Monday, August 8, 2011

Soft tissue, injury and toilet paper.

When I think of soft tissue I think of my Polish uncle in-law complaining that the toilet paper in the US was too soft. The stuff he was used to was like brown paper bag...anyway.

A quick lecture on soft tissue. Damage to soft tissue can be a nagging impediment that takes a long time to go away. The fastest healing soft tissue you've got is actually muscle. The problem arises when one of the other tissues gets damaged: tendon, ligament, fascia, as these can take much longer to heal. An interesting factoid that puts these into perspective is that the three I just mentioned are continuous.

If anyone is familiar with Rolfing or fascial manipulation (extremely painful but effective body work) this will sound familiar. The fascial sheathe is a continuous soft tissue layer that wraps each individual muscle fiber lending it support, wraps whole muscles, and continues on to become tendons (attaching muscles to bone), wraps around the bones and is continuous with ligaments (connecting bones at joints). Rolfers would say that this tissue also wraps the organs and can also affect organ function when damaged, knotted, or too tight. This fascial layer is described as being comparable to your skin in that it is a continuous sheathe that is present throughout your entire body. This means that a soft tissue injury can be very local but can lead to damage in remote tissues, or cause pain in areas seemingly unrelated. Your physical therapist who digs her knuckles into a muscle or the bottom of your foot and slowly slides it against your skin, while pressing hard into the tissue is doing fascial manipulation.

I think runners are particularly susceptible to discomfort from this tissue layer. I.T. band problems are a great example of issues arising from fascial tissue that can affect your entire training regime. The IT band is continuous with the fascia that wraps your quads (the big giant muscles on the front of your thigh). If your quads didn't have a tough wrapping around the entire muscle group, they would deform completely when you contracted them (think inch worm) and they wouldn't do a very good job of straightening your knee. The IT band down the side of your leg is part of the wrapping that maintains their shape, making them effective, but putting tremendous stress on the band, and often leading to problems.

Tools of the trade:
  • Foam rollers are super effective. Proper use of the roller involves putting your weight into the roller and finding places that hurt...then staying there and allowing the roller to contact and slowly penetrate the tissue. This is fascial manipulation: finding knots in fascial tissue and releasing them. It hurts...a lot, but it works.
    • Do this everywhere on your body, even places that don't hurt
  • Stretching of course. Making sure muscle groups like hamstrings aren't too tight will keep them from tugging on fascial and skeletal tissue that extends out systematically through your entire body. Tight hamstrings cause lower back and neck pain because their influence extends beyond the hips and knees.
  • Epsom salt/ice baths. I love ice baths. They constrict the circulatory vessels. As you warm up fresh blood and nutrients flush the tissue helping rejuvenate it. They also alleviate normal inflammation from stress (exercise), and they feel awesome...after the overwhelming painful stinging sensation goes away and you go numb. Epsom salts can help too.
Hope this helps. I'm going to be doing a lot of the above to get my foot back into shape.

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