by Jolene Steigerwalt, RN and Certified Massage Therapist, with Elaine Ward
[Jolene Steigerwalt and Elaine Ward are collaborating on a book called "Massage and High Performance - Tips for Self-Care" which will be available at the end of 2001. The following is from an interview Elaine had with Jolene in August of 2000.]
EW: Jolene, you are filled with fascinating information on ways of coping with the aches and pains all of us masters have. Would you like to discuss them with us.
I certainly would. I actually got into racewalking because I was injured from running. Many of us have come into the sport this way. It is usually the knee or hip that is causing a problem. Doctors like to tell us that the cause is a bone problem and that we should never run again. Or they tell us we have thin cartilage and are going to run out of padding if we don't ease up.
I have discovered that most of the problems racewalkers (or runners) have are due to something called "Recurrent Strain Injuries" (RSI) with underlying structural/functional etiology. What happens is similar to what happens to the front alignment on a car. You hit a bump, your steering wheel may not wobble at first, but every time you bump against something like a curb when you are parking, the wobble becomes more pronounced. This is when you take your car to the repair shop.
Well, there aren't any "one stop" handy repair shops for human bodies. What we do is go to a doctor and say, "This hurts or that hurts;" or we ask other athletes for advice. Athletes often have good shop talk for ailments. Most importantly you realize in talking with others, "I am not the only one with this problem." Then you think, "How can that person win a race while I sit crippled on the sidelines."
Fortunately, I fell into the massage world and discovered all types of remedies for aches and pains. I also discovered that no one needs to be intimidated by a physician recommending (1) that you take an extended rest (2) that you give up your sport, or (3) that you find another sport. The truth is that doctors and athletes have come full circle now. Athletes are teaching the doctors about sports injuries and most doctors are finally listening.
Before athletes think they are wearing out because of frequent aches and pains, they need to find out what is going on with their muscles, tendons and ligaments. The muscle attachment sites to the tendons are the most important places to check. Let's stop for a bit of anatomy.
Skeletal muscles attach to the bones via tendons and they have at least two attachment sites. The most proximal muscle attachment (nearest to the center of the body) is called the origin; and the more distal (distant) attachment is referred to as the insertion. If you look at a musculoskeletal map, you can easily see the origin and insertion points of the different major muscles.
Skeletal muscle can account for as much as 50% of total body weight in men and 40% in women. Each skeletal muscle is composed of thousands of muscle fibers. The muscle fibers are the portion that shorten or contract during exercise. These statistics leave no room for doubt about the importance of keeping muscles healthy and the importance of appropriate treatment planning.
The easiest part of the muscle to feel is its belly because the belly is the widest part of the muscle. When you have a massage, the masseuse typically works the belly of the muscle and neglects the origin and insertion points. As a result the effect of the massage is temporary and the symptoms return.
Visualize muscles tapering down to very narrow spaces as they attach to the bones via tendons. If an athlete is training every day, he or she risks getting microscopic muscle tears from the repeated stress of the muscles lengthening and contracting. If these tears are left unattended, scar tissue is apt to form in these spaces. Add a residue of lactic acid and carbon dioxide to the scar tissue from skipping post exercise activities that flush out the muscles, and the scar tissue may calcify. It may not happen quickly. It may take as much as 20 years. But hard nodules will eventually form and interfere with athletic performance.
Because calcified muscle fibers feel like little pieces of bone, people commonly mistake them for arthritis. Furthermore, they sometimes hurt when they are touched or pressed, especially if aggravated by inefficient muscle function, and everyone knows that arthritis is painful. It cannot be emphasized enough, however, that calcified muscle fibers may not have anything to do with arthritis. They may be strictly the consequence of scarring and possible calcification from repeated athletic stress. If it is from scarring, then it is realistic to expect that you can return to your normal activity and sport after remedial treatment.
I am a case in point. For a period of four years, I would get to a certain level of training and then get injured from simple strains/sprains to major multiple fractures. I was totally frustrated and was trying everything and anything that promised to help me including anti inflammatories for arthritis.. It was during these trials that I started to pay attention to the hard , painful little knots in my hips and legs. I learned that these hard points were injury debris collected in the muscles and they acted like speed bumps when I was exercising. When I tried to go faster and better my race times, these little bumps increased the work load on my muscles and suddenly my body said, "No more!"
Older athletes are more prone to having hard, calcified muscle knots. Some young athletes can get away with ignoring muscle problems, but by the time they hit 50 or 60, they are "hurting". If they should poke around, they would find that they could feel tiny, and sometimes not so tiny, solid bumps nested in their muscles.
As older athletes, we need to keep our muscles stretched out or massaged so that lactic acid and carbon dioxide can't build up and trigger calcification. That is what the racewalking team at the ARCO Olympic Training Center is doing so well. The Coach is insisting on massages, hot and cold showers and other post workout modalities that flush the toxins out of the muscles after a hard exercise. The Olympic athletes, particularly in Europe, have been practicing pre- and post-race massage for years! Now it is our turn.
[JOLENE STEIGERWALT: 2000 Masters Outdoor Championships in Eugene, OR. W55 (1st) - 5km 31:08.12; (1st) 10km 1:03:33. National 5K Championship, Kingsport, TN (2nd) 31:01. Registered Nurse and Certified Massage Therapist. Graduated from College of William and Mary/Riverside Hospital School of Nursing, VA, 1965, San Diego State University, 1978, B.A. in Psychology; San Diego State University, 1985, Bachelor of Science in nursing. Certification as a Massage Therapist from the International Professional School of Bodywork with a specialty in chronic pain and muscle dysfunction.]
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