to change in a good way, can also cause us to change in a way that makes our lives more difficult and unpleasant (Moseley, Butler). In order to explain this, let’s dive into what is really happening with pain.

The basic types:

  1. Nociceptive pain arises from different kinds of trouble in tissues, reported to the brain by the nervous system. This is the type of pain everyone is most familiar with. Everything from bee stings and burns to repetitive strain injury, nausea, tumours, and inflammatory arthritis. Nociceptive pain typically changes with movement, position, and load.

  2. Neuropathic pain arises from damage to the nervous system itself, central or peripheral, either from disease, injury, or pinching. The simplest neuropathies are mechanical insults, like hitting your funny bone or sciatica, but this is a big category: anything that damages neurons, from multiple sclerosis to chemotherapy to alcoholism to phantom limb pain. It’s often stabbing, electrical, or burning, but nearly any quality of pain is possible.

  3. Some common kinds of pain are not a great fit for either of the two official categories. The prime example is the pain of fibromyalgia. Other major examples:

 Let’s look at nociceptive pain:

Nociception is our alert surveillance system. Unpleasant stimuli can activate sensors called nociceptors. These sensors send potential danger signals from the body to the spinal cord through your nerves. These signals mean there is the potential for tissue damage,  and you just may want to do something about it. The spinal cord then decides if that signal gets passed onto the brain. So, say the signal does get passed onto the brain, then you get to make a subconscious decision of how important that information is. “Is there really a threat here?” If your brain thinks there is, pain will likely emerge.

 Pain is an alarm which is meant to protect you. But, pain is poorly related to damage. Pain is more about sensitivity than damage. Protection can be overamplified and persist past healing. Our nervous system can produce unnecessary warning signals.  If you have persistent pain, the brain can stay on high alert. Pain can be created to keep protecting the body even though the body no longer needs it/ there is no injury. We then can get better and better at protecting, and get better at being in pain. That is when adaptation can cause problems. We adapt to becoming very good at being in pain.  Pain itself is modifying the way the central nervous system works, so you  become more sensitive and can feel more pain with less provocation. This is called “central sensitization” because it involves changes in the central nervous system in particular (the brain and the spinal cord). Potentially, you are not only more sensitive to things that should hurt, but sometimes just to ordinary touch and pressure as well (Lluch et al).

This means that sometime you cannot really be sure that pain is actually worse than it “should” be, because there is nothing to compare it to except your own memories and experience of pain.

A nerve should never be called a “pain” nerve. It doesn’t detect “pain.” It only detects some kind of stimulus in the tissue … and the brain decides what to make of it, how to feel about it, and what to do about it. Joints, muscles, nerves...they don’t send pain signals, they can only send danger signals, and then the brain decides whether that information is worth making pain for. The brain is the boss.  Once a danger message arrives at the brain, it has to answer a very important question: “How dangerous is this really?” In order to respond, the brain draws on every piece of credible information — previous exposure, cultural influences, knowledge, other sensory cues — the list is endless.  Once your brain has made a decision, it also sends messages downwards that actually affect the sensitivity and behaviour of the nerves. Thus everything that hurts involves a conversation, a sort of debate between the central and peripheral nervous systems.

This widespread brain activity associated with the experience can be referred to as your pain neuromatrix (Louw, Puentedura). What ignites your pain neuromatrix is again completely personal, and can be highlighted by things like smell, vision, and even just words.

Because of this, pain is not always a reliable sign of what’s really going on. Chronic pain is a potion of different factors, complex by nature. Pain depends on the perceived stimulation level, not the actual stimulation level.  

If you only have 5 minutes, watch  this Understanding Pain video:     https://www.youtube.com/watch?v=gy5yKbduGkc          

If you have 15 minutes, watch Lorimer Moseley, Professor of Clinical Neurosciences and pain researcher. He is very entertaining, and even funny, for a scientist:     https://www.youtube.com/watch?v=gwd-wLdIHjs#t=8s 

 So how do you know when your nervous system is learning to be in pain? If this is happening, that old injury from years ago can start to hurt again. Your mood can change your pain. A small stressor or annoyance could make it worse. Your pain can change where it hurts or can spread, and could come on randomly.  

 Remember, the longer you have pain, the better your system can get at producing it. So you need less and less to aggravate your pain.  We are not saying that it becomes: “why does this person think this hurts so much?”.  The question is “why does this hurt so much?”

This is very important: We are not saying your pain is not real. It is very real. We are just trying to give you insight on to why you have pain, and that it is more complicated than tissue damage alone. You may be thinking: ‘I understand that hurt doesn’t always equal harm, but my pain really hurts’, or ‘This information is good for those who think they have pain, but it is not for me - I have real pain.’

  • If anyone tells you your pain is not real, don’t listen to them! What we do want you to hear is that the danger implied by pain may be exaggerated.

  • Our point is to explain that all pain is an output of the brain, no matter what kind of pain it is. Our brain’s response to nociception is what matters.

  • We are not ignoring biology, biomedical, and structural factors in pain. Not at all: the point of explaining this biopsychosocial approach is to highlight the “it’s complicated” relationship between these things and pain. Tissue damage is real, and pain arising from it is real… but it’s complicated.

  • And if there is no tissue damage, again, your pain is still completely real.

 So what do we do about this?

We look at YOUR story. Pain is personal, so we find clues from the chapters of your life.

 We look at pain from a broad perspective, so we don’t potentially miss any contributing factors. This means that we look at all possible drivers of your pain, so that we can address all areas, not just one. We rule out any red flags for injury that should be looked at by a professional. From there, we remind you that your bodies adapt, and can change even if you have been in pain for a long time.  We show you how much your body can tolerate, and then we continue to increase your tolerance.  We remind you that your bodies are strong and resilient, we are just here to help facilitate this trend. We can mitigate the pain, and then make things strong again.

And remember that biomechanics matter!! All of this pain science does not rule out the basic fact that tissue trouble still usually leads directly to pain. So we continue to focus on exercise, and in that, we look at you and make sure your shoulder/hip/knee is in the best position for that exercise and for your body.

Consider for yourself the biopsychosocial approach. Remember that it is your response to nociception is what is important. So, you can:

  1. Change expectations, thoughts, fears: Anything that changes your brain’s evaluation of danger will change pain. Ask yourself:  What in my life...thoughts, beliefs, behaviors, diet, relationships, implies danger?  What about safety?

  2. You may need to test yourself physically. Really looking into your attitudes and beliefs about your body and pain can help.  Maybe write down what you think about your strengths and your pain…

    • Take note of any movement you are fearful of. Fear of movement usually applies to certain movements (e.g. neck extension in patients post-whiplash, overhead presses in patients with shoulder impingement syndrome, or forward bending in patients with low back pain). Even though these movements provoked pain in the acute phase, they are often perfectly safe to perform in a chronic stage. The problem is that the brain has acquired a long-term pain memory, associating such movements with danger/threat (Nijs et al). Be aware of these movements if you have any, and we can help you slowly add these movements back in.

  3. Fear and anxiety probably have more power to aggravate pain than any other emotional state, and acquiring knowledge and perspective are superb treatments. A confident and happy brain amplifies danger signals less than an anxious, miserable brain (Louw et al).

  4. Things can hurt more when you’re stressed or sad, and the increased pain makes you both stressed and sad. To break this cycle, look to change how you feel about suffering and setbacks. This is perhaps your greatest challenge as an athlete. So, goners, with fortitude of heart, face this challenge head on!

  5. Sleep has a tremendous impact on pain. Multiple studies show that sleep deprived subjects “reported more musculoskeletal symptoms” and “a significant increase in muscle tenderness (Lautenbacher et al). I know sometimes we just can’t get the sleep we need, but it is worth putting in the effort.

  6. Think about your neuromatrix map of your brain. If your map is associated with fear, think about positively influencing your map. The altered thoughts may change the pain experience, thus resulting in reduced pain and increased function

Ok, lean in closely and listen to this: you are not broken, you are strong and resilient. We are not here to “fix all of your problems or issues” but we are here to facilitate you getting stronger.

We do think that there is an optimal way to move, and that your quality of exercise is very important. Injury avoidance is our passion, and we will help you optimize your exercise, in our Paragon prehab fashion. But injuries do come, so we can give you specific exercise that can help to either calm an injury down or to change your nervous system, desensitize it in a way. And sometimes we do need to take away an activity, but only temporarily. If we do take it away, we will slowly build you back up so that you can tolerate it again.  And often we can keep you in your activity. Pain is ok, it just needs to be monitored.  We will often ask: What should this specific joint be able to do? If it cannot do that, how can we get it to tolerate these certain movements? And then we apply an exercise from there. We want your bodies to move in pain-free, efficient, optimal ways. So when we nag you for the 100th time about your spinal position or the way your shoulder is moving, just know, it is all out of love, Goners, all out of love.  

 Let’s look at a real life examples of how our thoughts could potentially add to our pain:

Let’s say you have back pain, and go to get an MRI, and it shows that you have a bulging disc. What you may think after seeing this image is that your back is fragile, and that you shouldn’t bend it, and that you need to protect your spine. But what if we explain to you that 40% of people with no low back pain have similar bulges and yet continue on with their life and their daily activities? Would this reduce your fear of movement? Could there possibly be less threat than you may have originally thought? Could this perceived threat be making your pain worse?

 Instead, could we look at the spine for how strong it really is? We are not saying that a bulging disc means nothing. And there are certain red flags we would rule out if you did have one. But we are saying that your pain signal could be turned up too high.

Understanding your pain is important, because it can change how much things hurt. We don’t want you to be afraid of any movements, or think that your spine is weak. We want you to remember that there are many factors involved, and we are here to help you.

Just remember, pain is not about what is actually happening, it’s about protection. Begin to consider ways to make your brain feel safe, rather than threatened. This month think about your story: your triumphs and your struggles and your pain. Think about your life as an athlete now, and where you want to go. The galaxy inside of you is always changing. New stars are forming as we speak.


-Laurel


References:

Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present, and Future. J Pain. 2015 Sep;16(9):807-13. doi: 10.1016/j.jpain.2015.05.005. Epub 2015 Jun 5

Adriaan Louw, PT, PhD, Kory Zimney, PT, DPT, Christine O, Hotto, PT, DPT, and Sandra Hilton, PT, DPT. The clinical application of teaching people about pain. Physiotherapy Theory and Practice.

Taulaniemi A1, Kuusinen L, Tokola K, Kankaanpää M, Suni JH. Bio-psychosocial factors are associated with pain intensity, physical functioning, and ability to work in female healthcare personnel with recurrent low back pain. J Rehabil Med. 2017 Aug 9.  

Ingraham, Paul.   https://www.painscience.com/

 Lluch E, Nijs J, Courtney CA, Rebbeck T, Wylde V, Baert I, Wideman TH, Howells N, Skou ST. Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis. Disabil Rehabil. 2017 Aug 2:1-10. doi: 10.1080/09638288.2017.1358770.

Ina Diener PT, PhD, Mark Kargela PT, DPT, OCS, FAAOMPT & Adriaan Louw

PT, PhD (2016) Listening is therapy: Patient interviewing from a pain science perspective,

Physiotherapy Theory and Practice, 32:5, 356-367

Arnoud Arntz*, Lily Claassens. The meaning of pain influences its experienced intensity. Pain 2004.

Cory Blickenstaff PT, MS, OCS & Neil Pearson PT, MSc (RHBS), BA-BPHE (2016) Reconciling movement and exercise with pain neuroscience education: A case for consistent education, Physiotherapy Theory and Practice, 32:5, 396-407

Adriaan Louw and Emilio J Puentedura. Therapeutic Neuroscience Education, Pain, Physiotherapy and the Pain Neuromatrix. International Journal of Health Sciences September 2014, Vol. 2, No. 3, pp. 33-45

 Stefan Lautenbacher. Berndn Kundermann.Jürgen-Christian Krieg. Sleep deprivation and pain perception. Sleep Medicine Reviews Volume 10, Issue 5, October 2006, Pages 357-369  

Adriaan Louw PT, PhD, Kory Zimney PT, DPT, Emilio J. Puentedura PT, DPT, PhD & Ina Diener PT, PhD (2016) The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature, Physiotherapy Theory and Practice, 32:5, 332-355,

F. BENEDETTI, M. LANOTTE, L. LOPIANO AND L. COLLOCA. WHEN WORDS ARE PAINFUL: UNRAVELING THE MECHANISMS OF THE NOCEBO EFFECT. Department of Neuroscience.

Jo Nijs, Enrique Lluch Girbes, Mari Lundberg, Anneleen Malfliet, Michele Sterling. Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories. Manual Therapy Journal.

Mastering the Classics

Mastering the Classics

“Humility is integral to strength.”

Wise words from your very own Ryan Whited.

Here at Paragon we absolutely believe this to be true. If your heart has the patience to stay in something difficult, and revisit these things over and over, then one day something new can be born out of the fire. This is what we want from you....sink into yourself, embrace what is hard, and let something good emerge.

And with that want comes many others:
 

We want you to train hard and train smart. This will lead to you getting stronger and more powerful.  

We want to build up your tolerance, endurance, and capacity.

We want you to be able to produce strength in all ranges.

We want your joints to be able to do everything they are made to do.  

We want control, speed, agility, the ability to bounce and spring, all done with fearlessness and confidence.


So, with all of these desires for our athletes, where do we start?! 

Well Goners, we start with the classics. We start with the fundamentals of movement. And not only do we start there (like most of you of course already have) but we continue to visit the fundamentals in order to keep your body strong and injury free. And of course, to improve and push your perceived limits.

There are tenants to strength training that NEVER CHANGE!  Lifting heavy things is good for us... all of us. Our connective tissue, our hormones, our bones (which is connective tissue) our brains, all love when we lift heavy things! Push, pull, and exert yourself. Live on these tenants. Don't get caught up in facial meridians, blood flow restriction training, or whatever other newest thing has come along.” More knowledge from Ryan Whited. Read that again if you need, it is important.

There are basic movements like walking and squatting that are so fundamentally human that they are necessary for optimal health. There is no replacing them. We want you to be better humans, bottom line. So, when it comes to a strength and conditioning program, these basic movement patterns become the building blocks for all movement. They are combined and varied and tweaked to generate a huge stockpile of complex movements.

When you are learning a language, you begin with letters and simple words. You then use these to form complex sentences. So, we master the basics in strength like we master letters and words, so we can then master the complex.  It is simpler for the nervous system to rely on a small number of general movement patterns that can be assembled together to form more complex movements. Creating these patterns makes the movement easier to organize . So, you can keep building and building until you have an extensive vocabulary of  movements!

When a foundational building block is missing, the entire structure built on top can be compromised.  If your movement vocabulary is missing one or more important patterns, like a squat, there are very wide range of everyday movements that will be compromised. The good news:  if you improve your squat/lunge/push up/pull up, you will improve many other aspects of your physical life. Simple as that, folks.

So, what are the movements that we want you to master?

  1. Hip Hinge/deadlift

  2. Lunge

  3. Squat

  4. Push-up

  5. Pull-up

  6. Loaded Carry

  7. Sprints

  8. Jumps

  9. Kicks

  10. Crawling

Developing sound movement patterns and challenging them through various training methods is the single most effective way to develop strength, build muscle and prevent injuries.

Yeah, movement patterns are that important.

1. The hip hinge/deadlift is so great because it works the entire posterior chain. And that backside is what helps you to generate power and explosiveness. Do your hamstring ever feel “tight?” Chances are, what they need is load. Those tight hamstrings need to be strengthened, rather than stretched. We hope we have talked about this concept enough now that it is starting to sink in: tendons and muscles like load. So give them what they like!

2. The lunge is my personal favorite way to build a strong, resilient lower body. Compared to your typical squats and deadlifts, single leg movements like the lunge require additional stability through the foot, ankle, knee, and hip and are an effective way to build strength and increase your maximal force output. (If you ever come to any of my classes, you should know this by now!) And if you are a runner, I believe you should ALWAYS do one legged exercises.

3. The squat is the king of all lower body movements. But even though they may seem simple, it is very difficult to execute a good squat. Movement quality is the foundation that all training effects depend on. And if you are struggling with your squat, let’s fix that, shall we? All people are built differently in terms of their hip and pelvis structure (in addition to pretty much every other anatomical and physiological aspect of the human body). That means that all people must squat differently. What we want to do is help you to find YOUR best squat, and be able to perfect if from there. Because there is no way to go through life without squatting!

4. A proper push-up requires precise levels of motor control and strength, as well as the ability to smoothly integrate each portion of your body in one seamless coordinated movement. They obviously work the upper body in an intense fashion, but they also require tension throughout the whole body. Sherrington’s Law of Irradiation describes when muscles recruit nearby muscles. Strength guru Pavel Tsatsouline called this law “muscle cheering,” as nearby tight muscles cheer the working muscles to work harder. The push-up is a great way to feel the effects of muscle irradiation.

5. The Pull-Up (or row variations) are staple foundational movements in nearly every type of strength and performance program. Pull-ups work your entire upper body, especially the muscles of your back, scapular stabilizers, shoulders as well as your abs and your biceps. A dead-hang pull-up is one of the toughest exercises you can do, and mastering it will improve your overall fitness level. You'd be hard pressed to find an exercise that gives you more bang for your training buck – especially in the upper body – than the pull-up.

6. Loaded carries: Just like many things at Paragon, heavy carries may seem simple, but they are extremely challenging.  They are a very effective way to build resilient core stiffness, grip strength, and improved shoulder stability, all while developing a brutal total body work capacity.

7. Sprints will help to increase your endurance and work capacity. And they will also obviously increase your maximal oxygen consumption, radically altering your conditioning level. Sprinting will improve your overall athleticism, making you more powerful and more efficient.

8. Jumps require explosive power, and also the ability to slow yourself back down. It is very important to be able to eccentrically control your body. If you run, you are doing this with every step, over and over, so you want your body to be proficient with this concept. And if you don’t run, well, you are still needing to control your body for day to day adventures. And jumping/plyometric training will increase your bone density. Even bone has a certain kind of rationality –  it is smart enough to start strengthening itself in areas that receive a lot of compressive shock. If you were a bone and wanted to maintain your structural integrity, isn’t that what you would do?

9. Kicking is essentially a balance and pivoting movement off of the non-kick leg with obvious mobility/power implications of the kicking leg.  They are a great way to train strength and power at end range. You have to have mobility, and mobility is defined as strength + flexibility. In other words, the term refers to not only having an increased range of motion, but also complete control of any newly acquired range.

10. Crawling, because humans are contralateral beings when it comes to their neurological organization. The automatic sequencing of upright muscle movement like walking and running is meant to be always coordinated the same way: the right arm goes forward, the left leg will do the same and when the left arm goes forward, the right leg will do the same. So there it is: cross pattern neurological organization.  So, can you think of what this can apply to? Changing your nervous system will change your overall quality of movement, so it will help you improve with your sport of choice. Want to become a stronger climber? Just think about the interlimb coordination in climbing and crawling biomechanics. Want to run farther? Organizing your movement will help you run with efficiency and with an optimal gait pattern. Crawling is one of the best ways to organize this movement, while simultaneously working your shoulders, legs, and trunk in a very real way (we all know the pain by now!)

Like Ryan says: “Position and quality of movement is always paramount: we believe there are better ways to move, ways of moving that have the potential to reduce pain and potential for injury, while enhancing performance. How we move dictates so many of our systems: nervous system, quality of connective tissue, joint wear and tear...etc. The quality should never be sacrificed for a better time or the ego. Humility is integral to strength.”

So, goners, get ready to master the classics. If you encounter a struggle, embrace it. Work to improve your quality of movement, and from there, your world as an athlete will only get bigger.

-Laurel Lippard

 

Foot Forward

WHAT THE FOOT?!

Confession: we at Paragon are total foot nerds. We love the feet. They tell a story (a very useful story) full of vast amounts of information.  As an athlete, you’re built from the ground up. The body is a powerfully interconnected system, and your feet are the foundation. The foot is beautifully complex: made of 26 bones and more than 100 muscles, tendons, and ligaments. And it has a lot to brag about, acting as a shock absorber, locomotor, and support system, and also a major source of sensory input (which we will talk about more later). You have all probably heard us tell you about the foot tripod. It consists of the center of the calcaneus (heel), the base of the 1st metatarsal (big toe) and the base of the 5th metatarsal (pinky toe).  If you have a stable tripod of the foot, then that stability can travel up the chain. So, this is a great place to start: by working on your foot tripod. Go ahead and try it. Stand up on one foot, lift all of your toes, and see if you can put even weight on the middle of your heel, ball of foot, and base of the pinky toe. Feel easy? Close your eyes and try again. Ok, now let’s get moving.

 

The Gait Cycle

During gait, the foot must be stable at initial foot-strike and also at push-off. However, during mid-support, the foot must become a mobile adaptor and attenuate loads. It also possesses spring-like characteristics, storing and releasing elastic energy with each foot-strike. This is accomplished through the deformation of the arch, which is controlled by all of those intrinsic and extrinsic foot muscles.

                                                                      (www.physio-pedia.com/Gait)

Gait can be broken down into phases:

1. Initial Contact      2. Loading Response    3. Midstance    4. Terminal Stance

5. Pre swing        6. Initial Swing        7. Mid Swing           8. Late Swing

 

A growing body of research shows that strength of small muscles in the foot can have big implications for a range of foot-health issues, like running-related injuries, and that interventions for strengthening the intrinsic foot muscles may help (so don’t you worry, we will have you  covered with that!)  Anyone out there ever been diagnosed with plantar fasciitis? Have you ever had achilles pain? Preventing and managing these injuries should start with a focus on your foot mechanics (Elbaz et at. 2017).

The body is really, really good at compensating. So if the feet are not doing their fair share of the work during your gait cycle, or in any activity, then the buck will be passed elsewhere. The load is going to go somewhere.  It doesn’t just magically disappear into thin air. And our bodies are really, really strong, and will adapt. And in some cases, your body may have a bony structure that is not going to change, so we will make you stronger so that your system can tolerate your structure. But, we often see things we can change, and we think that there is an optimal, efficient way to move. We can make the foot stronger in an optimal way, just like any other part of the body.

 

The mighty team of the foot, ankle and hip!

Now, we hope that it is obvious that when we are talking about foot we are also talking about the ankle. We know you have heard about the importance of ankle stability and also mobility. Let’s first take a look at ankle range of motion. In a huge chunk of the population that has limited ankle mobility, that stiffness and loss of ankle rocker is actually there as a coping mechanism to find stability. Again, your foot should be a mobile adaptor, but also very important is the ability to lock off to push you through your gait cycle when walking or running. So, if you don't have a stable enough foot/arch and are passing your body mass over that unstable structure, collapse ensues before ankle rocker is completed during stance phase of gait (Cheung et al. 2015). Thus, the body goes into a strategy the next joint complex up the chain and attempts to gain stability at the ankle complex. Now, let’s continue to look up the chain.

The hip and foot are a team: they both have a job to do during gait.  In their pre-game huddle they discuss the motor plan and attack the loading and unloading together. So, if either the foot or the hip does not have the motor control to load and unload correctly, then your body may not be moving optimally or efficiently (Koshino et al. 2014).  In many studies, athletes with chronic ankle instability demonstrated decreased muscle activity of ankle, knee, and hip musculature during common functional rehabilitative tasks (Sheng-Che et al. 2017).  It has also been shown that hip and ankle coordination during walking was impaired in subjects with chronic ankle instability. So you if want your star team to play well, you need to work those feet and ankles!

Now, if you goners want to get really, really detailed, this is for you: here is an example of the chain of events that can happen in your gait, and it shows just how much one action affects another.  If your right ankle rocker (dorsiflexion) is impaired, early heel departure can occur and hip extension will be limited. An alteration in right glute function can then follow. From here, the left step length (the length of measure from right heel strike through to left heel strike) could very likely be shortened. This would cause a premature load onto the left leg, and could very well force the left frontal plane to be more engaged than is desirable. This could lead to left core and hip frontal plane weakness and compensation patterns to be generated. A bit complicated, we know. Bottom line, the ankle and hip work together, and one affects the other. There is a good amount of research on this subject. So, in order to address one, we must address the other. As the Gait Guys say: “If there is impairment of hip extension motion and gluteal weakness due to insufficient ankle dorsiflexion in gait to acquire it, then prescribing corrective exercises to address things at the hip/pelvis level is layering a corrective to an adaptive response. We are nowhere near the problem.”  We must address the foot and ankle!  

 

Sensory input: Your brain’s map of your body

Can we all just take a moment to appreciate how cool it is that the connections among the cells in our brain change, adapt, and reorganize. We can rewire our brain. So, you want something to get easier? Do it more. Want to move more efficiently? Focus on your from and have intention in your movements. And what better place to start than the ground up.  Let’s talk about about the sensory input we get from our feet.  Sensation and movement of different parts of the body are controlled by different areas of the brain. For instance, when you move your big toe, a specific area of your brain triggers a signal that tells the muscles on your big toe to move.  When you touch something with your toe, a neighboring area of your brain receives a signal about that touch sensation.

Look at your hand.  Now look at your arm.  Which is bigger?  Your arm, right?  Does that mean your arm has larger area of  the brain devoted to its control? Actually, no. Sensations and movements of your hand are controlled by more of your brain than sensations and movements of your arm.  This larger area allows you to make finer movements and a have better sense of touch.  In this way, your brain essentially makes a map of your body. This is called the cortical homunculus. It represents how our body is perceived within the brain and how the neurons are distributed in these areas in order to create this perception.  The amount of cortex devoted to any given body region is proportional to how richly innervated that region. The homunculus is split in half, with motor representation for each side of the body represented on the opposite side of the brain. So, in this map, our feet would be very big (take a look if you’re interested in this, https://www.pinterest.com/pin/393924298626461247/ ).

This is because the brain gets a lot of stimulus through the bottom of the foot. Sometimes that can be lost: we can be disconnected from our feet. How is your control of your toes? Now, we will not ask you to paint a masterpiece with your toes, but can you do a simple toe wave? Can you move them independently? Well, if not, we can help with that. And if we can challenge and work the feet, then we can essentially remap the nervous system by reorganizing the connections throughout the brain and nervous system (Wall 2017). And as we continue to work and move, and make smaller and finer distinctions between movements, then map of our body can change and become more clear.

 

Ok Goners, time to get started:

If we can strengthen feet and ankles in different positions and ranges of motion, then we can help to protect your body from injuries. We can wake those muscles up that have not had much work, and we can remap the system! This month we will help you work the feet and ankles. And this will in turn help you up the chain, with knee and hip function. And do you think that hip function affects back, shoulder and neck? Well of course it does. It is all connected folks! So get ready to give those old dogs some love!
-Laurel Lippard

 

References:

Avi Elbaz, MD ,Irina Magram-Flohr, MPT, MD,Ronen Debi, MD, Leonid Kalichman, PhD,  Association Between Knee Osteoarthritis and Functional Changes in Ankle Joint and Achilles Tendon. January 2017.

Carter, J. C., Sturnick, D. R., Vacek, P. M., DeSarno, M. J., Argentieri, E. C., Slauterbeck, J. R., Johnson, R. J. and Beynnon, B. D. (2016), Relationship between geometry of the extensor mechanism of the knee and risk of anterior cruciate ligament injury. J. Orthop. Res.. doi:10.1002/jor.23366

Cheung RT, Sze LK, Mok NW, Ng GY. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. J Sci Med Sport 2015 Nov 22

Feger MA1, Donovan L2, Hart JM3, Hertel J4. Lower extremity muscle activation during functional exercises in patients with and without chronic ankle instability. Epub 2014 Jan 8.

Koshino Y1, Yamanaka M2, Ezawa Y3, Ishida T4, Kobayashi T5, Samukawa M6, Saito H6, Takeda N7. Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability. November 2014.

Péter A, Hegyi A, Finni T, Cronin NJ. In vivo fascicle behavior of the flexor hallucis longus muscle at different walking speeds. Scand J Med Sci Sports. 2017.

Sheng-Che Yen, ,Kevin K. Chui ,Marie B. Corkery ,Elizabeth A. Allen, Caitlin M. Cloonan, Hip-ankle coordination during gait in individuals with chronic ankle instability. February 2017.

Wall, Tyler.  Your Brain, Neuroplasticity, & the Feldenkrais Method. 2017.

Wezenbeek E, Willems TM, Mahieu N, Van Caekenberghe I, Witvrouw E, and De Clercq D. Is Achilles tendon blood flow related to foot pronation?. Scand J Med Sci Sports. 2016.


Wink, A.E. et al. Varus thrust during walking and the risk of incident and worsening medial tibiofemoral MRI lesions: the Multicenter Osteoarthritis Study\. Osteoarthritis and Cartilage. January 2017.

 

 

Eccentric Load

January at Paragon:

Eccentric Load

Get ready goners, it’s time to lengthen and strengthen…

During any movement where muscle tissue is lengthening, if you are resisting a load, it’s an eccentric contraction.  Most "down" motions are eccentric contractions working to oppose gravity: the down phase of a pushup, or the down phase of a squat, involve eccentric muscle contractions (so, no escaping that folks!) Eccentric load could also be contractions of surrounding muscles (so, yeah, like any active movement), or an externally applied load (like strength training). When you do a bicep curl with a dumbbell, as you curl the bell, your bicep is contracting concentrically (muscle is shortening). When you uncurl the bell to straighten your arm, you are eccentrically contracting your bicep (muscle is lengthening).

Eccentric contractions have been a bit of a mystery: for many years, we didn’t quite understand what was happening or how they worked (and really, they are still poorly understood).  We all remember learning about the sliding filament (cross-bridge) theory, which states that the shortening of a muscle occurs as the myosin cross-bridges cyclically attach to actin and draw the actin across the myosin, creating force and shortening.  Well, there are some shortcomings to that theory; namely, it does not explain how an eccentric contraction works.

So, in eccentric exercises, the muscle lengthens while still producing force.  The number of possible cross-bridge formations is diminishing, yet the muscle is still capable of producing force.  Muscles can even produce force in the absence of cross-bridge formations, when muscle is stretched beyond the thick and thin filament overlap.

What the heck is going on here? Titin, that’s what. Titin is a third filament, in addition to the thick filament (myosin) and the thin filament (actin). During an eccentric contraction, actin is pulled away from myosin and the distance between the Z-lines increases while titin binds to actin to contribute force in the absence of cross-bridge formations (Herzog 2014). This is how your muscle produces force as the cross-bridge formations diminish. When it comes to the way our crazy, intricate bodies work, there is so much we don’t know. But, here are a few things we do know about why eccentrics are so important.

Eccentric exercise results in less oxygen consumption, greater force production, and less energy expenditure than concentric exercise (Lindstedt et al. 2001).  The energy requirements are typically 4-fold smaller than in concentric exercise of the same load (studies have shown that when a muscle is eccentrically lengthened, the energy requirement falls substantially in comparison to concentric contractions because ATP breakdown and heat production are both slowed). Applying eccentric load can also increase Type 1 collagen synthesis. This is really, really cool, and we will talk about this more in a bit.

Eccentric actions are so important because they often involve the control or deceleration of a movement. Muscles activated during lengthening movements function as shock absorbers, to decelerate during landing tasks or to precisely deal with high external loading in sports. So, when you are hiking down into the Grand Canyon...so many muscles need to eccentrically contract to control your body...and when you are downhill skiing at Snowbowl, eccentric activity of your quadriceps muscle is dominant through all of your turns. They happen all the time, during so many everyday movements. But not only are they an important part of our day to day activities, they are also an important tool in injury rehab and injury prevention.

Managing injuries:

Many studies recently have substantiated eccentric exercise as an effective treatment for tendinopathies. Eccentric work requires less oxygen consumption than concentric work, making it ideally suited for the rehabilitation of tendinopathies. Oxygen consumption is seven and a half times lower in tendons/ligaments than in skeletal muscle. Tendons have a low metabolic rate and anaerobic energy generating capacity, so that they can maintain tension for long periods of time.  But, the low metabolic rate results in slow healing after tendon injury. We all know how nagging that achilles pain from running can be, or have felt that elbow pain after a long day of climbing. Because eccentric movements require less oxygen than concentric movements, they can be a good choice for managing those nagging injuries.

Studies have shown there are many injuries that have been shown to improve with eccentric load: ACL reconstructions, muscles strains, hamstring injuries, elbow tendinopathy, patellar tendinopathy, and achilles tendinopathy (Lorenz, Reiman  2011).  Multiple studies have found that Type I collagen synthesis increased after eccentric training in athletes with unilateral achilles tendinosis.

Ok, in case you missed that, let me say it again. Eccentric load can increase Type 1 collagen synthesis.  Do you know what is made of type 1 collagen?  Ligaments and tendons are, that’s what!  Let’s take a minute to talk about how cool this is….Type I collagen is amazing. It’s fibrils have enormous tensile strength; that is, such collagen can be stretched without being broken. These fibrils are packed side-by-side in parallel bundles, called collagen fibers, in tendons, where they connect muscles with bones and must withstand enormous forces. Gram for gram, type I collagen is stronger than steel.

When a tendon in injured, the collagen near the injury site becomes disrupted. Those neatly packed little bundles can become distorted. And then during the healing phase, the the collagen produced can also often be disorganized. But, adding eccentric load can help to remodel old tissue, aligning the collagen, at the same time increasing its synthesis (Galloway et al. 2013).

Preventing injuries:

So, if you don’t have an injury, eccentrics are just as important for you.  We want you to climb, run, ski, bike, hike______(insert your awesome adventure of choice here), for a long, long time. Eccentrics are another important piece to add to the puzzle of keeping you healthy during your athletic endeavors. They are another way to make your body strong, and when your body is strong, it can better tolerate those many hours on the trail or the bike or the climbing wall. There is a lot of evidence that indicates eccentric strength training methods will encourage neuromuscular adaptations. So this can help with muscle coordination. (Eccentric compared with concentric muscle contractions require different activation strategies and programming processes by the central nervous system).

Eccentric training is a potent stimulus for enhancements in muscle mechanical function, and enhances the way the muscle and tendon work together.  Including eccentric loads into your workout can improve your strength, power and speed performance (Douglas et al. 2016). Many studies suggest that increases in peak torque and strength-related performance parameters were greater following a program consisting of maximum concentric and eccentric muscle actions than resistance training using concentric muscle actions only (Colliander, Tesch 1990).  

Improving range of motion:

Since tendons are mechanically responsible for transmitting muscle forces to bone as they connect bone to muscle belly at their ends, this is how motion is allowed and joint stability is enhanced. So, if your tendons, (are therefore the muscles attached to those tendons) are working as they should, then your joint will be more stable. And sometimes, the best way to gain mobility is to impart stability. One reason why joints lose mobility is because your body is locking them down in order to provide stability. The nervous system always wants to feel safe. So, by adding strength work to improve tendon and muscle performance will provide stability, ultimately leading to more mobility.

Ok Goners, time to put this knowledge into action:

There is no question that your exercise program should include periods of eccentric exercise, as this will provide protection from injury or reinjury, will help improve coordination and balance, and can increase strength in the full range of motion in your joints. Remember, you are stronger in a eccentric movement than a concentric. So, that means that you can you can handle more resistance or weight, so it is yet another way to boost your system and improve your athletic performance. It is another way to push beyond your perceived limits. And what a great way to start of the new year, by redefining your limits. So get ready to lengthen and strengthen, goners!  

-Laurel Lippard

 

“If you always put limit on everything you do, physical or anything else. It will spread into your work and into your life. There are no limits. There are only plateaus, and you must not stay there, you must go beyond them.” Bruce Lee

 

References:

Colliander EB1, Tesch PA. Effects of eccentric and concentric muscle actions in resistance training. Acta Physiol Scand. 1990 Sep;140(1):31-9.  

Daniel Lorenz, DPT, PT, ATC/L, CSCS, USAW1 and Michael Reiman, PT, DPT, OCS, SCS, ATC, FAAOMPT, CSCS2   The Role and implementation of eccentric trainging in athletic rehabilitation: tendinopathy, hamstring strains, and ACL reconstruction..  Int J Sports Phys Ther. 2011 Mar; 6(1): 27–44.  

Debenham JR1,2, Gibson WI1, Travers MJ2, Campbell AC2, Allison GT2.  Eccentric Loading of Triceps Surae Modulates Stretch Shortening Cycle Behaviour- A Possible Therapeutic Mechanism. J Sport Rehabil. 2016 Aug 24:1-22.

Douglas, J., Pearson, S., Ross, A., McGuigan, M. Chronic Adaptations to Eccentric Training: A Systematic Review. Sports Medicine Journal. 2016. Galloway, Marc T., Andrea L. Lalley, Jason T. Shearn. The Role of Mechanical Loading in Tendon Development, Maintenance, Injury, and Repair. J Bone Joint Surg Am. 2013 Sep 4; 95(17): 1620–1628. Published online 2013 Sep 4. doi: 10.2106/JBJS.L.01004Herzog W. The role of titin in eccentric muscle contraction. J Exp Biol. 2014 Aug 15;217(Pt 16):2825-33. doi: 10.1242/jeb.099127.

Langberg H1, Ellingsgaard H, Madsen T, Jansson J, Magnusson SP, Aagaard P, Kjaer M. Eccentric rehabilitation exercise increases peritendinous type I collagen synthesis in humans with Achilles tendinosis. Scand J Med Sci Sports. 2007 Feb;17(1):61-6. Epub 2006 Jun 19.

Lindstedt S.L., LaStayo P.C.,  Reich T.E. When Active Muscles Lengthen: Properties and Consequences of Eccentric Contractions. Physiology Published 1 December 2001 Vol. 16 no. 6, 256-261 DOI:  

Mitchell, Jules. http://www.julesmitchell.com

Woodley, B., Newsham-West, R., Baxter, G. Chronic tendinopathy: effectiveness of eccentric exercise.   Br J Sports Med      2007;41:188-198.