Being stiff is a drag. It may possibly make all motion — not simply operating — vary in really feel from uncomfortable to downright depressing. But, the one factor extra depressing than stiffness is devoting big efforts into stretching with none enchancment. Muscle tissue and joints are stiff as ever and operating stays sluggish and uncomfortable.
And whereas stiffness might appear to be a typical a part of growing old, many masters runners are capable of preserve their mobility, efficiency, and delight of operating.
As stiffness started to personally have an effect on me over the previous few years, I doubled down on efforts contained in the clinic and out to seek out out why. What’s chargeable for cussed stiffness and what, precisely, should we work on to remain cell?
After 25 years of operating, 20 years of teaching, and 13 years of bodily remedy follow, I’m rounding towards the reply: fascia.
In search of Fact, Arms-On
I do plenty of hands-on remedy in my bodily remedy follow. And with every passing yr, I discover myself doing extra guide remedy remedy than the yr earlier than.
That is more and more ironic. I entered the occupation as each a aggressive athlete and dedicated operating coach. Optimization by train and motion teaching have been big values of mine. So why a lot hands-on remedy?
It will get outcomes. Outcomes occur a lot quicker than train, and sometimes when stretching, strengthening, and motor management fail altogether. The extra sufferers I efficiently deal with, the extra usually I see instances with advanced and cussed dysfunctions that solely my fingers — as a part of a whole-body, systems-based method — can create the modifications mandatory for ache reduction and wholesome, sustainable operating.
However as my hands-on remedy emphasis has elevated, so, too has the standard and nuance of remedy. It’s now not adequate to push or pull on a given physique half to facilitate motion. Whether or not I do it with my fingers, or a runner does it to themselves with a foam curler, yoga class, or therapeutic massage gun, the effectiveness of a mobility technique depends upon what particular kind of tissue wants to maneuver, and what’s stopping that movement.
The creator Joe Uhan (left) at a manual-therapy certification class in 2019. Photograph courtesy of Joe Uhan.
What Truly Must Transfer and Why Stretching Typically Fails
As outlined a number of years in the past, there are a number of kinds of tissue that want to maneuver for ache and damage reduction and prevention, and environment friendly operating. They embrace:
I’d wish to increase upon that listing, by including:
- Comfortable tissues — These embrace all muscle mass, but additionally all connective tissues like tendons and ligaments.
- Fascia — That is the granddaddy of all connective tissues that covers and connects the whole lot, together with pores and skin, muscle, bones, nerves, blood vessels, and organs.
Understanding what precise tissue kind is limiting movement is essential for sustainable mobility enchancment.
As a result of if we merely do the motion — say, stretch a hip into extension when it appears a hip flexor is tight — we regularly solely get non permanent enchancment. It is because one thing else is limiting that practical motion.
Pam Smith stretching out in the course of the 2021 Badwater 135 Mile. Photograph courtesy of Pam Smith.
How have you learnt what wants to maneuver? It takes plenty of failure — clinically and personally — to study the teachings of sustainable enchancment.
When In Doubt, It’s the Fascia
However with successive failures and redemptive victories, the reply is changing into more and more clear. When unsure, it’s the fascia.
Fascia covers and connects the whole lot. Developmentally, fascia grows first — as a type of scaffolding — then tissues (bones, muscle mass, and connective tissue) develop into the areas fascia supplies. It’s each construction and performance. Thus, its ubiquity and multi-purpose operate make it tough to disregard.
Furthermore, as we lately lined, wholesome fascia is heat, gentle, hydrated, and thus cell. However when it loses any of these issues, bother can come up. If fascia loses mobility, something it touches can even lose movement.
Diagram of skeletal muscle exhibiting the fascia. Photograph: Shutterstock
Certainly, fascia can limit wholesome muscle and tendon mobility. In actual fact, fascial stress (domestically or regionally) can limit movement a lot {that a} given muscle or tendon can intrinsically pressure. However whose fault is it? A “weak” and “tight” muscle, or a fascia that fails to permit it to operate usually?
Let’s take a look at a few particular examples:
Ankle Stiffness
A runner suffers a critical proper inversion ankle sprain. It requires a few weeks on crutches, then a really sluggish return to operating. 4 years later, the fitting ankle is way stiffer into dorsiflexion than the fitting.
What tissue is inflicting the ache and vary of movement loss, requiring remedy? Is it the gentle tissue at the back of the ankle? Or is it the joints within the entrance?
Such complexity is one reply to why so many people — each as athletes and clinicians — fail to get sustainable mobility enchancment.
We do our prescribed wall or stair calf stretch. We achieve this as a result of we or our clinician imagine the calf muscle and fascia are chargeable for the stiff ankle. However what whether it is joint stiffness associated to the tibia, fibula, and talus? In such instances, this ankle joint stretch is a much more efficient choice — and the “calf”/ankle mobility train I prescribe most ceaselessly.
Fascial restrictions in and across the calf, but additionally the foot and ankle (entrance, sides, and again) can restrict dorsiflexion. We’re additionally realizing that fascial connections run the size of the physique. Tightness within the higher leg — and even the higher physique — may cause and preserve cussed ankle stiffness.
Low Again Ache
A runner experiences power lumbar backbone ache. Their low again is proscribed in ahead flexion, with stiffness and ache not solely within the again but additionally the perimeters of the pelvis.
Once more, we ask this query: what tissue is inflicting the ache and vary of movement loss, requiring remedy?
Is it gentle tissue within the low again, or alongside the lateral margins of the pelvis? Or is it a stiff stomach that fails to maneuver to permit the ahead folding? Or do the lumbar vertebrae have to be pushed posteriorly?
To deal with, along with pushing lumbar vertebrae posteriorly by the stomach, I each carry out and prescribe stomach mobilization to make sure the intestine strikes sufficient to permit the backbone, pelvis, and hips to maneuver effectively.
Within the low again, fascia surrounds the muscle mass in addition to the bones within the stomach, in entrance. The center are additionally lined in fascia, and people neighboring layers should slide-and-glide atop each other for wholesome, pain-free lumbopelvic movement. As such, I now acknowledge that each power lumbar ache shopper — no matter exercise or damage mechanism — has deficits of intestine mobility.
Myofascial Ache Is a Deficit of Muscle Play
In one other latest column, we mentioned these fascial ideas when addressing decrease leg and foot dysfunctions. In that piece, we outlined muscle play: the concept that adjoining tissues want to maneuver comparatively independently of each other.
If we return to our ankle and low again examples, what this implies is:
For the ankle, the muscle mass of the decrease leg (these connecting to the tibia and fibula, in again and in entrance); the tendons and nerves of the medial shin; and the layers of tissue on the underside of the foot (together with, however not simply the plantar fascia) want wiggle room between adjoining muscle mass and the bones to which they connect or run alongside.
For the low again, the muscle mass and fascia on the again and sides of the backbone and pelvis want the identical mobility, and the intestine and numerous belly organs want to maneuver on prime and in entrance of the backbone and pelvis.
However essentially the most fascinating instance for runners might lie within the thigh. The thigh homes a big amount and quantity of muscle mass that transfer the leg in each attainable path. But all of them connect with a single bone, the femur. However their operate — and the supply of a lot dysfunction — lies within the fascial connections between them.
The anatomy of the thigh. Photograph: Gray432.png: Marshall Strotherderivative work: Mcstrother, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, through Wikimedia Commons
Even when we simplify issues and be aware solely six motions of the thigh — flexion and extension, abduction and adduction, and inner and exterior rotation — you’ve at the very least two dozen muscle mass, large and small, lengthy and brief, and thick and skinny, which can be each chargeable for these particular person motions and dwell proper subsequent to 1 one other. As such, there’s a excessive propensity for adjoining muscle mass that do opposing motions to stay to 1 one other!
One instance is iliotibial band (ITB) syndrome. The ITB is a large expanse of fascia that covers the glutes and tensor fasciae latae and runs alongside the lateral thigh to insert on the knee. It largely stabilizes and modestly strikes the hip and knee whereas strolling and operating.
The ITB itself usually turns into painful, but a sustainable pain-relieving technique is elusive for a lot of. Typically, the ITB appears tight and nice effort is put into stretching or in any other case making an attempt to instantly therapeutic massage it.
However maybe it’s painful as a result of its fascia is caught to the tissue underlying it. The ITB can generally get caught to adjoining hamstrings (posteriorly), quadriceps (anteriorly), or to the pelvis and hip flexors (superiorly). My quickest and greatest ITB ache reduction comes from releasing it — re-establishing muscle play — from the adjoining quads, hamstrings, and hip flexor muscle mass. That is, in fact, along with restoring environment friendly pelvis, femur, and tibial-fibular movement and alignment.
Certainly, I’m now discovering that many of the hamstring and even hip flexor tightness I discover as a clinician and athlete comes from the hamstrings being caught to the adductors or quads, or lateral tissues just like the glutes and hip rotators limiting the movement in additional refined methods — the “aspect doors.”
Certainly, the one sustainable enchancment in my very own hamstring flexibility has been by these methods. Like many, standard hamstring stretching, alone, irrespective of how diligent, has gotten me nowhere.
Plainly sustained ache reduction and practical mobility are greatest achieved when the main target is on the fascia between muscle mass, bones, and all different tissues.
Warmth, Soften, Hydrate, and Transfer: The Keys to Wholesome Fascial Motion
Hydration
A few months in the past, we mentioned the significance of timing and hydration in mobility: to introduce movement and hydration within the morning, such that we are able to transfer effectively early and all through the day. Along with a mobility jump-start, this means that the chemistry (hydration) of fascia and its intrinsic fluid, hyaluronic acid, is perfect.
However getting the tissue hydrated generally is a problem when it’s compressed and caught collectively.
Staying hydrated all through the day, not simply throughout and proper after operating, is essential to wholesome fiscal motion. Right here, David Sinclair rehydrates following the 2022 Canyons by UTMB 100k. Photograph: iRunFar/Meghan Hicks
Warmth and Soften
Analysis and follow in fascial mobilization have additionally proven that extended friction drive has two optimistic results on fascial mobility.
First, it softens tissues. That is the premise of the therapeutic massage remedy occupation: tissue strategies to lower tissue stiffness, tone, and density by the appliance of guide drive.
We now know, by in vivo research, that extended friction additionally heats tissue. In doing so, researchers and practitioners, alike imagine that the elevated warmth “melts” that sticky, dehydrated hyaluronic acid. This each promotes movement — like warming a stiff, strong glue — but additionally helps introduce hydration, which “thins” that sticky fluid and helps preserve it much less sticky.
Trendy, self-treatment methods — reminiscent of Graston-like or skin-scraping instruments, and percussive therapeutic massage weapons — are efficient methods to each mobilize numerous fascial layers whereas introducing warmth.
Testing an Addaday percussive massager. Photograph: iRunFar/Eszter Horanyi
Transfer!
As soon as one fascial layer is unglued from the opposite, it’s now in a position and keen to elongate, shorten, and in any other case transfer through standard stretching and practical actions. Loosened fascia will enable commonplace mobility strategies, reminiscent of hamstring, hip flexor, or calf stretches, to create sustained mobility enchancment.
The take-home lesson: actual mobility features require a concentrate on fascia, and this multi-faceted method.
Take-Residence Methods for Runners
In the event you’re stiff, in ache, and/or your stretching makes an attempt have gotten you nowhere, contemplate the next:
Discover a Practitioner Who Understands Fascia
The simplest of all of the methods is to discover a physique employee who is aware of their anatomy and understands the construction and performance of fascia. They’ll use their robust, high-stamina fingers and elbows to offer focused and sustained mobilization forces to your areas of want. This can be a far simpler, extra environment friendly, and normally much less painful various to the do-it-yourself method.
But when that isn’t an choice, you could possibly care on your points in several methods.
Acknowledge the Facet Doorways
If in case you have ache or stiffness in elementary motions — hip flexion and extension, hamstring lengthening, and calf and foot flexion — contemplate the “aspect doorways.” These are adjoining tissues which may be pain-free, however could possibly be considerably stiff and — by fascial connections — be perpetuating ache and stiffness in your delicate areas.
For hip mobility, work the adductors and lateral glute muscle mass. For again and pelvic mobility, work the stomach.
Study Your Anatomy and Restore Muscle Play
Even a Google training in gentle tissue anatomy will enable you acknowledge the wealthy complexity of the human motion system, and all of the locations we are able to get caught!
In doing so, it might enable you use numerous instruments — together with scrapers, weapons, balls, and even your fingers — to focus on fascial tissue borders and assist free one muscle from one other. This would possibly embrace ball massaging on the border between the ITB and hamstrings, or hands-on wiggling mobilization of the medial and lateral muscle play alongside the shin bone.
Soften, Warmth, Hydrate, and Then Stretch
When you’ve restored even a marginal quantity of tissue freedom (say, between muscle mass, or between muscle and bone), then apply a stretch. Softened, warmed muscle mass will successfully transfer — and achieve and preserve elevated size — much better than by stretching, alone.
Closing Ideas
Stiffness will not be a terminal sickness. Certainly, of all of the growing old processes, there is no such thing as a proof that tissue mobility is completely misplaced. Quite, tissues accumulate stiffness over each time and exercise load. However, utilizing these strategies, we are able to curb and even reverse these losses to not solely enhance mobility, however lower ache and optimize operate!
Name for Feedback
- Do you endure from stiffness?
- Did you discover the above recommendation useful?
- Is there anything that’s labored effectively for you?
