Here is some great insight in Trauma Injury vs Overuse Injury
Posted in Uncategorized on December 8, 2015 by mike boyle
Trauma versus Overuse? ( Originally published 2008)
There are two types of injuries, trauma and overuse. Our sports medical model is based in the trauma model. The trauma model works great if you sustained a sports injury from a collision etc.. It doesn’t work as well for gradual onset injuries like tendonitis.
The problem is if the mechanisms have nothing in common, chances are the treatments are not going to be similar either. Trauma treatment revolves around the RICE concept. ( rest, ice, compression, elevation) or possibly surgery. The overuse model involves much more. If your problem took time to develop, it will probably not be solved with a conventional approach. Rest and ice will only cure your tendonitis until you start working out again.
Just remember, cleaning up the puddle is not the same as fixing the leak. If you have water on the floor, you’d better look on the roof. The solution is not on the floor.
We posted three articles about Sports Hernias that illustrate just this concept at www.strengthcoach.com.
In his bestselling book, The Anatomy Of An Illness, Norman Cousins tells the story of how he cured himself from the debilitating condition ankylosing spondylitis by laughing along with Marx Brothers movies. He wrote, “I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep. When the pain-killing effect of the laughter wore off, we would switch on the motion picture projector again and not infrequently, it would lead to another pain-free interval.”
Play with animals.
Snuggling with our pets fills us with oxytocin, endorphins, and other healing hormones that support the body’s self-healing mechanisms. This is why pet therapy can be so effective, both mentally and physically. So go cuddle Fido, rub Fifi’s belly, and let them cut your cortisol levels while ramping up your body’s capacity to self-repair.
When Cami Walker was diagnosed with debilitating multiple sclerosis, conventional medicine had to offer. Then a South African medicine woman suggested that, instead of focusing on herself, she needed to shift towards thinking more about others. The medicine woman wrote Cami a prescription- Give 29 gifts in 29 days. So she did. And as if by magic, her MS symptoms started to diminish. How? Because giving activates relaxation responses, which bolster the body’s natural self-repair mechanisms.
Express yourself creatively.
Creative expression releases endorphins and other feel-good neurotransmitters, reduces depression and anxiety, improves your immune function, relieves physical pain, and activates the parasympathetic nervous system. This lowers your heart rate, decreases your blood pressure, slows down your breathing, and lowers cortisol.
Practice yoga, tai chi, qigong, or dance forms.
All of these modalities, which combine the benefits of exercise and meditation, steep you in healing hormones and have been proven to effectively drop cortisol levels and improve your body’s ability to heal itself.
You can also get a massage, the ultimate relaxation response activator. A nurturing massage not only relaxes your muscles, it relaxes your nervous system and kicks those self-healing mechanisms into high gear.
Get it on.
Those with healthy sex lives live longer, have a lower risk of heart disease and stroke, get less breast cancer, enjoy the benefits of stronger immune systems, sleep better, appear more youthful, enjoy improved fitness, have enhanced fertility, get relief from chronic pain, experience fewer migraines, suffer from less depression, and enjoy an improved quality of life. Oh, and their cortisol levels are lower!
Pray or join a spiritual community.
Those who attend religious services live up to 14 years longer than those who don’t, but don’t go to church if it’s not in alignment with your authentic beliefs. Find or create your own spiritual tribe to enjoy the hormonal benefits of gathering together with the intention of loving, healing, and lifting the vibration of each other and the planet. Your nervous system – and your body – will thank you.
Lonely people have twice the rate of heart disease as people who aren’t lonely. In fact, loneliness researchers suggest that alleviating your loneliness is more important to a healthy lifestyle than quitting smoking or starting to exercise (read more here). As Robert Putnam put it in Bowling Alone, “As a rough rule of thumb, if you belong to no groups but decide to join one, you cut your risk of dying over the next year in half. If you smoke and belong to no groups, it’s a toss-up statistically whether you should stop smoking or start joining. These findings are in some way heartening. It’s easier to join a group than to lose weight, exercise regularly, or quit smoking.”
Take radical action in order to reduce your stress responses.
Ask yourself, “What does my body need in order to heal?” If your intuition says, “You have to quit that soul-sucking job” or “You’ve got to get out of that abusive relationship,” listen up. You’ve just written The Prescription for yourself. (To learn more about how to write The Prescription for yourself, read Mind Over Medicine.
Too scared to take a leap of faith? As my friend and co-conspirator at the Whole Health Medicine Institute says, “If you want big miracles, you have to take big risks. If you’re wanting to take smaller risks, you’ll have to accept smaller miracles.”
Great interview! After reading Supple Leopard I consider Kelly Starrett an industry pioneer with a gift of making the complex simple.
Kelly Starrett, Doctor of Physical Therapy and co-owner of San Francisco CrossFit, is fond of saying humans beings should be able to perform maintenance on themselves. In Starrett’s mind, the days of seeking physical therapy to merely resolve pain and are over. He believes that if we can understand how to get ourselves into proper positions for any activity — whether it’s our elbows in a push-up, foot placement for a squat, or shoulder position when we’re texting — we can minimize injury and maximize performance. This would translate to running faster, achieving downward dog more fully, or even more efficient flip turns in the pool.
A former whitewater slalom paddler for the US Canoe and Kayak Teams, Starrett led the Men’s Whitewater Rafting Team to two national titles and competition in two World Championships. He’s now a sought-after speaker and educator, traveling all over the world and lecturing audiences from college strength and conditioning coaches to members of the military. At home in San Francisco, clients of his orthopedic sports medicine practice have included world champion rowers, Tour de France cyclists, Olympic weightlifters, and ballet dancers.
Starrett’s methodologies evolved alongside his involvement in CrossFit, which he discovered in 2004 when it was still an obscure strength and conditioning program. He became an early adopter, earning a certification to coach and opening one of the first CrossFit gyms in the country. Even though he’s been producing instructional content for the CrossFit community since 2008, Starrett is best known for MobilityWOD.com, a website he started in 2010 with one video demonstrating how to deepen one’s squat. MobilityWOD now contains three years worth of daily video posts on everything from knee pain and shoulder extension to breathing mechanics and post injury rehab.
We caught up with the mastermind behind MobilityWOD to talk about his new book (Becoming a Supple Leopard), injury prevention, and why ballet dancers should deadlift.
How did you first get interested in physical therapy?
I was at a ski race camp [in Austria] with the reigning world champion, diagramming the arc of the turn, and I remember being like, “I love this, I understand this, this is it: Making the complex simple. Show me the constituent parts and I can do it. Let me understand the process.” I’ve always been obsessed that way. Always.
I quit the [kayaking] national team and moved to San Francisco, where I realized that I needed to go to grad school. This is crazy, but I literally had a moment of satori. I was out surfing and… I heard God’s voice, I saw the spheres, I was like, “Oh, I guess I have to go to grad school.”
How did you discover CrossFit?
I was Olympic lifting once a week with a guy in [South San Francisco] in [the basement [of an old gym]. The first semester of physio school, I was looking for information on how to Olympic lift with dumbbells and I was searching the web. I saw this website, CrossFit. This was early, early CrossFit. And I think there were four or five CrossFit [gyms] in the world. I saw this website and was like, “Whoa, this is interesting.” I read the little manifesto and tried a workout.
I’m a good athlete, I’m a fucking good athlete. And I got crushed. It was “Cindy*” I was devastated. The work secret is out of the bag now. CrossFit has already fundamentally changed the fact that people’s intensity is higher. Now there’s P90X, “Insanity.” People are working harder. This was the dark ages, no one was doing it.
*Note: Cindy is a popular CrossFit benchmar workout consisting of pull-ups, push-ups, and squats.
What made you want to combine physical therapy and CrossFit?
As a Physio, it was perfect because I was getting all this classic medical Western thought diagnosis stuff and I was forced to deal with the dissonance of, “This is how I have to learn how to move. I have to be a better Olympic lifter. I have to learn the tenets of power lifting. I have to be more fit. I have to be a skilled runner.” And at the same time I [had to] reconcile that with what I’m understanding and learning about with rehab. And they were clearly disconnected.
I don’t want to say I am the first person to do this, but I had never seen anyone mobilize someone’s hip to improve something that wasn’t painful. People weren’t doing mobilizations for position. They were stretching, but they weren’t understanding why we were stretching.
I started tinkering with mobilizing a guy’s hips because he was an MMA fighter and he could get into guard better and I wondering if that would work for squatting, too. The physical therapy texts are not about performance or rehab or diagnosis or even injury prevention. It’s about the techniques we use when someone is injured.
The whole medical system is predicated on, “Oh, your issue is resolved and you’re functional.” And it should be, “Oh, you’re out of pain, functional, now go solve the rest of it on your own.”
How didcome about?
I started teaching some friends. Some little gyms were like, “Can you do a shoulder thing?” And I would talk about shoulders, I would talk about knees. I did this one day course down in Santa Cruz, it was called “A Day with Kelly Starrett: Chasing Performance.” And all of a sudden I have this kind of image. “Why am I seeing the same things in my physical therapy practice? Why is it that no one knows this?” Then I was like, “Well, I can change that! Here’s what we do: I have this iPhone, I have Blogger, I am going to put up a video a day for a year.”
Soon it started to gain momentum and people found out about it. And I realized people needed templates, they need recipes, they needed examples. I needed to make a case.
Can you talk about mobility to stretch and stay loose versus mobility to optimize performance?
Do you have what we know as the full range of motion for the human being? That’s decided. We know how much elbow flexion there is. That’s not debatable.
What’s interesting is how we can divest ourselves of the fact. It’s like, “Hey, it’s okay that I don’t have the range of motion to do this sport, it doesn’t matter because I can still do the sport. It’s okay if I’m at 50 percent of my capacity as a human — that’s okay because I’m still a human.”
And I think that’s the problem, that we’ve sort of made this case where we’ll be like “Well, I can roll out a little bit, stretch, bend over, pull my hamstrings a little bit, I’m not so stiff. Great, goodbye!” I don’t think people are going after the corners. We’re leaving this 20 percent margin of function. So, we were confusing the fact that we didn’t have pain… with the fact that we were working at peak efficiency.
I only know a handful of people that are working at 90 percent of their efficiency. We’re so robust that you can buffer bad diet for decades and it doesn’t matter. You can move like crap for decades and it doesn’t matter. What does that tell you about the resiliency of the human being?
Are some people naturally more or less flexible?
Watch kids crawl — look at all the hip flexion. It’s all the same. You have infinite potential as a child. It’s very level. That’s why you don’t see any difference between boys and girls in middle school, dude.
Kids in the playground just tear off at recess, right? Do they have to activate their glutes? No, they have all that potential. They can put their arms over their head. You know they have full ankle range of motion.
When do we lose this innate mobility?
Not teaching movement practices. Why aren’t those kids in gymnastics? Why are [kids who take gymnastics] little cheetahs the rest of their lives? Remember those kids? They learned to backflip and they can always do a backflip? And they can jump off the trampoline and they can do all that crazy shit? I think that’s why—talk to any coach, they’re like “Oh, yeah, your kid has to be in gymnastics. Period.”
You say people should be able to perform basic maintenance on themselves. Is there one thing that people ought to do?
Protect your nervous system. That’s it. What is it about your spinal positioning that’s wretched? I’m less worried about how stiff your calves are because the number of calf injuries and the number of Achilles injuries [are] low compared to the number of back tweaks and hip tweaks. If you have one thing to do during the day, what is it that you can protect about your nervous system? Your nervous system is your limiting factor. Period.
What is the one movement for that?
I’d say the single most significant thing is to… get people to stop sitting. The “smoking” of our generation is sitting. A treadmill is not the answer. The answer is not to sit. So, you need a cheap-ass barstool and a higher desk and you can lean and put your foot up and change position and just by removing that stimulus alone, life would change.
Is there such a thing as sport-specific training?
My ballet dancers don’t want to deadlift heavy. They have to deadlift, but, like how do I improve their [dancing], right? My male dancers need to be better overhead so they’re not broken when they’re holding their partner. So, the real thing I think is interesting is [that so much of] this is transferable to anything that’s important to you.
You know, I have an idea about what it means to be the best human functionally but people don’t want to work so hard. Have a deeper understanding of what it is you do. Like, if you love to go, you know, fight and you like boxing — box more efficiently, I think that’s where the scalability is; the revolution of it.
How can an athlete know if their programming is safe?
Because you get better at your sport. And you’re working at the limits of your positional understanding. If you have full range of motion or are working towards it, then chances are you’re going to be very protected. It’s built in. Because you’re not going to dive into the pool and dislocate your shoulder because for the last month we’ve been pressing, we’ve gone overhead a gazillion times.
Thanks for your time, Kelly, and looking forward to seeing your future projects!
Note: This interview has been edited for length and clarity.