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Back pain, Core strengthening, Health, physical therapy, physiotherapy

Beating Low Back Pain – Must know Physiotherapy Exercises

July 20, 2017 • By

Don’t put up with low back pain and Sciatica. Below are the best and safest exercises to treat your low back pain yourself.

With 80% of the population experiencing low back pain in their lifetimes, and 84% of those having a recurrence within the same year, this is a huge problem, but a problem that can be helped… alot! As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five exercises for you

As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five of the best exercises for you to rehabilitate your low back pain at home.

1. Bridge, level one:

Start by lying on your back on the floor or bed with your knees bent. Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds, then lower down. Repeat 10 times twice.

Brideg - up

Bridge level 2:

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

SL bridge 1SL bridge 2

2. Glute sling stretch:

Our favorite stretch!

glut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibility

 

Start on your hands and knees then bring one knee between your hands. stretch the other leg out behind you and across to the other side. Now slowly walk out over your knee with your hands until you feel a good stretch.

Hold for 1 minute each side.

Tip – If that is too much of a stretch then go down onto your elbows first.

3. Bird-dog: 

Instructions: In four point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in a controlled manner and repeat, 10 times each side twice.

Beginners: Start by raising one leg only.

birddog 2birddog 1

4: Hip flexor stretch: This is important to unload the Low back and pelvis:

hip flex 1hip flex 2

Tip: to get a good stretch “tuck your bum in” or draw the bones at the front of your pelvis up towards the roof. You should feel it in the front of your hip or top of your thigh.

Hold for 1minute.

5: McGill Curlup

Place your hands down on the floor underneath the natural arch in your lower back (Don’t flatten your back.) Only lift your head and shoulders off the ground – unlike crunches, there should be no movement of your lumbar spine. Your hands are there to make sure your back is not curling off your hands or crushing them.

Once you have good spine control then you can take your hands onto your thighs and slide them to the top of your knees to do the curl-up. It doesn’t feel like you are going far but with repetition, it can get your abs firing well.

Begin with 20 at a time, and build up.

mcgill curl up

The key to all of these exercises is to maintain control and don’t rush them.  Do these exercises twice daily for 6weeks and notice the difference (but don’t stop there!)

Also see Slipped disc: what is it and how to fix it.

And if you want more and harder exercises to strengthen up your low back: Get into some QL strengthening!

 

Please Share, like and comment to let me know how you go.


Back pain, Core strengthening

Acute Low Back Pain – Getting up and moving

July 3, 2017 • By

Low back pain is an incredibly common condition and is the single most common thing I see in practice every day. Luckily there are some great exercises to do early on to get you up and moving.

The following facts show just how seriously we should take back pain!

The bad

  • Low back pain affects 84% of the population at some point in their lives (1,2)
  •  38% of people have back pain each year (3)
  • Close links with low back pain and neck pain (15 fold increased risk of neck pain)

The Good

  • 50-80% recover within 4-6 weeks
  • This is not uncommon

It may feel really sore and at times disabling but as long as you follow my recommendations below you have a good chance of recovering 100%

In most cases, the majority of low back pain is not serious. What a lot of health professionals do not tell their patients is that 85% of low back pain is categorized as “Non-specific low back pain”. This means that the pain and disability do not have a definitive cause or diagnosis. This non-specific low back pain is what we will be talking about today and I will be giving you the information and exercises to get you walking right and up straight again.

Because 50-80% of people recover in 6 weeks the usual advice is to take painkillers and keep active – but the thing is there is more you can do to speed it along!

First I need to say, yes there is the remaining 15% of back pain that is specific and does have a diagnosis so it is important to have these ruled out and see your doctor – especially if the pain is not improving.

Below I am going to outline a guideline for getting your back to the best it can be when you experience acute low back pain.

Phase 1. Initial inflammatory phase:

This is the stage where most likely it is uncomfortable to walk, bend over etc and you just want to curl up in a ball and stay there (that will not help!). In this phase you need to abide by the Tips below:

  • Number one rule is to keep moving, within reason. This prevents the structures around the spine such as the muscles in spasm from stiffening up too much. This is also very important in order to decrease the loss of stabilizing muscle activity. Now you don’t need to continuously keep moving – just don’t stay in one position for a long period (more than 20 minutes).

Bed rest is one of the worst things for back pain

  • Gentle range of motion exercise: knee rocker – Lying on your back with your knees bent up and feet on the ground – slowly let your knees drop to one side, and then the other. This is a gentle exercise and not to be forced or pushed into pain. Little and often throughout the day.
  • Safe sleeping positions: The best position is in side lying with your knees bent up a little and a pillow between the knees. This position decreases the forces on the spine and allows muscles to relax.
  • If you must sleep on your back then have a pillow under your knees to unload the spine.
  • Stretch to straighten up: when in back pain your hip flexors tighten up and put a shear force through your spine and cause you to have a bent over, shuffling posture.

hip flex 1hip flex 2

Tip: to get a good stretch “tuck your bum in” or draw your front hip bones towards the roof. You should feel it in the front of your thigh or hip.

Hold for 1 minute.

Phase 2. Recovery:

In this phase, the main things causing stiffness and pain are muscles that are tight and in spasm in your hips, glutes and low back.

1. Glute stretch: To get into the below stretch, start in four-point kneeling and bring one knee forward between your hands. then extend you

To get into the below stretch, start in four-point kneeling and bring one knee forward between your hands. Then, extend your other leg out behind you and across to the other side. Lean forward in this until you feel a stretch in your glute region. To add more of a stretch, walk your hands out in front of you. Hold for 1 minute each side

glut and Lat stretch - Hip flexibility glut and Lat stretch - Hip flexibility

2. Hip flexor stretch: as above in phase 1

3. Bird-dog exercise:

In four point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in control and repeat, 10 times each side twice.

Beginners: Start by raising one leg only.

birddog 1birddog 2

4. Bridge, level one:

START POSITION: Lying on your back with your knees bent.
Stabilization: Tighten abdominals.
Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds and then lower down. repeat 10 times twice.

Brideg - up Brideg 1 legges - up

Phase 3: Strengthening and back stability – and maintain!

To do this make it a routine to do my top five Low back pain exercises daily.

Maintaining core stability is important in preventing flare ups and ensuring you at your best if flare ups do happen, to speed up recovery.

Thanks for reading and remember looking after your back is ALWAYS important, not just when it is sore.


Core strengthening, Health, physiotherapy, training

Exercise for Flippies, Floppies and Stiffies

September 23, 2016 • By

You might be thinking I’ve gone mad and your mouse is sliding towards closing the tab… but using the Flippy, Floppy and Stiffy principle is actually a brilliant way of preventing injury!

It has been used for some time among physiotherapists to group patients simply and effectively and has nothing to do with anyone’s nether regions! In fact, it has also been used by top tier rugby and football teams as well , instead of grouping all their players together.(1)

Training your body according to your body type has huge benefits and if you get it wrong, you can be putting yourself at real risk. Take for example someone that is super flexible. If they were to do a lot of yoga and stretching only, they would get more and more mobile and lose more stability, which they didn’t have much of to start with, potentially leading to a joint sprain.

So here are the 3 types and how we can apply exercises to them:

Floppy

beighton-hypermobility-scoreIf you are a floppy, you can probably bend down and touch the ground easily or bend your thumb down to touch your wrist. You are hyper-mobile, meaning you have a lot of mobility in your joints and laxity in your ligaments. You can get your Beighton score here to see how hyper-mobile you are.

If you are a floppy, you don’t need a lot of stretching.

You need strengthening of your muscles. This will help develop the muscles around your joints to improve stability and limit your joints going too far.

 

Stiffy stiff jointsStiffy

Stiffies, believe it or not, are typically male but that’s not a strict rule.

I’m a self-confessed stiffy. I can’t touch my toes without bending my knees a little, I’m terrible at sitting cross-legged and am simply not very mobile. For those of like me, of which there are a lot, you need to stretch and mobilise.

You need to stretch regularly, practice yoga and work on joint mobilisations and you will notice a huge difference.

 

Flippy

And lastly, flippies have a foot in both camps. They are those lucky ones that aren’t over-flexible or stiff as a board.

You flippies probably have more work to do unfortunately as you will benefit from keeping mobile and strong, having a good mix between stretching and strengthening for the best outcome.(3)

 

So are you a flippy, floppy or stiffy? Categorise yourself and take a closer look at your regular workout routine – do you need to individualise it a bit better to suit your body type?

 


Back pain, Core strengthening, Spine

QL Muscle Strengthening: Beat Low Back Pain

February 16, 2016 • By

Your Quadratus Lumborum muscle (better knows as your QL muscle) can cause you all sorts of back pain and refer pain into your hip and glutes. Having weakness in your QL muscle can mean recurring and frustrating back pain that can cause way too much trouble

So following on from our previous article on how to treat the QL yourself through an easy muscle release, here is how to strengthen it up and beat low back pain.

Strengthen QLSo, what does your QL muscle do?

Easy, it comes from the top of your pelvis (the iliac crest) and attaches on to the bottom rib and the side of your spine. From there, it acts to help you extend backwards, bend to the side, bend forwards and can help in breathing.

So the QL does rather a lot. Not only that but because it attaches to all your lumbar vertebrae and your pelvis, when it goes into spasm, it can really pull on your spine and can also lift one side of the pelvis – Making it seem like your “back is out”

 

Strengthen Quadratus lumborumAnd you know what? The QL can be a real pain in the butt.

Literally. As with a lot of muscles in the body which cause you to feel pain elsewhere and not where the real issue is. The QL refers pain into the buttock and side of the hip, making it quite deceiving as to where the pain is actually coming from.

 

Symptoms of QL muscle dysfunction:

  • Deep, aching in the low back, often worse in sitting or standing
  • Pain with coughing and sneezing
  • Pain rolling to either side when lying on your back
  • Pain can refer to the groin and mimic sciatica symptoms
  • You may have one side of your pelvis lifted higher than the other

 

Strengthening exercises for the QL:

  1. Side plank

Level 1: Hold

Side plank QL strengthening

Build up your QL endurance by holding a side plank.

Aim for a one minute hold (this is the goal, you may not be able to do it straight away!)

Tip: don’t stick your bum out, tuck it in

.

.

Level 2: Leg lifts

Side plank leg raises

When you can hold a straight side plank comfortably for a minute, step it up.

Lift your hips up into a side plank but now lift your top leg up and down while holding the side plank.

Aim for 3 sets of 10 reps, but you may need to start with less reps!

Tip: don’t let your top leg come forward or toes point up.

 

 

2. One sided farmers carry

one sided farmers carry for QL strengthening

 

Here, the QL muscle on the opposite side to the weight you are carrying is working hard to keep you upright.

Hold onto a dumbbell or kettlebell in one hand and do some laps (e.g. 10 x 10m laps on each side)

Tip: try to stay upright!

 

 

And that’s it. Easy. Combine those few exercises into your workout at least 3 x weekly to improve the strength of your QL muscle and help beat back pain.

Tip: This is a great stretch to help unload the low back!


Ankle, Core strengthening, Health

Level 3 Ankle Sprain Rehab – Heal strong and fast

November 16, 2014 • By

Anmle excursion exercise, balance rehabThese are the rehab exercises that you need to get your ankle 100% and to minimize chance of re-injury which is far too comon. This ankle sprain rehab is aimed at improving range, balance and strength with simple, effective home exercises.

Too many people simply sprain re-injure their ankle is the full rehab isn’t followed through with and actually 33% still have pain remaining after one year! And on top of this, a history of ankle sprain ( you have injured it before) is the single most predisposing factor for ankle injury.(2,4)

This means after you have an ankle sprain it is very important to rehab it right as you have a high chance of ongoing symptoms and re-injury. And remember the research shows that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery – so get started as soon as possible for best results.(3)

In earlier posts covering the Level 1 and Level 2 rehab stages I have outlined the best exercises and self-treatment to help you heal strong and fast.

Quick test:  here is a great little test to see if your ankle range is back to it’s best. The other easy test to see if you need to do the level three exercises is to balance on the balls of your foot, one leg at a time – you should be able to do this for at least 30 seconds and you should be even between legs.

 

Grade 3 ankle rehab has 3 main goals:

  • Achieve full range of motion
  • Have good ankle  and leg control through this range
  • Full strength of the ankle stabilizers

To get there, here are the exercises that you need to do:

1. Toe balance

ankle sprain balance exerciseankle sprain balance exerciseThis is a great balance exercise to strengthen your ankle in this vulnerable position and better yet, it is simple and you can do it anywhere.

Stand on the ball of your foot. You will most likely need to start with one finger on the wall for balance.

Goal: 1 minute each side

Make it harder: Do some one leg standing and toe balance on one of my favorite rehab equipment: a BOSU Ball

 

2. X excursion exercise – Balance re-training

This exercise has come about from a well-used test within the health industry – the Star Excursion Balance Test. The great thing about the tests we use as physiotherapists is that they really do challenge you, which make them great as exercises also as if your body is challenged, it is going to adapt to improve.

 

3. Ankle stretch

Ankle stretch exercise

Along with the classic calf stretch, this one is great for getting full range in your ankle and making sure you are even.

Hold for one minute.

 

 

 

 

 

4. Ankle self-mobilization

 

Putting in the time to rehab your ankle fully is so important, not only will it decrease or get rid of any pain but it will improve your mobility and performance. Even just working on retraining your balance decreases your chance of re-injury by 22-33% – nothing to scoff at right!(5)

So write the exercises down, favorite this post and make it a routine.

 

Return to Sport:

As a simple rule, once both sides are even, you can get back to training and playing. So to test yourself out, see how far you can single leg jump and make sure both legs are within 5cm of each other and then do the X-excursion exercise as above and again, make sure both sides are within 5cm of each other. If they aren’t even, keep working at it.

Also if you are returning to sports such as basketball or volleyball etc that reuqire a lot of jumping, twisitng and hopping, or if you have sprained your ankle more than once, it is definately worth yor while looking into getting a good lace-up Ankle Brace.

 

Yours in health,

Shaun