Is Back Pain Interrupting Your Life?

Let me show you the exact 2 steps you need to all but eliminate the ongoing discomfort in most cases.

Considering 90% of people suffer from it at some point in life, “I have a sore back” is not an uncommon phrase. Just last week in Castle Hill I had a patient who’s been saying it for 18 months!

The hardest part for him…
it came from nowhere

No major fall, no sporting accident, nothing significant he could remember.
Being in pain and not knowing the cause, that’s frustrating!

Injuries like his, which occur innocuously are usually the result of everyday tasks. Turning to the shut door, picking the kids up or carrying the groceries in. Movements you need to live!

It’s not like you can just avoid getting in and out of the car..

Instead…

You subconsciously create a behaviour pattern called fear avoidance.

You still perform those daily activities, your body just compensates.
It get’s on with the job.

In fact, sometimes the pain even goes away…
Well for a few days anyway, before it usually creeps back.

This really resonated with my patient.

‘Matt, you’re right – I’m actually not feeling too bad today, I wasn’t sure I needed to see you’.

It’s almost as though he felt like a fraud walking in.
He wasn’t sure there was an issue because it doesn’t always hurt.

I can tell you now,
the pain will always return.

That niggle in your back does not just go away!

Want To Know How To Fix It?

The problem here lies in function, not the condition. Even though it ‘feels stiff’, the underlying cause is weakness not tightness.

As it was in this case, the chronic back pain was the result of the true core muscles not working

Step 1 – Make sure your core is working and strong

This is always the first step..

And I don’t mean start doing crunches and holding planks for time. I’m talking about your inner core. A group of muscles consisting of the transverse abdominus, pelvic floor, internal oblique, diaphragm and multifidus.

The most effective method I’ve seen for achieving this is clinical pilates. Not the choreographed classes on every gym timetable, but performing individually chosen exercises on reformers and trap tables in a studio.

In this case, we got the core working and within two weeks his back was feeling better than it had in a long time…

After 4 another four weeks of Pilates, his back had improved out of sight. I thought it was time to ask if he felt pain anymore?

“Nick, it’s so much better! I only get the odd niggle now and then..”

So it’s better, but not right!

Step 2 – Go Back and Fix Your Old Injuries

That old ankle sprain or shoulder problem may be why you core is putting in a sub par performance, forcing your back to pick up the slack.

Let me explain…

When you injure a joint, the natural reaction is for the muscles to spasm into flexion.

Think of what someone does when they hurt their shoulder. Immediately they lean forward, bend the injured arm and hold onto it for support.

They’ve flexed the torso, both shoulders and both arms!

This response is a primal instinct for survival. Safety of the injured area is your brains priority. In my experience, if you don’t do your rehab properly this ‘protective mechanism’ becomes an ingrained movement pattern..

Your ‘shoulder’ will function first instead of your inner core. This compromises your central stability causing what problem?

That’s right…back pain!

Whatever you do – don’t try and diagnose then fix this yourself.

You must get it properly assessed…
determine which old injury is the problem…
then formulate a plan to correct it!

Stop wasting time, putting up with the pain and get your body sorted…

Connect Your Brain to Your Body - And Your Body to Your Brain

It’s a bit of a tongue twister, but it is one of the easiest way to explain the concept of motor control. Why is this so important?

It’s the cascade effect. Poor motor control lead to an…

→ inability to coordinate muscles with movement

→more pressure through passive structures (joints, ligaments)

→injury

But what is it exactly?

Motor Control Technical Explanation

 According Roller et al (2012) in Contemporary Issues and Theories of Motor Control, Motor Learning, and Neuroplasticity, the production and control of human movement is a process that varies from a simple reflex loop to a complex network of neural patterns that communicate throughout the Central Nervous System (CNS) and Peripheral Nervous System (PNS).

In simple terms…

connecting brain and body to produce movement

In clinic, the first step with any new injury is to work out the diagnosis. You need to know what you’re trying to fix right!

In my experience, this diagnosis can be loosely grouped into two categories:

1. The result of direct trauma

2. Behaviour and motor control

And guess what?

Direct trauma creates a change in behaviour and altered motor control….

I’m sure you’re starting to get an appreciation for just how important motor control is in how your body functions. I’d love to share with you a couple of examples to highlight this…

Motor Control and the Shoulder

You may be aware the shoulder is a ball and socket joint. Its structure is designed to provide freedom of movement.

Imagine a tennis ball sitting on a golf tee…

This allows movement in all planes – forward, backward, up, down, and internal/external rotation.

Holding the joint in place through movement is your rotator cuff. The role of these muscles is to pull the humeral head in various directions ‘stabilise’ the ball and socket joint as it moves through range..

If the control isn’t there…

We start to encounter problems:

• Shoulder instability

• Rotator cuff or bicep injury

• Reduced shoulder rotation

• Reduced scapular muscle activation

All of the above contribute to poor biomechanics and thus reduce control, quality of movement, stabilisation and efficiency. A motor control problem.

These dysfunctions then lead to common injuries like shoulder impingement. Pushing through the pain feeds the issue and can lead to greater injury, such as tendon or muscle tears and labral injuries.

Motor Control and the Pelvis

For those runners, heavy lifters or even dancers! Lack of pelvic control, whether it be forward/back or side to side, places increased stress on lower limb muscles and tendons.
For example; poor core activation during activity

• leads to excessive anterior tilt of the pelvis,

• the hamstrings work overtime…

• overuse and tendinopathy or hamstring strains.

Another example at the hip…

Do you know someone who complains of knee pain walking up/down stairs or during a squat? I’ve had it myself!

Poor control and activation of the gluteus medius (muscle at the side of your butt) leads to

• a drop of the hip on the same side

• internal rotation of the upper leg (causing the knee to drop inwards)

• increase load and force through the outside of the knee joint

• pain and dysfunction.

Have you noticed the pattern?

Issues with motor control have a cascade type effect that almost inevitably ends up with some type of injury.

So the million dollar question…

Can You Fix a Motor Control Problem

Short answer is YES!

With a physio or chiro assessment, we determine what’s compromising your movement and provide treatment and rehabilitation to conquer the problem. The most important thing is that you do your homework!

This will allow you to move pain free, with more freedom of movement, control and efficiency!

The earlier you identify and work to correct a motor control problem the easier and quicker it is to fix…This begs the question:

How Do You Know If You Have a Motor Control Issue?

Be aware of how you move…

• Do you take most of your weight through one leg?

• Is it easier to rotate one way over the other?

• Do you find ways to cheat with exercises?

Alternatively – get your movement assessed by someone who knows what to look for…

Men's Health: Action-> Awareness-> Reduction

Awareness is not only for men – It’s important for partners, friends or family!

When people hear the term Men’s Health… inadvertently you think worst case scenario:

• prostate cancer and

• testicular cancer

Yep that’s right, we always have our family jewels on our mind!

But what about other issues like sexually transmitted infections, erectile dysfunction, male-pattern baldness, cardiovascular disease, and in my mind one of the biggest issues of them all: mental health, also known as The Black Dog.

I’d like to bring to your attention some alarming facts about men’s health that doesn’t involve cancer or depression.

Men…

• on average, live 4.4 years less than women.

• are more likely to die from heart disease at early ages.

• are at a significantly higher risk of dying from liver disease.

• have an increased risk of dying from diabetes

Plus:

• 80% of spinal cord injuries occur in young men.

• 70% of developmental and learning disabilities affect boys.

• Men make up 56% of the workforce, yet 94% of all workforce fatalities are men.

• Alcohol kills almost 6x more men than women.

Most of these facts above are lifestyle related. Which means THEY ARE REVERSIBLE!

That is 70% of a Man’s overall health is determined by unhealthy lifestyle choices, meaning 30% of men’s health is determined by his genetics. The image below sums this up perfectly.

Lets take a look at different decades in a man’s life and see the biggest issues that arise. If you are a guy reading this, or you’re a partner reading this, I like to look at this as “planning ahead”.

20’s – I call this “the fun decade”.

That’s why in young men their is a high incidence of contracting STDs. Some advice for you all: WEAR PROTECTION

It’s called a condom and don’t be afraid to ask if your partner is on some sort of protection too. Their is never a dumb question when it comes to this, and a recommendation, get an STD check, especially if you experience burning while urinating, itchiness (down there), pus discharge from your penis, and discomfort in testicles.

In fact, it is suggested to get a physical and blood/urine tests yearly, and after each sexual partner.

And now to the fun part… lads, get your hands in your trousers, because its testicular examination time from now until late into your life.

Movember describes this as “Knowing Thy Nuts”. Grab 1 of your mates downstairs and feel around for any irregular bumps, granules, tenderness or any change in size or shape. Then rinse and repeat on the other mate down there. I know we spend a lot of our time with our hands in our pants, but it is recommended that you also ask your GP for an exam too.

30s – This decade is the greatest rate for suicides among men.

Very close behind are teenage and 20s years and 40s. This is one of the most ‘in your face’ topics we need to address. Suicide and mental health issues among men have increased significantly over the years.

Great initiatives and organisations such as Movember, Man UP, Beyond Blue and R U OK? are the segway into dealing with suicide and mental health.

One of the hardest things for men to do is open up about such issues, whether they believe it to be embarrassing or an inferior trait. 1 in 2 Australian men experience some form of mental health problem at some stage in their life, and 3 out of every 4 suicides are men.

Guys, don’t be afraid to talk. Talking leads to asking, asking leads to listening, and listening leads to encouraging action!

40s – The decade where all our bingeing, drinking and inactivity really catches up with us.

Cardiovascular and coronary disease are the leading issues here, as well as the scary finger up the bum. Yep that’s right, screening for prostate cancer, well really starts in your 20s/30s, but you’re going to get 1 every year from now on until late in your life. Male pattern baldness, if it hasn’t already popped its head in (pun intended), is surely on its way if your family has a tendency for it. And as 1 bald man to another, fuck it…embrace the baldness and rock the living shit outta it!

50s and 60s –

The time where health checks become more regular as all the issues above are still present, and even more so colorectal screens for cancer and Alzheimer’

So, how do we combat all these issues that arise in men’s health? Lets keep it simple and sweet.

Eat healthy – spend 80% of your diet eating fairly healthy, 10% of your diet eating moderately healthy, and the last 10% eating whatever you want. In simple terms we need a balanced lifestyle when it comes to eating “right”. This will help reduced cardiovascular and coronary disease, diabetes, and improve mental health and physical health.

Be active – not going to say train 6/7 times a week, because lets face it, it probably won’t happen. Try and train 3x/week at moderate intensity. I would recommend 1 cardio session (run, swim, hike, bike), 1 strength session to include weights, and 1 workout session (HIIT is great!).

Get regular checks from the GP – getting regular checks from the GP regarding your health is recommended. Staying on top of your health, whether it be lifestyle related or genetics is an important part of the screening process into Men’s health and prevention.

Be heard – someone is always listening, and from 1 guys to another, we are here for you! Don’t be afraid to speak out, especially if something is bothering you physically or mentally. People often think action requires motivation. No. It is action that generates motivation to create more action to continue the cycle.

Don’t be afraid to take action today, so that we can live life tomorrow.