Understanding Fascia

PR Friday — Post your training updates, PR’s, and questions to the comments and the 70’s Big crew will respond. 

I love anatomy and physiology, especially musculoskeletal anatomy. I don’t claim to know everything, but I’m pretty decent at taking the scientific stuff and breaking it down into usable, practical chunks to apply into training. I’ve gotten to study anatomy on a variety of cadavers and animals, and it’s just…fascinating.

There are times when I see or learn something, whether it be anatomy or medical related, and a feeling washes over me in an awesome wave. I mean that literally; I get goose bumps and tingly because I’m having a god damn nerd jizz. And recently I had a nerd jizz that you need to hear about.

Fascia is traditionally known as a sheath of fibrous connective tissue that surrounds organs, muscles, and connective tissue to provide stability, transmit force, or compartmentalizing groups of structures. When you see the white stuff in meat, it’s likely fascia, though it’s so much more than that. Some new work suggests that fascia includes most of the soft tissue in the body, but by studying biomechanics it’s easy to see how fascia is interrelated with muscles, tendons, ligaments, and bones with respect to force transmission and movement.

lat-TGFor example, the latissimus dorsi, or “the lats”, are a primary shoulder extensor and internal rotator. Notice how in this picture from Trail Guide to the Body, 2nd Ed that the origin of the muscle is essentially along the entire thorocolumbar aponeurosis. Thorocolumbar just means “relating to the thoracic or lumbar spine” and “aponeurosis” is just a term for a flat broad connective tissue. Most texts identify it as a tendon, yet it’s just a big sheath of connective tissue that, in this case, is integrated with that lower portion of the lat. We could even say it’s an fascial integration that connecting to bone. By observing this picture, you could see how the lat could have an effect on spinal function, or how tightness in the lat could effect the lower back, hip, and/or shoulder. (Note: For more on the lats, read The Lats While Benching)

This applies all over the body. Fascia is woven around and between all muscles creating a network of tension to not only maintain the muscles’ position under the skin, but to facilitate function. This is why when you sit on your butt, knees extended, and your feet in front of you, then you crunch forward and pull your chin to your chest, you’ll feel a stretch along the entire back side of your body, possibly down to your feet. Fascia is not isolated to the forearm or leg; think of it as a sheath of connective tissue around muscles, then compartments of muscles, then body parts, then areas of the body, and the body itself (Note: Here’s an example of muscle compartments). If you think of the body like this, then it may help you when you’re trying to do soft tissue work or limber up before training.

In the last fifteen years the fitness industry has warmed to the idea that soft tissue work, called “self myofascial release” in some circles, is beneficial for mobility, prehab, and performance. The world of strength and conditioning has always known this, but it has become more mainstream and has blossomed into the concept of “mobility” in CrossFit or the fact that you can buy a (shitty) foam roller at any Wal-Mart. Yet there’s an idea that things like foam is enough to have an effect on fascia, and it couldn’t be more wrong.

And here is where the nerd jizz comes.

Recently I saw living human anatomy down to the bone. I saw a person move their leg, and I watched the muscle itself contract and elongate right before my eyes. On a human. It was one of the most incredible things I’ve ever seen, but we’re here to talk about fascia.

The fascia that makes up the border of a compartment is tougher than what you could possibly imagine. What I imagined as the IT band — a thick fibrous duct-tape-like tissue — was the compartment fascia. I’ve seen IT bands and fascia on cadavers, but this was the real deal; it was thicker than I thought it would be, and it literally seemed impervious to a lousy foam roller.

As I felt this fascia between my fingers, I realized that our understanding of this whole mobility and soft tissue thing is fair at best. Foam doesn’t do shit. Rolling a lacrosse ball for a few reps doesn’t do shit. This is tissue that doesn’t get massaged out in a few minutes. This is a structure that can’t be addressed in a given session or even a week. This tissue is so tough it needs long term care, especially if it’s messed up.

I’ve worked with hundreds and hundreds of people and have felt their scar tissue, bound up fascia, and injuries. Nothing prepared me for how the compartmental fascia would feel. No picture, no mobility expert, no cadaver, or no animal could possibly provide what I learned in half a minute of palpating this fascia. Yes, I’m a fucking weirdo, but hopefully you can benefit from it.

If dysfunction is present in the fascia, muscles, and tendons, then it needs aggressive treatment. Not a single beat down session as this would accomplish nothing on rugged fascia, but sessions throughout the day, every day. Luckily, this is how I prescribed long-term, nagging mobility problems — perform soft tissue work and stretches at least five sessions a day, every day until further notice.

Yes folks, fascia is tougher than social studies, but what’s even tougher is choosing the right strength training, soft tissue, and stretching exercises to address dysfunction, but that, my friends, is another post. Until then, start respecting the integrity of your fascia and really get into it when treating it.

 

 

 

Stop Flopping After A WOD

CrossFit workouts are hard. If you’re really working, you’ll be at your physiological limit. You’ll have a deficit of oxygen, a surplus of carbon dioxide, and your respiratory drive will be amped up to try and suck in as much air as possible. Your muscles will fill with acid as metabolic energy systems red-line to produce energy. Every system in your body is straining to hold it together, to not shit yourself and perform.

When you finally finish, it feels so nice to simply lie down on the ground and rapidly suck air like a fish out of water. Besides, that’s what all the cool people in CrossFit do.

I used to do it too. I was wrong.

I used to do it too. I was wrong. (circa 2008)

Let’s ignore the fact that lying down is symbolic of giving up. Let’s ignore the fact that flopping on the ground and showing your belly is an act of submission. Let’s also ignore how there’s zero practicality in it since you would never do this in an emergency situation, a fight, or a combat scenario. Let’s just focus on it’s physiological shittiness.

By the way, yes, I’m saying if you flop after a workout or WOD that you’re symbolizing giving up, submitting, and not training yourself to recover on the move.

What’s Going On During Peak Work Output

Let’s review “conditioning”. It’s a term I use to imply “WOD”, “met-con”, “energy system development”, and other fancy terms. In FIT we even say “high intensity endurance training” since that’s what is (we’re consistent with endurance research terminology). Conditioning the body occurs in two ways: physically and metabolically. In my chapter in FIT, I talk about how conditioning the structures for various movements is important, and then I explain conditioning the energy systems. It’s a multi-purpose term, but all of its definitions are important in programming training. Here we are talking about high intensity conditioning workouts.

Generally speaking if you impart an efficient sub-lethal stress on the body and allow proper recovery, the result is an increase in performance (AKA super compensation). We use conditioning to improve work output performance.

The paradigm Dr. Kilgore and I developed for conditioning is the high intensity forces a deficit in substrates, and that deficit is the stress that the body isn’t used to that forces the adaptation. Substrates are converted into energy. If you make the body use up a lot of those substrates, it has trouble converting them to energy. The body says, “Holy crap, I need to be able to handle this better in the future,” so it adapts and improves performance.

But this high intensity has side effects, and I briefly alluded to them in the first paragraph. Let’s focus on the lactic acid build up as a result of pushing muscles to their limit. Generally speaking, the pH of blood is relatively neutral, yet having a lot of acid get into the blood stream will lower the pH and make it more acidic.

What’s The Result

Changing the pH of the blood is something the body isn’t used to, and buffering the pH back to normal levels is part of the body’s adaptation. This is just one small element to a complicated metabolic system, but I’m focusing on it for the sake of discussion.

Let’s say you’re doing a lot of stuff with your legs. You’ve been doing thrusters, sprinting, and box jumps. Your legs feel feel useless, like you physically cannot move them on your next sprint round. It’s because they are engorged with acid and blood as a result of the physiological changes. They are likely in a deficit of oxygen and maybe glucose (both are substrates). Their entire physiologic environment is disrupted to a point where they cannot function properly.

Now, you may notice that after a short recovery, about three minutes, they will feel good enough to exert again. But sometimes you’ll finish a workout and you just feel completely fucked up. I remember feeling this way the first time I did “Fran” and “Cindy” or most summer football workouts.

The reason you feel so shitty after an intense workout is they have a local effect on muscles and structures, but also a systemic effect. The systemic effect is why these workouts are effective at increasing fitness, but it’s also why so many people get injured or burned out because they do too much and the system can’t recover.

To Flop Or Not

Think about the two minutes after finishing one of these hellacious workouts. The body constantly aims for homeostasis, but instead it’s experiencing a hurricane. CO2 levels are high, O2 levels are low, acid is rampant, blood vessels are dilating, the heart is wildly pumping, breathing muscles are on overdrive, the alveoli of the lungs are stressed due to the rapid breathing — the whole fucking body is going crazy.

And then the brain decides to just lie down. It’s cool bros, we just need to have ourselves a sit down. 

Everyone reading this is aware their legs are on the bottom of their body and that their heart is near the top. You intuitively know gravity pulls straight down into the earth. This poses a problem for venous return to the heart, so natural selection developed  one-way valves in the veins to prevent a back-flow of blood. Also, when skeletal muscles contract, they squeeze the veins to help push blood up and back to the heart (since the pressure from the heart is too weak to do it alone).

Imagine those legs are full of acid and CO2 and lack oxygen. If the body listens to the brain and lies down, the muscles aren’t helping to pump the acidic blood. No flow means no O2/CO2 exchange and no acid buffering.

This means that for the entirety of lying down, your legs are not dealing with the chemical environment that caused them to not work properly. This means that you’re exposing them to this chemical environment longer than they need to. This means that you’re potentially causing more and/or unnecessary damage to this area. This means that you could be delaying your recovery and limiting your performance increase.

The amount of detriment is arbitrary; there’s not a practical way to quantify the debilitating effect of lying down. The point is that by putting your body flat on the ground and remaining still only means your body isn’t recovering as well as it could. And if you give enough of a shit to do this to yourself in the first place, then why not do everything you can to recover well? There’s a reason track coaches include a cool downs in their programming; it helps take bad stuff out and the circulation brings good stuff in.

Instead, Do This

Stay on your feet and walk around. Yeah, I know it sucks, but the pain fades away. Put your hands over your head or grab onto something, and go through the “frantic catching of the breath” process, but start walking around as soon as you can. I’m not in the “Tommy Tough Guy says, ‘Don’t be a pussy,'” clan, but you shouldn’t train yourself to be one. Lying down is defeat, it’s submission. It also says, “I’m not ready for what’s next.” So stay on your feet and keep moving. You’ll recover faster and you won’t look like a diva who feels sorry for himself.

A Better Spinal Cue

I was being coached on rack pulls and was told to arch my back as hard as I could. I did so, started pulling the weight, and YANK; there went something in my lower back. Severe sharp pain indicated the end of my lifting session as well as the next week or two of training. I didn’t know as much as I did now, but the injury — and time away from training — all could have been avoided with a better spinal cue.

There are two basic types of incorrect spinal position in lifting: over extension and over flexion.

Over Flexion, Round Back, or Lumbar Hyperkyphosis

round

Obvious flexion

This is the position that most coaches, especially the inexperienced, are most afraid of. It’s the default position for new trainees and very easy to identify. New trainees look like this because a) they do not have any kinesthetic awareness (i.e. have no control of what their body is doing), b) typically have no hamstring or lower back strength, and c) have very poor mobility.

Correcting kinesthetic awareness and mobility take time, so the quick and easy fix is to say “arch your back”. Usually this cue will improve a new trainee’s mechanics immediately, and usually hamstring strength, kinesthetic awareness, or mobility don’t have to be addressed for months. This means that people who only coach beginners will default into cuing “arch the back” and ignore other variables. If you neglect to address these variables and just focus on increasing the lifting load, then at some point they’ll experience an injury, great or small. Increasing the weight lifted is not necessarily synonymous with getting stronger.

Over Extension, Arched Back, Hyperlordosis

Too extended

Too extended

This position is difficult to distinguish from a neutral (i.e. correct and optimal) spinal position, therefore inexperienced coaches overlook it. Experienced coaches occasionally think an overly arched back is acceptable to avoid a rounded back, but a good coach will cue the correct position to avoid injury.

Two areas are often affected by hyperlordosis: the thoracolumbar junction (where the thoracic and lumbar spine meet) and the lumbosacral junction (where the lumbar and sacral spine meet — see image below). These are easy landmarks any coach should be able to identify on their trainee, but don’t worry about the more complicated anatomy under the skin right now. Here we will focus on how the overly arched position is a great way to cause disc irritation or strain muscles.

spine1

Note the junctions between different areas of the spine. Click for larger view.

Why These Positions Are Bad

Both spinal position extremes, flexion and extension, can cause injury and are indicative of a lack of strength and positional control. Whether we call this kinesthetic awareness, neuromuscular efficiency, coordination, technique, or mechanics is irrelevant; let’s set the rhetoric aside and briefly discuss why each position is poor.

An overly flexed spine means that the related spinal muscles are not doing their job of holding the spine and pelvis in place. It’s important to remember the integration of spine and pelvis in lifting mechanics as it will determine stability, transmission of force, and subsequently overall strength. If the muscles aren’t doing their job, then they don’t get stronger. But a secondary impact is that other muscles can’t do their job when the spine and pelvis are out of position. The best and most obvious example is with the hamstrings.

A fantastic image I made long ago for this topic.

A fantastic image I made long ago for this topic.

If the pelvis and spine are rounded — which is lumbar flexion and a posterior pelvic tilt — as they are on the right, then the hamstrings will be slack and the trainee will look like a dog pooping. If the spine and pelvis are in a neutral, stable position — a relative lumbar extension and anterior pelvic tilt — then it pulls the proximal (or higher) attachment of the hamstrings back, thus putting tension on them. If they are stretched and tense, then they can contract (left picture). If the hamstrings are slack and shortened, then they cannot be contracted any more and therefore will not contribute to the movement (right picture).

This example applies to the start of a deadlift or the bottom of a squat. Note the emphasis on “relative lumbar extension and anterior pelvic tilt” — if they occur too much then we can have the “over extension” problem.

Think of an overly extended spine as putting a kink in the body’s trunk, or something that weakens the transmission of force. However, unlike the rounded back, various muscles are contracted and maintaining tension, so everything may look and feel correct…until an injury occurs. This over extension puts a lot of stress on the vertebral bodies. Arching the back can open the intervertebral space in the front and close it in the back (see image below). Structures like the disc, tendons, muscles, or ligaments can fail in an acute injury and produce that “yanking” sensation followed by pain and inflammation.

Note how the posterior aspect could be pinched down under a load.

Note in the right image how the posterior aspect of the lumbar spine could be pinched down if this spine was loaded with a lot of weight.

This is not supposed to be a comprehensive look at acute or long-term injury, but merely a demonstration to understand how loading the spine in this way could result in one. Long-term loading with hyperlordosis can worsen or cause poor mobility issues as well as degenerative disc issues. Using poor mechanics chronically is probably the most common cause of lifting related injuries as they will cause nagging problems, or will result in a “final stroke” injury (see The Final Stroke).

How To Cue A Better Position

Enough talk about how and why, let’s correct it. The concept revolves around adding tension to the lower abdominals by simply contracting them a bit prior to moving the bar and maintaining the tension throughout the lift. No, this is not a monumental cue, but it’s something that many ignore and it can eradicate a lot of positional errors.

Simply contract the lower abs. They don’t need to be clenched like Houdini readying himself for a gut punch; just put some light tension — about 25 to 50%. Yet this cue must be accompanied by a solid “chest up” position. While standing in a neutral position — anatomical position will suffice for the teaching process — lift the chest towards the chin. Do not lower the chin to the chest, but lift the chest. This is thoracic extension and is the first step to good spinal positioning. Next, contract the lower abdominals, which are usually lower than the belly button. The trainee or coach can lightly press on the area to test the tension. Go ahead and contract them as hard as possible and then lighten the tension to 25 to 50%. Don’t worry about being exact, just maintain a little bit of tension. This creates lower abdominal tension, which is the second step to good spinal positioning.

Some people might call this “pelvic floor activation” or other five dollar phrases, but abdominal contraction will a) place tension on the abdominals to not allow the pelvis to anteriorily tilt, thus preventing an over-extension fault, b) helps actively increase the intra abdominal and thoracic pressure which increases the trunk stability which increases the transmission of force which inevitably increases lifting efficiency and safety, c) provides tension on the front of the pelvis to compliment the posterior chain’s tension, and d) ultimately helps keep the spine in a neutral, force transmitting position. I could probably write a single post on each one of those points, but I think you now understand why abdominal tension is helpful.

The biggest fault with contracting the lower abdominals is not emphasizing the “chest up” thoracic extension with it, which is why I make “chest up” the first step. If you contract your abs without “chest up”, you can possibly round your back and fall into the pooping dog model (extremely safe for work). Pooping dogs are funny, but not on the platform.

How I Integrate These Cues

I have a few rules for lifting, and one of them is, “Whenever the bar is moving, treat it like a maximal lift.” This means you put yourself in the most stable, efficient possible whenever the body is loaded regardless of the weight. That means a big, full breath is held with the chest up with tension on the lower abs. When I coach, I think in terms of “passive” and “active” cues. I want spinal stability to be a passive cue, meaning it is something that I shouldn’t have to cue and is routine to the trainee. If they always have good spinal position, I don’t have to cue it and can focus on the “active cues” associated with their mechanics in the lift.

We want a solid spinal position to always be there. Remember the steps from earlier:

1. Extend the thoracic spine
2. Contract the lower abs

After explaining what these concepts are and teaching their respective positions, I cue them with:

1. “Chest up”
2. “Lock the abs”

Remember that cues are supposed to be representative of a concept you concisely taught the trainee. You will almost always need to adapt the way you act, speak, and use terminology with your respective trainee. Teach the concept, teach the position, then use a short cue to remind them of that position. I like the simplicity of “chest up” and “lock down the abs” or “lock the abs”. I specifically teach trainees to lift the chest, take a big breath, and lock the abs when the breath is held. This gives them a sequence to perform every single rep on every single set. Lift the chest, take a breath, and lock the abs. It should be automatic, so teach it as such. If this is taught in a single session, then the coach only needs to occasionally remind the trainee and instead can focus on the mechanics of the squat, deadlift, and so on.

This spine is mostly neutral, but I figured you'd think it was nice to look at.

This spine is mostly neutral, but I figured you’d think it was nice to look at.

The Result…

…is a nice, neutral spine that transmits force without any spine or hip deviation throughout the lift. Most athletes, lifters, or trainees who don’t use this method would benefit from a short linear progression focusing on this spinal position (i.e. 2 to 4 weeks).

A strong, neutral spine will allow the hips to properly externally rotate during squats and pulls (a very important concept that leaves the scope of this post). It will also avoid subjecting the soft tissue structures around the spine from receiving force incorrectly, which is ultimately the best way to prevent lifting related injuries. Most linear progressions are associated with nagging aches and pains with the occasional injury that prevents training. Lifting does not cause injury; improper mobility and mechanics in lifting do. Anyone who tells you that injuries are a byproduct of training is just making excuses for hurting their trainees. You’ll probably experience an injury in your pursuit of strength, but they don’t happen “just because”. Lower spinal injuries are entirely preventable, and by using the cues described above — with appropriate mobility work, programming, and recovery — you can actively work to avoid injuries.

Some other articles you may be interested in are:
Rack Pull Tidbits
The RDL
The Butt Wink
Hyperlordosis
“Hip torque”, toe angle, and squatting

Rhabdomyolysis Is Systemic

I know, I know. Some of you CrossFit or lifting veterans are tired of hearing about this. But I’m having an xkcd moment (pictured below) where I need to explain something. It’s important to me. And I haven’t been able to write anything in a while anyway.

duty_calls

What are you crying about?

If you follow the 70’s Big Twitter you may have seen an exchange talking about a traumatic condition called Rhabdomyolysis, or “rhabdo”. I asked the lovely Shana Alverson (@ShanaAlverson) how she was feeling for CrossFit regionals, and she mentioned she had a mild case of rhabdo (seen below). I then asked a weird, inaccurate question of whether it was systemic or local. Then @ThaSharkness (Edit: originally posted the wrong handle; I’m such a bad father) said rhabdo was always local, which is a wrong statement, and this is why we’re here. Let’s get down to it.

What is rhabdomyolysis?

According to the A.D.A.M. Medical Encyclopedia:

Rhabdomyolysis is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to the kidney and often cause kidney damage.

It’s a simple definition that is quantified by the disruption of the skeletal muscle membrane — remember this sentence because it’ll be important later. CrossFit et al. has an oversimplification stating that the muscle is damaged via exertion stress, the muscle leaks myoglobin — the protein that carries oxygen in skeletal muscle — and the circulating myoglobin interferes with kidney (renal) function, and can cause acute renal failure (which can very easily lead to death). This can occur, yes, but there’s more to it.

The disruption of the membrane of the skeletal muscle means that things that are supposed to stay in the muscle cells get out, and things that are supposed to stay out get in. It’s like leaving your door open and your dogs get out while the neighborhood cats come into your house and creepily spy on you. The point is that rhabdo is defined by this breach in the membrane, and even minor cases still have this shift in contents in and out.

Why is this a systemic reaction instead of solely a local one?

I’ll try to be as simple and concise as possible for the following. The pumps on the cell membrane get damaged and they can’t function properly. Potassium leaks out of the cell into the blood stream causing a high blood serum level of potassium (hyperkalemia). Calcium increases inside the cell, which destroys the muscle fibers (necrosis). Some other stuff leaks out of the cell like phosphate, myoglobin, creatine kinase (CK) and urate, which all have an effect on their respective serum levels in the blood. My point, the catalyst argument for writing this, is that these events are systemic as opposed to local.

For example, let’s say you eat 200g of sugar. Is there a systemic response to this? Regardless of the current adaptation of the person, the answer would be yes. Serum levels of sugar increase, therefore insulin levels increase to bring the blood sugar down. Insulin, along with all hormones, has a dynamic relationship with other hormones to regulate the amount of sugar in the blood and therefore we would see arbitrary repercussions from other hormones as a result. The same goes for blood levels of anything, particularly potassium and calcium. If these levels change from homeostasis, then there is a systemic response to return to homeostasis. This is systemic, hence validating my point that rhabdomyolysis is a systemic condition, even if it’s minor.

If you’re wondering what the hell is going on, it goes like this. Muscle is damaged and stuff goes into the blood that is not supposed to. Each part of that “stuff” can do bad things if it stays there. If the total effect of all of that stuff is not enough to kill the body, then the body, AKA the system, will have a response to regulate and control it. The end.

It’s not a semantics conversation because the exact definition of rhabdomyolysis states that not only does muscle break down occur, the contents of the cell will be leaked. Simply being really sore and having damaged muscles isn’t rhabdo. It’s defined by the stuff being leaked, and it’s more than just the myoglobin. For example, the potassium and calcium being in the wrong places can cause heart arrhythmias, which can throw someone into a cardiac code and potentially kill them if treatment is not available. And, if you’re still interested, the serious cases can cause other issues like compartment syndrome, sepsis, seizures, and DIC — which are just more easy ways to die.

I’ve studied anatomy, physiology, and rhabdomyolysis itself on a personal, academic, and medical level and have been fortunate enough to talk to ER doctors and nurses, medical doctors, physician assistantants, and more about it over the years. A few people will get full blown rhabdo where they need hospitalization and help to perfuse their organs, but most of us have just been really god damn sore and sluggish for days after a physical exertion beat down. That is the systemic response of the body trying to deal with the skeletal muscle membrane disruption.

As an aside, we treat regular non-traumatic muscle damage from things like squatting, pressing, and pulling as systemic stress anyway, so I could have just ended the discussion there.

If you want to learn more about rhabdo, I’ve written an article on how to avoid giving clients, trainees, or athletes rhabdo. The message is simple: don’t do too much shit too soon with people who aren’t ready for it. Also, be aware of the continuum of symptoms since rhabdo is a systemic condition that will be debilitating to training.

Soft Tissue Work Isn’t The Enemy

It bothers me when people, even the educated ones, say that muscles are “just not firing”, as if there is a total lack of innervation in an otherwise healthy individual (i.e. no radiculopathy or motor unit issues). Sure, muscles can be rendered ineffective because of tightness or bad mechanics — and thus their inclusion in movement is impaired — but they aren’t “not firing”. Subsequently, you don’t “teach muscles to fire” in the absence of the pathology mentioned above. This was my first issue with the article “Your IT Band is Not the Enemy” by Robert Comacho.

There’s so much silly in-fighting in the strength and conditioning world I feel the need to preface this god damn article by saying I’m sure Robert is a nice guy, an effective coach, and I don’t think he’s a piece of shit. I’m just going to disagree with the point of his article and I’m sure he’s man enough to accept that. And if he’s not, then he’ll scream into his pillow.

I’m actually disappointed in this article since it said the foam roller may be the enemy, yet there wasn’t much evidence supporting the statement. There are a lot of things that can result in a tight iliotibial tract, or IT band, because there are quite a few structures that interact with it. The author is right in the roles of the TFL and the gluteus medius in how they attach to the IT band with their inferior (or lower) attachments and help stabilize the knee. The vastus lateralis (the outside quad) also has some IT interaction and can affect function in the area as well. Note that other muscles that don’t actually touch the IT band can exacerbate tightness or pain too. But describing articulations with the IT band is incomplete because movement and mechanics will dictate muscular function and therefore tightness and pain at the IT band.

Bad posture, movement, and lifting mechanics will influence what muscles are used, overused, or ineffectively used (though they will still fire, mind you). This is the stuff that will dictate whether or not muscles like the TFL, glute medius, or vastus lateralis are tight and whether or not the IT band incorrectly receives stress and loading. It leaves the scope of this article to detail a comprehensive look at mechanics that effect the IT band, but some mechanic faults include the navicular drop (collapsed foot arch), knees moving in on any movement including walking, running, squatting, etc., and having tight internal rotators at the hip and weak external rotators (for the IT band’s purposes, I’m referring to the posterior fibers of the glute medius). If none of that made any sense, it just means doing athletic stuff with shitty technique will cause IT band issues and that a coach should be fixing it.

But I want to focus on two ideas:
1. Soft tissue work is being demonized.
2. Readers are so quick to hear someone’s opinion and immediately accept it as gospel, stroke its dong, and revel in its post-coitus warmth.

The Demonization of Soft Tissue Work

Foam rollers increase range of motion and reduce pain. My IT bands are tight and my knees hurt. Therefore I should apply the roller to my IT bands to solve these problems, right? Unfortunately, more often than not the answer to this question is a resounding “no.” It’s quite possible you’re actually doing more harm than help and further stretching an already abused and over-elongated piece of tissue. (From Robert’s article)

 

Unfortunately, most people do roll on their IT band excessively to try to fix it. Robert is right to criticize this, but he makes it seem like there is no place for it and fails to acknowledge that good coaches will not prescribe this. In his defense, he does clarify that, “It wasn’t my intention to state that foam rolling/stretching have no place in this type of rehab, It was more to point out…that the solution may be a bit more complex. (From a reply of his in the comments).

Fair enough, but then why suggest in the title of the article that the foam roller is potentially the problem? That’s like saying guns are a problem instead of the psycho pieces of shit who wield them against innocent people. It may be Breaking Muscle’s fault (the website that published the article); I know that The CrossFit Journal gave my article a shitty title when they published it. A website or journal needs to sell, and unfortunately people are more likely to click something if it’s controversial or big boobs.

As much as people want to say foam rolling or using lacrosse balls is actually harmful, the practical evidence suggests otherwise. Should we just mash on shit when it hurts? No, sir. But well thought out and executed soft tissue work can not only improve a lot of issues, but they are necessary in the absence of a good physical therapist. If you — whether you’re a trainee or a coach — want to improve your knowledge about this, then get your nose in a book or a college class and learn musculoskeletal anatomy. Learn about biomechanics and how to optimally distribute force efficiently. Learn about trigger point therapy and different types of injuries. I wrote two articles (“Why Anatomy Is Important” and “Learning About Strength and Conditioning“) that include some resources about this material, but I’ve learned most of it by doing and thinking.

This article isn’t a guide on how to do soft tissue, but I want to defiantly stand against the notion that it’s the enemy. Stupid soft tissue work is the enemy, just like the stupid use of Valium and a heavy machinery is the enemy. Coaches and trainees who actually give a shit need to think, which leads me to my next point.

Use Your Fucking Noggin

Below is something I saw on Facebook.
CaptureA few things:

1. The post the person linked to is from “I Fucking Love Science”, which is a stupid fucking piece of shit Facebook page that is the epitome of irrelevant material and aims for self popularity instead of the dissemination of knowledge. Read Maddox’s entertaining article about it.

2. I really wanted to be way more of an asshole, but I actually have a pretty thick filter. The point: if there were a giant ligament in every person’s knee, don’t you think somebody would have noticed in the last 2,000 years?

3. People ate this steaming bullshit up and then asked for seconds and thirds. This is a problem.

Readers are so god damn quick to immediately and irrevocably believe whatever they are being told, regardless of the qualifications of the person writing it. It could be written by some goober who has never coached anyone or someone who has many degrees and athletes, but is borderline retarded.

As a consumer about training information, you need to be openly skeptical about everything you read or hear. Hearing something that makes you feel good or that you agree with doesn’t make it 100% true. If the coach who has been watching you squat for two years tells you to do something, they should have the ability and the proverbial balls to explain it to you, even if it’s merely a hunch or experiment.

When a guy like Robert writes an article that says your foam roller is the problem, don’t immediately say, “I FUCKING KNEW IT. THIS PROVES WHAT I’VE THOUGHT ALL ALONG.” Read what the dude is actually saying, question it, and see what info you can use. Discuss it. Think about it.

Foam rollers, rumble rollers, lacrosse balls, and Theracanes are not the enemy; our brains are. Let’s hold them accountable.