As a Physiotherapist muscles and what they do, or sometimes what they need to, is a fairly regular topic of conversation with our clients. This is often a very interesting conversation and allows us Physiotherapists to explain the difference between types of muscle, muscle function, and muscle building which, for progressive and effective Physiotherapy is something that at times forms the mainstay of what we do.

To begin with let me explain that within the body there are different types of muscle that have different roles to play. Namely skeletal muscle, smooth muscle and, cardiac muscle. Let me explain the difference.

Skeletal muscle or “voluntary muscle” is anchored by tendons to bone and is used to effect skeletal movement such as locomotion and in maintaining posture. Though this postural control is generally maintained as an unconscious reflex, the muscles responsible react to conscious control like non-postural muscles.

Smooth muscle or “involuntary muscle” is found within the walls of organs and structures such as the stomach, intestines, bronchi, bladder, blood vessels, and the arrector pili in the skin (in which it controls erection of body hair). Unlike skeletal muscle, smooth muscle is not under conscious control.

Cardiac muscle (myocardium), is also an “involuntary muscle” but is more akin in structure to skeletal muscle, and is found only in the heart

Of particular interest to Physiotherapists (and exercise and health professionals) is skeletal muscle which in itself can be further broken down in to type one and type two fibres.

Type one, slow twitch, or “red” muscle, is dense with capillaries and is rich in mitochondria (the power houses of muscle cells) and myoglobin (oxygen and iron carrying proteins within muscle cells), which gives type one muscle tissue its characteristic red colour. It can carry more oxygen and sustain aerobic activity using fats or carbohydrates as fuel. Slow twitch fibres contract for long periods of time but with little force.

Type two or fast twitch muscle. Fast twitch fibres contract quickly and powerfully but fatigue very rapidly, sustaining only short, anaerobic bursts of activity before muscle contraction becomes painful. They contribute most to muscle strength and have greater potential for increase in mass.

There is one further consideration and piece of knowledge that any client, patient or exerciser should know. When you commence muscle building one will not see changes in muscle mass for six weeks. This is because during this time the nervous system of the body is developing its ability to recruit muscle fibres, it is not until this has been developed that muscle fibres will begin to grow. The take home message from all this is train to your specific needs but to also hang in there, the body shape changes will come, you might just need to wait six weeks.

Ever gone to a physiotherapist and heard them say just going to try trigger point this muscle or you have a myofascial pain or you have a knot in this muscle and wonder what the hell they are going on about.

Well, the word myofascial is Latin for:
Myo = muscle tissue
Fascial = connective tissue in and around it

So myofascial pain is hyperirritable spots in the muscle or in the connective tissues surrounding skeletal muscles. These irritable spots in the medical profession are called a trigger points and in lame man terms are called ‘knots’.

Trigger points are often caused by muscle injury or repetitive strain. They often cause pain, tightness/ stiffness and limited range of movement which can lead to loss of normal function. Trigger points often secondary pain to other types of pain caused by injury.

These shortening muscle fibers can cause pain when pressed on. Trigger points also have special properties in that they can refer pain. This means that the pain people feel is often in different area of the body compared with the location of the trigger point.

A common trigger point people can relate to the most, is the one found in the trapezius muscle (muscle located in the upper shoulder). This trigger point can refer pain up the side of the neck up the posterior part of the neck and across the eyebrow making you feel like you have a headache.
Trigger points can either be active or latent. When they are active they cause this constant aching or evening burning pain. This is usually when people seek treatment. Lantent trigger point usually only cause pain when you press over them. Both active and lantent trigger points can cause the muscle to be weak due to it being taut and not as flexible.

When treating trigger points physiotherapist use numerus techniques. One of the most is to apply pressure to over the trigger point and allow the short fibers to relax under there pressure given. Once these muscles been triggered off we need to prevent them from shortening again by stretching them through full range and treating the cause of them triggering in the first place.

People often feel instant relief after a muscle has been triggered or after a few treatment sessions.

Do you have knots you want released? Why not make a booking now to see one of our physiotherapists.

The anterior cruciate ligament (ACL) is a common injury in active individuals. Statistically females are up to five times more likely to suffer injury and ACL tears are also particularly prevalent in sports that require any pivoting or twisting such as football, netball, rugby or rugby league.

Although ACL injuries are multi-factorial and cannot be linked with any one specific cause there is recent research into preventative actions that can limit your risk of injury.

As we are heading into a new winter season of sport I thought that it would be a good time to review a few of these areas.

Learn to land well

When watching sports that require a high frequency of jumping and landing it is evident that most ACL injuries occur during the landing phase. When we land our joints are required to distribute load effectively. If our movement patterns are less than adequate then tensile forces are increased inside the knee joint which places stress on the ACL.

Improving your movement patterns, learning how to appropriately stack your joints and both load and land efficiently reduces these large tension forces inside the knee.

Improve core strength

A lot of the time a lack of strength higher up the kinetic chain can lead to poor control at the knee. A lack of trunk and pelvic control has been strongly linked with ACL injury. We frequently find that with inadequate core control the knee rotates inwards and forwards which again increases the forces distributed through the knee.

Taking the time to build up dynamic core strength and load effectively through the pelvis can mean that the knee holds better patterns when pushed on the sports field/court.

Mobilise

Possibly most important factor is the need to check your joint mobility above and below the knee. More specifically a lack of ankle dorsiflexion or full range of hip movement has been linked to knee instability, poor loading patterns and increased risk of ACL injury.

This doesn’t always mean stretching and quite often routine static stretching will miss the specificity needed to improve range at these joints. Joint mobility conditioning emphasises an understanding of what is required from individual joints when performing particular movements or actions.

In short the best thing that you can do for your prevention of ACL injures or any lower limb injury for that matter is check whether your body is prepared adequately for what you are asking it to perform.

If you would like any assistance in assessing or conditioning in any of these areas do get in touch with our team at North City Physiotherapy. We are experts in movement assessment and joint conditioning and would love the opportunity to prepare you for your upcoming season.