June/July 2008

Metamorphic Massage Newletter

Patellafemoral syndrome & Patella tendonosis

In this issue

The Smart People
-- cyclists --

Have you joined the smart people? – getting out of your gas guzzling car and onto a bicycle?

As the price of gas increases, bicycle sales have also increased. What a healthy consequence! As you know, the cost of gas is exorbitant but fortunately people's habits are changing. Since May, bicycle sales have increased 15-25% throughout the country from Mississippi to Massachusetts and San Diego to Chicago. Many people are using bicycles primarily for commuting; others are using them for athletic endeavors. The STP and the RSVP rides attract hundreds of riders in July and Aug. Nikki is planning to ride 450 miles in 8 days around the Cascades loop. She'll be gone from July 26-August 2.

As the amount of cycling increases, people feel better because endoprhins and cardio-respiratory fitness increase, which may help improve brain function. As the amount of cycling increases, the amount of SELF CARE NEEDS TO INCREASE.

"An ounce of prevention is worth a pound of cure".
To help prevent problems, it's invaluable to have one's
* BIKE FITTED to the rider so that misalignment of hips, legs, knees and feet can be avoided.
*STRETCHING before and especially after riding is important to do. *NUTRITION is important (see article "you are what you eat").
*MASSAGE THERAPY applied to sore muscles can prevent injuries from developing. And, if one's body starts "talking" it's important to listen. One area that may speak loudly is the knee. The knee, the largest joint in the body, is the most vulnerable to athletic injuries. There are about 25-30 injuries that can occur at the knee.

The following two conditions are ones that occur most frequently with the repetitive actions of cycling and both can be treated with massage (soft tissue manipulation), and other treatments.

The PATELLAFEMORAL (kneecap and thigh bone) SYNDROME is the most common cycling injury, accounting for about 25% of all cycling problems. The patellafemoral syndrome is pain behind the kneecap due to irritation of the inside of the kneecap with repeated bending and straightening of the knee. The primary cause of the problem appears to be incorrect tracking of the patella during extension. People often report that they feel like their knee is giving way when they have patellofemoral syndrome. Massage therapy can help reduce the tension in the quadriceps and other surrounding tissue. Other treatments that may be beneficial are: cryotherapy (Ice pack), anti-inflammatory medications, wearing a band (infrapatellar strap) or knee brace across the patellar tendon, elevating the knee, and doing strengthening exercises.

PATELLAR TENDONOSIS (tendonitis) ** is very common amongst cyclists -- as well as hikers, runners, and skiers. Patellar tendinosis is intermittent anterior knee pain and tenderness, above or below the knee, aggravated by activities that engage the knee extensors (bending and straightening the leg) , like cycling, climbing or descending stairs, jumping, running or doing squats. Misalignment of hips, legs, knees and ankles can also add to the problem. It is a degenerative process of the patellar tendons. Those tendons connect the anterior thigh muscles (quadriceps) to the kneecap (patella) and that to the shinbone (tibia).

Massage therapy, cryotherapy, infrapatellar strap,( see Chopat strap on internet) strengthening exercises (as long as the condition has not progressed too far), and orthotics are all potentially beneficial treatment forms. **(per Whiteny Lowe, Orthopedic Massage, Theory and Technique "Tendinosis is a degenerative condition, generally associated with repetitive stress injuries, whereas tendinitis is an inflammatory pathology which often is not the case with the tendon fibers.)

(Photo by Jeff Gnass of Geolight Image Courier)

You are What You Eat

WHAT you should eat depends on who you are and what you are doing.
WHEN you eat is also important. Along with food, exercise is a key element for a healthy body. Food provides the building blocks for the ongoing maintenance and replacement of cells and repairs damaged cells. Nutrition can be complex yet there are some simple nutrition guidelines to keep you healthy.

A sedentary school teacher client told me that he eats once every 2 days! Obviously, eating so infrequently, the body doesn't function at its maximum. For him, I advised that he follow the USDA food pyramid which encourages eating a wholesome diet from a wide ranging menu. The Harvard School of Public Health has a website with a great amount of helpful information about the food pyramid. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/

There are Six Great Cures For Men, according to Joy Bauer in Joy Bauer's Food Cures, : Sardines for heart health, Brazil nuts for prostate health , Edamame (green soy beans) for mood, Sesame seeds for sex drive , blueberries for memory and lentils for energy.

Active athletic people (be it a gardener working several hours in the sun, a person lifting weights in a gym, a weekend warrior, a backpacker, a long distance cyclist, or a triathlete) need to replenish the nutrients that they expend. DURING VIGOROUS ACTIVITY,THE BODY IS ABLE TO REPLACE ONLY ABOUT ONE THIRD OF WHAT IT LOSES IN FLUIDS, CALORIES AND ELECTROLYTES. Electrolytes are chemicals that form ions, electrically charged particles in body fluids. They carry the electrical energy necessary for many functions, including muscle contraction and transmission of nerve impulses. Without proper amounts cramping, dizziness, nausea, can occur. Drinks with electrolytes are invaluable.

Also valuable, surprisingly enough to a "non-caffeine drinker," is CAFFEINE. It's generally best consumed an hour before an athletic event. Though a diuretic, it increases fatty acids in the blood, sparing muscle glycogen, the energy source stored inside the muscles; therefore, stimulating more forceful muscle contractions (some recent research disagrees with this theory from older research) It also stimulates the nervous system thus decreasing the perception of fatigue.

It's important for an athlete to eat frequent small meals maybe 4- 6 times per day ( breakfast, snacks and other meals). During a long distance ride a cyclist needs to eat an energy bar, or comparable food, every hour and drink some fluid every 6-12 minutes.

ENERGY BARS are an easy, good food source for athletes as well as for many other people, including children. There are numerous types of energy bars on the market. Some triathletes eat energy bars as their primary source of nutrition immediately before and right after their event. Kathleen Putnam, a nutritionist in Seattle, can answer your questions about energy bars, plus help you create your own dietary plan (www.NutritionWorkSeattle.com).

(LAUGH after reading--this is not to be taken seriously) Though energy bars are far superior to the TWINKIE, the age old Twinkie, that may have been sitting on the shelf for years, does have a lot of uses that are especially great for cyclists:
*a food source--rich in sugar, oils, carbohydrates
*part of your repair kit --the white filling is a high quality lithium grease, water resistant of low friction and just right for repacking a dry bearing and you can oil the chain with it
*part of your first aid kit--oil for sunscreen and the spongy cake can clean and dress road rash; or sit, on an unopened pack to get a gel saddle.

Metamorphic Massage
"where injuries are transformed into wellness"
Specializing in athletes with injuries

Nikki LMP -- provider of massage at 3 Olympic Games
WA Sports Massage Team - active member for 12 years

Hope to hear from you soon.
Nikki Nichols LMP, RN, BSN
Metamorphic Massage
206-499-4281
Nikki@metamorphicmassage.biz