Thursday, April 28, 2016

The Most Important Muscle You’ve Probably Never Heard Of…Part 2 – The Gluteus Medius


 
Ahhhh, the gluteus medius.  Or as I will call it throughout this blog…the glute med!  Unless you are a runner, ballet dancer or a yogi, you probably have never heard of this muscle.  But it is a very important muscle in everyday activity.  It is one of the three gluteus muscles, along with the gluteus maximus and minimus. 
The main function of the glute med is abduction of the hip.  Abduction is when you move the leg away from the center of the body.  The glute med is also responsible for external rotation of the hip when the hip is extended and internal rotation of the hip when it is flexed…more accurately; it prevents external rotation when flexed.  The most important job of the glute med, however, is stabilization of the pelvis.  Activation of the muscle prevents dropping of the pelvis when standing on one leg.  When the glute med is injured or weak, it allows the opposite hip to drop when weight bearing on one leg such as when walking or running.  This is called a Trendelenburg sign. 
While glute med is very important to athletes like runners and dancers, it is equally important to chiropractors.  The figure above shows three different trigger points in the muscle and the pain referral pattern for each.  All three of these referral patterns present to our office on a regular basis.  Patients come in with low back pain and are surprised to learn it’s not their low back at all, but their glutes.  The glute med is constantly firing when we are upright so it makes sense that the muscle is overworked. 


Performing self myofascial release at home with a foam roller or a tennis ball can help work out the trigger points between appointments with your chiropractor.  Also, doing therapeutic exercise to strengthen the muscle will help.  Exercises such as “clam shells” and “monster walks” are effective exercises to try. 
Certain activities, or lack thereof, can increase the risk of injury to the glute med.  Sudden increase in frequency, intensity and duration of training can lead to glute med injury.  Poor strength and flexibility, endurance sports like triathlons, lack of proper warmup before activity, unequal leg lengths and pelvic misalignment can all increase the risk of injury.  Correcting these things will help prevent injury to the glute med.  If you feel you struggle with any of these risk factors, talk to your chiropractor so you can work together to fix the problems. 
 
If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

Thursday, April 21, 2016

The Most Important Muscle You’ve Probably Never Heard Of…Part 1 – The Soleus



Have you ever heard of a muscle called the soleus?  Unless you’re a doctor or a runner, you most likely haven’t.  The soleus is a muscle in the superficial posterior compartment of the lower leg.  It lies just below the gastrocnemius (calf muscle).  The tendon of the soleus muscle joins that of the gastrocnemius to form the Achilles tendon.  

The soleus aids the gastrocnemius in plantarflexion, or pointing the toe.  These two muscles work together to allow for walking, running and dancing.  The soleus is vital for maintaining upright posture.  If not for the constant pull of the soleus, the body would fall forward.  Another important role of the soleus is to pump the venous blood from the periphery back to the heart when in an upright posture.  Due to the bony attachments of the soleus, it is the main muscle for plantarflexion when the knee is bent.  The gastrocnemius originates from the femur (thigh bone), so a bent knee limits the effective tension of the muscle, leaving the soleus to do all the work.  When performing tasks such as walking, the soleus is primarily used because it is made mostly of slow twitch muscle fibers which allow for better endurance.  
 
The most common injury to the soleus is a strain to the muscle.  A strain is micro-tearing of the muscle fibers caused by trauma.  Strains of the soleus, or either calf muscle for that matter, can be caused by a direct blow to the muscle or overstretching the muscle during activities like sports where there is frequent jumping or changing of direction.  These injuries usually occur when the muscles are already tight due to a lack of stretching. 



Stretching the soleus is super easy.  Just make sure to warm up before you start.  If you stretch a “cold” muscle, it can increase the risk of injury.  Since there are two muscles in the calf, there are two different positions to stretch it…one for each muscle.  Almost everyone knows how to stretch the gastrocnemius.  The picture on the left shows the knee straightened out…that stretches the gastrocnemius.  The picture on the right shows the knee bent…that stretches the soleus.  It is extremely important to stretch both muscles to avoid injury and maintain proper function.
There are several different ways to treat a soleus strain.  Icing the lower leg may help relieve pain and swelling within the first 48 hours.  The ice will help reduce any inflammation created by the muscle fibers tearing.  After 48 hours, applying moist heat to the lower leg will help warm up the muscle and increase blood flow to the area which facilitates healing.  Performing self myofascial release using a foam roller or a tennis ball can help work out any trigger points, fascial points or muscle knots that may develop as the micro-tears heal.  Applying kinesiology tape to the affected area can also help with pain relief and healing.  The tape can help decompress the tissue and if applied correctly, can help reduce swelling.  If you experiencing excessive swelling, cruising or alteration of gait, make sure to seek the help of a medical professional.  At Pro Chiropractic, we specialize in sports injuries and are well trained and well equipped to help with soleus strains.  



If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

Thursday, April 14, 2016

What is Fascia and Why is it Important? Part 2


Last week, we discussed what fascia is and why it is important in general.  This week, we are going to talk about why it is important for athletes specifically.  Of course, these things correlate to the non-athlete as well.   To review…fascia is a fibrous connective tissue that is literally EVERYWHERE in the body.  If you were to remove all tissues except fascia, you would still have a 3D model of your body.  Fascia plays an integral part in how we move, especially for athletes.  Here are 3 reasons fascia is important for an athlete.



1.       Fascia is our body’s equivalent to a sponge!
Think of it this way…when a sponge is dry, it is hard and very brittle.  Thus, with very little effort, it is broken apart.  But…when a sponge is hydrated, it is resilient and bounces back easily!  Fascia is the same!  When dehydrated, it becomes brittle and breakable; but when it is hydrated, its resiliency allows for effortless gliding over, around and through the muscles without dysfunction.  Our stability and ability to move are determined mainly by the health and hydration of our fascia.  This is extremely important for athletes because movement and stability are everything when it comes to success.  Unrestricted mobility gives an athlete the advantage over an opponent because they are able to do things their competition cannot do, especially if the opponent is restricted by dehydrated fascia.  Stability is important in preventing injury.  Fascia that is properly hydrated will move and stretch and glide effortlessly over muscles allowing them to contract at their highest potential then return to its original shape and position without any integrity loss.  Dry fascia will pull apart and separate from the muscles leading to injury and muscle dysfunction. 
How do we hydrate fascia?  Do we drink more water?  Not necessarily.  While keeping your body hydrated in general will help, that kind of hydration is more for cell and organ function than fascia.  In order to hydrate fascia, you must have it manipulated.  At Pro Chiropractic, all 5 chiropractors are highly trained in many different soft tissue techniques, including Graston Technique, FAKTR, Myofascial Release, Fascial Manipulation, and Rapid Release.  Using these modalities, we are able to rehydrate fascia and rid the body of “fascial points” (similar to trigger points) that may cause pain or hinder proper motion.  We all know that being pain free and mobile are very important to athletes of all ages and levels.
2.       Movement variation plays an important role in fascial hydration.
Movement itself helps to bring hydration back to the fascia, but that movement must be varied…in both type and tempo.  Doing the same repetitive movements can be damaging to your joints, leading to issues like arthritis, but those repetitive movements are actually draining the water from the fascia in those particular directions.  When that happens, the dehydrated fascia turns brittle causing breakage in the tissue leading to injuries.  Changing up the workout routine, like cross training, can help rehydrate tissues in all directions, thus keeping the resiliency and preventing soft tissue injuries. 
Always always always incorporate proper rest periods into your workout routine.  Rest also helps to rehydrate the fascia.  Think about how when you walk on the beach near the water…when you step on the sand, you see the water leave the area where you stepped, but as soon as you lift your foot, the water returns.  It works the same way with the fascia.  When you work out, it is like stepping on the sand, water leaves the tissues.  When you rest, it is like lifting your foot, water returns.

3.       Fascia is the largest sensory organ in the body!
Research has recently surfaced showing that the fascial system may be the largest sensory organ in the body and is thought to have six to ten times more sensory nerve receptors than muscle tissue.  In simpler terms…fascia feels more than muscle.  According to Gibson in a 2009 study,  when you feel soreness a day or two after a tough workout, that Delayed Onset Muscle Soreness (DOMS) is actually coming from the fascia, not the muscles.  Therefore, it is believed that the fascial system is a system of proprioception (awareness of your body in space).  Maintaining hydrated fascia is very important in your body’s ability to stay aligned and functional which aids in keeping small issues and injuries from progressing into larger ones.  In order to fully utilize the sensory and proprioceptive qualities of the fascia, all you have to do is keep moving…especially those varied movements we talked about before! 
 
 
 
 
 
If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.



Thursday, April 7, 2016

What is Fascia and Why is it Important?



Have you ever heard the word fascia?  If you’re an athlete, you may have.  If you’re not, you most likely haven’t.  If you’re a Pro Chiropractic patient, you most certainly have!  Fascia is one of the most ignored and misunderstood systems in the body…and it is also one of the most important.  Fascia is EVERYWHERE!!!  You can’t escape it in the body.  Believe it or not, it is one continuous structure from head to toe without interruption.  It is the framework for all connective tissue.  If you were to remove all non-fascial tissues from your body, you would still have a 3D model of what you look like.  Cool, huh?


There are three different kinds of fascia: superficial, deep, and visceral or subserous.  Superficial fascia is actually a part of the skin.  It is the lowermost layer of skin throughout most of the body and is responsible for creating the shape of the body.  You can find it surrounding glands, organs, neurovascular bundles (groups of nerves and blood vessels that travel together) and basically any space unoccupied by other structures.  It stores water and fat, serves as a passageway for lymph fluid, blood vessels and nerves, and can act as protective padding to cushion and insulate. 
Deep fascia is a layer of fibrous connective tissue that surrounds individual muscles and also separates muscle groups into compartments.  For example, the lower leg (calf region) is separated into four fascial compartments: anterior, lateral, superficial posterior and deep posterior.  The anterior compartment contains the tibialis anterior, extensor hallicus longus, extensor digitorum longus, and peroneus tertius muscles.  The lateral compartment contains the fibularis (peroneus) longus and brevis muscles.  The superficial posterior compartment contains the gastrocnemius, soleus, and plantaris muscles.  The deep posterior compartment contains the tibialis posterior, flexor hallicus longus, flexor digitorum longus, and popliteus muscles.  The fascia that separates the compartments can also be called intermuscular septums.  Deep fascia is made primarily of elastin fibers which help determine the extensibility and resiliency of the tissue.  It is primarily avascular which means it has no blood supply.  It does, however, have a high density of sensory receptors including mechanoreceptors which respond to a physical stimulus like mechanical stress or strain (movement), proprioceptors which give position sense or tell your brain where your body is in space, and nociceptors which respond to damage or the threat of damage thus triggering the feeling of pain.
Visceral or subserous fascia provides suspensory elements to organs in their cavities.  Each organ is surrounded by two layers of fascia which are separated by a thin serous membrane.  The outer layer of organ fascia is known as the parietal layer.  The inner layer of organ fascia is called the visceral layer.  This is actually the skin of the organ.  Visceral fascia may have different names depending on the organ it belongs to.  For example, in the heart, it is known as pericardia.  In the lungs, it is known as pleura.  And in the abdomen, it is the peritoneum.  Visceral fascia must maintain its tonicity due to the suspensory component thus it is considerably less extensible than superficial fascia.  If the tonicity is compromised, organ prolapse can occur.  If the tonicity is increased, organ motility (like intestinal digestion) can be limited.

Fascia is similar to ligaments and tendons in the structural components.  They are all made up of fibrous connective tissue containing closely packed bundles of collagen.  These collagen fibers are designated in a wavy pattern parallel to the direction of pull.  Fascia is flexible and able to resist great forces with unidirectional tension until those wavy fibers are straight.  Fascia differs from ligaments and tendons in location.  Ligaments connect bone to bone.  Tendons connect muscle to bone.  Fascia essentially connects muscle to muscle because it surrounds all muscles.

To learn more about fascia and why it is important, be sure to check back next week for “What is Fascia and Why is it Important? Part 2.” 

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.