Athlo Blog

If you have IT Band Syndrome, you know that when it first occurs it is typically so intense that any activity beyond walking is unbearable.  With rest alone the discomfort will reduce and you’ll be able to jump back into running and other activities however still feeling some pain when bending your knee or moving side to side abducting your hips.  Assuming you don’t want this pain to continue, there are three key aspects to proper rehabilitation and long term maintenance.

1. Take 2-3 weeks to rest and get several tissue massages (self or professionally administered) to reduce muscle tension and stimulate blood flow.  Foam rollers (picture) work great for IT Bands and many other stretching and balance exercises.  If you don’t give your body time to mend good luck ever getting back to 100%.
2. Focus on gradually warming up and incorporating IT band stretches before any activity.  A cold, stiff IT band is much more likely to result in injury especially if you have a history with this syndrome.
3. After activity make sure to stretch the IT band while it is warm and flexible following up with a 5-8 minute direct ice application to prevent inflammation.

I also recommend IT Band stabilizing braces like the Cho-Pat pictured here, which minimize rubbing against the thigh bone.  Coupling this with a sound warm up will reduce the chance of re-injury.

If you’re reading this with IT Band pain good luck in your recovery.  If you’ve never had IT Band pain I encourage you to prioritize proper warms ups, stretching, and cool downs to avoid ever having to go through this rehab.

Since there are a lot of avid cyclists in the Athlo community, I thought this would be a great topic to write about. I recently came across a good article by Elizabeth Quinn that this post provides a summary of. The main cause of erectile dysfunction from bicycling is the amount of time and pressure placed on the tissues of the perineum which can eventually damage the blood vessels and nerves that allow men to have an erection. The perineum is the area of the groin between the male reproductive organ and the anus. Continually damaging this area with constant pressure can permanently affect erectile function in men. 

Factors that are associated with an increase of risk for erectile dysfunction in cyclists include the weight of the cyclist, saddle design, length of rides or a cyclist’s intensity, and skill of the cyclist. Obviously heavier riders will have an increased pressure on the perineum and certain saddle designs increase these risk factors.

Many cyclists have felt some type of symptom in that area consisting of numbness, tingling, pain, etc. There is some good news though. Most of these symptoms will be felt long before any serious problems do develop and well before erectile dysfunction would be diagnosed. 

So, what can you do to prevent erectile dysfunction and continue riding pain free? One of the most important things to do when you ride is to keep the weight of your body on the pedals through your feet instead of on the saddle to reduce the pressure on the perineum. Cyclists need to take breaks on long rides if pain or discomfort is felt in the area. Changes positions frequently during rides will decrease some of this pressure as well. Adjust the saddle height so the knees are slightly bent at the bottom of the pedal stroke and avoid saddles with lots of padding because this will only cause you to sinker lower on the seat, putting more pressure on the perineum. You can also raise the handle bars causing the rider to sit a bit more upright. I also highly recommend wearing cycling shorts that have the proper padding in them. 

The last thing to consider is the type of saddle. Most studies show that wider saddles are better than narrow ones because it actually allows more blood flow throughout the groin area and more weight will be distributed to the ischial tuberosity (bottom of the butt). Newer saddles, like the Selle SMP, offer a larger cutout and downward facing nose. It is more advanced than the traditional saddles and allows more blood flow through the perineum. So, for those of you experiencing any types of symptoms, address the issue with some of these solutions and hopefully you will enjoy a new pain free ride.

How many of you have seen athletes hunched over holding a stretch or bouncing a stretch repeatedly to warm-up?  The main focus of this article is to give you, the athlete, a general understanding of stretching.  But also talk about a newly advanced technique which may be taking a front seat to our common stretches.  There are three main forms of stretching that the majority of the athletic world uses today which include static, ballistic, and PNF stretching.  What is PNF you say?  PNF is also known as Proprioceptive Neuromuscular Facilitation. 

            Ballistic Stretching focuses around using a rapid, bouncing motion with a high force to increase muscle elasticity.  However effective it can be for some people, ballistic stretching is not recommended for daily use and can actually increase the risk of muscle injury and soreness.  Using the bouncing motion, it actually activates the spindle reflex, which is counterproductive for muscle elasticity, causing the muscle soreness (Frontera 1999).  So the next time you see someone bouncing a standing hamstring stretch, throw them a hint with a better technique for muscle stretching!

            The most common form we see today is the static stretching.  This is your basic stretch by holding it for a short period of time (ex. Bending over touching your toes).  It is an effective technique for improving flexibility and minimizes activation of the spindle reflex.  This type of stretching activates the Golgi tendon reflex by holding it long enough usually decreasing muscle soreness and decreasing risk of injury (Frontera 1999).  Static stretching needs to be held for at least six to ten seconds. 

            The last form of stretching is the PNF technique.  The two most popular and beneficial styles are the CR (contract/relax) and the CRAC (contract/relax agonist/contract).  Stretching the hamstrings using the CR method, one person lies supine (on their back) while their partner passively (no help) lifts their leg to a point where a stretch is felt.  Hold the stretch for about 10 seconds, then contract the hamstring against their partner resisting movement of the leg for a couple seconds.  Once the person relaxes his hamstring, the partner pushes the leg up further, increasing the ROM (range of motion) and holding once again.  This process is repeated three times for each leg.  The CRAC method is basically the same, however, the person being stretched lifts their own leg while the partner assists.  The partner then holds the leg for 10 seconds at the end stretch point. The person then contracts the quad once again trying to increase ROM and then the partner assists and holds the stretch once again.  Repeat three times on each leg.  The main difference between CR and CRAC is that the CR method is a passive stretch and the CRAC method is an active-assistive stretch.

            PNF stretching has become a popular new way of stretching, however usually requiring a partner and taking some practice to perform correctly.  It incorporates some neurological and physiological principles like the autogenic and reflex inhibitions that alter spindle reflexes, which in turn helps increase flexibility and decrease muscle soreness (Frontera 1999).  Give these new methods a try and see how it affects your flexibility.

Frontera, Walter R.  “Exercise in Rehabilitation Medicine.”  Human Kinetics;

Champaign. 1999.

I had never heard of the Navicular Bone until I took a slap shot to the foot during a hockey game and could barely walk for the next few days.  A PT friend of mine took a look and thought it might be a Navicular Bone stress fracture and that I should get an x-ray.

Before visiting the doc I did some reading on the web regarding this bone I had never paid much attention to.  I learned that the Navicular is the pronounced bone you can find by sliding your fingers from your inner ankle towards your big toe.  Several medical articles mention Navicular fractures being a common running injury, mainly related to excessive pronation, that often go undiagnosed because the  x-rays don’t always pick up the stress fracture.   The scary part is that most fractures come with ligament damage and severe cases must be surgecially repaired.

After two weeks of not being able to run (although I was still biking and swimming to stay in shape for an olympic tri) I gave in and made a rush x-ray appointment that sure enough turned up negative.  This would normally have been great news but the radiologist confirmed my research and told me to take it easy because the fractures are hard to detect on the Navicular.  Fortunately, after toning down my training for 2.5 weeks I started gradually feeling better and was back to running.  I consider myself lucky and would recommend that anyone having foot discomfort imparing walking or running seek immediate medical attention for a faster overall recovery; and of course to avoid taking slappers off the inside of your skate boot.

One needle, ten shots, a pair of scissors, one pair of pliers, and 45 minutes later my toe was fixed with a little minor toe surgery! This sounds like one awesome experience, that is if you like pain. But for most of us, we could possibly think of 100 different things we could find better to do with our time. This is a story of why we should take care of our feet before it becomes too late.

I’ve had a history of ingrown toenails but never one I could not take out myself with a little careful maneuvering and trimming. Two weekends ago, I started having extreme pain in my right big toe with some bleeding and swollenness. I noticed that it had become infected and needed a little doctor’s attention. Come Monday, I sought help from my good friend who just happens to be a doctor for some advice. With the help of some prescription anti-biotics, the infection went down but the toe nail was still ingrown. Tuesday morning rolled around and I thought it was time to take further matters and just have that part of the nail removed. 

After prep, he proceeded with the needles into my toe (sides, top, bottom) with about nine all together (worst part) because it would not fully numb with the first dose. I learned that after he started pulling on the nail which caused some extreme pain! With the toe numb, he took his pliers and began pulling the nail out from underneath the skin, not a pretty site. He then cut the toe nail the entire length up to the cuticle, which amounted to about 1/3 of my nail. Grasping the pliers once more, he pulled the cut piece completely off the toe and dug out the remaining few fragments still lodged into the skin. After using a walking boot the last two days, I completed my first run and workout session as I was able to finally get my foot into a running shoe. The nail should fully grow back in about a year and back to normal!

The moral of this story is to really take care of our feet and practice proper nail cutting techniques and hygiene. 

TIPS

- Cut the nails straight across; do not round edges or cut to short.

- Soak feet in warm, soapy water if ingrown nails do occur.  Once skin has loosened, then carefully try to lift the ingrown portion from underneath the skin.

- Once lifted above the skin, take a cotton ball and roll very thinly and slide underneath that portion of nail to allow for it to grow out.

- Wear properly fitted shoes

- If infection occurs or condition worsens, seek proper medical attention.

My brother Patrick graduated from Robert Morris University in Pittsburgh in 2007 with a Masters in Sports Medicine and Athletic Training. He is a certified athletic trainer and works for Advance Physical Therapy and Sports Medicine. Advance has 12 clinics in multiple cities throughout the midwest. He currently resides in Quincy, IL.

Patrick will join the Athlo team as a regular contributor the blog. He has worked with athletes from grade school level up to professional teams. I look forward to reading about helpful tips and the latest research in the fields of sports medicine and physical therapy. He is happy to answer all your questions as well. So, if you have been wondering what to do about that nagging knee pain when you run, tennis elbow or any other ailment, he can help.