Category Archives: back pain

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Core Strength and Injury Prevention, patient exercise

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When people hear about the benefits of core strength and injury prevention, they usually think of lower back weakness and kegels.

While core strength is essential in the prevention and rehabilitation of lower back injuries, it plays a much bigger role in overall function and sports performance, and goes well beyond the kegel exercise. Core strength plays a major role in posture, strength, coordination and power in all types of activities from running to throwing.

At Sheddon Physiotherapy and Sports Clinic in Oakville we assess both static and dynamic core stability as it relates to your sport. From our assessment findings specific core exercises will be prescribed and progressed to prevent injury and improve athletic performance.

Basic core exercises initially teach how to recruit the core muscles. Once this can be done successful, various progressions can be used to challenge the core by adding limb movements, unstable surfaces and different forms of resistance.

The video below demonstrates a core stability progression exercise, which incorporates functional extremity movements and resistance.

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Swing into Golf without Lower Back Pain

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With the warmer weather approaching, the driving ranges and golf courses will become much busier with golfers eager to start the season. Although golf is usually perceived as a fairly low impact, leisure activity, it has been estimated that every year roughly 40% of recreational golfers sustain an injury, with the most common site of injury being the lower back. Research has shown that the compression force going through the lumbar spine in amateur golfers when driving the ball, is roughly 6100 N. In comparison, cadaver studies have shown that a lumbar disc will herniate at forces around 5500 N. As such, although the golf swing appears fluid and easy, there is certainly enough force produced in the spine to lead to lower back injury. Many other factors can lead to lower back pain, including aspects of the golf swing itself, overall fitness level and regular habits on the golf course, such as how you transport your clubs, whether you warm up or not and how often you practice. 

Why do golfers get lower back pain and what can you do to prevent it?

Core strength

The core muscles play a critical role in protecting and stabilizing the lower back during the golf swing. Furthermore, using these muscles properly during the golf swing has also been shown to help increase club head speed and power. Research has shown that golfers with lower back pain have decreased core strength and don’t use their core properly during their golf swing. A golf specific core exercise program begins with learning how to isolate the key muscles to progressions on how to incorporate them into your golf swing. TIP: Next time you’re getting ready to hit the ball, reduce the amount of stress on the lower back structures by turning on your core muscles. In order to do this, think about drawing in your belly button and tightening your abdominal muscles prior to starting your backswing.

Flexibility

Flexibility is a key component, especially in the hips, shoulders and trunk in order to achieve a full range of motion from the back swing to the follow through. Research has shown that lack of rotation in the hips (especially the lead hip) will put increased stress through the spine. TIP: If you are lacking mobility in your hips or lower back, you may want to try turning both your feet out 25 degrees when setting up to hit the ball. This slight toe-out position will decrease the amount of rotation that needs to come from the spine.

Transporting your clubs

clubs

As nice as it would be to have a caddy carrying your clubs, the vast majority of recreational golfers have to depend on themselves to lug their clubs around the course. Research has shown that golfers who carry their clubs are significantly more likely to develop lower back pain, since the weight of the bag leads to increased compression loads on the spine. However, pull carts can also be problematic, as they require twisting of the spine, and riding in a golf cart doesn’t allow the muscles to warm up and stay loose as they would while walking. TIP: If you’re an avid golfer with lower back pain, your best bet is to splurge and get a remote controlled electronic cart that you can walk beside; second best would be a push cart.

Golf Club Fit

Off the shelf clubs are a standard length, with womens’ clubs designed for someone who is 5’4″ and mens’ clubs for someone who is 5’10″. As such, if you’re a 6’3″ male, buying a set of clubs off the shelf, you will certainly notice that you need to bend a lot more during your downswing to make contact with the ball. This will lead to increased flexion and side bending in the spine, which over a course of 18 holes will eventually lead to strain on the lower back. TIP: Spending the extra money to get your clubs properly fitted, will help your swing and your lower back.

Posture

Set-up posture plays a crucial role in how much stress will be generated in the lower back. If the lower back is slouched, then there is increased risk for injury. TIP: Make sure that when you’re addressing the ball that your knees are slightly bent and you are bending from the hips, not the back.

posture

Want to read more tips on preventing golf injuries, click here.

At Sheddon Physiotherapy and Sports Clinic, our level 4 FITforeGOLF™ certified providers focus on innovative research on the science of golf health and performance. Therapy focuses on swing mechanics, coupled with a golfer’s specific injury to get the him/her back on the course faster and injury free.

This blog was based on the works of David Lindsay PT MSc and Dean Walker CPGA who have taught excellent courses to our therapists through the FITforeGOLF™ program. For more information you can visit the FITforeGOLF™ website at www.fitforegolf.com

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Not all Sciatica is the Same

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Sciatica is a general term that a lot of people throw around to describe their lower back pain and any pain radiating down the leg. However, there is a lot of confusion as to what sciatica really is and why people get it. Sciatica is NOT a diagnosis, but rather a symptom that can be caused by any number of different conditions. In this blog we will describe what the sciatic nerve is, some of its common causes, as well as the different ways that it can be treated.

Anatomy lesson: The Sciatic Nerve

The sciatic nerve is the largest nerve in the body. It originates in the lower back from spinal nerves L4-S3 and travels down the buttocks, back of the thigh, lower leg and foot. Sciatica occurs when the nerve is pinched or irritated, which causes pain, burning, tingling, shooting and/or numbness anywhere along its path. If you have sciatica-like symptoms, it doesn’t automatically mean the nerve is involved. Certain muscles and joints have referral patterns that mimic sciatica, but the nerve is not actually involved. For example, sacroliliac joint dysfunction can refer pain to the buttock and back of the thigh, without involvement of the nerve. Likewise, trigger points in the hamstrings, piriformis and glute muscles all have referral patterns similar to sciatica. The key to getting rid of your sciatica is finding out what is causing it.

Causes of Sciatica:

There are a number of conditions that can cause sciatica. Below we will briefly discuss the more common ones and the different treatment options for each:

  • Acute Nerve Root Irritation:
    Sciatica can be caused by irritation to any of the nerve roots that branch into the sciatic nerve; remember from the anatomy lesson above, the sciatic nerve originates from nerve roots L4-S3. A nerve root irritation can be caused by disc herniations, spinal stenosis, infection, tumours, or instability. It is characterized by swelling around the nerve, which will produce constant pain along that nerve root path. The goal of treatment with this condition involves improving the swelling around the nerve root, patient education, and pain control.
  • Disc Herniations:
    A disc herniation from any level between L4-S3 can cause symptoms of sciatica. For example, an L5 disc lesion will affect the L5-S1 nerve root, causing symptoms in the lower back, buttock, leg and foot. Treatment will generally consist of education (especially on posture), pain control, manual therapy to restore mobility and open up the space around the disc, and exercise consisting of McKenzie exercises, strengthening and posture re-education.
  • Instability:
    An instability in the lower back can be due to fractures, infection, degenerative disc disease, pregnancy, or repetitive movements into extreme ranges (ie., gymnastics, wrestling). An instability in the spine will lead to abnormal range of motion because one or more segments are no longer held together tightly. The unstable spinal levels can lead to nerve compression, which causes the sciatica. Treatment for instability will consist of pain control, education, manual therapy to address stiffness above or below the unstable segment, exercise for core stabilization and specific retraining of the muscles at the level of instability, and in some cases the use of lumbar supports/braces.
  • Piriformis syndrome:
    The sciatic nerve either runs through the piriformis muscle or directly under it. As such, if the piriformis muscle is irritated or tight, it can lead to sciatica as the nerve becomes impinged in the muscle. Treatment will usually focus on manual therapy to actively release the muscle and exercise to address tightness/weakness in the area.

There are many other causes of sciatica; however, this blog is meant to highlight a few common ones and stress the importance of having your sciatica assessed by a therapist instead of ‘Doctor Google’. A thorough assessment of the muscles, joints, and nerves will help find the root cause of your symptoms, which is the key to getting healthy. Not all sciatica is the same, therefore not all sciatica is treated the same. A proper diagnosis will lead to the most effective treatment protocol.

Keeping a Healthy Back

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Skiiing, Tobogganing, snow shoeing…these are all the great things that come with winter.  Shoveling the mess about is not one of our favorite pastimes.   If done correctly (and with the right attitude) it can be a great anaerobic exercise.  I often shovel extra driveways in my neighborhood because I feel like I’ve done a great workout.  However, if you do it improperly, you will regret it later that day or the next morning.

Snow shoveling is very hard work and can put severe stress on your heart, as well as, stress and strain on your spine. So, as we aren’t going to wish it away, let’s be safe when we clear the white stuff from our driveways and walkways.

Here are 10 tips for how to keep your back healthy when shoveling snow.

  1. Pick the right shovel.
  2. Warm-up thoroughly.
  3. Pace yourself.
  4. Take breaks.
  5. Push the snow, do not lift it. Pushing puts far less strain on the spine than lifting.
  6. Switch off between snow shovelling right-handed and left-handed, so that you’re working different muscles.
  7. When the snowfall is heavy (1 foot in depth, let’s say), don’t try to clean right down to the ground with a single scoop. Instead, skim the top 6 inches off, then scoop up the bottom 6 inches. Otherwise, you could be hurting yourself by lifting too much. Remember that wet snow can be very heavy. One full shovel load can weigh as much as 25 pounds.
  8. Take breaks. Every 15 minutes or so, stand up straight, walk around, and drink water to avoid dehydration and overheating.
  9. Listen to your body and pay attention to your body’s signals, such as pains, shortness of breath, or chest discomfort.
  10. Use ergonomic lifting techniques such as:

Always face towards the object you intend to lift.

Bend at the hips, not the low back and remember to bend your knees and lift with your leg muscles, keeping your back straight.

Avoid twisting the back to move your object to its new location – always pivot your whole body to face the new direction.

Walk to the new location to deposit the item rather than reaching or tossing.

Take breaks. Every 15 minutes or so, stand up straight, walk around, and drink water to avoid dehydration and overheating.

If you have any questions, send us an email at admin@sheddonphysio.com.

Treating Your Neck Pain and Lower Back Pain

Neck pain and lower back pain can be such a debilitating issue. Here, in Oakville, Ontario, we see a flood of patients come in during the winter months from a season of poor shovelling mechanics. Poor posture while in front of computers and laptops are also big culprits contributing to patients coming in with neck pain and lower back pain.

Here are just a few quick tips that you can do to help yourself when neck and/or back pain arises.

If your pain does not resolve, or is getting worse, book to see your Sheddon therapist for professional help.