Watching an exciting tennis match in the Australian Open Tennis Tournament I noticed Rafael Nadal rubbing his Quads. A little later on a dipping return he must have 'tweeked' his knee as he asked for injury time, stopping the game. One of his team came out and started to work on his knee. The TV camera gave a really close shot of his therapist working and I watched with some dismay and sadness because all that he was doing was not going to help. Within a short while, after two brilliant sets, now in the third set, he suddenly conceded the game, walked of the court and out of one of the most important championships of the season. This knee problem had been long term resulting in knee surgery one year before. After years of therapy and finally surgery, the knee pain was still impacting his professional career. This is a tragedy.
The same is true in Athletics. There is a famous Track Meet every year in Eugene Oregon that attracts the fastest sprinters in the world. This year the commentators continually mentioned nagging injuries the athletes had been dealing with for some time, even years, and how it was affecting their performance.
These are the fastest, the fittest, the healthiest of young people who can afford any therapy available – and they still cannot keep out of injury. What is the problem?
If Microsoft came out with some new software that continually had some serious problems, would they just keep on promoting and distributing the same flawed product or would they go back to the drawing board to develop a product that was tried and tested and worked every time? The main principles of injury and rehab taught and practiced today were alive and well in the fifties and sixties. Every field of technology has progressed in leaps and bounds year after year, do you remember when we didn't have e-mail? The general approach to injury and rehab is not only fifty years old but is based on concepts that are redundant. Because elite athletes suffer persistent injuries we must assume the therapies that they are receiving are 'flawed' and we need to be modest enough to 'go back to the drawing board'.
If you have knee pain and go to Physical Therapy, after assessment and mobilization techniques, ultrasound and the use of Tens units ect. they start strength condition using Cybex or Nautilus equipment. Injury is viewed as weakness of the muscle group and so needs to be isolated and strengthened. One of the end results of the inflammation process is a shortening of the muscle length. in this case between the large Vastus Lateralis and the compromised Vastus Medialus. The tracking angle of the patella is now pulled laterally so that it hits the lateral epicondyle resulting in knee pain. The answer is to regain muscle balance, not to strengthen a shortened muscle. Muscle balance is the key, getting the Quads back to their original resting length. Lengthen then Strengthen!!
The first fatal error is concentrating and working on the sight of pain. If you focus on origins and insertions, tendons, ligaments and muscles at the site of pain - you have simply missed the point.
After twenty years working only on injury, acute and chronic pain, I find I'm working far more generally. I use a fairly gentle pressure and stretch technique that I have developed over the last two decades and is known as Soft Tissue Release (STR). After only one treatment I expect immediate change and relief. After three treatments the pain should be reduced by at least 50%.
The client is given specific active isolated stretches and this is the main success of speed healing. The success of STR is a motivated client and a motivated and skillful therapist. If you spend time training your client how to do these active isolated stretches correctly you will have given them a gift that may insure that they will never be injured again. Whatever therapy you use it has to be fast acting and the results have to be long lasting.
You cannot tell a dedicated runner that he cannot run. It is his or her drug of choice. After a treatment a runner will look at you and with desperation in their eyes ask, "When can I run again?" I tell them to go and run this evening but don't overdo it. They usually overdo it but now after the first treatment the recovery time is going to be even faster. Giving them back the gift of running is such a boost to the higher centers of the brain and central nervous system, the systems that are responsible for the injury holding patterns that the release starts immediately. All the physical work I do is viewed as supplying new information to these higher centers, as they are the ones that provide the release. That is why the results are long lasting.
This approach and Soft Tissue Release techniques have worked for the fastest sprinters in the world where all other therapies have failed. This gives a quiet confidence that in itself is therapeutic. When your client can tell that the problem that has bothered them for a long time is better the very next day, there is a change in demeanor, a sudden determination to do their self stretches, which is the most important part of their recovery.
Working on the extremities, arms and legs, is comparatively easy. Low back pain, neck pain and other pain syndromes have an emotional component, but the same approach still works well. Chronic low back pain can be reduced by 50% in one to three treatments.
Most therapists do not have the confidence that you can take a client to a pain free state in a short period of time. If your intention is strong and you have a fast acting therapy and a motivated client the results obtained are outstanding.