Back pain

Four simple exercises for lower back pain

 

Low back pain is the most common reason people book an appointment with us. It is rarely serious and often improves by taking over the counter painkillers, (anti-inflammatories normally, although always check with your GP before starting any new medications), staying active by adapting your normal activities rather than completely avoiding them and by exercise.

The following exercises are easy to do in the comfort of your own home, they are safe and will help get your back moving.

Exercises provided courtesy of rehabmypatient.com our exercise programme partner.

It is normal for these exercises to feel uncomfortable or mildly painful but do not push into severe pain.

Lumbar rotation

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Bend your knees, and keeping your feet flat on the floor, rotate your hips to one side creating a rotation through your lower back. Only go as far as feels comfortable, you do not need to get your knees to the floor. Return to the opposite side. This is an excellent lower back mobility exercise, especially if you have acute lower back pain or disc problems.

Perform 30s times daily | Repeat 2-3 times | Hold for 2-3 | Perform both sides

Video: http://youtu.be/UxORTXzuU9E

Read more: Marginal gains: what are they and should I use them?

Pelvic tilt lying

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Lie flat on your back, and engage your deep core muscles by drawing your belly button inwards (towards your spine slightly), while flattening your spine against the floor, then relax. Repeat as required.

Perform 30s times daily | Repeat 2-3 times | Hold for 2-3

Video: http://youtu.be/44D6Xc2Fkek

Read more: What is Pilates and how can it benefit you?

Single leg back stretch

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Lie flat on your back, and bend your knee towards your chest. Hold this position and feel a gentle stretch in your back. If you get any groin pain while doing this exercise, stop and inform your therapist. Relax, and then repeat as necessary.

Video: http://youtu.be/lka-1VKjrew

Read more: Returning to sport: how to balance injury prevention and performance

Back extension medium

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Lie on your front, and rest on your forearms. Straighten your arms to a 90 degree position as shown. Hold this position. Your back will be arched. Start gently with this exercise as it can cause some stiffness when you first begin.

Video: http://youtu.be/jwI8g1dNzbw

If you have any concerns or questions about your back pain then please get in touch on 01236 425661, email at admin@jmcphysiocures.co.uk or contact us on social media.

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Injuries

Returning to sport: how to balance injury prevention and performance

Returning to sport after injury can be a daunting process. There is never a perfect time and especially after a prolonged period of time injured it can be difficult to know when you are truly ready. It is important to adapt your training regimes during a return to sport to help reduce the risk of flare-up and chronic injury before returning to your normal routine. I don’t make any claims of being an expert in this field and every person is different, but there are a few general things worth considering when returning to sport.

Injury prevention vs performance:

If you are returning to sport after a muscle/tendon/joint injury and have been attending physio, then (hopefully) you will have been gradually increasing the amount of resistance or load by exercising. Injury prevention generally focuses on slow, controlled movements possibly with low repetitions and high resistance. While this is helpful in your rehabilitation and can help you to feel strong again most sports require high speed specific movements with low resistance.

It is therefore important that when you begin to return to sport that sport-specific training forms the last part of your rehab. This could be as simple as kicking a football, having a bounce match of badminton, going to the driving range or just running. Ask your physio about any drills that you could do which will help with your injury but are also targeted at your sport.

Injury prevention plans have been shown to have some benefit particularly when tailored to individual sports such as FIFA 11+ programme for football players.

exercise

How hard is too hard?

The first stage of this is finding out what your limits are and then setting a baseline level or normal. Training sessions should be based around this and are generally advised to be at between 80-120% of normal. It is important to bear in mind when returning after an injury this is your current normal and not your pre-injury normal!

High loads or quick increases in load of 150% of normal can place you in the “danger zone” for injury and should be kept to a minimum, only used around competition times for example. Likewise exercising at too low a level such as 50% of your capability doesn’t adequately strengthen your muscles or prepare you for a normal session. Light sessions should be used for recovery sessions with a sensible balanced plan of intense work, rest and rehab work.

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How much to increase it?

Although the answer to this question would be different for every person a relatively safe rule of thumb would be to increase the amount of exercise by 10% per week. While this can make return to your previous level a laborious process and may be too slow for some people it has been shown to reduce flare-ups.

When returning to competitive sports it is also worth spending some time returning to training only before a full return. This is especially important for any team contact sports where you have to consider other people and a naturally competitive instinct which might encourage you to push harder than planned.

Make sure you are mentally and physically ready!

The psychological aspect of return to sport is often undervalued particularly if the injury happened on the field of play. Fully trusting your body to do what you will ask it can be a difficult process and Sports Psychologists are the real experts in this.

From a Physiotherapy perspective one way to help with mental readiness is to be confident in your physical ability. A rough set of targets which are specific to you are worth setting such as for a footballer to be able to:

  • Run 5-10Km
  • Sprint 20-30yards x5-10 with changes of direction
  • Hop/Jump/Land in multiple directions – (making sure that both legs are relatively equal)
  • Strike a ball full force pain-free
  • Tackle

If your targets consider, the physical demands of your sport and you know your body can meet these without any problem then hopefully you are ready to get back to normal.

 

Back pain, Injuries

What is the perfect posture?

The answer is your next posture! A number of studies undertaken to find the perfect posture reveal that how you sit or stand is miles less important than how often you change position.  No one position has been linked to increased pain or days off work

So Mrs McK my old teacher who told me that if I slumped I would end up in a wheelchair – my gut instincts were right you were talking rubbish!- I would also like to point out that now that I do a lot of ergonomic assessments I was also correct about the chair being too small for me and THAT was why I slumped!! (Not that I am one to hold a grudge for 25 years 😊)

Read more: Marginal gains: what are they and should I use them?

Common sense tells us that sitting in awkward positions for long periods of time is bad for us, but it would be healthy if we all stopped worrying about this as much.

Where this all goes wrong is when we go to work and sit in the way that the chair/desk/PC has been laid out for us rather than sit how we do watching TV at home. Most people find that sitting in a chair which provides support through our spine in a slightly reclined rather than upright angle is more comfortable. This is why we lounge into the couch when watching Dancing on Ice on a Saturday night (note to self should have lied and said while out at fancy restaurant/pub!).

When you go back to work, or even better if you are at work just now. GET UP AND GO FOR A WALK. Try having a bit of a stretch in the chair or do a hula hoop on the desk.

When you finally sit down after all of that then adjust your chair so that it is comfortable, your feet are flat on the floor, your spine is rested against the backrest and your elbow is at desk height.

Read more: What is Pilates and how can it benefit you?

Only then should you pull it into your desk, move your mouse and keyboard close to you at elbow distance, and then adjust your screen to a natural height without leaning forward or angling your head-up. That should do the trick and then finally set an alarm for 30-45 minutes so that you can get up and do it all over again!

If you need any advice on alternative equipment or how to set your workplace up effectively then please ask us about workplace/DSE assessments by contacting us on 01236 425 661, or admin@jmcphysiocures.co.uk

 

Injuries, neck pain

Pain in the neck? Exercises for neck pain

Neck pain is a common problem and can often radiate out to the shoulders and arms or cause headaches.

Please try the exercises below to help with any neck pain. Also remember to take painkillers if needed and stay active as neck pain is rarely serious.

Thanks again to www.rehabmypatient.com for providing us with the exercises.

N.B. It is normal for these exercises to feel uncomfortable or mildly painful but do not push into severe pain.

Neck rotation:

neck rotation

Rotate your neck slowly to the left by looking over your left shoulder. Take your neck to a comfortable end of range. Repeat to the right. Make sure you keep your shoulder and back relaxed. This is an excellent exercise to improve rotation and mobility in your neck.

Repeat 4-6 times | Hold for 2-3 | Perform both sides

Video: http://youtu.be/UbHEH6t_OJQ

Neck side flexion mobilisation:

neck side flexion mobilisation

Ensuring your nose is pointing forwards, bend your neck as if you were taking your left ear towards your left shoulder. Now repeat to the right. Keep the movement gentle and rhythmical. This exercise will help improve mobility to your neck.

Repeat 4-6 times | Hold for 2-3 | Perform both sides

Video: http://youtu.be/MpUIDH-atys

Neck retraction:

neck retraction

Pull your head back as far as comfortable and down slightly. You will feel some gentle tension at the front and back of your neck. This exercise will help your neck and upper back posture.

Perform 2-3 seconds times daily | Repeat 6-8 times | Hold for 2-3

Video: http://youtu.be/VYcifC6BFgc

Pendulum:

pendulum

Lean over holding on to a chair or table, let your arm hang down by your side, and swing your arm gently in circles. Try to let momentum and gravity move your arm. Go anti-clockwise and clockwise. This exercise is a great way to passively mobilise a stiff shoulder.

Repeat 2-3 x 10 each direction times | Hold for 2-3 | Perform both sides

Video: http://youtu.be/YYvl59eU78M

Standing/sitting retraction:

standing or sitting retraction

Standing or sitting, with good posture, pull your arms backwards while squeezing your shoulder blades together. Hold the contraction and then relax, or simply hold the contraction for a longer period of time. You will feel a muscular contraction around and between your shoulder blades.

Perform 3-5 seconds times daily | Repeat 6-8 times | Hold for 2-3

Video: http://youtu.be/JYyw8Uewdms

Shoulder shrugs up:

shoulder shrugs up

Shrug your shoulders upwards, towards the ceiling, to increase strength in your upper shoulder muscles (upper trapezius).

Video: http://youtu.be/YT6qn6HVQyE

Shoulder shrugs back:

shoulder shrugs back

Shrug your shoulders backwards, squeezing your shoulder blades together. You will feel a muscular contraction around and between your shoulder blades (rhomboid and shoulder blade muscles).

Video: http://youtu.be/1MmXbrOeJ9c

Bruegger’s posture sitting:

bruegger's posture sitting

Sit on the edge of a chair, and open your legs and allow them to relax outwards. Keep your body and spine tall, lift the crown of your head towards the ceiling, and arch your lower back slightly. Turn your arms outwards so your palms are facing forwards, and draw your shoulder blades down and towards the midline. Make a gentle double chin with your head at the same time. Breathe deeply throughout. You will feel a stretch across your chest and front, as well as muscles working in your back, all helping to improve your posture.

Video: http://youtu.be/_uQ_-JeWTgU

If your neck pain is not improving and you would like some advice or treatment then find out how we can help by calling 01236 425661, email admin@jmcphysiocures.co.uk, contact us via Social media or visit our website on www.jmcphysiocures.co.uk 

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Injuries

IT band problems? Here’s what to know if you run or cycle…

ITB injuries are a common problem we see in our clinics especially when runners or cyclists are training for a race.

This normally presents itself as a vague pain or extreme tightness down the outside of the thigh, either after finishing an exercise session or towards the end of a session.

Similarly to shin splints this injury is more likely to happen when increasing the amount of exercise being done. It’s why marathons, 10ks, Tough Mudders and The Big Cycle tend to result in busier clinics for us at JMC Physiocures, as people regularly pick these injuries up during training.

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What is the IT band and what does it do?

ITB stands for Iliotibial band meaning it is a band which connects the ilium (crest of the pelvis) and the tibia (shin bone forming part of the knee). It also has attachments to other muscles such as quadriceps and hamstrings. Although there is some debate in physiotherapy about the range of functions of the ITB, its main purpose is to support the pelvis when standing to allow the opposite leg to swing through. It does this by pulling on the pelvis along with the gluteal muscles to lift the opposite side of the pelvis.

As you can imagine if you are training for a marathon or doing the Edinburgh to Glasgow cycle, this movement is repeated multiple times. If this gets inflamed or aggravated then it becomes increasingly difficult to keep exercising.

What causes it?

An exact cause for ITB syndrome or an agreed test/set of symptoms has yet to be identified. A sudden increase in training frequency or intensity appears to be linked with it. In my opinion, this problem typically comes with a muscle imbalance of the muscles of the hips and knees. I don’t like to use the term muscle weakness for this as the majority of people I see with ITB problems are fit and exercise regularly meaning they could not be described as weak.

The muscle imbalance can come from focusing on one type of exercise and forgetting to balance this out by working the opposing muscles. As all muscles have an opposite muscle which pulls against them; if one is stronger than the other this can lead to pain. This can prove difficult to manage as a number of sports require a slight muscle imbalance to improve performance, think of Andy Murray’s shoulder and the force he needs to generate forward compared to how much he has to move backwards. If the training programme is correct, balanced, and spread over the appropriate period of time then muscle imbalance can be a positive. If you are confused then welcome to the world of physio!

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How do I treat it?

As with all injuries prevention is better than cure. If you are planning to enter a race which is longer than you are used to, or if you are trying to improve your times (See our blog on marginal gains 😉) then starting with a well-thought out training plan is essential. This should allow you enough time to gradually increase your distance, load (resistance) or speed without any sudden changes. It is also important to consider how you will vary your training by introducing rest days, weight training for a variety of muscle groups, interval/speed work and possibly even yoga/pilates style gentle exercises.

Form is temporary class is permanent

For most sports I would say that getting your “form” or technique right is vital. Ensure your technique and equipment is right before starting any training. Ask a cycling club about your bike set-up, invest in new footwear, or speak to a running club about your running style.

If you are reading this because it is too late and you already have some pain then there is some good and bad news.

The good news is that it will get better, total rest isn’t likely to help and your physio can provide advice and treatment.

The bad news is that this will probably mean altering your current training schedule to reduce the exposure and will require an effort from you to work on exercises to address any imbalances.

There are also a number of techniques that your physio can use such as massage, mobilisations, and acupuncture which may provide some short term relief although the priority is to get your exercise regime correct.

If you have any questions or would like an assessment for thigh pain then please get in touch with us at www.jmcphysiocures.co.uk  or by calling 01236 425 661 to book an appointment in Lanarkshire today.