IronMan 70.3 Dun Laoghaire

This year I was able to be, again, involved in the Dublin Ironman event.  The Dublin Ironman is a half Ironman and the route normally involved entering the Irish sea for the swim at DunLaoghaire. After a 1.9 km swim participants will transition over to the bike section which involves a 90 km cycle up the Wicklow mountains. The last section is a 21.1 km run back towards and around DunLaoghaire finishing close to the starting point of the race. If this is a half Ironman you can imagine how physically exhausting and mentally challenging full events are as well as something as, to be frank crazy as the Kona Ironman race in Hawaii, which is a 3.86 km swim, 180.25 km cycle and 42.2 km run in searing heat and hostile terrain.

Those in the event range from professionals, seasoned veterans, triathlon club members, endurance sport activists and then some of the most normal people who decided this was to be their new obsession for the coming year. Prior to race day I spent the 2 days beforehand dealing with various cases and individuals with issues ranging from simple checks on niggles, strapping, soft tissue work and full on consultations and real down to the wire decisions regarding if a certain person could compete in the race. The two days beforehand were long and tiring but being able to prepare so many people for such an event felt great.

On the race day myself and seven other therapists set ourselves up well before the end of the race was even in site. our first patient of the day had injured themselves in the water which was incredibly choppy on the day. The slow and steady stream of people who had injured themselves during the race and those professionals who had finished the race in an inhuman time suddenly became droves of being being accessed, looking for soft tissue work and even a few being stretch out because the could no longer do it themselves as a result of exhaustion. From 8:00 am in he morning until nearly 5:30 pm we provided care to a large number of the participants.

The Ironman event is such an endurance event that even the therapists are exhausted after it all. The event makes you feel like you can really do any kind of event. For all the people who loved and hated the training process you were hard pressed to find a single participant who wasn’t happy that they choose to compete, maybe only a few disgruntled partners and family members not as enthralled in the sport having to wait an entire day for the event. Yet the comradery expressed in the event and the dedication needed and shown by so many people, you can only appreciate and admire all those who decided to undertake the event.

This was my second year involved with the Ironman, in different roles between both roles and I definitely hope to involved again in the future especially with events such as the first full Ironman event being held in Cork in 2019 and the Hell of the West triathlon which I have been persuaded to train and enter next year.

 

 

 

 

Foam Rolling

What exactly is foam rolling and why does everyone talk about it and also treat it like a way to fix every kind of muscular pain /problem in the body. Well foam rolling is normally the use of a hard cylinder shaped object placed against a fixed point that a person will apply there body weight to it and cause it to move. The fixed shape and weight applied causes the soft tissue directly underneath to experience increased pressure directly at the point of contact acting as a form of self myofascial release.  Self myoyfascial release can be done using a classic foam roller, lacrosse ball, theracane, muscle roller sticks or even something like a yoga block. Self myofascial therapy has gone from something only done by people who compete in sports and endurance activities to something many people have introduced to their everyday routines, like stretching.

The goal of self myofascial therapy and in turn foam rolling is to return muscle and soft tissue to its original elastic state. People aim to apply these pressures so that tissues that feel sore, stiff or shortened return to a more normal state and sensation. When creating this motion many people experience pain or referred pain with many stating knots in the muscle. There a re no such thing as knots in muscles but areas of tenderness or trigger points as a result of tissue having to produce a function it is not fully developed for or under great stress can cause this pain or the referred pain may be experienced.

 (Repost Discoveries Soccer club)

The force applied by the weight of your body upon the object can allow for tissue to produce a reactionary force often causing a release of the tension built in muscular tissue. This often alleviates the pain which s a symptom normally allowing for the cause of the pain to be better identified and solved. When the pain or reduction in functionality of the tissue is not that bad self myofascial release in the form of foam rolling can be used as an effective method of maintenance and preparation for activity.

Caution should be taken when using such methods though as it is best used into areas with large or deep surrounding muscular tissue such as the lower or Lumber spine or the neck. Areas that only have a scant amount of soft tissue can be aided by these methods but as many people often find it difficult to judge the force they are applying by the use of their body weight it can also cause bruising or low grade strains into sensitive areas.

Foam rolling is best used in conjunction with other injury prevention and maintenance methods such as stretching and warm up/ coll down protocols as well as prehab exercises put in place to strengthen often problem areas while reducing the sensation of pain into areas often plagued with pain as a result of their nature of being the bodies natural force absorbers. To keep our tissues in as good a condition as possible while maintaining a high quality of activity is one of the most important benefits foam rolling can have for many people. reducing pain and allowing people to experience relief from tightness and stress allowing for a greater quantity and quality of movement and as such performance.

Some of the best techniques for foam rolling are the most basic the roll out areas such as the T-Spine and calfs but also areas such as the base of the neck and lower Trapezius between the scapula. using a lighter force in more specific areas can be more beneficial than trying to apply as much pressure as possible as many people foam roll regularly but don’t benefit greatly from it due to poor technique.

New Therapies from Old Ideas

In our modern world the old and the new seem to inter mingle and over take one another as we see them with fads and waves of interest, fashion and ideas. This is very much true when it comes to the way in which we view how to treat patients. What is currently in fashion, what are the therapies currently used or being studied. We often see these first hand from professional athletes or at major events like the Olympics or World games. What are the athletes currently receiving for their rehab or their pre-event work. This can be clearly shown when we see therapies like cupping or kinesio tape which were around for many years especially cupping, originally an Asian treatment, making their big world showing at the Olympics and suddenly becoming the new “It” therapy.

As such, are the therapies used or wanted, implemented like a popularity contest, with the fashionable and cool person winning even without knowing for sure what it is they do. This can often lead to therapies evolving and becoming more stream lined and specific such as the therapy dry needling, coming from the Asian medical practice of acupuncture. It seemed to work for centuries but not exactly for the reasons described. Does that mean that all therapies possibly have a sell by date before they are either updated and brought forward or left to the way side.

We often see this being heavily influenced by where our school of thought lies. Western medicine for nearly a century has implemented the R.I.C.E method of Rest, Ice, Compress and Elevate to treat initial injuries and for early stage rehab. Whereas Eastern medicine often implements the use of stimuli to injured or affected areas to hopefully cause increased levels of healing. So who is right? Well neither can 100% claim that their way is without a doubt the best, it is purely based off where a therapist received their training. Many therapists will learn new methods, ideas and therapies to keep themselves up to date and relevant. So no therapist who has practiced for a long enough period is the exact same as they were when they first entered the industry.

An article I recently read put it somewhat into perspective that fad therapies often come and go due to initial popularity and exposure but they mainly end up being contained by the school of thought they come from. Which is why when therapies such as cupping, dry needling and the many different forms of soft tissue therapies that become long term and major therapies within both bodies of medicine, it is a pretty major thing,

https://newsstand.google.com/articles/CAIiEGOf56AyetebYcZ4FsuiE5wqGAgEKg8IACoHCAowy-2kCjCw_3cwjs7sAQ

The reason behind many therapies ability to reduce pain have yet to be scientifically shown, such as the term “trigger points”. A trigger point has never been shown to actually occur in enough pieces of literature to be a definitive reason behind pain or reduced mobility, but I can find them and release them somehow in patients. Sometimes we practice things that are not fully backed or that we don’t quite know why they are helpful and yet we use them regularly and we can see that they are beneficial. So unless its somehow a placebo effect present in most people or sometimes we implement different methods of treatment without needing to know why they are effective as long as they don’t cause harm. Maybe this means the way we view rehab needs to slightly change from everything being rock solid truths. Yet maybe we also need to better educate those who come to us in what exactly the methods we use do so that rehab becomes less of a popularity contest where we case what people want and provide a wide enough spectrum of treatments from several schools of thought.

I believe that my ideas were first challenged when on placement when the fully qualified Athletic Therapist in charge of me asked me as question.  We had spent a little while assessing patients with him asking me anatomy questions, which had me sweating to like good in front of this person. Eventually we went out to cover the game and he asked me what I thought about different therapies I was learning about, especially modalities and if they were any use at all. I then said that I thought R.I.C.E was the “most effective rehab”. He laughed and then asked me “So should you put ice onto an effected area straight away even though ice will reduce pain but slow the repair phases possibly causing issues later if its over used like it normally is”. After hearing this I was quit for a solid half an hour because I couldn’t answer him and my 2nd year college mind couldn’t yet comprehend the idea that “wait that cant be right”.

So after years I’ve come to the conclusion that I still do not have a conclusion and that each and every individual must be taken as an independent case and that any therapy be they strange, tried and tested, old, revamped or the simple thing you skipped because it was simple I believe that having predetermined methods and schools of thoughts cant really work anymore.