back and injury

The power of being human in healing & recovery

Photo by Anete Lucina via unsplash.com, edited by KT

Photo by Anete Lucina via unsplash.com, edited by KT

In the last month of 2016, I was deeply struck by the death of AA Gill, a "journo giant", who died from cancer. It inspired me to write this article about why being human to each other, and to ourselves, can have a profound affect in healing and recovery and at the very least make an individual feel that they matter, especially when facing terminal illness.

 

AA Gill's last article, published just one day after his death explained his traumatic and frustrating journey of care from the NHS in the last months of his life. I was struck by how beautifully he narrated his situation. He was denied a life lengthening treatment, immunotherapy, because it is too expensive to get on the NHS. He acknowledged the genuine care towards of the people who work within the NHS towards him, mentioning in particular a nurse who was devastated to learn that his chemo was no longer working. He ended his article by saying,  "you don't get that in the private sector" referring to the humanity and empathy of the nurse.

You can read AA Gill's parting gift to the world here:

http://www.thetimes.co.uk/article/more-life-with-your-kids-more-life-with-your-friends-more-life-spent-on-earth-but-only-if-you-pay-d7lwpht3j

 

Same same but same

The turn of a new year always makes us a bit more philosophical as we look back at what we have achieved and then look forward to what lies ahead for us. I see countless Facebook posts about 2017 being the year of kindness, of solidarity, peace, togetherness, humanity. I myself posted my new years message, urging people "to be the change you want to see".  New year or mid year, we all want the same thing to feel the humanity of others and to feel that we matter. It's what connects us and it has powerful healing properties.

 

How to be human 

Above all, whether you work with people or have people in your life who are in pain or recovering or not, the way we can help each other in a daily way is just by being human. Being human to me means being kind. It means holding space for someone when they need you; listening to someone in need of being heard; giving of your time, energy and love. It also means holding space for yourself, listening to yourself and allowing yourself to be quiet, giving back to and loving yourself. I believe the body knows how to heal itself otherwise our species would not have survived this long. It needs the right conditions - physically, mentally and emotionally to help it along. 

 

Humanity heals

This is relevant in our personal lives, in our work life and particularly in medicine and therapy when you seek help for illness and injury. Being human or what the medical profession often call "bedside manner", can have a profound affect on your perception and ability to recover.  It is really important that you choose therapists and medical practitioners you trust, have a good relationship with and who hold space for you without judgement or ego during your healing and recovery. If you feel you need more "human" than what is being offered do not be afraid to walk away and find therapists who better suit your needs. My new guru, the late Louis Gifford, believed that the human part of therapy and medicine is as important as the healing of tissue, because you, your consciousness, is part of that healing. Your synaptic connections, your thoughts, play a part in what messages get sent from the brain to the tissues. Feeling safe and cared for positively impacts your emotional and mental outlook on recovery.  

 

Human yourself  

And kindness and humanity doesn't always have to come from others. Being human to yourself is just as important. I firmly believe part of the self-management of your own injury or condition is being kind, loving and compassionate to yourself. So go be more human to yourself and others in 2017 and see what impact it has on your healing and recovery, your life and the lives of those around you.

 

If you are struggling with an ongoing injury, or have suffered with ongoing pain that just won't go away we can help. Please contact KT at KT@precisionmovement.co.uk for a complimentary phone conversation. 

 

 

 

 

Is this the best hotel gym space in London?

 

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As many of your know Precision Movement has been making extensive additions and changes to our little Mayfair studio space courtesy of Grosvenor House Apartments.  And though she be little she is (mighty) fierce and versatile.  Here are the new changes to the space and how they optimise your workout.

 

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The rig 

This March we had a custom designed BeaverFit rig installed into the ceiling.  This has been the most anticipated change in the studio since we moved in.  The rig will be used for pullup/chin up and brachiation training. Also check out the fat GRIPZ for extra intensity without extra load.  It has proved super popular so far! 

 

 

 

Suspension Training 

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The rig also enables us to use TRx, Crosscore180 and Olympic Rings for suspension and aerial training.  Bring on the strength!  The rig is 3.5m long meaning we can have someone working on the Kinesis, someone working on the TRx and someone in the weight area quite comfortably.

 

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The floorspace 

The matted floorspace has been increased by a third meaning more workable space for people to use and more people using the space at the same time.  It also means the floorspace becomes more versatile - we can bring out a barre for a ballet workout or clear the space for kickboxing or a yoga based work-in.  We have had some guests using the space to practice their karate katas and MMA moves.  We have left the space open for just this purpose because no single person's workout is the same and we want to cater to that as much as possible.

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We now have adjustable weights up to 41kg each alongside the original rack of 1-10kg.  We have a few olympic bars and weight plates for more traditional strength training as well as weighted medicine balls and powerbags.  The original Kinesis cable machine is still installed as well.

 The bring out put back system 

We have lots of different equipment that can be used in the space - kettlebells, powerbags, battling ropes, agility equipment, olympic bars, medicine balls.  We bring out what we need into the space for your specific workout and then put it back to open the space up again.  It sounds really obvious but many gyms, particularly hotel and residence gyms are the same space as our little studio but packed full of machines which limits the type of exercise you can do in the space. Training has moved on past machines... there are some uses for machine work but at Precision Movement we are more steered towards challenging your body in different ways. Which is why we think our space is becoming one of the best hotel gyms in London. 

The space is being used more than it ever has been and it's being used in many ways, for all kinds of movement, workouts and sports conditioning.  If you haven't been down to visit yet, then please do. We'd love to have you! 

Do you want to know what KT is really like?

Let's face it, I'm hard to sum up in a tidy little phrase - though many have tried!  So I asked my lovely clients, the recipients of my knowledge and expertise to describe their experiences of working with me. My fabulous web/video/media guys at SquareGlu sprinkled magic dust over it to produce this little movie... 

 

Thanks to to my lovely clients for taking part - I did tell you I'd get you your five minutes of fame! And thanks to SquareGlu for making such a professional end product.  

 

Popcorn at the ready.... ;) 

 

How to get a fitter body with less exercise

We live in a culture of more is better but when it comes to exercise more is not always better.  In some cases it's just down right worse.  There is a growing culture in the fitness industry of late that more intensity, more volume of workouts per week and more of the same thing is the only way to get serious about your fitness.  I wholeheartedly disagree and I have seen this result in serious injury, total burnout and illness as well as mental and emotional fatigue and irritability.  I consider over exercising a form of self sabotage or self-harm and I can speak from personal experience on this.  I have grossly over-exercised at times in my life and it's never led to anything good.  So, this week I talk about how much is too much and how to find a balance that works for you and your life.  Remember you are only ever competing against yourself!

 

Too much intensity

In the past few years there has been an uprising of high intensity group workouts which really push the limits of intensity to the threshold.  But the most shocking story I recently heard was of a gym in NYC that does the toughest workout ever burning a minimum of 1000 calories in a hour.  Apparently you get a badge of recognition if you can get through the warmup without stopping.  Are you kidding me?  A warmup is not a place to compete - EVER!  That is just dangerous.  The point of a warmup is to prepare your body for the intensity of your workout.  If your warmup is the workout you are putting yourself at greater risk of injury because your body is not warm yet!

 

Monitoring intensity

An easy way to measure the intensity of your workout is to wear a heart rate monitor.  Set your age and weight and it will calculate training zones for you.  A high intensity workout oscillates between 70-90% of your maximum between 1-3 minutes.  You can work longer than 3 minutes depending on what you are training for and your current fitness level.  For strength training heart rate monitors are not so effective because time under tension is often shorter than a minute and you get a delayed heart rate increase.  And FYI a warmup should work from 50-70% over a period of 7-10 minutes.

 

Too much volume

This is the biggest problem I have with too much - too much volume.  Volume is the number of training sessions or the total amount of hours spent exercising per week.  Everyone thinks the more I exercise the quicker I'll achieve my goal.  Not true.  Over exercising induces a prolonged sympathetic stress state which leads to mental, emotional and physical burnout.  It can also lead to injury. 

 

Monitoring volume

I talk more about volume in next weeks blog (The work-in is the new workout)  but here are the basics; for general health, wellness and fitness choose 2-3 high intensity (between 70-90% of your max effort) 40-60 minute workouts a week. Balance that out with 1-2 calmer work-ins like yoga or tai chi.  When you go through more stressful times you can switch this to 2-3 work-ins and 1-2 workouts.  For very stressful times I would opt for the work-ins only.  Movement helps to relieve stress if it is done in a gentle and reparative way.

 

Too much of the same thing

Another problem of too much - is doing too much of the same thing.  This can lead to injury because of continuous repetitive motion particularly from running and cycling.  It also becomes very boring and can lead to mental burnout and then stopping exercise altogether.  As humans we have amazing movement potential and I believe we should utilise and practice the diversity of human movement as much as possible.

 

Changing it up

I always encourage my clients to a variety of different exercise and sports.  Try new things until you find something you like.  Team sports are always fun to be a part of and I also really value solo workouts like running or cycling when you can be with yourself.  Hit the gym, go to a class, in London there are so many options!  As long as you are doing good movement - vary it as much as you can.

 

Train smart

So in conclusion your body and your mind will thank you if you train smart.  Harder is not always better.  If you are training for a specific sport or event that does require very high intensity training then seek out a professional to guide you.  Just as you are specialist at what you do and people seek out your skills to help them, so are sports and fitness professionals specialists at helping you train. 

 

Lastly, as I said in the third paragraph, as long as you are doing good movement.  If you are not sure what good movement is and have never sought out help with learning what good movement is then I would highly advocate that you do.  We seek out specialist advice for everything else - movement masters are there to help you learn better movement.  Once you know the basics then you can apply it to any sport, class or workout.  We can definitely help you with that at Precision Movement! - contact us to discuss your specific situation.

How to detox your whole life

It's that time of year when the word detoxification is in every conversation you have.  And I had the great privilege of being asked by Men's Esquire to advise on detoxification which you can read below.

If you are going to start afresh with anything it makes sense to start at the beginning of the new year.  Let me know your thoughts on Facebook and Twitter!  

Can I really help you?

I spoke with someone on the phone a few weeks back with Mr BackPain, who has a particularly complex back problem and at the end of the call he asked me "can you really help me?".  It's a brilliant question that should be asked more frequently and my answer to him is what inspired this blog post.  If you are wondering if I can help you or someone you know then read on.... (and at the end I reveal what happened with Mr BackPain!)

 

Mr Back Pain

Mr BackPain has had a problem with his back for more than 15 years.  He had an operation to try to fix the problem and it made no difference.  He had given up hope of ever being pain free. 

Most of the people who walk through my door have exactly the same problem - long term pain that just doesn't seem to go away no matter what they try.  At Precision Movement we make sure we find out what is really going on.  If that means you need more specialist assistance we'll make sure you get it.  Our MO is to get you better - we want you walking out of the clinic a changed person and we'll do everything we can to make sure that happens. 

 

But I've tried loads of things...

Mr BackPain is a proactive man and tried many many treatments and remedies to get better but to no avail.  Just like you, so have most of the people I work with.  They have taken a stab in the darkness of treatments and thought ok I'll try this.  Then when it hasn't worked they've gambled on something else.  Or they have been blindly led from one practitioner to the next with little improvement.  Would you blindly hire someone to take care of your children?  Or run the accounts in your business?  Probably not! 

 

Combination of specialists

There are many components of recovery from back pain.  At Precision Movement we are experts in rehabilitation and movement and we also know our limits!  We have found that it is the combination of treatments from the best experts working together that get you better faster rather than one treatment or random treatments that don't fit well together or in series.  We have hand picked the experts we collaborate with in orthopaedics, physiotherapy, osteopathy, specialist chiropractic, nutrition, lifestyle and stress management - check out our Partners page coming soon, or ask me in person or by email (KT@precisionmovement.co.uk).  We want our work to benefit you at the right point in your recovery so we may send you to another specialist first or in conjunction with the work we are doing.   Remember our MO is to get you better - whatever that takes we'll make it happen.

 

The RIGHT exercise for you

Mr BackPain had tried some exercise on the advice of a practitioner some rehabilitative corrective work and some more conventional exercise like running and it often made his pain worse.  

One of the key components to getting better from pain caused by inactivity, structural damage, degeneration and trauma is the right movement therapy.  Any old movement just will not do.  I see many people who have been 'moving' or given specific exercises some of which have merit.  The issue comes with remembering how to do them correctly alone and actually do the exercises regularly! 

 

We're different and we work 

The first important difference we give people who work with us is the foundational principles of movement.  We educate and teach our clients the 4 pillars of movement - alignment, mobility, stability and strength so all of their exercises become more effective and beneficial. The second important difference is consistency - we make sure you do your exercises correctly and regularly.  The third component that makes our process so successful is we educate you on why we ask you do to do certain exercises.  It makes the experience more mindful and purposeful.  Our clients leave understanding how their body works better and they are able to identify themselves when they are in and out of good alignment.

 

So can I really help you?

The answer is yes I believe I can help you.  I have an excellent track record of helping people out of pain, improving alignment, stability and strength and I'm pretty good at judging when you need additional assistance from other areas.  If you need to see some even more brilliant specialists before you focus on rehabilitative exercise with us we're totally cool with that! 

Incidentally, if you were wondering what happened to Mr BackPain he said, "thank you so much for being honest with me.  I have had back pain for 15 years and even after my operation it is just as painful.  You are the first person in all my experience who has taken an active interest in helping me get better."  I have referred him on to a specialist who I'll be collaborating with and when he's ready he'll come and do his rehab work with me - 'coz that's just how I roll!

Contact us today to find out how we can help you - make 2015 the year you sort out your aches and pains for good! 

The red flags of skiing injuries

Downhill Skiing

Downhill Skiing

We are fast approaching snow sports season!  January through to April is my busiest sports injury time.  I see more injuries during this period from snow sports than any other time of the year.  Let's face it there is a risk to engaging in any sport - snow sports perhaps a bit more than others.  However, if you adhere to some basic advice you can minimise the risk of injury.  In this article I share that advice with you....

Not conditioned for snow sports

If you are going on a skiing vacation this winter now is the time to start getting your body ready.  I would recommend a gym programme that trains the biomotor abilities of skiing and snowboarding, which are balance, power, strength, and agility.  Specifically you need to have a strong stable pelvis and spine to widthstand the forces of skiing and snowboarding movements.   Rotational and lateral stability are very important too.  And you need stability and balance training so your brain and body can figure out quickly how to change direction and deal with the unstable surface of snow underneath you. This sounds like a lot I know.  The art of training efficiently for snow sports is something we can help you with at Precision Movement.  If you would like to learn more then get in contact with us for a chat. 

Attempting level that is beyond your current ability

Whether you are a daring beginner with a penchant for danger or a seasoned veteran of snow sports, it is always prudent to work within your abilities.  I have seen many injuries throughout my career caused by over-zealous dare-devil stunts!  I cannot stress enough how important it is to be sensible and the reason why is highly linked to my next point…

Someone running into you

Now this is probably the most common reason people get injured in snow sports and it is not something you have much control over unless you are the one crashing into someone else.  The best advice I can give here is, stick to runs that are within your ability, always have your wits about you, don’t rush, always wear a helmet even if it cramps your slope style and lastly, give crazies a wide berth!  Also, I’m going to add watch out for young children who are speed demons – they have no fear and also believe they are small enough to fit through the tiniest gaps between people. 

Lack of sleep and alcohol consumption

I personally think skiing and snowboarding is one if the best holidays because you get to be active as well as taking lengthy lunches atop a mountain and then partying with your friends into the wee hours of the morning.  It has everything that makes a holiday good!  With the good times also comes lack of sleep and more often than not a larger than normal consumption of alcohol.  Firstly, lack of sleep will impair your cognitive and neuromuscular abilities on the slopes the next day.  Basically, when you are tired all your communication channels become smudgy and lackadaisical which can increase your risk of injury.  Be aware of how many hours you sleep and if you’ve had a particularly late night then take it easy on the slopes the next day.  Alcohol makes you more tired and impairs your sleep.  I’m not saying don’t drink – just be mindful of what you consume with a thought to your activity the next day.

Ignoring weather conditions

I have had personal experience with this.  On my first snowboarding trip I decided to bravely venture out by myself on my last day and prove that I could snowboard unaided and find my way around the slopes like a pro.  Unfortunately, I picked the worst day – a complete whiteout.  I didn’t even know what a whiteout was until I was in it!  Obviously I thought I was going to die - first from motion sickness, then from losing my way and getting stranded.  Amazingly I survived without a scratch!  Accidents are much more likely to happen during adverse weather conditions because visibility is so poor.  Really consider whether it is worth going out when the weather is bad.  Sometimes staying in your chalet for the day in your long johns and ugg slippers sipping hot chocolate is a better option! 

I know some of these points seem a little obvious but it never hurts to be reminded, especially in the spirit of minimizing the risk of injury.  It’s always easier to say “in hindsight…”.  Let’s make this an injury free ski season – well as much as possible!  Happy skiing and boarding have some Raclette for me!

Top 4 Essentials for Injury & Back Pain Recovery

Precision Movement essentials for injury and back pain recovery
Precision Movement essentials for injury and back pain recovery

Injuries are not fun - they hurt, they stop you from doing things that you love and they do take time to get better.  There are certain essential elements to effective recovery that if adhered to definitely help speed up the process.  Read on to find out more...

The Right Exercise

Every injury will need some form of exercise rehabilitation.  If you have broken a bone or have had surgery your rest time will result in atrophy (shrinkage) of certain muscles surrounding the joint/area.  It is essential that you get these muscles firing again for appropriate support and functional movement.  Injuries that are caused by other than trauma are often accompanied by muscular imbalance which results in a joint or area taking too much stress or not having enough support.  In this case it is imperative that you rebalance the body with exercise, break down poor postural habits and movement patterns and learn ones that serve you more effectively. 

Once you have had the go ahead to begin exercise it is essential that you go through appropriately progressive and specific exercise that is bespoke to your needs.  This is where a corrective exercise specialist can really help you.  Jumping back on the treadmill or hitting it hard in the gym, however tempting, is not the answer and will most likely put you back on the triage stretcher.  For more information on the difference between corrective exercise and regular exercise click here.

Sleep

Sleep is where healing and recovery happens.  When you sleep your body is in a parasympathetic state.  This means it focusses on digestion, absorption of nutrients, transportation of nutrients to cells for healing and reparation and the removal of toxins.  The body revives itself from the daily stressors it has gone through as well as larger issues like the regrowth of broken bone or the healing of tendon or muscle tears.  Make sleep a number one priority if you are healing from injury.  Aim to sleep a minimum of 8 hours ideally between 10pm-6am Your physical recovery happens between 10pm-2am and mental recovery between 2am-6am. This is especially important if you are doing rehabilitative exercise as both your brain and body need this rest time to process new patterns, make new connections and strengthen those connections to make them the preferred pathways for stability and movement.

Nutrition

You are what you eat - or more accurately, you are what you absorb.  I have broken this section down further to three important areas - sugar, fats and proteins and hydration.

Sugar is very inflammatory to cells - especially ones that are trying to heal.  Limit your intake of sugar and processed foods and focus on eating as clean as you can.  Clean eating means eat from the earth - nothing processed, nothing boxed or packaged, nothing containing preservatives.  It also means eliminating anything that is inflammatory to your body.  Gluten containing foods and dairy are two such groups that may need to be eliminated.  Eating foods that you are intolerant to sets off an immune response, puts your body into a nutritional state of stress and diverts the focus of injury recovery to survival against a substance that is considered dangerous to you.  It means taking precious nutrients for healing and recoveryof your injury to deal with the food that is irritating your digestive system. 

Proteins are the building blocks of cells.  I often recommend to clients who are healing from injury to use Great Lakes Gelatin Powder.   You can add it to tea or soups.  It contains high levels of collagen which are the building blocks for tendons, ligaments and bones.  You can purchase Great Lakes Gelatin from Pure Body Balance and for more information on how to use it look at Karen Maidment's cookbook Meals that Heal.

Hydration is an absolute essential to good health as well as healing and recovery from injury.  Aim to drink at least 2L of water a day, preferably mineral or filtered. 

Thoughts become things

Of all the elements of healing and recovery, in my clinical experience, your mind is the most important factor.  You will recover quicker and more effectively if you maintain a positive mental outlook about your injury and about life in general.  I often ask my clients to say affirmations with each repetition of a rehabilitative exercise, such as, "I am getting stronger", or "I am getting better every day".  I also advocate good old meditation to cultivate good mental energy and you can even target it to heal your injury.  It might sound a little hippy, but I promise you thoughts become things.  You can choose to be grumpy and irritated about your injury and tell yourself that it won't get better or you can tell yourself that you are getting better every day.  As one of my favourite sayings by Henry Ford goes, "Whether you think you can or you think you can't you're right".  My favourite healing mental states include gratitude and laughter.  Of late I've been reading a lot of articles about how laughter is becoming part of Cancer treatment.  So give thanks for all you have in your life and get your friends round for a good old laughter session.  You'll be healed in no time!

For more information about the right type of Corrective Exercise for the recovery of your specific injury please visit our website or contact KT direct at KT@precisionmovement.co.uk

My 5 recommended Articles on Fitness Nutrition

At Precision Movement, I get asked about what to eat for health, fitness, weight loss and general well-being all the time.  I have had nutrition as a topic to write about on my list for ages.  It is not for lack of knowledge.   The real reason is because I read articles that basically say what I would say and advise.  So, in the spirit of time economy and not being able to do better myself, here are my top recommended 5 articles on nutrition for general health and wellness including my top recommendation for a nutritionist in London who I regularly send my clients to.

You are what you absorb

The phrase you are what you eat is sadly outdated.  It doesn't matter how healthy your diet is unless you are absorbing the nutrients that you are consuming.  One of my favourite bloggers, Mark Sisson, explains why gut bacteria is an essential part of nutrient absorption and how to cultivate good bacteria from nutrition.

16 things that affect your gut bacteria 

Gut health

Another one on the health of your digestive system.  I interviewed my go-to nutrition guru Hannah Richards on why digestive health is the keystone to weight loss and good health.  I send all my fitness, injury and pain clients to Hannah and I only ever get amazing results!

Healing the Inside of You

Protein power!

What with the rise of Paleo eating there has been a real buzz around protein and it's importance in health and wellness as well as sustaining appetite.  Optimal protein intake is imperative if you are wanting to gain muscle mass but it's equally important for recovery from any exercise.  This is an interesting article on the symptoms you can experience from not eating enough protein:

Signs you are not Eating Enough Protein

Fats

Fats are always a controversial topic for discussion when it comes to weight loss and health.  I am siding with Johnny Bowden on this one as he discusses the power of coconut oil and how it actually helps you burn fat!

The Benefits of Coconut Oil 

But what should I actually eat?

I know I know its the million dollar question!  Ok here is my favourite list of pre and post workout snacks from Greatist.com.  They don't call themselves greatist for nothing!

50 of the Greatist pre and post workout snacks

So now you know what to eat for your workouts and how to get the most out of the food you eat come over to Precision Movement to improve your fitness.  Guaranteed we have a workout to suit you - check out the options here.  Contact KT at KT@precisionmovement.co.uk.

Ligamentous Creep the Poisonous Weed of Inactivity

Precision Movement's KT explains how ligamentous creep causes back pain

Precision Movement's KT explains how ligamentous creep causes back pain

I often get asked by people why do I have back pain but my friends and family don't?  What is it about my back that is different?  There are many factors that contribute to back pain - genetics, activity throughout life, nutrition, stress and rest ratios, how you perceive pain and threats to your body.  In my clinical experience, I have found that lack of movement and poor posture are common with back pain.  In this article I explain a theory called Ligamentous Creep, how it occurs, how it makes the spine more vulnerable to injury and pain and what to do to minimise the chance of it happening to you.  Read on to find out more...

The Poisonous Weed of Inactivity

Sounds scary right?  It is true that inactivity is like a weed.  It sprouts one day quietly and then before you realise it's everywhere throughout your life.  You stop going to the gym, you stop cycling to work, playing frisbee with your friends in the park and then the couch becomes the love/hate friend you spend most of your time with. 

A typical inactive work day includes getting up and sitting on the tube to work.  Then sitting at work for 7 hours with minimal movement throughout the day, followed by more sitting on the tube home and then sitting to watch TV on your couch.  Noticing the trend here?  Sitting - it's the fertiliser for weed growth.

Ligamentous Creep - How it occurs

In the spine you have the bones (vertebrae), intervertebral discs, connective tissues (ligaments, tendons), muscles, nerves and blood supply.  Ligaments are super strong cables that connect bone to bone. They respond to tensile loading - being pulled apart.  When they are lax, they give no support. 

Precision Movement shows how sitting badly can cause pain

Precision Movement shows how sitting badly can cause pain

In a poor sitting position (see picture right) the ligaments at the back of the spine are being stretched and the ligament at the front of the spine is lax.  Ligaments can be stretched but they do not return to their original length.  If you sit like this throughout the day your ligaments will gradually 'creep' - or stretch over time.  Do this for long enough and it will create an imbalance and leave you susceptible to pain and injury.

Why it leads to injury and pain

When the ligaments are overstretched it changes the posture of the spine.  Remember the body adapts to it's environment.  Instead of the spine maintaining a neutral alignment that helps keep all the discs, nerves, vertebrae in place the spine warps into poor posture.  This poor posture can encourage the discs to push out onto the nerves.  It can cause impingements (pinching) of the nerve roots.  It also changes the length-tension relationships of the surrounding muscles - so muscles that help maintain good alignment become weaker or tighter, the spine can become  unstable and more susceptible to injury and pain. 

How long does it take to 'creep'?

Liagmentous creep happens over years.  Often in my practice, I see clients in their mid 30s to mid 40s with 'unexplained' back pain.  One day they just crouch down to put their socks on and their back 'goes out'.  The socks are the last straw.  Chances are that if you are inactive and sit for work all day, ligamentous creep will occur without you even knowing over a number of years.  Serious painful problems generally occur after 10-15 years of inactivity and poor posture. 

What to do about it

I am starting to think I sound like a broken record when I say activity throughout life is a big factor in keeping pain away.  The body loves movement and it should become a regular part of your life - a lifestyle choice.  The best type of foundational movement if you are desk bound is a gym session which blends corrective remedial work to maintain good core and back stability and alignment and functional strength training.  Other activities such as running, cycling and sports are also brilliant and you'll see these improving when you are aligned, stable and strong. 

Top tips for keeping the 'creep' away

1.  Invest in a Corrective Exercise Specialist or an experienced and knowledgeable Personal Trainer who can identify your weaknesses, correct postural alignment and teach you the fundamentals of functional strength training.

2.  Stay active throughout your work day by walking a few tube stops to work or cycle.

3.  A lunch time workout is a good choice if you have family commitments.

4.  Don't forget your weekends - you can take a walk or a cycle in the park or the countryside. 

5.  Kids are great for more activity.  Try to get involved in what games they are playing - whether its 10 mins in the garden or a whole day of kite flying on the beach.

At the first sign of any discomfort in your back, especially upon waking or with extended periods of sitting speak to your GP about getting a referral to a physiotherapist.  Also tell your Exercise Therapist or Personal Trainer so they can advise you and adapt your training programme accordingly.

For more information about how Precision Movement can help you with back pain or other discomforts from sitting at work all day please contact KT at KT@precisiononmovement.co.uk.  We are highly experienced in dealing with and helping the recovery process of all kinds of discomfort, pain and injury.  

When on vacation do what KT would do!

Precision Movement's KT shares top tips for avoiding back pain on summer holiday vacation

Precision Movement's KT shares top tips for avoiding back pain on summer holiday vacation

It's that beautiful time of year when we get to take a vacation.  Whether it's long haul or an hour from home, trekking amoung ancient ruins, exploring the hidden streets of a european city or chilling out on the beach - you want to make sure that back pain doesn't wreck your time away.  In Part 1 of this article I talked about back pain occuring during the travelling part of your trip. In part 2 I talk about how back pain can occur whilst you are doing the 'vacation' part of your trip and of course how to avoid it so you can enjoy every moment of the vacation that you have worked hard for all year and that you thoroughly deserve!

The Deck Chair

The deck chair, although a British institution, is the worst seating invention for back pain - ever! When you sit it the deck chair you have no spinal support at all - in fact it encourages the spine to excessively curve (see photo above) which can contribute to Ligamentous creep (read more about this theory here) and then to the intervertebral discs pressing out on to the nerves. On holiday when you want to sit for a good few hours in the sun perhaps reading a good book or the paper your back could really suffer from a lack of support in the deck chair.

Solution:

Choose a more supportive chair with an upright back. If the deck chair is the only choice then pad the low back area out with a pillow, cushion or a towel so your back is more supported and get up regularly to walk around and stretch.

The Sun Lounger

The sun lounger is a more preferable choice to the deck chair as you can vary your position throughout the day.  However, I myself am guilty of setting my lounger up so I can read comfortably for the entire day without changing.  The worst angle is setting the back support at a 45 degree angle.  It puts your back in a similar position to how it is in the deck chair.  It is also common to crane the head forwards when reading which places strain on the back of the neck and upper back.

Solution:

If you must use the 45 degree angle then place a towel or a cushion behind the low back to place your spine in a more neutral position.  Rest the head back or support your head with a cushion or pillow avoid excess strain in the neck muscles. Also, changing up your resting position really helps to minimise the risk of discomfort.  This can be a regular change in the angle of the back support to alternating between lying down and sitting, lying on your front and even on your side.  The more variation of resting positions you use the better your back will fare. 

Upping your activities

On vacation we like to do things that we can't do at home such as watersports and mountain sports .... We tend to forget on vacation how inactive we have been for the rest of the year in place of living in the moment and having an exciting time.  The forces that go through your body during sports like windsurfing, waterskiing, mountain biking, are very high.  These sports require excellent balance, strength in three planes of motion, co-ordination and endurance as well as a highly tuned neuromuscular system to react quickly to changes of direction.  Boris biking a couple of times a week really wont cut it! 

Solution:

The best thing to do to prepare yourself is to train before you go.  Ideally if you have an active nature then you should be training all year round so your body is aligned, stable, strong to withstand the forces of these adventure sports. We train clients in this way on our Fit for Life programme (LINK).  If you are a spur of the moment person opt and are not fit for the sport then approach it sensibly and ask about modifications to minimise the risk of injury.  Another good option for exercise on vacation is Hatha Yoga, tai Chi or Qi Gong - more gentle forms of exercise that carry less of a risk for injury.  If you are heading East then these options will be plentiful!  Many European resorts and main towns and cities have good yoga options too.

Horizontal paralysis

I'm not one for lying on the beach all day I personally get very bored.  But I know many people who see the beach as the holy grail of relaxation and they can quite happily lie out in the sun all day without moving a muscle.  This is not great for back pain or avoiding discomfort.  If you are going to lie down all day and then sleep all night your muscles will quickly atrophy (shrink and lose strength).  This includes the muscles surrounding the spine which leave the spine unsupported and vulnerable to injury. 

Solution:

Move regularly throughout the day by taking a dip in the sea or the pool.  Play a ball sport or tag with your kids or friends on the beach.  I remember when I was young my Mum used to chase me around the beach with soggy seaweed for hours of fun! If you are not keen on so much activity then just take a walk a couple of times throughout the day.  Lastly, if you like to dance then go dancing in the evenings - it's a real calorie burner.  Watch the ankles in the high heels though and avoid daring back bends if you are partial to a bit of back pain! 

I wish you all happy and safe vacations wherever you are relaxing, exploring or going a little crazy!  Remember these essential factors to minimise back pain occurring and look out for my article on safely returning to exercise post vacation which I am writing for The London Orthopaedic Clinic.  It should be out when you are all back to your London routine!

Planes, Trains, Automobiles and Back Pain

Avoiding back pain on your summer holiday vacation

Avoiding back pain on your summer holiday vacation

It's that beautiful time of year when we get to take a vacation.  Whether it's long haul or an hour from home, trekking amoung ancient ruins, exploring the hidden streets of a european city or chilling out on the beach - you want to make sure that back pain doesn't wreck your time away.  You might think that vacation is the last place that injury or pain can strike - you are in a beautiful place, your time is your own, you are happy and relaxed.  How could you possibly get injured?  In part 1 of this article I discuss why back pain can occur during the travelling part of your trip and give you tips on how to minimise the chance of you experiencing back pain so you can enjoy every moment of the vacation that you have worked hard for all year and that you thoroughly deserve!

Why is sitting so bad for the back?

The low back has a natural lordotic curve which helps the intervertebral discs stay centred between the vertebrae.  When you sit the low part of the spine becomes rounded and the lordotic curve is reversed.  Curving the spine for long periods encourages ligamentous creep (read more about this theory here) - the stretching of structural stabilisers that help keep your discs and spine aligned.  Ligaments can be stretched but they do not return to their original length.  Over time the spine becomes unstable and the discs can push out on to the nerves causing discomfort.  Instability of the segments means unwanted movement which can also create problems.

Sitting for long periods also causes compression of the spine.  Depending on what position you sit certain parts of the spine may take more pressure than others which can result in certain muscles taking on more work than necessary whilst others switch off.  This can cause discomfort also.

Travelling to your destination often requires sitting on a plane, on a train or in the car.  The back doesn't like sustained postures like sitting in a chair for several hours.  For each situation you might find yourself in there are a few changes you can make to make your back more comfortable.  So here are my top tips for minimising back pain on your vacation this year.

In the driving seat

Car seats are not great for back pain.  The back seat is often slanted downwards which means your hips are lower than your knees when seated.  This is especially true in supercars such as the bugati, porsche, maserati, ferrari and maclaren which are set very low to the ground.  The first thing you can do is change the angle of your seat so that the back of the seat is higher than the front.  If this is not possible i advise my clients to get a wedge cushion and place the raised part at the back of the seat.  This will help to raise the hips higher than the knees and place the spine in  better alignment thus reducing the risk of discomfort.

Props

Another common problem is that car, plane and train seats do not give adequate low back support.  I recommend to all my clients who have disc injuries that they invest in the Mckenzie inflatable back support for their car seat.  Place it in the mid part of your low back opposite your belly button and inflate to a size that makes your back feel supported - everyone will need a slightly different adjustment but aim for supper that keeps your back neutral.  This means a slight arch in your low back.

I like to move it move it

The third and most important part of avoiding low back pain when travelling is to take regular breaks to move around.  That means actually moving around not more sitting at a service station for a cup of tea or walking for 10 seconds to your friend at the back of the plane or the other train car and sitting with him for a natter.  Walk around, stretch, mobilise and move as much as you can where you are.  If you are travelling by car and you take regular breaks I know it takes longer to get to your destination and if it means making the choice between two weeks of discomfort and grumpiness over two weeks of happy, relaxed fun... I'll let you make the decision on that one! 

Switch it up baby

On the plane if you have the option to recline and lie down alternate between reclining, sitting up and lying down as this counts as changing your position.  If you are particularly tall opt for a business class seat with more leg room or at the very least the front row of economy class.  If you are already in discomfort a seat which allows you to fully recline on the plane is your best option as this is where pressures and forces on the spine are at their lowest.  Regularly stand up and walk the aisles of the plane even if your flight is a couple of hours.  Movement is absolutely key to keeping discomfort to a minimum.  Don't wait until you feel uncomfortable - take a walking break every twenty minutes.  I often find drinking lots of water helps as I need to use the restroom a lot which means getting up.  It also helps you stay hydrated...

Water your back

Whatever mode of transport you are taking drink lots of water - not juice or tea or coffee - WATER.  The discs of the spine are filled with fluid.  When you are dehydrated they reduce in height which means the vertebrae are more likely to cause compression of the nerves where they exit the spine.  Staying hydrated helps keeps the discs plump and maintain good height.  Hydration is also one of the most important parts of good health so never skimp on water!

In Part 2 of this article I discuss the culprits of back pain when you have actually arrived.  If you can't wait then click here to read it.  I wish you all happy and safe vacations wherever you are relaxing, exploring or going a little crazy!  Remember these essential factors to minimise back pain occurring and look out for my article on safely returning to exercise post vacation which I am writing for The London Orthopaedic Clinic.  It should be out when you are all back to your London routine!

Endless back pain gone in 6 weeks!

Precision Movement Case Study Mrs A

Precision Movement Case Study Mrs A

It's that time again when I share another one of my success stories with you all.  Meet Ms A, a 72 year old lady who loves walking holidays, travelling and puts my social life to shame!  Ms A came to see me because she had been suffering with constant upper back pain for many years from a collapsed vertebrae in the middle of her spine.  She also has osteoporosis and fractured her hip 12 months ago, fractured her elbow four years ago and injured her knee in a skiing accident 50 years ago which has always bothered her.  When she first came to see me she was unable to walk from the grocery store to her house carrying a light bag of shopping without experiencing pain.  Her main goal was to get out of pain so she could go back to enjoying her walking holidays.  Here is what happened...

The Assessment

Ms A was experiencing pain in her neck, upper back and mid back.  As you can see from the photos below Ms A had a very rounded upper back, a kyphosis, and this part of the spine had no movement - it was blocked.  You can see from the photos that the back of her neck was very crunched and the head had migrated forwards.  The muscles of the chest and front of the shoulders were very tight.  This was creating great strain on the front of the neck and the upper and mid back as the muscles try to hold the bones from falling forwards and down.  Not so visible from the photos was the increased lumbar curve (low back).  Both the upper and lower curves of the spine were too big.  In the middle of these curves is the thoracolumbar junction created where the T12 vertebra meets the L1 vertebra.  Ms A's L1 is collapsed which meant the increased curves here were putting excessive pressure on this joint causing more discomfort.

Precision Movement Case Study Mrs A before photos

Precision Movement Case Study Mrs A before photos

Referral to a Specialist

The assessment results revealed that Ms A needed specialist manual therapy for her neck.  I referred her to Mr Nicholas Potter, world renowned chiropractor who specialises in neck and upper back injuries.  Mr Potter was able to realign Ms A's neck so that I could begin working on strengthening the muscles around the neck and upper back to maintain the newly adjusted alignment.  Ms A had great success with her treatment and felt it highly complimented the work I did with her.

The First Phase

The first part of Ms A's programme centred around opening up areas of her body that were tight - namely the chest, anterior shoulder and the upper back.  I used specialist mobilisations to gently open up the upper back encouraging more movement in the area.  Then as the upper back and chest started to open I introduced some gentle exercise to work on the muscles that encourage a more upright position for the upper back and help the shoulders stay open and back.  It was the combination of opening up tight areas and strengthening weak areas that helped Ms A's posture begin to change.  For the old knee and hip injuries I used exercises to stabilise the pelvis and knee joints - starting with isolated exercises and slowly integrating more and muscles to work with each other.  I worked with her twice a week and gave her a mini home programme of stretches to do every day.  Ms A was exceptionally diligent and as a result her body began changing very quickly - despite her age.

Initial Changes

Ms A began to experience changes within 2 weeks of beginning her programme with me.  The treatment she received for her neck had an instantaneous affect - relieving years of neck discomfort.  Within 6 weeks her upper back pain was gone and she was able to happily carry out daily tasks like shopping and walking without discomfort.  Ms A loves the theatre and found sitting for long periods very troublesome for her back.  We were able to increase her tolerance to sitting from 10 minutes to 2 hours.  Her reassessment results showed more than double the initial range of  movement in the spine in all directions.  Her initial head alignment was 7.2cm forwards of her sternum and reduced to 4.2cm which greatly reduced the strain on her upper back.  Her shoulders also migrated backwards by 1.5cm each side which was a result of opening up the chest and front of shoulders and strengthening the upper back.  Ms A noted that she felt less round shouldered, and all of her movements in daily life were easier as well as feeling dramatically reduced discomfort.

The Second Phase

As Ms A had improved so much in the first phase we quickly moved on exercises that encouraged the endurance of her postural muscles and also more functional movements such as a modified squat pattern.  Ms A tired quickly in her sessions, so we focussed on the quality of the key movement patterns and I gave her the rest and recovery she needed.

More Changes

A week 8 of the 12 week programme Ms A went on a walking holiday for 4 days and only experienced discomfort once through the whole trip which she was able to ease with the stretches and mobilisations I had given her.  She was delighted with her progress having suffered with daily discomfort for years to hardly any problems at all even on her walking holiday!  You can see from the photos below that Ms A's posture dramatically improved.  An unexpected development was weight loss.  Because Ms A had less pain she was able to move around more during the day and she also took up swimming twice a week.  Even though the exercise I did with her was gentle and progressive, it enabled her to return to swimming increasing the total volume of weekly exercise and resulted in a drop of 2 dress sizes in just 12 weeks!  Ms A came in to see me during week 9 and told me she was able to fit into trousers she hadn't worn in years - she said she had a whole new wardrobe of old clothes to choose from.  Look at her dramatic improvement from week 1 to week 12 below:

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

In Ms A's words...

"I was really keen to reduce and manage my back pain and I thought KT's approach sounded like it would help me.  It didn't take very long for me to be able to get through my day without pain and she helped me identify what was likely to make it hurt - things like sitting for too long.  She gave me exercises and stretches that I do every day now.  I particularly like rolling out my back.  The big test came when I went on my first walking holiday about 7 weeks into working with KT and my back was miraculously pain free for the whole holiday!  I was so pleased.  I've also been able to get back into my swimming.  An added bonus was that I have lost quite a lot of weight which I wasn't expecting.  I have a whole 'new' wardrobe of clothes that I can fit into again!  So many people have noticed how different I look.  I thought I would be riddled with pain forever but now I am pain free thanks to KT's help."

You are never too old!

So there you have it - you are never too old to make changes that improve the quality and enjoyment of your life.  If you are interested to learn more about how I can help you reduce discomfort and improve posture then please email me at KT@precisionmovement.co.uk.  Let's have an informal chat about your specific situation to see how I can help.

What to do if you have back pain from cycling

Bradley Wiggins

Bradley Wiggins

It's Tour De France time!  And if like me, you live in London, you could probably mistake London Town for the French Alps as there are so many cyclists on the roads these days.  In fact, cycling has become the most popular mode of transport in recent years.  Perhaps Londoners are becoming more health conscious, maybe it's the lure of trying out the Boris Bike.  I think it's amazing to see so many people taking a practical approach to health and making their commute part of their fitness regime.  I've seen a few people fall in love with cycling, getting the latest carbon fibre frame, custom aligned to their body, all the cycling garb, the cleats - before you know it they are wearing a yellow jersey!  But then, unexpectedly, back pain strikes and feeling pro very quickly becomes feeling low.  So how do you avoid back pain when your bike becomes your best friend?  Read on to find out....

The cycling position

If you assume the pro position on the bike or even a metropolitan modification of this position then you'll probably look a lot like Bradley Wiggins (see above).  Maybe you even think of yourself as looking a bit like Bradley but I'm not here to comment on that!  You can see that the spine is rounded - excessively rounded which makes you more streamline and therefore faster and more efficient.  However, sustaining this position for long periods can create imbalance in the spine which can lead to irritation, discomfort and injury.

Getting your bike fitted properly

There is not much you can do on the bike - although it goes without saying that you see a bike specialist to make sure your bike is optimally fitted to your proportions.  If you can, try to find a company that can observe you actually cycling so they can see what's happening when you move.  I would recommend www.bike-science.com who can do a 3D analysis of your position and movement on the bike.

Rebalancing your body

I have several clients that cycle to work and recreationally at weekends.  For these Tour De France wannabes, I make sure that I put in exercises that extend the spine or reverse the bike position curvature of the spine.  I also include exercises to upright and extend the upper back as well as externally rotate the arms and retract and depress the shoulders.  All these actions are the reverse of the position on the bike which encourages flexion of the spine, internal rotation of the arms, protraction of the shoulder blades.  I also include exercises that work the glutes, hamstrings and lower back in an extended position.  In cycling the glutes and hamstrings work against a flexed torso but we need these muscles to co-ordinate in upright as well.  Here are a few suggestions to get you started and make sure you go through them with a trained specialist to make sure you are in the correct alignment and use correct technique.

Precision Movement exercises for cyclists with back pain

Precision Movement exercises for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

The best bike solution if you have a back problem

dutch bike best for back pain

dutch bike best for back pain

The best bike for bad backs is the Dutch style with high handle bars.  Yes it's more of a cruising bike with a vintage feel - you are not going to see Chris Hoy on one of these - but it is the best choice for those who have back problems or structural damage.  The higher handle bars encourage your spine to stay more upright which helps keep to maintain the discs and vertebra in the optimal alignment thus reducing the risk of discomfort. 

If you are prone to back problems or have an injury like a disc prolapse it is better to take short journeys between 20-30 mins and then get off and walk or stretch a bit rather than doing a 3 hour power cycle.  The spine does not like sustained postures so the more you can change up your position the less likely you'll irritate your back. Cycle for enjoyment which means take it easy with the speed and the resistance.  

Don't forget your helmet and happy pain free cycling! 

For more information on exercise for cyclists whether recreational or professional please contact KT at KT@precisionmovement.co.uk.  If you are injured and would like more information on how KT can help you please visit the website at www.precisionmovement.co.uk.

The case of the wonky man who became straight

Screen Shot 2014-07-11 at 11.51.53

Screen Shot 2014-07-11 at 11.51.53

I've had a few requests for some real life Precision Movement case studies.  I do love suggestions and I also love sharing my success stories with you.  So meet Mr G, a man in his early 60s, who approached me to work with him after a recent diagnosis of a degenerative central nervous system disorder.  He had previously engaged in some exercise but his posture was poor and he had several injuries and surgeries in the past.  His main goal for working with me was to improve his posture and gain better stability and strength to be as well as possible physically to cope with whatever happens in future.  Here is what happened...

Just a mini disclaimer to say I have tried to make this as readable as possible - not too technical and dry.  I've also reduced it down so it's not too long.  With that said, I do hope you enjoy getting a deeper look into the inner workings of how I actually help people and could help you too!

Day 1 - The Assessment

As you can see from the photos below his posture needed attention.  His assessment results showed that his upper back was too rounded and his low back had no curve at all.  He was also stiff in his neck, shoulders, spine, and hips and a severely restricted right knee. The biggest visual discrepancy you can see from the photos is that his right hip was 7 degrees higher than the left and his left shoulder was 5 degrees higher than the right.  There were many more complex results from his initial assessment but for the purposes of giving a digestible overview I won’t divulge any more.

Case Study by KT at Precision Movement

Case Study by KT at Precision Movement

Weeks 1-6

The first stages of training focused on breathing mechanics, teaching him core function so he understood it consciously and was able to then activate and have awareness of this during exercises. I also focused on opening up the areas of Mr G's body that were locked and tight with a series of bespoke mobilizations and stretches.  I worked specifically to target the muscles that were contributing to his mal-alignment – notably the tightness of the right side of his body that was causing the shoulder and hip height discrepancies.   I then taught Mr G specific exercises to strengthen the areas around his shoulders and pelvis.  After just 6 weeks he had significant improvements in alignment and joint stability.

Weeks 7-12

Once a base level of stability and alignment was established I continued to work on this as well as improving Mr G’s neuromuscular (brain and muscle) communication to wake up and continually stimulate his central nervous system.  After 12 weeks you can see from the photos that Mr G’s hip and shoulder heights were almost equal.   His spinal curves had improved although still needed more work.  His head carriage (position of the head in relation to the body) reduced by a third.  His shoulder blades moved 2cm closer towards his spine.  He had a significant increase in hamstring (back thigh) and quadriceps (front thigh) flexibility as well as internal and external rotation at the hip.  He was able to successfully stabilize his hips and shoulders whilst his legs and arms moved around the joints.  Most notably he ‘grew’ 2.5cm. 

Case Study by KT at Precision Movement

Case Study by KT at Precision Movement

In Mr G's words

"I signed up for KT's 12 week course when I had been diagnosed with Parkinson's Disease.  I felt that I should be as well as possible physically to cope with whatever happens in future.  KT devised a programme specifically for me and within a short period I was seeing fantastic results.  I am most definitely taller and much better physically.  I cannot count the number of very flattering comments I get from old friends as well as feelingsignificantly stronger.  KT also makes detailed records of all aspects of my body and the results at the end of the course are there for all to see.  Now that my 12 week schedule is over I will see KT on a regular basis every 6 weeks to ensure that I am following the programme she has set me correctly.  Her demeanour and knowledge make her an excellent and caring coach and she always knew how to flatter me to get the best out of me!  I have no hesitation in recommending her."

For more information on how KT can help you get out of pain, improve your posture and gain strength please contact her on 07515 856 009 or email KT@precisionmovement.co.uk.  

How corrective exercise helps disc injuries

Disc herniation Precision Movement

Disc herniation Precision Movement

The most common injury I see in my practice is varying stages of disc prolapse.  Most people steer clear of any movement when they have a disc injury for fear of setting off the intense and unbearable pain and making the injury worse than it already is.  However, as my client Mr A discovered, the right type of exercise is actually the safest and most effective way to manage your disc injury going forwards.  Read on to find out how Mr A went from daily agonising pain for years to no pain at all in just 3 months.

What is a herniated disc?

A disc prolapse (often called a slipped disc) is where the jelly (nucleus propulsus) in the disc inbetween two vertebrae pushes out and sometimes through the outer ring (annulus fibrosis) of the disc into the spinal cord canal.  It can push on the nerve roots and cause pain in the local area, or affect the nerve down through the hip or down the leg.  Other more severe symptoms that can occur are numbness, tingling, an electrical feeling and temperature change down the leg often referred to as sciatica which I talk more about in my article entitled '

How Corrective Exercise can help Sciatica

'.  

Causes

There are many reasons why a disc prolapse occurs.  It can occur from a trauma such as a sports injury or a car crash that results in a blow to the spine or surrounding areas.  A more common cause is from poor posture leading to ligamentous creep over a number of years.  The vertebrae are designed to keep the discs in place but it is repeated poor posture and inactivity that leads to the disc creeping out.  I talk more about this concept in another article entitled "Ligamentous Creep - the poisonous weed of inactivity" - coming soon so make sure you stay tuned via my newsletter!  Other factors such as nutritional health play a part in disc and spine health.  

In the case of Mr A - there was no traumatic accident.  He had been inactive for most of his adult life and his sedentary desk bound job probably did not help in preventing his back pain and subsequent injury develop.

The 4 stages of disc herniation 

The first stage is referred to as a disc bulge.  This is where the outer ring is intact and the inner jelly just pushes out creating a bulge.  The second stage is called a disc prolapse where the outer ring is weakened and the jelly begins to push into the weakened area but the outer ring remains.  The third stage is called extrusion where by the jelly breaks through the outer ring.  The fourth stage is called a sequestration where fragments of the jelly enter the spinal canal.  

The last two stages have an added complication in that pain may also occur from chemical irritation of the jelly in the spinal canal.  This can be more challenging to manage as the pain is not just coming from mechanical causes.  Unfortunately, once your structures, namely the disc, is damaged it cannot be repaired.  However, management through medical treatment and corrective exercise can be exceptionally effective.  

In the case of Mr A, he had suffered from back pain for 15 years.  It was diagnosed as a disc prolapse and 12 years later he had surgery, a micro-discetomy to remove part of the disc that had moved into his spinal canal and was causing agonising daily pain.  12 months after his surgery, he came to see me still in terrible pain.

Exercise to the rescue!  

Exercise is an incredibly important and often successful part of recovery from discomfort with disc herniation.  Nearly all people I see in my practice have a disc herniation from inactivity, poor posture and sitting at a desk all day.  

A common postural imbalance that correlates with disc herniations is a very flat low back often coupled with tight hamstrings.  I also see a fair amount of people with an excessive upper back curve and weak postural stabilisers throughout the spine.  However, just sticking your butt and chest out and stretching your hamstrings will not fix the problem - in fact you could make your pain much much worse!  

There are specific stretches, mobilisations and exercises I give to correct these imbalances and help the disc sit better between the vertebrae.  Often breathing mechanics, core activation and localised spinal stability are compromised as well.  Each person I see has different imbalances and to a different extent which is why it is not possible to give blanket advice and exercises.  

John Medina explains in his book 'Brain Rules' how exercise also helps to increase the growth of new blood vessels throughout the body to get  deeper access into the tissues.  This helps the tissues dispose of toxic waste that builds up in and around an injury and areas of pain.  The more you exercise, the more tissues you can reach and the more toxic waste you can get rid of.  Exercise actually physically aids your recovery.  

Mr A had many postural imbalances that were causing more stress on his disc injury.  Even though he had surgery to remove a part of the disc that was most irritating, his spine was very unstable and he had lots of tight muscles in his pelvis and upper back.  He worked with me for 3 months and diligently followed his exercise programme. Within 4 weeks he was noticing a marked decrease of discomfort on a daily basis and by week 8 he was virtually pain free.  

What can I do now?

Ideally seek out a specialist in corrective rehabilitative exercise who can assess your  whole body postural alignment.  It is increasingly common to hear and see of patients doing exercises poorly or completely wrong which can make symptoms worse.  It is imperative to do your exercises with good form and it is advisable to do them under the observation of a corrective exercise specialist like we have here at Precision Movement.  This is mainly because your body will have a preferred way (poor alignment way) of doing movement and with each repetition you do you'll need to remember and apply newly learned alignment to make desired changes.  

If you are suffering with disc herniation related pain please do email me at 

KT@precisionmovement.co.uk

to set up a complimentary 20 min phone consult to see how I may be of assistance to you.  You don't have to suffer forever - life is too short!  

Is chiropractic right for your injury or condition?

Dr Luther Moss Chiropractor

Dr Luther Moss Chiropractor

I am often asked about which medical treatment is best for back pain or a particular injury.  I refer clients to chiropractors as they share a similar philosophy of movement and health as I do.   Dr Luther Moss DC, MChiro, PgCert, MCC, co-owner of ML Chiropractic in Fulham, SW London is one such chiropractor that I refer to and I had the opportunity to interview recently about why chiropractic is so helpful to clients recovering from injury and with general overall health.  Read on to find out more....

What is chiropractic? 

Chiropractors are concerned with maintaining the alignment, flexibility and strength of the body in order to ensure optimal nervous function and health. Although adjustments (which can often result in a crack or pop) are commonly used by chiropractors, we have many other techniques for treatment that I use with patients who still experience fantastic health benefits of proper alignment strength and mobility.

What is the nervous system and how does good joint alignment help its function?

The nervous system is the master control system of your body.  The brain is the main computer and the spinal cord and nerves are the wires that allow your brain and body to communicate.  Every process within the body is, at its source, controlled by the function of the nervous system and therefore having a healthy and well functioning nervous system is a fundamental requirement for health. Alignment and flexibility of the body (especially the spine) influences the nervous system’s ability to communicate signals from the body to the brain and then back to the body. Through a specific nerve sense called proprioception (movement sense) movement helps to regulate the function of the nervous system.  Movement and the nervous system are interdependent - they both need each other and when healthy, help each other function better.

How does chiropractic help poor alignment and injury?

If joints, specifically spinal joints, are misaligned or inflexible then their ability to produce this movement sense is reduced and so compromises the function of the nervous system. Of the 100billion or so nerve fibres in the spinal cord, over half are responsible for transmitting this movement sense and of those 90% come from the spine. Therefore movement, alignment and function of the spine is of paramount importance when considering the health of the nervous system.  

In injury better alignment and flexibility leads to faster recovery due to increased nervous function and in daily life it leads to better performance, co-ordination and protection against injury.

(In essence movement represents to the brain what electricity is to a battery on charge, it literally charges the brain to allow better function. Once you understand the huge influence that alignment and flexibility of the spine has on this process, the need to take good care of your spine quickly becomes apparent.)

What roles does chiropractic play in general health?

95% of all health issues are related to one or more of the 3 key areas of health; how we move; how we eat and how we think. Dysfunction in one or more of these areas forces the body to adapt which over a period of time comes at the expense of our health.

Chiropractic focuses on the physical alignment and function side of how we move, optimising function with a view to optimising nervous system performance and allowing our body to express a better level of health. We also help to address the other key areas of nutrition and cognitive function in order to provide a whole health approach to patient care.

What do you specialise in?

My personal area of interest is headaches and migraines. Through detailed neurological testing I firstly help to identify if there is any cause for concern and can make the appropriate referral if necessary.  Following this a combination of detailed history taking and chiropractic and orthopaedic physical examination helps to identify the likely cause of the complaint. In many cases misalignment or dysfunction within the neck region is the main culprit. With proper correction of alignment and function of the spine in these cases, the responses can be incredibly powerful with some lifelong sufferers of headaches reporting a complete resolution of their problems  I find these patients very satisfying to work with.

What do you think your treatment is MOST helpful with?

The patients that we get the best results with are those who are trying to turn their lives around and have under exercised and overeaten for many years and have normally suffered from long term spinal/body pain. The work we do allows us to coach these patients in the different aspects of their life helping them to become pain free and more importantly have a better level of physical and physiological function.

What do you typically see patients for?

Although the range of patients we see is very large the most common complaint we see is those suffering from lower spinal pain of no apparent onset. This is normally a result of long term problems with posture, movement patterns, diet and stress. People are often confused as to how so much pain can come from no-where but unfortunately that is often the result of failing to properly look after your body.

We also see a range of athletes looking to improve their performance and injury resistance and many people simply come for regular checks to help counteract their physically and emotionally stressful jobs.

How often does someone need treatment?

That is a difficult question to answer as every case is different. However just like getting fit, restoring alignment takes time and dedication; there is no quick fix as we are trying to retrain the body and how it functions.  For example someone suffering from acute lower spinal/disc injury a treatment programme may involve 6 treatments in the first 3-4 weeks followed by a further 6 over the next 2 months.

Is your system an intense short term treatment method or more of an ongoing maintenance? 

Acute injuries or people with a long term problem often require a period of high intensity treatment initially but our aim is always to get the person as independently healthy as possible as quickly as possible.

Chiropractic is based on a system that is dedicated to optimising people’s long term health and function.  Many people then return to us on a regular basis to help maintain alignment and nerve function, they see it as part of their normal health routine alongside exercise and a healthy diet.  The frequency of these ‘maintenance’ visits vary from 4-12 weeks.  These people are the ones who experience the maximum health benefits from maintaining alignment.

How do you use your treatment for back pain? 

Chiropractic adjustments and treatments are recognised as one of the safest, best techniques for the treatment of lower spinal pain. Studies have shown that recovery from mechanical lower back pain using chiropractic has proven to be faster, more effective and less expensive than medical alternatives.

We also see many people recovering from injury or surgery. We can help improve healing times and maintain function during these difficult and often painful periods of time.

Do you believe the patients you see need corrective exercise? 

Absolutely.  Everyone should be exercising regularly as it is actually impossible to be optimally healthy without exercise and movement being a regular part of your life.

In patients that present with a specific problem, after resolution of their pain or alignment it is essential that they undertake some form of structure exercise in order to maintain the benefits of the treatment and to protect them against injury.  

For example someone who presents with headaches as a result of their posture in front of the computer at work can benefit hugely from chiropractic care, however if they fail to improve their postural muscle strength and movement patterns after stopping chiropractic treatment the reality is that their problem with re-occur at some stage. 

It is vitally important that these people follow a properly structured routine of exercise focussing on the appropriate muscles and guided by a well trained professional. Pounding miles on a treadmill will not help with alignment problems, patients require a detailed, bespoke and structured exercise routine.  Patients who follow a routine show faster recovery from injury, better resilience against future injury and of course, a better overall level of health.

What general advice can you give? 

The most important piece of advice is to keep mobile. Immobility i.e. too long hours of sitting or staying still is literally damaging our bodies and our brains. Research now shows that keeping mobile helps to maintain normal brain/neurological function and helps to prevent the onset of many chronic diseases such as arthritis, cardiovascular disease and diabetes.

Luther's top 5 tips for optimising your health:

-Do a minimum of 3 minutes stretching in the morning and the evening (make sure you follow good advice on stretches)

-Set an alarm on your computer for every 40-60minutes and then move when it goes off. Even rolling your shoulders and turning your head from side to side makes a difference, ideally get up and walk for 2-3 mins.

-Do at least 3 sessions of 20 minutes intensive exercise per week - ideally get a personal trainer!

-Challenge yourself regularly by learning new exercise routines or movement patterns to force it to maintain its strength and adaptability.

-Finally drink at least 1.5-2 ltrs of fresh (preferably filtered) water each day. Many people are dehydrated and this is very damaging for your health.

For Precision Movement readers, Luther has kindly offered 50% off initial chiropractic consultation (normally £75) and he is also happy to talk to anyone on the phone for a 10 minute phone consultation free of charge or answer any questions by his personal email - 

luther.moss@ml-chiropractic.co.uk

.  You can book an initial consult by calling

0207 731 7640

.  For more information please visit 

www.ml-chiropractic.com

.  ML Chiropractic is located at ​

604 Fulham Road, London, ​SW6 5RP

How corrective exercise can help sciatica

sciatica

sciatica

Sciatica is the irritation or compression of the sciatic nerve which originates in the lower spine and runs through the buttocks and down the legs.  Although very painful, sciatica is the cause of an underlying issue which I explore here in this article.  I also explain the value of exercise in helping to relieve discomfort and for management of sciatica going forwards.  

Sciatica is the irritation or compression of the sciatic nerve which originates in the lower spine and runs through the buttocks and down the legs.  Symptoms are often pain of varying degrees described as burning or tingling or a sharp stab in and around the buttock and down the legs and can also be accompanied by numbness, tingling, a giving way of the leg or a sense of weakness. Pain may also worsen with sitting and can make walking difficult.

Although sciatica can be debilitatingly painful the pain and irritation of the nerve is a symptom of the underlying cause which could be from a disc bulge or prolapse, disc degeneration, stenosis, spondylolisthesis,  piriformis syndrome and sacro-iliac dysfunction.  Any of these causes can compromise the exit of the nerve from the spine and compress it causing pain.  

The symptoms versus the cause 

The point I would like to emphasise here is the underlying cause - if we can get to the root of the problem and manage it effectively the symptoms of sciatica will go away.

Often sciatica is caused by a structure like a disc pushing on a nerve.  It is true you cannot fix structural damage but you can improve alignment, stability and strength of the surrounding area.  Malaglined discs are often associated with poor posture or weakness of the surrounding muscles.  Without wanting to complicate things further, an initial problem starting elsewhere in the body can cause the spine to adapt and change thus leading to sciatica.  Ideally when treating an injury or chronic pain the body should be observed as a whole.  

Exercise is essential

This is where exercise becomes invaluable as part of a long term recovery plan for sciatica sufferers because corrective exercise can help realign poor posture and strengthen weak muscles.    

Stretching can ease off localised tension that a muscle takes on when the nerve begins to hurt.  Exercise helps to strengthen weak areas of the spine, core and pelvis.  This in turn can improve alignment of the spine and reduce the pressure on the nerves.  As posture improves and the individual becomes stronger the chances of reoccurrence are reduced.

John Medina explains in his book Brain Rules how exercise also helps to increase the growth of new blood vessels throughout the body to get  deeper access into the tissues.  This helps the tissues dispose of toxic waste that builds up in and around an injury and areas of pain.  The more you exercise, the more tissues you can reach and the more toxic waste you can get rid of.  Exercise actually physically aids your recovery.  

What exercise can I do?

It is common to give stretches for sciatica because the affected muscles and the sciatic nerve itself can be stretched and this provides a certain amount of short term relief.  sciatic stretches alone are usually not enough to make a long term change to symptoms.  They are, however, a valuable inclusion in a bespoke series of exercises given to an individual.  Stretching and mobilisation of the fascia (connective tissues) and nerve flossing techniques are also common inclusions for sciatica exercise programmes. 

Exercise for sciatica is focussed around relieving discomfort and realigning, stabilising and strengthening areas of weakness as well as opening up areas of tightness that are contributing to poor alignment.  Finding out what the underlying causes are is imperative as it determines what exercise is needed.  Exercises given for disc related issues are almost the opposite for stenosis and spondylitis.  Ideally exercise should be bespoke to the postural needs of each individual.

What can I do now?

Ideally seek out a specialist in corrective rehabilitative exercise who can assess your  whole body postural alignment.  It is increasingly common to hear and see of patients doing their exercises poorly or completely wrong which can make symptoms worse.  It is imperative to do your exercises with good form and it is advisable to do them under the observation of a corrective exercise specialist like we have here at Precision Movement.  This is mainly because your body will have a preferred way (poor alignment way) of doing movement and with each repetition you do you'll need to remember and apply newly learned alignment to make desired changes.  From personal experience of this in my practice, for the first 3-4 weeks each repetition of movement requires a correction of alignment from me to the client until they start to learn new patterns of movement and create programmes in the brain for the new alignment.  

The back bone of life

Screen Shot 2014-01-05 at 21.21.53

Screen Shot 2014-01-05 at 21.21.53

Last week I was asked to speak at the L Club in on Sloane Street about the importance of the spine for health throughout life.  I thought I would share with you what I shared with the audience of the L Club how your spine develops, what injuries it is most vulnerable to at certain parts during your life and how you can minimise the risk of injury as you age.  If you are tempted to just read what it says under your current age bracket this would be foolish.  Remember what you have done in the past and what you do now will all influence how the spine will respond in later years. Read on to find out more....

0-3 years 

When we are born our spines are curved like a shell.  In the first 2 years up to when we walk we go through huge amounts of development and change in the spine.  We learn how to move it and stabilise it and to sit up, crawl and walk the spine changes alignment.  As we grow our spines take on three curves - cervical, thoracic and lumbar and these curves are responsible for maintaining good posture, keeping our intervertebral discs in place and providing shock absorption.  This is one of the most important developmental stages of our lives and we should never underestimate the value of babies learning to move efficiently and effectively.  The movements and postures that babies learn here serve them for the rest of their lives which means if faulty movements are developed it will affect movement, co-ordination, posture and strength development in later years.

3-21 years

This is the time when we should move and learn sports.  Jumping around and pounding on our bones is the best way to make them dense and strong coupled with a good intake of calcium from leafy greens and vitamin D from the sun as well as good overall nutrition.  Any weight bearing sports are good for bone density development (swimming is a non-weight bearing sport).  Intense learning of sports is not recommended until age 7.  Ideally children should try out lots of different activities.  At age 7 if children show an interest in a particular sport they have enough neural development to learn more intensely.  Children should not lift heavy weights as it can stunt growth.  

21-30 years 

When we get to 21 we have fully grown but we can still increase our bone density.  Bone density is exceptionally important for the prevention of osteoporosis.  Between 30-35 our bones begin ageing and it is no longer possible to increase our bone density - we can only slow the rate of decline.  This is effectively done by weight bearing exercise such as strength training.  The discs between your vertebrae have fluid and a jelly like substance inside which acts as part of the shock absorption I mentioned earlier.  At at 30 our bones cannot get any denser.  From here our bones go through a process of becoming less dense.  

30-45 years 

This is the time when the spine is most vulnerable to disc injuries.  Mostly because of our lifestyles - too much sitting and not enough movement.  Up to age 45 the discs are refilled with fluid each night as part of the recovery process when we sleep.  This is why you are taller in the morning and shorter at night!  One of the reasons why disc injuries happen between 30-45 years is because of years of 'ligamentous creep' the connective tissues in the spine stretching over time to accommodate poor posture.  Ligaments are the strongest structures in our bodies connecting bone to bone and they give our skeleton stability.  Once ligaments are stretched they do not go back to their original length.  Over time, years of time, it makes the spine unstable and then the discs become vulnerable to pressing out on to the nerves.  

45-55 years 

Past 45 the discs begin to dry up and the spine becomes stiffer.  This actually has an advantage as the discs are less prone to pushing out against the nerves because they are less plump.  However, less fluid in the discs means loss of disc height.  Firstly, you lose height which is not so bad.  Secondly, your vertebrae are much closer together so the ligaments become lax and can create instability.  This hinders movement, particularly rotation, and can also lead to bone spurs and stenosis.  

55 onwards 

Depending on what you have done or not done with your body you may experience some pain or injury in your spine as you age - common but not normal issues are osteoporosis, arthritis, spondylitis, ankylosing spondylitis and postural imbalance.  What I always find interesting is that most people as they age will have some sort of disc degeneration but not all suffer with pain from it.  The key here is movement - the more active you are the less likely you are to feel pain.  

The most important point here is what you can do to minimise the risk of injuries and diseases when you are older.  Once you have these issues they can be managed but they are not reversible.

If you want to know more about minimising the risk of spinal complications when you are older or maybe you have a spinal injury that you'd like to know how to manage better then contact me at 

KT@precisionmovement.co.uk

.

5 common desk bound injuries and how to avoid them

ipad user slouching

ipad user slouching

The office environment does not lend itself to an optimal pain free and posturally aligned existence.  Our postural alignment is often the last thing we think about until we begin to experience pain.  Here are the 5 most common aches and injuries from a desk bound environment and how to avoid them.

RSI - Repetitive Strain Injuries 

This is an umbrella term given to a collection of upper limb injuries including thoracic outlet syndrome, double crush syndrome, carpal tunnel syndrome, golfers elbow, tennis elbow.....  These injuries mostly start in the neck and shoulder area and commonly come from postural misalignment.

How to avoid it 

Try to avoid typing for long periods of time - take a break for a few minutes every half hour or so.  If you have a smart phone with voice activation then use it to give your hands, fingers and wrists a break.  Take time off your phone and tablet by reading a newspaper or a book or listening to music.   

Low back pain

This is probably the most common complaint of all desk bound workers.  Back pain can occur for many different reasons and your office environment can contribute and exacerbate it.  The most common cause of back pain is slouching in your chair and then sustaining postures for long periods that encourage certain structures to be stressed more than others.

How it avoid it

Sitting for long periods is not great for your back.  Make sure you move frequently throughout the day.  Get out of the office for lunch, walk to the water cooler, take a few flights of stairs up or down between floors, get out a tube station early and walk the remaining distance to your office.  If you can exercise before or after work or even during your lunch break.  Without fail get your workspace assessed by an ergonomics specialist - insist on one from your company.  

Upper mid back pain 

Another common compliant especially from writers, architects, artists and anyone who hunches over their desk.  Mid thoracic aches and pains often come from an imbalance between the muscles in the front of the shoulder and chest area being too tight and the upper back muscles being too weak.  A common occurrence is a strained feeling which comes from the back muscles being stretched but at the same time contracting to stop you from collapsing over your desk.  It is call tautness - the muscles are weak and tight at the same time from being over worked.  

How to avoid it

Work on your upper back alignment - do not hunch over your desk.  If you are writing and reading or drawing a lot then invest in an architects desk that you can tilt to an appropriate angle for your work.  Invest in a few sessions with someone who can teach you upper back exercises and stretches for postural alignment that you can do daily to strengthen your upper back.

Neck pain 

Neck pain is exceptionally common especially these days with the use of smart phones and tablets that we look down to use.  Even at your desk you are inclined to crane your head forwards towards the computer screen in front of you.  This puts incredible strain on the neck and can cause injuries such as a cervical disc prolapse.   

How to avoid it

Mobilise your neck throughout the day with head rolls and shoulder rolls.  If you have a chair with a head support consciously press your head back into the support whilst you work.  Make sure your chair alignment is assessed by an ergonomics specialist.  This will help correct the alignment of your head and neck as you work.  Do not place the phone between your ear and your head - use your loud speaker or invest in a head set.  Use a stand for your tablet if you are working at your desk to avoid hunching over it.  

Shoulder pain 

Shoulder pain can come from excessive use of smart phones and even typing on your keyboard.  Mostly pain will come from misalignment and if often associated with neck and mid thoracic issues.  Shoulders are vulnerable joints so seek out help with postural alignment.

How to avoid it 

Mobilise your neck throughout the day with head rolls and shoulder rolls.  Make sure your workspace is optimally aligned for your arms and shoulders.  Take a rest from your smart phone - some phones now have voice activation so you can give your hands and arms a rest from the constant furious typing.  Find a corrective exercise specialist or a rehab specialist to help you with your shoulder alignment.

General advice 

If your pain does not resolve itself within 7-10 days and if it gets continually worse then seek treatment from a physiotherapist or osteopath.  Early treatment often results in a quick recovery.  It is tempting to ignore aches and pains until they become unbearable - the longer you leave something the longer it will take to recover.  If you would like more information on how to resolve a desk bound injury please email me at

KT@precisionmovement.co.uk

.