Home care during stage 4: Move and Soothe your back and hips
This post is for anyone missing their normal routine and would like some tips on getting rid of the tension and restriction you may be starting to feel in your back and hips.
As most of you are aware, during the stage 4 restrictions in Melbourne, allied health are only allowed to practice on an urgent care basis, meaning that a lot of our regular clients are missing out on getting their regular adjustments as well as maintaining themselves while living in lock down!
Never fear however as Martin and Kieran have got your back and are still in practice!
If you have a specific issue please do not hesitate to contact the practice so we can see how we can keep you going.
Due to popular demand, here are some more stretches and mobilisation exercises to use at home!
Below is a video Martin made at home about how to keep yourself moving at home, helping your back and hips feel human again after the change in routine from the last few weeks of stage 4 lock downs.
As usual with our videos, the transcript is available below, but I strongly recommend you have a watch as Martin runs through some excellent tips, stretches, exercises and muscle releases that will have you feeling a lot more yourself during this period.
Enjoy!
Welcome:
Hi, it’s Martin here from Align Chiropractic. This is a follow-along video, so you can follow along as I run you through a series of exercises. Today’s video is really about moving and soothing the lower back, hips and sacroiliac joints.
When we are taking care of people in the practice in this area, there’s kind of a hierarchy that we work through to help people’s bodies work at their best. We want to restore movements to the joints first, because if the joints aren’t moving then it tends to create increased stress and strain on everything else. Lack of movement also affects the alignment, and if the movement and alignment of the joints is not the way it should be, then it causes changes to the firing patterns of the nerves. This affects the muscles, which affects the ability of your spine to balance overall, and affects the stability of how that whole system and the body works.
Begin: 1:01
We’re going to work through a sequence. Whilst it’s not as good as getting an adjustment- which is often the only way to get each of the segments working, we can use movements of our body to maximise the amount of movement we’ve got with our spine. We want to make sure that we’ve got everything moving nicely first, and then we’re going to move into increasing and improving the alignment so that we can translate that into having things working as stably as possible.
Often your body will hold onto muscle tension when things not working properly. We’re going to run through a few releases that you can do to help things feel as comfortable as possible.
Lateral Flexion: 1:40
We’re going to start off with some lateral flexion movements. Lateral flexion is a really important movement in the way that our spine works because the coupled motion of the spine means that if you’ve got lateral flexion, every other movement will perform better.
We are going to slide our right hand all the way down your right leg. We don’t want to force this movement- just get to a point where we feel a point of tension. We are going to go through a count of 3 here, then come all of the way up to go to the other side. We are going to go through this sequence 5 times each way. This should be nice and gentle. We really want to get each of the vertebrae moving as much as they can.
Flexion and Extension Introduction: 3:45
So, next we’re going to move into flexion and extension. It’s a bit of bias towards really wanting extension as much as possible because so many of our activities, whether we are sitting or bending forward, encourage flexion. For this reason, there is a bit of bias towards encouraging extension.
Flexion/Extension Exercise: 4:03
We are going to start off with extension. Hands on the lower parts of your hips here, and then we’re bending back this way. You just want to be careful that you’re not jamming things, so we’re not going super far into this one. Just get to a point where you feel a degree of tension, then holding for 3.
From here, we’re going into flexion. I’m going to be nice and gentle here. If your back is feeling a little bit tight then just stop at the first point of tension. It’s fine to have your hands on your legs there, or if you’re feeling free then we’re just going to go as far forward as we can. In this case, the fingers are touching the ground for 3, and then we are going to come all the way up.
Nice and slowly, coming back into extension. Hand is on the lower back for 3. Same thing coming forward. Nice and easy, just dropping from the hips. That’s our second time through. I’m going to come back here. All the way forward for our third sequence of five. Onto four. Nice and easy coming forward, then last one. All the way back for 3, and then last one forward.
Rotation: 6:22
For the next part, what we want to do is increase the amount of rotation that we have with our lower back. There are a couple of different ways that we can do this, but I’m going to pick an easy way.
So, what I’m going to have you do if you’re able to, is get your foot over so that it’s at the level of the other knee- that’s ideal. If that’s not comfortable, you can end up just with the leg down like that- but ideally, we want it up like this, so we’re then using leg as a bit of a lever.
So, with this one, we’re going to incorporate a little bit more breathing. So, this time I’m going to get you to breathe in through your nose, and then out through your mouth. Rather than rotating back and forth, we are just going to hold in a rotated position for three breaths.
So, we’re going to come all the way around, I’m just hooking my elbow onto my knee. The other hand goes around like this way so I’m getting a nice rotational stretch, then just increase it a little bit if I’m able to. That’s two, so we can get a little bit more.
So just little point of performance there, we’re not wanting this sort of position, we’re wanting a more upright stretch, so stretch comes through our back. So nice 3 breaths there, and then we’re going to swap legs there and stretch to the opposite way.
So, leg over and then this way. Get that rotational twist in there- in through the nose and out.
Sacroiliac Joint Movement: 8:33
Okay. So from there, we have some rotational movement. Now we want to get some movement through the sacroiliac joints. They’re the pelvic joints, the joints right at the very bottom. Their plane of movement is rather than this sort of plane, they twist forward and backward a little bit this way. The best way of working them is we want to pop one foot right out in front, and with the other we’re basically going into a long lunge here, and so the back leg is there. It’s really important that this front knee is behind our front foot, and we’re wanting to get this knee back nice and long. Then what I’m going to have here is I’m going to reach my hands in on the inside of my hips there. So, it’s a bit of a hip flexor stretch as well as mobilising the sacroiliac joints. So, from this position I’m going to hold here. I breathe in through my nose, and out through my mouth, just dropping a bit further in with each breath.
Okay so that’s 3 for that side, just going to swap positions here. I pop that leg forward and this leg back and keep my hands on the inside. If that’s too much then you can do more or less the same thing from this position, but ideally we want to really encourage a lot of movement into those sacroiliac joints because when we’re sitting, they’re not getting much movement at all. Some breathe in through the nose, and out. Just gently come out of that.
Exercise for Postural Alignment Introduction- 11:03
Okay, so we’ve now got some movement through both the spinal joints- the lumbar spinal joints, and the sacroiliac joints. So, what I want to move onto now is an exercise to just help in terms of our postural alignment. We’ve got everything moving, so let’s do an exercise that will kind of offset that tendency toward flexion and slumping forward that many of us have just from hours spent sitting. What I’m about to show you now is an exercise called a superman exercise
Superman Exercise: 11:30
It’s a really great exercise both in terms of encouraging better posture in your spine, and also it can translate to some improvements in stability.
So really simple exercise. You can lie face down, arms extended in that classic sort of superman position, and what we’re wanting to do here is just quite simply start of quite low. Lift up and hold for 3- that’s one repetition. Making sure you just sort of pinch your shoulders back as well, and having better posture through the middle back as well. That’s 10. Okay, so movement and alignment taken care of. Now we want to see if we can get rid of and release some of the tension that builds up.
Glute Tension: 13.22
The biggest driver of tension tends to be that tension in the gluteal muscles, so we want to focus on that for this sequence. You can use a lacrosse ball, a tennis ball, a cricket ball, a spikey ball, or a foam roller- this is a little short one, but the same thing works with the bigger roller. For today I’m going to use the spikey ball, but any of these will work.
So, to start with we’re going to go on our side. We’re going to work this big fleshy part on the side here called your gluteus medius. What you’re aiming for here is if you reach down you’ve got the side you’ve hit that top of your hip bone, which is called your iliac crest. There’s a fleshy bit between that and the next part of your hip called your greater trochanter. So, what we’re going to do here is we’re going to lie on our side with that there. Just find a tender spot, and then we’re going to hold that tender spot while we breathe. You’ll notice I’m slightly backward of exactly on my side- your tender spot could be slightly forward or back of there.
Breathing Introduction: 14:35
From there, I’m just going to breathe in through my nose, then one more deep breath until we’re at that full point, and then out. We’re going to repeat 3 times.
Okay, so that’s the gluteus medius released. That type of breathing also helps to get us relaxed, or what’s technically called a parasympathetic, or rest and repair state.
Piriformis Release: 15:24
Now we’re aiming for is a muscle called the piriformis muscle, which is kind of in this fleshy part right where the pocket of a pair of pants might be. We can either just put the thing on the floor and go straight on there. If you want to increase it a little bit more, you can pop that ankle of the right leg onto the knee of the left. Find that tender spot, and then we’re just holding pressure there. We’re going to do double breathes again. Let’s just relax into it. Last one.
Gluteus Medius: 16:30
That’s it, so now I’m going to flip over to the other side there. Again, we’re going to start with the gluteus medius, so come onto that side and find that tender spot- that’s the one right there. Breathe in through the nose (double breath). Alright, so let’s just released that gluteus medius.
Piriformis: 17:20
So now we are going for the piriformis. Now I don’t have a pocket on this side, but imagine where a pocket would be. I’ll pop my ball there and just have that leg straight like this, with the other one like that, or if that’s too much, just like that works fine as well. We’re going to find that tender spot- yeah that’s the one, it’s a bit more on this side than on the other side. So, I’m going to breathe in, and again.
Conclusion:
Perfect! So, there we have it. Sequence to move and improve the alignment, and then soothe and release the muscle tension there. Thanks for watching
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.