Posted on Wednesday, August 10, 2016

Q & A: What Causes Headaches?

Q. Several members of my family frequently get headaches. Thankfully, I rarely get them, but what causes headaches? Why do some people get them and others do not? Thanks, Ben! -Brad

A. Thanks for your question, Brad! Headaches are a very complicated subject. I will do my best to answer your question from a physical therapist’s perspective.

Headaches can range from mild to severe with symptoms varying wildly. Approximately 15-20% of the population will suffer from headaches at any given time. It’s one of the top medical ailments for which people seek treatment. Headache suffers are also one of the most heavily marketed to group. There are no shortage of scammers and snake oil salespeople trying to sell you the next great remedy to cure your headaches.

Although there are many potential sub categories of classifications a person could use (particularly, within the tension class), I tend to classify headaches in one of five categories: tension; cervicogenic; sinus; migraine; and cluster.

Classifications of Headaches:

Tension

These are the most common type of headache. These headaches are often related to tension in the muscles of the head, neck and jaw and are frequently stress related. The actual physical cause is still not fully understood, but it’s likely linked to how the brain and nervous system perceives muscular pain and stress.

Tension headaches are categorized as either episodic (meaning that you experience less than 15 headaches per month) or chronic (meaning that you experience more than 15 per month). Women tend to experience them more often than men. Many food or environmental factors can trigger tension or migraine headaches. Food and environment triggers for headaches could easily be a classification of their own.

Please refer to Prevention and Treatment Strategies for Tension Headaches.

Cervicogenic

Not everyone would say this is a separate class of headache, but I tend to classify cervicogenic headaches separately. Cervicogenic headaches are often associated with tension type headaches. There can be a lot of overlap with tension headaches, but in this class the underlying cause of the headache is from the cervical spine. There are many pain generating structures in the cervical spine. A few potential causes could be nerve related, trigger points, facet joint or cervical mal-alignment related, or cervical disc related. I find that postural dysfunction tends to go hand in hand with this type of headache as well as in tension headaches.

Cervicogenic headaches tend to be found more often found in women. This seems to be primarily due to the anatomical differences of men versus women. Men tend to have more muscular necks while women tend to have more long and slender necks with less muscle to provide support to the head (meaning that there is less muscle strength for support).

Please refer to Cervicogenic Headaches: A Real Pain in the Neck (and Head).

Sinus

Your sinuses are located on your forehead, behind the bridge of the nose and under your cheek bones. In cases of infection or allergy, the mucosal lining will become inflamed and causes pressure and pain. This results in headache type symptoms. Pain is often worse when bending over or straining.

Other than headache type pain, you may also be suffering from other symptoms of illness including a stuffy or running nose, earache or fever. Sinus headaches are often a trigger to other types of headaches such as tension and migraines.

For more information, please refer to 9 Treatment Tips for a Sinus Headache.

Migraine

Migraine pain is the second most common type of headache (with tension/cervicogenic type headaches being the most common). Up to 16-17% of the population complains of migraines. These headaches can be far more debilitating than the typical tension/cervicogenic type headache. Migraine pain is often in combination with tension headache pain. Migraines can also be caused by menstruation or hormonal imbalances.

Frequently, people will classify any type of severe headache pain as a migraine although it may or may not actually be the case. The severity of pain is not what leads to a migraine classification, but which symptoms are present.

Symptoms of a migraine will differ for everyone. Initial symptoms and patterns may occur one to two days prior to the actual migraine.

Typical symptoms may include:

Throbbing pain on one side of the head (but pain can be present on both sides)
Pain behind the eyes
Difficulty performing typical activities which worsen with activity or heat
Nausea
Vomiting
Sensitivity to light, noise, and smell

Less common symptoms may also include: difficult with speaking; tingling in the face, arms, and hands; and short term upper body weakness.

Migraines are more commonly found in women. Like tension headaches, migraines are often associated with known varying triggers like food, smells, excessive heat, fatigue, and dehydration.

Please refer to How to Prevent and Treat Migraine Headaches.

Cluster

This type of headache tends to appear in cycles (clusters) which last hours to days. By most accounts, these are the most painful type of headache. Typically, cluster headaches present with a sudden onset and usually subside as quickly as they start.

These headaches are the least common and only affect approximately 1% of those who suffer from headaches. The first onset for this type of headache is usually between 20-30 years old.

Please refer to Cluster Headaches, the “Suicide Headache” for more information.

When to Seek Emergency Care:

Although most headaches do not require emergency medical attention, the following signs and symptoms indicate when to seek emergency care.

If you have any of these signs or symptoms, please seek emergency care:

Abrupt, severe headache
Severe unrelenting pain
Headache with a fever; stiff neck; mental confusion; seizures; double vision; weakness, numbness; and speaking difficulties
Headache after a head injury (especially, if the headache gets worse)
Muscle weakness/paralysis and/or face drooping (signs of a CVA)

How to Determine the Cause and Design an Effective Course of Treatment:

The symptoms of headache pain are nearly as diverse as the causes of headache pain. Regardless of the onset whether sudden (such as from an injury, from a fall or motor vehicle accident) or more subtle and chronic, there are few aspects of care that are important for all headache suffers to consider.

Start a headache log or diary. I always recommend beginning the process by keeping a diary in order to determine the most likely culprits prior to working on less common scenarios. There are many obvious and common potential causes to address first. Sometimes, it takes some serious detective work to rout out the cause and design an effective course of treatment. The patterns noted in the diary will be clues to guide you down the right treatment path. Don’t perseverate over every little detail of your headaches, but you need an accurate account of frequency and triggers.
Look for patterns. Try to establish patterns to the headaches. When do they occur? Do certain foods trigger the headache? Which activities will cause a headache? What makes the symptoms better or worse? Are they associated with certain movement patterns, activities or even certain times of the day or month?
Which treatments work for you? Everyone has his/her preferred cure, but what really works for you? Don’t feel bad if someone else’s cure doesn’t work for you as we are all different.
Leave no stone unturned. When looking for patterns, consider all aspects including: food, medications, and supplements. Also, consider your living environment. Could there be mold in the home? Other unknown allergens? How is your micronutrient status? Dental issues?

Don’t give up hope! Headache pain is difficult to manage, but with proper care most headache pain can be cured or effectively managed. The most frequent mistake I see people make is to not stick with a thorough plan. Jumping around from one treatment to another rarely works.

With severe and/or chronic headache pain, a very thorough and specific plan of addressing all aspects of your health and wellbeing will need to be addressed for long term success. This process can be slower than desired, but when executed properly, it will almost always leads to significant success.

Thanks, Brad, for the question! I hope you and your family members find this information helpful and that they are able to experience some relief from headache pain! Stay tuned as I will profile typical self-treatment strategies for each type of headache in upcoming posts.

Do you or a loved one suffer from headaches? Which treatments have worked the best for you? Please share your experience. Together we can all grow and learn how to best manage this condition.

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!

Disclaimer: The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.

Posted on Wednesday, July 20, 2016

Why Your Upper Back Hurts When You Run

http://running.competitor.com/2016/06/injury-prevention/upper-back-hurts-run_151708

Competitor

June 13, 2016

As featured in this post for Competitor, I explain how poor technique or weak back muscles can contribute to upper back pain while running. You’ll learn why it’s important to get your body to do the opposite of hunching forward and to stretch out the neck and upper back muscles in order to eliminate pain when running. I also recommend a series of exercises to strengthen the lower and mid trapezius muscles, and the rhomboid muscles, along the spine at the base of the neck.

At the end of a long hard run, you expect your legs and lungs to be burning, but your upper back? No way.

Unfortunately, “it’s a very common thing,” said Nick Studholme, a sports chiropractor in Colorado. As the intensity and length of a run increases, many runners will often experience a worsening sharp pain in their upper back, in between or under the shoulder blades. It’s not quite debilitating, but it sure is painful and annoying.

It’s particularly common in novice runners, said physical therapist Ben Shatto, but it can happen to anyone with poor technique or weak back muscles. And that’s most of us. Continue Reading

Posted on Wednesday, July 6, 2016

The Number One Reason Why You Won’t Reach Your Training Goals

http://marathontrainingacademy.com/number-one-reason

Marathon Training Academy

June 6, 2016

In this guest post for Marathon Training Academy, you will learn how to effectively exercise and work the core muscles in order to prevent or treat low back pain (LBP) as well as other common running injuries affected by weakness in the core and pelvic muscles.

The number one reason why runners won’t reach their goals is also one of the most preventable reasons: injury! Nothing derails a perfectly developed training plan like an injury.

The most common injury to runners is also the most common injury for those in the western world: 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. Continue Reading

Posted on Wednesday, June 29, 2016

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

http://marathontrainingacademy.com/low-back-pain-2

Marathon Training Academy

May 25, 2016

In this guest post for Marathon Training Academy, you will discover the three most common mistakes runners make that can lead to low back pain (LBP), and you will learn prevention tips in order to avoid injury.

Low back pain (LBP) is one of the most prevalent medical conditions treated in the United States and throughout the western world. Avoiding the following 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! Continue Reading

Posted on Wednesday, June 22, 2016

Take a Peek 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.

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

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

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!

Use discount code LBP to receive 15% off now!

Purchase Package

Still on the fence about the Treating Low Back Pain during Exercise and Athletics Video Package? I understand that the full package may not be the right choice for you. You still have the option to purchase only the Treating Low Back Pain during Exercise and Athletics eBook.

Use discount code LBP to receive 15% off now!

Purchase eBook (Download)

Posted on Wednesday, June 15, 2016

How to Leverage your Nutrition to Train Harder and Recover Faster

As a physical therapist, I help to educate my clients about a wide variety of strategies from nutrition to physical components including advice on exercise, hands-on techniques (such as myofascial and joint mobilizations), and self-care techniques. Time and time again in my practice, a client will struggle with healing from an injury. He/she may be performing the right exercise and receiving the proper treatment, yet he/she is unable to properly heal because his/her body doesn’t have the proper nutrition level to allow the healing to occur. Poor eating habits not only sabotage your results, but can also lead to severe chronic illnesses (such as heart disease and diabetes).

Your body’s ability to train harder and recover faster is not just about the exercises performed. It should also be centered on the fuel you put in your body. Your body cannot perform optimally, recover adequately or heal from injury properly without adequate nutrition.

Focus on your Recovery Nutrition

The majority of your diet should be from real food. My personal belief is that food which is minimally processed, organic and/or home grown is likely to have a higher nutrient load and will therefore be healthier for you. Your body simply cannot heal and recover quickly or adequately when substandard fuel “food” is consumed.

Initially, focus on macronutrients (fat, protein, carbohydrate) when it comes to food. For me, this includes a diet high in protein from many sources (plant and animal-based), high in fruits and vegetables, and low in processed carbohydrates.

Runners and endurance athletes should pay particular attention to protein intake as maintaining muscle mass is critical for performance and injury prevention. For more information on protein supplementation, please refer to How Much Protein Do I Really Need?

Consider Supplementation

I am a believer in supplements although you must choose wisely. Your dietary belief system, genetics, and the type of exercise and/or activity you mainly participate in will determine which supplements may work best for you.

When choosing supplements, I tend to gravitate toward supplements that can enhance performance, improve recovery, stabilize blood sugar, and reduce systemic inflammation. The ultimate goal with supplements is to aid your body in improving health and/or performance. Try to choose the most natural products as possible and experiment to see what works best for you. Look for supplements that don’t contain extra fillers, sweeteners or additives. For more information on supplementation, please refer to My Top 10 Supplement Recommendations.

Add Super Greens to your Diet

Most people do not consume enough greens. Green super foods, such as spirulina algae, chlorella algae, and wheat grass are packed high in antioxidants. They can have a cleansing and an alkalizing effect which will decrease your inflammation level and aid in recovery. Super greens boost your immune system and are generally good for you. I think the argument can be made that algae is the king of “super” foods. It is likely the most important food/supplement most people are not taking.

I have been experimenting taking algae for the last four months, and it has allowed me to train harder and recover faster. I am setting new milestones in my ability to perform many of my more difficult CrossFit exercises (such as ring muscle ups). I have seen more improvements in strength, cardiovascular performance, and recovery then at any other time in my life.

My new favorite way to add greens and protein are supplements called ENERGYbits® and RECOVERYbits®. They are made from organically grown NON GMO spirulina algae or chlorella algae. Spirulina algae have a high concentration of plant-based protein (64%). It also contains 40 vitamins and minerals including iron, nitric oxide, Omega-3, and all of the B vitamins.

Because of their overall nutritional profile I now consider spirulina and chlorella algae a top performance and recovery supplement. I take 30-45 of these small tablets per serving. I have had great success taking them prior to a work out and directly afterward. I also take them mid-day as a snack or meal replacement.

A general rule is to consume spirulina prior to exercise (which are the ENERGYbits®) and chlorella (which are the RECOVERYbits®) after exercise. Chlorella is high in protein. It also has detoxing properties and an impressive micronutrient profile.

Also, be sure to listen to Ben Greenfield’s interview with the founder of ENERGYbits®, Catharine Arnston, on the benefits and importance of algae. Please refer to Is This The Most Dense Source Of Nutrition On The Face Of The Planet?

In full disclosure, I am now an affiliate for ENERGYbits®. I signed up primarily to get the same 20% discount I can offer you. You can only purchase them online, so when you check out, just enter discount code PTAdvisor for 20% off all products.

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Avoid Injury and Overtraining Syndrome (OTS)

Nutrition is an important component for both performance and recovery. Proper recovery is critical to avoiding injury and Overtraining Syndrome (OTS). Every recovery protocol should include a multifaceted approach that incorporates strategies to positively affect the muscular, nervous, and hormonal systems. This includes proper nutrition, getting adequate sleep, cross training, and implementing self-care modalities (such as compression band use and foam roller use).

OTS usually starts with muscle soreness and a feeling of fatigue. Then it quickly progresses into a case of overtraining syndrome or injury. Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from. It’s always best to prevent OTS rather than attempt to recover from it.

Nothing can derail your best laid training plans and goals like an injury or suffering from OTS! If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury and return to a normal training schedule.

AVAILABLE NOW ON AMAZON!

In my book, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of 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! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

Discover how you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

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Posted on Wednesday, June 8, 2016

Why You Keep Hurting Your Back

Low back pain (LBP) is one of the most prevalent medical conditions treated in the United States and the western world. In fact, an estimated $50 billion dollars or more is spent annually on back pain related issues. Nearly 80% of the U.S. population is affected by LBP at one time or another. So why are we all hurting our backs? Why does the pain seem to always reoccur?

2 Reasons Why Low Back Pain tends to Reoccur:

The original risk factor(s) or precipitating actions that caused the initial low back pain (LBP) were never addressed.
The inner core stabilizing muscles were never properly rehabilitated. This makes the spine vulnerable to re-injury.

Just imagine if you had a significant knee injury which required surgery. The injured leg would be weak and require specific exercises to help it to rehabilitate. In most cases, the muscles of the injured leg would be obviously smaller due to muscle atrophy. This same atrophy happens deep within the muscles of the lumbar region (particularly, the muscles known as the multifidus shown below).

These muscles are responsible for spinal stabilization and to prevent shearing between vertebrae to vertebrae. Just like the muscles in the thigh (in the knee example above), these muscles will shrink and atrophy when injured. The problem is that you cannot see or feel them easily, so most of us never know that the spine’s ability to stabilize during activity is compromised. This is a critical factor as to why reoccurring LBP is so prevalent.

Low back pain is a serious and debilitating condition. It will either most certainly affect you or someone close to you. The good news is that you don’t have to be a statistic! You don’t have to live in fear of your next episode of LBP. First, you need to address the likely causes that lead to the initial episode of low back pain, and be mindful of your risk factors. Please refer to 12 Risk Factors for Low Back Pain.

Next, by implementing the proper exercises for prevention and rehabilitation, you can live pain free, train pain free, and live the life you want without fear of reoccurring low back pain! Treating Low Back Pain (LBP) during Exercise and Athletics is designed for individuals of all levels from weekend warriors to soccer moms to elite athletes. These principles can help you live the pain free life that you desire!

Treating Low Back Pain during Exercise and Athletics

In this complete self-treatment 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. 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.

In this package, you get an in-depth look at treating LBP with a 7-part series of instructional videos in which I address low back pain prevention during exercise; specific warm ups for exercise and activities; what really is the “core” and why it matters; treatment techniques (including how to apply Kinesiological tape); and long term management strategies. This includes nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports (such as running), and athletics.

In this BONUS eBook, 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! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

LEARN MORE

Posted on Wednesday, June 1, 2016

12 Risk Factors for Low Back Pain

We all work hard exercising and training for the next race, game, and/or competition. We invest hundreds and thousands of dollars and hours upon hours training for our sport or activity. We learn everything we can about our sport. We buy the newest gear and fitness apps. We invest in the newest and greatest training plans and programs. Yet, we often fail to address the obvious. 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. 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.

What if you could prevent injury and the loss of training days? What if you could prevent costly physician visits? What if you could spend your money on the best fitness and training programs and gear instead of on pain relief gels, oils, and scams?

The following list of potential risk factors for LBP addresses how you can be proactive in maintaining a healthy back. How many of the following 12 risk factors can you relate to?

12 Risk Factors for Low Back Pain:

Smoking – Smoking is a major risk factor for low back pain (LBP). The chemicals in cigarette smoke affect both the lung’s ability to exchange oxygen and the body’s normal healing response. These chemicals alter the blood supply to the discs and other spinal structures which affects nutrient exchange and increases the risk of pain. Healing time for all medical conditions worsen with smoking. Although research is forthcoming, it’s likely that vaping also has a negative impact on healing and LBP. Anything that negatively affects optimal health will increase your risk of LBP and recovery from injury.
Gender – This is an interesting one. It may relate to certain behaviors more than anatomical differences, but males have a higher risk of LBP. Females tend to experience more cervical or neck pain.
Pregnancy – Pregnancy increases your risk for LBP due to structural changes as the baby develops and hormones change. The expectant mother releases relaxin, a hormone which loosens the whole body, to prepare for the baby’s delivery. Again, a risk worth taking! Most women can manage the pain by modifying posture and movements while learning techniques for self-management.
Heredity – A family history of low back pain increases your risk. In some cases, this may be due to actual structural deformities which may be genetically linked. More commonly, it’s a learned behavior, such as chronic sitting and slouching (poor posture), that can lead to a higher risk of LBP.
Prior Episodes of LBP – Once you have experienced LBP, you are more likely to have re-current episodes. This is typically due to not addressing the precipitating factors that led to the first episode of LBP. It’s also likely due to weakness in the deep multifidus muscles that help to support the spine and prevent shearing forces. This weakness can be addressed with proper physical therapy intervention. (Please refer to Why You Keep Hurting Your Back.)
Lack of Exercise/Activity – A sedentary lifestyle will increase your risk for LBP. The spine is designed to work and move. In order for the spine to remain healthy, it requires exercise and movement.
Too Much Sitting – Sitting for even a moderate amount of time not only affects your general health status in a negative way, but it also increases your risk for LBP. Sitting for more than 30 minutes at a time can increase your risk. Worse yet is sitting with poor posture or unsupported. Sitting on vibrating surfaces such as a heavy equipment operator will increase your risk further. Please refer to The #1 Way to Extend Your Life Span for the reasons why sitting has such a negative effect on your body.
Poor Posture – In western culture, we spend most of our day sitting slouched or standing hunched over. This is an excellent way to increase your risk for LBP. It’s one of the major risk factors for disc herniation and development of spinal stenosis. Please refer to How to Improve Posture & Eliminate Pain for exercises that can help you to develop better posture and strength to eliminate back pain.
Lack of Warm Up Before Exercise – This is a common mistake which can lead to injury. A proper warm up prior to an event or exercise session is critical for injury prevention and in order to achieve peak performance. A poor warm up affects your ability to get the most out of each training session. A warm up should consist of a cardiovascular component, a spine specific component, and a dynamic stretching routine of the actual exercises you will be performing to insure you’re ready for the movement. This is pertinent for any training session regardless of sport including weightlifting and running.
Training when Exhausted – Allowing yourself to become over fatigued will increase your risk of all types of injury including LBP. This is a common problem among CrossFitters and anyone who trains at a very high intense level. Typically, this results in poor technique which further increases your risk. Combine poor technique with muscles which can no longer perform the proper movement pattern, and you’re likely to become injured.
Poor Technique – Poor technique often occurs when performing exercises that are too advanced, with too much resistance, and/or when feeling exhausted. Performing unfamiliar lifting techniques or lifting too much weight will likely result in poor technique.
Training Volume – Overtraining syndrome (OTS) can occur when you train too hard for too long. Your training plan should include scheduled rest and recovery cycles to allow your body the time to recover between competitions and high volume or intense training cycles. OTS definitely increases your risk of injury.

The key component to preventing reoccurring episodes of LBP is to address your risk factors. Determine what initially caused your LBP. If you are looking to finally prevent those reoccurring episodes of LBP that derail your training and/or are currently suffering from LBP, then Treating Low Back Pain (LBP) during Exercise and Athletics is the solution. This complete guide and system will help you to prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures.

Treating Low Back Pain during Exercise and Athletics

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Posted on Wednesday, May 25, 2016

Why Low Back Pain almost always Reoccurs

I had waited all year for the City of Trees half marathon. My goal (as always) was to post a PR (personal record) for the event. Since it was a fairly flat course, I figured it would be a good opportunity to run fast (at least, fast for me). As part of my training protocol, I was squatting two days per week and working on general leg strength and cross training (practicing yoga) one day per week.

My back had been sore off and on for almost five years. Medical professionals didn’t offer me any specific reasons as to why. Neither chiropractic nor physical therapy seemed to help much, so I just ignored it. But not this day!

I had just completed my second work set of squatting at the gym. At the time, I wasn’t experiencing any notable back pain. I was on my second repetition and on my third set when my low back gave way. The weight came down and hit the rack safety rails! My back hurt, but worse, it felt unstable. I decided to leave the gym in shame. I picked up the weights I was using, but the pain began to worsen.

By the time I drove home, I could barely get out of my truck. I decided I was tough, so I took some ibuprofen and still went to work. By the time I made it to the office (about 10 minutes), I was in real trouble. I walked around for a while, and I took some Tylenol before I decided to go home. I got in my truck, but by then the pain was so bad that I couldn’t push in the clutch or hardly use the brakes. I really don’t know how I make it home that morning, but I needed help from my wife to get out of my truck.

It only got worse from there. I went to lie on my bed. Again, another bad plan! An hour later when I needed to urinate, I realized I couldn’t even get out of bed! The pain was worse than anything I had ever experienced. After much struggle and help from my dad (who was called in to help), I was able to get upright, only to break out in a cold sweat, start shaking, and nearly pass out from the pain. Still having to urinate, I experienced one of the more humbling things I have ever done. I had to ask for help from my wife to urinate into a plastic bottle because I couldn’t get out of bed.

Long story short, I went to a doctor who diagnosed me with low back pain (LBP) from a lumbar strain and prescribed pain medication and a steroid pack. After many more days of pain, I was finally upright again.

A month later, I was ready to start back into my training, but frankly, I was nervous! My back felt weak, and I had no idea how much was too much. The worst part of it all: I’m a physical therapist! Shouldn’t I known what to do? It sure didn’t feel like it at the time.

The medication did mostly relieve the pain, but I had a chronically sore back that felt weak and unstable. I was performing physical therapy exercises and stretches. I was even using heat and electrical muscle stimulation (EMS).

My treatment wasn’t helping me that much. At least, not to the point that I felt I could get resume my training for my upcoming half marathon. All I wanted to do was to get back to training, but I was too scared to!

This experience started me down a path of study that changed my life. I realized how incompetent I had been as a physical therapist who treated others experiencing severe low back pain. I had new appreciation for those patients who wanted to get back to their sport and activity. I also realized that my prior physical therapy interventions were not preparing people to get back to sport nor most high level activities.

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? 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? Can I train as hard as before? Am I really better? I have lost so many days of training, should I even compete in my event?

Often after a severe case of low back pain, 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 low back pain almost always reoccurs and what you can do to prevent it.

The most common treatment strategies for low back pain are too general for most active individuals, weekend warriors, sport enthusiasts, CrossFitters, weightlifters, and runners. I have spent the past 11 years researching, studying, and refining best practices for treating LBP. I have combined research with known anatomical and physiological principles in order to develop very specific strategies for LBP prevention among active individuals. I have designed a complete guide and system to help you to prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures.

Treating Low Back Pain during Exercise and Athletics

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Posted on Wednesday, May 18, 2016

5 Tips to Prevent Low Back Pain during DIY Projects

Many of us will be planning our yearly DIY (Do It Yourself) projects now that it’s nearly summer time (in the U.S.). I have a few minor landscaping projects that will be addressed this summer, too. Whether it is an outside landscaping project, an indoor painting project, moving furniture around, and spring cleaning (don’t forget the garage!), you are likely to be exercising different muscles and performing activities that you aren’t used to. It’s easy to imagine the new paint color or a beautiful landscape design. Now imagine crawling around on the floor because you can’t stand up as your best laid plans are derailed by a bad episode of low back pain (LBP). Not exactly the picture you were hoping for!

Whether you are an avid exercise enthusiast, runner, CrossFitter, weekend warrior or couch potato, you are likely to experience an episode of LBP despite being young or old. LBP is estimated to affect nearly 80% of the U.S. population at one time or another, and it’s one of the top reasons for physician visits. Fortunately, most LBP is mechanical–meaning it’s from a physical or structural cause not related to conditions such as cancer or infections. The problem with this type of LBP is that it usually comes back. People who have had an episode of mechanical LBP are 90% more likely to experience it again.

If you are going to be tackling those DIY projects and desire to still be standing upright at the end of the day, it’s best to minimize your risk factors for experiencing LBP by being proactive!

5 Tips to Prevent Low Back Pain during DIY Projects:

1. Warm up.

Just like any other exercise and/or event, you should warm up first. A good place to start is to perform standing back extensions and press-ups.

2. Loosen up.

So many of us sit too much! This causes tightness in the hip flexors and hamstrings. Try stretching your hip flexors and hamstrings.

3. Limit the amount of time spent in one position (including sitting).

Don’t sit or bend over for a prolonged period of time without at least standing up straight (and preferably, performing additional standing back extensions and press-ups as well as stretching your hip flexors and hamstrings).

If you are sitting, maintain proper 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 great tool to help you with this is a lumbar roll.

4. Use common sense.

If you don’t think you can comfortably lift something, be sure to ask someone for help. Stay within your limits, and don’t over estimate those limits! Just because you could lift 100 lbs. in high school, it doesn’t mean that you still can. Use common sense and proper technique when lifting a heavy object or when performing repetitive lifting.

After taking a prolonged rest, be sure to spend a few minutes warming up and loosening up again. Don’t make the mistake of sitting down and resting during your lunch break, only to launch back into the project without making sure that your back is ready. Take the extra time to be certain that your back is ready to start working again.

5. Preventing LBP is always best.

Once you have experienced an episode of LBP, you have a 90% chance of it reoccurring. Be proactive! Reoccurrence rates can be impacted and reduced!

Developing adequate strength in the lumbar extensor muscles and core musculature is the primary way to prevent initial episodes and to prevent reoccurring episodes of LBP. Research clearly indicates that the right targeted exercises are the most effective way to manage LBP.

Stay tuned in during this upcoming month as I introduce you to my new complete self-treatment package, Treating Low Back Pain during Exercise and Athletics. I have designed a complete guide and system to help runners, CrossFitters, exercise enthusiasts, and weekend warriors just like you (and me) prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures. In the meantime, be sure to check out my FREE resource, 10 Minutes per Day Low Back Pain Prevention Guide. Download the .pdf file, which is full of photos and exercise instructions, to get started!

For additional information on LBP, please refer to the following:

Which DIY (Do It Yourself) project do you hope to accomplish this upcoming summer? Please share below.

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