CHRISTMAS IS COMING – HOW TO COPE WITHOUT BACK PAIN!

This time of year is often a mad rush – but to make sure you don’t end up in bed with a bad back, here are a few things to consider before you do something silly that means you can’t enjoy it!

• When you go to get the tree, be careful when you lift it and get it into the car – don’t lean forwards too far and then twist – that is a recipe for disaster for a back – you need to keep your back in a ‘neutral’ position and use your legs to take the strain. On the left is an illustration of how NOT to lift your tree – bent back, reaching out in front of you.

 

 

 

 

 

 

Can a Chiropractor help with Sciatica?

What is it?

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. You may not be aware of back pain, however. The majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical treatment. Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine, often as a result of faulty movement patterns over years.

Sciatica symptoms

For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse. While sciatica can be very painful, it is rare that permanent nerve damage will result but it might take many months to recover on its own. It is important to undergo a thorough examination to establish how badly the nerve is damaged.
What can I do about it?
An important thing to understand is that sciatica is a symptom of a problem. It arises as a result of something compressing or irritating the nerve roots that comprise the sciatic nerve rather than a medical diagnosis or medical disorder in and of itself. This is an important distinction because it is the underlying
diagnosis that often needs to be treated in order to relieve sciatic nerve pain. If you visit a Chiropractor they will conduct a thorough examination of the back to establish what may be causing the sciatic pain. Common causes of sciatica are a lumbar herniated disc, spinal stenosis, degenerative disc disease or spondylolisthesis.

A Chiropractor will decide whether you need an x-ray or MRI scan before treating or whether you need referral to a neurosurgeon or orthopaedic surgeon. However, chiropractic treatment can be very effective in relieving the pain of sciatica.

Can a Chiropractor help your Shoulder Pain?

Shoulder pain may occur as a result of an injury or for no apparent reason. It may be due to a problem within the shoulder itself or as a result of neck or back problems referring pain to the shoulder area.

Determining the source of the problem in the shoulder is essential before anyone recommends a treatment regime. Therefore, a comprehensive examination will be required to find the causes of your shoulder pain.
The first step is a thorough medical history – some conditions such as liver, gall bladder, stomach can refer pain to the shoulder – is that the cause of your pain?. A British Association Chiropractor will determine your general health as well as the possible mechanical or neurological causes of your shoulder problem.
Next, the Chiropractor will perform a physical examination, which may include looking for physical abnormalities, swelling, deformity or muscle weakness, or feeling for tender areas, and observing the range of shoulder motion, how far and in which direction you can move your arm. When the cause of the pain has been established, you may be treated by some or all of the following: manipulation, mobilization, ultrasound, exercises, acupuncture or soft tissue work. The Chiropractor will also discuss your posture and how you sit at work or what you do for recreation. Your daily activities may be causing your problem without you even realizing it!

What can you do to help?

If you have a problem that is suitable for physical treatment, it will probably need exercises to help increase the strength as well as balancing any faulty movement patterns that have either contributed to the problem or arisen as a result. Below is an example of exercises that may help strengthen your shoulder, however, exercises need to be specific for your particular problem and need to be observed – so contact your local Chiropractor for advice. You may progress to using weights or therabands and you will probably need to do these exercises for the rest of your life to avoid recurrences. Don’t forget too that over 50% of the strength of the shoulder girdle comes from your core – so you must do core strengthening exercises too. To use your extremities efficiently you need a solid base!

Can a Chiropractor help with a whiplash injury?

Whiplash injury is really an acceleration/deceleration accident that involves a complex of potential symptoms that can follow not only from a car accident but any time that the head and neck are involved in a sudden impact that strains the tissues of the neck.

 

 

 

 

 

 

 

Do You Have Whiplash?
The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder and/or arm pain, parasthesias (numbness/tingling), blurred vision, and in rare cases difficulty swallowing. Symptoms may appear as quickly as two hours following injury.
The symptoms usually result from injury to the neck’s soft tissues. Muscle tears characteristically present with burning pain accompanied by tingling sensations. Ligaments affected by excessive joint movement can cause muscles to defensively tighten limiting motion.
Age and arthritis may increase the severity of whiplash. As people age, their range of motion declines, muscles lose flexibility and strength, and intervertebral disc and ligaments lose some of their elasticity so can cope less with sudden movement.

 

 

 

 

 

 

 

What can you do to help?
Whatever your symptoms, it makes sense to consult a BCA Chiropractor as soon as possible after any kind of acceleration/deceleration injury so that your condition can be examined carefully to assess the degree of injury. It may be that you require x-rays prior to any manual treatment and then if appropriate a short course of treatment may help to reduce inflammation and pain quicker than just taking painkillers and resting. The quicker you move properly again, the less strength you lose and thus you may avoid developing a more long term problem.
What can you do for yourself?
Acceleration/deceleration injuries often overstretch the ligaments holding joints together and these overstretched tissues will not regain their original length. It is therefore very important to strengthen the muscles surrounding the joints in order to promote stability.
A BCA chiropractor is trained to show you the most appropriate exercises to do depending on your problem.

Can a Chiropractor help you do gardening without pain?

Gardening is like any exercise; you need to warm up first there are a few basic rules to avoid back pain when you garden.

Warm Up First
Don’t go straight into heavy garden work, start off with lighter jobs first or do some stretching before you begin, this will reduce the chance of a muscle strain Don’t do stretches first – they can weaken muscles. You are better off to do some gently exercises that use your muscles in a way that is similar to the activity you are about to do. For example shoulder strengthening exercises if you are going to cut a hedge – but don’t forget the importance of core stability when you are using your shoulders..
Avoid twisting
If you have to use a ladder for any of your gardening tasks make sure you are always facing it. Rather than lean or reach, take the time to move it regularly
When using the ladder, always keep your shoulders, hips and knees pointing in the same direction
Clever pruning
Get as close as possible to the things you are pruning; avoid overstretching to reach the area you are dealing with
Invest in some long handled secateurs to reach plants and bushes that are beyond normal reach
Take a break
Vary your activity; spend no more than 20-30 minutes on any thing and take regular breaks. It is repetitive tasks that cause the problems
Be clever with your lifting
If lifting or laying slabs, rocks or sleepers, keep the load close to your body and bend your knees!

 

 

 

 

 

 

 

Remember it is better to get help lifting at home than to get help out of the car when you are in too much pain because you have lifted badly

Plan ahead
If you are planning a trip to the local garden centre or DIY store and buying heavy items, such as cement or gravel, buy smaller bags rather than one big bag as they are easier and safer to carry

REMEMBER, PAIN IS A WARNING SIGN – DON’T IGNORE IT – TAKE A BREAK

However, if you do overdo it with the trowel – don’t panic! A Chiropractor specializes in high quality individual care which will involve a thorough examination to establish what tissues you have injured and what is the best treatment to ensure you recover as quickly as possible. They use tailored rehabilitation protocols to complement chiropractic care so you can avoid the problem recurring when you go back into the garden. Chiropractors are trained to assess the underlying causes of joint, muscle and nerve injuries and provide effective treatment using a wide range of drug-free techniques to relieve pain, restore movement and prevent further problems.

Should you see a Chiropractor before you exercise?

A lot of us are going to Pilates classes in the belief that they are ‘back friendly’ but research shows that they can actually do us more harm than good! You may have seen articles recently suggesting that pilates, yoga and other exercise classes are not as good for us as we first thought. Why is this being suggested?

Pilates classes focus on teaching people to target the transverse abdominis muscle by ‘drawing in their navel towards the spine’. However, one of the world’s leading experts in back pain research, Professor Stuart McGill has found that this ‘drawing in’ may in fact be responsible for reducing the stability of the back supporting muscles – the very thing you are trying to improve!! There are also a lot of exercises we can do that strengthen muscles but some of the most effective exercises also compress the discs in the low back and this can cause more damage rather than help you. You need to know if your back is capable of undertaking strengthening exercises before you start them. Yoga can lead to overstretching when what we should be doing is correctly strengthening weakened muscles. Stretching on its own can lead to problems.

So what should you do instead and why?

Professor McGill states that it is the imbalance of muscle groups that is more likely to give rise to back pain than simply ‘being unfit’. Therefore the best scientific approach to help chronic back pain is to do exercises that address imbalance rather than those that just aim to strengthen one particular muscle group.

A Chiropractor has undertaken extensive study into exercise regimes that best help you to make a full recovery from a bout of back pain but also prevent recurrences whilst ensuring that the exercises you are prescribed are not overloading your already weakened spine.

Therefore, before you embark on a course of unprescribed exercise classes, do discuss with a Chiropractor what you propose so that they can ensure you are doing the BEST for your spine.
Is this good for your back if you have a problem? It is a pilates exercise …………….

Ask your BCA chiropractor before you try it!

I’ve done the exercises, I feel a bit stronger…Is that it?

The answer is NO!
Sorry but it is just not enough to ‘do exercises’ however well you do them, however often and however well.
But don’t be downhearted and imagine that you have read all of this stuff just to be told that it doesn’t work…..it DOES. However there are two things that you must remember. You must first find which exercises are the most appropriate for you, then you must do some every day and then the most important thing to remember is that you must APPLY what you have learned.
What I mean by this is that you must remember the following:

• When you reach forward, you brace your abdomen lightly; you adopt a neutral position and you keep your back in that neutral position with one leg out behind you in the golfer’s lift position.
• When you bend over the sink to clean your teeth, wash the dishes, reach for a towel – anything where you need to reach forwards.
• If that leaning involves reaching to one side – you do so without twisting – by incorporating the wall roll stability – so when you need to put on a seatbelt, put on your trousers, tights, unload the dishwasher, washing machine, get things out of the car boot – you brace, adopt the neutral position and keep the body in one plane…..NO twisting allowed!
• When you are working in an awkward position – under a sink or you are hunting for something in a cupboard – you adopt the quadruped position – on all fours, brace, keep the spine in neutral and reach forwards in that stable position.
• If you are flat on your back under a car – working by reaching above you – apply the ‘dead bug’ position – whereby you brace your abdomen and flatten your spine into the floor, again with a braced abdomen.

You can imagine all sorts of situations that you might get into every day and if you look at the exercise positions and adapt them you should be able to do the job with a braced, neutral, untwisted spine ….but you can only achieve this by getting the gluteus medius muscles stronger along with the internal and external oblique muscles, abdominal muscles and make sure that the feet, ankles, knees and hips are moving well and that the muscles are balanced. This can only be achieved by a trained chiropractor going through how you move – then you can practice the exercises, gain strength and pattern you brain so you always remember to move correctly without having to think too much about it. Then you start to have control over your back again and gain confidence that you are not just a ‘backpain waiting to happen’.

Don’t twist again like you did last Summer!

Want to avoid back pain in your everyday life – then stop twisting!
Think it is impossible? Well it isn’t – you just need to practise – like everything else – if you work at it – you will do it automatically!
First thing to practice is wall rolls.

For these you stand 10 inches or so from a wall facing it; lean with your forearms on the wall; spine in neutral, abdomen braced and you go up on tiptoes, drop one arm down and twist to that side ONLY using your toes to twist – NOT your back. Repeat to the right and left 10 times each side and hold for 10 seconds each side. When it becomes easy, move your feet further back from the wall gradually so you are leaning more and more – but take your time to achieve this and talk to your chiropractor first to make sure you are doing it correctly – guessing is no good – you need the one to one of a practiced eye to watch you.

Dead Bug
This will recruit your oblique muscles back and front to further reduce the twisting of your spine.
Again you need to brace into the floor so that there is no space between your spine and the floor. You then start by raising your arms to the ceiling then reach over your head with one arm then the other whilst breathing and also keeping your back firmly stuck to the floor. When you have mastered that – you can raise your legs in the same way and when this is easy – you raise opposite arm and opposite leg…keeping that brace into the floor. Takes time to master but worth it.

I only just bent forwards to pick up a cup of coffee and my back ‘went’!!

So on to forward bending – the BIG bugbear for us all….why?

Well we have what is termed a lumbar lordosis – which means that the lowest part of our back curves gently inwards. In this position the back part of the disc and the joints that allow movement of the spine are held in a neutral position, whereby they are not under any strain and so unlikely to be over strained or tear. As soon as we bend forward, these tissues are put under strain and overloaded either by doing the same movement too often  incorrectly or if we try to lift more weight than our spine can cope with – in both cases the tissues fail and we experience back pain, then the muscles around those tissues spasm to try to stop you moving any more and doing more damage. PAINFUL!!

The things that can lead to this tissue overloading are things like sitting hunched over a computer or desk for hours every day; gardening without considering our back position; doing sports without preparing the body first; lifting heavy weights without thinking; twisting repeatedly – in fact anything that takes our spines away from that magic ‘neutral’ position.

So what can we do? We need to address our muscular co-ordination, endurance and strength:

Co-ordination Exercises Relieve Back Pain

Without exercise to counteract the hunched over body position, the body will become “stuck” in the position with hunched-over shoulders and a slight backwards tilt of the hips. Bad posture will cause non-specific low back pain. It can also lead to core weakness and eventually serious injury.

Endurance Exercises Train Core Muscles

A study by Professor McGill claims that the best way to train the core muscles is by increasing endurance versus strength training. Exercises performed in rehabilitation environments were the “cat-camel” movement, floor bridges, the “bird-dog” exercise and different types of crunches.

From left to right: “Cat-camel”, “Bridge” & “Bird-dog”

The “cat-camel” movement is performed on hands and knees. Suck in belly button and arch the back like a scared cat. Then push the middle of the back down while lifting head and posterior – arching your back up and down like a cat.

Floor bridges are performed lying face-up on the floor. The heels of the feet should be about six inches away from the posterior with knees bent. Push off heels and squeeze gluteus muscles to elevate hips off the floor.

The “bird-dog” exercise is performed on hands and knees. Extend one arm forward and the opposite leg backwards. Keep back straight and abdominal muscles tight.

These three movements, combined with crunches, build co-ordination within the core muscles. They also produce muscular endurance and increase gluteus muscle strength. They really should not be done without consulting an expert in rehabilitation such as a chiropractor – it is important that exercises are done correctly – quality is far superior to quantity and if you try to exercise and get it wrong – you could be wasting your time or even aggravating the condition….this is what happens in a lot of exercise classes without one to one supervision.

When to Implement Strength Training

Strength training can be gradually implemented as the low back pain decreases. Patients should also perform strength-training movements that squeeze the shoulder blades together. The upper back affects the strength of the lower back and vice versa.

See a chiropractor before you do anything though would be my advice. A British Chiropractic Association member will be trained in how do diagnose your particular problem and to look at you as an individual to see where you are going wrong in your day to day life.

SO WHAT ABOUT WALKING??

Where do we go wrong here?

We need to consider several things here.
1. The big toes need to be fully flexible. How many of us have bunions or have stubbed our big toes and they just don’t bend like they should. So what? Walking is a complex activity made up of stretching one leg forward to ‘heel strike’ whilst pushing off with the other leg. If we do not push off with a flexed big toe, the sacrum may not be able to move forwards as it should in the pelvis and therefore the pelvis will not be as stable as it should be. Given that we must have stability in our trunk for our limbs to function from, this can potentially cause pain in the pelvis, hip, low back or ever the shoulder.
2. Sitting a lot can cause shortening of the psoas muscle. This in turn can inhibit the gluteus maximus muscle. If the gluteus maximus is not activated at heel strike, the knees collapse inward, and the foot arches collapse. The result is that the “shock absorbers” in the legs are not fully functional, and the back is jarred. In addition to this, the back is not supported by the gluteus maximus pulling the thoraco-lumbar fascia tight – and reduced stability occurs again – all from sitting too long!
3. Flat feet – or simply feet that don’t look particularly flat but when we try to push off when walking, the arch drops down rather than arching up. This affects knee, hip and back movements in such a way that they rotate in completely the wrong way. How long will this happen before pain arises somewhere along the chain? Where we feel pain depends a lot on what we have inherited – a tendency to knee arthritis or what we have done in our lives – a sporting injury – either may make our knees more vulnerable to pain whereas someone with a spinal curve or disc wear may be more prone to feeling the pain in the back. Where we feel pain is multi factorial – hence the need to seek the advice of a British Chiropractic Association Chiropractor who is trained to check all of these areas – chiropractic is definitely NOT just “All about backs”!

The psoas muscle                  The Gluteus maximus muscle