Welcome to the first of many post in the Resiliency Series!
What is this series all about? Here’s a brief…
Over the next few months (or however long it takes for me to run out of content), I will be covering the most common areas of the body where people have their aches and pains. Each week will cover a specific area that we suggest people work on in order to resist injury.
This will NOT serve as a way to treat an injury or direct medical advice, but it will be a resource that will house the most up-to-date information on how to make yourself stronger and and more⌠RESILIENT! We ALWAYS suggest you seek medical attention if you feel you need more help.
So, you’re continuing to read because you think I am going to give some secrets about how to help the lower back… right?
Keep reading… Unless you have been helped by us for lower back pain in the past, this is going to be information that you have NEVER been told before.
All the information I am going to provide will be through answering the most common questions that we get when we help people (many people) with lower back pain.
First question…
“What exercises should I be doing? Probably more core and stretching?“
Exercises are great at helping take care of and prevent lower back pain! Before I show off some of our favorite exercises, I want to point out a VERY important point… It is NOT all about exercise. There are MANY, MANY factors that affect lower back pain. Just adding ‘more core and stretching’ will definitely not do the trick.
…But because you asked, here are some of our faves!
*DISCLAIMER* IF you are having pain, please don’t just go wild with these thinking they are right for you. Try these if you want to help BUILD your lower back but you aren’t currently in a flare-up.
Assisted sit ups!! What?! Sit-ups?! Yes! These are GREAT at not only building strength but also at building flexibility in the lower back and hamstrings. Try this with a thick band, dog leash, something attached to a firm pole and work your way up like the video! Start with 2 sets of 8, 3 days per week.
Back Extensions!! Yup! You need to go the other way, too… The lower back is meant to bend forward AND backwards. You can use a bench, ball (like the video), ottoman, bench… just anchor your feet and extend away! Start with 2 sets of 8, 3 days per week.
There are MANY more, but those are some gem’s… There is also A TON of research backing the importance of a FULL-BODY resistance training program for long-term low back pain management… JUSY FYI.
Next question…
“Will I have back pain forever?”
The greatest risk factor for injury… Is a previous injury! Once you have had it, the likelihood of it coming back is higher than before you had it. The good new is that if you know how to manage it, it can be, well… managed!
We discussed some exercises above that are great at keeping you limber and strong, but that just covers the physical. There are MANY other factors that can contribute to symptoms:
Stress
Being tired
Fear of the pain itself
… Just to name a few. It’s not all about the movements and activities, it is the inner environment that can contribute to a flare-up or a period when you “notice” your back pain coming on.
Find ways to manage your stress, get some sleep, and try to lower your fears of the pain. 80% of cases of low back pain get better! That’s a promising number…
You will not have to deal with this forever if you get some help… Be heard, get some explanations, set some goals, trust the process and stay as positive as hell.
Last question…
“What could have caused this pain? I don’t remember doing anything?“
Factors such as poor sleep and high stress can put you at risk for an injury or a flare-up. Outside factors CAN contribute to setting off a flare-up, they make you more susceptible!
It’s VERY similar to be common cold. When you are under more stress, you’re tired, your immune system is low, you are more likely to get sick.
Same thing goes for lower back pain!
On the other hand, sometimes we can’t find an exact cause… it’s usually a handful of things that bring it on so don’t rack your brain!
Many people want to know the cause so we can prevent it from coming back. Most times, we don’t nail it down, we figure out how to handle it in the future by a bit of trial and error and seeing how your body responds to what we do.
I really hope you got something out of this. I am super passionate about helping people with short and long-term lower back pain!
Stay tuned for more Resiliency Series monthly topics!
Everyone likes to try to search for the best “How-to” when it comes to helping their own injuries.
There is NO WAY that you can tell me you haven’t googled for “the best treatment for [ENTER PAINFUL AREA HERE]”
I decided that it would be a great idea to put out some content that I am calling the “Resiliency Series“. Over the next few months (or however long it takes for me to run out of content), I will be covering the most common areas of the body where people have their aches and pains. Each week will cover a specific area that we suggest people work on in order to resist injury.
This will NOT serve as a way to treat an injury or direct medical advice, but it will be a resource that will house the most up-to-date information on how to make yourself stronger and and more… RESILIENT! We ALWAYS suggest you seek medical attention if you feel you need more help.
Topics that will be covered include:
The lower back! The most common area of long lasting pain for MANY people in our population.
The knee! A very common area for many active people to have issues with at some point in their lives.
The shoulder! Another very common place that needs long-lasting attention in regards to strength and flexibility. There are SO many misconceptions about what someone should or should not do with regards to their shoulders – with a history of pain or not…
The foot! Lots and lots of foot pains have hobbled into the clinic from all the COVID-19 warriors looking to become runners all of a sudden… Feet need strength training, too! In pain or not, if you want healthy and happy feet, stay tuned.
I will probably keep going but that’s all for now đ
I am going to start off the series today with some of the BEST ways that you can stay resistant to injury on a more general level.
Here are my most helpful tips that you can apply TODAY.
Sleep is the most effective performance enhancing drug known to man… And it’s free. This is INCREDIBLY important to remember and should be the #1 place to begin when trying to address long-term resiliency and injury prevention. Sleep doesn’t only improve and enhance your physical state, but it also enhances your mental capacity as well. We all function better with more Z’s… You can do all the stretching and strength training in the world, but if you are running on 4-5 hours or sleep per night, its like driving with your E brake on. You’ll get to your goals but it will absolutely take longer to get there
Most injuries are from doing too much, after doing too little for too long… If you do more than your body can handle, it will tell you. If your capacity to handle that said activity is low, then the ramp up needs to be MUCH slower than you may think it needs to be. If you have a goal to increase how much you do (ie. increase how far you are running), you should absolutely be adding to your overall activity (mileage in that case) little by little. Also… think about the entire week of activity, vs day to day. In the example of running, you should be thinking about your total mileage over the course of the week vs just the day itself, it all adds up.
Understand that when your stress levels are high and life is a bit nutty, you can be at risk of an injury. Just like when your body is a bit stressed and tired you are more apt to get sick? Same thing goes for injuries. If life’s tossing you lemons, don’t try and squeeze the shit out of them with super hard workouts. Ease up a bit, stay active but don’t shoot for personal bests.
Your GREATEST risk of an injury is a previous injury. Sorry folks, this is a proven fact and complete prevention isn’t ACTUALLY possible. If you have had an injury once, you are at risk for developing it again. You can only reduce your risk of getting hurt!
How can you reduce your risk? Learn more in the Resiliency Series to come!
There were many great things that happened during quarantine. I was able to get to know some awesome new people AND establish a Virtual PT service. I had no idea how things would go and I only hoped for the best. Fortunately, we had some great successes.Â
Today, we are highlighting Jody, a very motivated, driven and disciplined individual I had the pleasure of treating. She was dealing with some pretty debilitating shoulder pain and was in some dire need of help. It took her some time, but she finally found her way into my inbox and off we went. It wasnât long before she showed me that she trusted the plan and was ready to get to work.
âIn February my shoulder/arm began to bother me. I was handling it at first but it was lingering and not fully healing. Within a few weeks of quarantine, it became much worse and unbearable. I couldn’t do a burpee, child’s pose, wipe the counter, reach into a tall cupboard, dry my back with a towel. I couldn’t hook/unhook my bra!! I also turned 50 within the first weeks of quarantine and this along with my shoulder were really messing with my confidence. I am an avid Orangetheory “athlete” and was very worried about losing all the muscle I’d gained in the past three years. The trifecta of Orangetheory closing, turning 50, and not being able to exercise properly due to the injury caused me stress and worry.â
Her shoulder was dramatically affecting her life. We talked a lot about how much her identity was slowly stripped away from her as her shoulder worsened.Â
âBefore starting my virtual PT appointments with Loni, I felt like I was losing a part of my identity, a very healthy part in which I felt strong and capable. I was pretty depressed about the whole situation (quarantine didn’t help) and it all felt out of my control because I didn’t know how to fix it. Exercise would hurt so much at first but then seemed to stretch my muscles and make the pain go away for awhile. Was I making it worse with that initial pain or challenging my arm and making it better? I really had no idea particularly as things were getting worse overall.â
We did our best to collaborate on a plan that she trusted and was committed to. Virtual PT is not like being in the office but for Jody, it worked very well. We try to set ourselves apart from other PT clinics in the way that we program and plan our treatment sessions. She had never ceased to amaze me by how hard she worked every day. We had some ups and downs, but over time the victories began to outway any days that the pain returned.
âVirtual PT was amazing for me. Quite honestly I went into it feeling like I might be untreatable. That I wouldn’t do it right. I’d never done PT before for anything, so I was afraid I’d miss the most important piece. That if there was a way to mess it up, I would. Meeting Loni (virtually) in my home, where I feel comfortable, was a perfect first step for me. Loni understanding and seeing what I had to work with helped us both help me – having done the exercises in my home with her (on my computer screen) was a great lead into the days of the week that I had to do the exercises on my own. I already knew what to do in my home, with my bits of pieces of equipment (full rum handles weigh 8 pounds). I can’t imagine that PT would’ve worked any better had I been visiting the office versus doing online appointments.â
Jody is absolutely killing it and making such awesome progress. We have not only surpassed MOST of her long term goals but made some new ones. I have strong hopes that she will have a stronger shoulder than ever before.
We asked Jody where she is now…
âI am back in control of my health and wellness. That’s the best feeling! I’m confident that I can do what I set out to do and I’m humbly reminded that there is no secret magic trick that will give me my strength, flexibility, and health. I have to put in the work. (a perfect life lesson to be mindful of during quarantine) And I’ve seen the results over the past 5 weeks, so I’m so eager to continue and get my shoulder/arm working as it had before this injury.â
I cant thank you enough Jody, for trusting the process and making it work with your 8-pound rum handles, haha! In all seriousness, this was such a great success story to share and I am incredibly grateful to have been able to work with her!
To sum up her experienceâŚ
âShe patiently reminded my arm how it was supposed to function through a very thought out and ever changing exercise plan. Her attention to detail and genuine interest in my well being gave me confidence in her. Knowing I could trust her, kept me doing anything she asked of me. She encouraged me to keep moving forward, doing the things I could until my shoulder fully healed. She educated me on the inner workings of my injury. She was always available through our shared spreadsheet, email, and text. She celebrated victories with me and walked me through setbacks. When I told Loni that she helped me find my confidence again, she had the biggest smile, she was truly happy for me and she said, that’s what it’s all about. I say, that’s what Loni is all about, helping others get their confidence back.â
One question I get all the time is, âHow do I know when Iâm ready to make an exercise harder?â. Usually thatâs followed up with another question, âHow do I safely make an exercise harder?â. These questions are really important! When youâre working out consistently, itâs important to continue to challenge yourself so you stay on track to make steady progress. Today Iâm going to list 6 tips to help you answer these questions and make sure you keep making progress.
1. Have a goal
This is really important because a goal helps determine what we are prioritizing in your exercise program. For example, if you goal is to lift heavier weights the program should be built around improving strength. If your goal is to run a certain distance, your program will look completely different! So, first thing you have to do is figure out what your goal is. It could be focused on strength, endurance, or even just burning calories to stay fit. Keep that goal in mind as we go through the next few tips.
2. Understand the different parts of an exercise
Every exercise can be broken down into a few specific things. We have the movement itself, the how much weight youâre using (intensity), how many times youâre doing this (sets and reps), the speed of the exercise (fast or slow), and how many days/week you do this (frequency). So for example if youâre doing squats as part of your program, think about those different components. Are you doing bodyweight squats or are you adding weights? How many reps and sets do you regularly do? Are you moving fast through each squat or are you intentionally moving slow? Also, how many days per week are you squatting? Each of these different factors can be changed to make an exercise harder or easier. The fun is you can pick and choose which one you want to use!
3. Which of these do I pick?
Think about your goal for your exercises. If youâre trying to build strength, I would probably recommend increasing the weight of the exercise. If youâre more focused on endurance, it might make more sense to add more reps or sets. If you exercise to burn calories and stay fit, you might try to increase the speed or even add an extra day of the week youâre exercising. Having balance is important here so make sure you only pick one of these factors at a time!
4. Things to track during a workout
Tracking a few small things during a workout can be really helpful in deciding when youâre ready to progress your exercises. First off, keep a workout log and write down what you do each day and how you felt doing it. For example, you would write down that you did squats on Monday, 3 sets of 10 with a 25# kettlebell and at a smooth controlled speed. You also would write down how that felt, âThey were definitely challenging, but I felt in control and by the end of each set I felt as if I could do probably 4 or 5 more repsâ. The key things here are writing down exactly what you did and then how you felt in that moment. A great way to do this is writing down how many more reps you could have done at the end of a set. Another thing to record is how tired you were at the end of the exercise. I recommend using a RPE scale that measures how hard youâre working from 1-10. Here is the chart, so you can see where you fall on the scale after each workout.
So make sure to keep track of these few things and they will help you know when you can make an exercise harder.
5. How do I use this info to know Iâm ready to make the exercise harder?
So you wrote down the workouts you have been doing, how many more reps you feel like you could do at the end of your sets, and you scored 1-10 for how tired you were at the end of your exercises. If you feel like you can 5 or 6 more reps at the end of each set, youâre probably ready to make the exercise harder. If youâre scoring less than a 7 on the 1-10 scale, youâre probably ready to make your exercises harder. The key is NOT to score a 10/10 or to feel like you canât do any more reps at the end of each set. The idea is to work hard, but feel like youâre not draining yourself.
6. Keep up with your program and tracking your workouts
Consistency is the most important part of every exercise program. If you get used to tracking your exercises and making them more challenging, you will get a lot better at it! You will also get great results towards your goals.
This can be a lot of information to process but using it can really help you with your exercise programs. These tools will give you the ability to safely make progress towards your goals. If you want to talk this over with us so we can get specific about you and your goals, let us know!
We also did a webinar on this topic in a little more detail last week, so if you want to check that out you can see the information presented online too.
I donât need to remind anyone of all the lifestyle changes weâve had to make over the past few months. Everyone has had to make different changes depending on your particular habits, but we all can relate to the common theme of being able to do less. We definitely are spending more time at home, less time in the gym, and less time being active in general.
Because of this, weâre seeing a difference in our ability to stay fit and healthy. A lot of how we know this is based on how we feel. Personally, I feel like I havenât been as healthy as Iâd like because I canât play in my soccer leagues anymore and I havenât been able to go to the gym at all. Itâs hard to measure being less active and healthy, but thatâs what research is for! There was an article published in the European Journal of Sports Science on May 12th, 2020 that looks at this exact topic. The authors review the impact of being sedentary due to COVID-19. Even better, they also provide some recommendations for how to combat the effects of being more sedentary. Iâm going to do a birdâs eye review of this article and help outline their tips for physical activity and nutrition.
The first thing this article talks about is how we can lose muscle strength very quickly if we are totally inactive. You can see these changes after just 2 days of total bedrest. Thankfully, we are not on total bedrest. Even if we are confined to our homes and are only able to leave the house for groceries or a walk in the neighborhood, that is still a great way to maintain some muscle strength. Combine that with some structured exercise and you can definitely prevent muscle loss during this time at home.
The article also looks at some more specific topics like blood sugar levels and how people with conditions like diabetes or heart disease should especially take action to stay healthy during this time. Decreased activity has a direct effect on our bodies blood sugar levels and our cardiovascular fitness. One thing they found is that most of us are getting a lot fewer steps each day. I usually aim to get 10,000 steps on a normal day, but recently that is not even a remote possibility. I find that by the time I finish doing some work in the afternoon Iâm lucky if Iâve done 1,000 steps. This article recommends that you aim for at least 5,000 steps each day, which is much more manageable in my opinion. If possible, try getting outside and go for a walk, jog, or hike. Mixing it up and trying different ways to keep moving will help make it easier to get your steps in each day. By doing this you will help keep your blood sugar more regular and even help maintain your cardiovascular system.
Finally, the article also talks about nutrition and how we need to strike the balance between eating enough without overeating. I found it really interesting that they mention it is common for people in very stressed environments to actually under eat. People who are sick or have a very strict home confinement situation may feel so stressed that their diet is suppressed. Personally, that is how I felt at the start of quarantine. Things were changing so fast and we had no control over it. I found myself not hungry or getting full after just a few bites of dinner, which is highly unusual for me. Itâs definitely gotten closer to normal now, but I still feel my diet has changed the past few months.
The other side of this is the group of people who are finding themselves much less active, bored, and with a free time to snack and eat more. Since we have been social distancing you might have started watching more Netflix, reading, or just relaxing around your home. If you combine that with your normal eating habits, you may start to gain weight or lose some of the fitness you were maintaining. The article states people are seeing 35-40% less energy expenditure than they usually do. This basically means we are burning a lot less calories and if we donât make a slight adjustment to our intake, we will probably gain some weight. The article recommends reducing your daily intake by about 15% or so. Of course this will vary person to person so ask for help if youâre not sure what you should be doing!
Overall I found this article to be really interesting and practical for making some lifestyle changes that will help keep us healthy during this time of quarantine. The big takeaways I found were:
Exercise at least 30 minutes each day
Take at least 5,000 steps each day and getting outside can be helpful to do this
If youâve been really stressed and lack appetite, make sure youâve been eating enough
If you feel youâve been overeating, try reducing your daily intake by 15%
Stay positive and optimistic! Things will get better and return to normal
Keep these tips in mind and please let us know if you have any questions or concerns on how to use this information!
Here is the article citation for reference: Narici M, De Vito G, Franchi M, et al. Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures [published online ahead of print, 2020 May 12]. Eur J Sport Sci. 2020;1â22. doi:10.1080/17461391.2020.1761076
