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Injuries Chronic & Acute

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Old 02-07-2006, 09:43 AM   #1
Rich Krauss
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anyone have experience with this injury? I started xfit around a month ago and been having pain on flexion against resistance in antecubital fossa area; really feel it when doing pullups. Plan on staying away from pullups until pain subsides which is a hassle since pullups are a major part of xfit
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Old 02-07-2006, 09:55 AM   #2
Christian Lemburg
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Massage your biceps and brachialis muscle:

- http://www.triggerpoints.net/userfil...ps_Brachii.jpg
- http://www.triggerpoints.net/userfiles/Brachialis.jpg

Look here for some info on why, what, and how to massage:

- http://www.crossfit.com/discus/messages/27/14941.html
- http://www.crossfit.com/discus/messages/27/15843.html

If you have already developed a real inflammation (tendonitis with swelling and continuous pain), take some anti-inflammatories (e.g., ibuprofen) and rest for about a week before starting the ramp-up again. Icing after workouts is also recommended by many.

Good luck, and fast recovery,

Christian
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Old 02-07-2006, 10:10 AM   #3
Rich Krauss
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thanks for your response, will try it
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Old 02-07-2006, 10:37 PM   #4
Jason Erickson
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Have a health pro take a look and verify whether you have something going on. Trying to massage an undiagnosed injury fitting the description you gave may result in additional soft tissue damage.

Further, trigger point charts are of little use for the untrained individual. This is because trigger points often do not occur where charts generally show them, and the work requires anatomically precise placement and depth which can only be determined by palpation of the tissue. Based on the info Rich provided, it is highly unlikely that a Trigger Point is involved, and if one is, it should be addressed by a professional massage therapist.

Rich - see a pro. Better safe than sorry.
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Old 02-08-2006, 04:38 AM   #5
Rich Krauss
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Thanks, actually getting an MRI as only way of knowing exactly whats going on and will proceed from there
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Old 02-09-2006, 01:59 AM   #6
Christian Lemburg
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"Further, trigger point charts are of little use for the untrained individual. This is because trigger points often do not occur where charts generally show them, and the work requires anatomically precise placement and depth which can only be determined by palpation of the tissue. ... Based on the info Rich provided, it is highly unlikely that a Trigger Point is involved, and if one is, it should be addressed by a professional massage therapist."

As the results from numerous members of this board show, trigger point massage can easily be learned and applied by the average CrossFitter. Just take a look at these messages (cited with names of members that gave positive feedback), found by a simple search for "trigger point" and taking the top 5 articles:

- http://www.crossfit.com/discus/messages/27/15921.html (Eric Moffit, Nikki Young, William Hunter, Rob McBee)
- http://www.crossfit.com/discus/messages/21/3822.html (John Frazer)
- http://www.crossfit.com/discus/messages/27/15155.html (Kelley Brownlie, Matthew F. Bunch)
- http://www.crossfit.com/discus/messages/27/12757.html (Kelley Brownlie)
- http://www.crossfit.com/discus/messages/22/6842.html (Eugene R. Allen)

It even works for our famous sceptic John Walsh - see http://www.crossfit.com/discus/messages/27/14941.html (John Walsh).

Of course the charts are only guidelines, and you need to feel around and try, but the "professional massage therapist" will do nothing else.

Hopefully, he will have more experience and maybe a better knowledge of anatomy. But - and this is a big but - because of cost and time issues, most people have no chance of getting massaged often enough to cure the issue. Self-massage is an easy, cheap, and safe way of helping yourself.

"Trying to massage an undiagnosed injury fitting the description you gave may result in additional soft tissue damage."

Massaging a fresh injury (muscle or tendon rupture with swelling) is not a good idea. I was cautioning Rich against that (ibuprofen and RICE if there is swelling), but this may have not been as clear as I wanted. Good point to make.

"Based on the info Rich provided, it is highly unlikely that a Trigger Point is involved, and if one is, it should be addressed by a professional massage therapist."

About point 1 (trigger point not involved) - in the average CrossFitter I would doubt this. Many people on this board have developed trigger points due to the intense training. Few have had real structural damage after exercise. I think a trigger point is likely here, from overdoing pullups.

About point 2 (trigger point should be addressed by professional therapist) - well, if Rich has the money and access to a good therapist - cool, he is blessed - if not, he should better start learning how to help himself by self-massage.

Maybe some people want to chime in with their feedback about trigger point self-massage? Does it work? Is it unsafe? Can it be learned easily? Is a professional therapist needed?

These are interesting questions for us CrossFitters - let's get some more answers from the lurkers out there!

Looking forward to many interesting and informative responses ...

Cheers,

Christian

(Message edited by clemburg on February 09, 2006)
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Old 02-09-2006, 08:11 AM   #7
Rich Krauss
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I was diagnosed with a tendinosis of distal biceps tendon which is a chronic overuse injury(as oppsed to an acute tear) which basically reuires rest at this point. I'm sure there was a baseline injury which was aggrevated from many pullups(and chinups) over past couple months. My only problem is looking for a substitute for this movement while doing crossfit. In any case, I appreciate Christian and Jason's input and this is why I love this site. So many points of view and interest by individuals that don't know you for your overall benifit. Thanks again for your opinions.
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Old 02-09-2006, 10:59 AM   #8
Marty Lotspeich
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I am recomending that people take full responsability for their own bodies. I mean this in several ways, take it to a professional when you need to and in concert with this take it into your own hands as you are CAPABLE AND COMFORTABLE WITH DOING SO. Remember that anything I say here is for information purposes only.

To work on your own trigger points you need to know what they are, how they are caused and how to effectively work on them without exascerbating the problem.

What they are:
A portion of muscle fibers that has for various reasons gone into chronic metabolic energy debt.

How they are caused:
Most of the time trigger points are caused by microtears inside the muscular structure i.e. strains. If the internal scarring of the tissues are not dealt with through active recovery and tissue re-alignment techniques the small scars lead to further small strains and more scars. This buildup of internal scarring of the muscle fibers leads to a decrease in blood flow to the area which begins the metabolic debt to the specific area. At some point the particular fibers of the muscle are no longer capable of responding to neurological actions and the tearing and scarification process increases rapidly. Eventually as the tissues attrophies (sp?) the body encapsulates the area with connective tissues in an effort to slow the spread of the problem. At a certain point the tension and lack of ROM created within the muscle structure creates compensatory patterns in adjacent muscle groups and adjacent fibers in the same muscle. This leads to a chain of tension, refered pain and eventually more trigger points because of strains associated with reduced ROM from the original point. A trigger point literally begins a process of internal micro tears that are translated through the whole body.

How to avoid trigger points:
Make sure that every time you strain (tear) muscle tissues and other soft tissue you give sufficient time and effort to recovery and healing the tears and most importantly re-aligning the collagen (scar tissue) that the body uses to repair the tears. Every time you get strains in the tissues you are creating micro tears, if you push the muscle into increased metabolic debt durring the healing process you are asking for trigger points.

Tissue re-alignment techniques:
My favorite self care techniques, first off is active range of motion exercises such as Pavel's Super Joints or Sonnon's Warrior Wellness. These types of movement drill do a number of things. They increse blood flow to the muscle tissues, they actively work the full ROM of the joints in a non-taxing format that helps to facilitate an adaption process in the connective tissues that effectively re-aligns the tissues, and they help you to assess where your reduced ROM's are so that you can address them actively. My second favorite tissue re-alignment technique is more dangerous to apply to yourself without knowing how to do it correctly, propper useage is critical so as to avoid injury. Pin and stretch, is very simply exactly what it sounds like, you pin down the fibers and move the joints so that the fibers are stretched and pulled through the pinning. This re-aligns the connective tissues, but it must be applied very carefully especially to fresh injuries and trigger points. This technique is contraindicated when inflamation is present. Finally applying direct pressure to trigger points to help break up and release the binding of the tissues. If you are trying to break up a trigger point it is very important that you use a subtle touch that follows a release at the rate the tissue is capable of moving, if you push past this rate of release you will rupture cells and make the problem worse. This applies to both direct pressure and pin an stretch techniques, avoid at all costs rupturing cellular structures in the muscles. This means working very slowly until you become very comfortable with how deep you can work without injuring your tisues. If you notice any inflamation even slight inflamation from the work you are doing on yourself you are doing it too hard or too much or both. Knowing that pushing too hard or further straining trigger points will only make them worse, is paramount in healing them.
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