Motion Stability's Blog


The Pains of an Entrepreneur by Motion Stability

Brian Yee PT, MPhty, OCS, FAAOMPT

Did you know that 8 out of 10 people experience back pain sometime in their life?

image source: plywoodpeople.com

image source: plywoodpeople.com

Unresolved back pain leaves people feeling stuck, perhaps even losing hope with the belief that they may have to live the rest of their lives in pain, which often significantly impacts every aspect of their lives.

I can usually pick out the entrepreneurs as they walk through my door, even before I actually talk to them. You are a highly motivated, self-driven, and goal-oriented group. As an entrepreneur, you do not conform to the 40-hour workweek. Instead, entrepreneurs are obsessively focused on creating that one big thing. So you go through periods where you’re stuck on the computer for hours writing a business plan, or finding yourself traveling from city to city to make business happen, or eating a meal at odd hours of the night as you’ve lost track of time. What becomes of you is a person who puts a huge amount of stress on your body while you try to do what your entrepreneurial spirit drives you to do.

Ultimately your back pain occurs not only once, but starts to happen more often. Simple rest does not alleviate it anymore, and even injections or medications do not make a difference. Guess what? You now have unresolved back problems due to the lifestyle you live.

What’s different about the entrepreneur’s back pain than others is that it’s driven more by the mindset within you than a simple herniated disc that came from nowhere. The countless hours where you sit slouched on your sofa typing away on your laptop creates a physiological pathology called ‘creep phenomenon’. Think of a cold piece of salt-water taffy. If you were to warm it up in your hands and slowly mead it and pull it, slowly the taffy would stretch out. Essentially the same thing can happen to your back. As you sit there for hours upon hours, a slow ‘creep’ stretch of the ligaments and muscles of your back get stretched out. Over years they lose their inherent capacity to hold your back up. And just like a bending a paper clip back and forth, eventually something breaks and back pain occurs.

The entrepreneur in you also wants to exercise either for an outlet of stress or simply because you are goal oriented by nature. What ends up happening is that you perform at levels or distances that eventually your physical body may not be able to handle. There is nothing wrong with striving to achieve a goal, but many times the entrepreneur’s mind will tell them “do it anyways, even though I did not have the time to train” or “just keep going, like I always have.” Over time, your brain ends up outlasting your body, especially the structures in your back. Eventually too much compressive or shearing force happens and back pain occurs. Most importantly, your entrepreneurial spirit tends to have an all-or-none persona. Your mentality weighs more on the side of “it’s on me and no one else.” What becomes of it is an affective component that tells you to keep going, even if it hurts.

To see the conclusion of this article, read it on Plywood People.

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Stretches for the Lower Back by charlestlee

image source: nzwomansweekly.co

Brian Yee PT, MPhty, OCS, FAAOMPT

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 you 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 your 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.

Stretching should not increase your back pain or other symptoms you are experiencing. Please recognize as well that stretching, in certain cases, may be detrimental to your condition. Please consult with a qualified health practitioner, such as a Physical Therapist, to determine the proper stretching progressions.



What Exercises Can Help to Alleviate My Lower Back Pain? by charlestlee

image source: lakeviewchiropractic.net

Brian Yee PT, MPhty, OCS, FAAOMPT

Usually low grade/oscillatory exercises can help alleviate low back pain. This includes stretches such as knees to chest, knees side to side/trunk rotation, prone press ups (like a Cobra position in yoga), pelvic tilts/clocks. Please consult with a qualified health practitioner to assess your causes of low back pain to then develop a proper exercise program.



What are the treatment options for back pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT

Accurate diagnosis of the sources of back pain will indicate the type of treatment you should receive. However, after structural reasons of back pain have been ruled out (such as a herniated disc), the majority of patients are diagnosed with ‘non-specific low back pain’. 

What we find clinically is that traditional interventions such as medications and injections, although perhaps needed and based on a physician’s recommendation, provide short-term relief.

There is growing research and clinical attention on trying to diagnose or sub-group ‘non-specific low back pain’. This can include movement dysfunction, fascial restrictions, muscle control dysfunction, myofascial trigger points, psychosocial variables, pelvic pain, nerve referred pain, or internal/systemic issues such as referred pain from internal organs or hormonal/vitamin deficiencies.

It is important to find a clinician that is able to differentially diagnose the various contributing factors of back pain, and then be able to provide effective treatment for those sources – and then coordinate with other practitioners that can address other needed areas. Especially in chronic low back pain management, a multi-disciplinary team of health practitioners is usually needed.



When Doing Squats, How Do I Avoid A Stiff Back? by charlestlee

image source: media.tumblr.com

Brian Yee PT, MPhty, OCS, FAAOMPT

If your squatting is causing your low back to feel stiff it indicates that either your form, the amount of load or repetition, or the sequence of muscle contractions are incorrect and not safe for your back. With your form – there are many proper ways to squat, but people we see that have back pain or stiffness after lifting typically let the back arch or round too much. It may be the angle your squatting at, but it may also mean that your spine is more structurally unstable than you may think it is. Have a qualified practitioner observe your form to look for any inefficiencies.

In regards to load or repetition – even if your form is perfect eventually your back can wear out due to excessive weight or overdoing the number of times that you squat. I would recommend finding out the repetition, sets, or weight that you feel like you back just begins to stiffen. Next time you do squats, do less than that so your back does not stiffen. As you improve your form and the proper muscle sequence you should notice that you can increase your weight and repetitions gradually without worsening your back stiffness.

Most importantly – back stiffness can occur with squats due to improper muscle sequence. With a squat, the trunk and back muscles should all activate to provide stability to your spine. The muscles that should provide the most power and movement in the squat are your gluteal / buttock muscles. The primary joint that moves in the squat should be the hip – which is controlled by the glute muscles. But what we see are patients that use their knees or back more – causing the quadriceps or back muscles to be used more. This develops an improper sequence of muscle firing patterns and ultimately places more stress on your back as your form and coordination of movement is inefficient. You should contact a skilled health practitioner such as a Physical Therapist to assess the strength and control of your hip, back, and leg muscles if your back stiffens while squatting.



What Exercises for My Core Can Help Prevent Lower Back Pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT

First – generally there are different roles of muscles in your trunk. Typically the smaller ones closest to your spine are considered ‘local’ muscles. Such muscles as the transversus abdominis, diaphragm, pelvic floor, and lumbar multifidus provide segmental control of your lumbar vertebra. Real-time ultrasound imaging can be used to visualize the proper contraction of these muscles as we cannot see these muscles from the superficial skin. So first step in core stability is to ensure that the smaller muscles are engaging properly. Then you have ‘global’ muscles which are the larger muscles – such as rectus abdominis, obliques, paraspinal muscles. These muscles are designed for power and stability at higher loads. Core stability exercises should integrate the function of the ‘local’ and ‘global’ muscles in proper sequence.

Once that is established, any asymmetries of the muscles should be determined. In back pain patients, it is very common to have one side of the oblique muscles contracting properly while the other side does not. This causes an imbalance of forces on your trunk and can cause increased torque to your spine – eventually leading to back pain due to excessive torsional stresses in your daily function or sport.

Once the asymmetry is addressed, integration of muscles from above and below the core need to be assessed.  The old saying ‘the knee bone is connected to the hip bone’ goes too with the muscles in your body. Such lower leg muscles as the gluteal muscles in your hip or the latissimus dorsi in the mid back affect the way your core muscles in daily function and sport. People with back pain, typically have an improper tone and sequence of these muscles working together. Over time this places increased stress on the back – regardless of how strong your core is.

As you can tell, there is a lot to consider when training your core. To recommend a standard protocol of exercises to help your back is not specific enough. A proper assessment of your muscle control and movement patterns should be assessed by a qualified movement specialist – such as a Physical Therapist – to determine what the appropriate level and progression of exercises for proper stability and prevent back injury.



Could Uneven Shoulders Indicate Any Issue? by charlestlee

image source: helloamanda.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Uneven shoulders can be observed in a couple of planes. One of the most common observations is when one shoulder looks higher than the other. This could indicate either a structural, muscular or neural imbalance.

Structurally, the patient may have a leg length discrepancy or a scoliosis that causes the shoulders to be raised on one side.

Muscularly, the shoulder blade or scapula has multiple muscles that stabilize it in position. Muscular imbalances can easily occur that cause certain muscles of the scapula to pull it in a certain direction. For example, in many single arm-dominated sports such as baseball or tennis, the dominate arm tends to over-develop the latissmus dorsi which is your ‘wing’ muscle. With more muscular development it actually pulls the shoulder blade down. In standing postures, most of these athletes will look like their shoulder is lower on the same side. This can create problem for the lowered shoulder, especially when the arm is required to repetitively raise over their head. With the shoulder lowered it takes greater work of the opposing muscles to raise the arm overhead. Over time, it can cause poor shoulder mechanics and lead to injury of the shoulder.

When someone has chronic nerve symptoms in their neck and arm due to a radiculopathy or pinched nerve in their neck, many times you may see that the shoulder on the same side looks elevated. This is due to the adaptation of the muscles to shorten or spasm to elevate the shoulder girdle and allows more room for the nerve to conduct. Patient’s with this pattern often feel tight in their neck and upper shoulder. When they try to stretching the muscles it makes their nerve symptoms worse. This happens because the muscle is not tight but in protective spasm keeping the nerve from being injured further. In this case it is important to treat the nerve first before trying to lower the shoulder girdle.