Spine

 

To Stretch Or Not To Stretch?

by Jake Reynolds, PT, DPT Spine & Sports Clinic of Motion Stability   I frequently have clients ask about stretching and tend find a lot of confusion about proper technique and dosage. This confusion can lend itself to injury as opposed to injury prevention and performance enhancement (the intent of stretching). If we are stretching incorrectly you may actually prime your muscle for injury. For the sake of clarity, lets get a one thing out of the way: yes—stretching is important. In fact the American College of Sports Medicine (ACSM) outlines the following guidelines for flexibility training in terms of risk factor reduction for the development of injuries and preventable diseases:   At least two or three days of stretching…

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The Athletic Hip Series: Piriformis Syndrome

Post by Maggie Gebhardt, PT, DPT, OCS To a runner, the word “Piriformis” is a dreaded, scary, and frustrating word. However, the diagnosis for Piriformis Syndrome is commonly overused and misdiagnosed. I would venture to say that in the years I have been working, I have never actually seen a true case of Pirifomis Syndrome. Many people assume that  hip tightness must be their ‘Piriformis.’ Well I am here to spread the word…that is just not true! Actual Piriformis Syndrome is when the piriformis muscle becomes so tight that it causes numbness, tingling and/or pain down into the respective leg. The piriformis muscle spans the backside of your hip, sits amongst your gluteal muscles, and runs from your tailbone to the outside of…

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Is Back Pain All in Your Head?

Post by Brian Yee, PT, MPhty, OCS, FAAOMPT What a great article from NPR! This article identifies that recurring back problems are not solely from the structure in your spine such as a herniated disc or degeneration or the vertebra, but rather it brings attention to the nervous system itself. Your nervous system, located within your spine, is your main transducer that signals to your brain that you are or are not in pain. This article states: “Research is showing that the pain often has nothing to do with the mechanics of the spine, but with the way the nervous system is behaving, according to Dr. James Rainville of New England Baptist Hospital in Boston.” “This is a different way…

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It’s All in How You Breathe…

Post by Brian Yee PT, MPhty, OCS, FAAOMPT Here’s a link by a well known Physical Therapist, Mike Reinold, which was passed onto me, that discusses the role of breathing and its correlation with low back pain. Many people think core strength for spinal stability is simply done by your abdominal muscles, but your diaphragm and respiratory patterns are also shown to help improve spinal stability. This article goes into further detail to discuss how a study has shown that people without low back pain tend to inhale slightly at the time of lifting an object, where people with chronic low back pain tend to exhale. The staff at Motion Stability are versed in breathing recruitment techniques that can help…

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Exercises To Prevent Lower Back Pain

What Exercises for My Core Can Help Prevent Lower Back Pain? Brian Yee PT, MPhty, OCS, FAAOMPT First – generally there are different roles of muscles in your trunk. Typically the smaller ones closest to your spine are considered ‘local’ muscles. Such muscles as the transversus abdominis, diaphragm, pelvic floor, and lumbar multifidus provide segmental control of your lumbar vertebra. Real-time ultrasound imaging can be used to visualize the proper contraction of these muscles as we cannot see these muscles from the superficial skin. So first step in core stability is to ensure that the smaller muscles are engaging properly. Then you have ‘global’ muscles which are the larger muscles – such as rectus abdominis, obliques, paraspinal muscles. These muscles…

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Play Golf? Avoid Lower Back Pain With These Stretches.

Brian Yee PT, MPhty, OCS, FAAOMPT There are numerous studies that have come out recently that show the loss of lead leg internal rotation of the hip in the golf swing has a high prevelance of low back pain in golfers. This is due to the lead leg in the golf swing acting as your swivel / finishing point in the swing. With limitations in the hip, the back has to work harder to finsh the swing.  You should work on the foam roll to loosen the lead leg hip musculature, knee to chest and pirformis stretches can also help. Standard back stretches can help alleviate your back after golf, but consider the causitive reasons why your back is hurting…

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How Does Posture Affect Back Pain?

Brian Yee PT, MPhty, OCS, FAAOMPT The way you sit and stand significantly affects your back. Especially for prolonged duration, the tissues around the spine experience what clinicians call ‘creep phenomenon’. Think of a cold piece of taffy. As you hold it, warm it up, and then hold it by its ends, it slowly stretches and lengthens. Very similarly, the tissues in the back can due the same thing. The fascia, muscles, nerve, joints all experience increased strain when the spine is statically held in one position for a long duration of time. When you then place yourself in a poorly sitting or standing posture, that then accentuates the amount of tissue loading that is placed on the spine and…

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How Can a Weak Core Lead to Back Pain?

Brian Yee PT, MPhty, OCS, FAAOMPT According to Panjabi’s model, we can view spinal stabiilty based on 3 key elements:1. Passive Structures: The spinal column itself and the ligaments, fascia and other static tissues that hold it together. 2. Active Structures: The muscles that surround the trunk and pelvis ‘actively’ contract to provide muscle support. 3. Cognitive / Motor Control: The brain has a way to coordinate how muscles will be used to anticipate how the spine is used with functional activities. The passive structures and the spine itself is limited in its ability to stabilize the spine, especially in dynamic function or prolonged positions such as standing or sitting. The brain thus needs to coordinate the proper timing of…

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What Is The Right and Wrong Way to Bend Over?

Brian Yee PT, MPhty, OCS, FAAOMPT Proper bending requires a fluid ‘lumbopelvic rhythm’. This means the hips and spine should coordinate to be able to touch the ground. Ideally there should be a 2:1 ratio hip movement to spine movement.  What we see typically in the clinic is that patients have significant restriction of what we call ‘hip hinging’ as the patients hips have restricted motion, thus requiring increased movement from the spine..with repetitive and excessive movement at the spine it creates greater torque to the spine. The other scenario we commonly see are patients who have fear to move their spine and essentially ‘lock’ their spines in slight hyper-extension and try to bend entirely from their hips. This creates…

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Stretches for lower back pain?

Brian Yee PT, MPhty, OCS, FAAOMPT The most common muscle that is strained on the side of your back is the quadratus lumborum (QL). The QL attaches from the side and bottom of your rib cage to the top of your pelvis. There is a right and left QL and when it contracts its side bends your spine, as well as extends the back.Lets say your right QL feels tight – to stretch this: 1. While sitting place a thick book or half foam roll under your opposite / left hip. 2. Lean to the left, away from your painful side, fulcruming over the roll and left hip. 3. Slightly bend forward and rotate towards the right. Keep your right…

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Motion Stability