Category Archives for "back pain"

Pandemic Back Pain

Mark: Hi, it's Mark from Top Local. I'm here with Wil Seto, Insync Physio in Vancouver, many time winners of Best Physiotherapists in Vancouver, Best Physiotherapists Clinic, and will himself has one Best Physiotherapists in Vancouver as voted by his customers. And of course, today, we're going to talk about something that's a little bit different pandemic back pain. What the heck is pandemic back? 

Wil: Yeah. Yeah, they basically you know, with this pandemic that we're all living through right now, it's just a lot more people working at home and trying to set up whatever they think is you know, sort of a workstation or an office it can be ranging from like super great ergonomics to really poor. And I still see the people that have the great ergonomics. To especially the people that have poor ergonomics, you know, back pain. 

And so the other thing that's also important to understand with how this pandemic back pain is also the history behind each individual. Like I can say right now before the pandemic, like I used to see maybe like 25, 30% of this in the clinic on my caseload, and it's jumped from like 25 to 30% to more than 75% of everybody, if not more, like they have some form of this pandemic back pain. So someone comes in for, yeah, it's my shoulder and they're trying to stay active, but then they also work at home a lot.  But then my, yeah, my neck and my back also hurts too. 

And so a lot of it is posture related. So when we talk about pandemic back pain, it's really just the postural insufficiencies. And if you have a preexisting injury, or co-existing injury and that can actually contribute to that pandemic back pain even more. And so obviously, you know, that's a huge factor, but then if you've never had any history and you start getting this pandemic back pain, then that's also another can of worms.

So, you know, if you're doing a lot of sitting and I've said this to a lot of people before and sitting is like the new smoking. It's basically, so horrible for your body. And when you're sitting, especially if you're doing a lot you know, that's all you do 8, 10 plus hours a day. Your hip flexors will get really tight and everything just stiffens up and you get obviously lack of blood flow in your whole body and the muscles.

And then you get all this compression in certain areas in your spine. Then what happens is that your body learns that. And then you start to develop a new normal for your range of motion and your mobility. And then also the muscle extensibility, you know, so the joint mobility, joint range of motion and the muscle extensibility, all that starts to adapt to your new way of working and how we've been working mostly from home now, a lot of people.

And so someone that doesn't have a previous history, now this is the thing that I want to talk about today, because this is the thing that really has been on rise with the whole pandemic. And so I started to see all these muscle imbalances. So the biggest thing is really when you have a lot of imbalance happening in your hips and like, I see people like they wanted to try and get a running a little more, but then if their hips are super tight, then they're going to start having issues in their lower back. Like your hip flexors are really tight. It can change the alignment. And the positioning of your pelvic bones and then cause more compression in your lower back. And it can increase your what's called your lumbar lordosis, which is a natural curve in your lower back.

And so there's like, you know, a few main hip flexors, muscles that make up your hip flexors. And so when you're sitting all day long, you know, those hip flexors will just shorten. And then if you're not doing things that augment that by trying to switch up your position, stand a little bit, sit a little bit, then that will start to be adaptively more sore.

And even with standing, you know, someone comes in, I had a client that came in , I stand all day long. I don't know why my back hurts. Well, you know, it's that long position. And if your hip flexors are tight to begin with, and you're standing all day long, then now your back is going to have that increase a lordotic curve even more. And then you're getting even more compression in certain areas. 

So they did some research studies where they looked at even just the imbalances that are happening in the hips and if certain areas are less flexible or less mobile, and then you have weaknesses in certain areas, then, you know, when you go to walk or you go to run, you know, that's going to be accentuated.

And so then you're going to start to have the sort of repetitive strain and what we call running related injuries. And I treat a lot of runners. We treat a lot of runners in the clinic and we have like a treadmill to look at, the biomechanics and to really assess, you know, the mechanics of running.

And it's interesting to see before we even get them on the treadmill. It's like, you got all this going on and just by looking at alignment and movement, we can already do a lot of things to help with that. 

Mark: So the answer isn't having a standing desk like I have here, it's a standing and has sitting desk because I have listened to my good friend Wil and I don't stay in one position all the time. I like to talk standing up though. I feel more natural with that, but it's switching between the two on a regular basis is really important all day long. 

Wil: Yeah. As a ergonomic strategy yes. And then if you're like looking into getting into something that you haven't really done before, if you're doing a little bit more of, or if you're doing a lot more sitting now, and then you're still maintaining your sport of running or whatever it is. Looking at making sure that you have that mobility in your hips. Have that mobility and the strength to be able to compliment you to keep doing, or to start that new sport or activity that you want to do.

Mark: Yeah. So what's the treatment protocol? What's the prognosis for somebody with pandemic back pain? 

Wil: Yeah. So with someone that has never had a trauma or anything like that, and it's just sort of creeping up on them. And the most common thing that I find is all these muscle imbalances. So we want to start to correct that. We want to basically start to get areas in the hip, areas in the back even to be more mobile. So it's about the mobility of the joints. The mobility of the whole segments around the back so it's also the upper back. So if it's lower back pain that you're getting, then you want to make sure everything above there is moving well. And then the hips and pelvis are moving well. 

And then the supporting strengthen core stabilization. And so there's a lot of different things that we can do in the clinic, obviously, that kind of help facilitate that from doing a lot of like soft tissue release techniques that, even getting in there with some IMS with some dry needling kind of thing, and then very specific exercise rehab stuff to really kind of facilitate that process.

Mark: And typically what's the more of a normal treatment course. 

Wil: Yeah, it ranges like it can be someone like, you know within a session or two they're like, wow. It's from like, you know, an eight out of 10 pain to like now it's like a one to two out of 10 pain. And just one or two sessions to like, it takes them up to like maybe even four or five sessions, depending on how chronic and how long you've left it for or they left it for. Yeah to basically up to maybe even eight to 10 sessions and be like, I'm totally 100% better. 

Mark: Well, let me ask you a little bit of a wild card question here, because I bet you see this a lot. People come in, they feel better, they got some exercises, they kind of started doing it. And over time a month, two, three months later, they're not doing those exercises anymore. Is that a really good way to do things? 

Wil: Yeah, obviously not. And I think the biggest thing is that a lot of the times, once it becomes out of sight then becomes out of mind. So the pain goes away and then you think you can let it slip. And then once the imbalances start to come back and you may not even be symptomatic, I may not have pain, but once those imbalances that to creep up, then it's a lot harder to try and rectify that. But you can, you definitely can because you know, it just takes a little bit of work. But then sometimes it gets to the point where now you're in this pain and this function, and then, you know, it becomes desperate. But yeah, it's definitely not ideal. 

Mark: So, if you're desperate with back pain, the guys to see your Insync Physio. We highly recommend that you don't wait until you're desperate and go and see Wil because they'll get it fixed up really quickly and get you on an exercise program that will keep you fit and healthy and surviving this whole pandemic hoo-ha in a much better way.

So reach them at their website insyncphysio.com. You can book online for both of their offices right there. Or you can call. For Vancouver at the Cambie Street office is at (604) 566-9716. Or in North Burnaby, you can call (604) 298-4878. Get yourself booked. Get in there. Get feeling better. Let's survive this thing. Wear a mask.

Thanks Wil. 

Wil: You bet. Thanks Mark.

Low Back Pain Injuries – Single Leg Bridges

Start out lying on your back with your knees bent. Hug one knee to your chest. With the opposite leg, squeeze your bottom and push through your heel to raise the hips up towards the ceiling. Hold at the top for 10 seconds. Slowly lower down.

Repeat 3 sets of 10 repetitions.

This exercise is great for low back pain to strengthen the gluteal muscles. 

Chronic Low Back Pain – Forward Lunge Reach Ups

Progressively strengthening your core stability muscles after a back injury can help you become functionally stronger.

Start by lunging forward with your right foot and reaching up with the opposite arm and hand high up above your head while keeping the low back in neutral position. When you lunge forward make sure your knee stays over your ankle and aligned with your second toe, hip and shoulder and that the low back doesn’t arch. Don’t let your knee fall into the middle or go past the front of your toes and the opposite arm reaching straight up without deviating past the midline or off to the side.

Push back up to the start with the forward foot and repeat this for 10 repetitions doing 3 sets for each side.

This exercise is great for returning to activities and sports that require a lunge and reaching motion. If you’re unsure about the exercise or have uncertainty about where you’re at with your lower back book an appointment and have one of our Physiotherapists at either our North Burnaby or Vancouver locations to check things out. 

Low Back Strain Injuries – Thoracic Rotations

Increasing mobility in your middle back or your thoracic spine when it’s stiff can help you rehab and recover from those low back strain injuries even faster. By doing something like thoracic rotations, you can utilize the entire mobility of your spine and also improve the overall functional movement of your body!

Start by taking a wider stance, cross your hands over your opposite shoulders and pull in your inner core muscles. Without rotating the hip or pelvis, turn the body leading with the shoulder in one direction until you reach the barrier of your full range of motion.

Then turn the body leading with shoulder into the opposite direction until you reach the barrier of your full range of motion. Do this for 30 reps two to three times per day.

If you’re unsure about the exercise or have uncertainty about where you’re at with your low back book an appointment and have one of our Physiotherapists at either our North Burnaby or Vancouver locations to check things out. 

Low Back Strains – Advanced Strengthening Nordic Push Ups

You can perform this exercise with your ankles secured under a bar, on a squat rack or wall bar or have a partner hold your feet and ankles down.

Use a yoga mat to make it more comfortable for your knees. Start by pulling in your inner core and keep it engaged the entire time. With your hands out in front of you, then slowly lower yourself down to the ground in a controlled manner into a push up position.

Once you make contact with the ground, then push yourself back up. Repeat this for 10 repetitions, doing 3 sets daily.

This is an advanced level strengthening exercise for your low back that works on increasing your functional core stability strength. 

Low Back Strain Injuries – Big Ball Roll Outs

Kneel down with a big exercise ball in front of you. Keeping your back straight and your inner core muscles engaged, slowly roll down your forearms on the pinky finger side.

Straighten out your elbows and move slightly past them on the ball. Come back up with control to the start position. Repeat this for 10 repetitions, doing 3 sets per day.

This is a great exercise to strengthen your lower back after an injury and retrain your core stability muscles to help them work better.

If you’re unsure about the exercise or have uncertainty about where you’re at with your recovery book an appointment and have one of our Physiotherapists at either our North Burnaby or Vancouver locations to check things out.

Low Back Strain Injuries – Lateral Band Walks

Whether it’s returning to sport or just being physically active, part of the rehab for your low back strain injury is to regain the functional strength of your gluteus medium muscles with lateral movements.

Wrap a closed loop resistance band around the balls of your feet. Start with the feet about shoulder width apart. Keep your posture straight and tight and your core muscles engaged. Lift one foot up and out 3 inches to the side leading with the heels.

Resist the lateral movement of the foot with the opposite foot, leg and hip that’s on the ground. Make sure that the knees don’t buckle into each other, don’t bob your head up and down, and keep the toes pointing forward (Avoid having the toes pointing outward with the hips externally rotated).

Repeat these robotic type of lateral movements for 5-10 steps going right to left and then left to right for 3 sets on each side. 

Low Back Herniated Disc Injuries- Sloppy Push Ups

Start by lying flat on the ground, on a yoga mat or a firm bed. For the beginning stages of this exercise, lift your upper chest off the ground by supporting yourself on your forearms.

Take a deep breathe out to make sure your low back is relaxed in this position and your hips are on the ground. Stay here for 10 seconds, then lower and repeat.

To make this exercise harder, put your hands out in front of your head and push up from your hands instead of your forearms. This will help lift your chest even further off the ground and get more extension through the low back.

It’s still important that you are able to relax the back and glute muscles in this position. If you can’t do this, or if your hips come off the ground, you should revert back to the first stage of this exercise. Once again, stay here for 10 seconds & return to the ground. Do this for 30 repetitions, 3 times daily.

Low Back Sprain and Strain Injuries – Kneeling Thoracic Rotation

Start by kneeling on the ground with the leg closest to the wall up in a lunge position. You can kneel on a yoga mat or pillow to provide extra cushioning and support.

Bring your arms up to 90 degrees in front of you, maintaining the arm that’s closest to the wall right up tight against the wall. Open up your other arm, like you are opening up a book, and try to get it as close to the wall behind you as you can without bringing your other arm off the wall.

You should feel a stretch in your mid back area. Return to neutral and repeat 10 repetitions doing 3 sets on each side. Make sure to keep your neck neutral without straining it, and follow the movement of your arm with your head.

If you can’t get your other arm against the wall, that’s ok. Bring it to the end barrier of it’s movement but don’t force it. A stiff mid back or Thoracic spine can contribute to lower back strains and sprain injuries and it’s usually a good idea to incorporate this into your lower back rehab.

Low Back Strain: Running Rehab Knee Highs

Resisted knee highs strengthens the hip flexors in conjunction with your core and can help you rehab your functional running strength after a low back strain.

Loop a resistance band around your ankle. Step the opposite foot forward while having the opposite arm also forward and position yourself in a running stance with your core muscles engaged below the belly button.

Bring the knee up towards the chest matching the motion with the opposite arm and then bring the foot back down with control.

A few things to look out for when you’re doing this exercise is to control the motion of the foot so the resistance band doesn’t uncontrollably pull your foot back and also keep the arms and knees from crossing the mid line of the body and prevent the low back from flexing or extending backwards too much by keeping it in neutral.

Repeat this for one minute on each side doing 3 sets 2x/day.

Resisted knee highs strengthens the hip flexors in conjunction with your core and can help you rehab your functional running strength after a low back strain.