Stride Strong PT’s Formula

• Manual therapy to improve spinal joint mechanics and symmetry. Manual stretching and soft tissue release to address muscles spasms and pain.

• Increase core strength and stability with gradual progression in difficulty and dynamics.

• Posture coaching for activities in sitting, standing and walking.

Nearly everyone has been plagued by low back pain at some point in their lives. Reasons can stem from a number of issues ranging from your average I-tweaked-my-back strain to the more serious herniated disk and lumbar fusion. Whatever the cause and however intense the severity, there are some fundamental things you can already start doing to help you on your road to recovery. Follow these steps sequentially:

#1 Take care of your muscle spasms 

Low back pain almost always consists of muscle spasms – it is the body’s natural way of protecting and guarding itself. However, this self-preservation mechanism is counter-productive to healing so you need to make sure spasms are kept at bay. Do gentle and repetitive range of motion activities such as walking and gentle twisting stretches. Stay away from large-range movements like swinging a golf club. Also, avoid being static for too long. Usual offending positions are: prolonged standing, sitting and driving. Make sure to switch positions often so muscles don’t tense up. Soft tissue massage and heat help to bring blood flow into the muscles so they are less reactive.

#2 Core strength
Establishing core strength is the NUMBER ONE therapy to dig you out of your low back pain – but exercises have to start easy (think abdominal tensing) and progress gradually according to symptoms. Jumping from pelvic tilting to planking is a sure-fire way to exacerbate pain. Start by tensing abdominals and actively bracing your core while you are doing regular daily activities. You can also engage your core by maintaining a “neutral pelvis”. How to do this: cup your hands around your hip bones like you’re cupping a big bowl of soup or basin. Now imagine your pelvis filled to the brim with water and your goal is to not spill it. Find the mid-way point between tipping your basin backward and forward and you will achieve neutral spine. Now keep this basin ‘full’ relative to your spine all day long while doing activities and this should engage a constant and easy contraction of your core.

#3 Posture, posture, posture!
This goes hand-in-hand with core strength and keeping neutral spine. Avoid the extremes: sitting or standing with an excessively back-extended spine; or slouching with a forward-curved posture. Sometimes back pain can lead you to side-bend, twist or curve away from the side of pain. It is important to work away from skewed postures like these and gradually return back to neutral spine. Combining stretching, core strengthening, and mindfulness of your posture will allow you to do this. It is healthiest for the body to be as symmetrical as possible so muscles can work in their most ideal lengths. (There are exceptions to this however, such in the case of scoliosis, where the emphasis will be on core strength and stability.) Don’t forget to be mindful of your posture while sitting at your desk at work. Adjust your workstation to achieve best ergonomics.

#4 Modify your activity level

You may have to put ultra-marathoning through the Gorge at a lower priority temporarily. Allow time for your muscles and joints to heal and deflate from inflammation. Place more focus and attention to core strengthening instead. Engage in easier, rhythmic activities such as walking pr light swimming. Yes, your cardiovascular endurance will suffer a bit temporarily but your back will thank you. You can absolutely gain it all back after you heal up.

#5 Ask yourself: are you too flexible or are you too tight?

Most people with low back pain belong to one of either categories. Adults who are tight and inflexible in their hips and shoulders need to be coaxed to become more flexible so joints and muscles don’t lock up. They also tend to achieve good results from combined chiropractor adjustments, yoga and physical therapy. Adults who tend to be very flexible suffer from instability of joints, where they dislocate or “go out of alignment” often. These patients need more rigid emphasis on core and hip stability so diligence on frequent at-home exercises is a must.

 

How my Physical Therapist can help

Your PT can guide you through the proper progression of core exercises so you don’t under- or over-do it. We can also coach you on proper lifting and posture techniques so you don’t hurt yourself again. We coax your muscles to calm down with manual and stretching techniques. PT’s are also able to readjust joints that are locked down, stuck or mal-aligned. We also check and treat for other strength and joint deficits in the hip and shoulders that contribute to low back pain. Therapy duration ranges from 1 week to several months depending on severity of issues. However one thing for sure is: the longer you wait to act on it, the longer your therapy stint will be so make an appointment today.

 
By Alice Holland, DPT.
Alice’s Google + page.