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By Bernard L. Gladieux, Jr.

Overuse injuries, although they often seem quite straight forward, can be, in fact, quite complicated in that they are often caused by a combination of factors that vary widely from person to person. So, whether you are a weekend jogger and spend your work days at a desk or a bench or you are an elite, daily training, competitive athlete, there are some ways you can safely navigate around and through the many risk factors that will threaten your continued mobility, fitness, good health and longevity in the short or the long run.

So, as you make choices about your exercise, how often, how intensely and at what activities, here are some things to think about:

Form and style:
Much athletic coaching and training concentrates on the details of movement. If you are fortunate to have been taught by a skilled and experienced athletic instructor as a young person in, say, junior high or high school, you will have learned all about how to run, how to breathe, how to pace yourself. Now, as you may be contemplating your athletic renaissance, remember all that good advice and put it to use.

If you are just now starting from scratch, find a trainer or an experienced mentor coach or friend to help you get it right.Very often a local club is a good place to start with club runs or rides among contemporaries. Keep your eyes and ears open for tips on how to move smoothly and efficiently. In running especially, economy of movement follows form and style very closely and will minimize early fatigue that will in turn help to forestall injury from inefficient form.

Frequency in balance
One of the earliest decisions you may have to make is how often you are going to challenge your body in the activity you select.Be aware that one of the most serious risks in the early stages of most quality exercise programs results from an early excess of enthusiasm. It doesn’t take long for the beginner jogger or cyclist or walker or weightlifter to start feeling the uplifting effects of physical activity. You will know it by the giddy feeling of exhilaration and invincibility that recent converts often demonstrate while in the “honeymoon phase.” It is typically a happy time, but, as rewarding as regular exercise can be, it is not without its hazards. So it pays to be aware that injury can sneak up on you. Your best defense is to listen to signals from your body and to schedule your program so that you allow an appropriate amount of time for recovery after every effort. For a normal workout that may be only a day or for something extraordinary like a marathon, it might require a month before you are back to a normal.

Learning curve:
In time you will accumulate knowledge about your own limits and what works for you and what doesn’t.Always be open to learning more – more about yourself and more about everything that bears on your well being from diet to rest, stretching to cross training. Although exercise is not like neurosurgery in its intellectual demands, it greatly benefits from a basic academic knowledge of anatomy, physiology, nutrition and any sports medicine you can absorb. These days extensive research information is widely available on the Internet.

Taking your time:
Look first at your carefully structured plan to become permanently more fit and strong in the longer term. Consider the stepping stones towards whatever goal you decide to aim for. It may simply be to remain upright and moving for the next twenty or forty years.If you are aiming for something more dramatic and shorter term, your accelerated schedule will demand more intensity as well as more discipline and caution. In terms of your daily activities, try to get in the habit of easing into your training mode of choice with deliberate restraint. One technique that you may soon discover on your own will increase your endurance significantly: Simply warm up slowly for twenty minutes to half an hour before starting any demanding activity.

Muscle balance:
Every experienced athlete knows that the exercised muscle inevitably becomes stronger, and the unexercised muscle does not. Accordingly a sport in which only a limited number of specific muscles are engaged may leave you with neglected, relatively weaker muscles.That difference between opposing muscles can easily result in an imbalance that often leads to acute muscle strains and other injuries that are entirely preventable by a regular, balanced strength training regimen. Maintaining a basic muscle balance is not difficult and does not necessarily involve an extraordinary time commitment. At the outset, however you may have to alter your habitual routine in order, for example, to begin a twice a week weight training program.

With the help of a trained exercise therapist or athletic trainer, you can create a sequence of exercises appropriately tailored to your own, specific needs and goals.

Become an adventurer; mix it up:
Once you are in the habit of training regularly, you can start experimenting with new ways to add variety to your exercise that will enhance your enjoyment. Increase your resistance to overuse related injuries and improve the efficiency of your form. This approach is often referred to as “cross training.” In concept, cross training is simplicity itself: you exercise your primary muscles and allow plenty of time between workouts to allow your muscles to recover and repair; but instead of taking a nap, you go workout at something entirely different. Of course cross trainers can wear down, become plagued by chronic fatigue, reduce their resistance to colds and other infections, but by spreading the stress around your own, more vulnerable trouble spots, you reduce the risk that any one will break down.

Outlook and simple pleasures:
Always keep in mind that whatever you do to attain and protect your health and fitness, it should be something that yields you intrinsic rewards.That is pleasure from the sheer pleasure of the experience. Never let that thought go.Everything else is gravy.

In Good Health
(Bun)
Bernard L. Gladieux, Jr.
President
The Pressure Positive Company

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Self Care in Trigger Point Therapy
By Bernard L. Gladieux, Jr.

Pain, as most of us know by our own life experience, comes in a variety of forms, at any age and at any time of the day or night, often when we least expect it or when it is most inconvenient. Accordingly we would do well to consider devising an accessible approach to self care for that time when, by accident, over-use or chronic condition, our pain level rises to the point at which we become dysfunctional or distracted or both.

If the idea of taking positive charge of your own well being in this way leaves you anxious or confused or weak in the knees, seek out the help of a knowledgeable friend or health professional. Often a coach or personal trainer or massage therapist can offer insights and pointers that will lead you in the right direction.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

“Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.”

Prevention:
There is no way to guarantee that you will be able to live pain free, no matter how protective or cautious you are. However, a regular program of moderate, well balanced exercise with generous amounts of aerobic, cardio vascular activity, some strength training and stretching with some variation in routine will go a long way to keeping your body tuned up, strong and limber enough to do all of the things you have always enjoyed and which give color, texture and energy to your life without your having to be concerned about hurting yourself.

Of course if your interests turn toward mountain climbing, sky diving, or skiing steep and deep powder, and the like, you will certainly want to step up your conditioning to levels appropriate for your sensible and realistic aspirations.

First Aid:
Pain is often the signal that something is amiss when injury strikes. Listen to it even as all of your best plans are falling apart. Assess the damage. Is it a broken bone, a joint sprain, a muscle strain, a traumatic injury or an over-use syndrome on the rise? Your answers may or may not point you in the right direction, but they will add to your store of experience that should help protect you in the future. For most athletes and sport oriented therapists and trainers, icing, rest, compression and elevation are the traditional first treatments for soft tissue injury. Broken bones and more severe muscle and joint damage take longer and more complicated repair and recuperative protocols.

Long Term Pain Management:
Eventually prevention and first aid lead to and then blend in with long term management of symptoms. All of these care phases then become a seamless whole. In the quest for pain free and optimally functional long term fitness, serious seekers of effective self care will search for knowledgeable, pain management clinicians, but, as David Simons, M.D. has said,* “…finding a truly skilled practitioner can be frustratingly difficult.” But, he adds, “There is no substitute for learning how to control your own musculoskeletal pain. Treating myofascial trigger points yourself addresses the source of that kind of common pain and is not just a way or temporarily relieving it.”

This self care principle is a direct outgrowth of the trigger point identification and treatment protocol that was developed both before and after World War II by Hans Kraus, M.D. and Janet Travell, M.D., among others including aerospace researcher and physician David G. Simons, M.D. By the late 1970s, nationally popular exercise therapist and promoter, Bonnie Prudden and friend and associate of Drs. Kraus and Travell, had developed her own, non invasive trigger point protocol that was a direct extension of the early work of Kraus and Travell.

Prudden called her technique Myotherapy, wrote a book on it and founded her own Academy for Physical Fitness and Myotherapy in a former elementary school in Lenox Masachusetts to train professional myotherapists. The elements of the Prudden Myotherapy treatment include the following key elements:

The success of this therapeutic protocol is measured by the subjective reduction in pain, increased flexibility and range of motion as well as in increased strength, endurance and over all physical function. Success is also measured by the degree to which patients become active participants in their ongoing self care.

Over the past thirty years the myotherapeutic model has been widely practiced by physicians and therapists representing the span of professional disciplines that define mainstream, physical medicine. And it is now well accepted as an effective and conservative treatment option.

Precipitating factors. By thorough patient intake interviews, the myotherapist
seeks to discover the conditions and circumstances that contribute to the patient’s symptoms.

Deep, manual, soft tissue ischemic compression and myofascial release of trigger points.

Individualized active and passive stretching exercises often facilitated with topical application of coolant spray.

Detailed patient instruction in home self care including deep muscle compression, stretching and strengthening exercises and the management and avoidance of precipitating factors.

In Good Heath,
Bernard L. Gladieux, Jr.
President,
The Pressure Positive Company®

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Pain, as most of us know by our own life experience, comes in a variety of forms, at any age and at any time of the day or night, often when we least expect it or when it is most inconvenient. Accordingly we would do well to consider devising an accessible approach to self care for that time when, by accident, over-use or chronic condition, our pain level rises to the point at which we become dysfunctional or distracted or both.

If the idea of taking positive charge of your own well being in this way leaves you anxious or confused or weak in the knees, seek out the help of a knowledgeable friend or health professional. Often a coach or personal trainer or massage therapist can offer insights and pointers that will lead you in the right direction.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

Prevention:
There is no way to guarantee that you will be able to live pain free, no matter how protective or cautious you are. However, a regular program of moderate, well balanced exercise with generous amounts of aerobic, cardio vascular activity, some strength training and stretching with some variation in routine will go a long way to keeping your body tuned up, strong and limber enough to do all of the things you have always enjoyed and which give color, texture and energy to your life without your having to be concerned about hurting yourself.

Of course if your interests turn toward mountain climbing, sky diving, or skiing steep and deep powder, and the like, you will certainly want to step up your conditioning to levels appropriate for your sensible and realistic aspirations.

First Aid:
Pain is often the signal that something is amiss when injury strikes. Listen to it even as all of your best plans are falling apart. Assess the damage. Is it a broken bone, a joint sprain, a muscle strain, a traumatic injury or an over-use syndrome on the rise? Your answers may or may not point you in the right direction, but they will add to your store of experience that should help protect you in the future. For most athletes and sport oriented therapists and trainers, icing, rest, compression and elevation are the traditional first treatments for soft tissue injury. Broken bones and more severe muscle and joint damage take longer and more complicated repair and recuperative protocols.

Long Term Pain Management:
Eventually prevention and first aid lead to and then blend in with long term management of symptoms. All of these care phases then become a seamless whole. In the quest for pain free and optimally functional long term fitness, serious seekers of effective self care will search for knowledgeable, pain management clinicians, but, as David Simons, M.D. has said,* “…finding a truly skilled practitioner can be frustratingly difficult.” But, he adds, “There is no substitute for learning how to control your own musculoskeletal pain. Treating myofascial trigger points yourself addresses the source of that kind of common pain and is not just a way or temporarily relieving it.”

This self care principle is a direct outgrowth of the trigger point identification and treatment protocol that was developed both before and after World War II by Hans Kraus, M.D. and Janet Travell, M.D., among others including aerospace researcher and physician David G. Simons, M.D. By the late 1970s, nationally popular exercise therapist and promoter, Bonnie Prudden and friend and associate of Drs. Kraus and Travell, had developed her own, non invasive trigger point protocol that was a direct extension of the early work of Kraus and Travell.

Prudden called her technique Myotherapy, wrote a book on it and founded her own Academy for Physical Fitness and Myotherapy in a former elementary school in Lenox Masachusetts to train professional myotherapists. The elements of the Prudden Myotherapy treatment include the following key elements:

The success of this therapeutic protocol is measured by the subjective reduction in pain, increased flexibility and range of motion as well as in increased strength, endurance and over all physical function. Success is also measured by the degree to which patients become active participants in their ongoing self care.

Over the past thirty years the myotherapeutic model has been widely practiced by physicians and therapists representing the span of professional disciplines that define mainstream, physical medicine. And it is now well accepted as an effective and conservative treatment option.

Precipitating factors. By thorough patient intake interviews, the myotherapist seeks to discover the conditions and circumstances that contribute to the patient’s symptoms

Deep, manual, soft tissue ischemic compression and myofascial release of trigger points.

Individualized active and passive stretching exercises often facilitated with topical application of coolant spray.

Detailed patient instruction in home self care including deep muscle compression, stretching and strengthening exercises and the management and avoidance of precipitating factors.

In Good Health,
Bernard L. Gladieux, Jr.
President,
The Pressure Positive Company

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