Relieve Low Back Pain | Reduce Low Back Pain | Canada's Leading Authority in Human Movement | Dev Chengkalath

In my humble opinion and using my knowledge as a physiotherapist, the solution to the above noted problem is quite simple.

But as I’ve stated many times before, simple does NOT mean easy.

To recap the previous blog post, there are two behaviours and their resulting effects that need to be addressed to stave off the dangers of prolonged sitting.

These are:

1. The benefits of regular moderate to vigorous intensity physical exercise

2. The risks of too much sitting and limited non-exercise everyday life activity

In today’s post, I’ll take a deeper look at the first point and offer what I believe are realistic actions you and any other reader of my blog can take immediately and without significant changes to your life.

It’s been proven over and over again that regular physical activity, typically undertaken at a moderate to vigorous intensity, as noted above, has numerous health benefits to the various body systems including the cardiovascular system, the neuromusculoskeletal system, the endocrine system, the neurological system etc.

Intense Physical Activity

Key words: moderate to vigorous intensity.

So taking a leisurely stroll around the block, walking to the corner store, going up some stairs, doing housework…just won’t cut it as exercise. These are typically not intense enough and don’t last long enough to stimulate the body the way a more focused exercise regimen would.

The thing with exercise is that you have to do it to get the benefits and you have to keep doing it to keep the benefits.

The other thing with exercise is that most people do it in one big burst (e.g. early morning before heading off to work) and then remain sedentary the rest of the day.

A better option may be to do smaller bursts of higher intensity physical activity, frequently throughout the day.

Here are some options of how you might be able to fit in multiple bouts of exercise-based physical activity:

-Early morning high intensity interval program combining resistance training and cardiovascular training for 30-45 minutes.

-Lunchtime body-weight workout for 15-20 minutes just doing lunges, squats, push ups, burpees or other equipment free movements.

-Post work exercise class for 30-45 minutes – just find one you enjoy!

-Join a recreational or competitive sports team for an activity that you love.

-Take your kids out to the park and play those games you used to love to play, have races, climb and jump around.

-Schedule it and respect it like you would any other appointment.

As you can see, with a little imagination, the physical activity possibilities are endless!

The objections:

I know many people will tell me that they don’t have time for the above amount of exercise in their day.

I don’t buy it.

It’s not that they don’t have time, it’s that they haven’t prioritized their health.

Cut out 1 or 2 television shows and you’ve just gifted yourself an extra half hour to an hour of exercise time. Or if you just can’t give up on the reality TV shows, do some exercise during the commercial breaks.

Want to find some more time in the morning? Stop pressing snooze 3 or 4 times in the morning and you’ve got another 15-20 minutes.

If you have kids and you take them to their various extra-curricular activities, use the time that you’re there to do some quick exercise. While watching little Timmy’s hockey practice, why not use that time to lunge around the rink?

It may look strange, but you’ll be the one improving your health. Plus that will probably also get you away from the pop and chips from the concession stand.

While this is by no means an exhaustive list of how you can find exercise time during your day, it should give you a place to start.

If you have any other ideas on how to fit in exercise drop a comment and let me know.

Yours in movement.

Dev Chengkalath

Over the past couple of weeks a few articles have been published in the popular press that have seemingly undermined the usefulness of the physiotherapy profession, and by extension, given us physiotherapists a bad rap.

In my practice, there are three things I consider of utmost importance, my own golden triad if you will: my clients, my profession and my reputation. And I will endeavour to protect all three.

The following link will take you to one of the most prominent articles cutting down the physical therapy for injury rehabilitation.

“Treat me, but no tricks please”

After my first reading, I could feel my blood pressure bubble over and and those small hairs on the back of my neck rise in defensive posturing.

Within the first few lines of the article Gina Kolata wrote:

“But the letter the angry doctor had received from his insurer made me wonder whether physical therapy was different from the plasma treatment. Is there rigorous evidence showing it works?”

Here’s this journalist cutting up the profession which has given me so much and allowed me to help so many people.

Then it all made sense.

Therapeutic ultrasound

A few lines later, I realized that Ms. Kolata lumped all physiotherapists with what I refer to as “CHUM therapists” (Cold/Heat/Ultrasound/Massage):

“When I’ve gone to physical therapy, the treatments I’ve had — ice and heat, massage, ultrasound — always seemed like a waste of time. I usually went once or twice before stopping.”

It seems as though my profession had been boiled down to a few “modalities” of treatment that are typically used as quick time filler or that could or should otherwise be done at home.

Ice Pack: Not really physical therapy

It seemed as though the actual “physical” aspect had been forgotten.

Most importantly, the cerebral nature of our job description was completely omitted.

And this reminded me of something the esteemed Dr. Shirley Sahrmann, physiotherapist extraordinaire, spoke about at one of her movement impairment syndrome courses. I can’t recall her words verbatim, but in broad terms she lamented the fact that the way the industry is set up, we get paid for procedures, not to think.

Modalities are procedures. Actual physical therapy work such as progressive exercise programming requires thinking. And time.

As physiotherapists, we should be first and foremost educators. We should be teaching our clients what may be causing them pain. We should be teaching them what they can do to  get out of that pain. And we should certainly be teaching them how to stay out of that pain.

And we should be using movement as our medication of choice.

Yours in movement.

Dev Chengkalath

Toronto Physiotherapist

One of the most common questions I hear in my physical therapy practice is whether or not my client should be doing yoga to help relieve their low back pain. Most of the time these clients had heard of a friend or colleague who had gone and within a few sessions had been able to resolve all their physical ailments and issues while building their bodies, muscles and fitness. 

While I’d love to give a straight-up, cut and dried answer, a “yes” or a “no” if you will, it’s not that simple.

As is common with physical rehabilitation and corrective exercise, there is not one answer that will be applicable to everyone across the board. What is true, however, is that there is no panacea.

When it comes to yoga, there are a few key points you do want to think about:

1. Invest in the services of a qualified instructor: Angela Plaquin was my first clinical supervisor in my first clinical placement during physio school. When I came under her tutelage, I was but a young grasshopper with great ambition, and little practical experience. Not only was she a phenomenal physical therapist, but she was an incredible yogi as well. I had an opportunity to attend one of her yoga classes and I can tell you I was amazed at her attention to detail, her biomechanical acumen and her combined knowledge of injury pathology and human movement. Another good friend of mine, Mina Khan-Lee, would also be the type of instructor I would have no hesitation sending my injured clients. Under her expert guidance, you couldn’t help but improve your situation. She has put in the time and effort to not only improve herself as a yogi, but as a teacher. While yoga instructors with the level of knowledge described above are rare, they are out there. These are the instructors you need to find and invest in, just as they have invested in themselves.            
   

   Mina doing what advanced yogis do.

2. Know your limits: This is pretty self-explanatory. Just because the person beside you is coiled up like a salty-pretzel, doesn’t mean you need to do the same thing. As well, just because the instructor at your local yoga class is telling you to keep bending or twisting or contorting to “release the toxins in your burning joints”, doesn’t mean you have to listen (I actually heard this type of statement at a yoga class a few years back). You are the master of your own body and only you are responsible for listening to what it’s telling you. If your back or knees are screaming in pain when you attempt a certain pose or posture, there’s probably a reason you shouldn’t be doing it. Pain is your body’s way of telling you something isn’t right. Know your limits.                
   

   Beyond most people's limits and not good for your back.

3. Yoga is not necessarily exercise: I have no doubt that this point will raise the ire of some of my yogi friends and colleagues. In my mind, yoga is great for posture, breathing, parasympathetic training and body awareness. However, it is very seldom going to initiate significant physiological changes to be deemed as high intensity exercise. Don’t get me wrong. If you are extremely de-conditioned or unaccustomed to those yoga poses or postures, they will be challenging. But very few people will practice yoga to an extent where high levels of muscular strength or endurance are required. If you look back to the root causes of low back pain (lack of knowledge, motor control issues and de-conditioning) yoga will help with motor control issues (such as posture, muscle imbalances, movement patterns, and mobility issues) but won’t really touch upon the other two issues. So to bring home the key point here, for most people yoga is not necessarily exercise, but may be a great complement to your complete GOYA Therapy program.

Part of a complete GOYA Therapy program

So in the end, under the care and attention of a qualified instructor, yoga may be a great adjunct to your low back rehabilitation program. As with all physical activity, know your limits and play within them. 

Yours in movement.

Dev Chengkalath

P.S. Special thanks to Mina Khan-Lee for letting me use her incredibly awesome yoga photo for my blog. I will admit that I did spend all evening trying to hoist my body into that position. I will also admit that it was a stupendous failure.

As you all know, I’m a huge proponent for movement as a safe, effective and dangerous-side-effect-free “cure” for many of the health issues faced by a large percentage of the population. This includes relieving low back pain, treating diabetes, lowering cholesterol and conquering obesity and its related deadly disorders. 

In this post, I’m going to be switching gears a bit from discussing low back pain to discussing body fat.

Don’t get me wrong. The two are still intimately related and that’s why, if you’re carrying extra body fat, you need to get rid of it. 

Potentially Fatal Body Fat

 As I subscribe to dozens of physical therapy, health and fitness newsletters, I’m always looking to pass along information that will benefit you in relieving your low back pain or just getting you in the best shape possible (which is one of the best ways to avoid low back pain!). 

Here is one such newsletter I recently received that caught my attention:

[ Editor's Note:  Fitness author Jon Benson shared this letter with me and gave me permission to share it with you. ]

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I agree with Jon. You can keep waiting on the sidelines or you can suit up, take action and take charge of your health and fitness. 

Yours in movement.

Dev Chengkalath

the core?

In contrast to popular belief, the core not only encompasses the abdominals or the six-pack muscles on the front of the body, but also some smaller and larger muscles that are involved in stabilizing the lumbo-sacral-pelvic region, or as more commonly known, the torso (which includes the low back).

This includes muscles in the back, hips, pelvis and trunk. Furthermore, this includes the passive structures that help transmit or dampen forces such as fascia (connective tissue network), bones, tendons and ligaments.

Functional Core

And let’s not forget, all of these fall under the control of the nervous system. For our purposes here, this includes the brain, spinal cord and the nerves that activate those core muscles.

All of these systems must work together to form a fully functional core. 

And a fully functional core is what will protect you from low back pain and optimize your performance.

In my book, those are both worthy outcomes!

So to help you continue on your journey of back pain relief and optimal core performance, here is another short video clip.

This one shows the proper execution of the side plank, which will really hit the obliques (love handle area) while minimizing potentially dangerous compressive loading on the spine.

To your optimal core function and performance.

Dev Chengkalath