Three gym exercises to avoid with a bad back – Johns’ story
Written by Matthew Bennett Sunday, 24 November 2013 05:13
When John came to see me with a recurrence of his back problem he was really fed up. He had been going to the gym and doing the core stability exercises that he had been shown by the instructor. He had been exercising two or three times a week since his bad back had recovered 3 years before and he felt fit and strong. His back felt great too. He didn’t do anything to upset his old problem – it just came on. Unfortunately he had been doing the wrong back exercises. The exercises he had been doing actually contributed to his back pain.
The last time John’s back was bad all he needed was a short course of chiropractic care and he was fine again. He wanted to prevent his back getting bad again so decided to get fit. Usually this is a good idea. People who exercise regularly tend to get a lot less back ache.
John asked the instructors at the gym to put together a program with his back in mind. The program they came up with included a mix of upper and lower body exercises and abdominal exercises to help with core stability. The program relied heavily on machines to provide the weights and resistance – even for the abs. Here is the first problem.
Abs machines, the sort where you sit in them with straps or a bar across your chest, can aggravate back problems. Worst of all they aren’t that good at working your core stability muscles which are important for back strength. There are safer and more effective abdominal exercises that are easy to do – when you know how.
John was doing two other exercises that could also be irritating his low back. The first one was a deadlift. Deadlifts are one of the commonest reasons gym users end up at a chiropractors. Even when done well there is a risk of damaging the low back discs. When done badly they can destroy a healthy back.
The other exercise that concerned us was a leg press. In this exercise you sit in the machine, load up the weight and push a plate away from you with your feet. Because your leg muscles are so strong you can move large weights. Lifting your own body weight is not that unusual. Again this is a disaster for the back, not because of the weight itself but rather that your low back is flexed forward when you load it up.
If there is one thing the low back discs hate it is bending forward and then having a load applied as happens when you lift something. The reason has to do with the architecture of the disc itself. The disc consists of a tough outer wall with a jelly inside. Some have likened it to a doughnut but I prefer thinking of it like a toffee eclair. As you bend forward the toffee like core is forced backwards against the back wall of the disc. If you compress the disc in this position, as you do when you lift a weight or do a leg press, then the core or nucleus, exerts huge forces against the wall. This can cause the wall to crack.
Once that tough outer coat splits or cracks then pain can come on. The pain can last for a very long time and be intense. If the crack is big enough then the toffee can ooze out and press on the nerves causing sciatica. Because the disc is slow to heal the pain can become chronic.
The good news is that other exercises can easily strengthen the low back, allowing the discs to heal and help prevent further pain. In the second part of this article we will show you how to exercise safely at the gym and protect your back from harm.
Following criticism on Twitter by several physio’s of the piece above I thought it would be useful to provide the reference for the views expressed. Most of the work comes from an excellent book by Prof Stuart McGill Low Back Disorders – Evidenced Based Prevention and Rehabilitation published in 2007. In a 27 kg deadlift McGill found the compression and shear forces amounted to 7000N – enough to damage some weak spines.
On an anecdotal basis we regularly see people who claim to get back pain associated with certain gym exercises. Deadlifts are the commonest cause amongst these by a long way. In the case above, John was in a 1:1 training session with a gym instructor so can be assumed to be doing the exercise correctly. He still got injured and he felt the moment his back went on the deadlift.
There are other safer ways of exercising the muscles worked in a deadlift and we prefer to recommend these. There are some people who will benefit from deadlift training , especially if their work or play requires conditioning in these movements.
Picture credit: Adrian Valenzuela
Mind your posture – carers, care for your backs with a free check up
Written by Matthew Bennett Sunday, 6 October 2013 05:41
There are currently around 140,000 thousand carers in East and West Sussex with the figure set to rise to 180,000 by 2037. For many carers physical activity such as lifting is a significant part of their daily routine. However, not all carers will be aware of their back health when looking after someone.
Although paid carers may receive training on how to protect their backs during the physical aspects of their work, many unpaid carers, of which there are 5.8 million in England and Wales, may not receive any training or information about back care.
To coincide with Back Care Awareness Week (7 – 11 October) Sundial Clinics in Brighton is offering carers a free back check with advice on how to avoid back problems. Sundial Clinics have developed the following simple tips for all carers to help them whilst they’re helping others.
Golden rules for carers
- Think ahead – assess each situation and look for the best and easiest way to achieve the desired result, this may mean using any available equipment whether it be for specialist lifting or a simple sack barrow for moving boxes of supplies
- Follow the weight – always try and face the direction in which you want to carry any weight – your body is strongest when you are square on to the weight
- Take care when lifting - never lift while twisting from the waist. Bend your knees, try to have a relaxed, straight back and if possible, brace your abdominal muscles. For added stability make sure that your feet are about a shoulder width or more apart before lifting
- Ask for training – whether you are caring in a formal setting or helping someone at home, make sure you have been properly trained in how to use any equipment
- Supportive shoes are essential – wear good, soft-soled shoes that are supportive and have a good grip on the ground
- Take regular breaks – if doing a repetitive task, take a break every 20 minutes and do some simple stretches to relax your muscles.
Carers – Straighten Up
Matthew Bennett from Sundial comments: “Carers spend long periods of time on their feet and put a lot of strain on their bodies, from lifting and assisting the person they are caring for, to moving equipment. Even though our bodies are very well adapted to a variety of tasks, carers need to be particularly careful not to overload themselves and put their backs at risk.
“Formal care settings should have lifting and moving equipment available and staff should always make sure that they have been trained in the proper use of all equipment. Home carers should make sure they receive home assessments for the person they are caring for as equipment can be loaned out – this will require appropriate training for proper use.”
Matthew Bennett recommends a very simple three minute exercise routine entitled ‘Straighten Up UK’ from the British Chiropractic Association (BCA) has developed which is really easy to incorporate into daily life to help strengthen the spine and improve posture. The exercise routine can be accessed on the BCA website here: http://bit.ly/straightenup.
 According to data from the Office of National Statistics from the 2011 census
The hidden dangers of Christmas: Top Tips to avoid back pain
Written by Matthew Bennett Monday, 10 December 2012 04:43
Never mind the feeling of being more stuffed than the Christmas turkey there are other hidden dangers lurking around the Christmas tree. Turkey Lifters Back, Shoppers Shoulder, TV Remote Thumb may not be well known but they stalk the unwary festival reveler just the same.
Ok maybe some of those names are made up but Brighton chiropractor Matthew Bennett says “We do notice a marked increase in patients coming in with aches and pains directly related to the Christmas holidays. Probably the biggest increase is in back pain associated with spending more time doing very little. We sit around watching television, eating and drinking and sometimes even a fair bit of stress.”
Tree Mayhem for Backs
Bending and lifting awkwardly is well known to cause back pain. Lugging the Christmas in and trying to get it straight has its own hazard but also bending, stretching and twisting to put on the fairy lights and baubles start the strain. Add in traipsing around the shops buying gifts and bending over on the floor wrapping them up pile on the pressure on your back joints and muscles.
Turkey Lifters Back
Who would have thought that a turkey could be so menacing. The benign bird becomes 25lbs of sizzling danger when bending over to get it out of a hot oven. The other option of several manageable pre-sliced fillets somehow doesn’t conjure up the same feelings of festive cheer though.
No-one wants to be a killjoy but alcohol is a factor in many of the injuries we see. There is the obvious “PFO” (Pissed and Fell Over) to the more insidious pro-inflammatory effects of booze over several days. On the plus side there is a muscle relaxation effect of moderate alcohol intake but after 2 or 3 drinks this doesn’t work anymore.
Adrenal Stress and Back Pain
Loads of sugar can affect your back too amazingly. Sugar stimulates your adrenal glands amongst other things and this combined with alcohol, caffeine and stress can over-work your adrenal glands leading to adrenal fatigue. Not only can this leave you feeling very tired but your adrenal glands produce anti-inflammatory corticosteroids. Without this chemical any injury is likely to be more painful.
You made it into the afternoon on Christmas Day uninjured. You may have been working in the kitchen on your feet for hours and your back or shoulders may be tightening up but now it is time to relax. You slump down into the sofa and watch a bit of TV. It seems like you stay there until the end of Boxing Day and by the time it is all over you feel like your back is shouting.
Top Tips to Avoid Back Pain this Christmas
- Take regular breaks when doing housework or cooking
- Use a table rather than standing up for some food preparation like peeling spuds
- Get help lifting awkward items
- Bend over by going down on one knee when pick up light stuff
- Bend your knees and stick your bottom out when lifting heavy stuff
- Use a step ladder rather than stretching when putting up decorations
- Get out for a regular walk over the holidays
- If you don’t go for a walk, do some squats
- If you don’t do squats or go for a walk vary the seat you seat in, possibly putting a cushion in the small of your back
- Take it easy on the alcohol and sugar
We hope you don’t have need of us but be assured that if you do, we are here between Christmas and New Year.
Happy Christmas from us all at Sundial.Learn More
Does back pain increase as you get older?
Written by Sundial Clinics Wednesday, 12 September 2012 05:32
Back pain is one of the areas that we think gets worse as we get older but is this true? We often think that as we get older we will get more aches and pains. To find out researchers scoured all the research on the topic to see if a trend could be found. Brighton chiropractor, Matthew Bennett, sums up the latest research.
It is reasonable to assume that back pain, or lumbago as it sometimes called, will worse as we get older because of the accumulation of wear and tear, arthritis and general use and abuse. As we get older we tend to exercise less, pick up more injuries in falls and generally recover more slowly from trauma, especially in the back. In spite of this the studies over the last 10 years don’t show an increase in back ache beyond the age of 60. In fact, in some studies, back pain actually seemed to be less frequent over the age of 60 compared to the years leading up to 60.
Why doesn’t back pain get worse as we get older?
There are several theories why back pain does not get worse as we get older. It could be that the people in the research just happened to be born at a time when they were very fit and robust naturally. Computer games, television and dishwashers were not around 60 years ago so people were growing up then were less sedentary. This may be the answer. Only a study that follows a large number of people for the whole of their lives would tell and this has not been done yet.
Another theory is that we get more tolerant to pain as we get older; our pain threshold goes up perhaps. The most likely explanation seems to be, however, that we do less physically demanding activities in old age so we don’t injure our backs so much. There are not many rugby players, mountain bike riders or kick boxers over the age of 60! Also we tend to stop work around this time. So if work posture or activity, or even work stress is the factor that brings the back ache on then stopping work might help prevent future occurrences.
Here at Sundial the average age of our patients is 38. Central Brighton has a younger demographic than other parts of the country where the average age of patients with back pain is around 45. That is not to say we don’t get people in their 60’s and 70’s coming in – we do, but the peak age to get back pain is in the younger, early middle aged groups. We also treat a few teenages with back pain which brings the average down.
If you are getting back pain and want to see if chiropractic or physio treatment can help you then pop in for a free check. We can also advise on a few simple exercises that you can do at home to keep your back healthy and pain free.
Does back and neck pain become more common as you get older? A systematic literature review. Chiropractic & Manual Therapies 2012, 20:24
Further research on the prevalence of bone and joint problems in older people show all sorts of aches and pains do continue into old age. Women tend to get more pain than men.Learn More
Benefits of Rock Tape kinesiotaping, Brighton physio Quentin Guichard explains
Written by Sundial Clinics Wednesday, 22 August 2012 07:44
How does Rock Tape kinesiology taping work?
What does Rock Tape help?
This shows video shows Rock Tape being applied
Is there any proof that Rock Tape Works?
Back pain – what car is best?
Written by Sundial Clinics Tuesday, 14 August 2012 12:56
Previously, Brighton chiropractor Matthew Bennett, looked at what causes back pain in cars. As we saw, correct adjustment of your car seat will help. Seats are partly to blame but that is not the whole story. Poorly positioned pedals and steering wheels can make a bad problem worse.
So what is the ideal car for back sufferers?
Rule out small hatchbacks and super-minis. Their short wheelbase and often poor ride may well aggravate a bad back. Also rule out low slung sports cars with firm suspension even though sports seats can be very good. The ideal car must have all the usual car attributes of being reliable, economical and reasonably priced of course and for our purposes a high driving position is preferable.
So what car does all this? The Skoda Yeti. The Yeti wins our Sundial award for the best car to prevent back pain. The Yeti is slightly higher off the ground than a normal hatchback. It has a reasonable wheelbase and is available with 16 inch and 17 inch wheels. Avoid the 18 inch wheels though as there is not enough rubber to cushion the ride. It has large doors and is spacious inside. In fact it feels larger on the inside than it looks on the outside.
If it had been called the Skoda Tardis few would have complained. Following on with the Dr Who theme there was a monster called the Yeti in the 1968 version of the show. That Yeti lived in the London Underground. Now we have Boris.
The Yeti It also won the Auto Express Driver Power 2012 award for the best car as voted by 29,000 owners.
Taking the time and trouble to buy the right car in the first place may well prevent miles of driving misery. If in spite of setting the car seat up well you are still getting back pain then give us call so we can book you in for free check-up. We will see if you have an underlying issue with your back joints or muscles which can easily be sorted out.
Top tips to avoid back pain in the car
- Buy a bigger, high riding car.
- Adjust seat and steering wheel position to your frame.
- Avoid large wheels over 17 inches.
- Avoid firm suspension.
- Choose a car with seats with good side support and lumbar support.
- If you don’t have a lumbar support stick a rolled up towel or jumper in the small of your back.
- Avoid potholes (hard on British roads)
- On a long journey, take a break every hour, walk about and stretch.
Preventing Back Pain on Holiday and Chiropractor Treatment Abroad
Written by Sundial Clinics Tuesday, 17 July 2012 10:43
Back pain on holiday is very common. One of the biggest causes is lack of activity and an already stiff spine. Mobilising the spine and a few simple exercises are often enough to prevent back pain from spoiling your holiday.
In daily life we are often fairly active even if we work behind a desk. Travelling to work as well as getting up and moving around when we are there keeps us mobile. On a summer holiday however we may spend hours lying on a sun bed, sunbathing or reading. Sun beds are notorious for poor support for the back. The odd plop into the pool to cool off does little to help counter this.
At the end of a long and inactive day we tumble into bed where the back can be in for more punishment. Hotel beds are often unsupportive allowing your back to sag. Sometimes the bed is too hard and your back has to adapt to the mattress rather than the other way round. Back pain is the result.
What can you do to prevent back pain on holiday?
Your back is designed for movement and hates being still. First thing in the morning, before it is too hot, go for a half hour walk or swim to wake up your back muscles and mobilise the back joints that have stiffened up over night.
If you spend a lot time on a sun bed then vary your position frequently. Move to other furniture throughout the day so you are not on the sun bed for more than an hour at a time, less if you are getting back pain already. Changing to a chair every now and again can help a lot.
Through the day do these back exercises every couple of hours. The exercises will keep the back joints mobile and muscles supple.
Any other activities are also likely to help. If the resort has any aquarobics, fitness classes, yoga or Pilates then sign up and give it a go, your back will love you. More vigorous exercise like tennis, cycling and water sports can also help.
Hotel beds and back pain
Back pain is often caused by a poor mattress. If the bed is too hard putting a duvet under the bottom sheet can help soften it up a bit. It the mattress sags or is too soft then pulling it off the base and onto the floor may improve matters. If all else fails then complain and ask for different bed.
Treatment for back pain whilst abroad
If these tips are not helping enough then the most accessible help is likely to be a deep massage. Massage is widely available in resorts but it needs to be quite firm rather than gentle and relaxing for the most benefit for back pain.
For more serious back pain you would benefit from seeing a local chiropractor. To check for the nearest qualified chiropractor in Europe go here and for the rest of the world go here. If you have seen us before we can email your notes to the local chiropractor to help you get the best treatment. Here are some tips on choosing a good chiropractor.
Of course if you are on holiday in Brighton and want a local chiropactor, give us a call.
Pre-holiday chiropractic check-ups
If your spine is already a bit stiff before you travel you are much more likely to get pain whilst you are away. We recommend a pre-holiday check-up even if you are currently pain free. A bit of prevention can go a long way in keeping you pain-free.
7 Tips to Prevent Back Pain in Golfers
Written by Sundial Clinics Monday, 19 March 2012 12:20
Preventing back pain in golfers is easy with these tips. Brighton chiropractor, Matthew Bennett, shares the 7 essential tips. By following these simple rules your back will be pain free and your game can even improve.
Back pain in golfers is quite common. Four out of five will experience some back pain at some point and up to one in five will have pain now. Here’s how to make sure you are not one them:-
1 Don’t stretch beforehand
2 Get fit to play golf, don’t play golf to get fit
3 Strengthen trunk and shoulders muscles
4 Do flexibility exercises
5 Use brains not brawn
6 Wear orthotics if needed
7 Wear a hat
Golf is an un-natural activity. Evolution has not caught up with our leisure activities yet, otherwise golfers would have rubber spines and knees that bent in all directions. The twisting action whilst bending forwards can put large strains on the muscles and joints of the back and knees.
Tips to Prevent Back Pain in Golfers
1. Don’t stretch beforehand
Believe or not stretching before sport can actually decrease a golfers performance. Scientists think stretching may decrease the resting tone of a muscle making it less able to respond to sudden bursts of activity. In one study a group of sprinters who stretched before the timed run ran more slowly. Other studies have not conclusively shown that pre-sport stretching helps to prevent injuries. The benefits remain uncertain.
2. Get fit to play golf, don’t play golf to get fit
Whilst many of us play golf to improve our fitness we need to exercise in between trips to the golf club. Walking is obviously helpful but swimming can also be good as it works the shoulders as well. Other sports like tennis and badminton are great too.
3. Strengthen trunk and shoulders muscles to take the strain off the back
The core stability muscles have been getting a lot of good press recently. These deep trunk muscles in the abdomen and back provide support in the same way that a weight-lifters belt does but in a more flexible and dynamic way. You don’t need to go to Pilates classes in your best lycra though, simple abs exercise are good enough. If you want to get the best abs and back exercises get a gym ball and do sit-ups and back extension exercises on the ball instead. It works more quickly and tunes the muscles up more effectively. It’s fun too!
Shoulders and upper back muscle are often overlooked when it come to golf specific exercises. This may be because few of us relish the idea of lifting weights which can get boring very quickly. Instead try a flexi bar. These simple exercises will work on the strength, flexibility and control in the shoulders and back very quickly. Just a few minutes a day really does make a difference.
4. Do flexibility exercises to prevent back pain
Strength is nothing without flexibility in golf. The lower back joints are not designed to twist very much. If you have a stiff mid-back or hips this will place more strain on your lower back joints and discs increasing the chance of injury. If your shoulders are stiff you run the risk of Impingement Syndrome or other shoulder damage.
Yoga and Tai Chi are excellent at improving flexibility. If you don’t fancy classes try one-to-one sessions to be shown a few moves or try these.
5. Use brains not brawn
This tip will make the golf club pros happy. The cause of many strains whilst playing golf is incorrect technique. A few lessons and driving range sessions can lessen the load on your joints and muscles and relieve back pain in golfers. Over-hitting the ball for those last few yards can force a muscle or ligament that may be under strain already to finally give out and tear leading to the pain and inflammation which causes back pain.
6. Wear orthotics if needed
Orthotics can improve swing speed and improve distance research has shown, if you have even slight flattening of your feet arches (over-pronation). Interestingly many people are unaware of over-pronation as it can even happen in people with seemingly good arches whilst standing still. On the move, however, especially trying to swing a golf club at 100mph any minor defects can get emphasised.
7. Wear a hat
Of all the tips for golfers here, this is the most unusual. On a cold day you may get cold. If that happens your body decreases blood flow to your arms and legs to preserve what little heat you have in your blood for the essential internal organs. Muscles which you carefully warmed up (not stretched!) don’t get the oxygen and nutrients that they need and are more likely to pull. Wearing a hat keeps your core temperature up by slowing the heat loss out of your exposed head.
If you have any aches and pains that are causing problems with your golf or just want a preventative check-up then give us a call so we can make you an appointment to see one of our chiropractors or physio’s.Learn More
Bad Backs in Children
Written by Sundial Clinics Wednesday, 14 March 2012 01:16
Back pain in children is common. About half of school age children report back aches at some time. Poor school chairs are often to blame. In this video Matthew talks to BBC’s Newsround about the importance of good chairs at school.
If you would like your child to have a free spine check-up then please call us to book an appointment.Learn More
Getting bad backs better – slowly
Written by Sundial Clinics Tuesday, 28 February 2012 11:05
On bad backs Brighton chiropractor Matthew Bennett says “Lots of people come in to see us wanting a quick fix for their back pain. They may have had their back ache off and on for years. They may be out of shape physically, having done no meaningful exercise since school. They may be sitting 8 hours a day in a poor chair working at a stressful job. And they want us to get them better in a visit or two. We tell them honestly – it isn’t going to happen that way”.
We do get patients with a bad back better. Lots of patients. We get great results and they are really happy with our care when we ask them for feedback. One reason we get great results with back pain is we know that for most it is going to take a while.
Healing bad backs takes time
We know that unlocking stiff spinal joints takes about 6 to 8 weeks of regular care. We know that our rehabilitation exercises will not achieve their potential for 12 to 16 weeks. We know that we may have to use several different techniques to get people better. We may need to prescribe orthotics, a new chair, a new mattress or even a change in lifetstyle.
One thing we won’t do is tell you that it will be easy and you’ll be better in a visit a two.
When a bad back goes bad it very rarely happens instantly even if the pain come on instantly. Minor injuries over many months or even years cause damage to delicate spinal joints and muscles. This affects spinal joint movements and can cause weakness in other areas.
These niggles ease off in a few days and are forgotten. The niggles often become more frequent; they may hurt more than before and they take longer to go. Slowly the elastic tissues of the back stiffen up until the back cannot bend and twist normally and then PING! Acute and severe pain develops.
Of course it is true that every once and while someone crawls in to see us in agony and skips out all straightened up again but that is rare. Of the thousands of people we see each year we only see that sort of response in one or two. Usually these bad back cases have a very specific joint locking that has come on recently in the last day or two and no previous history of back pain. For most however it takes several sessions and some hard work to get a good improvement.
If you have back pain and our get better slowly approach appeals to you then we would love to hear from you. We will work with you to get you better as quicky as we can. Give us a call to make an appointment. Your back will love you for it.Learn More
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