Improving Your Golf Performance

Golf Analysis:

Your golf swing is all about proper body mechanics. A good golf swing requires full rotational capacity of nearly every joint involved and must be done – efficiently – easily – explosively – repeatedly. Many swing faults are directly attributable to poor joint mobility, resulting from soft-tissue restrictions.

A proper golf analysis will focus on the following:

  • Determining which structures are affected along the Golfers kinetic chain. We focus on more than just the chief area of restriction.
  • Identifying the antagonistic structures (opposing muscle groups) to those that have been identified as the primary structures causing the imbalance.
    Since function and performance is based upon balance and coordination, an opposing soft-tissue structure is always affected by restrictions in the primary structure.
  • Treating each soft-tissue dysfunction with the appropriate technique to restore full function to the affected structures.

The result is almost most always an improvement in Golf performance. Using this process has helped hundreds of Golfers achieve their goals and prevent numerous injuries from occurring.

Common swing faults occur due to tight shoulder, tightness in the hip joint, spinal injuries, and repetitive strain injuries. When shoulder rotation is restricted the body compensates with excessive spinal rotation. This can result in back injury because most people already lack flexibility in the spine. In addition, golfers will notice that they have difficulties in keeping their eyes on the ball and/or maintaining an optimal swing plane. This results in fat or thin shots. When the golfer attempts to compensate at the shoulder joint, the chances of a hook or slice increases. Tightness in the hip joint rotational muscles places additional strain on the rotational requirements of the shoulder or spine. Often a golfer will compensate by lifting up during the back swing and then chop down on the ball resulting in a fat shot. Wrist and elbow injuries often occur when the body does not have the capacity to effectively compensate at either the shoulder or spine. The wrists are then over-used to drive as well as decelerate the golf club. These swing faults are often easily corrected by addressing the physical restriction the golfer has in their body.

Stretching is often not enough to release these restrictions

Even individuals such as professional golfers who are constantly stretching find it difficult to release soft-tissue adhesions. This is why so many professional and amateur golfers are turning to Active Release Technique (ART), Graston, Acupuncture and stretching to release and remove these restrictions.

Often muscle groups will literally adhere to each other, preventing the sliding necessary for full mobility. During normal stretching, the first tissue that elongates may not be the scar tissue, but the normal healthy tissue. After the restriction has been removed an effective program of stretching will often be enough to stop the restrictions from returning.

Applying soft tissue techniques to golf related injuries

In order to effectively balance your muscles and remove joint restrictions, you must first identify your unique pattern of muscle imbalances. By utilizing a series of muscle balance and swing analysis tests,  the exact type, extent, and location of muscle restriction can be identified.  The use of ART treatments and follow-up stretches will help remove and resolve these restrictions, in addition to strengthening the muscles with weight training to prevent re-injury.

 

Written by:

Dr. Robert Inesta

Charles DeFrancesco

 

 

Why Does Everything Hurt?

As we get older,  it seems as if we discover a new ache or a pain in our body every day that never bothered us before.  Many of us are plagued by chronic pain and we often do not know how to alleviate it. Part of the issue is that we are constantly doing things during the day which exacerbate our symptoms and we don’t even realize it. Additionally, as we get older, we often forget that our bodies are not quite as resilient; after a week of sedentary behavior, we will hit the gym or play sports full-force on the weekend which lead to us injuring ourselves.

One of the most common complaints is lower back pain. This often results from sitting for too long and from sitting incorrectly. Sometimes lower back pain can be a result of a disc injury or arthritis, but for most of us, it is just the result of not moving enough. First, position your desk so you are sitting with proper posture. It is also important to get up for frequent breaks and to stretch and to move around. Outside the office, lower back pain can be exacerbated while exercising. It is imperative to make sure you are not using your lower back during weight lifting or other exercises. Instead, focus on activating the hips and glutes to protect your lower back during your workouts. Additionally, strengthen your core muscles to stabilize your trunk, which will also decrease the load on your back.

Another common malady is neck pain and stiffness. This can result from sitting improperly, walking incorrectly, driving with your head jutting forward, or from sleeping with you neck turned.  Also, stress and tension play a significant role in neck pain and stiffness as well.  Neck pain can increase outside during exercise as well. Often, while performing exercises, we lead with our chin and put extra pressure and strain on our necks without realizing it. Proper form and activation is key to keep the neck pain free. Meditation, stretching and other stress relief techniques are also helpful for decreasing neck pain.

Other common ailments are knee pain, joint pains, muscle strains, and carpal tunnel syndrome. If symptoms are severe and you do not see improvement, you should visit a doctor to rule out a major injury. Assuming there is no disc issue or major tear, sprain or break, many of these problems are caused by our activities of daily living and improper form during therapeutic and strength exercises. The way we sit, walk, talk on the phone, sleep, and exercise all impact how our body moves and feels. Form during exercise is extremely important. Many clients don’t realize their positioning is off and might be affecting their mobility, flexibility, cardio endurance, and strength.

Most people will feel better by engaging in a routine that includes stretching to improve join mobility. It is helpful to use tools like a foam roller or baseball to alleviate knots and to help stretching. Secondly, weight loss often helps with daily aches and pains. Extra weight can put pressure on the joints and cause pain and discomfort. A healthy diet and cardiovascular exercise can help decrease weight and issues with pain. Lastly, strength training, especially core training, helps decrease muscle pain because the muscles stabilize the joints.

It seems like the answer to feeling better and decreasing pain is to engage in physical activity with proper form. Always make your body a priority! If necessary, meet with a personal trainer to ensure you are performing exercises correctly and to make sure you are utilizing exercises to help with your individual issues.

Living With Back Pain

Back pain can be a debilitating and life altering problem for many Americans. In fact, according to the Mayo Clinic, 80% of Americans will experience some type of back pain in their lifetime. Most of the time back pain is an uncomfortable annoyance, although in some cases, it may be serious and require medical attention. Pain is usually associated with how our bones, muscles, ligaments and tendons work together.

While back pain can occur at any age, it more commonly effects those between 35-55 years old. Other risk factors for back pain include a sedentary lifestyle, stress, anxiety, depression, smoking, pregnancy, sleep disorders, obesity, strenuous physical activity, and strenuous exercise, especially if exercises are not performed correctly. There are many possible causes of back pain, but the most common is due to strained muscles, strained ligaments, and muscle spasms due to heavy lifting, improper lifting form, or abrupt or awkward movements. For most of the population, everyday activities, poor posture or a bad mattress are frequently responsible for back pain.  This may be the result of sitting or standing too long, driving for long periods, sitting in a hunched position, over-stretching, bending awkwardly, or pushing/pulling/carrying items. Back problems may also be due to structural problems, such as ruptured disks, bulging disks, sciatica, arthritis, scoliosis, or osteoporosis. More seriously, pain may sometimes be due to cancer of the spine, spinal infections, bladder or kidney infections, and shingles, so contact a doctor if your pain is accompanied by fever, inflammation, numbness, pain radiating down the legs, or incontinence.

In most cases, back pain can be treated at home and will not need imaging scans or treatment by a physician, though surgery may be indicated for those with structural issues.  For pain, doctors usually suggest over the counter NSAIDS, codeine, and cortisone injections. To alleviate pain, complementary therapies such as acupuncture, shiatsu, chiropractic manipulation, and osteopathy are also sometimes recommended. TENS therapy (transcutaneous electrical nerve stimulation) may also be utilized; it emits small electric pulses through electrodes on the skin.

Wouldn’t it be great if we could avoid back pain altogether?  Well, there are steps you can take to prevent the onset of back pain. First, adopt healthy behaviors such as smoking cessation and maintaining a normal body weight. Additionally, it is important to engage in regular exercise to build strength and flexibility. Physical activity also helps to prevent obesity, which, on its own, is a risk factor for back pain. It is also important to be aware of your posture both when sitting and standing and to correct poor posture as often as possible. When standing, keep a neutral pelvis with straight legs, stand upright, and keep your head forward. While sitting, keep your feet flat on the floor and make sure your knees and hips are level. Your arms should be at right angles if you are using a keyboard, and your lower back should be supported. Next, be careful when lifting. Always bend your knees, never twist and lift, and push rather than pull objects!  Finally, make sure you have a supportive mattress so that your spine can remain straight.

If you follow these suggestions, you can help reduce the onset of back pain and also alleviate some of your discomfort if back pain does occur. Be as active as possible in a safe and effective way, and you can keep your body moving pain free as long as possible!

 

 

 

 

 

 

Osteoporosis & Exercise

Over 53 million people in the United States have been diagnosed with osteoporosis or are at risk for osteoporosis due to low bone mass.  Osteoporosis is defined as a disease which weakens the bones so they become fragile and break easily. It is especially prevalent in the bones of the hip, spine, and wrist. Often, osteoporosis is a “silent” disease because the person does not exhibit symptoms or knows he/she has it until a bone is broken or the vertebrae in the spine collapse.

While anyone is susceptible to osteoporosis, it is more common in older women, especially non-Hispanic, white women and Asian women. Other risk factors include being small and thin, having low bone density, taking certain medications, and/or having a family history of osteoporosis. Bone mass can be tested with a bone mineral test.

There are a few ways you can prevent osteoporosis and keep your bones strong, such as consuming a diet rich in calcium and vitamin D, exercising, not smoking, and not drinking alcohol excessively. Falls are the number one cause of broken bones, so weight bearing exercise and balance are extremely important to prevent falls and to increase bone density. If bones become extremely fragile, fractures can also occur through normal daily activities, such as bending, lifting, coughing, or from minor bumps or stresses.

Exercise improves bone health, muscle strength, coordination, balance, and overall health, and it is vital for treating and preventing osteoporosis. Weight-bearing and strength training exercises are both recommended for peak bone mass because you are working against gravity. Weight-bearing exercises include weight training, hiking, jogging, walking, stair climbing, dancing, and tennis. They can be either low impact or high impact. Strength training is also known as resistance exercise, and it includes lifting weights, using bands and balls, and utilizing your own body weight. Yoga and pilates are also great options since they improve flexibility, balance, and strength, but certain positions will need to be avoided to avoid spinal injury.

Consult a doctor before beginning any type of exercise program, especially if you have osteoporosis. You may have to avoid bending, twisting, and flexing to protect your spine if your bone mass is low. Additionally, high-intensity exercises should be avoided to avoid fractures. It is important to stretch and strengthen the muscles properly and to improve posture. It is good idea to consult with a personal trainer to learn how to perform exercises properly and how to progress your activities and routines.

 

References:
The National Institutes of Health Osteoporosis and Related Bone Diseases ~
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/ (National Osteoprosis Foundation)

Why Your Workouts May Not Be Working

Have you been exercising & not seeing the results you’re expecting? Have you developed pain or made an already painful condition worse with exercises that were supposed to help? Have you been told by a trainer or physical therapist that your glutes are not firing or that you have poor balance and you just can’t seem to correct the problem?

These are very common issues that I hear about in my practice which can have multiple causes. The first thing to examine the program itself – what exercises are being done and are they even appropriate for the individual, based on their health history and present condition. I often see people doing exercises that they should definitely not be doing because they are harmful and will cause injury. Unfortunately, I also see many trainers and specialists prescribing these same exercises.

The second thing to examine is form to determine if the exercises are being done properly. A good exercise, if done incorrectly, can also be a bad exercise. Always be meticulous with form. The purpose of exercise should be to improve our health, whether the goal is increasing strength and endurance, rehabilitating tissue, or correcting movement patterns.

The above are very obvious reasons and should always be ruled out first. However, if the exercises are appropriate & being done with correct form but the issue is still present, there may be another less obvious culprit. This hidden hijacker of a good workout results could be fascial tension.

You may have heard of fascia recently, as it getting more attention due to research. Fascia is connective tissue that literally wraps and connects every structure in the body. To visualize this, imagine removing every organ, muscle, and bone. If we were to leave all the fascia intact, we would have a 3D outline of the entire body – a completely continuous web.

Fascia transmits energy and force, in addition to holding everything together. We often think of muscles contracting independently to perform an action. For example, flexing our elbow we attribute to the biceps and brachialis muscles. But in reality, it is much more than that. Tension is created throughout the entire arm and shoulder, into the trunk and down to the hand through fascial connection. Other muscles are also performing at different levels in order to stabilize the arm. So really, everything is working, but at different levels of intensity.

We often think of muscle contraction generating force in the tendons (which attach the muscles to bones) in order to produce a movement. Studies have recently demonstrated that only 70% of the generated force of a muscle contraction is transmitted to the tendons. The other 30% is transmitted outward to the fascia surrounding the muscle by way of attachments along its entire length. Because fascia is completely continuous throughout the body, this force is transmitted to other muscles and structures. This shows that when a muscle acts, it is doing much more than its attributed movement. It is communicating with and working in conjunction with other muscles along a line.

Fascia is also a sensory organ. Another recent discovery is that there there are more sensory nerve endings in the fascia than there are in the muscle. These nerve endings provide information to the brain and spinal cord about position, tension/stretch and pressure – a sense of where we are in space and what is happening to keep us there. Keep in mind that most of this is happening without us even realizing it.

Fascia is made up of different layers that need to slide over each other in order for movement to happen, and in order to have accurate information exchange with the nervous system. If there is restriction of this sliding, usually due to a densification of hyaluronic acid, the substance that lubricates the fascial layers, overall movement can become restricted. Muscle activity can become inhibited due to the lack of efficient communication through the nerve endings that live in the altered fascia.

The densifications causing this altered function can be a result of old trauma/injuries, surgeries, scars or repetitive strain. For example, an old ankle sprain that didn’t heal properly may subtly cause dysfunction either locally in the foot/ankle, or above in the knee, hip, pelvis or even in the shoulder on the opposite side of the body. These densifications may be difficult to detect because they are often found in different areas than where the symptoms manifest. In this case it would be helpful to be evaluated by a professional who understands this process to properly determine the dysfunction and correct it.

Fascial Manipulation is a diagnostic and treatment system developed by the Stecco family in Italy. It sees the body as an interconnected network of points along the fascia that make up different motion planes. The points are centers of coordination for underlying muscles. Interestingly, many of these are also acupuncture points. Densification, or dysfunction, in these points can alter the muscle activity. Fascial Manipulation practitioners find these areas of densification and remove them through a very specific, deep massage technique. When normal sliding is restored to these points, or centers of coordination, very often pain is relieved and muscles function much more effectively with less stress. It is worth noting that Fascial Manipulation has the most scientific research behind it than any other manual soft tissue technique.

Freed movement in the fascial planes leads to normal coordination of muscle activation. This can allow workout results to be more consistent with the targeted actions of exercise and desired goals. If you feel you are not getting the most out of your workout and you know you are doing the proper exercises with good form, consider a fascial evaluation.

Robert Inesta, DC, L.Ac, CCSP

Foam Rolling

Foam rollers have become very popular in gyms as they can be used for all fitness levels for training and recovery. However, many people don’t know the correct way to foam roll or the reasons why they are beneficial. Foam rolling is self-myofascial release, which is a method of self-massage that releases tight muscles and knots (trigger points). The goal is to release the muscles in order to increase elasticity for proper functioning, to improve flexibility, and to reduce inflammation.

Muscles are surrounded by fibrous connective tissue called fascia. Over time, individuals may develop painful points along the muscle and fascia due to trauma from injury, scar tissue, or structural imbalances. These trigger points can shorten the muscle, restrict blood flow to the muscle, and restrict mobility, which causes inflammation and pain and inhibits motion. This can lead to additional problems with posture, joint alignment, neuromuscular transmission, and exercise form, all of which make the body more vulnerable to injury. Further, the surrounding muscles then have to compensate for the weakened areas and may become strained due to overuse. Foam rolling helps the fascia stay mobile, and removing the knots enables exercises to be more effective so that structural balance and joint stability is restored, flexibility is increased, and stress on the surrounding muscles is decreased.

When our muscles are tight, we are often uncomfortable and display poor movement patterns. Our muscles can become tight for a variety of reasons ranging from poor posture, poor flexibility, training, hydration status, stress, sleep, etc. The idea behind foam rolling is to break up muscle knots, prevent knots from developing and create normal blood flow and nerve function back to the area. This decreases recovery time after a workout and decreases the risk for injury. Additionally, a greater range of motion allows for more effective workouts since there are no muscular restrictions. The ideal time to use a foam roller is before your workout as it will increase range of motion and bring blood to the tissues. In addition to foam rollers, tennis balls, golf balls and lacrosse balls can be used to break up muscle adhesions.

When foam rolling tight muscles, you will frequently feel pain which may radiate to another area. This pain should be uncomfortable, but certainly not unbearable. You can foam roll any muscle in your body by using moderate pressure and your bodyweight. When you locate tight/painful areas, you should concentrate on rolling those areas slowly, letting the muscle relax. If the pain is too intense, roll the surrounding areas instead and slowly work your way into the painful area. Do not overwork knots or painful areas, as this may damage the tissue. Avoid rolling bones or joints. Roll slowly. Make sure your form and posture is correct. Using a personal trainer to guide you will ensure that you do not cause more damage and will reach the muscle in the most effective way.

Not only are foam rollers beneficial for muscles, but they are also brain exercisers since the brain and nervous system need to be retrained to correct faulty movement patterns. The use of foam rollers requires complete concentration since they are unstable. Unstable exercises also improve proprioception and challenge core muscles.

Overall, foam rollers are a great tool that should be used by everyone in the gym, no matter their fitness level, to enhance their workout and prevent injury.

To see videos on how to foam roll properly, head to our video category & check them out!