At some point you are going to deal some sort of an injury. Maybe you are already have. Maybe you are dealing with something right now.
I am going to walk you through some different ideas as you approach different scenarios or pain and rehabbing injuries.
There are going to be 6 parts to this post, with each part having its own video.
General guidelines for rehabbing injuries.
Your post-surgery home exercise program.
The idea of layers. Fixing one problem often reveals another one.
Modify your approach to sets and reps.
You are thinking about starting an exercise program. You are ready. You are motivated and you are going to dominate and accomplish all of your goals. How do you know what exercises to start with?
Is it some random drawing by throwing exercises in a hat and pulling them out? Do you hit up the internet and find the latest and greatest to follow? Do you turn to Instagram and the girl with the painted-on yoga pants or the guy-that-never-seems-to-wear-a-shirt-in-any-video?
Many of us know someone who seems to be a little more clumsy. Maybe they trip a lot, stumble often and sometimes even fall. Maybe I am describing you.
Occasionally losing your balance or stumbling here or there is not a balance problem.
Vertigo is a true balance disorder. Issues that involve the vestibular system (which is a fascinating system) are true balance disorders. These can be triggered by head, neck and eye movements and are often associated with nausea, dizziness and true loss of balance (LOB) which often results in a fall.
Balance is a difficult thing to quantify since it involves many systems and many variables. Your balance is maintained by a dynamic interplay between three systems in the body. In the ideal world, all three systems would work harmoniously together.
These ideas work best for chronic shoulder pain. If you recently hurt your shoulder, I would not start messing with these strategies unless you have been evaluated and they are indicated for your rehab.
All of the strategies will have multiple videos to help guide you through the process. These are strategies I have used with both clients and patients to not just manage but ultimately resolve their shoulder pain.
I am going to go over each in more detail, but the 5 strategies are:
Thoracic mobility - if the t-spine lacks mobility the shoulder and neck try to compensate.
Assisted range of motion (ROM) - if your ROM is limited, use something to help assess and improve your ability to move the shoulder and arm.
Supine exercises - this position helps utilize improved thoracic mobility, supports the body and makes controlling shoulder movements easier.
Rows - rows are shoulder-friendly and most people do not do enough of them - especially those who have shoulder pain.
Isometrics - learning how you can engage the muscles around the shoulder is key to managing pain. These are way harder than they look.
Low back pain (LBP) is common. Way too common. Treating it is difficult as there are often many factors contributing to your pain. The strategies I am going to share are meant to improve your situation. At worst, they should do nothing, meaning they will not make it worse.
All of the strategies will have multiple videos to help guide you through the process. These are strategies I have used with both clients and patients to not just manage, but ultimately resolve their LBP.
I am going to go over each in more detail, but the 5 strategies are:
Supine deloading - I will also share how to deload in sitting and standing
Core stabilization - it’s not so much what you do but HOW you do it
Glute exercises - in general, when the glutes are strong there are less issues with the knees and low back
Hip mobility - when the hips are tight, there tends to be more movement through the low back to compensate
Hip hinge - poor awareness and understanding of how to properly bend at the hips will routinely flare up the back
Low back tightness is common. Feeling some tightness in the low back is not uncommon. The reasons why the back can be tight are numerous. Most do not even involve the low back itself.
Other problems in the body (weakness, tightness and poor mechanics when moving) tend to manifest as low back pain. Sneaky sneaky.
Because of this, stretching the low back directly is often not the solution.
Decreased shoulder range of motion.
Decreased neck range of motion.
Numbness and/or tingling in the arm or hand.
Any of these issues can have an origin within your thoracic spine. In case you are not familiar, the thoracic spine is that fancy piece of real estate between the neck and the low back.
LBP is complex. No one thing is going to resolve your back pain so stop looking for it. If you truly want to resolve your pain, you will have to tackle this on multiple levels. This means you will have to:
Let’s keep the holiday train rolling along. In Part 1, we discussed just getting moving more using dynamic warm-ups.
In Part 2, we are going to look at a bunch of different stretches that you can utilize to avoid ending up a complete ball of stress and knots come January.
Back on Thanksgiving morning, I started sharing different ways to help get people through the holiday season without having to give up exercise.
I even suggested that it is NOT a crazy thought to begin doing some extra activity or exercise during this time of year.
Understanding that many people would view that as crazy advice, I gave examples of things you can do.
Most people stretching their hamstrings are really stretching their sciatic nerve. The hamstring runs from the bottom of your butt to the back of the knee.
Rounding your back to stretch the hamstrings makes no sense. It does not improve hamstring flexibility but it does tension the sciatic nerve.
Most people attempt to stretch the hip flexor incorrectly by moving too far forward and arching the low back too much. If this is you, watch the video. The key is the setup.
Rows, pulldowns, pull-ups, and other movements that initiate movement through the scapula should make up a good amount of your upper body exercises in your program.
Rows and other horizontal pulling movements should outnumber both pressing movements and vertical pulling movements.
Set up with your feet anchored under a dumbbell rack or other solid structure that will not move. Focus on bracing the abs, staying tall throughout the motion and not bending at the hips. Perform the hamstring drop with only one leg on the way down and both legs coming back up. Try to keep the emphasis on the hamstring, not the arms and shoulders. The upper body is definitely assisting the movement, but the hamstrings should be the focus. Enjoy.
This is a great alternative if using some attachment for the hands increases back pain or you find yourself pulling too much with the arms. Start by setting the pulley so it is around hip-height. Set the strap so it goes around the front of your hips. Set and brace your neutral spine position. Focus on keeping pressure through the heels and sitting back through the hips. To return to the start position, squeeze the glutes and push the hips forward. Avoid overextending the hips and straightening the body as this will cause you to lose your balance and fall back.
Stand in front of a bar (or another surface that is stable and will not move - kitchen counters also work great for this).
Walk the feet back, perform a hip hinge and pivot forward until you feel so resistance to the movement in the thoracic spine. Hold this position for 5-6 seconds. Repeat as needed.
NOTE: this may cause the back to crack. Not getting a crack in the back does not mean the movement was ineffective.
Mobilizing the first rib is not something many people know about which is unfortunate. The first rib is right under your collarbone and can be elevated which causes all sorts of issues for the neck and shoulder(s). Check out the video to see how to mobilize the fist rib.
This is an excellent movement for mobilizing and stretching the hips. Start with the first position and progress to the others as needed. Remember, focus on a mild-to-moderate intensity in the hip and glute area when performing these. Start in a pushup position. Bring one leg forward to the outside of the arm. In the second video, bend the elbow and try to get it as close to the floor as you can. In the third video, rotate the arm up towards the ceiling. Make sure to rotate the body, not just the arm. One way to help do this is to keep your eyes on your hand. The arm should not travel where the eyes cannot follow it.
When I first started as a Physical Therapist, I used to get nervous any time one of my patients came in with any neck diagnosis.
I mean, its the neck. I could snap their spinal cord and the person would never be the same after that.
Now, that is not true at all, but that is what I thought. What a weirdo.
Once I worked with some of these patients, I started to realize there were commonalities to most of my patients. Once we fixed a few underlying issues, they got better.
Almost 100% of them.
After awhile, I started to look forward to treating any neck issue because the outcomes I was getting were so good.
The fact of the matter is, pain can bring each one of these situations to a grinding halt. Even worse, if the pain is left unchecked it usually gets worse and can even cause pain in different parts of the body.
It is not uncommon for a right ankle or knee issue to cause pain in the low back or the opposite hip and knee. I will explain how at a later date. The short answer as to how this happens is that everything is connected.