David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Tuesday, June 18, 2013

GOOD BACKS GONE BAD

Muscle imbalances are another cause for persistent back pain. A sore or tight muscle sends a signal to opposing muscles to relax even when they are supposed to contract for movement, resulting in overuse strain of related muscle groups. This pattern of reciprocal inhibition can be reversed by stretching the tight muscles immediately before retraining the inhibited ones.




DOCTOR'S NOTE: Seek evaluation by a health professional if your back pain is associated with fatigue, weight loss, fever, arm or leg weakness, or incontinence, which are symptoms of more serious causes of persistent back pain.




LOWER BACK RETRAINING

Stretching left flexors and right extensors
(WVSOM)

1. Stretch the tight hip flexor and opposite hip extensor:
  1. Lie on your back with one leg hanging off the end of the bed or table;
  2. Pull the other knee toward the chest as far as it will comfortably go;
  3. Let the foot of the leg hang down as far as it can comfortably go;
  4. Take a few deep breaths and stretch for 10-20 seconds;
  5. Repeat for the other side.

2. Contract the inhibited hip extensors:

    Contracting right hip extensors (WVSOM)
  1. Lie on your stomach with the legs straight and toes pointing downward;
  2. Slowly lift one leg 3-6 inches, hold it there 5-10 seconds, and slowly return it to the floor;
  3. Repeat this leg lift and drop 5-10 times;
  4. Repeat for the other leg.

3. Repeat this sequence of stretch and contraction daily and before other exercises.





 
 
UPPER BACK RETRAINING
Upper trapezius stretch
(WVSOM)

1. Stretch the tight upper shoulder muscles:

  1. Hold onto the chair with one hand and hold the top of the head with the other hand;
  2. Allow the head to slowly fall to the side as far as it will comfortably go, letting the weight of the arm move the head;
  3. Take a few deep breaths and stretch for 10-20 seconds;
  4. Repeat to the other side.








Right pectoralis stretch
(WVSOM)

 
2. Stretch the opposite chest muscles:
  1. Stand with your shoulder and hip against a wall;
  2. Place the arm that is against the wall straight behind you, with the hand facing the wall;
  3. Push your other hand into the wall in front of you to turn the chest away from the wall;
  4. Take a few deep breaths and stretch for 10-20 seconds;
  5. Repeat for the other side.







Right trapezius contraction (WVSOM)
3. Contract the inhibited lower shoulder muscles:
  1. Lie on your stomach with the arm straight out to the side;
  2. Turn the hand to point the thumb upward;
  3. With the arm straight, slowly lift the hand 3-6 inches, hold it there 5-10 seconds, and slowly return it to the floor;
  4. Repeat this arm lift and drop 5-10 times;
  5. Repeat for the other arm.




4. Repeat this sequence of stretch and contraction daily and before other exercises.


Tuesday, June 11, 2013

WHEN SWAY BACK SWAYS BACK

A common cause of chronic back pain is increased lumbar lordosis, otherwise known as sway back. What's cute in teen years often causes pain in the back muscles and ligaments when abdominal muscles become weak after prolonged inactivity, pregnancy, abdominal surgery, or aging. The resulting hyperlordosis upon standing will stretch the iliolumbar ligaments, strain the paraspinal muscles, and compress the spinal joints. In other words, OUCH!

Abdominal strengthening is the key to reducing hyperlordosis pain because the front muscles help to support a straighter spine. These exercises can be painful for an already sore back so it's better to begin with a little relief. First use the LUMBAR POSITION OF EASE to reduce back pain and the PELVIC TILT to gently stretch the back muscles before proceeding to this abdominal strengthening routine.




DOCTOR'S NOTE: Seek evaluation by a health professional if you have leg weakness or incontinence because sway back (hyperlordosis) can cause pressure on the spinal cord, resulting in these symptoms.



ABDOMINAL CURL

Midline abdominal curl (WVSOM)

  1. Lie on your back with knees bent, feet on the floor, and arms crossed;
  2. Slowly lift your head and shoulders until the head is 3-6 inches from the floor;
  3. Hold your head and shoulders in this position for 20 seconds, return to the floor, and rest for 5-10 seconds;
  4. Repeat this head and shoulder lift by reaching your right elbow toward the left hip for 20 seconds, return to floor, and rest for 5-10 seconds;
  5. Repeat by reaching your left elbow toward the right hip for 20 seconds, return to the floor, and rest for 10-20 seconds;
  6. Repeat the midline, left, and right abdominal curls 3 times. If the third time is easy, increase the holding time 10-20 seconds in the next session;
  7. Do this abdominal curl every other day;
  8. Add the SUPINE LIMB LIFT when low back pain is no longer present.


SUPINE LIMB LIFT

Supine limb lift (WVSOM)
  1. Lie on your back with legs straight, toes pointing downward, and arms straightened above your head;
  2. Tighten your buttocks and slowly lift the legs, arms, and head until your hands and feet are 3-6 inches from the floor;
  3. Hold your legs, arms, and head in this position for 30 seconds, return to the floor, and rest 5-10 seconds;
  4. Repeat 3 times. If the third time is easy, increase the holding time 10 seconds in the next session;
  5. Do this supine limb lift every other day.