Blog Posts

Low back Fix

1/31/2018

Low back pain is one of the most common musculoskeletal diagnoses in the world. Did you know, that approximately 9 to 12% of people (632 million) have LBP at any given point in time(1,2). About 40% of people have LBP at some point in their lives, with estimates as high as 80% among people in the developed world(3). Low back pain most often begins between 20 and 40 years of age, and men and women are equally affected(1,4). Low back pain has become the leading cause of decrease in activity and absence from work. So let's see if we can help "FIX" the low back.

Below are a few exercises that may help reduce your risk of injuring your lower back.

The pelvic rock exercise.

When referring to the low back most people think about the lumbar spine, but it is also important to remember the pelvis and the hips are heavily involved in the motion at the low back. After an injury or pain in this region, the brain can cause a rewiring of its movement. This rewiring can cause rigid abnormal motion throughout the low back, hips and pelvis, leading to more pain and discomfort. This exercise is great to help decrease that rigid abnormal motion and to help retrain proper motion in the low back.

✅Focus on✅
✅Knees bent and feet flat on the floor
✅Slowly flatten your low back to the floor, push your tailbone away (posterior pelvic tilt)
✅Hold this position for 2-3 seconds
✅Slowly start to arch your low back (anterior pelvic tilt)
✅Remember to breath throughout the movements

❌Avoid❌
❌Moving too quickly
❌Holding your breath

The next progression is moving to an all fours position (quadruped position) on your hands and knees as this increases the demand on the low back.

✅Focus on✅
✅First, start with legs in a 90-90 position (hips and knees at 90 degrees) and arms perpendicular to our body.
✅Bring your belly button in, bracing through your core.
✅Flatten your back to the floor, tucking your pelvic bone up.
✅Breath slowly and controlled.
✅Slowly extend opposite arm and leg, maintaining core stability and a flat back to the floor.

The proper DEADBUG exercise.

This exercise will help you learn to activate your deep spinal muscles, build core strength and develop trunk stability. This increase in strength and stability will protect the back from unexpected motions, which can cause disc herniations and mechanical (pain arising from spinal joints, vertebrae, and soft tissue) low back pain.

❌Avoid❌
❌Arching your low back
❌Flaring your rib cage
❌Holding your breath
❌Moving quickly through the motion

Remember the reason for going slow and controlled is about building a solid foundation and learning control.

The proper BIRD-DOG exercise.

This exercise is an awesome core exercise and great for overall low back health. This exercise strengthens the back against shear stresses too, while also teaching independent motion of the hip and shoulder from the trunk. This is helpful to desensitize (decrease your sensitivity) back pain.

.

✅Focus on✅
✅Neutral spine.
✅Reaching the arm out and kicking the leg straight back.
✅Pull the pelvis down towards the ground, locking it in place.

❌Avoid❌
❌Hyperextending the low back
❌Reaching up and kicking up the arms and legs
❌Hips spun open and trunk turned

References

Hoy D, Bain C, Williams G, et al. (June 2012). "A systematic review of the global prevalence of low back pain". Arthritis Rheum. 64 (6): 2028–37. doi:10.1002/art.34347. PMID 22231424.
Vos, T (15 December 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607.
Vinod Malhotra; Yao, Fun-Sun F.; Fontes, Manuel da Costa (2011). Yao and Artusio's Anesthesiology: Problem-Oriented Patient Management. Hagerstwon, MD: Lippincott Williams & Wilkins. pp. Chapter 49. ISBN 1-4511-0265-8. Archived from the original on 8 September 2017
Casazza, BA (15 February 2012). "Diagnosis and treatment of acute low back pain". American Family Physician. 85 (4): 343–50. PMID 22335313.

Surviving Desk Work

10/31/2017

Most work in today’s world is done at a desk. Americans sit a lot, on an average of 8-13 hours a day. Medical research is showing that prolonged sitting is dangerous; it has been shown to be associated with a significantly higher risk of heart disease, diabetes, obesity, cancer, and depression, as well as muscle and joint problems. Those muscle and joint problems result in an inflexible spine, disk damage, mushy abs, tight hips, and limp glutes.

Below are a series of exercises and stretches that will help you survive sitting at a desk all day. Practicing these daily will help improve your posture and alleviate certain aches and pains associated with sitting all day.

If any of the stretches or movements below cause pain, stop and seek a professional help. You could have an underlying issue.

Now that we’ve worked on our seated posture it’s time to do some stretching. Working at a desk can be a killer on the neck. Resulting in neck stiffness, neck pain, headaches, even upper back and shoulder pain. Try these 3 simple stretches 3-5x/day for up to 30 sec holds.

Scalene stretch
Upper Trap stretch
Levator scap stretch

Many of us spend way too much time sitting at work with poor posture, which can add significant stress to our bone structure and tissues. Sitting up straight and pulling your shoulders back and down and tucking your chin are important, but it is also necessary for you to keep a neutral pelvis while seated. Here is how to find your neutral pelvis

Make sure your feet are flat on the floor
Slouch forward by letting your chest fall towards your knees (your pelvis will fall backwards, aka posterior pelvic tilt)
Then sit upright by arching of your low back (your pelvis will move forward, aka anterior pelvic tilt)
Rock your pelvis back and forth by alternating between a posterior and anterior tilt, as described above - try and find the middle point of halfway between a full posterior tilt and a full anterior tilt
You should feel like you are sitting on your butt-bones - this is considered your neutral spine position.

Once you find your neutral pelvis sit up tall and pull your shoulder blades back together and down and tuck your chin.

As stated previously, getting up and moving more is most important. Below is a quick movement routine you can do at your desk. Ideally you should do this once every 2-3 hours. See the videos below.

Bruegger’s Postural Exercise (palms out, shoulder blades together and tuck your chin) - Hold for 15 seconds
Hamstring Stretch (hinge at the hips) - Hold for 5 seconds

Kneeling hip flexor stretch (tuck your tailbone) - Hold for 15 seconds
Wall Angels (keep elbow and wrist on the wall) - 4 counts moving arms up, 4 counts moving arms down

Repeat each movement 3 times.