Sock Doc 19: It’s Not The Hammy! For Hamstring Injuries, Look Elsewhere To Heal, Plus: Our Take on ‘Toxic’ Concerns with Butter and Salt

March 24, 2023


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On this episode we have The Sock Doc, Dr. Steve Gangemi, joining us. Steve is a natural health care doctor who founded and practices at Systems Health Care, an integrative wellness center in Chapel Hill, NC. Steve is also a longtime endurance athlete and is a wealth of knowledge for athletes looking to optimize wellness.

Intro Banter

Toxic, Chemical Concerns in Everyday Foods and More

  • Kerrygold bummer
    • Label is found to contain “forever chemicals” PFAS. Our take and butter choices moving forward… Read more here.
  • Salt choices for lowest microplastics and metals, etc.
    • What are the best types of salt to buy as far as those lowest in microplasctics, heavy metals, etc.
    • Celtic Sea Salt, Himalayan Pink salt, etc.
    • Is there really a concern as far as how much of the “bad stuff” is in these salts?
    • Crucial Four is a new brand dense in minerals that Tawnee is trying for her morning adrenal-health drink.
  • Where else are concentrated sources of chemicals in our daily lives–look there!
    • E.g. city water or water source for your home, drinking water, clothing, etc.
    • Any recommendations for a good bathtub water filter?
  • A healthy body should be able to handle low levels of heavy metals, microplastics, etc., and detox that properly.

Holistic Hamstrings

Hamstring Basics

  • Read Steve’s in-depth article on hamstring injuries here.
  • Quick hamstring 101: hamstrings consists of 3 muscles, the motion they provide, bridge between glutes and calves, etc.
  • Generally, hams are more often injured in running, jumping.
  • Upper hammy are more often injured in endurance athletes/runners than lower (behind knee, which is usually a calf muscle issue).
    • Upper hamstring more often a glute issue, often weak due to pelvic instability–hamstring is doing extra work to make up for glute weakness
  • Steve’s philosophy of “don’t treat the hamstring” when hamstring hurts or is injured.
    • Either coming from a different muscle or the hamstring function is being disrupted by some other muscle imbalance somewhere else in the body.
    • Hamstring might be in spasm–gastroc, soleus (i.e. calves) or glutes are not working well and hamstring is compensating.

Upper Hamstring Injuries 

  • What is usually going on, what needs to be done? i.e. glutes, hips
  • Glute test, do this BAREFOOT: stand on one leg, how well can you support yourself, stabilize pelvis, feel pain-free, etc.
  • If super solid on both side for 10-15 seconds, try doing it with your EYES CLOSED.
  • Basic balancing exercises to begin with.
  • Sacrum is really important when talking about glutes due to sacrotuberous ligament–remnant of bicep femoris, embryological piece, integrates sacrum to ischium.
  • SI nerve/joint issues
    • Sciatic nerve can go above, below or through piriformis.
  • With pelvis, glute medius (lateral, stability) and piriformis (hip rotator) are critical.
    • Piriformis balance each other, eg fatigue on one side and pain on the other.
    • Glute med and piriformis issue WAY more common than true hamstring issues.
    • if hamstrings have to kick on too often or too much, they get over-worked, too tight and hurt.
    • Why are these areas so often affected? Basic movement patterns, sitting too much, shoe choices (heel lift), etc.
  • Low back pain
    • Low back pain and anterior (front side) hip flexor connection. Psoas or even obliques, look for trigger points to help.
    • Simple test for psoas (hip flexor) tightness: If you lie on your back and low back hurts or if you can’t lie on back without putting something under your knees or bending them, then you have a hip flexor problem.

Lower Hamstring Injuries 

  • Lower hamstring pain (at back/inside of knee): way less common! Almost always an upper gastroc issue or tibialis posterior instead.
  • Tibialis posterior: probably the most important muscle of lower leg for movement: involves plantar fascia, link between tibia and fibula, affects how you pronate, how you absorb shock, toe splay, etc.
  • Actually, is that really MCL or meniscus pain or something else…
  • Pes Anserine–what is it, why does it matter here?
    • People confuse this with MCL or medial meniscus pain when it is actually a weak hamstring muscle issue.

Adrenal Connection

  • Muscle-organ relationship; applied kinesiology; biofeedback.
  • When a muscle isn’t functioning properly is that muscle injured or is it an organ influence?
  • Clinically: tibialis posterior, soleus, gastroc, sartorius, gracilis are very closely tied into adrenal gland function, more so on the right side of the body.
    • Injuries include: plantar fasciitis, shin splints, medial knee pain, calf strain… tie in with over-stress happening in life (dysfunction in cortisol, aldosterone, DHEA, etc.)
    • Muscle is not responding as it should, inhibited, instability, etc., when this over-stress is taking place (the organ connection).
    • Then what will happen another muscle will over-compensate, leading to some kind of injury (e.g. hamstring, etc).

Shoulder Issues…. for Hamstrings?!

  • Shoulders often the hidden source of lower-leg injuries.
  • Two main reasons:
    • Force closure–it’s how the hamstrings affects the SI joint through the coupled action of the latissimus dorsi; lats reach from sacrum to humerus.
    • Our gait cycle, which is contralateral. E.g. As hamstrings fire on the left side, lats fire on right side and vice versa. Integration of flexors and extensors. Glutes/hamstrings with lats/traps (on opposite sides)… and it goes deeper (e.g. knee and elbows).
  • Shoulder girdle and hip joint connection is huge.
  • Shoulder issues often from lack of movement; how often do we even have to reach overhead? How about posture awareness.
  • Many shoulder exercises often do more harm than good, e.g. bench press problems! Why we don’t like it…
    • Start focusing on the fundamentals with rotator cuff, proper shoulder mobility (e.g. external rotation), etc.

Exercises To Do

  • Steve’s philosophy on warming up…
  • Single leg work, all of it! It starts with brain-body connection and reintegrating this back into our life. Get to the point of being able to close your eyes with SL exercises.
  • SL RDL/SL DL with weights…. or SL RDL with knee drive (opposite side) and hop (with holding a weight if possible).
  • Rocking… to crawling… etc.
  • Dead hangs, scap pushups (protraction/retraction), scap pullups… take a video to know your form and work on it!
  • Single leg work vs. something like a banded lateral monster walk.
  • Caution with isolating muscles in your exercises; instead, think about using them as they are naturally used by the body i.e. functionally.

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