Move & Soothe - Express Neck, Shoulders, Low Back & Hips
Welcome to 2021, the year where everything could, but so far, usually nothing has had a chance yet to change!
All jokes aside, it feels to Martin and I that our clients are sitting more than ever, and it can be really hard as a lot of you and your loved ones are still having to work from home.
Outside of Melbourne’s Lockdown 3.0 (for those of you unfamiliar, it was like 2.0 but thankfully shorter and for some reason there was tennis), we have found a lot of people are still struggling with their home work set ups, or even struggling to transition between home and office work spaces as working in the office becomes a possibility again.
As always, Align is here. in this, our newest title in our ‘Move and Soothe’ series, Martin has made an express version to help you free up your neck, shoulders, hips and low back.
As always, the transcript can be found below.
Hi, Martin here from Align Chiropractic and this is another in our series of ‘Move and Sooth’ videos today's video is designed to be a super fast one that you can do and it's specifically aimed at people who are having to spend a lot of time stuck at their desk, which then tends to cause a lot of pressure, a lot of stiffness, a lot of tension in our neck and down into our shoulders, but also down into around your hips and lower back.
So we're going to run through a little routine that we can do.
Ideally all you will need is a ball you can use, this a lacrosse ball, you can use this or a spiky ball or a tennis ball and that's all the equipment you'll need to be able to really take a lot of that tension out of neck shoulders and back.
Neck ROM exercise
So first up what we're going to do is get some movement and encourage full range of motion of our neck.
Our joints in our spine work at their best when they can move through their full range of motion and the challenge for us in our daily, sort of more sedentary lifestyles is that we really don't use that range of motion, so taking our joints through the full range of motion really helps to free things up and helps all the tissues around your spine be healthier and happier.
First up we're just going to introduce rotation, so we're just going to turn all the way gently to the left. We’re never forcing anything, we're just going to that comfortable range, just waiting there for a moment and then we'll go all the way over to the right.
For this express version, we're just going to do three times through each of these movements.
So that's the second time to the left second time to the right, just that little pause at the end there, just being aware that your shoulders are holding tension, that’s the third time to the right.
Next, we're going to go into lateral flexion.
Left side just bending all the way over to the left and all the way over to the right.
Lateral flex is such an important but often neglected aspect of our range of motion because there's not that many things that we're doing in day-to-day life where we use it but the movement that your spinal joints do when you're doing this movement
translates into healthier movement in every other range…so that's three times each way, that's the third to the left, to the right, we're really recovering lots of that range of motion.
One little variation you can do if you're aware of a lot of tension at the top here is rather than thinking ‘ear towards your shoulder’ you can do that one as thinking of the ‘opposite ear going up towards the sky’, it just focuses a lot of that lateral flexion in the very top part of our neck so again just going gently from side to side.
Thats it, nice and easy, never forcing anything, just going within the comfortable range.
One more…okay.
So that's the end of our initial mobilising sort of routine getting range of motion back into the joints, next we're going to grab our ball against the wall, we're going to use some pressure to release or soothe built up tension.
With this what we want to do is use the ball across all this muscle, from near your shoulder blade and in between your shoulder blade and your spine and your neck.
The easiest way of doing it is raise your, arm up just pin the ball just next to your shoulder blade and then just roll across to get into this little bit between spine and shoulder blade and then again, I’m just going to move up and down and when I find this, oh that's a really tight spot there, just going to hold pressure, I can move my arm, I can move my neck just get some movement, as well as some pressure, to just dissipate tension in there.
I’m just going to move up a little bit higher, I’m just going to work all through this area, this fleshy part of the levator sap and trapezius muscle, all through the rhomboid muscle.
Just working my way through there you might spend 30 or 40 seconds working through there and then really it's as simple as taking the ball and popping it on the other side.
Just do this, you don’t need to necessarily see that but you get the idea, just 30 to 40 seconds of applying some pressure there.
There we go, let’s see that's releasing nicely. You can spend longer or if you can come back to that.
We're going to move on now to the lower back.
Low Back Exercise
So now we're going to move on to movement, but this time in the lower part of our spine.
And so, first up what we're going to do here is go through lateral flexion again
I don't use that that often but it’s super important in terms of how all the soft tissues in our lower back and hips work.
So, really as simple as just running your hand down the side of your leg, I mean if you follow the seam on a pair of trousers or shorts in this case, the second time, that's the second time to the left, just pausing, never forcing, nice and gently, shouldn’t be any pain, just touch that end point where you feel a little bit of resistance and then just hold there a little brief pause and that's three each side.
And now what we're going to do is move on to rotation, but to do rotation we need to be on the ground.
So next what we're going to do is introduce some rotation into the lower back so just lie on your back, nice and gently let the hips both roll, rather, let your both hips roll that way so you're getting nice rotation through the lower back.
We're just pausing at that end point. It’s really critical with this one to just work within the comfortable range of motion.
Just a little pause there, last one, and then from there we can use our ball to just gently, gently release a little bit of the tension.
So, on the back just on the area, just above where your belt line might be, up into the upper glute area there, that tends to get really tight, and again just rolling 30 degrees, 45 degrees onto my side, working through any tight areas there, oh that's a tight one, just applying a little bit of pressure there.
If I find a really spicy one I can just move my leg up and down and once I've done some work through there, it's really nice to just move right onto your side this is the gluteus medius muscle, which is the main muscle that stabilises your hip, but it tends to get really really short if we're sitting a lot, so just applying some nice pressure there, just holding that tender spot, letting the weight of gravity just gently push down on there, release that tension, swap over to the other side and do that 45 degree.
Another way you can use it is just to gently move your leg up and down like that and then move on to the side get that gluteus medius.
I'm showing a fairly short version, you can spend as long as you want and doing this.
Generally you're going to get a really nice improvement with as little as a minute or so.
So there we have it the express version of ‘Move and Soothe’ covering neck, shoulders, hips and back.
See you next time
The 5 Do’s and Don’t of Mid back, rib or chest pain
If you have pain in your mid back or chest and you aren’t sure what your next steps should be, then read on.
If you have been following this blog recently you will know that previously I have written about what causes rib pain as well as some ways to know if your mid back or rib pain might be something more worrisome that you shouldn’t miss. If you have missed it, read that post here.
However, during the last week I had a client who hadn’t been able to get into the practice for an extended period after their mid back pain had started and to make matters worse, not only did they not know what to do to try manage their issue, they had spent the best part of a week getting anxious about what was causing their issues.
This situation got me thinking;
“How do people what sort of chest/mid back pain they have and how do they know what to do for it?”
This thought inspired me to write these blog posts, the top 5 ‘Do’s’ and ‘Don’ts’ of how to manage chest/mid back pain.
The top 5 Do’s of mid back pain:
Get informed!
It is important to know your enemy. By far the most likely cause of your mid back/chest pain is something mundane and mechanical, but it is important to be aware of problems not to be missed that can cause your chest pain.
To read about some of the ways to screen to know if your mid back or chest pain is of more…immediate concern, read the “So how do I know if I need…to go the emergency room?” section of my previous post about rib pain.
Use ice and/or heat to calm down your inflammation and pain.
Yes, you CAN take an immediate active role in helping to calm down the discomfort you feel, even if you don’t wish to take pain killers or anti-inflammatories.
The correct use of heat or ice on your area of injury can help to decrease the level of pain you feel while still allowing you to take it easy while you have the injury.
There is a lot more to this topic but to make it as simple as possible; the general consensus is to try ice (frozen water…not the other type…that has too many side effects) if the injury is “acute”, that is, under 48 hours old.
Put the ice/icepack/peas on the effected area wrapped in a damp tea towel, 20 minutes on, then taking the cold off the area for 20 minutes. Repeat this for 1 hour and 40 minutes.
Beyond the first 48 hours the research suggests trying heat and Ice alternatively, or just heat.
To be completely honest with you, in my opinion, the research is not as conclusive as it was once thought to have been. As a result, although I recommend you try the guidelines, your only goal is to help ease inflammation and make the area feel better, if you find that one works better than the other, the goal is to make you feel better so that you can heal, so I would recommend that you use the modality that works best for you.
For a full run down of when you use, check out my previous post “Ice Ice Maybe”.
Keep moving.
If you have mechanical mid back or chest pain you’re likely to find that sitting is your worst enemy. Keep moving but don’t over do it.
When I say move I do NOT mean “take up squash”, “weed your garden” or “help your friend move house”, rather I mean that movement within your pain tolerance, at a relaxed and easy pace like walking, will help your body dissipate inflammation as well as start injured soft tissues to heal.
Listen to your body however, do not over do it! If you have decided not to take pain killers your body will be able to tell you if you’re doing too much. If you have taken pain killers, the absence of pain is NOT a signal that you have had the opportunity to heal and fix the underlying issue, the last thing that you want is for the pain killers to wear off only for you to discover that you are now in worse shape than you were before you took them.
Frequently in practice I will tell my clients to avoid sitting but don’t over do it, and if you ARE settling down to watch TV or a movie later in the day, commandeer the couch to lie down, preferably with ice or heat on the area, lying down doesn’t place as much strain on the affected tissues and so should give your body a chance to heal.
Watch your posture.
Specifically for mid back and chest pain, I am referring to Forward Head Posture (FHP). This one goes hand in hand with number 3, if your head is sitting forward compared to your shoulders it places an immense amount of extra pressure on your neck, upper and mid back, as well as promoting closing in and seizing up of your anterior chest structures.
In fact, I believe that FHP is a major contributor to mid back and rib pain, especially when its the “this came out of no where” type.
For discussion on posture, click here.
Get Help!
There is not prize for having the most pain in your mid back and chest. No one is helped by you waiting to see if it calms down only to arise again out of the blue down the track.
The faster you deal with issues like this the easier it generally is to get positive change. Not to mention, given how important it is to make sure you aren’t missing any of the more pressing reasons you might have mid back and chest pain, it is important that a health professional check you over and make sure you’re OK.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
The top 5 Don’ts of mid back pain.
DON’T have your partner or friend “crack” your back or stand on your back for you.
I know this might sound like I am being funny but it’s real. Believe me, I understand the temptation, especially when you feel like “getting it to crack” is all you need for it to feel like it will let go, but trust me when I say, that sort of thing is best left to the experts.
Chiropractors go to university for 5 years to learn how to adjust people be as specific as possible and minimise risk as well. Most importantly, we know when NOT to manually adjust someones mid back pain.
Your partner or friend might have good intentions but it is not worth putting that responsibility on them.
At the very least, you wouldn’t want someone to accidentally re-enforce the negative behaviour your mid back, rib or chest is exhibiting.
DON’T Panic!
Even if you are concerned that your chest pain IS something you will need to visit an emergency room for, panicking about a possible diagnosis will make things worse.
As I said before, the most likely cause of your mid back, rob or chest pain is mechanical and non life threatening, so be alert but not alarmed.
If you feel OK but are in pain and you want to do something about it, get in contact with us quickly so we can help you get on track ASAP.
However, if you are genuinely concerned about your chest pain, rib pain or mid back pain, and think it might possibly be a heart attack or stroke, DO NOT HESITATE to call 000.
There is no point worrying about what would happen if it turns out you didn’t need to go to hospital. I have spoken to several medical doctors and ambulance officers about this and all of them say the same thing, they would much prefer to see someone who didn’t have a heart attack than not at all when they did.
Again, if you think you’re having a stroke or a heart attack, do not wait for confirmation, call an ambulance immediately.
DON’T put off managing the problem or hope it will go away.
This sort of magical thinking does NOT lead to good health outcomes.
Imagine applying this type of approach to a car, if it’s not running properly and you haven’t gotten it serviced, you probably shouldn’t drive it to Queensland (assuming one day we can again).
Waiting to see if an issue like this calms down and “fixes itself” is in my opinion one of the best ways to create a chronic recurrent injury.
Commonly in practice we will see client’s who are on their 4th or 5th relapse of the same problem “only this time it’s just not calming down like it normally would.”
Typically injuries, even ones that come out of no where and can come and go will get worse over time. They get more frequent, take longer to calm down, get more painful and eventually, they become all 3.
The sooner you get onto your injury is generally the fastest way to recover and in my experience involves the least risk of recurrence.
DON’T work through it.
This one obviously goes with our last point as well as the “keep moving” point from before. Do not overdo it.
Your body is in pain for a reason, even if that reason isn’t always immediately evident.
If you have chest pain, rib pain or mid back pain, there is an underlying cause to it, and if that cause is mechanical, pushing through the pain and acting as you would normally runs the risk of injuring you further or exacerbating your pain.
DON’T go it alone.
This is potentially the most important point and yes, I am aware that this is literally the same as the “Get Help” section above.
Again, there is not prize for having the most pain in your mid back, ribs or chest.
Health care professionals are here for you to use when you need us. Living your life at half speed because you are in pain isn’t noble, it just limits your quality of life and no matter how good your intentions of not looking after yourself first and focusing on those around you, none of them want to see you suffer and all of them appreciate you the most when you are at full strength and not in pain.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
How to set up your car seat
If you spend a lot of time in your car then this post is for you…and let’s face it, if you're reading this you most likely live in Melbourne, so there is a good chance you DO spend too large a portion of your life driving, sorry, I mean, in traffic.
If reading this whole post isn't really for you, then feel free to skip down to the end where I will summarise how to set yourself up in your care in a checklist.
What is the issue?
As a society, we appear to give a lot of attention to ergonomics for when we are setting up an office work station, or using a computer, but thats often where our attention to the issue ends.
We are guilty of it too!
If you follow this blog you will know that we have recently posted about how best to set up your computer or your laptop, we have talked about ways to avoid text neck when using your smart phone or tablet. We have even discussed how to sit and the importance of limiting how long we sit for, yet all of those are predominantly centred around screen time, or when you are in an office.
The reality is, the office, be it at work or at home is only a PART of how we spend every day. Important as good ergonomics are during these times, we need to remember that improved spinal health, being mindful of our posture and maintaining high levels of function are 24/7 activities.
We are the result of what we do the most.
To be more precise, our body will get better at whatever we ask it to do the most, so it is important to ask yourself regularly throughout the day:
“What am I asking my body to do right now?”
This is why we often tell our clients that the most important thing they can do for themselves throughout the work day is to get up out of their chair and move around.
One place where getting up and moving around is not really an option however is when we are in the car.
Kieran, I will not be getting a beaded car seat cover so don’t even mention it.
Fair point. I wouldn't want one either. I am far too car proud for that.
Most of my clients will probably already know that I am into cars and that I love driving.
I am fortunate enough that my commute is very short, so much so that I mostly get the opportunity to walk or ride my bike to the practice. I do however get to spend a lot of time in the car though, as I enjoy driving almost everywhere else and spend most of my weekends heading out of the city to go camping, hiking or traveling to visit family in Bendigo.
One thing I don’t like about driving though, is how easy it can be to make myself very sore if I haven't set the car up properly.
A poor driving position can lead to (among other things):
Low back pain,
headaches,
sore shoulders,
pins and needles in your legs or arms,
fatigue,
Sciatic pain and most dangerous of all,
an inability to control your car properly.
Setting your car up is easy
Fortunately we live in a world where other people have done most of the hard work for us and your car is no exception.
Car companies have employed a literal team of people to make your car so that it is able to get you to YOUR ideal driving position, however most of us rarely use all of the functions they have bent hundreds of hours developing.
It doesn’t matter whether you drive something fun and sporty, or purely as a taxi you use to ferry your children, the following suggestions should be able to apply to nearly every car you drive.
Step 1: Seat height and distance
When it comes to how high you sit in the car, too much of anything is a bad thing. Too high and you have to bend down to see out of the window clearly, too low and you will struggle to see everything you have to avoid.
You want to be a comfortable height to be able to see everything easily over the steering wheel without extra effort. Seems like a no brainer I know but you do wee some weird things out there.
Distance from the pedals is important too. You never want to be reaching for the pedals…obviously but you don't want to have your knees too bent either.
If you are too close, you have to actively position your feet for too long leading to hip issues. On top of this, if your knee is close to or is resting on the dash board, then your leg bones will have to act like an air bag to slow you down in an accident…which is less than ideal if you're the kind of person that enjoys having legs.
Ideally, the best distance from the seat to the pedals would mean that in a manual car, your knee should be *almost* straight but not quite when you press the clutch in all the way. About a 5 degree knee bend in that position should be it.
In an auto, the same rule applies for you to be able to leave your foot on the foot rest (look for it, you most likely have one to the left of the brake pedal) but if you don't have one, you should have that same 5 degree knee bend when your foot rests on the firewall (thats the carpet behind the pedals).
This should also mean that when you take your left hand off the steering wheel it should be able to rest comfortably on the gear stick without having to reach for it, allowing your shoulders to remain relaxed.
Step 2: Steering wheel position
Have the steering wheel at a distance where you can relax your hands onto the 10 and 2 positions on the wheel without leaning forward and having to round your shoulders, keeping a relaxed bend in your elbows.
This means you have the most control of the wheel without having to grip onto it, strain your shoulders or your low back to reach for it.
Another easy way to know if its in a good spot, is when you rest your wrists onto the top of the steering wheel, it should sit *just* at your wrists.
Move it to a height where your hands can sit at 10 and 2 roughly in front of your shoulders, you don't want to have to go reaching up or down to find the steering wheel.
Most cars now have an electric steering wheel movement, but if not, its easy to unclip the handles on the steering column and play around with its position, moving it up and down or forward and back. Take your time with its one, when you get it right, you’ll know.
Step 3: Head position
If you have done the other two right then this should already be set, but just make sure your head isn't having to lean forward too far and is relaxed over the top of your shoulders.
If it is leaning forward, readjust your steering wheel closer to you.
Watch out for car seats that push your head forward. Bad posture is so common that engineers in some car companies have started building their seats to have the head rests moving forward to meet where they assume people with poor postures heads will be.
This forces you into a bad position and over time will GIVE you forward head posture. Personally I have not been able to buy certain cars because of this, and I know it has meant Martin has had to choose a different brand when replacing one of his.
You also shouldn’t need to rest your head back on the head rest.
The name is deceptive, you should have active control of your head, it shouldn't have to be pushed back into the head rest. Its the name of a safety feature in a crash, not a suggested use.
Step 4: Lumbar support
If your car has inbuilt lumbar support, don't be afraid to use it. When you find the right spot for you, you will be amazed that you ever drove without it.
If need be, you can always buy a lumbar support pillow to use when you are driving for long periods or on longer road trips.
Step 5: Never drive with something in your back pocket.
Thats right men who keep a wallet in your back pocket when you're driving, I am talking to you. I don’t care how long you have done it for, it causes an unevenness under you that WILL eventually lead to back pain and even sciatica in some cases.
The same goes for mobile phones. They seem small but even on a short trip they make a difference to how you have to sit. I don’t care HOW short the drive is.
Again, it seems obvious but people do it.
Step 6: Take breaks regularly.
Especially if you are driving a distance. They don't only stop you from feeling fatigued, they allow your body to wake up as well, and they don’t even have to take long! Even a 2-5 minute walk can do the trick.
As promised, here is the checklist:
Step 1: Height and distance
Seat at a height where you can see everything without straining to have your eyes above the wheel or below the sun visors.
Sit at a distance where your foot can relax at the back of the foot well with your knee bent slightly to around 5 degrees.
Step 2: Steering wheel
Bring it close enough to have a slight bend in your elbows when your hands are at 10 and 2, you should be able to rest your wrists on the top of the wheel without reaching for it with your shoulders.
Step 3: Head position
Like sitting at a computer, above your shoulders, not poking forward at the steering wheel.
Step 4: Lumbar support
Play around with it until it feels good for extended periods. This might take some experimenting. If you need to, buy a support cushion.
Step 5: Nothing in your back pockets.
Step 6: Take breaks.
If you have any questions or concerns, would like to chat about how to set up your car please contact us at Align, we would love to help you.
However, if you're happy with your car set up but would like to chat about cars specifically, please feel free to talk to me about it…don’t bother talking about them with Martin…they aren't really his thing.
Kieran
The most important step to choosing the right pillow
If you are one of the many people who are not sure where to start when selecting a pillow then please watch our quick video on what we think is THE most important step when making your choice.
Let's face it, there are too many options for pillows out there. There are so many materials, shapes, and seemingly random options for you to choose and the hardest part for a lot of our clients is that nearly all of them seem incredibly expensive!
Choosing the right pillow for you is very important but it shouldn't be something you lose sleep over.
At Align we believe that there is one simple factor that you need to consider above all else before settling on a new pillow.
If you have any further questions after you have watched the video about choosing a pillow or how best to approach sleep to manage your issues (be it posture, neck pain, low back pain or headaches), please do not hesitate to contact us at Align. We have a select range of pillows on hand at any time that are available to you even if you have never been in before.
Knowing how important sleep is to our community, we are always happy to offer a complimentary pillow fitting for you so that you can be confident that you are making the right choice.
Watch our video below to hear what advice Drs Martin and Kieran start with for anyone who is considering an updated pillow. If you'd prefer not to watch, the clip has been transcribed below.
Hi, Martin Harvey from Align Chiropractic here.
One of the most common questions that we get asked in practice is: “What sort of pillow should I be sleeping with?”
We have people coming in who have entire collections of pillows, made out of everything from feathers, through to the latest space-age materials, and they wonder:
“Why can't I find a pillow that’s comfortable for me?”
The first thing that we always want to make sure is that the pillow is the right size and the right fit for you.
Obviously some people are different sizes and there are also people who choose or are most comfortable in, different sleeping positions.
Make sure you check out our “which sleeping positions should you be using” video as well, but if you’re somebody who predominantly sleeps on your side, then you're going to need a larger pillow.
In side sleeping, the idea of the pillow would be to take up a significant amount of the space between your shoulder and your neck, so that it’s supporting your neck.
If it is not, when you’re sleeping on your side and it's too low, your pillow is going to force you to tip over quite a bit that way, and at the same time if it's too big for you, it's going to tend to tip you the other way.
If you're somebody who mainly sleeps on your back, then wanting to keep your head fairly balanced over your shoulder, you’re not going to want to big a pillow because a really big pillow is going to tend to force you forward quite a bit.
To that end, the type of pillow that typically is the best compromise if you're one of the many people who sleep a bit in both is a contoured pillow.
The contour allows the thicker part of your head when you're lying on your back to be in the contour and it also supports your neck without forcing you too far forward.
This is a low-profile pillow and this would be for somebody who primarily sleeps on their back or they're a smaller person who sleeps on their side.
If you're a bigger person who's a side sleeper, then you're going to want to go to a larger, higher profile pillow.
You can see here that it's much thicker than the other pillow, again it's the same basic structure.
So there you have it, a simple way of getting a bit of an idea of which pillow you should be using.
The most important first thing is that it's less about the material that it’s made from these ones are made out of latex which is a really comfortable and durable material but the most important thing is to make sure you get the right size based on how big you are, as well as your preferred sleeping position.
Simple exercises for people with neck pain
If you have neck pain, tight shoulders or headaches that come from your neck then I suggest you watch the video below.
In the video I run you though some very simple movement exercises to keep you mobile, try and get your neck moving again and hopefully help make you more comfortable as you go through your day.
I have tried to keep them very quick and easy so that you can incorporate them into your day simply and without having to make it too obvious that you're doing them.
If you are concerned about your neck pain or you have any questions, or if you experience discomfort doing them, then please do not hesitate to get in contact with us.
As always, the video has been transcribed below, but I recommend you watch to get a demonstration...and to see me in my solo video debut. Enjoy.
Hi I'm Kieran from Align Chiropractic. I just wanted to run you through a quick exercise for getting your neck moving.
Now if you're somebody that suffers from neck pain, a tight neck or headaches that feel like they come from your neck then this video is for you.
One of the main group of exercises that we recommend for our clients regularly are to get their neck moving again.
It's really important that your neck range of motion is even to both sides, it should be pain free and it shouldn't feel too tight one side compared to the other.
The important thing to remember when doing these exercises is don't push through a pain barrier or push to the extremes of your motion.
What we are wanting to do is get to the point of restriction and just relax into that position.
So its very simple to do; first of all we're looking at rotation.
Turning your head to one side holding it at that point of restriction for three seconds come back to the middle then turning the other side.
You're looking for it to be even on both sides and pain-free, hold for three seconds, back to the middle.
Next we go straight to side, lateral flexion for three seconds, back to the middle and then to the right-hand side for three seconds and finally, back to the middle again.
Remember, it’s three seconds on each side and you cycle through all four of those five positions 5 times to keep things moving.
If you are finding a lot of restriction or are particularly uncomfortable on one side more than the other, that can be an indication of a more significant underlying imbalance.
If you are feeling that or have any concerns about how your body is moving, I'd recommend that you get on to us and let's figure out what's happening for you.