Ask Dr. Christopher Anselmi

Questions

What are three of the most common training injuries/issues that triathletes or cyclists come to you with?

Are there ways an athlete can perform a modified version of ART on themselves?

For the issues/injuries you listed in answering the first question, are there any types of self-massage or stretching or recommendations for what an athlete can try on her own to see if it helps the problem before going to see a doc?

What are a few warning signs that an athlete should not try to tackle an injury on her own?

What are three of the most common training injuries/issues that triathletes or cyclists come to you with?

• Lower Back and Gluteal/Butt pain
• Hamstring and calf pulls (Posterior Leg issues)
• Shoulder and Upper Back pain

Describe in everyday-people language what ART is and how it works, and who/what kind of injuries benefit the most from it.

Active Release Techniques® (ART), is a patented, soft tissue movement and stretching technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Overuse of muscles can cause your body to produce tough, dense scar tissue. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis and nerves can become trapped. This can cause reduced range of motion as well as loss of strength and pain. If a nerve becomes trapped you may also feel tingling, numbness and weakness.

The goal of ART® is to restore optimal texture, motion and function to the soft tissue, and release entrapped nerves or blood vessels.

Each ART® session is a combination of examination and treatment. The practitioner evaluates the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves in the affected area. He or she then treats any abnormalities with a combination of precisely directed tension and very specific patient movements. There are more than 500 specific movements that are unique to ART® treatment protocols and the practitioner customizes a unique approach to each individual patient.

What responds most positively to ART are injuries that arise from overuse syndromes. This could be something as simple as an office worker who sits in a poor ergonomic position for long periods of time, or a more complex issue such as an athlete training for an iron-man event.

Many people who try ART have tried multiple doctors for their problem with little success. ART is highly specific and very effective if warranted.

Are there ways an athlete can perform a modified version of ART on themselves? I.e., with my leg issue, for instance, what would you have suggested as something I could try at home to see if it helps the healing process? If it's possible to describe as a step-by-step remedy, that wouldbe great. (I.e., start by placing your thumbs on either side of the shin bone, and pressing firmly, slide them from your ankles to your knees. Or some such.)

If someone wishes to simulate an ART movement or even better perform an active stretch to facilitate an ART treatment there are options.

Example:
Neck and shoulder pain are common problems with swimmers due to the nature of their training. If you place your hand on the fleshy portion of your upper back in between the base of your neck and your shoulder you will grab your upper trapezium. Use your left hand to work your right shoulder. Find a good knot in the region and place minimal pressure on the region. Laterally flex your head away from the pressure zone and hold your contact firm. Repeat until the knot or sore spot begins to dissipate. Again remember to work towards your heart at all times. This helps with lymphatic flow and prevents bruising.

A person with plantar fascitis (bottom of the foot pain) can rehab the area themselves on off days (non-ART treatment days). While seated at your desk take a cold can of soda and place it on the floor perpendicular to your foot. Now rub your foot in a slow controlled manner back and forth over the can. Move slowly and in a controlled manner. If you feel an area that is particularly tight, focus on it and work the area until it eases.

A common problem with runners who put in long distances are hamstring pulls. Hamstring pulls can occur high near the glut or low near the knee. They can be small and easy to treat, but more commonly they tend to be moderate in nature. Another issue with hamstring pulls is the inability to train when they become severe. One way you can treat your hamstring pull is with a foam roller. In a seated position on the floor with your legs stretched out in front of you place the foam roller under your hamstring perpendicular to the leg. Start at your knee and slowly roll your leg forward while the foam roller rolls towards your butt. Similar to the last example once you have found a spot that is particularly tender work that area with slow controlled rolls.

For the issues/injuries you listed in answering the first question, are there any types of self-massage or stretching or recommendations for what an athlete can try on her own to see if it helps the problem before going to see a doc?

You might want to incorporate the examples above into this question. Another good stretch done on your own to prevent injury is a classic hamstring stretch. The difference is the use of a stretch strap. It allows the athlete to use an interlocking assist from the strap in order to gain maximal stretch from the exercise. The foam roller can be incorporated into both a pre and post exercise program. It seems most effective on large muscle groups (hamstrings, ITB, Gastrocnemius) and is safe enough so patients have less of a propensity of injuring themselves.

What are a few warning signs that an athlete should not try to tackle an injury on her own?

Good question,

1. If you feel numbness or tingling (radiating nerve type pain) into any of your extremities you should stop the exercise or stretch and seek professional help.
   
   
2. Any pain that lasts more than 2-3 weeks and does not resolve with the basic acronym RICE.
   
   
1. Rest
2. Ice
3. Compression
4. Elevation above your heart in a resting position


3. Any pain that wakes you up at night should be assessed by a medical professional