Category Archives for "Low Back Pain"

Low Back Pain – Adam Mann

Mark: Hi, it's Mark from Top Local. I'm here with Adam Mann, Insync Physio in Vancouver consistently, currently rated one of the top physiotherapists clinics in Vancouver as voted by their customers, the people who count the most. And we're going to talk about that low back pain. Adam's going to talk about a client of his, that injured themselves. How they injured themself?

Adam:  So came on kind of out of nowhere they were cycling, for about 50 kilometers on the weekend. And then they felt this sharp pain in their back the next morning. and it was pretty sharp, but the thing that was really bizarre about this pain is it actually caused a shooting pain down into the heel of her left side.

And so it was pretty short and it was different than other back pain that she's had in the past. And she's had back pain in the past, but this was something new where there was this kind of zinging, electrical feeling down into the foot. So, she was quite scared and she went to the doctor and the doctor referred her to physio.

Mark: So how did you go about assessing the injury? 

Adam: So, yeah, we started with a thorough assessment. We basically, again, did a nice history where we talked about, what caused this. And so again, it kinda came out of nowhere, but we found out that she did have back pain in the past, but usually it was just in the lower back and never shot down in the past.

I found out that actually she was born genetically with an extra vertebrae in her back, meaning an extra spinal segment and that's different, but it's normal. It's considered just a normal thing. Isn't something that would have caused that pain necessarily.

 What we found out is where the numbness and tingling, where that zinging pain in the leg was. That gives us a clue where that possible nerve could be compressed. So it gave us a bit of a homing signal where we should focus our assessment. Nerves if we think about them. So tingling and zinging pain is usually a sign of a nerve injury and so nerves perform three things. They do reflexes, muscle strength and they do sensation. 

So we tested all three of these components and we just basically compared, the reflexes sensation and the muscle strength to the other side, to find out what was normal for her. The thing that we did differently in the way I approach back pain is I actually really want the spine to move.

So I look at the range of motion pretty carefully. And this is a, this is a different style of assessment. It's called The Mackenzie Method or MDT. And we use it for diagnosis and treatment. And basically it's a very safe method where we get people to perform some repeated spinal movements. So we find out if their spine has a preference to go in the direction of backwards or forwards, or if that increases or decreases some of the numbness or tingling sensation.

We look at if sitting is aggravating or if I'm walking is aggravated. So basically we find different ways how their spine likes to move, and doesn't like to move. And so with these repeated movements, we found out that actually this person, liked a flex spine. So we found a certain type of motion that her spine responded to.

And how did we find that their spine responded that way? It was basically, the pain stays relatively constant at first, but the location of the shooting pain moved closer to the spine. So it wasn't necessarily in this case that the pain or the shooting sensation went away entirely, but it was closer to the area where there was a problem. If that makes any sense. 

Mark: So tell me some more about that. How does that work? 

Adam: So basically if we can get the pain closer to where the spine is, that's called centralization in this McKenzie Method. And basically at that point, we can really focus in on the joints that might be dysfunctional or the muscle tone or the pelvis position, some of these other components and deal with it.

If we find emotion, alternatively, that makes the pain in the foot stronger or more intense then we can sort of get a clue that that is emotion, that the spine doesn't like, but that further aggravates pain. And the reason why we do this is at the end of the day, back pain, although we can get people pain-free and get them moving much, much better, it tends to come back. So if someone is doing something that's pretty explosive or snowboarding, and if they haven't done it in a long time, they haven't been keeping up with their exercises. It tends to come back. I'm not sure if that's just why they call it the back, but, this is a good way for us to find how each spine likes to be moved and what exercises we can give them so that they can self manage some of these problems on their own. 

So basically when we found that this person liked to flex spine, we gave them some exercises that basically would get their spine into a more flexed position. And it would take away the pain. And so once the pain got under control and that shooting electrical pain was in the spine area, we actually could work on other things. Like joint mobilizations, how this position, like I just sort of talked about and of course, core strengthening. 

Mark: That sounds really good. So any final points you want to make? How did this end up for the client? 

Adam: So basically this person is back to full activity and we talked a little bit about return to full activity looked like, cause they really like cycling. So, if they're going to go for a longer cycle, they have a routine of exercises that they do basically right before it. They keep up with some strengthening components that we give them, you know, that they have to do at least once a week, maybe twice a week.

And if they do those things, their back pain is pretty well under control. They don't have any of that shooting, electrical sensation anymore. And they're able to return to full activity, which is snowboarding, cycling, and climbing. And they live a very active, happy life. So basically, the idea is that this Mackenzie Method is a fantastic way for addressing back pain because it gives the clients some self management tips. Like I mentioned before, and then they also have a bit of self awareness.

They know if they're going to do something in particular, like walk for a long distance or get their spine in a position where their spine doesn't like it, they can avoid it or they can prepare for it. 

Mark: There you go. If you're looking for some relief for your back pain and especially, if you're willing to take some responsibility and maintain it, the guys who can really help you with a course that not only takes the pain away, but helps keep you pain free as much as is practically possible. Back pain is the number one problem that people have in terms of pain in their bodies.

Adam: It is Mark. 

Mark: So this is really important and I'm sure lots of people who are watching this have encountered this in the past. I certainly have. Adam Mann, at Insync Physio, you can check him out at their website, insyncphysio.com. Give him a call in Vancouver, (604) 566-9716 to book or in Burnaby (604) 298-4878 to book. You can also book online right on their website. Thanks Adam. 

Adam: Hey, have a good one.

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 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. 

Core Stability – Why does it matter?

What is the core, and why is it important?
The core is the center of our body, and its function is to stabilize the trunk while the arms and legs move. The core consists of muscles that stabilize the hips, torso, and shoulders, therefore having a strong core can help us prevent major injuries, while improving balance and stability. Building a strong core can make it easier to do most physical activities, whether it just be daily tasks or sport performance. Weak core muscles can lead to poor posture, low back pain, and muscle injuries, therefore it is crucial to build a strong core alongside your daily exercise routine. 

Benefits of core strength/stability include:

  • Injury prevention
  • Low back pain prevention
  • Improved posture
  • Balance and stability doing every day tasks such as housework
  • Improved athletic performance. 

Exercises for core stability strengthening

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Healthwise Staff (2017). Fitness: Increasing Core Stability.
Retrieved from https://www.healthlinkbc.ca/health-topics/zt1226

Chronic Low Back Pain: Rectus Femoris Muscle Stretch

This stretch can help with the chronic low back pain you may consistently have.

Prepare a nice cushion for your left knee to be on and a step stool to place the top of the foot on to have greater knee flexion. This will isolate the muscle stretch.

Keep your posture nice and tall and imagine there’s a string pulling your whole spine upwards from your pelvis, right up your entire back and neck and up to the top of your head. Then engage your inner core muscles tight below your belly button and keep your low back flat and contract your left butt muscles.

Next, bend the right knee forward and keep your posture nice and tall without leaning backwards. Hold this stretch for 30 seconds and repeat 3 times for each side.

This stretch can help with the chronic low back pain you may consistently have. If you experience pain or have any problems doing this exercise then consult your local Physiotherapist before continuing.

Preventing Repetitive Strain Injuries At A Desk Job

Labour-intensive industries get a lot of attention when it comes to work-related injuries, but employees who work in office settings are also at risk. Poor ergonomics and organization can lead to common office injuries such as computer eye strains, falls and most importantly, repetitive use injuries.

Our bones and muscles make up our musculoskeletal system. This system allows us to perform activities such as walking, running, and anything requiring the movement of the body. A repetitive strain injury occurs when repeated movements produce stress on your body. Unfortunately, many office jobs require repetitive motions to fulfill our duties, and for this reason, they are the most common type of injury found in the office (WCB). Examples of repetitive strain injuries include carpal tunnel, tendonitis, radial tunnel syndrome, and others.

Symptoms of repetitive strain injuries include:
  · Dull aching
  · Loss of sensation (numbness) especially at night
  · Tingling and burning sensations
  · Swelling around wrist/hand
  · Clumsiness (impaired dexterity, loss of ability to grasp items, etc.)
  · Muscle weakness, fatigue, and/or spasms

Prevention:
  · Stop or reduce the intensity of activity causing the pain
  · Taking breaks from repetitive tasks
  · While at the desk…
      · Ensure proper ergonomics
      · Avoid slouching
      · Avoid bending the wrists when typing
      · Avoid hitting the keys too hard when typing
      · Don’t grip the mouse too tightly
      · Ensure you are working in an appropriate temperature
Standing up and performing stretches such as the following:

WCB (n.d.) Office Ergonomics. Retrieved from: https://www.wcb.ab.ca/assets/pdfs/public/office_ergo.pdf

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