What to Do For ‘Pulled’ Muscles or Strains – and How to Prevent Them!

Have you ever been playing a sport or doing your favorite activity when suddenly a muscle goes into spasm and quite literally “grabs” your attention and steals your movement mojo?

If so then you know what it’s like to experience a muscle strain, or “pulled” muscle.

There is one thing you absolutely MUST do to recover quickly – and one thing you must NOT do.

I’ll get to those in a moment.

First, it’s important to understand WHY strains happen, because – while I am sure some of you are here and currently experiencing a strain or pulled muscle – I am hoping the rest of you will use this information to prevent this from happening in the first place (can we make prevention sexy please?!)

In order to understand why and how a strain happens, we have to understand how muscles work.

Reciprocal inhibition – the key to understanding muscles and injury recovery/prevention!

I’ve had my eye on this process for over 5 years as a guiding touchstone for how to help people in pain and it’s never failed me. I’ll certainly do an entire episode dedicated to just this because the topic seems sorely lacking in the field of pain relief and injury recovery/prevention; but for now we’ll explore it in relationship to strains and pulled muscles.

Reciprocal inhibition is a process by which opposing muscle groups (and the nerves that act on them) work synergistically on a joint: one group flexes that joint while the other extends it.

In order for one muscle or group to contract, the opposing muscle or group MUST relax and stretch.

The simplest example of this is: when you contract your hamstrings your quad has to stretch and relax, right? The opposite is true as well: in order to stretch the quads, the hamstring must contract. (Think of a standing quad stretch).

How this relates to muscle strains:

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How to Release Your Pec Minor Fascia – For Shoulder Pain & Shoulder Mobility Issues

Pec minor – a small but very important muscle!

If you have shoulder issues of any kind – from shoulder pain, rotator cuff or shoulder mobility issues (including partially frozen shoulders or seriously forward rotated shoulders) then this technique should be at the top of your list for self-help techniques.

If you have breathing or rib issues this could be related as well.

Pec minor is actually somewhat difficult to get into. Pec major and the clavipectoral fascia sit on top of it, and when your arm is resting or hanging at your side you can’t get into it at all. In order to get at this triple headed small muscle and its fascia you’ll need to raise your arm and target a very specific spot for release. (I show you exactly how in the video).

To be clear, what we’re actually going after here is the fascial adhesion that can occur between pec minor and pec major (specifically the , the clavipectoral fascia and possibly coracobrachilais as well.

For such a small muscle, pec minor plays a critical role in shoulder joint, scapular/rotator cuff and rib health.

From the picture to the left you can see how (because of its attachment at the coracoid process of the scapula), if shortened or adhesed, pec minor can pull both the shoulder joint and the scapula into forward rotation, and/or elevate the ribs. Someone who, later in life, has a serious hunch or “wings” showing in the upper back – you can bet they have a very short, tight, adhesed pec minor (in addition to probably a lot of other fascial tightness in the front as well).

If you’re someone who has ribs “go out” a lot, I would instantly suspect ridiculously tight pec minor tissue. This would not be the thing itself that makes a rib go out, it just sets you up and makes it much more likely. This has been true of my clients who play lacrosse, train jiu jitsu or those who have experienced a traumatic fall or impact such as a car accident, falling onto a shoulder or their head while snowboarding etc.

How to get the most out of this technique:

  • You’ll need a lacrosse ball for this one. I do NOT recommend a tennis ball, softball, golf ball or really any other ball. This particular area is SO TRICKY to get into in a way that you can hold the position, so you’ll need the grip or stickiness of the lacrosse ball to make it work.
  • Spend however long you need to get the right spot! This technique will be almost useless (for its intended purpose anyway) if you don’t successfully find pec minor. It can be incredibly tricky to nail. Watch the video as many times as you need to get it right.
  • Look for (or FEEL for) a slight “THUMP” that would indicate an adhesion between pec minor and pec major.
  • MOVE SLOOOOOOOWLY. Slowly. Very very slowly.
  • Did I say move SLOWLY? Haha. If you move too fast on this one you’ll pop off of pec minor in half a second and not even know it.
  • There are probably only 2-3 spots MAX you can find and release here. Most people probably only have two spots worth doing.
  • Spend 20-30 seconds on each spot WHEN YOU GET IT RIGHT. If it takes 10 seconds at a time to find and re-find a good spot, that’s ok.
  • Move your arm after!
  • Notice what changed, if anything.
  • Obviously, if you have a serious impingement, mobility issue or pain present, this technique alone probably isn’t going to eliminate it. Use the search function on this website to find other techniques for your particular issue, or leave a comment with your questions.

 

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How to Choose a Body Worker for Pain Relief (Opinion)

 

So you’re in pain or dealing with an injury and you want the help of someone in the bodywork field to sort you out. How do you choose the BEST person for you?

This can be a daunting decision, with thousands of choices that often looks similar on paper (or the web).

If you’re NOT in pain, then my opinion is simple: see whoever you want! Do what feels good. See the person you like the most.

When you’re in pain, however, there are a few critical distinctions to make and important points to consider if you want help actually getting out of pain AND finding the root cause so it doesn’t come back.

How to choose a body worker for pain relief:

First of all, here are some very basic things to consider:

  • MANY (I would say the majority of) manual therapists – massage therapists and other body worker practitioners – are not necessarily trained to help people eliminate pain.
  • Having said that, there certainly ARE capable manual therapists and body work practitioners out there who have been trained to relieve pain at its source, and this post is designed to help you find THOSE people and learn how to differentiate between your average massage therapist or someone you would go to for relaxation vs. someone who can help you get and STAY out of pain.

First off, let’s weed out the therapists who probably CAN’T help you:

Before I list these, I want to be clear I’m not knocking these therapists or discounting their work – I think there’s room for ALL of us and room for every modality. I just think it’s important for all of us (clients and practitioners alike) to know who we are seeing and WHY, with an honest look at scope of practice. I was a massage therapist for a year (8 long years ago!) and in that time I never helped my clients eliminate their pain for good. I wasn’t trained to do that and I went through a very comprehensive training that included myofascial massage, orthorpedic massage as well as the typical deep tissue, swedish etc.

Here are the modalities and people I would NOT consider seeing if you are looking for pain relief:

  • Your corner massage chain or generic massage therapist.
  • This includes therapists whose work consists mostly of Swedish, deep tissue or very general whole body massage.

Here are the practitioners and modalities you might consider, CAREFULLY: (and use my interview questions to make a wise decision here!)

  • Massage therapists or massage businesses who list “sports massage” or something like this as an option (often an “upgrade” that you pay extra for). A lot of the time these therapists are allowed to say they practice “sports massage” when they had a few hours of training for “athletes” while they were in massage school. This does NOT mean (in my opinion) that they know how to find the root cause of pain. MAYBE THEY DO. Some people have had extra training that gives them the authority to make this claim with confidence. This is where I want to encourage you to interview people, because you never really know from the average website bio (see below for questions to ask and what to look for when interviewing practitioners).
  • Manual therapists who say they do “myofascial massage.” Like I said above, I was trained in myofascial massage but NONE of that training included teaching us how to find the ROOT cause of pain. Generally speaking, THIS IS SIMPLY A MASSAGE MODALITY or technique. It does NOT mean this person will be able to release your fascia (it takes a very skilled person to do this with their hands. They absolutely ARE out there and if you can find one of these that’s AWESOME!)
  • All other modalities that do not (necessarily) include training to find the root cause of pain, from energy work to deep body work – reiki, craniosacral therapy, shiatsu, trigger point therapy, thai massage, reflexology etc. I like to speak from personal experience and personally, I haven’t directly experienced eliminating physical pain with any energy technique. Maybe I’m not open minded enough. That said, I have friends who have and I believe them. The mind is extremely powerful! If you believe in energy work and believe your practitioner is saving your ass, then they probably will! I definitely believe in energy being stored in the body, as well as emotions, trauma etc. My personal preference is to access that energy in a very physical way. So – if energy work is your jam, carry on! As for some of the other ones I listed above, it’s for the same reasons as the above two that I list these: most of the time the training for these modalities does not include how to find the root cause of pain. This doesn’t mean there aren’t some really skilled practitioners out there who specialize in shiatsu, Thai massage or trigger point therapy that can help eliminate pain. So once again – please refer to the interview questions to help you determine if one of these practitioners is right for you.
  • ALL other body work modalities fall into this category of being potentially supportive (if you interview them and like their answers): Alexander technique, Feldenkrais, Bowen, chiropractic, Trager and Rolfing, or Structural Integration, ART, Mashing, Rossiter etc (I’m sure there are many more).
  • Just because someone was trained in something potentially helpful does NOT mean they are GOOD! Your job is to find out if they are, and their job is to make sure you know it when you call or walk into their office.

Questions to ask when interviewing a practitioner:

The very FIRST thing I urge you to ask any professional before you see them is

Question #1:

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How to Release Your Plantar Fascia – Helps Plantar Fasciitis, Heel Pain, Ankle Mobility & the Whole Body!

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This is a simple technique that will help your WHOLE body.

I’m pretty sure ALL of us could use this one!

If you have plantar fasciitis, heel pain, ankle mobility issues, big toe articulation problems or Achilles tendonitis then this is definitely a technique you’ll want to add to your mobility toolbox. Just make sure you’re taking care of the root issue first! For plantar fasciitis, heel pain and Achilles tendonitis – click here for my main technique that addresses these issues at the source.

As usual with Mobility Mastery techniques, this is NOT intended to be a massage for your feet! (Though your reward for doing the technique is massage-like ๐Ÿ™‚ )

We are attempting to PIN and RELEASE the restricted fascia and any fascial adhesions on the bottom of the foot.

There are a BUNCH of tiny muscles down there.

The fascia that wraps each of those muscles along with the plantar fascia itself can get stuck to each other. All of that fascia can get dehydrated, brittle, inelastic and because of these things pain and all the “itis’s” can happen – plantar fasciitis, heel pain, tendonitis on the tops of the feet, big toe articulation problems, ankle mobility restriction, Achilles tendonitis…etc.

This can happen due to a variety of factors: if you’re a woman who wears high heels, it’s almost inevitable you will have one or more of the above issues eventually; if you work on your feet all day, especially if you’re not moving much but standing in place; if your body type, lifestyle, sports, habits etc have created fascial restrictions UPSTREAM, you may have PAIN here and you’ll need to find out if the plantar fascia is actually tight and restricted, or simply getting irritated and pulled on – or BOTH.

How to get the most out of this technique:

  • Make sure if you have pain on the bottoms of your feet or any of the issues listed above that you FIRST look for the root cause and go after THAT first – then come to this technique as a way to “comfort” what is hurting.
  • PLEASE USE A LACROSSE BALL! For the best possible result, a lacrosse ball is the single best tool. All other balls will NOT give you the same result.
  • If you don’t have a lacrosse ball and you’re desperate to try this immediately – use what you have and then get your booty to a sporting goods store ASAP! They only cost $6 (give or take). And then do it right ๐Ÿ˜‰
  • Make sure the entire weight of your leg is resting on that ball before doing the technique.
  • Make sure your heel doesn’t drop down too much, nor your toes. Try to keep the weight of your leg directly over that spot you’re targeting.
  • Start near the ball of your foot and work your way towards the heel.
  • If you feel or hear “crunching” noises while opening your toes, you’re doing it RIGHT! That’s the feel and sound of your plantar fascia releasing.
  • If this SUCKS – you’re probably doing it right, and you can be sure your plantar fascia is restricted and needs help to relax.
  • If this doesn’t suck at all and you have pain in your feet – perhaps you didn’t find the right spot, OR – your plantar fascia may not be restricted at all, but is in pain because of something else that is. It could be your calf, your hamstring, glute or even upper body fascia. You’ll need to look for the root cause.
  • Try 3-4 spots with the technique, and then…
  • DON’T FORGET YOUR REWARD! After releasing all that fascia, roll your foot around on the ball for as long as you want. This usually feels AMAZING afterward. If you prefer a different kind of ball, a frozen waterbottle or rolling pin for this part – go for it. This is simply meant to be a FEEL GOOD endorphin releasing reward for your WHOLE body!
  • Speaking of your whole body – if you DON’T have pain in your feet, but you have pain ANYWHERE ELSE in your body and you are ON your feet all day – give this a try!
  • In fact, if you’re on your feet all day I HIGHLY recommend buying yourself a lacrosse ball to keep at work and doing this one daily, or several times a day. Your entire body will thank you!

 

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Are You (Unknowingly) Making Your Pain WORSE? Learn to Help Your Body Find the ROOT CAUSE

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What if the FIRST thing you do when pain happens is the LAST thing you should do if you want true relief?

If you’re like most people on the planet when pain happens then you probably do the ONE thing that seems to be in our biology. It’s instinctual, habitual and seemingly benign. But chances are it WON’T get you out of pain, and it just might make things worse.

You go to and touch whatever is hurting:

  • Your knee gets a stabbing pain, folds you in half and you reach down to touch it.
  • Your back seizes up and you instinctively grab it and feel around as you try to stand upright.
  • Your shoulders hurt, so you massage them (or ask someone else to).
  • Your elbow hurts, and you grab hold of it.
  • You get a tension headache and hold your head in your hands.
  • Et etc.

This first act in and of itself is perfectly natural and it makes total sense that we’d instinctively want to make contact with our pain.

It’s what we do NEXT that truly matters.

Do you REACT to the pain and fixate on what’s hurting?

OR

Do you get CURIOUS and try to find the root cause?

The habit most of us have is to fixate on what’s hurting followed closely by an attempt to silence, comfort or eliminate the pain: maybe you take an over the counter pain killer that’s already in your medicine cabinet; maybe you gently rub or massage that area; maybe you ice it (because you probably learned the very outdated RICE protocol in middle school, which for the record I’m not a fan of at all).

When these mild reactions don’t work you might seek out help from professionals who are a little more aggressive than you: perhaps you try a deep tissue massage or a chiropractic adjustment. And while these might seem like very good ideas, if they are also fixated on the site of pain and not looking elsewhere for the CAUSE, then you’re still caught in the same trap.

Or maybe you try to isolate and immobilize the area via a knee, back, wrist or ankle brace or boot…

What’s missing from this approach?

What ALL of these reactions have in common is a complete lack of curiosity about and awareness of THE REST OF YOUR BODY.

This habit of fixating on what’s hurting at the exclusion of the rest of the body is so ingrained that most healing modalities in western culture have adopted it as well.

If you seek out a medical professional for help with your pain, chances are – unless they are very holistic in their approach to pain (and these professionals DO exist, though it’s been my experience that they are rare) – they will look at/palpate and/or X-ray, MRI or ultrasound the site of pain and suggest a course of action that focuses only on the site of pain: cortisone shots, pain pills, surgery, a brace, a boot, orthotics or shoe lifts etc.

Even so-called alternative and holistic methods more often than not (in my experience, and I was one of these when I was a massage therapist) focus on where the pain is, instead of looking for the cause. If you go to a massage therapist for back pain, I’d be willing to bet that a large majority of therapists will go straight for your back. If you go to a chiropractor for neck pain, chances are pretty high they will adjust your neck.

I will say I have sought out chiropractors, massage therapists and acupuncturists who “get” the idea that where the pain is isn’t the problem, so they absolutely do exist; but I had to weed through a bunch of others first who didn’t get it and I still see this mentality being the status quo of both western and alternative practitioners who deal with people in pain.

It’s my position that this is precisely why there are so many people in pain who aren’t getting the relief they so desperately want, because MOST of the time…

Where the pain is is NOT the problem!

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The Psoas – Our Body’s Insurance Policy Against Pelvic Instability & The Case for Leaving it ALONE

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Difficult to palpate, a challenging area to master as a manual therapist and dreaded by everyone getting worked on because of the horrible pain associated with it – in some ways “the psoas” is approached like the holy grail of the body: finding it can feel like a “quest” and while few are rewarded for their efforts many seem willing to die trying.

If you’ve jumped on the psoas-is-the-root-of-all-pain bandwagon, I have a few questions for you: if you’ve gone after the psoas attempting to release it – on your own, with a massage therapist, physical therapist or other method – are you better? Are you out of pain? If you’ve spent a lot of time trying to “release” this muscle, shouldn’t it be “loose” by now?

There’s been a LOT of hype about the psoas the last decade (or more). Is the hype justified? Is it really the most important muscle in the body and the biggest contributor to all of our pain?

I’ve instinctively felt for years that all this psoas hype is misplaced. I finally feel prepared to present my counter argument.

I’ve come to believe the iliopsoas are the most adaptive muscles in the human body, and our insurance policy against pelvic instability. This might make the iliopsoas two of the most important muscles in the body; however…in this scenario, if we are in pain then these muscles ARE LIKELY NOT THE PROBLEM, and if they appear “tight” they’re trying to HELP US. We’ve (unknowingly) taken out our insurance policy. Bolstering, blaming or otherwise focusing on the insurance policy that’s quickly running out because we haven’t fixed the root issue does nothing to heal the system that originally failed. If we heal the root issue our insurance policy can once again resume it’s role as critical back-up in case of system failure.

These are my theories and findings after 8 years in private practice and careful consideration of the science, anatomy, client stories and inner reasoning regarding this famous muscle group. I’m open to being wrong. I’m committed to keeping an open mind and learning alongside you, so please chime in with your thoughts.

Anatomy and function of the Iliopsoas:

Important distinctions: psoas major and iliacus are often lumped together (because they function synergistically) and are called the iliopsoas; psoas major and minor make up the psoas group; most of the hype talks about the psoas but either neglects iliacus, OR they use the word psoas when they really mean iliopsoas.

I’ll attempt to stick to these distinctions in this article.

Functions of the iliopsoas:

The iliopsoas flexes the femur at the hip joint (think of a hanging leg lift), and raises or flexes the trunk toward the hips from a supine or laying down face up position (think of a sit-up). They also laterally rotate the thigh at the hip, and psoas major laterally flexes the spine (side bending).

Psoas major also acts as a “shelf” for our organs to sit on, providing a barrier between those sensitive organs and nerves and our spine.

Iliopsoas – the most adaptive muscles in the body?

Most muscles have a primary function (action or movement). For example, your biceps flex your forearm while your triceps extend it.

Consider that all of the functions or actions of the iliopsoas can be performed by muscles that are bigger and usually stronger:

  • HIP FLEXION: The quad hip flexors in most people are overworked, almost always “on” and will attempt to perform hip flexion for the iliospoas in exercises like hanging leg lifts if given half a chance. Unless you’re extremely body aware and know how to turn your quad hip flexors “off” and let your psoas do the work, chances are you’re initiating and controlling most of this movement with your quad hip flexors, while the iliopsoas play backup.
  • TRUNK FLEXION: The quad hip flexors along with rectus abdominus will attempt to engage to help “flex” the trunk towards the hips through movements like sit-ups. You know this is happening if your lumbar spine curves (creating space between your back and the floor), your quads tighten up and your “abs” and even throat muscles like the sternocleidomastoid (SCM’s) engage to do the sit up for you. For the iliopsoas to be the major mover in this motion the legs must be kept stationary, the hips and head must remain in a neutral position and the iliopsoas becomes the main workhorse. If you’ve ever done a ton of sit-ups and your ABS got sore (rectus abdominus) but NOT your deep core muscles near your hip bones and toward your back, then you probably weren’t engaging your iliopsoas much.
  • LATERAL ROTATION OF THE FEMUR: The iliopsoas are NOT the major lateral rotators of the hip. This job belongs mostly to piriformis, gemellus superior, obturator internus, gemellus inferior, quadratus femoris and the obturator externus.
  • ADDUCTION: The iliopsoas also helps with hip adduction, but the primary hip adductors are adductor magnus, longus and brevis, with pectineus and gracilis obturator externus playing a part as well.
  • LATERAL TRUNK FLEXION: The quadtratus lumborum or QL muscles perform lateral flexion of the vertebral column, while psoas major contributes to the movement.

The primary actions of the iliopsoas are without a doubt hip and trunk flexion (in my opinion, and apparently the opinion of the internet). Yet I believe we rarely use the iliopsoas as the primary movers of these actions, relying instead on other muscles like the quad hip flexors and rectus abdominus, while the iliopsoas provide ancillary support and/or exist as our back-up muscles in case the primary movers fail to perform or become dysfunctional.

Many muscles, while responsible for a primary movement, also perform more than one action. The human body, after all, is a fully connected system that works as a whole to support movement.

Isolating ANY muscle group isn’t wise, because NO muscle functions in a vacuum and ALL muscles require the participation of the whole body.ย 

I propose that isolating the iliopsoas or psoas muscle(s) specifically and attempting to “treat” them in isolation is especially dangerous, because of ALL muscles in the body these are the most adaptable, the most willing to change based on our habits, posture, sports, lifestyle…and this is a very good thing! That’s their job!

It’s my position that the primary role of the iliopsoas is as an ADAPTIVE MUSCLE GROUP that, by being highly adaptable, supports the primary functions of many large and small muscles.

Because they are SO adaptable, they can step in (if the brain asks them to) to stabilize the pelvis if necessary.

I believe the iliopsoas is our body’s insurance policy against pelvic instability.

They are likely NEVER the cause of pelvic instability, and “releasing” them may destabilize our spine or pelvis making us more prone to injury, pain or instability.

If we are to help the iliopsoas do its job, then we would do best looking at the surrounding muscle groups and see who is overworking, who us under-working, who is inhibited and/or fascially restricted. Taking care of all of this IS taking care of the iliopsoas.

What if the psoas appears “tight”?

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How to Relieve Menstrual Cramps – Partner Technique for Abdominal Fascia Release

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Women – have you ever planned something fun, like a date or a backpacking adventure, only to realize with horror after you step out your door that your period is here and all you want to do is go home, curl up on the couch and try not to die?

Men – how many of you are impacted by the horrible period cramps of the women in your life? (Please keep those eyeballs from rolling back in your head!)

This post isn’t just for women. If you men forward this to your female friends, or better yet learn to do the partner technique in the video, you just might become hero of the year ๐Ÿ™‚

First, a disclaimer: there are a LOT of factors that can impact periods, including the existence of cramps. I do not claim to be a hormone specialist, doctor or period afficionado. I DO, however, know fascia; and we have a TON of it in our abdominal cavities. How healthy our abdominal fascia is can mean the difference between horrible period cramps and mild or non-existent ones. I’m speaking from personal experience as a woman, and having worked on friends. If you try this and it doesn’t work – chances are your cramps are not due to fascial restrictions.

What if we’re not doomed – by nature – to experience horrible cramps?

It’s my belief (through experience) that one major cause of horrific period cramps is restricted fascia within the abdominal cavity.

I don’t want to get crazy graphic here, because that’s not actually what this post is about, but basically during menstruation the female body is shedding the lining from the uterus. This blood has to travel through the lower abdominal cavity to and through the cervix.

Every organ and muscle requires innervation, including the female reproductive organs and the surrounding pelvic muscles. Innervation is critical for optimal function of organs and muscles, and this process can become inhibited or slow due to restricted fascia.

Proper space in our fascial system is what allows nerves to communicate properly and blood to flow (throughout the entire body, including the abdominal cavity).

Releasing this restricted fascia allows for better innervation of the organs and muscles that are responsible for menstruation, the blood starts flowing without impediment and cramps ease or are eliminated.

I’ve successfully used this technique with friends, and I’m sending my man this blog post so he can do this for me ๐Ÿ™‚

How to get the most out of this technique:

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Abdominal Fascia Release – Try This if You Have Digestive Issues or Process Anxiety in Your Gut

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Do you have knots in your stomach? Do you process anxiety and stress in your gut, or have digestive issues?

The gut is a HUGE and very complicated topic. This post is meant to be a signal in the dark, a stopping point where you might glimpse a piece or two of your own unique “gut” puzzle; and I’ll give you a self-help abdominal release technique you can use to begin chipping away at the tension in your belly.

While this self-help work can be extremely beneficial, if possible I highly recommend that you find someone in your area who does Mayan Abdominal Massage. My entire abdominal region has never felt so light, free and spacious as it did after a massage with someone who specializes in this work.

Before I teach you today’s technique I have a question for you:

Are you listening to your gut?

I had horrible digestive issues for nearly 20 years that often meant I opted out of parties, excused myself from dates and hermitted at home even though I wanted to be around people because it was preferable to be alone than put a fake smile on my face and pretend I felt “normal” when I was really in a lot of pain.

The KEY (for me) to healing my gut wasn’t releasing the fascia in my abdomen.

I’m not going to tell my whole story or we’d be here all day, but essentially this boiled down to two things:

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How to RUN Without Knee Pain – Try This Experiment If Running Pain-Free is Your Goal

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First of all – I am NOT a running coach and this is NOT meant to be advice for how to be faster or a “better” runner; this is my opinion (based on personal experience with knee pain as well as my work with countless knee pain clients) on how to run without knee pain. That’s it.

If you love running and your goal is simply to enjoy running again without knee pain…this post is for YOU.

Running this way might make you slower (or faster), it might feel awkward or fantastic…I leave it entirely up to you to try this as an experiment – and then run this way or not.

Changing how I run (and taking care of my fascia in general) helped me run again after 8 YEARS of not being able to. Personally, I don’t care how fast I run as long as I’m out there bouncing on a trail again without knee pain!

One more quick disclaimer: this post is NOT meant to address knee pain in general. I’m specifically addressing knee pain that only seems to show up while you are running. If you get knee pain while running and it stops as soon as you stop running, then this post applies to you. If you have knee pain 24/7, there are likely other things going on and this post may not apply to you.

What causes knee pain while running?

While there are certainly many causes and types of knee pain, the vast majority of the time knee pain while running has a basic pattern.

Most of the time knee pain while running shows up on the lateral (out)side of the joint, and feels like a knife stabbing you under the kneecap. That sharp excruciating pain can bring you to the ground as the knee gives out.

A lot of people like to blame the IT Band. Understandable, given the IT Band’s size and the fact that it attaches laterally at the distal (far) end of the kneecap.

However, it has been my experience that the IT Band is 3rd in line as the cause, behind two other major players that contribute far more to both the cause and the reversal of this pattern.

Meaning…addressing these two other things often makes the IT Band issue obsolete. Not always, but very often.

The first major cause is fascial restriction (often in the form of huge knots the size of golf balls) in the lateral upper calf or gastrocnemius muscle.

The second major cause (both of these should be considered together), is the fascial restriction within the hamstrings, particularly the biceps femoris where the long and short head meet and where the long head meets the IT Band.

Often there are GRAPEFRUIT sized lumps of inflamed irritated fascia stuck between the IT Band and the hamstring. Please note that these adhesions are NOT within the IT Band OR hamstring muscles themselves, but rather…it is the fascia that wraps both muscle groups that is stuck BETWEEN these muscles (essentially the ITB and hamstring muscles are adhesed together via giant knots of dehydrated or inflamed fascia and all of that tissue is no longer able to GLIDE through movement).

(DO NOT ATTEMPT TO ROLL YOUR ITB TO SOLVE THIS ISSUE!)

It’s also a distinct possibility that your hamstrings are weak, if you sit at a desk all day and don’t intentionally work on strengthening that posterior chain.

All of this creates a powerful force that pulls the ITB and lateral knee ligaments even more laterally, which can cause the patella to slip off the bursa and create a bone on bone feeling (which I believe is that sharp knife-like pain in the knee).

What does this have to do with running?

Many runners use a short quick gait that emphasizes extensive use of the quads and quad hip flexors as well as the calves to create forward movement. This is especially true of trail runners, even more so distance trail runners. The other common stride I see (mostly in marathoners or road runners who run for time on mostly flat surfaces) is to have a long thrusting forward stride that uses extreme hip flexion followed by knee extension that happens in FRONT of them, causing a hard heel strike that forces the knee joints to stabilize their body through the entire run.

The first scenario I described above is certainly the most common, and if you are a barefoot runner or toe striker and your heel barely or doesn’t even touch the ground while running then you are especially likely to create fascial restrictions in your calves.

What all this does while running is put your hip and knee joints into a near-constant state of flexion, and all that overuse of the already restricted fascia within the upper lateral gastrocs combined with fascially restricted WEAK hamstrings (which probably aren’t tight from overuse but actually under-use, especially if you sit at a desk all day with bent knees and contracted/weak hamstrings and run with your quads and calves) means near constant tension on the lateral fascia of the knee joint, including all the tendons, ligaments and bursa.

The IT Band is supposed to stabilize us through sports like running, but its job becomes increasingly difficult with these fascial restrictions constantly pulling it off track (laterally and posterior), combined (possibly, if your foot strikes in front of you) with a gait that doesn’t allow for hip stabilization and instead relies on the knees for that, and to top it all off…so many people are now foam rolling the bejeezus out of their IT Bands in an attempt to change all of this, but the IT Band actually NEEDS to be extremely tight from hip to knee since it is made up mostly of dense fascia (it’s basically a giant tendon) whose job it is TO STAY TIGHT AND KEEP US STABLE. While the fascial adhesions between the ITB and hamstring DO need releasing (strategically), I’m not a fan WHATSOEVER of rolling out the IT Band from knee to hip.

Take a closer look at the knee joint and surrounding muscles.

Now imagine someone tugging on the lateral upper calf tissue while also tugging at the hamstring and ITB tendons that attach to the knee and patellar tendon (the “balls” or knots of fascia are doing the “tugging”); these two things pull everything laterally and posterior, possibly taking the patella with it, creating a nice set-up for bone on bone action unless released from this pattern.

What reverses all of the above as far as running is concerned is reversing the muscle patterns that lead to these restrictions while running, and changing where our foot strikes the ground.

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Relieve Heel Pain and Recover from Rolled Ankles – Inner Calf Release

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This area of the body warrants a close look at the anatomy, while the technique itself is very simple.

This one small area, when fascially restricted, can wreak havoc on the entire foot, ankle, heel, plantar fascia and quite possibly a lot of things upstream as well, such as knees, the groin, the SI area and possibly even your neck and head (headaches CAN sometimes be related to this line of fascia being too tight/restricted).

We’re not going to look at the entire body or ALL the ways this one area can impact the body.

Today I want to focus on 3 main things: plantar fasciitis and/or heel pain that is showing up directly in line with the flexor digitorum longus and tibialis posterior tendons, and how this area plays a part in rolling ankles.

You’ll need a lacrosse ball for this one. I do NOT recommend using any other ball, nor do I recommend a theracane (I’ve seen some people use this). The first is too big, and the second too pointed and you’ll likely bruise (something I’m always trying to avoid).

This one small area packs a punch, fascially speaking:

There’s a lot going on in this one small area: the medial head of the gastrocnemius along with the soleus (meidal) and their fascia can get stuck to each other and to the flexor digitorum longus fascia. The flexor digitorum longus, when over-tight (or stuck to other muscles via their connecting fascia), can over-invert the foot, making the ankle susceptible to being rolled.

Also potentially leading to over-inversion of the foot is tibialis posterior, and via its tendon can contribute to ankle pain or heel pain between the ankle and calcaneus.

While we won’t necessarily be getting it directly, this technique can help free up the tibialis posterior, particularly the posterior tibialis TENDON which has a big impact on heel and ankle health.

If you have flat feet, fallen arches or your foot drops (arch collapses) while walking, this is one area to look at (it may not be the culprit) along with everything in the lateral line – ankle and foot fascia, tibialis anterior, perroneals, IT Band fascia etc.

The relationship these two (the medial and lateral lines of fascia) have with one another can determine SO much of what happens in our bodies, because everything in the foot and ankle determines our stride and what happens upstream. If your ankle doesn’t articulate well or creates an unhealthy gait pattern, that pattern transfers up to the knees, hips and shoulders.

As usual around here, I’m less concerned with naming all the muscles involved than talking about the restricted fascia between and around all these muscles.

Fascia also wraps our bones, and I believe this is one area of the body where the fascia of these muscles is particularly clogged or stuck to the bone (in this case the tibia).

The technique I demonstrate in the video isn’t nearly as effective as the in person version that I use on clients, but it’s an acceptable self-help solution (or I wouldn’t be giving it to you).

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