 Proprioceptive Neuromuscular Facilitation (PNF) is an advanced manual therapy technique, which combines passive stretching and isometric contraction (gentle resistance) to break neuromuscular holding patterns and help reset muscle holding patters and overall length. Every individual’s body is accustomed to some type of repetitive motion whether it be sitting long at a desk, favoring one side to hold a child or swinging a racket or club on a dominant side. These repetitive motions cause muscle imbalances that effect both sides of the body. For example, when sitting at a computer reaching forward to type, your chest muscles contract (tighten) while your back muscles stretch, creating an imbalance that is imprinted in your muscle memory that can restrict your range of motion. When natural range of motion is limited, other muscles tend to pick up the slack and we start to see painful conditions due to over compensation. PNF for the Athlete PNF is used to make quick gains in range of motion to help athletes and “tight” individuals relax muscles to improve performance. With proper muscle resting length and greater joint range of motion, biomechanics greatly improve and there is less muscle fatigue. This is where we see a tremendous decrease of injuries. At Milestones, each client’s needs are assessed and PNF techniques can be integrated into any of the treatments or sessions offered. PNF is particularly helpful for rotational sports such as golf or tennis as the player’s performance relies on the rotational range of motion in the trunk and limbs in order to drive power and precision into the swing. PNF is also often administered during a pre-race and post-race sports massage or during a rehabilitation session. 
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  Let’s talk foam rolling! Yes, you hate it. Yes, it makes you grimace in pain. And yes, you probably need to foam roll if you use your legs for anything; especially if you use your legs a lot! Whether you’re a runner, cyclist, squat loving gym goer, kid-chasing grandparent, or a committed daily walker, chances are you’ve noticed your quadricep muscles are consistently tight. Any activity where your legs are being used in a repetitive or loaded motion causes your muscles lengthen and strain, leading to micro-tears in the tissue. Don’t worry, this is natural and can be a good thing because the body responds by repairing these micro tears with stronger tissue for future use. This process of breakdown in our muscle tissue is normally followed by a period of soreness called delayed onset muscle soreness (DOMS) typically lasting between 2-5 days. During this time it is common to encounter sensations of pain (to touch or movement), tightness, or discomfort as our tissue works through a natural inflammatory response. When we start to see this normal discomfort go awry is when our muscles are not repairing fast enough to keep up with the demand of use and without counter acting it with some mobility or flexibility work, we leave ourselves open to injury. So what exactly are our Quadriceps? Can we talk a little anatomy? There are four muscles in the quadriceps group in the front section of your thigh. This is why they are called your quadriceps. The large muscle you feel closest to the surface in the front of your thigh is the Rectus Femoris, the Vastus Medialis and the Vastus Lateralis lay on the inside and outside (respectively) of the Rectus Femoris, and the Vastus Intermedius lays deep underneath along the femur bone. What causes tightness in the quadriceps? As an athlete, you are contracting your quadriceps with almost everything you do. As a runner you are contracting your quad muscles with each and every one of your hundreds and thousands of steps. As a volleyball player, you are using them to help propel you airborne for a spike. As a football player you are using them to help accelerate and decelerate your body into and out of quick cuts. As you can imagine, a constant state of use requires a constant state of repair. Athletes continuously undergo a breakdown and repair cycle that when not properly cared for can lead to increased tone (neural tension) and fascial densification, or simply put, you feel TIGHT! Without addressing this, your muscles may shorten and hold in a chronically tightened state over time and because you are an athlete, you’re constantly using your legs and they are tight. I can’t say it enough… your legs are tight because you my friend, are using your legs a lot! What does foam rolling actually do and why does it “Hurt so Good”? Foam rolling may increase blood flow and circulation to targeted areas while also helping to increase range of motion and decrease tissue tone. In short, it is a form of self-applied massage due to the pressure of the roller loosely mimicking the pressure of manual manipulation by a massage therapist. I don’t know about you but when I see a sports massage therapist for a deep tissue massage, I’m deep breathing my way through the “pain” caused by the deep pressure and trigger point contact. Just as massage can correct muscle imbalance, alleviate muscle soreness, relieve joint stress and improve neuromuscular efficiency, it is thought to be that foam rolling can assist in the same way on a smaller and more personally manageable scale. Most athletes do not have the ability to get a daily sports massage (though such a thing would be AMAZING) but they sure can take a few moments before and after to a workout to roll out. Foam rolling for knee pain. Two conditions that can cause knee pain are Patellar Tendonitis and Patellar Tendinopathy which is pain in your patellar tendons that connect to your quad muscles and tibia. There are strengthening techniques that will address the resiliency of the tendon itself, however, addressing the surrounding tissue with neuromuscular stimulation with foam rolling can be extremely helpful in relaxing the tight quad muscles that are pulling and tugging on the sensitive tendon. Already love foam rolling but want to add more to your routine? At Milestones, we’ll take you through a screening process that will identify tight quads and their range of motion limitations. We’ll work with you to customize a program tailored to your rehabilitation or training needs, often utilizing a combination of therapies including massage, training and movement rehabilitation. We will also help guide you through the daily do’s and don’ts for you to continue to self-rehab between visits. Give us a call, we’d love to help you!  |
AuthorMiles G. CMT, CPT, FMS 
Miles is a Certified Massage Therapist (CMT), Functional Movement Trainer (CPT) and owner of Milestones Movement Therapy in Davis CA. Miles and his team specialize in taking clients from pain to peak performance.
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