What is causing my back pain?

Herniated disk or SI joint?

How do you know which exercises are helpful to prevent your recurring low back pain? Often you will see your healthcare provider for low back pain and they will tell you it is likely coming from your lumbar spine (disk or joints). But what if it is coming from your sacroiliac joints (SI joint)? Both injuries have similar patterns of pain. But the exercises for SI joint are often different the for lumbar disk pain.

Here are some frequent signs of sacroiliac joint (SI joint) injury:

• Increased pain in the lower back and lightly out to either side of upper buttock, in the hamstrings, hips and/or groin.

• Pain gets worse with prolong sitting, standing and/or walking

• Pain is worse when getting up/down from a chair, bending over, and/or walking up a hill

• Pain gets worse with too much activity and better with resting

• Pain DECREASES if you frequently change positions, a gentle walk, and/or lying on your side with pillow between your knees

What does your sacroiliac do? It transfers the weight of your upper body onto your legs. How can you injury it? A slip and fall on your buttock, lifting something heavy while twisting, pregnancy, or standing on one leg for long periods of time.

What exercises should I AVOID?

• Running, jogging, stair climbing, twisting, standing on one leg, prolong sitting and heavy weight lifting

What exercises can I DO? First see your doctor to make sure nothing is seriously wrong that is causing your back pain. If you get the OK from your doctor to exercise then work on core training exercises such as

• Pelvic Tilts, stomach and pelvic floor strengthening.

Kim Deeck, Post Rehab Fitness Trainer

267-467-1662

Do you have good balance?

How do you know?

Can falls be prevented?

What causes loss of balance for some people?

• Poor vision (cataracts, glaucoma, bifocals)

• Hearing problems

• Decreased exercise (muscle weakness)

• Recent surgery and/or illness

• Medications (usually > 4)

• Natural aging

• Health complications such has high blood pressure, diabetes, heart disease or COPD

How do you know if you are at a to fall risk?

• If you are grabbing counters, walls, sink to steady yourself

• If you cannot easily get out of a chair, bed, car

• If you have a fear of falling

• If you get dizzy and/or fall

• Take more than 4 prescription medications

• Do not exercise regularly

Statistics

Research reveals that 1/3 of people over 65 years of age will fall each year. Many times the falls lead to hip fractures, wrist fractures and head trauma. Falls are the #1 cause of seniors losing independence in their own home. 95% of hip fractures are caused by fall. Usually the falls are sideways, such as when you turn to look to the right and then you fall to the left.

GOOD NEWS!

• Falls can often be prevented with simple exercise

• The population is aging better and healthier than previous generations

• There are so many more resources to help you discover why you are falling and prevent future falls

• Many exercises for balance can easily be done in your home

Why not start today?

• FIRST consult your doctor if you feel unsteady or fell

• Have your eyes and hearing checked once a year

• Test yourself with some simple exercises: Note do the test with a friend and support each other to prevent a fall

Test

Standing on one foot

Normal = 10 seconds

Sit to Stand x 10 reps in row

Normal < 28 seconds to complete 10 reps

What can I do if I failed the test?

• Speak with your doctor about your balance

• Do a safety check in your home to remove loose rugs, add lighting in dark hallways, put grab bars in the bathroom

• Have your eyes and ears checked once a year

• Get more exercise if your doctor feels that is safe

• Call me to help you with a home exercise program

Kim Deeck (post rehab fitness trainer) @ 267-467-1662

Resources: Free Guide by National Institute of Aging by US Department of Health and Human Services

www.NIHSeniorHealth.gov

CDC- Center for Disease Control and prevention

www.cdc.gov

Stretching Before & After Exercise

Does it help?

In 2005, the Journal of Athletic Training did a research study on post exercise soreness and risk of injury. Their research was looking at articles in MEDLINE 1966-2000 to see if there were any benefits to stretching. The results did not strongly support the benefit to stretching to improve performance or decrease injury. Mayo Clinic did research on benefits of stretching and stated that the benefits of stretching were mixed. They reported stretching could help improve the joint range of motion to normal ranges, thereby allowing for better exercise performance.

There are different types of stretching:

• Static – Stretching a muscle to the point of mild discomfort and then holding it for 10 seconds or longer

• Dynamic – gentle repetitive movements such as leg swings to gradually increase joint range of motion

• PNF – (proprioceptive neuromuscular facilitation) which is taking a muscle to stretch then contracting and relaxing that same muscle.

• Ballistic – bouncing into and out of a slightly stretched muscle

So what do we do? Stretch? Not stretch? Well, it feels good to me to stretch but I also don’t want to spend too much time doing it. Much of the newer articles recommend a sport specific warm up instead of stretching. For example, if you were going to play tennis it would be best to do some casual volleys to bring up your body temperature and heart rate. Maybe a light jog up and back from the net before playing your game.

It might also be helpful to look for the joints in your own body that seem tight and start to work on increasing them to normal limits to prevent injury. For example, many people have tight calf muscles. This blocks normal ankle range of motion. That could cause Achilles tendinitis if not corrected. So maybe stretching your ankles with runners stretch on a regular basis thought out the day to bring it back to normal ranges would be a good reason to stretch.

Kim Deeck, PT

www.kimdeeckpt.com

267-467-1662

Normal life after Total Hip Replacement (THR)

By Kim Deeck, Post Rehab Trainer

In recent years, the surgical technique for total hip replacements has changed from posterior to anterior approach. WHAT??? That means the surgeon makes an incision in the front of your thigh not the back. Why would they change the surgical procedure? Well, by changing their surgical approach they do NOT have to cut any hip muscles. That means your recovery time after hip replacement is much quicker than it was years ago.

So now you had the surgery and physical therapy. It has been > 3 months and you are back to work, household chores and exercise. What you might not realize is that there could be hidden muscle weaknesses and imbalances lurking in the shadows. Maybe you have more hip pain after yard work or a walk with the neighbor. Maybe you find that your hip is still very stiff in the mornings. Or maybe, a family member asks you why you are still limping. Funny, you don’t feel like you are limping and/or having leg weakness.

Research studies have shown that it can take up to a year to fully recover all your muscle power and strength after a hip replacement. It often depends on how sever your old hip joint was before the surgery and if you have other health issues. You can try more physical therapy. You can try doing your home exercises. You can try working with a very skilled personal trainer to help you find your weaknesses and correct your alignment. But you do need to correct your body alignment to adjust to your NEW hip if you wish to fully recover.

The main weaknesses can come from the gluteus, quadriceps and hamstring muscles. If you can’t stand on your injured leg for 10 seconds without loss of balance it could be hip weakness. If you can’t easily go up/down steps it could be hip weakness.   A good exercise is lying on your side and lifting your hip that was replace up to ceiling 20 times.   See picture at top article for example of hip abduction.

Kim Deeck, PT

www.kimdeeckpt.com

267-467-1662

Surprising Health Risks from Poor Posture

The cell phone has changed our lives and our postures.  Have you ever been told to sit up straight and stop slouching?   Did it annoyed you to hear it?  Did you think it was a ridiculous command?   Well, it turns out not to be so ridiculous.

Poor posture can lead to Heartburn and Indigestion.  Yes, slouched sitting posture can cause pressure on the digestive system that redirects the digestive acids up into the esophagus instead of down into the stomach.  This can cause pain and potential cancer.

Poor posture can cause Incontinence.  Slouched sitting posture can increase pressure on your bladder.  This can promote  stress incontinence by decreasing the pelvic floor muscle activation.  We laugh or cough and urine leaks out of our body.

Poor posture can cause Constipation by  partially closing the anus while defecating.  It  might close down parts of the large intestines as the waste is moving through our body.  It can put the stomach muscle in a weaker position and less able to move the waste in our intestines.

Poor posture can cause neck pain.  When we sit in good posture our head can weighs 10-12 lbs.   As we bend our head forward to look at the cell phone or computer the weight on the neck muscles and joint can get stressed.  Leaning your head forward 30 degrees to read  can add 30 lbs to your neck muscles and joints.  Imagine holding  a 30 lb weight in an outstretched arm for hours.  Now you can see  why you have a pain in your neck after being on your phone or computer.

You might wonder..... how am I suppose to live my life not looking down?  You need to be aware of your posture.  Take breaks from sitting,  working on the computer or reading a book.  Be proactive and do posture exercises during the day to improve the endurance of your posture muscle.   There are many exercises you can do to keep yourself in good alignment and healthy.  See my  home program page for good exercise ideas.

Kim Deeck, PT

267-467-1662

Information on this blog come from Harvard Medical School 2018 (Meghan Markowski)