Introductory Myofunction Workshop

Transcription

1 Myofunction: self-myofascial release and assessment exercises for functional movement Myofunction is the combination of functional movements and self-myofascial release techniques. These two concepts help reduce wear and tear on the joints of the body by improving biomechanical function, and therefore improving sports performance. By practicing the exercises in this workshop you can maintain proper posture, range of motion, and improve muscle strength. This workshop is an overview of the self-myofascial release movements possible to address the muscular causes of postural and joint dysfunctions that develop from many sports and daily activities. (chondro-malatia patella syndrome, IT band syndrome, lower back pain, rotator cuff issues, impingement, limited range of motion, poor posture, etc.) It is the hope of the presenter to establish a better appreciation for self-therapy and an understanding of which maladies warrant more homework, and which ones are outside the scope of self-care and need proper diagnosis by a medical professional. Tight muscles restrict the movement of the joints to which they attach. With proper care of the muscles that affect them, your joints should function with full range of motion throughout your entire life. Page 1 of 14

2 1. Foot & Ankle -- Soleus Rock & Rotate (BACK of lower leg) Your Soleus muscle does not attach to the knee itself, but if it is knotted up it will feel like it is pushing your lower leg apart as you close you knee real tightly, like when sitting on your heels. You will develop dysfunctional patterns of movement to compensate for the inability of your calf muscle to compress, such as leaning forward with your knee and bending forward sharply at the hip & lower back instead of bending at the knee and lowering your hips into a deep squat. Sit down on a level surface with your right lower leg lying on top of the little roller, with the block underneath it. Ensure that the little roller is at the far edge away from you, so that you can get the maximum range of motion with the roller as you conduct this exercise. With your knee straight and foot relaxed, inhale as you draw your knee towards your chest until your heel hits the block or the roller reaches the nearer edge of the block. Exhale as you apply gentle pressure to your leg and extend your knee until it is straight. Repeat 4 more times. While maintaining pressure with the roller, rotate your ankle clockwise 2 times, and then counter-clockwise 2 times. Shift your leg outward to the wheel and rotate it inward to address the inside portion of the back of your lower leg. Repeat the 5 strokes and 2 circles each way, then rotate your leg outward so that you are addressing the outer ridge of tension on the back of your lower leg. It is this ridge that is of special interest if you have the pressure in the back of your knee when you bend it. Repeat the 5 strokes and 2 circles for the outside of your soleus area, but you might need to do another set of 5 and 2 a little higher, and even higher, as the Soleus runs the length of the Fibula bone all the way to the back of the knee. So take your time and follow the tension as far as it goes. Page 2 of 14

3 2A. Rectus Femoris -- Center Quad Roll (FRONT center thigh) If you stand or walk kinda likeachicken with your hip tilted forward (anterior pelvic tilt), then do this exercise daily. If it takes more than two minutes to roll from knee to hip, get off the roller and get some circulation through your leg to help it loosen. Come back to where you left off and continue the 2-3 inch rolling up your thigh. It's more important to relax your thigh and get your hip as close to the ground as possible than it is to roll your entire thigh in one continuous movement. Lay down on the floor, face-down on your stomach. Place the large roller about 1 inch above your kneecap under the center of your thigh. Draw your elbows underneath you like a Sphinx. Take a deep breath, and as you exhale push your body 2-3 inches towards the roller (so that the roller moves up your thigh towards your hip). Try to keep your hip as close to the ground as possible. Take in another deep breath and draw your arms underneath you again. As you exhale, repeat the pushing motion towards the roller, allowing it to move 2-3 inches up your thigh. Continue this process of rolling 2-3 inches up your thigh until you reach the hip bone where your center quad muscle attaches to the hip. Get off the roller and flex & extend your knee a few times while lying on your side. Once your leg feels like it can handle walking on it, get up and walk around for 5-10 steps. Do a few squats, gently trying to squat a little deeper with each movement. Repeat the rolling technique until you have no discomfort at any point between your knee and hip. If tension or discomfort within your thigh worsens with repeated rolling, call a proper therapist (massage or physical therapist) to enlist their assistance. Page 3 of 14

4 2B. Vastus Lateralis (VLO) -- Outer Quad Roll (FRONT outside thigh) This muscle is indicated if your knee "locks." Use cross-fiber rocks to gently loosen excessively tight areas. If your thigh is so tight that after 2 minutes you are not at your hip with the roller, then take a break & walk around. Come back to where you left off and continue up your leg. Take as many breaks as necessary to roll from your knee to your hip in 2-to-3 inch rolls. Remember that relaxing your muscles is more important than pushing harder on them. Lay down on the floor, face-down on your stomach. Tilt your hips about 45 degrees. Place the large roller about 1 inch above your kneecap under the outer portion of the thigh that is closer to the ground. Draw one elbow underneath you and support yourself with the elbow or hand of your other arm. Take a deep breath, and as you exhale push your body 2-3 inches towards the roller (so that the roller moves up your thigh towards your hip). Try to keep your hip as close to the ground as possible. Take in another deep breath and move your arms underneath you again. As you exhale, repeat the pushing motion towards the roller, allowing it to move 2-3 inches up your thigh. Continue this process of rolling 2-3 inches up your thigh until you reach the hip bone. Get up and walk around for 5-10 steps. Do a few squats, gently trying to squat a little deeper with each movement. Repeat the rolling technique until you have no discomfort at any point between your knee and hip. If tension or discomfort within your thigh worsens with repeated rolling, call a proper therapist (massage or physical therapist) to enlist their assistance. Page 4 of 14

5 2C. Vastus Medialis (VMO) -- Inside Quad Roll (FRONT & inside thigh) This muscle is primarily indicated when your knee "buckles." Whether your knee buckles or not, if you experience pain on the inside of your leg either above or below the knee, be mindful there are 5 other muscles that cross over or near the medial quad. The true culprit of your knee dysfunction could be one or more of these other muscles. Take your time and follow the path of tension in the tightest band of muscle, and you'll gradually find relief. Lay face-down on your stomach, with your right leg out to the side like a sniper. Place the big roller under the leg that is positioned out to the side, so that the inside of your thigh is able to roll on it. Much like you did with the other quads, take a deep breath and exhale as you roll 2-3 inches up the inside of your thigh. However, this time you push your body sideways, instead up downwards. Inhale and draw your leg back to the starting point and repeat the 2-3 inch push as you exhale. Roll the same area 3 times, then move the roller a little closer towards your groin and continue in this fashion until you roll as high on your inside thigh as is comfortable. Your flexibility will limit how close to your groin you can get with the roller. DO NOT force it! Allow your body to relax and work the roller towards your pubic bone with your hips as close to the ground as possible. As you get higher on your thigh the Vastus Medialis muscle lies deep to the adductor muscles. Regardless of which muscle is tight, take your time, relax, and roll towards your hip as you exhale. Remember to roll each 3-inch section 3 times before continuing a little higher up your thigh. This method of multiple short strokes best addresses the many layers of muscle in the inside of your thigh. Page 5 of 14

6 3A. Piriformis -- Slow Leg Drop (low on the BACK of the hip joint) Many people who suffer from Sciatica have tight hip muscles that contribute to their discomfort. In some people the sciatic nerve runs through the piriformis muscle, and tension within the muscle pinches on the sciatic nerve, causing sciatica symptoms. There are 5 muscles deeper than the piriformis in the hip joint. The exercise below addresses several of these at a time, with the piriformis being the biggest of them. This movement requires that you can comfortably sit on a flat surface with your legs out in front of you and your hands just slightly behind you. Sit down and place the massage ball under your right buttock about halfway between the bony notch high on the outside of your thigh (the greater trochanter) and the center of the back of your hip (your sacrum). Once you are sitting on the ball, gently lay your right knee out towards the ground without lifting your left buttock off the ground. Shift your hips left about one inch, right, forwards, and backwards to find the spot that has the most tension within your hip area. (not necessarily the most painful... chase tension, not pain) Once you've found "your spot," take a deep breath and draw your right knee inwards towards the center with your right heel staying planted on the floor so that you are rocking left and right on the back of your right heel. As you let out a l-o-n-g exhale slowly drop your right knee outward towards the floor. Breathe in and lift your knee, breathe out and drop your knee. Complete 5-10 rounds of this movement, then remove the ball and gently rock left and right on your bottom. If you feel like there's a "dent" in your behind, rock on your bottom until it is gone. Then get up and walk around, do a few squats, lift and rotate your thigh to check ROM. Page 6 of 14

7 3B. Gluteus Medius -- Rotate & Press (high on the BACK of the hip joint) There are three gluteal muscles that begin on the back of the hip bone above the origin of the piriformis muscle and insert at the greater trochanter very near the insertion for the piriformis. These muscles can cause discomfort similar to sciatica. Clearing this area along with the piriformis area can bring tremendous relief from a variety of hip muscle dysfunctions and restore proper range of motion in the hip, thereby restoring comfort with hip movement. This movement requires that you can comfortably lay down and roll onto your side on a flat surface. Lay down and press the massage ball against the side of your right buttock about 2 inches below the top of your hip. Gently rotate your body towards the ball so that your hip rolls onto the ball. Shift your hips left about one inch, right, forwards, and backwards to find the spot that has the most tension within your high-hip area. (not necessarily the most painful... chase tension, not pain) Once you've found "your spot," take a deep breath and rotate away from the ball, and rotate onto the ball as you exhale. Hold this position on the ball for 3 deep breaths and then rotate onto your back as you relax for a couple breaths. Complete 3-5 rounds of this movement, then remove the ball and gently rock left and right on your bottom. If you feel like there's a "dent" in your behind, rock on your bottom until it is gone. Then get up and walk around, do a few squats, alternate standing on one leg for a moment to check hip function. Repeat as needed until your there is no discomfort or tension when you rotate your hip onto the ball. Page 7 of 14

8 4A. Psoas -- Core Press & Knee Raise (FRONT of the core, under your abs) The Psoas muscle is the deepest of the muscles in the core on the front of your body. It is attached to the vertebrae of your spine and the inside of your thigh. It functions as a hip flexor (pulls your leg towards your core or your core towards your legs), which means that excess tension within it loads your spine & hip all day long. DO NOT ATTEMPT this exercise unless your doctor has cleared you for exercise and participating in activities that apply pressure to your body, such as massage. This muscle lies beneath your abdominal muscles and intestines. You will apply pressure to your abdomen with this exercise, so it is absolutely critical that you PROCEED WITH CAUTION. This exercise can relieve tension that can cause lower and middle back pain, and hold your hip in a "pooping dog" position so that you cannot push your hips back properly. Because of it's effectiveness, I believe if you are healthy and cleared by a doctor you should do the exercise below regularly. Begin by lying on your back. Take the ball and place it against your belly about 1 inch to the right of your belly button. Place the block vertically on top of the ball. Gently hold the ball in place with the block as you inhale. Exhale and apply gentle pressure with the block while you slowly raise your right knee to the block. You should feel the pressure intensify under the ball as you raise your knee. If not, shift the ball 1 inch lower or higher, and repeat the breathing and knee movement. Apply pressure to the spot with the most tension (not necessarily pain!) and repeat the knee movement 5-10 times. Allow your head to clear before you get up. Repeat as needed until you do not feel pressure in the abdomen when doing this movement. You should feel marked ease of lifting your leg when you've done this correctly. Page 8 of 14

9 4B. Quadtratus Lumborum -- Rotate & Press (BACK of the lower back, above hips) The Quadratus Lumborum muscle (QL) is absolutely critical to standing and walking. It is attached to the back side of your spine in your lower back, the top of your hip bone, and the bottom of your lowest rib. It stabilizes the space between your ribs and your hips. You address other back muscles while addressing the QL, so be aware you might need therapy in more areas than the one described below. When in doubt, contact a therapist for assistance. The QL is one of three primary areas you should address for relief of lower back pain (the rectus femoris and psoas muscles are the other two). You should be able to lie on your back on a flat surface and easily roll towards either side. If you have any disc issues (herniated discs, L4-L5 issues, etc.) you should CHECK WITH YOUR DOCTOR before proceeding with this exercise. That said, begin by laying on your back. Press the ball against your right side just above your hip bone, slightly underneath you. Gently roll towards the ball thereby pinning it between your lower back and the floor. While lying on the ball, shift your body about 1 inch up, down, left, and right to once again find "your spot." Once you've found the area of the most tension in your lower back, inhale and relax your back while you roll slightly backwards, off of the ball. As you begin to exhale roll back onto the ball and gently apply pressure against the tight area of your back with the ball. Complete 5-10 rounds and then remove the ball but stay lying down. Gently wiggle your hips until your head clears and you feel you can stand. Get up and walk around, consciously checking your hips and lower back for ROM. Any intense discomfort or questionable sensations, stop this exercise and CONTACT YOUR THERAPIST. Page 9 of 14

10 5A. Pectoralis Minor -- Raise & Squeeze (FRONT of the shoulder, in the chest) Always start with your Pectoralis Minor muscle when dealing with shoulder issues because it has incredibly good leverage with which to pull your shoulder blade towards your sternum (chest) and round your shoulder forwards. This is good an bad. Good in a confrontation or fall, but bad when walking or reaching above your head. Loosen these small but powerful muscles so that they return to full stretch length. You'll lose the humpback and your shoulders, back and neck will thank you! Grab the ball and place it in your armpit for the same arm of the hand that s holding the ball. Gently but firmly roll the ball from your armpit towards the center of your chest. When you reach the "speed bump" as I like to call it (about 1-2 inches from your armpit), stay on top of it and gently but firmly roll up towards your coracoid process (the front tip of your shoulder blade, just below your collar bone) or down towards the 5th rib (at or slightly above the nipple line). Somewhere along that muscular ridge you ll find a knot or two that s pretty stubborn and doesn t want to relax around the ball. Hold your position over the tightest of those knots (not always the most painful try to chase pressure, not pain!) Either using your hands over the ball or use the block for added leverage between the ball and your hands, decrease pressure over the knot in your chest as you inhale and raise your elbows. Increase the pressure against the knot as you exhale. Repeat 5-10 times in one spot and roll your shoulder backwards. Notice the range of motion possible with the shoulder rolls. Do the other side. Gradually you should notice fewer knots that you need to address in your pecs, and an easier time stretching your shoulders backwards. Page 10 of 14

11 5B. Infraspinatus -- Winged Rotations (middle of the BACK of shoulder blade) The middle and most of the lower part of the back of your shoulder blade is covered by your infraspinatus muscle. (It rotates your arm backwards.) You need to have the ball under this area as you are lying on the floor on your back. If you cannot easily rotate left or right from a lying position, you should not attempt this maneuver. You should not apply pressure to your back muscles, spine, or ribs without being able to easily lift your body off the ball if you have a problem. Lie down flat on your back and lay your arms out on the floor to the side of your shoulders with the elbows bent at about 90 degrees, with your head resting on the ground. Shift your body so that the ball is under your right shoulder blade. If it s tough to tolerate the pressure of the ball against the back of your shoulder blade, place the block under your elbow to take some of the weight of your arm off your shoulder. Whether or not you have the block under your elbow, your head should be on the floor and your knees should be bent with your feet flat on the floor. Inhale and rotate both of your arms so that your palms move towards the floor by your ribs, and then rotate your arms so that your knuckles (the back of your hands) move closer towards the floor by your head as you exhale. Do this 5-10 times with a slight effort to get your knuckles a little closer to the floor with each breath. (don t force it!) After the rotations, lay your arms straight out to your sides. Inhale as you shrug your right shoulder towards your ear, and exhale as you push your shoulder away from your ear. Repeat 5-10 times and remove the ball. Relax, breath, move your arm around to check ROM. When your head feels clear enough to stand, do so and again check ROM. Page 11 of 14

12 6. Neck -- Turn & Rock (BACK of the neck between head & shoulder) This is the "feel good" of all the movements you can do to address trigger points with self-myofascial release. It addresses 5 layers of muscle and more than 8 different actual muscles on either side of the neck. The path of the levator scapula is illustrated because it best demonstrates the area you should work on. You can relieve tension headaches and other head and neck issues by spending a little time working on this very complex area of the body. Some of the previous movements carry significant risk with them. This particular movement is one of the safest and best feeling movements of the bunch. You begin by lying on your back with your head supported by the block. Place the ball on the right side of your spine between your neck and the block, with your chin turned towards the side the ball is under. Your neck forms a pocket to hold the ball in place while your head is turned. Gently rock your head back as you inhale, and tuck your chin down as you exhale. If the ball shoots out from under your head, replace it and turn your head a bit more to the side or place the ball a little closer to your head so your head and neck hold the ball better. You can do as many rocks up and down, and slightly back and forth as you like (5-10 rocks of your head are the suggested amount, with one breath per rock) but it is entirely safe to do this while watching a film or TV show, alternating sides every so often. You'll notice less tension as you continue to work either side of your neck against the ball. If you need to work the area lower and closer to your shoulder blade, you might need to remove the block to rest your head on the floor while you use similar head movements to address the tight muscles in your neck. Take your time, take deep breaths, and r-e-l-a-x. Page 12 of 14

13 7A. Forearm Flexors -- Center/Inside/Out (FRONT side of forearm) Many people with carpal tunnel syndrome, arthritis in the fingers, hand, or elbow, or other troubling discomforts in the arm or hand can greatly benefit from relieving excessive tension in the forearm muscles. The 7 flexors and the Brachioradialis of your forearm are all addressed using the same method. You will find different muscles tighten up after different activities, so take your time with this exercise and do a few extra rolls where you need it most. Your grip strength is the best indicator of progress. The best place to do this exercise is standing next to a strong table or counter top, with your forearm resting on it, although you could do this while sitting or lying on a flat surface. To begin, place the small roller near your wrist under the center of your right forearm with your palm facing downward. Place your left hand on the back of your right forearm over the roller. Take a deep breath, and as you exhale apply gentle pressure with your left hand and roll the width of your left hand (from pinky to thumb, about 3 inches) up your right forearm. Roll back to where you started as you inhale (while applying less pressure with your left hand) and repeat for a total of 3 rounds in the center of your forearm. Rotate your right thumb towards yourself to shift the area you are rolling to the thumb-side of the front of your forearm and repeat the deep breathing and 3 rolls. Next, rotate your right forearm outward to the pinky-side of the front of your forearm and repeat the 3 rolls there near your wrist. Once you've rolled all three areas near your wrist, place the roller a little closer towards your elbow (the stopping point with the previous set of rolls), and repeat all three section rolls with the deep breaths. Continue in like fashion until you roll all the forearm muscles between your wrist & elbow. Page 13 of 14

14 7B. Forearm Extensors -- Bottom/Center/Top (BACK side of forearm) This movement is done in a similar fashion as the flexor rolls, and a strong counter top is still the best location to do this. There are 10 extensors, a supinator, and the Brachioradialis. Pay special attention to the Brachioradialis muscle on top of your forearm near the elbow, as this muscle is best addressed using the following exercise, and tremendously helps when flexing your arm. Grip strength is the best indicator of progress for this group of muscles, too. The best place to do this exercise is standing next to a strong table or counter top, with your elbow and forearm resting on it. To begin, place the small roller near your wrist under the bottom of your right forearm with your thumb up (like a karate chop). Place your left hand on top of your right forearm near your thumb. Take a deep breath, and as you exhale apply gentle pressure with your left hand to the top of your right forearm and roll the width of your left hand (from pinky to thumb, about 3 inches) towards your elbow. Return to where you started as you inhale (while applying less pressure with your left hand) and repeat for a total of 3 rounds on the bottom of your forearm. Rotate your right forearm outward to shift the area you are rolling to the center of the back of your forearm and repeat the deep breathing and 3 rolls. Next, rotate your right forearm outward even more to the thumb-side of the back of your forearm and repeat the 3 rolls there near your wrist. Once you've done all three areas of the few inches of your forearm near your wrist, place the roller a little closer towards your elbow (the stopping point with the previous set of rolls), and repeat all three section rolls with the deep breaths. Continue in like fashion until you roll all the forearm muscles between your wrist & elbow. Page 14 of 14