“Stack your joints.” As students, we hear this in every class. “Stack your joints.” As teachers, we offer this reminder throughout our asana practice. But when it comes to forward folds, it seems we forget this cue in our journey toward the floor. Or do we even know what it means to stack our joints?

Examine the joints involved in a forward fold. We flex our spine, pelvis & hips over our stable knees and ankles. Proper alignment in this position would have us stack our hips over our knees & ankles instead of moving our hips posterior and behind our ankles. (see the image below)

So why do we make this shift? Simply stated, it makes the forward fold easier and we feel more balanced. Mechanically, we end up flexing farther forward when we shift our hips backwards. But anatomically, we are no longer stacking our joints in this position.

Notice how the line of gravity differs from the angle of her legs. Her pelvis is behind her ankles and therefore is not stacked properly. This causes stress on her hamstring tendons, knees & ankles.

Why all the fuss? When we shift our hips behind our ankles we put a lot of extra stress on the upper hamstring tendons. Their attachments on the ischial tuberosity (sits bone) begin to fray and get damaged. Over time, the repetitive stress of this improper movement can cause significant pain and damage making yoga, and especially forward folds, very challenging. Also, when our hips are behind our ankles our weight shifts into our heels often causing us to lock our knees in order to regain stability. Without a microbend in our joints, we create a lot of unnecessary friction and the potential joint pain & long-term damage.

So the next time you begin a forward fold, remember your cues. Ground the “4 corners” of your feet into the earth, rise out of your joints expanding up toward the sky, microbend your knees, and stack your hips over your knees & ankles. Your body will love you for it!

This is a great example of proper alignment in a forward fold. Notice how the center of her hip joints are aligned over her ankles making her legs straight but without locking her joints (note the microbend in her knees). Don't make the mistake of trying to align the back of your glutes with your ankles or heels as those are not the correct reference points.

Here is an example of a knee scope & microfracture.

The scope cleans the uneven surfaces to make the cartilage “smooth”. The goal is to keep as much of the original cartilage as possible while removing the worst areas that are frayed or uneven. Microfracture creates tiny fractures in the bone which causes blood and bone marrow (which contains stem cells) to seep out of the fractures. This creates a blood clot that releases cartilage-building cells. The microfractures are treated as an injury by the body, which is why the surgery results in new, replacement cartilage

We have observed knee surgeries, shoulder surgeries & a carpal tunnel release for numerous clients. We can explain our findings to you and work as an advocate in your health care. We can also help you make modifications to your activities, sports & yoga practice. While we always recommend discussing your medical procedures with your doctor, it can be helpful to have us review your surgeries. By the way, we’re not necessarily advocating surgery. Talk to your doctor first if you’re concerned.

For more information on how we work with knee pain, click on our page Massage Therapy for Knee Pain .
For other injuries, go to our page Common Injuries we Treat .

We Were Quoted in a Recent Article

The Real Cost of Quitting Smoking

Original article by Bloomberg.com 4/13/12

read our quote……. see full article

Our Injury Specialist, David, was contacted by Bloomberg.com in February to discuss using massage therapy to help people who are trying to quit smoking. We told them that our work was about supporting people on their path to making healthy lifestyle choices. We believe that people who choose to quit smoking are ready to make other positive shifts in their lives and we’re here to help empower them.

Those of you who have already experienced our work know that it’s, well, not that relaxing. So instead of only focusing on the relaxation aspects of massage, we explained that when people are ready to quit smoking, the focus for us would be to encourage body awareness & to help them make shifts in their physical health. Perhaps they’re ready to start exploring other aspects of their bodies, like how postural imbalances can cause back or neck pain, to fully optimize the way they feel. Because after all, we should feel great as often as possible!

Here’s the quote:

“David Abookire, injury care specialist at Boulder Therapeutics in Colorado, says therapeutic massage can help relieve stress and make quitting easier. It often goes along with other therapies such as hypnotherapy and acupuncture.”

OK, so the quote doesn’t fully embody all the content we had hoped it would. But it’s a step in the right direction. And as many of you already know, we’re here to support our clients and educate the community. A big thanks to Bloomberg for including massage therapy and for contacting us as “experts” in the field.

It’s important to recognize that yoga, like any physical activity, has the potential for injury. But unlike sports, yoga is NOT about competition. Let’s start there to maintain a safe yoga practice.

Yoga is NOT a Competition

Yoga is about getting in touch with our bodies, understanding our physical limitations (many temporary) and reaching a full-expression of our safe movement patterns…and so much more. Recognize that we’re all built and shaped differently so certain poses come easier for some people than others. Stay grounded in your practice and focus on getting to know yourself while trying to avoid forcing poses to please your instructor or out-do your neighbor. Once you’re in touch with your body, and truly understand the mechanics behind an advanced pose, slowly start to challenge yourself in a safe way. Practice consistently and be mindful of your limitations to keep your practice safe. And for the yoga instructors out there, please remember to remind your students to be safe, not to push students too hard and to focus on the goal of “doing no harm.”

A Yoga Class is for You, Not Your Instructor

An amazing yoga instructor can guide you thru a class with intelligent sequencing and proper verbal cues, but even a well-trained instructor can lead you into harm. Always make the class your own. The instructor is there to help facilitate your practice. Don’t be bound by every word they say, and be sure to do some research before jumping into a class or studio to make sure the education & training matches your needs. And when ego gets involved, whether from the student or the teacher, it’s best to check in with yourself and remember why you’re in class.

Modify Your Yoga Class to Meet Your Needs

The focus on the yoga class should be on you. If you have an injury or are new to yoga or a certain pose, trust your instincts and modify the class to fit your needs. An instructor and the studio should always honor your decision to modify a pose or to simply take a rest while the class continues. If they don’t, you may want to look elsewhere. Know your body, listen to any physical warnings and always be patient to help maintain a safe practice and avoid getting injured

Which Verbal Cues Are Correct?

At your first yoga classes, you’ll often be trying so hard to keep up that you won’t hear many of the cues given to help prevent injuries. Please be patient with yourself, move slowly and don’t push too hard. As you progress, you’ll start to hear the cues more clearly. It’s important to understand the poses so you can properly align your body to prevent injuries and ultimately find some freedom & release in your pose. It can be confusing when different studios & even instructors give cues that can oppose what you’ve heard in another class. My philosophy is to use cues that support proper anatomical alignment in order to maintain a safe practice. Cues like “stack your joints,” “don’t lock your joints” and “maintain a neutral neck” follow sound advice based from injury rehab & prevention practitioners.

Just Because you Can, Doesn’t mean you Should

Individuals who are very flexible or are hypermobile are often drawn to yoga because they’re good at it from day one. It’s so important to understand proper alignment of the joints and your spine to avoid doing harm. Just because you’re extremely flexible does not mean you should push your body thru its full range of motion. Doing so may actually be harming your body. I recommend reviewing our blog article on “Hypermobile vs. Hypomobile Joints” for a basic understanding of the difference.

Research Your Studio & Instructor

There are many teachers who lack a deep understanding of proper alignment to prevent injuries in their class. Also, some studios focus on really pushing people and their limits. Look into the philosophy behind your local studios; are you in the right place? Does the class description match your goals? Has the instructor been trained properly and does their bio represent an individual that provides what you need? Do some research and remember that it’s a difficult task for an instructor to teach 8, 12 or 40 people at a time so do your best to find a class that meets your needs. And at the end of the day, be patient and listen to your body. There is a lot of wisdom within each of us if we just listen.

Watch how your spine moves when bending forward. Notice the increase in pressure on the vertebral disc when sitting without back support. Traumatic injury or force can cause the disc to protrude, weakening its outer wall called the annulus fibrosis. As your disc weakens, a disc bulge is more likely. A bulging disc can push on the spinal nerves or spinal cord. Over time or with enough force, a disc herniation can occur where the inside of the disc, called the nucleus pulposis, protrudes thru the outside wall.

Common symptoms of a weak, bulging or herniated disc are pain, numbness or weakness. These symptoms may be in your lower back or they could travel to your hip, buttocks or down your leg, especially if your disc is pushing on your spinal nerves. Often, the disc protrudes toward the back and to one side or the other (posterior & lateral) causing symptoms on that side of the body.

There are many treatment options for lumbar disc injuries. The video outlines a few and we often recommend rest first and then ice. While we strongly recommend you see your medical doctor, we also know from experience that massage therapy can help…when applied properly.

If you have back pain and have a question about how we can help you, we encourage your comments below. You can also view our injury page on Massage Therapy for Back Pain.

It’s not uncommon for people to wake up with discomfort in their neck or back. Sleeping is the time for our bodies and brains to rest and “reset.” It’s unfortunate that many people wake up in pain. Below are some tips to help you find a comfortable, biomechanically correct posture while sleeping.

Avoid Sleeping on your Stomach!

It puts too much torque on your neck and upper back. For those stomach sleepers out there, I know it’s tough to hear. I used to love falling asleep on my stomach. It took a few months but I was finally able to change my sleep position and find it more comfortable over time.

Sleeping on your Back or Side is Ideal!

When thinking about sleeping posture, imagine what you’d look like if you stood up in your sleep position. Is your head jutting forward, is your back overly curved, are you leaning? If you’re bending your hips in side position, are your knees slightly bent or tucked too close to your chest? Try to emulate proper standing posture in your sleep. Recognize that it won’t be perfect but just try to get as close as you can.

Start Slowly…There’s no Rush

It takes time to change your sleep positions. Lower your expectations and just START each night on your side or back. Of course you’ll likely roll into a less-desirable position. But if you start each night correctly, you’ll slowly retrain yourself to sleep thru the night with better posture.

Tips to Stay in a Proper Sleeping Position

For your body, pillows are your friend. If sleeping on your back, put pillows next to your thighs to make it more difficult to roll over. If on your side, put a pillow behind your back. Then, it will be waiting for you if you roll over to your side.

Pillows

When sleeping on your back, use a very thin pillow to support your neck. I often use a thin pillow and roll up the edge to fit the curve of my neck. You can also use a small hand towl rolled to fit under your neck. Try not to lift your head too far off the bed with a pillow as that’s not a healthy position for your neck.

When sleeping on your side, your pillow should keep your head in a neutral position. It should fit in the distance between your ear and your shoulder when supporting the weight of your head. Try to avoid curling your head too far forward as that’s not as supportive for your spine & neck. Use a pillow between your knees to keep your top hip level with the ground.

Firm Beds are Best

Be sure to sleep on a firm to medium firm bed. Soft beds don’t support your bodyweight well and they can alter the curves in your spine.

Show me Pictures

To see images of proper sleep positions, check out our stretching page and download the “Proper Sleep Positions” pdf.

We’re fortunate to be a part of Impact Sports Performance , Colorado’s Premiere Sports Performance and Injury Rehab facility in Broomfield. For the past 2+ years, we’ve been working on creating packages for youth and professional athletes that bring together massage therapy, physical therapy, nutrition, chiropractic care and sport-specific training sessions. The facility also has a full gym, offers classes for youth and adult athletes and has a training facility for MMA fighters.

Recently, Boulder Therapeutics has been providing sports massage therapy to a professional baseball player & a professional skier, coordinating our treatments with the skilled trainers at Impact. This work helps the athletes recover from their workouts more quickly and receive maintenance on the imbalances in their bodies. We look forward to more collaboration with such high-level athletes and trust they’ll soon see a dramatic increase in their performance.

This month, we launched an Ultimate Performance Package for Figure Skaters which combines sports massage therapy, performance trainings & nutrition consultations for high-level youth athletes. We’ll likely be launching many more of these programs in 2012.

If you’re an athlete in the Broomfield area looking to increase performance, reduce injuries and find an edge in your sport, give us a call or send an email to see how we can help you.

Boulder Therapeutics believes that healthy living is a lifestyle choice and something we do for ourselves and family everyday. During our massage sessions various health-related issues and topics are often discussed and we feel this information should be shared with all of our clients.

We have created a list of links that we refer our clients to regularly. By paying attention to the products you use and the food you eat, you can take some simple steps to have a more healthy lifestyle. The list is always changing and being updated, please check back often.

Safe Body Care Products

Many skin care products, shampoos, toothpastes, and cosmetics, etc. contain ingredients that are harmful to your skin and your long term health. Read ingredients labels and whenever possible, choose products with natural ingredients.

Toxic ingredients to avoid: Sodium Lauryl Sulfate (SLS), Ammonium Lauryl Sulfate (ALS), Paraben Preservatives, Propylene Glycol, Polyethylene Glycol (PEG),Isopropyl Alcohol, Aluminum, Mineral Oil, Talc, DEA, TEA, MEA.
For more information, click on the link below.

Skin Deep: Cosmetic Safety Database

An amazing resource that allows you to search by product, ingredient or company to find or compare great, natural products.

Environmental Working Group

The mission of the Environmental Working Group (EWG) is to use the power of public information to protect public health and the environment.

Deodorant:
Lafe’s and
Aubrey Organics.

Lotion/Oil: Many of our therapists use Zen Organics Lotion for your therapy sessions and for personal use.
We also recommend oils from Home Health.

Salve: Good for wounds, sores, bites, burns, itching & rashes including diaper rash. Kuumba Made Herbal Healing Salve.

Shampoo/Conditioner: Giovanni and Aubrey Organics.

Sunscreen: Kabana Green Screen and Badger Sun Care.

For faces, La Defense by Luzern Laboratories.

Safe Baby Care Products

Baby Shampoo & Body Wash: California Baby

Bottles:: It’s best to avoid plastic bottles when possible. Evenflo makes a glass bottle in 4oz and 8oz sizes. Several companies sell these online.

Diapers: 7th Generation offers chlorine-free diapers. They’re good for the environment and for your baby too.

Diaper Rash Cream: Weleda (from Germany) makes a calendula diaper cream that works and smells great.

Nutritional Food:

Organic is BEST!!! You can buy organic in most stores now, and you can even have organic produce delivered to your door every week. Check out Door to Door Organics.

Avoid dairy and meat with rBGH. Genetically-engineered bovine growth hormone (rBGH) in milk increases cancer risks.

Avoid sugar when at all possible. Sugar is in much of the foods we eat, so make sure you read ingredient labels. For example, sugar is commonly found in yogurt, bacon, crackers, peanut butter and pasta sauce.

When cooking or buying food that contains oil, stick to olive oil, coconut oil, sunflower oil, safflower oil, and butter. Canola and soybean oils should be avoided. These are marketed as healthy oils, but are far from being so.

GET OUT OF THE BOX!!! Try buying and eating fresh food instead of processed food that comes packaged. Although this is difficult and more time consuming, your body will thank you.

Clean Water:

Water Bottles: Klean Kanteen has stainless steel water bottles for adults and children.

Water Purifiers: APEC Reverse Osmosis Systems. Install under your sink to to purify your tap water.

Water Sanitizers (Hot Tub): Water Tonic is a great chemical-free hot tub solution. Easy to use and it works great!

The Doctor is in Meditation

We’d like to thank Chris Kassar for recently interviewing our Injury Specialist, David Abookire, for her article on healing athletic injuries thru alternative medicine. Look for it in the September issue of Elevations Outdoors Magazine. The article quotes many local practitioners from acupuncture, yoga and massage therapy and even some local athletes. For you Boulder locals out there, you may recognize a few names.

Chris approached us as “experts” in injury rehab & sports massage therapy to contribute to her article. Check out the online version to read the entire article yourself. We appreciate the opportunity to share our knowledge (on pages 2 & 3) and look forward answering any questions you may have.

Now get outside and play!

On page 2:
“By the time I see an athlete, they have often already tried a number of things and nothing has worked,” says David Abookire, founder of Boulder Therapeutics, which specializes in sport and injury massage. “Alternative therapies look beyond the pain to the patterns behind it. Often, we need to put a system in place that will unwind these patterns and get the body back into balance.” By honing in on the body’s weaknesses and finding the injury’s source, practitioners can empower athletes to care for themselves over the long term.

On page 3:
“When you’re treating athletes, there’s a totally different mindset,” explains Boulder Therapeutics’ Abookire. “The focus has to be on helping an athlete heal so they can get back in action, back to what they enjoy—whether it’s running 100-mile races or going on a short hike.”

If you’d like to discuss how we can help you with any of your injuries, feel free to contact us or call at 303-444-1171.

We encourage you to review some of the stretching routines we have outlined on our website or contact us for guidance with your new programs.

A balanced cross-training routine will help you perform better for your active lifestyle. No matter what the weather brings.