Back pain treatment – drug free!

Looking for effective back pain treatment?

There can be multiple causes and multiple solutions.

The first steps in any back pain treatment are:

  • Diagnosis
  • Figuring out whether it’s a muscular, skeletal or nerve issue
  • Seeking help from a health care professional.

back pain treatment

**The following article presumes you don’t have something nasty like a herniated disc or sciatica.**

If your (particularly lower) back pain is deemed due to muscular tightness, there is a drug free back pain treatment you can try. It’s like this. In my experience, doing this gets rid of the problem in 9 out of 10 cases. Even if it isn’t the solution, it won’t do any harm.

Sounds like a pretty good back pain treatment, right?!

Here goes:

Squat and Stretch.

That’s it.

Check this out for the ‘What’, ‘Why’ and ‘How’:

First of all, let’s start with the squat.
Here’s a video of Coach Nav with a beautiful demonstration.

Having a squat that goes deep without losing back position is fundamental to hip and spine health.
No part of the system is having to compensate for another part.
If you can squat like this then chances are you don’t suffer from back pain. 🙂

squat

gluteal stretch

shinbox stretch

hip flexor stretch

pretzel stretch

hamstring stretch

plank hold

Here’s a squatting drill (do this freestanding or holding a post):

  • Go to the bottom of the squat
  • Hold it there
  • Hang out as long as you can (up to 10 mins)

If you can stay there for 10 minutes, you probably don’t have back problems (anymore!)
If you can’t stay there (muscles of the legs or back start hurting too much), then do this every other day – building up to 10 minutes.
We aren’t looking for excruciating. Aim for improvement over time.

Now stretching. Hold each for at least 30 seconds. Let’s have a look!

Gluteal Stretch

Tight, weak ‘glutes’ are a common factor in sore lower backs.
Turns out, muscles ‘go to sleep’ when you sit on them 8+ hours a day!

Get into this ‘figure 4’ position and pull your knee towards you.
Play with the knee position until you feel it in the meat of the muscle.

Alternative Gluteal Stretch

For those that ‘don’t feel’ the other one, this is an alternative that works for many.
Get the foot of one leg to touch the knee of the other leg.
Stay ‘tall’ and hinge at the hips to apply the stretch. Don’t bend your back.

Hip Flexor Stretch

Chronic sitting leads to short hip flexors.
This set of muscles attaches to the back of your pelvis.

  • Get into a long lunge position
  • ‘Tuck’ your tail bone under to get into the front of the hip of your rear leg.
  • Let your hips ‘sink’ forward as you relax and breathe into this stretch

Pretzel Stretch

A great multitasking stretch.
This combines gentle lumbar twist, hip flexor, quad, pec and some thoracic mobility too.

  • Lie on one side and grab your ‘bottom’ leg at the back (like a quad stretch)
  • Bring your ‘top’ leg up to 90 degrees.
  • Aim towards getting both your top knee and opposite shoulder to the floor. Enjoy!

Hamstring Stretch

Another important link in the ‘posterior chain’.

  • Keep the stretching leg straight, or slightly bent
  • Don’t pull your toes back – that’s a nerve stretch
  • Your other leg can be bent or straight
  • This can also be done standing, but keep your back straight

The Plank

  • Use your posterior chain to keep your whole body in a straight line.
  • Great for developing global core strength and endurance.
  • Can be scaled back by putting your knees on the floor.

Check out these links for more ways you can move better, hurt less and look after yourself.

For more information on more serious issues and back pain treatment for them, read this article from Gordon Physio.

Injury treatment: When to ice and when to heat

Injury treatment: Ice or Heat?

Thank you to Chirotherapy for this special guest post.

When to use Ice

injury_treatment_ice
Use ice if it’s within 5 minutes of the injury occurring. It should be used up to 48 hours after the injury.

If you can recall a mechanism for injury, use ice.
Tip: keep an icepack or frozen bag of peas in the freezer in case of an emergency. You could also use ice in a plastic bag.

  1. Wrap cold source in a tea towel or similar. Place this directly on to the skin above the injured area. Make sure clothing is removed from the affected area.
  2. With injuries that have just occurred, compress and elevate the area where possible.
  3. Leave on for 15-25 minutes depending on the area. Leave on for a longer time for deeper or bigger areas like the hips or lower back and less for more shallow areas like the neck and fingers.
  4. Remove and rest from the ice for as long as you applied it.
  5. Repeat until you have repeated the cycle 4 times.
  6. Use 2-3 times a day for up to 48 hours after the original injury.

When to use Heat

injury_treatment_heat
Heat is a very soothing therapy that can be used to ease tense muscles by improving circulation. Use heat when the issue has been around for more than 48 hours.
Do not use heat if there are altered sensations, pain, numbness or pins and needles running down the legs or arms.

  1. Heat wheat pack or similar item according to instructions.
  2. Wrap heat source in tea towel or similar or by itself over clothing.
  3. Leave on for 20 minutes.
  4. Further repeats are not necessary.

NB: Do not use heat or cold therapy if you cannot feel the difference between hot and cold, like in the case of nerve damage.

In the case of torticollis or “wry neck”, you can alternate between heat and cold as per the ice protocol except swap between the ice and heat sources.

If in doubt, use ice.

USING ICE AND HEAT CAN BURN YOU SO BE SURE TO REMOVE THE ICE/HEAT BEFORE ANY DAMAGE OCCURS.

Thanks again to Chirotherapy for this special guest post.

Real Self Defence is Risk Management

Risk managment flow

Personal Risk Management matters

Please take a moment to reflect. What steps do we take to ensure we can enjoy a safe, happy and healthy life?
We take out insurance for car. For our home and contents. For travel. Some for death or permanent disability.

Almost all of us have learned to swim. Initially to prevent drowning and then for enjoyment. Many of us will have undertaken a first-aid course. Knowing how to treat injury and save lives is important.

On the North Shore we are very fortunate. We have access to a range of quality health practitioners who are skilled in injury diagnosis and treatment and future prevention.

These demonstrate proactive measures (planning for issues in advance – swimming, insurance and injury prevention) and reactive measures (first aid and physical therapy).

risk management chart

Sadly, there appears to be a breakdown in the prevention logic when it comes to self defence skills.

I think it’s due to a couple of factors. “Good people” (productive and social members of the community) not wanting to learn how to hurt others. This combined with an inaccurate perception of what comprises self defence training.

risk management circle

Self defence training is risk management.

It’s learning awareness and avoidance strategies to keep you out of dangerous situations.
It’s verbal tactics to de-escalate conflict.
It’s body language cues to alter the mood.
It’s understanding (but not agreeing with!) the thought process of the attacker so you are better prepared.

Physical training does make up a large part of training. This is so the practitioner has effective skill that work under pressure or if taken by surprise. However, physical is the last option. When all the other risk management skills have failed.

The scenario matters.
Adults may be at the pub. At the ATM or waiting for a taxi.
Teens may be catching public transport. Going to the movies. Hanging out in a park.
Kids may be waiting for school pickup. Walking to a friend’s house.

All these situations offer a higher degree of risk than sitting at home.

While the practice of self defence may not be compatible with every personality, ignoring the need for self defence skills will not make you safe from violence.

So, why are we averse to learning risk management skills that can PREVENT physical injury and psychological trauma?

Get in touch about self defence training now!

9 ways bands can help you stretch

Have you ever used bands to stretch?

Aside from providing elastic resistance in workouts, bands are also a great tool for stretching. Improve your flexibility by using this guide for a 9 stretch sequence you can do with just one little band.

See also this video and these drills.

Give these a try and post your thoughts and experience to comments.

Upper Back Stretch
Upper Back

  • Keep weight on your legs – don’t rely on the band
  • Your arms stay as close to your head as possible
  • Try to get your bicep behind your ear
  • Relax and breathe into the stretch
  • Go to discomfort rather than pain
  • Hold for 30 seconds to 1 minute

Lat Stretch
Lats

  • Keep weight on your legs – don’t rely on the band
  • Your arms stay as close to your head as possible
  • Try to get your bicep behind your ear
  • Try to lengthen the whole way from shoulder to hip
  • Relax and breathe into the stretch
  • Hold for 30 seconds to 1 minute

Chest Stretch
Chest / Shoulder / Obliques

  • Keep weight on your legs – don’t rely on the band
  • Your arm stays above shoulder height
  • Try to open your chest as much as possible
  • Try to open from shoulder to opposite hip
  • Relax and breathe into the stretch
  • Hold for 30 seconds to 1 minute

Hamstring Stretch
Hamstrings

2 options:

  • Leg straight and toes pointed or
  • Leg slightly bent and toes back
  • Keep both hips on the floor
  • Band around upper back; Relax and breathe
  • Hold for 30 seconds to 1 minute

Adductor Stretch
Adductors

  • Same setup as the hamstrings stretch
  • Keep both hips on the floor
  • Open hips / take foot out to the floor
  • Band around upper back; Relax and breathe
  • Go to discomfort rather than pain
  • Hold for 30 seconds to 1 minute

Internal Rotator Stretch
Internal Rotators

  • Same initial setup as the hamstrings stretch
  • Put both feet into the band
  • Move your knees to outside the band (the band will run to the inner knee/thigh area
  • Move elbows/forearms to inside the band
  • Put your feet on the floor and add pressure with elbows
  • Hold for 30 seconds to 1 minute

Hip Stretch
Hips

  • Get into squat position with feet on the wall
  • Keep both hips on the floor
  • Run the band under you – at pelvis level
  • Loop the band over each knee
  • Let femurs draw to hips; Relax and breathe
  • Hold for 1 to 2 minutes

Hips and Shoulders Stretch
Hips and Shoulders (Less Intense)

  • Same initial setup as the hips stretch
  • Continue to keep both hips on the floor
  • Take broom handle “overhead” with hands wide
  • Keep neutral spine
  • Relax and breathe
  • Hold for 1 minute

Hip and Shoulder Stretch
Hips and Shoulders (More Intense)

  • Same initial setup as the hips stretch
  • Continue to keep both hips on the floor
  • Take broom handle “overhead” with hands narrow
  • Keep neutral spine (no raised or puffed chest)
  • Relax and breathe; allow shoulder to ‘sink’ open
  • Hold for 1 minute

As at the top: see also this video and these drills.

The Pick-up Password – Safety tip to protect your child

kids safety password

If you’re a parent then you care about your kids.
You want to know your kids are safe.
You want to know where they are.
A simple password can make all the difference.

Having a system for school pickup is a must. Most parents tell their kids if they are going to be picked up by someone else. Sometimes the parent might forget. Sometimes the child may not remember. A simple, yet effective solution is the pick-up password. The parent and child agree on a password. Only the parent, child and authorised collector know it. That way, if someone forgets an arrangement there is a quick solution.

Situational examples:

“Hi Billy.”
“Hi Mrs Jones.”
“Billy, your mum asked me to pick you up from school today.”
“Oh, ok. What’s the password?”
“Oh, yes. Your mum said you’d ask me that. The password is (correct answer)”
“Thanks Mrs Jones. Let’s go!”
(Gets in the car)

“Hi Billy.”
“Hi Mrs Jones.”
“Billy, your mum asked me to pick you up from school today.”
“Oh, ok. What’s the password?”
“Password? She didn’t tell me one!”
OR
“The password is (incorrect answer)”
OR
“Get in the car. I don’t have time for this!”
“Thanks anyway Mrs Jones, but my mum said “No password, no go!”
(Billy now goes to find a teacher)

Simple steps any kid can learn:

  1. Choose a password you and your child can easily remember
  2. Any time you arrange someone to collect your child remember to tell them the password!
  3. At pickup, your child will challenge the collector for the password.

If the password is correct, your child knows they are safe to go (and will probably be chuffed with the system!)
If the password is incorrect your child knows to run and find a teacher immediately.

Using a simple (polite) challenge/response system like this achieves a number of things.

  • Your child is safer at pickup time
  • You and your child will be more aware of personal safety without any fear or paranoia
  • Remove situational ambiguity so your child can practice making confident choices
  • Give your child the ability to say “no” to adults in certain appropriate situations

The exact wording can be modified depending on the age of the kids involved. The message must stay clear.
This tip (and many others) are the sort of thing taught in the self defence classes at FunFit.

Do you think this system would work for you? Please post your thoughts to comments and share this with parents you think could benefit. Thanks.

Quad, Hamstring and Lower Back Mobility Video

Mobility Wod Quote

Here’s the inimitable Kelly Starrett of Mobility WOD delivering a great lesson on how to improve mobility to hips and spine and flexibility to quad, hamstring and lower back.

Also check out an earlier post on thoracic spine and hip mobilization.

Check it out – and do it!

Also have a look at Kelly Starrett’s book, Becoming a Supple Leopard, for more great mobilization tips.

Pregnancy and exercise – a guide for training

pregnancy_exercise

Many people seem to treat pregnancy as an illness. Pregnant women do not need to be wrapped in cotton wool. While pregnancy does mean significant physiological changes, the expectant mother has not turned into an alien! [1][3] A sensible approach to pregnancy and exercise training can mean a happier, [9][11] healthier, [2][3][6][10] fitter [2][3][10] mum. This can lead to better recovery post-delivery [2][4][5] and better headspace [2][9][11] for dealing with sleepless nights!

If in any doubt at all consult your obstetrician. This is especially important if you have complications. Some of the things to discuss include:

  • The type of exercise you like to do
  • Your general fitness level
  • How much exercise you did before you conceived. [1][3]
  • Your desired intensity level [7]
  • Any complications with your pregnancy

Ultimately – see the conclusion below – especially number 5!
 

Some general benefits of exercise

  • You might actually (shock, horror!) enjoy exercise – or at least the social aspect [9].
  • A more efficient engine means more energy
  • Improve your posture [2] and circulation [10]
  • Improve your cardiovascular health
  • Get stronger
  • Improve your work capacity (see work capacity below)
  •  

    Pregnancy specific benefits of exercise

    • Stronger back muscles – help alleviate back pain as your belly grows [2]
    • Stronger core muscles – help prevent incontinence [2][4][5]
    • Relieve stress [9][11]
    • Improve your sleep and ward off insomnia [11]
    • Ward off pregnancy-induced bone loss [6]
    • Prepare for the physical demands of labour (see work capacity below)
    • Improve your recovery after labour [2]
    • Initiate a faster return to pre-pregnancy fitness and weight [2]
    • Increase your ability to cope with the physical demands of motherhood (see work capacity below)

     

    Changes Cautions (things to be aware of)
    Increase in body weight Changes in Balance / Coordination due to increased weight and the distribution of the weight
    Loosening of all ligaments (Relaxin) The loosening of ligaments can make you more prone to sprains and other injuries
    Increase in resting heart rate Don’t use heart rate to guide intensity as it has increased – use Rate of Perceived Exertion (RPE)
    Decrease in Blood Pressure (2nd Trimester) Avoid rapid changes in position due to decreased blood pressure
    Increase in Blood Volume, Haemoglobin and VO2 Max (First few weeks after birth) Improved performance!
    Abdominal separation (painless) Sit-ups or crunches may worsen this, and are ineffective.

     

    Things to avoid

    • Overheating has been linked to developmental problems for baby in animal studies
    • Lying on your back (from 4 months) can restrict circulation. Modify exercises to on your side.
    • Excessive intensity is thought to have effects on birth weight (3rd Trimester), though there is conflicting evidence and opinions, so this is still inconclusive [2][3][7][8]

    Avoid jolts or falls [3]. Unfortunately vigorous or extreme activities such as horse riding, skiing, mountain climbing are out. You should also avoid most contact sports, such as football, basketball and so on. In the later stages of pregnancy, avoid activities that involve jumping, frequent changes of direction and excessive stretching (such as gymnastics).

    Pregnancy is not the right time to start any new intensive [7][8] exercise, but it is safe to continue with most types of exercise if you’re used to them.
     

    Limitations of Guidelines

    Public health recommendations by their very nature are designed to capture as many members of the public within their umbrella as possible. They are an excellent starting template. They often have current information and links to resources for further inquiry and should not be overlooked.

    A great example of sensible pregnancy and exercise recommendations can be found at:

    http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_and_exercise

    The reason I particularly like these recommendations is their acknowledgement of relative capacity, which is often lacking in Public Health statements.
     

    Relative capacity

    If you haven’t exercised before becoming pregnant, you would approach the new activity pretty much the same way as if you weren’t pregnant. That is, you’d seek the help of a professional who can design a structured program with your particular goals and needs in mind. Gradual development of strength and fitness with incremental improvement over time.

    On the other hand, someone who’s been exercising for years, has built up a baseline of strength, endurance and other general physical skills is going to have greater physical capacity than someone who has not. This woman would be able to do much more than her previously inactive counterpart. Her loads and speed would be reduced compared to pre-pregnancy levels as a margin of safety, but she could still outperform others at her gym of lesser capacity.
     

    Pelvic floor exercises and pregnancy [4][5]

    Strong abdominal muscles support your spine. The internal core and pelvic floor abdominal muscles act as a natural ‘corset’ to protect the pelvis and lumbar spine.

    Your pelvic floor muscles are weakened during pregnancy and during birth (vaginal delivery), so it is extremely important to begin conditioning the pelvic floor muscles from the start of your pregnancy.

    Appropriate exercises can be prescribed by a physiotherapist or a personal trainer who has training and experience with pelvic floor. It is important to continue with these throughout your pregnancy and resume as soon as is comfortable after the birth.
     

    Warning signs when exercising during pregnancy [3]

    If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:

    • Headache
    • Dizziness or feeling faint
    • Heart palpitations
    • Chest pain
    • Swelling of the face, hands or feet
    • Calf pain or swelling
    • Vaginal bleeding
    • Contractions
    • Deep back or pubic pain
    • Cramping in the lower abdomen
    • Walking difficulties
    • An unusual change in your baby’s movements
    • Amniotic fluid leakage
    • Unusual shortness of breath
    • Decreased foetal movements

     

    Conclusion

    If the exercise you’re doing makes you feel strange or hurts in a non-working-muscle kind of way – stop! The best guide to whether something is working for you or not is how it feels. The rough guide can be summarised as follows:

    1. Get advice for your particular circumstances
    2. Every woman is different
    3. Try things out
    4. Listen to your body
    5. You can still work hard but don’t overdo it.

    Consider exercise during pregnancy an opportunity for ‘maintenance’ rather than for ‘improving performance’.

 

Further Reading

Victorian Government Better Health Channel Guidelines:
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_and_exercise

Sports Medicine Australia FactSheet:
http://sma.org.au/wp-content/uploads/2009/10/WIS-ExPreg.pdf

The website babycenter has some useful articles, including:
http://www.babycenter.com.au/a622/tips-for-a-safe-workout
http://www.babycenter.com.au/a637/when-not-to-exercise
 

References

[1] Lokey, E. A., Tran, Z. V., Wells, C. L., Myers, B. C., & Tran, A. C. (1991). Effects of physical exercise on pregnancy outcomes: a meta-analytic review. Medicine and science in sports and exercise, 23(11), 1234-1239.

[2] Nascimento, Simony L.; Surita, Fernanda G.; Cecatti, José G. (2012). Physical exercise during pregnancy: a systematic review. Current Opinion in Obstetrics & Gynecology: December 2012 – Volume 24 – Issue 6 – p 387–394

[3] Horak, T. A., & Osman, A. (2012). Exercise in pregnancy: review. In Obstetrics and Gynaecology Forum (Vol. 22, No. 4, pp. 13-16). Sabinet Online.

[4] Hay-Smith J, Mørkved S, Fairbrother KA, Herbison GP. (2008) Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD007471. DOI 10.1002/14651858.CD007471.

[5] Mørkved S, Bø K. (2014) Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48:299-310 doi:10.1136/bjsports-2012-091758

[6] Brandao KL, Mottola MF, Gratton R, Maloni J. (2013) Bone status in activity-restricted pregnant women assessed using calcaneal quantitative ultrasound. Biol Res Nurs. 2013 Apr;15(2):205-12. doi: 10.1177/1099800411423807. Epub 2011 Oct 13.

[7] Salvesen KÅ, Hem E, Sundgot-Borgen J. (2012) Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes. Br J Sports Med. 2012 Mar;46(4):279-83. doi: 10.1136/bjsm.2010.080259. Epub 2011 Mar 10.

[8] Szymanski LM1, Satin AJ. (2012) Strenuous exercise during pregnancy: is there a limit? Am J Obstet Gynecol. 2012 Sep;207(3):179.e1-6. doi: 10.1016/j.ajog.2012.07.021. Epub 2012 Jul 20.

[9] Poudevigne MS, O’Connor PJ. (2006) A Review of Physical Activity Patterns in Pregnant Women and Their Relationship to Psychological Health. Sports Medicine – January 2006, Volume 36, Issue 1, pp 19-38

[10] Kramer MS, McDonald SW. (2006) Aerobic exercise for women during pregnancy. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD000180. DOI: 10.1002/14651858.CD000180.pub2.

[11] Goodwin, A., Astbury, J. and McMeeken, J. (2000), Body image and psychological well-being in pregnancy. A comparison of exercisers and non-exercisers. Australian and New Zealand Journal of Obstetrics and Gynaecology, 40: 442–447. doi: 10.1111/j.1479-828X.2000.tb01178.x

Tennis Elbow: Cause and Treatment

Tennis elbow is a type of tendinitis, with it’s name coming from the sport commonly associated with causing it.
In this condition there is inflammation of the tendon of the forearm muscles that extend (pull back) the wrist.
Many activities that involve repetitive gripping can aggravate the tendon structure.

Typically people have: pain over the outside of the elbow, inflammation on the outer tip of the elbow and extreme tenderness over the inflamed area.

People with a tennis elbow injury often find it difficult to pick up objects (especially heavy items) and grip or hold objects for an extended period.

20130416-095532.jpg

Movement is Life

Whether in sickness or health, you are committed to your body. You only get one. Time and time again, research suggests movement is the cheapest and most effective cure and prevention for musculoskeletal disease.

Musculoskeletal disorders are the leading cause of global disability, second only to psychiatric disorders. We go to extreme efforts to look after our possessions. Yet, collectively, we completely ignore our most valuable asset and resource – the body.

So get moving, and help share the message!

More info from the makers of the video at http://candmedic.wordpress.com/