This is a fundamentally important question when considering a “healthy” spine or body.

In the Western World health care is concerned mainly with getting you painfree, and unfortunately in general only lip service is paid to the preventative side of therapy. The commonest way of doing this is with medication until the pain goes, then you are healthy! This is fundamentally wrong and short-sighted.

Health is NOT an absence of symptoms, health is good function, everything working correctly, in a good environment, efficiently. Just focusing on being painfree will not result in good health.

In modern times we are all (well most of us) leading very busy lives, we are having to work harder, for longer, many of us travel ever increasing distances to work. We are under more pressure due to the cost of living, we have less time for ….

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The Basics Of Back Pain Prevention

When you get low back pain it can be excruciating, it can also be quite frightening for the uninitiated. Most of the time the damage caused is actually slight and the body’s reaction is disproportionate to the damage present. The reason for this is due to the high sensitivity to pain, of the structures of the back. These are the facet joints and the capsule and ligaments that hold the vertebrae together.

When theses structures are stressed beyond their normal range due to poorly functioning muscles, excessive force or lax ligaments they send pain signals that cause a reflex contraction of muscle to splint and protect the joint from further damage. For further information click here.

When we don’t have back pain we tend to get lazy and take route one to pick things up etc. When you have back pain you don’t because the body won’t let you. This is the type of movement pattern that you should be striving for when you don’t have back pain.

So What Is That Movement Pattern?

Very simply it is using your body’s muscles to form a corset around the lumbar spine, or neck for that matter that gives stability and control to help protect the spine from any excessive motion. This co-contraction of the trunk flexors and extensors (stomach and back muscles) stabilises the spine and gives it support. This photo shows bracing of lower back and abdominal muscles to provide stability when sitting.

Correct bracing of lower back and abdominal muscles

How Do You Do It?

The easiest thing to do is tense your back muscles so that you hollow your back, then tense the abdominal (stomach) muscles as if you were avoiding someone poking you in the stomach. Then to bend, you have to flex from the hips and not the low back. If you have good Hamstring length you’ll only be able to get about 40 degrees of flexion, which means you’ll struggle to reach your knees!

Great, not very practical really is it? So you have to bend the knees if you want to get lower, but unless you were in the circus you still will struggle to reach the floor if you keep the back locked out. Especially if your hips are a little stiff. If you want to reach the floor you’ll probably have to flex the lower spine, but by this time your lower back will be supported a little by the thighs. To minimise stress further keep one leg flexed and kneel on the other, ie for tying up laces.

How to bend to tie up laces

By the way can you spot what he is doing wrong? He is letting his head move forwards too far, he should be bracing his deep neck flexors as well. Click here to find out how to do this.

If you need to pick something up off the floor you can balance on one leg, lean forward from the hip and let your other leg counter balance you. Always a good idea to do this where you have a lot of space, or you could damage someone or something. Use a support for your free hand if there is one, like a golfer using his club to rest on when getting a ball out of the hole, but as I couldn’t find a photo of that here’s a close example of what I mean.

This demonstrates good postural control when bending forwards

Building Resistance

You’ve Should Have The Flexibility Now It’s Time To Go For Strength And Stamina. Only complete this part if you can comfortably get your arms flat to the wall and keep them there as you lower them on the Wall Angel. Make sure you read this first if this is the first you’ve heard of Wall Angel.

You Need Equipment For This!!

What? Equipment? I hear you say. Never fear this is where the wonderful world of exercise bands come in to play. These are relatively inexpensive but highly versatile rubber bands, the beauty of these is that they improve your control of joint movement while under resistance. As the rubber is constantly working against you you have to work harder to control the bounce back so to speak. They come in a variety of resistances that are colour coded.

The other great thing about them is that they fold away and you won’t stubb your toes on them like a set of dumbells just hidden out of sight beneath the bed!

How To Add Stamina And Strength.

Take a two metre length of band and fold it over, start with a resistance that is comfortable. Remember no pain no gain is frankly a stupid way to train, so if you are struggling after just a few reps, get an easier band.

• THIS IS ABOUT STAMINA PRIMARILY NOT POWER.  

It’s great to be able to do a huge lift, but after one go you’re bust, what practical use is that in every day life?

Take the band as shown below between the hands and make sure you have some tension, then lower the arms and the band will stretch. Hold for a few secs, SLOWLY raise the arms back up, pause for a few seconds and repeat until you feel that you are starting to lose good form or begining to tire between the shoulders. Remember if you are getting pain, reduce the resistance, if it continues to give pain STOP, go back to unloaded exercise, i.e. no band.

Start position (arms are actually not bent enough!)

Ladies, a little advice…don’t do this before going out, it can do strange things to the hair on the back of your head and you may end up looking like this.

Aim to do the exercise once or twice a day with a rest break of 2 days in the week. If you require more assistance you can contact me through the clinic website.

Have Fun

Steve Oldale BSc, DC

 www.backinform.co.uk

Here Is A Daily Stretch That Will Help You Stay Free Of Upper Back Pain And Neck Pain.

This exercise is called the Wall Angel, you start by standing about 6 inches from a clear wall, sit onto the wall so your lower back is comfortable. Then tense the deep neck flexors as you did with the Bruger’s postural relief. Now raise your arms up with the elbows at shoulder height and bent at 90 degrees.

Start position for Wall Angel Exercise

Here’s the side view:

Note the chin is tucked in

You should aim to get the elbows back to the wall and the hands flat to the wall WITHOUT letting your body arch like this:

This is wrong, back is arched too much

Now if you have a tight upper back and shoulders you won’t be able to get flat without the back arching. So you need to gently tense the stomach muscles to make your spine rigid, then just take the elbows back until you feel a stretch. Refer to do’s and don’ts of stretching for more tips before doing this. Remember this should not cause pain. If it does, go back to the previous exercise Bruger’s Relief Position.

Now you should be comfortable, back stiff and relatively flat to the wall, your arms will be somewhere between being on the wall or a long way forward. Now you need to lower the arms to your sides keeping the elbows bent at 90 degrees. As you do so you will feel a stretch on the front of the chest and tension between the shoulder blades on the Rhomboid muscles.

Note the elbows stay bent at right angles

If you have tight shoulders you will feel the hands lift away from the wall. This is fine, the trick now is to keep the spine still, so make sure you maintain tension in the abdominal muscles. As long as you feel some stretch on the front of the chest that is fine.

Note back is still flat against the wall

This shows the wrong way to do it:

Back over-extended, less specific for shoulder

OK, now you should be getting an idea that this is all about control, you really need to focus on the only movement occuring at the shoulder. Got that? Good.

Now you simply bring the elbows back up level with the shoulders, pause for a second or two and repeat about 15-20 times. Always remember quality is more important than quantity and if it hurts you stop straight away.

Within a few weeks you’ll feel alot more freedom in the shoulders.

All the best for now

Steve Oldale BSc, DC                        Chiropractor                                                                                                                                                                                                                                                         Back In Form Chiropractic Clinic                                                                                                                                                                                                         65-67 Commercial Rd                                                                                              Poole                                                                                                                                                                                                                                                                   BH14 0JB

Upper Back And Neck Postural Relief Exercise

This simple yet powerful exercise will help reduce the tension that commonly builds up in the shoulders and upper back when sat at a desk, or driving.

When we sit at a desk for prolonged periods we tend to let our heads move forwards, our upper back becomes rounded, the chin pokes out and our lower backs slump. This causes stress and deformation of the ligaments and joints and leads to pain. If it goes on for 30 years there could be obvious postural changes.

Here’s a simple exercise to help:

This exercise is called the Bruger’s postural relief, after Mr Bruger who first developed and recorded it.

First stand up tall, look straight ahead, and then retract your head so that it stays level. Try doing this in a mirror as you should still be looking straight at yourself. If you are doing this correctly you’ll feel tension under the jaw, you’ll have a double chin and if you talk you’ll sound a bit nerdy. See photo for poor posture and correct posture.

Typical slumped Upper Back Posture

Backing away from your hand can help achieve correct posture

It’s Time To Stretch

Now reach up with your arms going in front of you, not to the side. Reach as high as you can with one arm and hold it there, then do the same with the other and alternate until they won’t go any further. This releases tension in the upper back and mobilises the upper thoracic spine.

Reaching Up And Mobilising The Upper Back

Now lower the arms in front of you and rotate the shoulders outwards, then extend the wrists. This stretches the chest muscles, strengthens the upper back muscles and mobilises the nerves into the hand.

Arms are rotated back and hands extended

Note the shoulders are not pulled back, but only rotated

This will help to reduce the effects of creep on the spine, for a full guide on causes of back pain look at our website www.backinform.co.uk 

It’s Not The Years In Your Life That Counts, It’s The Life In Your Years.

Ok before you think that’s an excuse to go out and get inebriated most days of the week lets take stock. I’ve got a question for you…

How many people do you see everyday struggling to get about? Obviously we all see the elderly struggling at times, but it can also apply to much younger people of all shapes and sizes. Why?

Will Back Pain Leave You Looking Like This?

We are bombarded by media images of healthy, fit, athletic people of all ages (at this point I had to check the photo at the top of this page for hypocrisy, I think they are human enough to pass that test). The result of this bombardment is to make some people motivated to get fit, for others it helps them to feel sad and depressed. So you have to ask yourself..

“What Do I Want From Life?”

I’m not talking about that Bugatti Veyron or a Butler in some revealing uniform. What do you want to acheive with respect to your quality of life?

If you are reading this it is likely that you want to be able to carry on sports and hobbies late into life. However there are many elderly and more importantly, not so elderly people around, that we literally bump into everyday that also felt the same way.

So if you want to be able to keep up that sport or hobby into later years, you need to do a few things:

• Train without injury
• Keep good nutrition
• Think positively
• Keep your body moving and working efficiently
• Keep a good network of good friends and family
• Get things fixed properly before they become chronic

You’ve Only Got One Body So Look After It

Regular exercise followed by balanced nutrition, a few regular good times with friends and family, can make a great difference to your outlook. If you want to stay painfree you need to keep the machine of the body working well both mechanically (joints, muscles etc), physiologically (nutrition) and pyschologically.

Each of these compliments and affects the other. For instance, if you are restricted in activity your cardio-vascular health will suffer too, and this will affect your mood.  Don’t let minor niggles and neglect lead you slowly down a degenerative path. Get your joints and muscles functioning well, keep it that way through a program of specific exercises and feel the positive physical and mental benefits.

You’ve only got one shot at life, let it be focused on inner health and happiness!!

Stay tuned for the exercises, they are coming!!

You’ve looked forward to it for a good while, rushed around getting ready, jumped in the car, hung around in the airport, sat in a bad position on a plane for a few hours as you’re over 5ft tall, pick up your cases at the other end and your back goes.

First stop, the local chemist for painkillers, spend the next 3 days shuffling around while everyone else gets fed up with the moaning! Sound familiar?

Here’s how to avoid getting a pain that spoils your family’s enjoyment of the holidays.

Firstly try not to get too stressed running around and squeezing all those essential tasks into the frenetic last two days before you go, stress will increase your chance of a back or joint strain by increasing tension, but more likely by causing you to take short cuts with how you move, leading to bad positions and increased chance of injury.

Try to keep the weight of your suitcase down to a sensible level. Lets face it if you’re flying RyanAir you’ll need to or they’ll hit you so hard in the wallet, not to mention the lost hour of your life stood in the baggage excess queue that you wont be able to afford to spend a penny, or is that a pound these days! Keep the weight distributed as evenly as possible too.

Don't do this or you'll be asking for trouble!!

If you’ve had a long car journey to the airport walk around for 5 minutes before lifting the cases out of the boot, make sure you keep your back straight, swivel your whole body and not the spine.

In the departure lounge don’t spend all your time sitting, walk around. Obviously this is not a problem for those about to spend an hour in the Ryanair excess baggage queue, in fact that could be a blessing in disguise. The fee is cheaper than a visit to the Chiropractor.

On your flight, try to sit upright, (some of us have no option or our knees get crushed), get up and walk around if able to without hindering cabin crew. If you are going to nod off get a travel pillow to help support your neck and prevent injury and keep yourself hydrated, dehydration is a factor in muscle injuries.

At the other end, don’t rush too much to get your case and especially don’t lean too far forward or round someone to grab your bags as they pass you by, this is a great time to get your back injury.

Take care loading your bags and unloading again at the other end. Finally when you do arrive at your destination have another walk around and save the unpacking for an hour or so, except to maybe get your swimmers out for a relaxing dip.

Most importantly of all though, make sure you have a great time and recharge those batteries. Happy holidays .

Summary:

• Keep calm and avoid stress
• Don’t overdo the packing, keep the weight down (better for the environment too)
• Walk about between legs of the journey when possible.
• Try to sit upright on your flight or car journey.
• Watch out when picking up bags from carousel, don’t rush and reach round people.
• Walk about again before lifting bags from car or bus at other end. If it is a bus transfer let the driver do it if possible or someone else with longer and stronger arms!

Have a great time!

For some the answer to that is quite easy, for those that have to do it, or love to do it here are a few tips for avoiding or reducing your chance of getting back pain.

The biggest problem with gardening is that most of the work is done at ground level, so you will be spending alot of time flexed. A prolonged fexed posture will stretch your ligaments and allow increased motion. This can lead to reduced control and a buckling effect to cause the joints to get sprained. Heavy lifting after a flexed position, e.g. getting that bag of compost or moving that pot arount the patio, can cause a disc herniation.

TIP 1: If you have been bent forward for a while,  make sure that every now and again you stand up and gently arch your back. Hold this position for about 2 minutes. Alternatively, do a bit of dead heading, prune something over head height or just stand there with a glass of water or cup of tea and survey the fruits of your labours, it works for the guys who fix our roads,there’s method in their madness!!.

Tip 2: Mowing: Do you have a hovver? Then what ever you do don’t swing it around in a huge arc, the twisting action puts a huge load on your back, repetitve twisting significantly increases your chances of an injury. Considering you may have just done the equivalent of an assault course to get the thing out of the shed or garage, your back is probably already feeling the strain before you even start.

So when mowing always try to do stripes, imagine yourself as the head groundsman at Lord’s.  When turning move yourself in a large arc around the mower and not the mower around you. It stops the twist that can easily lead to an injury.

If you’ve got alot of lawn again stop and survey your manor!!

Tip 3:Weeding

Urgh, the dreaded weeding, why do they always grow better than the stuff I put in? When weeding try if you can to get down on all fours, use a pad to protect your knees and brace your stomach muscles as you dig them out. You’ll actually be strengthening your core muscles at the same time, who says men can’t multi task? If you feel brave point out your opposite leg to the arm you are weeding with, at the same time. This is actually one of the elusive exercises that will one day be on this blog. ( I’ve just got to lose a little weight first as the photo’s aren’t that flattering, my web guy said he’d photoshop me onto some athletes body, cheers for that!!)

Tip 4: Pruning / Working overhead

Where possible use ladders and move them to the area you are working so that you don’t have to overstretch, simple really.

Tip 5: Brushing and sweeping

Similair to mowing really, always aim to push or pull to or from your midriff, don’t twist. There’s a theme building here, don’t you think?

Summary:

Don’t bend form the waist for too long, if you do straigthen up for a while before attempting a heavy lift, don’t twist with brushing or mowing, don’t overstretch on ladders, do get down on all fours to do the weeding and most important of all…..

Make sure you stop, get out a chair and enjoy what you’ve created, don’t let it be a labour of Hercules!!
Till the next time

Steve Oldale

Back In form Chiropractic

As its been a while since I posted and while I still struggle to organise my time a little better I thought about the teenage years and how perfectly agreeable children morph into adults.

Could it be that the grunting, awkwardness and general lethargy that seem to hit between the years of 12 and 16 are not just down to hormones or that craving for independence.

If you consider that your nervous system constantly checks and updates where you are how fast you move and what stretch or tension you are under, is it possible to hypothesise that teenagers are suffering from a systemic confusion due to their bodies growing faster than the nerves ability to catch up, retrain and adapt?

Could this explain why some teenagers have trouble putting a few words together or dressing themselves, maybe they just can’t quite co-ordinate the nervous system, it could explain a few things!!

This is tongue in cheek, but there could be an element of truth in it. It’s the fine reflexes that happen millions of times a second in your body that are responsible for controlling your everyday activities such as speech, movement, balance, strength etc. If these get disturbed we compensate but only up to a point, this paces other joints under stress and the problems start to get compounded, so over the next few weeks I’ll be adding photo’s (yes they are done) and exercises that will help to hone balance and improve your awareness of the joints, this will enable you to train harder, or just to get that confidence back to help you avoid pain. So starting soon we will be up and away, video will follow later.

Active Stretches. 

Before exercise do what is known as an active stretch. That is swing the limb in an arc that replicates the movements you will be doing, don’t do what is known as a passive stretch ie stretch and hold. 

An active stretch wakes the muscle up, stimulates blood flow and heightens your body awareness for that area. A passive stretch reduces your body’s awareness as already mentioned. (See previous blog).

Make sure that you don’t overdo the stretch, let the limb limber up at it’s own pace, do some gentle exercise in the sport or activity that you plan to do and combine it with the active stretch. For example if you are going to swim, swing the arms forwards and back in an ever increasing arc, then also pull the arms back tightening between the shoulders and reverse across the chest.

 When doing an active or passive stretch try not to stretch the spine or neck too much.

Passive Stretching. 

Passive stretching is used after exercise when you are cooling down, then you can gently stretch and hold. The aim of this is to maintain muscle length, but again don’t get carried away with trying to achieve the flexibility of a gymnast, if you overdo it you can tear weakened muscles and as mentioned before the longer the muscle the less feedback you’ll have from it unless you train your proprioception (balance sense).

Suggested Order Of Exercise.

 This should be the program for your exercise;

• Firstly picture yourself doing the exercise, this primes your nervous system.
• Secondly do the active stretches in combination with a warm up, then go for it, within your limits, making sure that you have good form and are in control of your exercise.
• If you feel that you are losing control, e.g. dropping a hip or getting tired, then stop for a while try again until your form goes and repeat, if you can’t maintain the good form then stop.
• It really isn’t good to be jogging when you can barely raise your feet off the ground, you’d be better off walking, and your shoes will last longer!!!
• Do your warm down then gentle passive stretches.
•  Try to focus on the limb so that most of the movement comes from there. I’ll explain why on a later update.

For example, to stretch the Hamstrings keep the low back locked out hollow, never bend from the waist to touch toes, it will weaken your lower back and could even cause a disc prolapse.

 You can either put your leg up on a low stool or step and bend forwards from the hips keeping the low back straight or you can do the Cossack as I call it.  Leg stretched out straight, low back locked out straight and lower your body by bending the other knee that supports your weight, keep the knee out don’t let it buckle in. It’s a good idea to hold on to something for additional support if you are a little unsteady.

 As this blog develops it will gradually build into a volume that has many more specific exercises and stretches in it. Stay tuned for the next one it won’t be long. I’ll be adding photo’s and video soon.