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Low back pain

Spine

QL muscle release – Exercise for low back pain

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Your Quadratus Lumborum (QL) muscle is a very common cause of back pain, so being able to treat this yourself, effectively, can be a huge relief. Here is a great self QL muscle release to loosen off your low back and reduce your low back pain.

First of all, here is a bit of information about the QL:

QL release anatomyAnatomy:

This muscle runs down either side of your low back, from the top of your pelvis, all the way to your bottom rib. This is why it can affect your breathing when it is in spasm and it pulls down on the lower rib of yours. It also attaches along the way to the side of your spine.

Purpose:

  • Side flexion/bending of the spine
  • Fixation/stabilization of the low rib

The problem:

QL release trigger pointsWhen muscle knots form in the Ql or it goes into spasm due to overload or injury, then it can give you real grief! Often this is more one-sided than the other also, giving you a real lopsided feeling and can make it seem like you have one leg shorter than the other or that your “pelvis is out” (which can’t really happen). The QL refers pain elsewhere and isn’t always felt at the muscle. The referred pain is generally felt in the outer hip and in the glutes and is often described as a deep ache but can be a sharp pain when moving. The trouble is that this muscle is very hard to stretch – but, it is quite easy to do a QL muscle release!

QL muscle release: Release your low back

QL muscle release1. Position

Lie on your back and place a firm massage ball (or a specific, purpose made tool like what the QL Claw) under your QL muscle, which you will find in-between the top of your pelvis and your bottom rib, off to each side of your spine.

QL muscle release low back and erector spinae2. Action:

Bring the knee on the same side as the ball up towards your chest, which puts pressure on the ball. Once you feel like you have the right spot (you will feel it!), holding onto your knee you can either:

1. Rock your knee out to the side and then in again and repeat, OR

2. Repeatedly bend your knee up and down towards your chest.

Slowly and gently work into it for 1-2 minutes on each side and feel free to move the ball up or down slightly to get the right spots.

Do this great myofascial release once a day for two weeks for longer-lasting results and check out new Complete Low Back Self-Rehab Guide that you can download that is packed with self-treatment advice and exercises for more.

Tip: Help prevent this recurring and giving you ongoing trouble by strengthening your QL and the surrounding muscle so that they can handle everything that is asked of them!

Note: If you have acute low back pain, pain going down your leg, or any neurological symptoms please see your local health professional first.


Calf Pain, Foot pain, Health, Shin Pain

Flip-flops and moon boots

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jandals profWhenever I see a patient with a lower limb injury come into the practice wearing flip-flops I cringe inside. Really, these simple bits of plastic are causing a lot of pain and injury and are not something you should wear all day.

Flip-flops absolute lack of arch or heel support puts you at risk of unnecessary pain and injury. We are (I am generalizing here) so careful to wear the best footwear when exercising, keeping up to date with the latest running shoes, orthotics, braces etc but when it comes to relaxing and what we wear outside of work and sport – we aren’t so smart. A study found that in a large shopping center, 43% of all women were wearing flip-flops(1) – That is a huge amount of foot, calf, shin, knee and back pain! Yes this may keep Physio’s and podiatrists in business but it keeps a lot of the population out-of-pocket – And often there is a very simple thing you can do to ease your pain and injuries….

Throw your thongs away!!

Really flip-flops aren’t that bad if you just wear them to the beach, around the changing room or shower etc – It’s when you start wearing them out shopping, to lunch, all day, everyday that they can cause real problems. What problems can flip-flops cause you may ask? and why? Flip-flops can lead to:

  • Plantar fasciitis
  • Stress fractures – Hence the moon boots
  • Shin splints
  • Calf pain and strains
  • Foot pain e.g. Mortons neuroma, metatarsalgia
  • Low back pain
  • and more

And Why?

Flip-flops change the way we walk

They wouldn’t be so bad if our feet weren’t so weak and de-conditioned. Yes we evolved to roam the open plains and jungles barefoot but now that we live in this concrete world – we need a little more protection for our feet. Also because we so often wear cushioned supportive shoes the rest of the time, our feet are not able to handle the complete lack of control and support when wearing flip-flops – Like sleeping on a nice comfy bed one night and then on concrete the next – You will get sore right?

And because they change the way we walk, we use our muscles in a different way, while increasing the shock going through and feet and legs due to lack of shock absorption. Wear them for a long time and the repetitive strain leads to overuse injuries. For example:

  • Every time you step, you need to squeeze and scrunch your toes to hold the flip-flops in place! Meaning your feet and calf have to work very, very hard = tight, tight calves.
  • Due to the total lack of arch support the arch can repeatedly over-pronate, increasing the stretch on your plantar fascia. Repeat this over hundreds of steps and you get micro-tears, inflammation and pain. You can read more about this here.

Good things in moderation

So, you don’t need to go and throw your flip-flops out but PLEASE limit the amount you wear them as they can be a huge cause of pain and injuries. This is also such an easy thing to change that can drastically improve your function and decrease injury risk, so why not do it huh?

jandalsAddendum: As a proud Kiwi I feel I should give a quick history on the proud origin of flip-flops.. or should I say Jandals! The flip-flops was originally invented in Auckland, New Zealand in 1950. The idea came from the original Japanese sandals which allied soldiers saw while doing occupation duty in Japan during WWII. The original name Jandal (Japanese sandal) was trademarked so that lead to other countries having t come up with other names such as:

  • jandals 1Flip-flops
  • Sandals
  • Slippers
  • Thongs, etc

So wear this great invention in moderation and save yourself a lot of trouble. Please Share, like and comment away!


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!


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


Back pain, Core strengthening, Health

Sciatica and low back pain – All you need to know to sort it out

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You may have heard of Sciatica or Low Back Pain, or been told that you have it. BUT do you really know what the sciatic nerve is or how it gets sore?

In this post I we will go over, common causes, misperceptions and finally, self-treatment techniques.

Sciatica is a buzz word used by a huge amount of back pain sufferers and medical professionals but is really an umbrella term and can be caused by a number of things:

– Tension on the sciatic nerve as it passes through the gluts by your Piriformis muscle.

– Compression on nerve roots as the exit the spinal cord by disc herniation.

– Compression or irritation by rough surfaces and extra bone growth (spondylosis or arthritis of the spine).

The symptoms of sciatica range from radiating pain down the buttock and leg to altered sensation in the leg and foot. Back pain may or may not be present.

Physio exercises and information on low back pain

It is very important that you see a good physiotherapist who can diagnose what is causing your low back pain and/or sciatica as this gives a better picture and leads to a more specific treatment approach.

A large proportion of “sciatica” pain is caused by Lumbar disc herniations which is where the disc bulges backwards into a spinal nerve due repetitive flexion (bending forward or slouching), compressing it and restricting movement and sliding of the nerve.

Self-treatment technique #1: Extensions in lying. In order to know whether it is a disc contributing to your pain, lie on your front with your hands under your shoulders like you are going to do a push-up.

In order to know whether it is a disc contributing to your pain, lie on your front with your hands under your shoulders like you are going to do a push-up. (Now remember not to push into too much pain here)
What I want you to do now is push your shoulders up, keeping your hips relaxed a hanging down. Hold this for 10 seconds 10 times and if this either decreases your pain, or decrease your leg pain and causes pain more centrally in the back then, most likely this is a disc problem which is helped greatly by doing this McKenzie exercise twice daily.

Tip: as in the picture above it is best to slowly progress this exercise, so begin only pushing up into the middle position if you have moderate to severe back pain and then progressing up over the next fortnight.

For more information on how this exercise was developed check out Physiopedia.

Self treatment technique #2: The exercises in this great post lay a great foundation to start rehabilitating your back and is an excellent place to start. They are also fantastic for all common causes of back pain!

Make sure to share, comment and subscribe to future posts for more information on Disc pain.

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

Disclaimer: It is important to stop this exercise if it increases back pain and seek medical attention if symptoms worsen or you lose strength in your legs


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