Strength Training

Resolve Low Back Issues Part 4: Most Common Myths Of Low Back Pain

Few musculoskeletal conditions have a cult-like following of myths as Low Back Pain, many of which have been said by various healthcare providers across all specialties. To help clear the air, let's take a look at the 5 most common misunderstandings and myths that we encounter in our chiropractic clinic that could actually make your low back pain worse.

Before we get started…

These myths and misunderstandings are not aimed at making low back pain seem 'made-up,’ it is a very real and challenging condition. These myths are just folklore passed down from old, unsubstantiated in the research, ways of thinking. Our truth is that, if you believe one thing and that makes you feel that your low back is wrecked for life, they a long road of pain is what you are in store for. We call this fear-avoidance and catastrophizing, the medicalization of a condition. We will touch more on this when we cover imaging next week. But a big part of recovering from low back pain is believing that you can get better. It may sound silly, but no more ridiculous than believing these myths below!

NUMBER 1: Your back pain is from a misalignment, bone out of place, or a ‘subluxation.’

We don’t practice this way any longer, stop using explanations from this era.

We don’t practice this way any longer, stop using explanations from this era.

These are common descriptions patients and doctors alike will give when describing their back pain.  The most common being...you threw your back out, and it is now misaligned...commonly spoken by chiropractors of a generation ago or current doctors, chiropractors, and physical therapists that have not caught up with current research.  The truth to this is that your spine is a dynamic structure designed to move, what we ACTUALLY find is that the pain you are feeling is often associated with immobility, or areas of the spine that should be moving, but due to tight muscles and previous injury, may not be moving well or correctly anymore.  Spinal manipulation or an ‘adjustment’ is designed to restore normal motion to these restricted areas.

A bone did not shift out of place and therefore needs to be put back in! That’s not how it works.


NUMBER 2: Arthritis is the root of all evil!

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Arthritis is like wrinkles on your face…lets just keep it nice and say they are signs of wisdom. Truthfully, if you live and play hard and long enough, we will all experience some degree of degeneration.  However, and please understand this, it is a natural process and does not necessarily equate to pain! When conditions present that are more challenging, using arthritis as the ‘fall guy’ is the easy way out for a provider and an often acceptable answer for the patient.


NUMBER 3: “But…I have scoliosis and a short leg” that is the cause of my back pain.

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Just like arthritis, scoliosis and an actual short leg (1cm or shorter than the other) are comfortable areas to place blame when someone presents with back pain.  Both can absolutely lead to dysfunction, and if unaddressed, pain and discomfort. To a certain degree, uneven leg lengths and spinal rotation/curvature are normal variants, meaning most people have these at a mild level and are unlikely to be a pain generator. For most (not all) look to place the blame elsewhere.


NUMBER 4: Rest is what I need to recover, right?

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The days of ‘take 2 of these, rest, and call me in the morning’ are long gone. You likely have a relative who spent a good amount of their life with back pain that limited some or all of their activity. When you see a case like this or someone who is much too young to be experiencing recurrent back pain, it may seem like the right thing to do is rest up for a while. Fortunately, we now have stacks of research that supports the fact that bed rest is the worst (top 3 at least) idea when it comes to low back pain. The new adage is ‘Movement is Medicine.’ When someone presents to our office, we are not only just trying to relieve pain, but to relieve pain SO THEY CAN GET OUT AND MOVE. Even walking, WALKING, has been shown to reduce low back discomfort and be a great tool to prevent future occurrences.

NUMBER 5: Slap a brace on it & it will be fine.

Brace low back pain long term & you should join the circus with that thinking.

Brace low back pain long term & you should join the circus with that thinking.

This is excellent advice if you are looking to weaken your core muscles completely. Did you know that powerlifters use the belt to their advantage to complete amazing feats of strength not to brace their low back, but to give their stomach something to press in to, creating intraabdominal pressure (think bracing your stomach if someone was to punch you) that stabilizes the spine from the inside? Our bodies are amazing, it has its own ‘weight belt’ built in. Using straps, belts, or any other contraption like this for extended periods of time tells your body that you do not need it to do its job anymore. This core weakness and inability to naturally brace yourself through muscle control —> LEADS TO CHRONIC LOW BACK PAIN.

In summary, things change. Our treatment methods and your outlook on your condition must change. Every single one of these five myths is still spouted today in an office somewhere near you. Knowing the validity of that is often more important than the care you receive. While in certain circumstances, these can be valid reasons for low back pain. For most, especially those who come through our Cottonwood Heights, Utah Chiropractic and Rehabilitation clinic, we want a better answer. One that helps address and correct the dysfunction. One that promotes confidence and encourages the patient to try harder, that they can feel better and live a life they enjoy.

Next week, in part 5 of our Fix Your Low Back Series, we are going to discuss red flags, when you need imagining, and why you shouldn’t always rest your diagnosis and pain on those images.


Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.



Runner's Knee Bonus: Patellofemoral Pain Syndrome - Not Just For Runners

For several weeks we have been covering patellar femoral pain syndrome (PFPS), or runner’s knee as many like to call it. However, as with many of the conditions we see, it can be found in more than just one population of people. PFPS can also be caused by other physical activities that put repeated stress on the knee. This can include squatting, jumping, climbing stairs, etc. Along with that, PFPS can occur when you have patellar malalignment, which was touched on in Part 1 of our Runner’s Knee series.

With most PFPS we see, it comes from a sudden increase of load placed on the knee. So if you have recently increased your weight at the gym, time on the Stairmaster, or taken on a new activity, if the stress level on your knees has increased you could experience “runner’s knee” even if you do not consider yourself a runner.  With that said, here are a few preventative measures we can implement that could help.

PREVENTIVE TECHNIQUE #1:

If you are squatting, jumping, or finding difficulty hiking or doing stairs, ensure that you are getting a proper warm up.  In addition to the treatment options listed in Part 3 of our Runner’s Knee series, you can also perform band exercises prior to your activity. Each of these exercises is
beneficial in increasing our mobility and strength, as well as providing our bodies with the proper preparation for the activities we are engaging in. 

 
 

PREVENTIVE TECHNIQUE #2:

An additional preventive measure is to always use proper form. In all things we do, improper form can cause extra strain on our bodies. In all activities, especially lifting and squatting it is important that before we increase weight we ensure that our form is correct. Squatting with our knees in line with our toes, and our back naturally arched allows the weight to be properly distributed throughout, rather than having all the pressure on our knees.

PREVENTIVE TECHNIQUE #3:

The last preventive measure is simple but effective. It is important that we increase our training gradually and not all at once. If you are a lifter, gradually increase weight. If you are a hiker or climb stairs, increase your distance and pace gradually. Our bodies are adaptable, and with steady increase, it can adjust accordingly.

FINDING ANSWERS

So for those of us who are experiencing knee pain in the front of our knees and are not runners, there are answers here for us as well. It just so happens that those answers are very similar to those who run many miles a day. So don’t be afraid to dive into our multi-part series about runner’s knee. I think you will be able to find answers to your knee pain as well.

Check out the Part 1, Part 2, Part 3, and Part 4 of our Patellofemoral pain syndrome series here.


Janaye Freeman is a Certified Athletic Trainer & Lead Therapy Technician at Revive Sport & Spine in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management for the Greater Salt Lake City Utah Valley. 

Injury Prevention For Runners: Tips To Support Your Training

As runners, we really only have 2 goals... 

  • Run faster/farther than we ever have before.
  • Remain injury free.

For the last 4 years, it has been our goal at Revive Sport & Spine to be the leading sports chiropractic clinic serving the greater Salt Lake City area when it comes to running-related injuries and prevention.  Having aimed for the same goals mentioned above through my own running the last 20+ years, there are few endurance sport related injuries that I have not encountered either personally or clinically.  

While we field questions about running form, injury prevention, running shoes, pre-race meals, training plans, strength training, etc., some questions are better answered by those who work in that arena day in and day out.  

Over that last few months, we were able to sit down with a few local specialists in sports nutrition, mental skills training, strength training, and running shoes.  Our goal was to find out how each component can aid runners with injury prevention.  


INTERVIEW 1:  Nutrition Tips For Runners with Dietitian Tayla Russell

INTERVIEW HIGHLIGHTS:

  • Runners and other endurance athletes are different from athletes who play soccer, football, baseball, etc., and therefore have higher specific nutritional needs that fluctuate depending on the distance and type of race.  One must is that we need more carbs during our training cycles.  Choose good carbs like grains, fresh fruit, and fresh vegetables.  
  • As runners, injuries are inevitable.  Know what foods can help during the healing cycles can speed up your recovery and get you back out on the road or trails quickly.  Great Anti-Inflammatory foods include healthy fats like avocados, nuts, and seeds, high anti-inflammatory fruits like pineapple, and spices such as ginger and turmeric.  
  • Myth:  All runners must carb load before a race?  False, while long-distance runners do need some extra for energy stores later in the race, most people just over-eat the night before a race.  So if you are waking early the next morning for a 5k or 10k race, you are better served to have a light dinner of fresh veggies, lean protein, and a small amount of carbohydrates.
  • Contact:  Tayla Russell - dietitiantayla@gmail.com - 435.553.5698 - Max Muscle Cottonwood

INTERVIEW 2:  Mental Skills Training with Nate Last, M.S. from Mental Grit Consulting

INTERVIEW HIGHLIGHTS:

  • Negative Self Talk:  Negative talk puts us in our own way on our path to our goals.  Everyone does it and it is a major contributor to not performing at our best.
  • Ideal Mindset: We have an ideal mindset, we have to practice it just like everything else we are working on.  Understand you can accomplish your goals, we can and will fail at things in the process, but use it as a building tool to strengthen your mindset.  
  • Process Before Outcome:  When training and racing, focus on the basics, focus on doing everything you can do RIGHT NOW, in the moment that will help you perform better in the future.  It is okay to think ahead and dream about the future, but don't stay there!  Bring yourself back to the process.  
  • When Injured:  Stay on track through an injury.  Believe your body is capable of healing and training again.  When you believe this, it will happen, and it will likely happen faster.  
  • Contact: Nate Last - Mental Grit Consulting - 801.368.7564

INTERVIEW 3: Strength Training For Runners with Ryan Carver, CSCS from Leverage Fitness Solutions

INTERVIEW HIGHLIGHTS:

  • Should Runners Weight Train:  YES!  Weight training can help prevent injury by building the strength of not just your muscle, but ligaments, tendons, and joints.  Weight training can also make you faster by improving your overall economy and efficiency.  
  • Increase The Weight Or Volume:  As runners, we spend most of our time doing high volume training.  So when it comes to weightlifting, increasing the weight and shift toward lower reps is ideal to obtain the most benefit.  Also, just because we run or cycle, we still need to lift with our legs, don't shy away from the squats, lunges, and deadlifts.  
  • Top Exercises For Runners: (1) Weighted Step-Ups (2) Nordic Curls - Hamstring (3) Hip-Hike (4) Shin Strength - Toes To Shin w/ Resistance (5) Stir-The-Pot Core Exercise.
  • Contact: Ryan Carver - Leverage Fitness Solutions - 385.985.3603

INTERVIEW 4: Running Shoes & Injury Prevention with Darrell Phippen from Wasatch Running Center

INTERVIEW HIGHLIGHTS

  • New Technology: All name brands have great technology, but which one is best for you and your running style and goals?  Shoes are lighter, have better and more comfortable uppers, and have more fits than ever before.  Getting a correct fit, and finding the best shoe for YOU, is almost as important as your training plan.  
  • Shoe Fitting:  Trying a shoe on is not enough to make a decision.  How does it feel with movement, walking and running?  Working with the professionals who have been trained in shoe fitting can make all the difference in finding the right shoe to help you remain injury free.  
  • How Many Shoes Do You Need:  As runners, more shoes is always better.  But when you look at the average mileage of shoes, 250-350, and how often you run, having multiple shoes has its advantages.  Our suggestion is to have a minimum of 2 shoes if you are primarily a one surface runner, 3 if you mix trails with road running.  This allows them to last longer, continually challenge your feet and allow them to adapt to a variety of surfaces, and help prevent injury.  
  • Contact: Darrell Phippen - Wasatch Running Center - 801.566.8786

Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.