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Top 10 lower back pain Myths!

Lower back pain and the unhelpful beliefs that could negatively impact your behaviours

 

Most of us will have inevitably suffered from some form of lower back pain in our lives, to varying degrees of severity and volumes; but it’s almost certain to have affected us somewhere along the way! That opening statement in its itself is a perfect example of how beliefs and experiences around back pain can negatively impact our behaviours, fortunately I am going to now expand on it and point you in the direction of some fantastic editorial research that has recently been published for the benefit of the general public.

back-painLower back pain (LBP) is the leading cause of disability worldwide, but the way we as health care professionals and you as patients understand the pathology may differ. In an ever-progressing world of research; there are even gaps of knowledge within sub-groups of practitioners that negatively impact the way LBP is perceived and treated. We hear about it through all media channels and we have an understanding of the ways pain management is prescribed and how we are instructed as patients to manage LBP. Common beliefs and understanding on these factors can influence the way individuals perceive and understand LBP and ultimately the affect it can have on the way you live your life.

In this blog I will review the aforementioned article and address the fact’s from my own point of view and experience;

Ten unhelpful LBP beliefs;

Unhelpful LBP beliefs are common, culturally endorsed and not supported by evidence.

Myth 1:  LBP is usually a serious medical condition

You can feel debilitated or in an amount of pain that indicates a serious pathology; but the facts are the vast majority of LBP cases are not life-threatening pathologies that cause permanent disability.

Myth 2: LBP will become persistent and deteriorate in later life

There is no strong research to support an association with age and deterioration in LBP; age is not a risk factor – we are all subject to the same level of risk; of which there are very well supported methods of managing LBP.

Myth 3: Persistent LBP is always related to tissue damage

Having a reoccurrence of the same type of LBP doesn’t mean the same structures are being damaged to an increasing degree each time – it may feel that way because the pain can get worse but the soft tissue structure that are involved in LBP will heal within a normal time frame. There are a multitude or internal and external factors that relate to pain replication which can be managed and overcome.

Myth 4: Scans are always needed to detect the cause of LBP.

Scans are unlikely to tell us anything different to what we already know. There can be the same scan presentation in a person with and without LBP; again, it’s the multi-faceted level of factors contributing to our pain which are more important than scan results.

Myth 5: Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity

There are really clear and accurate ways to monitor painful responses during exercise; most of the time – pain is acceptable during exercise/rehab and is more likely to be beneficial than harmful. Increasing your exposure to painful movement/tasks is one of the more effective way to reduce your sensitivity to these painful triggers.

sitting-at-desk-pain

Myth 6: LBP is caused by poor posture when sitting, standing and lifting

A really common one; posture does not cause pain, plain and simple. Stress, anxiety, sleep deprivation, periods of persistent working/inactivity are more likely to be the cause of posture related pain rather than the position its self. Get up, move, meditate, talk to your peers and share experiences; it will make a difference.

Myth 7: LBP is caused by weak ‘core’ muscles and and having a strong core protects against future LBP

Our ‘core muscles’ control spinal movement; so, it makes sense that weakness increases our injury risk, right? Wrong. Varying the degree and quality of movement in our lower back; along with the able to transfer weight through our trunk gives us more dynamic movements; but weak muscles do not cause pain.

heavy-lifting

Myth 8: Repeated spinal loading results in ‘wear and tear’ and tissue damage

Heavy lifting and forward bending do not wear out the spinal discs, it actually lubricates them and some studies have found evidence to support increasing strength of discs with increased loads, just make sure these movements are familiar and build them up.

Myth 9: Pain flare-ups are a sign of tissue damage and require rest

Similar to Myth 5; there are a number of factors that can cause pain replication, sensitivity related to previous movements, tasks, scenarios and intrinsic factors are most likely to be the causes of pain; and your practitioner should talk you through understanding this and how to manage it before you refer back for re-assessment (if needed at all).

Myth 10: Treatments such as strong medications, injections and surgery are effective, and necessary, to treat LBP

These interventions are invasion, have varying success rates, complication risks and secondary symptoms; the long-term benefits are not guaranteed. Of course, there are pathologies and examples where these treatments are more likely to be necessary; but for the majority of LBP patients; they just aren’t needed.

 

adamSo that’s it, also check out this useful infographic about Back Facts
Keep your eyes peeled for more on this subject!
Adam 😊

Blog post by Adam
Senior Physiotherapist at Emma James Physio

 

Growing Pains in young footballers

Growing pains (Traction Apophysitis) can occur in children following a period of rapid growth and/ or increase in sporting activity. During periods of rapid skeletal growth (think teenagers suddenly almost growing overnight) the cartilage within long bones of the body is weaker and becomes more susceptible to injury.

Growing pains most commonly affect tendon attachments at these sites: the heel (Sever’s disease), below the knee cap (Osgood-Schlatter’s) and at the base of the knee cap (Sindig-Larsen-Johansson). Often these children participate in football as well as other running and jumping sports.

Onset is usually gradual with pain over the areas mentioned above. Unfortunately, often growing pains mean the child ends up resting from their sport. However, rest alone often does not solve the issue, with pain returning when the child attempts to return to activity.  Bone often grows quicker than the muscle has time to stretch and adapt causing increased tension at the tendon attachment which can cause pain to develop. We cannot control this!

However, we can have some control over other contributing factors such as;

  • Training load- how frequently/ intense training is, is it varied and balanced with good emphasis on technique and rest?
  • Poor biomechanics
  • Poor capacity of muscles to deal with rapid skeletal growth

Obtaining an early diagnosis and appropriate management plan should reduce the impact on a child’s participation in sport.  An individualised rehabilitation program should be devised with the help of your physiotherapist to address the factors outlined above. A physio will also advise on which activities to temporarily limit and which to continue with and future training strategies.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Exercises you can do at your desk!

Following my post about the benefits of Pilates, heres some useful exercises you can do at your desk!

Note: With all sitting exercises you must be sitting up tall on your sit bones. Keep your core engaged (almost feel like you are pulling your belly button in towards your spine) and shoulders relaxed and down.

desk-exercises-1

Dumb waiter

Sit with your elbows bent at 90 degrees. Keep them tucked into your waist while you open out your forearms and keep your back straight. Keep pressing your shoulders down while you repeatedly open and close your forearms.

Spine twist

Hold your hands on the back of your head. Keep elbows out to the side. Hips facing forward. Inhale through the nose and as you exhale through the mouth twist though the mid-point in your back to one side. Inhale and on exhale come back to center repeat on the other side. Do as many as you want but make sure you keep an even count.

desk-exercises-2

Spine stretch forward

Sitting nice and tall, resting your hands on your lap. Breath in through your nose as you exhale tuck your chin to your chest and start rolling down through from the top of you back, only to half way down your back. Breath in and then on the exhale use your abdominals to pull your torso back up to sitting tall. Rolling through your spine bone by bone.

Lateral/side bend

Sitting up nice and tall, arms by your side as you breath out reach your right arm down one side of your chair with out leaning forward or backwards. Repeat on the other side.

desk-exercises-3

Hip opener/Hip flexors

Cross one leg over the other (ankle on the knee) and bend forward over your legs with a flat back.

Single Leg raises

Sitting nice and tall with feet flat on the floor, extend one leg at a time focusing on activating the quadricep muscles and then slowly lower down. Alternate each leg.

Why not try a Pilates Class?

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Pilates – gain a balanced body and mind

Pilates practice can help you gain a balanced body and mind. … A balanced body is one in which each part of the body works with one another to create and maintain a stable person. A balanced body is one that is mentally, emotionally, and physically stable.
The beauty of Pilates is that anyone, at any age can get started. Through the controlled and progressive movements, you can totally reshape your body.

Improved posture

By strengthening your core and improving your alignment of your spine.
Desk jobs encourage bad posture which can lead to kyphosis (rounding of the upper back) by working on muscular imbalances this can be reversed. Most Pilate moves help with scapula, shoulder and spine stability.

Improve flexibility

flexibilityWith longer hours of sitting we get tight hip flexors and generally stiff. Pilates encourages you to lengthen and expand your muscles.

Strengthen core

All Pilate moves require you to hold your core. Core muscles are not just your abdominals but the deep muscles running from the bottom of your head to your pelvis. They help support the trunk. Having a strong core will help support your back, which will help with pain and injury prevention.

Improve your balance

As you get older your balance becomes worse over time, this can then cause falls and injury. Pilates exercises require a more holistic approach and require activation and coordination of several muscle groups at the same time, which in turn improves your balance reducing the risk of falls.

Mental Health

pilates-classes

In Pilates you are told to regulate your breathing. Breathing is one of Joseph Pilates key principals. Pilates breathing directs your focus inward for the duration of the class, focusing on the present, feeling the muscles work and reconnecting with your body.

Exercising even if low impact helps produce endorphins in the body, which are also known as the happy hormones. It is natural drug to help boost your mood.

 

Pilates Classes

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

Look out for my next pilates post coming soon!
pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Benefits of working with a Personal Trainer

There are many reasons why having a Personal Trainer (PT) can benefit you, people of all ages and abilities. See better results by living a happier more active lifestyle.

A Personal Trainer will help build a unique training plan for each individual, which can easily be adapted and adjusted. Exercises can be regressed or progressed depending on the level of fitness, injury, results driven, time and if having an ‘off day’.

Top 5 Benefits

1. Faster and Better results

person-training-1Having a Personal Trainer will make sure you stick to your programme and push you to your limits during a workout session. Often when you work out solo you can become distracted and don’t push yourself as much. Time is always an excuse as not to work out but having a PT can adjust programs so they are just as affective no matter what the length of time you have available.
By pushing your boundaries, you will see faster results, this could be weight loss, toning up, cardio/fitness level or strength.

2. Fat loss and Muscle Gain
This is not everyone’s main goal but for 80% off people hitting the gym it is. Having a Personal Trainer, they know the right exercise each individual should be doing to achieve their goals. A mixture of weight training to gain muscles and become stronger and cardio to get fitter and leaner

3. Reduce chance of injury
A Personal Trainer will teach proper form and technique, which will prevent injury. Injuries can easily occur from not warming up properly or doing exercises incorrectly.

4. Establish a lifestyle habit and routine
A Personal Trainer can help motivate and encourage to create new habits. Once a routine is established it is easier to stick to, making it part of your lifestyle will make it easier to achieve results. Exercise and diet are all about consistency if you want to see those results.

5. They fit into your schedule
We all have busy lives and lots going on the beauty of a Personal Trainer is that they will adapt their time to fit in with you. So if you need an early morning or late evening workout a PT will be there.

person-training-outside6. Flexibility on Location
Many do not like working out in a gym as it can be crowded and over whelming. A Personal Trainer can change the location of any workout from either the gym, a home work out or even outside.

7. They can help with specific goals – an Event
As well helping set realistic goals a Personal Trainer can help set a training plan and train for specific event whether this be a run, triathlon, swim or a sporting event etc. With events you need to reach a certain level of fitness to be able to compete and stay injury free.

8. Mentor / Mental Health
Exercise realises endorphins which are ‘happy hormones’ they can help make you feel good physically and mentally. A Personal Trainer can help motivate you when you are suffering from mental health issues, they can help keep you on course to release the greatest number of endorphins. This in turn helps with a person’s overall wellbeing. A PT cares about how stressed you are, they will listen to you, they want to give you the best results which can be impacted on how you are feeling.

If this sounds interesting and you need that extra push why not call or email Emma James Physio to find out more….
reception@ejphysio.co.uk
01442 870686pippa

Pippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Work related stress & how to manage it

Up to half a million people in the UK experience work-related stress every year, which often results in illness (Health and Safety Executive 2011).

The signs of stress can vary from one individual to the next (NHS Choices 2011). They may manifest physically as an illness, tiredness or lethargy or as symptoms such as sore, tight muscles or erratic sleep patterns. Mental stress can result in depression, mood swings, anger, frustration, confusion, paranoid behaviour, jealousy or withdrawal.
Treatments include medication such as anti-anxiety drugs, cognitive behavioural therapy, relaxation techniques (NHS Choices 2011), acupuncture and floatation therapy.

How acupuncture can help

Stress is a common complaint cited by acupuncture and these individuals present with a variety of symptoms. Can acupuncture help with stress and anxiety? Let’s look at the research…..

One small randomised controlled trial (RCT) suggested that acupuncture might be successful in treating the symptoms of chronic stress (Huang 2011). Another study which looked at healthy individuals subjected to stress testing found acupuncture at an acupuncture point used for stress was more effective than a ‘control’ point (Fassoulaki 2003). A study by Pavao (2011) found acupuncture might be effective in attenuating psychological distress, as well as increasing cellular immunity. acupunctureIn a small pilot study, the use of one particular acupuncture point led to marked reductions in stress (Chan 2002).

Acupuncture is proposed to have many effects, including stimulating the nervous system and causing the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic (state of equilibrium) mechanisms, thus promoting physical and emotional well-being.

Floatation Therapy

In addition to acupuncture, another alternative treatment for stress and anxiety is floatation therapy. During a floatation session you effortlessly float in an Epsom-salt solution. The solution is heated and maintained at skin temperature (37°C) and the environment in the tank is controlled so that the air is also skin temperature.

floatation-therapy
This creates an environment similar to that of the Dead Sea (but nearer to home!) which lets you float effortlessly on the surface of the solution, enjoying a feeling of total  freedom & complete weightlessness!

Preliminary research has shown that floatation therapy may lower stress, anxiety and even depression by reducing how much sensory input the brain and nervous system receive (Feinstein, 2018).

At Emma James we have our own Floatation Tank. Please just call us if you would like any more information on how this, or acupuncture, could help you.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Rheumatoid Arthritis Awareness Week

nras-logoRheumatoid Arthritis (RA) Awareness Week 2019 takes place between June 17th and 23, and is an annual event to raise awareness of the condition. The event is run by the National Rheumatoid Arthritis Society (NRAS).

Physiotherapists are members of the multi-disciplinary team involved in the treatment and management of people with rheumatoid arthritis to help an individual achieve their short and long-term needs.

They work closely with multi-disciplinary team colleagues, such as occupational therapists, podiatrists and orthotists, and will refer you to them when necessary.

When will you see a physiotherapist?

Physiotherapists have a key role throughout the course of the disease. The extent of their involvement will vary throughout that time, dependent upon the individual’s needs.

What physiotherapy can offer an individual with Rheumatoid Arthritis:

After diagnosis they will offer education and advice, which is likely to include information regarding how to recognise and manage a flare, when to rest and when to exercise, and advice on how to modify activities to reduce pain and maintain/ improve function. People with rheumatoid arthritis often find that their joints become stiff and muscles become weak and therefore carrying out normal daily activities, such as getting up and down the stairs or in and out of a chair, can become hard. Physiotherapists can help by teaching mobility and strengthening exercises to increase movement and strength allowing better function.

Why exercise is important

exercise

Exercise is important as part of a healthy lifestyle to maintain fitness, control weight, maintain joint range of movement, improve muscle strength and endurance and improve mental wellbeing maintaining joint range of movement, strengthening muscle and increasing endurance.

A Physiotherapist is a specialist in advising on exercise. It is important to find a safe way of exercising that the individual enjoys and will be able to continue in the future.

Further reading:

anyoneanyage

 

lisa

Lisa
x

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

 

 

Stretching – why is it so important?

It’s the one thing we should all do before and after exercise but the one phase everyone tends to skip… I think maybe because it’s boring, we are always pushed for time and it’s not perceived as being that important.

Stretching is so important at the start of a work out, as it gives your muscles the opportunity to warm up and become more elastic, which means you will be able to perform better when you start your main set or workout.

Stretching will help prevent injury as cold muscles are more likely to be torn or strained. It is always best to start your work out with 5 minutes of cardio of your choice then dynamic stretching – stretching while moving as it will help increase blood flow and muscle temperature.

At the end of the workout your muscles will be warm and maybe sore depending on what you have been doing.

pippa-2a

There are many reasons why you should stretch after exercising:

  • It will help maintain elasticity within the muscles, improve strength and keep them healthy. This is so important to keep the flexibility up as it will help in turn with joint movement which will have an impact on your overall performance of working out and everyday life activities.
  • When your muscles are warm and you hold a stretch for longer, 45 seconds it will improve the elasticity of that muscle making you more flexible.
  • Decrease the risk of injury
  • Enable your muscles to work more effectively
  • Help keep a healthy body and mind. Stretching can also be really relaxing and help your mind switch off, decreasing stress.
  • It helps relieve the stress on muscles after a hard work out, your muscles can often get tight and stiff, stretching will slow down the process of aches and pains.
  • It can help improve your posture, stretching your lower back, shoulders and chest will help keep your body in better alignment.
  • Reduces lower back, better flexibility in your hamstrings, hip flexors and other muscles around your pelvis helps relieve stress on the lower lumber. This is especially good for those who have desk jobs.

pippaHappy Stretching!

Pippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

Don’t be scared of eating good fats…..

Good fat is found in foods like:

  • Seeds
  • Avocados
  • Seafood
  • Oils
  • Meat
  • Fish
  • Nuts

Why you ask?

  1. Good fat helps you from overeating because it tells your brain to stop eating
  2. Fat slows the rate at which sugar hits your bloodstream, and this allows your blood sugar levels to remain steady
  3. Most importantly, keeping your hunger and cravings at bay

More information & health advice:

kerry-gym-managerHappy, healthy eating Buddies!
Kerry
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Kerry
Personal Trainer & Group Gym Manager

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