Fix the "Stick"

Have you ever experienced a pulled muscle?  The chances are that you have, whether through some sports endeavor or just an every day task such as bending over to tight you shoe.  If you have, then you're familiar with the pain and functional limitation associated with it.  For mild (grade 1) strains, some simple rest, ice and ibruprofen will do the trick, and you'll be feeling better within a few days.  But that can lead to a false sense of security.  The reality is that you may be more prone to re-injuring yourself in the near future.  Here's why.

When you strain a muscle or tendon (you sTrain a muscle/tendon, you sPrain a ligament), microtears occur in the tissue.  Your body responds accordingly by beginning a cascade of repair responses.  Fluids rush to the site with all sorts of tools to begin the repair.  It's similar to an emergency response team rushing to a collapsed construction site.  This rush of "first responders" to your injury site is what causes swelling in the area.  This is when we ice, not to completely shut down the repair process, but rather to control it so as to avoid compression injuries to nerves in the area.  As part of this process, the body begins to lay down scar tissue to repair the damage.  And here's the key to long-term management of a muscle strain.

Think of that scar tissue adhesion as "glue" in your muscle belly.  Muscles rely on the smooth gliding of fibers over one another as they contract and release.  Now picture a spot in that smooth gliding mechanism that won't move.  It's stuck.  If left alone, the next time that muscle is put under a rapid change and stressed, the muscle is likely to re-tear near that "stuck" point.  The same healing cascade effect will begin all over again, with more scar tissue being laid down.  Without proper treatment, this can become a chronic condition.

Many of you have probably been taught that once your strained muscle feels better, then you should begin some light stretching of that muscle.  Not a bad idea, but that's only half the picture.  Let's say I strained my hamstring (muscles in the back of my thigh).  Two week later, I might have no pain and pretty close to normal function.  I may begin to diligently but cautiously work on my hamstrings with slow, static stretching.  That's great for all the muscle fibers that are still smoothly gliding over one another. But what about that stuck, "gluey" adhesion?  That area is not getting stretched!

The solution?  I highly recommend seeking help from somebody who can teach you how to "release" that adhesion.  I'm not just talking about your typical Swedish massage, which will bring much needed blood flow to the area but won't necessarily break up the adhesion.  There are techniques that are VERY effective in undoing these adhesions, and the good news is that they work fairly quickly.  The technique involves finding the "hot" spot (you can typically feel the area of restriction by palpating with your fingers), applying pressure, and lengthening the involved muscle through it's range.  Picture dragging knotty hair through a hairbrush that is held static.  

So, don't let those muscular sore spots turn into a chronic problem.  Learn how to "free up" your muscles after injury (or even restricted spots due to chronically poor posture) so that they can move correctly and reduce you chances of re-injury.  As always, feel free to call me with any questions!

James W. Horn, MSPT

Owner/Director

Chelsea Physical Therapy & Rehabilitation, LLP

119 W. 23rd Street, Suite 1002

New York, NY 10011

(212) 675-3447 (W)

(212) 243-5213 (F)

@Manhattan Spine & Sports Medicine

300 E. 56th Street

New York, NY 10022

(212) 935-1700 (W)

(212) 753-9856 (F)

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