Motion Stability's Blog


Stretches for the Lower Back by charlestlee

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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.

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

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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.



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.



Stretches for lower back pain? by charlestlee

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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.



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


Can Strengthening your neck muscles prevent headaches? by charlestlee

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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.