| Low Back Injuries |
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While over 80% of the population wll experience pain in their low back at some point in time, there are many different reasons for this. Some people get pain from instability (too much movement) while others get pain from stiffness. Some people have problems with their discs, while others have problems with the joints or nerves. It is always essential to get a correct diagnosis before commencing any rehabilitation or treatment for any kind of pain, but this is especially important in the low back. What is a very appropriate treatment for one kind of back can be the worst thing possible for another. The information here is provided as a guide only, so please ask your treating therapist if you have any questions about how the information here applies to you. Disc Injury
Within the spine, inbetween our vertebrae we find our discs. Our discs help to absorb the load through the spine and assist in smooth movement. The disc has two main components, the nucleus pulposis and annulus fibrosis (outer layer). Sometimes we can get a herniated disc (disc bulge) wherein the inner gel like material bulges out and the outer layer pushes out against the nerve exiting at that level of the spine. This causes a chemical response and irritation of the nerve. Symptoms include, but are not limited to, localised pain (especially on bending forward ), radiating pain in the buttocks and leg, pins and needles, and even numbness in the buttocks and legs. Sometimes a minor irritation may resolve spontaneously, but normally physio interjection is required. A whole range of techniques can be applied to relieve symptoms but this must be accompanied by a carefully guided core stability programme and postural advice for your activities of daily living. Always remember that investigations (x-rays, MRI, CT Scans etc) can be misleading. Just beacuse there is a disc injury does not necessarily mean that it is causing your pain! Many people have injuries to their discs and have absolutely no pain so it is important for your therapist to establish exactly where the pain is coming from. Spondylolysthesis
Spondolysthesis is a condition of the spine (normally in the lower back). It is a defect in construction of bone between upper and lower vertebral joints that causes a forward displacement of the upper vertebrae upon the lower. It is often seen in joints L5/S1 and L4/L5. It can be either a hereditary structural defect or due to injury (ie. fracture) or degeneration. The symptoms can vary from being completely pain free to debilitating back and leg pain. Referred pain (leg and buttocks) is caused by the nerves being irritated usually at the site of the defect. Treatment will also vary depending on the severity of the slip, and can range from a more conservative stability exercise programme (such as clinical pilates) to surgery designed to stabilize the segment. With the first method, the aim of treatment is to promote the body’s own stabilising system working efficiently to minimize further movement of the vertebrae and thus alleviate tension upon the nerves and strain on the bone. It is obviously preferable to try this route first and all of our therapists are very well trained to deal with rehabilitating a spondylolisthesis, no matter what your activity level. Spinal Stenosis
Spinal stenosis is a narrowing of the spaces in the vertebral column. It can affect any part of the spine from the neck through to the low back. It is a condition that generally increases and presents with age and can be as a result of many factors such as poor posture, osteoarthritis, rheumatoid arthritis, scoliosis, obesity and poor nutrition. Symptoms range from local pain to referred nerve symptoms and even mild paralysis in the legs. Symptoms are often worse when upright, standing and walking. Physiotherapy is of great importance in correcting posture and helping to stabilize the back using the bodies muscular system. The earlier we can commence tratment, the more we can prevent progression of the condition. If the stenosis is quite pronounced a decompression surgery may be required with a guided post surgical physiotherapy programme to follow. Posture and its effect on pain
Posture is how the body is placed whether standing, sitting or lying. There is an ideal version of posture and various deviations from it. Over time if we adopt poor posture it can lead to dysfunction and pain in any area of the body. The foundation of many of our treatment sessions is based around the correction of posture and creating subsequent balance between the muscles, nerves and even organs. Each individual requires his/her own ‘tweaks’ to posture, whether it be low back, pelvic, shoulder alignment in standing or even sitting at work. The Pilates method of exercise is great way to correct posture, and on a regular basis in a class format, can provide long lasting results and keep pain at bay. Come and visit one of our therapists for a full postural analysis and learn how smple exercises can make it easier to sit, stand and sleep easier! The Core
One of the biggest ‘buzz words’ of the moment is The Core! There are many definitions that we could use, however, most simply it is described as the stability system of the trunk/ abdominal region. A healthy core system should actually switch on before you begin to move and stabilise the body during actions brought about by the larger muscles of the body. However, if we experience back pain, abdominal inflammation (like IBS) or even continuously poor posture, our core muscles can malfunction. This can lead to further pain, and if not treated, additional problems in the future. Correct core activation can be a tricky business and requires a one on one initial review and instruction. Once this is established, private or group Pilates classes are excellent to continue with your core strengthening and integration of this strength into your every day life. Beware of any ‘Core’ training progrms that involve lots of sit-ups! This is not what core training is really about. Join us to learn the truth about training your real ‘core’. Hypermobility
Have you ever wondered why some people just seem floppier than others? Can you do weird things with your joints that freak other people out? Do you find it really hard to sit up or stand straight for any period of time without slouching? If so, you may be Hypermobile. Hypermobilty refers to an increase in the laxity of the joints, meaning that the ligaments that support the joints are a little soft and allow excessive movement. It is more common to find hypermobilty in women, and especially children and adolescents. The loss in stability is often a result of not enough strength building collagen, or similar protein, found in the ligaments and is generally considered to be genetic. Hypermobilty can be measured with the 9 point test (beighton scale) that indicates your general joint mobility level. A score of 5 or more out of 9 is generally considered to be hypermobile. With this condition some people can remain completely pain and symptom free and are therefore classed as ‘hypermobile people’. However some individuals can also be affected by joint pain and/or swelling that may continue for many months. This is referred to as’ hypermobilty syndrome’. Due to the laxity of the joints these individuals are prone to many more injuries than stiffer people. Injuries such as dislocations, fractures, ligament sprains, muscle strains, pulled tendons and even disc prolapse. Often people wh are hypermobile do well in sports that require increased flexibility such as Ballet, gymnastics and swimming, however, these activities can also put them at risk of injury if they are not strong enough to control the body properly. Treatment needs to be focused on activity modification, stability and strengthening exercises and mobility exercises rather than stretches. Our therapist all have lots of experience dealing with hypermobility as most of them are hypermobile as well! Hyper mobility can be well managed with exercise alone. Arthritis
Arthritis translates as inflammation of the joint. It is also known as degenerative arthritis due to the wear and tear nature of the problem. Osteoarthritis (OA) is not to be confused with rheumatoid arthritis which is an autoimmune disease presenting with joint inflammation as a main feature. The process of OA can be due to many reasons including hereditary factors, developmental, metabolic, and mechanical. OA commonly affects the knees, spine, hips and hands. Symptoms of OA may include joint pain, tenderness, stiffness, creaking, locking of joints, and sometimes local inflammation. These symptoms lead to pain upon weight bearing, including both walking and standing. As a result of decreased movement and pain, muscles may weaken which will cause further instability. Treatment is concerned with regaining strength in the affected area and relieving tight and painful muscles. Although the process cannot be reversed it can be prolonged and symptoms kept at bay. When arthritis becomes intolerable in the hip and knee a surgical joint replacement may be performed. If this is the course of action then a guided exercise plan is helpful both pre-operatively and after the surgery to ensure a speedy recovery. Fibromayalgia
Fibromayalgia is a condition wherein symptoms consist of generalized pain and stiffness. Pain can be worsened both after rest and after activity and can be accompanied with poor sleep, extreme fatigue and Irritable Bowel Syndrome. It can be very difficult to diagnose, but often the Doctor/Therapist will be checking for certain tender points throughout the body and assessing the length of time of their presence. X-rays, scans and blood tests show nothing as the muscles behave normally. It has been shown that exercise can assist in this condition, but it is vital to start slowly and gently and ensure a good balance between activity and rest. Sufferers usually respond very well to Clinical or Studio Pilates sessions to achive fluid movement and strength without too much load. |