facebookpixel
Browsing Tag

crossfit

Back pain

Slipped Disc: What is it and how to fix it

• By

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


Mobility

Is Your Shoulder Mobility good enough? Quick Test

• By

shoulder mobility, get full shoulder rangeSwimmers, wight-lifters, cross fitters and more – you need full overhead shoulder range to prevent injury and perform well  – but how do you know if your shoulder mobility is up to scratch?

Do this easy test to see whet your overhead shoulder mobility is like!

All you need to do is lie on a bench, bed or table with your owns straight out in front (why it is often known as the superman test).

 

Combined extension test for swimmers shoulder rangeAction: Keeping your head down the entire time, raise both arms up as high as you can.

Now, you will need either a camera or someone else watching as you wont be able to see.

Pass or Fail?

For optimal range your arms need to be at least horizontal – See the photo above, the long red line is the horizon line and the other is the arm line. In this example, this is roughly negative 20 degrees of overhead range. This is a fail!

 

How to improve this?

 

What now? Get out there, find a helper and test yourself – this is very important range that, if below par is a real risk factor for injury, not just for your shoulder, but your neck and back.

 

You might also enjoy:

 


Health, Mobility, Shoulder pain, Upper limb

Shoulder Stretches: Only the Best

• By

Shoulder stretching is an essential part of gaining a Pain-free, functional and strong shoulder. Whether you have had shoulder injury in the past, have tight shoulders due to poor work posture or you just want to have full range for an overhead squat – then these shoulder stretches and for you – all of you!

(Skip down the page if you want to get straight to the Shoulder Stretches!)

Following injury: regaining flexibility and range in the joints and soft tissues is an important aspect to the rehab process and if not addressed, you can develop other, secondary injuries such as sub-acromial impingement, postural dysfunction and any number of neck problems.

Poor posture: In today’s world, too many of us have sedentary jobs which require a lot of time sitting at a desk or behind the wheel. This leads tightness in muscles the pull your shoulders forward (namely your Pecs and Upper Traps) and weakness in muscles that hold your shoulder in a good, functional position (lower traps, Serratus ant etc). This is explained well by the Jandas Upper Crossed Syndrome.

Overhead squat and shoulder range: To hold a barbell overhead and squat down  we need great mobility around the shoulder and hip to do this safely. The main muscle that affects this is the Lat (along with your Glutes and Thoracic extension) as the come all the way from your pelvis to your shoulder.

Exercises:

Ideally you should do these everyday – You can water it down and do it less often but you will not get thew best result and it will take longer.

Horizontal abduction stretch for the shoulder. posterior capsule and deltoid stretch

1. Posterior capsule stretch:

Action: Pull your arm across your body.

Hold for 1 Minute.

 

 

Shoulder stretch for the triceps muscle and inferior capsule to decrease shoulder pain

2. Triceps and inferior capsule:

Action: gripping the elbow as shown, pull back and across.

Hold for 1 minute.

Tip: bend upper body away from side being stretched.

 

 

 

sleeper stretch for the shoulder - to stretch the post capsule and rotator cuff

3. Sleeper stretch:

Lye on your shoulder with your arm in front of you and your elbow bent to 90 degrees. using your free arm, grip your wrist and rotate it down towards your feet until you feel a moderate stretch.

Hold for 1 minute

shoulder stretch for the pectorals and thoracic spine. good for swimmers, cyclists etc4. Streamline stretch:

This is a great stretch as it stretches, Pecs , Lats and thoracic spine.

No balls – You do not have to use a Swiss/Physio ball – I use the back of my couch.

Action: when on your knee place both arms on the surface and relax your shoulder and upper back down. you can adjust the force that goes through your shoulders by moving your knees further away or closer.

Hold for 1 minute.

TIP: to get more of a tricep stretch place your hands behind your neck with elbows on the ball/couch!

5: Lat Band Stretch: 

The best way I have found for stretching Lats is using a band (a technique picked up from Crossfit) – now you can use a proper exercise band or a simple belt (yes one of the ones that holds your pants up) at home. Below is a nice simple video on how to do it:

Overhead distraction with Band

Hold for 1 minute.

Tip: you can also do this by holding on to a pole.

streamlined

And THAT my fiends is ten minutes well spent!

For Best results combine the above stretches with a good Shoulder stabilisation regime and you will really reap the rewards.

 

Note if you feel any pain (other than stretching pain) or have range of motion limitations post surgery then consult a trained health professional.

 

Please LIKE, SHARE and COMMENT!


Core strengthening, running, Spine

The importance of Core Stability on injury

• By

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


Back pain, Core strengthening, Health, running

Glute activation, the missing link

• By

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!


Core strengthening, physical therapy, physiotherapy, training

Resistance training for an injury free and functional body.

• By

Free, Body and weight training – this post is not just for the gym junkies, it is for everyone that wants their body to perform well and likes to look after their body home or the gym.

As a physiotherapist I am a huge fan of functional exercise and so in this post I am going to briefly talk about what type of weight training is best for your body.

Below is a brief description of all three types and a table outlining the pros and cons:

1. Body weight exercises: exercises in which the resistance is provided by your body weight. Eg. push-ups, pull ups, lunges, curl ups, tricep dips.press up training body weight

2. Free weight exercises: exercises where the resistance is applied by a object that is not attached to anything else such as dumbbells, resistance bands, medicine balls.

3. Machine exercises: this is fairly self explanatory but is any exercise where the weight is stabilized by the machine and you just have to apply force in one plane of movement.

Cost

practicality

versatility

Functionality

Difficulty

Muscle mass

Body

none

moderate

moderate

high

moderate

Low – mod

Free

low

high

high

high

moderate

Moderate

Machine

high

low

low

low

low

High

Conclusion: Both free and body weight exercises make your stabilizing muscles work, leading to much greater functionality and cross over into everyday life and I would recommend them over weights machines absolutely any day.  Weights machines are ok if you purely want to build muscle mass, but this has little functionality due do the machine guiding the weight and stabilizing for you.

The best thing to do would be a combination of body and free weight training as you have a much larger range of exercises and workouts available to you and great coss over.

 Why is stability important?

Stability is very, very important, if you do not have a stable base to work off then you are much more likely to get injuries, AND it makes the exercise a lot harder.

Imagine: trying to lift up a heavy object while standing on ice (or mud)(unstable base) and how hard that would be compared to lifting a heavy object with feet firmly planted on a rubber mat (stable base) – what is easier?

This is exactly the same as the following two examples:

    1. Having weak shoulder stabilizers such as your rotator cuff. If these are weak then the shoulder is not stable and so all the muscles working off it will struggle and are much more likely to get injuries such as rotator cuff tears or tendinopathy due to impingement.
    2. Weak core and hip stabilizers:  If you don’t have good strength and endurance in your stabilizers here, you are more likely to injure your back, hips, knees and ankles purely because you are working off an unstable base, leading to poor form and bio-mechanics.

So although weights machines are at times easier – they are not practical the majority of the time, can be costly and do not cross over functionally in to everyday life and sports. If all you want to do is build muscle – then make sure you also do stabilising exercises such as rotator – cuff strengthening for your shoulders in order to reduce the risk of overuse injuries.

And so It is only fair that I give you some great exercises to increase the strength and the endurance of your stabilising mucscles!  These will be for EVERYBODY. Subscribe or stay tuned for these in up-coming posts.


Get 25% OFF all Rehab Guides for a limited time (use code: TAKE25)

X