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Back pain

Back pain, Chronic Pain, Health

Low Back Pain – Why it sticks around

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Lower Back Pain can be very limiting, annoying and really hang around. Her is how you can help that with some great info and lower back exercises!

In my previous posts on low back pain I have shown you how to get up and moving when in acute low back pain, what sciatica is and how to treat it and finally I made you a maintenance regime to keep your back strong and mobile.

Today I want to run through one of the reasons back pain can really hang around and affect our lives so much AND run through some effective lower back exercises to address these reasons.

As with a lot of other injuries such as ankle sprains, simple injuries can linger around and even turn chronic because proprioception is lost in that area. This means that you lose kinetic awareness, the ability to know where your body is in space. Our bodies are amazing in the fact that normally you can know where your body parts are with your eyes closed – like holding your arm up in a certain position, closing your eyes and copying it with the other arm – you will be very similar if not spot on. You can do this because you have proprioception.

A recent study compared chronic low back pain patients to pain free patients and looked at the ability to reposition into a good sitting position from being slumped down. they found that the patients with low back pain were undershooting and not getting into good positions – this increases the risk of further back injury and aggravation and you wouldn’t even know it. Also when a sample of the fascia surrounding the back and connecting the legs and arms together (thoraco-lumbar fascia) is taken and analysed – patients with back pain have lost the innervation to that area. This all adds up to you not knowing when your back is in a bad position when you have back pain and this can lead to ongoing problems.

So to re-train your back and get the feeling back there is a couple of things you can do:

  1. bird-dog exercise for glute and spinal strength, stability and balance. physiotherapy exerciseBird-Dog: This lower back exercise is great for retraining the thoraco-lumbar fascia – this connects two of the largest muscles in your body – Latissimus dorsi (Lats) and gluteus maximus. It helps to promote coordinated movement between upper and low limbs while having a stable low back. Action: start on your hands and then extend opposite arm and leg. Do this slowly and KEEP YOUR BACK STRONG (imagine there is your dinner or a fish bowl on your low back!). Do 2 sets of 20, alternating each side (you may need to start off doing less or just using the leg).
  2. Body checks: when at work, at the gym and especially when sitting – stop and check where you are in space , make sure your low back isn’t rounded out and your shoulders aren’t rounded forward. every 20 minutes check your self and right it.
  3. Keep you back strong and mobile with these great lower back exercises

Looking for more? We have compiled all the best info in one, evidence based rehab guide

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Chronic Pain

Chronic pain – All in my head?

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Your central nervous system plays a massive role in ongoing and chronic pain, Here we will discuss why patients are often told pain is in their head and how you can help it train your brain.

chronic pain - is it in my head? - explained and how to fix itPain is subjective, meaning every single person responds to and feels it differently. This is because the pain receptors (nocioceptors) around your body sense something going on and send the signal up to your brain. How the brain processes/perceives this signal depends on a combination of things:

  • Gender: Hormones can affect perceived pain.
  • Family: How you were taught to react to pain as a child.
  • Past experience: The degree of pain felt in the past and how traumatic it was changes how your brain reacts to pain, for example.
  • Mood: Your mental state can affect how you feel pain. Things such as sadness, depression can increase pain perception. Be aware that it can also happen the other way around!

This is why there is a huge variety of pain tolerances in our society – the varying upbringings and experiences that occur in everyone’s lives.

Chronic pain and you:

Chronic pain is pain that exists after an acute injury has healed or after the normal tissue healing time (generalized to 3 months). For one reason or another reason, the injury does not fully heal (this could be because of some overlooked contributing factor but often for unknown reasons) and the nerve fibers continue to send pain signals up to the brain. With all these signals shooting up to the brain telling it that there is something bad going on, the brain begins to accept these like they are a normal thing, improving the pain pathways, making them more efficient. This results in more pain. Also along with this the chemical messengers that are used in the pain network increase and over time the threshold (how much stimulus is needed) for pain lowers.

Put more simply, with the continued and increased pain signals the brain gets used to them, think of them as normal and becomes more sensitive to them so a smaller and less intense stimulus is needed to feel pain! This is called Central Sensitization.

This is why people are often told that “it is in your head” and yes your brain is definitely contributing to your pain because it has become more sensitive but ALL PAIN IS REAL.

So how can we mitigate the effects of chronic pain and reduce the pain? Try some of these steps:

  1. Relax: Stress and tension will increase pain so practice relaxation techniques – these are easy and can reduce pain by up to 50%. There are multiple options here, find something that works for you! e.g. relaxation.
  2. Keep active: Physical activity boosts endorphins (natural pain-killer), boosts the immune system and helps get your body stronger!
  3. Get serious about rehabbing yourself – find out what you need to do from a Physio that will find your deficits and get to it, regularly and you will improve.
  4. Find appropriate healthcare providers e.g. a doctor that specializes in pain management, a psychologist and a physiotherapist that not only looks at your injury but you as a person.
  5. Eat healthy and don’t over indulge (no overeating, excess alcohol or tobacco consumption).
  6. Drink enough water: Females over 2 litres and men over 2.5 liters.
  7. Get enough sleep: Infants need about 16 hours per day, teenagers need about 9 and for most adults 7 to 8 hours a day is the best amount.
  8. Positive: Get social support by going to events etc that you enjoy(sports, music, dancing etc.) and keep positive people around you, not negative.

Remember all pain is real and everyone experiences it in a different way and most importantly it is NOT something you have to live with. It can be helped and improved.

Please like, share and comment.

 

You may also like:

5 great exercises for neck pain

Mobilise yourself!

 


Core strengthening, running, Spine

The importance of Core Stability on injury

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core strength minimizes lower limb injuryHaving a stable core and pelvis has huge benefits through-out the body, including laying a stable base for your legs to work off. This means more bio-mechanical efficiency, less injury AND less pain.

In order to do any lower limb exercise well, including running, squat, weight lifting, tennis etc, you need to be in control of your core. If you don’t have a stable base, everything working off it is going to struggle and compensate. This can lead to tight hip flexors, ITB syndrome, patellofemoral pain, ankle sprains, niggles and more.

Imagine a tennis shot, for example. Your are stepping forward and driving off your back foot while at the same time swinging your raquet forward to strike the ball. If you core isn’t in control then you are losing force between your legs and arms – losing that strength of the drive from your legs.

Core strength makes your body stronger, not just your abs, by conserving and transmitting energy.

Just for clarification, as “core” can mean different things to different people. Core for me is your Lumbo-Pelvic stability. The combined control and strength of your spine and pelvic muscles.

Quick self test: A great way to test and see how good your Lumbo-pelvic stability is yourself is to do the Single Leg Squat Test. If you see your hip dropping or knee tracking inwards, then you are at risk or injury and need to get started strengthening ASAP.

 

Poor core stability can also lead to and contribute to all sorts of injuries and pain, including in your:

  • Low back
  • Shoulder and neck
  • Knee and hip

 

So how do we sort this problem you ask?

Below is an exercise program to get started on that will really make a difference if you stick to it. I also fully recommend finding a good Physio in your area to have your specific deficits assessed to get some manual therapy to speed things up.

Exercises to improve Core stability:


1. Single leg Bridge:Bridge 1 leg - glute activation, leg strength and core stability. the best exercise for hip stabiltiy, great for runners

Position: lying on your back, bend one knee so that your heel is close to your backside and straighten the other leg as above so that your thighs are horizontal. Your arms can be crossed over your chest or down by your side to make it easier.

Action: Pushing through your grounded heel, lift your bum off the ground as above, straighten your back and hold for 30 seconds then lower and repeat on both sides.

 

2. Clam Plus: (Do them right and they are surprisingly hard!)Clam exercise plus - gluteus medius strengthening, pelvic stability, leg strength

Position: Side lying  with top elbow on the ground, knees bent, ankles together and importantly the top knee sticking out 1-2 inches further that the bottom knee.

Action: Making sure not to let your pelvis rotate backwards and keeping your ankles together – lift your top knee up roughly 20cm and lower down in control. Reps: Build up to 50 reps on each side.

If you have found in the past that normal clams don’t do much for you, try it this way with your hip s rolled forward more to isolate Glute Med better and get less Tensor Fasciae latae activation.

 

3. Double or single leg squatSingle leg Squat, Glut Med activation - hip stability and strength:DL squat
Try performing the Single leg squat, but if you are too unstable (cannot stop your knee going inwards) then start with the double leg squats.

Single leg: 2 sets of 12 reps

Double leg: 3 sets of 12 reps

Tips: stick your bottom out like you are going to sit down and keep your knees out!

 

4. Front Plank: 
plank

Hold this for 60  seconds (if you can, otherwise build up to this).

Tip: do not hang on your hip flexors, tuck your bottom in and bring your hip bones up towards your head.

 

 

 

 

5. Side plank: side plank

Again aim for 60 seconds here, keeping your body straight!

 

Too easy? Add in leg raises to this – Raising the top leg straight up and down, building up to 50.

 

 

Do this short program  DAILY and stick to it for at least 6 weeks -Let me know how you go!

 

You may also be interested in:

Iron out your running – What you never got taught

Get your spine moving

Smash your Glutes


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