In this video, Stuart McGill, researcher from the University of Waterloo and one of the foremost experts on back pain discusses how doing crunches can damage the back and lead to back injuries. He also gives alternatives to the typical crunch.
Personally I have seen a number of people who have hurt themselves while doing crunches and instruct my patients to modify their workouts.
It might not surprise you to hear that we see a lot of low back pain in our office, what might surprise you is that a vitamin deficiency might be contributing to the lower back pain that many people experience. A recent study out of Canada looked at patients who had chronic back pain and found that there was a significant rate of vitamin D depletion in these patients. When given Vitamin D supplementation patient showed improvement in reported pain levels.
Who is deficient is Vitamin D?
It is estimated that 60% of Americans are deficient in vitamin D. Why is this? Vitamin D is obtained from two sources, the sun and food. Because we are spending more and more time indoors, people are not getting exposed to the sun and therefore not getting vitamin D. As far as food sources go, fish is one of the best sources of vitamin D and most Americans don’t consume fish on a regular basis.
Are you deficient?
Most people don’t know if they are vitamin D deficient. You can obtain a blood test that will test your levels of vitamin D. You can ask your doctor about this test next time you see them or your next physical.
What can you do?
If you suffer from chronic lower back pain you might considering increasing your vitamin D intake. As we get closer to the winter it is going to be harder to get outside and more of our bodies will be covered preventing sun exposure. Vitamin D can easily be obtain in food and supplement form. For a list of foods with the highest levels of vitamin D click Vitamin D foods. If you don’t find yourself eating many of the foods on the vitamin D list you can get vitamin D through supplementation. Vitamin D3 has been found to be the most beneficial. The Vitamin D3 that I recommend is from Metagenics and you can see it by clicking Metagenics vitamin D3.
Most of the studies done on vitamin and pain have looked at lower back pain, but it would stand to reason that if you have other pains such as neck, upper back and shoulder pain that vitamin D might also help. There are numerous benefits from getting a healthy dose of vitamin D and very few risks if taken appropriately.
For more information of vitamin D you can view these other articles on our blog, You need more vitamin D and Vitamin D as an anti-inflammatory.
by Katie Culver
For a lot of you, you come in for your adjustment, and afterwards, I ask you to do a few minutes of balance work. Whether its performing exercises while balancing on the exercise ball, Bosu, balance disk, or even just standing on one of the balance boards, I’m sure you’ve wondered why. Rest assured… there is method to our madness.
Because life is lived, at times, in unstable positions (such as walking on icy surfaces in the winter, running on uneven ground, or dodging toys and other obstacles as you chase your kiddos around the house),working on balance boards helps you safely and quickly keep up with the demands of life. Working on balance boards improves the strength of the small muscles of the foot and lower leg, improves reaction time, reduce the incidence of injury, increases your body’s awareness of where it is at in space, improves movement mechanics, and helps the body to work together as a whole!
One of the main reasons that we want to do balance work with our patients is to increase your proprioception (your body’s awareness of where it is at in space… ie knowing where your foot or arm is at without having to look down at it). After a spinal adjustment, when the body is in its corrected alignment, working on a balance board creates continuous neural stimulus that is perceived as information in the brain. It reinforces that correct alignment and encourages the body to remain in that position (which in turn would lead to more spread out adjustments).
Conclusive research has also been done with balance boards. In one study, it was found that simple balance exercises, as part of early treatment for injuries such as ankle sprains, increases the strength and stability of the joint and therefore decreases the chance for residual symptoms and sprains. Additional research has shown that exercising on these unstable surfaces significantly strengthens muscles when tested against stable equipment. For instance, in one particular study, untrained men approximately doubled abdominal muscle activity when a crunch was executed on an exercise ball versus a static bench.
So if you want a stronger and quicker body whose muscles all work together in unison, try doing exercises on unstable surfaces. Remember, though, to be safe and begin easy, with no weight, and progressively get more difficult, as exercises on these surfaces can be deceivingly difficult!
Sleeping is obviously an essential part of each of our daily routine. Most of us sleep between 3 and 10 hours a day, and if you spend that 8%-42% of your day in a poor position, you are putting yourself in a position of risk for injury to the length of your spine. The position I would recommend most to sleep in is on your back. It is there that your spine and musculature is able to rest in a neutral position. While there, it is important to choose a pillow that allows your neck to maintain a neutral position as well (not allowing the chin to tuck or extend back excessively). A pillow that I recommend is the Therapeutica sleeping pillow.
Additionally, low back pain is present in 8 out of 10 Americans at some point in their life. If you’re one of those, placing a pillow under your knees allows your pelvis, too, to rest in a stress free position. Also, check out our post on foods that help low back pain.
If sleeping on your back just isn’t working for you or if you’re pregnant and unable to sleep on your back, I would next recommend sleeping on your side. Again here, its important to pick a pillow that will not put your neck in too much or too little side tilting side but rather keeping it in line with the rest of your spine. Although side sleeping might be more comfortable for some, it may put the outside of your hip, the gluteus medius specifically, at risk for overstretching as your top leg relaxes at an angle below the horizontal. Your gluteus medius is one of the main stabilizers in the hip and is a key muscle in a number of daily activities such as walking, squatting, transitioning from sitting to standing, and even standing on one leg. If you choose to sleep on your side, I would recommend keeping a pillow sandwiched between your lower legs.
Unless you’ve found a different and unique way to sleep, your final sleeping-position-option is one I would not recommend: stomach sleeping. This is the hardest on your spine as you need to dramatically twist your neck to rest on your belly. Since your body works best balance, stretching and shortening the neck muscles can cause other problems in your upper back and neck. Additionally, it also shortens your pectoralis minor, causing your shoulders to round forward and put more stress on your cervical spine and mid back.
In this video we look at a great way to strengthen your core and prevent back pain. After an episode of back pain, the muscles that support the back start to atrophy or waste away. This is what leads to future episodes of back pain. Katie Culver, our Athletic Trainer, shows us how you can use a simple device to strengthen you back and prevent back pain. For more information about back pain, check out our back pain page.
Back pain is a big problem and a complicated problem. Like most things there is not a simple solution to this problem that costs consumers 30 billion dollars in 2007. For most people curing their back pain involves a number of modalities and lifestyle modifications, one change that is not commonly discussed in the treatment of back pain is the the relationship that food has with this pain.
How can food help low back pain?
The pain that you experience when you have back pain is due to inflammation. This inflammation can be caused by repetitive stress to the muscles and joints or could be due to a single event. Inflammation plays an important role in the healing process, but it often continues beyond its helpfulness. Food can aide in decreasing this unhealthy inflammatory response by removing the elements that create the inflammation. Just as there are food that can aide in fighting inflammation there are also foods that can increase inflammation see the list below for food to eat and foods to stay away from.
Below is a list of foods you should eat more of to prevent and help treat back pain:
Here is a list of foods to stay away from:
A recent study out of Stanford Medical School showed that patients with low back pain who had an MRI performed were more likely to have surgery than their counter parts who didn’t undergo advanced imaging. This is concerning because previous studies have shown that increase surgery rates don’t improve patient outcomes for low back pain.
Low-back pain is the second most common reason for missed work after the common cold. It was the fifth-most common reason for physician visits in the United States, with 26.4 percent of adults reporting low-back pain for a day or more during a three-month period in 2002. More than 80 percent of low-back pain was diagnosed as nonspecific, a category that includes lumbar strains and sprains, degenerative disk disease and spinal instability.
My take…
It has been found in study after study that patients typically fair very well with conservative treatment of low back pain. Conservative low back pain therapies include but not limited to chiropractic, massage and exercise. The majority of patients that come to Compass don’t get advanced imaging unless I determine that is it completely necessary. Because I see low back pain cases all day I feel more comfortable with treating these conditions conservatively prior to ordering an MRI. If we’re not making progress with conservative we will pursue advanced imaging or a referral to another healthcare provider.
MRIs are a great advancement and have helped to diagnoses conditions that would have previously gone undiagnosed, but with most things you can have too much of a good thing. Since the advent of MRIs it has been easy to rely on the technology in place of the diagnostic skills of the clinician. It should come as no surprise that I see new people everyday that present to my office with low back pain. Some of these patients with low back pain require advanced imaging because they’re presenting with symptoms beyond back pain such as pain that radiates along with numbness and tingling. The majority of patients don’t require advanced imaging and a diagnosis can be rendered with0ut the additional cost and exposure associated with advanced imaging.
In order to make the correct diagnosis it often doesn’t require sexy high-tech gadgets, rather the oldest diagnostic tool known to man, listening. Most people who know me know that I love technology, but technology is an enhancement rather than a replacement for a skilled, compassionate doctor.
For more information about low back pain, visit our Back Pain Page.
Approximately 90% of adults experience low back pain at some point in their life and it is the second common cause for primary care visits in the United States. The number of people who suffer from back pain is staggering and the effect it has on quality of life is immeasurable. Before we can address this problem we need to first understand the cause of low back pain. There are numerous cause of back pain, but in this post I am going to look at one particular cause, the Sacroiliac (SI) joint dysfunction.
In this picture we are looking at the pelvis from behind. The two bones that look like elephant ears are called the Ilium and the bone that resides between the Ilium is called the Sacrum. On each side of the Sacrum is a joint that articulates with each of the Ilium. This joint is named for the two bones on each side of it’s articulation, the Ilium and the Sacrum, therefore the name of the joint is the Sacroiliac or SI joint.
When we are born the SI joint is smooth and becomes irregular and roughened in order to support the weight of the body. It was once believed that this joint was fixed with no movement but with the development of advance imaging studies we have learned that this joint does in fact moves and can lose it’s normal movement pattern, which is called a joint dysfunction.
Typical symptoms associated with the SI dysfunction are sharp pain on either side of the spine at the very lowest part of the low back. This pain is often exacerbated by stressing the joint with activities such at rolling over in bed, getting up from a seated position and getting out of the car to name a few. Most often the pain is local to the area over the SI joint, but it can radiate down the back of the leg and typically around the front of the thigh. If you experience these types of symptoms it is likely that you might have an SI joint dysfunction, but there are a number of other conditions that can also create similar symptoms. It is important to make sure you have been properly diagnosed in order to determine the cause of your symptoms.
If it is determined through an examination that the cause of your low back pain is an SI joint dysfunction the next step is to determine the proper treatment and lifestyle modifications. Typically when someone is suffering from an SI joint dysfunction the joint is either malpositioned or not moving correctly. The initial treatment involves restoring the alignment and movement to this joint, which is accomplish by adjusting or manipulating the SI joint. Often times the first attempt to move the SI joint is met with resistance from the muscles that protect the joint. In this case we use massage or electrotherapy to relax the area in order to restore movement. A series of adjustments are used depending on the severity of the dysfunction to restore the normal motion and bio-mechanics of this joint.
Any time there is an injury to the body it becomes weakened and subsequent injuries are more likely. In order to prevent future injuries we work on restoring the strength and stability of the joint and surround muscles. These is accomplished through specific exercises that are designed to maintain functionality and increase stability. The exercises are simple and and can be performed with minimal equipment and space.
Once we have corrected the underlying problem we address what caused this problem in the first place. Sometimes the answer to this question is very simple and straight forward, ie slip and fall on the ice. Other times to causative factor may not be as cut and dry, ie getting up out of a seat accompanied by sudden back pain. Most times we can find specific activities of daily living that contribute to the low back pain you’re experiencing. We work to find ways to modify these behaviors in order to prevent the return of the condition.
For more information about how we treat low back pain, visit our back pain page.
Recently channel 13 news came to the office to do a story about inversion tables and how it compare to decompression therapy. In this video I discuss the benefits of each and which condition is appropriate for each therapy. This video was from a local channel here in Indianapolis discussing low back pain and decompression therapy.
“I believe Bryan was born to be a chiropractor
and relieve people’s pain. He’s been a godsend to me. Thank you, Bryan!”
by JM 43
