Nerve Flossing to Improve the Pike

It is an all too common occurrence. A new – or seasoned – aerialist finds themselves stuck in their flexibility journey. It seems that no matter how often and hard they stretch, no matter how many different approaches they take, their flexibility simply will not improve. Maybe it’s just the way our bones are shaped? Or maybe even our muscles are just too large? The list of possibilities goes on and on… But something that maybe you haven’t heard of yet is that your nerves might be highly involved. What does this have to do flexibility and how can we fix it? In this post, Jenn Crane of Cirque Physio discusses how to improve your nerve flexibility specifically in the hamstrings. Hamstring mobility directly impacts many of the popular flexi-positions we find ourselves in during aerial dance, such as splits and the pike.

 

  • Anatomy of the Posterior Thigh (The Back of Your Leg)

 

There is a lot going on in your posterior thigh. For the sake of simplicity, I’m going to discuss the anatomy of the two main structures that most frequently limit flexibility in your pike stretch: hamstrings and your sciatic nerve.

Hamstrings

There are three hamstring muscles (per leg) and they all originate on the bottom of your pelvis (half of one originates on the back of your thigh bone, if we’re being picky). They course down the back of your thigh, and insert on the bones of your lower leg- the top of your tibia and fibula, just below the back of your knee.

backofhamstrings

What Makes Hamstrings Stretch?

To fully stretch any muscle, you have to move the insertion away from the origin. For hamstrings specifically, this often looks like the standard forward fold/pike stretch. However, frequently in this stretch, we let our pelvis rotate downward (“tail tucked” position), which technically means you’re not fully stretching the hamstrings, because the origin is creeping towards the insertion.  To get a true hamstring stretch, the knee must be extended straight, and the pelvis must not be posteriorly tilted.

Sciatic Nerve

The next potentially pike-limiting structure of the posterior thigh is the sciatic nerve and its branches. This is the largest nerve in your body, and is about the diameter of your pinky finger. The sciatic nerve is formed from several segments of nerves exiting your spinal cord in your lower back, then it courses down behind the gluteal muscles, in between your hamstrings, and all the way under your calves and into the bottom of your feet (it branches into other nerves at several points along this course, but they’re all connected).
sciaticnerve

What Stretches the Sciatic Nerve?

Because this nerve runs from your low back to the bottom of your feet, to completely stretch this nerve, we can also be in a pike stretch- but there are several key differences with this vs the aforementioned hamstring stretch! Here’s what puts the sciatic nerve on max tension: Sitting in a pike, slouching forward (spinal flexion/tail tucked), and feet flexed.  ​​

sciaticnervestretch

  • Nerve Flossing

 

​Okay, so…how do you un-stick the nerve? Nerves tend to respond very well to a “gliding/flossing” action as opposed to a long hold “tensioning” action.  This means that you increase tension at one end of the nerve, and put the other end of the nerve on slack- then reverse this motion. Nerves respond better to slow rhythmic movement, and as such, you want to repeat this “gliding” pattern for multiple repetitions in one set.

This video discusses proper nerve gliding technique.

 

  • Nerve Mobility Exercises

 

For the purpose of your pike, I like to use the following sequence of events in this order:

Tissue Prep

​Sit on a hard surface (chair, panel mat, weightlifting bench) with a lacrosse ball or peanut right below where your glutes meet your hamstring, and knee bent. Start by straightening and bending your leg, and apply light pressure to the top of your thigh if you want to ramp up the intensity. Do this at three different points along your hamstring. You can also do this along your calf with your legs stretched in front of you.

Video demonstration: https://youtu.be/mgvr_NLUtvU

Nerve Flossing/Gliding

There are a lot of ways to do these, but the variation that seems to be the one that works quite well for most performing artists starts with lying on your back. First, grab behind the back of your knee and pull towards your opposite shoulder. Keep your toes pointed and straighten your leg as much as you can before you feel a slight tug – you could feel it in a few different places- hamstring, behind the knee, calf, or foot. Once you start to feel the tug, back off the stretch- bend your knee and flex your foot until you’re back in the starting position. Repeat this 10-15 times per side. ​**It is not beneficial to push into a big stretch or go to the point of pain, improving nerve mobility is not a “no pain no gain” type thing. Do not worry if your leg doesn’t straighten completely.

Video Demonstration: https://youtu.be/1zD1pTNbrhg

Active Flexibility: Bend and Snap

This is a great exercise for active hamstring flexibility. Start standing on one leg, with the other foot propped beside the standing ankle (for balance). During this whole exercise, you must keep your back straight and standing leg knee not locked out- with a very slight bend. Slowly reach forward, back straight, as far as you can go before your back bends or your hamstrings tell you to stop. Think about “booty out” the whole time. This keeps your pelvis anteriorly tilted, and ensures maximal hamstring stretch. If this is too easy, try the same thing but balancing on one leg instead of using the other leg for support. Keep your non-weight bearing foot glued to opposite ankle, don’t let it drift back.

VIdeo Demonstration: https://youtu.be/ByfhMjI0PJo

 

A big thanks to Jenn Crane for providing all of the material for this blog post! Dr. Jennifer Crane is a physical therapist, athletic trainer, board certified orthopedic specialist, and published author. She has been a sports medicine professional for eleven years, and has worked with a wide variety of athletes and performing artists throughout that time. In 2015, she worked as a physiotherapist living in China with the Chinese Olympic Teams in preparation for the Rio 2016 Olympics. Now, in addition to maintaining her practice in California, she works on a contractual basis with Cirque Du Soleil, as a physiotherapist in their performance medicine department. You can visit her website here – cirquephysio.com. I would highly recommend checking out her MyFLEX program if you’re looking to improve your flexibility!

 

 

 

 

 

 

Everything Hurts and I’m Dying: How Much Soreness is Too Much?

Authored by Dr. Jennifer Crane, PT, DPT, OCS, ATC of Cirque Physio.

What does current performing arts culture tell us about muscle soreness? Aches and pains? Bruises, burns, and rope rash?

“CIRCUS HURTS.”
“Train through it.”
“Tears are for home, not circus”
“Here, have some circus candy (advil/ibuprofen).” 

These are all common “circus-isms” that I’ve heard, and I want to talk a bit about soreness- is it productive? How much is too much? How do you train optimally while simultaneously avoiding OVERtraining and subsequent injury?

This is a HUUUGEE topic, and I’m only going to address a small component of it in this post.

​I was recently reading an article on implementing pitch counts in little league players (woah, #notcircus?! I know…what was I thinking…) and it REALLY got my gears turning. Not because I love baseball (…I don’t), but because one of the criteria they used for progressing pitch intensity and frequency was something I felt could also be applied to circus artists who are returning to training after a long hiatus, or even to those who are wanting to progress skill and strength levels in an efficient amount of time, without getting injured.

THE SORENESS RULE

​This criteria for training progression is referred to as the “Soreness rule.” It was initially created for pitchers, but has since been adapted and modified to fit other sports as well (running, weight lifting, etc). These rules give athletes the ability to modify their progression of skill/strength according to the soreness they experience. If the athlete feels sore, tender, or stiff, then they can use the soreness rules to guide their training for the rest of that week.

BUT FIRST…

​Here are the ground rules before I dive into WHAT the actual soreness rules are:

  1. THESE DON’T APPLY IF YOU’RE INJURED.  If you have pain that is NOT from working out a muscle, GET IT CHECKED OUT by someone who’s qualified to do so.
  2. These rules are based on stepwise progression of overall training volume, strength or skill acquisition. This means that before you get started, you need to create multiple steps/phases of training- whether its breaking a trick down into 5 phases, or just generally increasing the number of hours you train per week. For example: if you’re an aerialist that is coming back from having a baby (and have been cleared to return to aerial by all involved healthcare providers), you should first sit down and create a multi-phase return-to-full-time-aerial plan. This must be well defined, so work with a qualified coach to do so, if you get stuck!
  3. Ok, sit down for this one…I’m serious, you’re not going to like it. EACH TRAINING DAY SHOULD HAVE ONE DAY OF REST BETWEEN to ensure proper recovery and adaptation to the stimulus and load!!
    1. Yeah, I said it. The “R” word. In this context, it doesn’t mean complete Netflix and chill bedrest status for 24 hours, it just means that if you’re working on an upper body skill, to give your upper body a break the next day. Yes, handstands count. Yes, contortion counts. Yes, vinyasa yoga counts. Yes, one day = 24 hours.
  4. Each step/phase in your progression should last for at least one week. This means that you should be working on whatever conditioning/training drills comprise ONE step for SEVEN DAYS- without soreness. You must be able to do step one, completely free of any muscle soreness, for 7 days before progressing to step 2. If you have soreness during step one, you stay on step 1 (with 24 hour break between each training session) until you’re doing it WITHOUT soreness. For 7 days.
    1.  I do realize I just said the exact same thing three times. I’ve had the rest day conversation with enough circus artists to know that repetition is key, and over-defining each term is required. It is also often required for me to define how many hours are in a day, and how many days are in a week. 

CLIFF NOTES VERSION

 ​Overwhelmed? Here’s the cliff notes version: Pick a skill to work on, or an overall training goal. Break the goal down into at least 5 steps. Assign drills and conditioning for each step. Start with step 1, and don’t move on to step 2 until you’ve been doing it every other day for one week, without any muscle soreness.

Oh yeah…one more thing. WORK WITH A QUALIFIED COACH.

​PRESENTING: THE SORENESS RULE



YOU’VE GOTTA BE KIDDING ME.

Alright, there we have it. The rules. You guys, I KNOW. Your heart rate and blood pressure just spiked, and you’re getting anxious just THINKING about all those rest days, and how slowly you think you’ll progress. I’m aware that in the circus world, these rules seem SUPER conservative.

​However…as a circus PT, at least 80% of the injuries I treat are from overuse…too much training, and too little rest. These injuries tend to last upwards of 3 months (because again, no rest…) and can significantly impact performing artists career length and career quality. The kicker is, these injuries are caused predominantly by modifiable risk factors…aka, proper dosage of training and adequate rest. So yes…I understand that you’re panicking thinking about this. And yes, I understand that implementing any big change in training program is something that does NOT happen overnight, but I think these rules have a potentially huge positive impact on the overall rate of overuse injuries in circus artists, and I think there’s value to planting this seed in your minds…even if you don’t actually DO anything about it for a while!

As I said, the topic of adequate rest, proper training load and volume, as well as overall periodization of training in circus arts is a MASSIVE subject. I’ll likely have a few more posts on this topic, so if you have any specific requests, leave them in the comment section!



DR. JENNIFER CRANE, PT, DPT, OCS, ATC

Dr. Jennifer Crane is a physical therapist, athletic trainer, board certified orthopedic specialist, and published author. She has been a sports medicine professional for eight years, and has worked with a wide variety of athletes and performing artists throughout that time. Most recently, she worked as a physiotherapist living in China with the Chinese Olympic Teams in preparation for the Rio 2016 Olympics. While in China, she worked with multiple sports teams: diving, weight-lifting, fencing, gymnastics, synchronized swimming, and track and field. Of the athletes she worked with, 18 of them went on to get an Olympic gold medal in Rio.

Now happily back in San Francisco, Jen’s practice is based at Circus Center, where she specializes in injury prevention and treatment of athletes and performing artists. When she’s not working with circus artists, she can usually be found standing on her hands, swinging on flying trapeze, or spinning on a single point trapeze.

Click here to visit Cirque Physio.

Not All Bones Are Created Equal => Not Everyone Splits the Same

Have you ever heard one of your students say they don’t feel a stretch at all, but just that things feel stuck. One person recently put it this way, “When I’m in a seated straddle I can not forward fold over the center at all, there is no pain or stretch, when someone puts pressure on me I begin to feel something but it is very faint.” Our bodies are not all created equal and this article is going to highlight where some of those differences come from – particularly in the hip joint.

When someone can’t do the splits, we want to jump to the classic conclusion that they must be tight and inflexible, but that’s just simple not true. It may be true, but we can also be misled by anatomical variations of the hip joint.

Femur_Torsion_4

femur inclination

In the pictures above, do you notice the differences at the top of the femur? The ball on the end of this femur goes inside the socket of the hip joint. These two people are not going to squat the same, nor obtain the same flexibility level in their splits safely. One of these people will be able to perform a wide straddle with no issues. The other will experience pain and feel much comfortable in a narrow stance.

Hip_Socket_1

Above are two pelvic girdles. The person on the right might run into a block when trying to perform a forward fold in pike position. Below is a side view looking at the hip socket. One is pointing straight out and the other is pointing down and towards the front. Again, this lends itself to people having different positions where they are immediately comfortable and other areas where their bodies are sending them messages that say “Don’t go in that direction!”

Hip_Socket_3

Of course it would be great if every student could get perfect 180 degree splits in every direction, but if we honor the way our bodies are made, this simple isn’t anatomically possible for everyone to do safely. In the end, our goal should be to get to know our bodies better and to use our strengths, improve our weakness, and work safely to find the edge of our individual abilities and potential. Very few people are at the edge of their limits, so its important to keep working and not make excuses, but it also important to recognize anatomical limits that may exist! Most importantly, the race to flexibility is against yourself – never against the next person. Don’t compare your range of flexibility to anyone else’s. Embrace who you are and how God made you – bone structure and all.

 Photos used with permission from Paul Grilley.

www.paulgrilley.com