Kieran Whelan Kieran Whelan

Home care during Stage 4: Move and Soothe your Neck and Shoulders

This post is for anyone missing their normal routine and would like some tips on getting rid of the tension and restriction they are starting to feel in their neck, upper back and shoulders.

As most of you are aware, during the stage 4 restrictions in Melbourne allied health are only allowed to practice on a more urgent 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 I 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.

Below is a video Martin made at home about how to keep yourself moving at home, helping your neck keep moving, free up a lot of the tension you have felt building, especially over 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.

The video has a few sections so if you REALLY felt like it you can skip to a section you find most relevant, however the way that Martin has filmed it the segments build on each other to get the most out of each one.

Enjoy!

2:00 Todays video is about...

3:52- Where to begin?

4:15 Rotational Movements of the Neck

5:32 Lateral Flexion of the Neck

7:12 Flexion/ Extension of the Neck

8:07 Shoulder Exercise

9:28- 3 exercises to open shoulders

13:48- Overhead position for shoulders

14:54- Focus on Alignment

17:23- Intro Spikey Ball Exercise

18:27 Beginning of Spikey Ball Exercise

23:27 Conclusion

Hi, Martin here from Align Chiropractic. Today's video is a follow along video, meaning I'm going to be taking you through some things that you can do, and you can more or less just watch the video and follow on. 

So, the purpose of this video, it's really about moving your upper spine, your neck, your shoulders, your middle back to get mobility in those areas but also to soothe those areas.

It's really based on the clinical model that we use in our practice where we see that there's a real benefit in looking at the spine in kind of a sequential way, that spinal problems generally what's happening is that segments of the spine rather than having the ability to move through their full range of motion and kind of jammed up from either trauma, or long periods of time in particular postures, or stress tightening up the muscles around it. 

And then as the joints jam up that changes the way the nerves and muscles and all the other soft tissues work, which then changes the alignment of your spine, and this change in movement and alignment of the vertebra causes misfiring of nerves which has a whole range of effects on your body, but specifically it can affect your ability to kind of balance the whole system. 

If you're not balancing the whole system then your spine's going to be less stable. It's much more common for you to have problems with your back, your neck and the rest of your body if things aren't stable. So, if we look at that it goes movement, then alignment, then balance, then stability and so a common thing that I’ll see is people talking about ‘I need to do stability work or core stability work’. 

I actually think it's really important that we do the basics first we've got to get movement happening first, and then once we've got movement, then we want to have a proper alignment so that when we're stabilizing first of all it's more effective, but we're also locking in a good movement pattern and a good alignment pattern rather than locking in poor ones.

2:00 Todays video is about...

So this one specifically, today's video is really about dealing with this upper part of the spine because many of us are locked into these postures working at a desk or the effect of stress tightens up our neck and shoulder muscles and pushes our head posture forward and so this is really about restoring movement to those areas and then getting our alignment back into that nice upright posture. 

I'm also going to be combining some approaches that come from new research into the interplay between how we breathe and our stress response and in particular if you want to dive deeper into this, there's a neuroscientist called Andrew Hubermann who's based at University of California, sorry based at Stanford and we're going to be using a couple of different approaches to breathing that we're combining with the movement approach and using a ball-  spikey ball, or a tennis ball, or a lacrosse ball that we'll be using to just release muscle tension and some of that will be just I'll be cueing you to breathe in through your nose, and then we'll also be using an approach called a physiological sigh, which is really where you just take in a deep breath through your nose and then another deep breath through your nose before

letting it out and the emerging evidence is that this is a really quick and easy way of us helping to unwind some of the neurological effects of stress which we know can have really significant impacts on how we feel and how healthy we are. So, let's dive straight into this follow along routine to help release tension in neck, shoulders, upper back, and get movement into those areas so that you can have a healthier, happier, more active body

3:52- Where to begin?

Well the first thing that we want to do is we want to encourage movement back into the neck, so with the postures that we've been in and the lack of movement and there's a tendency for our neck to kind of stiffen up, and there's a segmental part of that which is what wewould address in office with an adjustment, then there's kind of an overall regional movement that we can address with exercise.

4:15 Rotational Movements of the Neck

So first movement we're going to do is we're going to be doing rotational movements. With this I just want you to be taking nice slow breaths, in through the nose, out through the mouth. 

So first of all just turn your head all the way to the left, and then go all the way to the right. I'm going to go through this five times each way, and we're not pushing we're just holding at that end range- nice and gently. 

Let's see it just easing into it letting your shoulders drop, just letting that tension, that sort of habitual tension ease away. That's it. I think that's four, probably need a better way to count to be able to do this. Okay, I'm going to say that's five.

5:32 Lateral Flexion of the Neck

So next we're going be moving into lateral flexion so we just need to be cautious with this, if you get any pinching, any sort of sharp sensation that says you don't want to go that far, you want to stop before that point. 

All of these mobility things are done within what feels just you're touching that point of tension or restriction. So sideways it's going all the way over there. 

I'm just pausing at that end range, maybe a count of three. Just working our way into that range, just getting every vertebrae in our neck and even into our upper back starting to move. 

This is our third one. Maybe just pause a little bit longer there, any sort of knotty points you can just almost sort of focus on it, just get that movement happening, just nodding a little bit back and forward. Okay that's four. So one more to go. 

Last round for lateral flexion. Lateral flexion's actually a really important movement there's not many day-to-day activities that we do to encourage this range of motion, so it's often an exercise that we'll have people do because getting lateral flexion actually encourages movement in the other range.

7:12 Flexion/ Extension of the Neck

So now we're going to go flexion/ Extension. Flexion I'm going to get you to go nice and gently on, because we all tend to spend a lot more time in flexion than we do an extension. With extension which is the one going back, again just be really mindful that you don'twant to be getting any pinching sensation with that. With this one I'm doing it up against the wall. If you feel any dizziness with this then back off, maybe skip this part of it. This is our last one, our fifth repetition. Okay. 

8:07 Shoulder Exercise

Now functionally interlinked with your neck is your shoulders, and so again all this time spent like this, there's an alignment component of that, but before we can really address the alignment we've got to get the ability for these joints to move, so first up I’m going to do a stretch across the body, trying not to mess up my mic here. 

So come all the way across, and we're just going to breathe in through the nose, and out. I'm going to do this one for three breaths. Just going to go a little bit further on this third one. Okay and then we're going to swap our arms. Bringing the arm across, the other arm just hooks in next to the elbow there. Breathe in, out. Breathe in, and out.

9:28- 3 exercises to open shoulders

So, it started to get some mobility, but really if we want to be able to bring our shoulders back which is what most of us need because so much of our activity is in front of us, we want to be opening up and restoring that movement that way. 

So what we're going to do here is spend sort of three exercises bringing and opening up this in the front of our shoulder. 

The first one what we're going to do here is we're going to put our hand up on the wall above horizontal, so if that's horizontal first one we want is up here, and then i've got my body sort of facing away there my elbow is straight, and then i'm turning out this way, and then i'm going to do three breaths there. So in through the nose, and out. That’s two. I can just rotate a little bit more, and three. 

I'm just going to take that tension off, and now i'm going to that horizontal level, and it'll feel a little bit different, it's going to hit a slightly different part of the shoulder. 

So again in through the nose, and out through the mouth. And three. Now we're just going to do just below horizontal to again getslightly different part of the shoulder. 

We're going to come across. One, Two, that’s three. Okay, so now we're going to repeat exactly the same thing but on the opposite side. So first one, if that's horizontal we're going up maybe 30 degrees above horizontal, rotating away feeling the stretch at the front of the shoulder maybe a little bit into the arm. One, Two, That's three. 

Then we're going to a horizontal point now, taking that stretch back up, and then in through the nose, out through the mouth. That's three. So, I'm going to get out just below horizontal one there, take that stretch up. And then in through the nose, and out. Then that's it, just move your shoulders around enjoy that extra mobility there.

13:48- Overhead position for shoulders

So next what we're going to be working on is bringing up into flexion or sort of like an overhead position for our shoulders. So, with this I'm standing sort of basically like arm length away from a wall, and I reach out, I put my hands down keeping my elbows straight and then what i'm doing from here is keeping my arms straight and dropping my body all the way down. 

I'm not rounding my back, I'm keeping my back quite straight, and then getting that movement back into the shoulders giving them that full range. We're just going to do three breaths here, so in through the nose and then out. 

14:54- Focus on Alignment

So next what we're going to do is move on from looking at movement and we're going to focus instead on alignment. What we're really wanting to do is to reverse that tendency that we all have to have this sort of position, and so what we're going to do is do an exercise called a W exercise, which is where you make your arms into a W shape with the thumbs facing backward. 

I always like to sort of correct the head posture so pull your head back, and I also like to look up slightly because that helps just release the activation here. What we're really wanting to do is use these muscles down here in between our shoulder blades. So, make the W shape look up slightly and then what we're doing is trying to not use these muscles but use those ones in between your shoulder blades. 

We're squeezing back one two three. Relaxing one, two, three. One, two, three. One two, three. We're going to go for ten so that's four, three. One, two, three, so I'm going to say that one's four, and five

Six. If it's getting uncomfortable, if things are starting to burn just take a little break, six and seven. 

So it's kind of this back and down movement that we're after- just caught myself looking down too much. Nine and last one. Good. 

What we've done there is really kind of reset our alignment, and that'll mean that rather than when your heads forward everything through has to be working overtime just to stop your head from going forward with gravity. So we're going to use that we've gotmovement, we've got alignment.

Spikey Ball: 17:23

Now what I want to do is just kind of soothe this area. We're all doing a lot of this, let's just work through with some pressure on those areas, and for this i'm going to suggest that you use a ball, a spiky ball. In this case this is a lacrosse ball, and what we're going to start with is we're going to be doing three individual spots. We're going to be doing one right in between the spine and the shoulder blade here, then we're going to be doing one that's up, almost on the meaty bit above your shoulder blade, and then we're going to be doing this little corner in here where your arm joins onto your shoulder blade there. 

We're going to do that on each side. We're going to use that slightly different breathing where rather than just breathing in through your nose and then out through your mouth, if you want to experiment with it, this is a really good place to use that physiological sigh, which just helps reset our nervous system from a stress sort of state, into what they call a parasympathetic state, which is putting your nervous system in a state to promote rest and relaxation and kind of de-stressing.

18:27 beginning of spikey ball exercise

So let's start off. You put the ball against the wall, and then just drop it down a little bit so you can get into that spot and rather than rolling around, what I like to do for this is just find a tender spot, hold pressure there. And then we're going to go breathe in through the nose, and then second breath, and then out. So just moving into a slightly different spot there. 

Breathe in, second breath, and out. Breathe in. 

Now we're going to move to the top of the shoulder. So, for this one you almost need to angle back a little bit. I'm just going to find that fleshy bit there. All right so I’m going to breathe in. Okay, so that's our three breaths there. Now for this one, I've got a really a choice of going on the actual arm here, or for most people this area in the side of the shoulder blades the spot that you want to hit, so I'm going to hit that one. 

If you're doing this by yourself you could maybe do an extra round where you go to the other one if you're feeling tender in both, but I'm on the side of the shoulder blade. 

The easiest way of getting there is having your body sort of on a 45-degree angle there, just finding that tender spot- okay that's definitely it. And so I'm going to breathe in through my nose, that's number two, let's go for number three- that's a really tender one. 

Okay, so now what we're going to do- oops dropped my ball. And i'm back. All right so same sequence, we're just going to do the opposite side. So again, ball against the wall, I'm just going to roll into that spot just next to my shoulder blade there. All right that's it, I've got the right spot, so I'm going to breathe in through my nose. Second breath. 

So now I'm just going to reposition that ball. I'm getting ready from the top of that shoulder blade there. First breath, double breath. Second breath, that's our third breath there. 

Now we're just going to move to the outside of the shoulder there. So again, looking for either on the shoulder blade or the back of the arm. So I'm going to keep it consistent that 45 degree angle here. I’m going for that spot on the shoulder blade just breathing in I'm just moving up a little bit, finding that real epicenter of tension there. All right that's it, so breathe in at that spot...really relax into it. One more, breathe in through the nose.

Conclusion: 23:27

So there we have it, we've got movement through shoulders, neck, sort of upper back as well, then we've reset our alignment so thatwe're in a nice upright position and then we've kind of reset the tension, reset the nervous system giving you the best chance of having ahealthier, happier more active body. Thanks for following along.

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Kieran Whelan Kieran Whelan

Rib Pain and Chiropractic Part 1

This post is for anyone suffering from rib pain and wants to know how to get on top of it as quickly as possible.  

Part one of our 2 part rib pain series explores the common causes of rib pain as well as some issues not to be missed in case you have rib pain. 

Part 2 will follow shortly and discusses the Align chiropractic approach to assessing people with rib pain.

Rib pain is a common condition that most of us will suffer from at some point in our lives. As a Chiropractor for South Melbourne and Albert Park I can say that our practice sees a lot of clients suffering from rib pain on a weekly basis. 

It can arise for a whole host of reasons and if you have ever suffered from rib pain, you know that it can feel like the end of the world! 

Rib pain can make it harder for you to sleep, work, exercise, enjoy time with your friends and family or even just breathe.

Pain through the ribs can be a symptom of more serious conditions as well, so it is important that you take care of it right away. 

More serious problems that can cause rib pain will be outlined below.

Chiropractor Albert Park

Rib pain can often refer to areas such as your shoulders, arms, upper back and middle back as well as your lower back and the front of your chest. 

COMMON CAUSES OF RIB PAIN INCLUDE:

  • Poor posture (the way your body is positioned when standing or sitting.

  • Sleeping in an awkward position.

  • Upper back and neck muscle tension.

  • Injury such as a muscle strain.

  • Whiplash. 

  • Prolonged sitting, especially when using a desktop or laptop computer.

  • Previous injury to your ribs.

  • Stress.

  • Sneezing and coughing.

You will notice a common theme to the list above and that is; all of them appear relatively trivial when compared to the impact that rib pain has on our lives.

In fact, for a lot of our clients suffering from rib pain, that adds to the frustration. It doesn't matter if the pain is mild or severe, recent or decades old, most frequently, our clients will say that it just doesn't add up. “Why they are in so much discomfort? Why won’t the pain just go away by itself? Why does it keep coming back?”

HOW CAN SOMETHING SO MUNDANE CAUSE SO MUCH PAIN?

In these situations it is highly likely that there is an underlying imbalance of function that meant that their body was ‘on edge’. 

There was a build up of tension in an area of their spine and that mundane event was just the straw that broke the camels back (for the want of a better term).

Does it make sense to you that if your spine is functioning well that a trivial stress would be enough to make your mid back and ribs hurt? 

If your range of motion was symmetrical, your muscles, ligaments and tendons were relaxed, elastic and strong  does it make sense that it would suddenly start to hurt you? 

Of course it doesn’t. 

An underlying imbalance of function is most likely why you notice rib pain that comes out of no where, or won’t calm down, or keeps coming back. 

This is why our initial assessment of someone with rib pain looks for two things:

  1. What is the cause pain and how do we get it to calm down as quickly as possible? 

  2. Is there an underlying imbalance and if so, what can you do to address it to minimise the chances of it coming back?

For a more detailed account of how we assess these 2 features, be on the look out for Part 2 of rib pain which will be posted soon.

As stated earlier, there are also more serious causes of rib pain that, although much more rare than the list above, we need to screen for and you need to be aware of. 

Some of the more serious causes of rib pain are: 

  • Fractured ribs or vertebrae, 

  • Disc prolapse compressing on nerves,

  • Cancer, 

  • Pleurisy,

  • Heart attack,

  • Shingles

We have designed our assessment to be able to determine if your rib pain arises from an issue that we can start to address immediately, requires referring for further testing (such as X-rays or MRI etc.) or if you require immediate referral for medical assessment. 

SO HOW DO I KNOW IF I NEED TO SEE YOU OR GO TO THE EMERGENCY ROOM?

If you are experiencing intense rib pain after a severe injury, have intense pain when breathing that stops when you hold your breath, have lost or severely altered bowel and/or bladder function, your rib pain is linked to intense fever and/or unexplained weight loss, your rib pain also shoots down your arm or is accompanied by a rash, we advise that you visit your ED as soon as is possible to make sure that you aren’t suffering from more serious conditions. 

As always, if you are concerned that you might be having a heart attack, contact 000 IMMEDIATELY, you are better to be too eager to call for an ambulance than not eager enough. 

If you have any questions or concerns about rib pain, please do not hesitate to get in contact with us at Align.

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Kieran Whelan Kieran Whelan

HOW TO TRAIN WHEN YOU HAVE AN UPPER BACK INJURY FOR THE CROSSFIT, F45 AND HIIT ATHLETE

If you are a cross fitter, f45…er, boxer or just love that type of high intensity training and you have an injury then this post is for you.

At align we know that getting back to exercise is likely your number 1 priority!

Please watch our video or read the transcript below the video to get our tips on getting you back on track as soon as possible and learn how to maintain your gains despite injury.

As we said in our last posts on back pain and neck pain, taking time out of training is boring and can seriously impact on the gains that you have made.

When you have put the time and effort into your training to a level where you are really enjoying your high intensity exercise, taking time out for recovery can be tedious but can also hold you up on your way to achieving your goals.

The reality is, the better you allow your body to heal, the quicker you can be back to 100% and the less likely you are to have recurring injury, and the rehab is going to take some effort on your part, so what CAN you do to get back into it at full speed?

The first thing to work on is recognising that just like gains you have made, THERE ARE NO SHORT CUTS in healing your injury.

It is important to know what you CAN do to stay moving and enjoy your HIIT training without setting yourself back.

In the video below, Martin outlines some of our possible recommendations for managing upper back injury while still keeping up your training.

As always, if you have any concerns, upper back issues, be they old or new, or just want to get the most out of your training, we are here for you so don’t hesitate to get in touch!

Hi, I'm Martin here from Align Chiropractic and today's video what I’m going to talk about is a really common thing that we see in our practice which is: people who love doing high-intensity exercise. 

We're talking people who do CrossFit, people who do f45, and all the other versions of HIIT like boxing those type of things where the whole idea of it, is that it's something that people love doing and they want to do it regularly and obviously, it's something that you're doing at a high level of intensity so does create some pretty specific demands on your body.

Sometimes people have an injury and then they've got this sort of challenge where, they want to keep training, they don’t want to lose the gains in fitness that they've created but they’re also managing an injury and our experience is that there's a lot of things you can do where you can keep getting a lot of that metabolic effect, you can keep losing weight, can keep your cardiovascular fitness and you can keep a lot of your muscle mass by keeping training while you're having the injury addressed through chiropractic care. 

So one of the areas that we commonly see are people who have an injury in the upper back, so it might be that the vertebrae are jammed up there, which is a really common thing we see, can be a problem with the way rib is joined onto the vertebrae, can be a problem with the muscles in the area, there's a bunch of different things, a bunch of different types of injuries that you could have there but the common thing is that it makes a lot of high intensity movements uncomfortable and can actually be exacerbating the injury by doing certain movements. 

So there are things that we suggest you don't do to manage these injuries. Firstly you’re not doing things where it's really high highly dynamic, so burpees can be really uncomfortable, box jumps can be really uncomfortable, anything with jarring can be uncomfortable as well as things where you’re demanding a lot of range of motion from your upper back that you don't necessarily have. 

Within a CrossFit context, kipping pull-ups, within F45, battle ropes and those sort of things where there's a lot of movements for in that area that isn't moving properly it can create a demand that your body's not able to correct. 

The sequence that we look at is that early on if you've got an injury and we're actively trying to get things back on track we’re going to get a shift focus to doing a lot of the lower body exercise because you can work your lower body without having that impact on your upper body. 

For most people, air squats are completely comfortable and lunges are really good and that’s because of that single leg aspect to it it's a really good opportunity to develop that sort of balance and stability in your lower body when you're taking the load off your upper body. 


As far as not losing all your upper body strength, often what most people notice is while overhead stuff, pushing overhead and pulling overhead can be really uncomfortable, often reducing the load and going horizontally so we’re talking things like really slow controlled push-ups or a dumbbell press chest press or even a barbell chest press can be okay as long as you’re super conscious of your posture. 

We’re making sure that a head is staying over our shoulder because often the reason that people end up with these mid-back injuries is that it's not from the exercise it's from too long spending time at the computer in this crappy posture. 

Therefore, if you're wanting to maintain some upper body stuff we're going to do some horizontal pushing and we might do some horizontal pulling as well. 

In doing those actions, we’re going to work on pulling our shoulder blades back by doing actions like a ring row, where you’re lying down when you're pulling back towards yourself or you doing them with a machine, some sort of rowing exercise. So rowing is good and also push-ups can be good.  

The next level up from there let's say we've got some improvement but things aren’t 100% in terms of function and we're not out of the woods yet but once we've got some improvement and movement in that area, and we're starting to change in overall posture, we can start reintroducing some things. 

So what we might do in the early phase, while we've taken out jarring activities like box jumps out, we might get back into doing a step up or we might go back to doing some pull-ups.

Pull ups are where we are going overhead and doing a pulling movement, but rather than doing a more dynamic movement, like kipping pull-ups, we will make it a little less dynamic and only do strict pull-ups - even if that means that we are applying a band.

Another option that we could look at is some overhead pressing movement with a dumbbell but we're not going to have the dynamic ones where we're using momentum and that faster cadence that we might normally use in high intensity training. So we are just going to slow things down focus on very slow movements that are a little bit easier to stabilise through that area. 

The bottom line with this video is that - yes you love your training and yes it's inconvenient to have an injury but for most people they can maintain the momentum, they can maintain their gain, if they just tweak a little bit what they do, shift focus to the lower body, shift focus to slow controlled movements, cut out the overhead work initially and keep going when you training when you’re managing an injury. 

I hope you found the video interesting leave a comment if you've found it valuable, and we hope to catch you soon.


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