TUNING ATHLETIC PERFORMANCE

Fixing the Glitches that Hold You Back

by Eric Winder, DC

What’s your glitch? Is it a shoulder that only twinges when you swim backstroke? A knee that is fine except when you’re cycling? A sore hip from the follow-through of a golf swing? Many people have minor physical aches and pains which are exacerbated by athletics. This can reduce activity and performance levels—or even force a hiatus from a beloved sport. However, with a detailed assessment, the underlying problem can often be identified and resolved. I’m a fan of careful motion analysis with particular attention to the specific muscles and joints involved. Here are some examples to show what relief is possible with this kind of treatment protocol (names changed for privacy):

Swimming:

Betty swam on a regular basis for years, but recently developed limiting pain in both shoulders. She only felt the pain while swimming or raising her arms high overhead. Another knowledgeable swimmer noticed that she used mostly shoulder joint movement to swim instead of a shoulder blade motion. The swimmer coached her to change to the stronger, safer method. This helped but did not resolve the pain.

I suggested she that she could have built-up restrictions in her fascia (connective tissue) due to years of incorrect swimming form, and those restrictions could still affect her even with the improved stroke. I asked her to demonstrate the motions of this incorrect stroke she had previously used. I detected too much contraction and strain in the infraspinatus muscle on the back of the shoulder blade. Pressing into the muscle, the sensation of fascia restriction was obvious. We released the restriction on both sides with manual therapy, and as a result, Betty’s shoulder pain was greatly reduced.

Tina was swimming on her high school swim team when she came to my clinic with intense left shoulder pain whenever she swam. Asking her to recreate the motions of her swim stroke showed a problem that occurs in some competitive swimmers—rounded shoulders from only swimming forward strokes which builds the chest and low back muscles, but not the upper back. The round-shouldered posture that results causes narrowing of the space where one of the shoulder tendons runs between bones.

This makes it possible for the tendon to become pinched when reaching or swimming. Tina learned how to exercise to balance her muscles and stop the shoulder from rounding, and we treated her pectoral muscles for fascia restriction that made the rounding worse. Within four weeks, Tina was swimming without pain.

Tennis:

Jerry’s backhand had been causing him shoulder blade pain for about two months, with no apparent cause. He demonstrated his backhand motion for me, and it was clear he was over-rotating his back to compensate for a faulty rhomboid muscle (a muscle connecting the shoulder blade to the spine). Careful examination showed that restrictions in the fascia of some of his rib joints caused the rhomboid weakness. When these were released, the rhomboid was able to work correctly, and his backhand became smooth and pain-free.

Kim felt persistent soreness in her left hip after playing tennis, and she particularly noticed the pain after serving. On examination of her serving motion, there was a telltale shift in her posture with the downstroke, showing weakness of the psoas muscle that flexes the hip. The weakness was traced to fascia restrictions of the psoas and two other hip muscles, but the psoas became stronger after these were treated with manual therapy. Not only did Kim achieve pain relief, but her serve’s accuracy and speed also increased after treatment.

Pickleball:

Let’s examine the most common issue in pickleball—weak lower leg muscles. Pickleball demands ankle strength due to the quick, sudden changes in direction of motion on the court. Ankle sprains, tendinitis and Achilles tendon injuries are common. Most of us don’t use our lower leg muscles much, so many people are not ready for the demands of pickleball.

Frank had to quit pickleball due to Achilles tendon pain that was aggravated by the sport. During his exam at the office, his ability to hold his ankle rigid while pressure was applied to the foot showed weakness in two directions. This was due to certain weak leg muscles. The weakness traced to restrictions in the fascia of the leg, thigh and lower back. Releasing these restrictions, in combination with exercises to stretch and strengthen his leg muscles, allowed Frank to resume pickleball without pain or worry about his tendon.

Golf:

Irene was still an avid golfer in her 80s, but after awhile, was able to control the alignment of the clubface as it struck the golf ball. Suddenly she was hitting the ball in all directions except for where she wanted it to land. She had no pain, but physical therapists found that her right shoulder was weak. However, these efforts to strengthen the shoulder made no change in her wild inaccuracy. When she was referred to my office, her exam included detailed assessment of her golf swing in slow motion.

It was apparent that weakness in the supraspinatus muscle affected her ability to

control her shoulder position on the downswing. Connective tissue restrictions in the fascia of several shoulder and neck muscles were the culprits behind this weakness. Releasing these fascia restrictions restored Irene’s strength and control, and she then returned to hitting tee shots down the middle of the fairway.

Every “glitch” that causes performance issues for an athlete is unique to that person. Five people with pain from hitting a tennis backhand might have fi ve completely diff erent causes. For this reason, careful detective work is important. A detailed understanding of joint function and muscle anatomy is important for fi nding the cause of a problem, but that is not enough. Because each problem is unique, it is important to study the problem by watching the athlete in motion, to see which clues point to the source of the problem.

Dr. Eric Winder has 24 years in practice with a focus on pain relief and restoration of alignment and motion. He uses fascia release therapies, without forceful manipulation. For more information, visit Gentlebay.com.

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How to Keep Mosquitoes at Bay

It’s no fun fending off uninvited airborne guests at the family cookout, but bloodthirsty bugs are an inevitable part of summer. Mosquitoes aren’t just an annoyance; they can carry infectious diseases like West Nile and Zika viruses, so it’s important to know the best ways to keep them at bay. Sprays containing the chemical DEET— developed by the U.S. Army after World War II and made commercially available in 1957—have long been the go-to option for mosquito repellent. DEET sprays came under scrutiny after isolated reports of seizures; these were subsequently dismissed as involving “off label” applications such as ingesting DEET (it’s best not to drink bug juice). DEET can occasionally cause a rash or skin irritation; however, the U.S. Environmental Protection Agency (EPA) and Centers for Disease Control and Prevention have both deemed DEET sprays as generally safe and effective for both adults and kids as young as two months. DEET also breaks down quickly in the environment, posing minimal danger to wildlife.

For outdoor lovers seeking a more natural bug repellent, one formula performs as well as DEET at stopping mosquitoes and even better at repelling ticks: products containing oil of lemon eucalyptus extract, which contains the naturally occurring compound para-menthane-3,8-diol (PMD), a byproduct of the leaves of Corymbia citriodora tree. In a study published in the Journal of Insect Science in 2015, researchers from New Mexico State University found that it deterred mosquitoes for up to six hours, unlike largely ineffective candles, bracelets and ultrasonic devices.

The PMD compound differs from lemon-eucalyptus essential oil, so look specifically for repellents containing PMD, found at most outdoors sports stores and major retailers. Lemon-eucalyptus essential oil itself is also sometimes touted as a natural mosquito deterrent, but like other essential oils like clove or citronella, the limited protection it offers is short-lived, as their volatile compounds evaporate quickly. While DIY insect repellents made from essential oils smell wonderful and are easy to make, they can also irritate the skin at higher concentrations and in some cases, such as clove oil, be toxic to pets. Products containing essential oils are also not registered by the EPA, and therefore not tested for efficacy.

Products containing Picaridin, a chemical modeled on black pepper, also have proven to be as effective as DEET. Picaridin-based products are better at deterring mosquitoes from landing than DEET, and are less oily and strong-smelling.

The percentage of DEET or Picaridin in a product determines how long it protects, with higher concentrations providing longer protection with fewer reapplications. Those benefits taper off at 30 percent DEET and 20 percent Picaridin. Covering up with long sleeves and spraying clothes, not just skin, with insect repellent will help keep skeeters at arm’s length and also help keep off ticks.