Another adventure…to the 2016 New York Marathon

Written by Roger White on . Posted in Blog

2016 has been one incredible year for me as a therapist.  In the summer of 2015, I had the goal of trying to get picked to work at the USATF Olympic Trials in July.  But before that happened, through a series events on pretty short notice, found a spot to help at the 2016 USATF Marathon Olympic Trials.  I wrote about that trip here.  This trip was amazing, and found an incredible passion for helping marathoners.

July came for the Track and Field Olympic Trials and I spent two weeks in Oregon where I had an amazing time working hard all day, every day I was there.  After that trip, I had to re-focus on what was to come next.  As I wrote in both blogs, those trips didn't come cheap.  I don't have an endless travel budget, and since I'm consistently geographically disadvantaged from so many major running events, I needed to come up with a new plan.

I have been doing therapy since 2007.  Having learned from Waldemar and Charlie Francis, I still had some doubt as to my skill level.  I further learned insightful techniques from Dr. Mike Prebeg and Alejandro Elorriaga at the McMaster Contemporary Medical Acupuncture course using a Neurofunctional approach.  The soft tissue techniques I picked up focusing on nerves has been a game changer.  A good friend of mine, Tyrone Edge, competed as a Masters level sprinter for a few years, and had visited Waldemar on several occasions.  If you know Tyrone, he doesn't BS.  Yet he gave me one of the greatest compliments after I treated him for a few races a while back.

Still, I had doubts in my level.  Finally, after working the 2016 Trials, I gained a new confidence in my skills as a therapist.  With goals of hopefully being chosen to work for a USATF National team in the future, I needed athlete recommendations for the application.  Reading what the athletes wrote helped my confidence but also brought tears of joy to my eyes to read their genuine words about their experiences working with me.

I feel one of the things that makes me unique as a therapist is my ability to fix things quickly with the least amount of stress to the athletes body, and also my ability to prepare the muscles for competition, something I learned from my Canadian teachers.  A runner who puts value in therapy, will appreciate these skills.  The last thing you want before a race is to get pummeled by elbows leaving your legs feeling bad.

A few months ago, the elite women's field was announced for the NYC Marathon.  As a fan of running, this was going to be exciting, with the debuts of Molly Huddle and Kim Conley, in addition to the Kenyans and the second marathon of Neely Spence Gracey, this was going to be exciting!  Out of the blue, a few weeks before the New York City Marathon, I was asked to be a personal therapist for one of the featured female runners, a runner I have worked with for a while but since moved to another state.  This runner values my skills and I couldn't be more excited to connect with her once again.  As luck would have it, my schedule was open and I was heading to NYC!

Elite runners have dozens of items to get done prior to a race.  Everything from credentialing, media interviews, drug testing, uniform checks, rules meetings, eating, and sponsor meetings to name just a few things.  Working this event as a personal therapist was different from my Trials work.  Our sessions had to be scheduled in between these events.  There was some down time for once!  I arrived Friday and soon after arrival began to work.  With the race on Sunday, any issues needed to be addressed today.

Saturday morning there was a 5K race in Central Park, where several big names ran the challenging course.  During this time, the runner I was with went for her run in another part of the park.  Most times I work with athletes I'm stuck in the treatment tent or I see runners inside on my table.  This was a unique opportunity to observe her running and doing strides.  Taking mental notes for the therapy session later that day.  After the Saturday session, things looked to be feeling good.  We went through a timeline for Sunday's race.  Her bus was to leave a few blocks from the hotel at 6 am.  Figuring out the sleep schedule for Sunday morning, we determined I had to be ready at 5:15 am for any last minute tune up work before she left.  At 6am, the runners headed to the busses.  Her husband, coach, agent, friend and myself all walked her to the bus, gave her some "Go Get 'Em's" and then had to wait several hours until the start of the race.  The women's race would end between 12:30 and 1pm.

img_4166I was able to get a Grandstand pass at the finish line and headed there early to get a good spot.  (The finish line is just behind me in the photo).  Watching the telecast at the finish line, it was exciting watching the splits every few kilometers, wondering what was going on in the race on the roads.  Eventually the runner came to the finish giving everything she had left.  Watching all the runners finish, it was clear this course is pretty brutal at the end.

After a post race drug test and a quick meal, we had time for a quick post race treatment to help facilitate recovery before I had to head to the airport to catch my flight.  It was an amazing experience, and I hope there are more like this in the future.

Unless something last minute comes up in the next month, this will be the finishing trip for 2016.  I am excited for 2017 and can't wait to see what new adventures await!

 

Sports Massage at the 2016 Track and Field Olympic Trials

Written by Roger White on . Posted in Blog

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In 2014 I started doing interviews with therapists who had been a part of special events, such as the Olympic Trials. Through a series of events over that time, I was able to participate in the 2016 Track and Field Olympic Trails in Eugene, Oregon. Counting the Marathon Trials in February, this was essentially my second Olympic Trials, I was part of the Track Town Medical Team.

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The medical team was made up of massage therapists, physical therapists, athletic trainers, chiropractors, acupuncturists, medical doctors, and a sonographer who was able to provide diagnostic ultrasounds for athletes with injuries. One fellow team member called this a “medical utopia.” Further down the way from us was a section reserved for personal medical, where athletes brought (likely paid them as well) their own therapists/chiropractors.  These athletes were often sponsored and bigger names. Our medical team did see it’s share of world class athletes as well! We also saw many college athletes.  Between these two tent sections was the ice tubs.

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The Track Town Medical Team is a volunteer group, paying our own travel expenses to Eugene. Since we were IMG_1960volunteers, there was some flexibility in our availability. I felt that this might be my only chance to work an Olympic Trials and after discussing the financials of the trip with my wife, decided to attend for 12 days, essentially the entire duration plus a few extra days.

Although I was volunteer, TrackTown did provide housing in the campus dorms for no additional charge, as well as breakfast in the dining hall each morning. This accommodation is essentially what allowed me to stay the extra days. I spent just over $1000 in travel (flight, bag fees, airport shuttle), and about $200 in food (mainly dinner, snacks, lunch, etc). I am a middle school teacher, and taking 12 days to go to an event like this is somewhat easy to do. However, with three children under 7 years old, going away also cost quite a bit more in child care. To be specific, $800 more in childcare for the two weeks I was gone, brining my total costs of this trip to nearly $2000.

IMG_2047Being from suburban Detroit, there are few opportunities to be a part of these large special events. Travel is a necessity to get to where the action is. Others on this medical team lived in Oregon, California, Washington state, Arizona, Maryland, New York, and Georgia to name a few off hand. My main job is a math teacher, and therapy has become a hobby of mine, an expensive one at that. Give the amount of money I have spent on courses, licensing, insurance, and now traveling to Los Angeles in February and Eugene, there certainly is a price to pay when one wants to work with elite athletes. The athletes I prefer to see at home often have little money to afford the services I provide. Many have bartered with me for various things as well. I see these athletes when I have free time and provide multi-hour sessions as a result, giving them quality care. Given the large financial cost to be a part of events like this out of state, I will have to be very selective moving forward, and look to find opportunities to at least cover travel and small daily income. Talking to many veteran therapists, they all say I’m crazy to think this will happen, but one can only try!

I flew out of Detroit June 28 and got to Eugene midafternoon. After checking in to the dorm, I went to get my credential and work clothing. We were provided with two t-shirts, a hat, a jacket and a water bottle. I can’t even tell you how many people commented on liking the jackets. During our work time, we were required to wear this along with khaki/tan pants/shorts.

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After getting my credential I walked to Hayward, which was a short 5 minute walk from the dorm. A few other people on the Medical Team were already there, but the day was not very busy at all. I wanted to get an idea of the layout and how things would work.

My first work day was June 29. From this day on, I essentially worked “double shifts” the entire time, by choice. I came out there to work, and work I did! Those who worked double shifts were able to get lunch coupons, where lunch was paid for. I did this for a few days and realized I was missing out on seeing athletes at the tent. So I decided to get a sub sandwich to bring with me and eat in between athletes, if I was busy. I barely took a break most days, eating my sandwich and throwing down some caffeine to keep me going. This hard work didn’t go unnoticed by other members of the team. The beginning of shifts was often slow, and in some cases, athletes wouldn’t arrive for a few hours. However, once they started to arrive, it got busy until we closed.

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Athletes from any event (coaches, agents, and event track officials also came in at times) came in and filled out a temporary chart that served for documentation during the Trials. The intake table was run by a group of chiropractic student interns. They would get the athlete’s file and assign them to the desired medical team member. Many athletes received multiple treatments depending on their issues being treated. For example, it was common for a competitor to see a chiropractor first, then hope on a massage table, and some even topped it off with an acupuncture session as well.

 

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Going in, I was hoping to work with a lot of distance runners in the 5000m and 10000m events, but, for whatever reason, the medical team barely saw those runners. I did get to work with a few, however. The first session of the trials included the 10,000m, 100m, 400m, 800m, long jump, high jump, men shot put, decathlon, men pole vault, men javelin and the first round of the steeplechase and mens 5000m. All other events took place in session two in the second week. Athletes from these events came in for various reasons, including general massage to take “the travel out of them” a few days prior to competing, spot work due to injury coming into the trials, or just a general light massage, often called a “flush.” Once the events started, post race treatments usually were short “flush” sessions. Some athletes came in for stretching as well, either before their event, the day before the event, or after their events. It was very common for athletes to come in on race day for a pre-competition adjustment from a chiropractor. Few people saw a massage therapist before their event, unless there was an issue that needed to be worked out.

Being new to this event, only a handful of runners knew me from previous encounters or mutual friends/coaches. Athletes often requested a specific therapist because they had worked with him/her in prior events. Other athletes didn’t mind who they saw. Coaches and agents often came with the athletes, often keeping a watchful eye on what was going on. After a few days, I started to get a few requests and return athletes. This gave me confidence that I was doing a good job. However, some athletes saw me went to see other therapists in other days. Although I would have liked everyone to come back to see me, this is why we had so many therapists, each with their unique style., in order to serve the athlete’s needs.

Is one style/person better than the other? It’s hard to say, and hard to prove since you can’t really do a scientific control. Does the therapist make a difference in the athlete’s performance? In general, likely it does not. In situations where an athlete is hurt, injured, or has an ache or pain, I do believe the therapist can become a life saver. During my stay, there were situations where I was that life saver for athletes, who often were randomly assigned to me and had complaints of nagging pains. In my time as a therapist, these special cases are something I have done very well with. Getting rid of an athlete’s pain, often a pain that has been with them for a long time, is one of the easiest ways to create trust in them and result in repeat visits down the road. There were other situations where the athlete didn’t perform well, also. Was it something the therapist did? Or was the athlete not prepared? Or maybe over prepared? It’s hard to say. In general, I would say the majority of the athletes were thankful for us being there to provide support, whether they performed well or not.

Many of us worked dozens of hours (I was around 90+ hours in my time there), and to get a hug, high five, Twitter/Instagram shout out, or a small “thank you” means so much when we are working for t-shirts, away from our families for days and weeks at a time.

Overall I had an incredible time in Eugene.   I met some great people from all over who have incredible stories themselves working in high level athletics. I met some incredible athletes and created some wonderful bonds with them. Hopefully I will be able to see them again in future events.

 

 

Working the 2016 Marathon Olympic Trials

Written by Roger White on . Posted in Blog

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A few years back I was interested in finding out what happens at big races and how one gets selected to work these events. I did a series of interviews with some of the top names in the US in sports massage for runners. One thing was certain, a therapist must be good at what they do. I have always felt that athletes spend countless hours and years training to become world class, then I need to spend countless hours and years studying and perfecting my skills to be world class as well. What follows is my “behind the scenes” look into my experience at this event.

Through a series of events, I was invited to be part of the medical support team for the 2016 U.S. Olympic Trials for the Marathon, held in Los Angeles in February. The support team was comprised of massage therapists, physical therapists, and chiropractors. The Trials race was held on Saturday, and the room hours were open Thursday and Friday throughout the morning and afternoon, Saturday before the race and also after the race.

Travel

I live in a suburb of Detroit, Michigan and had to fly to Los Angeles on Wednesday. Living in Detroit has limited opportunities to work with high level runners, so if your goal is to work with these type of athletes, you need to go where they are, and that might mean having to volunteer to get experience in front of them. Out of the support team, a good portion of volunteers were from the Los Angeles area, and a few others had made the trip from afar. Yes, you read that correctly. Everyone was a volunteer for this event, paying their own way to provide free services to the runners in this race. From what I have gathered, many events provide therapists on staff who volunteer their time and money to be there for the runners. Every runner I spoke to about this was shocked, surprised, and at the same time very appreciative of the service we were providing them. For a great majority of the runners, they have limited funds for therapy, and certainly cannot fly their own therapists to races (something that does occur with the top runners and is one of my future goals). This free opportunity provides many runners with treatments to get their bodies ready for the race.

We were provided with a shuttle from the airport to our hotel, or in my case, an Air BnB apartment. The athlete hotel was already booked, and room rates were over $200 a night. With my flight costing $522, I was ok staying at some place less expensive, since I had planned on working morning to night while there anyways. I had never used Air BnB before but had known about it since a few close friends have used the services to rent and also rent out their place previously. I found a place for $50 a night about 1.5 miles from the hotel I would be working at. I figured that was a short walk I was capable of and booked the room. A few other rooms a few blocks closer were near $80 and would have cost me another extra $100 or so, and I went with the budget move. Upon arriving and catching a shuttle (which was actually Suburban), I was dropped off at the apartment.

Let the Work Begin!

Upon getting situated in my room I was renting, I made contact with Terrel Hale, who had been the therapist who allowed me to have this opportunity. He was staying a few blocks away at another hotel, so I made the short walk to see him before it was too late, and also for me to explore the area I’d be walking each day.

Roger and DaniI was scheduled to work Thursday 10am -2pm. I arrived extra early, part from excitement, part from being on east coast time still. Around 10am runners started to come in. In the athlete reception area, there was a sign up board for 30 minute sessions on Thursday and 20 minute sessions on Friday. As athletes came in, they were directed to whoever was available at that time. As a courtesy to the runners, we did not want them waiting around. If they wanted to see a specific therapist, then they may have to wait. It was steady that morning, and I was able to see four runners in that time frame. One of the runners who came in to see me was a local runner from the Hansons-Brooks Team Dani Miller.

After my shift was over I went to help a few others who had previously contacted me to help them out but had landed after the room hours were available. The first night I finished around 10pm, and after walking about 6 miles that day, with my massage table on my back, courtesy of the Mobiloop strap, I had little energy left and called an Uber to take me the two miles back to the apartment. I crashed and had to wake up for an 8am-12pm shift on Friday.

On Friday I had seen three runners that morning, and then a few others after my shift. With the race the next day, the treatment should be light to just loosen them up. Aggressive treatment is needed only in extreme situations, and there were plenty for this race. A recurring theme with the runners that came was injuries that occurred in the last hard week of their training (usually 2-3 weeks prior). For many of these runners, their goal was to finish the race, as a few were deciding on not racing at all. I finished Friday evening again by calling an Uber back, but this time a bit earlier than the previous night. In the two days so far, it looked as if I walked nearly 13 miles with my massage table on my back through DTLA. I went to bed excited for race day, and couldn’t imagine what the racers must have felt.

Saturday was an 8am start time for me. I took my early morning wake up and walk across Downtown Los Angeles (DTLA for short) to the hotel, and made a special trip to cross the streets Hope and Olympic Blvd. The racers had to be at the start area early, which was about a half mile walk from the hotel we were working out of. Originally our group was scheduled to be at the start and finish line, but a day prior was told we would remain in the hotel before and after the race. The morning of race day was very slow. I saw one runner, which was great, because some therapists didn’t see anyone.

Roger and NeelyI went out to watch the race on the course with friends Neely and Dillon Gracey. The therapists were asked to be back at the hotel by the end of the race to handle anyone needing treatment post-race. The race was run in warmer than usual temperatures for a marathon, and it was not pretty. Many runners dropped out due to cramping and heat related issues. Most ran poor times as a result and the theme from reading many of the runner’s blogs is they just wanted to finish the race, regardless of the time.

Post race was pretty slow as well. A few runners came in much later than anticipated and in that time, I didn’t see anyone. A few runners that did come in needed some injury treatment as a result of the race.

Overall the energy was incredible. Having been a spectator in 2012 in Eugene for the Track and Field Olympic Trials, there is something spectacular about this environment. Observing the runners, they appeared to share this excitement. There is also a comradery associated with seeing people you don’t see often.

The experience was priceless. I am very glad to have been able to attend. I felt I did a great job meeting new people and networking. I wasn’t there for a vacation, but as an opportunity that may lead to more of these type events in the future. Well, the experience wasn’t quite priceless. All in all, I spent $1184 on the trip (Flight, airport parking, baggage fees = $747, apartment room rental =$247, Uber costs=$ 45, food = $84 for all the meals from the airport departure to the airport return). However, it was a great experience I won’t forget.

Interview with Dr. Jess Greaux on the Noraxon system

Written by Roger White on . Posted in Blog

Dr. Jess Greaux founded Innersport Chiropractic in Berkeley, California, with a focus on sports injury management for those seeking an active lifestyle.  Dr. Greaux is an Active Release Techniques (ART) instructor, and a certified ART Ironman Provider.  In Dr. Greaux's clinic, she uses Noraxon, which measures EMG, pressure mapping, and real-time 3D video analysis.  Dr. Greaux had some time in her busy schedule to answer some questions about Noraxon.

Dr. Greaux, your clinic has a specialization in sports performance. Also unique to your practice is your use of surface EMG using the Noraxon system. Can you explain what sEMG is and how you utilize it in your practice?

sEMG tells us which muscles are firing when (or not!)  We learn muscle sequencing and firing patterns while someone is running, biking, squatting, jumping, etc.  We found most athletes are extremely good compensators, mimicking near perfect form.  However, once we look at the sEMG data synced with video, we are learning how they are accomplishing the technique, which usually involves compensatory, asymmetrical firing patterns.  It’s a BS-ometer.  

Very interesting stuff! There are constantly new releases of technology on the sports performance market that measure different aspects of athlete performance. However, interpretation of this data is not always simple.   In my experience for example, it took a period of months to be able to understand what HRV data meant, and how I would change athlete training as a result. Thus interpreting the data is quite nuanced, and usually the black and white process that every coach would hope for.

How would you describe your learning curve with the Noraxon system? How long did it take for you to get useful data? Who guided you to be able to gain useful information from this system?

We are still learning how sEMG can help us. Seems like the applications are endless.  Noraxon sent reps to work with us one-on-one with our own clients.  I’ve also learned some analysis through Chris Powers during his courses at his Movement Performance Lab.   And, then it’s research and trial and error.  We’ve learned a lot by experimenting with patients and ourselves.  

Do you think there is a clear-cut connection between Noraxon data with athletes doing isolated movements vs. when they are doing dynamic movements like a sprint?

Nothing is ever clear-cut.  Or not as much as we’d like when we are dealing with the human body.  However, yes, we are finding that if someone has difficulty with activating the glute max doing a supine bridge, then it has carried over to running.  In fact, that’s why sEMG is so useful.  We notice they can’t fire the glute max during running, then we work backwards to find WHICH exercise they can be successful in firing the glute max.  Sometimes we may only find 1 exercise where they are successful, then we eventually work forward with more dynamic exercises to get them to running with glute activation.  

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Analysis before treatment intervention

 

 

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Post-treatment analysis showing improvements

Many therapists do assessments with patients on tables, some also include movements such as squats or other exercises. In your experience using sEMG to quantify the assessment, does the patient’s position make a difference? In other words, does a traditional table assessment show similar patterns as those when doing dynamic movements such as squats etc? What about, for example, if someone shows impaired glute firing doing a glute bridge (or another exercise you use to assess), do you expect impaired glute firing during a full effort sprint?

I have to say the sEMG shows us more consistency across various movements vs. movement screens.  However, with that said, every patient is different and not everyone is consistent.  And that is why we use sEMG, to see what THAT particular patient’s compensatory patterns are.  It takes out the cookie-cutter approach to assessment and treatment.
Along with the glutes, it’s common to see trainers and therapists talking about glutes not firing and then” turning them on” or “activating” them with exercises or therapy. Based on your data, can these exercises, such as a bridge, show noticeable changes on sEMG?

Again, everyone is different.  We have given exercises to patients to get the glutes firing, only to learn they still compensate and fire hamstrings, or even glute med instead.  So, this is where we find the exercise that THEY are successful in to fire the right muscles at the right time.  Once we find the exercise that makes them successful, we have them perform the exercise while watching the sEMG data to perfect it.  Then we move on to more dynamic exercises eventually working our way to their particular sport.  

Noraxon is a data gold mine! I’ve seen a professional runner’s report that was several hundred pages long. For someone like a runner, how do you filter this data report to get the most useful information to direct your treatments for that athlete?

It’s all a process.  We don’t use sEMG alone.  We look at videos and force time plots and foot pressure to learn the whole picture.  Many of us have several dysfunctions and asymmetries.  Using sEMG synced with video and other technology we are able to learn the key problem areas that may be causing more than one dysfunction.  Basically we are weeding out the bad data from the useful data by looking at more than one system.

For a new patient/athlete coming to see you, can you walk us through what they would go through in the initial session, and how you use sEMG on the subsequent sessions is used to guide treatment?

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Foot Pressure Mapping

We have several services.  Some come to us for an injury in which they go through a diagnostic exam.  Then we put them through a data collection session with one of our staff.  The patient and I will review the data at the next appointment in which we will determine course of treatment.  Some we go right into gait retraining if they don’t need treatment, but most people need treatment for adhesions that can alter mechanics.  We’ve used sEMG pre/post ART treatment with amazing results.  It verifies our treatment approach.

Sometimes runners and cyclists come to us just for a run analysis or bike fit.  We use sEMG during the analysis.  Some continue to schedule gait or pedal retraining where we use sEMG as biofeedback.  It’s a very power biofeedback tool. 

In addition to foot pressure for runners, you also do seat pressure analysis for cyclists. If a cyclist comes to your clinic of knee pain during rides, what might your assessment using seat analysis look like?

 

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Saddle Pressure Mapping

Yes, we love using saddle and foot pressure for cyclists along with sEMG.   These two technologies allow us to learn HOW the body is responding to a change in fit and treatment!  For instance, we make a change to the fit, does the body perform more symmetrical?  Do they get better glute activation?  When I see dysfunction on the bike and they are unable to load one sit bone on the saddle (seen on the saddle pressure), and then I treat the thoracic spine or hip rotators, does it improve the saddle pressure data? If it does, then I know which exercises to give them and what to treat with ART, Graston, or Myofascial Decompression.  Again, it’s a BS-ometer.  Test, treat, and retest.   Many bike fit systems look only at numbers or knee alignment.  However, the angle measurements do not tell us HOW they are accomplishing the movement or alignment.  sEMG and saddle/foot pressure does.  We learn if the knee alignment looks better because they are activating the muscles correctly to accomplish good technique or are they using the wrong muscles at the wrong time.  Or are they able to get good knee alignment because they are shifting their weight to one side and twisting on the saddle.   This is where treatment is vital.  If they are compensating to “look” good on the bike, then we can treat so they don’t have to compensate.  I think this is what is missing in most bike fits.  The BS-ometer.  :)

(On Dr. Greaux’s website, she wrote up a case study report on how a high school runner was helped using what she talked about.   http://innersport.com/archives/date/2012/12 )

Amazing stuff Dr. Greaux. Thank you for taking time and sharing. This is incredible.

You can learn more about Dr. Jess Greaux's clinic and extensive services at http://www.innersport.com and her own blog The Straight Scoop

 

 

 

Runners Massage Studio - 2013