Seasonal Tension Patterns – Part 2

Heli shoulder stretchBy Helgrit Howard, Ph.D., R.MT. and Tad Howard, R.M.T., P.T.

As discussed in Part 1, we observed, that we had to address certain problems more in our clients during different times of the year and we discussed the winter/spring season already. Here is what we observed for the rest of the year:

June/July: sore and/or swollen knees

The many clients who suffered from pain, stiffness and swelling in their knees early in the summer had just started exercising again, after spending the winter and early spring without much physical activity. Most of them took up vigorous exercise regimes or long distance running without allowing their bodies to ease into the process. Too much exercise too soon. Their ligaments, tendons and joints were simply not conditioned enough to withstand the strain that was put upon them. Those Structures in the body that are not directly supplied by blood take longer than muscles and the circulatory system to adjust to new stresses (4). In fact, it can take month till the tendons have grown thicker, become more elastic and better load bearing.

The pain in their joints put most of those clients off further activities and consequently, I countered fewer and fewer clients with knee problems as the summer went on.

August/September: sore feet

During the warmer month, people in Illinois walk a lot more than during the colder seasons. Enjoying long walks with friends and relatives over the weekends, it was not surprising that not only did we see more people with sore feet at this time of the year, but they also tended to see us earlier in the week, just after their weekend hikes.

October to Spring: shoulder and neck problems

As the weather cooled again, people tended to become less physically active. The colder temperatures made them hunch their shoulders in an attempt to stay warm. And then there is of course the stress of the holiday season, all factors that made many want to pull their shoulders to their ears and to curl their chin to the chest. Muscles such as levator scapulae, trapezius, sternocleidomastoid, scalenes, subclavicularis, seratus anterior and pectoids were the main muscles hat people used to hold themselves in this protective posture and those were also the muscles that gave the longest lasting relieve if treated by a combination of muscular relieve and stretching.

Interestingly, we encountered different seasonal problem clusters in Colorado. We practiced in areas of the Rocky Mountains where many people are physically active all year round, be it with sports or working on their houses and farms. Not surprisingly, the seasonal problem clusters in Colorado tended to be mostly connected to various types of physical activities such as sports, building and farming. For instance, in the winter we saw many people with knee, shoulder and wrist problems related to skiing. During the road and mountain biking season we saw more people with tightness in their calves, a combination of overuse and dehydration. In the summer we saw various clients with pain in their backs caused by falls during building projects.

It is of course much easier to see the correlation between physical activities and seasonal problem clusters. Problems in the body caused by luck of physical activity and seasonal stress are somewhat harder to trace to their origin, but I hope that this article has helped to get a better understanding of some of the mechanisms that may be involved in the formation of common problem clusters.


(1) Spine. 2007 Jul 1;32(15):1687-92. Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest. Hides JA, Belavý DL, Stanton W, Wilson SJ, Rittweger J, Felsenberg D, Richardson CA. Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.

(2) Diagn Interv Radiol. 2007 Sep;13(3):144-8. CT measurement of trunk muscle areas in patients with chronic low back pain. Kamaz M, Kireşi D, Oğuz H, Emlik D, Levendoğlu F. Department of Physical Medicine and Rehabilitation, Selçuk University School of Medicine, Konya, Turkey.

(3) Br J Sports Med. 2008 Oct;42(10):509-13. Epub 2007 Dec 7. MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. Hides J, Stanton W, Freke M, Wilson S, McMahon S, Richardson C. Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

(4) www.gesundheit – Sport: Langsamer Einstieg in den Frühling

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