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Understanding Muscle Injuries:

There are three ways in which injuries of the soft tissues in the body can arise:

• 1 - Acute Conditions: pulls, tears, crush injuries.
• 2 - Repetitive Stress: accumulations of small tears over time (micro-trauma).
• 3 - Posture: Your body's response to bad posture and stresses that occur over time directly related to the way one holds their body, and the body's response to it.

Each of these can cause the body to produce scar tissue. Scar tissue is a tough, dense network of collagen fibers that develops to repair/protect the area that has been injured.  Excess scar tissue can prevent the muscles and other structures from working properly, which can lead to changes in normal movement, muscle shortening and weakness, misalignment of bones, and even disruption of the movement/structures in the surrounding areas. A compromised muscle, or muscles, not only places more tension on the tendons that attach muscle to bone, which can cause tendonitis/tendonosis, but can irritate nerves that pass though or supply the muscle.  This injury process can cause the following symptoms:

• Loss of range of motion;
• Loss of strength;
• Aching, pain, tingling, numbness;
• Swelling;
• Spreading of symptoms if untreated;
• Further injury.

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The sports Rubdown comes of age – a number of revolutionary techniques are turning masseurs into miracle workers – By Joseph Hooper

After years of working like a madman in the weight room, Dr. Marc Polimeni had finally achieved exactly the physique he wanted – and a chronic backache in the bargain. "Many mornings I could barely get out of bed to go to work" recalls the New Jersey internist. Four different chiropractors and two orthopedic surgeons were no help beyond, confirming that his problem wasn’t bulging disk, but spasming muscles. When they suggested he try muscle relaxants or physical therapy, he really knew he was in trouble, because as he recalls, "it was the same advice I’d given my patients and I’d always been frustrated that I couldn’t do more for them."

The three years ago, Polimeni meet Rob DeStefano, a north-Jersey chiropractor who takes an unusual approach to muscle pain. Instead of manipulating the spine like a traditional chiropractor does, or dispensing a relaxing but medically ineffective massage like a conventional massage therapist might, DeStefano used an approach called the Active Release Techniques (ART). Moving his fingers spot to spot somewhat like a vigorous acupressurist, DeStefano succeeded in getting the fibred to relax their excruciating grip. After one-ten minute session, Polimeni knew he had happened upon something pretty amazing. But when he told his colleagues about it, they reacted as if he were confessing to being abducted by aliens. "They weren’t even polite", he says.

The traditional-medicine community has never done a very good job with muscle pain. There is little research devoted to it and few physicians who specialize in it. However, in recent years, a small but growing network of chiropractors, trainers, massage therapist and intrepid M.D.’s has developed their own kind of grassroots muscle medicine. The various methods, combining principles of chiropractic and massage with those of acupressure and more esoteric Eastern arts, were mostly devised by elite trainers ministering to one star-athlete client or another. Mike Leahy, the Colorado Springs – based founder of ART, for example, used the techniques to tweak the stride of Canadian gold-medal sprinter Donovan Bailey. Craig Buhler, the pioneer of another method called Chiro MAT (Muscle Activation Techniques), perfected his approach through years of keeping the Utah Jazz’s seemingly ageless John Stockton in top form.

Now, thanks largely to Leahy, these techniques are trickling down to the recreational athlete. Leahy has trained some 3.000 therapists, and most people can find a credentialed practitioner near them simply by visiting: active-releasetechniques.com. The treatment experience follows a general routine: The therapist will explore the areas of your body that are in pain or limited in their range of motion, his fingers tracing the muscle fibers to locate the spots that feel tense and rough to touch. Most of these are adhesions, knots of scar tissue that cause tendons, fasciae or muscle fibers to stick together and that impede them from sliding smoothly against one another. The therapist then directs the patient to bend or extend the area in question (the "active" part of ART). At that point, he presses down – hard – on the adhesion. Often he can actually feel the stuck fibers coming apart and the muscles like a rope unraveling.

In theory ART is fast, not to mention cheap (treatments rarely exceeds six $100 sessions). And it’s especially effective for pain and stiffness in the lower back, shoulders, and elbows as well as for carpal tunnel syndrome. But there’s an art to ART. "I tried doing it on patients and it wasn’t any good", admits Dr. Vert Mooney, former professor of orthopedics at University of California at San Diego, who did however manage to conduct a major study of ART that was the first of its kind on the new muscle-medicine techniques. "Our results were good. But I wouldn’t count on a lot of physicians getting into this. Most of them still see manual-therapy as hocus-pocus, besides there’s not enough money in it."

Craig Buhler has been working with Stockton for more then 18 years, and he’s still waiting for his props for the team’s medical staff. "They attribute the results I get to the placebo effect", he says. Interestingly, Buhler takes the opposite approach from Leahy’s. Whereas ART concentrates, logically enough, on the tight and adhesion-riddled tissue that causes pain and weakness, Buhler’s Chiro MAT focuses on the muscles that cause the tightness and adhesions in the first place. Say your hamstrings are tight. Rather than going to town directly on the constricted fibers, Buhler will do precise response tests on the quadriceps muscles, some of which are likely misfiring and failing to move in sync with the hams. If he’s right ("and 100 percent of the time I am", he jokes) the answer can be as simple as using his hands to clear the "neurological inhibition" that’s keeping the quads from firing properly. Later, specialized strengthening exercised might be involved or a blend of supplements, nutritional advice, and

Chinese reflex practices.

In any event, it’s been difficult for other practitioners to get the hang of Chiro MAT. When Buhler offered his first training course, last year, 70 percent of the students dropped out. (For a list of those who passed, go to chiromat.com). That’s why, for now, the best hope for spreading Buhler’s ideas may lie with the colleague Greg Roskopf, a bio-mechanic specialist for the Denver Broncos. Roskopf has worked with Buhler for years to create a simpler system dubbed MAT (mucleactivation.com), which seams better positioned to compete with ART nationwide. Roskopf, of course thins MAT is better than ART, though even he acknowledges that no one system is right for everyone. If MAT doesn’t deliver satisfactory results in three to six treatments, he suggests you try one of his competitors’ methods, or several of them.

Wayne Winnick, a top Manhattan sports chiropractor who treats Mets pitcher Al Leiter, says he has fewer than four distinct manual therapies in his "toolbox". These include "myofascial trigger-point therapy" and the Graston Techniques (grastontechniques.com), a slightly medieval-looking approach in which the practitioner uses curved steel instruments to break down adhesions.

Personally, I’m partial to ART. While talking to Rob DeStefaon about Marc Polimeni’s case, I happened to mention the problem I’ve been having with my own back. DeStefano thumbs found my psoas muscles, two diagonal muscles that traverse either side of the abdomen. "From a lifetime of sitting, the psoas contract", he said as he instructed me to straighten out my right leg and got his thumb into position. "And that pulls your back muscles forward the..." I failed to hear the rest of his sentence during the two or three seconds of blinding pain. Even so, after he performed the same trick on my left psoas, I dropped off the table, noticed that my back no longer hurt, then reached down and touched my toes for the first time in 15 years.