Low Back Discomfort and Ways to Address It

Well, I got such a great response from folks about my knee discomfort post last month that I thought I’d discuss a similar issue around low back discomfort. Now to start off let’s be sure that we distinguish between pain and discomfort. We’re going to categorize “pain” as something that is sharp, chronic, rarely subsides, and often comes with referred pain, numbness or tingling down to the legs and even feet. By discomfort I mean the achy feel that comes from prolonged sitting, prolonged standing, or the classic “not sure what I did the other day, but my back is stiff”. This usually comes from an overdone level of activity such as heavy lifting, reaching, gardening, workouts, etc.

Discomfort is what we’re are discussing here. Remember, our job as fitness professionals and as active individuals is NOT to diagnose or treat medical conditions, including low back pain. This is NOT to serve as a guide for diagnosis, but an article to recommend some strength and flexibility exercise choices for clients that report discomfort in the low back. If you at all suspect other structural issues, always refer the client or yourself to a qualified health-care provider. Remember folks, our world is about motion and exercise, not medical conditions. Now on with the show…

So why would someone’s low back be prone to being sore or stiff with extra activity? Most likely it is because their back is what we like to call “hyper-tonic”. It has more tone to it than normal. Now I know we all want to be toned up, but not like this. A hyper-tonic low back is one that has a level of constant tension in it that is higher than normal. This also generally means that the fibers in it are shorter than normal. We also may not feel the effects of this tension until we overdo something. So, a group of muscles that sits at this level of tension let’s say, is already angry. An increased level of work placed on these angry muscles, well, gets them really ticked off, and they in turn let you know it. Along with angry low back musculature, the hip flexors are often just as angry and as they go, very often so does the low back.

Now without having to go into detail too much about how this works (if you want to know the detail just email using the info below), the ab muscles and glutes (butt muscles) are actually the opposite. They are a bit more mellow than normal, in fact we’ll call them drowsy. This all puts the body in a position that favors this mish-mash of angry/drowsy muscles and leads to more and more discomfort and maybe even more serious issues.

How does this all come about in the first place? Well there are a couple schools of thought on this and I happen to believe both play a part in this widespread problem. The first one being quite simple, we sit A LOT as a society now. When we’re seated, our hip flexors maintain a shortened position and are just asking to become hyper-tonic (aka angry) over time. This can often lead to an angry low back. The second one being about available motion. Just like we talked about with the knee, if the segments above and below the one in question don’t have enough motion, our body will find it elsewhere. In this case, we’re talking the shoulders/thoracic spine and hips/pelvis. Our low back vertebrae (or lumbar spine) are fairly mobile relative to the thoracic (stabilized by the rib cage) and sacral/coccygeal (stabilized by the pelvis and/or fused) vertebrae. So whatever motion my body may not have at the shoulder girdle and hips, my body will find at my lumbar spine since that is a nearby segment with some extra mobility to it. That is, my low back takes the hit for what my shoulders and hips cannot do.

So how do we work with this?

1) Open up the front of the shoulders (increase mobility)
2) Strengthen the back of the shoulders and upper back (helps with posture maintenance)
3) Open up the hips (quiet angry hip flexors)
4) Increase glute activation (wake up drowsy glutes)
5) Stretch the low back (quiet angry low back muscles)
6) Wake up the abs/core control (wake up drowsy ab/core muscles)

That’s a tall order, so I’m going to give you a few suggestions when consulting with other fitness professionals, or if you are a casual exerciser, about what to look and ask for.

1) Pec major/minor stretches, latissimus dorsi (lats) stretches: usually shows up as stretches that you see people doing in a doorway or with their arm up on a wall
2) Scapular (shoulder blade) retraction exercises: usually some form of bringing the arms from a position in front of the body to one behind it while maintaining elbows out away from the torso
3) Hip flexor stretches
4) Types of squats, lunges, or deadlifts: these need not at all be heavy and must be done perfectly to target glute activation otherwise other muscles may try to step in and take over the motion
5) Low back stretches: usually involve a rounding of the low back while standing or “on all fours”
6) All types of core exercises including, but by no means limited to, variations of ab crunches

There are all kinds of ways to accomplish the above and this should serve only as a starting point of discussion and research for the best selection of exercises to “wake up” and “quiet” the right muscles for your or your client’s specific needs and body. This is to get you thinking about programming, not serve as the detailed guide on it. There could be other muscular imbalances at play and a thorough motion analysis is warranted before beginning individualized programming. And don’t forget my mantra “When in doubt, refer out.”

Got questions? Please email me at rich@oraclefited.com

Thanks for reading and talk to you soon!

Rich

About the author:
Rich Fahmy MS is the Director of Education for Oracle Fitness Education, a company that specializes in continuing education for health and fitness professionals (more info can be found at www.oraclefited.com). He is a trainer’s trainer; and some, although very few, would say he’s a cross between Chuck Norris, a Real Man of Genius, and The Most Interesting Man in the World. And by some, that means just him.

This entry was written by rfahmy, posted on March 28, 2010 at 10:40 pm, filed under Life is Fitness, Lifestyle and Spa, Los Angeles, Santa Barbara and tagged , , , , , , . Leave a comment or view the discussion at the permalink.

Common knee discomfort issues and what to do about them!

by Rich Fahmy

I’ve been getting asked a lot lately by client and trainer alike about knee discomfort for exercisers. You know, the knee discomfort that appears usually as the subtle tugging feeling or tightness felt at the outer side or front of the knees. And can at times escalate to pain.

Let’s talk about the knee a little. It essentially is a pretty helpless joint. By this I mean it does what the ankles and hips tell it to do, the knee is at their mercy.

So what’s the point? The point is that when a client or you has knee discomfort, it almost always is never the knee itself, but what lies above and/or below it. To put it quite simply: the motion I don’t have in my hips and ankles will be found in my knees. Remember when we move, our body will get us from ‘point A’ to ‘point B’. It may not look pretty and it may not be the most efficient or optimal motor recruitment pattern, but it will find a way. So it is quite common that my knees take the hit for the lack of mobility of the joints around it. This sets up overuse patterns, and structures that normally would be responsible for let’s say, stabilizing the knee in a particular plane of motion, end up doing even more work than needed. This often leads to some form of pain and tendinitis.

**READ THIS** It should be noted that our job as fitness professionals and as active individuals is NOT to diagnose or treat medical conditions, including tendinitis. This is NOT to serve as a guide for diagnosis, but an article to recommend some flexibility exercise choices for clients that report discomfort in the knee. If you at all suspect tendinitis or other structural issues, always refer the client or yourself to a qualified health-care provider. Remember folks, our world is about motion and exercise not medical conditions. “We now return to our regularly scheduled programming.”

While traditional muscle group exercises for the quads and hamstrings, usually in the form of leg curls and extensions, will do fine at strengthening the muscles surrounding the knee, they may not do much, if at all, to increase motion in the joints that are impacting the knee.

So what do you do exactly?

1) The idea is to increase the mobility of the hips and of the ankles so they can do their jobs, and the knees won’t have to pick up the slack. There are all kinds of ways to do this but to keep things simple, seek out good stretches for hip flexors and calves, these are the most common muscle groups that reduce the available motion in the hips and ankles respectively. And if you or your client doesn’t even have any knee issues, these are good to do anyway.

2) It’s a good idea to also build stability in the joints of the lower body. It is one thing to increase the available motion in a joint with flexibility exercises, it’s entirely another thing to train the body to actually know what to do with the new-found motion once it has it. For the sake of keeping things simple again: for the lower body this just means get your clients standing and actually bearing their weight. If they are sitting on machines all workout long, the body isn’t learning to manage and stabilize their body weight with their lower body. You can then try staggering a stance, narrowing the width of the stance, or even trying single leg exercises if they qualify for them.

Until next time…

Rich

About the author
Rich Fahmy MS is the Director of Education for Oracle Fitness Education, a company that specializes in continuing education for health and fitness professionals (more info can be found at www.oraclefited.com). He is a trainer’s trainer, and some, although very few, would say he’s a handsome man’s man. And by some, that usually refers to himself and his mother. Contact him at rich@oraclefited.com.

This entry was written by rfahmy, posted on February 15, 2010 at 5:50 pm, filed under Bodywork, Fitness, Life is Fitness, Los Angeles and tagged , , , , , , . Leave a comment or view the discussion at the permalink.

A Review in Vital Juice for Soma Get Fit

Check out our most recent press in the daily healthy online magazine Vital Juice.

We hosted the LA editorial team here for one of our weekend retreats and they absolutely loved it.

Click below to read the full review and save 20% off your next retreat.

http://vitaljuice.com/entry_detail/la/1037

This entry was written by scrawford, posted on January 13, 2010 at 8:16 pm, filed under Bodywork, Experiences, Fitness, Food, Green Lifestyle, Hiking, Life is Fitness, Lifestyle and Spa, Los Angeles, Meditation, Nutrition, Outdoors, Press, Retreats, Santa Barbara, Stand Up Paddle Surfing, Yoga and tagged , , , , , , , , , , , , , . Leave a comment or view the discussion at the permalink.

Foundation – Returning to the Basics

by Nina Bennett

Upon completing my through hike of the Pacific Crest Trail, I found myself in a peculiar situation. I had no major ties to anything. No job, no relationship, no responsibilities. The world was my oyster, so to speak, yet I found this to be an overwhelming and stressful position to be in!  I would oscillate between dreaming about all the amazing places I could settle down, jobs to pursue, potential relationships to be cultivated, and being completely lost and without direction, overwhelmed by the sheer number of choices. My internal compass was spinning uselessly!  Having no clear idea in which direction to focus my energy, my mind used the energy to wind itself up even more! An unfocused mind quickly becomes destructive, pondering the “what- ifs” and worries it likes to create. Things that are not actually a truth in the eternal NOW. Stress is a construction of an overly active mind.

During stressful times in our lives, so many of us do not know which way to turn, what action to take. Our minds spin, out of control, mulling over the millions of possibilities, attempting to figure the answers out through logic. My brother, recently through with college, is in the same situation. “Where should I choose to settle down, to start my life? “ he asks me. Another friend, unhappy with his relationship and living situation also finds himself a victim of his highly creative mind. He wants his life to be different, but doesn’t know how to make it happen. There are so many of us seeking direction; people who have recently lost a job due to the state of the economy, people needing change, people who have lost a loved one. We are all so lost in our thoughts, we are incapable of taking action in the physical world.

So what do we do when we find ourselves in these situations? How do we pull ourselves back into the present moment, back into our bodies, and out of the mental realm in which we have become lost?

My sister is fond of saying “root down to rise up.” The key lies in building a strong foundation. The strength and integrity of the tree begins with its root system. The stability and ability of a building to endure starts with a strong base, a solid foundation. The peace, grace, and sense f direction in our lives begins with the cultivation of our most basic needs. We cannot expect our minds to be healthy and able to make good decisions in regard to our actions if our bodies are unhealthy.

Step 1: Slow Down

The first step to building my strong foundation was to give myself permission to not take any action. I decided that I would allow myself a month to get my body in good health before I made any decisions or took any major action steps. Not only does this reduce the immediate stress of feeling the need to make a decision, it allows the foundation of good health to build slowly, which translates into sustainability in the long run.

Slowing down also brings you closer to the present moment, which is the only place we truly have any control or influence over out lives anyway. In stopping, we can look around us and really see what IS true in our lives at this moment. Not with our minds, but with our total being.

Have you ever tried to draw a flower? Did you draw the traditional “daisy?” Then what if you try to draw one specific flower? Look closely at it and all its unique individual characteristics. The way the light casts shadows, its petals, perhaps the imperfections of it’s specific form. When you look at the flower as one unique flower unlike any other out there, it takes your complete attention. So do this too with your life. Instead of taking a quick, cursory glance at it and saying, “yeah, I know it,” look at it closely and see all the intricate detail. Really study all the minute details. Try not to think about and attach meaning to what you are seeing, just observe. We are able to make an accurate assessment of our situation with the knowledge provided by clear vision.

Step 2: Eat Well

On a chemical level, we are what we eat. Whatever you put into your body is what eventually makes up your body. And your brain! Proper nutrition can go a long way in affecting your experience of life. Trail life made this, too, abundantly clear! My usual meals consisted of nuts, dried fruit, hummus, lentils, couscous, granola, dried milk, and the like, and usually I had plenty of consistent energy to hike 30 miles a day. One resupply, I was unable to get my normal fare and I ended up eating pop tarts and crackers for every meal. Needless to say, I did not feel well physically or mentally. I struggled up hills and was in tears by days end. My malaise did not pass completely until almost three days after resuming normal eating patterns! I observed this trend with other hikers as well. Those who ate healthy foods tended to be more consistent hikers than those that chose refined, sugary, and starchy foods.

There are millions of books and articles out there on diet. Find what works for you. Don’t let diet become another avenue for stress to enter your life! As a general rule, choose foods that are closest to their natural state; the less processed the better. Pay attention to how you feel after eating certain foods. The power of observation applies to all arenas of life! Your body will let you know how particular foods affect you. Keeping a food and feelings journal can be quite illuminating. I discovered that caffeine makes me happy for a few hours after I drink it, but that the next day, I feel like a toddler that hasn’t had a nap! Cranky, uncomfortable and inconsolable! With a little time, attention and experimentation, you will find a diet that optimally supports you .

Step 3: Get Some Exercise

Exercise releases endorphins. Exercise makes our bodies healthy, toned, vibrant. It increases self confidence. Exercise makes you breathe deeply and increases your heart rate, assisting your body in the release of metabolic waste. There is no excuse! Get out there and find some physical activity that you enjoy! And do it! Your stress will decrease immediately!

Being physically active anchors you back into your body, helping you let go of thought for awhile. Pay attention to the physical sensations in your body. Notice your breath, your heart beat. Bring your senses into the present moment. As you become more accustomed to experiencing life through your body during exercise, you will be able to maintain this in leisure as well.

Step 4: Get Plenty of Rest

Sleep is important. It is when our conscious thinking turns off completely. Our bodies go into repair mode. Do not underestimate the importance or rest! Try to get at least 7-8 hours of sleep a night.

Try bringing your awareness to these four things, as an experiment, and see where you are in month, or whatever time frame you give yourself. If you find yourself off course, confused and stressed, just patiently bring the focus back to the foundation. In doing so myself, I have found my internal compass has begun to direct me again! In leaning to be here, now, observing without preconceptions, magic happens. Clarity occurs. The unimportant and unnecessary fall away. Give it a try and I have a feeling that you will discover some healthy sprouts rising toward the sunshine, sustained by a sturdy, supportive root system!

Peace and patience on your journey!

Namaste

This entry was written by nbennett, posted on January 12, 2010 at 5:42 pm, filed under Experiences, Fitness, Green Lifestyle, Life is Fitness, Lifestyle and Spa, Outdoors, Santa Barbara and tagged , , , . Leave a comment or view the discussion at the permalink.

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