This is the most important time to flush the body out, through soft tissue techniques and a skilled manual physical therapist. Traditional PT includes evaluation, exercise prescription, home program, some apparatus (bike, treadmill, etc - i.e. time killers..) and modalities (such as ultrasound and e-stim). Unfortunately, this plan of attack does not help a thing! Included in this is treating the pain symptoms and increasing blood flow, but here are some questions:

1. Why strengthen the body is you are strengthening improperly - if the biomechanics are off, you are encouraging the habits and compensations?

2. If there is scar tissue, adhesion buildup, and muscle strain, you need hands-on treatment to help!

Hands-on therapy does include the feel good massage, the flushing and light touch. But, unless you are with a PT that really understands the problem (the attachments of the muscles, the difference between tendon, muscle, nerve, and ligament pain) then the treatment is really just moving things around, not goal oriented!

Post Ironman is the BEST time to pledge to take care of yourself - to take time to stretch, to get the gait evaluation you know you need, and to actually listen to the results of the gait evaluation and break down your strength and conditioning routine and start from the beginning. Yes, this may actually mean no running for days, even weeks, but rebuilding is important to prep for next year. PT's can help with this through biomechanics evaluation via video or live analysis.

ART (Active Release Techniques) is the Performance Care Treatment for Ironman North America races. Almost 50% of Ironman racers, Elite or Age group, have their own ART practitioner in their hometown. ART is a continuing education manual therapy technique, very advanced, mostly used by chiropractors and physical therapists with extensive knowledge of the body- muscle placement, their job, the nerves that supply them, and the whole kinetic chain. ART is a 3-part certification for whole body, with over 300 protocols. Then, the advanced practitioners who treat the Elite athletes will have Biomechanics certification (picking apart gait, why pain happens, and enduring efficiency of the musculo-skeletal system through treatment). There is also a course in nerve entrapment - to help to differentiate between muscles that are off-balance in their jobs, and nerves that are not allowing the body to function properly.

ART can be done to:
1. Treat pain and problems that exist already; whether chronic or acute.
2. Figure out why mechanics and gait are "off".
3. Increase efficiency of muscles, muscle groups, and body parts in sport.
4. Release nerve entrapments otherwise medically diagnosed and guided for surgery (carpal tunnel or tarsal tunnel, sciatica, neck disc herniation).
5. Increase recovery after race, after workouts, and in preparation for peaks and valleys of training season.
6. Increase oxygenation of muscles to make the most out of strength workouts, training, and muscle re-education.

Once the race and season are over, find someone that can help you. See them to introduce yourself and your body, so that when crisis hits, you know who to go to and how to get the job done. Don't wait until it's too late. In addition, it's not a bad idea for PIMS (post Ironman Season) revamping and body makeover- fix your biomechanics so that your off-season is the most productive that it can be!

So long cortisone shots; so long rest and ice - treat where the problem is! In combination with TP Therapy tools, stretching, and proper warm-up and cool-down, you can take care of your body.

Trigger Point, the "at-home ART supplement"

As it pertains to self massage

- If you have a pre-existing condition, such as tendonitis, muscle strain, or orthopedic injury, the TP products will help to flush the system out post-race (night of, day after, and week after - even though it may hurt!)

- Even if you are not injured, the products need to be used after racing or long training days for injury prevention purposes. Consider 1 mile of running what the body can handle without recovery - anything above and beyond that, you need to assist the muscles in recovery, the nerves in tension decrease from surrounding muscles to avoid entrapment, and the lymphatic system to flush out the muscle waste and byproduct. We sleep after a long day of being awake, so TP after exercise!

- Injuries often happen the week or two after a major peak race. The body is tired, certain muscles are fatigued, and even though you perform the same activity after racing, such as a shorter ride, or a slower run, the body still needs the same kinematical motion. Biomechanics change, due the body self-adapting to fatigued muscles, and overuse injuries, or secondary injuries, occur. Prevent this - use TP Therapy.

Gina Pongetti is the co-owner of OccuSport Physical Therapy, Chicago's largest provider of elite endurance sports medicine, as wel as a biomechanics expert, and Race ART Lead for North America Races. She also serves as a medical advisory for the Timex Multisport Team.