Posted on 21 Comments

The thigh

The thigh

The thigh is the area between the pelvis and the knee. We divide the thigh into three compartments: anterior, medial, and posterior.

Anterior compartment muscles

 
SartoriusIt is the longest muscle in the body. It assists in flexing, weak abduction and lateral rotation of the hip, and knee flexion.
Origin:
anterior superior iliac spine (ASIS)
Insertion:
1. upper medial surface of body of tibia

Pain and symptoms associated with the Sartorius muscle– Burning stinging pain under the skin starting at the outside of the bottom of the hip, traveling down the thigh to the inside of the knee (pain and/0r stinging can occur anywhere along the muscle)
– Inside of knees may be painful or hypersensitive
– Sleeping with a pillow between the knees often eases painActivities that cause sartorius muscle pain and symptoms

– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Sports that require planting one foot and making a sharp turn (basketball, football)
– Walking with an extended long stride

Quadriceps femoris: It is the knee extensor muscle.  As a group, the quadriceps femoris is crucial in walking, running, jumping and squatting. It´s subdivided into four separate “heads”:


Rectus femoris: It is the only muscle of the group which crosses the hip joint and is a powerful knee extensor when the hip is extended but is weak when the hip is flexed.
Origin:
1. anterior head: anterior inferior iliac spine (AIIS)
2. posterior head: ilium just above the acetabulum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
 

Pain and symptoms associated with the Rectus Femoris muscle

– Knee pain that feels as if it originates under the knee cap
– Pain in the front of the thigh extending down into the inside of the knee
– Weak knee
– Stiff knee
– Inability to fully straighten knee
– Pain walking down stairs
– Restless Leg Syndrome
– Sharp pain deep in the front of the thigh while sleeping

Activities that cause rectus femoris pain and symptoms

– Cycling
– Climbing
– Running and power walking
– Swimming
– Kicking a football or soccer ball
– Swimming
– Wearing high heel shoes
– Sitting excessively

Vastus lateralis or externus: It´s the largest part of the quadriceps femoris.
Origin:
1. greater trochanter
2. lateral lip of linea aspera
3. lateral intermuscular septum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Vastus Lateralis– Knee pain
– Pain on the side of the thigh extending down into the front and back of the knee
– Pain under the buttock extending toward the hip joint
– Pain occasionally descends into the back of the calf
– Locked knee
– Extended walking increases pain in the thigh and kneeActivities that cause vastuslateralis pain and symptoms

– Climbing
– Skiing
– Sitting excessively
– Immobilizing the knee ie. casting, inflexible knee brace.

Vastus medialis: It is the deeper muscle of the quadriceps muscle group. The intern is the most difficult to stretch once maximum knee flexion is attained. It can´t be further stretched by hip extension as the rectus femoris can, nor is it accessible to manipulate with massage therapy to stretch.

Origin:
1. intertrochanteric line of femur
2. medial aspect of linea aspera
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Vastus Medialis– Pain on the inside of the knee extending half way up the front of the thigh
– Persistent pain in the knee joint
– Can cause the knee to ‘buckle’ (trick knee)
– People often sleep with a pillow between the knees to relieve the painActivities that cause vastusmedialis muscle pain and symptoms

– Deep knee bends
– Running
– Step masters or running stairs

Vastus intermedius: It contributes to correct tracking of the patella.

Origin:
anterior lateral aspect of the femoral shaft
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament
 

Pain and symptoms associated with the Vastus Intermedius muscle

– Pain down the middle of the front of the thigh
– Pain increases when walking
– Contributes to weak buckling knees
– Pain greatly increases when climbing stairs
– Problems straightening the knee after sitting
– Stiffness in the knee causes a limp

Activities that cause vastusintermedius pain and symptoms

– Climbing
– Running
– Over exercise of the quadriceps muscles
– Overuse of the knee
– Sitting for long periods of time


Medial compartment muscles

Gracilis: Is the most superficial muscle of the medial side. It adducts, medially rotates and flexes the hip, and aids in flexion of the knee.
Origin:
body of pubis & inferior pubic ramus
 
Insertion:
1. medial surface of proximal tibia, inferior to tibial condyle

Pain and symptoms associated with the Gracilis muscle– Hot stinging pain under the skin on the inside of the thigh
– Pain is constant even at rest, changing position does not subside painActivities that cause gracilis muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Skiing
– Slipping or a misstep
– Doing the splits

Pectineus: It is the most anterior adductor of the hip. Its primary function is hip flexion. Also, it adducts and medially rotates the thigh.

Origin:
1. pectineal line of the pubis
2. superior pubic ramus
Insertion:
1. the pectineal line of the femur
2. (just below the lesser trochanter on the posterior aspect of the femur)
 

Pain and symptoms associated with the Pectineus muscle

– Pain in the fold where the leg joins the body
– Groin pain
– Pelvic pain
– Pain increases when walking
– Sleeping with a pillow between the knees eases the pain

Activities that cause pectineus muscle pain and symptoms

– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Spreading legs too far apart vertically or horizontally
– Power walking
– Gymnastics
– Splits
– Horseback riding
– Lifting with legs spread too far apart
– Hip replacement surgery

The pectineus is often injured when a person starts a regimen of power walking. During power walking, a person will often extend their stride, reaching farther than they would in a normal stride. Overextension, while walking or running, can stain the pectineus.

The adductor muscle group is used pressing the thighs together to ride a horse, kicking with the inside of the foot in soccer or swimming. They contribute to flexion of the thigh when running or against resistance (squatting, jumping…)

 

Adductor brevis: immediately deep to the pectineus and adductor longus, the adductor brevis pulls the thigh medially. Also stabilizes the movements of the trunk when standing on both feet,m or to balance when standing on a moving surface. Primarily known as a hip adductor, it also functions as a hip flexor.

Origin:
body & inferior ramus of pubis
 
Insertion:
superior portion of linea aspera
 

Pain and symptoms associated with the adductor brevis muscle

– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when turning the leg outward
– Pain above the knee
– Pain can descend down into the shin
– Pain increases while carrying objects
– Restricted movement in the hip and thigh

Activities that cause adductor brevis muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on ice or slick surfaces
– Moving legs too far apart horizontally or vertically

Adductor longus: Adducts the thigh and medially rotate.

Origin:
anterior surface of pubis, just inferior to the pubic tubercle
Insertion:
medial lip of linea aspera on middle half of femur
 

Pain and symptoms associated with the adductor longus muscle

– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when rotating the knee outward
– Pain above the knee
– Pain can descend down into the shin
– Restricted movement in the hip and thigh
– Pain is greater when carrying something

Activities that cause adductor longus muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on slippery surfaces
– Moving legs too far apart horizontally or vertically

Adductor magnus: Powerful adductor of the thigh made especially active when the legs are moved from a widespread position to one in which the legs parallel each other.

 Origin:
1. anterior fibers: inferior pubic ramus
2. oblique fibers: ischial ramus
3. posterior fibers: ischial tuberosity
Insertion:
1. proximal 1/3 of linea aspera
2. adductor tubercle
 

Pain and symptoms associated with the adductor magnus muscle

– Groin pain during activity, pain lessens at rest
– Pain in the front of the inner upper thigh
– Pain and stiffness in the hip and knee that is often felt throughout the inner thigh
– Deep and or sharp pelvic pain that can affect the vagina, rectum, prostate, and bladder

Trigger points in the adductor magnus can cause pain deep in the pelvic area. Pain may present as a dull ache or a sharp stabbing pain. Those suffering from adductor magnus symptoms often sleep with a pillow in between the knees to ease pain.

Activities that cause adductor magnus muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Climbing stairs
– Horseback riding
– Skiing
– Slipping on ice
– Moving legs too far apart horizontally or vertically

Posterior compartment muscles
 
Biceps femoris: It has two parts or “heads”. Both heads perform knee flexión. The long head (1 of the three hamstring muscles) is involved in hip extension. It is a weaker flexor when the hip is extended as well as a weaker hip extender when the knee is flexed. When the knee is semiflexed, the biceps femoris rotates the leg slightly outward.
Origin:
1. long head: ischial tuberosity
2. short head: lateral lip of linea aspera and the lateral intermuscular septum
 
Insertion:
1. head of fibula
2. maybe to the lateral tibial condyle

Pain and symptoms associated with the biceps femoris muscle– Pain in the back of the knee
– Pain toward the outside of the knee going up the outside of the thigh
– Pain worsens while walking
– Pain in the back of the leg when rising from a sitting position
– Persistent sitting can cause pain in the anterior thigh and deep in the buttock
– Pain when rising from a sitting positionActivities that cause biceps femoris muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a chair with a small seat in which the edge puts pressure on the thigh
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Football
– Soccer
– Swimming
– Cycling

Semimembranosus: It helps to extend the hip joint and flex the knee. Also medially rotates the femur when the hip is extended. It can counteract the forward bending at the hip joint.

Origin:
ischial tuberosity

Insertion:
1. posterior medial aspect of medial tibial condyle
2. fibers join to form most of oblique popliteal ligament (& medial meniscus)

Pain and symptoms associated with the Semimembranosus muscle– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Deep aching pains in thigh and knee while sleeping
– Deep pain in the back of the thigh when rising from a seated positionActivities that cause semimembranosus muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits

Semitendinosus: It lies between the other two muscles. Collectively flex the knee and extend the hip.

Origin:
ischial tuberosity

Insertion:
1. medial aspect of tibial shaft
2. contributes to the pez anserine

Pain and symptoms associated with the Semitendinosus muscle

– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Aching pain down the back of the thigh while sleeping
– Deep pain when rising from seated position

Activities that cause semitendinosus muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits

 

Posted on 3 Comments

Lower leg muscles

Lower leg muscles

The gastrocnemius is in the back of the lower leg. Deep to the gastrocnemius (farther from the skin) is the soleus muscle. They share a common insertion via the Achille´s tendon.

Gastrocnemius

Origin:
1. medial head: just above medial condyle of femur
2. lateral head: just above lateral condyle of femur

Insertion: calcaneus via lateral portion of calcaneal tendon

Action:
1. plantarflex the ankle
2. knee flexion (when not weight bearing)
3. stabilizes ankle & knee when standing

Pain and symptoms associated with the Gastrocnemius muscle

– Pain in the arch of the foot
– Pain toward the outside of the back of the knee
– Pain toward the inside of the back of the knee
– Pain going down the inside of the inside of the lower leg
– Pain around the inside ankle
– Pain on the inside of the foot in the high arch

Activities that cause gastrocnemius pain and symptoms

– Walking uphill
– Climbing
– Climbing stairs
– Cycling
– Jumping
– Swimming with toes pointed (flutter kick)
– Wearing high heels
– Tight banded socks or stockings
– Using footstools and recliners that put pressure on the back of the calves
– Sitting in a chair with knees pressed against the seat
– Sleeping with the covers tucked in too tightly requiring the toes to remain in a pointed, downward position
– Immobility of the lower leg due to a cast or brace

Soleus is a powerful muscle in the back part of the lower leg (the calf). It runs from just below the knee to the heel, and is involved in standing and walking. It is closely connected to the gastrocnemius muscle and some anatomists consider them to be a single muscle, the triceps surae.

Origin:
1. upper fibula
2. soleal line of tibia

Insertion: calcaneus via medial portion of calcaneal tendon

Action: plantarflex the foot

Acting via the Achille´s tendon, the gastrocnemius and soleus cause plantar flexion. That is, they increase the angle between the foot and the leg. The soleus plays an important role in maintaining standing posture. Together, the gastrocnemius and the soleus are involved in walking, dancing, running, jumping…

Pain and symptoms associated with the Soleus muscle

– Pain in the heel often to the point of not being able to put weight on the heel
– Pain in the ankle
– Pain in the calf sometimes extending into the back of the knee
– Deep aching in the back of the knee
– Deep pain in the low back
– Hypersensitivity to touch in the lower back
– Poor circulation in the lower legs and feet
– Pain in the jaw and on the side of the head

Activities that cause soleus muscle pain and symptoms

– Walking uphill
– Climbing
– Climbing stairs
– Cycling
– Jumping
– Wearing high heels
– Using footstools and recliners that put pressure on the back of the calves
– Immobility of the lower leg due to a cast or brace

A calf muscle tear is graded from 1 to 3, with grade 3 being the most severe.

Grade 1 symptoms

Grade 1 calf strain is a minor tear with up to 10% of the muscle fibers affected. The athlete will feel a twinge of pain in the back of the lower leg. They may be able to carry on playing or competing in mild discomfort. There is likely to be tightness and aching in the calf muscles two to five days after injury.

Grade 2 symptoms

Symptoms of a grade 2 strain will be more severe than a grade one with up to 90% of the muscle fibers torn. A sharp pain at the back of the lower leg will be felt with significant pain walking. There is likely to be swelling in the calf muscle with mild to moderate bruising. Pain will be felt on resisted plantar flexion or pushing the foot downwards against resistance. There may be tightness and aching in the calf muscle for a week or more.

Grade 3 symptoms

There will be a severe immediate pain at the back of the lower leg. The athlete will be unable to continue and unable to walk. There will be considerable bruising and swelling appearing and the athlete will be unable to even contract the calf muscle. In the case of a full rupture, often there is deformity where the muscle can be seen to be bunched up towards the top of the calf. A grade three is a near, or complete rupture of the muscle.

Posted on 8 Comments

Muscle #1

Muscle #1

Let´s talk about muscles. How many muscles are there in the human body? It´s hard to say. Usually, the number oscillates between 640 to 850 named muscles. It depends on how you count them.

There is more agreement to classify them into three categories: skeletal, cardiac, and smooth.

If the cardiac muscle doesn´t work right, the whole system doesn´t work. Often, healthy people forget this point. Fitness is about good looking but also, about good health. The primary muscle of every single athlete is the heart.

Cardiac muscle is a striated muscle, but its contractions are involuntary. Some of the cardiac muscle cells are autorhythmic. They contract even in the absence of neuronal innervation (known as pacemaker cells). Between cardiac muscles cells, there are disks intercalated. These disks contain gap junctions which provide communicating channels between cells.

Inactivity is one of the major risk factors for heart disease. Exercise helps improve heart health, and can reverse some heart disease risk factors.

The heart becomes stronger as a result of exercise, so it can pump more blood through the body with every beat. Any amount of exercise is beneficial. If you are a sedentary person, aim for 30 minutes of moderate-intensity activity (such as brisk walking) at least 5 days a week. Experts recommend doing some form of moderate aerobic activity for at least 150 minutes or 75 minutes of vigorous aerobic activity each week. You can spread the minutes out in any manner that works for your schedule. The key is scheduling some form of moderate to vigorous cardiovascular activity into your week and actually doing it. You can also switch between running, cycling, swimming, interval or circuit training.

Regular exercise, especially aerobic exercise, has many benefits. This type of activity can do the following:

  • Strengthen your heart and cardiovascular system
  • Improve your circulation and help your body use oxygen better
  • Improve your heart failure symptoms
  • Increase energy levels so you can do more activities without becoming tired or short of breath
  • Increase endurance
  • Lower blood pressure
  • Improve muscle tone and strength
  • Improve balance and joint flexibility
  • Strengthen bones
  • Help reduce body fat and help you reach a healthy weight
  • Help reduce stress, tension, anxiety and depression
  • Boost self-image and self-esteem
  • Improve sleep
  • Make you feel more relaxed and rested
  • Make you look fit and feel healthy

In time, you can make your workouts longer or more challenging. Do that gradually, so your body can adjust.

Stop and get immediate medical help if you have pain or pressure in your chest or the upper part of your body, break out in a cold sweat, have trouble breathing, uneven heart rate, or feel dizzy, lightheaded, or very tired.

It’s normal for your muscles to be sore for a day or two after your workout when you’re new to exercise. That fades as your body gets used to it. Soon, you might be surprised to find that you like how you feel when you’re done.

Posted on 2 Comments

Cardio on an empty stomach?

Cardio on an empty stomach?

Cardio on an empty stomach?
Everyone should experience and check the results in person. Far from settling the issue, I would like to point out some advantages and mistakes about it.
Aerobic exercise on an empty stomach can increase the amount of free fatty acids used as fuel. But, this is not becFood 6ause our glycogen deposits are empty in the morning. This would happen if we went to bed last night with low glycogen levels.
Almost all the energy we consume during sleep comes from free fatty acids. So glycogen deposits are not affected overnight. Next morning these fatty acids would be “free”, ready as fuel for our cardio workout.

Low-intensity aerobic workout (50-70% of maximum) on an empty stomach, increases the insulin sensitivity after exercise, and the mobilization of fatty acids.
It is important to note that at a higher intensity (> 75% of maximum) we´ll get the opposite effect.
Moreover, not all are positive. Aerobic exercise is  catabolic because it increases the production of cortisol. Cortisol levels are high in the morning, so this would lead to greater muscle wastage.

For greater efficiency of aerobic workout, your stomach should not be completely empty. I recommend a mixture: 5g of BCAA, 5g of glutamine and 5 grams of essential amino acids 15-30 minutes, before training.

Posted on Leave a comment

Warm up & Cool down

Warm Up & Cool Down

Spending time on warming up and cooling down will improve your level of performance and accelerate your recovery process.
Research work by McNair (2000)[1] and Knudson (2001)[2] suggests that the use of dynamic stretches – slow controlled movements through the full range of motion – are the most appropriate exercises for the warm up. By contrast, static stretches are more appropriate for the cool down.
Warm up increases the blood flow to the muscles, allowing them to loosen up, which can raise the flow of oxygen to the muscle cells. Doing this gradually increases the body’s temperature. This then increases the speed and force of muscular contractions, because nerve impulses travel faster at higher body temperatures, and muscles become less stiff or more pliable.

10854908_381059255406976_6757254183806810548_oWarm up also helps to gradually increase the heart rate and ensure that the demand made on the circulatory and metabolic systems is gradual as well. This initial part of your exercise session helps to improve neural function and coordination, protect major joints as it takes time to increase the supply of lubricating synovial fluid.

The warm up’s intensity should cause transpiration but not fatigue. The type of warm up needs to be appropriate for the activity planned. It also needs to be appropriate to the age range and fitness level of the participants.

The following examples cover a warm up:

  • walking or jogging to increase the body’s temperature (5-10 min)
  • dynamic stretches to reduce muscle stiffness (10-15 min)
  • specific stretches for muscles that will be used during exercises (10-15)

So in warming up thoroughly, we are preparing the body and the mind for the more energetic demands to come.

It is important to rehearse common movement patterns and skills which will be used in the match/competition. This will not only help to improve performance through ensuring the muscles are prepared for the task in hand, but will also help to improve coordination, reaction times and accuracy.
Examples of sports specific exercises include:

  • Dribbling drills (soccer/hockey etc)
  • Passing drills (soccer/hockey/netball/basketball)
  • Shooting drills (soccer/hockey/netball/basketball)
  • Cutting maneuvers (All team sports)
  • Hitting practice (cricket/tennis/baseball etc)
  • Throwing drills (netball/basketball/cricket/baseball)
  • Serve/bowling practice (tennis/cricket/baseball)

Cooling down after a workout is as important as warming up. After physical activity, your heart is still beating faster than normal, your body temperature is higher and your blood vessels are dilated. This means if you stop too fast, you could pass out or feel sick. A cool-down after physical activity allows a gradual decrease at the end of the episode.
It’s good to stretch when you’re cooling down because your limbs, muscles and joints are still warm. Stretching can help reduce the buildup of lactic acid, which can lead to muscles cramping and stiffness.

The cool down should consist of a gentle jog, decreasing in speed down to a walk followed by light static stretching. Remember to stretch all muscle groups used in the sport. Upper body muscles especially are often forgotten is sports such as football, soccer and rugby.

[1]MCNAIR, P.J. et al. (2000) Stretching at the ankle joint: viscoelastic responses to holds and continuous passive motion. Medicine & Science in Sport and Exercise, 33 (3), p. 354-358
[2]KNUDSON, D et al. (2001) Acute Effects of Stretching Are Not Evident in the Kinematics of the Vertical Jump, Journal of Strength & Conditioning Research, 15 (1), p. 98-101