How Kinesio Tex Tape Benefits the Athlete

Unlike other types of athletic tapes, Kinesio Tex Tape is designed to mimic the superficial layers of the skin - very thin and light with an effective logitudinal stretch between 40 to 60%, roughly the stretch capacity of the epidermis in areas like the knee, low back and cervical regions. When applied properly, it lifts the epidermis in waves as the athlete moves, promoting the movement of interstitial lymphatic fluid and thus reducing the edema and pain that are generally associated with muscle dysfunction. In essence, a walking massage! Secondly, unlike other imitation tapes, the 40 to 60% stretch is longitudinal only (stretches lengthwise only, not cross wise) which allows the therapist to facilitate or inhibit muscle action. The sensitive nerve receptors in the skin communicate with the mechanoreceptors in the muscles that initiate either muscle contraction or release. By orienting the bias and intensity of the stretch applied, the therapist can encourage the muscles to contract or release. Combinations of these two major effects can be used to aid in a number of beneficial corrections in the athlete’s body.

Overall, the tape can be used to follow-up and enhance the therapist’s treatments for 3-5 days after the athlete has left the treatment room.

The effectiveness of Kinesio Tex Tape depends entirely on the skill level of the therapist applying it. As always, safety first – the person applying the tape should be a certified therapist, athletic trainer, chiropractor or medical professional who has a thorough understanding of anatomy & kinesiology, all the body’s systems and the contraindications for using the tape. There are few general contraindications, but they need to be respected, and then applications must be considered on a case by case basis, allowing for the athletes history of activities, injuries, surgeries and conditions. Secondly, in depth training insures a solid understanding of theory and application – a Certified Kinesio Tape Practitioner (CKTP) has this training, so look for those initials! Lastly,  focus and care are crucial! Increased pressure and speedy standard applications often “feel great” to the athlete who is used to the restriction of athletic tape, but athletic tape and kinesio tape in general are used for two different purposes. Athletic tape is heavier and used to provide limits to support and protect the athlete. Kinesio tape is light and designed to move with the athlete, wrinkling/lifting the skin with movement, and should barely be felt, if at all.

Kinesio Tex Tape is a powerful tool to help my athletes heal faster and perform at their optimal level. I look forward to helping you all excel with it.

Core - It's Not Just for Breakfast Anymore!

Had to laugh at this one! One of my swimmers came to me last week with pain in both his groin and shoulder. We tested, identified the lesions and then went on to evaluate the cause. The overall cause was compensation due to dysfunctional and weak core musculature. He was surprised - he'd heard of the connection between low back pain and weak core musculature in swimmers, but had no idea is could be the cause of more distal repetitive stress injuries. Not being a fan of core exercises, he was not pleased.  After I explained and recommended he talk to his ATC about intervention and his CSCS about an appropriate post season program, he chuckled and parodied the old beer joke cynically stating  "Core - its not just for bad backs anymore!".

As amusing as this anecdote may seem, it is true. Dysfunctional and weak core musculature can lead to compensation and injuries in the distal aspects of an athlete's body. In cases like a swimmer, where a dysfunctional core is a weak link between the upper and lower body, or a baseball pitcher who has to coil and explosively uncoil his body, compensation by the extremities for power loss in the core is obvious. But the cause or partial cause of conditions like Achilles tendonitis and various knee conditions in many sports can also be traced to a dysfunctional core.

Bringing an athlete out of pain and restoring function is the job of the Athletic Trainer (AT) and I am blessed to work with some of the best among the universities sports medicine staff in Boston. Keeping them out of pain and improving their athleticism is the job of the certified strength and conditioning specialist (CSCS, NSCA) or a certified personal trainer (CPT) who has a background in periodization training. I have the cards of both great CSCS and CPT on the desk in my office, all very capable of helping the athlete develop a functional core appropriate to their sport. 

Medford/Somerville/Tufts Runners Rejoice!

Big news for all those Somerville/Medford runners, bikers, marathoners and triathletes.The Alewife Brook Greenway is really showing some promise of completion! The final bridges are now being constructed and they laid the entry stones today!



 This stone marks the spot where you will soon be able to bypass route 16 and run on the quite side of Alewife Brook!



This addition to the other greenways links the Mystic River running/biking routes with the Charles River and the Minute Man Trail. You will very soon be able to run/bike from the Mystic River to the Minute Man Trail without more then 100 yards exposure to Route 16 - a very nice run or ride! Come check it out!

Cardiovascular Conditioning: adaptations to aerobic training

This piece is written for those with little background in exercise physiology, breaking concepts down as much as possible without losing the integrity of the general concept, adaptations our body makes to aerobic training. For health, safety and performance sake, however, I feel it needs to be made clear from the outset that aerobic training is not the “be all and end all” in taking care of our bodies. Other types of training are necessary for a variety of health and safety reasons. Emphasizing only aerobic training can compromise our ability to respond to emergency situations with the speed and power necessary to protect ourselves and can prevent us from maintaining tissues that have the type of mass, flexibility and elasticity needed to respond with quick movements and absorb minor fall. Please feel free to ask me or your trainer more about this.

Cardiovascular Adaptations

Aerobic training, as the adjective implies, develops our ability to utilize oxygen in processing energy. The aerobic response in the body involves the nervous, endocrine (hormonal), cardiopulmonary and muscular systems most directly. The ability of the heart to transport oxidized blood to the muscle tissue is the dominant and easiest response to measure. With the appropriate stimulus, the primal part of our brains triggers a neural and hormonal response that dilates the arteries that supply the skeletal muscles and constricts those that supply less essential structures. Neural and hormonal responses also trigger the heart to expand as fully as possible and contact as forcefully as possible to bring in as much blood as possible and push out as much blood as possible. The complete filling of the heart causes this muscle to stretch to its fullest capacity, therefore enhancing the expulsion blood by way of an added elastic release to the powerful muscular contraction. This allows more blood to be ejected with fewer contractions. This characteristic is maintained and developed in the cardiovascular system with training, so that at rest the heart will continue to need fewer contractions to provide the body with the oxygen it needs to process energy. This, over time, presents itself as a lower resting heart rate in aerobic athletes.

Energetic Adaptations

The advantage behind supplying so much oxygen so quickly to the muscles is that it allows for a very efficient energy processing system called the oxidative system. This system can produce a lot more energy than the other two major energy systems in our body and better utilizes more fuel sources. Aerobic training encourages the production of those enzymes that aid in the oxidative process, allowing the breakdown of carbohydrates and fats to produce energy.

Neuromuscular Adaptations

Processing energy using large quantities of oxygen happens in the muscle cell within an organelle called a mitochondria. This is a complex structure and in itself requires considerable resources. Some muscle tissues are better adapted to utilizing mitochondria. These are the type I muscle fibers. Aerobic training emphasizes the development of type I muscle tissue. As training continues, muscle filaments and neural connections that are deemed as unnecessary in the type I muscle fibers are replaced with mitochondria to process oxygen. Collagen (a light, tough element in the connective tissue) is added to support the muscle cell in the absence of contractile filaments.

The Overall Result

With continued aerobic training, the athlete develops a cardiovascular system that can transport great quantities of oxygen to an oxidative system that supplies the enzymes that produce energy within very light, efficient muscles that are able to produce movement over and over again for long period of time without rest.
This is perfect for the distance runner and has health benefits for us all but, as stated above, it should never be the only form of exercise one gets. It can diminish flexibility, strength, balance and power (the ability to respond quickly with strength) and by itself is not the best way to lose weight or maintain a healthy weight or body mass.

For the complete story…

The above explanation has gaps big enough to drive a truck through. The full story covers a couple of hundred pages in an exercise physiology book and it’s probably best if you’ve had your biology and chemistry before reading it. If you have any questions about this or the body’s adaptation to different types of training stimuli, feel free to book an appointment with me.

Cardiovascular Conditioning: Maximum Heart Rate

Most people and most athletes don’t fully understand the relationship of cardiovascular to their training goals. We’ve had a string of over-training injuries and conditions during August. Cross country runners pumping out 100 mile weeks and soccer players determined to toughen up quickly with excessive road work, to name just a few. This is no surprise – aerobic training is addictive, easy to do and it is not a simple subject to understand. Even the rationale for the standard formula currently accepted for maximum heart rate is questionable for training purposes. Since the gyms seem to be full of people wearing fashionable heart rate monitors, maximum heart rate seems like a good starting point,  for athlete and non-athlete alike, to better understand the cardiovascular response to training in their bodies.

MHR = 220 – age

The standard formula for maximum heart rate (MHR) and its derivatives is MHR = 220 – age. It’s so commonly used in the training world one would think the scientific foundation for the statement was solid and profound and absolutely the last word. It’s none of the above. The equation was derived in the 1960’s from an observation of data Dr. William Haskell had collected and graphed from a study about heart disease. The subjects were male, under fifty, not in particularly good shape, and many smoked. The original goal of his study was to determine just how hard heart disease patients could push themselves and was not designed at all to evaluate healthy individuals or conditioned athletes. So, how did it become "law"? It wasn’t the study, but the timing of its release. Cardiovascular training was just becoming popular in gyms and on the streets (I can still remember neighbors teasing me, yelling “Hey, what are you running from?” when running in 1968!). Doctors and trainers were hungry for an answer to the question “How hard should I run?”. The formula stuck. Not very scientific when it comes to training perhaps, but whole industries grew up around it so it’s probably going to be in people’s repertoire for a while.

For training purposes we like to manipulate different physiological responses within the body which we know are related to how oxygen is exchanged, which can be roughly related to percentages of the maximum heart rate. Therefore, a Target Maximum Heart Rate formula (TMHR - a percentage of the MHR) is used to target these changes.

For example:

A 40 year old woman is instructed to run at an intensity of 75 to 80% of her maximum heart rate.

TMHR(lower limit) = (220 – 40).75 = (180).75 = 135bpm (or about 23b/10sec)
TMHR(upper limit) = (220 – 40).80 = (180).80 = 144bpm (or about 24b/10sec)

Now for my money, if we are going to use a set formula like this, we need to be looking for the percent of change between the minimum heart rate (resting heart rate, RHR) and maximum heart rate. We can then add in the resting heart rate at the end to provide us with a real countable beats per minute number.

Therefore, that same 40 year old female athlete with a resting heart rate of 60 beats per minute would be:

TMHR(lower limit) = (180 – 60).75 + 60 = 150bpm (or 25b/10sec)
TMHR(upper limit) = (180 – 60).80 + 60 = 156bpm (or 26b/10sec)

One of the reasons this formula has stuck around is that it is relatively safe for the average person. For general conditioning purposes, however, it has been suggested that rate of decrease in heart rate from maximum heart rate to resting heart rate after exercise might be a better indicator of when to increase the intensity of an aerobic workout. That is, in general, how long does it take your system to recover is a better indicator of your health and conditioning. In training athletes, perceived exertion levels are often used instead of specific heart rates, which really does make sense, especially with elite athletes whose heart rates often don’t fit the MHR format at all.

One final note – don’t trust the built-in heart rate monitors in the cardio equipment at the gym. The accuracy varies wildly – depends on the machine and the gym maintaining them. Check it yourself. Yes, your calculations are correct – the machine is wrong.

In future blogs, we will examine the specific changes cardiovascular training promotes in the body.

References Utilized:

1. Ultimate Fitness
     Kolata, Gina Farrar, Straus and Giroux 2003 NY, NY

2. Essentials of Strength and Conditioning, 2nd Edition
    Baechle, Thomas R., Earl, Roger W. Human Kinetics 2000 Champaign, IL

Vision Tests: Saving Life & Limb

When addressing the topic of preseason pre-habilitation and competition readiness, a thorough screening and testing of athletes usually involves routines that check the cardiovascular, neuromuscular and connective tissue response to the demands of an athlete’s particular sport. One aspect that is often underappreciated is a thorough vision exam. A thorough vision exam is essential to insure optimal performance by the athlete and provide the highest degree of safety for the athlete. This is more than being sure that an athlete can read black-on-white lettering at 20 feet. In fact, bringing the athlete up to the 20/20 in most cases should not be the standard, but just the starting point.

There are four aspects of vision that an athlete should be checked for, their sport depending on how heavily to weigh the results: visual acuity, peripheral vision, contrast sensitivity, depth perception.

Visual Acuity – how clearly can an athlete see? Black-on-white clarity. Essential starting point.

Peripheral Vision – this is visual awareness outside of direct line of sight. All the plyometric exercises and agility drills won’t prevent an ACL injury or a concussion if an athlete can’t see a lateral hit coming.

Contrast Sensitivity – this is the ability to detect the subtle difference is shades of color. The shade of color a moving object or an angled object can make a huge difference in split second responses by the athlete.

Depth Perception – crucial for performance (quarter back) and safety (gymnast).

These tests take very little time and every second they do take is a valuable investment in the safety and success of our athletes.

If your organization does not offer these preseason vision screenings, please visit www.aoa.org/x5428.xml to find a doctor in your area.


References Utilized:

www.aoa.org

Prehabilitation: Hamstring

One of the most frustrating injuries for any athlete to overcome is the hamstring strain. A strain can occur anywhere in the muscle but most commonly lesions can be found near the musculotendinous junction of the muscle/tendon unit. This is due to several factors. Two of the most important factors are inefficient recruitment patterns of the lumbopelvic (lumbopelvic core) musculature in gait and the accumulation of scar tissue in vulnerable areas of the muscle due to injury.

These two factors can be independent factors but often work together to cause injury and reinjury. It is not uncommon, for example, for a distance runner to have weak hip stabilizers, causing stress along the distal aspect of biceps femoris and the iliotibial band due to over reliance on gluteus maximus and tensor fasciae latae or for a field hockey player to experience to experience pain in her proximal left biceps femoris due to her right hip flexors being locked short. Once these patterns lead to injury, the accumulation of scar tissue near the musculotendinous junctions by itself make these points vulnerable to reinjury but may also interfere with the proprioceptors in the region possibly reinforcing and exaggerating the patterns that caused the injury in the first place.

Taking action before an injury occurs (prehabilitation) is always your best option. Appropriate core training and warm-up for the sport (which crosses a wide spectrum of training from weight training through plyometrics and active warm-ups) can strengthen the necessary structures and prevent overdependence on patterns that cause hamstring injuries. Manual therapy to open and loosen the muscle and break down the accumulation of scar tissue and resolve adhesion may also decrease the probability of injury. Once an injury has been incurred, both these procedures become important to the rehabilitation process as well.

If you want to know more about your specific hamstring injury and how to heal it more effectively, please schedule an appointment by visiting www.soarbody.com.