Have you ever examined the truth behind ice for injuries, swelling, and pain? In this article, I’m going to review the science and research for using ice on injuries to help you heal faster.

I’m not here to bash ice packs and cold therapy. Instead, I hope to bring you the science and evidence to cut through the misinformation available. You will better handle your injuries, aches and pains without wasting time or money. In fact, I still occasionally uses ice for my patients (just not for myself). Much like my patients, I will provide you with information and you can make your own unbiased decision.

Ice makes intuitive sense but isn’t used as intended

Here’s the logic:

Ice vasoconstricts blood vessels. This means it will shrink the diameter of vessels (think arteries and veins). Logically, if we place ice on the area that’s swelling it will constrict the vessels and reduce swelling right? Here’s where we S&T (stop and think).

“Why would you want to reduce the availability of a product that has evolved over hundreds of thousands of years?”

Your mind is ingrained with the idea that “Inflammation is bad”. You don’t even consider the benefit that it brings. Your body is a well-oiled machine with mechanisms that have developed to protect, repair, and strengthen itself. If, and only if, you get out of the way. Your goals after an injury are to protect, recover/restore, and minimize muscle loss.

• REAL LIFE vs RESEARCH:

Studies: Research that shows effective changes to blood flow use ice that is colder than a polar bear’s toenail for an extended period of time.

Real Life: In real life, people apply a moderately cold ice pack over 2 layers of clothing or wrapped by a towel. The only constricting this is doing is in your clothes!

Before moving on, let’s review the process by which your body handles inflammation after an injury and how ice would fit into the equation.

The lymphatic system removes swelling from an injured site. Your lymphatic system DOES NOT have a heart working around the clock like your circulatory system. Instead, it’s a passive system that relies on your muscle’s contraction as the engine. The muscle contraction pumps to rid your body of excess fluid.

Again, inflammation happens for a reason. Dr Bahram Jam has a great analogy:

“If you cut yourself, would you take

an anti-coagulant (blood thinner) to stop the clotting process?

Of course not! It’s a tremendous system!”

So why would you want to stop or slow down the inflammatory process after an injury?

The use of ice lacks significant evidence from meaningful randomized control trials.

A handful of studies actually show value and the chance of harm. However, they are not quality, randomized controlled trials. If a study is not a randomized control trial, it’s of little to no value.

A randomized control trial removes bias and has a verified outcome. Both of which are critical to effective science. Otherwise they are using reports of symptoms which opens the door to bias.

A 2006 Cochrane review on low back pain…

CONCLUSION –  There is some evidence supporting the use of heat but no evidence on the use of cryotherapy (ice).

A 2012 analysis looked at 11 trials involving 868 patients…

CONCLUSION – There is insufficient evidence to determine the relative effectiveness of RICE (rest, ice, compression, and elevation) therapy for acute ankle sprains. (Vandenbockrom citation)

Think of our body like a highway with an accident somewhere along the line. Would you want to shrink the highway from 4 lanes to 2 just when the emergency and clean-up crew is on the way? Of course not!

If you cut yourself, would you consider doing something to stop or slow the clotting process? Of course not!

The issue that most people want to avoid is actually persistent swelling.

Persistent swelling becomes an issue not because of the clean-up crew coming to the scene. Congestion makes it impossible for the clean up crew to leave after it’s complete. It’s like that accident happened on the busiest highway near your home. It can take hours to clear due to the amount of congestion!

Icing would be like slowing the influx of additional cars coming into the highway. This may help lessen additional build up. But in no way will ice help the congestion that is already at the accident scene (aka actual healing). This is due to the fact that you would actually be shrinking (vasoconstricting) the exit ramps. In turn, this may actually worsen the congestion!

The answer is to focus on 3 things:

• Decongestion (clearing the area)
• Safety (protecting the injured tissue)
• Loss prevention (minimizing atrophy of surrounding muscles)

This will let the body do what it does best – signal and call for appropriate healing activity.

Now, if I’m starting to make some sense, but your hesitant to buy, pick up a dual-purpose hot/cold pack. You can pop them in the microwave to use as a hot pack for low back pain, but can leave it in the freezer in case you still have that urge to ice (keep reading to see when ice is actually useful). Click on the link for my recommended dual-purpose pack. It’s an amazon affiliate link so if you’re looking for one anyway, please click on the link. I get a small commission from Amazon which helps me continue with this site and channel.

Powered Low Back Hot pack with strap
https://amzn.to/34kbgyv

Microwavable Hot/Cold Pack
https://amzn.to/30maKic

NEXT SIMILARITY:

3 . They both give us a feeling of control.

As humans, there is nothing we dread more than feeling helpless. There are some times where intervening is helpful and in fact essential (you suffer a compound fracture and your bone is poking out through your skin-Yikes!). Other times, it’s preferable to let your body do what it does best.

In coaching youth sports, I rarely see a player suffer an injury without a parent or coach feeling like they need to intervene with an ice pack. Placebo can certainly play a factor here. That’s not a bad thing. Humans balance risk. There’s something called risk homeostasis. If you’re protected from one thing, you lower your guard on others. This leads to unintended consequences

You spend all night standing with my friends with a newly sprained ankle because you can “ice it later”.

Here are 3 scenarios where ice would classically be applied. I’ll explain the science and research, and talk about what you should actually do in each scenario.

SCENARIO 1 – Inflammation in a New Injury

Your kid falls and bumps their elbow , you sprain your ankle, you or a loved one has surgery.

• Studies have shown that ice may be beneficial IMMEDIATELY after the injury by potentially reducing injury to surrounding tissue by limiting inflammatory mediators into healthy, accessory tissue spaces.
• We’ll discuss ice for pain in a later scenario

BEWARE – Often times, the acute pain is simply because of congestion. Icing doesn’t help the congestion. It doesn’t even make sense that it would!

Research following total knee replacement (TKA) concluded that cryotherapy (ice) after surgery resulted in small improvements in ROM but provided no benefits on pain, pain medication use, swelling or functional outcomes (Adie et al 2010, 2012).

Clinical trials on the efficacy of RICE (Rest, Ice, Compression, Elevation) have supported the use of compression but have found no value in icing (other than a temporary numbing effect) (Hubbard et al 2004).

Does the body really need help in reducing inflammation? The lymphatic system naturally and slowly removes all the waste products and excess fluid buildup caused by the inflammatory process. Elevation and compression may assist the lymphatic system in its efforts at draining excess fluid but the impact is likely minimal. Interestingly, studies have shown that icing may actually reduce skeletal muscle contraction (Bleakely et al 2012). This could result in a temporary reduction in lymphatic drainage at the injury site.

Perhaps most significant, was a 2012 paper published in the Journal of Athletic Training. The author’s concluded that
“The practice of using ice to treat sprained ankles is based largely on anecdotal evidence. Evidence to support the use of ice in the treatment of acute ankle sprains is limited.” – Journal of Athletic Training 2012

“The practice of using ice to treat sprained ankles is based largely on anecdotal evidence. Evidence to support the use of ice in the treatment of acute ankle sprains is limited.”

Journal of Athletic Training 2012

RECOMMENDATION – track your loading vs unloading schedule daily and manipulate the amount of time you spend on your feet. When you are not standing, use elevation and compression to assist in drainage. Actively contracting the nearby muscles to assist in fluid return is paramount. Ice can be used, but for pain relief only.

SCENARIO 2 – Persistent Swelling

If you’re suffering from chronic systemic (or body wide) inflammation, this is entirely different. What I’m referring to is a localized area of chronic pain. A classic example would be arthritis. If you’re knee is swollen all the time, you must address the underlying movement issues that are leading to the arthritis in the first place. As for the inflammation, the focus should be on regular decongestion as discussed in the previously. One way we help this in our PT centers is through the use of muscle pumping electric stimulation devices. This is an Affiliate link for a MarcPro unit that is similar to what we use in our physical therapy centers. It produces a muscle contraction resulting in a pumping like removal of the inflammation.

MarcPro

https://amzn.to/2SgKTDX

Marc Pro Plus

https://amzn.to/36k7BDs

SCENARIO 3 – Soreness after a workout

There is a notion that using ice after a workout will reduce the degree of muscle soreness that you will experience in the following days.

A 2013 study by Tseng et al examined this very notion about ice. Does icing muscles after a hard athletic workout help recovery and promote earlier return to activity?

Interestingly, their findings demonstrated the opposite to occur. After performing 6 sets of a heavy triceps workout, half the athletes were randomly placed into groups that received either 15 minutes of cooling ice pack or a sham ice pack. After 2 and 3 days the ice group had significantly greater creatine kinase and myoglobin (which are signs of muscle overload). They also reported having more triceps fatigue than the sham ice group.

“These data suggest that topical cooling, a commonly used clinical intervention, seems to not improve but rather delay recovery from eccentric exercise-induced muscle damage”.

It gets worse. A 2019 study by Earp et al found that icing (with cold water immersion) after resistance exercise significantly reduced testosterone after exercise. This supports prior studies that have shown a reduction in muscle protein synthesis after resistance training when ice baths are added.

The purpose of doing any type of resistance work is to gain strength which relies on your body’s ability to synthesize protein. Adding ice potentially thwarts this effort by reducing testosterone and new protein growth? Sounds like a great idea!

SCENARIO 4 – Pain

This is conclusive! Ice slows all metabolic activity including firing of nociceptors or pain nerves. Translation:  ICE HELPS PAIN…..temporarily.

A 2004 Systematic Review from Hubbard concludes that cryotherapy seems to be effective in temporarily reducing pain and providing a localized numbing effect.

Studies looking at ice after ACL surgery find that icing added no additional benefit with respect to reducing swelling or improving ROM. Ice does significantly lower post-op pain and potentially reduced the use of pain meds (Raynor et al 2005).

ORIGIN STORY

Perhaps most importantly, Dr Gabe Mirkin, the physician that coined the term RICE no longer promotes it. I quote – “It’s perfectly fine to ice if you want, but realize it’s delaying healing,” Dr. Mirkin said, “[Icing] is not going to change anything in the long term.”

Instead of icing to reduce inflammation, athletes might be better off letting it run its course. Better yet, get moving again, Mirkin said: “Don’t increase your pain, but you want to move as soon as you can.” This isn’t to say ice has no physiological effect. Since we know that ice helps reduce pain, it can cut down on pain medication use and allow you to get things moving sooner.

“It’s perfectly fine to ice if you want, but realize it’s delaying healing. Icing is not going to change anything in the long term.”

– Gabe Mirkin, MD

If I’ve sparked an interest and you’d like to learn more, check out Gary Reinl’s book ICED.

Book – “ICED” by Gary Reinl
https://amzn.to/36D48jD

There’s always new research on the horizon. It’s safe to say, if you’re trying to help your injury and inflammation, its best to leave the ice where it works best.

There’s something to be said for GENUINELY believing that something is helping you. The Placebo effect is real and has a tremendous impact. If you’re someone that feels ice is critical to your recovery, have at it!

But if you’re like most people, and actually dislike that frozen feeling, you can safely place that ice pack down and keep it moving!

Remember, next time you have an injury, it’s likely related to how you control your movement. If you’re not back to feeling your best, it’s a must that you find a movement specialist to help get you back on track.

Join the Movement by Subscribing to my YouTube channel – MovementprojectPT

https://www.youtube.com/c/movementprojectpt?sub_confirmation=1

Sign up for the newsletter

The post Why Ice Isn’t Nice: The Surprising Truth About Using Ice for Injuries? appeared first on Movement Project.

The muscles of your calves live on the back of your lower leg and run from behind the knee to below the ankle attaching to the heel via the Achilles tendon. They are the motor behind much of your forward movement throughout the day especially with running or quickly climbing stairs. It’s no wonder that these important muscles are prone to overuse and tightening when you consider how often they’re called into action. Do you feel minimal relief with all of the basic calf stretching on the internet? What if your calves keep tightening up regardless of the amount of stretching you do?

Tightness of the calves is commonly seen and diagnosed in physical therapy and medical centers as a driver of foot and ankle pain. It is thought that tightness of the calves will result in faulty biomechanics of the foot and ankle resulting in inflammation of the plantar fascia, and various tendons in the foot most notably, the Achilles. How can you appropriately stretch to provide pain relief and prevent injury? To understand, first we need to look at the role the calves play in your walking and running.

The calves make up a key part of your posterior chain. This includes the muscles on the bottom of your foot, moving up into the hamstrings, gluteals, and back extensors.

When it comes to walking, running, jumping, and climbing, these muscles groups are hopefully working as a team to propel you forward in the desired direction. However, underuse of the hamstrings, glutes, and arch muscles leave your calves alone in the quest for forward propulsion! Think about any team you’ve been on. When you’re asked to shoulder the load for an extended period of time, you try to compensate to pick up the slack but eventually break down!

Lasting relief of tight calves for pain relief and injury prevention requires:

• An effective program to mobilize or stretch your calves the right way
• Changing how you use the calf during the day so you can “own” the new length
• Strengthening the weaker, neglected muscles of your posterior chain (getting those other lazy team members off their butts – sorry, pun intended) to help with ownership

Stretching your calves and strengthening your posterior chain muscles will result in improved carryover of relief, performance gains, and (most importantly) fewer injuries!

TRI PLANAR SOLEUS STRETCH (Ankle Dorsiflexion)

Stand near a wall with one foot in front of the other, front knee slightly bent.

• Bend your front knee, attempting to touch the knee to the wall. Keep your foot pointed straight ahead and keep your heel on the floor at all times.
• Determine how far you can move the foot from the wall while keeping good form.
• Once your position is established, progress the stretch by moving from point 1, to point 2 and 3 for 3-5 seconds each.
• Feel the stretch in the lower part of the ankle near the Achilles tendon. If you have pain or pinching in the front of your ankle that doesn’t go away, back off the stretch and work through a comfortable range. You may want to connect with a movement specialist for evaluation of joint mobility if this doesn’t improve.
• Complete 3-5 cycles on each leg.

TRI PLANAR CALF STEP STRETCH

To stretch the bigger and more superficial gastrocnemius muscle, stand on a step with both feet and hold the railing. The heel of one foot should be hanging off the step.

• Drop your heel down, keeping weight on this stretch leg. Once you feel a stretch, begin to shift your hips from side to side to move the stretch throughout the entire calf muscle.
• Continue shifting while holding the stretch position for 20-30 seconds.
• Complete 3-5 repetitions for each leg.

TRI PLANAR RUNNER’S CALF STRETCH AT WALL

• Loading the calves in the extended position will mimic the way the calves work while running.
• Stand near a wall or counter with one foot in front of the other, front knee slightly bent.
• Keep your back foot completely straight, and keep your heel on the ground as you lean forward.
• Once you feel a stretch, begin to rotate your upper body from side to side to stretch the calf and ankle throughout its entire range.
• Continue shifting while holding the stretch position for 20-30 seconds.
• Complete 3-5 repetitions for each leg.

Check out my video on the right way to stretch your calves for lasting relief and injury prevention.

Carryover of this flexibility is dependent on how much you can use this new range of motion throughout your daily activities. The activity that uses your calves the most is walking. If you’ve used any type of step counter, you know that you are literally taking thousands of steps per day. This is a great opportunity to gain ownership of the new found calf flexibility. You can accomplish this by keeping your foot relatively straight throughout your stride, avoiding the tendency for the foot and ankle to externally rotate away from the body.

Contact your Physical Therapist or Physician if the tightness of your calves doesn’t resolve with stretching and rest. You may have a more serious condition or need a more complete evaluation from a medical professional.

See your physician if you have swollen or inflamed calves, redness, fever, or pain that worsens with stretching and exercise.

BE sure to subscribe to my newsletter for more information on this topic (like posterior chain strengthening) and programming to prevent injuries and avoid surgeries altogether!

The material and content contained in this channel, website, products, emails, or messages is intended for general guidance only and must never be a substitute or attempt to replace an actual evaluation, diagnosis, or treatment.  Always seek the advice of your physician, physical therapist, or other qualified healthcare professional (that specializes in human movement) with questions you may have regarding your medical condition. Any injury sustained or perpetuated while performing these exercises or activity changes is solely the responsibility of the individual performing these exercises or changes.  Movement Project and its partners disclaim any and all liability from injury sustained from performing the exercises or changes demonstrated in this video while you, the viewer, claims full responsibility. To the extent permitted by mandatory law, Movement Project shall not be liable for any direct, incidental, consequential, indirect, or punitive damages arising out of access to or use of any content available on this channel, regardless of the accuracy or completeness of any such content.

The post How to Stretch Calves to Break Through Your Foot and Ankle Pain Immediately! appeared first on Movement Project.

Figure 1 – Most lower back pain treatments are nothing more than bandages attempting to “stop the bleeding”.

Allow me to set the stage. You’ve just returned home from the hospital after welcoming your new baby into the world.  You feel like you’re starting to get the hang of this parenting thing and are even starting to notice a difference between their cry sounds.  Why does that matter? Of course, because you want to know WHY your bundle of joy is crying so you can help.

Are they hungry? Do they have a fever? Do they need a diaper change? We instinctively go searching for the root of the problem so we can put our new loved one at ease.

If you just wanted to stop the crying, all you’d have to do is muzzle the baby to turn down the volume.  Just the thought of this probably makes you cringe but this is exactly what millions of people do every day when they use medications, receive injections, or undergo unnecessary surgery targeting the “crying” tissue and not the root cause.   (Word of caution, even if you’re a big fan of using pain meds, don’t muzzle your baby…bad idea).

The pain (crying) and difficulty that we experience in our bodies is no different than the crying baby and deserves the same level of focus and problem-solving.  Whether it’s lower back pain, sciatica, neck pain, knee pain, shoulder pain, arthritis, headaches, plantar fasciitis, heel pain, or carpal tunnel syndrome, they all have one thing in common. That is, the inefficient and undesirable movement patterns that developed from your years of human existence.

Despite the significant progress and awareness about the positive benefits of movement and exercise in our society, most information is still focused on producing superficial outcomes like getting ready for swimsuit season, getting shredded, or developing 6 pack abs.

Figure 2 – Most exercise is focused on outcomes related to appearance rather than quality of life and movement.

We see a similar problem in healthcare when it comes to pain. Look around one day and you will see a barrage of messaging for products and services to “fix” your pain. Closer inspection will reveal that very few (if any) of these products or services are doing more than masking symptoms.

To illustrate this problem further, allow me to use an auto analogy. You’ve noticed that your car is making a rattling sound once the vehicle’s speed rises above 55 mph. You take it to the mechanic and they walk outside, look at your car and without even turning it on, tell you the tire is worn and needs replaced. I’m quite certain you’re going to hop back in your car and find another mechanic! Guess what? This is exactly how most lower back pain and other musculoskeletal conditions are handled in our country!

Let’s say my knee hurts both when I run and climb stairs. I visit the physician, they do or don’t take an x-ray (which is just like looking extra close at the tire in our analogy), have me move my knee back and forth (if I’m lucky), prescribe medication and maybe refer me to Physical Therapy. All without ever watching me run or climb stairs!

Figure 3- The medical system is simply not set up to properly evaluate problems that are movement related.

Despite efforts from the American Physical Therapy Association, Physical Therapists have not moved into a primary provider role for musculoskeletal conditions. Primary care physicians (PCPs) remain the first point of contact. This is not a criticism of the providers but rather the system. With increasing medical complexity of the primary care patient coupled with changing delivery and payment models, PCPs, Nurse Practitioners (CRNP), and Physician Assistants (PA-C) are facing greater pressure to deliver care that achieves improved population health.  Primary physician offices are also faced with significant challenges when you consider that the average time spent with a patient is about 10 minutes!  Compare that to the 45-60 minutes that a Physical Therapist will spend with a client on their first session alone.

At $190 billion per year, musculoskeletal health accounts for 10% of the total healthcare spend in the US. This is more than the combined cost to treat all cancers and lower back pain is a big portion of it. In most cases, these rising costs are being shifted directly to the consumer. Despite these costs, funding for research continues to decrease.

Figure 4 – Despite costing more to treat than cancer, musculoskeletal research receives less than 20% of the funding.

Whether you’re seeing a Physical Therapist, Physician, Nurse Practitioner, Physician Assistant, or Chiropractor for your pain, they must be a movement specialist, using that specialty to uncover the true driving force behind your problem. That being said, Physical Therapists are uniquely trained and positioned as experts on human movement. They know above all, how negative changes to the movement system can create dysfunction and how treating those dysfunctions will fix the problem.

Remember, next time you have a muscle spasm or feel stiffness in your lower back, it’s likely related to how you control your movement. If you’re not back to feeling your best, it’s a must that you find a movement specialist to help get you back on track.

If you want to feel, perform, and live your best, you’ve got to MOVE your best.

Until next time…Keep it movin’!

Join the Movement!
Subscribe to my YouTube channel – MovementprojectPT
Sign up for the newsletter

Freburger, J.K., Khoja, S. & Carey, T.S. Primary Care Physician Referral to Physical Therapy for Musculoskeletal Conditions, 2003–2014. J GEN INTERN MED 33, 801–803 (2018) doi:10.1007/s11606-018-4426-6

The post The Most Common Cause of Lower Back Pain appeared first on Movement Project.

Chances are you or someone you know has experienced an episode of lower back pain.   How to help lower back pain depends on a variety of factors, many of which are tied to how well you can control your movement. This back pain may be called sciatica, sacroiliac pain, herniated disc, or my favorite, “Lumbago”. This translates to, “You have low back pain”. Can’t get more specific than that!

Some Statistics:

• It’s estimated that 80% of Americans will experience back pain at some point in their lives.
• 10% of the world’s population is suffering from significant back pain RIGHT NOW.
• Despite tremendous advances in medical imaging, treatment, and surgical techniques, the number of people suffering from low back pain is INCREASING.
• Fusion surgeries to the lumbar spine alone increased by 62.3% from 2003 to 2015 (1) despite no significant change in outcomes.

When you consider that low back pain is the leading cause of physical disability in our country, these statistics should be taken seriously! (2)

Low back pain is NOT a diagnosis, it’s a symptom!

One of the most commonly used diagnosis codes for conditions of the lumbar spine is M54.5 which means….Low Back Pain! That’s like taking your car to the mechanic because it’s making a rattling noise and they diagnose your problem with what they call “rattling turns”. You would never accept that as a diagnosis on your car because you know there’s more to it! Your lower back pain is no different but people routinely accept a vague diagnosis without a root cause.

When we help patients with their lower back pain in physical therapy, they are commonly present with a medical diagnosis of bulged, degenerative, or even herniated disc.  Don’t forget that every tissue in our body was put there for a reason. The disc is unlikely to break down, disintegrate, or tear without some form of external force exerting itself on the tissue. Is the herniated disc the cause of the pain or is it simply a result of an underlying movement problem or movement inefficiency that is leading to unfavorable forces at the disc?

After almost 2 decades of helping people with lower back pain in orthopedic physical therapy practice, it’s clear that addressing the issue causing your disc to bulge or herniate not only produces results but leads to lasting changes! We see many movement patterns that can and do produce back pain and stress to the ligaments, muscles, joints, and discs in our lower back.  Let’s check out the 3 most common movement-related risk factors for low back pain.

Check out my video on movement related low back pain risk factors.

Top 3 movement-related causes of LBP with a test for each

*There should be absolutely no pain with any of these tests. If you feel discomfort, reach out to your movement specialist (Physical therapist, Physician, or other professional trained to evaluate human movement).

3 Movement related risk factors for Lower Back Pain

1. Your spine segments are moving too much

Excess ligament looseness can be partly genetic but is often a result of certain muscles weakening or just shutting down completely.

Many times, this can be the result of other areas not moving enough. In these cases, the spine compensates by moving more than it should. The hips are a classic example.  If they lose their ability to move backward (or extend as they do in a normal stride), your low back will need to hyperextend to achieve the normal walking stride. If you’re a runner, this is even more critical as the stride required to run is longer than that for walking. If the hips struggle to move forward (like bringing your knee to your chest), the spine will compensate by flexing more to accomplish any necessary bending to the floor which will lead to increased disc pressure and stress.  The presence of inadequate movement or mobility in one area leading to compensation in another area is more common than you would imagine. This is why finding and connecting with a movement specialist is critical for your journey towards feeling, performing, and living your best!

You can do a simple test at home to see whether or not the muscles in your lower back are inhibited (sleepy) or working properly.

SELF TEST #1 – In standing, shift your weight back and forth from the right leg to the left leg. The muscles in your lower back should relax on the side where you are shifting your weight and the muscles on the other side should contract and tighten. If this is not happening, this is a sign that your nerve to muscle connection is not working properly!

2. Your spine segments aren’t moving enough

With jobs becoming increasingly sedentary, the adaptive stiffness that develops in the hips, lower back (lumbar), and mid-back (thoracic) is staggering. It’s not a matter of if but when the pain will set in.

Think about your diet and nutrition. When you fall out of your healthy ways for a few days, you might try to “right the ship” by focusing on healthier options for several days or even weeks to restore balance (hence the popularity of “the cleanse”). This same approach works wonders for our body but is rarely practiced.  Many people spend 8-12 hours sitting and once they get home, jump on the couch and sit some more!  5 minutes of simple stretching or better yet, micro stretching throughout the day is like giving your joints and muscles those healthy foods they so desperately need for balance.  We’ll dive into specific joint stretches in future posts.

Ironically, our body will frequently stiffen an area in an attempt to stabilize the unstable joint.  This is often the cause of mild or severe muscle spasm.  If you’ve experienced pain anywhere in your body and felt a sense of relief when you stretched only to have the pain return immediately or soon after, then the tightness is likely your body’s way of trying to protect this unstable region. This is entirely different from true joint stiffness and another reason why a careful examination and accurate diagnosis of your movement system is paramount.

SELF TEST #2 – With your heels, back, shoulder blades, and head against a wall, attempt to bring your arms forward and up as close to the wall as possible without bending your elbows. Be sure to keep your thumbs pointed upward toward the ceiling to avoid impingement of the shoulder. There should be no pain with this or any of these moves. Can’t reach? Measure and track your progress by using a ruler in your hand to measure your distance from the wall.

3. You’re out of control! Your ability to control your movement is out of balance.

This is usually due to weakness or poor activation of the posterior chain (also known as the muscles on the backside of your body) like your hamstrings, glutes, and spine extension muscles (basically your back muscles).

This can be an acquired weakness from disuse and/or driven by excess hip flexor and abdominal tightness. Excess tone and tightness on one side of a joint will typically result in weakness and decreased tone on the opposite side.

This lack of control is usually seen in someone’s sitting posture:

Poor joint awareness (proprioception) in a sitting position will result in an excessive posterior pelvic tilt (slumped), an inability to self-correct, and even a complete lack of joint position awareness. If you have no idea how you’re holding your body, there’s no way you can correct it!

How much we sit is a problem because it decreases circulation to your spinal muscles, ligaments, and discs. But how we sit is every bit as important!

This same lack of back, pelvis, and hip control can be seen when we watch someone with lower back pain attempt to bend.

Properly executing a hip hinge using the aforementioned posterior chain muscles is one of the most important exercises that we teach patients suffering from low back pain.  In our video, you will see a way you can check and progress this at home.

SELF TEST #3 – Assess your ability to hip hinge at home by seeing how far you can move from the wall while still being able to gently touch your butt to the wall. Use a tape measure and/or painter’s tape on the floor to measure and track your progress.

Properly executing a hip hinge using the aforementioned posterior chain muscles is one of the most important exercises that we teach patients suffering from low back pain.  In our video, you will see a way you can check and progress this at home.

There you have it, my top 3 causes and risks for developing low back pain. 

Next time you have a muscle spasm, back stiffness, or lower back pain, realize that it may be related to how you control your movement.  If you’re not back to feeling your best, it’s a must that you find a movement specialist to help get you back on track.

Whether you’re seeing a Physical Therapist, Physician, Nurse Practitioner, Physician Assistant, or Chiropractor for your pain, they must be a movement specialist, using that specialty to uncover the true driving force behind your problem.  That being said, Physical Therapists are uniquely trained and positioned as experts on human movement.  They know above all, how negative changes to the movement system can create dysfunction and how corrections can eliminate it.

If you want to feel, perform, and live your best, you’ve GOT to MOVE your best.  Until next time…Keep it movin’!

Join the Movement!

Subscribe to the channel – MovementprojectPT:

https://www.youtube.com/channel/UCoefGhWAiovwTfyiFXgHXpA?sub_confirmation=1

Sign up for the newsletter

References:

• Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, Brodke DS. Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015. Spine (Phila Pa 1976). 2019 Mar 1;44(5):369-376.
• https://www.cdc.gov/arthritis/data_statistics/disabilities-limitations.htm

The post How to Help Lower Back Pain? appeared first on Movement Project.