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chronic back pain

Back pain

Slipped Disc: What is it and how to fix it

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Slipped discs are very common, right? Well, to tell you the truth… they don’t actually happen! Find out what a slipped disc really is and how YOU can sort it out yourself.

Slipped disc, Herniated disc, disc bulge and sciatica are all interchangeable and often used to explain the same thing. Now I need to say first of all that intervertebral discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments – Slipped disc is just a colloquial term which has bred a lot of fear over the years but really there is nothing to fear!

The two common sites for herniated discs are the lumbar spine (low back) and the Cervical spine (neck). Today we are going to cover the low back as this is the most common, but stay tuned for self-treatment of herniated discs in the neck!

Discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments

Basic anatomy:

lumbar anatomy - slipped discs and herniation

The spine is made up of vertebrae stacked on top of each other, held together by ligament and muscle. in between each vertebra is an intervertebral disc. Now in the lumbar spine, there are 5 vertebrae and the most common level for disc herniations are L5/S1 – this is the Disc between your lowest lumbar vertebrae and your Sacrum. roughly 80% occur here with the second most at L4/5 above it.

The Lumbar discs are made up of a harder outer layer, holding in a gooey middle.

How does a Disc herniation occur?

When too much force is repeatedly put through the front of the disc (such as bending forward, slouching and lifting heavy objects) the gooey center of the disc is forced forward and eventually (after thousands of bends)it forces through the outer layer.

A lot of Discs are injured doing very simple things light, changing a light bulb or picking up a baby but it is not that action that does it, it is a build up over time and it can take any little thing to tip it over the edge!

Now there is different levels of disc damage as you can see in the picture below:

disc bulge levels herniation - how to fix slipped disc

Now, sequestrations are serious and often need surgery but the remaining levels can be and should be treated conservatively (non-surgically) first.

Depending on the level of disc herniation, they can cause symptoms in different places down the leg due to the nerve roots that get annoyed. Keep in mind though that Disc herniations often do not have pain or change on sensation into the legs – there is a very wide range of presentations.

Herniated disc symptoms: You can have some or all of these.

  • Pain worse in the morning and cold/bad weather
  • Sciatica – Common back and leg pain caused by irritation to one of the 5 Lumbar spinal nerves. The nerves are irritated by the disc compressing on it or inflammation from the disc herniation. This usually only occurs down one leg.
  • Back spasm – often people are given this as a diagnosis but muscle spasm DOES NOT HAPPEN FOR NO REASON – there is always something behind it. Muscles around your back tighten up and go into spasm to protect your back and try to stabilize it so that no more damage is done.This is called muscle guarding and is a natural mechanism initially but in the following days, it can lead to a lot of discomfort, pain, and limitation.
  • disc bulge, slipped disc, herniation - self treatment physiotherapyAggravated by sitting, prolonged standing, bending and twisting.

Recovery and healing time

Recovery: Up to 80 percent recover within 6 weeks

Healing time: 12-18 months due to poor blood flow into the discs.

When to go to the hospital or see your Doctor

  • Weakness in your legs
  • Change in bladder or bowel (toileting) function.
  • Constant unremitting pain or pain not improving

If in doubt see your local health professional as this information is not meant to replace the assessment and advice of a health professional.

“Slipped disc” Self-treatment

1. keep active: back in the day bed rest was the first port of call, now it is the opposite. keeping relatively active is the best thing for your back and you need to remember that the chances are your back will get better and that over 80% of the population get back pain just like yours!

2. Exercises: to get the right muscles firing again to stabilize your spine and to loosen off the tight muscles (so that you dont feel hunched over and shuffling!) follow this link: Must know exercises for acute low back pain

3. Stiffness in your upper spine puts a huge amount more stress though your low spine and gets worse when in back pain! Here is a great way to mobilise your own spine

4. The greatest exercise for Disc Herniations: this exercise was developed by a top Physiotherapist Robin McKenzie. Repeated Extensions In Lying (REIL) act to centralise the disc and gradually reduce the disc Herniation.

Prone extensions in lying McKenzie exercise for disc low back pain

Position: Lying on your Front with your hands in front of you like you are going to do a push up.

Action: Keeping your hips and back relaxed, push your shoulders up. Do not push into pain, so stop when and if you feel pain and hold it for 10 seconds then relax down and repeat 10 times.

Initially start on you elbows as shown, then progress to straight arms.

Prone extensions in lying McKenzie exercise for disc low back pain physiotherapy

Reps and sets: 10 x 10 second holds 3 x daily


Remember: if pain worsens with this exercise do not push as far or as hard. If pain continues to worsen then consult a health professional.

These easy steps will help you so much, just remember that you WILL have good days and bad days but if you stick to the above 4 things, your Disc pain will get a lot better. Try and persevere with these exercises for 6 weeks at least!

Let me know how you get on and don’t forget to like, share and follow and remember, a slipped disc doesn’t exist!

For a more thorough rehab plan, download our Complete Low Back Self-Rehab Guide

Also see: progressed exercises for keeping back pain away


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

Beating Low Back Pain – Must know Physiotherapy Exercises

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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 check out our Lower Back Rehab Guide

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, 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

Please comment, share and follow me for more!


Back pain, Core strengthening, Health, running

Glute activation, the missing link

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Glute activation, building a good squat pattern and reaching your Peak.

A strong, healthy back (not to mention your knees!) needs the areas above and below it to work optimally to avoid overload injuries and pain. Whether it is running, lifting up your child or building the perfect squat, good glut activation is essential to all body movement and is one of three aspects essential for a healthy low back and lower limb.

  1. A mobile thoracic spine to unload the low back.
  2. Good muscle length in Gluts, hip Flexors and Lats.
  3. Normal Glut muscle activation.

Today we are going to cover glut muscle activation and the best ways to optimize this as this is the hidden cause behind many injuries such as low back pain, sciatica, patellofemoral pain, meniscal injuries and groin pain.

Here is a quick Test to see how strong your glutes are.

You might ask why bother with increasing your glut activation – your gluts work right? well you could be wrong! The main reasons why glut activation may be missing are:

  • Past back pain or injury. The Lower crossed syndrome is very common in anyone with a history of low back pain of any kind: A syndrome developed by Dr Janda proposed that those with a history of low back pain and troubles all had a characteristic pattern of weak and tight muscles. Weak: Gluteals and abdominals. Tight: Hip flexors and Erector Spinae. It is very common to have people arrive at the clinic with history of low back pain or tightness showing this pattern.
  • Poor technique and lack of body conditioning.

What happens if you have poor gluteal activation:

  • With poor activation in a squat, you cannot protect your back as you use the hamstring and erector spinae (back muscles) to push your body into extension – This leads to Erector spinae increasing the load and compression on the Lumbar spine. So healthy glut function is needed to unload the spine and decrease low back pain.
  • Poor glute activation leading to you hanging on your hamstrings also leads to over extension of the spine – leading to much-increased risk of injuries such as spondylolisthesis (stress fractures) and muscle spasm.
  • Lack of gluteus medius activation causes internal rotation of the legs (knee dropping inwards) leading to increase force on the knee and higher chance of injury.

Now one thing to mention here is that it is impossible to rebuild proper Glute function without a good hip extensor pattern and certainly not with traditional squat exercises utilizing barbells and free-weights (don’t even get me started on leg press machines).

Below is your pathway to achieving optimal glute activation, reaching your goals and decreasing lower limb and back injuries:

Gluteal Muscles - building the best squat pattern.

 Before you get to the exercises, above are the three gluteal muscle and here their function:

  • Gluteus Maximus: External rotation and extension of the hip.
  • Gluteus Minimus and Medius: Abduction of the Hip (pulls your thigh out to the side and stops your hip dropping.)

Must-know exercises for glute function:

1. Clams: This exercise has been shown to be the best for isolating glut Med and Min and really gets the legs shaking if done right!

Clam exercise plus - gluteus medius strengthening, pelvic stability

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 – lift your top knee up roughly 20cm and lower down in control. Reps: Build up to 30 reps on each side.

2. Single leg squats: Now don’t get daunted! these will really get your gluts firing functionally and are far superior to double legs squats.

Single leg Squat, Glut Med activation - hip stability and strengthSingle leg Squat, hip stability and strength

Position: standing on one leg with your arms straight out in front, chest up and looking straight ahead and the other leg directly out to the side.

Action (1st image above): Squat down, like you are going to sit down in a chair(stick your bum out). Only go down as far as your body allow (come back up before you fall over!) and don’t leg your free foot touch the ground. come back up and repeat, no hold needed.

Reps: build up to 2 sets of 12 reps on each leg.

Too hard? – try it with the leg out in front or bent as you can see in the second picture above.

Single leg bridges: The third and final Glut blasting exercise:

Single leg bridge - glut medius activation for hip stabilitysingle leg bridge for hip stability

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, hold for 5 seconds then lower and repeat.

Tip: make sure to keep your pelvis level.

Reps and sets: Build up to 2 sets of 12 reps on each leg with the 5-second holds.

Go hard at these exercises – Twice a day ideally and you will notice a huge difference in everything from running, squatting and weightlifting to low back and knee pain.

You might even like to give The Best Glute Stretch a try as with poor muscle activation, you also often end up with tight muscles!


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