3 Strategies to Start Right Now to Improve Health Span

You have likely heard about the life span revolution in the media. Many feel we are on the cusp of significantly advancing the length a person can live.  When in fact, the actual average number of years a person is expected to live has been stable or slightly decreasing.  This is entirely due to poor nutrition, lack of physical activity, and environmental factors.  Although the promise of a long life is appealing, one must ask an important question: Is a long life really what you want if there is no quality? Increasing the number of years that you live is not as important as increasing the way you can live those added years.  Spending an extra 5 or 25 years alive, but ill, is a curse not a blessing.

Today’s pharmaceutical giants, who fund much of this research, don’t want you to feel well during this time. Their intentions are likely not altruistic.  Imagine a longer lived population that is chronically ill.  Sounds like a lucrative opportunity, doesn’t it?

Now the good news! There are very simple and scientifically proven techniques that will allow you to improve your health span AND life span.  Health span refers to the period of time during one’s life that you are generally healthy and free from disease.

Physical factors that address health span include strength, balance, flexibility, and endurance. All of these factors affect your mobility during your life.  These same factors all contribute to your body’s physical resiliency.  Maintaining your mobility is critical for all body functions and is fundamental in avoiding chronic illness.

Elderly couple walking through the park hand in hand

3 Strategies to Start Right Now to Improve Health Span:

Weight Training

Weight training (in particular, barbell training) is a critical component in physical resiliency. Lifting appropriately heavy weights is applicable for almost everyone regardless of age and/or present health status. Weight training has positive benefits on: muscle strength; bone density; cardiovascular performance; neurologic performance and adaptability; mental and cognitive function; and proper hormonal regulation.

Barbell training is the most effective method due the progressive load on the skeletal system and the muscle pull which is exerted on the bone. It fights off frailty! It increases your body’s margin for error when illness or injury occurs. With proper guidance and the right exercise prescription/dosage, nearly everyone can improve in strength and benefit from weight training. To quote Mark Rippetoe, “Stronger people are harder to kill than weak people and more useful in general.”

Resistance training (other than through barbell training) can also be beneficial. An example of resistance training would be any type of pushing or pulling exercise that exerts a force on the muscle, which causes it to work harder than it would normally.  The key to all training is that the system must be properly overloaded to produce the desired effect.  Too little and you will not receive a positive benefit.  Too much and you risk injury.  This overload principle must guide all exercise routines if there is to be actual success and benefit from the program.  Although any properly dosed/prescribed form of resistive exercise would be beneficial, the most effective exercises either activate large muscle groups and/or load the skeletal system.  Examples include squats, lunges, and dead lifts.

High Intensity Training (HIT)

High Intensity Training (HIT) or High Intensity Interval Training (HIIT) involves performing short bursts (ranging from 30-60 seconds at a time) of activity followed by a 1-2 minute recovery. The 30-60 seconds should be at a high intensity, meaning that your rate of perceived exertion (RPE) is high and you’re breathing heavy.

The research involving HIT is ever evolving. Thus far, it appears that HIT may provide superior health benefits when compared to almost any other type of exercise. It has significant positive effects on hormone regulation, particularly Human Growth Hormone (HGH). It regulates insulin sensitivity and increases cardiovascular function (VO2 Max). It not only boosts metabolism, but it leads to greater fat loss than traditional forms of exercise.

There is ongoing research on its effects on all forms of chronic disease and illness, including Alzheimer’s disease, dementia, and cardiovascular disease. Preliminary evidence shows that HIT (when performed correctly) leads to superior benefits in much shorter bouts of exercise.

Walking after Meals

Diabetes and metabolic syndrome are major contributors to cardiovascular disease and most neurologic disorders, such as dementia. Heart disease remains the number one killer in men and women today. Regulation of blood sugar and insulin levels is such a critical aspect of being healthy in today’s sedentary, high fructose corn syrup filled lifestyle. Proper blood sugar and insulin regulation should be a primary concern of anyone desiring to live a long healthy life.

Walking after meals has been shown to stabilize blood sugar levels. It’s also an excellent way to boost metabolism and connect with friends and family.  Frequent walking is the most important physical activity a person can engage in.

Although there are many aspects (mental, social, financial, physical, spiritual, and emotional) to address in order to optimize your health span, it is clear that strength training, high intensity training (HIT), and walking after meals is critical in maximizing your health span and aging well.

What are some practical actions that you can take today to improve your health span? Please leave your comments below.

I would encourage you to sign up to receive each week’s blog post sent directly to your e-mail–making it even easier and more convenient! Advice will be related to physical therapy related topics; physical fitness and performance; health and nutrition; injury prevention and rehabilitation; and successful aging and elder care. I will provide useful and practical types of “how to” information, including methods to safely self-treat and manage common physical therapy related conditions. In addition, you will receive priority when submitting questions to be featured in an upcoming blog post by e-mailing contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

6 Reasons to Self-Treat and Manage Your Health

The United States spends more money by a wide margin than any other country on health care.  Our health care system is set up to keep us from dying, not thriving.  Our average life span barely makes it in the top 30 when compared to other nations.  As it stands now, the American health care system is poorly equipped to help us maximize our health span.  Health span is defined as a period of time in which a person is generally healthy and free from serious disease.

Health care costs in America continue to increase without actual positive change in our health status as consumers.  It is imperative that we take a leadership role in our own health care by continuing to be proactive.  Part of being proactive is learning how to care for and manage common non-life threatening injuries and illnesses.  The medical system is not designed to help you to maximize your health and well-being.  It is designed to prevent you from dying and to maximize profits for the corporatocracy that controls our health care system.  It is imperative that we manage our health by learning how to self-treat non-life threatening and non-emergent injuries and illnesses.

Senior woman suffering from neck pain with eyes closed in the medical office

6 Reasons Why You Should Self-Treat and Manage Your Health:

  1. Money – Health care is expensive. Many of the most common treatments and fancy diagnostic methods are not necessary. Costs are only going to rise more in the future. As this occurs, it will be even more important to be able to take care of the simple common place injuries and illnesses. It will save you a lot of time and money!
  2. Empowerment – There is nothing more important than your health. You have control of most of the aspects in your life that affect your health status. Taking care of yourself and your health needs leads to a sense of empowerment.
  3. Improved Care – If you understand how to be healthy and take care of yourself, you will be able to assist your medical practitioner in making the best decision on how to manage your care. Remember, it is your body and your health. Being your own advocate will insure that you receive quality care.
  4. Quicker Recovery Time – Often by taking out the middle man, you can help to increase the speed of recovery. You can address the condition and help your body to initiate the healing response to insure a faster recovery.
  5. Emergency Situations – You never know when an emergency, such as a motor vehicle accident or inclement weather, may occur. You may experience an injury or illness during a camping trip when resources are a far distance away. In the event of an emergency situation, you will be knowledgeable and equipped to take care of yourself and your loved ones. (If necessary, please seek appropriate medical assistance as soon as possible.)
  6. Healthy Living – Take the time to focus on your health. Often, small changes in your diet, activity level, and relationships can make a big difference. You can take control of your health and your life! For more healthy living tips, please refer to My Top 10 Anti- Aging Tips and How to Age Successfully.

Taking a passive role in your health is not a wise choice in America’s current health care environment.  Only you are responsible for your health.  My goal is to have a positive impact on the lives of others and on the health care system in general.  I desire to accomplish this by providing useful and practical types of “how to” information. With the cost of healthcare on the rise, I desire to help proactive adults of all ages to understand how to safely self-treat and manage common physical therapy related conditions in a timely manner so they can reach their optimal health.

To accomplish this goal, I need to hear from YOU!  What are your pains?  What injuries are you suffering from?  Please submit your questions to contact@thePhysicalTherapyAdvisor.com.  I look forward to answering your health related questions!  You CAN achieve optimal health!

Get started now by checking out the Resource GuideThe specific exercise section is full of rehabilitation exercises ranging from low back pain to knee pain.  These .pdf files include photos and detailed descriptions to help you get started.  This list of resources also includes books, products, resources, supplements, topical agents, videos, and web sites that I personally use and recommend to my family, friends, clients, and patients (for use in the clinical setting).

Also, be sure to 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.

7 Reasons Why the Squat is Fundamental to Life

If you were born and raised in an industrialized nation (like the U.S.A.), then squatting was probably something you did as a child.  As soon as you became school age, you rarely squatted again.  In other countries around the world, squatting is a normal part of daily life.  In countries such as India and in many Asian countries, it is common to see very aged individuals who are still perfectly capable and comfortable in a full squatting position.  When was the last time you saw a 75 year old man in a full squat?  (A full squat will vary from person to person, but typically your hips are well below your knees and your thighs are past a parallel position.)

Here are 7 reasons why we should continue squatting as a lifelong pursuit:

1. Maintain Lower Extremity Strength: The squat activates nearly all of the muscles in the lower leg. It is particularly effective at activating the muscles in the legs referred to as the posterior chain, which includes the hamstrings, the glutes (or buttock muscles), and the hip adductors (or the groin muscles). It also activates the calves, the stabilizing muscles in the ankles, the quadriceps, as well as the core (the abdominals and lumbar extensor muscles). In short, the squat works just about every muscle in the trunk down toward the legs. These muscles are critical for all functional mobility related movements, including walking; getting up from a chair or a toilet; or picking up someone or something.

2. Maintain Lower Extremity Range of Motion (ROM): Moving into a full squat position takes quite a bit of flexibility. Most children have no problem squatting. As we age, we tend to become less flexible which is primarily due to non-use. Physiologically, muscles, tendons, and ligaments lose some elasticity and can become stiff. The squat requires good hip mobility, knee mobility, lumbar and pelvic mobility as well as ankle mobility. It requires adequate muscle length and joint range of motion in all of the major joints of the lower leg and all of the major muscles of the lower limb.

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3. Maintain Bone Density: Squatting activates the major muscles of the lower limb and trunk. The pull of the muscle against the bone stimulates the bone to grow and improve its density. Squatting is also a weight-bearing exercise meaning it is against gravity. If you add any type of resistance, then that load to the bone once again stimulates bone growth. Squatting is a fundamental movement to prevent osteoporosis.

4. Maintain Balance: Squatting activates the lower leg muscles. Adequate lower leg and trunk strength is a critical component to balance. It also activates the somatosensory system. This is the integration of the neurological system (including the brain and nerves throughout the body) with the musculoskeletal system. This includes all the touch and movement nerve receptors in the muscles, tendons, and joints. (Please refer to How Do I Improve Balance? (Part I) and How Do I Improve Balance? Part II.)

5. Aids in Digestion: Many people in “civilized nations” might not know this little known fact, but incidences of constipation have increased since the advent of the toilet. This is because people are no longer squatting in the woods, over a hole, or some form of plumbing. The body’s colon has three major parts: the ascending, transvers, and descending colon. When you are in a full squat, the thighs put pressure on the ascending and descending colon, which stimulates the smooth muscles to move (this is known as peristalsis). When in the full squat position, the rectum (which is a short, muscular tube which forms the lowest portion of the large intestine and connects it to the anus) is allowed to straighten and unkink. Feces collects in the rectum until pressure on the rectal walls causes nerve impulses to pass to the brain. The brain sends messages to the voluntary muscles in the anus to relax, which permits expulsion. If you are experiencing constipation, take a walk and then spend time relaxing in a full squat position.

6. Prevents Osteoarthritis: There are many potential causes, like trauma or infection, for osteoarthritis. Trauma can be from a one-time accident or due to accumulated trauma or over-use syndrome. Just as common as over-use causing osteoarthritis is under-use. A joint cannot remain healthy if it does not move through its full available range of motion (ROM) on a regular basis. If you never move into a full squat, then you likely never take your knees or hips through their full ROM. According to osteoarthritis statistics, countries in which people still rest and spend extended time in a full squat have the lowest incidences of osteoarthritis. Squatting does not cause arthritis; it actually protects the body from it.

7. Fundamental to All Mobility: Maintaining your ability to squat, and (more importantly), come up from a squat is vital. Your ability to do so is critical to your ability to function independently. In my experience of working with seniors, there are two main reasons why a person will need additional care and support: 1. The person can no longer safely get from point A to point B (this usually involves walking). 2. The person is no longer able to stand up from a sitting position. This means he/she cannot get up and down from a chair, a toilet, or even the bed. If you cannot perform these activities safely and independently, then you will need additional care. Typically, it is a major sign of failing health when an aged and infirmed person loses the ability to care for him or her due to weakness and other factors. (This statement is not directed at someone who has suffered a spinal cord injury or has some form of paralysis which affects his/her ability to utilize lower extremities.) The squat is a critical exercise to maintain mobility and function as we age.

Squatting is one of the first abilities we develop as a child, and it needs to be one of the last ones we lose as we age.  Your ability to perform a squat is fundamental to how you are able to function throughout your life.  Keep squatting!

If you have a question that you would like featured in an upcoming blog post, please email contact@thephysicaltherapyadvisor.com.

Taping for Posterior Tibialis Tendon Dysfunction (PTTD)

Pain along the inside (medial) portion of your ankle is often due to Posterior Tibialis Tendon Dysfunction (PTTD), also known as posterior tibial tendon syndrome or tibialis posterior syndrome, and it can be very difficult to treat.

The posterior tibialis muscle is a particularly important muscle in runners as it is used in plantar flexing the ankle (pointing the ankle/toes downward) and inverting the ankle (rolling it inward).  More importantly, its role is to support the arch of the foot. Injury to this muscle is common in runners as well as those who play sports involving high foot impact such as basketball. It can be associated with a fall or can generally develop overtime depending on your risk factors and the strain your foot has taken. (Please refer to 9 Tips to Self-Treat Posterior Tibialis Pain.)

In this video, I demonstrate a taping technique for supporting the arch and the bottom of the foot for those suffering from PTTD. (I recommend using KT TAPE.)

CLICK HERE TO WATCH NOW

PTTD most commonly starts out as an over use injury. Although more common in runners and those who are involved in high impact sports, this condition can affect anyone. If the condition is left untreated, the end result is usually a falling of the arch which causes adult acquired flatfoot. When this condition is caught early, it can be self-treated. Once the arch has fallen, surgery would most likely be indicated.

If you’re interested in more thorough guide along with other videos on how to self-treat lower extremity injuries and pain like PTTD, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by following The Physical Therapy Advisor!

How to Self-Treat Knee Pain

Knee pain is a common complaint among exercisers and non-exercisers alike. So often the actual cause of the knee pain is actually a muscle imbalance elsewhere. Weakness in the hip musculature, particularly the deep hip external rotators muscles, is a common contributing factor for knee pain.

In the following videos, I demonstrate different exercises designed to specifically strengthen your hip and lower leg in order to address muscles imbalances common with knee pain. Addressing these muscle imbalances can lead to the permanent resolution of your knee pain and symptoms.

My Top 3 Videos to Self-Treat Knee Pain:

The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain – The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. In this video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

How to Use the Clamshell Hip Exercise to Treat Knee Pain – Knee pain is the most common running related injury. The root cause of many of the most common knee related issues is hip weakness. One of the best ways to treat many common running aches and pains is to focus on strengthening these muscles which include the gluteus medius, the tensor fascia latae, and the other deep hip rotators. In this video, I demonstrate how to perform the clamshell exercise. It’s an excellent non-weight bearing exercise to work on hip rotator strength which will directly affect knee stability.

A Barbell Knee Stability Exercise for Runners – 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.

If you’re interested in more thorough guide on how to self-treat knee pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

I WANT TO BE RESILIENT!

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

7 Strategies to Renew Your Health

I often hear others comment, “It’s too late to make a change now. I’m too old!” Worse yet, so many people actually believe that, but I don’t! I believe that it is never too late to change. You are never too old or out of shape to make improvements and renew your life. Being healthy and aging well is not a single choice to be made once and then never re-visited. It is a series of constant choices that add up to a way of living and constant renewal.

Aging well encompasses all of the following aspects of our being: physical, mental, emotional, and spiritual. It also includes the community around us. This year, choose to make small consistent choices to renew these areas of your life. This will make all of the difference in aging well. Each person’s physical journey as he/she ages is different. Taking consistent and appropriate action now can vastly change future outcomes.

7 Strategies to Renew Your Health: 

Walk more!

Walking is one of the most fundamental activities we perform as humans. Research is very clear that frequent movements (like walking) are the key to avoiding many chronic conditions. Walking lowers your risk of Alzheimer’s disease, heart disease, stroke, and diabetes. It can lower blood sugar levels when performed directly after meals. Elevated blood sugar levels are a major contributing factor to excessive internal inflammation which is associated with most chronic illnesses. Walking can also be an essential component in psychological well-being. Walking as exercise and generally walking more during the day should be considered the first line defense in slowing the aging process and maintaining functional independence.

Embrace fashion.

The first step in adopting a new healthy behavior is to envision and feel what it would be like as if you had already adopted that new behavior. This allows your brain an opportunity to already feel what it would be like to make a change without fully doing so. This can be very motivating. Investing in gadgets or new work out attire, including new walking shoes, can be both motivating and fun. Get in the mindset of adopting the new behavior. Envision how you will look and feel once you have made the changes. Then go for it!

Take control.

There is nothing more important than your health. You have control over most of the aspects in your life that affect your health and well-being. Take charge, and empower yourself. You must be your greatest advocate. Western medicine is designed to keep you alive, not to help you thrive. Taking a passive role in your health is not a wise choice in America’s current health care environment. Only you are responsible for your health. Decisions now will determine how successful you age in the future.

Make the decision.

Research on willpower has shown that it is a finite resource. We actually use up our willpower during the day and have to replenish it daily. This is why you are more likely to “fall off the wagon” later in the day rather than earlier. Decide on the change and commit to the decision. Then implement structure to your day that causes the behavior to be more automatic. Therefore, eliminating the need to rely solely on willpower.

Maintain your strength.

Although all muscle fibers decline some as you age, the fast twitch (Type II) fibers show the most declines. Some loss of strength is anticipated as you age. Losing strength to the point of complete debility or loss of mobility and independence is not a normal aging process.

Strength training is a critical component to maintaining and growing additional Type II muscle fibers. The stronger you are, the more resistant to injury you are. You are more likely to maintain proper functional mobility. Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain.

Perform high intensity training (HIT).

The research on the effectiveness of HIT continues to grow. Even more impressive are the findings that HIT can be safely performed at any age and with almost every medical condition. It is now even being implemented in many progressive Cardiopulmonary Rehabilitation Programs, where people are recovering from all kinds of cardiac and pulmonary disorders such as COPD, heart attacks, and heart valve replacements.

Perform your cardio activity in short bursts (ranging from 30-60 seconds at a time) followed by a one to two minute recovery. The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high. You should be breathing heavy. Accommodations can be made for almost any type of medical condition. For example, HIT may be performed while using a stationary bicycle, an upper body only bicycle, a rowing machine or in the pool. You can also walk uphill at a quick pace, then stop and rest. The point is to get your heart rate up, and then bring it back down for a full recovery prior to repeating.

If you feel unsure as to how to safely perform this type of training, please seek the help of a competent cardiopulmonary trained physical therapist or exercise physiologist.

Get started!

Make 2022 your year to renew your commitment to make the necessary changes that will empower you to age well. Most importantly, just get started! It’s never too late to maximize your health and well-being in 2022 by implementing these 7 strategies.

Which strategy can you implement in order to age well in 2022? Please leave your comments below.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2022! 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. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

A Year in Review: 2021

The COVID-19 pandemic and the events of the past two years have impacted all of us. Through this hardship, we have learned the importance of working together and being proactive in taking control of our own health and well-being. Working together and supporting one another makes taking the necessary steps to age well easier and more fulfilling. Being proactive is a key component to aging well.

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

A recap of my top 3 posts that resonated with you the most in 2021 include:

Fitness Exercise Won’t Help Your Low Back Pain – With so many active individuals and crazy fitness trends you would think that all of this exercise would actually help reduce low back pain, right? Wrong…It turns out that not all exercise (and especially, not all “core” exercise) is created equally. Learn how to safely self-treat your low back pain through movement and exercise as well as some helpful methods for a speedy recovery.

Want Stronger Hips? Do This – Learn how to perform a unique and advanced exercise designed to specifically strengthen your hip and lower leg in order to address common muscles imbalances found in the hip musculature. In this video post, I demonstrate a different version of the monster walk using an assistance band. This is an excellent exercise for hip strengthening.

How to Fix a Crack in your Heel – Worrying about a crack in the skin of your heel might seem a bit odd since cracks are quite common. However, they are painful and can become infected so they need to be taken seriously. Discover the risk factors for a cracked heel and how to self-treat it.

As 2021 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being. In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively. We must truly focus on health and wellness care for ourselves, loved ones, and friends. Together we all can age well.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2022! 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. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

Simple Guidelines for Treating Low Back Pain

Did you know that low back pain (LBP) affects nearly 80% of the US population at one time or another? It is one of the most prevalent medical conditions in the United States and one of the most common reasons why people miss work. However, in MOST cases, LBP is not a sign of a serious life-threatening condition. Only approximately 3% of serious pathology cases report low back pain as a symptom.

While most LBP is not serious, it can be very painful and have a significant impact on your mobility and quality of life. The good news is that you can follow simple guidelines to navigate an episode of LBP.

To safely self-treat your low back pain, first take a moment to assess your symptoms and pain level. What led to your pain and/or injury? Did the pain come on suddenly or slowly? Evaluate the severity of the injury. If you’re experiencing any of the following, please seek immediate medical attention:

  • Loss of bowel/bladder function.
  • Uncontrollable pain. The pain is so severe you cannot function or move.
  • You are losing muscle function or control. The muscles in the legs will no longer work. (This is different than pain preventing the muscle from working.) This sensation of paralysis occurs when the muscles will not actually function.
  • Significant loss of sensation in the leg or groin area. This is not a tingling sensation, but an actual loss of sensation. For example, you cannot feel the toilet paper when you wipe after using the toilet.
  • Onset of pain without any known mechanism for the injury. (Thoroughly consider your activity. Many times, a slow onset of pain begins several hours after performing an activity.)

Simple Guidelines for Treating Low Back Pain:

Opt for conservative care

Most episodes of LBP improve quickly with conservative care. Research has effectively shown that early intervention with physical therapy is more cost effective, improves long-term outcomes, and decreases downstream health care dollars spent in unnecessary imaging and treatments. Unfortunately, the longer persistent LBP is ignored, the more fearful a person can become. This fear leads to decreased mobility which only makes the episode worse.

Surprising to many, but imaging does not correlate well to the causes of LBP. Worse, it often induces fear. The use of imaging is to rule things out. Negative imaging is good news! If your symptoms don’t match what is found on imaging, then more than likely that is not the cause of the pain you are feeling.

Keep moving

Exercise and movement in all directions is safe and healthy for the spine, even when it hurts! If you have LBP, move. If it is painful, modify and try moving again.

When your back hurts, aim for neutral posture to minimize any strain. Spine posture during sitting, standing, and lifting does not predict LBP or its persistence very well.  However, improper posture in sitting, standing, and lifting can increase shearing, torsion, and loading on structures. Avoid putting an excessive load on irritated tissues which can certainly exacerbate an already sore back.

Fortunately, most LBP is mechanical–meaning it is from a physical or structural cause and isn’t related to conditions such as cancer or infections. Most LBP will have a directional preference for extension. A majority of injuries occur when performing a forward biased (flexed movement) like chronic slouching or a spinal flexion biased movement. For discussion purposes, I will be addressing an extension biased program.

With mechanically driven low back pain, you should be able to alter and change your LBP within a short period of time. First, establish a directional preference by identifying a pattern to the pain. Does the pain get worse when you bend over or does it improve? What happens when you repeat this movement?

Determine how your pain responds. If it spreads away from the spine and down into the leg, beware that you are moving in the wrong direction. Stop that particular movement, and instead try flexion biased movements. In my experience, most episodes of LBP tend to respond better to extension biased movements. If flexion or extension doesn’t help or change the pain in any way, then you may need assistance from a medical provider.

The rule of thumb for movement: If the pain worsens by spreading peripherally down the buttock and into the leg and/or foot, then the condition is worsening. We must stop that activity. If the pain centralizes and returns back toward the spine (even if the pain worsens slightly), then keep moving as the condition is actually improving.

Strengthen your core muscles

Your core is likely not what you think it is. Weak abs do not cause LBP. However, poorly coordinated pelvic musculature can precipitate and perpetuate LBP.  Stop performing sit ups and start learning how to truly activate and strengthen the muscles of the inner core. Watch now as I describe what really the “core” is and why it matters. CLICK HERE

Constant low back pain can result from chemical inflammation to sensitized or damaged tissues. Intermittent pain is more often mechanical. Understand that medications are useful for helping reduce chemical inflammation, but addressing mechanical factors as well will lead to a quicker (and long term) recovery in most cases.

Unfortunately, low back pain will re-occur almost 90% of the time. To ensure a complete recovery from an episode and to help prevent re-occurring episodes, address other contributing areas such as the upper back (thorax) and your hip mobility. Typically, there is weakness in the deep stabilizing muscles known as the multifidus muscles. In the presence of LBP, these muscles will reflexively shrink, weaken, and lose function. Without proper rehabilitation, the muscles will not fully recover. This increases the risk of future episodes because the spine no longer has the ability to stabilize itself normally. Not all “core” work is created equally, so the strength of these muscles should be addressed.

Be as active as you can

Don’t stop moving, but avoid exercises that make your back hurt more. Typically, this includes flexion biased movements like sit ups. It’s important that you remain as active as you can. You may need to taper down certain activities that you know will increase your pain. This typically would be activities involving heavy loading of the spine such as squats with weight, deadlifts, and other activities that may cause forward flexion (particularly, under a load).

As you are able, continue to work on cardiovascular conditioning and core muscle activation (particularly, the lumbar extension exercises). Lift weights if you are able. Refer to the rule of thumb for movement (the concept of peripheralization and centralization). If your pain progresses from the area of the injury into your leg, then you need to stop that activity. If the pain remains constant or is progressing out of the leg, then continue with the activity as you are helping the body to heal.

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

If you’re not sure how to effectively and safely exercise your back or if you’re already experiencing low back pain, be sure to check out my Treating Low Back Pain (LBP) during Exercise and Athletics Book and Video Package. USE DISCOUNT CODE LBP AT CHECKOUT FOR 15% OFF!

For the approximate price of just one co-pay to see a doctor, you will receive my easy to read book with step-by-step instructions and a complete video package designed to help you prevent and self-treat re-occurring low back pain episodes.

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

Advanced Techniques on How to Treat Hip Impingement

Hip impingement pain is commonly felt in the groin, front of the hip or sometimes the side of the hip or deep in the buttocks. Like many lower extremity injuries, hip impingement is often multifactorial stemming from muscle strength imbalances (often due to weakness in the deep hip external rotators) and/or hip mobility imbalances. These mobility imbalances combined with muscle strength imbalances lead to altered hip biomechanics and ultimately, pain and inflammation in and around the hip labrum. These issues can be accelerated or started by a traumatic event or an overuse situation. The biomechanical imbalances cause the labrum of the hip to become inflamed and painful. This inflammation makes the biomechanical issues causing the impingement worse which just perpetuates the problem. Addressing these muscle imbalances can lead to the permanent resolution of your pain and symptoms.

In a previous video, Treating Hip Impingement: Basic Techniques, I addressed the basics of how to self-treat hip impingement syndrome. In this video, I go over advanced techniques of how to utilize a EDGE Mobility Band or a pull up assistance band to help self-mobilize the hip and very quickly eliminate your hip impingement.

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If you work on your deep hip external rotation strength (as demonstrated in this video) along with the mobilizations you are likely to see results even faster.

If you’re interested in a more thorough guide along with other videos on how to self-treat lower extremity injuries and pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by following The Physical Therapy Advisor!

Basic Techniques on How to Treat Hip Impingement

A common reason for anterior hip pain, groin pain or even side of the hip or deep buttock pain can be hip impingement. Hip impingement, like most hip pain, is often multifactorial stemming from muscle strength imbalances (often due to weakness in the deep hip external rotators) and/or hip mobility imbalances. These mobility imbalances combined with muscle strength imbalances lead to altered hip biomechanics and ultimately, pain and inflammation in and around the hip labrum. These issues can be accelerated or started by a traumatic event or an overuse situation. The biomechanical imbalances cause the labrum of the hip to become inflamed and painful. This inflammation makes the biomechanical issues causing the impingement worse which just perpetuates the problem.

In this video, I go over the basics on how to treat hip impingement. I discuss what to stop doing immediately and what you can start doing to eliminate your pain in order to get back to activity quickly without surgery or painful injections.

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Be sure to check out my other video, Treating Hip Impingement: Advanced Techniques.

If you’re interested in a more thorough guide along with other videos on how to self-treat lower extremity injuries and pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by following The Physical Therapy Advisor!