Do I Have To Keep Going Back?
/
Continually needing to go to the chiropractor is a myth.
Read MoreDead Butt Syndrome
/Chiros see this constantly and it is also called gluteal amnesia. It's mainly because most of us sit all the time. We drive to work or sit on the bus/train, sit at work, drive or catch public transport home then sit in front of the tv or read. We might throw in a walk or a gym session but that isn't enough to undo the number of hours we have spent on our bottom.
When we sit down our glute (bottom) muscles need to relax in order for us to maintain that posture. Our hip flexors (muscles at the front of our legs) are switched 'on' and they often stay that way when we stand up.
Lower limb muscles
How can I tell if I have a 'dead butt'?
- Flat/saggy butt
- Tight hamstrings, lower back or hip flexors
- Lower back pain
Why is it a bad thing?
If your glutes don't work, then your lower back and hamstrings (muscles at the back of your legs) need to work overtime to compensate which is why they get tight and often don't loosen up regardless of how much stretching you do.
What can be done about it?
Work it, baby! but even if you do glute exercises, these muscles may not even switch on because in a way your brain may have forgotten about them. That is where chiropractors can help as we work on the spine which influences the nerves and causes our brain and glutes to communicate again. Also, all of our practitioners are able to check you have the correct form when doing exercises.
Some great exercises for it are clams and hip hinges, both pictured below. Glute bridges usually have too much hamstring activation, if our glutes have switched off so don't go nuts thinking you are firming up your bottom because most likely you aren't.
Clam exercise: make sure your hips/lower back don't roll backwards
Hip hinge: keep your weight over your heels and evenly between both feet
Standing Work Station Ergonomics
/So, you have yourself a standing work station. They're awesome! Whilst they take a lot of strain off the discs in your lower back and muscles it also means you are burning more sugar and fats i.e. calories. We will be taking a look at the benefits of having one, how it should be set up correctly, common postural mistakes and how to correct them.
Benefits
- It is much better for your core spinal muscles – providing you stand properly and can lower the incidence of neck and upper back pain by up to 54%. https://www.ncbi.nlm.nih.gov/pubmed/23057991
- Reduces the risk of cancer, particularly breast and colon cancer which seem to be affected by activity. It also reduces the risk of obesity because you burn more calories which helps to prevent heart disease and metabolic syndrome.
- It can also help to increase productivity and boost your mood.
- Our core muscles become less active when we sit especially for long periods of time. When we stand they're much more active but only if they're strong and haven't been damaged, think use it or lose it. I won't go into how to strengthen your core as that's a whole topic of its own. The problem with this is they support all the joints in our spine and if they are weak you are more likely to injure yourself.
Set up
As with sitting down to use a computer the set-up is very important as well.
- Desk height should allow a 90degree angle at elbows with keyboard at a comfortable distance in front of you
- Monitor arm's length from eyes
- Top of screen not monitor level with eyes
- If wear bifocals, top of screen level with upper most part of near sighted section.
- If using two monitors, whichever monitor you use the most be directly in front of you. If you use two equally, put them together on an angle with the edges touching.
Problems that may arise
A picture speaks a 1000 words so have a look at the accompanying image. I caught myself a couple of times standing with my weight significantly over one leg and then also leaning on my elbow. This caused my spine to curve which creates wear and tear.
Also, watch out for rounding your shoulders and sticking your chin forward. This causes a huge increase in strain for your upper back and neck, again, causing wear and tear which eventuates in pain and arthritis.
Standing up is hard work. Partly because it takes time to get used to it but even after you have been doing it for a while your heart needs to work harder to pump the blood around your body and your muscles have a fatigue cycle so they need some rest. To help out with this, alternate between sitting and standing every 45-60 minutes.
Acquiring a standing work desk is absolutely a win for your health. Please remember to have it set up correctly and stand properly as this does wonders for your spine and body.
If you have any questions regarding this or would like help with any spine, muscle or joint pain please contact us, book online or call our North Ryde chiropractor on 8096 6781.
What This Biomechanics Professor Wishes People Knew About the Real Causes of Low Back Pain
/
Over half of the patients that Dr. Stuart McGill sees were injured by improper personal training. The following article debunks long-held myths to help you keep clients pain free.
As a spine biomechanics professor of over 32 years, I share with you an astonishing fact: Over half of the patients that had been referred to me for back pain were caused by personal trainers!
That is quite an indictment of the results from personal training, but make no mistake, I am the biggest supporter of trainers. Trainers, however, have the potential to be the most important determinant of a person’s lifelong health–perhaps more important than their family doctor, therapist, psychologist, or any other type of clinician. But personal trainers often misunderstand the true mechanics behind back pain.
My recent book, Back Mechanic, contains information that is culled from decades of research in various laboratories and clinics. In it, I provide guidelines to assess the cause of pain, then show the reader what to do, as well as what not to do. Part of what’s discussed are several myths that get perpetuated by the public and personal trainers alike. We dispel those myths and help create the framework for making better clinical decisions.
Here are just a handful of those myths, republished from my book with my own addendums, to make sure that you trainers change people’s lives for the better.
Let’s get started.
Myth 1: Back pain is linked to having tight hamstrings
Truth: Our research has found that in most cases, tight hamstrings are a related symptom of back issues rather than a cause. Interestingly, hamstrings often decrease in tightness as back pain subsides. That being said, when one hamstring is tighter than the other, the asymmetry has had mild influences on back pain, particularly in athletes. This book [Back Mechanic] will teach you proper movement patterns for daily activities such as tying your shoes. You will learn that even those of you with tight hamstrings are able to perform such activities while sparing your back.
From a performance perspective, many explosive-type athletes, such as jumpers, need tight hamstrings to store and recover elastic energy. Here the hamstrings are “tuned” rather than stretched (I dive more into this in Ultimate Back Fitness and Performance).
Myth 2: Lying in bed is good for back pain
Truth: In reality, lying in bed for excessive periods actually causes back pain. Let’s examine this more closely. A little known fact is that we are all actually taller first thing in the morning than we are before we go to bed at night. This comes down to our spinal disks. The disks in between each of our vertebrae are packed with very concentrated protein chains that love water. In scientific terms, this means they are “hydrophilic.” When we lie horizontally, the discs fill with fluid and gently push the vertebrae away from one another, lengthening the spine. The reason, our backs are often stiff in the morning is that the discs are so full of fluid, like water balloons ready to burst. When we get up in the morning, and our spines are once again vertical, the excess of fluid in each disc begins to seep out and an hour or two after rising from bed we have returned to our normal heights.
This natural ebb and flow is health and is what allows the discs to obtain nutrition. Problems arise, however, when the spine remains in a horizontal position for too long. While about eight hours in bed is healthy, much longer than that is not as it allows the spine to continue to swell and cause disc pain.
Limiting your time in bed can help with this, as can selecting the right mattress for your back.
Myth 3: My daily workouts at the gym will get rid of my back pain
Truth: The key is doing the right workouts that will preserve your back instead of destroying it. I see patients often perplexed by the fact that they take care of their bodies when an “unfit Joe” they know seems to get by with no back trouble at all.
The truth is that someone hitting the gym every day without spine sparing techniques during their workout, will develop cumulative trauma in their discs. Repeatedly bending your back at the gym, followed by long periods of sitting at work, chased down with poorly executed daily tasks such as getting dressed or gardening conspire together to cause the slow delamination of some of your disc fibers.
“Unfit Joe,” who sits all day, doesn’t experience the same strain on his back that a gym superstar does by aggravating their disc injuries every time they sit. In terms of pain, their spines are better off! The key is not to stop working out! The secret is in changing your default movement patterns so that you can enjoy the benefits of fitness without compromising your back.
Myth 4: Yoga and Pilates are great ways to alleviate back pain
Truth: While many doctors and therapists will suggest this type of exercise to their patients because of its “therapeutic” properties, our studies have not supported these claims and in fact have indicated the opposite. While some poses and movements may be beneficial or feel good at the time, there are components of both exercise systems that will aggravate an individual with back conditions. There is no such thing as an exercise program that is beneficial to all back pain sufferers and to broadly prescribe either yoga or pilates to a patient with undefined back pain is, in my opinion, irresponsible. Every single exercise should be justified and then modified if necessary to suit each person.
One of my major issues with Pilates is that one of its key principles is to flatten the spine and “imprint” the lower back to the floor when lying down. This deliberate effort to disrupt the spine from its neutral position and “straighten” one of its natural curves is not healthy and can trigger pain sensitivity in a person who is already sensitized.
Some people experience a false sense of relief while going through this motion because it stimulates the back’s stretch receptors. In reality, this relief is fleeting and pain symptoms typically return with a vengeance due to the stresses placed on your discs.
Another staple of the Pilates regimen is called the “Rollup.” This movement is essentially a sit-up that involves segmentally rolling through each joint of the spine. Our science has justified avoiding sit-ups as part of a routine for a healthy spine and the Rollup essentially takes a bad exercise and makes it worse.
Consider bending a slender branch back and forth–no stress develops. But repeat the bends with a thicker branch and it will crack and break due to the higher stress. This is why stronger people with thicker spines actually create delamination of their disc fibers with fewer bends than a slender-spined person.
Further, training mobility softens the matrix holding the collagen fibers together and decreases the load-bearing ability. Training strength toughens the collagen matrix reducing mobility. Thus, the adaptations are specific, which means that a person must choose between training predominantly spine mobility or spine strength with load- bearing ability. Very few people can have it both ways.
Thus the exaggerated fashion of the Pilates’ rollup puts an emphasis on moving through the spine, putting unnecessary load and strain on the discs. The real goal should be to minimize spinal movement and instead use our hips as primary centers for motion. This philosophy will allow the back pain to settle.
As we’ve already discussed, a therapeutic exercise must be recommended that correlates with the results of a detailed assessment. Many doctors mindlessly suggest Pilates, buying into the unexamined orthodoxy that says Pilates is good for the back. This needs to stop. Don’t get me wrong. There are many Pilates and Yoga instructors I have met taking my clinical courses and have expertise in matching specific exercises to specific people. These instructors are well aware of the importance of avoiding certain pain triggers and adjusting exercises to prevent the worsening of pain.
The bottom line is that if the specific components of Yoga and Pilates are selected and modified for the person doing them, they can help a back patient, but neither of these programs should ever be recommended as a “blanket cure” to all back pain sufferers.
Myth 5: Stronger muscles will cure my back pain
Truth: Therapists often begin strength training early in rehabilitation simply because strength is the easiest attribute to increase and requires very little expertise. Or, curiously they have decided to measure strength as a metric for disability–this is driven by a legal process seeking monetary settlements based on strength loss (or sometimes loss of motion).
Too many patients remain long-term patients because of their misguided efforts to train their back strength. In many cases, their training approach needs an overhaul. Think of strength in relation to the body like horsepower in relation to a car. If a souped-up 500 horsepower engine is put inside a dinky, broken down car and then raced around town at top speed, it’s only a matter of time before the mega-engine rips the frail frame and suspension to piece.
Similarly, a back patient who has developed a disproportionate amount of strength in relation to their current level of endurance can only expect further injury. We have measured this time and time again in strong back patients. Specifically, a resilient back has endurance matched to strength.
Back injuries are a result of putting a spine under load and then breaking healthy movement form. Maintaining proper movement patterns requires endurance. Therefore, we must always place endurance as a higher priority to strength when it comes to rehabilitating a patient with a spine condition. Only after the back-pained person has increased our endurance for sustaining healthy movement patterns, and in turn their stability and mobility, should they progress to more aggressive strength training.
Myth 6: Stretching is good for reducing back pain
Truth: Although stretching is considered universally beneficial for back pain sufferers, this is an old-fashioned notion that needs challenging.
There is no such thing as a stretch that is good for all patients, just as there is no such thing as a single source of pain. Each back pain case is different, and as such each stretch must be chosen very, very carefully and tailored to the individual. Too often, therapists prescribe stretches that are totally wrong for a patient often with the ultimate goal of improving mobility in the spine. For most back pain sufferers, this is the opposite of what they should be doing in order to gain control of their backs.
Physiologically, pulling your knees to your chest, or other similar stretches, trigger the “stretch reflex.” This is a neurological phenomenon that reduces pain sensitivity. This provides about 15-20 minutes of pain relief for some, making it a short-term fix. The problem is that in putting in your spin in this position, you are aggravating your discs and after you’ve experienced temporary relief, the pain will return, often worse than before. Thus begins a vicious cycle with a misinformed back patient who thinks their only solution to pain is to “stretch it out,” not realizing that this is in fact contributing to their pain. The key is to stop the cycle!
Instead of focusing your energy on stretches that bend the spine, turn instead to stabilizing and controlling the spine. Follow the self-assessment of the pain triggers shown in Back Mechanic. Modifying your daily movements to keep your spine in postures that do not trigger pain, which for most people is “neutral.” In following this path to recovery, your discs will experience less strain, your pain will subside and your mobility will return!
Essentially, when dealing with stretches with back pain, avoid those that involve pulling your knees to your chest. Your pain triggers will de-sensitize faster.
Myth 7: Having a powerful back is protective
Truth: Power is the product of velocity and force. So high power is generated when quickly bending the spine together with a forceful exertion. Generating power in the spine is highly problematic, as it increases the risk of injury. Let’s break it down. If spine movement or bending occur at a high velocity, the forces (or load) on it must be low in order to avoid injury. For example, the golf swing has high velocity but low force.
Alternatively, if the force being placed on the spine is high, then the velocity must be kept at a low level in order to maintain a low risk of injury–think the deadlift. Essentially, the risk of back injury can be controlled by keeping spine power low.
—————-
This article has been adapted from ptdc.com
All of this information can be found in my comprehensive book about back pain, Back Mechanic. Everyone needs to learn good movement for optimal health and absence of injury and disease. Well-executed motions, postures, and loads can build the body, maintain a high-level performance, and preserve pain-free enjoyment all throughout a person’s life. By contrast, little to no movement, inappropriate exercise choice, and poor programming that lacks appropriate rest and adaptation can create cumulative trauma and ill health.
If you have any questions about this article or would like help with any spine and joint issues, please either call our North Ryde chiropractor on 8096 6781, book online or contact us.
Constant Stress
/
We have all experienced stress at times in our lives. The source of our stress can vary from things such as: our relationships at home, work deadlines, colleagues at work or illness. Constant stress can become unhealthy particularly when it causes us to crave foods that may taste good but don't nourish our bodies - did someone say comfort food?! If we don't receive the correct nutrition it becomes harder for our bodies to deal with stress and we're more likely to put on weight.
The Cortisol Made Me Do It
Also, known as “the stress hormone,” cortisol can increase when you’re feeling tense or stressed. This may cause you to reach for comfort foods such as pasta and bread as well as sugary foods. This isn't such a great idea as eating those foods causes our blood sugar to quickly rise. This combined with the fact that cortisol causes our blood sugar to rise too as our bodies are preparing us to either 'fight or flight' can lead to type 2 Diabetes. Of course, one can enjoy these foods in moderation. Try to eat a diet filled with nutrient-dense foods such as lentils, beans, lean protein and plenty of vegetables.
Chronic Stress
Long term increases in cortisol can lead to a lower life expectancy, interfere with learning and memory, lower immune function and bone density, increase weight gain, blood pressure, cholesterol, heart disease. Chronic stress and elevated cortisol levels also increase risk for depression, mental illness, and lower life expectancy. (1)
How To Manage Our Stress
Whilst alcohol can help to relax us it isn't a great way to deal with stress long term.
If you are stressed and you have been a couch potato lately it is time to get moving as this can reduce your cortisol levels. It also boosts our endorphin levels which are our 'feel good' hormones. You don't need to go for a run, going for a walk is great but do try to get your heart rate up and push yourself.
Receiving chiropractic treatment may have a positive impact on reducing your cortisol levels. (2) Chiropractic can also help alleviate muscular pain and tension which may help to your alleviate stress. (3)
Meditation and breathing exercises can help to reduce stress and clear you mind - try out this video. A lot of people say they can't keep their mind still enough to meditate. Meditating won't necessarily make you a zen-like Buddhist monk and it is very normal to have thoughts going in and out of your mind, try not to get frustrated by this. Instead, notice that your mind has wandered, and start focusing on your breath again. Your mind may wander a hundred times and that is ok!
If you would like help with your stress management, contact us today to schedule an appointment.
(1) https://www.psychologytoday.com/blog/the-athletes-way/201301/cortisol-why-the-stress-hormone-is-public-enemy-no-
(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2050804/
(3) 'Mechanism of action of spinal manipulative therapy' Joint Bone Spine, Vol 70, Issue 5, September 2003, pg 336 - 341
Fighting Off The Grumps
/
I wanted to share with you a recent experience of mine and before I do I would like to state there is no scientific proof for this but it did happen to me.
Last weekend, I was in a grumpy mood. My back was sore from picking my kids up. I was tired, snapping at my husband for the tiniest things and did not want to do any of the household chores that desperately needed doing. So, I got an adjustment from my colleague, David. As soon as I got up from the table, I was no longer in pain but the best thing was I was in a better mood and had tonnes more energy!
I went home a much happier person. I was productive and my whole family had an enjoyable weekend. My husband was very glad I stopped snapping at him!
The reason I am sharing a not so glamorous story about myself is that it might just help you or a loved one if they have similar behaviour.
Putting The Weight On
/
Apart from aesthetics, carrying excess weight puts increased pressure on our spine and knee joints causing them to wear out faster. For every 5kg of weight gain, there is an increased risk of developing osteoarthritis by 36%. 1. Thought you might find it interesting to know what happens to your joints when you are carrying excess weight but before we dive in, it is important to note that even a healthy weight individual can develop osteoarthritis in their spine through poor posture, sitting too much, lifting objects whether big or small without bending their knees and it can also be genetic.
The progression of arthritis is faster in those who are overweight/obese. They're also more likely to have an altered walking pattern (gait) and muscle weakness, usually their quadriceps and lower back muscles which often leads to pain. 2. As the leg muscles are weak, there is an increase in the amount of shock one's joints need to absorb. Overtime, this causes damage to the cartilage inside the joints and it wears away, causing arthritis.
When someone is obese, they deposit fat in their muscles which increases inflammation in the body. Inflammation makes osteoarthritis worse. There is good news though, losing weight takes pressure off one's joints and reduces inflammation in the body, so it is possible to either prevent the onset of osteoarthritis or slow it down. 3.
And of course, I do need to mention that if someone has osteoarthritis, chiropractic can be beneficial in reducing the pain associated with it and keeping the joints more mobile. 4.
1. Obesity and osteoarthritis. Lementowski PW, Zelicof SB. American Journal of Orthopedics. 2008;37(3):148–151.
2. Nebel MB, Sims EL, Keefe FJ, et al. The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2009;90(11):1874–1879.
3. Obesity and weight loss in the treatment and prevention of osteoarthritis, Physical Medicine and Rehabilitation. 2012 May;4(5 Suppl):S59-67. doi: 10.1016/j.pmrj.2012.01.005
4. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. Pollard, H. et al J Can Chiropr Assoc. 2008 Dec; 52(4): 229–242
It Does Wonders
/Have you ever found that standing up straight makes you feel better? My Mum used to tell me this and when I was younger I would dismiss it but now science shows it does. You were right Mum! Sorry I doubted you!
Research by Dr Elizabeth Broadbent at the University of Auckland showed a relationship between mood and good posture. It shows that one can increase resilience, make you feel more confident and after a success help you to feel more proud. It also suggests that you can feel less fearful, have higher self esteem after a stressful situation and feel more alert and enthusiastic. (1)
Broadbent also did research on people with depression and found that those who held themselves with good posture reduced their fatigue and had increased enthusiasm. They also performed better at stressful tasks. (2)
Having poor posture doesn’t mean you will have pain but it most likely will contribute to trigger point or knot formation in your muscles. These are more likely to be painful when you carry yourself with poor posture.
When you have poor posture, your joints aren’t moving correctly which can cause the joint to break down and eventually lead to arthritis. (3) So, having good posture does wonders for us by improving our mood and confidence and reducing the likelihood of developing arthritis. Chiropractors perform spinal manipulation as part of treatment which has been proven to be safe and effective for back pain (4) and it is much easier to stand up straight when you aren’t in pain.
1. Nair S et al. Do Slumped and Upright Postures Affect Stress Responses? A Randomized Trial. Health Psychol. 2015 Jun;34(6):632-41
2. Wilkes C et al. Upright Posture Improves Affect and Fatigue in People with Depressive Symptoms. J Behav Ther Exp Psychiatry. 2017 Mar;54:143-149
3. Swiss Medical Journal, 19 July 2012, doi:10.4414/smw.2012.13583
Milk
/We have all heard that drinking milk helps to reduce the risk of a fracture however there isn’t any solid research to prove this. Researchers are leaning towards eating a healthy diet and lots of weight bearing exercise to improve your bone health instead. Particularly eating tofu, beans and greens as they contain lots of calcium. 1 Drinking 3 or more glasses of milk per day can increase your risk of a fracture. It causes oxidative stress and inflammation, which basically means this causes damage to our cells. 2
What about organic milk? It contains twice as much omega 3 as non-organic milk but the levels are still really low relative to other sources. The reason for the extra omega 3 is organic cows are allowed out to eat more grass. Organic milk contains less iodine as the cows don't get it in supplement form. Iodine is extremely important for pregnant women. Some good news though, cows in Australia aren't allowed to be given growth hormones. It is unclear at this stage whether growth hormones from external sources may promote cancer growth so best to avoid it. 3
Other dairy products, cheese and yoghurt, promoted lower fracture rates. This is due to the fermentation process however they don’t fully understand why, it's possibly due to the reduction in lactose during the process. 1
Why not choose soy milk? It often comes pre-sweetened, so choose the unsweetened ones and per 100 grams only contributes 2% to your daily calcium intake whereas cow’s milk contains 12%. People often drink it due to its cholesterol lowering benefits, however, it only offers a 3% reduction in LDL or harmful cholesterol. The proclaimed phytoestrogenic effect to help reduce the risk of breast and prostate cancer isn't scientifically backed yet and a small number of studies say it may increase the risk of breast cancer. 4
1. New Scientist 11/3/17
2. http://www.bmj.com/content/349/bmj.g6015?etoc=
3. https://www.newscientist.com/article/dn27898-so-many-milks-but-do-their-health-claims-really-stack-up/
4. https://www.hsph.harvard.edu/nutritionsource/2014/02/12/straight-talk-about-soy/
It Needs To Start Now
/As school is back next week, we would like to remind you that heavy, poorly fitted and packed backpacks may lead to spinal health problems in children.
Spinal health problems in school children often go unnoticed. However, poor posture, back pain or ‘growing pains’ need not become an accepted part of everyday life for your child.
When choosing a backpack for your child, choose one that allows for even distribution of weight across the back. Otherwise the backpack can place unhealthy stress on a child’s spine.
School can be a challenging time for any child, so ensuring they are as comfortable as possible is important for their physical and mental development.
Despite the increased use of technology in schools, school children still overload their backpacks with textbooks, sports and other gear or simply do not wear them correctly.
Five simple tips for wearing a backpack:
- Pack the heaviest items closest to the spine
- Make sure to do all the zips up
- Secure the sternum, waist and compression straps
- Always use both shoulder straps
- Don’t wear the backpack below the hollow of the lower back as this causes the child’s head to go forward. This starts the process of spinal degeneration and it starts in kids as young as 10 years old.
The Chiropractors’ Association of Australia worked with Spartan School Supplies and Macquarie University to research and develop the ‘Chiropak’. This durable, functional and comfortable backpack is proven to reduce the incidence and severity of neck and back pain associated with the carriage of heavy loads. Find out more about the Spartan Chiropak.
Check out this video for further information about school bags, shoes and nutrition.
If you know anyone who has school aged children, this information is important so please forward it on to them.
