Back Pain Prevention 3

Core Stability vs Pilates

The whole 'core stability' phenomenon started back in the 1920s with a chap named Joseph Pilates, who's exercise regimes have become quite trendy in the last ten years.Pilates talked about developing a 'girdle of strength' by learning to recruit the deep-trunk muscles. Even without complete knowledge of anatomy and the benefits of the latest muscle activity research, he was aware of the importance of these deep muscles and their supportive effects.Put simply; core stability training targets explicitly the smaller and deeper back and stomach muscles. Once recruited, these muscles control the position of the spine during dynamic movements of your body.

Is Pilates for Everyone?

Sadly, No! Exercise programs that aim to develop your deep core strength can often do just the opposite. The most common reason for injury and back pain is the incorrect timing of core muscle recruitment. Pilates, Yoga, gym strengthening and other forms of exercise place high demands on your core stability system. Abnormal core muscle recruitment order increases your injury chance proportion with the exercise difficulty.Remember, if you build a tower on a weak foundation, it will eventually topple. Look what happened to the Leaning Tower of Pisa. It's got lousy core stability! The same goes for your core stability muscles.However, recruiting the deeper core muscles before your superficial layers just like adding floors to a sturdy skyscraper and your back will be healthy and pain-free forever.

Why is it Important to Specially Retrain your Core Stability Muscles?

Once the core muscles become weak, and their timing is incorrect, you can experience prolonged back pain and are at much higher risk of re-occurrence. Research has identified that the order of core muscle recruitment is one of the most critical factors in the prevention or resolution of pain.  Real-Time Ultrasound Physiotherapy has proven particularly useful to correct the muscle recruitment order.To solve your back pain and to reduce your re-injury risk, you must retrain these muscles back to an appropriate level for your needs. If you are relatively sedentary, you may only need a low level of control, however, if you are a high-level sportsperson or a manual worker you will need to work up to a much higher level of core strength.

What Should You Expect?

In the initial stage, you need to be able to activate these muscles consciously and incorporate them into an exercise program. A lot of people find it difficult to isolate these muscles and need help to be able to activate them effectively.Research has discovered that real-time ultrasound-guided treatment is the most effective way to retrain an isolated and well-timed core stability contraction successfully.

More information

Pilates is available at some of our PhysioWorks clinics.
Real-Time Ultrasound Physiotherapy is available at some of our PhysioWorks clinics.

Chronic Back Pain

If you suffer back pain, you’ll know that it has a nasty habit of returning. Not only is it painful, but it can interfere with your work, sport or just everyday life.Acute back pain usually settles with conventional spinal treatment. However, the recurrence rate is extremely high. In fact, there’s an 84% chance of recurrence within one year! (Hides et al 2001)

Why Do You Keep Getting Back Pain?

Researchers discovered that a couple of deep muscles in your abdomen and lower back need to contract to support your spine. When they work correctly, you’re much less likely to suffer back pain. The bad news is that these muscles turn off every time you suffer back pain and don’t automatically turn on again. This leaves your back at risk of injury.However, the good news is these deep muscles in your abdomen and lower back can easily be retrained. The most effective retraining method is via real-time ultrasound. The chance of lower back pain (LBP) recurrence within one year is reduced significantly.

Back & Neck Pain Prevention Tips

Here's some very useful advice to help you prevent back pain and enjoy life to the maximum.

Posture

I'm afraid that your mother was right. If you slouch you'll end up with problems. Just one of those problems is back pain. You'll find other problems elsewhere on this website. Think "Grow Tall".  Imagine that you have a string screwed onto the back the back of your head, just above your hairline. Then think that someone is dragging you up off the chair you are sitting on. Hold this "grow tall" position for 10 seconds and repeat every half hour.As well as greatly reducing your chances of back pain you'll note that your chest has lifted, shoulders are relaxed, chin is tucked in, head is level and stomach muscles have contracted.  Not bad for such a simple exercise. This posture can be repeated in sitting, standing, sleeping, walking or running. Try it and physio will work for you too!

Lifting

The best method to avoid back pain from lifting is delegation. If this isn't an option for you, try the following:
  • Use a back support to lift loads over 15 to 20kg.
  • Bend at the hips and knees with your feet shoulder-width apart.
  • Firmly grip the load and hold it close to your body.
  • Think "grow tall" to tighten your stomach muscles and look upwards to straighten your back.
  • Stand using your strong thigh and buttock muscles to lift.
  • Once upright, turn by using your feet. Avoid twisting your back.

Sitting

Use the "grow tall" principle each 15 to 30 minutes while sitting. A supportive chair or lower back cushion is essential if you must sit. If possible don't stay seated for too long. Regularly stand up, stretch your back and walk short distances for a variety of posture. We were, after all, designed to hunt and forage - not sit in front of a computer!

Exercise

Fitness has many benefits. Stronger, more flexible muscles and less weight to stress the bones and discs. PhysioWorks specialises in the provision of exercise programs to keep your back flexible, strong and painfree. Exercise can involve aspects of flexibility, strengthening and postural control.Consider Real Time Ultrasound Retraining to ensure you are doing it right!

Sleeping

A quality pillow and mattress are necessary for a healthy spine. You do spend somewhere between one-quarter (1/4) and one-third (1/3) of your life sleeping.Do it in comfort!  You'll need to consider a new mattress if you wake up through the night or in the morning with back pain.  Please ask your PhysioWorks therapist for advice at your next visit.

Driving

Use the "grow tall" principle each 15 to 30 minutes while driving. The combination of sitting and bumpy roads are a recipe for back pain. A  lower back cushion is essential if you must drive any distance.If possible don't stay seated for too long. Regularly break your travels to have a walk and perform simple stretching exercises for a variety of posture and a healthy spine. We were, after all, designed to hunt and forage - not sit in front of a computer!
It's more bad news for smokers. A new study strengthens the link between smoking and lower back pain. It also sheds light on the causes of degenerative lumbar spine problems.Numerous researchers have proposed a link between smoking and low back pain, but the exact nature of that link had remained largely untested in long-term studies.The new study on smoking and low back pain, which examined 1,337 doctors, followed some participants for more than 50 years.

Research Findings

Researchers discovered that smoking history, high blood pressure, and heart disease - all of which are risk factors for narrowing of the arteries - significantly increased the likelihood of low back pain.These same risk factors, along with high cholesterol levels, were also significantly associated with the development of lumbar spondylosis (degeneration).

Why?

These findings support the theory that narrowing of the arteries may cause lower back pain and degenerative disorders of the intervertebral discs.  Researchers have suggested that damage to the vascular structures (blood supply) of the discs and joints is the mechanism of injury in low back pain.

Conclusions from Smoking and Low Back Pain Study

The study concluded that development of lower back pain was significantly associated with smoking history and high blood pressure, and the development of lumbar spondylosis was significantly associated with smoking history, and high blood pressure and cholesterol.

What about Diabetes and Lower Back Pain?

The good news for diabetics was that diabetes did not increase the incidence of lower back pain or lumbar spondylosis (degeneration).

Back Pain Conditions

Ankylosing Spondylitis Back Muscle Pain Bulging Disc Core Stability Deficiency Cramps Degenerative Disc Disease DOMS - Delayed Onset Muscle Soreness Facet Joint Pain Fibromyalgia Lumbar Stress Fractures (Cricket Fast Bowlers) Muscle Strain Osteitis Pubis Osteoporosis Overuse Injuries Pinched Nerve Piriformis Syndrome Pregnancy Back Pain Rheumatoid Arthritis Sacroiliac Joint Pain Scheuermann's Disease Sciatica Scoliosis Side Strain (Abdominal) Spinal Stenosis Spondylolisthesis Spondylolysis (Back Stress Fracture) Spondylosis (Spine Arthritis) Stress Fracture

Back Pain FAQs

Common Physiotherapy Treatment Techniques What Causes Back Pain? What is Pain? Physiotherapy & Exercise Massage Styles and their Benefits What Causes Post-Exercise Muscular Pain? What are the Best Core Exercises? Can Kinesiology Taping Reduce Your Swelling and Bruising? Chest Pain: Is it a Heart Attack or Your Spine? Does Smoking or Diabetes Cause Lower Back Pain? Heat Packs. Why does heat feel so good? How Do You Prevent Back Pain? How Does an Exercise Ball Help Back Pain? How to Achieve the Best Standing Posture Lower Back Pain Research Posture Trainer? Check out the BackTone 4000 Sports Injury? What to do? When? What are Growing Pains? What are the Benefits of a Standing Desk? What are the Benefits of Good Posture? What are the Common Adolescent Spinal Injuries? What are the Common Massage Therapy Techniques? What are the Early Warning Signs of an Injury? What are the Healthiest Sleeping Postures? What are the Signs of an Unsupportive Pillow? What are the Symptoms of a Low Back Strain? What Can You Do To Help Arthritis? What Causes Pins and Needles? What Causes Repeat Low Back Strains & Sprains? What is a TENS Machine? What is Chronic Pain? What is Good Standing Posture? What is Musculoskeletal Physiotherapy? What is Nerve Pain? What is Sports Physiotherapy? What is the Correct Way to Sit? What to do when you suffer back pain? What to expect when you visit PhysioWorks? What's the Benefit of Stretching Exercises? What's Your Core Stability Score? When Should You Use a Shoulder Posture Brace? Why are Sprains and Strains of the Low Back Common? Why are Your Deep Core Muscles Important? Why does Back Pain Recur? Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker

Lower Back Pain

Lower back pain (LBP) is one of the most common conditions in health care. It is suggested that 80% of the population will suffer low back pain at some point in their lives. Lower back pain costs our country billions of dollars every year through absenteeism and injury rehabilitation.It is critical to all those who suffer from low back pain that a safe and effective treatment protocol be developed to beat lower back pain. Australian physiotherapists lead the world with groundbreaking research to improve the treatment and prevention of low back pain.At PhysioWorks, we are glad to offer both immediate pain relieving techniques and a longer-term preventative programs to stop recurring lower back pain.

How PhysioWorks Can Help Your Lower Back Pain?

Well-designed research and highly skilled clinical practice has provided evidence for physiotherapy as a safe, effective and low cost management approach for low back pain.PhysioWorks' physiotherapists are highly skilled in the assessment, diagnosis and successful treatment of patients with low back pain arising from a musculoskeletal dysfunction.Our injury management involves not only 'joint manipulation' like some other health practitioners, but also less forceful but equally effective passive examination and treatment techniques, effective therapeutic exercise (strengthening and stretching) and vital advice on posture, lifting and movement pattern abnormalities. In other words, your physiotherapist will fix the immediate problem and then help you to stop it coming back using a multitude of techniques and skill.Call PhysioWorksBook Online

Evidence Based Physiotherapy for Low Back Pain

There has been substantial research undertaken by physiotherapists investigating the techniques used. This research has been conducted according to extremely strict research guidelines. Unlike some alternative back pain remedies, physiotherapists base their treatment protocols on scientific research evidence.Based on a comprehensive review of the scientific literature the Australian Physiotherapy Association (APA), with assistance from the Musculoskeletal Physiotherapists Association (MPA), has developed a recommendation for the successful treatment of low back pain.

Low Back Pain - Acute (less than 3 months)

There is considerable evidence to support that spinal manipulative therapy (SMT) including passive mobilisation and manipulation, McKenzie therapy and the encouragement of early active movement, rather than bed rest, is effective in the short-term management of low back pain.SMT provides better short-term improvement in both pain and the return to normal activity levels than the comparison regimens of traction, massage, short-wave diathermy and epidural injections.Compared to placebo or other conservative treatment, a recent meta-analysis reports twelve out of sixteen trials as favourable for SMT.

Chronic Low Back Pain - Greater than 3 months

There is strong evidence to support that exercise programs result in a faster return to work rate, reduced absenteeism and disability when compared to control groups.Your PhysioWorks' physios possess the necessary skills and education to individually assess each low back pain candidate and then appropriately design, prescribe, supervise and progress your successful low back pain exercise program. Currently, physiotherapists are pioneering research investigations into the mechanisms contributing to chronic and recurrent low back pain. The research evidence to support their efficacy is continually increasing.Spinal manipulative techniques (SMT) has been strongly shown to be more effective in the management of chronic low back pain than bed rest, pain killers and massage, with six out of eight trials supporting this evidence.More importantly, the combination of SMT and specific exercises has increasing support in the management of low back pain. Your PhysioWorks physio has the necessary skill and knowledge to provide you with optimal low back pain care.

Real-time Ultrasound Guided Treatment

The best way to activate the correct core stability muscles is to actually see them working on an ultrasound scan. Yes, it's just like seeing an unborn baby. We now have this fantastic technology at several of our PhysioWorks clinics. 
  • Real Time Ultrasound Physiotherapy
 

Electrical Stimulation

There is no harm in applying a home TENS unit to minimise pain while you strengthen the muscles supporting your spine. 
  • TENS Machine

What are the Benefits of Good Posture?

good-posture-sitting

Good Posture:

  • Keeps your bones and joints in the correct alignment.
  • Helps to decrease the abnormal wearing of joint surfaces.
  • Decreases the stress on the ligaments holding the joints of the spine together.
  • Prevents the spine from becoming fixed in abnormal positions.
  • Prevents muscle fatigue.
  • Prevents any backache and muscular pain.
  • Contributes to a competent and confident appearance.

To Achieve Good Posture You Will Require the Following:

  • Good muscle flexibility
  • Normal motion in the joints
  • Strong postural muscles
  • A balance of muscles on both sides of the spine
  • Awareness of your posture, plus knowledge of proper postural position, which leads to conscious correction.
Practise the correct posture for standing, sitting, and lying down (as described below) to gradually replace your old position.

What is Good Posture?

Standing with the good posture looks and feels fantastic, plus it's very healthy for your joints, muscles, bones, blood circulation and most importantly, your self-esteem. That's why proud and confident people stand tall with excellent posture. It's a habit!How you hold your body in space is your posture. Your posture is a direct result of the postural habits that you commonly exhibit. You can choose to hold good posture or poor posture. Gravity is your worst enemy while standing or sitting. You could also refer to this as your spinal posture, back or neck posture.The good news for you is that you can quite easily change your postural habits and train your body to sit, stand, walk, and even rest in great postures. Good posture also places the least strain upon your supporting muscles and ligaments.But, no one posture is good to maintain all day. As a human, you were designed to move from posture to posture to avoid muscle fatigue and abnormal sustained tissue loading. This means that your best posture is your next posture!

Benefits of Good Posture

Good posture:
  • Prevents postural muscle fatigue.
  • Correctly aligns your joints and bones to encourage efficient muscle activity.
  • Helps minimalise joint stress.
  • Avoids passive ligament overload.
  • Prevents backache, neckache and muscular pain.
  • Contributes to your enhanced confidence and a good appearance!
Standing comfortably with good posture should feel natural and energy efficient. Bad postural habits can cause a few muscular aches and pains for a few days during the early transition (posture habit change) phase. You may experience temporary joint or muscle discomfort or fatigue as your joints realign, ligaments stretch and postural muscles start working. The good news is that if you keep at maintaining a good posture your body will quickly adapt and you'll feel more comfortable and strong in your new normal posture.Plus... the up side is that not only will you be less likely to suffer pain, you'll look confident and feel fantastic too!

How to Improve Your Standing Posture:

The number one tip to achieve a great standing posture is to simply"stand tall"! All the muscles that you need to push you taller are the same ones that improve your posture.
  • Stand tall!
  • Extend your head directly up (think balloon lifting your head with a string in the top of your scull) - but keep your chin tucked in. Avoid tilting your head forward, backward or sideways.
  • Your earlobes will line up with the middle of your shoulders.
  • Keep your shoulders back, your knees straight and your back straight.
  • Let arms hang naturally down the sides of the body
  • Lightly draw in your core stomach muscles. Avoid tilting your pelvis forward.
  • Avoid locking the knees
  • Ensure your feet arches are in a neutral (not flat) position.
  • Stand with weight over the the centre of your feet.
  • Stand with your feet slightly apart (shoulder-width).
  • When standing for a sustained periods, shift your weight from one foot to the other, or stand in walk stand and rock your weight from your front to back foot.

How to Quickly Check Your Standing Posture

Stand against a wall with shoulders and bottom touching wall. The rear of your head should lightly touch the wall.

How to Correct Your Posture?

If you experience discomfort in the above test and you can't easily correct your posture, you may have some restriction of joint, ligament or muscular movement. All of these problems can be quickly assessed and quickly improved by your physiotherapist. Please consult them for advice.Having difficulty maintaining a normal upright posture? You are probably suffering from reduced muscle endurance or strength. But these can both be easily improved with some practice of the right exercises. Your physiotherapist is an expert in prescribing the best postural exercises for you in a stage-appropriate manner to help your improve your posture without causing unnecessary pain or injury.You physiotherapist may also advise a posture brace or prescribe some posture taping to assist you to quickly achieve and maintain a good posture.Contact your physiotherapist for posture advice specific to you and your needs.

What is the Best Standing Posture?

Standing with your best posture not only looks and feels fantastic, but it's also very healthy for you.Great posture is the best thing for your muscles, joints, bones, blood circulation and most importantly, your self-esteem. That's why proud and confident people stand tall with excellent posture. It's a successful habit!Good posture also places the least strain upon your supporting muscles and ligaments.How you hold your body in space is your posture. Your everyday posture is a direct result of the everyday postural habits. You can choose to hold good posture or poor posture. The constant compressive weight of gravity is your worst enemy while standing or sitting. You could also refer to this as your spinal posture, back or neck posture.It's actually quite easy to improve your postural habits. But it is a habit and researchers suggest that it takes 10000 attempts to create a habit. That's a good or a bad habit! Why not start the new you with a proud and posture perfect body today?

What is Your Best Posture?

Humans were always designed to move and be versatile. You were designed to move from posture to posture to avoid muscle fatigue and abnormal sustained tissue loading. When we were hunters and gatherers it was easy. But, with specialised jobs and postures, we tend to become static for too long these days and that causes postural fatigue, which leads to posture failure. This means that your best posture is your next posture! 

Benefits of Good Posture

Good posture:
  • Prevents postural muscle fatigue.
  • Correctly aligns your joints and bones to encourage efficient muscle activity.
  • Help minimalise joint stress.
  • Avoids passive ligament overload.
  • Prevents a backache, neckache and muscular pain.
  • Contributes to your enhanced self-esteem!
Your ideal standing posture should be comfortable, easily attained and maintained. Your best posture should feel natural and be energy efficient. Bad postural habits can cause a few muscular aches and pains for a few days during the early transition (posture habit change) phase. During this period you can experience some temporary joint or muscle discomfort. These discomforts are related to mild joint adaptation as your joints realign, ligaments stretch and postural muscles start working. The good news is that if you keep at maintaining a good posture your body will quickly adapt and you'll feel more comfortable and strong in your new normal posture.Plus... the upside is that not only will you be less likely to suffer pain, you'll look confident and feel fantastic too!

How to Improve Your Standing Posture:

If I had to tell you one "switch" tip, it is simply to "stand tall" whenever you think about it. The muscles that you use to stand taller are exactly the same muscles that improve your posture.
  • Stand tall!
  • Think tall neck (ballerina or model style)- but keep your chin tucked in. Avoid tilting your head forward, backward or sideways.
  • Your earlobes will line up with the middle of your shoulders.
  • Keep your shoulders back, your knees straight and your back straight.
  • Let arms hang naturally down the sides of the body
  • Lightly draw in your core stomach muscles. Avoid tilting your pelvis forward.
  • Avoid locking the knees
  • Ensure your feet arches are in a neutral (not flat) position.
  • Stand with weight over the centre of your feet.
  • Stand with your feet slightly apart (shoulder-width).
  • Shift your weight from one foot to the other when standing for a sustained periods. Alternatively, stand in a walk-stand and rock your weight from your front to back foot.

How to Quickly Check Your Standing Posture

Stand against a wall with shoulders and bottom touching the wall. The back of your head should lightly touch the wall. If you can't do this without pain or strain, you may have some restriction of some spinal joints, ligament or some muscle tightness. All of these problems can be quickly assessed and quickly improved by your physiotherapist with some joint mobilisations, stretches, massage and/or strengthening exercises. Please consult your physiotherapist for specific advice regarding your posture.

Posture Fatigue?

Having difficulty maintaining your normal upright posture? You are probably suffering from reduced muscle endurance or strength. Postural muscle fatigue can be improved quite easily with repetitive contraction and periodic posture breaks. This will help to strengthen and improve your postural muscle endurance.Your physiotherapist is a professional in prescribing the best postural exercises for you in a stage-appropriate manner.  They may consider temporarily prescribing you with a posture brace or prescribe some posture taping to assist you to transition, achieve and maintain the best posture for you.

What is the Best Way to Sleep?

Your Best Sleeping Position?

best sleeping position
Everybody has their favourite sleeping position. However, some are better for you than others. Try to sleep in a posture that helps you maintain the curve in your lower back. We recommend lying on your back with a pillow under your knees (if more comfortable) or on your side with your knees slightly bent.

It is preferable to not sleep on your side with your knees drawn up to your chest (the foetal position). However, having said that some back conditions will find this preferable. You should seek the advice of your physiotherapist if you are in doubt.

If you are suffering back pain, you could try lying over a lumbar roll or peanut cushion at night to make you more comfortable. A rolled sheet or towel tied around your waist may also be helpful. You may wish to avoid sleeping on your stomach, especially on a saggy mattress. This sag can cause back strain and can be uncomfortable for your neck.

What is Your Best Mattress?

Select a firm mattress or an ensemble that does not sag. If necessary, place a board under your bed's mattress. You can also set the mattress on the floor temporarily if needed. If you've always slept on a soft surface, it may be initially painful to change to a harder surface. Try to do what's most comfortable for you.

How to Rise from Bed

When standing up from the lying position, turn on your side, draw up both knees and swing your legs over the side of the bed. Sit up by pushing yourself up with your hands. Bend forward at your waist with your core muscles activated.

What is Your Best Pillow?

The human neck curves slightly forward (to sustain the weight of the head when upright), and it is crucial to maintain this curve when in a resting position. If the height of the pillow is too high or low when sleeping, your neck is bent abnormally out of alignment, causing muscle and joint strain. You can even wake with headaches.

Poor pillow support can also cause narrowing of the air pipe, resulting in obstructed breathing, and sometimes snoring, which can hinder sleep.

The best lying or sleeping position may vary, depending on your symptoms. No matter what posture you lie in, the pillow should be under your head, but not your shoulders, and should be a thickness that allows your head to be in a normal position.

To give your body the proper rest it needs, and to ensure the health of your spine, physiotherapists recommend only two sleeping positions: Side sleeping and supine sleeping.

Sleeping Tips

Sleeping on your side, with the spine straight.  Sleeping on your back, maintaining the primary curvature of the cervical spine. Both of these positions prevent poor alignment of the neck and upper back. Proper alignment can help to reduce the number of neck aches, backaches, pinched nerves, shoulder and arm referred pain, insomnia, and mental fatigue from a lack of effective sleep.

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