Ever had Back Pain??

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On Halloween last year I was crippled with spasms in my back. Not the kind of spams that constantly hurt but the kind of spasms that literally, well . . . spasm! They come in waves triggered by any little barely perceptible movement.

My 17 year old son drove me to the doctor, helped me into the office and helped me pick up my meds all while panicking inside because he had never seen his mother immobilized by pain.

I couldn’t move! Couldn’t breathe! Couldn’t believe . . . It was my hip flexor!


There are two muscles that blend together to form your hip flexor muscles. The iliacus  (il-ē-AK-us) and the psoas (SŌ-az). Together they are referred to as the iliopsoas (il-ē-ō-SŌ-az).


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  • The iliacus runs from your pelvis to your femur.
  • The psoas runs from your spine ~ vertebra and discs ~ to your femur. It is the only muscle that connects your legs to your spine!


For more detailed info check out this video! 


They are primarily responsible for lifting your knee up toward your chest or your foot off the ground. BUT they also play a role in stabilizing or moving your spine and pelvis in various situations . . . for example:

  1. The psoas helps to stabilize your spine
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    Iliacus Stabiliing
    1. when you are sitting especially without back support
    2. or when you are carrying or holding something on the opposite side of your body
  2. The psoas can move your spine ~ either bending to the side or curling up
  3. The iliacus helps to stabilize the pelvis when you are standing on that leg and the other leg is extending behind you.
  4. They both work when you are performing a sit up (and you thought that was working your abs didn’t you!).

Whenever I see someone with back pain, I always look at the hip flexors to make sure they are as they should be ~ strong, flexible and being used appropriately. Nine times out of 10 they are not, regardless of the origin of the back pain. And at least 50% of the time they contribute to or are the source of the back pain! Why?

Well lets first consider the origin of these muscles ~ they attach to the vertebra and the discs in the spine, they are very deep muscles not near the surface of your hip or abdomen ~ so it is logical from an anatomical perspective that this would cause the back to hurt.

The way that the core muscles attach creates a system of stability around the spine and pelvis assuming that everything is as flexible and strong as it should be . . . for reference your core muscles include the abdominals, the gluteals, the hip flexors, back extensors, and if we are getting detailed all the muscles that function at the hip and spine.

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If your abdominals and glutes aren’t helping to stabilize your back when you lift, bend and twist then the hip flexors have to help too much and are overused. This pulls your lumbar spine forward (Lumbar Lordosis) and impacts alignment.

If your hip flexors or back extensors are too short or tight they can pull your spine forward increasing the arch in your back and compressing your joints and disc. Again this pulls the spine forward (Lumbar Lordosis) changing alignment. images-3

So how do you injury your hip flexors?

  • Athletes or active folks usually do something traumatic like straining them while kicking a ball, they over use them when walking up a hill or lifting incorrectly.
  • Sedentary people may overuse them when sitting too long, standing or sitting with improper posture or lifting incorrectly.
  • Finally some people are just built in a way or have developed movement habits that tax or activate hip flexors preferentially over other more appropriate muscles and then eventually . . . ouch! (This is me :D)

Now that you know the different components affecting the hip flexor, you see that there may be a few different sites or locations of pain, but let’s talk about one specific source ~ the muscle itself. When you injure or overuse a muscle it develops these little pesky muscle knots called trigger points . . . these guys send all kinds of signals all kinds of places and make you think the pain is located in one place (Your Back) when it’s actually coming from another (Your Iliopsoas!). This is referred pain:psoas21

Why does one person feel it in the back and another in the front ~ its based on how we are wired.

If you have postural imbalance, weakness or tightness, and overdo a sport/activity or stay still too long, you create movement dysfunction which only feeds the beast!

So . . . are you surprised, confused, feeling pretty smart because you already knew this?

If you have this type of problem I will be discussing how to deal with it so stay tuned . . .

If you know someone with back pain share this post.

I invite you to comment below . . . and email, text or call with questions!

drroxi@zptforinjury.com

424.247.6987

Be well! Roxi

Patellar dislocation VLOG?!?!?

Hello! I am trying my hand at video blogs because . . . why not! I spend time talking to people all the time about questions they have, why not answer some in a more personable fashion than on the phone or via text!

So here is my first . . . Click this link!

This Vlog is about knee cap dislocation ~ the who, what, where, when and why (although not entirely in that order) 🙂

Hope you enjoy . . .

Click here to see the video 

 

Life Gets in the Way!

If I had a dime for every time I made this excuse . . .

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I’d be rollin’ in dough!

A perfect example is vacation right?

We have a routine that keeps us doing t
he things
that keep us healthy ~ eating right, exercising, taking our vitamins, etc. Then we go on vacation! We relax, indulge, pamper, overdo (or under-do), and return home feeling like we need a vacation from our vacation before we return to work. Because we are tired and have lots of laundry or yard work to catch up on we skip returning to our regular routine until we realize we have been back for a month and still haven’t gotten to the gym or studio . . .

This can happen with the holidays, projects at work, illness, renovations or any number of other things that make it easy for the majority of us to set aside our commitments to our heath and wellbeing and focus on outside things.

Do you find yourself in these examples?

(I hope I am not alone~heeheehee)

I think of this because our family is currently on a college touring road trip. And I have 8 hours in the car . . . We have toured 5 campuses in 5 days, from Iowa to Pennsylvania! Driven 1,288 miles (not including the 1700+ it to get to the first campus ~ #roadtrip) and walked 21.8 miles!

It was good exercise but not complete exercise. We were all missing the flexibility component of our routine, as evidenced by our taking every opportunity to stretch ~ in line at the gas station, during the standing portions of the tours, and while in bed!  We are now done with the college tours and starting the family vacation portion of our road trip . . . so what did we do when we got to Mackinac Island?? Walked around a lot the first afternoon and rested from our college touring ~ its actually quite tiring! Yesterday we slept in and then rented bikes! We were so excited to not be walking that we road the entire island and then some! The circumference of the island is 8.2 miles, but we also wanted to see the interior and only had yesterday left (as I write we are traveling to Two Harbors, Minnesota to spend five days with family).  So . . . we biked around the island sightseeing, returned to the hotel to get our swim suits, biked to a place to swim in Lake Huron and back to the hotel again ~ A total of 20 miles (gasp). Needless to say the legs were jello, the joints were achy, the spirit was blessed and the mind was clear!

IMG_8417I know the rest of the week holds hiking and water activities, shopping and more. Of course there is the long drive home as well (sigh). So what will happen when I get home?

Back to the same routine of 3 day a week strength training, 3 days a week walking the dog, 10-15 minute of yoga and foam rolling, cooking healthy meals, taking my vitamins?

Or will I let life get in the way?

Stay tuned . . . I’ll give an update September 1st!

“If I Tell You it Hurts . . .

. . . You Won’t Let Me Play!”

Its a complicated subject really . . . PAIN

There are may different kinds of pain and each structure in our body hurts differently depending on why it is hurting!

I have heard these words many, many times and my biggest concern is twofold:

  1. Kids not telling their parents they are in pain because they really fear that their parent won’t let them play and they want to keep playing! OR WORSE
  2. Mom/Dad/Coach saying “suck it up” and play through it while turning to the parent next to them to say kids are “too soft” these days.

Ever experience either of those scenarios? I have seen it first hand on the fields!

How do we find a middle ground?

Well first we need to look at the type of injury ~ how did you wind up with pain?

If you have an acute injury:

  • You probably have lots of pain, some swelling and are not in the mood to play ~ follow those instincts!
  • If you are feeling better in a few minutes try playing again ~ you’ll know if you need to stop.

If you have a chronic injury:

  • You probably have intermittent pain and of varying intensity.
  • This is the most confusing pain to deal with because there is no simple answer . . .
  • You may be able to play through the pain BUT that doesn’t mean you should . . . you could be doing more damage to the injured tissues.

If you don’t have an injury at all:

  • Your pain could be the start of an overuse injury that develops slowly or you happen to “just notice” one day – see acute and chronic injuries above . . .
  • Your pain could be just from regular muscle use and totally normal ~ when you play through it you will feel better and better.

Next we need to consider the tissues involved in your injury ~ Muscles, Tendons, Ligaments, Bone. All of these tissues send different pain signals and heal at different rates.

Muscles can be sore from normal exercising, when you are sick in bed or just from growing! These types of pain feel sore or achy and you can play through them if it feels good to do so.the healing time of muscles can range from a few days to several weeks depending on the type of injury.

Tendons are sore when you are growing or when you have overused the muscle that is attached to that tendon. This kind of pain is more sharp, like a pinch or a stab and also intense achy. You can play through this pain ONLY IF it feels better when you play 🙂 If it hurts to play then DON’T 😦 Tendons healing phase is about 10-12 weeks.

Ligaments and bones are sore when you are growing or when you have injured them (see acute and chronic injuries above). These kinds of pain are typically deep achy or very sharp and intense. You should not play through these types of pain because you can be doing more harm than good. Bones take about 2-3 months to heal and ligaments continue to heal for up to a year.

Another thing to consider . . . “Growing Pains”.  Remember above that I mentioned pain can be related to growth . . . layer on top of that the repetitive actions of some sports or the frequency with which your child participates in that sport and/or an acute injury and you have the makings of a perfect storm. How do you tease out what the pain is from in order to decide if it is okay to play through or not?

Like I said, Its a complicated subject really . . . PAIN.

Bottom line: IF it hurts to play DON’T and see your Physical Therapist for guidance.

What kind of injury or pain does your child have? Reply to this post and tell me about your situation!

Have questions? Comment and ask away! I love to answer questions ~ yes I’m a nerd!

Look forward to hearing your story . . .

The Active Play A.T.H.L.E.T.E.

The forth and final in the series: The Athlete and the Injury . . .

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Active Play Athlete

Here are some guidelines for the Active Play Athlete:

Accommodate your body

You are already doing this by participating in a variety of activities! This is what our bodies crave and what limits our injury risk

Continue this habit!

Take time to  . . . do what you dislike 🙂

There is something you don’t like to do ~ admit it! And then do it anyway!

Even though your performance is already a mixture of sports and activities you still need to strengthen, stretch and get in some cardio work to decrease your risk of injury.

Have goals

Is there a fitness goal you are working toward? If not make one. This will keep you motivated and engaged in your physical health.

Lift Weights

So many people forget to do strength training – you don’t need dumbbells or machinery, you can simply use your body weight.

Girls between the ages of 12-25 can lose bone mass and set themselves up for osteoporosis later in life if they are not getting stronger in their teens!

Environment will enhance your athleticism

If you prefer one type of activity over another then vary the environment in which you perform it! If you like  to hike or bike then do it in the mountains, the beach, trails and asphalt. The varying terrains will force your muscles to work differently reducing your overall risk of injury.

Take a class

Classes can offer flexibility, strengthening, cardio, agility all in one hour or less!

Sometimes it is easier to be motivated when you are with your friends!

Also, since variety is your spice of life you can take a different class each day and stay a well rounded athlete!

Exercise your judgement

If your body is telling you something isn’t right, listen to it. Sometimes the “No Pain No Gain” adage is not correct! (sometimes it is!)

Take rest/recovery days

Eat right to fuel your body for the activity you do

If you have an injury, or are not sure how to round out your routine . . . see a PT, the human movement specialist, who can provide you will information to make educated decisions.

So there you have it . . .  tips for all types of athletes . . .Have you decided who you are? How about your child?

Leave a comment and tell me how you are going to prevent injury now that you know?

No matter the type of athlete you are, risk of injury is part of living. Use the tips above to mitigate your risk and see your PT for more help!

Be Well, Roxi

The Sport Specialized A.T.H.L.E.T.E.

The third in the series: The Athlete and the Injury . . .

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Sport Specialized Athlete

Here are some guidelines for the Sport Specialized Athlete:

Allow for rest and recovery

You must build in recovery days to your training schedule to maximize the benefit of your training as well as reduce risk of injury.

Your training is designed to build specific skills but in doing this the muscles, tendons, and ligaments take stresses that the body is not designed to take. The body needs time to recover and heal from these stresses placed upon them in order to improve your athletic performance.

Take time to condition

Incorporate flexibility, strengthening, agility, and cardiovascular exercises into your training. If you are just playing your sport you will miss out on needed conditioning that will prevent injury and improve your skill!

Hydrate

As you sweat you will need to replenish with water. You should be taking in about one ounce of water per 2/3rds of your body weight, so if you weight 150 pound = 100 oz of water a day. This can change based on how active you are. If you are sweating for more than an hour a day drink more maybe add a sports drinks for the electrolytes you are losing.

Two hints

  1. If you are thirsty you are already dehydrated! 
  2. Chocolate milk is a great recovery drink for after competition or a intense workout!

Live your whole life

Remember that sports is one component of you life ~ school, family, friends, relaxation, and fun must all play a role!

Expect overuse problems

When you perform the same types of motions day in and day out those body structures can suffer fatigue and failure. Because you are training at such a high performing, highly skilled level you are prone to injuries that we used to only see in adults. And your growing body presents other challenges as well. Sometime in your athletic career you will have an injury, the important thing to know is how to manage it without creating permanent problems or losing your edge.

Talk to your PT

Your Physical Therapist is the human movement specialist. They will help you with injury prevention strategies, general and sport specific conditioning, and injury rehabilitation. If you do not have a physical therapist you consult and trust, FIND ONE!

Exercise in other ways

Like living your whole life, be active in ways that don’t involve your sport. Take a walk, hike, bike or swim. Play a different sport with friends. The physical demands of soccer are much different than the physical demands of basketball! Providing your body with multiple physical experiences helps to prevent injury and enhances your overall sport performance!

Stay tuned . . . Up Next, the Active Play Athlete!

The Virtual A.T.H.L.E.T.E.

The second in the series: The Athlete and the Injury . . .

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Virtual Athlete

Here are some guidelines for the Virtual Athlete:

Activity pacing – ease into it.

Start slow 15 minutes once or twice a day with walking, biking, cardio equipment. Daily stretching for 15minutes. Every other day for strengthening – push ups, crunches, squats and the like. Most importantly . . . MOVE EVERY DAY for about 60 minutes!

Technique is everything!

Proper technique is critical to performance, if you are doing an exercise unsafely you could get injured, hate the exercise or just quit your activity altogether. Proper technique also helps you get the most out of an activity with the least effort!

Hydrate

As you sweat you will need to replenish with water. You should be taking in about one ounce of water per 2/3rds of your body weight, so if you weight 150 pound = 100 oz of water a day. This can change based on how active you are. Sports drinks are not necessary but . . . Chocolate milk is a great recovery drink after sweating!

Laugh and engage your core

We hear a lot about work your core but what the heck does that even mean?A good belly laugh causes you to tighten your tummy muscles and tone them. So . . . seeing a comedic movie is technically exercise? HAHAHAHA. But seriously, any full body exercise will strengthen your core muscles as long as you are tightening your tummy while doing it!

Enjoy . . .

. . .What you do, or you will not stick with it!

Take a class

Sometimes it is easier to be motivated when you are with your friends! Classes offer you the opportunity to experiment with different types of exercise and find something you like. Classes also are generally designed to incorporate flexibility, strength and cardiovascular exercise so you get more bang for your buck!

Exercise your judgement

If your body is telling you something isn’t right, listen to it. Sometimes the “No Pain No Gain” adage is not correct! (sometimes it is!).

Eat right to fuel your body for the activity you do.

If you have an injury,  are concerned about the best exercises for you, have a  health issue or don’t know where to begin . . . see a PT, the human movement specialist, who can provide you will information to make educated decisions.

Stay tuned . . . Tomorrow we will talk about the Sport Specialized Athlete!