What Are You Running For?

After the runner’s high fades…ouch!

It’s marathon season in the Northeast. Thousands of people participated in the ING NYC Marathon on November 3rd . For those who may not know, the race traverses all corners of New York City’s 5 boroughs covering a distance of 26.2 miles (never forget the .2). Three years ago, I volunteered to provide post marathon massage to members of the FDNY; all of whom took part as a charity effort, competing against the NYPD‘s team. I think the firefighters made the better time that year – gotta love them!

Outside of marathon training, many New Yorkers whose favored form of exercise is running describe themselves as runners and only runners. I found this fascinating, for as much as I train in Thai kickboxing, I never call myself a kick-boxer. Other people I know who incorporate Olympic lifting into their workouts also will never call themselves Olympic Lifters. So why do people who run become so defensive about their running. When told, Oh, so you like to run? their immediate reaction is No, no…I’m a runner. I run (insert mileage/distance covered) every day, such and such times per week followed by accolades like and I’m about to do my third marathon.

After the initial defense, to which you nod and note their determination and dedication, they begin to list their assorted musculoskeletal injuries. This is where my mind really gets blown. Is it normal for a thirty four year old non-athlete to have had multiple knee and a hip replacement surgery? Answer is no; however their injuries  are worn like metals of honor. What I have also come to realize is the more they are able to run through the pain, despite their cartilage and tendons fraying to strands, the prouder they are. The only way you would know that something was off would be by observing their running gait (professional eye helps in that department) and the appearance of their knees and hips post run.

A little self massage of the Plantar Fascia…

Since many of my clients in the last two weeks have been runners, I decided to share with you all some of the more popular injuries experienced amongst this group. Blisters, weakened toe nails and callouses aside, feet suffer from the manner in which the individual runner pounds the pavement. Plantar fasciatis is an inflammatory condition that affects the connective tissue sheath that covers the sole of the foot. This inflammation leads to heel pain that radiates to the center of the foot. We test for it by pressing a thumb into the base of the great toe and extending the entire foot.  Most clients that I have had with this condition feel it more acutely in the belly of their arch into the medial/inner side of their foot. In normal walking gait, our heel strikes the ground first followed by a rolling out of the balls of our feet from left to right to push off for the next step. Running gait sends the strike further up into the middle part of the foot. In the case of plantar fasciatis, the runner is usually putting too much roll/strike into the inner arch of the foot, which leads to the inflammation they experience and related pain pattern.

Sharply related to the bottom of the foot is another condition known as Achilles Tendinopathy. The achilles tendon is a thick band of connective tissue that anchors the calf muscle’s two heads into the heel of the foot. Constant wear and tear from activity leads to degeneration and a weakening of the tendon, which makes it vulnerable to rupture. The areas that are weakened often feel tender to the touch and the tendon itself appears thicker looking. Much like with the plantar fasciatis, it is believed that an over rolling/striking into the inner arch of the foot can cause the achilles to become over strained, thus leading to the tendinopathy. The only way to heal both of these conditions is to reduce activity to allow for the collagen fibers to rebuild/repair themselves. Also, the wearing of insoles and a correction of one’s striking gait can help. However, many runners do not allow themselves this rest and repair time. At some point, it will become impossible to take even walking steps, let alone to run.

Achilles Tendinopathy in the left foot is clearly delineated by the black marker – thicker, misshapen and you bet, painful!

Moving further up the leg we have a condition that affects both the knee and hip known as Ilio-Tibial Band Friction Syndrome. Stats say that over 10% of runners will experience this condition at some point in their running life. Much like the other two overuse conditions mentioned, this one occurs from excessive training/activity. The locus of pain is on the outside of the knee over a bony prominence where the IT Band passes over each time the knee flexes and extends. It can radiate down into the shins or up into the hip, where the IT Band originates. It is super painful during activity and for some, even at rest, depending on how aggravated that huge strip of fascia is.  Stretching the glutes, especially the sides which encompass your little kickboxing muscle behind the pelvis known as the TFL, definitely helps as well as correcting, like the other two conditions, running gait and posture. But again, these conditions stem from pushing one’s limbs to their limits. In tandem with Ilio-Tibial Band Friction Syndrome, there is also “Runner’s Knee” or Chondromalacia Patellae. This condition is an inflammation of the underside of the patella or knee cap which leads to Patellofemoral Pain Syndrome.  This area is covered by smooth cartilage that normally allows the femur to glide easily when the knee is bent. However in runners, the constant friction causes the cartilage to get irritated which leads to thinning and softening, hence the moniker chondro (cartilage) and malacia (softening). Also, if one’s gait is out of alignment, the patella will not track properly and will also irritate the cartilage. A tight IT Band also relates to this condition as do the Lateral and medial quad muscles. Knees will crackle audibly with pain often felt in the front of the knee and on the condyles of the femur slightly above the knee.

If you wear all your cartilage away, surgery is the only route you will be covering.

Outside of physiotherapy, anti-inflammatory medications and icing one’s painful parts, taking the time to properly heal tissues, which should include massage to break up adhesions (i.e. knots or stuck points in tissues), clear toxins, build up the blood supply and elongate taut fibers will extend one’s running “career.” Let’s face it. If you are going to call yourself a runner and wear your battle wounds proudly, you should also invest in the care necessary to make your mileage count!!

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Fertility Massage: You + Me = Baby

Loving that procreative vessel!
(Copyright Linnea Lenkus Studio)

Within the past few weeks, I found that the majority of my new female clients are trying to get pregnant. Most are going about it the natural way, but a few have begun fertility treatments after that route didn’t produce any result. Their ages range from as young as 25 all the way to 43. Some have had children before; others are trying for the first time. They span multiple nationalities and economic brackets, but despite their differences, these women do have one thing in common – STRESS. Their bodies are experiencing and storing the physical and emotional strain of wanting to get pregnant, which if you have read any of my previous posts, wreaks havoc on your muscles, tissues and overall health. When in STRESS mode, one of the best things you can do is get a massage, as it is extremely effective at managing and reducing the negative effects that stress hormones like cortisol have on the body. However, there is a less obvious reason why a woman wanting to get pregnant should be getting massaged and it’s Doctor recommended.

Standard massage turns on the “rest and digest” switch in the body, sending feel good hormones coursing through your system that bring down blood pressure, flush toxins and increase circulation to tense areas of the body you wouldn’t be able to reach yourself. This is the stress reduction factor. Naturally, with a more restful state promoted in the body and nourishing blood flooding to all regions above and below, the ability for one to conceive could be increased physiologically. However, what M.D.’s and case studies have found to really prepare the “womb” is a more direct approach. Currently, there are two forms of massage that deal with fertility issues and both address the uterus and surrounding abdominal muscles and organs, specifically.

The first form of fertility massage is Mayan Abdominal Therapy, a form of abdominal massage brought to North America and Europe by herbalist and respected authority on Mayan healing techniques, Dr. Rosita Arvigo. It is an external, non invasive manipulation that repositions internal organs that have shifted, thereby restricting the flow of blood, lymph fluid, nerves and chi. Its founding principle is that when a women’s uterus is out of “balance” so is she. Centuries of Central American midwives and healers have found this to be the number one impediment for conception. Dr. Arvigo’s technique is focused on the position and health of the pelvic and abdominal organs. The work corrects a prolapsed, fallen, or tilted uterus and structurally realigns the spine from the thoracic to sacral regions. The practitioner will also prescribe herbal remedies to support the treatment and teach self-care methods that the client can practice at home. More information on session specifics and locating a practitioner near you can be found here: https://www.arvigotherapy.com/practitioners

The second method is called the Wurn Technique. This unique type of massage was developed more than 15 years ago at Clear Passage Therapies, a physical therapy network by a massage and physical therapist husband and wife team, Larry and Belinda Wurn. While treating an infertile woman for low-back and pelvic pain, the therapists discovered their client became pregnant, after seven years of unsuccessful attempts. This client had been diagnosed with two blocked fallopian tubes and had been sexually active the entire time. Intrigued, they tried the same technique on eight other infertile women. Half of them became pregnant following treatment. The therapy itself combines site specific abdominal massage with elements of physical therapy.  It addresses adhesions, spasms and mechanical factors that cause almost half of all female infertility. Most of their clients shared a history of inflammation, trauma and/or surgery of the structures involved in conception. The Wurn Technique is patent protected by the U.S. government and practiced all over the country. A 2004 case study that followed 22 women who had completed the treatment program, indicated 16 (73%)  became pregnant and carried to term.  On average, the women that were able to conceive had received between 20-25 hours worth of treatment before becoming pregnant. Ongoing studies are being conducted on the efficacy of the technique, but the results look promising.

Overall, conventional treatments for infertility are extremely expensive and oftentimes invasive, both physically and emotionally.  I have seen it first hand with my clients. It’s nice to know that there are forms of massage that are an affordable option for couples dealing with this frustrating and painful reality. They are slow, methodically deep and client centered with little to no side effects. It’s my belief that anything done to the body with love, promotes love. And if you are just a smidgen sentimental, the ultimate act of love between 2 people is the creation of a life.

The fruits of your labor…