Category Archives: Low Back Pain

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A Core Stability Exercise that Anyone Can Do

Proper core and lumbar extensor strength is the key to preventing an episode of low back pain (LBP) as well as an important component to treating LBP. Low back pain is estimated to affect nearly 80% of the U.S. population at one time or another. In general, most of us don’t spend enough time properly strengthening our core muscles. In this video post, you will learn how to engage your abdominal muscles with a simple ball exercise that I recommend to all of my patients initially in my LBP rehabilitation program.

The core muscles are part of the body’s natural method of stabilizing the spine. The core muscles, along with intra-abdominal pressure, help to form the round cylinder that is utilized to support the spine. Ligaments and boney articulations are also important in spinal stabilization. Most people don’t realize that the core actually consists of two separate groups of muscles, the inner and outer core muscles, and neither group involve the rectus femoris muscles (the six pack).

The Multifidus Muscles

  • The inner core consists of the muscles of the pelvic floor, the transversus abdominis (TVA), diaphragm, and the multifidus muscles (which span the vertebrae along the back side of the spine as shown above). The TVA wraps all the way around the stomach and attaches to the spine. This is what helps to form the cylinder. When contracted (in conjunction with the pelvic floor and diaphragm), it helps to increase the intra-abdominal pressure to support the spine.
  • The other muscles that help to support the spine are known as the outer core muscles. These muscles are responsible for movement of the trunk and spine as well as aiding in stability. The inner core muscles do not actually produce any trunk or spine movement. The outer core muscles consists of the following muscles:  lumbar paraspinal muscles; the quadratus lumborm; the internal and external obliques; and the psoas major and minor (hip flexors). Some may also include the glutes (buttocks muscles), hamstrings, and quadriceps as part of the outer core muscles.

Those working on core strength may not be performing the correct exercises. Performing proper core exercises (and particularly, lumbar stabilization exercises) are the primary treatment modality for LBP.

In this video, I demonstrate an easy and effective way to actively engage the inner core abdominal muscles. This exercise is typically safe even early on during the rehabilitation process for low back pain. 

For more information on how to effectively exercise and work the core muscles in order to prevent or treat LBP, be sure to check out my book, Treating Low Back Pain during Exercise and Athletics. You will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

AVAILABLE NOW ON AMAZON!

In addition, check out this sample video, Segment 2: What are the Core Muscles?, taken from my Treating Low Back Pain (LBP) during Exercise and Athletics Video Package which you can purchase HERE.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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My Top 3 Most Popular Posts of 2018!

As 2018 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being.  In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively.  We must get to the root of the issue instead of placing a Band-Aid over it.  We must realize that our individual health is our responsibility.  We cannot rely on others to make decisions for us.  Our present health care system in America is not designed to help you optimize your health–that is your job!   

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

My Top 3 Most Popular Posts of 2018:

  1. Does Kinesiological Tape Really Work? – You will learn what can you use Kinesiological tape for and how exactly it works.  You’ll discover why it’s best used in combination with other interventions (such as manual therapy based techniques and exercise).
  2. How to Use an Exercise Ball to Improve Posture and Treat Shoulder, Neck, and Back Pain – Poor posture (due to poor thoracic mobility) and poor scapular muscle strength are often major contributors to neck, shoulder, and upper back pain.  In this video post, I demonstrate how to perform I’s, T’s, and Y’s exercises on an exercise ball in order to address lower and mid trapezius and scapula muscle weakness.
  3. How to Prevent Overtraining Syndrome (OTS) – You will discover why Overtraining Syndrome (OTS) not only impedes your immediate performance, but it also substantially increases your risk of injury.  Implement these recommended prevention strategies in order to avoid OTS while keeping your training at a high level.  Also, be sure to check out my book, Preventing and Treating Overtraining Syndrome.

2018 has been an exciting year!  Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2019!  If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  In case you haven’t already, be sure to subscribe to my e-mail list and join our community on Facebook by liking The Physical Therapy Advisor!

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Does Kinesiological Tape Really Work?

I was first introduced to Kinesiological (Kinesio) style taping during a continuing education class in 2005.  Since then, this style of taping has exploded in the mainstream with athletes and celebrities alike wearing it.  Research on this modality was initially scant.  Today there are over 540 published studies with even more antidotal testimony!  Although the research is ongoing and published regularly, I get asked all the time about what can you use Kinesiological tape for and how exactly it works.  I will review three theories on how Kinesiological tape actually works and the different reasons for using it.

Kinesiological Taping For Achilles Tendinitis

How does Kinesiological Tape Work?

  • Sensory Theory (also known as the Gate Control Theory) – The basic premise of this theory is that the Kinesiological tape, when applied to the skin, activates sensory receptors present on the skin. These receptors relay information to/from the brain.  Since the sensory receptors are faster than other types of receptors (such as pain) the brain reacts to the sensory information first.  This can lead to altered movement patterns and awareness to the area.  It can also allow for decreased sensations of pain.  This theory is similar as to why we think topical analgesics (such as Biofreeze) work as well as why transcutaneous electrical nerve stimulation (TENS units) can reduce pain.
  • Circulatory Theory – The basic premise of this theory is that the when the Kinesiological tape is applied with little tension it forms convolutions in the skin. These convolutions create channels and reduce pressure within the tissues, lymph system, and circulatory system which aids in blood and lymphatic flow.
  • Muscle Activation Theory – The premise of this theory is that when the Kinesiological tape is applied at different levels of tension on the skin over the muscles and tissues, the Kinesiological tape can either mechanically or neurological increase or decrease muscle activation via a nervous system response.

Presently the truth behind Kinesiological taping is that we really don’t know exactly how or why it works.  Based on my clinical experience, I believe that the Kinesiological tape interacts with the body’s tissues in different ways depending on how and where the Kinesiological tape is applied.  Depending on how the Kinesiological tape is utilized, any one or combination of the three theories is likely correct.

Research states that Kinesiological style taping is at least as effective as other minimal interventions for musculoskeletal pain which may include topical analgesics like Arnica montana (Arnica Rub) or Biofreeze.

Research has also shown that taping can reduce pain acutely within first week of injury and possibly even in cases of pain which has been present for as long as three to four weeks (or longer).

Research concludes that there are some improvements in muscle and joint range of motion (ROM) and a reduction of pain.  However, because the improvement isn’t significant or long standing it shouldn’t be used as a standalone intervention.  Kinesiological taping is best used in combination with other interventions (such as manual therapy based techniques and exercise) which have been proven to affect outcomes over the long-term.

When Kinesiological tape is used in conjunction with other treatments, it may help speed up the recovery as the Kinesiological tape can allow for other techniques to be utilized more effectively due to the loss of pain, swelling or easing of movements.

Although there have been hundreds of research studies performed, the effectiveness of Kinesiological tape is still questioned primarily due to issues with research design.  Many of the taping applications are based on theory and not science.  Since there isn’t a consistent application pattern, the research studies aren’t comparing the same techniques over large enough patient populations to show a true effect.  In addition, researchers still need to quantify how much tension is actually being used and the actual Kinesiological taping technique being used versus other types of techniques or interventions.

Unfortunately, without better quality research it’s unclear if the results shown in many of the studies are due to an actual effect or through placebo.  For now, none of the studies show significant benefits regarding long-term pain alleviation or improved strength or range of motion (ROM).  So for now, the main conclusion is that Kinesiological taping should be used only as a short-term treatment in combination with other treatments.  I personally use Kinesiological tape, and I often find that my clients experience success with specific tape applications for different conditions.

What do you use Kinesiological Tape for?

  • Reduce pain
  • Reduce swelling and edema
  • Support muscles and joints
  • Reduce muscle tension
  • Increase strength
  • Improve performance
  • Enhance or correct movement patterns through stimulation of sensory receptors
  • Provide compression
  • Enhance healing by slightly lifting skin away from sore or injured tissues to improve blood flow and lymphatic drainage
  • Support injured joints and muscles without impeding range of motion (ROM)

There are dozens of companies’ now manufacturing Kinesiological style tape.  There are many high quality tapes being manufactured with all kinds of colors, designs, and variations in adhesive quality and elasticity.  Personally, my favorite brands are based on price point and actual use.  This includes ease of application and how long the Kinesiological tape actual stays on.  The brands I use most include:  Kinesio Tape, RockTape, Thera-Band Kinesiology tape, Spider tape, and KT TAPE.  Although there are many more brands available, I have not personally used them.

There are many different applications Kinesiological taping can be used for.  Like any treatment modality, it can work wonders for one person and do nothing for another, but should we really be surprised?  Many of our most popular pharmaceuticals are no different.  Kinesiological taping has the benefit of rarely having significant side effects.  There are rarely side effects to utilizing this style of tape as the products utilized tend to be very hypoallergenic.  Occasional skin irritation has been the only noted side effect I have known of in my clinical experience.  In order to avoid skin related issues (including application and removal tips), please refer to Skin Care with Taping.

I have found success with utilizing Kinesiological taping as an adjunct treatment strategy and as part of a complete treatment approach.  If you are interested in specific applications for different conditions, please see the following in which I demonstrate different taping techniques.

Step-by-step guides:

Kinesiological Taping for Osgood-Schlatter Disease

Kinesiological Taping for Patellar Femoral Pain Syndrome

Kinesiological Taping for Shin Splints

Video:

How to Apply Kinesiological Tape When Treating Achilles Tendinitis

Books with step-by-step guides specific for ankle sprains and low back pain:

The Physical Therapy Advisor’s Guide to Treating Ankle Sprains and Strains

The Physical Therapy Advisor’s Guide to Treating Low Back Pain During Activity and Exercise

Have you tried using Kinesiological taping before?  If so, what was your experience like, and did it help you?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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My Top 3 Most Popular Posts of 2017!

As 2017 comes to a close, I become increasingly more excited for the years to come!  As science evolves and its understanding of how the human body functions, we’re seeing more technology that can help to enhance our lives and optimize function.  More people are realizing the value of taking control of their health care and personal well-being.  In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively.  We must get to the root of the issue instead of placing a Band-Aid over it.  Our present health care system in America is not designed to help you optimize your health–that is your job!  

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

Image courtesy of Unsplash.

My Top 3 Most Popular Posts of 2017:

  1. Why You Won’t Heal – Poor Nutrition (Part 4) – You will discover why consuming the proper nutrients is critical in order to fully heal and recover from an injury or illness in part 4 of my very popular 6-part series, Why You Won’t Heal.  The feedback was so positive that I written an even more thorough book on the topic!  Keep an eye out for Why You Won’t Heal (and What YOU Can Do About It) to be published in spring of 2018.
  1. How to Become a Resilient Runner – You will learn how to become a resilient runner so you can avoid injury, train more, recover quicker, and save money.  The Resilient Runner program, which includes prevention and self-treatment for running injuries, is a collaboration with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast).  The program is a virtual library of self-treatment protocols including downloadable podcasts, videos, and .pdf files of rehabilitation guides.  It also includes a 320 page eBook, The Resilient Runner, Prevention and Self-Treatment Guide to Common Running Related Injuries.  This is a must have program in order to learn how to prevent and/or self-treat lower extremity pains and injuries.
  1. Why Does My Shoulder Hurt? – I discuss the most common reasons why you may develop shoulder pain.  You will discover the key to treating most common shoulder related pain.  In addition, learn how to improve your posture while focusing on thoracic mobility and proper shoulder strengthening.  I offer simple stretches and exercises that you can use to eliminate the pain.

2017 has been an exciting year!  I have successfully published three books (which are now available on Amazon in Kindle and paperback formats) with wonderful feedback!  I am so grateful that more people are beginning to understand that many of the most common aches, pains, and musculoskeletal injuries can be safely managed and self-treated with proper guidance.

In Treating Ankle Sprains and Strains, I show you how to effectively self-treat and manage an ankle sprain and/or strain in order to resume your training and normal activities while minimizing the risk of additional damage, injury or re-injury.  When you can confidently self-treat, you can limit pain levels, return to activity faster, prevent reoccurrences, and save money!  A proper rehabilitation from the initial injury to the full return to sport and/or activity must include a full return to strength, mobility, and balance.

In Treating Low Back Pain during Exercise and Athletics, I share very specific strategies for general LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. 

In Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!

Be sure to stay tuned for upcoming books including Why You Won’t Heal (and What YOU Can Do About It) and Running an Injury-Free Marathon (Complete with Training and Rehabilitation Strategies)!

Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2018!  If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to subscribe to my e-mail list and join our community on Facebook by liking The Physical Therapy Advisor!

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What’s inside of the Treating Low Back Pain during Exercise and Athletics Video Package?

Did you know that an estimated $50 billion dollars is spent annually on back pain related issues?  It affects nearly 80% of the U.S. population at one time or another.  It’s one of the top reasons for physician and physical therapy visits and one of the most common reasons for missed work days.  The best training plan in the world won’t do us much good if we’re unable to implement that plan due to pain and/or injury.

WomanWithLowBackPain

When reviewing research or anecdotal evidence online, there is no shortage of articles, blogs, and opinions regarding low back pain (LBP).  But what about a specific resource for the athlete, the weightlifter, the CrossFitter or the runner who is experiencing low back pain during exercise?  How does an athletic population know how to handle episodes of LBP?  What specifically can an athlete or active person do to avoid low back pain to lessen the risk of injury and lost training days?  Is there a specific step-by-step plan that really works?

The prevention and rehabilitation strategies outlined in my rehabilitation guide, Treating Low Back Pain during Exercise and Athletics, answer those questions.  You will learn how to safely self-treat your low back pain and helpful methods for a speedy recovery.  (Not to mention, possibly saving you time and money by avoiding a physician visit!)

The good news is that participating in sports, running, CrossFit, and weightlifting doesn’t increase your risk of developing LBP.  On average, being in good health, physically fit, and active actually decreases your risk.

The Treating Low Back Pain (LBP) during Exercise and Athletics Video Package includes:

Treating Low Back Pain during Exercise and Athletics eBook

product-cover-lbp

In this eBook, you’ll learn why it is critically important to prevent the first episode of low back pain.  LBP has reoccurrence rates as high as 90%.  If you have already experienced an episode of LBP, you’ll learn why exercise is an important component to long term management.  Most importantly, you will understand how to avoid pain and injury in order to take your training to the next level.  Topics include:

  • Specific strategies for LBP prevention.
  • How to address specific causes of LBP.
  • Best practices on how to prevent and self-treat when you experience an episode of LBP.
  • A step-by-step LBP rehabilitation guide complete with photos and detailed exercise descriptions.
  • How to implement prevention and rehabilitation strategies.

7-part Series of Instructional Videos

Nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports, and athletics.  An in-depth look at treating LBP with a 7-part series of instructional videos in which I address the following:

  • Potential Risk Factors for Lower Back Pain
  • What are the Core Muscles?
  • Prevention during Exercise (Part 1 and 2)
  • Initial Treatment
  • Further Treatment and Taping
  • Long Term Management Strategies and Final Recap

Want to peek inside the video content?  Watch now as I describe what really the “core” is and why it matters.

Preventing and Treating Overtraining Syndrome eBook

product-cover-ot

In this BONUS eBook, you’ll learn how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  Topics include:

  • How to recognize the warning signs.
  • Specific strategies for OTS prevention.
  • How to self-treat OTS.
  • How to safely overreach.
  • A complete guide to Foam Roller Stretches and Mobilizations with photos and detailed exercise descriptions.

Is your low back hurting? Are you ready to take your training to a new level?  What are you waiting for?  Let’s get started! 

Purchase Package

Treating Low Back Pain during Exercise and Athletics by Ben Shatto, PT, DPT, OCS, CSCS (2017)

HAS AN EPISODE OF LOW BACK PAIN MADE YOU FEEL TOO SCARED TO TRAIN OR TO EVEN MOVE LIKE YOU DID PRIOR TO THE INJURY?

Many of us just accept occasional episodes of low back pain (LBP) as a normal part of life, but these episodes of LBP can have both devastating monetary and training consequences.  Your insurance money may be used up.  The pain may have dissipated, but you’re still not sure how to progress through the next steps.  What if it happens again?  Should you train or exercise as hard as before?

What do you do when you’re past the worst of the pain and want to resume training, but you don’t feel physically, mentally or emotionally ready? 

Often after a severe case of LBP, you may be too scared to train like you did prior to the injury, and it turns out you should be!  At least until you understand why LBP almost always re-occurs and what you can do to prevent it.  Don’t let LBP affect your ability to stay active and keep enjoying your favorite activities!

I share very specific strategies for general LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.  Let’s get started!

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When to Return to Activity after Experiencing Low Back Pain

“When can I return to my normal activity after experiencing an episode of severe low back pain?” is a question I am often asked as a physical therapist.  Low back pain (LBP) can be so severe and debilitating that it can completely derailing your training and lifestyle!  It’s hard to run, exercise or even move if your back, buttocks or leg hurts.  You either won’t try or if you do, you suffer through it only to be rewarded with worsening symptoms later on.  However, in spite of what your back pain is telling you, initial activity and exercise are critical when treating LBP. 

Everyone’s experience with low back pain is different and the severity of pain can vary wildly.  For some, even walking normally can be difficult.  This is why having a guide on which exercises and movements to do and not to do is so important.  One critical indicator that you’re ready to taper back into more regular activity (as you progress your rehabilitation-based exercise) is whether or not you can walk with a normal gait.  In particular, can you walk normally with a longer stride length during your normal gait cycle?

The ability to walk normally (notice that I didn’t say without discomfort) is an important milestone as it means that the spine is being stabilized well enough from the core musculature and that the nerves in the leg are not too tight or inflamed to tolerate and accommodate for the stretch that will occur from other activities.

If you are unable to walk normally, then the emphasis should be on regaining lumbar and lower extremity range of motion in addition to performing core and lumbar stabilization exercises.  Limit your sitting, but do not try to taper back into other activities (at least not yet).

It is critical to remember that everyone’s recovery will be different.  Recovery and tapering back into your normal activities should be entirely symptom dependent.  Listen to your body on what it can handle.  The pain will tell you if you need to stop.

When to Return to Activity after Experiencing Low Back Pain:

Follow the rule of thumb for movement:  If the pain worsens by spreading peripherally down the buttock and into the leg and/or foot, then the condition is worsening.  You must stop that activity.  If the pain centralizes and returns back toward the spine (even if the pain worsens slightly), then keep moving as the condition is actually improving.

  • Don’t resume your running, jogging or other training activities until you can walk normally at a quick pace.
  • Be sure to slowly taper back into your training as your back begins to feel better.  Don’t quickly resume your prior training volume.  Instead, taper back up.
  • Prior to activity and training, perform a very thorough warm up (including press-ups, superman exercises, and bridging).  Then transition into an activity specific warm up.
  • Continue with a core and lumbar strengthening program at least until you resume your full volume of training.

Prior to returning to your full and normal training activities, insure the following:

  • Complete lumbar mobility has returned.
  • You no longer have sensations, weakness or instability within the spine.
  • If you experienced leg pain, your involved leg is as flexible as the other.  The pain is now either gone or centralized (meaning that you’re not experiencing pain in the leg).
  • Your hip mobility on both sides is equal.
  • Your involved leg is as strong as the other leg, particularly hip abduction (glutes medius) and the hip external rotators.  Test this by jumping up and down on one leg.  Do you feel strong?  Is there pain associated with this?  If the strength isn’t there or the pain remains, you are not ready to taper up to full training activities.
  • You can jog, run, sprint, and jump without pain.

With proper treatment, low back pain (LBP) should resolve in as quickly as two weeks.  Severe episodes can take 4-6 weeks or longer.  Continue with your rehabilitation protocol until you’re performing all exercises normally.

I highly recommend continuing with a lower extremity stretching protocol and lumbar and pelvis stabilization exercises as a method of prevention for future episodes of low back pain.  There are countless “core” exercises and back stretches that you can perform, but which ones are best to help you to recover faster and experience less pain?  Research is clear that performing proper core exercises and particularly, lumbar stabilization exercises are the most effective treatment modality for LBP.  If you want to learn how to self-treat your low back and learn how to effectively exercise and work the core muscles in order to prevent or treat LBP, CLICK HERE.

AVAILABLE NOW ON AMAZON!

In my book, Treating Low Back Pain during Exercise and Athletics, you will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

Learn how to prevent, self-treat, and manage LBP so you can get back to your daily life and exercise goals more quickly without additional unnecessary and costly medical bills!

BUY NOW

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The Number One Reason Preventing You from reaching your Exercise Goals

We all know the importance of exercise, fitness, and generally staying active.  For some of us, we look to exercise and fitness as a way to have fun and stay in shape.  Others use activity to help manage stress or chronic illnesses such as diabetes, osteoporosis or heart disease.  Exercising and staying active is an important component to aging well.  It can be very disappointing when you don’t meet your training or exercise goals.  One of the most common reasons for not meeting goals is also one of the most preventable reasons:  injury!  Nothing derails a perfectly developed training plan like an injury.

The most common injury for those in the western world is low back pain (LBP).  LBP is estimated to affect nearly 80% of the U.S. population at one time or another.  And worse yet, once you have experienced an episode of LBP you have a 90% chance of having a reoccurrence.

Risk Factors for Low Back Pain (LBP):

  • Sitting too much.
  • Slouched sitting.
  • Prior episodes of LBP.
  • Smoking.
  • Poor core and back extensor muscle strength.
  • Lack of a proper warm up and a cool down.
  • High training volumes with inadequate rest (overtraining syndrome).

Some of the specific risk factors for LBP are also risk factors for other types of injury.  Lack of adequate core strength (particularly, strength in the outer core and pelvic/hip musculature) can contribute to injuries such as:

  • Iliotibial band syndrome (ITBS)
  • Hip bursitis
  • Runner’s knee (Patellar Femoral Pain Syndrome)
  • Piriformis syndrome
  • Meniscal injuries in the knee
  • Achilles tendinitis
  • Plantar fasciitis

Although this is not a complete list, it highlights many of the most common injuries affected by weakness in the core and pelvic/hip muscles.

Consider the amount of repetitive force your body must absorb even with walking (not to mention during sports or exercise).  The outer core muscles are responsible for movement of the trunk and spine as well as aiding in stability.  (Although critical for stability, the inner core muscles don’t actually produce any trunk or spine movement.)  The outer core muscles consists of the following muscles:  lumbar paraspinal muscles; the quadratus lumborm; the internal and external obliques; and the psoas major and minor (hip flexors).  Some may also include the glutes (buttocks muscles), hamstrings, and quadriceps as part of the outer core muscles.

Imbalances or a lack of strength within the core musculature often times will manifest in altered lower body mechanics and an inability for the body to properly absorb and distribute forces.  Over time and many miles, the body’s tissues eventually break down and can lead to a repetitive use injury in the lower extremity.

As a physical therapist, I always assess the core and hip musculature and look for imbalances in strength when determining the root cause of an injury.  In the majority of cases, I find that a component of hip and core muscle weakness has led to the injury.

The good news is that this is a completely preventable problem.  Most of us already know that we need to cross train and that proper core strength is important.  However, too many of us either don’t dedicate enough time to the process or we aren’t performing the correct exercises.  Performing proper core exercises and particularly, lumbar stabilization exercises are the primary treatment modality for low back pain (LBP).

Proper core and lumbar extensor strength is the key to preventing an episode of LBP and is also a critical step in avoiding other types of injuries affected by weakness in the core and pelvic/hip muscles.  The most important factor in meeting your goals is to be consistent in your training by avoiding injury!  Don’t let LBP affect your ability to stay active and keep enjoying your favorite activities!

AVAILABLE NOW ON AMAZON!

In my book, Treating Low Back Pain during Exercise and Athletics, you will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

Learn how to prevent, self-treat, and manage LBP so you can get back to your daily life and exercise goals more quickly without additional and unnecessary costly medical bills!

BUY NOW

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The 3 Most Common Mistakes Athletes make that can cause Low Back Pain

Whether you are an athlete or weekend warrior, we all want to perform our best.  Many of us live for the weekends so we can participate in the next run, Spartan race, CrossFit Team WOD, or any number of other adventures.  However, no one is immune to one of the one of the most prevalent medical conditions treated in the United States and throughout the western world–low back pain (LBP).

If you want to train hard and compete at a high level or even just enjoy the weekend’s events, then avoiding LBP is critical.  Avoiding the following three most common mistakes can save you from costly medical visits, prescriptions, chiropractic visits, and physical therapy services.  More importantly, avoiding injury and LBP insures that you can keep training and racing to your heart’s content!

The 3 Most Common Mistakes:

 

Sitting too much.

Prolonged sitting (and especially, prolonged sitting on a vibrating surface) is one of the biggest risk factors for LBP.  Sitting (slouched in particular) causes excessive strain on the lumbar discs and ligaments.  It also leads to tight hamstrings and hip flexors and generally tends to inhibit proper gluteal muscle function.

Even if you are running, exercising, and training during most days of the week, we all spend too much time sitting whether it’s at our job or traveling each weekend for destination races and events.  Even worse is sitting with chronically poor posture.

  • Limit the amount of sitting that you spend at one time.  Ideally, move from your sitting position every hour to walk preferably.  If you aren’t able to walk, then try to shift your position at least once every twenty minutes.  Frequent position changes can help you to avoid LBP.  Avoid a long car trip directly before or after a long run, race or event.  For destination events, it’s best to arrive at least a day or two early and wait a day prior to returning home.
  • Sit with correct posture.  Whenever possible, make sure that your knees stay below your hip level and that you are able to maintain your natural lumbar curve.  A McKenzie Lumbar Roll is a great tool to help you maintain correct posture.

Not training the core properly or adequately.  Don’t forget the back extensors!

Proper core and lumbar extensor strength is the key to preventing an episode of LBP, which is estimated to affect nearly 80% of the U.S. population at one time or another.  In general, most of us don’t spend enough time strengthening our core muscles (particularly, the back extensors).

The core muscles are part of the body’s natural method of stabilizing the spine.  The core muscles, along with intra-abdominal pressure, help to form the round cylinder that is utilized to support the spine.  Ligaments and boney articulations are also important in spinal stabilization.  Most people don’t realize that the core actually consists of two separate groups of muscles, the inner and outer core muscles, and neither group involve the rectus femoris muscles (the six pack).

The Multifidus Muscles

  • The inner core consists of the muscles of the pelvic floor, the transversus abdominis (TVA), diaphragm, and the multifidus muscles (which span the vertebrae along the back side of the spine as shown above).  The TVA wraps all the way around the stomach and attaches to the spine.  This is what helps to form the cylinder.  When contracted (in conjunction with the pelvic floor and diaphragm), it helps to increase the intra-abdominal pressure to support the spine.
  • The other muscles that help to support the spine are known as the outer core muscles.  These muscles are responsible for movement of the trunk and spine as well as aiding in stability.  The inner core muscles do not actually produce any trunk or spine movement.  The outer core muscles consists of the following muscles:  lumbar paraspinal muscles; the quadratus lumborm; the internal and external obliques; and the psoas major and minor (hip flexors).  Some may also include the glutes (buttocks muscles), hamstrings, and quadriceps as part of the outer core muscles.

Those that work on core strength may not be performing the correct exercises.  Performing proper core exercises and particularly, lumbar stabilization exercises are the primary treatment modality for LBP.  To learn how to effectively exercise and work the core muscles in order to prevent or treat LBP, CLICK HERE.

Not performing a proper warm up. 

An adequate warm up should always be performed to help minimize the risk of injury and maximize your ability to perform at an optimal level.  A proper warm up should include:  a cardiovascular warm up; a dynamic warm up; a specific spine warm up; and when indicated, a sport specific warm up.

Cardiovascular Warm Up

To properly prepare the body for activity, the first stage of the warm up is to increase blood flow throughout the body, but in particular, to the core muscles and spine.  I recommend approximately 10 minutes as this allows for better mobility in the joints and tissues of the body.  It starts to prime the nervous system for activity.  It also promotes healing as movement is necessary to bring in the nutrients necessary to heal (if there is already damage or an injury).

The cardiovascular warm up will vary and is dependent on your activity or sport.  I will typically start by performing a light jog or possibility some jumping jacks.  Then I may progress into some more intense heart rate increasing exercises, such as  jump roping or any other form of standing movement (jumping, bounding, and burpees), in order to increase my heart rate.  The goal is to increase your heart rate and promote blood flow throughout the body.  The warm up shouldn’t be overly intense.

Dynamic Warm Up

After my initial cardiovascular warm up, I progress into my dynamic warm up series.  This will typically involve warming up the muscles and joints of the spine, pelvis, and lower legs.

The purpose of the dynamic warm up (specifically in the lower extremity) is to insure adequate mobility in the areas that will be involved in the activity.  This will almost always include the hamstrings, hips, and pelvis.  Adequate lower leg mobility is important in order to perform your specific exercise or activity.  The more motion that can occur through the pelvis and legs, the more force can then be generated and passed through the pelvis.  More mobility in the lower legs and pelvis means less need for mobility in the spine.  This means less stress during motion will be placed on the spine—therefore, decreasing your risk of injury.  You want to maximize spinal stability and encourage movement through the hips, pelvis, and upper thoracic.

Within the dynamic warm up, you would perform exercises such as:  forward and backward leg swings; side to side leg swings; squats with rotation; and press-ups.  Utilizing a foam roller as part of a warm up is acceptable.  However, I don’t advocate static stretching before activity as it has been shown to decrease force production and performance.

Spine Specific Warm Up

I am a big proponent to performing a very specific spinal muscle warm up upon completion of the cardiovascular and dynamic warm ups.  Since you may have already experienced an episode of LBP, a very specific and thorough warm up is important for prevention.  Priming the specific muscles of the core (particularly, the multifidus and lumbar extensors) is a critical step to avoiding re-injury.  The multifidus is a critical muscle in preventing LBP and must be active to properly stabilize the spine.  It helps to prevent shearing forces from affecting the spine which is critical to avoiding LBP.

Sport Specific Warm Up

This warm up will vary significantly depending on the type of endeavor you are about to participate in.  For example, a sprinter will need a very different warm up compared to an ultramarathon runner or someone performing in a CrossFit competition.  For runners, the warm up varies.  Are you racing on a flat course or are you heading out for a very hilly trail run?

Examples of running specific exercises include:  butt kickers; strides or bounding; and warm up sprints.  Even running a little on the actual terrain you will be competing on is a good idea.

It’s important to evaluate the requirements for the event and be ready to perform the actual movements required to compete at a high level.  A proper warm up allows your body to immediately perform at its peak and reduces the risk of injury.  Regardless of the sport or event, this is also the perfect time to make sure all of your equipment is appropriate for the conditions of the event.

Don’t skip the warm up regardless of your training or event time and/or location!  You may be the only one performing a thorough warm up, but it’s because you understand the importance of one in order to prevent LBP and to improve your performance.

An inadequate cool down is another common mistake.  Be sure to take the extra time to cool down and stretch.  Start with a slow jog, and then progress to walking until your heart rate returns to normal.  This is an excellent time to utilize the foam roller as well as performing static stretches and press-ups.

It’s important to identify the common mistakes that can cause LBP.  By implementing these prevention strategies, you can avoid injury and keep training.  Fitness is a lifelong pursuit.  If you are injured or just not having fun, then you will not stay engaged and motivated in the long term.  Don’t let LBP affect your ability to stay active and keep enjoying your favorite activities!

AVAILABLE NOW ON AMAZON!

In my book, Treating Low Back Pain during Exercise and Athletics, you will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

Learn how to prevent, self-treat, and manage LBP so you can get back to your daily life and exercise goals more quickly without additional unnecessary and costly medical bills!

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My Top 5 Most Popular Posts of 2016!

As 2016 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being.  In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively.  We must get to the root of the issue instead of placing a Band-Aid over it.  Our present health care system in America is not designed to help you optimize your health–that is your job!

2016 marks the first time that the media started to wake up to America’s prescription opioid addiction.  The news and many research articles discussed America’s opioid addiction including their disastrous consequences on one’s health and the nation’s health care system in general.  Not to mention, how poorly opioids actually are in managing long term pain.

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively without opioid use.

My Top 5 Most Popular Posts of 2016:

  1. How to Use Shoulder Pulleys to Regain Shoulder Motion – Maintaining adequate shoulder mobility is critical after surgery and/or avoiding osteoarthritis of the shoulders.  The shoulder pulley is often one of the first exercises initiated after surgery or injury. However, it’s often performed incorrectly.  In this video, I demonstrate the proper way to utilize a shoulder pulley.
  2. Exercise as Medicine – Too often, people look towards pharmaceuticals in order to help manage medical conditions.  Exercise is a highly effective and often underutilized method to treat many common, yet serious, medical conditions such as diabetes, heart disease, and osteoporosis.  Exercise is medicine when prescribed and performed correctly.
  3. 3 Simple Exercises to Help You Age Well – Maintaining functional mobility as we age is critical.  First, you need to maintain the ability to stand up.  This insures that you can get up from a chair or a commode/toilet.  Second, you need to maintain your ability to ambulate to insure that you can perform the other needed activities of daily living more easily.  Lastly, you need the balance to safely perform these tasks.  Walking, squatting, and improving your balance will help you to age well.
  4. 5 Strategies to Train Smarter for your next Obstacle Course Race – Obstacle course racing (OCR) is one of the hottest new sports around for all fitness levels (including the novice to expert thrill seekers).  This post highlights the five lessons I learned from my training seminar on OCR races with Ben Greenfield from www.Bengreenfieldfitness.com and Michael Caron from www.Getburly.com.
  5. Got Text Neck? – Have you noticed that wherever you go nowadays that you constantly see people walking and looking down at their cell phones?  No wonder that the term “text neck” is now being used to describe chronically poor posture!  This post explores the role of poor posture related to neck and headache pain along with tips for prevention and treatment.

2016 has been a wonderful year!  I successfully launched my first eBook and video package, Treating Low Back Pain (LBP) during Exercise and Athletics.  I share very specific strategies for LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  This eBook addresses the specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  A 7-part series of instructional videos is also available and includes nearly 60 minutes of actionable advice to prevent and treat LBP.

CLICK TO LEARN MORE!

In addition to my new eBook, I have continued to feature reader submitted Q & A’s as well as many exercise and training posts including posts written for the Marathon Training Academy.

This past fall, I featured a six part series on headache pain which includes prevention and treatment tips.  An important focus continues to be on longevity and healthy aging.  This includes ongoing guest posts on healthy senior living for the Seniors Blue Book.  (Check out my top 3 recommended daily fall prevention exercises as featured in the latest Seniors Blue Book!)

Looking toward 2017, I will continue to offer free self-treatment advice to help YOU manage common musculoskeletal, neurological, and mobility related conditions in a timely manner.  Together, we can all learn to age well and reach our optimal health!

Don’t forget subscribe to my e-mail newsletter!  I will send you my blog posts on how to maximize your health, self-treat those annoying orthopaedic injuries, and gracefully age.  To thank you for subscribing, you will automatically gain access to my FREE resources, including a FREE CHAPTER from my eBook, Treating Low Back Pain During Exercise and Athletics.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2017!  If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!