Back pain affects us on such a psychological level it's crazy.
We tend to treat pain in our back as somehow different to pain elsewhere in our body (although I do believe the knees can also be thought of in the same way)
What I mean is that, say for example we had to lift a lot of boxes yesterday and our arms were very sore when we woke up today, we would probably rationalise that our muscles had been given a workout that they weren’t used to and that it would settle down itself in a day or so, no harm done.
On the other hand, if it was our back that became very sore this morning, the experience might be quite different for many of us. We might worry that we’ve damaged something in our back or because we've heard about ‘slipped discs’ then this soreness might begin to concern us.
The fact of the matter is that the vast majority of back pain is actually nothing to worry about and requires little intervention to resolve itself except for maybe moving a little more.
But any pain in our backs can be scary as hell if we don’t know what we're dealing with.
When we examine the MRI reports of people who are NOT experiencing low back pain, they look much the same as those who DO have back pain.
Degeneration is normal. It's like wrinkles…but on the inside.
Yes there are dangers (seen in roughly 1% of those who have LBP) but for the majority of LBP sufferers the pain is more about sensitivity of the body's systems than damage.
That doesn't make the pain any less real. But it can reduce the worry that something is seriously wrong.
A lot of the exercises I recommend are what are known as Muscle Energy Techniques.
But what are they exactly?
Muscle Energy Technique (MET) a collective name for stretches or movements that aim to relax, lengthen and strengthen muscles by using a person's own effort and movement in the form of gentle isometric contractions. (An isometric contraction is where there is a contraction of a muscle but that muscle does not move.)
Whatever the issue, be a muscle weak, strong or tight and regardless of whether it is a primary component or secondary problem, it does not matter, Muscle Energy Techniques can often help.
MET is based on the concepts of Autogenic Inhibition and Reciprocal Inhibition.
1. Autogenic Inhibition (also known as Post-Isometric Relaxation) is where, immediately following a period of isometric contraction, the muscle that was being contracted (the agonist) becomes inhibited and more hypotonic (relaxed).
2. Reciprocal Inhibition on the other hand focuses on the opposite muscle (also known as the antagonist). Therefore when the agonist muscle is contracted, the antagonist (opposite muscle) becomes inhibited and hypotonic.
MET's introduce a temporary state of relaxation or inhibition and because of this it works well on muscles that are excessively tight with the primary aim being to release this excessive tension and restore normal length to the muscle.
That being said, METs also work to activate muscles that are not contracting the way they should be. In a way you could say that an MET is like a reset button for the body.
And the great thing about it is that you can do it yourself.
When I first came across METs many many years ago when I first trained as a Fitness Instructor, I dismissed them, believing that they couldn't possibly work THAT well. After all, they were gentle (doesn't something need to hurt to work?) and easy (surely they were too simple to have such an effect).
Oh how wrong I was.
Not only do METs help release excessive tightness but they can help to restore function, aid in pain relief and generally kick ass despite being one of the gentlest forms of exercise you will ever come across.
I only wish I'd been open to the power of METs all those years ago!
The video includes some METs that you can use to release your Pelvis. Hold each one for 10-20 seconds using roughly 20% resistance. This can be completed multiple times a day or as part of your warm up/ cool down.
If you are working a desk job (or have a Netflix addiction....and tell me, who doesn't?) then chances are that your posture leaves a bit to be desired. You may have a forward-head position which has shortened some tissues and lengthened others within his neck and shoulders.
This gradual change in shape, occurs when tissues are subjected to a slow, continuous force. This can be from either compression, tension, or twisting and are usually cause by gravity or posture.
To start with, the change is temporary.
However, when the change occurs day after day after day then the change becomes potentially permanent.
And the more your body changes shape biomechanically, the more issues you may start to encounter.
But when people come in to see me they blame their bad posture for all sorts. But is bad posture really the problem? No. The problem is lack of movement.
There are ways around it though. Simply moving that little bit more during the day, standing up and having a walk around, changing positions, rolling your shoulders all help to prevent this change becoming permanent. Set a timer. Move every 20 minutes. Your body will thank you for it!
Many people start Pilates in order to ‘protect' their spine or help with longstanding low back pain.
But does it actually help?
As always you will find research that support it but you will also find research against. (You can find research for anything if you look hard enough).
But the truth is that WHAT you do doesn't matter as much as doing something….ANYTHING!
Pretty much all exercise has been found to help in one way or another.
So if you enjoy doing Pilates and if it makes you feel good, then please don't stop.
But if you don’t enjoy it then don't do it. Simple as. Find something else. Just get you moving!
The state of our gut can affect our brain.
If this is not something you have heard before then it may at first sound unlikely.
But did you know that up to 70% of the neurons outside of the brain exist in the intestines.
How then can we possibly ignore our gut (and what we put in it) when we are trying to change what goes on in our brains. Like pain. Or our mental health.
It has been said that the gut is our second brain. And I for one am discovering that for myself.
I guess that's what is meant by trust your gut. Maybe we need to start paying a little more attention to how we treat it.
Like it or not, we’re influenced by the 5 people that we spend the most time with in our lives.
These people affect everything!
From our way of thinking, our financial situation, our self-esteem, all the way to the decisions we make and even our personalities to some degree.
Of course, we are all our own person, but research has shown that we're more affected by our environments than we might realise.
So have a think about the people you spend the most time with.
Are they supportive, encouraging, and do they truly care about you?
That being said, while it's ideal to be closely surrounded by positive, supportive people who want you to succeed, it's also necessary to have your critics too. The ones who tell you exactly what you need to hear (even if you don't like it).
It's about balance.
You need honest, caring, supportive people who will have your back but also tell you when you're being an ass.
Sometimes it's worth considering who you let in to your “inner circle!”
The field of mind-body medicine is plagued by wild claims that mislead patients and instil false hope. But as scientists in a range of fields uncover solid evidence that our minds influence our bodies far more profoundly than previously thought, there is now great promise too.
I listened to this book during my long walks last summer and found myself getting more and more excited by each and every chapter.
I appreciate the power that the mind has over the body from the work I do on a day to day basis, but this book takes that appreciation even further.
This book is the reason for my fascination in the placebo effect, in pain and how we can change the body by using our mind, but I just don’t feel that anything that I write can really do the book justice.
It really is an amazing, thought-provoking book, that is packed with so much information and written with scientific accurateness.
Understanding the role of fascia in healthy movement and postural distortion is of vital importance to bodyworkers and movement therapists.
I bought this book many years ago but when I was completing my Sports Massage Qualification. Despite the first couple of chapters being a little technical to read at the time, I found it to be an excellent book with great illustrations, that provided an awesome place to start in terms of structural integration.
Although the book is based around theories of the Trainlines, many of which can be questioned, the book itself does make you think about the connections within the body in terms of movement. It's definitely a great book to flick through with the diagrams enabling you to pick up so much from just them alone.
The more I learn the more I question the theories of the lines. That being said, it's well worth a read.
A Guide to Better Movement offers a clear and practical look at emerging science related to the brain’s role in movement and pain. It is written for movement professionals, athletes, chronic pain sufferers, and anyone else interested in moving better and feeling better. In it, you will learn: the essential qualities of movements that are healthy and efficient; why good movement requires healthy “maps” in the brain; why pain is sometimes more about self-perception than tissue damage or injury; the science behind mind-body practices; general principles that can be used to improve any movement practice; and 25 illustrated and simple movement lessons to help you move better and feel better.
I read this book after reading Explain Pain and realised that this was very much a simplified version of that book with some added exercises based on the Feldenkrais method.
This really sounds like I'm dumbing the book down but I'm not at all. It's a great introduction to up to date pain science (as well as being a cheaper alternative to Explain Pain).
It's an easy guide of what constitutes better movement as well as explaining the physiology and research behind it
Perfect for therapists who are just starting to understand Pain Science as well as those interested in improving their own body and movement.
Myth 1: Carbs are bad for you
The Truth: Carbohydrates have been vilified long enough. As long as you don’t overindulge, starches are not inherently harmful.
Myth 2: Fats are bad for you
The Truth: If you stay in a caloric surplus, a low-fat diet won’t make you lose weight, especially since it can decrease your testosterone production. You need some omega-3 and omega-6 fatty acids, saturated fat won’t give you a heart attack, but too much trans fat may.
Myth 3: Protein is bad for you
The Truth: Protein, even in large amounts, isn’t harmful to your bones. It isn’t harmful to your kidneys either, unless you suffer from a pre-existing condition.
Myth 4: Egg yolks are bad for you
The Truth: Eggs are a great source of proteins, fats, and other nutrients. Their association with high cholesterol and cardiovascular disease has been severely overblown.
Myth 5: Red meat is bad for you
The Truth: Fears about cancer and red meat are exaggerated. Making healthy lifestyle choices (such as staying at a healthy weight, exercising, and not smoking) is more important than micromanaging your red meat intake. If you’re going to lay off red meat, start with avoiding too much processed/cured/smoked red meat.
Myth 6: Salt is bad for you
The Truth: Salt (sodium) isn’t strongly associated with high blood pressure, except in people with salt-sensitive hypertension. Still, anything in excess is harmful, and sodium is no exception.
Myth 7: Bread is bad for you
The Truth: While some people are sensitive to wheat, the gluten content isn’t necessarily to blame, and other foods may also be implicated.
Myth 8: Whole-wheat bread is far better than white bread
The Truth: Though whole-wheat bread is claimed to be far healthier than white bread, they aren’t that different, and neither contains high levels of fiber or micronutrients.
Myth 9: High-fructose corn syrup is far worse than sugar
The Truth: HFCS and table sugar are very similar from a health perspective. Though HFCS may sometimes contain more fructose, the difference is negligible.
Myth 10: Foods are always superior to supplements
The Truth: With regard notably to vitamins, foods are not always superior to supplements.
Myth 11: Supplements are superior to foods
The Truth: Supplements have their use. You can benefit from supplementing specific vitamins or minerals, and a protein powder can make it easier to increase your daily protein intake. But supplements should complete a healthy diet — not replace it.
Myth 12: You should eat “clean”
The Truth: “Clean eating” is the new fad, but gurus don’t even agree on which foods are clean and which are not. Stick to the basics. Favor whole foods (but don’t feel like any amount of processed foods will kill you), eat organic if you want and can afford it, peel or wash your vegetables and fruits (especially those with higher levels of pesticide residue, such as strawberries), and avoid stressing too much about what you eat, since stress can shorten your lifespan.
Myth 13: You should “detox” regularly
The Truth: Focus on sustainable health habits, such as eating nutritious food on a daily basis. Ample protein, leafy greens, and foods chock-full of vitamins and minerals are not just tastier than anything a “detox diet” has to offer, they’re also way better for you (and your liver detoxification pathways, ironically).
Myth 14: To lose fat, eat more often
The Truth: Digestion does slightly increase your metabolic rate, but meal frequency has less effect than the total caloric content of the food consumed.
Myth 15: To lose fat, don’t eat before bed
The Truth: Eating late won’t make you fat, unless it drives you to eat more.
Myth 16: To lose fat, do your cardio on an empty stomach
The Truth: There’s very little difference between cardio on a fed or fasted state with regard to fat loss, muscle preservation, daily caloric intake, or metabolic rate. What really matters, then, is you. Some people feel lighter and energized when they do cardio on an empty stomach, while others feel light-headed and sluggish.
Myth 17: You need protein right after your workout
The Truth: You don’t need protein immediately after your workout, but you might benefit from 20–40 g within the next couple of hours (and before bed). What matters most, however, is how much protein you get over the course of the day.
Original Source : https://examine.com/nutrition/awful-nutrition-myths/
Reading back over some of my previous posts it's clear to see how my thought processes have developed over the last few years. Where I have often 'blamed' a particular part of the body for causing pain and restricted movement, I now understand that just because pain is lessened or movement is improved by treating a particular joint or muscle, does not mean that that joint or muscle was actually the cause of the problem. This is something that has been bugging me for a long, long time but thankfully, after reading Louis Gifford's work it has just reinforced my thinking.
So despite wanting to cringe at my naivety (as well as wanting to re-edit all my posts!) this development in my thinking is a complete breath of fresh air. It means that we can 'treat' the body in a number of different ways and many of them will work regardless of where the issue is stemming from. We do NOT have to perfect!
That doesn’t mean that we are ignorant to the problem, it just means that we have so many more options available to us. There is not one exercise that will work for any particular issue. There are many. The skill is in finding a) the exercise/ treatment that the body will respond to and b) the exercise that the client will complete.
Both a) and b) should be a doddle compared to how difficult it is to get away from 'blaming' a particular body part. So forgive me if I forget. I'm still learning!
However that being said, you will still find me posting certain exercises for certain issues.* I don't believe I am being a hypocrite. It's simply because I have found these to work for many clients. And it's a great way of getting people working on their own body rather than opting for passive treatments.
But again, it's always the client that needs to be the focus and not the problem. The exercises will make no difference unless that is determined first and foremost.
*After all, sex sells. People want to exercises for issues. Who am I to ignore that!
According to the article below, when marathon runners are not in pain anymore, they underestimate their memory of pain.
The findings provide the first robust evidence for a causal relationship between memory of pain and present pain during recall.
How many times have you said "never again" during or immediately after a race only to find yourself signing up again soon afterward?
You're definitely not alone. I'm guilty too!
But maybe it’s a good thing that we forget pain. After all, if we DID remember fully the pain we were in, women would never go through childbirth more than once!
Original Source : https://www.physiospot.com/research/pain-begets-pain-when-marathon-runners-are-not-in-pain-anymore-they-underestimate-their-memory-of-pain/
WHAT IS IT?
The space between the acromion and the rotator cuff tendons is known as the subacromial space and is filled by the subacromial bursa. This bursa is a fluid filled sac that allows for smooth gliding of the rotator cuff under the acromion with overhead movements of the shoulder.
Should any abnormality occur affecting the rotator cuff then his can lead to dysfunction. Therefore as the arm is elevated the humeral head would ride upwards closer to the acromion causing impingement. The more the rotator cuff and acromion rub against one another caused by overuse the more the bursa can become aggravated and inflamed which is referred to as Bursitis.
· Gradual onset of shoulder symptoms over weeks or months
· Pain on the outside of the shoulder
· Pain may spread down the arm towards the elbow or wrist
· Pain made worse when lying on the affected shoulder
· Pain made worse when using the arm above your head
· Painful arc of movement – shoulder pain felt between 60 - 120° of the arm moving outwards and up overhead
· There is minimal pain when arm is resting at side and above 120°
· Shoulder pain with activities such as washing hair, reaching up to a high shelf in the cupboard
· Repetitive friction between the greater rotator cuff tendons and the acromion
· Calcium deposition
· Inflammation of supraspinatus tendon
· Shoulder instability
· Degeneration of muscle tendons
· Biomechanical dysfunctions ( such as shortened pec minor protracting scapula)
· Injuries from a fall or hard blow to the shoulder
· Overuse from repetitive activities such as Olympic lifting, overhead pressing
EARLY STAGE MANAGEMENT AIMS
· Increase Range of Movement
· Maintain CV fitness
· Increase strength (isometrics)
· Address causes of issues such as biomechanics, training loads and training environment
IMMEDIATE TREATMENT ADVICE
· Stop any activity that causes the bursa to flare up
· Manual Therapy, ice and anti-inflammatories may help to relieve pain in the short term
· Continue with exercise that does not aggravate the bursa further (such as walking, cycling or lower body weight training
· Address causes of issues such as Biomechanics, Training loads and Training environment
These isometric exercises will help to reduce pain whilst strengthening the muscles in the shoulder. They will also help to reduce any tension within muscles that are tight around that area.
When I first started out I remember being asked how many clients I had.
I was told that if I got more clients that I would be 'successful'!
And I remember thinking that no matter how many clients I had it was never enough.
So I worked to get more and more. After all, regardless of me enjoying what I do, I'm still running a business. And I want to be 'successful'.
But then I got so busy and so exhausted that what I was doing was not beneficial for me or my clients. I started to hate what I was doing. And that, in a nutshell, felt shit!
And so what I've come to realise is that the number of clients I have is no longer important to me. I realise that I was using someone else's definition of success.
But to me, success is not about how many clients I have but how well I serve each and every one of them.
They are not numbers. They are not targets. They are people. And they MATTER. Their health matters. Their recovery matters. Their progress matters.
And THAT is what makes me feel good about what I do, it's what makes me happy doing what I do. It's what makes me feel successful!
And it's also what keeps those clients I work with recommending me to others.
Yes I like being busy. But I don't like feeling that I need more and more clients to be 'successful'. That's not who I am.
When my clients no longer need me because they know how to help themselves, when they can live and move without fear of pain or 'damage'….THAT is what makes me successful!
1 Poor sleep can be a cause of persistent pain in healthy people
2 Being tired can give you pain
3 Poor sleep can lead to persistent pain or recovery delay
4 The number of hours sleep needed depends on the person
5 It is not only quantity, but also quality
6 Pain is one of the body’s protective responses to poor sleep
7 Sleep schedule is important
8 Exercising regularly is a must
9 Boosting mood and reducing stress is key
10 Poor sleep doesn’t always lead to back pain
Original Source : http://www.pain-ed.com/blog/2018/02/13/10-facts-about-your-sleep-patterns-and-back-pain/
Pain only tells us there is a problem.
It does not tell us what that problem is.
I often get asked "Why does my back hurt?"
Honestly? I don't know. I need to talk to you and see how you move (or how don't as is often the case!)
But it's a back? All backs are the same aren't they?
Sort of. But it's not really the anatomy that I'm interested in. It's YOU.
Treating back pain is about more than just your back!
Stop chasing pain!
"Deadlifts hurt your back".
Don't blame the movement.
Blame the way you're doing it.
If you don't lift from the hips but you bend from the back then yes you may have a few problems.
But we are designed to pick up heavy shit and carry it.
Our backs are strong. And believing that they are anything but can lead to even more problems.
Yes there are exceptions. As in everything.
But in actual fact, I see more problems with people who don't lift heavy than in those who do.
There is no bad movement guys.
Nobel Prize recipient Dr. Roger Sperry says that the spine is the motor that drives the brain.
According to his research “90% of the stimulation and nutrition to the brain is generated by the movement of the spine.”
Do we really need any more reasons to keep moving?
The human body is a self-regulating organism.
It does not just passively allow physiological crises to happen to it.
They are happening for a reason.
And more often than not it's doing it because of self protection.
It's simply saving itself. We just don't realise it.
One of the things I ask my clients when I first meet them is whether or not they suffer with any pelvic or Bowel dysfunctions. But what I'm really asking is do they have a history of recurrent UTIs (Urinary Tract Infections), Yeast Infections, IBS (Irritable Bowel Syndrome) or pain 'down below'.
This is important is you are coming to see me with any musculoskeletal issues.
Well even long after an infection has cleared or you no longer have issues with IBS because you've sorted your diet out, these issues can lead to the neuromuscular impairments that you are now having problems with.
Let me give you an example….
Nina is 29 and has a history or recurrent UTIs. This then causes her bladder and urethra to become inflamed. This results in urethral burning and pain in her lower abdomen.
This in turn causes the connective tissue around her urethra, the muscles in her lower abdomen and the muscles in her groin to become restricted. Hence more pain.
As it's a UTI it makes her feel like she needs to 'go' all the time. But she can't because she needs to work and so ends up 'holding' or clenching herself in order to ease the feeling of urgency.
This clenching causes so many of her muscles to become tight resulting in lack of blood flow and possible 'Trigger Points' (small, taut areas of painful, involuntary contracted muscle fibres).
Even after the infection has cleared, the resulting neuromuscular impairments can still exist. And strangely enough they can actually mimic the symptoms of the infection too!
Usually in cases like this it's not just one episode of infections but severe infections that last a long time or are recurring events over a number of years.
So again, when I ask you about your pelvic and bowel health there is a reason for it…I promise!
"Your neck is crumbling"
"You have degeneration in your spine"
"You have 10 years to live" (which was an incorrect diagnosis)
"You'll end up in a wheelchair"
"You need to be careful"
"You need to protect your back"
Holy shit, I swear not only do I cringe every time a client tells me what they have been told by other Health Care Professionals but I get SO angry!
Where the hell is the 'care' when making them absolutely petrified to move, to live.
So much evidence is coming out that pathologies do not indicate that there will be pain, dysfunction or a reduced quality of life.
And in fact, causing people to fear their body and how they move will have a more detrimental impact on their health, wellbeing and life than any pathology ever will.
At the end of the day, sticks and stones may break bones but words can hurt forever.
Think before you say something that may change the course of someone's life!
I always feel lucky for being able to spend as much time with my clients as I need to. And I believe that's important.
Because after all that I’ve learned about the body, biomechanics, and everything physical, there is one guiding principle that I appreciate more than anything else… if we feel safe, cared for and in control, we do better. That means in critical moments such as injury or disease, or generally throughout our lives, being treated as an individual is what matters. Being listened to. Being taken seriously. And having someone take the time to understand what is going on, is what matters.
And when we are treated this way, we feel less pain, less fatigue, less sickness. Our immune system works with us instead of against us. Our bodies ease off on emergency defences and can focus on repair and growth.
Being given confidence and hope can mean more to someone's future and healing than the physical treatments. It might sound 'new age'. But our mind is more responsible for our health than we still give it credit for.
Do you know what percentage of the average adult population has degeneration on their neck on their x ray?
98% of people have arthritic changes in their neck and have no pain.
So how can we possibly know that the pain in someone's neck is due to arthritis?
Watch the full video here…
Fibromyalgia (FM) is a musculoskeletal pain condition that is characterised by chronic widespread pain and increased pain sensitivity. It's also often accompanied by sleep disturbances, fatigue, memory problems and psychological issues and it is more common in women.
It used to be believed that FM was essentially an idiopathic (no known cause) or even psychogenic (having a psychological component) condition.
However thanks to current research these should be seen as definitively outdated.
Recent research has shown that there is evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients. This is the first time that such an extensive inflammatory profile has been described for FM patients and means that FM seems to be characterised by biochemical changes in the body.
So in addition to hyperexcitability of the nervous system and issues with regulating the sensitivity of the body, chronic inflammation probably plays a role in fibromyalgia.
So if it is a Chronic Inflammatory Condition will nonsteroidal anti-inflammatory drugs (NSAIDs) work?
The researchers concluded that although the results of the present study point to the importance of chronic inflammation in FM, it is important not to jump to conclusions concerning the use of NSAIDs in this pain condition. FM being a chronic condition, it is important to ponder the potential side effects of long-term NSAID use.
The other thing to note is that as most FM patients are women, the possible relationship between inflammation and levels of ovarian hormones in FM patients is also something to think about.