Tag Archives: chiropractor

Running Injury Prevention Strategies Part 1

Running has become one of the most common forms of physical activity in today’s society. It can be a community building activity, a personal challenge and most importantly a great work out. It is a sport that everyone can participate in; all you need is a good pair of shoes and a little motivation. That being said running can be extremely hard on your body, especially when you are just starting.  We are finding that injuries among runners are very common. From shin splints to rolled ankles, no one is immune from getting hurt; however, here are some tips to keep you healthy and on pace.

Photo by RUN 4 FFWPU

Do not do too much, too fast

            When runners are just starting and begin to make progress, they tend to push their limits. Although this is a great way to challenge yourself, it is important that you understand your body has a threshold that when exceeded results in injury. Your mileage should be tracked on both a daily and weekly basis. If you have never done much long-distance running, then your weekly mileage should begin quite low. It is important that as you improve your mileage increases gradually. A consensus among the running community is the rule of 10%. Do not increase your mileage by any more than 10% on a week to week basis. For many runners and new runners specifically, 10% may even be too much of a jump. This is why when preparing for a distance race, whether it is a 10k, half marathon or a marathon it is recommended you start as early as possible. Could you train and complete a half marathon in 6 weeks? Maybe, but the toll it could take on your body and the injury risk you are exposing yourself to are likely not worth it. A recent study showed that runners who only increased their mileage by 3% a week had a much higher rate of success in their upcoming races than runners who ramped up their mileage quicker.

            So how do you know where to start? First, start with walking. If you can walk an hour a day with out any injury you may start running. As a new runner, start with short runs and accumulate miles over the week. It is important to understand how far you have been running, so I recommend using an app on your phone such as “Map My Run” to help track each run. Personally I have a Garmin GPS watch , that links to Garmin connect. Garmin connect is an app. Most GPS watches can be linked to an app.

Photo by Mateusz Dach

Do not run through significant pain

            As runners, we all understand some discomfort is a part of the sport. Your legs and feet will likely be sore after a long run; however, if you begin to notice significant pain or discomfort while running consider taking a break. Breaks are one of the hardest things to convince a runner of doing, but it could save you from more severe injury. Aside from the odd rolled ankle, very few running injuries are acute and traumatic. Far more commonly runners ignore the pain and “tough it out” when they begin to feel discomfort.

This can result in a cumulative injury cycle. What is that you might ask? It means if you continue to stress an injury by running, you will continue to make it worse and it can become a much more significant issue. Sometimes all it takes is an extra day off when symptoms are minor to allow your body to recover. This is important because if you have an injury, it is very common for your body to adapt by altering your gait (running pattern).

This may lead you to be less efficient, develop bad habits or in a worst-case scenario cause an injury elsewhere in your body. Remember, everything is connected, so if you are running with a limp the biomechanical stresses will be placed on a different part of your body. Give your body a chance to recover and if you think that an injury is nagging have a medical professional look at it. It is much more beneficial to have an injury taken care with a couple of sessions of treatment rather than letting it persist and having to deal with it when it is much more serious, and your recovery time is extended.

Photo by RUN 4 FFWPU

Call the office if you’re having pain. Do not tough it out! It could only get worse. We work with a lot of athletes and help them return to activity. Athletes looking to prevent injuries or perform better see us.

Tips While Working at a Desk part 2

  • Movement
    • Mini-water breaks throughout the day.
    • 10,000 steps per day.
    • The triple exercise
    • Micro break
  • Stress Management
    • Mindfulness at your desk by closing eyes, sitting in good posture and slow deep breathing a few times per day. All technology off for the moment.
      • Improves mood, productivity and stress management
    • Abdominal breathing instead of chest breathing.
The triple exercise

We are here to help you with any pain you’re experiencing!

Tips While Working at a Desk Part 1

  • Move in every aspect of your life, at home and work
  • Set the alarm every hour to perform some movement. 3-5 minutes in length.
  • Place a Lacrosse Ball under your legs, top of legs, between shoulder blades while at the desk.  
  • Light dumbbells at your desk for fitness snacking throughout the day.
  • Park at the farthest spot away to get more walking throughout the day.
  • Walking meetings are a great way to get movement and productivity.
  • Seated Exercise throughout the day three times per work day minimum.
    • Seated Cat and Cows
    • Seated Twists
    • Neck Ranges of Motion
    • Shoulder Rolls
  • Find an accountability buddy.
  • Strategically plan your traveling to take your workouts with you.

More people are working from home now more than ever. If you are experiencing pain since this big change please give our office a call. We are here and ready to help!

Managing Neck Pain and Headaches Part 3

Neck pain and Headaches are a very common issue in our society, and understanding the causes and prevention of them will go a long way to leading a healthy and pain free life. In this educational summary, we discuss some of the most common conditions we see in our office. Below we will discuss the following neck-related pain conditions.

  1. Upper Crossed Syndrome
  2. Headaches
  3. Neck Sprain/Strain
  4. Disc Pain
  5. Cervical Radiculopathy
  6. TMJ Dysfunction

Potential causes of Cervical Discogenic Pain Syndrome

  • Direct trauma – falls, motor vehicle accident, whiplash, sports injury
  • Overuse, fatigue, repetitive microtrauma – over hours, days, months of the same position
  • Postural – can be either an intrinsic postural problem (e.g. loss of cervical curvature) or an extrinsic postural problem (e.g. prolonged stressful position, protruded head posture).
  • Sudden unguarded movement.
  • Degenerative disc disease.

Symptoms of Cervical Discogenic Pain Syndrome

The symptoms will vary depending on whether the condition is caused by a herniated disc or by a degenerative disc. With a herniated disc, some people will not experience pain in the neck but will have radiating pain, tingling, and numbness down the arm or around the shoulder blade due to pressure put on the nerve root. Discogenic pain due to an injury can result in immediate pain or pain shortly after the injury. Headaches (usually cervicogenic) can also result from cervical disc pain.

Treatment of Cervical Discogenic Pain Syndrome

Treatment for cervical discogenic pain will depend on the clinical presentation. Conservative treatment can successfully manage many cervical disc herniations. Initial treatment will focus on controlling pain and inflammation. Once pain and inflammation have decreased, early rehabilitation will help prevent chronic pain and disability. This will consist of osseous manipulation, soft tissue therapy, activity as tolerated, and pain-free range of motion exercises. Late rehabilitation will be administered as the condition improves and will include stabilization exercises, patient education, and postural training. Education in proper training, biomechanics, and a home exercise program will help strengthen the spine and decreases the likelihood of future injury. If you fail to respond to conservative treatment, or in cases of severe pain, diagnostic imaging (x-ray, MRI) will be warranted, and an orthopedic consult may be necessary.

Cervical Radiculopathy

Cervical Radiculopathy is a dysfunction of the cervical nerve roots resulting in various neurologic findings. The cervical spine consists of seven cervical vertebrae and eight cervical nerve roots. Cervical radiculopathy can result in pain, numbness, or weakness and though the problem occurs at the nerve root of the cervical spine, these symptoms will often radiate to parts of the body controlled by that nerve. The seventh (C7) and sixth (C6) cervical nerve roots are most commonly affected.

In younger patients, cervical radiculopathy is usually the result of a disc herniation or an acute injury causing foraminal impingement of the exiting nerve. In the older population, cervical radiculopathy is usually due to foraminal narrowing from osteophyte formation, decreased disc height, or degenerative changes. In elderly patients with osteophyte formation, repetitive neck movements may result in a more insidious injury. Cervical radiculopathy due to sports injuries can result from several mechanisms. Typical these injuries occur from forced extension, lateral bending, or a rotation mechanism, which closes the foramen and results in the exiting nerve root being injured.

Risk Factors for Cervical Radiculopathy

  • Heavy manual labor requiring lifting more than 25 pounds (especially repetitive activity)
  • Driving or operating vibrating equipment
  • Smoking
  • Collision sports (e.g. football, hockey)
  • Prior injuries, degenerative disc disease/osteoarthritis

History and Symptoms of Cervical Radiculopathy

The condition may follow a neck injury or be of insidious onset, and there may be a history of multiple episodes of previous neck pain or arthritis of the cervical spine. The pain may range from deep aching to severe burning neck pain. Usually, the pain will be referred to the shoulder blade, which might be described as shoulder pain. If the radiculopathy progresses, radicular arm pain (“sharp, shooting, electrical”) or sensory changes (“numbness, tingling, loss of sensation”) may develop down the arm and into the hand. Arm symptoms will depend on which nerve root is involved. Occasionally, a motor weakness may develop of the shoulder or arm. Certain neck positions which cause increased foraminal narrowing may increase the pain. The symptoms may be relieved by lifting the arm over the head which decreases the tension at the nerve root.

Treatment of Cervical Radiculopathy

Initial treatment will focus on reducing pain and inflammation and prevention of further neurological loss. The focus will also be on centralizing (reducing) any radicular symptoms by decreasing nerve root compression and pressure within the herniated discs. This will consist of manual traction and pain-free active non-resisted ranges of motion while avoiding positions that increase neck and arm symptoms. A cervical pillow at night can be helpful in maintaining the neck in a neutral position and limiting head positions that cause foraminal narrowing. Electrotherapy modalities may be used to help reduce any associated muscle pain and muscle spasms. Once pain and inflammation have decreased, therapy will progress to restore full range of motion and mobility of the neck and shoulder. This will include muscle stretching, strengthening and proprioceptive training, and corrective exercises as tolerated. Cervical manipulation and soft tissue therapy may be administered as tolerated and as long as it does not cause an increase in symptoms. If you fail to respond to conservative treatment, or in cases of severe neurological loss, a secondary consultation with a neurologist or neurosurgeon will be recommended.

TMJ Dysfunction

“I’ve got TMJ”  It’s a pretty common statement which is a bit of a misnomer.  Everyone has TMJ.  Why?  The TMJ is the tempo-mandibular joint(TMJ).  We all have it.  What people are probably trying to say is that they have TMJ disorder, aka pain and dysfunction of the jaw while opening or closing your mouth.

What happens is the mandible (your jaw) connects to the rest of your head at the temporal bone.  It’s a hinge joint that pivots through a cartilage disc called a meniscus in between the two bones of this joint.  Unfortunately, it’s a common place for the TMJ to become subluxated or in other words, a little bit dislodged.  After that, you can get overuse and degeneration of that joint.  One way to tell if you have this disorder is to open your mouth and measure, can you open your mouth the height of 3 fingers for your hand?  If not, you might have TMJ disorder.

The main physical causes of this condition are:

  • trauma
  • overuse from a commonly chewing on one side of your mouth
  • keeping the mouth open for extended periods of time (like at the dentist)
  • improper bite
  • grinding

From a physical standpoint, the best way to prevent TMJ disorder is to wear proper mouthpieces while playing sports, wearing mouth guards while sleeping, making sure to chew food evenly on both sides of your mouth, cutting tough meats and other foods into small pieces and minimizing gum chewing. Having better posture also improve the alignment of the TMJ.

Managing Neck Pain and Headaches Part 1

Neck pain and headaches are a very common issue in our society, and understanding the causes and prevention of them will go a long way to leading a healthy and pain free life. In this educational summary, we discuss some of the most common conditions we see in our office. Below we will discuss the following neck-related pain conditions.

  1. Upper Crossed Syndrome
  2. Headaches
  3. Neck Sprain/Strain
  4. Disc Pain
  5. Cervical Radiculopathy
  6. TMJ Dysfunction

This will be a multi part series, going over the list above.

Upper Crossed Syndrome

Upper Crossed Syndrome describes a type of common muscle imbalance. This occurs when the neck flexors and the middle back become weak while the pectoral muscles and the muscles at the base of the skull become tight.  This produces a familiar pain pattern at the base of the neck and the shoulders, as well as joint dysfunction at the base of the skull and shoulders.

The main physical causes of this condition are:

  • Desk job
  • Too much sitting
  • Driving long hours
  • Poor posture

However, with the proper education, you can protect yourself from many of these causes. The primary sufferers of this condition, especially chronic cases, often have poor posture while sitting at a desk for most of the day. A comorbid factor is a sedentary lifestyle with little physical activity. This poor sitting posture leads to a re-enforcement of the Upper Crossed Syndrome, and it is crucial that you arrange your workstation to facilitate a proper posture as best as possible.

The best way to combat this problem is, of course, to prevent it before it starts. If possible, minimize sitting for long periods of time and take frequent work breaks to take short walks around the office to reset your posture.

If the problem has already begun, Dr. Steve can teach you proper form and posture to prevent this problem in the future so that you are more mindful of the positions that can promote this problem. I am also trained in soft tissue techniques that will be able to relax your tight muscles, restore motion and reduce pain levels. There are also methods of rehabilitative exercise that can be taught to you to reverse any damage already done and prevent a progression of this condition, as well as instill healthy habits for you to employ for the rest of your life.

Headaches

Headaches come in many varieties, and nearly everyone experiences this type of pain at some point in their lives. The common symptom of all headaches is of course characterized by pain. Different types of headaches cause pain in different regions of the head and have unique pain sensations. Some portion of people experiencing headaches can be characterized as migraines. Migraines often feature symptoms such as nausea, vomiting or sensitivity to lights.

The physical causes of this condition are extremely numerous, but some of them are:

  • Allergies
  • Stress
  • Poor posture
  • Diet & exercise habits
  • Hormonal imbalance
  • Smoking

Since there are so many different types of headaches, as well as causes and symptoms, it is important to get a proper diagnosis so that you can better treat the cause. An assessment of your lifestyle habits is an effective way to diagnose common contributing factors that may be causing your headaches. For example, addressing your sleeping habits, making sure you get the proper amount of sleep and making sure you are getting restful sleep. A proper, healthy, balanced diet that is free of any substances that you may have a sensitivity to or may be a trigger for headaches is important for managing this condition as well. Posture and body habitus can be huge contributing factors and may be some of the simplest to diagnose and manage. Treatment such as soft tissue modalities as well as chiropractic adjustments coupled with posture analysis and correction can be a simple and effective way of managing headaches of this type.

Next week we will have more on this subject! In the meantime please call the office if you have neck pain or headaches that we can help you with!

Cost of Muscle Wasting after the age of 30: Top 10 List

Did you know that we lose 1-1.4% of muscle mass/year & 3% of our strength/year starting at the age of 40. Anyone who has turned 40 know this but in a different way.

Here’s some examples:

  • If I look at a cookie I gain weight
  • I don’t feel as strong as I once was
  • I’m more tired then I used to be.
  • I gain 5lbs a year with no major change in my diet
  • My clothes don’t seem to fit right
  • I don’t look good in the mirror
  • I get sore and tired from normal actives around the house
  • You see your Medical Doctor & they tell you that you have Arthritis & to just learn to live with it
  • The medical Doctor says it’s “Wear & tear” which is ironic because you’ve been sedentary. (Study after study shows exercise help arthritis and decease pain. Doing exercise correctly does not cause pain)
  • The MD say’s if you can’t live with it we’ll give you pills. You start taking NSAIDs which ⬆️ heart disease 30-40%
  • Now you’re getting desperate. Everyone  promises a quick fix – you reach for experimental things like stem cells. Treatments with side effects like steroids & you’re getting more & more depressed
  • Next you’re getting scanned (MRI/C.T).  Nobody has addressed the fact that you’re weak.  That you don’t have strength. All they are talking about are the tissues which are the victims
  • The next step is that they recommend surgery

How do you fix & reverse this?

Good question. It’s simple!

30m/day of general activity – choose whatever you like – hiking, waking the dog, swimming , biking or yoga & most importantly 2x/week resistance (strength) training

Come in or call the office and We could help you find the exercise that are the best for you.

Should Pain be Expected when Expecting?

Pregnancy is a span of time in which a woman’s body undergoes many changes, some changes being more comfortable than others.

Although we often picture pregnancy as a wonderful expectation in the growth of new life, the physical changes a woman’s body goes through can feel anything but miraculous. Over 50% of pregnant women report their biggest complaint during pregnancy is low back pain, sometimes lasting over 3 months!  Additionally, up to three-fourths of women will experience low back pain at some point during their pregnancy.1,2

Add to this pelvic girdle pain, which is experienced by up to 20% of women at some point during pregnancy,3, and it’s no wonder that pregnancy can be physically exhausting!

Although pain is usually experienced sometime between the fifth and seventh month of being pregnant, it can begin as soon as eight to twelve weeks after becoming pregnant.2

And as the fetus grows, a woman’s center of gravity changes to accommodate, shifting forward to accommodate for the growth of the baby.  The abdomen stretches, and the woman’s belly moves forward and out accordingly to increase in the baby’s weight and development; so, too, does the shift in gravity of a woman’s weight3 on her low back, pelvis, knees, ankles, and feet.

In fact, the thoracic (mid-back) and lumbar (low back) spine curvature can change during pregnancy, causing an increase in pain in the low back and pelvic regions.  This can also cause alterations to balance and gait patterns.3  Think of the pregnant “waddle” that some women do while walking, and you have an idea as to the changes that take place in the abdomen, low back, pelvis, and sacrum!

This can, and often does, place additional stress and strain on the joints in the low back and posterior pelvis, known as the lumbar and sacroiliac areas.  These postural changes lead to increased pain, muscle tightness, tenderness, and discomfort.2  Pregnancy can even lead to changes in the curvature of the woman’s spine.

Low back and pelvic pain can also be major deterrents in a woman who could, and would, be otherwise motivated to continue working and taking care of both herself and her home.  Pain has shown to influence pregnant women’s daily lives in the challenges they encounter concerning their physiological, psychological, occupational, and social functions.4

And it doesn’t always stop there.  Sometimes women can experience low back and pelvic region pain the year after birth, and even up to three years after labor and delivery.1,5  Pregnancy-related low back and pelvic pain, as well as post-partum mechanical spinal disorders, are not only common, but they can impede recovery, nursing, and caregiving – three very important components in taking care of the newborn after labor and delivery.5

How will a pregnant woman know if her pain is being caused by her pregnancy?  What is pregnancy pain like?  Some women describe it as a deep discomfort.   Others describe it as stabbing, continuous, recurrent, and intense.6  The discomfort can also vary in intensity; some days can be more difficult than others, and there may be times when the pregnant woman feels like even basic tasks are difficult to do.

Where might pregnancy-related pain be felt on the body?  For some, the pain occurs anteriorly, or in the front, by the pubic bone.  Others may feel discomfort directly at the low back above the gluteal area – sort of around the beltline.  And for others still, the pain also occurs between the hip bones and the gluteal fold. 

Sometimes this discomfort even travels down the back of the thigh to the knee and the calf6, or even down to their feet.2,7   Most women say that their pelvic and low back pain is more intense during pregnancy than after labor and delivery, and it is still physically limiting as it may cause a pregnant woman to withdraw from activities that she would normally gravitate toward, such as social interactions or work.6

Since pregnancy can drastically change a woman’s body in such a relatively small period of time with lasting effects, how can chiropractic care help with physical changes encountered during pregnancy, especially ones that contribute to pain?

While a chiropractor cannot help with changes in hormones that naturally occur with fetal growth, the resulting biomechanical changes that occur in a woman’s body during pregnancy can be lessened or alleviated by the help of a knowledgeable chiropractor.

A chiropractor who is well-versed in addressing pregnancy-related issues will be able to accurately assess, diagnose, and treat low back pain and pelvic girdle pain.

Some options for treatment include chiropractic spinal manipulation, soft tissue therapy, exercises, and ergonomic advice, as well as encouraging regular visits to her obstetrician.  Treatment could improve functional activities such as sitting, traveling comfortably in a car, walking, and more.3  And, addressing this discomfort sooner rather than later is preferred, especially if employment or maternity leave is a concern.  Low back pain is the most common cause of sick leave after delivery!7

Maintaining optimal function and reducing pain levels to more manageable levels are goals that should be discussed with a doctor of chiropractic as well as an OBGYN when it comes to pregnancy-related pain.2  A detailed history and clinical examination are essential for determining what biomechanical source is causing a pregnant woman’s low back or pelvic pain.6 

A knowledgeable chiropractor will be able to accurately assess changes in pelvic positioning, curvature changes in the upper and lower back, stress on the lower back including muscle tension and tightness in the lumbosacral area, and any radiating (shooting) pain that can travel from the low back into the legs or lower extremities.

A chiropractor can also help identify any areas of stiffness7 that may accumulate in weak areas of the body8, contributing to an increase in back pain during pregnancy.  This may be the case if poor posture, excessive standing, and bending over trigger or escalate any back and pelvic pain.

Low back pain and pelvic pain do not have to be an inevitable part of pregnancy.  If you are one of the 50%+ of pregnant women experiencing pain during your pregnancy, there are options for treatment available to help make your pregnancy more comfortable and productive!

Even as your body changes, a well-trained chiropractor will be able to give you conservative management options for your low back and pelvic pain.  Your doctor will work with your OB/GYN to make sure that your options for treatment are safe and effective.

References

  1. Yoo, H., Shin, D., and Song, M. (2015). Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J Phys Ther Sci. 2015 Jan; 27(1): 279–284.
  2. Montgomery, S.P. “Management of back pain during pregnancy.” (2009). Retrieved March 2020 from: https://www.spine-health.com/conditions/pregnancy-and-back-pain/management-back-pain-pregnancy
  3. Verstraete, V.H., Vanderstraeten, G., and Parewijck, W. (2013). Pelvic Girdle Pain during or after pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn. 2013; 5(1): 33–43.
  4. Bernard, M., and Tuchin, P. (2016). Chiropractic management of pregnancy-related lumbopelvic pain: a case study. J Chiropr Med. 2016 Jun; 15(2): 129–133.
  5. Maiers, M., et al. (2018). Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap. 2018; 26: 26.
  6. Katonis, P., et al. (2011). Pregnancy-related low back pain. Hippokratia. Jul-Sep; 15(3): 205–210.
  7. Sabino, J., and Grauer, J.N. (2008). Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008 Jun; 1(2): 137–141.
  8. “Back pain during pregnancy: causes, treatment and prevention.” American Pregnancy Association. Retrieved March 2020 from: https://americanpregnancy.org/pregnancy-health/back-pain-during-pregnancy

Working from home?

Are you working from home because of the Corona virus?

It’s a great feeling to accomplish work from the comfort of your kitchen table. While working from home can help avoid some of the headaches of a regular workplace — such as long commutes and inflexible work hours — it can still cause its own discomforts, especially if you’re using a laptop.

Imagine slaving over a hot keyboard from your kitchen table, doing work while sprawled on your bed, or hunched over a coffee table from your couch. It’s no wonder that  injuries and pain can happen just as commonly at home as it does from the workplace!

Working at home should be a comfortable, productive experience. With our training, we can identify habits and poor work setups that could cause you pain while you work at home. We help you so you can remain productive anywhere… even in your pajamas.

What do you imagine when you think of an office workspace? Many people envision designated cubicles, desks, coworkers, the proverbial water cooler, and computer setups with keyboards and mouses.

However, when you think of a home workspace, you may picture something else entirely: a kitchen table, or sitting in the familiar indentation on the couch or being flopped on a bed with a laptop and notebook nearby.

It is important to consider that working from the comfort of your home is not always comfortable. When we ask our patients that work from home to describe their workstation setup, very few tell us that they have a separate home office with a desk. 

Good ergonomics isn’t limited to the usual 9-to-5 workday. The same practices that can help avoid aches and pains at the workplace can be applied to your home office, too!

The most important tip that we can offer when working from home is to have a designated workstation with a comfortable office chair. Having the right setup will allow you to work productively, pain-free, and more easily while you work in the comfort of your home.

If so, I want to take a moment to look at your home office space.

If your workspace involves hunching over the coffee table with a too-low laptop and a sprawl of spreadsheets everywhere, then we need to talk!

Working at home should be comfortable, flexible, and beneficial to your time and energy. It shouldn’t be a source of pain.

If you’re not sure how to design a good office space within the comfort of your home, don’t worry. We can help.  Give our office a call, and our trained doctors of chiropractic can help review your workspace and make recommendations that work best for you and the space you have!

Laptops are fantastic for their lightweight portability. Unfortunately, the features that make laptops so versatile can also cause other issues!  Keyboard spacing, screen size and positioning, and pointing devices are all poorly designed when it comes to laptop computers, creating issues in your neck, upper back, lower back, and even hands. 

Furthermore, it is nearly impossible to have good posture when using a keyboard fixed to a laptop! Because the keyboard and the monitor are attached to each other, it is a challenge to sit ideally when working.

One tip is to have an adjustable office chair to get the proper body positioning and height when sitting, especially if your laptop rests on a surface that is not height adjustable. Put the laptop on a stand, so the screen remains at eye level to reduce neck strain, and if possible, use an attachable keyboard instead to give your wrists and forearms more support while typing.

For more tips, give our office a call.  We are well-versed in helping you prevent injuries, whether it’s at the workplace, your home office, or your local productive coffee shop!

Preventing Lower back pain Part 3

Body Preparation and Positioning

Sternum Up– Keeping the sternum up automatically sets the body into the good posture and maintains:

Neutral Spine: Maintaining good spinal alignment decreases the stress placed on the spine and discs.

Hip Hinging: Bending at the hips, and not the low back, decreases the stress placed on the low back and increases strength & power.

  1. Squating- The zone that will optimize lifting strength and injury reduction.

a. Bend your elbows at a 90-degree angle, and you are in the “Primary Power Zone.”

b. The area up to the shoulders and down to the hips is acceptable.

c. The more you can work in the “power zone” the less fatigue on your body

  • Abdominal Bracing- When all of your core muscles work together, a “Super Sti­ffness” occurs, and all three layers of the abdominal wall are activated to protect and stabilize the spine and discs.
  • Without bending forward, contract the abdominal muscles (like you are about the get punched in your gut – feel them tighten with one hand) and the buttock muscles (as if you are holding in a bowel movement). You will feel the lower back muscles contract (with the other hand) when you contract your abs and buttocks. Activities of Daily Living

Optimal Activities of Daily Living Considerations

The below images and descriptions were resourced from The Journal of Bodywork and Movement Therapies (2004) 8, 85–87 written by Craig Liebenson, DC

These are a sampling of some daily activities that you may encounter. We encourage you to practice and apply the body preparation and positioning described above. The Sternum Up, Power Zone and Abdominal Bracing should be utilized to protect and spare the spine.

Hip Hinge

  • Keep the spine upright by hinging from the hips as you bend your knees
  • Maintain all three points of contact as you move to an upright position

Going from Sit-to-Stand

  • Start in a seated position at the edge of your chair with your feet under your thighs before sitting up
  •  To initiate movement begin upward movement by using your hips and knees
  • To avoid strain to your back, keep your torso upright when rising from the chair.
A: Correct way B: Incorrect way

Picking up a bag of the ground

  • When picking up a bag from the ground, bend from the hips and knees.
  • Make sure to keep the back flat and keep lower back’s natural curve by keeping it curved forward while bending.
  • When lifting, initiate the movement by keeping the back flat while extending with the hips, and tightening the glutes.

Brushing your teeth

  • Keep your chest upright while brushing the teeth.
  • When you bend forward to rinse your brush or mouth bend from the hips, not from the waist.
  • Keep your chest lifted while you bend forward.

Changing a diaper

  • Before changing your baby ensure that you have a changing station that is the appropriate height.
  • If it is too low (below your waist), you will be forced to bend forward from the waist.
  • The correct height is approximately waist high and allows you to maneuver your baby without having to bend much.

Picking objects from ground

  • When lowering to pick up the object, bend from the knees and keep your chest lifted.
  • When lifting keep your spine upright by hinging from the hips and knees.
  • If the object is not directly in front of you, it is important to keep your chest lifted in front of you while keeping your lower back’s natural curve.
  • Avoid lifting immediately after sitting for a prolonged period.
A: incorrect B: correct

Lower back Pain Part 2

More common conditions

Lumbar Disc Disorders

The lumbar spine is made up of five bone segments called vertebrae. In between each vertebra are flexible intervertebral lumbar discs, which act as shock absorbers for the spine. The intervertebral discs are composed of two components, a tough outer ring of fibrous tissue called the annulus fibrosis, and a jelly-like center inside the annulus fibrosis called the nucleus pulposus. The structure is then held together by ligaments on the front and the back of the vertebrae. Additional support is provided by muscles of the trunk.

In most cases, lumbar disc disease is the result of a normal aging process called disc degeneration which causes structural changes in the normal disc. As we age, the disc begins to lose fluid and become dried out causing the disc to compress. This may lead to the breakdown and degeneration of tough outer ring of the disc (annulus fibrosis) allowing the inner core (nucleus pulposus), to bulge out. This is considered a bulging disc. This puts pressure on the outer ring of the disc, which may cause low back pain. As further degeneration of the disc continues, or with continued stress on the lumbar spine, the inner jelly-like core may rupture out from the outer ring causing a ruptured, or herniated, disk. Once the inner nucleus herniates through the outer ring, pain in the lower back may improve.

However, the fragmented disc material can inflame or put pressure on the spinal nerves leading to an increase in sciatic leg pain, weakness, numbness, or changes in sensation in one or both legs. Most disc herniations occur at the lower lumbar spine at L4-L5 and L5-S1 levels. Occasionally, severe trauma can cause a normal disc to herniate or may cause an already herniated disk to worsen.

Risk Factors of Lumbar Disc Disorders

  • Age and Gender – the highest incidence in men between the ages of 30 and 50.
  • Obesity – being overweight puts added stress on lumbar discs.
  • Sedentary lifestyle – lack of exercise and poor core body strength.
  • Smoking – Smoking decreases oxygen supply to the discs causing more rapid degeneration.
  • Improper lifting – using your back muscles instead of your legs to lift heavy objects. Twisting while lifting
  • Posture – hyperlordotic lumbar curvature, anterior pelvic tilt (lower cross syndrome).
  • Repetitive activities that strain your spine – jobs that require constant lifting, pulling, bending, or twisting.
  • Frequent driving – staying seated for long periods and the vibration from the car can put pressure on your discs.

History and Symptoms of Lumbar Disc Disorders

Lumbar disc disorders may include one or a combination of the following symptoms:

  • Intermittent or constant lower back pain and pain in the buttock,
  • Leg and foot pain, numbness or a tingling sensation in the leg and foot,
  • Weakness in the leg and foot
  • Decreased reflexes in the knee or ankle
  • Changes in bowel or bladder function.

The symptoms will vary depending on if and where the disc has herniated, and what spinal nerve root is affected. Leg pain is usually greater than low back pain with disc herniations and nerve root involvement. However, if there are only annular tears without herniation, the pain will be localized to the low back and buttock. The onset of pain can be sudden or gradual after an injury. Pain may follow heavy lifting, twisting, or straining activities or repetitive stress trauma. However, patients may not recall a prior injury or a precise time the condition began because it is often preceded by frequent episodes of less severe low back pain that usually resolved. Pain is usually characterized by sharp, shooting, or electrical pain that may be aggravated by movement, changing positions, sneezing, coughing, or prolonged sitting and standing. The pain is usually relieved with rest and a recumbent position.

Treatment of Lumbar Disc Disorders

Conservative care should be your first course of treatment to manage lumbar disc disorders, but treatment will depend on the clinical presentation, your age, overall health, and tolerance to therapies. With disc herniations, the first few days of care will focus on centralizing (reducing) leg pain, decreasing inflammation, and preventing further neurological loss by decompressing nerve root impingement and reducing the disc herniation. Osseous mobilization and manipulation and soft tissue therapy may be administered as tolerated. Home care will consist of pain-relief repetitive positional exercises and lumbar stabilization exercises. We will also educate you on ways to protect your lower back, positions to avoid, and how to manage activity. In most cases, bed rest will not be recommended as the sooner you are up and moving, the better the prognosis. Once pain and inflammation have decreased, we will continue working on lumbar stabilization and progress into proprioceptive training. We will evaluate muscle imbalances using posture and movement patterns with the goal of restoring good biomechanics and core body strength. Your home care will emphasize the progression of stabilization protocols and corrective exercises. If you fail to respond to conservative treatment, or in cases of severe neurological loss, a referral for a surgical consultation will be recommended.

Lumbar stenosis

This condition occurs when there is a narrowing of the spinal canal in the lumbar vertebrae (low back). Often this results in compression of the spinal cord, which can lead to pain, numbness, discomfort and radiating symptoms. What the mechanism of this is occurring is usually caused by the degenerative changes of aging. However, there are other causes.

The main physical causes of this condition are:

  • Degeneration of the lumbar spine
  • Lumbar disc herniation putting pressure on the spinal cord
  • Osteoporosis
  • Dwarfism (achondroplasia)
  • Tumor

Degeneration of the spinal column is inevitable with aging and may reflect normal changes in an aging spine. It does not necessarily always result in lumbar stenosis but is often the most common cause.

While it is difficult or impossible to combat normal aging of the spine, there are some habits and tips you can use to reduce this condition related to the other causes. Reduce your chances of a lumbar disc herniation by learning proper bending and lifting biomechanics by utilizing your lifting power from your legs and not your back. As far as osteoporosis goes, make sure you are meeting your recommended calcium intake as well as incorporating weight bearing activities into your exercise routine (lifting weights). Post-menopausal women tend to be more susceptible to this condition and should ensure they are doing everything they can to prevent osteoporosis.