Dr Mel Siff Blog

<< Another way to warm up without expending so much energy is to move each
major joint (shoulder, hip,knee, ankle, wrist, elbow) through its associated
movements. The hip can flex, extend, abduct, adduct, hyperextend, rotate
internally and externally. If you try this with one side and compare it with
the other, the moved side will feel warmer.

The motions warm up the synovial fluid in the joint…warm fluid has more
volume than cold fluid, thus giving the joint more cushioning and easier
range of motion. >>

***The extremely low viscosity of synovial fluid and relatively low
velocities of movement involved in warming up movements over a few minutes
will not produce any sufficient increase in fluid volume to increase the
cushioning capabilities of the synovial fluid. Moreover, the tissues
containing the synovial fluid will bulge to counter any small effects that
might occur.

Another issue is that any warming up will also increase the temperature of
the soft tissues surrounding and investing the joint, so that they will
become more extensible and will further diminish the value of any increase in
synovial volume which may take place.

The warming effect from exercise related increases in metabolic rate will be
far larger than that produced by gentle movements of the joints.
Interestingly, research has shown that intense iosmetric contractions of
muscle can also significantly increase the temperature of the muscle complex,
so that dynamic movement is not necessarily the only way of wwarming up the
tissues. One could equally well warm up by doing strong isometric or
quasi-isometric contractions at a few well-chosen joint angles in different
directions in free space.

PRE-ACTION PREPARATION

Of course, we do have to consider the neural components of warming up, as
well, so it would be a bit simplistic to choose one limited method of
“pre-action preparation” (I prefer a term like that to “warming up”, because
“warming up” activities involve more than mere temperature raising of the
soft tissues. In some respects, the term “warming up” is an unfortunate,
misleading and simplistic one, because it has led far too many coaches and
athletes to think in terms of the pre-exercise phase as one whose role is
simply to “warm up” the tissues.

Among other tasks, the “pre-action preparatory phase” (PPP) is there to warm
up tissues and to “prime” the nervous system. We are doing the PPP a grave
disservice to think of it only as a “warming up” phase. In the case of
animals stalking their prey or escaping predators, the neural aspect is of far
greater importance and it is high time that athletes were also made more
aware of this vital aspect of the PPP before a given event.

Dr Mel C Siff

<< I am from Bangladesh. In my country people have this conception that if
teenagers do more of stretching exercise or hang theirselves on to bar, they
will grow taller. Could you please tell me whether stretching does help a
person to grow tall? >>

*** Since height depends strongly on skeletal length, it is extremely
unlikely that short periods of time spent on stretching soft tissues will
have any noticeable effect on overall height. Height and general growth is
determined predominantly by genetics and nutrition.

A Russian book, called “School of Height” did discuss methods of increasing
height in youngsters (probably pre-pubescent), one of them being sleeping
under weighted traction, another being regular weight training. Dr Yessis
translated parts of this book, so he may be able to recall more details than
I can.

Pathological shortness of stature and impediments of growth have been treated
in very young children with human growth hormone, but stretching like in the
typical fitness class or yoga session has never been shown to produce any
significant permanent increases in height. To borrow an expression that has
been applied in other senses, “if you want to be tall, you have to choose the
right parents!”

Dr Mel C Siff

Remember that pain occurs for the very good reason of warning you about
something being amiss in the body, so it should be regarded as a subjective
indicator of how stressful or demanding a given activity is in terms of level
of loading at a given moment or of the volume of loading over a prolonged
period.

You have to ask yourself if it is absolutely necessary to indulge in intense
activity. Therapists generally tend to be satisfied if patients return to
their former level of activities within about 10 -12 months because some
rather radical surgery has involved relocation of some soft tissues to take
over the former role of the ACL. It is wiser to “hasten slowly” (festine
lente, in Latin), because you have the rest of your life to live and sensible
patience offers great rewards.

You did not say what the intense activity consists of ? What is it? If the
pain is associated more with duration than intensity of effort, then remember
that multiple episodes of short well-controlled intervals can be more
effective than prolonged, typical cardio style sessions lasting more than
20-30 minutes at a time. If you are finding your physical therapy boring, by
all means modify your current regime in consultation with your therapist -
don’t simply grin and bear something that is unchallenging or unenjoyable,
because this may not offer the best form of rehabilitation. Design a new
programme.

Meanwhile, here are a few websites that you might find useful:

http://akujunkan.stetson.edu/~smedina/ACL/acl.html
http://www.arthroscopy.com/sp05001.htm
http://www.snowcrest.net/sosm/acl/ACL.html
http://homepages.together.net/~casey1/

Here are some Personal tales by ACL “survivors”:

http://www.dcs.ed.ac.uk/home/ajcd/tales/acl.html
http://fountaindesign.com/acl/

Here is even an entire Knee Discussion Forum:

http://www.knee1.com/Body1/forums/gotokneeforums.cfm

Dr Mel C Siff