3 Simple Ways to Eliminate Back Pain

We’ve all been there..sitting at our desk for longer than we want.  Caught in a meeting that we can’t get out of and has gone on longer than ever imagined.  Driving and caught in traffic with no end in sight.  And then it happens…

Your back starts to get sore.  Not terrible.  But, at first you notice it.  It is just stiff and sore and wants you to stand up.  So you start slowly moving in your chair.  But as time goes on the pain begins to intensify.  Getting worse and worse with every passing minute and you can’t concentrate on work anymore because your back is throbbing.  All you want to do is go lay down and take some of the pressure off the back.

But you can’t just go and lay down or stop working..so now what?

Imagine if you didn’t have the option to just keep pushing through the pain, that you literally were unable to sit and you had to leave work?  Imagine if that back soreness or stiffness became back pain that you were unable to provide any relief to no matter how many times you adjusted in your chair.  Imagine that you had to go for routine shots in your back just to be able to get through the day.

I know, everyone says the same thing, that will never happen to me.

Well after 20 years in practice, I assure, chronic, debilitating back pain does not start off that way.  It starts off as stiffness and soreness that is ignored.  The stiffness and soreness gets worse until you can’t work or do anything you enjoy.  This is how most chronic back pain comes to be.  It isn’t some accident at work in or a car that completely debilitates you, it is simply pain that was ignored until it could not be ignored any more.

There are 3 simple exercises that you can do at work to help relieve that pain.  Now this is not the only solution, changing your posture, going from sitting to standing, and other changes need to also occur.  But the first step to take is to make sure that you doing what you can to relieve back pain when it comes on.  If you do not, you keep the pain cycle going and this can cause a life of medications, injections and even surgery.

One of the things you can do right away is you can get up every 15 minutes.  I’m not talking about getting up go get a drink at the water fountain or talk to you friends.  This “break” is simply standing up at your desk, or getting up and walking around your chair, doing some type of movement.  Put a pop up reminder so you remember to do this every 15 minutes.

Find little ways throughout your day to implement a change in position so that way every time that one thing occurs, you know you have to stand up.  For example, every time the phone rings, you stand up.  Or during every phone conference you stand up and walk around your chair.  Just something simple that doesn’t require a lot of thought but does allow for you to get up and change positions.

If you’ve had stiffness for a while it might take you a little bit longer to really get that blood flowing so make sure that you move around, walk or stand and shift weight back and forth, until you feel the back open up.   Any type of movement is going to allow the back to have a rush of blood, it’s going to allow those muscles to feel better.

I know it is very very easy but a lot of people over look it because they just keep plowing through the day and through the pain.  But in reality you are getting less done because your brain will begin to focus on the pain in the back and not on what you are doing.  So in taking a “break” or giving your self a chance to stand up, will actually allow you to get more work done then if you just sit there and try to plow through the pain.

The second thing you want to do is to drop your leg underneath your chair.  You can watch the video here to see what I am talking about.  And yes this violates the feet flat on the floor rule, I know.  But it’s okay it’s not going to mess anything up and actually what it does is it pulls your pelvis forward so you don’t have to do anything to sit up straight.

If you want to try that right now all you have to do is put your foot behind your chair or underneath your chair.  You can hook your foot onto the back leg if you are able to.  This posture is going to pull your pelvis forward and you’re going to be able to relieve some of that stress on the back without having to feel like you have to sit in military style attention.

This is not designed to be done all day.  But it is great to throw in there every couple hours or when you are caught in a meeting or just are unable to stand up.  It shouldn’t be replaced for a stand or a walk but this is just a great way to be able to adjust your posture during the day if you can’t stand up.

The final thing you can do right now, which is one of my favorites, is to cross your ankle over your knee in a figure 4 position, sit up straight and then lean forward.  You should feel a gentle stretch in the back, the back of the leg, and in the butt.  You may feel a stretch with just crossing your ankle over your knee.   You want to hold it for 30 seconds and perform 6 on each leg.

Here’s another thing about this stretch – if you have problems getting into this position, for example you have to pull on your pant leg to get your ankle on top of the knee, then there’s a problem and that problem is not just back pain.

Addressing back pain when you start to feel it, is the best thing you can do to make sure that you do not live a life full of medications, injections and surgeries.  And getting an accurate diagnosis is half the battle when dealing with back pain.  If you would like to have a free 3 point back pain package, just click here and enter your information!

The Top 3 Ways To Strengthen Your Hamstrings And Eliminate Your Knee and Back Pain

Imagine you have back pain or knee pain that seems to be getting worse and not better.  You have done everything over-the-counter you can think of to help with the pain.  But no heat, ice or ‘magic rub’ seems to be doing the trick.  And the pain continues to get worse and worse, causing you to stop more and more activity.

What if I told you the answer wasn’t stopping activity but actually adding activity.  I know seems like the complete opposite of what you should do when you have pain.  Actually adding activity?  But why?  And can’t that wind up hurting worse then when it started.

What most people don’t realize is that the reason they have pain is due to muscle imbalances.  One or several muscles is working harder than the others, this imbalance causes knots that can lead to pain.  One of the biggest problems with weakness we see in the body is with the hamstrings.

The quads (or the muscles in the front of the leg) are very well defined and the hamstrings (the muscles in the back of the leg) are non existent.  But your body can’t let the quads work harder otherwise you would not be able to walk.  Imagine someone pulling extremely hard on one side of the rope and another person barely resisting on the other side of the rope.  The rope would be pulled in the direction of the person pulling harder and if the person pulled too hard, the other person would fall over.

Same thing with the quad and hamstring relationship.  And the truth is the quads are pulling hard enough to pull teh hamstrings over so the hamstrings recruit help from the other muscle groups and this is where the pain starts.  The other muscle groups are not used to working that hard and give out, it may even cramp up on you.

This improper use of other muscles is what begins to cause pain in the back and in the knee.  That is why strengthening is the answer in this case.  If you strengthen the hamstrings the other muscles do not have to work as hard and therefore, will relax enough to allow the pain to stop.

The problem is with hamstring exercises, most people cheat because they hamstring are so weak.  So I’m going to actually take you through a couple progressions and show you what not to do and what to do in order to perform the exercises correctly.

The first exercise is going to to use a ball.   You don’t have to use a ball but when you get to that point it is necessary to make the exercise more challenging.  We will start with a bridge.  This is where some people needs to start.  Then you want to progress to a hamstring curl.

If you’re just starting off exercising your hamstrings probably don’t want to do the curl right away.  So start with the bridge.  For the bridge you’re just going to push your butt off the table nice and easy as high as you can. The goal is to get it as high as you can, you’re going to lower it down nice and slow.  If you really want to really make it a challenge don’t actually rest all the way down, just keep going nice and easy through the motion.

To make it even harder you can lift one leg up.  As you do that, you want to make sure that your hips stay level.  If your feet are flat on the floor, you want to make sure you imagine there are four points on the bottom of your foot, little toe, big toe, inside of your heel, outside of your heel.   You want to be pushing through those equally to push your butt off the table.  A common mistake is people using their toes to push themselves up.

Another suggestion to activate the core and the hamstrings is to put a pillow in between your knees and squeeze.  That’s going to allow you further engage that hamstring and core.   Then to go right into the hamstring curl you are going to roll the ball out and in.  Make sure that as you do this you aren’t dropping your hips down as you roll the ball in.  Make sure the hips stay level and you’re rolling it in nice and easy.  If you want to make it challenging keep the hips up the whole time.  If this is too difficult, drop the hips back to the table each time.

You also want to make sure that you are extending your leg almost all the way straight and then bringing it all the way to your butt.  If you can’t do that, you’re not ready for that single leg step up yet.  You want to do about 30 repetitions on both legs.  If you cramp up, stop and take a break then continue.  If it causes pain then stop and consult your physical therapist.

The next exercise is a full squat.   The only way to activate your hamstrings and your glute medius is to go below 90 degrees.  There is nothing wrong if you are a doing squat in proper form that you can’t go below 90 degrees.  It actually puts more pressure on your knees if you wind just going to 90 and stopping.  All you’re doing is a quad exercise at that point.

You really need to start with 30 body weight squats with perfect form going up an down before you load anything onto your back.  This is probably one of the biggest mistakes I see happen in the gym is that people are so eager to put a bar on their back and to squat with weight and they can’t do 30 body weight squats.

You have to watch as you go down that your knees do not go in.  They still go out, in line with your toes, but that they do not go over your toes.  Also as you go all the way down to the ground you wind up bringing your knees together to stand up.  That’s an indication of weakness.  Start with doing just doing squats to a bench.  Then progress to single leg squats to a bench.

The last exercise we’re going to do a single leg dead lift.  People like to load these pretty quickly with weight and I see maybe 15% of the population doing them correctly.  You leg and back and upper body has to move as one unit.  Your leg should go first and your back should only follow after your leg moves.  The only reason your back should start to come forward is that your leg is so high it cannot go any further without moving your back.  You should do these in front of the mirror.

A big mistake that people make when doing this exercise is they rotate their hips.  You want to keep your hips square to the floor.  If one hip starts to rotate up you need to stop and reset yourself.  And the other mistake that people make is that they do not stay in a straight line, their hips, and leg and back.  Usually the back begins to drop and they wind up in a “V” position.  There should be a solid straight line from the upper back through the leg.

Once you can do 30 on each leg nice and slow and controlled, you can progress to adding a weight in front.

For a video on these exercises click here to watch.

If you would like an exercise audit or more ways that you can strengthen your hamstring and you live in Bucks or Montgomery Counties in Pennsylvania, then click here to claim your FREE 2 week trial and have one of our body experts reintroduce you to your hamstrings.  

 

 

 

 

 

 

 

 

3 Things You Should Never Do With Shoulder Pain

As a physical therapist for the US Olympic Team, I see shoulder pain, a lot of shoulder pain.  Most of it, in fact all of it is not the result of some accident that happened, it just started hurting.  In fact, shoulder pain, whether you are an Olympic athlete or not, comes on and the most common phrase I hear is, “I have no idea what I did.”

However, there are 3 very important things that you should NEVER do with your shoulder when it hurts.  Doing these things can lead to chronic pain, injections and surgeries.  

1. You should NEVER stop using it.

This one seems kind of counter intuitive but this is a number 1 reason that shoulders do not get better on their own.  This goes against what you’re going to want to do if your shoulder hurts.  For example, if your shoulder hurts when you lift it overhead, you don’t want to lift your arm overhead so you don’t.  Maybe you don’t lift as high overhead  or use the other arm to lift overhead, you make some variation not to move that arm into a position that hurts.

When your shoulder hurts you should continue to gently move it to all ranges of motion.  To see a video demonstration of this click here.  

Your body is going to want to move your shoulder out of the painful position.  So you will need to watch yourself in the mirror as you do this.  Make sure your arm doesn’t turn out or your shoulder doesn’t shrug.  You need to make sure that you are moving your arm in the correct fashion, nice and easy.

Click here for exercises you can do in the comfort of your own home to fix your shoulder pain.

2.  Have poor posture

Bad posture does not just effect your neck and back.  If you have bad posture, your shoulder is not going to heal, and in fact it will get worse.

The problem is, is that most times people have poor posture that effects their shoulders and they don’t even know it.  Here’s a quick test to see if your shoulders are in correct posture, try to push your shoulders down.  To see a video of this click here.  If you can move your shoulders at all in a downward movement then your shoulders are not in the correct posture and you are harming your shoulders.

Having your shoulders elevated are using mechanisms that are going to hurt you.

But you are also using a mechanism that can cause a decrease in blood flow to the shoulder.   With decreased blood flow comes decreased ability to fix pain or a problem in the shoulder.  If you’re shrugging your shoulders, if you’re leaning forward, you’re not going to be able to have enough blood flow to the shoulders to fix them.

To get your shoulders in a correct position, you’re going to roll them up back and then you’re going to drop them down.   Do not roll them up and back and then pin them all the way back holding them in that position as long as you can.  This will bring in other problems so you want to make sure you roll them up back and you simply drop them down.

This is not a 1 time exercise, this is not a 10 time exercise, you have to retrain your body on how to sit correctly and how to stand correctly.  This can take weeks and months.  Set reminders on your phone to help remind you to do this.   Click here for other tips and tricks that you could be doing at home to eliminate your shoulder pain.  

3.  Sleep on the shoulder

If you have a sore/achy/painful shoulder you should never sleep on that shoulder.  You want your shoulder in the correct position when you sleep for the maximum amount of healing time.

If you’re laying on it and you’re crushing all the structures in your shoulder.  You’re limiting the blood supply, you’re putting all the pressure on things that are already inflamed and sore.  If you are a side sleeper, you want to make sure that you lay on your opposite shoulder.

Finding the exact cause of your shoulder pain and performing a few exercises at home, is important for healing your shoulder also.  Click here for our FREE shoulder pain solutions book and find out what you can be doing at home to solve your shoulder pain.

Posture Correction Exercises

Changing posture is not going to happen overnight.

You’re going to need to change the things about your environment in order to make permanent posture changes.  You’re going to have to find a way to remind yourself to sit up straight or to walk correctly or to have your shoulders in correct position.

Your posture got this way over a matter of time, it didn’t happen overnight so it’s not going to change back overnight.  Don’t get frustrated if one minute you sit up straight and the next minute you’re back into your old posture habits.

Poor posture has come from years and years of practice and this has caused changes to your muscles and how they behave, they’re used to working in a certain and whether that’s a correct manner or not they’re still used to working in that capacity so when you try and change your posture you’re sending signals to your muscles to say hey! I need you to work a little bit differently.

If you don’t constantly send those signals, your muscles are going to go back to what they know, which is poor posture.  It takes a minimum of 6 weeks to make permanent changes to the muscle so it’s going to take you at least 6 weeks to be able to maintain certain aspects of your posture without having to constantly remind yourself otherwise.

Poor posture can lead to herniated discs in your neck and back which will cause numbness and tingling.  It can also cause you to lose some function in your hands, or your feet, if it goes on long enough. Poor posture can decrease the amount of air you breathe so if you’re not getting quality air in your lungs you feel tired and this can cause sleepiness and less productivity.   If you have poor posture when you sleep if it can keep you up all night.

Poor posture can just decrease the overall quality of life.

When I tell people to correct their poor posture they always sit up super straight. Overcorrection is just as bad as slouching.  People just jam their shoulder blades back together and try to hold that as long as they can.  Their muscles in their back start burning and they can’t hold that posture anymore.  This is just as bad as slouching.

How to stand properly

First you have to find something to remind you to stand up straight.  If you just rely on yourself to ‘remember’ it will happen one or two times a day and no real change will come.  For example, every time you walk through the doorway, say to yourself stand up straight.  It’s putting little reminders like that throughout your day that will create a constant way of remembering to stand up straight.  You will have to do this until it becomes a habit, it won’t be a habit without constant consistent practice.

For the shoulders you roll them up back and drop them down.  When I say drop them down, you literally let them drop, don’t try and control the motion on the way down.  The problem is that 5 minutes later you’re going to find that your shoulders are elevated and you need to drop them down again.

One of the biggest mistakes people make with their low back is they stick their butt out too far.  If you look in the mirror you will notice that there is a pronounced curve in their low back.  If you look in the mirror you will see a really pronounced curve in your lower back.

So to find out the best position for your low back, you want to stick your butt all the way out and arching your back.  Then you want to go to the complete opposite direction and tuck your pelvis under.  No repeat both of those motion, sticking your butt all the way out and then all the way under.  After doing this 10 times, find the middle between the two extremes and then hold it there.

It will feel completely unnatural until you practice standing like this and it becomes natural which will take a minimum of 6 weeks.

Sitting

When you’re sitting, you want to change your environment as much as possible to force you into the correct posture.  If your environment is not set up correctly and allows you to still be able to do your work, then you won’t be able to change.  For example, if you have your monitor off to the right and try keep your head straight ahead and just have your eyes look to the right, your head will follow where your eyes eventually and your head will turn to the right after awhile.   If your monitors are off or if your keyboard is off, your body is not going to be able to sit correctly.

When you sit at a desk you want to make sure you monitor is at eye level and directly in front of you.  If you use 2 monitors you want to put the monitor that you use the most in front of you with one a little bit off to the side.  If you use both equally you want to put them directly in front of you with them touching so you’re able to look right in front of you.  Having the monitor(s) off to the side even slightly, will cause your neck to have to turn.

Your arms should be at 90 degrees.   Roll your shoulders up, back and drop them down then bend your arms to 90 degrees.  Then do not adjust your arms or hands to meet the keyboard.  Bring the keyboard to meet your arms.   Your mouse should be right next to your keyboard.  Your knees should be below your hips.  This will help pull your back into the correct position.

One more note about this and a question I get asked a lot of questions about this, a standing desk.  You need a sit/stand desk that has a lever that can go from sitting to standing without any issue.   A standing desk all day too long and sitting this all day too long.  Every half hour you should be able to switch your desk from sitting to standing that’s the ideal desk position.

Sleep

Don’t sleep on your stomach.  Period.  This is a really really good way to cause a lot of problems.  People who are stomach sleepers are fiercely loyal to sleeping on their stomach.  If you want to do this you have to buy a pillow that has a cut out so your face can go into it so your neck is not turned one way or the other.  You’re going to have to put pillows underneath your chest and your stomach so that way your back is not in a poor position.

Sleeping on your back or on your side is the best.  If you sleep on your side, put a pillow between your knees and hug a pillow.  You should have only 1 pillow.  This is the biggest thing I find people do wrong when they sleep on their side, they stack pillows.   You need 1 thick pillow.  It doesn’t need to be a fancy pillow, it needs to fill the gap between your head and the bed.  Your head should not have to drop down to meet the pillow.

If you sleep on your back, you want to have your knees elevated.  You’re only going to need 1 pillow under your head when you’re sleeping on your back to support that curve in the back of your neck.

If you struggle with back pain as so many do, come to our FREE back pain workshop.  Click here to sign up or call our office at 215-997-9898 and ask to be added to the list!

Why does your back hurt?

People who suffer with back pain generally describe the same signs and symptoms as to why their back hurts.  while the cause may be different, how it presents is often the same for people.  Common signs and symptoms of back pain is pain in standing, pain with doing the dishes, raking, vacuuming or anything in the bending position.  There can be pain when you get up in the morning, pain that wakes you up at night, pain with driving or sitting too long, pain with activities like running or exercising, pain with sneezing, pain with going from sitting to standing and many more those are just some common ones.  The bottom line is that back pain can present in many different ways.

An important thing to understand is pain that is reproducible is reducible.

What that means is that pain, that you can cause, sit too long, stand too long anything that we described above, that pain that we can cause that we can reproduce, pain like that is reducible, meaning it can be fixed.  If your pain gets better or worse depending on the hour of the day, then that is pain that is fixable.  You may always have pain but if that pain gets better and worse with activities, then that pain is reducible.

This gives a lot of people hope, to know that not only is their back pain fixable but it is fixable without medications, drugs or injections.

There are 3 different categories on how people chose to handle back pain or any kind of pain.

  1. You ignore it
  2. You alter it or
  3. You handle it.

Most people fall on category 1 when the pain starts they just ignore it.  Oh, this is just a spasm it will go away.  I’m getting older I’m getting back pain.  My dad had back pain so I’m going to have back pain so I’m just going to ignore it.  Many of you may have said some variation of these things to yourself at any given time.

My rule is 2 weeks, if the pain doesn’t go away in 2 weeks then you see a doctor immediately to get it worked on, 2 weeks is enough time for something to resolve on it’s own.  And if the pain is not occurring on a daily basis but you notice that now instead of spasms once every couple months, you have spasms every other week.  This is a sign of a problem that is not going to go away on its own.

The second way people handle it is to alter it.  Altering it means taking drugs, whether if it’s an epidural shot, or an over the counter medication like Advil or some heavier prescription drugs you are altering it, you’re not handling it, you’re not ignoring it.   Now in altering it, you actually make everything much worse, because instead of ignoring it or handling it, you are changing the game.  Your back will begin to come up with new movement patterns that will cause even more pain because it is trying to alter the pain.  So the pain that was just in one spot, now grows to involved many other spots.

There are 4 main causes of back pain: 

  1. Herniated disc
  2. Stenosis,
  3. Sacro Iliac joint or SI joint/ Pelvic pain and
  4. Compensation.

Let’s first look at the Herniated Disc.  So a herniated disc is also a bulging disc or a slipped disc, this can also indicate sciatica but sciatica is usually a catch all term for just pain going down the leg but could be from any cause.  If there’s pain in your back, in your leg, pain in your butt, this is not a herniated disc.   A herniated disc doesn’t cause pain, a herniated disc causes numbness and tingling.  If I were to examine you and I touch spots on your back you won’t be able to feel anything, it wouldn’t irritate you if I was touching, it won’t bother you but you will still feel pain going down your leg.

This is common in the 40 year old category, who bends and picks up their kids the majority of the time.  Bending and picking things up off the floor is some of the highest pressure you could put your discs.

70% of people who get an MRI get herniated disc have a herniated disc show up on the MRI.  It doesn’t mean they have back pain, I have herniated discs I don’t have any back pain.  So don’t be so quick to think that just because you have a herniated disc that is causing your pain.

Stenosis, is a narrowing of the spinal canal.  The common sign of this is when you see someone who has to bend over the shopping cart or who has to bend over to walk because they relief.  They will get immediate relief if they bend over the shopping cart or they sit down.  I’m not talking about pain that gradually eases up the longer you sit or the more hunched over you are, I’m talking about instantaneous relief that occurs with sitting or bending over a shopping cart.

Stenosis usually involves pain that is going to shoot down both legs and it’s going to be pretty unrelenting so it will constantly be there unless you are sitting or hunched over a shopping cart.

SI joint or Pelvic Pain is one of the most common diagnosis people walk into my office with.  “I have a pain right here” is most often what is said and described.  This is not to be confused with “I have a pain in the butt” because a pain in a butt is different diagnosis.  There may be pain all over the back pain but there’s one point right on the lower back that really bothers them.  This is the SI joint.

With pain in the SI joint, nothing’s going to show up on an Xray or MRI or any blood test or any type of work up that you could do it’s going to diagnose this.  This has to be diagnosed by a physical therapist who knows exactly what they’re doing because it’s not a definitive test, it is several different tests that need to be done.

Compensation.  Compensation is not a direct reason that you have back pain it is not an actual diagnosis like stenosis or herniated disc but this is the number 1 people seek treatment for back pain and that’s because they’ve ignored it, altered it and now they’ve decided to handle it and by the time they’ve decided to handle it, the muscles have compensated for everything and now do not know how to function.

Compensation is when you allow your muscles to work differently.  When your body feels pain, some muscles are going to work harder and some muscles are going to work a little less, which is how your body is designed to work, for a little bit.  If it can stop you from feeling pain, then it will.  The problem is, is that if the body uses the muscles differently for too long, it thinks this is how the muscles are supposed to work.

They start recruiting other muscles to help them out and this is a snow ball and it keeps going and going until your muscles finally exhaust themselves, and say ‘hey we can’t compensate anymore we’re all done here’ and then the pain can no longer be hid or compensated for an the pain goes from just being every few months to every week to every day.   This is a very long process to get here and unfortunately a long process to reverse.  In order to treat compensation, you have to get the knots out of the muscles, you have to then retrain the muscles on how they’re supposed to work.

The Number 1 way to fix back pain is posture.

Some people hear that and sit up as straight as they can and jam their shoulders back.  And that lasts for about a minute and then it goes away until some random times a couple days later when something reminds them they should jam their shoulders back.  But this sitting up as straight as you can is incorrect also.

Most people don’t have correct posture because their environment doesn’t allow them to have correct posture. If you have a desk at work and your monitors are off to the side and it’s not on eye level or you work off a laptop, you can’t have good posture.  You have an environment that forces you to have poor posture.

If you work on a laptop you don’t have a way to have good posture, if you work on your smart phone for more that 15 minutes at a time, there’s no way you’ll have good posture, if you sit on your couch with your laptop at night and do your work, you can’t have good posture.  In all of these situations you’re herniating your disc, you’re causing yourself back pain.

Posture is not just standing up straight, posture is not just jamming your shoulder back as far as you can.  It is making your environment force you to have good posture.  You want to make sure your low back has support and you should roll your shoulders up, back and drop them down.  This is where your shoulders should sit.  If you have compensation going on, maintaining your shoulder posture will be difficult.  Within a minute or two of you intentionally dropping your shoulders you will find them creeping up towards your ears.  You need to constantly set a reminder either on your computer or on your phone, to drop your shoulders until your muscles relearn not to be up near your ears.

For more exercises that can be done for the back click here.

 

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