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Enhance movement after an injury - Larry Parracino, LA Clippers
Enhance movement after an injury - Larry Parracino, LA Clippers
September 14, 2017
Injury, recovery, and movement enhancement are all common characteristics of an athlete.  It’s the balance of these three characteristics that becomes tricky. 

Lets start with injury.  Injury by definition is a disruption of unity.  The reality is that all athletes during their career will experience some form/degree of injury.  Even soreness after training is technically an injury!  In fact, muscle soreness is muscle damage.  Recently, BYU research shows immune system cells help to repair muscle damage after a workout, a normal response to injury, which is great, BUT do we want our immune system always activated after working out?  What does this reaction do to our movement enhancement?  Knowing soreness is an injury and chronic soreness decreases movement performance, learning a process to optimally recover should be a critical part of everyone’s plan if long-term healthy movement is the goal!

    As for the recovery, regardless of the level of injury, we need a safe/pain free environment for optimal adaptation.  All techniques can be categorized into either 1) pain control or 2) conditioning.  Pain science has taught us that the solution for pain is 1) change the sensitizing agent(s) and/or 2) build tolerance to the sensitizing agent(s) or the structural change.  Pain is a sensation of a perceived threat.  Perceived being the key word.  Pain, regardless of how one describes it can no longer be directly correlated to the degree of tissue damage. A great example is a paper cut hurts “big-time” yet a cancerous tumor may not hurt at all.  We can only imagine the cancerous tumor displaying much more tissue damage! 

  The solution to enhance movement after an injury is to first decrease sensitive tissue regions followed by building up tissue tolerance.   This leads me to what I refer to as Soft Tissue Hygiene.   We are all taught how to apply a hygiene approach to our dental structures, but what about the rest of our tissues?   Teaching athletes DAILY soft tissue hygiene, utilizing tools that improve soft tissue resilience/tolerance, is key to mitigating chronic damage – just like brushing and flossing.  We don’t brush only when we think we need it, we learn to create a HABIT.  The only way to make a chronic change to your tissues is to implement a chronic habit.  Research has demonstrated tools that compress the tissues SLOWLY change the internal fluid matrix in a beneficial way[1].  When there is increased viscosity (thickness) in the internal fluid matrix it can adversely affect many mechanisms in our body.  Free nerve endings and other mechanoreceptors can be altered, leading to chronic soreness, pain and/or stiffness, and altered motor control.[2] In addition, if the tool exhibits vibration with compression (such as with the Hyperice VYPER roller or HYPERSPHERE ball),  there is a greater benefit than just massaging over the skin or using an implement to roll up and down body parts.  Since the change occurs in the viscoelastic components of the soft tissue complex, SLOW compression/shear/vibration and heat tends to bring positive benefits in the conditioning phase.  If one is in the pain phase I would suggest ice/compression and client/patient pain free micro-movement.

In summary, chronic soreness (injury) should be avoided at all costs if the intention is movement enhancement.  Although there are MANY factors that can contribute, far more than just mechanical, the physical aspect can be assisted by proper soft tissue hygiene.  Although research is now available on this subject, results will speak for themselves. I recommend assessing, applying, and reassessing to adjust variables for optimal adaptation.  By sharing this process I hope I have spurred thought to yours.  By using your intelligence and not memorizing protocols we shift from a master-mechanical-technician to a creative-humble-facilitator.   Lets teach people soft tissue hygiene!

  [1] Roman, M., Chaudhry, H.,Bukiet, B.,Stecco, A., Findley, T.W., 2013. Mathematical analysis of the flow of hyaluronic acid around fascia during manual therapy motions. J. Am. Osteopath. Assoc. 113 (8), 600-610.
[2] Stecco C., Stern R., Porzionato A., Macchi V., Masiero S., Stecco A., De Caro R. 2011. Hyaluronan within fascia in the etiology of myofascial pain.  Surg Radiol Anat. 33(10):891-896.