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Why Hips Hurt- An illustrated explanation

hip

Why does your hip hurt if you didn’t do anything to injure it?

The short answer…you probably did a whole bunch of things to it, every day, for years and had no idea that you were doing something wrong.

The full answer…..read below…

Your hips are the centre of your universe.  They are the connection of your upper and lower bodies and most people have no idea where they are or how to use them properly.  It is a strange thing to suggest that someone doesn’t know where their own hips are, but take it from a guy that teaches people to move all day….most people have trouble distinguishing their hips from their pelvis or how to move in a strong, coordinated way through their mid-section.

There are way more moving parts to your body than you have the capacity to focus on at any given time so the best way to explain this to you is to simplify your body down to two pieces and then add on layers as you understand.  Start by thinking of your body as two wooden blocks with a round hinge connecting them in the middle.  Now remember that gravity pulls everything downward and imagine trying to balance the upper piece on the round hinge by holding onto the lower piece.  There are three likely scenarios:

To give these pictures some life, let’s add a head and neck onto them and see what happens.  You also need to understand that your brain has a head righting reflex that wants to keep your head and face looking straight forward, so if one part of your body is persistently leaning one direction your head and neck will accommodate for it.

So far we have block men with hips and necks; an upper body, a lower body and a head.  Read More

Posted in Blog, Hips, Pain Tagged with: , , , , , , , , ,
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Why Backs Hurt

Waking up with back pain

If you have ever had your back ‘go out’ on you, you will appreciate the following post and may just learn something about how to fix your nagging back issue.  Back pain can take many forms and is hands down the most common issue that brings people in to physiotherapy.

“It hurts when I bend over to brush my teeth”
“I can only sit for 10 minutes before I have to move”
“Walking triggers a pain deep in my butt”
“I bent forward and couldn’t get back up”

It happens to the best of us.  I have seen lazy, overweight people with back pain; insanely fit personal trainers with back pain, elite athletes, new moms, desk jockeys and I have personally suffered from it on occasion.  You can have the strongest core in the world and still be susceptible to hurting yourself or experiencing pain in or around your back.  In this article I have outlined the most important factors as to WHY backs hurt because back pain requires an explanation of what is going wrong as opposed to a diagnosis of a condition.  You can also watch the video Why Low Backs Hurt.

Step 1 to Understanding:

Things happen for a reason.  You don’t just catch back pain like you can catch a cold.  It usually is related to something that you have done or are continuing to do poorly, like stand, sit, walk, breathe, bend or lift.  An accident or acute injury can set pain into motion, but how you deal with the injury, pain and mobility after the fact is the important part.  You are a product of everything you have done or been through up to this point and if that product has left you with chronic back pain then something has to change.  You may need someone to loosen something for you, you may need to learn to move more efficiently, you may need to lose weight, or may even need surgery. 

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Posted in Blog, Low Backs, Mid Backs, Pain Tagged with: , , , , , , ,
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Principles to follow when your back is sore

 

one


 

Acute (Days 1-7)

  • Ask yourself “what have I done and do I need someone else’s help?”
  • If you have had an accident or acute injury, it is best to seek help
  • If you are concerned you may have broke something or need some medication to deal with intense pain: SEE YOUR DOCTOR
  • If it is not an emergency, but you need help with pain, function and mobility: SEE YOUR PHYSIOTHERAPIST FIRST, not your doctor
  • If you determine you don’t need help just yet, but your back is acutely sore:
  • Lie down on your back on a firm surface and ice your back for 15 minutes at a time every hour you are able to for the first 3 days
  • Start doing gentle pelvic rock movements to help your back from seizing up
  • Start doing gentle hip stretches on your back and pelvic rock movements on your hands and knees
  • Avoid soft couches and beds for the first week
  • Once the intensity of the pain has subsided start using heat and ice for days 3-5
  • Shift to just heat when you feel your problem is more stiffness than acute pain
  • Visit a physiotherapist if the pain has persisted more than a week

Sub- Acute (Days 8-90)

  • Ask yourself “why did this happen and what am I doing to make it worse?”
  • Seek to understand the root cause of your problem by referring to the Why Backs Hurt and discussing what you’ve learned with your physiotherapist
  • Consider how repeated daily tasks like sitting, standing, breathing, walking and lifting may be contributing factors
  • Consider what type of treatment is most appropriate for you:
  • Massage Therapy, Osteopathy, Visceral Release, Craniosacral
  • Chiropractic, Active Release Technique, Spinal Decompression
  • Pilates, Yoga, Basic Fitness, Strength & Conditioning
  • Start to create more body awareness about how you may have been compensating for the pain you have been experiencing for the past week to month
  • Look at your posture and alignment in a mirror
  • Pay attention to how you are breathing
  • Try to note your pain patterns (i.e.
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Posted in Blog, Healthcare, Low Backs, Mid Backs Tagged with: , , , , , , , ,
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Core Training: When less is more

Big Myth:
–    If you have low back pain that means your “core is weak” and a “core strengthening” program would help you.

Sometimes the above statement is true, but just as often it is absolutely not.  There is not a direct correlation between low back pain and core strength.  In fact, many people that have incredibly strong “core” muscles suffer from regular low back pain, which is because strength is only one element of having good posture, alignment and movement.  It is the overall muscle balance in your body and your relative ability at controlling movement that is the true sign of good core stability and a preventative factor to low back pain.

Many, many, many people are stiff as hell, many of these people have low back pain and many of these people think that their planks, crunches and strength program will make them better.  Well I am here to tell you that there is a good chance it will make them worse.  Granted some will get better, but the most efficient way to improve your strength, flexibility, alignment and pain is to first learn a bit about your body type before pursuing any type of new program.

From a very young age, as you were learning to function in the vertical position, you have been developing strategies for how your body deals with gravity.  You picked up some by watching how your parents stand, walk and move.  You picked up others from your gymnastics classes and soccer practices when you were six.  The hard fall you had on your butt 20 years ago likely altered things and that car accident 5 years ago probably created some compensations.  Long story short, your posture, flexibility, movement and breathing patterns are a cumulative product of everything you have done up until today. Read More

Posted in Blog, Fitness, Low Backs, Pain, Posture Tagged with: , , , , , , , , ,
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The Deep Inner Unit: "light core"

Your deep inner unit consists of four muscle groups that should work subconsciously to stabilize your pelvis, spine and ribcage under low load postures and movements like standing, bending and walking.  Accidents, injuries and developed muscle imbalances can cause portions of the deep inner unit to not do their job properly; the result can be pain and/or compensation from other muscle groups to try and brace to hold everything together.  Some of your other stronger muscles can make up for the deep inner unit, but this usually leads to too much compression on the joints and immobility in the area.  You function best when your body can use the little muscles to do light stuff and the bigger muscles to do harder stuff.  You can get away with purely building strength in your outer sling muscles, but you will be prone to breaking down more often if the little guys aren’t firing.

The four muscle groups are your pelvic floor, transverse abdominus, multifidus and diaphragm.  They form the bottom, front, back and top of your abdominal and pelvic cavity.  Recruitment of these muscles is more about thinking than doing.  They provide gentle compression to stabilize so your bigger muscles can move you.  I don’t like to re-invent the wheel so the best resource to learn about recruitment of these muscles can be found on Diane Lee’s website here: Training the deep muscles of the core

Although becoming aware of these muscles and consciously training them can be very important, they are supposed to act subconsciously and if you align your body in the proper way they will likely fire on their own.  I find it is the compensation strategies people choose in their posture that are inhibiting these deep inner unit muscles and that helping a person unlearn bracing strategies helps to fire up the deep inner unit more than trying to focus on them alone.  Read More

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What is my core? Depends who you ask

The word core has been very popular for quite a while now in the health, fitness and rehab worlds, but there isn’t really a true agreement as to what it actually means; it really depends on who you talk to.  If you ask physiotherapists, most will focus on the deep, subtle, picky muscles like your transverse abdominus.  If you ask strength and conditioning coaches, most will strive to build bracing stability using the obliques.  If you ask a Pilates instructor, most will focus on breathing and dissociation of movement.  Finally if you ask a lay person, most will just pat their stomach and say ‘I know I need to work on my core,’ without really knowing why.

You can watch the associated video at the end of this article.

So who’s right and who’s wrong?  The answer is you should be able to selectively use your body for whatever task you ask it to do.  The picky little muscles should work subconsciously while you stand, sit, walk and breathe.  The bracing muscles should work when you pick up or push something heavy and you should be able to bend, twist and stretch if you choose.  The people that are wrong are the ones that think their method is the only and best thing for everyone.  Typically the personal trainers need to be introduced to the Pilates instructors and the Pilates instructors need to do some personal training.  Most people have a need to work on something, but it is a misconception that building more strength and stability is always the best option.

Some people are naturally strong and stiff as a board while others are loose jointed with low muscle tone.  The first and best thing you can do for yourself before you attempt to do more of anything physically is to learn about your body type and learn what type of exercise would give you the most benefit.  Read More

Posted in Blog, Fitness, Low Backs, Posture Tagged with: , , , , , , , , , , , ,
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Shoes: good support or coffins for your feet?

Shoe Coffin

I will preface this post by saying the best thing I ever did for my feet, my posture and my pain was to stop wearing traditional shoes.  I am very hypermobile and have very high arches in my feet and throughout my athletic life I have been slowed down by foot pain and blood blisters on the balls of my feet and big toes (sorry for the details).  I had tried all different types of shoes, orthotics and tapes, so in 2008 I decided to start working in only socks most of the day and never turned back.  Going barefoot taught me a lot about my own body and how I was creating my own hip and back pain.  The feedback I was getting from my feet helped me become aware that I was standing entirely on the outsides of my feet and how that related to the tightness and aching in my hips.  From the ground up, I progressively became aware of how one part of my body was affecting the other and I have been able to successfully strengthen my feet, loosen my hips and eliminate almost all of the chronic issues I was having.

You will find the Why Feet Hurt video at the bottom of this post.

Being a physical therapist, seeing 14 people a day with different body and foot types, has allowed me to test my posture and movement principles within myself and on my clients.  I have helped a lot of people discover how their feet affect their bodies and their bodies affect their feet.  I have learned that how you hold your upper body can be the root cause of your bunions and how you use your hips can dictate if you pronate or supinate in your feet.  There is very much a trickle up and a trickle down effect on posture, alignment and movement.  Read More

Posted in Ankles, Blog, Feet, Posture, Shoes Tagged with: , , , , , , , , , , , ,
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How to Sit: The Plight of the Desk Jockey

Who taught you how to sit?  I’m guessing nobody, you probably just figured out how to do it by trial and error when you were a baby.  You learned how to stay upright and eventually not fall over while resting on your butt; that was a major milestone when you were 8 months old, but you haven’t been given much credit for it later in life, have you?  Unfortunately, it’s later in life that you are going to need to be good at it, because chances are you are going to be spending multiple hours a day staring at a computer screen.  It is time you learned how to sit properly.


*Movements and postures demonstrated well in the video at the end of this post

Our bodies are built to deal with the vertical load of gravity, but at the same time are inherently lazy when it comes to holding everything up properly.  We have a tendency to get engrossed in what is visually in front of us with little regard to how we have positioned our bodies to allow our eyes to see what we want to see.  Your brain has a head righting reflex that tries to keep your head looking straight forward in the easiest way possible; unfortunately this usually comes at the expense of your neck and back.

The goal of sitting properly is to effectively vertically stack your torso and head on top of your pelvis and hips in a nice gentle S-curve.  The odds of you doing this properly are stacked against you for a few reasons.  First, most people have one, two or three of the following: forward head posture, an overly braced lower torso, and/or really flexible or really stiff hips.   Second, most chairs are not designed very ergonomically and promote slouching more than support.  Read More

Posted in Blog, Posture Tagged with: , , , , ,
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How to Stand: Postural Pulp Fiction

The goal of standing is to vertically stack your spine with a gentle S-curve from your tail bone up to the base your skull.  If you look at your side profile, you should be able to draw a straight line down from your earlobe, through your shoulder, the mid line of your torso, your hip, knee and ankle.

This is my Pulp Fiction video/post (the video captures the movements you need to learn).  I am showing you the ending first, so you know what you are working towards.  You may find yourself coming back to this frequently and will progressively find it easier and easier to accomplish.  To start with, standing the way I am describing may feel weird and be really hard, but will look a lot more normal than it feels.  It will challenge everything you are bad at and your brain’s perception of what is vertical.  A mirror to look at your side profile can be an important tool to help you see what I am showing you, but you need to learn to progressively feel it instead of having to see it.

Step 1 is to learn to use your diaphragm to support your torso upward and stop leaning backwards.  Imagine there are two half balloons inside the lower part of your ribcage that you can inflate by taking a deep breath into your lower back ribs.  This should lengthen and stretch the lower part of your thoracic spine.  It may also feel like it tips you forward.  This is the part of your back that was accommodating your neck, but we are going to try and stop that.  If you look in the mirror, you will likely see that it is your head that is forward and that your trunk is now actually quite vertical instead of tipped backward.  Read More

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