Tag Archives: Low Back Pain

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Create Core Strength WITHOUT Crunches

Head over to onebody.live (by clicking the link below) to enhance your core stability, balance and access to intelligent, pain free movement for a full demo…and dare I say…a challenge.

Activate and engage 360 degrees of the true core.  Move it or lose it!

Movement Monday: Crunchless Core Concentration

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Running Essentials (Vol. 1)

Being a runner myself, and working with a good amount of road warriors leaves me sympathetic to some of the wear and tear suffered due to this (sometimes) healthy addiction.  While injuries and causes come in all shapes and sizes, there remain various foundational issues that can be applied universally in order to curtail potential issues along the kinematic chain.

Hyper contraction of the hip flexors is a common issue in our society mostly due to the amount of time we spend seated.  In the car during a commute, at a desk glued to computer or a couch glued to the television, around the table while breaking bread with family and friends, even putting in miles on the bike; these all lend themselves to a shortening of the front side hip flexors.

Two immediate issues created by this are a higher propensity for low back pain, and a longer stride out in front while running, which leads to a higher risk of injury due to the increased instability that accompanies a longer lever arm.

Low back pain is perpetuated by shortening and tightness in the chief hip flexor, the psoas.  This muscle has its origin on the lower lumbar spine and when over contracted, will pull down on the lower spine when standing, creating discomfort, and the perception that standing causes pain.  In actuality, while the discomfort is indeed experienced while vertical, the catalyst can be the shortened psoas due to bouts of long, uninterrupted sitting.

Tight hip flexors become an issue while running as it can lead to a longer stride out in front.  The further that leg lands out in front of you, the less stability.  This can interfere with an optimal strike, pronation, and ankle and knee stability.  Unless you are a sprinter or huddler this also is a less efficient way to run.

Modifying gait is a multi-pronged task, with frontside dominance being a key factor.  The flipside to this shortening of the hip flexor is the lengthening and weakening of the antagonist hip extensors, mainly the gluteus maximus and hamstrings.  These posterior chain muscles are designed to move us efficiently and powerfully through life, including while running.

Again we look to front side dominance now being a logical contributor to strain and aggravation to the posterior structures and tissue including the hamstrings, piriformis, SI joint and surrounding ligaments.

Easiest way to begin to avoid this is by breaking up the long, uninterrupted sitting.  Obviously total avoidance of sitting is not possible, but in most cases breaking it up is.

Try to get up and move AT LEAST twice every hour or utilize the increasingly popular and available stand up desk.  Set a silent timer on your phone as a reminder to get up every 15-30 minutes.  Not only will you create more of a balanced state between your hip flexors and extensors (advantageous for low back pain and running) but you will be metabolically awakening your system, which can help control blood sugar/insulin, as well as weight.

Another way to combat this is by working on your movement pattern and neurological firing to the hip extensors.  If when you squat your knees track forward past your mid foot, you are exhibiting front side dominance.  A good way to work on this is to practice getting into a squat with your toes underneath a chair.  The seat of the chair will serve as a barrier to your anteriorly drifting knees and force you to utilize and fire the gluteus maximus, the main hip extensor and power generator during a proper stride.

In directly addressing the actual tightened hip flexors, a foam roller works well with the quadriceps.  However the psoas (and adductors) become more difficult to release due to their positioning and may take the assistance of a trained practitioner in order to reap optimal results.

(The facial expressions and sound effects produced by patients undergoing the psoas release in our office serves as an attestation as to the necessity of the treatment.)

The front side dominant, tight hip flexor issue is obviously not the end all be all when it comes to addressing any problem a patient may present with, nor are the methods mentioned the complete package for doing so.  However, more often than not, there is some hip flexor involvement with low back pain or lower extremity issues in runners and non-runners alike.  Therefore the suggestions mentioned above are a solid addition to any athlete’s preventative or maintenance program, in order to intelligently reduce the risk of potential injury.

Be well and go get it.

Don’t Just Sit There (Part 1)

The phrase move it or lose it has been around for years and for good for reason.  The concept is contingent upon the process of adaptability or plasticity.  Without moving or utilizing certain processes within our bodies, over time we lose it.  On the flip side, when we utilize certain muscles or nervous system connections known as pathways, we have the ability to strengthen them.

This concept can be simply understood by looking at what happens when you work out or don’t work out a muscle.  If you are constantly doing curls, naturally your bicep will grow as it is your body’s way of adapting to the increased demand.  However, if you don’t use your bicep, another muscle, or various pathways in your brain, the muscle or process will become weakened or atrophied and could quite possibly go away completely.  This is your body’s clever way of adapting.  In our miraculous design, the body is designed to be as efficient as possible. Lack of an activity provides feedback that we don’t need to devote any energy or memory to this process; thus not moving it or using it, leads to losing it.

While the topic of utilizing different, diverse neurological pathways leading to plasticity is a main concept behind Functional Neurology and adjunct therapies like Lumosity, what we are talking about today is literally making sure you move as much as possible.  In particular, we are speaking of trying to avoid long periods of uninterrupted sitting as much as possible.

Mounting research has implicated extended periods of uninterrupted sitting as a major determent to your health.  We are not just talking about a culprit behind back pain, neck pain and headache.  We are not just referring to it being a contributing factor to various diseases or conditions like osteoarthritis, diabetes, and obesity.  The eye opener here should be the fact that research has shown that regardless of your fitness level, individuals who spend their days logging long hours of uninterrupted sitting actually have SHORTER LIFE SPANS.

I don’t know about you but that’s all I need to hear to perk up and pay attention.  Being someone who has always been active and involved in some level of daily fitness or sport activity, it is quite alarming (yet logical) to hear that even if you do get a good workout in multiple times per week, if you’re logging long hours at a desk without moving, you may just meet your maker sooner than expected.

I say logical because when you think about it, it does make sense that what we do the majority of our day (sitting) would have more of an impact that what we do a fraction of the day (a workout).  Studies out of NASA on the determents of microgravity situations that the astronauts find themselves in when they travel to space found the most comparable Earth situation to be sitting.

From a biomechanical perspective, there are a variety of reasons this position is bad news.  Your anterior muscles become shorted.  There are muscles in your lower half that connect to your spine and anchor to your pelvis or hip.  From prolonged, uninterrupted sitting these muscles eventually begin to shorten due to the flexed forward position.  Now when you stand up these muscles can pull down on your lumbar spine, creating the sensation of back pain and the misconception that standing up is the problem.  While standing up does actually cause the individual discomfort, it is actually due to the prolonged sitting and subsequent shortened muscles that the dysfunction and manifestation of pain as a symptom occurs.  This is a prime example of what we talked about in the previous post of going beyond addressing the pain or symptom and fixing the breakdown that led to this symptom in the first place.

If we move up the spine and throw in the fact that prolonged sitting is usually taking place at a desk or car, we begin to flex forward in the upper portion of your body as well.  This shortens the muscles of your anterior shoulder and chest and gives you that hunched forward, kyphotic thoracic spine, and anterior head carriage.  The muscles on the posterior side now become over worked as they must fight even harder to hold you upright.  This leads to that mysterious shoulder and neck pain that you experience after a long day at work.

Lengthening, overworking and weakening the posterior side muscles from uninterrupted sitting and poor posture leads to the breakdown in function that we touched on in last week’s post that so often leads to back pain and other dysfunction.  It is these posterior chain muscles (think low back muscles, glutes, hamstrings, calves, etc.) that are designed to keep us upright and moving smoothly, efficiently and pain free through space.  When the front side muscles become shortened and the back side muscles become lengthened and weakened we begin to not only assume poor posture but a faulty movement pattern that predisposes us to other injuries at proximal and distal locations throughout the body.

Actual sitting is also the worst position for your lower back.  This makes sense too if you think about it.  When we stand, our body weight is distributed through our spine and pelvis to the lower extremity where we have numerous muscles designed to assist in this matter.  When we sit we have removed everything from the upper portion of the pelvis down as far as support goes.   Now our low backs must support the entire weight of the upper half of our body.  This load is heavily placed upon the discs in between the individual vertebrae of our spine leaving them dehydrated and compressed. It is a major reason behind the widespread and seemingly “normal” degenerative disc disease and osteoarthritis seen in our heavily seated culture, but not in others.

Another pitfall of the effects of prolonged sitting is that due to the flexed forward, anterior posture assumed, you actually close down the space available for your organs to function correctly.   Full chest expansion (and thus filling capacity of the lungs) is impeded and you are no longer able to take in as much oxygen.  This leads to widespread systemic consequence because as we know, virtually all function within the body requires oxygen.  Organs within the abdomen can become compressed and deprived of optimal blood flow leading to dysfunction within the liver, digestive tract, reproductive organs, etc.

Hopefully all of these reasons are enough to spark some interest in learning what you can proactively do to make sure you are not included in the “normal” range of society.  It is currently estimated that some 80% of the population will, at some time or another, suffer chronic low back pain.  This widespread prevalence does not exist in other countries that are not sitting all day, every day.  This should tell us something.   I don’t know about you, but if “normal” is having an 80% chance of low back pain, I want no part of it.  I also don’t want any part of the other issues sited in the previous paragraphs.

Stay tuned for our next post which will illuminate some simple steps you can begin to implement as far as breaking up the sitting and doing what you can to avoid these seemingly “normal” issues.

Have a great weekend.

The Long Term Solution to Pain

To a clinician, there are a variety of reasons that the public comes knocking.  As a chiropractic physician, the overwhelming reason for that initial visit boils down to the presence of pain.  Pain is the problem and people come to us looking for a solution.  Sure, chiropractors are in the healthcare field and many have opened their own practices but the bottom line is that we are in the solutions business and to be successful you must give the people what they want.

Now, treating pain naturally is a chiropractor’s specialty.  The use of various soft tissue techniques, cold laser or e-stem, and of course the adjustment all can work wonders in alleviating pain.  However, many times the pain returns after the initial relief from treatment.  The reason for this is that the underlying cause of pain was never addressed.  This is where the profession and healthcare as a whole falls short.

When someone presents with a symptom such as pain, the goal of both the practitioner and patient is to get out of that pain.  However, pain alleviation should be just phase one of the treatment progression.   Throwing a treatment at pain, whether it be an adjustment or drug, is nothing more than symptom care at its best.  Granted, the all-natural former comes with virtually no negative side effects but the application of both by their lonesome remains the same.  This is “sick” or “symptom care” that usually leaves the pour soul dependent on treatments due to ignorance, greed, laziness or a combination of all three by the practitioner.

This is one of the main reasons that chiropractors are looked at in a negative light, as the constant need for treatment has many proclaiming, “that once you go to a chiropractor you need to go forever.”  On the same level, it is the reason people pop NSAIDs or prescription pain killers like daily vitamins (yet it seems there is less discontent in resigning to the latter).

It must be pointed out here that it truly does take two to tango in these situations.  The reason NSAID sales, prescription drugs and non-stop palliative chiropractic treatments even exist is because there is a market for it.  It is not just the practitioner who is lazy or ignorant.  Breaking the pain-treatment cycle takes more time and effort and thus many on both sides of the equation do not want to be put out.

The proper way to approach any health issue, whether it be pain or any other symptom, is to take it a step further and find the break down in function.  Symptoms such as pain are helpful signs from our body letting us know that something is wrong.  Somewhere along the line a breakdown in optimal function has occurred and because of that, symptoms of that breakdown are now outwardly manifesting themselves to the point that we have the pleasure of meeting and working together.

For the sake of this discussion, we will stay focused on pain and take it one step further to the chiropractor’s traditional forte: back pain.  Back pain continues to be one of the most debilitating conditions in this country and if the current trends continue, the majority of us will unfortunately fall victim to chronic back pain at some time or another.

Well, this is your wake up call.  You don’t need to be another statistic.  Just because something is deemed “the norm” due to the majority of the population succumbing to it, doesn’t make it right.  You can free yourself from the back pain sentence if you work with a well-trained healthcare professional to identify its cause and do what you can to properly heal and prevent it in the future.

As we stated, pain is a symptom that manifests due to an underlying breakdown in function.  Outside of trauma, back pain in this country is largely a result of our culture of desk jobs, prolonged sitting and poor posture.  What happens is our anterior muscles become tightened and shortened due to us always leaning forward.  This leaves our posterior muscles (think glutes, hamstrings, spinal muscles, etc.) lengthened and weakened.  The problem here is that it is these muscles of the posterior chain that are designed to move us efficiently through the world.

Somewhere along the way in our world of laptops and long hours seated we have picked up a new hunched forward posture and thus a new movement pattern.  Just like with anything else, we eventually adapt to this new mode of operation even though it is not the most efficient for our bodies.  The result is an eventual structural breakdown in the form of disc herniations, osteoarthritis, muscle strains and inflammation.

So how do we tie this all together?  Well, obviously the pain needs to be addressed.  It is the reason treatment was sought in the first place.  Once the pain is alleviated, it needs to be understood that this pain was not just a random, inevitable occurrence.  It occurred for a reason and many times it was due to these faulty movement patterns and a breakdown in proper function as we described.

At this point, it takes extra effort and commitment by both patient and practitioner in order to identify the exact breakdown in function and work together diligently to reset and reprogram the body’s movement pattern.  This is done through repetition and a controlled, intelligent progression through exercises and treatments in order to rebuild the foundation and retrain the body to move correctly.  Only then can we see long lasting relief and prevention of pain.

If any of this resonates with you as it has with me and you would like to work together to not only get out of pain but prevent it in the future, please give me a call (321-848-0987) and let’s get to work on a pain free, smooth moving life.

Pain? Discomfort? Fatigue? Your Workspace Could be a Culprit.

In today’s day and age, most of us can’t avoid spending way too many hours in front of a computer monitor.  Unfortunately, the posture and repetitive movement that this encourages is one that causes excessive stress on body parts like the hands, wrists, elbow, shoulders, neck, and back. This contributes to discomfort, fatigue and even outright pain.

Fortunately, there is a way to limit this stress put on your body and potentially reduce or eliminate the discomfort and fatigue.  This is done through the implementation of proper ergonomics.  Ergonomics is a discipline that involves arranging the environment to fit the person in it. This can be done anywhere but for the sake of this post, we will hit you with a few easily implementable tips for the office setting.

CHAIR

Adjust the height of the chair so feet rest flat on the floor, the thighs are parallel to the floor, and the knees are about the same level as the hips.

Adjust height of armrests so the arms can rest at your sides during typing, allowing for relaxation and a natural “drop” of the shoulders.  Shoulders should not be elevated in anyway by the armrests.

MONITOR

The top of the screen should be at or just below eye level when you are seated in an upright position to avoid encouragement of forward translation of the head and shoulders.  The monitor should also be directly in front of you to avoid excessive twisting of the neck.

KEYBOARD AND MOUSE

The angle between your elbows and forearms should be as close to 90 degrees as possible, with forearms parallel to the floor and keyboard directly in front of you.

Try to avoid resting your wrists or hands on the edge of the keyboard while typing or on the mouse when you are not using it.  While using the mouse, make sure your wrist is in a neutral position.

The mouse, keyboard, and every other thing on your desk that you frequently use should be positioned close to you to avoid excessive reaching.

AVOIDING EYE STRAIN

You may be unaware of it, but little changes can help you avoid unwanted eye strain throughout the day.  This eye strain can lead to headaches and increased forward head posture.

Monitor should be approximately 18-30 inches from the eyes (depending on the size of the monitor).

Reduce Glare by:

Positioning the monitor at a right angle from the window.

I know you love that window in your office, but closing the blinds also reduces the glare.

The worktop surface should have a matte finish (think desk blotter if you have a shiny desk).

GET UP AND MOVE

It is imperative that you break up the long periods of sitting.  Sitting is actually one of the worst positions for your back and can also lead to blood pooling in legs and feet.  Taking a quick break from sitting every 20 to 40 minutes is key.

Practice “dynamic sitting.”  Make sure there is enough room underneath the desk to move your legs.  If you do find yourself seated for extended periods of time, utilize a lumbar support or a rolled towel to support the natural curve of your lower back.

Getting up and walking to the bathroom or to get some water (the two go hand in hand and you should be drinking more water anyway) are an easy way to keep it moving.  If you need to stay at your station, simply stand up and perform a stretch like the Bruegger’s Stretch demonstrated here:

http://www.youtube.com/watch?v=EvwvbXrf6LU

Please do not underestimate the power of some of these simple changes.  Anytime I work with a patient, we always address the work station set-up through pictures provided by the patient or checking it out in person.  If you’re curious about your personal space or feel like those around you would benefit from a work space makeover, please contact me as we are now accepting patients and providing free ergonomic evaluations for all local businesses.  This is a standard part of your individual treatment plan when you become a patient, but a free office wide evaluation can be done as well.

As with all things, proper ergonomics is just one piece of the puzzle.  Couple this with a thorough chiropractic evaluation addressing overall posture, balance and any other issues you may have going on and you are making a strong proactive statement about regaining control of your health and ultimately your life.  Again, feel free to contact me if you’re interested in getting started.

Remember, a proper, less strenuous work station promotes better posture and less discomfort.  Better posture promotes better breathing (more oxygen) and less needless strain on numerous muscles, each leading to less fatigue and pain, and clearer, more creative thinking.  This means your work gets done faster and at a higher level.  Sounds like a bonus for employee and employer alike.