The Swim Coach and Massage — or, How Does This Rub You? by Vinnie Baum (1996)


Published


Vinnie Baum is a certified level 4 coach and a licensed Massage Therapist and has a Master’s Degree in Physical Education with an emphasis in Sport Psychology and Exercise. He has coached in New Jersey, Connecticut, New Mexico and now resides in Carson City, Nevada with his wife Paula and their two children, Brian and Dana who are both national level swimmers. Presently, he owns his own team, Sierra Highland Aquatics, which swims out of the Carson Valley Swim Center in Minden, NV. Vinnie got into massage to help the athletes that he trains and it has become an additional career. He has worked out of a Chiropractor’s office for 18 months while building his own massage business called Peak Performance Massage. Additionally, he works with 4 other massage practitioners where he specializes in sports massage, injury rehabilitation and therapeutic massage techniques as well as with relaxation techniques and stress reduction.

My whole purpose today is to teach you, and hopefully have you learn, some ideas that will keep your swimmers in the water. We’re going to do some first aid in a while, but I need to give you a little bit of background on massage and why we’re doing all this.

Massage, I think you know is not new. Sport massage is supposed to be new, but it actually started back in the original Olympic games. There is history of it going back to 776 BC when the Olympics were originated. Galen in Rome, who is supposedly the father of modern surgery, taught gladiators self-massage and partner massage to help them get though the games they play and to keep their muscles in tone. Health and beauty were important to the Romans and massage was a very important part of their lifestyle. There’s also massage listed in an ancient book on Chinese medicine, it goes back some 2000 years. And if you think about it, think back to the cave man, and if you were a caveman or cave woman and you were out there picking berries and hunting all day or if you were out there dodging the saber-tooth tiger, (that really didn’t exist during caveman times, only in Hollywood), and you came back to the hut or the cave that night, don’t you think that you’d like someone to rub your shoulders? I think that massage has been used for a millennium.

Yet, massage is still thought of as an alternative medicine. It’s one of the oldest ways to feel good and to help people heal that we know of and it’s an alternative medicine. I still scratch my head that we are not even considered part of health care in some areas yet I do more work with therapeutic massage and helping people get on the road to recovery from injuries that a lot of the doctors I know. I know because they send them to me now.

We’re going to go over what sport massage can do for your swimmers and how to go about getting someone to help you with sport massage, and teach you a few things yourself that you can use on the deck of the pool.

What is sport massage? Very simple, it is just using massage techniques to help an athlete reach peak performance. Most of you see massage being done occasionally at high level meets, but you hardly ever see it being done at age group meets. It can be done all the time, not just at swimming meets. It can be done during training, before events and competition and it should be done on a fairly regular basis if you want your athletes to achieve peak performance. If there is an injury, massage can be very helpful. Does anybody here have shoulder problems on your team? Some of you have problems individually, I know because I have worked on some of you this week. Has anyone here ever had someone on their team get a leg cramp during practice? We’re going to show you how to take cramps out and how to reduce the effects of cramps.

In the 4 or 5 years that I have been doing this, I have had only one swimmer I didn’t put back in the water because of a leg cramp. The rest of the swimmers have been able to go back into the water and even kick with fins on with no recurrence of the cramp — and I am going to show you that technique.

Here is a little bit about massage and how it can be used. Pre-event and post-event massage are very important for the athlete. You need to learn some techniques in it, but you also need to learn when to do it. I think the process of the timing of the pre and post massage is very critical. I feel that an athlete should not have a massage any closer than about half an hour prior to their event. Up to 15 minutes prior you are really pushing it and any closer than that you are really going to do detriment to that athlete. It is not going to be beneficial and could really hurt them. So you want to be able to time the pre-event massages a little further away then the time they actually get up to the blocks. You also want that time for the athlete to get psychologically ready.

Massage should be used as an adjunct to what they have done, not as a part of their warm-up but in addition their warm-up. I have had athletes that have come up to me and want to be warmed up. Yes, I can warm them up. I can get the circulation going, that is one of the benefits of massage — it increases the circulation in the body. On a particularly cold day it can help a swimmer stay warm but it is not used as a warm-up procedure. They should have already warmed up before they come to you, they should have already stretched out somewhat and then you or your therapist finish it off. After the event they should come over to you for a light rub.

It is a whole different therapy that is used after the event because at that point you have to determine whether they are going to swim again. You want to just give them a light rub in between, keep the muscles loose, shake them down a little bit. You are increasing the circulation and that helps to release some on the toxins but it does not take the place of the cool down. They need to come to you after the race, after they have cooled down and after they have talked to the coach.

During training and conditioning, massage can be used very effectively for recovery during the week during hard training. A number of countries use massage on a regular basis and part of their training regime. This is very popular in Europe and in the Far East. The USA hasn’t gotten very much into this yet. This is where athletes can benefit. If they have an easy day, for example, Wednesday morning off, and just train at night, see if you can get them to schedule a massage in there. Sunday, if you take it off, see if they can get a massage. It really does help the muscles and body recover, and will help to prevent injury.

Injury, restoration, and rehabilitation will be the primary focus of my talk because when a person comes up to me with a pain and says, “Hey coach, my shoulder is starting to hurt.” What do you do? Say, “Oh, you’ll be all right, get back in the water, no pain, no gain.” I don’t think so. I take seriously, guarding against excuses to get out of a work out. If the swimmer is really injured, if there really is a pain there, something is going on. How do you tell? You examine them, you touch them.

Here we get into the ethical side of massaging your athletes. I have to mention this, I don’t believe that you should rub your kids unless you are certified and licensed as a massage therapist. I am telling you that right now. Even though I am going to be teaching you some first aid techniques and some massage techniques, I don’t believe that you should be doing the massage on your team. And I think it is pretty obvious why, I don’t think I need to explain it. If you are thinking about doing your massage on your kids then just go into the yellow pages and open up under “massage therapeutic”, count the listings, then go look under “lawyers” and count the listings. If you are doing something you are not trained and licensed to do, in most states, you are liable. But you can do first aid. I am going to explain how to get hold of a massage therapist in your area, maybe how to get one as a part of your staff, possibly at low cost to you or your team.

The injury side; we have an overuse problem. Is there anyone that disbelieves this? I want to prove this to you. This is something you need to know and your kids need to know.

Let’s take a really average swimmer, not an elite swimmer. We’ll take the kid that goes 25 strokes for 50 meters and let’s say you do, an average workout, 6000 meters. What does that break down to? Twenty-five stoke cycles for 6000 meters, that’s 50 strokes per 100, 3000 stroke cycles. “No pain no gain?” I believe if there’s pain, there’s no gain to a certain extent. If you don’t believe that then we have 45 minutes left, go to the back of the room and lift your arms above your head 1000 times. Now I am not asking you to pull anything down with you, we ask our swimmers to do this 3000 times in a two-hour period, and then pull something besides. If that’s not overuse then I don’t know what is. You are going to get pains and aches.

The pains and aches they get in their muscles are called strains. A strain can become a sprain. All you do is change the letter. A sprain is probably a little worse that a strain, but there is a problem with the muscle tissue. So what do you do about it? You feel it, you find out if there is really a problem. If there’s really a problem then they are going to tell you. You touch and they are going to go, “Ouch,” if they don’t go, “ouch,” then they might not really have a problem. Then you can say, “you’ll be okay, just stretch out little more then go on in and continue your set.” But if they are really going “ouch,” and you just brought them down to their knees, then don’t neglect it. Because what’s going to happen? Their shoulder is going to hurt, you tell them to ice it when they go home they take a pile of ice out of the freezer, and throw it on their shoulder for the 10 minutes that you told them to leave there. After 3 1/2 minutes it starts to hurt because the tissue is frozen. They take it off after 4 minutes and then they don’t chill it down enough for recovery so the shoulder still hurts so then they go to a doctor and a physical therapist. They have the diagnosis right there. Do you know what it is? Tendinitis, inflammation of the tendons. You knew that before they went to the doctor but you didn’t get paid $68 dollars but the doctor did. And you know what? He didn’t even touch him. “Where does your shoulder hurt?” “It hurts here.” “You have tendinitis. I’ll give you a pain killer. Go home stay out of the water for 1 to 2 weeks. Give me a call if it still bothers you. Tylenol is okay. And then when you start up again start easy.”

You can prevent 99.9% of those instances with what we are going to do right now. The true injury that occurs in swimming often has to do with impact. I have had kids run into the wall, run into each other, paddle entries, and things like that. For those types of injuries you have to take care of in a different way. What were are going to do is show you how to take the strains and treat them before they become sprains or before they become the tendinitis, and keep the kid in the water. Any questions so far?

You need to know a little anatomy. Everyone here knows a little anatomy and physiology. I hope you all know a little bit about muscles. We are going to teach you a little bit about them. That’s one of the major muscles we use in swimming. We exercise that muscle quite a bit and we do a lot of dry land for that muscle. Notice how large it is, latissimus dorsi.

We all know a little bit about muscle recruitment don’t we? When a muscle gets tired other fibers come in and help it out. That muscle has a lot of fibers. We’ve also trained that muscle. That muscle is not a problem. Let me get rid of it. (referring to overhead display).

There is a another big muscle. We train this muscle a lot. We go in the weight room and do repetitions, we do dry land work, stretch cord work, for the trapezius muscle. “Oh, I got a pain in my neck.” It probably is your trapezius. Feel it. Pinch yourself on the top of your shoulder between the tip of your shoulder and your ear and that thick thing right there is your trapezius . That’s where it’s the thickest and it is a problem. Down along the back it is not very thick. If you have somebody near you, go ahead and feel the back of that person and feel how thick the trapezius is. You can tell how thick it is by feeling over by the shoulder blade, the scapula. I want you to do this, reach over back behind yourself when you feel that ridge of bone, you know its separating your fingers from that skin and part of your trapezius. It is not very thick is it? You can feel that bone pretty good. Right? So that’s a pretty thin and pretty spread out muscle with a lot of fibers and they go different directions because the trapezius does several different motions. But because of the number of fibers on that thing it is not always a problem. So we are not going to address that one too much.

We are going to get into these guys — the SITS muscle group. There are four major muscle groups you need to know about. SITS — remember the S.I.T.S. muscle group. This particular drawing just shows the one muscle.

What does the shoulder really look like? You have two bones that come up. Feel your clavicle, your collar bone, just follow it over, it will dip down and it will come back up again and then all of a sudden there will be a funny place with a line in it and then if you kind of feel back you go right down the ridge of the bone you felt before, the spine of your scapula below the muscle. The clavicle and the scapula come up and join at what is called the AC joint. Acromioclavicular joint. That part on the scapula is the acromian process — they come together. Most of anatomy is pretty simple. Names are based on where it is and what it does and so on. You have your AC joint and that forms the socket of the ball and socket. Most people think that a shoulder is a ball and socket joint, but it is not. The hip is, but the shoulder isn’t. The shoulder is more of a cup and saucer joint with a very shallow fossa, and then inside that is your humerus — or sometimes outside of it, when we have a dislocated shoulder, the humerus pops out of the AC joint.

What holds the humerus in? Muscles. If you don’t have strong rotator cuff muscles, these four, you don’t have a strong, stable shoulder joint, you need to develop the SITS group, the rotator cuff muscles, and the smaller that are actually doing the work of holding the shoulder joint integrity together. The first “S” in SITS is supraspinatus. Supra means above. Spinatus means spines. Above the spine and scapula. Now you know where it is so go back and feel that, or use your partner. I would really like you to use a partner if you have one, and feel the spine and then come up above the spine and push in there, you will probably find that it is a little tender. You guys have been sitting around all weekend and trying to keep you head from falling and it’s a little tender in there. Supraspinatus comes underneath the AC joint and attaches on to the humerus and is one of the rotator cuff muscles. It externally rotates the arm. So if you feel on the tip of your shoulder and rotate your arm you’ll feel something move. That could be the supraspinatus.

Next, the infraspinatus, below the spine and scapula, is also an external rotator muscle. Now, unless your arms are really long, you might need a partner here, feel down below the spine and you’re feeling right thorough the upper part of the lat and you’ll feel the infraspinatus. That comes along and you can see it attaches on the top of the humerus.

Now, you have a swimmer come to you and say, “I’ve got a problem, and it’s right here under my deltoid,” and you think, ah hah– your shoulder muscle hurts. Not necessarily. It could be the attachment of the supraspinatus or the infraspinatus, because you know where we feel pain? We feel pain in the tendons of the muscle because the muscle when it has a problem contracts to protect the body. When it contracts it’s under tension and it’s connected to the bone by a tendon, that’s where tendinitis comes from. A muscle under tension, pulling on a tendon which is attached to a bone and that’s where you get the pain, right there at the attachment. One swimmer might not have tendinitis, they might have a tight muscle, and if it is a beginning incidence of the pain, they might say,-“Hey coach, it is starting to hurt right here,” then that is probably what it is.

They don’t have tendinitis yet. They may in another couple of days, but not yet, their muscle is tight. You loosen that muscle up and relax it and it goes back to a normal position. Guess what, that pain goes away. And guess what, that swimmer goes back in the water and continues to swim and you can do that in 90 seconds instead on 2 weeks.

Question: Why is that muscle contracting? Answer: Because it is doing 3000 repetitions a day. It is getting a little bit of overuse. That muscle is fatigued and pretty sensitive so anything can set it off. A big thing that would set it off would be if the biomechanics are wrong. Maybe the kid came into the wall and touched the wrong way. You’ve got a sensitive situation anyway, lots of things can set if off. It doesn’t matter why they have the pain it matters that they do have it and you can do something for it.

But the way the infraspinatus starts with and “I,” now we have the “T;”- Teres minor. That goes right around the outside of the shoulder to under the deltoid, a little bit lower than the infraspinatus. These three muscles are external rotators and they are prime movers in external rotation, which we do over and over, sometimes up to 3000 times or more in a 2 hour period. That’s right at the border of the scapula. Sometimes you can feel the teres or the border of the scapula if you reach under your arm and way back, and come up, you will feel a little ridge there where the scapula kind of bends a little bit. You might even be a little tender in there yourself. You will feel the bottom of it and if you come over the top of the shoulder and come down about an inch or so and go in and rub a little bit you are probably on the other joint, the other insertion actually. The origin is on the scapula, the insertion is on the humerus. That’s the “T” in the SITS.

Take your swimmer and you feel the spine of the scapula. If can’t find it, just come up the clavicle and go back down the other side and something hard, you’ve got the spine of the scapula. That’s the only hard thing back there, unless you find a little lump of firmness and guess what that is? A tight muscle. You’ll know it’s a tight muscle because if you press on it they will go “Ouch, coach that hurts.” Now if I press on that spot and it’s above the spine and I am only pressing lightly it could be the trapezius, but if I am a little deeper and it is tender, it is probably the supraspinatus. I will come out the edge and go right to the edge of the acromium and I push my thumb in there and see if there is any pain right there, that’s about where it attaches. If it is then I am pretty sure it is the supraspinatus. The infraspinatus is a bit bigger so I feel that there usually aren’t that many hard spots in it. It doesn’t usually get that tense, but it will get tense up near where it inserts on the humerus. And you can follow right along there near the insertions, you can get right to the junction of it. It doesn’t take much time to develop that sense of feel.

If I come down a little lower along the border, right underneath, there’s the teres and the teres comes up and goes right below the infraspinatus. These three guys work together to do the external rotation. They could be all working together to hurt that shoulder joint right underneath the deltoid.

There is a technique I am going to show, the first aid technique, and it is very simple to do. A doctor of osteopathic medicine by the name of Lawrence Jones developed a technique called strain – counter strain. We have evolved and now we call it shortening. A little simpler to understand, shortening. What Dr. Jones found out is that if there is a sensitivity in the muscle, i.e. pain, then he could position the body in such a way that that pain was eliminated, and hold it there for a period of 90 seconds and the brain would shut of the pain signal. It would desensitize the muscle. The muscle would begin to relax and then once the position was let go of, the muscle went back to a normal size. Very simple.

Demonstration: Lie down on the table, on your face, please. Tom, I have determined has a tight supraspinatus, infraspinatus and or teres minor. They externally rotate his arm, so I am going to externally rotate his arm. I am going to put my hand on his shoulder and take my other hand and find the border of the scapula, and I am going to push the two together and I am going to hold it there for 90 seconds. I am taking the insertion and pushing it towards the origin, I’m contracting the muscle externally and while I holding there I will ask him if he is experiencing any pain. No? Great, I am eliminating the pain, and I am going to eliminate it for 90 seconds. Sometimes you have to hold it a little longer, it is a minimum of 90 seconds. As I hold it there I am going to look down at the area or maybe take my thumb and place it very gently near the insertion of those muscles, because I am going to look and feel for a response. I may see twitches, or I might feel it twitch under my thumb or I might see the whole area relax. That is the muscle responding to the shortening and it is relaxing.

Now what I am like to do at the end of the 90 seconds is ask him to take a nice deep breath with a nice long exhale and very often what will happen is during the exhale my hands may move closer together, that to me is the sign that the muscle has let go. It is very simple. You don’t need to be a specialist, it is the simplest technique in the world to use and it works. Then you say, “sit up and how are you feeling?” Move it around a little bit and you put your hand on the shoulder and say, “how’s the pain?” And you put your finger right on the spot that hurt them. “Is that still very tender?” And they will usually say, “Well, it’s still a little tender but it is way better.” “Good, go get a drink of water and get back into your lane.” What you have done is brought that muscle back to normal position, it’s no longer under tension, it’s no longer pulling. There is still going to be a little tenderness in there, very little. Probably 50- 60% of the time there is no pain at all, the pain is gone. They did get back in the water and can swim and the pain won’t necessarily come back.

Question: What do you do if you don’t have a massage table on the pool deck.?

Answer: You can lay him down on the pool deck, or it can also be done sitting, you will have bleachers or chairs. Sitting is more difficult because the swimmer must totally relax, that is why a table is better, it is easier to relax. It is also physically more difficult, for the person giving the massage, to do it without a table. You have to make sure the arm is rotated and you push the two ends of the muscles back together and hold it for 90 seconds. So, in 90 seconds we can take the pain out of that muscle.

Another muscle, Teres major, doesn’t seem to be a big problem all the time. It does not rotate as much as it abducts the arm. It goes far down the humerus. Most of the time they don’t have pain.

A lot swimmers, and coaches get pains in their neck. Breaststrokers and butterflyers, sometimes get pains in their neck. Every time you lift your arms up over your head you have to use your levator scapula, because for your arm to go up over your head, your scapula has to move otherwise your arm doesn’t go over your head. So sometimes they’ll get a pain, sometimes a slight headache, and it will usually be at the base of the skull. The muscle attaches to the first couple of vertebrae right underneath the base of the scull. But most of the times they will get a pain in the back of the shoulder when this happens. When you do a lot of computer work, sitting a desk for a long time and then you stand up you say to yourself, “Ah, I need to see my massage therapist.” That is usually the levator. I work on this just about constantly. Almost everyone that comes in my office has a tight levator scapula. This is a real difficult one to shorten.

But I found a technique that works real well with this one, called the IO technique – Insertion, Origin. You find the border of the scapula in your partner, you find that little angular part. Take your finger and put it on that and then go pretty much up diagonally to the base of the skull and put another finger there, and hold pressure on it for about 90 seconds. By putting pressure in those two points it shuts of the golgi tendon organ, the sensor in the tendon that sends a signal to the brain that the muscle is under stretch. And it gives the brain inputs as to where the body is in space and how much tension and stress is on it. By putting pressure on or near the tendon joint there, where it joins into the muscle, for some reason it interrupts the signal and it acts like a shortening. Sometimes it takes less than 90 seconds. Frequently on computer operators and people it takes only 30-40 seconds because that muscle is so ready to let go. And when it goes be prepared because your thumb is going to sink in. Sometimes I think I am going to lose my thumb in these people. This is a problem because any time the head comes up or the arms go up over the head that muscle is being used.

Rhomboids cover the whole side of the blade of the scapula, middle back, middle upper back. They are pretty thin and they get involved quite a bit because any time the scapula moves they move. So any time a swimmer moves their arm the rhomboids are working. We do some rhomboid work in the gym, reverse flys, to help develop those. I use the same kind of technique I just used in the demonstration for the supraspinatus, infraspinatus and teres, putting my hand in the same position, changing the angle a little bit. Feel for the spine, feel for the border of the scapula, you don’t have to internally or externally rotate the arm, just grab hold of the shoulder. Put your hand just over the border of the spine, you don’t put it on the opposite side, you don’t want to push the spine. You want to be on the side the muscle is on and depending on where I think the problem is I can change my angle depending on where that little knot is. “Do you feel any pain?” “No.” “Good.” What if they feel pain? “Yeah, that’s hurts a little.” Change your angle. You want to eliminate the pain. It should feel good or not feel at all. No pain, lots of gain. Always let ii out slowly.

Question: You have talked about, knots. In most of these cases are you going to find some sort of elevation, a hardening in one of these muscles?

Answer: In 100% of the cases I will find a knot.

Question: What about us?

Answer: That depends on your sensitivity, or the size of the knot. Now everybody has felt a knot in a muscle, right? You don’t have to be a fantastically educated and sensitive person to feel a big knot. But sometime a kid will come up to you and will have the pain and the only difference is that the tissue is firmer, that takes a little more sensitivity, a little more practice. So if you start doing this you will get better, some of you might be able to do this right away. It took me a while to get sensitive, once my fingers got sensitive and I understood what I was looking for, it changed my world, it really did. A lot of massage therapists don’t feel what they are doing, I am sorry to say. One of the things when you are looking for a massage therapist is to ask them what they are feeling. If they can’t tell you what they are feeling, enjoy your massage, say thank you very much and open up the yellow pages again. They are not going to help you in the long run.

We haven’t finished with our SITS groups, and here is the other “S.” Subscapularis. Can’t see it, can’t feel it, can’t really touch it, and man is it a pain. Look where it attaches. “My shoulder really hurts right here.” Well I tell you what, you’re going to have trouble figuring out exactly what that hurt right there is. The subscap is the major internal rotator and the fourth muscle in our rotator cuff group, the SITS group. This is a “tuffy.” There may be pain down the front of the arm, way up high on the shoulder, underneath the anterior part of the deltoid. The anterior deltoid goes right over all the insertions. It’s hard to figure out which one it is because you’ve got a pretty thick muscle covering those insertions. Look at the subscapularis closely, see where it is attached? No, because it’s covered on the inside of the scapula — way deep inside. But look where it pulls, it internally rotates the arm. It also crosses the arm across the body. We determine that there is pain in the shoulder joint and we touch the shoulder and we’re coming down here underneath the anterior deltoid and, “Ouch coach, that hurts.” So I am going to internally rotate the arm, which pulls the insertion, cross the arm across the midline of the body and I am going to put a little traction on it, and hold it there for 90 seconds. This will take care of the subscapularis and the pectoralis major.

This is a real easy one to do. You are going to have swimmers that are going to want to help you by holding their arm, but then they are using the muscles. So you have to make sure to hold the weight of the arm .They have to learn to let go.

We are going to go to the other side, that’s the major bugger right? Pectoralis major. Boy do we work that. We want all of our male swimmers to have nice defined pectoralis muscles, and some of our females, I guess too. That one does give lots of problems. That’s a major problem muscle, and that covers all of the other problems.

Question: How do you determine whether that pain is the chest muscle, pectoralis major or subscap, as opposed to bicipital tendon problems?

Answer: You can do this to yourself. Go straight down your arm and feel your biceps. You have two heads on your biceps, short and long. The short head on the inside and comes right up to a piece on the scapula that sticks underneath the clavicle. The long headed biceps is outside that and fits in a little tiny groove on top of your humerus. The major problem with some swimmers is that this tendon slips out, because they are doing 3000 repetitions a day, not counting dry land training. If they get that tendon under stress and move it the wrong way it can come out. You know it came out because when you go up that biceps they will be in a lot of pain. And when you touch that place where it should be you better be fast, because they are either going swing, scream or something, so know what you are doing. And usually you can feel the tendon, it will feel like a 1/4 strip of rope sticking out. Then you know the tendon is inflamed because it is straight up and down from the top of the biceps back to where that groove is. If you really have good palpation skills you can tell if it’s in or out. If it is out you do nothing, send them to a doctor, when in doubt refer out. Send them to a chiropractor or someone like that who can put it in. A massage therapist that has done it before, can put it in, but do not do it yourself. They need to get it put in and they can’t go back in the water until it is in. As soon as it is in, they need to ice it.

Let’s cover icing. Never pack ice an area. Why? Because you freeze the tissue. Then you have more trouble with the tissue than with the injury itself. You wind up with frozen skin and tissue. Take 3, 4 or 5 ice cubes put them in a wet wash cloth or plastic bag or something and take the ice and move it. Keep it moving for a full 10 minutes. 10 on, approximately 40 minutes off, 3 times. You will get that inflammation down. Once the inflammation goes down, the pain will go away. Then they go back in the water. That could be tomorrow. Be careful of freezing even with a gel pack, because you lose the benefit of ice massage. The best thing to do is to use ice cups, fill Styrofoam cups with water and freeze them and just tear them away as it diminishes.

Question: Can you use aspirin for the pain?

Answer: Aspirin or Ibuprofen can be beneficial if the pain is really great, but remember what that does, it just kills the pain, it does nothing to help the injury. If the injury is still there and they don’t feel it because of the pain killer and they get back in the water, and they could get a serious case of tendinitis, then you have not helped your swimmer. I would rather see them not use if they can get away with it because I want them to be able to feel if it hurts tomorrow. If they come in the next day and say, “wow this feels great!” The first thing I’ll ask is did you take anything for it. When they say yes I will use my palpation skills to find out because I can work through ibuprofen, I can go deep enough to see if it still hurts. Vitamin C, a natural anti-inflammatory is good for it.

So now I have a biceps problem here. The biceps will feel, tight especially on the upper part of the biceps. Bend the arm, let it totally relax — this is a difficult one. Take your hand and put it on the shoulder and with your body weight push the elbow in. That shortens the biceps. Come out slowly, there should be less tenderness there.

There is another problem with this area. Coracobrachialis right on the inside border of the biceps, that one gets tight all the time and can give you the same kind of trouble as a biceps tendon. So when you feel the biceps go to the inside a little bit to see if that is hard. Some time the biceps will be soft but just inside you’ll feel a hard band that is about an 1/8 of an inch, like a lane line cable thickness. And that will go right up to the front of the shoulder where it attaches. And you will have shoulder pain. Shortening for both is the same, except for the biceps you can come up a little higher and coracobrachialis you have to be a little lower.

A lot of swimmers have problems with the pec minor. To help your pec minor, strengthen your rhomboids. Shortening for the pec minor — take your thumb, put it right under the arm pit, other hand over the top of the shoulder, bring the elbow back a little bit and roll it forward and hold it for 90 seconds.

Leg cramps, the same technique works great for cramps. What do we usually do for cramps? Stretch them. So did I, until I went to massage school. A cramp is an involuntary contraction. A contraction holds with little hooks on the end of the filaments like Velcro in the muscle. You go to stretch that and you can micro-tear the muscle. Using the same principle, for a swimmer who has a calf cramp, pull the heel down, and hold the belly of the muscle for 90 seconds, only slight pressure to shorten the belly of the muscle. This will take the cramp out, then they can get back in the water and kick and the cramp won’t come back.

You want to take the area of the muscle that is cramped and shorten the muscle. You can go right on the muscle and do it. If you have a kid with a pain on the back and you feel a really tight band on the lower back, find the end of the band, take your thumbs push in on the band, push it together for 90 seconds. You’re shortening the muscle. It will work. Then do a light massage afterwards and feel that it’s gone.

Hamstring muscles. If you know where any muscle goes you can shorten it. If I bend the leg and lift the knee I am shortening the hamstring. Find the hamstring that is cramped and push it together.

How to find a massage therapist in your area: use the Yellow Pages. First look for a massage school and call the school and talk to the director. Find out if they are affiliated with ABMP or American Massage Therapy Association, also ask this of any massage therapist, if not – thank you. Try again. There are massage schools cropping up everywhere, check and see if they are certified. A massage therapist should have at least 500 hours of training, minimum. There are schools that offer 1000 hours of training for their basic massage training. There are others that offer 100. Check with your state, there are only 19 states that license massage therapists. Which means anyone could walk into the business license office in one of those other states and say they are a massage therapist. Find out want the requirements are. You want a massage therapist that knows the muscles and can talk to people. Schools will often go to events. Once students reach a certain level the schools will send them out for practice to events such as swim meets, for free. And you might even be able to work a deal with the school to send a student every Saturday morning, because it is part of their education to get licensed. It is great training and the schools love to do it. You may even find somebody, that after they get licensed, who wants to work with your club.

Questions; Once you find somebody what is ideal?

Answer: If they can come in once a week that is great

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