Motion Stability's Blog


What stretches should I do before I workout so I do not get back pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT
There are many stretches you can do to help loosen your back up before you work out. Please keep in mind  that stretching does not guarantee that your back will not hurt – as there other causes of back pain than just tight muscles. Some light stretches you can do to loosen your back include:
Pelvic tilts: Laying on your back with knees  bent – rock your pelvis back – flattening your back against the bed and return to neutral, and if it doesn’t bother you progress to arching your back a small amount. Oscillate back and forth.
Knee to chest: Bring one knee up to your chest, stretching your hip and your back. You can progress to both knees to your chest.
Trunk rotation: Laying on your back with knees bent and together slowly let your knees go to one side – allowing your trunk to rotate. Switch to the other side. If that does not bother you, you can progress to have one leg straight and let the other knee hook over it allowing the spine to rotate more. There should be a slow stretch in your spine.
Cat / Camels: On you hand and knees – you can arch your low back up and down. Focus on a slow stretch trying to move from your lower back and pelvis. Many times people arch their
backs but move mostly from the mid-back or thoracic spine, which does not stretch the lower back as well.
Prayer stretch: On your hand and knees – sit your bottom down to your heels and reach out along the ground with your arms to stretch your lower back. Take your arms and trunk side to side to feel more of a stretch along your sides of your back as well.
Please consult with a qualified health practitioner such as a Physical Therapist to recommend the proper stretches and form.


How do foot related sports injuries affect the body? by charlestlee

Image Source: static.coco.sensis.com

Brian Yee PT, MPhty, OCS, FAAOMPT

I pay particular attention to foot injuries and how it relates to the rest of the mechanics of the body. How the foot hits the ground affects how other joints in the body absorb shock as well as how the muscles around those joints work in sports performance.

The most classic example that we see are patients that have a one sided knee, hip or back injury – say the right side. When we take our medical history the patient tells us they sprained their ankle on the same right side ‘way back in high school…but that got better’. But what the patient does not realize is that after the ankle was swollen from the sprain the swelling settles and makes the ankle joint stiffer. As years go by, after running, walking, and playing sports, the limitations in ankle motion directly affect the way the hip works – causing the hip to lose mobility as well. Injuries can then occur at the hip, the knee, or the low back as both the ankle and hip are not able to provide proper support and power production in sports performance.



Can Strengthening your neck muscles prevent headaches? by charlestlee

Image Source: amazonaws.com

Brian Yee PT, MPhty, OCS, FAAOMPT
There are different types of headaches. One common type is called a cerivcogenic headaches or neck-related headaches. There is lot of research coming out of the University of Queensland in Brisbane, Australia that has discovered how proper stabilization of the neck muscles can reduce neck pain, whiplash injuries, and cervicogenic headaches.

Proper stability of the neck muscles comes first from the smaller muscles closest to the spine. This includes a wafer thin muscle on the front of the cervical spine called the longus colli. A skilled Physical Therapist can instruct a patient how to contract this muscle in isolation and train its endurance. As the longus colli function improves it is important to incorporate strength of the larger muscles such as the sternocleidomastoid and posterior neck muscles to provide stability and strength for the neck to function during the day and in sport.

Cervicogenic headaches are typically generated from dysfunction of the upper neck vertebrae such as C1-3 vertebra levels. With poor postures or previous whiplash injuries the smaller muscles can weaken or inhibit leaving the joints vulnerable to injury due to lack of muscle support.

By improving proper muscle stability, the cervical vertebrae have better support and can last longer in prolonged postures and sporting activities. In turn, the prevalence of headaches can be reduced.



Why should I work with a rehab specialists for back pain? by charlestlee

Image Source: collegesurfing.com

Brian Yee PT, MPhty, OCS, FAAOMPT

A rehabilitation specialist is able to identify reasons why your back pain is occurring based on the way the you move, palpation of the involved tissues, and rule out serious medical pathologies such as spinal based cancers. Back pain can derive from multiple sources including a herniated disc, a joint injury, a muscle strain, or referred pain from such things as vitamin D deficiency or internal organ issues.  If your back pain is due to musculoskeletal causes, the rehabilitation specialist should then be able to provide an accurate treatment plan that addresses the underlying causes of your pain and provide education, exercises, and ideas how to get your back to the functional or sports related goals you have.



Can Strengthening your neck muscles prevent headaches? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT
There are different types of headaches. One common type is called a cerivcogenic headaches or neck-related headaches. There is lot of research coming out of the University of Queensland in Brisbane, Australia that has discovered how proper stabilization of the neck muscles can reduce neck pain, whiplash injuries, and cervicogenic headaches.

Proper stability of the neck muscles comes first from the smaller muscles closest to the spine. This includes a wafer thin muscle on the front of the cervical spine called the longus colli. A skilled Physical Therapist can instruct a patient how to contract this muscle in isolation and train its endurance. As the longus colli function improves it is important to incorporate strength of the larger muscles such as the sternocleidomastoid and posterior neck muscles to provide stability and strength for the neck to function during the day and in sport.

Cervicogenic headaches are typically generated from dysfunction of the upper neck vertebrae such as C1-3 vertebra levels. With poor postures or previous whiplash injuries the smaller muscles can weaken or inhibit leaving the joints vulnerable to injury due to lack of muscle support.

By improving proper muscle stability, the cervical vertebrae have better support and can last longer in prolonged postures and sporting activities. In turn, the prevalence of headaches can be reduced.



Why can sitting lead to back pain? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT
Sitting, especially for a long time, can put undue stress on the low back structures. There is a clinical term called ‘creep phenomenon’ that describes how prolonged sitting can hurt the back. ‘Creep’ is like holding the ends of a piece of hard taffy and then watching it slowly stretch out over time. Similarly, with prolonged sitting the structures of the lower back can slowly deform and tissue breakdown occurs. This breakdown can include the muscles, fascia, ligaments, joints, and intervertebral disc in the back. Eventually with enough microtrauma to the tissues back pain occurs.



What conditions can lead to a ‘groin’ pull? by charlestlee

image source: buzzle.com

Brian Yee PT, MPhty, OCS, FAAOMPT

‘Groin pulls’ typically are due to over-compensation and poor mechanics in the legs and core stability. Groin pulls comprise mostly of the adductor muscles of the inner thigh. These injuries usually occur with sports that requie cutting, pivoting and side to side movement  such as soccer, lacrosse, and football. It can also occur in runners and cyclists when the hip is required to be used in situations like uphill terrain.

Strength deficits with these injuries are not necessarily in the adductor muscles, but instead from the posterior hip muscles – gluteus maximus and medius. The gluteus maximus and medius are the key stabilizing muscles for the hip to be able to plant and pivot off the leg. When the gluteal muscles are not strong enough to stabilize the hip, the adductor muscles are used to compensate. Anatomically, the adductor muscles are primarily designed to pull the hip inwards, but many people do not realize that the adductor muscles also have a role in extending the hip. As the gluteal muscles should extend the hip to push off, run, climb, the adductor muscles can be used instead – and with time groin strains occur due to overuse.

Groin pulls can also happen due to poor foot contact. Especially if someone is more flat footed or pronated, it causes the knee to draw inwards when you step through it. In this position, the adductor muscles are in a better mechanical advantage to stabilize the hip than the gluteal muscles. Again, groin pulls can occur due to repetition in a poorly aligned position.

Differential diagnosis of ‘sports hernia’, nerve referred pain – primarily from the obturator nerve, sacroiliac joint dysfunction, internal pain from the hip such as arthritis, or referred pain from your internal organs should also be considered as they all commonly refer to the groin.



What do the callouses on my feet say about my sports injury? by charlestlee

image source: a248.e.akamai.net

Brian Yee PT, MPhty, OCS, FAAOMPT

Even by looking at someone’s callouses on their feet we can begin to make an assessment why and where the patient is injured somewhere higher in the body. For example, runners that have an excess of callousing along the entire ball of the foot tells us that they are putting an excessive amount of force their. Like pressing on a gas pedal, we can deduct that the athlete is using alot of their calf muscles to generate movement and power. It is possible to make assumptions that calf cramps, achilles tendinitis and shin splints occur due to the increased stresses at the ball of the foot.

Another example are bunions along the first toe. What that indicates is an excessive force on the medial or inside of the foot. Like a rudder, if the foot turns inward when you step through it, the knee and hip will follow that line of force causing increased stresses along the inside of the leg. Commonly we see people with bunions have some type of medial knee or patellar pain as well as hip or back pain as the foot is not adequate in absorbing shock causing increased forces into the joints above. If you’re not sure what the callouses on your feet mean in terms of your overall sports performance, we recommend that you contact a qualified Physical Therapist that understands the relationship of your foot to the rest of your mechanics.



Are there alternative treatments for back pain? by charlestlee

image source: backpainreliefdaily.org

Brian Yee PT, MPhty, OCS, FAAOMPT

Even though Physical Therapy is not considered as an ‘alternative treatment’, what a specific Physical Therapist provides may be alternative to the ‘stereotypical’ regimen of hot/cold packs, electrical stimulation, traction, and basic exercises to improve core stability.

At our facility, we determine the type or category of pain the patient is experiencing as well what factors are contributing to the pain. This can include joint, nerves, or soft-tissue tissue pathologies. We also assess muscle and movement control patterns that can cause undue stress on the back. We then investigate if there are other factors such as vitamin / hormonal deficiencies, food allergies, or other systemic issues that could potentially be a source of back pain.

Once this is determined a treatment plan is implemented that encompasses the best evidence-based research to correct the contributing factors. This can include ‘alternative’ techniques such as trigger point dry needling, nerve mobilization techniques called neurodynamics, and utilizing real-time ultrasound imaging to visualize proper muscle control around the spine.



Can stretching my hamstrings get rid of my low back pain? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT

There are cases when stretching your hamstrings can be good for your back and other cases when it can make it worse. It can be good to stretch your hamstrings when they are tight due to poor mechanics and posture. Many times people use their hamstrings too much to move and stand. Your hips and butt muscles, as well as your ankle/foot joints and muscles should be the primary areas that provide stability and movement. If they don’t work correctly or fatigue easily, then your hamstrings will, by default, have to be used to get you through the day. Your hamstrings attach to the bottom of your pelvis that connects with your back. If they get tight it can put excessive stresses on your pelvis and back. In these cases, stretching the hamstrings followed up with exercises to improved the strength and mobility of your hips and feet can help reduce stresses and pain on your low back.

One reason not to stretch your hamstrings when you have back pain is when you also have current or recurring sciatic nerve pain. The sciatic nerve starts from the low back and runs down the back of your leg, in between your hamstrings. When sciatica occurs not only do you get pain down the back of your leg, but the muscles that surround the sciatic nerve can spasm and a feeling of ‘tightness’ can occur. The patient at times may perceive what they think is ‘hamstring tightness’ may actually be muscle tightness or guarding from an irritated sciatic nerve. We have seen patients trying to stretch their hamstrings and make their back pain worse because they were essentially overstretching their sciatic nerve instead. Nerves don’t like to be ‘stretched’ as much as muscles. The sciatic nerve also comes directly from the back. Over-stretching the sciatic nerve can thus put more stress on the back. In these cases, it is important to consult with a Physical Therapist that understands how to differentiate whether the sciatic nerve is involved.