It’s been a while since I’ve done any blogging and for that I apologize.
Things have been quite hectic with a whole slew of changes and happenings taking place.
So to get back into the swing of things, I’m just going to re-visit a very important component of low back pain rehabilitation.
Without further ado:
Your buttocks plays a vital role in saving your spine.
If you’ve read any of my previous posts, you’ll recognize that I’ve always touted gluteal activation and motor control exercises as one of the primary methods to get a handle on your low back pain. In physical therapy, exercise along with education, are our most powerful tools for resolving this and many other issues.
Your buttocks plays a vital role in saving your knees too.
So how do you get your butt back in gear?
There are four major activation movements I use in my physiotherapy practice to build better butts.
These are:
1. The clamshell.
2. Standing hip extensions.
3. The squat or sit-to-stand.
You can check out the above along with other important low back pain relieving movement in the exercise video area of my blog.
As you’ve probably figured out, this post will have nothing to do with relieving low back pain, motor control or injury prevention.
It does, however, have much to do with human movement.
Michael Jackson passed away today. The response was incredible. Humans were moved.
Whether you were a fan or detractor, whether you are young or old, I am certain he influenced you more than you’re aware.
It’s been a few hours since I heard the news, but I think it’s only really starting to sink in.
Michael Jackson has died.
Though his eccentricity has overshadowed his former artistic prowess of late, Michael Jackson represented more than just a musician, more than a dancer, more than just the King of Pop.
He represented the ultimate cool, the ultimate smooth criminal.
Red leather jackets. Sparkly white gloves. And the moonwalk.
He inspired a generation and made his mark on the world.
If you’re a low back pain sufferer, I’m sure you’re well aware by now about the lack of consensus on what truly causes your pain.
I wish I had a simple, easy answer for you, but I don’t. In fact, most medical professionals, physical therapists included, just don’t know. And the reasons for this are many.
We, as humans, are extremely complex beings and pain is one of our most complex experiences.
That being said, here’s a recap of what I believe to be the 3 major causes of low back pain. When fixed, this is where you’ll find your low back pain relief:
1. Lack of knowledge: This includes not knowing what movements, postures or positions put body tissues at increased risk of trauma or injury.
2. Motor control issues: This includes issues related to posture, muscle imbalances, mobility and movement patterning.
3. De-conditioning: This includes issues related to being unable to tolerate physical activity or physical stressors.
No matter what the source of the pain, the cause of the pain will almost always fall into the above three categories.
Over the next few posts, I’ll go through a disc-bulge related low back case study and work through the above steps.
In this short video clip, the bridge and a few of its variations are demonstrated.
This fantastic physical therapy exercise is great for activating and retraining your glutes and hamstrings. Just keep in mind when first starting with the bridge to focus on squeezing the glutes as the primary mover. Basically, try to keep your hamstrings relaxed as you lift your hips up.
For most people, this is one of the toughest parts of this exercise…hamstrings usually kick in too hard and may cramp.
As well, when executed properly, this movement will teach proper hip extension using a braced core. These are both essential components of preventing, reducing or relieving low back pain.
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:
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.
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.
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 peopleyoga 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.
