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How Fascia moves (or not) with lower back pain

https://en.wikipedia.org/wiki/Thoracolumbar_fascia

We’re going to continue looking at fascia’s role in the lower back and spine moving easily and freely.

We know lower back pain is no longer just an ‘older’ person’s challenge. I have met many college age students with chronic lower back pain. There is often a correlation between their activity level and the amount of time spent sitting and studying.

Healthy fascia is elastic – it should be able to stretch or lengthen and then come back to its original shape without stress.

Inelastic fascia doesn’t move well – it’s like having muscles that are stiff and unyielding. The two ultrasound clips below show the movement of the thoracolumbar fascia (shown in image above in gray). You can see how the fascia in the person with no low back pain moves easily while in the second clip the fascia has limited movement in the person with lower back pain.

Clips originally from Langevin H, Fox J, Koptiuch C, Badger G, Greenan- Naumann A, Bouffard N, Konofagou E, Lee W, Triano J, Henry S (2011). “Reduced Thoracolumbar Fascia Shear Strain in Human Chronic Low Back Pain”. BMC Musculoskeletal Disorders. (These clips are licensed under the Creative Commons Attribution 2.0 Generic license.)

Fascia needs to be well-hydrated, elastic and plastic (previous post) and kept in optimal order by good posture. Remember your postural habits influence and organizes your fascia. If you have a regular habit of slumping… then the fascia will shorten to reflect that. For dancers, it isn’t so much the posture we have in class, but our daily postural habits that can get us in trouble! And now… I’m going to go for a walk after sitting at the computer to type this!

To your success,

Deborah

Exploring Fascial Plasticity

Dancers are always concerned with maintaining or increasing the flexibility in their muscles. To really understand how muscles become more flexible we need to understand how to change the fascia that connect to the muscles.

Most dancers know that fascia, which is the dense connective tissue that surrounds the 200+ bones and the 600+ muscles of the body. It keeps structures (like muscles) separated from each other yet interconnected in a 3D like web.

Using an orange analogy, the outer rind is like the superficial fascia, and the sections of orange are similar to the fascia that surrounds our muscles, bones, nerves, etc. Fascia ties and connects everything together!

This is why if you have tightness in your neck, it may be influencing the flexibility of the hamstrings. There is a fascial line that connects the muscles along the back of the body called the superficial back line. I mention this because it bears repeating that if you are not getting the results that you want from your stretching efforts – look at other areas of the body that may be holding tension and creating a pull or tightness along the fascial line.

This young man is a perfect example of this. He was taking yoga classes and a student in the opera department. We found the tension at his neck significantly influenced his hamstrings. He was doing lots of hamstring focused stretching in yoga class but until he focused on releasing his neck tension he was unable to get release and relief along that back line. Doesn’t he look WAY more comfortable in his body in the picture on the right? That change took 3 months. As a side benefit – his vocal technique improved too!

Now back to talking about fascia and plasticity. Plasticity means the ease with which something is molded or shaped. Fascia will reshape itself when there is a slow, steady and sustained pull on it. Too fast of a stretch and fascia/muscle tears. Plasticity is different from elasticity. Elasticity is the ability of tissue to stretch and then go back to its original shape. Plasticity means the tissue over time (think potentially weeks/months) slowly reshaping itself into a new length. That is what dancers want from their stretching.

Bottom line… slow, steady, sustained stretching is the way to go. Doing some of that passive stretching that dancers love to do at the end of class can be very useful (at the end of class – not the start!) If you add on some muscular engagement from the opposite of the joint – you will get even more benefit! For example doing the typical standing quad stretch is good – but when you also lightly engage the glutes while using the abdominals to keep the pelvis in neutral – it becomes even more effective of a stretch! Hold that stretch for 30 seconds, take a quick break and then go back for another 30 seconds and see how your quads feel!

If you want to actively explore fascial properties and new ways to train your fascia to be both elastic and responsive think about joining me in the South of France this summer! I will be doing a deep dive into fascial training, alignment assessments, and exploring body/brain strategies for optimal performance. Registration is now open!

Fascia and Flexibility question

Hi Deborah!
We met at the Dance Teacher Summit briefly after your fascia and flexibility class;). I have been doing some of your exercises with my kids with awesome results!!  But I have one dancer who says that the stretches do nothing for her at all and she feels no difference:/. She is a somewhat difficult student who has even said she doesn’t believe fascia exists because she has never heard of it, which is ridiculous and I feel like part of her problem is mental and just a bad attitude towards it.  But my question for you is, would there be a physical reason why the stretches would not be helping her and is there anything I can do besides try to educate her to help her?  I have had numerous students that have never had their splits and are now getting flat in all three!  Thank you for sharing your knowledge with me;)
 
Thanks,  LL
stretchGlad to hear that you are getting good responses to changing to more dynamic stretching!  As to your student’s disbelief as to the reality of fascia… I’d let that one go.  Once upon a time people thought the world was flat too.   What you believe is true is true for you.
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What do I mean by that?  If your student has so embraced the belief that stretching is not going to help her – then there is a strong possibility she won’t get the results she wants.  You can ask her to pay attention to her own stretching efforts and tell you when she feels most successful.  Is there a certain time of day?  Temperature that she likes to stretch in?  After a shower? After using the pinkie ball?  Using breath? How often is she stretching – how long does she hold each stretch? Ask her to watch and pay attention to small changes – to where she is feeling the stretch and how strongly.

Increasing Flexibility

Greetings!
Hope everyone is keeping warm! One quick announcement before we get into the newsletter.

I have created two hip flexibility assessment forms. One is a form that you can duplicate (in case you want to test your students) and mark your results down, and the second document explains how to test for your turnout, hamstring flexibility as well as iliopsoas, quadriceps and ITB flexibility.

I will send you these 2 forms in exchange for a product testimonial. I would like to post on my website more specific testimonials about how you have used any of my products – or a specific aha or insight that was gained through a piece of information. (Which could include information you have received from the Dancing Smart Newsletter) For example, writing your story of how your arabesque improved with doing an exercise you learned from me – or how you put the anatomical pieces together on an issue that you were struggling with.

Send your testimonial to Deborah@thebodyseries.com, and I will send you the 2 forms as a thank you. I will be posting the testimonials on my website and will identify you by your first name only – or initials, whatever you feel most comfortable with. If you would like to identify your city and state or studio (if you are a teacher) that’s fine too, just let me know.

Thank you! And now to the newsletter…

Increasing Flexibility

In this newsletter I want to talk about flexibility in general and then specifically stretching your hamstrings.

Most dancers think of flexibility as the length of muscles and the range of motion they can create at a joint. This is what gives the dancer that beautiful line of an arabesque or the height of a développé.

Flexibility needs to be balanced with strength in order to be able to execute all those beautiful dance moves – so ultimately dancers are working towards the best muscle tone they can have – which is a muscle that is both flexible and strong.

I have dancers tell me they are stretching consistently and still not feeling like they are gaining flexibility. What else can influence your flexibility?

One answer is fascia. I’ve talked about in many previous newsletters how fascia is connective tissue. There are different layers of fascia but the anyone who has bought chicken breasts at the grocery store and then trimmed it has seen the whitish sheet of tissue covering the meat (which is the chicken’s muscle) This fascia helps to keep the muscles divided and protected. Sometimes this fascia can get knotted or adhere to other tissue which influences the whole fascial band and can create pain or challenges to your flexibility. This is where myofascial massage is useful. Myofascial means fascia related to the muscles and it is a different type of massage than just deep tissue. The focus is on releasing pulls and tensions specifically in the fascia.

There are sheets of fascia throughout your body. Tom Meyers has written a fantastic book called Anatomy Trains that goes into great detail about all the different lines of fascia. The fascial line I’d like you to look at today is the posterior back line. You can look at a picture of the muscles that are connected by this one fascial line by going to (cut and paste into a new tab or page of your browser – so you can keep reading!)

http://www.structuralwisdom.com/Anatomy_Train_Lines.html

When you look at the second image, which is the superficial back line you can see that the muscles at the bottom of the feet are connected to the calf muscles, then hamstrings, then up the back all the way onto the head!

Now it may make more sense that if you have a dancer who perhaps is a teenager, awkward about their posture, slumping slightly with a forward head – that the tightness in the fascia of her neck might influence her hamstring flexibility! Conversely, I’ve had dancers who work SO hard at standing up straight that they give themselves a stiffened spine – tightening the fascia in that area – which can influence their hamstring or calf flexibility! We aren’t trained to think of these other areas away from our intended stretching as impediments to our flexibility – but they might be.

Now, I’m not suggesting that we all go out and find a qualified myofascial massage therapist (although that wouldn’t be a bad idea☺), what I am suggesting is that if you aren’t getting the results that you want from your stretching you need to look at other areas of the body that are tight that may be influencing your muscles.

For example, let’s talk about hamstrings. For years now I have been introducing pinkie ball work to my students. Before I let them put the pinkie ball under their hamstrings to loosen them up I ask them to stand up, roll all the way over easily and compare how the two hamstrings feel. If one feels tighter, then they put the pinkie ball underneath their foot as they are standing and roll their foot on the pinkie ball. They are releasing the plantar fascia and massage the muscles of the feet. We do this only for a minute or two and then I have them roll back over to see how their hamstrings feel.

Typically, 75% of the students say that they felt the hamstring loosen up on the side they used the pinkie ball on! That’s pretty exciting! Then I go into talking about how they have a fascial band that goes from the bottom of their foot up to their head. (Remember the diagram?)

You could also try releasing the fascia closer to the top of the line. Round forward again so you can sense the difference in tension between your 2 legs. Let’s say your right hamstrings or calf felt tighter. Stand back up and take your left hand and place your fingers on the right side of your neck and massage gently where the muscles meet the base of the head as well as along the right side of the neck down to your right shoulder. Spend 30 seconds to a minute gently massaging this area. It should feel good – if it doesn’t you’re probably massage too hard! Now round back over again and see if you feel a difference in your legs.

If you do – then it is worth making time for either pinkie ball work or some other form of self-massage and then evaluating how your flexibility is improving with this additional focus. I’m not saying to stop doing more traditional hamstring or calf stretching – but if your stretching isn’t giving you the results you want, it’s useful to try a few other ways to see if your results change.

After all – you are smart dancers….

Signing off from another Dancing Smart Newsletter!

Warm regards,

Deborah

“Education is the key to injury prevention”