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Fitness Exercise Won’t Help Your Low Back Pain

It’s estimated that approximately 82.1 million adults in the United States spend an estimated $28.6 billion on gym memberships each year! Now combine that staggering number with the estimated $50 billion dollars plus spent annually on back pain related issues. Even with the general fitness craze we have seen over the past years, low back pain (LBP) remains one of the most prevalent medical conditions treated in the United States and throughout the western world. It affects nearly 80% of the U.S. population at one time or another. It’s one of the top reasons for physician visits and one of the most common reasons for missed work days.

With so many active individuals and crazy fitness trends you would think that all of this exercise would actually help reduce low back pain, right? Wrong…It turns out that not all exercise (and especially, not all “core” exercise) is created equally.

It’s time to address how to safely self-treat your low back pain through movement and exercise as well as some helpful methods for a speedy recovery. (Not to mention, possibly saving you time and money by avoiding a physician visits for pain you can manage safely and independently with a little instruction.)

To safely self-treat your low back pain, first take a moment to assess your symptoms and pain level. What led to your pain and/or injury? Did the pain come on suddenly or slowly? Evaluate the severity of the injury. If you’re experiencing any of the following, please seek immediate medical attention:

  • Loss of bowel/bladder function.
  • Uncontrollable pain. The pain is so severe you cannot function or move.
  • You are losing muscle function or control. The muscles in the legs will no longer work. (This is different than pain preventing the muscle from working.) This sensation of paralysis occurs when the muscles will not actually function.
  • Significant loss of sensation in the leg or groin area. This is not a tingling sensation, but an actual loss of sensation. For example, you cannot feel the toilet paper when you wipe after using the toilet.
  • Onset of pain without any known mechanism for the injury. (Thoroughly consider your activity. Many times, a slow onset of pain begins several hours after performing an activity.)

Fortunately, most LBP is mechanical–meaning it is from a physical or structural cause and isn’t related to conditions such as cancer or infections. Most LBP will have a directional preference for extension. A majority of injuries occur when performing a forward biased (flexed movement) like chronic slouching or a spinal flexion biased movement. For discussion purposes, I will be addressing an extension biased program.

With mechanically driven low back pain, you should be able to alter and change your LBP within a short period of time. First, establish a directional preference by identifying a pattern to the pain. Does the pain get worse when you bend over or does it improve? What happens when you repeat this movement?

Determine how your pain responds. If it spreads away from the spine and down into the leg, beware that you are moving in the wrong direction. Stop that particular movement, and instead try flexion biased movements. In my experience, most episodes of LBP tend to respond better to extension biased movements. If flexion or extension doesn’t help or change the pain in any way, then you may need assistance from a medical provider.

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. We 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.

Although most LBP isn’t considered serious, the pain tends to re-occur. One major reason for this is that the deep stabilizing muscles known as the multifidus muscles reflexively shrink, weaken, and lose function. Without proper rehabilitation, the muscles will not fully recover. This increases the risk of future episodes because the spine no longer has the ability to stabilize itself normally. Not all “core” work is created equally, so the strength of these muscles needs to be addressed.

How to Safely Self-Treat Low Back Pain:

Perform Press-ups

Once you have injured your back, immediately start press-ups. Perform this exercise with high repetitions and frequently throughout the day as long as the pain does not periperalize down the buttock and into the leg and/or foot. Lie on your stomach and perform 10-20 press-ups. Move slow and easy, but work your way up to full motion multiple times a day.

Perform Standing Back Extensions

After sitting, stand up and perform standing back extensions. Ideally, perform this exercise at least 10 repetitions each time you stand.

Activate the Multifidus

Start exercises to activate the multifidus muscles as soon as possible. Think spine extensor muscle activation. Again, perform this exercise frequently during the day after the initial injury. These Lumbar Extensor Exercises are designed to progressively activate the multifidus muscles (with the final exercise being the most challenging). Once the pain subsides and muscle function improves, more advanced lumbar extension strengthening and stabilizing exercises should be performed to decrease your risk of re-current low back pain.

Don’t Sit

Walking is critical to your recovery! It’s the number one way your spine receives nutrients and disposes of metabolic waste products. Walk frequently, and try to avoid any prolonged sitting.

If you Sit, Use Good Posture

Use a McKenzie Lumbar Roll to help insure a good lumbar curve. If you can’t sit comfortably, listen to your body and don’t sit! Be sure to stand up and walk every 20-30 minutes. Stand with good posture as well.

Stretch the Muscles of the Legs and Pelvis

Hip flexor and hamstring stretches can help to reduce muscle spasms and tightness throughout pelvis area when performed daily. Stretch for at least 30 seconds at a time, 2-3 times each session.

Be as Active as You Can

Don’t stop moving, but avoid exercises that make your back hurt more. Typically, this includes flexion biased movements like sit ups. It’s important that you remain as active as you can. You may need to taper down certain activities that you know will increase your pain. This typically would be activities involving heavy loading of the spine such as squats with weight, deadlifts, and other activities that may cause forward flexion (particularly under a load).

As you are able to, continue to work on cardiovascular conditioning and core muscle activation (particularly, the lumbar extension exercises). Basically stay as active as you can, even lifting weights if you are able.  Just remember the concept of peripheralization and centralization. If your pain progresses from the area of the injury into your leg, then you need to stop that activity. If the pain remains constant or is progressing out of the leg, then continue with the activity as you are helping the body to heal.

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. 

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, be sure to check out my Treating Low Back Pain (LBP) during Exercise and Athletics Book and Video Package. USE DISCOUNT CODE LBP AT CHECKOUT FOR 15% OFF!

For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat reoccurring low back pain episodes.

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

WATCH NOW

If you have a question that you would like featured in an upcoming video or 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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Why We Can Be Our Own Worst Enemy

I must warn you that this is not the typical post from me. All of the information is true and sadly, not exaggerated in any way. My hope in documenting this true account of events is that it will help others know how to better avoid injury. If you do develop an injury, then maybe some of my self-treatment strategies could be helpful.

What most people don’t know about me is that I have struggled with low back pain (LBP) for over 20 years. Early on, I had years of constant and chronic LBP. This pain helped drive me to seek out different self-treatment methods. I began to understand LBP along with the best practices on how to self-manage and most importantly, avoid future flare-ups. This has personally helped me manage my own pain while helping thousands of others either directly with physical therapy or by sharing my book, Treating Low Back Pain during Exercise and Athletics.

Even with all my diligent efforts (most of the time), the occasional LBP flare-up occurs. Unfortunately, the last incident was due to poor judgement on my part. In early November of last year, I had been sitting a lot while working on a few projects, and my back started to ache. It was mild at first. However, by mid-month, I could hardly get out of a chair and walk.

As a physical therapist (PT) that specializes in treating LBP, I should have known better, but I chose to do what most people do. I ignored it, and pressed on. I reminded myself that I’ve had this pain before, and it typically goes away. Right then, I didn’t have time to address it.

Monday morning rolled around, and I was scheduled for my 5 mile tempo run. As any runner or exercise enthusiast knows, if it’s scheduled, then it must be done (no matter what, right?). I was sure my back would loosen up as I ran. Often times, a warm up prior to running makes it feel better. (If I was being honest, the pain was pretty bad that particular morning. It was preventing me from sitting, getting out of my car, and even walking straight. Was that a good enough reason to cancel a run?)

I managed a short walking warm up since that was all I could muster and proceeded into a slow jog. About 2 miles into my jog, my right calf started to hurt. Why stop? I was sure it would all shake loose soon…

As mile 3 approached, I was falling apart. My back hurt to the point I couldn’t stand up straight. My right calf was completely locked up. It was giving me a sharp pain with every step. The bottom of my left foot started aching. I finally shut it down and limped home.

Later that day, my calf wasn’t any better (neither was my back), and now I had full on plantar fasciitis. Pretty good start to the week, but I got that run in. By the end of the day Monday (post run), I was miserable, but I didn’t dare tell anyone.

As a PT, I should have known better. I started to analyze exactly what was going on. For some reason, my disc bulges (a pre-existing problem at L4/L5 and L5/S1) had flared up for no apparent reason and were hurting terribly. My back pain had caused a left lateral shift in my spine, which meant I couldn’t stand normally. The nerve tightness down my left leg affected my walk, so I could not fully stride out.

In hindsight, my sad attempt at a run early that morning was actually a terrible idea! I had obviously been running with a poor gait pattern. This altered gait pattern with poor running mechanics resulted in a right calf strain and the development of plantar fasciitis in my left foot. (And this all started in 3 miles!)

My initial treatment was to determine my directional preference for my lumbar spine pain:  

A directional preference is a way to identify a pattern to the pain. Does the pain get worse when you bend over or does it improve? What happens when you repeat this movement? Determine how your pain responds. If it spreads away from the spine and down into the leg, beware that you are moving in the wrong direction. Stop that particular movement, and instead try moving in the opposite direction. If you were moving into flexion, try extension. If you had trialed extension biased movements, try flexion. Find the movement pattern that helps the pain improve and that has a positive effect on any other symptoms you may be having.

I determined my directional preference. As I performed my series of movements, my symptoms were peripheralizing (returning back to the middle of my back to the point I could stand straight and walk normal).

After a series of 10 side glides followed by 10 press-ups (as demonstrated below), I could eliminate 75% of my LBP and symptoms as long as I didn’t sit. Sitting would immediately bring the pain back on. For the next several weeks, I avoided sitting at all costs including during dinner.

I also started back extensions over an exercise ball (3 sets of 15 repetitions as demonstrated below) every morning as part of a lumbar strengthening program. I chose back extensions to insure that I was working my lumbar extensor muscles. I kept my movement patterns within my directional preference. This was preceded by and followed by side glides and press-ups as well as continuing to avoiding sitting. I stopped running since I couldn’t fully walk or jog without an altered gait pattern.

For my calf, I started foam rolling and stretching regularly. I used a mobility band (as demonstrated below) as a way to provide compression while I performed heel raises (typically a set of 20-30 repetitions). Thankfully, I had the opportunity to trial a product that not only utilized the compression from the mobility band, but added a way to self-mobilize the calf. The CTM Band worked exceedingly well for this. (“CTM” stands for compression, tension, and movement.) Use code MTA15 for a 15% discount. (If you suffer from any form of blood clotting disorder or are on blood thinning medications, I would advise against utilizing mobility bands for any type of deep compression.)

For my plantar fasciitis, I also performed calf stretches as well as used a small ball (as demonstrated below on the left) to mobilize the bottom of my foot. Pain in the morning seemed to be the biggest issue, so I would sit up and stretch before getting out of bed (as demonstrated below on the right). By the end of the day, my foot would really start to hurt. Since I was unable to sit due to my back, I used a padded stool to kneel on whenever possible.

I continued this treatment plan for over 3 weeks. For the first 2 weeks, I was unable to run, so I concentrated on rehabilitation exercises only. During this time, I utilized a self-prescribed course of over-the-counter Ibuprofen (anti-inflammatory). I didn’t have any medical issues with taking this medication. Please consult your physician before taking any medications or supplements.

I also initiated a supplementation protocol consisting of adding collagen hydrolysate to my daily smoothie as well as taking CapraFlex by Mt. Capra. (It combines an organic glucosamine and chondroitin supplement with other natural herbs and enzymes which are designed to reduce inflammation, promote bone and joint healing, and wellness.)

This continued for approximately 4 weeks. The rationale behind the supplementation was to insure that my body had the necessary building blocks to heal and to provide additional anti-inflammatory support to my body during my recovery.

After 3 weeks, I returned to running for only shorter distances (under 5 miles). I was tapering back into other exercise routines with appropriate modifications which included increasing my warm up and cool down times and avoiding bending forward since I wasn’t 100% better.

The reason I chose to share my most recent LBP episode with you is because I have heard versions of this story over and over again from other runners, weekend warriors, and patients.  We really can be our own worst enemy!

As a PT, I should have known better than to run that day. As a runner and weekend warrior, the feeling that it may be a “mortal” sin to miss a scheduled run or work out can be a powerful temptation to do it even though your body may be telling you to reconsider.

As any frequent exerciser knows, a few aches and pains is par for the course. In fact, it’s pretty normal! Oddly, I will have just as many if not more, aches and pains when I stop running and exercising as when I’m regularly training.

The moral of my story is a reminder to be very self-discerning and self-aware to understand what is a typical ache and pain versus something more serious. In my case, not being able to walk normally due to pain should have been a clue not to run abnormally either. My abnormal running pattern that day is what led to the overuse injuries in both my calf and foot. What was surprising even to me was how fast the pain developed and turned into a true overuse injury in only the course of 3 miles!

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, be sure to check out my Treating Low Back Pain (LBP) during Exercise and Athletics Book and Video Package.

Treating low back pain does not need to be difficult or expensive. For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat reoccurring low back pain episodes.

USE DISCOUNT CODE LBP AT CHECKOUT FOR 15% OFF!

SAVE 15% NOW!

If you have a question that you would like featured in an upcoming video or 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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Why Does My Lower Back Hurt?

Have you ever wondered what exactly makes your back pain worse? Why does your back continue to hurt on and off again? Why does it seem to “act up” right at the wrong time? Is it something you are doing? Is there something seriously wrong? Is it just bad luck?

These are all fantastic questions. It’s time to answer the age old question as to why your back keeps hurting. Here are the top reasons why your back may be hurting and what to do about it.

The Top Reasons Why Your Back may be Hurting:

You smoke or vape.

Smoking is a major risk factor for low back pain (LBP). The chemicals in cigarette smoke affect both the lunges’ 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.

You’re biologically male.

Males have a higher risk of LBP. Females tend to experience more cervical or neck pain. (Obviously, you have very little control over this factor other than the knowledge that you’re at an increased risk if you are a male.)

It may be your parents’ fault.

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.

You’re pregnant.

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.

You don’t exercise.

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.

I WANT TO GET RID OF MY BACK PAIN NOW!

You sit for more than 2 hours a day.

Sitting for a long period of time not only affects your general health status in a negative way, but it also increases your risk for LBP. It’s even worse if you’re a heavy equipment operator who sits on a vibrating surface.

You have 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.

You don’t warm up before exercise.

This is a common mistake which can lead to injury. Jump out of your bed in the morning without warming up, and then start your exercise routine. (Please don’t!) Instead, prepare your body for challenging activities in order to avoid injury. A warm up should consist of a cardiovascular component and a dynamic stretching routine of the actual exercises you will be performing to insure you’re ready for the movement. This is also pertinent for weightlifting and running.

You keep moving even when you’re exhausted.

This is a common problem among CrossFitters (including myself). Just keep pushing yourself even when you can’t see straight. 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. High Intensity Training (HIT) is a wonderful form of exercise and has many health benefits as long as you’re able to properly perform the exercise.

You’re using poor technique.

Poor technique, along with feeling exhausted, often occurs when performing exercises that are too advanced. Performing unfamiliar lifting techniques or lifting too much weight will likely result in poor technique. Please see your coach, athletic trainer or physical therapist for the proper technique for your activity of choice.

Your training volume is too high.

Who needs a rest day? ALL of us can benefit from taking a break. Training every day without regard to rest is an excellent way to cause over training syndrome and injury to your back.

You’ve experienced prior episodes of LBP.

Once you have experienced LBP, you are more likely to have re-current episodes. This may be the major reason why your low back pain re-occurs. This is partially due to weakness in the deep multifidus muscles that help support the spine and prevent shearing forces. This weakness can be addressed with proper physical therapy intervention. The loss of structural strength is the primary reason why your back pain continues to re-occur, and this can be changed.

Core strength does matter, but it is likely not what you think. Most people don’t quite understand the relationship between the “core” and lumbar stabilization. It’s way more than just doing sit-ups. In fact, sit-ups may actually make your back pain worse.

Low back pain is a serious and debilitating condition. It will either most certainly affect you or someone close to you. Be mindful of your risk factors and be pro-active in maintaining a healthy back! The good news is that nearly all low back pain is mechanical (meaning there is a physical reason for the pain). There are physical treatment options that not only can help you recover from the pain, but also to avoid re-occurring back pain!

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, be sure to check out my Treating Low Back Pain (LBP) during Exercise and Athletics Book and Video Package.

Treating low back pain does not need to be difficult or expensive. For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat reoccurring low back pain episodes.

USE DISCOUNT CODE LBP AT CHECKOUT FOR 15% OFF!

SAVE 15% NOW!

If you have a question that you would like featured in an upcoming video or 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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How to Prevent Back Pain while Working from Home

The COVID-19 pandemic has transformed work and how it is done. Many people transitioned from working in an office setting into working remotely from home. Many employers have extended work-from-home (WFH) options as coronavirus cases continue to surge. With the shift of working environments, there has been a rise in back pain and other posture and structural driven pain from the neck, shoulders, arms, and low back. Much of this increase in pain is due to poor home working conditions and more sedentary behavior as we spend more time at home during the COVID-19 pandemic.

Low back pain (LBP) continues 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. Yet most of us do not currently seek care or in some cases, we cannot even get appointments into our medical providers because of the pandemic.

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. It’s best to minimize your risk factors for experiencing LBP by being pro-active. This means that you can effectively self-treat YOUR low back pain without expensive medical visits, surgery, pills or injections.

How to Prevent Back Pain while Working from Home:

Fidget more. Limit the amount of sitting that you spend at one time. Since you’re at home, you can sit in different positions and in different locations. Get out of a sitting position every hour, and ideally, walk. If you aren’t able to walk, then try to shift your position at least once every twenty minutes.

Frequent position changes can help to avoid LBP. Don’t get stuck sitting for hours in the same position (particularly, if it’s uncomfortable or if you’re sitting with poor posture or with poor ergonomics). If you’re standing, then stand in different positions. Put your foot up on a stool, and then switch feet. Stand on different surfaces when possible (hardwood, carpet or softer padding like a standing mat). Variety is the key to avoiding low back pain.

Sit with good posture. If you’re going to sit for any period of time (regardless of the position), maintain your posture. Whenever possible, make sure that your knees stay below your hip level and that you are able to maintain your natural lumbar curve. Even if you don’t have an office chair at home, lean back in the chair (don’t slouch in your lower back). A great tool to help you with this is a lumbar roll. Ergonomics are important, so find ways to support your back while keeping your shoulders and neck in a relaxed position.

Stop looking down. Try to keep your devices at eye level, or slightly down. Don’t position them so that you have to look up at them. Limit the amount of time spent looking down whether that is from texting or reading a paper or even writing. If you tend to spend 30-40 minutes at a time looking down at your device, work toward reducing that time in half.

I WANT TO GET RID OF MY BACK PAIN NOW!

Stand more. A standing desk can be a wonderful luxury. At home, you can get creative and use a higher counter top for a make shift standing desk. Use boxes or books to improve the ergonomic positioning. The set up should allow you to look straight ahead when you work on your computer while in a position that your arms can hang down naturally with the forearms supported. No one can see your set up. Even if it’s not esthetically pleasing, it’s best to keep your body feeling good.

Take a break to exercise. Take advantage of being home and take a 15 minute stretching or yoga break. How about 10 minutes to roll out and utilize the foam roller or maybe a few core exercises like planks? Have some fun with it. My favorite 10 minute work-from-home exercise break includes: 25 air squats, 25 push-ups, 5 minutes stretching on the foam roller, and then a few press-ups.

I highly recommend press-ups. Lie on your stomach and perform 10 to 20 press-ups. Go slow and easy, but work your way up to full motion. Perform these multiple times a day as time allows. This is much easier to do when working from home versus an office environment.

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.

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, be sure to check out my Treating Low Back Pain (LBP) during Exercise and Athletics Book and Video Package.

For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat reoccurring low back pain episodes.

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

WATCH NOW

If you have a question that you would like featured in an upcoming video or 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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5 Tips to Prevent Low Back Pain When Shoveling Snow

In many parts of the world, snow season is upon us. Whether you are shoveling snow or using a mechanical snow blower, your risk of experiencing back pain is likely higher than any other time of the year. If you’re one of the lucky ones who live in a warmer climate, these tips can be just as helpful as you manage those DIY (Do It Yourself) projects.

Whether you’re shoveling snow, working on an outside landscaping project, moving furniture around or just deep cleaning, you’re likely to be exercising different muscles and performing activities that you aren’t used to. Your best laid plans can be derailed by a bad episode of low back pain (LBP). Don’t worry, you can prevent this! If it’s a little too late and you’re already experiencing LBP, I can guide you forward without expensive medical bills, pills, injections or surgeries.

Fortunately, most LBP is mechanical–meaning it’s from a physical or structural cause that is 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’re going to be shoveling that snow or 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 When Shoveling Snow:

  1. Warm up.

Just like any other exercise and/or event, you should warm up first. Pre-activity:  A good place to start is to perform standing back extensions and press-ups. This exercise can also very helpful if you are already experiencing low back pain.

  1. 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.

  1. Limit the amount of time spent in one position.

This means to limit the amount of time slouched over the shovel or snow blower. 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). TAKE A STANDING REST BREAK TO STRAIGHTEN BACK UP.

I WANT TO GET RID OF MY BACK PAIN NOW!
  1. Use common sense.

If you don’t think you can comfortably lift something, be sure to ask someone for help. If your back is starting to get sore from all that hard work, TAKE A BREAK, but don’t immediately go sit down in a slouched posture. Sitting (especially with poor posture) after working your back really hard is a major risk factor for developing low back pain.

Be sure to work within your limits, and don’t overestimate those limits! Just because you could lift 100 lbs. in high school doesn’t mean that you still can. Always use common sense and proper technique when lifting a heavy object or when performing repetitive lifting and shoveling.

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.

  1. 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.

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, I have the solution for you. For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat reoccurring low back pain episodes. 

The Treating Low Back Pain (LBP) during Exercise and Athletics Book and 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

LEARN MORE HERE

If you have a question that you would like featured in an upcoming video or 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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A Year in Review: 2020

The COVID-19 pandemic and the events of 2020 have impacted all of us. Through this hardship, we have learned the importance of working together and being proactive in taking control of our own health and well-being. Working together and supporting one another makes taking the necessary steps to age well easier and more fulfilling. Being proactive is a key component to aging well.

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.

A recap of my top 3 posts that resonated with you the most in 2020 include:

The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain – The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. In this video post, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

3 Easy Exercises to eliminate Wrist and Elbow Pain – In this video post, I describe three easy exercises to help you quickly eliminate pain in your hand, wrist, and elbow. I demonstrate two simple stretches with an easy variation to improve their efficacy and teach you how to easily improve your hand and wrist strength using a simple rubber band.

How to Improve your Recovery from Injury, Illness or Surgery – In this guest post for Smart Strategies For Successful Living, I share two basic reasons why nutrients are not getting to the injured area. There is either a nutrient delivery problem (which includes proper intake) or there is a nutrient absorption problem. This may be affecting your ability to physically recover from injury, illness or surgery.

As 2020 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 truly focus on health and wellness care for ourselves, loved ones, and friends. Together we all can age well.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2021! 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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Is this Pain really an Injury or not?

4 Steps to Identify if you need to engage in a Formal Rehabilitation Protocol or just Rest

Runners are accustomed to a certain amount discomfort. Training can be hard and uncomfortable at times which is exactly why it’s so rewarding and addicting. It can get a bit confusing when it comes to physical injuries and pain. Most runners have experienced that out of nowhere pain in a foot, knee or hip that had us wondering if we should really keep running. Then just as suddenly as it appeared, it faded away. How about the all too common sentiment: “It takes me 2-3 miles just to feel warmed up from all my aches and pains.”

  • How do we know when it’s time to stop and discontinue our activity or just push through those nagging aches and pains?
  • How do you know if the pain or discomfort you are feeling is something to be concerned about (a true warning sign of an injury) or just common transient stiffness and/or discomfort?
  • Are there really different kinds of pain? How can we differentiate between them?

It can be difficult to answer these questions at times. It can be difficult to self-diagnose the aches and pains we all feel (particularly, for newer runners). Even more experienced runners may question when to push and when to rest. Injuries can be confusing, and it can be surprisingly difficult to tell if we’re really injured and even where the injury really is located.

Although sometimes a challenge, knowing why you’re in pain is actually the most valuable knowledge there is for treating the root cause of the problem. The most important thing to understand is that getting to the bottom of your pain is the key in relieving it….permanently.

For example, treating your knee may not help to eliminate the pain if it’s actually your hip or low back that is the real source of the pain. Just to make things even more confusing, your pain might not even point to an injury in the first place! Often, we may experience pain that is fleeting and that disappears on its own or is referred from an entirely different part of the body.

Understanding the difference between a one-off pain and a chronic debilitating type of pain is absolutely crucial. If you don’t pay attention to the pain and it really is pointing to an injury, then you might end up exacerbating the injury and/or injuring your body even worse. This can lead to an extended time away from training with a prolonged rehabilitation and recovery.

4 Steps to Identify if you need to engage in a Formal Rehabilitation Protocol or just Rest:

  1. When it comes to pain, listen to your body. Your body is sophisticated and complicated. Its ability to signal injury in the form of discomfort and pain cannot be underestimated. Pain is a potential warning signaling a problem. If we listen carefully enough, our bodies will inform us of our ailments. When it comes to knowing if we’re injured or not, we have to listen. Another way to look at it is as a trust, but verify approach. The pain should give you pause.
  1. Look out for any signs of injury: swelling; discoloration; temperature spikes; trouble walking; difficulty placing pressure on the painful area; and sensitivity to touch. These are all indicators that something is wrong and a more formal rehabilitation approach may be indicated.
  1. If you feel pain for long durations of time (hours to days versus minutes), something is most likely wrong. Don’t make the mistake of believing your pain will disappear on its own. Listen to your body and make a decision to address the pain. Don’t continue to ignore it.
  1. If you find that the pain is not improving on its own and you are experiencing other symptoms of injury (such as swelling, tenderness, and/or changes in movement patterns), then it’s time to figure out exactly what type of injury you’ve sustained. Is this an overuse injury that has slowly creeped up on you? Was pain caused by a specific episode such as a fall? Start by analyzing the types of activities you’ve performed. Think about when the pain occurs and what activities is the pain associated with. Be cognizant that most running related injuries are overuse in nature. This means that there is likely an exacerbating mechanical cause. The actual painful structure may or may not be the associated with the root cause of the injury. Often, overuse injuries are due to a muscle or strength imbalance somewhere else in the kinetic chain which can lead to pain and injury in different areas. This can also be true when poor running mechanics lead to pain or dysfunction.

Understanding injuries and pain can be tricky. It may seem impossible to identify either the cause of the pain or its location, but one thing is certain: it cannot be ignored! Listen to your body and make a decision to get the help you need. Take action. Analyze your activities, stop doing those that you think may be detrimental, and seek professional help if you need it. (If you are unable to determine the reason for the injury, please seek a professional physical therapist in order to establish the exact cause and potential treatment needed.)

Given the complexities of the human body, it can be difficult to determine the root cause of the injury. However, most overuse injuries have very common patterns of dysfunction. Treating according to well documented patterns is often all one needs to recover and get back to running pain free and safely. Formal medical intervention is not always needed or feasible.

Angie Spencer (RN and Certified Running Coach), Trevor Spencer (co-host of the Marathon Training Academy Podcast), and I created the Resilient Runner Program to help you manage and self-treat many of the most common running related injuries and painful areas. This program uses common patterns of dysfunction as a guide to help you self-treat most running related issues.

More specific strategies to help you determine the cause of your injury along with more thorough treatment and prevention strategies for those suffering from overuse injuries are covered in the program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

What’s Inside the Resilient Runner Program:

  • Guidance on preventing and self-treating common running related injuries, including Hip Flexor Pain, Runner’s Knee, IT Band Syndrome, Piriformis Syndrome, and more!
  • Specific guidelines on when and how to return to running after experiencing an injury.
  • Rehabilitation guides with step-by-step photos demonstrating recommended exercises.
  • Step-by-step instructions on how to apply Kinesiological tape.
  • Downloadable podcasts, videos, and more!

If you’re tired of ongoing aches, pains, and injuries, learn how to become a resilient runner so that you can continue to train and compete in order to meet your goals!

I WANT TO BE RESILIENT!

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Good can be Great

Have you ever heard the following saying? “Don’t let great be the enemy of good.” We can often fall into this trap when considering our heath and aging successfully. If we can’t do something perfectly, then we just don’t do it.

However, this is exactly the wrong type of thinking. Successful aging is a worthy goal for all of us to strive toward. To be successful in the aging process, great initiative is necessary as we are solely responsible for our health.

Each person’s journey will be different. It’s not just about the destination. The journey is an evolving process. There will be starts and stops, ups and downs, and twists and turns. Focus on being consistent and making better choices. You don’t have to be perfect…Good can be great! As you make choices in your journey, focus on habits that over time will lead to successful aging.

5 Habits to Help You on your Journey to Aging Well: 

Walk Daily 

A walking routine can help you to manage each of these critical components to successful aging including: physical health; mental health; emotional health; community; and finances (particularly, if leading a healthy lifestyle helps you to avoid the ever growing costs of health care).

Walking has many benefits including:

  • Lowers the risk of heart disease, stroke, and diabetes.
  • Lowers your risk of cancer, including breast cancer.
  • Improves circulation and blood flow to the entire body.
  • Releases stress reducing hormones.
  • Releases hormones that can control blood sugar levels for up to 24 hours. This helps to reduce your risk of diabetes while keeping your energy levels stable throughout the day.
  • Keeps your mind sharp and reduces your risk of Alzheimer’s disease and dementia.
  • Boosts your immune system.
  • Improves sleep quality.

Maintain your Strength

Strength training is critical as you age. All muscle fibers show some decline as we age although the fast twitch (Type II) fibers show the most decline. Strength training is a critical component to maintaining and strengthening Type II muscle fibers. The stronger you are, the more resistant to injury you will be. Most importantly, you must maintain adequate strength to insure the ability to be independently mobile.

Maintain your Balance

Balance is critical to safe mobility. Assuming you have the strength to be mobile; you must also have adequate balance to be safe when moving around. Without adequate balance, you increase your risk of falling or injury.

Focus on your Mental Health 

Regardless of age, it’s important to remain engaged and mentally sharp through constant and varied mental stimulation. This means stay engaged by turning off the television and playing a game or reading a book instead. Better yet, join a book club so you can discuss your latest read with friends.

Other activities to keep mentally challenged include taking an online course, learning how to paint or play a musical instrument. Challenge yourself.

Proper nutrition and exercise also have an impact on your mental health and can help to prevent depression, Alzheimer’s disease, and dementia.

If you are hard of hearing, get appropriate help. Research has shown that a loss of hearing has a direct correlation to isolation, depression, dementia, and mental decline.

Focus on your Emotional Health

Active engagement in your community is a critical part of successful aging. People find community in a variety of ways including family, friends, church, civic organizations or volunteer projects. Others may choose to continue to work.

Remember to share the love. Research clearly notes that those who are more loving and caring tend to live longer and healthier. Be generous with the knowledge and wisdom that you have acquired throughout the years. Love others and purposefully share that love.

Research also validates the importance of friendship in living a long and meaningful life. Many argue that a sense of belonging and purpose combined with a strong social support system will have more influence on the aging process than more traditional factors such as diet, weight control, and exercise.

The importance of having strong meaningful friendships cannot be understated. Research continues to validate that friendship is a key to longevity and avoiding heart disease.

There are many aspects to healthy aging. Maintaining psychosocial support and friendships along with independent mobility and cardiovascular health are key components that can insure you’re living a successful purposeful life. Each person’s journey is different and unique.  We are all capable of successfully aging if we take the initiative and are intentional about the process.

Trying to make something great can actually prevent us from making it just good. Instead of pushing yourself to something impossible and getting nowhere, accept good. You are in control of your journey, so enjoy the ride!

This article appeared on Smart Strategies for Successful Living:

https://www.agegracefullyamerica.com/good-can-be-great/

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My Top 3 Videos on How to Self-Treat Knee Pain

Knee pain is a common complaint among exercisers and non-exercisers alike. So often the actual cause of the knee pain is actually a muscle imbalance elsewhere. Weakness in the hip musculature, particularly the deep hip external rotators muscles, is a common contributing factor for knee pain.

In the following videos, I demonstrate different exercises designed to specifically strengthen your hip and lower leg in order to address muscles imbalances common with knee pain. Addressing these muscle imbalances can lead to the permanent resolution of your knee pain and symptoms.

My Top 3 Videos to Self-Treat Knee Pain:

The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain – The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. In this video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

How to Use the Clamshell Hip Exercise to Treat Knee Pain – Knee pain is the most common running related injury. The root cause of many of the most common knee related issues is hip weakness. One of the best ways to treat many common running aches and pains is to focus on strengthening these muscles which include the gluteus medius, the tensor fascia latae, and the other deep hip rotators. In this video, I demonstrate how to perform the clamshell exercise. It’s an excellent non-weight bearing exercise to work on hip rotator strength which will directly affect knee stability.

A Barbell Knee Stability Exercise for Runners – In this video, I demonstrate how to perform an advanced exercise known as the clock or star drill. It’s an excellent exercise to work on knee stability and balance while specifically focusing on quadriceps and hip strength.

If you’re interested in more thorough guide on how to self-treat knee pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

I WANT TO BE RESILIENT!

If you have a question that you would like featured in an upcoming video or 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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Becoming Resistant to Running Injuries

https://www.marathontrainingacademy.com/becoming-resistant-to-running-injuries

Marathon Training Academy

November 14, 2020

In this podcast interview with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast), we discuss how you can become more resistant to running injuries. Topics include: key ways that people can prevent injuries from occurring in the first place; what type of strength training runners should be doing; and how to differentiate between discomfort and pain and when to seek help. Listen to the podcast

Disclaimer: This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.