Motion Stability's Blog


Play Golf? Avoid Lower Back Pain With These Stretches. by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT

There are numerous studies that have come out recently that show the loss of lead leg internal rotation of the hip in the golf swing has a high prevelance of low back pain in golfers. This is due to the lead leg in the golf swing acting as your swivel / finishing point in the swing. With limitations in the hip, the back has to work harder to finsh the swing. 

You should work on the foam roll to loosen the lead leg hip musculature, knee to chest and pirformis stretches can also help.

Standard back stretches can help alleviate your back after golf, but consider the causitive reasons why your back is hurting in the first place. I work at a Nike Golf Performance Center called Terminus Club (www.terminusclub.com) we utilize 3D Motion Capture Reality systems to analyze your swing, as well as utilize a Physical Therapist to determine the physical limitations of the body. From there we tailor your swing based upon who you are as an individual and not just the way a PGA Tour swings.

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How Does Posture Affect Back Pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT

The way you sit and stand significantly affects your back. Especially for prolonged duration, the tissues around the spine experience what clinicians call ‘creep phenomenon’.

Think of a cold piece of taffy. As you hold it, warm it up, and then hold it by its ends, it slowly stretches and lengthens. Very similarly, the tissues in the back can due the same thing. The fascia, muscles, nerve, joints all experience increased strain when the spine is statically held in one position for a long duration of time.

When you then place yourself in a poorly sitting or standing posture, that then accentuates the amount of tissue loading that is placed on the spine and its surrounding tissues. The ‘creep phenomenon’ is then accelerated and tissue breakdown and injury can occur quicker.

Correctly changing your postures can significantly place less stress on your spine.

Please consult with an appropriate practitioner to discuss proper ergonomics/postures.



How Can a Weak Core Lead to Back Pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT
According to Panjabi’s model, we can view spinal stabiilty based on 3 key elements:

1. Passive Structures: The spinal column itself and the ligaments, fascia and other static tissues that hold it together.

2. Active Structures: The muscles that surround the trunk and pelvis ‘actively’ contract to provide muscle support.

3. Cognitive / Motor Control: The brain has a way to coordinate how muscles will be used to anticipate how the spine is used with functional activities.

The passive structures and the spine itself is limited in its ability to stabilize the spine, especially in dynamic function or prolonged positions such as standing or sitting. The brain thus needs to coordinate the proper timing of muscle contractions and muscle forces to hold the spine together. Without proper muscle control and force the vertebrae of the spine will have increased shearing, torque or compression eventually leading to such things as vertebral degeneration, herniated discs, or other structural issues that may lead to back pain.

The notion of the ‘stronger you are – the better you’ll be’ needs to be carefully considered as it is more important to develop stability in the core that is efficient and properly coordinates with proper movements in your upper and lower body. There are many disciplines out there that teach movement patterning and stabilization, this can include pilates, yoga, functional movement training, feldenkrais, janda approach, and more. Each discipline has their specific methods, while there are also similarities. Please consult a qualified physical therapist or other health practitioner to learn more about proper movement training to stabilize your core.



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.



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’.



Can physical therapy strengthen weak bones? by charlestlee

image source: newbedfordguide.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Physical Therapy can focus on improving bone strength through proper prescription of exercise base therapy to properly gauge the intensity and load on a patient with weaker bones, such as osteoporosis, fractures, atrophic diseases. This could be through aquatic therapy, anti-gravity support systems, and other modified weight-bearing exercises. It is important to have an experienced Physical Therapist to know how to properly dose the intensity/duration of exercises to stimulate proper bone growth/density without over or under doing it.