The rotator cuff muscles help hold your arm bone against your shoulder socket (glenohumeral joint). The shoulder socket is very shallow and quite unstable, so the integrity of these muscles is very important.
Here is a picture of the rotator cuff muscles:
NOTE: Supraspinatus (see in right pic) is the little muscle with the tendon that goes under the bone there, to attach onto the arm. See where the two aqua lines are pointing? They show the muscle belly and then where the tendon joins onto the arm bone. Can you see that when the arm bone lifts up (as in lifting your arm out to the side) that tendon can get caught against the bone above it and pinch? But if the other muscles of the rotator cuff are strong and do their job, they hold the arm bone in the socket and help stop it from hitting the bone above.
Here's how to foam roll infraspinatus and teres minor (and the top part of lats). *You can get into supraspinatus yourself with your fingers.
Don't forget to sit on the trigger points until they subside.
Supraspinatus stretch:
I think you could manage this stretch using your unaffected arm to pull the affected one behind your back. Maintain posture by lifting chest as suggested. :-) You could also manage the contractions to increase the effectiveness of the stretch.
The broomstick stretch:
This stretch is good. You can also do it in the other direction, as in your hand coming forward as you lift the broomstick behind you. Ask me if you have questions and I'll show you what I mean.
The yellow part in the picture above, is the upper portion of the trapezius muscle (traps).
Movement wise, it:
- Elevates (shrugs) the shoulders
- Upwardly rotates the shoulder blade (as in when you lift your arm out to the side)
- Extend the head and neck (as in when you look up)
- Tilts the head to the side
- Turns head from side to side
It's pretty important and often gets really tight through overuse and bad posture.
Here are some good ways to give it some love:
Trigger points:
Get rid of the trigger points (knots) before you stretch.
Stretch:
Be gentle when stretching. Ask me to show you how to do the gentle contractions with this stretch to increase effectiveness.
Enjoy! -)
Monday, January 21, 2013
QL (Quadratus Lumborum) Muscle
Introducing the QL muscle:
This muscle begins on your hip bones at the back, and attaches onto your bottom rib and the edges of your spine in the low back region.
QL helps with hoicking one hip and side bending, and also assists when you lean backwards. It's put under stress if it has to slow you down/stop you from collapsing, as you bend to the opposite side or forwards (or a combination of both).
It is also under stress if it has to support you in a forward position, such as when you ride a road bike. Note, lifting something and twisting can also hurt QL. Lifting and twisting is never a good idea anyway!
As you can see, this muscle has a lot of responsibility and can complain if it's overused/abused.
See below a common pattern of referred pain from trigger points in the QL muscle:
The Fascia (connective tissue) that effects QL:
Across the low back region, there is a broad, flat expanse of connective tissue called the Thoracolumbar aponeurosis. Several muscles attach to it, including transverse abdominus (wraps around your stomach and back), internal oblique, glute max, lats, erector spinae (runs up either side of your spine), multifidus (in between spinal segments) and biceps femoris (hamstring). There are 3 layers to the fascia: anterior (front), middle and posterior (back). The anterior layer covers the anterior aspect of the QL muscles. (Lee, D. 2004)
The thoracolumbar fascia is used to transfer load from the trunk to the legs. (Schleip, R. et al, 2012) Here is a rough idea of how it all connects up when we move.
A good way of self-treating QL:
Note* You can roll a little further onto your back as well.
Remember- Roll slowly. The nerves in the fascia and muscles react to slow sustained pressure (at least 6 seconds). I would roll at about half the pace shown in the clip.
Make sure you settle onto any exquisitely sore points (trigger points) until the pain subsides. Roll off the spot, then back onto it, until the pain recedes again.
After foam roller work, you can stretch as shown below:
If your hamstrings are restricting you in this position, stretch them out first. :-)
This stretch is good because you can just relax into it.
Alternative QL stretches will be added to this blog in the future. :-) Watch this space...
Enjoy!
References:
"Fascia- The tensional network of the human body", Schleip, R. Findley, T. Chaitow, L and Huijing, P. 2012.
Calf muscles are not as simple as you might think! Above are a couple of the major players: Gastrocnemius (Gastrox) and Soleus.
Gastrox- *sits on top of soleus. It's what you feel at the the top of your calf.
Bends the knee and moves the ankle in the action that points your toes (or when you stand on your tip toes).
Soleus- *sits underneath gastrox, closer to the bone. You can feel it at the bottom of the calf area.
Doesn't do anything at the knee. It works with the gastrox and does the same thing (point the toes/stand on tip toes). This movement is called plantar flexion (like planting your foot on the accelerator).
Both of these muscles join onto the Achilles tendon which joins onto the heel bone (Calcaneus).
The fascia:
The connective tissue for these muscles (fascia) runs all the way from under the foot, up over the back of the leg, over the bum and up the back to the neck and head. See below.
This fascia acts as a support when you're standing/bending forward etc. It runs down over the Sacroiliac (SI) joint, and has an effect here if dysfunctional (tight etc). See below for a pic of the SI joint. This picture, although depicting SI joint pain, hopefully shows where the joint is relative to the rest of the body. Note that it joins your spine (via your sacrum) to your hip bones.
So, if you have tight calves, it might be a good idea to stretch out your hamstrings and glutes as well! This stretching can also have a positive effect on the low back area via fascial release. Need I mention a foam roller as a beneficial self treatment? ;-)
The calf fascia also wraps all the way around your shin to encompass the whole lower leg. It has attachments along the lower leg bones from the knee to the ankle. This forms compartments, inside which the muscles live. See below.
This fascia isn't very stretchy at all, and doesn't leave much room for swelling etc in the event of an injury. This is what compartment syndrome is all about. More info on compartment syndrome can be found here:
- Local pain
- Referred pain (see common trigger point referral areas below)
- Weakness in the muscles (from trigger points). This effects plantar flexion and hence pushing off from your toes when you run.
- Joint stiffness around the ankle/knee as the muscles are too tight to allow it to move properly.
- Higher susceptibility to injury (strains/tears etc)
- Tightness transferred through the fascia, all the way up the back of the body, effecting connected muscles (especially hamstrings) and joints.
- Increased risk of plantar fasciitis, heel spurs, calcaneal bursitis, compartment syndrome, shin splints etc.
What to do about helping yourself maintain good calf muscle/fascia integrity?
1. Self myofascial release/ Trigger point therapy using your foam roller (see below)
2. Stretch twice a week using PNF technique (see below)
3. See me for treatment so I can help break the pain cycle and make sure joints etc are being given some attention.
How to roll out your calves and hamstrings with your foam roller:
Below is a YouTube clip of a guy using a tennis ball and a foam roller. He covers other muscles, not covered in this discussion but copy him because it all looks good. The only suggestions I'd make are:
1. Roll slowly. The nerves in the fascia/muscles respond to slow, sustained pressure (like how I massage you).
2. When you find a trigger point (notably the spot where the pain is exquisite), linger on it until the pain dulls. Roll off it, and then back onto it until the pain goes away. You can also roll over it backwards and forwards, but I find the first technique works well.
3. I'd use the broad foam roller first (self myofascial release) then I'd use the tennis ball to get the trigger points and into the skinny bits of the lower leg.
*note. When the clip says gastrocs and soleus, he's actually working on Tibialis Anterior muscle...so don't get confused there! haha.
Some good ideas!
How to stretch gastrox and soleus using PNF technique:
PNF general instructions:
1. Go into the stretch and hold for 10 seconds
2. Push in the opposite direction that you're pulling yourself into, to achieve a stretch, for 8 seconds. You can use a wall or the floor for resistance or even a pair of pants wrapped around your foot instead of the cord shown in the clip.
3. Breathe in and out, and then pull yourself into a stretch again.
4. Repeat this process 3 times.
Note: This stretch is quite an intense technique in terms of stress on the muscles, so only do it perhaps twice a week (and not if you have an injury!). Other days it's fine to just do normal stretching, without the contractions.
