Demystifying ACL Tears: Why Do They Happen So Often?

Anterior Cruciate Ligament (ACL) tears are prevalent, especially among athletes engaged in sports like football, soccer, and basketball. Let's delve into the reasons behind the frequency of ACL tears and explore why they occur so often.

The Role of the ACL

The ACL is a vital ligament that helps stabilize the knee joint. Think of it as a robust band that prevents excessive movement of the shin bone away from the thigh bone. The majority of ACL tears occur without direct contact, often during activities involving sudden changes in direction, abrupt stops, or jumps. Athletes in high-impact sports, such as soccer, basketball, and football, are particularly susceptible.

While ACL injuries don't discriminate based on age or gender, certain factors elevate the risk. Female athletes, for instance, could be more prone due to differences in muscle strength and landing biomechanics. Anatomical features, joint laxity, and engagement in specific sports also contribute to the risk.

Unveiling the Mechanism

Understanding how ACL injuries happen involves recognizing the non-contact pivoting mechanism. Picture the shin bone moving forward while the knee is slightly bent and tilting inward. Additionally, a direct hit to the lateral knee can cause injury.

ACL tears often bring along other knee injuries, such as meniscal tears or damage to collateral ligaments. Chronic ACL deficiencies can even lead to more complex issues like chondral injuries.

Prevalence in Athletes

Given its commonality, almost half of all knee injuries are ACL-related. In the United States alone, around 175,000 ACL reconstruction surgeries are performed annually. The risk is not solely age-dependent, but factors like sports participation, especially in females, play a significant role.

Studies suggest a higher incidence of ACL injuries in female athletes. Factors like muscle imbalances, weaker core stability, and specific biomechanics during activities like changing directions contribute to this gender disparity. Genetic factors, such as collagen production, can also play a role in determining susceptibility to ACL tears.

How can sports massage help?

In the ongoing effort to reduce the occurrence of Anterior Cruciate Ligament (ACL) tears, sports massage emerges as a valuable and complementary strategy. Administered by qualified sports massage therapists, this specialized form of therapy focuses on manipulating soft tissues to enhance athletic performance, prevent injuries, and aid in recovery. Addressing critical factors contributing to ACL injuries, sports massage targets muscle imbalances, improves flexibility, and alleviates tension, promoting a more balanced and responsive musculature around the knee joint.

Collaboration between sports massage therapists and other healthcare professionals is paramount for a comprehensive approach to care. An interprofessional approach ensures that athletes receive personalized attention, combining the benefits of sports massage with other preventive measures. Ultimately, massage, when part of a well-rounded injury prevention program, stands as an effective ally in safeguarding athletes against the common occurrence of ACL tears, contributing to overall musculoskeletal health and resilience.

Dispelling Myths and Embracing the Benefits of Prenatal Massage

Pregnancy is a beautiful and transformative journey for many people, but it can also bring with it various physical discomforts and emotional challenges. One effective way to alleviate some of these burdens is through prenatal massage. However, finding a qualified prenatal massage therapist can be surprisingly challenging. In this post, we will explore the reasons behind this difficulty, debunk myths surrounding pregnancy massage, and highlight the numerous benefits it can offer to expecting mothers.

The Challenge of Finding a Prenatal Massage Therapist

The scarcity of prenatal massage therapists can be attributed to several factors. One of the main reasons is the specialized training and knowledge required to safely and effectively perform massage therapy during pregnancy. Prenatal massage therapists must be well-versed in the anatomy and physiology of pregnancy, as well as the various changes a woman's body undergoes throughout the different stages of gestation.

Additionally, certain misconceptions and myths about pregnancy massage have led to hesitation among some massage therapists. Fear of causing harm or the belief that prenatal massage is inherently risky has led to a shortage of practitioners willing to specialize in this area. As a result, finding a therapist who is confident and experienced in providing prenatal massage can be a daunting task.

Debunking Myths about Pregnancy Massage

1. Massage can induce labor: One of the most common misconceptions is that receiving a prenatal massage can trigger labor. In reality, when performed by a certified and knowledgeable therapist, prenatal massage is safe and has no proven link to premature labor onset.

2. Risk of harming the baby: Many pregnant people worry that the pressure applied during a massage might harm their unborn child. However, prenatal massage is designed to be gentle and tailored to the specific needs of pregnant bodies. Skilled therapists know how to avoid pressure points that could potentially cause complications.

3. Limited positioning during the massage: Some expectant parents assume they can only lie on their sides during a prenatal massage, which might make them uncomfortable. Skilled prenatal massage therapists use specialized pillows and bolsters to ensure the utmost comfort in various positions, including lying face down.

The Benefits of Prenatal Massage

Receiving prenatal massage from a qualified therapist can bring about a range of physical and emotional benefits:

1. Alleviating muscle tension: Pregnancy can put a lot of strain on muscles and joints due to the additional weight and changes in posture. Prenatal massage can help relieve tension and reduce discomfort.

2. Improving circulation: Massage enhances blood flow, which can assist in reducing swelling in the extremities, a common issue during pregnancy.

3. Stress reduction: Pregnancy can be emotionally overwhelming, but massage therapy can trigger the release of endorphins, easing anxiety and promoting a sense of relaxation.

4. Better sleep quality: Restless nights are a common plight of pregnant people. Prenatal massage can aid in improving sleep patterns and overall sleep quality.

5. Lowering the risk of complications: Studies suggest that regular prenatal massage can be linked to reduced complications during childbirth.

6. Enhancing maternal mental health: Pregnancy can sometimes lead to feelings of isolation or mood swings. Prenatal massage provides a nurturing environment that promotes emotional well-being.

Conclusion

While finding a prenatal massage therapist might be challenging, the benefits it offers make the search well worth the effort. Expectant mothers must prioritize their well-being, and prenatal massage can be a safe and effective way to nurture both the body and the mind during this transformative time. By dispelling myths and understanding the advantages of prenatal massage, one can confidently seek out qualified therapists to experience the joys of this gentle and supportive practice throughout their pregnancy journey.

The Impact of Exercise on Bone Health: A Pathway to Stronger Bones

Maintaining healthy bones is essential for overall well-being, and exercise has long been recognized as a beneficial practice. In this article, we will explore a study, conducted by Mingyue, et al., that highlights the positive effects of exercise on bone metabolism. By understanding the connection between exercise and bone health, we can make informed decisions to promote stronger bones and improve our quality of life.

This research study examined the effects of an eight-week exercise program on bone metabolism in a group of individuals. The findings of this study suggested that regular exercise, particularly weight-bearing exercises like walking or strength training, can have significant benefits for bone health.

The study observed improvements in bone mineral density and markers of bone turnover, indicating that exercise positively affects bone metabolism. These changes can help reduce the risk of osteoporosis, a condition characterized by weakened and brittle bones, particularly in older individuals.

Weight-bearing exercises, where the body's weight is supported by the legs and feet, have been shown to be particularly effective in promoting bone health. Examples of weight-bearing exercises include walking, jogging, dancing, and stair climbing. These activities put stress on the bones, stimulating the body to build and strengthen bone tissue.

Mingyue’s results suggest that incorporating weight-bearing exercises into our regular routine, at least three to four times a week, can have a substantial impact on bone health. Engaging in these activities not only helps to strengthen bones but also improves balance, coordination, and overall physical fitness.

In addition to weight-bearing exercises, the study also highlighted the benefits of resistance training on bone health. Resistance training involves using weights, resistance bands, or bodyweight exercises to build muscle strength. This type of exercise places additional stress on the bones, stimulating bone growth and enhancing bone density.

By incorporating resistance training exercises such as lifting weights or using resistance bands into our fitness regimen, we can further promote bone strength and reduce the risk of fractures. It is important to note that proper form and technique should be followed to prevent injuries and maximize the benefits of resistance training.

While exercise is a critical factor in maintaining strong bones, it is essential to consider other elements that contribute to overall bone health. Adequate intake of calcium and vitamin D, through a balanced diet or supplements, if necessary, plays a vital role in supporting bone health.

The study discussed in this article highlights the significant benefits of exercise on bone health. Engaging in weight-bearing exercises and resistance training can improve bone mineral density and promote healthy bone metabolism. By incorporating these exercises into our routine, we can enhance our overall physical fitness and reduce the risk of osteoporosis and fractures.

It is important to consult with healthcare professionals or fitness experts before starting any exercise program, especially if you have pre-existing conditions or concerns. By making informed choices and adopting a proactive approach to bone health, we can enjoy a more active and fulfilling life while safeguarding the strength and integrity of our bones.

References:

Lu M, Li M, Yi L, Li F, Feng L, Ji T, Zang Y, Qiu J. Effects of 8-week High-Intensity Interval Training and Moderate-Intensity Continuous Training on Bone Metabolism in Sedentary Young Females. J Exerc Sci Fit. 2022 Apr;20(2):77-83. doi: 10.1016/j.jesf.2022.01.001. Epub 2022 Jan 5. PMID: 35096081; PMCID: PMC8762074.

What is IASTM?

IASTM stands for Instrument-Assisted Soft Tissue Therapy. To parse that out, it just means that someone is using a tool to treat soft tissue such as muscles, tendons, and ligaments. IASTM has been around for thousands of years with beginnings in ancient China. That original version of IASTM was a form of scraping over the skin with the use of some sort of tool. The tools involved ranged from a metal coin to a sliver of ox horn. Anything could be used, as long as it was smooth and rigid enough to cause light bruising on the surface of the skin.

Today, IASTM has advanced only moderately. We still use similar tools to what the ancient Chinese healers used, however, today’s materials are a bit more advanced and regulated. For instance, ox horns cannot be used for IASTM. The material is slightly porous and can become a reservoir for bacterial growth. Most tools today are made of stainless or surgical steel and come in various shapes, depending on the purposes.

 The intent behind IASTM has also changed since the days of gua-sha. In ancient China and Vietnam, gua-sha was often used to rid one’s body of a cold in the early days of the summer. For this reason, it was also called summer therapy. There is no current evidence proving that gua-sha can work to remove colds or any other illness, however, there is plenty of merit to the placebo effect.

With the use of stronger materials, we are now able to use IASTM to help alleviate soft tissue pain and increase range of motion (ROM) in the short term. Several current studies have shown that there is an increase in ROM and a decrease in localized pain after a session of IASTM (Koumantakis, et al., 2020; Qadree, et al., 2022). These sessions can vary in length and frequency, but the results are fairly consistent.

A four week trial, conducted by Qadree, et al., showed that patients suffering from diagnosed sciatica were helped with IASTM. Using IASTM, neural mobilization, and lumbar traction, researchers were able to reduce sciatica related pain and increase ROM in all trial participants. The IASTM was performed along the lumbar spine, into the gluteal muscles, and along the hamstrings.

A further study, performed by Koumantakis, et al., showed that there was an immediate increase in ROM and proprioception in study participants after receiving a 5 minute IASTM treatment. This result was comparable to an 8 minute light hand massage, and a 5 minute vibration treatment. This shows that IASTM is just as effective for the treatment of soft tissue injuries as is massage therapy, or vibration therapy.

With this information, it can be concluded that IASTM can be as effective as manual massage. In some cases, it may be more effective since the treatment time is sped up a bit. It is also ideal in cases such as sciatica, to use IASTM to get into the smaller areas between skeletal structures and treat a more precise area for more targeted results.

Personally, I believe that IASTM is a huge upgrade to any soft tissue therapy, such as massage. I have seen immediate improvements in ROM and reduction in localized pain from my own utilization of IASTM. The next time you’re in for a session, don’t hesitate to ask for IASTM!

References

Koumantakis, G. A., Roussou, E., Angoules, G. A., Angoules, N. A., Alexandropoulos, T., Mavrokosta, G., Nikolaou, P., Karathanassi, F., & Papadopoulou, M. (2020). The immediate effect of IASTM vs. Vibration vs. Light Hand Massage on knee angle repositioning accuracy and hamstrings flexibility: A pilot study. Journal of Bodywork and Movement Therapies, 24(3), 96-104. 10.1016/j.jbmt.2020.02.007

Osailan, A., Jamaan, A., Talha, K., & Alhndi, M. (2021). Instrument assisted soft tissue mobilization (IASTM) versus stretching: A comparison in effectiveness on hip active range of motion, muscle torque and power in people with hamstring tightness. Journal of Bodywork and Movement Therapies, 27, 200-206. 10.1016/j.jbmt.2021.03.001

Qadree, M. S., Rehman, S. S., Riaz, M. U., Anees, M., & Rajput, H. I. (2022). EFFECTS OF GRASTON INSTRUMENT SOFT TISSUE MOBILIZATION IN PATIENTS WITH SCIATIC NERVE ENTRAPMENT. Pakistan Journal of Rehabilitation, 11(2), 83-91. 10.36283/pjr.zu.11.2/013

Self-care for runners

Developing a self-care routine is an integral part of any training plan. Steady self-care can help improve your range of motion, decrease pain and stiffness, increase your endurance, and it can help prevent common injuries. On the following pages, I will introduce you to some self-care exercises to help loosen up your feet, legs, and hips in order to keep you running at your best.

Palmar surface of the foot:

1. Stand erect with one hand on a table or something stable to maintain your balance.

2. Begin with your lacrosse ball below the ball of your foot on the pinky toe side.

3. Take a few deep breaths to slowly relax your foot into the ball, maintain this pace of breath the whole time.

4. Work your way over toward your big toe side, slowly rolling the ball up and down under your foot.

5. Move the ball to the arch of your foot, just below the big toe, slowly begin working the ball down toward your heel, using a back and forth motion.

6. Move the ball to the pinky toe side, the outer arch of your foot.

7. Repeat the same back and forth motion you used on the inner arch, moving up toward the ball of your foot again.

8. Repeat on the other foot.

Calf muscles:

1. Place your ball on a yoga block, or on a flat, stable surface.

2. Rest your leg on the ball, beginning at the top of the Achilles tendon.

3. Rest your other leg on top of the leg to be worked on, remembering to breathe deeply into the motion(you do not need any pressure, just rest the leg there).

4. Begin slowly working the ball in a back and forth motion, you can breathe for a few second into any spots that are particularly troublesome.

5. Work your way directly up the center of the calf muscles, being sure to notice and trouble areas.

6. Repeat on the other leg.

Hamstrings:

1. Sitting upright on the floor, rest the ball under your thigh at point A.

2. Place your other leg on top of this leg, as done with the calf muscle section.

3. Breathe into the pressure, allowing yourself to relax and focus.

4. Begin to work your way up toward point B in a back and forth motion, remembering to stop and any troublesome spots.

5. Once up to point B, find the hamstring origin(just under your ischial tuberosity), and rest there for a few deep breaths.

6. Repeat on the other leg.

Glutes:

1. Sit upright with your target leg in a butterfly position and the other foot flat on the floor for control and stability.

2. Place the ball under point A, remembering to breathe into the pressure.

3. Move your body slowly backward, so that the ball follows along the edge of the sacrum.

4. Move back up to point A, resting on any trouble points.

5. Move your body slowly, allowing the ball to follow along the back of your hip bone, toward point B, resting for a few breaths here.

6. Move the ball down toward point C, resting here for a moment.

7. Move the ball from here, back up toward the center of the sacrum.

8. Repeat on the other leg.

Quads:

1. Lie face down with your target leg straight and your other leg in a lunge position for stability.

2. Begin with the ball at point A, just above the patella. Try to slowly flex and extend your knee to loosen up this dense connective tissue, remembering to breathe slowly and deeply into the pressure.

3. Move the ball up toward point B, in a slow back and forth motion, if you can.

4. Rest here for a few deep breaths before moving up to point C, in the same back and forth motion.

5. Once at point C, Just below your hip bone, rest here and try to flex and extend your knee again to loosen up the tissue.

6. Repeat on the other leg.