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self treatment

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.


Mobility, running

Myofascial Release – Tight Hamstring Treatment

July 10, 2014 • By

tight hamstring treatment - hamstring anatomyTight hamstrings?

Ongoing hamstring niggles and pain?

Or if you just want to improve flexibility, then this tight hamstring treatment is for you. This is a great myofascial release that really targets the hamstrings and is often far more effective than foam rolling or stretching

 

Some of the many benefits are:

  • back pain while squatingLess low back pain and risk of back injury
  • Improved flexibility
  • Decreased hamstring pain
  • Decreased risk of hamstring injury
  • Endorphins released, increased blood flow + You feel better!

 

 

Challenge: Before you start – How are you going to know if it has helped improve your mobility? Here’s how:

Keeping your knees straight, bend down towards your toes – mark or remember how far down your leg the tips of your fingers get (you can even get someone to do a little mark with a pen!). After you have done this quick tight hamstring treatment, re-test and see the difference.

Hamstring myofascial release

Here is how to release your hamstrings:

Position: Sitting on a hard surface – such as a hard bed, bench or a chair. Preferably your feet should be off the ground. Place a hard ball (I use a lacrosse ball as they are hard and grippy, so it isn’t going anywhere!) under the hamstring, starting higher up as shown.

 

 

hamstring tight MFR - self muscle release

Action: Putting your weight through the leg then, as tolerable, flex and extend the knee (straighten and bend). By doing this you are gliding the muscle over the ball, stretching out the muscle, kneading out knots and breaking down adhesions.

 

 

Hamstirng, thigh self myo-fascial releaseRepeat: Straighten the knee out 10 times and then move then ball to the next tight spot (likely closer down towards the knee, in the middle of the muscle) and repeat so that you work out all those tight spots throughout your hammies. Do this on both legs so that things are evened out and then you are good to go!

 

Give it a go and let me know what you think and if you want more self-treatment ideas, check out our content-packed Ebook


Fist aid

Strains and sprains – Heal Your Injury Strong and Fast

November 26, 2013 • By

RICE injury treatment, heal strong and fastStrained muscle, sprained ligament, tear or bruise – The first 72 hours are critical and can mean the difference a season ending injury and a few weeks out. A few simple things that you can do will make the world of difference to any muscle strain or ligament sprain. Here I will give you all the information you need to look after your injury in the first 72 hours, including whether to use ice or heat for acute inflammation.

Why is the first 72 hours so important? Because of inflammation. Acute inflammation is your body’s natural response to harmful stimuli and occurs whenever an injury happens where there is  tissue damage, whether it is from a bruise to a full-blown ligament or muscle tear, it happens every time. There is a lot of stigma against inflammation but really it is a natural mechanism and there for a reason: It is the first stage of the healing process and so very important. So yes we do want it to happen, but it can also cause a lot of secondary damage and prolong healing and so we need to control it.

After tissue damage occurs, the inflammatory process moves in to kill and remove any infectious agents, remove the loose debris and then last, but not least lay the foundations for and activate the healing process. So not only is inflammation needed, but if you do not have it then the injury is never going to heal as strong as it can.

The healing process following soft tissue injury:

 tissue healing stages and self treatment

Phase 1: Inflammatory phase

This phase usually lasts up to 72 hours depending on how you look after the injury and is often called the protective phase as this is the time when our body is really trying to protect itself from further damage. The main signs of inflammation are heat, redness, pain and swelling.

When injury occurs soft tissue fibres are ruptured (to varying degrees depending on severity of injury) and then break down. A haematoma(blood clot) is formed from blood escaping out of damaged blood vessels filling the space between the torn fibers. At the same time, inflammatory cells enter the tissue from the damaged blood vessels. The inflammatory cells have a few jobs. The first job is to get rid of the broken down ruptured fibres and the second is to really turn up the dial on the process by producing chemical signals that dilate the blood vessels and increase their permeability so more calls can get to the tear. The third job is to attract fibroblasts, these guys are the builder cells that produce collagen – this is laid down at the tear to act as a natural band-aid.

Phase 2: Repair

This phase takes from 2 days to 6 weeks and pain can be intermittent throughout.

This is the phase where the tissues are re-built and regenerated. The initial re-builder cells, the fibroblasts have proliferated and produce more collagen into scar tissue. A new blood vessel system is also starting to form in this phase, bringing with it essential nutrients for healing. The injury is now a scar and so at this stage is still not very strong (even if it feels it or is painfree!). Because of this – this is a very risky phase of healing. As healing progresses we start to feel good about the injury, less pain, more mobile etc and we are tempted to go back to running, sport etc – Be warned it is not very strong!

Phase 3: Re-modelling

This final and very important phase takes 3-6 months and sometimes longer.  This stage is essential because up until now, all the new fibres produced have been irregular, just laid down all over the place into an inflexible scar instead of aligned nice and straight and strong. So the main aim in this stage is for the new scar to get strong and more flexible

 ——-

So why do we need to control the inflammatory process? If inflammation is left to run wild, the inflammatory chemicals can cause secondary damage and bleeding to the initially un-damaged tissue surrounding it. Also by applying the following principals we will decrease the amount of scarring and give ideal conditions for healing.

So here is what you should and should not do in the first 72 hours

Should:

sprain strain self treatment ice rest compressRICE to reduce extent of bleeding, swelling and injury

  • Rest, stop all aggravating injuries.
  • Ice, 10 minutes at a time every  hour you are awake.
  • Compression, an elastic compression bandage or tubing should be worn and only removed if needed for icing.
  • Elevation, if possible rest the injured area above the level of your heart.

Early mobilisation: it is important to begin moving the damaged area early, but gently as to avoid causing further damage. This early mobilisation means that normal muscle patterns are preserved, stronger new fibres are laid down, more scar tissue is re-absorbed, improved new blood vessel generation and last but not least there is less muscle wastage. Our bodies are amazing things that continually adapt to the forces that are out through them. So if you use the area functionally and normally, putting safe forces through the injured area, the body will heal according to these forces, making a much new tissue. Where as if you use crutches for a week or make yourself couch-bound you will end up with a weak, tight dysfunctional scar that could come back to bite you in the future.

Should-not:

HARM:

  • Heat
  • Alcohol
  • Running/Exercising the injured area
  • Massage

All of these things cause the blood vessels to dilate (open up)and increases the blood flow to the area, increasing the bleeding in the injured area. This is harmful to the repair process and will mean a drawn out recovery process.

Immobilize – unless it is a very significant tear or a suspected fracture. This is because immobilization can cause early and significant negative effects on various body systems. For example, metabolic processes leading to muscle atrophy(shrinking), and weakness of the quadriceps muscle start as early as 6 hours.

Immobilization does accelerate formation of new blood vessels and tissue, limits scar size, but as mentioned earlier unless it is a very significant tear or suspected fracture the benefit of early immobilization is much higher

NSAIDs (Anti-inflammatory medication): when used improperly these can hinder or even stop the first essential stage of healing and cause the tissue to be weaker in the future.

Final tip: If it is a lower limb injury you have (eg. Ankle sprain, calf tear, quad tear) then try to walk as normally as you can early. Just remember to walk heel-to-toe, heel-to-toe.

Whether you have a groin strain, sprained ankle or pulled muscle anywhere in your body, if you look after your injury right in the first 72 hours, you will be back to doing what you love faster and stronger! And remember if in doubt, go get it assessed by your local Physio.

If you are a trainer, coach, parent etc this is a great little resource to have around for quick information: Soft tissue injury info sheet.

Remember to Share, like and comment.

You might also enjoy:

Sprained ankle: heal strong and fast

Shin splints: the best self-treatment and advice

Self-myofascial release for neck pain

Tissue healing in more detail:

http://www.ncbi.nlm.nih.gov/pubmed/1897874


Ankle, foot pain, Health, Lower limb

Sprained Ankle – Heal Fast and Strong with Self Treatment

September 30, 2013 • By

Treating a sprained ankle the RIGHT way early on means a stronger ankle, faster recovery and less chance of re-injury. In this series I will tell you what a sprained ankle involves, the most effective self treatment and the best rehab exercises to get you back out there!

This post is Level 1 but when you need to step it up after the first 48-72 hours, switch over to the Level 2 and Level 3 rehab exercsies.

First of all, a little information about what a sprained ankle involves, but if you are in the know about Sprains already, skip the info and scroll down to Self – Treatment

Sprained ankles are known by a few different names:

  • Twisted ankle
  • Rolled ankle
  • Lateral ankle sprain
  • Inversion ankle sprain
  • And of course “Oh no!”

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inward (inversion) and down at the same time (often when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligaments

 

Quick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

 

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly) and keep in mind, even if it feels bad now, if you do all the right things you will be one of the 95% who return to sport and activity within 6 weeks.

 

Not taking ankle rehab seriously often leads to far too many chronic ankles, long-term disability and other injuries so YOU NEED TO TAKE THIS SERIOUSLY!

Note: it is important to rule out fractures early on. An accurate way of doing this is using the Ottawa ankle rules, or going to see your local Physio for a quick assessment – These rules are great for minimizing unnecessary X-rays.

 

Sprained Ankle Self – treatment

Initial management: In the first 72 hours it is very important to follow the RICE and HARM principles – This will take weeks off your recovery.

DoRICE injury treatment, heal strong and fast: RICE

      • Rest – From running etc.
      • Ice – 10 minutes at a time, no more, every hour you are awake.
      • Compression – Eg.Ankle Support Sleeve
      • Elevation – Get your foot above your heart when possible.

Note: Don’t wear compression at night time

Don’t: HARM

  • Heat
  • Alcohol
  • Running
  • Massage

HARM increases blood flow to the area, worsening inflammation and so causing more secondary damage and a longer healing time.

Protect: Braces have been proven to reduce re-injury rate and improve recovery so check out your options here

Keep moving (within reason of course) – It is important not to baby sprained ankles and start weight-bearing through them as soon as possible to normalize movement and decrease the loss of muscle activity. If necessary you may need to be on crutches for the first 24 hours (if very painful and you really have tried to walk on it) then move to partial weight-bearing and then full weight-bearing.

Foot paddling is a great exercise to do in these early days – In sitting or lying, simply point your toes up then down repeatedly in a pain-free range. You can try doing small circles with your foot also, remember not to push into pain. Do this every 1-2 hours (little and often)

Footwear: Wearing good supportive footwear with heel and arch support(such as your runners) is great as this takes the pressure off the injured ligaments and lets them heal well. DO NOT WEAR HIGH HEELS (Please!).

 

AND THEN: After the first 48-72 hours of doing this, click over to rehab exercises to get started rehabilitating your sprained ankle and check out our review of the Best 3 Types of Ankle Supports

And remember you still use ice after the first few days whenever it is sore or swollen.