Insult to Injury: Why You Haven’t Made A Full Recovery

Insult to Injury: Why You Haven’t Made A Full Recovery

Insult to Injury: Why You Haven’t Made A Full Recovery

 

        If you are a runner, fitness enthusiast, weekend warrior, or weightlifter then chances are that you have dealt with an injury at some point. You may very well be dealing with an injury right now and are unsure of how to overcome it. Unfortunately the sequence of events below is all too common and leaves you frustrated and concerned on whether or not you’ll be able to get back to your favorite routine. The typical sequence of events from injury to recovery looks like this:

  1. Injury Occurs
  2. Injury is rested for some time
  3. Athlete, runner, fitness enthusiast tries to return back but the pain is still there.
  4. Multiple doctor visits with frustration and no answers (or no plan on how to recover properly)
  5. Maybe even some Google or YouTube advice
  6. Frustration sets in even more with concern on how you will get back to your favorite activity whether it be running, exercising, weight lifting, or your favorite fitness class.

     Sound familiar at all? Whether you are on step 1 from above or step 3 the important thing to consider is WHY you haven’t made the full recovery yet. There are some very common reasons as to why the body has not fulled healed and the pain from injury remains which I will discuss below.

 1.Wrong Diagnosis

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              I’ve heard it a lot in my clinic. “I went to see a PT already but didn’t get better”, “I saw an orthopedist but I am still in pain”, “I already have been to see a Chiropractor but I only got minimal relief”. One common theme with these statements is that the person sought out help but was left disappointed when the treatment they received did not FIX their issue.  One question I always ask is ” What did they THINK the problem was” and unfortunately the answer I often get is “Well they weren’t really sure what the issue was” or “I was never given a clear diagnosis”.  That is MAJOR problem. Before fixing any injury (which essentially is providing the right healing environment for the body) you must figure out what is actually causing the issue to begin with (“the root cause”). Most injuries occur because of some sort of deficit or imbalance in the body. It is vital to go through a proper assessment to determine what the “cause” of the injury actually is. Once the true root cause of the condition is found proper treatment can be given. If treatment is given without this assessment and without identifying risk factors then you will not get the results that you desire.

2.Wrong Treatment

          Far too often I hear patients tell me stories about how they were given generic exercises (aka “cookie cutter approach”)  that did not work for them. They invested a good amount of time and money but weren’t given the tailored approach that their body needed for them to heal. Each person who deals with an injury should be treated according to their SPECIFIC needs. For instance not all knee pain should be treated with the same exercises and stretches. Treatment depends on #1 the diagnosis (see above). Even then after the correct diagnosis is given the treatment can vary depending on what stage of injury the person is currently at ( i.e very beginning, middle, end stage, chronic). Think about it this way. If you have a small leak in the roof then you get the roofing company to come out and diagnose the issue quickly right? They provide the immediate easy solution and the leak is fixed. However what if you let that leak linger and it becomes bigger? Does the issue become more complex? Maybe it starts to involve other parts of your home? The point is that the simple leak that is found quickly is treated much more differently than the  leak that has “been there for a while and is starting to cause more issues”. The same concept can be applied to an injury. Some key things to consider when resolving an injury is:

  1. What stage (early, middle, late) of healing are you currently at (your healthcare provider should be able to tell you this)
  2. What can you do to provide an optimal healing environment (i.e specific exercises, activity modification)

3.Wrong Healing Environment

          An optimal healing environment is CRUCIAL to overcoming injury. It is often one of the most overlooked factors that can help get you back to running, surfing, exercising, or playing your favorite sport.  Below are some of the factors that are involved in having the optimal healing environment for your injury:

Sleep

        Sleep is very important to allow for healing. During sleep our body takes the time to repair and remodel any damage that has occurred. In order for an injury to heal properly the appropriate amount of rest must take place. If you are waking up tired and find yourself needing that caffeine pick up in the early afternoon you likely are not getting the appropriate amount of sleep for optimal recovery.

Exercise

        Its likely that your injury has kept you from being able to exercise to the full extent. Yes, you may not be able to do a lot of your favorite exercises but it would be beneficial for you to find other avenues. For example if you love running but your knee hurts then try biking. If you have a hip injury that only hurts during squats and box jumps then skip those during your next workout (just do everything else that doesn’t cause your hip to hurt). Point being that its important to stay as ACTIVE as possible when dealing with any injury. It will help your mood and keep your moving towards your goal.

Diet

       This is another factor that is also overlooked. What kind of food have you been eating? The body relies on good nutrients to perform optimally. Take a good look at what you eat and drink then ask yourself if you think its beneficial or detrimental for you. Get your diet right so your body can make the best use of those nutrients it needs to heal.

Stress/Mood

       Keeping a positive mindset is crucial to recovery. There are so many psychological aspects that are overlooked when recovering from injury. People often fear the worst “What if this doesn’t work?”, “I guess I’ll have to live with this for the rest of my life”, “Nothing seems to work for me”. All of these negative thoughts WILL affect recovery. If you don’t think something will work or you are constantly worried you are wasting your time then it’s likely that you won’t put the effort in to reach your goals.  The stress of life can also affect our ability to stay focused and that is why being in a supportive environment is very important.

       If you are dealing with an injury and have not recovered the way you expected then consider what has been mentioned above. The most common reasons runners, fitness, enthusiasts, and weekend warriors are kept from doing what they love is because of the issues discussed in this article. There’s so much confusion out there about what to do or who to see and that can make the whole situation even more frustrating!  Click Here For a Free Injury Phone Consult if you are struggling and are not sure what to do. We’ll have an open and honest conversation about what you are struggling with and what the best step for you to take is. Here’s to happy and healthy healing!

 

 

 

Why does your low back pain keep coming back?

Why does your low back pain keep coming back?

Reoccurring Low Back Pain            

Low back pain will affect roughly 80% of the population at some point in their lives. A common problem that people have is that their back pain comes and goes. They go through periods of having no pain and then all of a sudden their back can “go out” causing a lot of pain and inability to move well.  Usually, these episodes of low back pain last for several weeks and the person gets better. However a few months later the SAME low back pain returns. This leaves people frustrated with low back pain that doesn’t ever seem to fully resolve. Watch the video to learn more about low back pain flare-ups and what to do about it.

How to Sit Longer WITHOUT Back Pain and Sciatica

How to Sit Longer WITHOUT Back Pain and Sciatica

How to Sit Longer WITHOUT Back Pain and Sciatica

Low back pain and sciatica can often keep you from sitting comfortably. It can cause pain during long car rides or while sitting at work. The different positions and postures we sit in during the day have a great effect on low back pain and sciatica. There are certain sitting positions that can help relieve your pain. However, there are also positions and postures that can aggravate your sciatica and low back pain. Learn how to fix sciatica and back pain in sitting below!

What is sciatica?

Sciatica” is the term used to refer to pain caused by irritation of the sciatic nerve. The sciatic nerve happens to be the largest nerve in the body (It is actually a bundle of nerves). It is comprised of several different nerves that branches off the spinal cord in our low back. This nerve then travels down the back of our leg and splits into two nerves around the back of the knee and goes into the foot. This is why when people have “pain in their leg” it can be a bit confusing because while the pain is felt in the hip, leg, or foot region it can actually be coming from the back. For a little more information about nerves and what they do you can refer to this article here (Signs of a Pinched Nerve).

sciatica

What are the signs and symptoms of sciatica?

There are several signs and symptoms to be aware of when determining whether or not you have sciatica. Some of the more common include:

  1. Pain, numbness, or tingling that goes down your leg (it can be just in the upper leg or go all the way down into the foot)
  2. Pain in the back, hip or leg with long periods of sitting
  3. Pain in the back/leg when bending forward to pick up objections.
  4. Radiating or sharp pain into buttock/hip region

What can cause sciatica?

Sciatica can arise from several different causes. It is important to understand what is causing your sciatica and to understand that the majority of the time the pain is originating from your low back. Even if you just have some mild low back pain or stiffness it can still be the cause of your sciatica pain. Many people will get confused with this because often times the sciatica pain down the leg can be more severe than some of the back pain that they may be experiencing. A history of back pain before a bout of sciatica can also help indicate where the root cause of the pain is coming from.

Below are some of the common causes of sciatica.

  1. A Herniated or bulging disc is the most common cause of sciatica. This occurs in the age range typically 50 yrs and younger. Some of the common symptoms include pain down the leg when sitting in a slouched posture, pain when bending forward, and relief when getting up to walk around. If the sciatica is caused by a herniated disc it is very important to pay attention to sitting posture which I will discuss later in this article.
  2. Stenosis is a condition which affects the 50 yr and older population. This causes sciatica down the leg during standing and walking activities . Stenosis occurs when the holes where the nerve exit the spine encroach upon the nerve causing irritation. Typically sitting down will help relieve this condition.
  3. Degenerative disc disease. As we get older our discs loose some of the cushion that they naturally have in our younger years. This can lead to changes in the ability to move our back through natural motions. Once we have lost the ability to move through a natural arc of motion we can start to impose an effect on our back and it’s surrounding structures including the nerves. When a loss of motion occurs the sciatic nerve is unable to move a freely as before causing sciatica symptoms down the leg.

What steps need to be taken if back pain and sciatica is making it difficult to sit?

The first step that needs to be taken is to identify which sitting posture gives you the “most relief”. This is not to say that your pain will completely go away but you will need to find the “position of most relief” in order to take some of the bite off the pain. Here are three different sitting postures you can try out.

You will need to ask yourself several questions when you are sitting in these postures.

  1. A. Does my pain increase or decrease?
  2. B. Do the symptoms in my leg/hip become less noticeable or more?
  3. C. Does my back pain increase?

1.Sitting slouched. This posture typically brings about the most pain in sitting. HOWEVER in a rare occasion you may actually get relief from the sciatica when doing this which is why I am discussing it now. All you need to do is slumped down in your chair so that your low back presses against the back rest.

2.Sitting in an extended upright position. The majority of people will get relief when sitting in this position. From a slouched position you will rock your hips forward. This will cause your back to straighten and you will immediately sit up taller. Keep moving forward and stick your bottom out so that you now have a backward bend in your back. (Think sitting with an extreme lumbar support in your back). You may also roll up a towel and place it behind your back so that you can hold this position.
sciatica

3.Sitting in a neutral position. The first two sitting postures we went over are on the ends of extreme. One causes you to slouch to the extreme and the other to arch up to the extreme. The third posture involves sitting in a more “neutral position”. As you rock back and forth from a slouched posture to and upright posture stop mid way. You should feel your tummy tighten and have the sensation that you are “holding yourself in place”. This is the neutral spine position.

 

Watch this video that discusses the different sitting postures that you should be aware of and how to closely find the position of relief.

 

Aside from finding the position of most relief for you in sitting it is important to perform micro stretches. This allows for pressure to be taken off the nerve and can reduce the sciatic pain. If you have the option for a standing desk you may want to switch over to standing instead of sitting for the majority of your day at work. Taking a short “walking break” every 30 minutes to 1 hour from sitting can also be beneficial as it can help loosen up a stiff back or hips which is often accompanied by sciatica. More stretches and exercises are talked about in detail here.

Keep in mind that these are some of the beginning steps to ending your sciatica pain. It is not just about one magic exercise or stretch to fix the issue but also about changing your movement patterns and postures throughout the day. Being aware of how you sit and move during the day will be one of the first steps you need to take in order to allow for proper healing!

If you would like more information on Back Pain the get our Free Report on Back Pain ” 7 Simple Steps to Naturally End Your Back Pain (and Stiffness) Without Needing Medications, Injections, or Surgery!”

Click Here to Get This Free Report

 

Top 3 Causes of Low Back Pain and Sciatica

Top 3 Causes of Low Back Pain and Sciatica

Top 3 Causes of Low Back Pain and Sciatica

Low back pain and sciatica can be a painful and debilitating condition. In order to get lasting relief from your pain, you must determine what is causing your low back pain and sciatica. Some of the common causes include herniated disc, bulging disc, stenosis, arthritis, and an SI Joint problem. Watch this video below to learn more about what might be causing your low back pain and sciatica.

How Should You Handle Your Low Back Pain?

How Should You Handle Your Low Back Pain?

Take Care of Your Back Throughout the Day

 

You floss and brush your teeth for good oral hygiene. Your goal is to prevent disease, delay decay, and help avoid expensive dental procedures that neglecting your mouth health might bring about.  By performing this daily maintenance routine, you ensure that you do not run into any future issues with your gums and teeth. This helps avoid costly dental bills. You also take good care of your skin by applying sunscreen to help prevent damage to your skin cells and any further medical issues down the line. So what are you doing for your spine? Are you practicing good spine health techniques to help limit your discomfort and pain? Do you perform “routine” exercises to help improve spinal mobility and muscle performance? There are several techniques you can perform throughout the day to help ensure good spine health. Best of all, these techniques do not require any fancy equipment or expensive products.

1. Engage your spinal stabilizing muscles.

Often times when people hear this they think of participating in Pilates, getting in a plank position, or performing some sort of rigorous workout targeting core muscles. While there is nothing wrong with partaking in these tasks, they are not always readily available or easy to do throughout the day. There are simple techniques you can do often throughout the day without anybody really noticing. First, sit towards the edge of your chair. Pretend there is a string on the top of the back of your head that is pulling you toward the ceiling. You should feel your stomach tighten a little. You should also have the sensation that you are “holding” yourself in place. Congratulations, you are now in a neutral spine alignment and relying on your “muscles” to do their job and support your spine.  You will want to hold this position for at least 10 seconds. Perform at least 4 times an hour. (The recliner and couch prevent us from keeping this alignment.) A                                                                                          B

Picture A demonstrates sitting without activation of the core muscles.

Picture A demonstrates sitting without activation of the core muscles.

Picture B demonstrates sitting with good activation of the core muscles in neutral alignment. 

Picture B demonstrates sitting with good activation of the core muscles in neutral alignment.

 

You can also perform this in standing when you walk. You will want to again pretend there is a string on the top of the back of your head that is pulling you toward the ceiling. You should feel your stomach tighten as if there is a “natural corset” surrounding your spine. This will help you engage those muscles when you are in more functional walking and standing positions.

2. Perform regular Low Back/Pelvic mobility exercises.

Sitting is often a position where a lot of back pain can be experienced. This can appear a lot with people who have a typical desk job or need to sit for extended periods of time. Try this technique out: Next time you are sitting down, try to perform pelvic rocking periodically to keep the spine nice and mobile. (It will often stiffen up after sitting for a while.) Follow these steps to perform a correct and safe pelvic rocking.

  1. When you are sitting down, slowly rock your hips back so that your low back slouches a little. This will put you in a flexed posture.
  2. Next rock your hips forward so that you begin to arch your low back. You will now feel that you are bending your back backwards.
  3. Now rock back and forth between these two motions in a slow and controlled manner.
  4. Note: If you have pain going into either of these positions you will need to stop just short of that pain in order to perform the movement in a comfortable pattern.
  5. Perform 15 repetitions each way several times a day as tolerated.

A                                                                                       B

Picture A demonstrates hips rocked forward with your spine slightly bent backwards.

Picture A demonstrates hips rocked forward with your spine slightly bent backwards.

Picture B demonstrates hips rocked backwards so that your back is slightly slouched.     

Picture B demonstrates hips rocked backwards so that your back is slightly slouched.

     

 

 

 

3. Standing Spine Stretch.

Often times people will focus on bending forward to stretch their spine, but is that what we should be doing? At times it will be necessary to do this, but for some conditions, the spine may prefer to bend backward more often than forwards.           Standing Spine Stretch, reduce low back pain

To perform a different kind of spine stretch, raise your hands above your head while they are locked together. Now reach your hands and arms high towards the ceiling. This should create a natural backward bend in your spine. The goal here is to not get too aggressive but to work out any stiffness that may be present. Hold this position for 10 seconds. Perform 1-2x an hour to take breaks from sitting.

If you have back pain that makes it difficult to sit, stand, or participate in the activities you love, then you may want to start putting a little more attention on your “spine health”. Much like maintaining good healthy habits for our teeth and gums to prevent any disease, we should also be focusing on a nice healthy spine regiment throughout the day. This will help you to feel less pain and stiffness while gaining more confidence about your back throughout the day.

Is It Ok To Feel Pain When Exercising?

Is It Ok To Feel Pain When Exercising?

Is Pain Ok During Exercise When Rehabbing An Injury?

Is It Ok To Feel Pain When Exercising? When enough is enough and how to tell when.So you’ve had back pain for quite some time and aren’t sure what to do. You’ve been dealing with it for months, or maybe even years, and it has kept you from enjoying the activities you love. You may have tried several treatments to improve your condition, but at times it seems difficult to understand your body and know if what you are doing is safe and good for you. Your doctor may have said you need more exercise, but exercise hurts and you aren’t sure where to start. Many people will begin an exercise program but stop short of completing it due to the increase in pain they feel either during or after it. There are several approaches to managing our pain, but first, we must understand what our body is telling us before we get any relief. Knowledge is important to reduce pain and fear.

“No Pain No Gain”

Often times people will begin an exercise regiment with the concept of  “no pain no gain”, thinking that if they push through the pain that it will go away. In reality what they find out is that their body cannot tolerate the amount of stress and load they are placing on it. In this approach, the person will push through the pain barrier. This pain barrier is present to protect our bodies. With multiple tries at this approach to make their pain go away, they will become overwhelmed with the failure and give up on exercise altogether because “it didn’t work”.  This will lead to further avoidance of activity. Example: You begin a walking program in hopes to improve blood flow and decrease stress. However, you walk too long to begin with (depending on your tolerance it could be 5 minutes or 20 minutes).  You then experience immense pain when you come home and cannot do any of your regular household chores. To no avail, you try again but with the same result, each time flaring up your condition with no improvement.

“If It Hurts Don’t Do It”

This approach will do more harm than good and can be characterized by avoiding any meaningful activity or exercise that can be beneficial to the body. It is often accompanied by fear, anxiety, and uncertainty about what might happen if “too much” activity occurs. You will become hypersensitive about any movements you perform and in turn, avoid the very movements that can help reduce your pain. Tolerance to activity and movements will decrease, limiting exercise and movement. But the key is that the body and tissues need to be stressed a little so they can adapt over time, which will allow for high tolerance for certain activities. Example: Having experienced pain during walking you decide that this exercise is bad for you and you may be fearful that it will continue to harm you.  However, this will not improve your body’s ability to perform certain activities and will decondition it further.

“Tease It, Touch It, Nudge It”

What does this entail you might ask? This approach is the happy medium between the prior two approaches. “No pain no gain” is too aggressive and “If it hurts don’t do it” is too passive. “Tease it, touch it, nudge it” lies in the middle of the prior approaches. It entails performing a specific exercise or certain tasks into a little discomfort. There will be some soreness and maybe an ache here or there, but this is necessary for the body to adapt to new thresholds of activity. Over time, as the task or exercise is performed, the body adapts to new activity levels. This will allow you to perform the exercise for longer periods of time or at heavier loads. You have successfully gradually improved your ability to perform tasks with less pain and at longer durations. Example: You decide to begin a walking regiment. Your first walk can last 6 minutes or whenever you start to feel some aching/soreness in your low back. You decide to not push through into further pain. That afternoon you have a noticeable soreness in your back as if “you have definitely worked it a little bit” but it doesn’t keep you from carrying on your chores and work for the day. This soreness or slight increase in pain would be a normal response to an appropriate amount of exercise. So do not fret if this is what you feel. You progressively add a minute to your walk and slowly build up your activity tolerance so that you can now walk 15 minutes without any pain. When dealing with pain it can be difficult to know what will benefit you and what will keep you in a state of persistent pain. Some important ideas to remember include: “hurt does not always equal harm” and “soreness is ok”.  In other words, you want to exercise, but not in the “no pain no gain” range and not in the “if it hurts don’t do it” range. Instead, your body will need a certain dosing of exercise all the while respecting the body and your pain. This will allow for you to begin tolerating other activities in your life that are normally painful. So the next time someone tells you “You just need to exercise”, they better have a good suggestion on what type of exercise will benefit you most!