Gardening and Your Back

We have seen quite a few clients recently who have hurt themselves whilst gardening. It can be quite a strenuous activity so warming up your body beforehand by rotating your arms forwards and backwards, doing some light squats and reaching down for your toes is a good start. At the end, do some gentle to moderate stretching to loosen up your muscles and minimise pain the next day. 

Gardening tip: If you are using a mattock, make sure you aren't using your back to bring you back up to the starting position, use your Glutes (butt muscles). Using your back to generate the movement is a great way to strain a muscle or sprain a joint.

If you experience back pain whilst gardening, please reply to this email or book online, as we can help you.

How Long Will It Take? 

My colleague, Dr Jerry Kennedy, wrote this great article on a common patient question and frustration. He did a great job in answering it.

One of the most common questions that patients ask their chiropractor is, “How long will it take?” Some people ask because their #1 concern is that the chiropractor is never going to let them go. Maybe they have heard the “once you go you always have to go” myth that some people say about chiropractors. If that’s you, I have good news. It’s not true. Your chiropractor isn’t ever going to hold you hostage. That’s not the reason that most people ask that question. The majority of people who ask, “How long will it take?” are asking because they are in pain or in some way hampered, and they would like to get back to normal as soon as possible. That makes perfect sense. If patients had their way, they would get better instantly. I jokingly refer to that concept as patients wanting a “Jesus visit.” That’s when they go into their chiropractor’s office, get an adjustment, and are instantly better. Healed! Unfortunately, it doesn’t usually work that way. Sure, there is the occasional exception to the rule, but for the most part, your body takes time to heal. It’s also important to note that healing and feeling are not the same things. There are times when a medication or a treatment can help your body feel better quickly, but that doesn’t mean it has healed yet. If your pain/problem comes back as soon as the medicine wears off, your body hasn’t yet fully healed. The same is true of treatment. If your pain/problem comes back a few days after your treatment, your body hasn’t yet fully healed. That doesn’t necessarily mean the medicine/ treatment isn’t working. It could just be the difference between feeling and healing. So that brings us back to our original question, “How long will it take?” Unfortunately, there isn’t an exact answer. It depends on the problem. It depends on the person. There are a lot of factors at work. It’s an oversimplification, but I used to tell my patients that 5 factors would determine how long it would take their body to heal.

First - how old are you? That’s an easy one. Younger people heal faster than older people. The older you get, the more you realize how true that is.

Second - how bad is the problem? Not all health problems are the same degree of severity. Let’s use a sprained ankle as an example. On one end of the spectrum, you could have a minor sprain that heals up in 24 hrs. No big deal. On the other end, you could have a major sprain that requires many weeks of rest and therapy to heal. As a general rule, the more severe a health problem is the longer it takes to heal.

Third - how long have you had the problem? Just to clarify, that’s not necessarily the same thing as how long you have felt bad. It’s possible to have a health problem much longer than you have felt bad. Arthritis is a great example. Most people who have arthritis will have it for years before they ever have any pain. As a general rule, the longer you have had a health problem the longer it will take to heal.

Fourth - where is the problem? You may not know this, but different parts of the body heal at different rates. Muscles heal faster than ligaments. Ligaments heal faster than bone. Even the different joints of the body heal at different rates. An injury to your elbow is likely to heal much faster than an injury to a more complex joint like your shoulder.

Fifth - are you (the patient) willing to do your part? Healing not only takes time but it also takes participation. Sometimes rest is required. That means the patient has to be willing to slow down or stop. Sometimes nutritional changes are required. That means the patient needs to add something or remove something from their diet to help their body heal. Sometimes stretching or strengthening is required to help heal an injury. Ultimately, a patient who is willing to do their part to help their body heal will heal faster than a patient who doesn’t.

So when you ask your chiropractor the question, “How long will it take?” often you won’t get a specific answer. Don’t worry…they aren’t avoiding the question just for the sake of avoiding the question. It’s a difficult question to answer because the answer is different for every person. More often than not, chiropractors will take the information that you have given them, and use their clinical experience to give you a timeframe. It’s not set in stone. You may do better than expected and heal faster. You may do worse than expected and heal more slowly. Everyone is different. What does all this mean for you? Well, it means a couple things.

First, it’s important that you understand that healing takes time. If you expect your body to heal instantly, you may quit doing the exact things you should be doing because you aren’t willing to give them the proper amount of time.

Second, it’s important that you have open communication between you and your healthcare providers. You should be able to ask questions and express concerns. They should be able to let you know what you are doing right and what you are doing wrong. When you and your healthcare providers work together as a team, you are more likely to get positive results faster.

Lastly, it’s important that you do your part. Patients who participate in their care heal much faster than those who don’t. Stretch when it’s time to stretch. Go to your chiropractic appointment when it’s time to go to your appointment. Do your exercises when it’s time to do your exercises. Rest when it’s time to rest. The bottom line is this…everyone is different. How long it takes your body to heal is going to be different than how long it takes my body to heal. If you want to heal as quickly as possible and get back to normal, you have to be patient and you have to participate in the process. You can do it!

If you are ready to have your back pain resolved, please contact us or call 8096 6781.

Fuel For Your Back

Your back pain isn't only affected by what you do or don't do throughout the day but also by what you eat. 

What you eat affects your back pain and body composition. Your body is like a car's engine, if you fuel it with e-10 and it needs 95 or 98 octane fuel, don't get upset when it doesn't give you the output you want. Research shows that a plant-based diet is best to help reduce pain and inflammation. Whilst a purely plant based diet makes it harder to get in enough protein and you may be sad to not eat meat, the Mediterranean diet is a happy medium.

If you would like to know more about fuelling your body properly to reduce pain please contact us or book in online to start feeling better today as our chiropractors love being able to help.

How Do I Strengthen My Back?

If you really want to make headway in regards to getting a stronger back to reduce pain and tension, you need to address the weak muscles and areas that aren't moving properly in your body. To obtain your best results you need to be assessed for these imbalances. Our chiropractors, are able to examine you and provide an appropriate strength and mobility rehab program tailored for your body.

If you don't have pain but you find your hamstrings and hip flexors or side of neck/shoulder muscles are always tight regardless of how much you stretch, you need to be assessed for weak areas because tight muscles aren't the root of your problem, they are a symptom of it. Stretching helps but only to a certain extent.

If you are ready to take this step please contact us or book in online to start feeling better.

If you aren't ready to take the step of coming in for a proper assessment to determine specific areas you need to work on, try these exercises at home. If you experience any pain with these exercises, please stop doing them and book in for an assessment with one of our chiropractors.

Dead 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

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

 

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

Hip hinge: keep your weight over your heels and evenly between both feet

If you think this might be stopping you from being more active or pain-free please book online or email us as our North Ryde chiropractor and remedial massage therapist love helping you out.

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.

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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.

Stronger is Better

I hope you enjoyed the October Long Weekend and have adjusted to the clock going forward.  I love this time of year as the days are getting longer.

People tend to get back into exercise if they let their exercise regime lapse over winter. I want to share with you a wonderful exercise to help strengthen your core stabilising muscles, it is called the Pallof Press. It is so important to have a strong core to minimise spinal injury.  Please take a look at this video on our new Riverside Chiropractic YouTube channel.   We will be uploading more videos to our channel in the near future which is very exciting.

 

We will be uploading more videos to our channel soon which is very exciting.

Yippee!!

Hooray for the arrival of spring! Recently I've been getting stuck into my garden at home by removing some small trees and lots of weeds.  It struck me as to what a good workout it was as well as other DIY activities, however, it is potentially quite damaging for one's spine.  Some of these tips might be really obvious to you but nevertheless a reminder is always good.

1) Vary your position when doing a prolonged activity eg if raking do it from the right and left hand side of body and when weeding change from between crouching, squatting and kneeling.  Doing a deep squat is best as it takes pressure off the balls of your feet and calves. 

2) Stretch: your muscles can get a really good workout so loosening them up when you finish will help you to not only feel better but also reduce the likelihood of injury later on.  Our resources page contains stretches

3) Bend your knees not only when you lift heavy pots and plants but also when picking up light objects such as a trowel or a paintbrush.

Gardening and DIY can be a great workout however it predominantly works the muscles at the front of your body so one still needs to do exercises to help strengthen their spine.  This helps to keep it healthy and reduce pain. Some of these exercises are: bridges, vertical row and core muscle exercises.  My colleagues and I can help you out if you have any questions regarding looking after your body whilst gardening.