Motion Stability's Blog


How long will I need therapy for chronic neck and back pain? by charlestlee
 


image source: clinicianleader.com

Brian Yee PT, MPhty, OCS, FAAOMPT
It really depends, as chronic neck and back pain are usually from a multitude of problems. Some areas could be from tissue dysfunctions such as muscle trigger points, fascial restrictions, joint dysfunctions, or herniated discs. It could be from abnormal movement patterns such as poor muscle stability, muscle imbalances, or improper ergonomics or technique in sports/lifting. Pain itself can be categorized into different types as well..so depending on the type of pain you have, should dictate the type of treatment you get. Lastly, internal issues such as medical pathologies, food intolerances, vitamin/hormonal imbalnces can be causing your pain. Receiving a thorough examination to determine the major contributing factors is vital in comprehensively treating chronic neck and back pain.
Advertisements


Are crunches the best exercise to eliminate my back pain? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT 

No. There is a misunderstanding that the stronger your abs are, the better it is for your back. Although strong abs can help stabilize your spine, current research indicates that there are different roles of muscles in the trunk. Generally speaking, the smaller muscles of your spine called ‘local’ muscles help stabilize the spine in low load situations such as prolonged standing, sitting, and light movements such as bending to brush your teeth. While, there are ‘global’ muscles that are the larger muscles –  such as the rectus abdominis, obliques, and back paraspinal muscles that are designed more for movement, power, and stabilization at higher impact.
It is important to have both ‘local’ and ‘global’ systems working correctly. The ‘local’ muscles – transversus abdominis, pelvic floor, and diaphragm help provide intra-abdominal pressure to your trunk. This pressure is similar to a sealed can of soda that maintains the carbonation of a drink. If you were to open the can, you would lose its pressure. Similarly, research from the University of Queensland suggests that with back pain the smaller muscles lose control and thus your intra-abdominal pressure is not as effective to stabilize your spine. Also, along the back of your spine is a muscle called the multifidus. The deeper portions of it run vertebra to vertebra and they are also designed to provide stability to the spine.
We can utilize real-time ultrasound imaging to visualize and cue a client to contract the ‘local’ muscles correctly. Once the ‘local’ muscle work correctly, it is important to do exercises that integrate the ‘global’ muscles – not just with the abs, but also the muscles around the trunk. It is much more effective to do exercises that coordinate the use of these muscles rather than just doing abdominal crunches. Please consult with a qualified health practitioner to guide you through the proper exercise progression


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.


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.



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.