low back pain - Gallagher Performance - Chiropractic, Sports Therapy, Training, and Massage

Exercise Hacks Ep. 11 - Train the Abdominal Slings for a Functional Core

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Two common sites for pain and movement problems are the low back and sacroiliac (SI) joints. The SI joints are a common site for sensitivity due to biomechanical overload.

Once we have screened for sensitivities, pain generators and movement dysfunction, the presence of SI joint dysfunction is often found along with poor abdominal sling function. Chiropractic adjustments are great for addressing joint dysfunction, but we must train movement through specific exercise.

Addressing abdominal sling function is critical as the SI joints receive stability from the force closure our musculature provides. Poor function of these abdominal slings results in poor stability (and often pain) in the SI joints during walking, running, squatting, lunging, bending, pushing or pulling.

Our abdominal slings are present on the front (anterior) and back (posterior) of our core. The anterior sling being made of the pec major, external oblique, internal oblique, and transverse abdominus. The posterior sling being made of the latissiums dorsi and opposite glute complex.

These exercises demonstrate how to strengthen the abdominal slings as a functional unit. You want to think transverse plane.

Cable chop variations are great for the anterior sling. Cable chops are excellent for building a functional anterior sling for stability and efficient force transfer, especially for front side mechanics as it relates to running, sprinting, jumping, and throwing.

The posterior sling can be targeted with Single-leg Romanian deadlift (RDL) variations as shown. Drawing tension through the lats and glutes provides the stability in the posterior sling to improve motor control of the lumbopelvic region for efficient hip extension. Clean, efficient and - at times - powerful hip extension is critical to a number of athletic movements as well as daily living.

Our hips should be the "King of Motion" in the body, yet many of us deal with tight hips and painful backs or SI joints as a consequence. Our hip movement must be trained and optimized, but the hips will only be as efficient as the abdominal slings allow.

For improved function and less pain, think outside the box when it comes to your abdominal training. Function serves a far greater purpose than aesthetics.

Give these exercises a shot. Let us know your thoughts or questions!

For more related reading:

https://gallagherperformance.com/beginners-guide-injury-recovery/

https://gallagherperformance.com/improved-approach-chronic-pain-management/

https://gallagherperformance.com/3-exercises-athletic-mobile-hips/

https://gallagherperformance.com/exercise-hacks-ep-8-breathing-bracing/

https://gallagherperformance.com/do-you-really-need-more-mobility/

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abdominal slings chiropractic functional exercise hips low back pain movement performance stability strength training

3 Common Reasons for Low Back Pain

According to research conducted by Dr. Stuart McGill, "People with back pain actually have stronger backs than people without back pain, so weakness is not the culprit." In our experience in both treating and training individuals suffering from low back pain, there are three common factors that seems to play a central role:

1) Breathing Pattern - of all the factors that play a role in back pain, breathing is the one that gets dismissed the easiest or patient's are quick to write-off as irrelevant. Truth of the matter is breathing plays a HUGE role. The diaphragm is our primary muscle for respiration AND serves as a deep stabilizer to the lumbar spine. If breathing is not normalized, no other movement in the human body can be. Breathing is that critical. Learning to properly breathing and integrate proper breathing into movement must be learned or else the rest of the stabilizing system of the spine will remain dysfunctional, continuing to contribute to pain.

2) Core Stability & Endurance - in order to build a resilient spine, the core must be stable and conditioned well enough to handle the demands of either daily living, exercise, or sport. The core does require higher levels of muscular endurance which must first be established before more specific qualities of strength or power can be trained. While training for endurance or strength, it's critical that one is aware of their core as it relates to static and dynamic postures in order to maintain stability that spares the joints and discs of the low back.

3) Hip Mobility - stiffness or tightness in the hips will ultimately result in more motion and stress being placed on the low back. The hips are designed for movement and when they get tight this will cause one to bend or twist too often in the low back region. Repetitive motions such as bending and twisting are commonly associated with low back pain. Simply put, the lower back is not designed for repetitive, excessive motion. Improving hip mobility will begin with proper breathing and the learned skill of proper core stability in posture and movement (do you see the theme here?) Then from there, specialized attention must be given to the musculature of the hips and core to correct imbalances and improve overall function.

To sum up - learn to breathe properly, stabilize the core, develop mobile/athletic hips.

More related reading:

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

https://www.gallagherperformance.com/blog/when-should-i-see-a-chiropractor

https://www.gallagherperformance.com/blog/3-ways-breathing-impacts-health-and-movement

https://www.gallagherperformance.com/blog/3-exercises-for-athletic-mobile-hips

Tags:

chiropractic core dynamic neuromuscular stabilization exercise functional low back pain mobility rehab

Low Back Pain Treatments That Just Won't Help

Back pain was believed to be a self limiting condition for the majority of individuals, meaning that the nature of back pain is that it would "run its course" and eventually pain would go away on its own. Current research has demonstrated that this understanding of back pain is flawed; yet many clinicians still hold this belief.

In fact, 85% of people with a single episode of low back pain will likely experience future recurrences and 2-8% of those individuals will develop chronic back pain.

Chronic pain accounts for 75% of all healthcare costs related to low back pain, is second only to the common cold in missed days from work, and is the number one reason for workmen compensation claims.

Considering the burden chronic back pain places on healthcare resources, patient management appears to be an issue in need of addressing appropriately as many patients find it difficult to find effective treatment.

Low Back Treatments That Don't Help
Now many experts are questioning the model in which back pain is treated as a growing body of research suggests many common back pain ‘cures’ just don’t work. These include:

Ultrasound
TENS machines
Strong opium-type painkillers, such as diamorphine
Spinal injections
Spinal fusion
Disc replacement

Prescribing drugs or cutting people open when you don't know what's causing the pain is very unlikely to be successful in the long term. Surgery should only be used as a very last resort. There is a significant lack of efficacy for many treatments, but the deeper issue here seems to be that many healthcare providers have difficulty in accurately identifying the cause of ‘non-specific low back pain’.

Top spine expert, Professor Stuart McGill is the world’s leading spinal biomechanics researcher and has identified common reasons for back pain and the importance of exercise as an intervention for effective treatment.

In Dr. McGill's opinion, based on over 30 years of research, every case of back pain has a cause and the reason many treatments are ineffective is because they are used on a one-size fits-all approach, rarely targeting the underlying problem.
There are many possible causes for back pain, but you must first find the positions and stresses that trigger pain. As Dr. McGill says, finding these positions and stressors allows the provider to formulate a precise diagnosis and a roadmap to recovery. This roadmap is guided exercises that can correct the harmful patterns and build a stable, firm spine.

Addressing Misconceptions
The importance of a firm spine can come as a surprise to many, as the common perception is that your back must be flexible in order to be healthy and pain-free.

The spine must be firm and have strong muscles surrounding it to help transmit forces from the legs and the shoulders while minimizing the stress on the spine. When the muscles of the spine aren’t strong enough, micro-movements can occur that eventually can sensitize the spine and lead to a painful back.

If you have some movements, which are comfortable to build on, this opens the door to conservative management and recovery through guided exercise

However, recommendation of exercise without a clear understanding of movement intolerances and muscles that must be strengthened can also be harmful

Guided Exercise: The #1 Intervention for Low Back Pain
Exercise is essential both to protect and repair your back, but simply hitting the gym or doing Pilates or yoga without knowing the movement patterns that are generating your pain or the ones that will protect and build a pain-free back, has little chance of being effective.

Thanks to exercises specifically targeted at a patient’s problems, we are able to help educate them on proper posture and movement so they do not put damaging load on their spine. The guided exercise model is truly about identifying a patient's underlying back pain generators and educating them on not only how they can get out pain, but also what they can do to keep it from returning.

When you consider that 85% of individuals who have low back pain will experience future recurrences, there must be a priority placed on educating patient's about proper posture, movement, and exercises that build a firm, strong spine. Guided exercises are showing clear efficacy for use in patients with low back pain and should be a staple in their treatment plan.

If you are suffering from low back pain, whatever the cause, consider Gallagher Performance for your evaluation and treatment. Our goal is to relieve your pain while teaching you what you can do to keep the pain from returning.

More related reading:

https://gallagherperformance.com/solution-long-term-improvement-back-pain/

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chiropractic exercise function Gallagher Performance injury intervention low back pain movement performance recovery research sports medicine Stuart McGill therapy treatment

Low Back Pain: Causes and Treatment Recommendations

Low back pain is not an uncommon condition among the American population. Several studies have supported data that demonstrates up to 85% of the population will experience at least one episode of low back pain during their lifetime. Low back pain is responsible for millions of dollars in healthcare costs every year.

In most cases, low back pain is relatively self-limiting condition, meaning it reduces naturally over a period of a few days. That said, it is not uncommon for many to experience severe pain. For this reason, it is important to begin treating low back pain conservatively with interventions such as chiropractic, manual therapy, therapeutic massage, and/or proper exercise prescription. All these conservative interventions have demonstrated their ability to successfully treat low back pain and its causes.

Some common back pain causes that respond well to a combination of chiropractic, manual therapy, massage, and/or exercise include:

Sprain/Strains: Injury to muscle and/or connective tissue, such as tendons or ligaments, suffered during activity, accidents, or lifting with poor form. Sprain/strains are extremely common and most range from mild to moderate (little to no tearing of tissue) and respond well to conservative treatment such as chiropractic, manual therapy, and progressive rehabilitation. Severe sprain/strains are characterized complete tears of ligaments or tendon ruptures. These may require surgical intervention.

Sacroiliac Joint Dysfunction: These pelvic joints usually produce pain as a result of alter joint mechanics from lifting or straightening up from a stooped position. The pain is usually relieved with sitting or lying down. Muscular tightness in the low back and hips is common.

Facet Syndrome: Pain in the low back that is localized, sharp and provoked with either extension (arching of the low back) or a combination of extension and rotation of the spine.

Sciatica: Radiating pain into the lower extremity on the posterior thigh/calf/foot. Sciatica can be caused by central issues (disc herniations) or peripheral issues (piriformis syndrome, nerve entrapment).

Disc Herniations: Low back pain which may also radiate pain into the hips or legs. Typically worse in the morning; worse with bending forward; usually better standing than sitting. Because of the disc injury, muscle spasms are not uncommon. These muscle spasms serve to limit movement in order to protect the disc from further injury.

Piriformis Syndrome/Nerve entrapment: Radiating pain on the posterior thigh and leg caused by tightness in the piriformis muscle. This muscle is deep within the hip lays underneath the glutes. Tightness in the piriformis can create irritation by entrapping the sciatic nerve, thus creating the radiation of pain. The sciatic nerve can be entrapped within the hamstring and calf musculature as well. Low back pain may also accompany hip pain.

Myofascial Pain Syndrome: This is a chronic form of muscle pain caused by trigger points. These trigger points are often present within muscles of the low back and hips due to any combination of joint dysfunction, postural imbalances, and/or poor stabilization/support function of the core musculature.

Spondylolishthesis: A fracture of the vertebrae resulting in pain with extension. Similar to sprain/strains, spondylolishthesis is graded in severity. Mild forms for spondylos can respond well to chiropractic manipulative therapy (CMT) and rehabilitation programs. This condition is frequent in athletic populations who perform repeated extension movements, such as gymnasts, football players, wrestlers, and weightlifters.

In many cases, several studies support that low back pain responds exceptionally well to the combination of chiropractic care, manual therapy, massage, and proper exercise instruction. If you are suffering from low back pain, whatever the cause, consider Gallagher Performance for your evaluation and treatment. Our goal is to relieve your pain while teaching you what you can do to keep the pain from returning. Please contact us as we have every expectation that our chiropractic and rehabilitation programs will help you Experience the Difference.

This blog post was written by Dr. Sean Gallagher.

Gallagher Performance offers customized treatment plans. Visit our website for complete contact information.
To schedule your appointment, call (724) 519-2833.

More related reading:

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/