People that come into our chiropractic clinic for treatment after lumbar disc herniation or disc bulging frequently have a history of pain which is worse in the morning and then improves after they’ve been up moving around for a bit.
Often they have some questions about what exercises and stretches they can do in the morning to make them feel better. We learned more about morning back pain in a disc – injured patient after the research of Michael Adams in the 1980s.(1,2) Adams referred to the “diurnal behavior of the disc” which mostly refers to the tendency for the discs to absorb moisture from the tissues around them overnight.
The discs soak up the fluids from the tissues around them while a person is recumbent in bed overnight. So in the morning when they wake up the outer layers of the disc are under a bit more tension, which we refer to as hydrostatic pressure.
In turn, the disc becomes a bit more plump, adding pressure to nerves and surroundingstructors.
So what should you do? Once you get out of bed you should not bend over right away. Try to keep your back straight or try stretching backward .
Next, use your hips to bend over the sink to brush your teeth.
A straight back using my hips to bend over.Bending at the lumbar spine causing lots of pressure on the lumbar discs
The above picture is a great way to cause sharp shooting pain in the morning.
Try to sit up straight or use a back support in the small of your back like in the picture above.
Sitting with a more normal curve in the lumbar spine helps take the pressure off of the lumbar discs and helps decrease pain.
A wrong way to sit
Sitting like this cause more disc pressure causing disc irritation. It can cause the disc to bulge more.
Discs are fatter in the morning because the absorb fluid overnight. So think of a jelly doughnut if the doughnut has more jelly its more likely to shoot out if you put pressure on it.
So remember back straight, stomach tight will help prevent lower back pain and help you heal if you have pain.
A weak core can increase your chances for lower extremity injury during exercise!
The core is important for your lower back and neck health for sure. It’s also very important for extremity health. If you have been dealing with an arm or leg injury (extremity) that has not been getting better with treatment, it might be good to add in some core exercise to improve outcomes.
Take Home Message from the study: A college freshman with dynamic postural control limb imbalances, decreased hip extension strength, or decreased core muscle endurance during bridging exercises is more likely to develop a lower extremity overuse injury.
This is a pretty cool picture. Can you believe the detail? The red in the picture is the muscle and the white stuff is the connective tissue is called fascia. A painful area in a muscle can be caused by damage to one or both of theses structures!
Ok, we’ve worked on any muscle imbalances, fixed any joints that needed fixing and now we’re working on running form. What’s next is everyone’s favorite: running shoes
Let’s talk about running shoes!
When I’m looking for a running shoe these are the things I look for:
Heel to toe drop:
This a zero drop shoe. That means the heel and toe are at the same level.
Here’s a large heel drop.
Now which one to choose?
You can not use a zero drop shoe if you were using a running shoe (with a large heel drop) like the one above your whole life. Doing that you would destroy your Achilles tendon and calves.
I would suggest using the lowest heel to toe drop you can tolerate. better to error on a bigger drop then lesser drop. You can always go lower the next shoe. This will lower your chance of soreness. Remember change can take time, don’t rush things
2. Where the shoe bends:
I like the shoe to bend where my big toe bends which is the “knuckle” part of the big toe. It only makes sense that the shoe bends where the body bends.
3. The toe box:
The toe box is the space around the toes. Take your foot out of the shoe or sneaker and take a look. I bet it does not look like your shoe. Most people don’t have elf shaped feet.
A big toe box gives more room for your foot and toes. The second picture is an insert( black one) from a shoe with a big toe box. My foot does not spill over the insert(green one) like the first picture.
If you have any question please call the office! Or you could bring your shoe in and we can go over it in person.
I’m going to do a multi-part blog on running and running shoes! Running and advice on the proper shoe are topics often brought up in my clinic so why not share for easy reference?
Starting with part one:
Here one question I get often: I’m going to start to run to get in shape, so what brand (x) of running shoe?
There so many variables that go into the question. Your biomechanic faults/deficiencies, anatomical variants, the current level of your strength, the current level of fitness, what is your running form/style. Plus add in what you do for a living. A construction worker has different stress on the body then a person who sits at a desk all day.
In my opinion, it’s better to start with yourself. First, improve your body and then work on your running mechanics. After, try to find the best style of running shoe based on comfort.
I like to take a “ground-up” approach. The first thing to do is to make your foot and lower extremity better. Fixing any joint dysfunction and then working on making your body stronger and more flexible is a great start.
Next is to improve your running form. I would video record the person running and make any necessary correction. RUNNING is a SKILL and will need to be practiced.
After doing all of the above, the patient will be less likely to get injured. Plus it will be easy to find the right running shoe.
When Is Standing Too Much? The new craze in standing at your desk has many asking if standing is for them, and how long should they stand for? Does everyone need a standing desk?
Standing can help with neck and back pain if done correctly!
If you get a sit to stand desk don’t start standing for 8 hours right away.
Most start at 15-20 mins within the hour in the beginning then it grows to 4-6 hours per day after 30 days. Start off slowly- taking breaks. Listen to your body. The flat surface and flat shoes (no heels!) Weight distribution right below hips and arms at a right angle looking straight ahead and slightly down.
The human body is designed to sit and stand throughout the day. There are many ways to get your standing throughout the day without the need for a sit-to-stand option.
• Sit-to-stand options can be useful and make the ability to stand more readily available.
As with most things in nutrition, there’s no simple answer. Your individual needs will depend on your health, body composition, the main goal you have, and level of physical activity (type, intensity, and duration). Even when taking all of this into account, you’ll end up with a starting number, which you’ll need to adjust through self-experimentation.
Daily requirements are expressed in grams of protein, either per kilogram of body weight (g/kg) or per pound of body weight (g/lb).
If you’re of a healthy weight and sedentary, aim for 1.2–1.8 g/kg (0.54–0.82 g/lb).
If you’re of healthy weight, active, and wish to keep your weight, aim for 1.4–2.2 g/kg (0.64–1.00 g/lb). Try for the higher end of this range, as tolerated, especially if you’re an athlete.
If you’re of healthy weight, active, and wish to build muscle, aim for 1.4–3.3 g/kg (0.64–1.50 g/lb). Eating more than 2.6 g/kg (1.18 g/lb) is probably not going to lead to greater muscle gains, but it can minimize fat gains when “bulking” — i.e. when eating above maintenance in order to gain (muscle) weight.
If you’re of healthy weight, active, and wish to lose fat, aim for 2.3–3.1 g/kg (1.04–1.41 g/lb), skewing toward the higher end of this range as you become leaner or if you increase your caloric deficit (hypocaloric diet).
If you’re overweight or obese, aim for 1.2–1.5 g/kg (0.54–0.68 g/lb). You do not need to try to figure out your ideal body weight or your lean mass (aka fat-free mass). Most studies on people with obesity report their findings based on total body weight.
If you’re pregnant, aim for 1.66–1.77 g/kg (0.75–0.80 g/lb)
If you’re lactating, aim for more than 1.5 g/kg (0.68 g/lb)
If you’re vegan or obtain most of your protein from plants, then protein requirements may be higher due to the inferior protein quality (both the EAA profile and bioavailability) of plant-based proteins relative to animal-based proteins.
We want to say a huge congratulations to one of our amazing patients! Bob recently completed the “Strolling Jim” UltraMarathon. This race included 4,000 feet of elevation, 4,000 feet of decline and a total of 41.5 miles! What an accomplishment, Bob! We are so proud of you!
We also received the message below from Bob after his race. We are so glad we could be a part of your journey. 🙂
“Thank you to Dr Steve and Nickie for, without whom, I could not have achieved my goal of finishing my latest UltraMarthon of over 40 miles and 4000 ft elevation AND 4000 of decline. Thank you Dr and Nickie!!!!!”
If you’re training for a race Dr. Steve can help! Call the office and get race ready!
Here’s a great exercise to help strengthen the Gluteus medius.
“Myofascial pain syndrome (primarily involving the gluteus medius) is present in the majority of patients with LBP (73%) , sciatica (50%), and LBP with sciatica (85%).”
