Here’s a key excerpt from the NY Times blog post:

“But a major new review article, published last Friday in The Lancet, should revive and intensify the doubts about cortisone’s efficacy. The review examined the results of nearly four dozen randomized trials, which enrolled thousands of people with tendon injuries, particularly tennis elbow, but also shoulder and Achilles-tendon pain. The reviewers determined that, for most of those who suffered from tennis elbow, cortisone injections did, as promised, bring fast and significant pain relief, compared with doing nothing or following a regimen of physical therapy. The pain relief could last for weeks.

But when the patients were re-examined at 6 and 12 months, the results were substantially different. Over all, people who received cortisone shots had a much lower rate of full recovery than those who did nothing or who underwent physical therapy. They also had a 63 percent higher risk of relapse than people who adopted the time-honored wait-and-see approach. The evidence for cortisone as a treatment for other aching tendons, like sore shoulders and Achilles-tendon pain, was slight and conflicting, the review found. But in terms of tennis elbow, the shots seemed to actually be counterproductive.”

Read the complete article at this link: NTimes.com – Phys Ed: Do Cortisone Shots Actually Make Things Worse?

These camps are amazing places where children who’ve been dealt a rough hand in life can go for one week out of the year and really enjoy themselves–a place to go and just be a kid.

Please check out the following links — the first link is the Association of Hole in the Wall camps. The second link is the particular Hole in the Wall camp for which I’m raising money, The Double H Ranch in upstate NY’s Lake Luzerne. I have good friends that have been involved with Double H for many years (both in part-time and full-time capacities), and it’s simply a wonderful outlet for these kids.

http://www.teamholeinthewall.org/Page.aspx?pid=333

http://www.doublehranch.org/

And for a little more info on the 100 miles of insanity I’ve decided to take on, please check out:

http://www.vermont100.com/

Some of you may remember that I completed an Ironman triathlon (2.4 mile swim, 112 mile bike, 26.2 mile run) a couple of years ago. That experience really opened my eyes to what the body is capable of doing once the mind jumps in to lend a hand! Not everyone understands why some people like to push themselves to extreme limits (actually, most don’t…), and that’s OK. I’m just glad I can choose to do something like an Ironman, or run 100 miles….some people don’t have the luxury of choosing some things.

Please join me in helping these kids experience a wonderful week of fun. I’ve set a goal of $10,000 – please help me reach it!

You can contribute online directly from: http://www.teamholeinthewall.org//wally

Thanks very much for any and all donations!!

Sincerely,

Wally

In early 2006, Wally Goller couldn’t even run a mile. He then signed up for and completed a sprint distance triathlon in August, raising a few thousand dollars in honor of his mother, a three-time cancer survivor. A few months went by and crazy thoughts started to happen. He started to think what it would take to get himself in shape to do an Ironman triathlon the following November (2.4 mile swim, 112 mile bike, 26.2 mile run.)  

All of his friends thought he was completely crazy, and after many rejections from coach’s/trainer’s (they just didn’t think one year of preparation was enough time..), he finally found a trainer and dedicated one solid year of mostly 6-days per week training. And after many 5k’s, 10k’s, and half-marathons, multiple sprint distance tri’s, a couple of Olympic distance tri’s, and a half-Ironman, he became an Ironman by completing the Florida Ironman triathlon on November 3, 2007.

Wally is now investigating the world of ultrarunning and is gearing up for the Vermont 100 mile Endurance race to raise money for the Hole in the Wall camps, specifically The Double H Ranch, which are camps to help kids with chronic and life-threatening illnesses.

Say’s Wally, “ These camps are amazing places where children who’ve been dealt a rough hand in life can go for one week out of the year and really enjoy themselves–a place to go and just be a kid.”

If you would like to donate to this cause, please contact Wally at 917.373.3310 or waltergoller@gmail.com

We’re going to follow Wally on his journey as trains for his race in July. He’ll also be checking in with posts to this very blog.

 Please join me in cheering Wally along!

 Types of Stretching

• Static (passive)
• Active Isolation (static)
• Active (dynamic)
• Contract – Relax (PNF)
• Strain – Counterstrain – Positional Release

 Static Stretching (Passive)
Static stretching is the most traditional way to stretch and remains a viable and popular option.  A muscle is put in a position of stretch over its entire length and held in its lengthened position (hence the name static) for a period of 30 seconds.  Research has demonstrated that the best results are achieved by repeating a static stretch four times.   Static stretches can be performed independently or with a partner.  There are a variety of positions in which muscles can be put on stretch, and some are more desirable than others.  For example, the hamstrings (in the back of the thigh) connect to the pelvis (at the ischial tuberosity – often referred to as the sit bone) and to the lower leg (just below both sides of the back of the knee).  The actions of the hamstring (when it contracts) are to extend the hip and flex (bend) the knee.  Therefore, to stretch the hamstring over its entire length, one must do the opposite – flex the hip and extend (straighten) the knee.  A good way to do this is to lie on your back and use your hands to draw your leg toward your chest, keeping the knee as straight as possible.  After you’ve taken up all the slack in the muscle and feel a stretch, hold the position for 30 seconds.  You will likely stretch a little further with each subsequent repetition.  

Not every passive stretch is a good one however.  Hamstring stretching positions that cause you to round your back as you lean forward go beyond the slack in the hamstring and stress the low back.  These are not advisable unless the forward bending comes exclusively from the hips and your back remains in a neutral position.  That also rules out hoisting your foot onto a very high surface and bending forward.  Try elevating your foot on a low stool instead (or sitting on the edge of a chair with your leg stretched in front of you) and bend forward from the hip with a straight back.  The result?  Less effort, better stretch, reduced potential for injury.

Studies have shown that a short-term effect of static stretching is the diminished force output of the stretched muscle.  This is one reason that some now eschew it as a warm-up prior to strenuous activity. 

Active Isolation Stretching – Static
Active Isolation stretching is exactly what its name implies – a muscle is stretched by actively contracting its opposing muscle.  Studies have demonstrated that the result of contracting one muscle (termed the agonist) is the relaxation of that muscle’s opposite, or antagonist.  Let’s use the hamstrings as an example once again.  Contracting your quadriceps (the muscle group in the front of the thigh whose action is to straighten your knee and assist in flexing your hip), will result in the relaxation of your hamstrings (in the back of your thigh).  Proponents of Active Isolation recommend holding the end position for only a few seconds.  Many athletes endorse this type of stretching and it has been shown to be very effective.

Active Stretching – Dynamic
Active Dynamic Stretching entails movements that put muscles on stretch.  Because they involve movement, these stretches are said to increase muscle temperature and prepare muscles for activity.  Dynamic stretches are also said to put joints through their full ranges of motion, though that is not likely because a joint can only be moved to its end range when the muscles crossing that joint are on slack (relaxed) rather than on stretch.   Examples of active/dynamic stretches include motions such as a lunge, which puts the hip flexors (in front of the hip/groin) on stretch, and the Inch Worm in which one creeps forward while maintaining a Downward Facing Dog yoga position (on the hands and feet with the butt high), which stretches the hamstrings.

If you like Active Dynamic Stretches I would not rely on them as the sole means of increasing your flexibility.  Because muscles are stretched in combination – for instance the calf along with the hamstring in the Inch Worm exercise – if one of those muscles is particularly tight, it will limit your ability to stretch the other.  Also, as with ballistic stretching, care must be taken to avoid setting off a stretch reflex due to the quick stretch that movement may elicit.

Contract – Relax (PNF)
PNF stands for Proprioceptive Neuromuscular Facilitation.  This is a broad classification that includes both strengthening and flexibility exercises.  PNF strengthening entails a variety of effective exercises that involve multiple muscle groups working in combination in functional cross-planar motions (working in diagonal patterns rather than strengthening individual muscles in isolation). 

PNF stretching is better known as Contract – Relax (C-R) and it has long been employed by physical therapists and athletic trainers to assist clients in developing increased flexibility.  Contract – Relax has both active and static components.  This type of stretching is based on research demonstrating that tension in a muscle is relaxed in the aftermath of contracting that same muscle.  This is quite different than the principle already described for active isolation stretching which shows that a muscle also relaxes with the contraction of its opposing muscle. 

C-R is most easily performed with a partner.  Using the hamstrings to illustrate once again: the hamstrings are held in a position of mild stretch (with the knee extended – straight – and the hip maintained in flexion) and are asked to contract gently.  This contraction is sub-maximal (only a mild force is exerted) and it is isometric (no movement is allowed).  This isometric hamstring contraction (to extend the hip) is held for several seconds, while the position of end range hip flexion with the knee straight is maintained with the aid of a partner.  Following the contraction there is a relax phase, during which the partner attempts to move the hip into greater flexion, thereby further stretching the hamstring.  The sequence is: contract (actively) – hold the contraction – relax/stretch (passively).  Several repetitions are performed with the ending position of each rep becoming the starting position of the next.  As a result, significant gains can be seen.

Strain – Counterstrain (Positional Release)
Another staple in physical therapy clinics, Strain – Counterstrain (S-CS) is a technique to release a muscle rather than stretch it, but the end result is more flexibility.  By passively maintaining a muscle in its fully contracted position for 90 seconds it has been shown that the muscle will relax, subsequently allowing it to stretch further.  Though often done with the assistance of a partner or health professional, Strain – Counterstrain positions can be maintained independently (as with holding the knees to the chest for the hip flexors) or with the help of pillows (as when releasing the hip abductors (outer thigh) in side-lying by elevating the upper thigh on pillows).  You may want to follow Strain – Counterstrain positioning with static stretching to capitalize on newly gained flexibility.

Conclusion
Just as we work to achieve balance in our lives, we also benefit from working toward a balance within our bodies.   Having normal flexibility is an important component of this balanced ideal and one that will help to prevent the stresses and strains that result in overuse injuries.