Issue link: https://www.massageandbodyworkdigital.com/i/68008
TUNING THE ATHLETE In March of 2008, just prior to the British Track and Field Olympic Trials, Mo Farah came to us at the Center for Altitude Training in Flagstaff, Arizona. Holder of the 2007 European Cross Country Championship, Farah relocated from London to Flagstaff to train in high altitude hypoxic conditions in hopes of qualifying for Great Britain's Olympic team. As world class athletes transition from sea level to 7,000 feet, the air thins and functional adaptations become more pronounced. Farah presented with a common condition where extreme exertion initiated shortness of breath accompanied by moderate low-back fatigue. Initially, our focus was on assessing and enhancing breathing function while removing postural kinks in the myoskeletal spring systems, illustrated below. Determined to maintain his title as the fastest man in Europe, Farah proved himself to be a very compliant client. MUSCLE/JOINT REFLEXES When screening for dysfunctional patterns in elite athletes, I'm always reminded of the phrase, It's all connected. This keeps me mindful of the importance of maintaining a global body view. In the myoskeletal method, recognizing the reflexogenic relationships between joints and muscles is the first line of defense in addressing chronic reflex muscle spasms. Although relaxation massage helps calm cutaneous receptors, long-term relief from back pain and accompanying diaphragmatic dysfunction requires that all facet joint capsules and ligaments be manually stretched to create joint- play. This process calms the joint's articular receptors and establishes proper function between osseous and myofascial structures. Although most sports therapists are acutely aware of the importance of proper central tendon functioning, the crura and the arcuate ligaments may be underappreciated by many bodyworkers. From the anterior longitudinal ligament in the lumbar spine, fascial columns arise to become the right and left crus. Just lateral to these fascial columns we see the medial and lateral arcuate ligaments. These ligaments can hardly be considered independent structures from the connective tissue relationship that encompasses the superior portions of psoas major and quadratus lumborum muscles. These tents of the diaphragm have attachments on the bodies of L1, L2, and L3, the disks and at the inferior margin of the 12th rib. What we found with Farah was a slight myoskeletal engine breakdown. Upon examination of the lumbar spine in the prone position (image 1), it was visually apparent that some of his lumbar facets were rotated posteriorly indicating they were not closing on the right as he attempted lumbar extension via pelvic tilting. Since the diaphragm originates from the lower six ribs and the upper two or three lumbar vertebrae, it is essential to restore proper movement to avoid reflex respiratory spasm. CORRECTING MOTION- RESTRICTED JOINT CAPSULES In the left sidelying position (image 2), Farah is asked to perform either pelvic tilts or hip flexion, both of which ask the facet joints to open. The therapist uses either thumbs or an elbow with a sustained headward pressure, applied to the tissues in the lamina groove, that asks any motion-restricted joints to open. This therapeutic maneuver helps restore joint play, downgrades the pain signals from mechanoreceptors, and eases the protective muscle guarding. We can imagine how sidebending and rotation of Farah's lumbar structure, facets stuck open or closed, may lead to the existence of tensile forces through his breathing diaphragm and abdominal musculature, potentially contributing to pesky side stitch problems, and lower back discomfort. Any kink in the myofascial or skeletal kinetic chain through the thorax and lumbar spine results in diaphragmatic weakness resulting in loss of speed and endurance. LATERAL SPRING SYSTEM When the lateral spring system (LSS) loses its spring, the body must rely more on the quadratus lumborum (QL) to lift the hip to swing the leg through. Running on relatively flat trails or roads should leave this muscle more at peace. Optimal firing order during right stance phase requires that the gluteus medius/minimus fire prior to Illustration reprinted with permission from Erik Dalton. the QL so the pelvis can right sidebend allowing the left leg to smoothly swing through. Hikers and ultra runners on steep trails may indeed need to recruit the QL more frequently to assist contralateral adductors and gluteus 64 massage & bodywork november/december 2008