Take a Peek Inside of the Treating Low Back Pain during Exercise and Athletics Video Package

Did you know that an estimated $50 billion dollars is spent annually on back pain related issues?  It affects nearly 80% of the U.S. population at one time or another.  It’s one of the top reasons for physician and physical therapy visits and one of the most common reasons for missed work days.  The best training plan in the world won’t do us much good if we’re unable to implement that plan due to pain and/or injury.

WomanWithLowBackPain

When reviewing research or anecdotal evidence online, there is no shortage of articles, blogs, and opinions regarding low back pain (LBP).  But what about a specific resource for the athlete, the weightlifter, the CrossFitter or the runner who is experiencing low back pain during exercise?  How does an athletic population know how to handle episodes of LBP?  What specifically can an athlete or active person do to avoid low back pain to lessen the risk of injury and lost training days?  Is there a specific step-by-step plan that really works?

The prevention and rehabilitation strategies outlined in my rehabilitation guide, Treating Low Back Pain during Exercise and Athletics, answer those questions.  You will learn how to safely self-treat your low back pain and helpful methods for a speedy recovery.  (Not to mention, possibly saving you time and money by avoiding a physician visit!)

The good news is that participating in sports, running, CrossFit, and weightlifting doesn’t increase your risk of developing LBP.  On average, being in good health, physically fit, and active actually decreases your risk.

The Treating Low Back Pain (LBP) during Exercise and Athletics Video Package includes:

Treating Low Back Pain during Exercise and Athletics eBook

product-cover-lbp

In this eBook, you’ll learn why it is critically important to prevent the first episode of low back pain.  LBP has reoccurrence rates as high as 90%.  If you have already experienced an episode of LBP, you’ll learn why exercise is an important component to long term management.  Most importantly, you will understand how to avoid pain and injury in order to take your training to the next level.  Topics include:

  • Specific strategies for LBP prevention.
  • How to address specific causes of LBP.
  • Best practices on how to prevent and self-treat when you experience an episode of LBP.
  • A step-by-step LBP rehabilitation guide complete with photos and detailed exercise descriptions.
  • How to implement prevention and rehabilitation strategies.

7-part Series of Instructional Videos

Nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports, and athletics.  An in-depth look at treating LBP with a 7-part series of instructional videos in which I address the following:

  • Potential Risk Factors for Lower Back Pain
  • What are the Core Muscles?
  • Prevention during Exercise (Part 1 and 2)
  • Initial Treatment
  • Further Treatment and Taping
  • Long Term Management Strategies and Final Recap

Want to peek inside the video content? Watch now as I describe what really the “core” is and why it matters.

Preventing and Treating Overtraining Syndrome eBook

product-cover-ot

In this BONUS eBook, you’ll learn how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  Topics include:

  • How to recognize the warning signs.
  • Specific strategies for OTS prevention.
  • How to self-treat OTS.
  • How to safely overreach.
  • A complete guide to Foam Roller Stretches and Mobilizations with photos and detailed exercise descriptions.

Is your low back hurting? Are you ready to take your training to a new level?  What are you waiting for?  Let’s get started! 

Use discount code LBP to receive 15% off now!

Purchase Package

Still on the fence about the Treating Low Back Pain during Exercise and Athletics Video Package? I understand that the full package may not be the right choice for you. You still have the option to purchase only the Treating Low Back Pain during Exercise and Athletics eBook.

Use discount code LBP to receive 15% off now!

Purchase eBook (Download)

How to Leverage your Nutrition to Train Harder and Recover Faster

As a physical therapist, I help to educate my clients about a wide variety of strategies from nutrition to physical components including advice on exercise, hands-on techniques (such as myofascial and joint mobilizations), and self-care techniques.  Time and time again in my practice, a client will struggle with healing from an injury.  He/she may be performing the right exercise and receiving the proper treatment, yet he/she is unable to properly heal because his/her body doesn’t have the proper nutrition level to allow the healing to occur.  Poor eating habits not only sabotage your results, but can also lead to severe chronic illnesses (such as heart disease and diabetes).

Preparing To Lift Heavy Weight Bar

Your body’s ability to train harder and recover faster is not just about the exercises performed.  It should also be centered on the fuel you put in your body.  Your body cannot perform optimally, recover adequately or heal from injury properly without adequate nutrition.

Focus on your Recovery Nutrition

The majority of your diet should be from real food.  My personal belief is that food which is minimally processed, organic and/or home grown is likely to have a higher nutrient load and will therefore be healthier for you.  Your body simply cannot heal and recover quickly or adequately when substandard fuel “food” is consumed.

Initially, focus on macronutrients (fat, protein, carbohydrate) when it comes to food.  For me, this includes a diet high in protein from many sources (plant and animal-based), high in fruits and vegetables, and low in processed carbohydrates.

Runners and endurance athletes should pay particular attention to protein intake as maintaining muscle mass is critical for performance and injury prevention.  For more information on protein supplementation, please refer to How Much Protein Do I Really Need?

Consider Supplementation

I am a believer in supplements although you must choose wisely.  Your dietary belief system, genetics, and the type of exercise and/or activity you mainly participate in will determine which supplements may work best for you.

When choosing supplements, I tend to gravitate toward supplements that can enhance performance, improve recovery, stabilize blood sugar, and reduce systemic inflammation.  The ultimate goal with supplements is to aid your body in improving health and/or performance.  Try to choose the most natural products as possible and experiment to see what works best for you.  Look for supplements that don’t contain extra fillers, sweeteners or additives.  For more information on supplementation, please refer to My Top 10 Supplement Recommendations.

Add Super Greens to your Diet

Most people do not consume enough greens.  Green super foods, such as spirulina algae, chlorella algae, and wheat grass are packed high in antioxidants.  They can have a cleansing and an alkalizing effect which will decrease your inflammation level and aid in recovery.  Super greens boost your immune system and are generally good for you.  I think the argument can be made that algae is the king of “super” foods.  It is likely the most important food/supplement most people are not taking.

I have been experimenting taking algae for the last four months, and it has allowed me to train harder and recover faster.  I am setting new milestones in my ability to perform many of my more difficult CrossFit exercises (such as ring muscle ups).  I have seen more improvements in strength, cardiovascular performance, and recovery then at any other time in my life.

My new favorite way to add greens and protein are supplements called ENERGYbits® and RECOVERYbits®.  They are made from organically grown NON GMO spirulina algae or chlorella algae.  Spirulina algae have a high concentration of plant-based protein (64%).  It also contains 40 vitamins and minerals including iron, nitric oxide, Omega-3, and all of the B vitamins.

ENERGYbits_ProductPhoto

Because of their overall nutritional profile I now consider spirulina and chlorella algae a top performance and recovery supplement.  I take 30-45 of these small tablets per serving.  I have had great success taking them prior to a work out and directly afterward.  I also take them mid-day as a snack or meal replacement.

A general rule is to consume spirulina prior to exercise (which are the ENERGYbits®) and chlorella (which are the RECOVERYbits®) after exercise.  Chlorella is high in protein.  It also has detoxing properties and an impressive micronutrient profile.

Also, be sure to listen to Ben Greenfield’s interview with the founder of ENERGYbits®, Catharine Arnston, on the benefits and importance of algae.  Please refer to Is This The Most Dense Source Of Nutrition On The Face Of The Planet?

In full disclosure, I am now an affiliate for ENERGYbits®.  I signed up primarily to get the same 20% discount I can offer you.  You can only purchase them online, so when you check out, just enter discount code PTAdvisor for 20% off all products.

BUY NOW

Avoid Injury and Overtraining Syndrome (OTS)

Nutrition is an important component for both performance and recovery.  Proper recovery is critical to avoiding injury and Overtraining Syndrome (OTS).  Every recovery protocol should include a multifaceted approach that incorporates strategies to positively affect the muscular, nervous, and hormonal systems.  This includes proper nutrition, getting adequate sleep, cross training, and implementing self-care modalities (such as compression band use and foam roller use).

OTS usually starts with muscle soreness and a feeling of fatigue.  Then it quickly progresses into a case of overtraining syndrome or injury.  Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from.  It’s always best to prevent OTS rather than attempt to recover from it.

product-cover-ot

Nothing can derail your best laid training plans and goals like an injury or suffering from Overtraining Syndrome.  In my new eBook, Preventing and Treating Overtraining Syndrome, I address the risk factors for OTS and how to recognize the symptoms.  Once you understand your risk factors, then you can take preventative measures to avoid developing OTS.  In order to continue training hard, you must prevent OTS and the associated poor performance, illness, and injury that can result in lost training days and opportunity.

LEARN MORE

Why You Keep Hurting Your Back

Low back pain (LBP) is one of the most prevalent medical conditions treated in the United States and the western world.  In fact, an estimated $50 billion dollars or more is spent annually on back pain related issues.  Nearly 80% of the U.S. population is affected by LBP at one time or another.  So why are we all hurting our backs?  Why does the pain seem to always reoccur?

2 Reasons Why Low Back Pain tends to Reoccur:

  1. The original risk factor(s) or precipitating actions that caused the initial low back pain (LBP) were never addressed.
  2. The inner core stabilizing muscles were never properly rehabilitated.  This makes the spine vulnerable to re-injury.

Just imagine if you had a significant knee injury which required surgery.  The injured leg would be weak and require specific exercises to help it to rehabilitate.  In most cases, the muscles of the injured leg would be obviously smaller due to muscle atrophy.  This same atrophy happens deep within the muscles of the lumbar region (particularly, the muscles known as the multifidus shown below).MultifidusMuscles

These muscles are responsible for spinal stabilization and to prevent shearing between vertebrae to vertebrae.  Just like the muscles in the thigh (in the knee example above), these muscles will shrink and atrophy when injured.  The problem is that you cannot see or feel them easily, so most of us never know that the spine’s ability to stabilize during activity is compromised.  This is a critical factor as to why reoccurring LBP is so prevalent.

Low back pain is a serious and debilitating condition.  It will either most certainly affect you or someone close to you.  The good news is that you don’t have to be a statistic!  You don’t have to live in fear of your next episode of LBP.  First, you need to address the likely causes that lead to the initial episode of low back pain, and be mindful of your risk factors.  Please refer to 12 Risk Factors for Low Back Pain.

Next, by implementing the proper exercises for prevention and rehabilitation, you can live pain free, train pain free, and live the life you want without fear of reoccurring low back pain!  Treating Low Back Pain (LBP) during Exercise and Athletics is designed for individuals of all levels from weekend warriors to soccer moms to elite athletes.  These principles can help you live the pain free life that you desire!

Treating Low Back Pain during Exercise and Athletics

product-cover-lbp

In this complete self-treatment package, Treating Low Back Pain (LBP) during Exercise and Athletics, I share very specific strategies for LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies.

LBP_Video

In this package, you get an in-depth look at treating LBP with a 7-part series of instructional videos in which I address low back pain prevention during exercise; specific warm ups for exercise and activities; what really is the “core” and why it matters; treatment techniques (including how to apply Kinesiological tape); and long term management strategies.  This includes nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports (such as running), and athletics.

product-cover-ot

In this BONUS eBook, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

LEARN MORE

12 Risk Factors for Low Back Pain

We all work hard exercising and training for the next race, game, and/or competition.  We invest hundreds and thousands of dollars and hours upon hours training for our sport or activity.  We learn everything we can about our sport.  We buy the newest gear and fitness apps.  We invest in the newest and greatest training plans and programs.  Yet, we often fail to address the obvious. The best training plan in the world won’t do us much good if we’re unable to implement that plan due to pain and/or injury.  Many of us just accept occasional episodes of low back pain (LBP) as a normal part of life, but these episodes of LBP can have both devastating monetary and training consequences.

Young woman out jogging suffers a muscle injury

What if you could prevent injury and the loss of training days?  What if you could prevent costly physician visits?  What if you could spend your money on the best fitness and training programs and gear instead of on pain relief gels, oils, and scams?

The following list of potential risk factors for LBP addresses how you can be proactive in maintaining a healthy back.  How many of the following 12 risk factors can you relate to?

12 Risk Factors for Low Back Pain:

  1. Smoking – Smoking is a major risk factor for low back pain (LBP).  The chemicals in cigarette smoke affect both the lung’s ability to exchange oxygen and the body’s normal healing response.  These chemicals alter the blood supply to the discs and other spinal structures which affects nutrient exchange and increases the risk of pain.  Healing time for all medical conditions worsen with smoking.  Although research is forthcoming, it’s likely that vaping also has a negative impact on healing and LBP.  Anything that negatively affects optimal health will increase your risk of LBP and recovery from injury.
  2. Gender – This is an interesting one.  It may relate to certain behaviors more than anatomical differences, but males have a higher risk of LBP.  Females tend to experience more cervical or neck pain.
  3. Pregnancy – Pregnancy increases your risk for LBP due to structural changes as the baby develops and hormones change.  The expectant mother releases relaxin, a hormone which loosens the whole body, to prepare for the baby’s delivery.  Again, a risk worth taking!  Most women can manage the pain by modifying posture and movements while learning techniques for self-management.
  4. Heredity – A family history of low back pain increases your risk.  In some cases, this may be due to actual structural deformities which may be genetically linked.  More commonly, it’s a learned behavior, such as chronic sitting and slouching (poor posture), that can lead to a higher risk of LBP.
  5. Prior Episodes of LBP – Once you have experienced LBP, you are more likely to have re-current episodes.  This is typically due to not addressing the precipitating factors that led to the first episode of LBP.  It’s also likely due to weakness in the deep multifidus muscles that help to support the spine and prevent shearing forces.  This weakness can be addressed with proper physical therapy intervention.  (Please refer to Why You Keep Hurting Your Back.)
  6. Lack of Exercise/Activity – A sedentary lifestyle will increase your risk for LBP.  The spine is designed to work and move.  In order for the spine to remain healthy, it requires exercise and movement.
  7. Too Much Sitting – Sitting for even a moderate amount of time not only affects your general health status in a negative way, but it also increases your risk for LBP.  Sitting for more than 30 minutes at a time can increase your risk.  Worse yet is sitting with poor posture or unsupported.  Sitting on vibrating surfaces such as a heavy equipment operator will increase your risk further.  Please refer to The #1 Way to Extend Your Life Span for the reasons why sitting has such a negative effect on your body.
  8. Poor Posture – In western culture, we spend most of our day sitting slouched or standing hunched over.  This is an excellent way to increase your risk for LBP.  It’s one of the major risk factors for disc herniation and development of spinal stenosis.  Please refer to How to Improve Posture & Eliminate Pain for exercises that can help you to develop better posture and strength to eliminate back pain.
  9. Lack of Warm Up Before Exercise – This is a common mistake which can lead to injury.  A proper warm up prior to an event or exercise session is critical for injury prevention and in order to achieve peak performance.  A poor warm up affects your ability to get the most out of each training session.  A warm up should consist of a cardiovascular component, a spine specific component, and a dynamic stretching routine of the actual exercises you will be performing to insure you’re ready for the movement.  This is pertinent for any training session regardless of sport including weightlifting and running.
  10. Training when Exhausted – Allowing yourself to become over fatigued will increase your risk of all types of injury including LBP.  This is a common problem among CrossFitters and anyone who trains at a very high intense level.  Typically, this results in poor technique which further increases your risk.  Combine poor technique with muscles which can no longer perform the proper movement pattern, and you’re likely to become injured.
  11. Poor Technique – Poor technique often occurs when performing exercises that are too advanced, with too much resistance, and/or when feeling exhausted.  Performing unfamiliar lifting techniques or lifting too much weight will likely result in poor technique.
  12. Training Volume – Overtraining syndrome (OTS) can occur when you train too hard for too long.  Your training plan should include scheduled rest and recovery cycles to allow your body the time to recover between competitions and high volume or intense training cycles. OTS definitely increases your risk of injury.

The key component to preventing reoccurring episodes of LBP is to address your risk factors.  Determine what initially caused your LBP.  If you are looking to finally prevent those reoccurring episodes of LBP that derail your training and/or are currently suffering from LBP, then Treating Low Back Pain (LBP) during Exercise and Athletics is the solution.  This complete guide and system will help you to prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures.

Treating Low Back Pain during Exercise and Athletics

product-cover-lbp

In this complete self-treatment package, Treating Low Back Pain (LBP) during Exercise and Athletics, I share very specific strategies for LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies.

LBP_Video

In this package, you get an in-depth look at treating LBP with a 7-part series of instructional videos in which I address low back pain prevention during exercise; specific warm ups for exercise and activities; what really is the “core” and why it matters; treatment techniques (including how to apply Kinesiological tape); and long term management strategies.  This includes nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports (such as running), and athletics.

product-cover-ot

In this BONUS eBook, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

BUY NOW

Why Low Back Pain almost always Reoccurs

I had waited all year for the City of Trees half marathon.  My goal (as always) was to post a PR (personal record) for the event.  Since it was a fairly flat course, I figured it would be a good opportunity to run fast (at least, fast for me).  As part of my training protocol, I was squatting two days per week and working on general leg strength and cross training (practicing yoga) one day per week.

Group of people running.

My back had been sore off and on for almost five years.  Medical professionals didn’t offer me any specific reasons as to why.  Neither chiropractic nor physical therapy seemed to help much, so I just ignored it.  But not this day!

I had just completed my second work set of squatting at the gym.  At the time, I wasn’t experiencing any notable back pain.  I was on my second repetition and on my third set when my low back gave way.  The weight came down and hit the rack safety rails!  My back hurt, but worse, it felt unstable.  I decided to leave the gym in shame.  I picked up the weights I was using, but the pain began to worsen.

By the time I drove home, I could barely get out of my truck.  I decided I was tough, so I took some ibuprofen and still went to work.  By the time I made it to the office (about 10 minutes), I was in real trouble.  I walked around for a while, and I took some Tylenol before I decided to go home.  I got in my truck, but by then the pain was so bad that I couldn’t push in the clutch or hardly use the brakes.  I really don’t know how I make it home that morning, but I needed help from my wife to get out of my truck.

LowBackPainIt only got worse from there.  I went to lie on my bed.  Again, another bad plan!  An hour later when I needed to urinate, I realized I couldn’t even get out of bed!  The pain was worse than anything I had ever experienced.  After much struggle and help from my dad (who was called in to help), I was able to get upright, only to break out in a cold sweat, start shaking, and nearly pass out from the pain.  Still having to urinate, I experienced one of the more humbling things I have ever done.  I had to ask for help from my wife to urinate into a plastic bottle because I couldn’t get out of bed.

Long story short, I went to a doctor who diagnosed me with low back pain (LBP) from a lumbar strain and prescribed pain medication and a steroid pack.  After many more days of pain, I was finally upright again.

A month later, I was ready to start back into my training, but frankly, I was nervous!  My back felt weak, and I had no idea how much was too much.  The worst part of it all:  I’m a physical therapist!  Shouldn’t I known what to do?  It sure didn’t feel like it at the time.

The medication did mostly relieve the pain, but I had a chronically sore back that felt weak and unstable.  I was performing physical therapy exercises and stretches.  I was even using heat and electrical muscle stimulation (EMS).

My treatment wasn’t helping me that much.  At least, not to the point that I felt I could get resume my training for my upcoming half marathon.  All I wanted to do was to get back to training, but I was too scared to!

This experience started me down a path of study that changed my life.  I realized how incompetent I had been as a physical therapist who treated others experiencing severe low back pain.  I had new appreciation for those patients who wanted to get back to their sport and activity.  I also realized that my prior physical therapy interventions were not preparing people to get back to sport nor most high level activities.

What do you do when you’re past the worst of the pain and want to resume training, but you don’t feel physically, mentally or emotionally ready?  Your insurance money may be used up.  The pain may have dissipated, but you’re still not sure how to progress through the next steps.  What if it happens again?  Can I train as hard as before?  Am I really better?  I have lost so many days of training, should I even compete in my event?

Often after a severe case of low back pain, you may be too scared to train like you did prior to the injury, and it turns out you should be!  At least until you understand why low back pain almost always reoccurs and what you can do to prevent it. 

The most common treatment strategies for low back pain are too general for most active individuals, weekend warriors, sport enthusiasts, CrossFitters, weightlifters, and runners.  I have spent the past 11 years researching, studying, and refining best practices for treating LBP.  I have combined research with known anatomical and physiological principles in order to develop very specific strategies for LBP prevention among active individuals.  I have designed a complete guide and system to help you to prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures.

Treating Low Back Pain during Exercise and Athletics

product-cover-lbp

In this complete self-treatment package, Treating Low Back Pain (LBP) during Exercise and Athletics, I share very specific strategies for LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies.

LBP_Video

In this package, you get an in-depth look at treating LBP with a 7-part series of instructional videos in which I address low back pain prevention during exercise; specific warm ups for exercise and activities; what really is the “core” and why it matters; treatment techniques (including how to apply Kinesiological tape); and long term management strategies.  This includes nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports (such as running), and athletics.

product-cover-ot

In this BONUS eBook, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

BUY NOW

LBP_Cover_298px

Treating Low Back Pain during Exercise and Athletics (2016)

product-cover-lbp

In this complete self-treatment package, I share very specific strategies for LBP prevention among athletes such as sport enthusiasts, CrossFitters, weightlifters, and runners.  These principles are helpful for anyone participating in athletics as well as those implementing a healthy lifestyle.  You’ll learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP.  In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies.

LBP_Video

In this package, you get an in-depth look at treating LBP with a 7-part series of instructional videos in which I address low back pain prevention during exercise; specific warm ups for exercise and activities; what really is the “core” and why it matters; treatment techniques (including how to apply Kinesiological tape); and long term management strategies.  This includes nearly 60 minutes of actionable advice to prevent and treat LBP as it relates to active individuals, sports (such as running), and athletics.

product-cover-ot

In this BONUS eBook, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of Overtraining Syndrome (OTS).  You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”).  This will speed up your results, so that you can train harder and more effectively than ever before!  In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

5 Tips to Prevent Low Back Pain during DIY Projects

Many of us will be planning our yearly DIY (Do It Yourself) projects now that it’s nearly summer time (in the U.S.).  I have a few minor landscaping projects that will be addressed this summer, too.  Whether it is an outside landscaping project, an indoor painting project, moving furniture around, and spring cleaning (don’t forget the garage!), you are likely to be exercising different muscles and performing activities that you aren’t used to.  It’s easy to imagine the new paint color or a beautiful landscape design.  Now imagine crawling around on the floor because you can’t stand up as your best laid plans are derailed by a bad episode of low back pain (LBP).  Not exactly the picture you were hoping for!

Exhausting work in garden

Whether you are an avid exercise enthusiast, runner, CrossFitter, weekend warrior or couch potato, you are likely to experience an episode of LBP despite being young or old.  LBP is estimated to affect nearly 80% of the U.S. population at one time or another, and it’s one of the top reasons for physician visits.  Fortunately, most LBP is mechanical–meaning it’s from a physical or structural cause not related to conditions such as cancer or infections.  The problem with this type of LBP is that it usually comes back.  People who have had an episode of mechanical LBP are 90% more likely to experience it again.

If you are going to be tackling those DIY projects and desire to still be standing upright at the end of the day, it’s best to minimize your risk factors for experiencing LBP by being proactive!

5 Tips to Prevent Low Back Pain during DIY Projects:

1. Warm up.

Just like any other exercise and/or event, you should warm up first.  A good place to start is to perform standing back extensions and press-ups.

StandingBackExtensions_PressUps

2. Loosen up.

So many of us sit too much!  This causes tightness in the hip flexors and hamstrings.  Try stretching your hip flexors and hamstrings.

HipFlexors_Hamstrings

3. Limit the amount of time spent in one position (including sitting).

Don’t sit or bend over for a prolonged period of time without at least standing up straight (and preferably, performing additional standing back extensions and press-ups as well as stretching your hip flexors and hamstrings).

If you are sitting, maintain proper posture.  Whenever possible, make sure that your knees stay below your hip level and that you are able to maintain your natural lumbar curve.  A great tool to help you with this is a lumbar roll.

4. Use common sense.

If you don’t think you can comfortably lift something, be sure to ask someone for help.  Stay within your limits, and don’t over estimate those limits!  Just because you could lift 100 lbs. in high school, it doesn’t mean that you still can.  Use common sense and proper technique when lifting a heavy object or when performing repetitive lifting.

After taking a prolonged rest, be sure to spend a few minutes warming up and loosening up again.  Don’t make the mistake of sitting down and resting during your lunch break, only to launch back into the project without making sure that your back is ready.  Take the extra time to be certain that your back is ready to start working again.

5. Preventing LBP is always best.

Once you have experienced an episode of LBP, you have a 90% chance of it reoccurring.  Be proactive!  Reoccurrence rates can be impacted and reduced!

Developing adequate strength in the lumbar extensor muscles and core musculature is the primary way to prevent initial episodes and to prevent reoccurring episodes of LBP.  Research clearly indicates that the right targeted exercises are the most effective way to manage LBP.

Stay tuned in during this upcoming month as I introduce you to my new complete self-treatment package, Treating Low Back Pain during Exercise and Athletics.  I have designed a complete guide and system to help runners, CrossFitters, exercise enthusiasts, and weekend warriors just like you (and me) prevent, treat, and manage LBP so that you don’t have to waste any training days because of ineffective treatment measures.  In the meantime, be sure to check out my FREE resource, 10 Minutes per Day Low Back Pain Prevention Guide.  Download the .pdf file, which is full of photos and exercise instructions, to get started!

For additional information on LBP, please refer to the following:

Which DIY (Do It Yourself) project do you hope to accomplish this upcoming summer?  Please share below.

Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!  If you have a question that you would like featured in an upcoming blog post, please e-mail contact@thephysicaltherapyadvisor.com.

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

A Barbell Knee Stability Exercise for Runners

Patellar Femoral Pain Syndrome (PFPS) is the physical therapy term for runner’s knee, a common condition experienced by runners.  It accounts for roughly 25% of all reported cases of knee pain.  PFPS is a term used to describe pain in many areas of the knee including:  pain near the insertion point of the patellar tendon, just below the patella or knee cap; pain just above the knee cap where the quadriceps muscle is blending in and forming the quadriceps/patellar tendon; and/or pain underneath the patella.

Although there are many types of knee pain, many of the potential causative factors for PFPS are similar to other conditions such as IT Band Syndrome (ITBS) and Patellar Tendinitis.  Treatments for knee pain can vary wildly from person to person.  It can be quite painful and significantly affect a person’s ability to run or move properly.  In the case of PFPS, the cause of the pain is often associated with a patellar or knee cap that is tracking in the femoral groove improperly.

Common Causes and Risk Factors for Knee Pain and specifically, Patellar Femoral Pain Syndrome (PFPS) include:

  • Poor quadriceps strength (particularly the inner/medial quadriceps).
  • Poor hip abductor and/or hip external rotator strength.
  • Improper foot biomechanics during the single leg stance phase of the gait cycle or the mid foot strike during running.

One of the primary treatments for nearly all types of knee pain (including PFPS, Patellar Tendinitis, ITBS, and meniscus injury) is to improve your quadriceps and hip strength.  Quadriceps strength is an important component to your long term management and recovery.  As part of the quadriceps strengthening protocol, I have found it useful to skew toward the inner quad, known as the vastus medialis oblique (VMO).  Although you cannot specifically isolate the VMO, I still recommend implementing exercises that are likely to activate the muscle more when performed correctly.

The other critical factor is weak hip abduction and hip external (lateral) rotation muscles, which significantly contribute to PFPS.  The purpose of the lateral and external rotators of the hip is to prevent internal rotation (rolling in) of the hip and knee.  They also provide the stability for the pelvis and lower leg when in single leg stance.  The hip muscles are critical in controlling knee stability and ultimately, patellar (knee cap) tracking.  Adequate strength of the rotators and abductors of the hip is critical.

In this video, I demonstrate how to perform an advanced exercise known as the clock or star drill.  It’s an excellent exercise to work on knee stability and balance while specifically focusing on quadriceps and hip strength.  Although I demonstrate the exercise with a barbell in the video, I recommend that you initially be perform it without weight (as demonstrated below).  As you progress, then you could add weight.

ClockExercise

Have you performed the clock or star drill before?  If so, what was your experience like?  Please leave your comments below.

For more information on how to self-treat differing types of knee pain, please refer to the following:

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Q & A: Spinous Process Fracture

Q.  My son was recently injured in a weight room accident that resulted in a C7 spinous process fracture. The neurosurgeon says not to worry about it and that he can return to sport in six weeks.  He is a very talented athlete, and he’s trying to get a college football scholarship.  I’m concerned for his safety and scholarship prospects.  Do you have any advice? -Jennifer

A.  I am so sorry to hear about your son’s injury, Jennifer. Weight lifting is such a critical component to any training program as well as for those who are trying to maintain muscle mass and general health. Sadly, accidents happen and can be very serious. However, weight training will be an ongoing critical training component if your son is to compete in football at a collegiate level.

Thank you for letting me share his imaging pictures. Viewing the imaging allows for a better discussion, but please note that I have not evaluated your son.  The following advice is only for the purpose of general discussion.

Spine_Collage

(Left: X-ray of C7 fracture. Right: CT Scan of C7 fracture.)

As you can notice on the imaging provided, only the spinous process was injured. Although close to the lamina of the vertebra (which has a primary role of protecting the spinal cord), it was not injured.  This was confirmed by the physician’s physical exam, X-rays, and CT Scan. I’m glad that the injury was taken seriously with appropriate medical follow up.  One should never take unwarranted risks when evaluating spinal injuries.

This particular fracture is also known as a Clay Shoveler’s Fracture. This occurs when the end of the spinous process is either broken off by a physical impact (as in the case of Jennifer’s son when the barbell hit his neck) OR as a result of the muscle pulling so hard that it breaks the bone and literally tears off part of the spinous process.  The role of the spinous process, particularly in the cervical region, is to help limit cervical hyper extension.  More importantly, the spinous processes are there as an attachment point for muscles and ligaments.

C7 is the largest cervical vertebrae in the neck. The C7 vertebra is right in the middle of transition from the cervical spine to the thoracic spine and is home to many fascial attachments and muscular attachments from the neck and shoulder girdle.  Many of the deeper neck extensors and rotators such as the splenius capitus and splenius cervicis as well as the trapezius, rhomboids and serratus posterior muscles have C7 attachment points.

Typical Symptoms

In most cases, there is pain immediately after the injury which is often described as a burning or “knife-like” stabbing pain.  Other symptoms include muscle tightness and sharp pain that increases with repeated activity and movement of the neck or shoulder girdle. The pain is often described as feeling similar to a severe muscle strain in the upper back.  The area of fracture as well as the nearby spinous processes is typically very tender as are the nearby muscles.

If only the spinous process is injured, you should not see any neurologic symptoms. You will likely see loss of cervical motion and possibly shoulder motion as those motions will cause muscles to pull directly on the site of injury which limits one’s desire to move.  Symptoms are typically worse with the head down or when the arms are active in front of the body (such as driving or working at the computer).

Treatment Considerations

Bone healing is a complex process and will differ significantly among individuals. Factors affecting bone healing include:  the type of fracture and the patient’s age; underlying medical conditions; and nutritional status.  For a person with good health status, the bone will take on average six to eight weeks to heal to a significant degree.  In general, children’s bones heal faster than those of adults.

However, with a spinous process fracture that is separated to this degree, the bone will most likely never heal. The bone will not re-attach itself back to vertebrae.  When this occurs, it’s known as a non-union.  Scar tissue and fascia will surround the injury site and in most cases, form a solid fibrous pseudo-union between the two pieces of bone.  In most cases, there will be no deleterious effects from the injury and healing process.  Like bone healing, this process typically takes six to eight weeks for most individuals.

Acutely there is likely to be pain, but long-term pain typically subsides. However, as with all injuries, there is the risk of chronic pain or long-term irritation to the area associated with the muscle and tendon that insert/attach onto the spinous process involved in the injury.

Pain Management

Initially, I don’t recommend treating with NSAIDS (non-steroidal anti-inflammatory medication) as there is research that indicates that the healing response could be delayed. Instead and whenever possible, I would recommend other alternatives for pain management like applying heat or ice. Typically no more than 20 minutes per hour would be recommended, and don’t apply heat or ice directly to the skin (use a towel as a barrier).

Pain medication, such as acetaminophen, is always an option if recommended by your physician. You may also want to consider utilizing topical agents, which can help to decrease pain and muscle spasms. The method of action varies greatly according to the product used.  You may find that one product works better than another.  Some of my favorite products in my medicine cabinet include:  Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.

Another option is oral magnesium. You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates. Taking additional magnesium (particularly at night) can help to reduce muscle cramps and spasming.  It is also very helpful in reducing overall muscle soreness and aiding in a better night’s rest.  Most people are deficient in the amount of magnesium they consume on a regular basis.  I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose as needed.  I would caution you that taking too much magnesium can lead to diarrhea.  Mag Glycinate in its oral form is the most highly absorbable.  Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

Soft tissue massage of the adjacent muscles as well as electrical stimulation can both be used to reduce pain.  If pain persists, please discuss the options with your physician.

Activity Modification and Exercise Considerations

Activity involving the head, neck, and shoulders should be limited initially. In some cases, the physician may ask that a cervical collar be worn for several weeks.  Opinions on this vary greatly and will be dependent on the exact location of the fracture.

The basic idea is to avoid heavy use of the muscles that would specifically pull on the injury site. This would include muscles that flex, extend, rotate or side bend the head as well any arm movements that move the shoulder.  This would obviously include any type of heavy lifting or placing anything on top of the injury site like a barbell.

Although this seems very limiting, you can still move the neck and shoulders. Gently perform range of motion (ROM) of the neck and shoulders to maintain full mobility. This will also help to limit pain and muscle spasms of the surrounding tissues.  The idea is to limit extreme movement, limit the movement under load, and limit the speed of movement.

I would specifically limit most activity for at least six to eight weeks to insure an adequate amount of scarring has occurred. In addition to the above noted limitations, I also wouldn’t perform any activities that would be jarring to the body (such as jogging).  If you want to maintain your cardiovascular endurance, you could peddle on a stationary bike while keeping your upper body mostly relaxed.

At around the four to six week mark, I would slowly start working on the cervical extensor and shoulder girdle muscle exercises (as demonstrated below).  You will want to engage the muscles symmetrically as to not cause asymmetrical pulling over the injury site.  These exercises will help to engage the muscles (the cervical extensors and scapular muscles, including the rhomboids and trapezius muscle) specifically used to stabilize the injury site.

ITYExerciseCollage

Begin by performing these I’s, T’s, and Y’s exercises on a Thera-Band Exercise Ball. Start slowly without resistance.  Keep your chin tucked and head aligned with the body.  Move your arms slowly up and down in each position of I, T, and Y.  Start with 10 repetitions for 3 second holds, and then progress the number of repetitions as long as there is no pain.

Once you can easily and pain free perform 20 repetitions with 3 second holds, add a 1-2 pound weight in each hand and start the progression initially at 10 repetitions.  Be sure to always let pain guide the progression.  The exercise should remain pain free.

After the six to eight week mark, initiate a slow, but steady return to exercise. Start with lower extremity exercises such as the leg press, body weight lunges, squats or step ups.  During this time, progress with targeted exercises designed to strengthen the muscles of the mid trapezius, rhomboids, and neck extensors.

Let pain guide your progression. If you perform an activity that causes pain near the injury site, then that activity should continue to be avoided in the short-term.  Continue to perform exercises bilaterally to be sure that the force/pull over the injury site is symmetrical.  For example, when you start on rowing, then it should be a two-handed row and not a one-handed version.

Progression of exercise of the associated muscles should be slow and again, pain should be carefully monitored. Any pain provoking movements early in the rehabilitation phase should be avoided.  When returning back to weight training, start with a weight approximately 50% of your prior max.  Work within that weight for a week or two, and then slowly progress back to the prior weight used (depending on your symptoms).

You may also return to light jogging. If there is no increase in your pain level, then slowly progress back into full running and sprinting.

Exercises to avoid for at least twelve weeks include: barbell squats; overhead press; power cleans; squat cleans; and snatches.  Avoid anything that would put direct pressure over the injury site or exercises that include a speed and power component under load (such as the power clean).

Rehabilitation Recap

Due to the amount of information presented, I want to re-iterate the important parts of the rehabilitation process. Be sure that you have your physician’s clearance prior to resuming activity.

0-4 weeks: This is the time for pain management and activity modification. You want the area to scar down.  Exercise and activity should be limited although you should maintain full range of motion (ROM) of the neck and shoulder girdle if possible.

4-6 weeks: Initiate a cervical stabilization program and scapulothoracic exercises starting without any resistance.  Perform the I’s, T’s, and Y’s exercises on an exercise ball (as demonstrated above).  Progress with these exercises and continue with cardiovascular exercise such as riding a stationary bike.  You may also start bench pressing, but begin light and monitor your pain level.

6-8 weeks: Progress with shoulder and upper back exercises. Be sure to use two-handed movements.  Depending on your pain level and strength, lower body exercises can be initiated.  Begin with body weight exercises, and then progress to resistive exercises.  Continue to limit direct pressure over the injury site or asymmetric forces.  Lower body exercises, such as the leg press and dead lift, may be started.  Exercise should be mostly pain free.  If you experience pain during an exercise or movement, discontinue for now and then retry it in a week or two.

8-12 weeks: During this phase, slowly start tapering up on all activity.  During this time, you can progress your jogging to eventually sprinting as well as road bicycling.  You can progress back into lower extremity exercises as tolerated as long as there isn’t any significant associated pain at the injury site.  Focus on neck and upper extremities exercises with two-hands/arms bilateral exercises.  Focus on exercises that develop strength in the muscles surrounding the injury site without causing increased pain or asymmetrical force.  The preference is for two-arm movements for now.  This is also the time to start working on thoracic mobility to insure the entire vertebral chain can move freely.  Be sure to have full shoulder and cervical mobility.  Continue to avoid any specific pressure on the injury site.  If you haven’t already, you could start the following:  dead lifting; front squat; and lunges with load.

12+ weeks: Return to full activity. However, let pain and common sense continue to be your primary guide.  At this stage, you can return to light squatting.  I recommend a low-bar position as this typically lines up just below the spine of the scapula and should be below the C7 injury site.  Start single arm movements, such as a one-armed row, as well as power movements, such as the clean and snatch.  You can also initiate overhead lifting.  The key is to progress slowly and see how your body responds.  Begin with 50% of the load used prior to your injury.

If you don’t already own a copy, I would highly recommend that you purchase Starting Strength: Basic Barbell Training by Mark Rippetoe. This text should be regarded as the authority on strength training and should be used as a guide for beginners to advanced weight training enthusiasts.

Once a full return to weight training activities has been accomplished, a full return to sport should also be possible. Any sports that involve high impact, such as football or mixed martial arts, should have your physician’s approval in order to insure that the fracture is stable.  In most cases, the level of pain present will be a great indication of how stable the injury site is.

If you are unsure about how to properly progress in your training and rehabilitation, I recommend that you work with a highly qualified trainer or sports medicine professional to insure that you are performing your particular exercise and sport in a manner that will keep you safe and the fracture stable. The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area.  In most states, you can seek physical therapy advice without a medical doctor’s referral (although it’s a good idea to hear your physician’s opinion as well).

Good luck to your son and you, Jennifer! I hope you find this information helpful.  Thankfully, this type of injury usually results in a full return to function without many long-term deleterious effects.  The key is to allow adequate healing time, and then slowly and strategically progress back into full activity.

Have you ever suffered from a spinal fracture or avulsion fracture? Have you experienced an accident while weight training?  Please share your story below.

If you have a question that you would like featured in an upcoming blog post, please email contact@thephysicaltherapyadvisor.com. For additional health and lifestyle information, join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

How to Self-Treat Patellar Tendon Pain with a Mobility Band

Patellar tendon pain (often called patellar tendinitis or patellar tendinosis) occurs when the tendon connecting your knee cap (patella) to your shinbone becomes inflamed and irritated. Patellar tendinitis is often called “jumper’s knee” because it occurs so frequently in sports like basketball and volleyball.  It also affects runners due to poor lower extremity biomechanics during running.

Patellar Tendinitis symptoms include:

  • Pain directly over the patellar tendon.
  • The tendon is usually tender and swollen.
  • Knee motion can cause “crepitus” (when you hear and feel a crunching or grinding sensation). This may or may not be painful. It’s usually felt under the tendon or the lowest part of the knee cap.
  • Pain with jumping.
  • Pain with kneeling.
  • Pain when walking downstairs.

PatellarTendonPain

The initial course of treatment should include RICE, which stands for Rest, Ice, Compression, and Elevation.

  • Rest. In this case, rest would indicate tapering down from your regular exercise activity and discontinuing running (for the short term).
  • Ice. Apply ice to the painful area. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel pack style. A bag of frozen peas can be ideal. Individuals with poor circulation or impaired sensation should take particular care when icing.
  • Compression helps to prevent and decrease swelling. Swelling can cause increased pain and slow the healing response, so limit it as much as possible.
  • Elevation. Depending on your pain level and the amount of swelling present, this step may be more or less beneficial.

In this video, I demonstrate how to utilize a mobility/compression band as a self-treatment method for patellar tendinitis. Mobility/compression bands, such as the Rogue Fitness VooDoo X Bands or EDGE Mobility Bands, are a novel way to self-mobilize tissue either of the quadriceps or the patellar tendon. The use of a mobility band not only helps to mobilize the tissue, but it affects blood flow to the area and speeds up healing.  A mobility band also helps to reset some of the receptor cells in the muscle tissue which cause excessive muscle tightness.

As demonstrated in the video, start by applying the mobility band just below the tibial tuberosity, and then over the patellar tendon to the base of the patella. Next, perform the seated knee extension and then the squats.  Typically, the mobility band will only be in place for one to two minutes.  If you experience numbness or tingling, please discontinue the treatment.  (If you suffer from any form of blood clotting disorder or are on blood thinning medications, I would advise against utilizing mobility bands for any type of deep compression.)

In addition to utilizing the mobility band, I often find that it’s critical to improve general tissue mobility. I recommend stretching and mobilizing the tissues of the lower legs.  Myofascial release of the quadriceps muscle is an important component in order to relieve the pain while reducing the pressure and tension through the patellar femoral tendon and joint.  This is typically a very effective and important step as most will find pain relief from improving quadriceps mobility.  I tend to utilize the foam roller for the larger part of the quadriceps.

LacrosseBallForQuad

I also use a tennis or lacrosse ball to aggressively work the tissue above the patella. You can use your hand to press the ball in and work it around the tissue.  To use the weight of your leg for a more aggressive mobilization, place the ball on the ground and mobilize the tissue with your leg on top of the ball.

For additional helpful tips and tricks on treating knee pain, please refer to my guest post for the Marathon Training Academy, How to Self-Treat Runner’s Knee.  Much of the advice and training recommendations are also relevant to treating patellar tendinitis.

Have you tried using a mobility band before to treat patellar tendinitis? If so, what was your experience like?  Please leave your comments below.

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!