Daily stretching routine for lower back pain

Do you suffer from chronic lower back pain (LBP)? Did you doctor or physical therapist suggest daily stretches? The video below is a daily stretching routine for the lower back, meant to encourage you to stick to daily stretching by removing the need to think about your moves: simply put your favorite music on, and follow the prompts! In approximately 6 minutes you will be done with your stretches for the day. After a few weeks, enjoy increased mobility and reduced pain.

Detailed sequence

The goals of this video are to stretch the back in all directions, except in flexion (see note below) and to stretch the hips as tight hip muscles can put strain on the lower back.

Note: most of the time, LBP is caused by staying for a long period of time with the lower back in a rounded position, slumped, or in flexion. So the stretches featured are focused on restoring lower back extension rather than flexion. In a few cases, such as during pregnancy or if suffering from hyperlordosis, LBP can be due to the lower back being over extended, in which case the extension movements in this video should be replaced by flexion movements, such as pulling the knees toward the chest or reaching the hands toward the toes.

Cat/cow

To begin by warming up the back, on all fours, round the back on a breath in, and extend in on a breath out. Continue for 5 breaths.

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Child’s pose

Then sit your hips on your feet, and extend the arms forward, to decompress the lower back. Hold for 30 seconds.

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Hamstring stretch

Lay on your back, both legs straight, and bring your left leg toward the sky. At the top of the movement, gently pull with your hands or a stretching band for 2 seconds, then bring your leg back down. Repeat 10 times, then switch sides and repeat on the other side.

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Glute stretch

Still on your back, cross your right leg over your left leg and pull your left leg toward you by holding onto your thigh or lower leg. Hold for 30 seconds, then repeat on the other side.

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Back twist

Now bring your left leg over your right, knee bent, and hold it as far down as comfortably possible with your right hand, look to the left and bring your left arm out. Hold for 30 seconds, then repeat on the other side.

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Side bend

Return to a sitting position and put your right hand down next to your hip, and bring your left arm over your head to reach out as far to the side as possible while still facing forward. Hold for 15 seconds then switch to the other side. Repeat twice on each side.

To read more about LBP, see our related articles:

As always, make sure to ask your doctor or physical therapist before starting any new exercice regimen, and stop if any movement causes pain.

At Phila Massages, your therapists can include some of these stretches in the session or go over them with you to ensure proper positioning.

References (retrieved 9/7/19):

  1. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

  2. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906

  3. http://www.backcare.org.uk/wp-content/uploads/2015/02/Exercises-for-Back-Pain-Factsheet.pdf

  4. http://mypainfeelslike.ie/mypainfeelslike/en_IE/Pathways-through-pain/stretching-and-exercises-for-back-pain.html

  5. https://www.nhs.uk/live-well/exercise/lower-back-pain-exercises/

This article/video is for educational purposes only; do not attempt without your physician’s clearance. If you are in pain or injured, see your physician.

Copyright © Vidal Sports LLC 2019

Flexibility vs Mobility

The ideas of flexibility and mobility play a vital role in the fitness and rehab industry. One is just as important as the other, but one thing I’ve noticed throughout years of practice is that many times both terms are used interchangeably, when in fact, both hold completely separate meanings. How you integrate both into your training could be one of the main factors in injury prevention and performance.  

Difference between flexibility and mobility

Simply Defined:

Flexibility is defined as the ability of a muscle or muscle groups to lengthen or stretch. Keywords here are ‘muscle’ and ‘lengthen’.

Mobility is defined as the ability of a joint to move actively through its range of motion. Keywords here are ‘joint’ and ‘move’.

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In order to have good joint mobility, muscle flexibility is imperative. A person could have great flexibility but still have poor mobility because muscle flexibility is only one of many factors in how a given joint moves. The primary factor of how a joint moves is its structure – the shape of its bones, how they meet and the joint’s ligaments and tendons connect to those bones.  

Take a straddle split for example. Come into a wide-legged seated position. Feel the stretch all along the inside of your leg as you slowly inch your legs further apart. How far you could get your legs apart while maintaining and holding proper upright alignment will show you the stretch capacity and flexibility in your Adductor muscle group. On the other hand, if you perform something such as a standing side to side lunge, how well you control the movement while going back and forth will determine an area of hip mobility. Even though you’re using the same group of muscles, passively holding a stretch is not the same as actively utilizing the muscle and making it work as you stabilize and control it through space in a concentric and eccentric movement. Strength, coordination, and body awareness are also elements of mobility.

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Another example, this time using the shoulder. Interlace your hands behind your back, straighten your elbows and begin to raise your arms to the point of feeling a good stretch across the chest and in the front of the shoulder. This indicates flexibility in the Anterior Deltoid and Pectoral muscles. Now, take a resistance band in both hands. Keeping the elbows straight, begin to move both arms overhead and back. How far back you’re able to comfortably keep control of your shoulders during this movement will give you a gauge of shoulder mobility.

Muscles can have good flexibility but be overactive because they’re trying to make up for lack of stability elsewhere. Muscles that cross multiple joints are muscles that tend to move us. Stabilizing muscles tend to cross only one joint. When the stabilizers are not doing their job well – or a person's posture does not allow them to do their job – mover muscles try to stabilize. But because they cross multiple joints, they end up limiting joint mobility. Take the hamstrings as an example. Many people say tight hamstrings are what’s limiting them from touching their toes, but inflexibility isn’t the issue; the muscles are overactive. If someone’s stabilizer muscles aren’t strong enough to keep the pelvis in proper alignment, the front of the pelvis will tilt down. As a result, the back of the pelvis tilts upward (anterior tilt) causing a dip in the low back. Remember, the hamstrings attach to the back of the pelvis. So now when you fold forward, you have an overactive muscle already stretched to its max, making it seem impossible to touch your toes. Remember: a joint will move in the path of least resistance (Relative Flexibility). If one area is restricted due to poor flexibility and mobility, compensation patterns and potential injury now become a concern.

When to Integrate Flexibility Training

Within the last decade, studies have shown that flexibility training and stretching inhibit the body to produce power and strength by relaxing the nervous system. Obviously, not ideal before a workout and best to hold off until post-workout. When performing post-workout flexibility training, focus more so on static stretches; holding the stretches between 15-20 seconds. An example of a thorough option is practicing yin yoga.

 When to Integrate Mobility Training

When comparing mobility training to stretching, it has the opposite effect on your body. It enhances your nervous system, warms-up the muscles more efficiently and prepares the joints for exercise. Examples of mobility drills include foam rolling, dynamic stretching, bodyweight squat and lunge variations. Check out the video clip to the right showing a few examples of hip and shoulder mobility drills.

Sports massage can be helpful to identify areas lacking in mobility or flexibility. At Phila Massages, your therapist will integrate stretching in a session when needed, as well as demonstrate stretches or warm up routines so you can integrate flexibility and mobility training to your fitness routine.

 

References (accessed 08/09/2019):

  1. https://blog.johnsonfitness.com/blog/flexibility-and-mobility/

  2. https://bjsm.bmj.com/content/34/5/324

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1250267/

  4. https://sites.udel.edu/coe-engex/tag/stretching/

  5. https://sites.udel.edu/coe-engex/2018/02/27/holding-your-stretch-is-holding-you-back/

  6. https://www.wired.com/2010/10/forget-pre-exercise-stretching/

  7. https://www.shape.com/fitness/tips/how-improve-mobility-versus-flexibility

  8. https://health.usnews.com/health-news/diet-fitness/fitness/articles/2018-05-29/heres-the-difference-between-flexibility-and-mobility-and-why-it-matters

Image references (accessed 08/12/2019):

  1. http://anitagoa.com/yoga-2/beginner-practice-3/attachment/arms-behind-interlace/

  2. https://www.lifehack.org/345771/36-pictures-see-which-muscle-youre-stretching

This article/video is for educational purposes only; do not attempt without your physician’s clearance. If you are in pain or injured, see your physician.

Copyright © Vidal Sports LLC 2019

GROIN STRAIN

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Every lower body movement connects in to your hips and pelvis.  At the base of your pelvis are your adductor muscles, also referred to as your inner thighs.  These muscles assist with adduction (pulling your legs together), flexion and medial rotation of the legs. 

Cause

A groin strain usually occurs from a sudden, awkward movement and often occurs with athletes that perform a lot of jumping, kicking, turning, sudden or lateral movements.  But it can also occur from lifting heavy objects or falling. 

Types of strains

A strain occurs when the muscle is overstretched.  There are 3 different types of groin strains from a simple over stretching of the adductors to partial or full tears. Less severe strains (grade 1) have no tears in the muscle fiber, moderate (grade 2) have some minor tears and the most severe (grade 3) tear more of the muscle fibers or all of them.

A doctor will diagnose a groin strain with a physical exam and tests such as an x-ray or MRI.

Symptoms

  • Pain with motion

  • Swelling or bruising

  • Limping

  • Redness or warmth

  • Over tight muscles or weakness  

Treatment

Right after the injury the main goal is to reduce pain and swelling.  To aid in this it is recommended to use ice, rest, elevate and compression of the groin region.  Your doctor may also recommend anti-inflammatories or ibuprofen.

After the acute stage of injury your doctor may recommend to start gently stretching the area (see some examples of stretches below), to apply heat to relax the tight muscles and may also recommend massage. 

Sports massage can help work relax and stretch the groin and surrounding muscle groups to aid in recovery and to help regain motion and balance. 

It is best to ease your way back into vigorous activities due to a higher recurrence rate with groin strains.

Groin stretch

Below are three stretches that can help your adductors once out of the acute stage of injury.

Standing Adductor stretch

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1.     Stretch one leg out to the side, keeping your other leg under your torso.

2.     Move into a lateral lunge.

3.     Your outstretched leg should have a straight knee and should feel the stretch in the inner thigh.



Seated Adductor stretch (butterfly stretch)

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1.     Sit with your feet together and knees bent. Grab your feet with your hands and place your arms on your thighs.

2.     Push your knees gently down toward the ground with your arms.

3.     Feel the stretch along your inner thighs.[D]



Supine Adductor stretch

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1.     Lay on your back, legs against the wall, legs and butt touching the wall.

2.     Let your legs fall to the side and relax in this position.

 

 

Picture references (retrieved 5/2/19) 

  1. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=a718efd4-8b6c-4b7b-af9c-adeb8a5e7745

  2. https://workoutlabs.com/exercise-guide/bodyweight-side-steps-lateral-lunges/

  3. https://workoutlabs.com/exercise-guide/butterfly-stretch/

References (retrieved 5/2/19)

  1. https://www.healthline.com/health/groin-strain#treatment

  2. https://www.medicalnewstoday.com/articles/321007.php

  3. https://www.summitmedicalgroup.com/library/adult_health/sma_groin_strain/

  4. https://www.verywellhealth.com/diagnosing-and-treating-groin-pulls-exercises-and-tips-4142070

  5. https://www.webmd.com/fitness-exercise/groin-pull#1

This article/video is for educational purposes only; do not attempt without your physician’s clearance. If you are in pain or injured, see your physician.

Copyright © Vidal Sports LLC 2019

The Lower Anterior Leg: 3 Stretches and 3 Self-Massage Techniques

The lower anterior leg (the shin) contains a group of long, tendinous muscles that are responsible for dorsiflexion and eversion of the foot, extension of the toes, and assist with ankle stabilization. Specifically, the Tibialis Anterior is the largest and most superficial of the shin muscles, and runs down the length of the shin in front of the tibia bone. Overuse, over extension and improper conditioning entering endurance activities such as downhill running or running on uneven surfaces can overload in the Tibialis Anterior, and thus the muscle is often associated with running pain.

Here are a few examples of stretches and self-massage techniques if your muscles feel sore and tight after activity.

Three Stretches:

Standing stretch

Supporting yourself with your left hand, step into a forward lunge with your right leg. Gently gently flip your left foot into plantar flexion.  Lower into a deeper lunge to increase the stretch.

 

Seated stretch

Sit in a chair with your right foot firmly planted on the ground. Carefully slide your left foot backwards unto plantar flexion underneath the chair.

 

Side-lying stretch

Supporting yourself with your left forearm, lay on your left side on a yoga mat. Keeping your right leg straight and planted on the floor for support, flex your left knee and catch your ankle with your right hand. Pull your knee into a deeper flex to increase the stretch. 

 

Three Self-Massage Techniques:

Longitudinal Roll

Place the foam roller on the floor. Carefully place your lower leg on the roller. Internally rotate the leg to avoid rolling directly on the tibia bone. With your other leg on by your side for support, gently roll up and down to massage the muscles lengthwise. This can also be done using a roller stick or a tennis ball.

 

Cross Fiber Roll

Sit on the floor with you leg extended. Using a roller massage stick, start at the ridge of the tibia and work laterally towards the floor, being careful not to roll over the bone. This can also be done using a tennis ball.

 

Pin and Stretch

Sit on the floor with your leg extended. Place your roller stick on a trigger point. Hold firmly, and gently dorsiflex and plantar flex your foot. This can also be done using a tennis ball.

 

These techniques, along with regular sports massage sessions, can be used as preventative care against shin pain as you amp up your spring training!

This article/video is for educational purposes only; do not attempt without your physician’s clearance. If you are in pain or injured, see your physician.

Copyright © Vidal Sports LLC 2019