Exercise

3 exercises to prevent low back pain

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These 3 exercises are termed ‘the Big 3’ by spinal researcher Dr Stuart Mcgill. The exercises are performed in a neutral back position – a spine sparing position and it helps to build muscular fitness along with stability and control throughout the spinal column. Spinal stability is what creates a strong core.

You do not have to be in pain to perform these exercises. These are actually best used as a preventative method to prevent back pain! Although if you are in pain, they are still a great way to help you get your core switching on again.

Some things to note:

·   The exercises must be performed daily

·   The best time is mid-morning or dinner time. Not upon waking – as this is when the spinal discs are at their fullest and therefore less room to move

·   Reps and sets are important to what you can tolerate. There is no point trying to push through excruciating pain. Find your level and then progress

·   Try and ensure that all 3 exercises are performed in a pain free posture for your spine.

1. Bird dog

Position yourself on all fours. Raise your right hand forward while simultaneously extending your left leg back, until both are parallel. Bring both arm and leg back into the resting position and then repeat with the opposite arm and leg. This is one rep.

Make sure your pelvis has minimal rotation while performing this exercise. The value of this exercise is coordinating upper back, lower back and hip movement all together.

Perform 1 set of 8, followed by another set of 6, with a final set of 4.

2. The side plank

Lie on your side, resting on your bent forearm, with your legs straight out

Lift your hips off the floor and hold for 10 seconds. You should feel your abdominal muscles and obliques (side) working. This exercise also works the quadratus lumborum (QL), a major spine muscle that plays a role in spine flexion and rotation. This exercise gets the  QL and oblique muscles working together in coordination.

Perform 3-4 holds per side of 10 seconds each. Repeat for 3 sets, but with each set, reduce the reps by 1.

3.      The curl up

The Mcgill curl up is not like your traditional curl up. There is no movement from lumbar spine.

Start by lying on the ground, with 1 leg bent up and the other leg straight (the painful side should be the one with the straight leg). Place both hands under the small of your back, this will ensure minimal movement through the lower back.

Lift your head off the ground by a few inches and then hold it there for a count of 10. The goal is to perform this without any movement in the lower back. If you feel your lower back rounding, then your head or shoulders are too high off the ground.

During this, you should feel your abdominal muscles brace – this is the spinal stability

Repeat another 5 times for a total of 6 reps. The recommended volume is 1 set of 6, followed by another set of 4 and the final set of 2. You do not need to hold the curl up for more than 10 seconds, rather to progress you can increase the reps.

Conclusion

I recommend using these exercises every day as the best preventive measure to avoid lower back pain. If you do have back pain, they are also great to perform as they can be done in a pain free position. The key is being consistent, once a day and before any exercise.

Mitchell Roberts – Chiropractor

Is it safe to exercise when you have the cold/flu?

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With winter here, it is that time of the year for the cold and flu season. Getting sick and taking time off of training / exercise can be a real setback for anyone who has put in the hard work throughout the year in achieving their fitness goals.

The question often arises, ‘how do I know if training will make me even more sick’? A general rule is the “neck check”. If you have symptoms in the head or throat, it should be ok to do light / moderate intensity exercise. If the symptoms are below the neck, it is best to rest.

Following the neck check rule, you can exercise when suffering from:

 

  • Runny / stuffy nose
  • Watery eyes
  • Mild headache
  • Mild sore throat

It is important to remember that you need to keep the intensity to moderate. Do not try and attempt a record weight or perform reps to fatigue. Stay hydrated and ensure adequate rest after exercise.

 

 

Avoid exercising when suffering from these below the neck symptoms:

  • Chest congestion
  • Nausea
  • Fever/chills
  • Coughing up mucus
  • Joint/muscular aches
  • Diarrhea

The benefit of exercising throughout the winter months – it helps to prevent respiratory infections. A 2012 study from Barret et al, found that moderate aerobic exercise of 30-45 minutes duration can half the risk for respiratory infections. Examples of exercises can be walking, running or cycling. So one of the best preventative techniques for avoiding the cold/flu this winter is to get moving!

  1. Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial. Barrett et al. Ann Fam MedJuly/August 2012 10 no. 4 337-346

Mitchell Roberts – Chiropractor

The 3 best exercises to prevent low back pain

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A question I often get asked in clinic is what are the best exercises to perform to prevent low back pain. The below exercises are my ‘go-to’ for prevention of low back pain. They have been termed ‘The McGill big 3’ – named after the researcher Stuart McGill.

Stuart McGill is a spinal biomechanics researcher from The University of Waterloo, Canada. These role of these 3 exercises is to create spinal stability and endurance – which is essential for creating a stable foundation for the lower back.

The exercises aim to tighten up the front and sides of the core, while supporting the spine and remove gravity from the equation. The exercises are of a low intensity and are safe to perform.

Curl up – 3 sets of 10-12 reps

Bird dog – 3 sets of 10-12 reps

Side bridge – 3 sets of 8-10 seconds holds, each side.

If the above rep scheme is too hard, you can always modify it by reducing the number of reps and work your way up to the noted rep scheme.

It is also recommended to do these exercises before training as well, as it has shown to tighten and stiffen the core post performing them.

Perform these exercises once a day, not into pain. If you do have questions, pain or discomfort when performing these exercises, come in and see us and we can either correct your technique or advise you on alternative exercises.

 

References:

McGill, S.M. (1997) The biomechanics of low back injury: Implications on current practice in industry and the clinic. J. Biomech. 30: 465-475.
McGill, S.M., Low Back Disorders: Evidence based prevention and rehabilitation, Human Kinetics Publishers, Champaign, Illinois, 2002.

Mitchell Roberts – Chiropractor 

Exercising into pain with a chronic injury?

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A recent systemic review and meta-analysis titled “Should exercises be painful in the management of chronic musculoskeletal pain?” by Smith et al 2017 was published. It looked at exactly what is mentioned in the title, should it hurt when performing rehabilitation exercises. This is a very common question I get when in clinic and prescribing exercises.

The findings as listed in the paper:

· Protocols using exercises into pain for chronic musculoskeletal pain offer a small but significant benefit over pain free exercises in the short term

· Adults with musculoskeletal pain can achieve significant improvements in patient reported outcomes with varying degrees of pain experiences and post recovery time with therapeutic exercise

· Pain during therapeutic exercise for chronic musculoskeletal pain need not be a barrier to successful outcomes

· Protocols using exercises into pain typically have higher loads and dose of exercise

So the short answer is yes! Exercising into pain is OK if you have a chronic injury.

The theory behind why exercising into pain being beneficial is that it effects the central nervous system. The exercises address psychological factors behind chronic pain, that being fear avoidance behaviours. When we have chronic pain, our movement patterns are different – due to the subconscious mind/nervous system tightening up and restricting/guarding against movements.

Therefore, by moving/exercising into pain, it tells the brain that the tissues are OK and that by progressing it is not causing damage to the tissues. A hurdle that is often hard to overcome in chronic pain is that pain does not equal tissue damage.

Please note, that this research is into chronic musculoskeletal pain (lasting greater than 3 months), not acute pain. Consult with your health care professional before starting an exercise rehabilitation program.

 

Smith BE, Hendrick P, Smith TO, et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis
Br J Sports Med Published Online First: 08 June 2017. doi: 10.1136/bjsports-2016-097383

http://bjsm.bmj.com/content/early/2017/07/12/bjsports-2016-097383

 

Mitchell Roberts – Chiropractor