DOMS - Delayed Onset Muscle Soreness

Maybe you have never heard the term, but I bet you have felt it.  What is the chemical process that takes place to cause such a terrible feeling (lactic acid, ion imbalance, etc.)?  I don't really care and, honestly, nobody really knows for certain.  What I know and care about is what information to gather from it and what to do about it.  Understand this:

1. We should never be sore in joints
2. It is okay to be sore in muscles
3. If we are sore, it is important to be sore in the right areas

Joint pain is a sign that you have done too much with perfect form, done too much with terrible form, or somewhere in between.  It is most likely that you have done too much of a bad movement and you will need guidance from an expert to help prevent the problem in the future.  Much the same, if you do a lot of squats, deadlift, o-lifting... hip extension, and you are sore in your low back more than in your glutes, you're doing it wrong!  The same could be said if you want to substitute "hamstrings" for "low back".  The big concept is that we want to do the motions correctly so that we are sore in the correct muscle groups and never in joints.  Soreness in joints or, proportionally, in the wrong muscle groups is a sign that we need help.  Help with mobility, stability, sequencing, skill?  The answer is most likely "yes to all" and the solution is to talk with someone who can give you good answers.

This video covers simple things you can do if you have DOMS, are at work, and it is socially unacceptable to get into a deep lateral lunge position (i.e. wearing a skirt, talking to the senior vice president of your company, pick an awkward work scenario):

Hey folks,

Many questions come up about what to do before higher intensity activity.  The answer is simple:

Do something that gets you sweating and uses your whole body (2-5 minutes of continuous motion)
Focus on preparing your body for the activity you will soon be doing at a high intensity

This video gives a little more background on this simple, but highly effective, approach to warming up.

FLEET FEET Runners - Yes, even you!  You have to get your body warmed up and prepared before you do anything as repetitive as long distance running.  You can accomplish this in one of two ways:

1. Take 2-5 minutes to run at a slow pace (~60% of max effort), then do your preparation mobility drills and exercises, then have at it!
2. Take 2-5 minutes to do multi-joint, functional movements (jumping jacks, burpees, squats, pushups, jump rope, step-ups, etc.), then do your more specific mobility drills and exercises, then have at it!

Very interesting article comparing running methods that will hopefully start a revolution in understanding that running isn't something everyone does well.  On the contrary, it is a developed skill.  In other words, everyone can get better to become safer and faster!!!

Reduced Eccentric Loading of the Knee with the Pose Running Method
REGAN E. ARENDSE', TIMOTHY D. NOAKES', LIANE B. AZEVEDO', NICHOLAS ROMANOV', MARTIN P. SCHWELLNUS 1, and GRAHAM FLETCHER 2

'MRC/UCT Exercise Science and Sports Medicine Research Unit, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, SOUTH AFRICA; and 2University College of the Fraser Valley, British Columbia, CANADA

ABSTRACT

Purpose: The aim of this study was to compare the biomechanical changes during natural heel-toe running with learned midfoot and Pose running.  Methods: Twenty heel-toe runners were instructed in midfoot running and a novel running style in which the acromium, greater trochanter, and lateral malleolus are aligned in stance (Pose running). Clinical gait analysis was performed for each running style and the biomechanical variables compared. Results: In comparison with midfoot and heel-toe running Pose running was characterized by shorter stride lengths and smaller vertical oscillations of the sacrum and left heel marker. Compared with midfoot and Pose running heel-toe running was characterized by greater magnitudes and loading rates of the vertical impact force. In preparation for initial contact, the knee flexed more in Pose than in heel-toe and midfoot running. The ankle at initial contact was neutral in Pose compared with a dorsiflexed and plantarflexed position in heel-toe and midfoot running, respectively. The knee power absorption and eccentric work were significant lower (P < 0.05) in Pose than in either heel-toe or midfoot running. In contrast, there was a higher power absorption and eccentric work at the ankle in Pose compared with heel-toe and midfoot running. Conclusions: Pose running was associated with shorter stride lengths, smaller vertical oscillations of the sacrum and left heel markers, a neutral ankle joint at initial contact, and lower eccentric work and power absorption at the knee than occurred in either midfoot or heel-toe running. The possibility that such gait differences could be associated with different types and frequencies of running injuries should be evaluated in controlled clinical trails. Key Words: KINETICS, KINEMATICS, MIDFOOT, RUNNING STYLE MODIFICATION

Nonsurgical treatment is often the cure for Runner's Knee
www.stltoday.com/lifestyles/health-med-fit/fitness/article_b030f593-f36c-5d34-a557-ecb23d82d228.html

This is an excellent article which provides another opportunity to stress that "TECHNIQUE TRUMPS PROGRAMMING".  Again, how you do something is always more important than how much and how often you do it.

"There is no point in getting really good at doing something really bad!"
-Dr. Jared

So many opinions and theories are spreading around the running communities that it is difficult to understand what is truth and what is fad.  If you have read previous posts on the topic, you undoubtedly know that I am an advocate for the Pose Concept of running.  This is true not because I love Dr. Romanov or because I am drinking cool-aid, etc.; rather, it is because I understand all motion as a skill governed by the laws of nature (gravity/physics).  Due to that fact, I like Pose because it utilizes such laws in teaching skilled running.

What part of the foot hits the ground and what covers the foot as it hits the ground does have surface level merit.  But the concept every study and article has neglected to discuss or even consider is the relation of the runners CENTER OF GRAVITY to the contact point.  The picture below highlights this concept:

We want to share our excitement over getting some new equipment that will further assist us in delivering not only great care, but also care that our patients can't receive anywhere else.  Whether you are a desk jockey, grandparent, power lifter, or marathon runner it is very important to understand mechanics.  Health & Performance Center has always used video analysis to both diagnose and educate, but we are very happy to make this announcement. 

We now have a work station dedicated solely to patient care.  Functional movement re-evaluations, running mechanics, movement patterns, and anything else we can film will now be a step away for both the physician and the patient.

Your experience should always be positive and beneficial.  This addition will hopefully make each visit more efficient for heightened results and increased understanding. 

Thanks for being great patients.  Your hard work has helped us grow in the midst of tough economic times.

Dr. Jared & HPC staff

There are many trends in health care delivery that have prevailed over the past several years that lack sufficient support.  Health & Performance Center always strives to produce logical approaches to patient complaints, instead of relying only on protocols and "accepted" approaches.  One trend that HPC consistently corrects is that of "listening to your body".  The following video highlights the major differences between "listening to" and "communicating with" your body.

Key Points:
1. If you don't know what you feel or why you feel it, you can't produce a purposeful or meaningful response
2. If you lack a purposeful and meaningful response, you will do nothing
3. If you do nothing, you set yourself up for Vicious Cycle Disorders (term speaks for itself)
4. You need the ability to accurately interpret what your body is telling you and have the education and physical ability to effectively respond.
5. If you can't accurately interpret and/or effectively respond with a high degree of certainty, you need to seek expert advice/help.

All right all you crazy desk jockey's.  Get your goggles strapped on tight for a messy ride.  In all seriousness, we need to look at our work day as an athletic event.  Yes, chess is a sport! 

And what do chess athletes do all day... sit, think, and move sporadically. 
And what do you do all day... sit, think, and move sporadically (if your boss is lucky!)

The concept always holds true to the point it will soon move past Theory into Law: What we do will either kill us or make us stronger (similar to "Whatever doesn't kill you makes you stronger... it's my version so bare with me please).  There is no in between or around (of course there is, but, again, just play nice!) 

This video discusses the decisions we can make regarding our desk/chair posture.  Take it seriously because it lays the foundation for your overall health... after all, you spend about 8-12 hours a day in some variation of this position.  Make it work for you instead of against you.

Everyone moves.  Some move bars with weight; others pick up children.  Regardless, we all should use the same motion patterns to achieve specific tasks.  Inefficiency, or wasted motion, will either result in decreased performance for the athlete or pain and degeneration for the athlete and "non-competing" athlete alike (we all move, so we are all athletes in the sport of life). 

This video shows very efficient motion with a deadlift.  The picture shows the amount of tension that is built up for excellent recoil to help the athlete out of the lift's bottom.  Remember, tension (rubber band/sling-shot effect) is free; whereas, concentric contraction burns energy.  The more tension we build, the more recoil we have, the less energy we need to burn for any given task.  Whether the object is a bar and weight or a child, the motion is the same.  The better you do it, the stronger and healthier you are!

The hip and shoulder are portals for force production/transmission to and from the core.  Building mobility in the hip and shoulder will allow for improvements in health and performance above, below, and around these joints.  This video instructs on how to increase mobility in the hip and why it is essential for efficient improvements in stability, injury prevention, and performance.  Have fun and good luck!

Runners - this is another great exercise to help you get back into multiple planes of motion after being stuck moving in one direction for an extended period.

Patients - remember the 48-72 hour rule:  if you can manage aches and pains within that time frame, great job!  If not, make an appointment so we can help prevent compensation patterns and the development of a chronic issue.