Motion Stability's Blog


How Is Rehabilitation Used to Treat Neck and Back Pain? by charlestlee

In Physical Therapy we treat neck and back pain by the following interventions:

1. Examination: Take a thorough subjective and physical examination to determine the causes and severity of pain. The examination helps determine what specific interventions need to be done. Each patient is unique in the medical history and interventions should also be individualized to the patient’s progress.

2. Reduce Pain: Especially in more severe pain complaints, it is important to reduce the symptoms to allow for the patient to simply feel less pain. This can include manual therapy to decrease muscle spasms, restricted joint mobility, or decrease nerve irritation. Modalities such as ultrasound, electrical stimulation and traction can also be used.

3. Restore Motion: As pain decreases, it is the goal for rehabilitation specialists to restore patients back to their functional activities. Mobility / range of motion is important to allow the patient to move again. Manual therapy, exercises including stretches and stability training, posture and gait/walking education are all necessary to improve the patient.

4. Improve Stability and Strength: In the neck and back there are key muscles that are designed to stabilize the spine, while others provide power and torque. In chronic pain conditions, it is important to improve the efficiency of muscle function rather than just ‘get people stronger’. Such muscles as the longus colli in the neck, shoulder blade / scapular stabilizers – such as the lower trapezius, or trunk stabilizers -including the transversus abdominis, multifidus, obliques, and gluteal muscles are all necessary to provide proper stability for dynamic function. Rehabilitation specialists have strategies to improve the stability of these muscles.

5. Function / Sports Specific Training: Once basic stability has been established, it is important to provide the patient the tools to return to full work, functional, and sports-related activities.

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What Is The Right and Wrong Way to Bend Over? by charlestlee

image source: media-cache-lt0.pinterest.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Proper bending requires a fluid ‘lumbopelvic rhythm’. This means the hips and spine should coordinate to be able to touch the ground. Ideally there should be a 2:1 ratio hip movement to spine movement. 

What we see typically in the clinic is that patients have significant restriction of what we call ‘hip hinging’ as the patients hips have restricted motion, thus requiring increased movement from the spine..with repetitive and excessive movement at the spine it creates greater torque to the spine.

The other scenario we commonly see are patients who have fear to move their spine and essentially ‘lock’ their spines in slight hyper-extension and try to bend entirely from their hips. This creates greater muscle spasms in the spine and the fear of moving can lead to altered movement patterns that do not help the back in the long run.

Please consult with a qualified health practioner to observe your bending patterns, and provide education and the tools to give you the confidence and ability to bend properly.



Custom Orthotics and Low Back Pain by charlestlee

image source: doctorsorthotics.com

Brian Yee PT, MPhty, OCS, FAAOMPT

The way the foot contacts the ground significantly affects the way your back absorbs compression to the spine. People who are flat foot footed can lead to decreased hip stability and motion. This is due to the foot not being able to provide proper support each time you step or stand on them. Over time the entire leg musculature, most importantly in the gluteal muscles lose their ability to provide proper support. This can lead to increased stress to the back…like jamming your thumb into a wall a thousand times over…you back gets ‘jammed’ or compressed.

Proper orthotic fitting can help the feet be placed in better alignment and thus provide proper support for the rest of the legs and ultimately the spine to be in a more efficient position to function during the day.

You should also consider that the bottom of the feet are highly sensitive with proprioceptive receptors..which detect spacial awareness. If the foot has better sense of its position, typically the rest of the body will also have better proprioception and spatial stability. It is thought that poor proprioception can make people more susceptible to injury. Orthotics can provide better proprioception.

There are many theories of how orthotics should be made. Please consult with various health practitioners to see what their opinions are about the design of the orthoses.



Can high-arched feet have any complications? by charlestlee

image source: amazonaws.com

Brian Yee PT, MPhty, OCS, FAAOMPT

People with high-arches typically have less give in their foot as compared to those with flat arches. It can affect different body parts. With a more rigid support at the arch there tends to be greater forces dispersed at the heel and ball of the foot. Whether it be callouses, neuromas, or spurs many times they are formed due to excessive forces on that area. People with high-arches also tend to walk on their outside of their foot This makes them have more weight-bearing forces to along the outside of their legs. Commonly you see associated problems with ankle sprains, lateral knee pain such as iliotibial band syndrome (ITB), or lateral hip pain. There is also a tendency for people with high-arches to be generally stiff in their joints and muscles. This is due to a greater amount of ground reaction forces not being absorbed in the foot and sent higher into the legs, back and trunk as weight-bearing occurs.

Physical Therapy typically focuses on improving the soft tissue and joint restrictions that are associated with the rigid / high-arched foot mechanics. Use of proper shoe wear and possible orthotics can help reduce the stresses on people’s feet as well.



Stretches for lower back pain? by charlestlee

image source: teraputics.com

Brian Yee PT, MPhty, OCS, FAAOMPT

The most common muscle that is strained on the side of your back is the quadratus lumborum (QL). The QL attaches from the side and bottom of your rib cage to the top of your pelvis. There is a right and left QL and when it contracts its side bends your spine, as well as extends the back.

Lets say your right QL feels tight – to stretch this:

1. While sitting place a thick book or half foam roll under your opposite / left hip.

2. Lean to the left, away from your painful side, fulcruming over the roll and left hip.

3. Slightly bend forward and rotate towards the right. Keep your right hip bone on the seat.

4. You should feel a nice stretch on the right side where the QL muscle is.

This stretch should not cause increased back pain or nerve symptoms down the leg. Please consult with a qualified health practitioner to display proper technique.



How do I manage my back pain on a daily basis? by charlestlee

image source: itechmedical.files.wordpress.com

Brian Yee PT, MPhty, OCS, FAAOMPT

First, remain positive. Many people dealiing with chronic back pain can become discouraged and even depressed that their pain does not let them do what they want to do. This can lead to a fear-avoidance belief that takes them away from doing activities that they physically should be able to do. 

From there it is important to establish 2-3 activites during the day that cause back pain – such as sitting, standing, or household activities such as vacuuming. It is just as important to determine the time in which the pain begins. Many patients will complain of pain with a prolonged/sustained activity after 10-20 minutes. What this means is that the muscle endurance of your body is fatiguing quickly and pain begins 10-20 minutes later as increase stress to your spine is occuring.

Like a marathon runner who is hurting and conditioned to run 2 miles. The runner knows well enough not to run 20 miles thereafter, as they will end up hurting themselves. They will instead train to run 2-3 miles until they can condition themselves to increase their distance without hurting worse.

Likewise, with chronic back pain, it is important to stay active, but stay just short of the time that your pain exacerbates itself. As a physical therapist can teach you ways to decrease your pain and improve your stability and movement, slowly you will be able to improve your time in activities that used to hurt you early on. As things progress, you will gain the confidence to do things you couldn’t do before with less pain. We call this ‘pacing’.