How to get better

I believe the fundamental stages required to get better and overcome an injury are: correction, rehabilitation, maintenance and resistance.

There's a lot to be gained from following the steps and making sure that healing has occurred and chance of  re-injury is limited:

Correction:

Correction entails moving the joints and vertebra back to the most ideal position. To allow a vertebra to move the muscles automatically change their tension, stiff muscles begin to relax and movement patterns begin to change.

If appropriate correction does not occur we can examine to find out why not.

Rehabilitation:

All spines degenerate over time; if it were possible to transplant a perfect spine how long would it take before it started looking like the former?

Traumatic injures and our habits cause stresses on our spines and affect their position and structure.

A previously injured spine is more likely to resume habits that may cause further damage.

Rehabilitation means changing our habits for the better to prevent re injury.

Sitting, sleeping, standing, exercising, our movement patterns and the way we time our muscle contractions whilst moving, how things work when we're stressed or off balance.

Most of the time simple Ergonomic changes may be implemented and have very favorable outcomes. Learning a new exercise or technique can teach your body to function better and prevent reinjury can have long term benefits.

The typical example is a mom who's had a C/section, cutting through the abdominal muscles forces the body to use other muscles to try and stabilize the spine the habit of using the wrong muscles is retained. It takes a 5 minute exercise to feel the abdominal muscles work again. If this is maintained it boomers the new habit.

These changes can be tested and monitored as improvement occurs.

Maintenance:

How well the corrective and rehabilitative steps have gone determines the required maintenance one may require to prevent a relapse of a condition. If a you have a desk job and you hunch over a laptop all day the likely hood of full recovery is limited without ergonomic improvement and postural improvement, once posture is improved what schedule is required to maintain it before it deteriorates again and symptoms reoccur.

We can test this with functional orthopedic tests and exercises that require specific muscle recruitment. Improvement and Prognosis can be measured and scheduling can be done accordingly.

Resistance.

In sports such as tennis  and golf it's often said that to make real gains in ones ability you need to make your weaknesses strengths, if your volleys or short game are weaknesses work at them until they're an asset to your game. Why not apply the same logic to an injury; if your core muscles are weak don't just rehab them until they work continue until they become an integral part of your functioning.

There's and endless number of exercises that can challenge your balance and stability, range of motion and control, the challenge can be fun and again measurable outcomes can be rewarding.

If you'd like any help with Correction, Rehabilitation, Maintenance or Resistance please don't hesitate to give me a call.

Description of Exercises

These Rehabilitation exercises aim to create stability initially and then test and exercise it with varying amounts of stability and a motion. Once basic exercises and movements are mastered more complex movement patterns can be attempted. Eventually even when stressed the Abdominal Muscles and Glutes work to stabilize instead of sudden Back and Hip Flexor (Iliopsoas) contraction which causes injury.
Chiropractic care Corrects the position of the joints and controls muscle tension. Movement patterns and Rehabilitative exercises help to prevent further or future injuries. Maintenance care follows and should test and examine the boundaries of ones fitness so that you know when you're likely to injure yourself and can take action before getting sore.



1. Abdominal Activation whilst Breathing

• Are you able to breath and Maintain Abdominal contraction?

• Place one hand on your abdominal muscles and the other in the small of your back and focus on maintaining your abdominal contraction whilst changing your breathing pattern.
• You should maintain Abdominal contraction during all exercises irrispective of your breath... this teaches you to maintain stability even whilst tired. 
• Exercise 7 can be done as a precursor to learn the initial activation or the Abdominals.

 

2. Lunges and quadriceps stretches

• Stretches the Iliopsoas and Quad muscles the antagonists to the Gluteal Muscles.

• Hold for at least a minute on each side

 

3. Bosu ball stability exercises. Standing Balance Exercise

• Learn to create a functional connection between the trunk and pelvis and stabilize the body.

• This can be done with eyes open and closed, on both and then one foot and on various unstable surfaces such as sponges or bosu to increase the difficulty.

 

4. Planks/ bridges

• Lift your Pelvis and hold the position

• Maintain Abdominal and Gluteal Contraction

• When comfortable with maintaining the position on two feet; lift a foot by straightening the knee and keep the position without allowing the opposite hip to drop, To do this you need to use your stabilizers.

• Keep your Pelvis in position whilst changing legs. How Stable can you make the transition?

• A sponge under the feet or back can make the exercise more challenging later on
  

5. Opposite extensions/ superman’s/ kick-backs

• Hold Pelvis Still with Abs and Glutes.

• Start with one arm and the one leg and do opposite leg and arm only when technique is correct.

 

6. Lunge with rotation

 

• Lunge first with good posture and arms forward.
• Make sure your knee stays in front of your hip inline with the foot and doesn't buckle inwards, if you are unable to maintain the knee position don't progress to rotations.
• Rotate to the open side first. progress to the closed side when the open side is mastered. Maintain posture and trunk control with your Abdominal and Gluteal Muscles.
• If Technique fails stop!

 

7. Abdominal specific crunches

•  Lie on your back with your feet on an exercise ball, bend your knees and press downwards on to the ball.
•  If the pressure on the ball changes start again. This is more important than the Crunch!!! If your Glutes are working you eliminate your Iliopsoas from contracting, this makes it specific because you cant bend from the waist.
• Hold Abs tight and use them to do a small Crunch; the idea is to isolate and teach you how to contract your Abs.
• Can do rotations to each side to activate the Oblique Muscles too.

All Exercises should be done with the correct technique and should not cause any pain!
There are no set number of reps or sets, technique is what determines how many to do. A difficult exercise should not be attempted unless you're able to master the basic variant.
Should you require further explanation, supervision, or would like to discuss these exercises please don't hesitate to contact me.
Chiropractic Adjustments correct the position of the joints to make these exercises more comfortable and prevent injury (Correction/Rehabilitation/Maintenance).
 

Rehab of Low Back Pain; Steps, Goals and Exercises

Steps for lower back rehab: 1. Abdominal bracing 2. Hip flexor stretches/ releases 3. Stability exercises 4. Static postural muscle exercises 5. Gluteus muscle strengthening 6. Dynamic stability exercises 7. Abdominal crunches (without hip flexor activity) Goals: 1. Begin activating the abdominals 2. Decrease the forward pull of the hip flexors     (Iliopsoas) 3. + 4. Strengthen and test the appropriate            muscle groups in the correct posture. 5. Change amount of forward tilt of the pelvis by     activating the abdominals and gluteal stabilizers 6. Decrease the amount of required spinal     extensor activity (injury to posterior joints) 7. Decrease excessive lumbar curvature Exercises: 1. Static abdominal activation with breathing     exercises 2. Lunges and quadriceps stretches 3. Bosu ball stability exercises 4. Planks/ bridges 5. Opposite extensions/ superman’s/ kick-backs 6. Lunge with rotation 7. Abdominal specific crunches (activate the glutei while doing crunches)  Consult a qualified practitioner or trainer before embarking on a new training or rehab program.

How I Fix Low Back Pain

I've wanted to share how I correct what leads to low back pain for some time. This will be an explanation as to what causes back pain two or three weeks after an initial traumatic event, the bad habit if you will, that eventually causes damage to tissues and ensuing pain. 

I've had great success in using my method and explain it 10 times a day so hopefully this can also serve as a resource if I fail to explain it well enough in consult.

It starts with your Iliopsoas or Loin Muscles. Your Iliopsoas connect from your Lumbar Spine to your Hips, they are meant to flex your Hip or bring your Knee to your Chest, they also try to stabilize your lumbar spine when your abdominal muscles aren't functioning as they should. When your Iliopsoas muscles contract or shorten while sitting for hours at a time, they pull your spine downwards when you stand up. They are antagonistic to your Gluteal or Bum muscles that hold you upright. 

If your Glutes aren't working to hold you up, because your Iliopsoas is contracted, the work is left to your Back Muscles and Hamstrings. Your back muscles now have to resist your Iliopsoas and grab your Vertebra whenever you lack coordination to keep you upright; they are Strained and they Sprain the Joints of your Spine.

When your Gluteal muscles are deactivated by the actions or your Iliopsoas the muscles around your Hip have to take up the work load and become painful causing hip pain.

If your Iliopsoas is shortened and your Abdominal Muscle activity is reduced by sitting for long periods of time, by traumatic injuries, by Abdominal surgeries and by weak Gluteal muscles. 

So how is it fixed?

We reeducate your nervous system and correct the position of your joints with specific Chiropractic Adjustments, release your Iliopsoas and stretch it, and then learn to use your Gluteal and Abdominal Muscles again with special exercises.

When your Abs and your bum work your Iliopsoas no longer pulls on your spine.
Look for my Exercises and stretches in my next blog. 

 

Stretches and Strengthening Exercises to Protect Your Back

Depending upon your current or previous injuries, level of physical fitness and whether you are already implementing a rehabilitation program, the intensity and the exercises may vary.

Please consult with your doctor of Chiropractic prior to starting a new exercise or rehabilitation program so that individualized exercises and proper instruction on the stretching techniques and exercises can be provided.

All exercises should be done with the correct form and technique and include activation of the muscle to be strengthened whilst bracing with the Abdominal Muscles. Your Breathing Rate should also remain constant; don’t hold your breath while contracting the abdominal muscles during the repetition of the exercise.

No exercise should ever be painful. If an exercise does become painful or you lose the correct form and begin making compensatory errors: STOP.

Hamstring Stretch

Lie on your back with both legs straight. Extend one leg straight up in the air. Loop a towel over the arch of the lifted foot, and gently pull on the towel as you push against it with your foot until a stretch is felt in the back of the thigh. Hold for 30 seconds. Relax. Repeat 3 times on each side.

Piriformis Stretch

The piriformis muscle runs through the buttock and can contribute to back and leg pain. To stretch this muscle, lie on your back and cross one leg over the other; gently pull the knee toward the chest until a stretch is felt in the buttock area. Hold 30 seconds. Relax. Repeat 3 times.

Back Stretch

Lie on your stomach. Use your arms to push your upper body off the floor. Hold for 10 seconds. Let your back relax and sag. Repeat 10 times.

Cat Stretch

Start on your Hands and knees. Drop your buttocks to your feet, stretch and extend your arms out in front of you and push your body downwards so that the stretch is felt in your back. This stretch can be done with lateral flexion of your trunk or with rotation. Hold for a minute.

Knees to Chest Stretch

Lie on your back and hug your knees to your chest. Stretch should be felt in your lower back. Hold for a minute.

Hip Flexor Strech/supported lunge

Take a long stride forwards so that your front knee is bent and your back knee touches the mat. Rest your hands on your front knee for stability and push your body forwards and downwards so that the stretch is felt at the top in the front of your back leg. Hold 30 seconds. Repeat 3 times on each leg

Leg Raises

Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat 5 times with each leg.

Bridges

Lie on your back with your knees flexed and your feet flat on the floor. Keep the knees together. Tighten the muscles of the lower abdomen and buttocks so as to flatten your lower back against the floor. Slowly raise your hips up from the floor and hold for a slow count of 10. Repeat this exercise 3 times.

Planks

Lie on your stomach. Lift yourself on to your elbows and feet, and raise your pelvis so that your body is in a straight line. Hold for 30 seconds, repeat 3 times.

Lie on your side. Lift yourself on to your lower elbow, and lift your pelvis so that your weight is on that elbow and on the outside of your lower knee or foot. Keep your body straight. Hold for 20 seconds. Repeat on each side 3 times.

The Superman

Kneel on mat on hands and knees, with palms directly under shoulders and knees hip-width apart. Slowly raise right arm, and extend it forward parallel to floor. (Balance by contracting your abdominal muscles.) Keep right palm parallel to the floor, then lift the left leg, and straighten it behind you. Hold opposing limbs off the ground for 30 to 60 seconds without arching your back. Switch sides. Repeat 3 to 6 times.

Lunges with Rotation

Hold a weight in front of your chest with straight arms at shoulder level. Take a long step forwards into a lunge position. Whilst in the lunge position turn your shoulders towards your back leg, keeping the weight at shoulder level. Perform 3 sets of 10 repetitions on each side.

Abdominal Specific Crunches

Lie on your back with your feet on an exercise ball, bend your knees and pull downwards on to the ball. Keep the tension on the ball whilst you do a crunch. Your gluteus muscles and hamstrings should be contracted while you are performing the exercise; this eliminates your hip flexor muscle from contracting and isolates your abdominals. Perform 3 sets of 15 repetitions each.

The Cardio Component

Engaging in cardiovascular exercise can help aid in rehabilitation of the spine and help prevent future injury. Most health care professionals recommend 20 to 30 minutes of cardio exercise three to four days per week to improve cardiovascular endurance and help lose weight. Until you’ve recovered from back pain, select low-impact activities that burn calories, but won’t place undue stress on your joints. Consider alternating cardio exercise and strength training to get the most from your workouts and to allow your muscles time to recover.

Stretching Tips

To get the maximum benefit from stretching, proper technique is essential.

• Warm up your muscles before stretching by walking or doing other gentle movements for 10 to 15 minutes.

• Slowly increase your stretch as you feel your muscles relax. Don't bounce.

• Stretch slowly and gently only to the point of mild tension, not to the point of pain.

• Don’t hold your breath. Inhale deeply before each stretch and exhale during the stretch.

• As your flexibility increases, consider increasing the number of repetitions.

• Stop immediately if you feel any severe pain. 

Chiropractic Theory

Physical, emotional and chemical factors can cause injuries to your spine and dysfunctional patterns called Subluxations to occur. A Chiropractic Subluxation consists of a collection of elements that are controlled by the nervous system; they create a dysfunctional pattern and nerve irritation which diminishes nerve function.

These can be described as subconscious bad habits or muscle memories that are controlled by the nervous system.

The nervous system is the mediator of health and vitality to all the tissues, muscles and organs. Alterations in nervous system function can alter the functionality of motor responses (muscle contraction and function), reflexes, pain reception, and touch sensation reception.

Chiropractic Adjustments/Manipulations stimulate the nerve receptors and cause an alteration in the flow of sensory nerve information or nerve signals into the spinal cord and from there to the brain. The brain corrects the dysfunction and natural healing can occur!

Adjustments can alter the dysfunctional sensory information and induce a completely new sensory input. This corrects Subluxations!