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.
The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.
Common Achilles Pathology
Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.
Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.
There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:
Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.
In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).
Causes
Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.
Common factors that may lead to the development of disorders of the Achilles tendon include:
Weak and/or tight calf muscles
Rapidly increasing the amount or intensity of exercise within a short span of time
Hill climbing or stair climbing exercises
Presence of bony spurs in the back of your heel
Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
Exercising without adequate warm-ups and stretching
A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
Excessive mobility
Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)
Symptoms
Common symptoms include:
Pain and stiffness along the Achilles tendon especially first thing in the morning
Pain along the tendon or back of the heel that worsens with activity
Severe pain the day after exercising
Visible thickening of the tendon
Tenderness to touch
Bone spur
Swelling that is present all the time and gets worse throughout the day with activity
If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.
Diagnosis
If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.
You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.
An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.
Treatment
Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained. Full recovery may take between three and nine months.
Initial treatment options in the early stages may include:
Rest – to avoid further injury to the area
Ice – to reduce inflammation
Elevation – to reduce swelling
Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.
How physiotherapy can help:
Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.
Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.
Shin splints, medically known as medial tibial stress syndrome, is a collective term used to describe multiple conditions that cause shin pain. Therefore, it is important to establish that there is not one singular cause.
