Pectoral Strain

[grprahl]

I strained my left pec today. Didn't get it diagnosed by anybody but I've strained my hamstring enough times that I'm pretty sure this is what it is. Not too severe though. Definitely grade 1 and no worse. No tear larger than microscale, I pretty sure. Sometimes the hamstring strains feel like you get hit with a shotgun while running. Well I'd call this getting hit by a paintball gun from long range, so not as bad. It actually took me a second to figure it out. I was like, "did I just strain my pec? Hmm... Yep, must of".

The stupid thing is how I did it. Ring strength? Heavy bench? Nope. I was doing plyos. I was doing an exercise called double knee jump. This is where you kneel on a mat next to a 30" box. In one motion, you "jump" off your knees onto your feet, and then immediately explode onto the box. Well, that first movement requires a powerful arm block for me, and it was during that arm block that it happened.

What are some good rehab exercises for strained pecs? I'm assuming this has to be somewhat common in gymnastics. I've been icing it off and on (haven't used compression, don't really have the tools to wrap my chest). I'm also trying a topical anti-inflamatory called traumeel. Don't know if it really works or not. There aren't a ton of studies on it, but it probably can't hurt. I will follow this protocol for probably the first 48 hours post injury to get the swelling and inflamation under control, and then I'll start rehab exercises.

I don't plan on it taking too long to get this one back to healthy. Maybe 3 weeks all together. But I don't want to risk reinjury during the healing process, because I know from experience that multiple strains in the same spot can lead to chronic injuries.

[Joshua Naterman]

I don't mean to be insulting, but I would like to point out that this is a perfect example of why plyometrics shouldn't be done by anyone who hasn't developed the proper basic strength levels for the plyometric exercise in question! I realize you may not be new to strength training or plyometrics, so please don't take it that way.

I'm sorry, I don't mean to be insulting. It is simply a very, very classic example of just how much force can be generated in plyometric work! The problem may have been as simple as you being insufficiently warmed up. It happens! Usually you want to do a plyo warm up that starts with very easy plyometrics, just so you know for future reference! The line of force involves the pecs to a much greater degree than push ups do in the arm block you describe, so you may simply have not conditioned the specific muscle fibers and connective tissue involved in that line fo force! You'll have to build up by just doing a lighter arm block at first, and slowly increasing it once you're back into training! This may not have been your first time doing the exercise, so consider that perhaps this injury has slowly been building and that big arm block is just what did the final bit of damage.

You're doing it right, as much ice as possible for the first 24-48 hours. After that, you need heat. The heat increases bloodflow which increases healing. Plenty of protein, plenty of sleep, plenty of fish oil (ideally) and probably a week off will get you to where push ups aren't a problem. Make sure that once you hit that point you take 4-6 weeks to scale back up to your previous programming, and be a little more conservative about the plyometrics for a little while! You haven't done anything terrible, you probably won't even notice it in 3 weeks but it will still be lurking in the shadows waiting for you to get saucy!

Make sure you stick with the WODs and the FSP warm up to make your body as injury proof as you can!

[grprahl]

It is simply a very, very classic example of just how much force can be generated in plyometric work! The problem may have been as simple as you being insufficiently warmed up. It happens! Usually you want to do a plyo warm up that starts with very easy plyometrics, just so you know for future reference! The line of force involves the pecs to a much greater degree than push ups do in the arm block you describe, so you may simply have not conditioned the specific muscle fibers and connective tissue involved in that line fo force!

I'm definitely not new to the explosive exercises. Before I lifted, I did a 15 minute dymanic warm up and played a couple games of pick up basketball, which required strong arm blocks on most of the rebounds and shots in the paint. I should have been warm. Granted I didn't do specific plyo warm-up, but I've done this type of stuff plenty of times before with just my normal warm up, usually without the basketball.

This is why I personally think that

perhaps this injury has slowly been building and that big arm block is just what did the final bit of damage.

. I really can't think of any other reason that it could have happened in this case. My only question is why there was no warning, no gradual build up of pain recently. The first time I pulled my hamstring long jumping, I could feel the muscle gradually getting more tender and tight in the practices leading up to competition, but tried to push through anyway (lesson learned).

It really hasn't been hurting too bad. No noticable swelling. ROM is almost normal. Slight bit of discomfort right before I get to where it'd normally be a good stretch. So yeah, I'll continue icing. Today I'll start some pain free mobility and flexability exercises that I got off of the sportsinjuryclinic website and continue to do those everyday. My guess is I'll have pain free ROM in a few days tops. After 48 hours, I'll start strengthening as well, starting with pectoral isolation exercises (probably band work), and adding exercises, intensity, etc, as long as the muscle responds well, gradually making the switch from pec isolation to chest/shoulder combination exercises and functional exercises.

I don't plan on doing the same level of certain exercises or extremely high intensity work like you said until 4-6 weeks, assuming everything else has gone as planned.

[Joshua Naterman]

Huh. I tend to agree with you. Scar tissue could have a lot more to do with the problem than the actual conditioning of the tissues you hurt, so perhaps an ART practitioner could help you. If that's not available at least look into myofascial release and trigger point therapy. All of those can help with breaking up any tissue adhesions that may have contributed to your injury. Are you familiar with tissue adhesions? What do you think about that possibility?

[grprahl]

Are you familiar with tissue adhesions? What do you think about that possibility?

I've had ART, Graston, and deep tissue massage on my hamstrings. Out of the three I feel like ART was the least effective, although it could have to do with the practitioner. Case in point: 1 grade-one hamstring strain during track, followed by 2 more reinjuries in the same spot trying to come back too early. Then took a couple weeks off. Talk about scar tissue. It was so thick I couldn't go through a normal day without some sort of pain. Then I found out about ART and went 3x a week for a couple months. It made it somewhat better, not a full recovery though. Then saw trainers back at college. They started deep tissue massage (very painful) and graston (like a deep tissue massage using metal tools to dig in). But after a week or two, I was back running and lifting as if nothing had ever happened. For some odd reason, the more painful the therapy, the more effective it seems to be for me. Perhaps the guy doing ART on me simply didn't work deep enough.

Anyways, I had my first half hour massage of the summer at the Y on wednesday. The therapist worked mainly on the legs, but commented on how I seriously need work (it was his first time working on me). In fact, every person that's ever worked on my muscles has said they're abnormally tight. I've been told my hamstrings are like "braids of rope". But basically, they get better. With some good deep tissue work my adhesions generally clear up pretty fast. I'm going back for a one hour massage on friday. I'll have him mainly work my legs, but perhaps start working LIGHTLY around the tight tissue of the pectoral.

Considering I've never had deep tissue work done on my upper body, I believe scar tissue built up over time probably could be the cause. And if this is the case I'm actually suprised nothing's happened sooner.

[Joshua Naterman]

I noticed the same thing. The ART I had hurt like hell, but cleared up problems in my shoulder and arms almost 70% in just one session. It was the closest thing to magic I have ever encountered for my injuries. Coach pointed me to a guy out in San Diego and he was fantastic. Doesn't specifically advertise as ART but he understands active release, so while it may not be the exact method the general principle works great!

The therapist was like dude... your biceps feel like one big lump. It's supposed to be soft and fibrous. What the heck have you been doing?! So I told him my history very briefly and he was like "OH. That makes sense. Well, it's no wonder you're screwed up but we're going to fix that. How is your pain tolerance?" So I told him about BUDS and it's high, so he went all out pretty much, going as hard as was safe. It was a combination of active release and deep tissue and trigger point work. He told me about a really neat trick that another patient used to deal with the pain, which is to intentionally laugh as it starts to hurt really bad. It works! Nothing bothered me at all once I started that, and there were moments that I needed it. I stayed for 100 minutes, paid 100 dollars, and it's the best investment since I bought my rings and Coach's book.

[grprahl]

He told me about a really neat trick that another patient used to deal with the pain, which is to intentionally laugh as it starts to hurt really bad.

LOL, I can imagine a person walking past a therapy room and hearing laughing and thinking "WTF is going on in there?" Never thought of that before.

There's another plausable idea that I hasn't crossed my mind until now. My coach once told me of a certain thing that can happen during high intensity activity. We have adhesions in the muscle. Sometimes it's possible that a certain movement will set off a pain that feels much like a strain, when in reality a large adhesion was released. It's still sore for a while, but much shorter recovery time than an actual strain. Not sure if that's what happened in this case, but I suppose it's certainly possible.

[Joshua Naterman]

I was thinking the same thing, but then I thought " You know, if you have an adhesion and it rips, there's going to be damage to at least one of the fibers involved, and large adhesions are attached to quite a number of fibers, so in the end I suppose it's not that much different." I didn't know things like that would heal faster than a classical strain[degrees][/degrees], that's very interesting!

Edit: If that IS the case, some fascial stretching is exactly what you need to make sure that adhesion doesn't re-form. THe "extreme ISO" push up and dip positions are going to help a lot. I only did them for a month during my layoff and they made a huge, huge, extreme difference. Sorry about using the "extreme" again lol! Just remember, it's a stretch not a hold. Kind of like the German hang.

[grprahl]

Sometimes it's possible that a certain movement will set off a pain that feels much like a strain, when in reality a large adhesion was released.

I'm really thinking this has to be what happened. It's simply healing too fast to be a strain (unless it was a VERY minor strain). Within 3 days a had a complete pain free ROM. Daily activities are completely pain free (even using my arms to adjust myself in a chair or flexing chest muscles a decent amount, even pushups). Today I did a dynamic warm up and ran 14 x 100m on the minute and I completely forgot there was anything wrong to begin with. If it had been a strain, I would think that fast running would have at least given it some discomfort.

Also, I had a massage on Friday, and I had the guy poke around a bit in there. He felt where the tightness was right away but said it didn't feel all that bad and didn't think I had strained it. He worked out much of that tightness as well.

You know it was interesting, as I did some research on the fascial stretching, I found out that some bodybuilders do it to increase muscle size. I guess the theory is that if the fascia is tight is holds back potential growth. That seems like a good idea in theory but I kind of doubt it could make a measurable difference. The therapeutic benefits are good enough for me.

[Joshua Naterman]

Fascial stretching has a LOT of other things happening. When a muscle is progressively loaded in the most stretched position, muscle fibers start to divide longitudinally and make more muscle fibers. This leads to a longer muscle with more fibers. THe existing fibers also appear to migrate and physically make the muscle itself longer as well, independent of any hyperplasia that takes place. Fascial stretching does a lot more than just help keep adhesions under control, and it is all beneficial to athletes.

[grprahl]

What would be a good length of time to hold a fascial stretch for? And one long set or multiple short ones?

[Joshua Naterman]

From what I understand, it doesn't actually matter so much whether it is in one long hold or many short holds, but fewer longer holds will get results somewhat faster. You don't have to start that way, and you may not be able to.

Jay Schroeder suggests 5 minute holds, which honestly aren't as bad as they sound after about a month. At first, they absolutely are lol! You're not going to do that, and neither did I. It took me a few weeks to consistently get a lot of 5 minute holds. At first, if you need to do sets of 30s that's fine. I'd say to first build up to a 1 minute single hold using 60s totals, and when you can do 60s single sets start doing multiple sets, building up to 5x60s. Eventually you can save a lot of time by doing longer holds, like a single 2-5 minute hold. It doesn't have to be every single day, but the more often you do it the faster the body adapts. You CAN do it every day without injury, but that may not be possible for every stretch. For what we do here, the two best things to practice are weighted pike stretch and the German Hang. Don't add any weight to the German hang until you get to at least a 2 or 3 minute hold. Yea, I know. That's a long way off for me too lol! The strength gains you can get out of this are immense, and the flexibility is simply excellent. The results are long term, both in showing up and in how long they last, because they come from physical changes in the muscle, not just nervous system adaptation though that happens too. Just like our FSP, consistency is the key.

If there was a third stretch, I'd do either a chin up hang OR a chair shoulder/chest opening stretch like this one:

Source: http://www.trickstutorials.com/index.php?page=content/flx3#dsf_2b4

There are some other holds that will enhance performance in other areas, but for gymnastics these are where it is at.