How do you prevent low-back pain?

Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Most occurrences of low back pain tend to go away within a few days. However by strengthening your core, improving your posture and increasing your daily exercise you could prevent it from happening at all.

Back pain is a common condition—affecting 8 out of 10 people at some point in their lives. - Josephine P. Briggs, M.D.

What is my "core"?

Your core is made up by the muscles found at the obliques, abdominals, lower back, and the glutes. They are essentially the powerhouse of the body and make up the areas that frame the posture of a person. Hence, a good posture reflects the good condition of these muscle areas.

Why should I strengthen my core?

Strengthening your core muscles has many benefits, some of which directly effect pain management, increase range of motion and increase quality of life. Since having a strong core is critical for decreasing the amount of pressure that gets placed on the lower back and abdomen, performing various exercises that are targeted to increase their strength makes sense.

What’s the best way to sit?

Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure, sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
- See more at: http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=1398#sthash.pJm6oMxU.dpuf

What’s the best way to sit?

Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure, sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
- See more at: http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=1398#sthash.pJm6oMxU.dpuf

What’s the best way to sit?

Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure, sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
- See more at: http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=1398#sthash.pJm6oMxU.dpuf

What's the best way to sit?

Office work often results in poor posture and strain to the lower back. Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure:

• Sit in ergonomically designed chairs or those with low back support.
• Be aware of your posture throughout the day and make adjustments to correct it.
• Take regular breaks from sitting at your desk to stretch and move around.

What’s the best way to sit?

Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure, sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
- See more at: http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=1398#sthash.pJm6oMxU.dpuf

What’s the best way to sit?

Sitting puts more pressure on your back than any other position, even more than standing. To reduce this pressure, sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
- See more at: http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=1398#sthash.pJm6oMxU.dpuf

Since low back pain can be caused by various injuries to the spine, it is advisable to see a practitioner who specializes in back pain prior to beginning any exercise program. After seeking professional advice, try not to let low back pain prevent you from light to moderate exercise. While it can cause some pain in the beginning, it can reduce your pain in the long run. Common activities include walking, hiking, yoga, and Pilates.

Targeted exercises, as mentioned above, lead by a physiotherapist or strength trainer would have the most benefit for long term prevention. The best strategies for treating or preventing low back are to aim to keep your core strong, your posture straight and include some regular physical activity.

References from the SIRC Collection:

1. CATANZARO J. Posture Improvement Through Strength Training. Fitness Business Canada. January 2014;15(1):30-32.
2. de Sousa P, Silva M, de Lima-Pardini A, Teixeira L. Resistance Strength Training's Effects on Late Components of Postural Responses in the Elderly. Journal Of Aging & Physical Activity. April 2013;21(2):208-221.
3. Han C, Wang W, Cheng B, Liu S. Basic Issues of the Core Strength Training: The Core Area and Core Stability. Journal Of Tianjin Institute Of Sport / Tianjin Tiyu Xueyuan Xuebao. March 2012;27(2):117-120
4. McKean M. Understanding the role of strength training. Australian Pistol Shooter's Bulletin. December 2012;19(3):6-9.
5. Strength Training Best for Reducing Back Pain. IDEA Fitness Journal. May 2009;6(5):12. 
6. Worobey S, La Rosa Loud R, Westcott W. Strength training for posture: put your clients on a regular program of strength and stretching exercises to improve posture and reduce back pain, both of which are often a cause of muscle weakness. Fitness Management. June 2002;18(7):46;48-49.
7. Yu J, Lee G. Effect of core stability training using pilates on lower extremity muscle strength and postural stability in healthy subjects. Isokinetics & Exercise Science. June 2012;20(2):141-146.

Getting the right fit for your bike

Whether you are an elite cyclist in the Tour de France or a recreational rider, you and your bike should fit well together. Ensuring your bike fits you properly will increase your performance, improve cycling economy and will minimize injury or discomfort.

Getting your bike set up properly can be a challenging task, where the most important principle to remember is comfort. If you are not comfortable, it will make it more difficult to ride for long distances, make you prone to injury and ultimately reduce your enjoyment of the whole experience. A good bike fit is essential for good posture, coordination, flexibility and strength, so we've provided a check list to get you started:

1. Frame Size - A simplified method to follow is approximately 2.5-5cm clearance between the crotch and the top of the frame.
2. Reach or Posture Length - This is the distance from the back of the saddle to the handle bars. It's important to remember that full arm length and torso length needs to be considered at this point. The back and neck should be in a relaxed position - if the posture is too short, it will place more strain on the lower back.
3. Saddle Height - A basic formula to calculate saddle height is the heel method. The cyclist should be sitting on the bike in a normal riding position, rotate the pedal backwards, unclip and place the heel flat on the pedal.  Correct saddle height is the point that the heel remains in contact with the pedal at the bottom of the pedal stroke.
4. Angle of Knee to Pedal - A suggested knee angle at dead-bottom-centre is 35 degrees while the foot is in the pedal position.
5. Handlebars - The position of the handlebars affects the comfort of your hands, shoulders, neck, back and the overall handling of the bike. For the recreational rider, the width of the handlebars should allow the hands to be slightly wider than the shoulders. For the road cyclist, hands should be approximately 2cm wider than the shoulders for comfort and optimum handling of the bicycle.

Since a good bike fit involves so many factors it's recommended that cyclists go to a bike fit specialist before getting in the saddle. After your fitting, you may have to go back for some minor adjustments to get the most out of your bike.

References from the SIRC Collection: 

1. Finding the Right Bike Fit for You. PT: Magazine Of Physical Therapy. October 2, 2006;14:4-5.
2. How-to: Bike-Fit Assessments to Prevent Pain and Injury. PT: Magazine Of Physical Therapy. June 2, 2006;:3-4.
3. Ill-Fitting Bicycle May Increase Risk of Injury. PT: Magazine Of Physical Therapy. September 2004;12(9):78-80.
4. Lobby M. A PERFECT FIT. Triathlon Life. Fall2011 2011;14(4):70-71.
5. PRACTICAL GUIDE - BIKE SET-UP IN CYCLING. Sportex Medicine. July 2008;(37):8-9.
6. Schultz S, Gordon S. Recreational cyclists: The relationship between low back pain and training characteristics. International Journal Of Exercise Science. July 2010;3(3):79-85.
7. YOUR FIRST FEW MONTHS: FINE-TUNE THE FIT. Bicycling. April 2006;47(3):138.

Yoga and low back pain

Low back pain is one of the most common reasons for work absenteeism and the second most common complaint at doctor visits. It is generally caused by one of the following: repetitive incorrect lifting technique, degenerative or structural changes in the vertabrae, excessive sitting or standing, bending, twisting or falls. There is good news for low back pain sufferers, as there is a growing body of research that shows that yoga can be an effective treatment for people with chronic back problems.

What does yoga do for the body?

• Strengthen and stretches the muscles
• Provides stress relief
• Increases flexibility
• Improved coordination
• Good for overall health and fitness

While yoga may be good for overall back function, depending on the individual and the severity of the problem, it's important to note that yoga may not always alleviate the pain. Yoga classes were shown to be more beneficial than self care exercises or home videos. Performing yoga poses at home without the supervision of an instructor may prove to be a risky business if the poses are not done correctly.

Recent studies have shown that yoga combined with stretching can be a good, safe option for people who are willing to try physical activity to relieve moderate low back pain. Classes should be designed with a beginner in mind and taught by instructors that are able to modify postures for individual needs and or limitations. Before starting a new fitness regimen or class, please remember to contact your doctor or physiotherapist first to minimize risk of injury.

References from the SIRC Collection:

1. Archer S. YOGA HELPS MANAGE LOW-BACK PAIN. IDEA Fitness Journal. March 2012;9(3):69.
2. DeAvilla N. In the Classroom: Adapting Class for Students with Low Back Pain. Yoga Therapy In Practice. September 2005;1(1):7-9.
3. DAWSON-COOK S. STEERING CLEAR FROM A REAL PAIN IN THE BACK. American Fitness. May 2013;31(3):48-50.
4. Girdwain J, Mcgee K. Fix It with Fitness. Health (Time Inc.). May 2013;27(4):47.
5. HOWE D. Oh, My Aching Back. American Fitness. January 2011;29(1):54-55.
6. LARGEST U.S. STUDY SHOWS YOGA EASES BACK PAIN. American Fitness. March 2012;30(2):10.
7. Selfridge N. Yay Yoga! More Evidence for Helping Low Back Pain. Alternative Medicine Alert. March 2012;15(3):33-34.
8. Suffering from Low Back Pain? Maybe You Should Try Yoga. Tufts University Health & Nutrition Letter. February 2012;29(12):3.

Core Training - Not just for your abs!

We've all heard fitness experts claim that core training is important for overall fitness and health. Health clubs offer core training exercise groups and physio therapists recommend it for those recovering from injury. Your core is the collection of muscles that stabilize the spine, this includes the hips, pelvis, abdominals, lower back, mid-back, and neck regions of the body. These muscles are extremely important in all sports, so why do so many athletes overlook core training?

The reason most athletes skimp on this vital part of their workout is because the benefits are simply overlooked.

Benefits of core training:

• Develop better posture
• Decreases back pain
• Helps injury prevention and rehabilitation
• Increased flexibility
• Greater physical strength
• Improved respiration and lung capacity
• For seniors, it can help to improve balance, reduce injury, and maintain mobility

It's important to note that performing a few crunches is not proper core training. Since your core involves many different muscles groups, a variety of exercises are needed to ensure you work them all; some exercises to explore include, but are not limited to, lunges, bridges, planks, and crunches. Pilates and Yoga classes are also excellent for strengthening your core muscles while also improving balance and posture.

When your core is strong, your whole body works better. Core training isn't just for athletes, it's for anyone who would like to have their body working at its greatest potential. For anyone just starting an exercise program, be sure to talk to your family physician first.

References from the SIRC Collection:

1. Aggarwal A, Kumar S, Kumar D. EFFECT OF CORE STABILIZATION TRAINING ON THE LOWER BACK ENDURANCE IN RECREATIONALLY ACTIVE INDIVIDUALS. Journal Of Musculoskeletal Research. December 2010;13(4):167-176.
2. Han C, Wang W, Cheng B, Liu S. Basic Issues of the Core Strength Training: The Core Area and Core Stability. Journal Of Tianjin Institute Of Sport / Tianjin Tiyu Xueyuan Xuebao. March 2012;27(2):117-120.
3. LaRue L. Wave of the Fitness Future: 3-D CORE TRAINING. Volleyball. May 2011;22(4):26-29.
4. Nelson N. Diaphragmatic Breathing: The Foundation of Core Stability. Strength & Conditioning Journal (Lippincott Williams & Wilkins). October 2012;34(5):34-40.
5. Sudicky A. Core without the Crunches. Volleyball. April 2012;23(3):24-27.
6. Yu J, Lee G. Effect of core stability training using pilates on lower extremity muscle strength and postural stability in healthy subjects. Isokinetics & Exercise Science. June 2012;20(2):141-146.

Walking on pins and needles?

Nerves that get stuck and irritated by swollen muscles or ligaments can be a torment to athletes.  The ultimate goal for any athlete experiencing the pain of a pinched nerve is to alleviate any pain or discomfort you are feeling, all while working within your boundaries and keeping up a comfortable range of motion.  As an athlete it's important to know what to look for so you'll have a better chance of getting the proper treatment.

The symptoms of a pinched nerve are more intense than a mild soreness and athletes experiencing the pain of a pinched nerve will often complain that the area has:

• numbness
• tenderness to the touch
• pins and needles
• burning
• tingling
• an aching pain that won't go away

Common nerve injuries for athletes are Tarsal Tunnel Syndrome, Morton's Neuroma, and Piriformis Syndrome.  Depending on the severity, a pinched nerve can be treated a number of ways, such as supportive braces, anti-inflammatory drugs, injection therapy, massage, chiropractic manipulation, physical therapy and sometimes surgery.

Once diagnosed, a good practice along with the various treatments above, is to keep moving but at a minimal or modified level.  As soon as pain will allow, it is recommended that rehabilitation starts as soon as possible.  Take the time to review your exercise regimen, revise your fitness goals to accommodate your recovery and make sure you give yourself extra time for warm ups.  Focus on building up and stretching out core muscles like the chest, back, legs and abdominals. 

Most people that have nerve injuries will improve in time with rest, heat, limited activity and anti-inflammatory drugs.  The problem can reoccur but can be avoided if you apply the treatment methods mentioned above.  It's important to keep in mind that with all pain that lasts between 7-10 days and doesn't respond to self care measures, it's a good idea to consult a doctor or physiotherapist about possible treatments.

References from the SIRC Collection: 

1. Alshami A, Babri A, Souvlis T, Coppieters M. Strain in the Tibial and Plantar Nerves With Foot and Ankle Movements and the Influence of Adjacent Joint Positions. Journal Of Applied Biomechanics. November 2008;24(4):368-376.
2. Beare S. Pain in the Butt! Piriformis Syndrome. Sportsaider. 2004;20(4):9
3. Filley A. Piriformis syndrome: don't let it become a pain in the backside!. Peak Performance. June 15, 2009;(277):1-4.
4. Hariri S, McAdams T. Nerve Injuries About the Elbow. Clinics In Sports Medicine. October 2010;29(4):655-675.
5. Kinoshita M, Okuda r, Yasuda T, Abe M. Tarsal Tunnel Syndrome in Athletes. American Journal Of Sports Medicine. August 2006;34(8):1307-1312.
6. LeRoux M. FEELING THE PINCH. American Fitness. November 2006;24(6):32-33.

Yoga Poses and Meditation for back pain

Yoga- the ancient physical, mental and spiritual discipline - has been found to be a great intervention for chronic back pain. And many high level athletes use yoga as a part of their training and recovery programs. The physical stretches are the most helpful part of the recovery but let us not forgot that the mental aspect of the discipline is quite beneficial to recovery as well.

By holding a pose in yoga, our muscles strengthen. If you can hold it for about a minute and start to feel a burn you are strengthening your muscle. Yoga is a workout that reduces stress, increases flexibility and coordination.

Studies have found that sixty to ninety percent of adults will suffer from back pains. Outside the athletics world, we put our back through so much lifting, heaving, twisting and shoving in every-day life. Some of the numerous causes of back pains include: poor posture, excess body weight, herniated disc and degenerative disks to name a few. With all that work our backs are doing it’s not surprising that with 20 small intricate joints building our vertebrae, our backs are taking a beating. Add to that any athletic endeavor and it is obvious that we need to be mindful of our back health.

Although yoga is ideal for back pain recovery, simple stretching activities also work to help relieve the pain. The focus on mindfulness is what makes yoga differ from simple stretching. It calms the body and gives peace of mind. A large emphasis in yoga is good posture, which help counter the initial causes of the back pain. Before stretching your way into recovery, try asking a healthcare professional what works best for you.

Contact SIRC for more information on yoga!

Reference from the SIRC Collection: 
(2012) Suffering from Low Back Pain? Maybe You Should Try Yoga. Tufts University health & Nutrition Letter, 29(12), 3.

Online Resource:
Shepley Caron (2012). Yoga for Sports Performance: Why Yoga is an Athlete’s “Secret Weapon”. Presented at the 2012 Coaches of Ontario Conference. Retrieved from the Internet March 29, 2012.

Holingshead, Sue. Yoga for Sports Performance. Retrieved from IDEA Health & Fitness Association website March 29, 2012.