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I have a back problem… so why are we working on my abs?

Nearly every one of my patients that comes to see me for back pain, regardless of the source of the pain (bulging disc, strained it while lifting, poor posture etc.), will get a pelvic tilt as their first exercise. Why? Because I’m sure you and I, and the rest of the average people out there have weak abdominal muscles. But what does that have to do with my back you ask? Let me explain. Think of your abdominal muscles like a girdle and your back muscles like the laces of that girdle. Ladies know what I’m talking about, guys think of your football pads. If the laces are tied in knots but the pads don’t fit it’s not doing you any good when the lineman hits you, right? It’s the same thing with your back. If your abdominals, or your “core”, isn’t strong, those poor back muscles have to work overtime which leads to all kinds of problems and ultimately, pain. So we give you a pelvic tilt where you are asked to tighten up your stomach muscles. If only life were that simple though. You have to be sure that you are using the muscles appropriately and not including any other muscles, say for example you gluts (your bum) otherwise, you will continue to promote the problem; hence the need for physical therapy. We are trained and educated to tell you if you are using the muscles correctly or incorrectly. I can’t begin to tell you how important it is to have a strong core and strong glut muscles. This is not to say that you need Arnold Schwarzenegger six pack abs. You just need to have a good balance of strength between your back and your stomach muscles. So if you have been compensating with your back, it’s time to give those muscles a rest and let your abdominals take over for a little while.

The next question we get is, “Do I have to do this forever?” Well, honestly, yes. You can’t eat healthy for 4-6 weeks and expect that to last you the rest of your life, so you can’t expect to come to therapy to work on your core muscles and expect your back pain to be gone forever. Ideally we are retraining you and your body to work the way it’s supposed to so that it becomes automatic for you. You should be able to naturally lift a heavy object with your legs and gluts and not your back. You should naturally be able to activate your abdominal muscles when carrying a heavy object or lifting it overhead instead of relying on your back. So I wouldn’t think about it as something you have to do forever, but rather it’s retraining you to work more efficiently and more effectively. Like putting your left shoe on before your right shoe every morning because that doesn’t cause you pain.

My job is educating and retraining your body to work how it’s supposed to in order to avoid pain. It doesn’t matter if your pain is limiting you from getting up out of bed every morning or if it’s limiting you from your recreational activities (golfing, walking, standing, bowling etc.) I may not know the proper way to hold a golf club, but I know the basic motions your back needs to go through and how to avoid that little bit of extension after the swing which shoots that pain up or down your body. We look at the motion that’s causing you pain and modify it in ways you maybe haven’t thought of before. That’s the beauty of understanding how the body works. Unfortunately, we don’t have magic wands to suddenly make everything feel better. If we did I can assure you I would be on a yacht somewhere in the Pacific sipping a cold beverage. It’s going to take some effort and a change in habit, but I can assure you that if you work on those abdominal muscles and those glut muscles, your back will be much happier with you in the long run.

Kacey Kline, PTA

Looking For Sciatica Treatment in Surprise?

If you are looking for sciatica treatment in Surprise, Vital Care Rehab can help.

How to obtain Sciatica pain relief  often mystifies new sufferers.

Patients need help understanding that Sciatica is really “irritation of the Sciatic nerve,” and that this nerve “comes from either side of the lower spine and travels through the pelvis and buttocks, passes along the back of each thigh…(then) divides into branches at the knee, that go to the feet.”

Sciatica pain can flare up due to a rear-end-auto collision, from a blow to the lower back or hip, after a fall, from a sudden twisting of the spine, or from a herniated (ruptured) disc. Each sufferer can have a different pain experience when there is undue pressure on the Sciatic nerve. One person may get shooting pain “down the back of one buttock or thigh.” Another may have “mild aches.” Yet others literally jump from “sharp, burning sensations.” And, Sciatica is known to cause “numbness and tingling” in the affected areas.

Therapeutic Exercise Should Be Your First Choice

Advising exercise to patients with osteoarthritis or sciatica may be a highly recommended approach to treatment, but it’s an approach that may not be widely used by physicians, according to a recent factorial experiment (abstract). Researchers found that out of 192 primary care physicians studied, fewer than a third said that they would advise physical activity as part of a course of treatment for patients presenting symptoms of either condition. The results of the study were published online in early October in Arthritis Care & Research.

In the experiment, the physicians watched 2 videos of (actor) patients who presented with pain from undiagnosed sciatica or knee osteoarthritis that had been diagnosed. Afterwards, the physicians were interviewed to find out what recommendations they would make.

Results showed that 30.2% of physicians would give exercise advice to the osteoarthritis patient, and 32.8% would provide this advice to the patient presenting with sciatica.
Reference: https://www.apta.org/PTinMotion/NewsNow/2013/11/7/ExerciseAdvice/

As You Can See, Exercise, Isn’t Prescribed as Often as It Should Be

A physical therapist can guide those with discomfort through the following–or similar–exercises for Sciatica pain relief:

EXERCISES FOR THE LOWER BACK–Appropriate “spine alignment”–along with increasing “flexibility”–can  decrease tension/compression on the Sciatic nerve. The therapists at Vital Care Rehab, will come up with a custom treatment plan based on your specific condition and limitations.

STRETCHING FOR THE PIRIFORMIS MUSCLE–This muscle–located “on top of the Sciatic nerve and within the buttocks”–can become so “tight” it irritates the nerve. Relaxing the Piriformis muscle with specific stretching and hands-on techniques, provided by our physical therapists, can help ease Sciatica pain resulting from Piriformis muscle issues.

STRETCHING THE HAMSTRING MUSCLES–These large muscles–which “run along the back of the thighs.”  Given that the Sciatic nerve closely approximates the hamstrings, it’s common for Sciatica pain to increase the tone (or tightness) of the hamstrings.  Specialized stretching techniques can help ease the tightness of these muscles and decrease Sciatic nerve related pain.

Conservative Care Starts with Vital Care Rehab

Contact us to learn more about Sciatica, and about other exercises and treatments to decrease your pain and promote healing.