Active Therapy & Sports Injury Consulting

Active Therapy & Sports Injury Consulting, located in Winnipeg, Manitoba, Canada, is owned and operated by Darryl Thorvaldson, BA(Kin), PCP, CSCS, CAT(C)

Wednesday, September 5, 2012

Flexibility for Neck Health!

Flexibility for Neck Health!

So, it's been a busy tour, or shift for that matter, you had a fire, did some overhaul and took down a ceiling. Or, you had busy day with patients, no one could walk today and a lot of 3 story walk-ups with no elevators. Had to use the stretcher a ton. Is your neck sore? Do you have a headache? Probably.

You see, as you get tired (or stressed), what happens is we inevitably start to shrug our shoulders, whether you are conscious of it or not. In fact, push your shoulders down right now. See how much they moved? Poor computer placement is also a terrible thing. With your shoulders elevated, 2 large muscles are being activated, or shortened, the trapezius and the levator scapula. Both play a role in shoulder elevation and neck movement, with the trapezius playing a larger role in other shoulder movements such as squeezing your shoulder blades together. Guess what. These 2 muscles are also GREAT stress carriers! Have some stress? They love to get tight and knot up when you do. This causes trigger point activation, headaches, and general soreness to the area.

With my last post, I told you about those little buggers called trigger points, and how to try to self treat them. Here is the next tool in your arsenal. STRETCHES! Anecdotally, barring any external force trauma, most of the musculoskeletal injuries I see in the clinic are directly related to flexibility, or the lack there of. So how do we attempt to permanently lengthen a muscle? Stretching? No way. Now I know it is semantics and yes, I am providing you with stretches, but I prefer to look at stretching like this: stretching is what you do to prepare for activity, whereas FLEXIBILITY is what we do to cause a permanent change in the length of the muscle. Difference? Time. When we are trying a cardiovascular workout, we are generally engaging in the activity for at least 20 minutes, correct? Strength training. How long? Say... 25-60 minutes? Well, flexibility training will also take you an extended period of time in order to do it properly and gain the most benefits from your time and effort.

How to Perform the Program Properly

Below are some basic stretches in a FLEXIBILITY program applied to some very troublesome muscles in the neck and shoulder girdle. These muscles are the same muscles I spoke about in the trigger point blog. When doing the flexibility program, you MUST hold each stretch for 30sec. NO CHEATING! Use a timer or clock with a second hand because if you try to count, you will count too fast and not obtain the timeline we require for the program to be effective, 30 seconds for each repetition. Now, each stretch should be performed 3 times per side (if it is a unilateral movement). Ensure all 3 are done on one side before switching to the other.

No warm up is required prior to the flexibility program. This program should be done at least once a day, but keep in mind, the more you do the better. You can't over stretch! My guidelines for patients in the clinic are 3-5 times per day! When your neck is sore, you're stressed, or have a headache, give these stretches a thought!

Tuesday, July 17, 2012

HEADACHES! No need to suffer.

Are you plagued by headaches? Do you get headaches once in a while and don’t know why? Do you get headaches during or after a tough tour? Then please, read on, it might be one of the best things you have ever done!

With the nature of the work involved in firefighting and paramedicine, such as over haul with a pike pole, carrying the trauma bag, or repeatedly lifting patients over and over, the potential for headaches increases significantly. Throw in everybody’s abnormal, normal posture, and we are prime candidates for chronic headaches.

Let’s start at the beginning. Abnormal, normal posture? Look at yourself in the mirror from the side. Odds are, your shoulders are what we call rounded, your earlobes are forward of that bump on the top of the shoulder (forward head posture), and your face is probably still looking straight ahead (neck extended). Right? Well this creates a prime condition called cervical dysfunction.

Cervical dysfunction? Basically, what it means is you are shortening the muscles at the base of the skull, making the 2 big muscles at the front of the neck (sternocleidomastoid) work too much, and the deep flexors of the neck are just going along for the ride, getting weaker and shorter. Not to mention your trapezius and levator scapula (the muscle that elevates your shoulder blades) working over time on a normal basis. If the front of your neck hurts with crunches, then odds are, you have this! Why is this bad? This creates a perfect environment for these little things we call trigger points to activate. What the heck is a trigger point?

Trigger points are a taut band of skeletal muscle located within a larger muscle group. These taught bands are tender to the touch and can refer pain to distant parts of the body, including the head. You can experience regional, persistent pain resulting in a decreased range of motion in the affected muscles. Typically, we know where in the muscle these points are located, but it is whether or not these points are active or latent. When active in the muscles of the neck, pain is referred all over the head and neck, including the most common points of a headache, like along the temple or behind the eye. The following diagrams demonstrate where the referral patterns of pain are (red areas) with the most common trigger points associated with cervical dysfunction (x's).

Heat and what we call accupressure, or pressing with your finger on the trigger point origin (not where the pain is) can help alleviate this pain very quickly. Although the pain may increase with the acupressure (this is a good thing, you know you hit the right spot!), over time the pain will decrease or go away. Once this occurs, you may let go and voila! The pain is gone! You may require someone else to press on the trigger point depending on how flexible you are. This is a quick and easy method I have had great success with in the clinic when treating acute headache pain. Ultimately, you will need to see your Athletic Therapist for follow-up in order to correct the cervical dysfunction, which can ultimately be the cause of the trigger point activity (unless it was due to trauma, which can happen as well). Yes, exercises and a FLEXIBILITY program are the requirements of the day. That will be the only way to correct the dysfunction.


Next article in the series: Flexibility for neck health. 

Tuesday, July 10, 2012


I know what you are thinking. What is an “industrial athlete”? Well, you could very well be an industrial athlete. Firefighters, paramedics, nurses, construction workers, mechanics, welders, assembly line workers, trades people and people working in industry are all industrial athletes. Basically, anyone who performs physically demanding work requiring their body to perform exact and/or repetitive body movements, body positions, and manual tasks is considered an industrial athlete.

Why is this important to you? Are you one of these athletes? Have you been injured at work? Have you had therapy for your injury? Most of you would answer yes to all of these questions.

As an industrial athlete, what you may not know is in order to successfully return from a muscle, bone or joint injury, you must be provided with proper stretching and exercise so you can safely return to your job duties. This exercise has to be harder than your job requires. What I mean is, if you have a rotator cuff injury, and you continually lift heavy items at work weighing 6, 8, 10 pounds or more, a 2 or 3 pound weight for exercise is not going to cut it.

Unfortunately, this is a common mistake made by therapy practitioners when dealing with an injury sustained in the workplace. We would never make an athlete work less than what their sport demands of them. If we did, the athlete is at risk for further injury. So why would we do this for the industrial athlete? Truthfully, proper therapy will make you, the patient, stronger than you were prior to the injury. If you were injured at work, odds are you weren’t strong enough to begin with to continually put those stresses and demands on your body, so you need to be stronger than those stresses to prevent re-injury. Makes sense, doesn’t it?

Next time you get hurt and require therapy, which all muscle, bone and joint injuries do, ensure your therapist is exceeding the strength demands and physical activity required by your job, or trust me, you will be back!

Darryl Thorvaldson, BA(Kin), PCP, CSCS, CAT(C) is the owner of Active Therapy and Sports Injury Consulting. He is also an Athletic Therapist at Joint Effort Sports Injury Clinic in Winnipeg, Canada.