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Category: back pain

Physio FusionNewsback pain
By Physio Team back pain, chronic pain, Exercises, Home exercises, Injury, pain management, physical health, Physio, tendon , , , , , , , , , , , , , , ,

Piriformis Syndrome

Piriformis syndrome refers to the dysfunction of the piriformis muscle which irritates the sciatic nerve. It is characterized by deep buttock region pain that radiates down leg and foot often accompanied by pins and needles and numbness traveling along the path of the sciatic nerve.

The simplistic reason for this widely distributed pain comes down to the piriformis muscle itself – Their close proximity means that direct trauma to the buttock region or the supporting structures can result in inflammation and muscle dysfunction which can compress and irritate the sciatic resulting in referred symptoms.

Piriformis syndrome symptoms may include:

  • Localised deep buttock region pain
  • Pain with continuous sitting or standing for 15 mins or over
  • Pins and needles along the leg down to the outer foot
  • Numbness in outer leg or foot (often resolves on movements)
  • Deep squatting or bending
  • Pain on direct palpation

Anatomy

 

The piriformis muscle originates from the outer surface of a large fused bone of our pelvis called the sacrum. It travels adjacently and inserts into the top of the hip joint. The piriformis muscle is a very active muscle involved in stabilizing the hip and pelvis during majority of our activities (walking, running, standing, sitting or standing, turning in bed). When the piriformis muscle contracts it helps the hip rotate outwards (external rotation) and lift thigh out and up (abduct).

The sciatic nerve originates from where the very base of the spine and the sacrum join known as the lumbosacral region (lower back and saddle region). In this region five separate branches of nerves travel outside of the bony openings of the spine called the nerve roots and connect into a single large nerve – the sciatic nerve. It then travels through the pelvis deep into the buttock region close proximity the piriformis and gluteal muscles. In some individuals the piriformis muscles can travel through the piriformis muscle subjecting them to piriformis syndrome.

Diagnosis

There are no specific tests to diagnose piriformis syndrome. Diagnosis of piriformis syndrome is made by the report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

In cases where there is underlying pathology (such as disc injury, arthritis, sacroiliac dysfunction or hip injury) resulting in true sciatica – piriformis syndrome may develop to become an additional muscular dysfunction that is required to be addressed. Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Consultation with a physiotherapist in this case is highly recommended as they will perform a comprehensive clinical examination to identify the root cause of your symptoms.

Exercises for piriformis syndrome

Corrective exercises with a combination of strength and flexibility regimen is an essential way to treat true piriformis syndrome (without involvement of other underlying pathologies).

The exercises outlined below follow a phase-by-phase progressive regimen to strength key muscles of the hip, buttock and legs.

As you work through these exercises expect to feel some pain during and after your exercise. Pain you may feel during the exercise is an expected sign of muscle activity. Pain you may feel after the exercises is an expected sign of muscle healing and recovery. However, if you are unable to participate in the exercises due to symptom deterioration – it is highly recommended you consult your physiotherapist to rule out other potential causes.

Otherwise, to help you gauge the correct amount of pain you should expect during exercise – use this scale. The ideal range should be 2 to 5. If your baseline pain is over 6 or 7 – it is recommended that you consult your doctor for pain relief appropriate to manage your pain, followed by a consult with a physiotherapist. Your physiotherapist will be able to modify the following exercises or prescribe alternative exercises best suited based on your current level of function and symptoms.

Symptom noting – is a great way to keep track of your progress and symptom behaviour.

  • Take a diary
  • Note down pain before you begin the exercise.
  • Note down the pain rating after each exercise.
  • Note down pain at the end of the day
  • Repeat the pain recording process for the next 4-5 days
  • Examine the trend in your symptoms.

Interference with everyday tasks – Your participation or level of exertion with everyday activities may interfere with your symptoms impacting your exercise tolerance. It is therefore important to note any of these interferences’ contributory to your pain.

Phase 1 – is a beginner stage.

This phase is intended for gently priming muscle activation. It will demand your concentration on technique and compliance to change the possible compensation your body has been used to as a result of pain. This phase can last between 1-2 weeks.

Instructions:

3 sets of 10 repetitions. Hold each repetition for 8-10 seconds. Rest 10-15 seconds between sets, 30 seconds between exercises. Do this exercise 1-2 times per day.

Bridges

 

Lie on your back.
Bend both knees and place your feet flat on the bed.
Lift your buttocks from the bed.
Place your buttocks back on the bed.
Repeat this exercise and remember to continue to breathe properly.

Clam shells

 

 

 

 

 

 

Lie on your side with your feet, ankles and knees together.
Bend the legs a little and tighten your core stability muscles.
Keeping the feet together, lift the top knee up.
Make sure you don’t roll your body back with the movement.
Control the movement as you bring the knee back down to the starting position.

Phase 2 – intermediate stage

The intermediate phase is similar to the beginner stage with the difference of using changing elements of progression to challenge the muscles capacity further. In this stage you may choose to progress the exercises by choosing to change ONE factor:

  • Increase repetitions
  • Increase hold time
  • Increase sets
  • Add appropriate resistance

Instructions:

  • 3 sets of 10-15 repetitions. Hold each repetition for 10-15 seconds.
  • Rest 10-15 seconds between sets, 30 seconds between exercises.
  • Do this exercise 1-2 times per day.

Bridges with resistance

 

 

 

 

 

 

 

Tie a resistance band around both thighs, just above your knees.
Lie on your back with your knees bent and legs hips width apart.
There should be tension in the band.
Raise your hips up into a bridge, keeping the knees hips width apart.
Control the movement back down to the start position, maintaining constant tension on the band.

Clams with resistance

Lie on your side and place a band above your knees, approximately an inch or two above the knee joint.
Bend your legs a little, keeping the feet in line with your back.
Use your core stability muscles to keep the body stable.
Keeping your feet together, lift the top knee up against the resistance of the band.
Ensure you stay on your side and do not roll your hips and your body back with the movement.
Lower the knee back down, controlling the resistance.

Phase 3 – advance stage

Body weight squats

Start position is standing straight with the arms out in front and bent at the elbows, the fists should be clenched and the palms facing inwards.
Move downwards into a squat position so that the knees are aligned over the toes and the heels are in contact with the floor, make sure the back is straight.
Keep the head and chest upright and the gaze horizontal.
Hold for 2 seconds and return to the start position.

Lunges

Stand straight with your arms to the side or on your hips.
Take a large step forwards on your affected leg, then drop your hips directly down between both feet, bending your hips and knees to a 90 degrees.
Push back up to the starting position, and repeat.
Make sure you take a large enough step that your front knee does not travel over your foot, and ensure your knee travels directly forwards.
Keep your body up straight throughout the movement.

Crab walks

Place a band around your ankles and gather some tension.
Side-step keeping constant tension on the band.
Make sure you do not bring your feet too close together and keep your toes and knees pointing forwards.

Phase 4 – return to activities

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Stretching

Do you always need to stretch the muscle? The answer is NO. While stretching is an important tool to improve muscle elasticity. You may not always need to stretch a muscle if it is NOT tight. Thus, stretching is recommended to be limited to areas you feel are TIGHT when you perform a given movement. Check the affected side and unaffected side – don’t need to stretch a muscle that doesn’t need to be stretched.

Seated piriformis stretch 

Start in a seated position.
Cross the symptomatic leg your ankle is resting on, to the opposite knee.
Apply gentle pressure to the knee as you lean forward, increasing the depth of the stretch.
Hold this position, you should feel a comfortable tension with no pain.

Pigeon stretch

 

Start on your hands and knees.
Cross the symptomatic leg underneath you, then lower your hips down to the ground.
Rest your body forwards on your arms.
You should feel a stretch across the buttock.

 

 

 

 

 

 

By Physio Team acute pain, back pain, body parts, bones, chronic pain, ergonomics, Exercises, good posture, hand and wrist pain, Home exercises, Injury, muscles, neck pain, pain, pain management, physical health, Physio, rehabilitation, repetitive stress injury, shoulder pain, sitting posture, Sprain, Uncategorized, WFH, Working from home , , , , ,

EASY STRETCHES DESK STRETCHES

Sitting at a desk working, studying or surfing the net for long hours at a time makes it extremely difficult to maintain proper posture. That’s because our bodies are not designed for hours of idle sitting. So as the clock gets ticking many of us have the tendency lean forward, slouch our shoulders and hunch our backs.

Unfortunately, this increases pressure on multiple areas in your body. This explains why most of us experience pain and stiffness in our neck, shoulders, back and in some cases your tailbone!

So what do I need to do you ask?

The answer is simple, STAND, MOVE AND STRETCH!

It sure does sound easier said than done, especially if you are pressed with time to complete set work tasks. BUT the good news is that stretching or moving is a buildable habit that can be easily implement as you work. It doesn’t take long!

For starters set an alarm to take micro 2–3-minute break for every 20-30 minutes. Use this time to stand up, walk over to a colleague, go for a toilet break, drink water or make yourself tea or a coffee.

Or try out these simple easy stretches while you sit or stand at your desk

So let’s get started!

SPINAL TWIST:

  • Sit up tall, relax your shoulders
  • Cross one leg over the other, then place your opposite elbow on your top thigh.
  • Take a deep breath and as you exhale slowly twist your body (not your neck) and look over your shoulder.
  • Hold for 10 seconds.
  • Slowly return to resting position and repeat on the other side.

BACK ARCHES

  •  Sit tall, set your feet flat on the ground hip-width apart.
  • Rest your hands behind your hips, then slowly arch your back as you gently tilt your head back.
  • If you experience pain or discomfort in your neck or tingling in your arms – do this stretch without head tilt.
  • Hold for 10 seconds, return to start and repeat

ARM REACHES 

  • Sit up tall with your feet flat on the ground.
  • Interlace your fingers and stretch your arms straight as you turn your palms up to the ceiling.
  • Hold this position for 10 seconds and repeat

SHOULDER CIRCLES

  • Sit or stand up tall, feet hip width apart
  • Relax your arms and shoulder, begin by rolling your shoulder backward in a circular motion.
  • Do this 5 times, repeat forward circles

NECK CIRCLES

  • Sit or stand up tall, with feet planted flat on floor
  • Slowly begin to roll your head in a clockwise position
  • Do this 20 seconds, then repeat in a counterclockwise direction

CHEST STRETCH

 

  • Stand close to wall or a door frame
  • Place your forearm in a 90-degree angle at shoulder height.
  • Take one step forward on the leg closest to the wall and slowly rotate your chest away until you feel a stretch across your chest.
  • Do not hunch or round your shoulders.
  • Hold the stretch for 20 seconds, repeat
  • Do this both for both sides

BACK EXTENSIONS

  • Stand with your legs at hip width apart and straight.
  • Place your hands on your hips.
  • Lean your body backwards, trying to arch in the lower back as much as you can, lifting your chest up towards the ceiling.
  • Try to avoid allowing your hips to swing forwards too far.
  • Hold this position for 10 seconds, return to start position & repeat 5 times.

 FLOOR REACHES

  • Sit on a chair with upright posture
  • Slowly bend forward to plant your hands on the floor.
  • Hold for 10 seconds, return to start

SHOULDER BLADE SQUEEZE

  • Start in an upright position.
  • Practice bringing your shoulder blades back and down.
  • Picture gently drawing your shoulder blades towards the centre of your lower back.
  • This is a subtle movement, ensure you do not over strain your shoulder blades when performing this action.
  • Hold for 10 seconds, repeat 3-5 times

SHOULDER BLADE STRETCH

  • Clasp your hands together and hold them in front of your body.
  • Push your arms as far forward as you can whilst rounding your shoulder blades.
  • Gently drop your chin down to your chest.
  • Hold this position while you feel a stretch between your shoulder blades.

 WRIST STRETCHES

  • Stretch out your arm straight in front of you with your palm facing away
  • Use your opposite hand to gently pull your palm back
  • Hold for 5 seconds, repeat with your palm facing your body
By Physio Team Appointments & Fees, back pain, body parts, chronic pain, Injury, Leg, OA, pain, pain management

Sciatica Pain

Sciatica is not a diagnosis, it is a term that describes symptoms of pain, pins and needles, numbness and in some cases weakness that radiates along path of the sciatic nerve from the lower back to buttocks and leg.

Causes of Sciatica?

  • Disc derangement / herniation
    Disc injuries are most common cause of sciatica. Discs are cushion like pads located between each spinal segments that act as shock absorbers. The core interior of the discs is made up a gel like substance called the nucleus pulposus surrounded by thick fibrous outer ring called the annulus. Sudden forces applied to the disc can result in the the core interior to push through the outer ring resulting in a disc bulge or in severe cases can rupture the outer ring resulting in disc herniation which can compress the nerve root.
  • Disc degeneration / Arthritis / stenosis
    Age related degenerative changes in the spine can result thinning of the disc and narrowing of the spinal joints. Overtime the narrowing results in bony growths that can compress the nerve roots resulting in sciatica.
  • Soft tissue injury resulting in inflammation
    Thick ligaments and connective tissue envelope the spinal segments to optimize stability. Injury to any of the structures will result in inflammation and swelling which can affect the sciatic nerve directly resulting in sciatic symptoms.
  • Piriformis syndrome
    Piriformis muscle is a located deep in the buttock region. It originates from the sacrum and inserts into the upper part of the hip. The sciatic nerve travels adjacent to the piriformis muscles. Injury to the muscle resulting in tightness or spasm directly affects the sciatic nerve resulting in symptoms.
  • Other possible causes:
    • Sacroiliac Joint Dysfunction
    • Hip joint injury or arthritis
    • Spinal fractures
    • Tumors

Anatomy of the Sciatic nerve

Sciatic nerve is the largest nerve in the human body. It originates in the lower back from five branches of nerves that extend from the spinal cord. The branches exit the spine at nerve roots L4, L5, S1, S2, S3 connect together to form the sciatic nerve.

The large sciatic nerve then travels deep in gluteal region and descends vertically down to the back of the thigh. It supplies motor function and sensation to the skin and all muscles in the posterior compartment of thigh.

At the knee joint the sciatic nerve then divides into two branches the tibial nerve and common fibular nerve.

What exactly does it feel like?

Symptoms of Sciatica are often characterized by one or more of the following features:

  • Unilateral. Sciatica is typically affects one leg.
  • Pain. Nature of pain is often constant with heaviness or dull ache. You may experience sharp, shooting, electric shocks intermittently with postural movements.
  • Neural irritation. pins and needles with occasional postural numbness is common. Postural numbness can occur when you sit or stand for a period of time, but should resolve with movement.  However, if numbness is constant you must be reviewed by your general practitioner or your physiotherapist. 
  • Location of pain: symptoms of sciatica are felt along the path of the large sciatic nerve. The following picture shows the potential pathways you may feel your symptoms radiate to depending on the origin of nerve irritation or entrapment. Most commonly the areas affected included the lower back, lateral thigh extending to the calf and foot.

If symptoms are presented on both sides with additional symptoms outlined below – this could warrant an urgent medical review.

Red flags

Signs and symptoms that require prompt medical assessment include:

  • Age >50 years
  • History of trauma
  • Severe unrelenting pain that does not resolve with rest or pain control
  • Partial or complete loss of bowel and bladder function or control
  • Numbness in private regions and the affected side of leg or both
  • Discoloration of skin in comparison to unaffected side
  • Recent or current infection with fever chills and night sweats
  • Sudden unplanned weight-loss
  • History of cancer, kidney dysfunction

Diagnosis

It is important to correctly identify the cause your sciatica is essential in order to formulate an effective treatment plan to manage your symptoms and improve function.

Your GP or a physiotherapist will conduct a thorough diagnostic assessment. Your consultation with your clinician will begin with a comprehensive conversion that allows your clinician to formulate an understanding around potential causes of your symptoms. This includes questions specific to your presenting concerns, general health, history of injuries contributing and medication history and your symptoms management strategies. A physical examination is then followed where by your clinician will assess the range of movement of your lower back and lower extremities, reflexes, strength and sensation assessment to test the integrity of the nerve.

Radiographic examination

Further diagnostic examination in forms of radiographic imaging may be recommended by your clinician to assess the quality of your joints, alignment and check for the presence of any potential lesions contributing to your symptoms.

  • XRAY – commonly used in initial stages to review underlying joint pathology such as wear and tear of joints, fractures or in some cases to view lesions or tumors
  • MRI – high standard imaging that is able to examine in very refined detail possible soft tissues such as muscles, ligaments and internal organs as well as the bony architecture and possible disc injuries.
  • Discogram – A discogram test may be helpful in determining abnormalities in an intervertebral disc. A contrast dye injected into the tissues may allow abnormalities in the disc, such as bulging or herniation to be seen on a medical imaging scan (such as computed tomography scan).

Treatment 

It is advisable to treat sciatica as early as possible in order to avoid the progression of symptoms. Treatments for sciatica may include both non-surgical and surgical approaches.
Typically, non-surgical management is recommended first. Surgery may be required if non-surgical methods have failed to manage your symptoms or the underlying cause is causing deterioration of symptoms. However, in a few severe cases where red flags are presented, surgery may be considered as the first option

Non-surgical approach is the first step to management. This includes intake of pain medications as prescribed by your doctors and referral to physiotherapy.

Pain medications 

Your doctor will prescribe pain medications best suited for your symptoms. These may include

Non-steroidal anti-inflammatory medications such as ibuprofen, celecoxib
Neuropathic medications such as gabapentin, amitriptyline
Analgesics such as codeine, tramadol or oxycodone.
Muscle relaxants such as norflex

Physiotherapy

Physiotherapy will incorporate a combination of gentle strengthening, stretching, and the use of manual therapy to facilitate therapeutic gains.

The goals of physiotherapy for sciatic symptom management includes:

  • Strengthen muscles of the spine, core and lower extremities.
  • Improve flexibility of any tight muscles
  • Improve mobilization of the sciatic nerve
  • Facilitate optimal circulation through slight conditioning exercise (walking, swimming)
  • Education around activity modifications (especially for work-related participation)

Alternative therapies such as acupuncture may be recommended in combination to physiotherapy to facilitate management of your symptoms.

Acute mild sciatica usually improves with 4 to 6 weeks with regular conservative treatment. However, for moderate to severe cases of sciatica especially with a chronic underlying pathology pain may last over 8 weeks and, treatment time may take longer.

Steroid Injections 

Steroid injections are slightly an invasive method used for pain management. Your specialist or an orthopedic surgeon may recommend and administer the injection. In addition to this, injections are also used as a diagnostic method to identify the target nerves or nerve roots affected. The common types of injections for sciatic pain relief include epidural injections.

Surgical approach

In cases where pain and or weakness persists for more than 6-8 weeks or if your symptoms are affecting everyday activities – Surgery may be considered. Your physiotherapist or doctor will arrange the referral for you to meet with an orthopedic back surgeon. Depending on the cause of your sciatica, your surgeon will discuss with you in detail the intended surgical approach, risks involved, post operative management and possible adverse reactions you may have after surgery.

By Physio Team acute pain, Appointments & Fees, back pain, body parts, chronic pain, ergonomics, Exercises, good posture, Home exercises, Injury, Lockdown, neck pain, online consultations, pain, Physio, posture, rehabilitation, sitting posture, Sprain, Therapy , , , , , , , , , , , , , , , , , , ,

Pressure on the Spine in Different Posture

Did You Know?

 

Low back pain is a common health problem which affects up to 80% of the population at some stage in their life.

 

In New Zealand ACC spends in excess of $130 million a year treating back pain related injuries.

Most back pain occurs between the ages of 25 and 60, and most typically in the 40s.

 

 

 

In an era of smart devices, posture has never been more important or harder to achieve. As technology continues to grow, sitting at a desk on a computer or on our phones is becoming more prevalent at work. Having a sedentary desk job can result in sitting for around 8 hours a day. This position actually increases the load on your spine more than standing. Spinal pressure “sits” around 140mm pressure. This pressure usually does not hurt the back right away however, builds up over time and can even change the structure structure of your spine. So, if you slouch then spinal pressure increases to 190mm; add some weight and you’ve put 275 pounds of pressure on your spine.

 

A compromised spine constricts your blood vessels and nerves, causing problems with your muscles, discs, and joints. And all of these problems can lead to headaches, fatigue, and even breathing problems. Your back is a delicate machine. When one part falls out of alignment, it can affect everything setting off a domino effect and wreak havoc throughout your back and body.

 

 

Below is a graph showing different postures and the pressure it exerts on the spine;

But, remember: While you may feel comfortable and supported in your chair and find a perfect sitting posture, staying in the same position for long periods is not healthy for your spine. Varying your postures by occasionally standing and moving around for at least a few minutes each half hour will help keep your spinal joints, muscles, tendons, and ligaments loose and pain free.

 

Stand Up for Your Spine

If you don’t have a sit-stand desk, you can still combat “sitting disease” and protect your spine. Consider these tips:

  • Do some work standing at a high table or counter.

  • Use a lumbar roll behind your back when sitting to improve seated posture

  • Set a timer on your computer for a stand-and-stretch break every 30 minutes.

  • Exercise to assist in improving body weight to lessen additional load on the spine

  • Strengthen the core to provide additional support

The focus is simple: Reduce your sitting throughout the day. But, remember that varying postures is best for your back and neck, so do not go the opposite extreme and never sit. Alternating sitting, standing and movement throughout your day is the best way you can keep your spine safe and body healthy—at work and beyond

 

Still having back pain?

Schedule an initial assessment with one of our Physiotherapists so they can determine the root of the problem.  During this assessment your physiotherapist will be able to decide whether your pain is a source of nerve root irritation, discogenic, postural related, or musculoskeletal.  After arriving with the consensus of the problem, we will be able to use many techniques to relieve the back pain.  These include: manual therapy, therapeutic exercise, and postural recommendations.

 

To find your nearest Physio Fusion clinic and book an appointment call 09 6266186 or visit our website https://physiofusion.co.nz

By Physio Team acute pain, Appointments & Fees, back pain, bones, chronic pain, ergonomics, Exercises, good posture, Home exercises, Injury, Lockdown, muscles, neck pain, online consultations, pain, pain management, Physio, posture, rehabilitation, sitting posture, Sprain, Studies, Therapy, WFH, Working from home , , , , , , , , , , , , , , , ,

Do You Have a Healthy Work Station Set Up?

An ergonomically correct workstation has all the best practices to help maintain a healthy posture and improve your health and productivity.

Here are a few helpful tips;

1. Set up your screen

Adjust the monitor height so that the top of the screen is at—or slightly below—eye level. Your eyes should look slightly downward when viewing the middle of the screen. Position the monitor at least 20 inches (51 cm) from your eyes—about an arm’s length distance. If you have a larger screen, add more viewing distance.

2. Set up your chair

  • Height – You should be able to sit with your feet flat on the floor and your thighs roughly parallel to the floor. If you require a taller chair in order to reach the floor you can use a foot rest to ensure you achieve the right angle.

  • Backrest Recline and Tilt – Research has shown that a reclined seat (at least 135 degrees back)  significantly reduces the pressure on your back, and is particularity beneficial for people with back

  • Lumbar support – the shape of the backrest should have a natural curve to support your lower back.

  • Arm rests – Look for armrests that are not just height adjustable and support the entire length of the forearms.

3. Adjust your Desk Height

  • Your legs should fit comfortably under the desk if you are sitting with your feet flat on the floor: you should have enough space to cross your legs.

  • The angle between your forearm and upper arm should be between 90 degrees and 110 degrees while your arms are at rest on the desk.

  • Make your desk organized using storage accessories i.e. Document holders

  • Use an ergonomic mouse pad; to keep your wrists supported.

4. Organizing your Desk space

Organize all the items on the workstation according to their priorities and assign them to the proper ergonomic reach zones.

  • Primary Zone: High use items, easiest access

  • Secondary Zone :Medium use items, comfortable reach

  • Third Zone: Low use items, reduction in efficiency

:sparkles: MOVEMENT IS KEY :sparkles:

Its a simple action step, but mighty! Get up out of your chair and take frequent posture breaks!

When we sit in one position for hours without moving, our performance slowly starts to deteriorate, our body slows down, static loading takes over our muscles and we actually get fatigued even when we aren’t putting in any physical effort. However, when you consciously integrate these microbreaks into your day, you’re giving your body a much-needed refresher and an opportunity to wake up your muscles and replenish blood flow. Research has shown that movement can also help with creativity, or get you ‘unstuck’ so you can approach your work with a different or fresh perspective and energy.

If you think your desk set up could be better, or want us to have a quick look we can do this via a video call. Book in for an appointment www.physiofusion.co.nz or give us a call on (09) 626 6186

By Physio Team Appointments & Fees, back pain, body parts, ergonomics, Exercises, good posture, Home exercises, Injury, lifting, Lockdown, muscles, online consultations, pain, pain management, physical health, Physio, posture, rehabilitation, Sprain , , , , , , , , , , , , , , , , , , , , , ,

Lifting Mechanics

IS IT DANGEROUS TO LIFT WITH A BENT BACK?

One common belief about lifting is that rounding your back when lifting an object is considered dangerous while lifting with a straight back is considered safe…

 

 

However, there is a lot of misinformation circulating around lifting mechanics and what is deemed “good technique” versus “bad technique.”

Here are some key myths and misinformation that you may have heard:

 

A ROUNDED BACK WHILE LIFTING OVER STRESSES THE BACK MUSCLES AND LIGAMENTS

  • Research has shown that regardless of lifting position, whether you’re stooped, squatting or weightlifting, your back has to produce the same amount of force. Statistically speaking, it’s not significantly different.

 

 

FLEXING THE SPINE WHILE LIFTING INCREASES THE LOAD ON THE LUMBAR DISCS

  • Under heavy loads, discs are unlikely to fail unless >95% flexion is achieved (which is near impossible)

  • With low loads, the disc is unlikely to fail unless you do thousands of repetitions continuously

  • Your body is an amazing adapter, this includes discs! Your discs can adapt and become more and more able to handle loads when stressed appropriately

 

THESE COMPOUND TO CAUSE INJURIES AND PAIN TO THE BACK MUSCLES AND DISCS

  • Resistance training has demonstrated through countless studies the ability to increase bone mineral density (BMD) of the lumbar spine. BMD is actually positively associated with the strength of the spinal discs and ligaments at that level. With appropriate loading and training, disc, ligament, bone and muscles are going to adapt favourably

 

A NEUTRAL SPINE IS SAFER, STRONGER, MORE EFFICIENT AND BETTER TO LIFT WITH

  • There is no significant difference between activities that encourage more spinal flexion and one’s that do not in the long term

  • Lifting with lumbar flexion is not a risk factor for low back pain

  • Research has shown lifting with a bent back is more metabolically and neuromuscularly efficient

  • When the spine is in extension during bent over activities, the hip is actually flexed to a greater degree – decreasing the ability for the glutes and hamstrings to create as much internal torque. Flexing the spine reduces this effect and reduces the moment arm for the hip extensors

 

STOP BACK PAIN & INJURIES BY LIFTING WITH A NEUTRAL SPINE

  • Your lumbar spine flexes every time your hip flexes! It is impossible to isolate one versus the other. It is also impossible to not flex while doing common movements

  • Extreme flexion however (>/=100%), may pose an increased risk under heavy loads, but not at light loads

 

You may still be wondering why you have back pain (stay tuned for our next blog!). Your pain may not be directly related to your lifting strategy.

 

 

Could you have pain with forward bending? Absolutely.

Is bending at the lumbar spine an increased risk for pain or injury? In the vast majority of situations, no.

If I have pain with forward bending, is it bad to temporarily limit doing so? Not at all.

Should I fear bending at the spine with or without pain or injury? No. Being fearful of flexing/moving your spine is actually a stronger predictor of disability and back pain.

 

Work on moving through your spine, after all it’s what it is designed to do! Choose comfortable movements and gain confidence over time, then build up your strength gradually with resistance training – try and not to push too fast, we want nice, healthy adaptation! Give your body time to adapt, back pain is not quick fix sometimes but you are resilient and with healthy, normal movements and some patience, you will be okay.