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I've Got Back Pain... Now What?  The 5 Most Important Rules For Back Pain Management

10/31/2017

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During our initial consultations, one of the first things we do is ask our clients to tell a story about how their pain developed.  We listen to find out how long it’s been around, if any specific activities make it worse, and what doctors, chiropractors, and physical therapists have told them about their condition in the past.  Without fail, I’ll have several clients a month wince as they explain they were diagnosed with a ‘degenerative disc,’ a ‘bulging disc,’ or ‘herniated disc.’ It’s been explained to them (incorrectly) that it’s a condition they’ll have to live with for the rest of the life, and it will probably get worse as time goes on.

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A definite life sentence of back pain couldn’t be further from the truth.  While the pain that you are feeling is most definitely real, it does not have to last forever. There is still plenty of hope that you will have a pain free future that allows you to sleep through the night, lift up your kids (or grandkids), and do all the activities you love doing without frustration, fear or worry.
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So what can you do to manage and eventually eliminate your back pain?  Follow these 5 rules and you’ll be back on track.

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5 Neuro Activation Exercises (NAE) to Relieve Low Back Pain

10/24/2017

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​In a past blog post, I’ve explained why stretching may not be the best solution to finding back pain relief (If you’d like to go back and read that post, click here).  By popular demand, this article includes video to a few activation exercises you can do instead. 

In short, the previous post explained that ‘tightness’ is not actually a mechanical property related to ‘shortened’ muscles (contrary to popular belief).  Research indicates that it’s actually a sign that your nervous system is not comfortable operating in extended ranges of motion. 

To give an example, let’s use the hamstrings. If you do a toe touch, you will reach a point that feels like you can’t go down any further.  At that point, your brain is telling your muscles that it isn’t comfortable extending the range of motion any further.  The brain is not used to operating in a deeper range of motion, and puts the brakes on in order to protect the body (the brain’s top priority is safety). 
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You can compare this to how you feel walking into a dark, unfamiliar room.  You’ve never experienced it before, so it’s likely the brain will cause you to exert extra caution or not go in the room at all. Our job is to turn the lights back on and get the body functioning properly again.

It's well known that back pain can be caused by a number of things going on in the body, one of which is when the brain/nervous system is not confident using muscles in the legs through a full range of motion. 

When the nervous system is not confident here, the muscles become weaker in a lengthened state.  When the muscles become weakened, more stress is put on the back during everyday movement, leading to pain. In order to develop strength through an extended range of motion, the nervous system must become comfortable using these muscles in the lengthened state (we call it ‘strength at length’).


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So how can we help the brain and nervous system to develop more trust in our muscles’ abilities in the lengthened state?  We must contract  the muscle in its lengthened state.  By doing so, we re-develop the neuromuscular (mind-muscle) connection in extended ranges of motion, allowing the nervous system to become more confident.

So, rather than passively stretching the muscle (lengthening the muscle without contraction), I encourage our clients to add manual resistance through the full range of motion, displayed in my ‘Neuro Activation Exercise’ videos below. 

In many (not all) cases, I find that our clients experience back pain because of issues in the hamstrings and hips.  Chances are, that if you add these movements (3 hamstring exercise, 1 IT band/glute exercise, and 1 hip flexor exercise) to your daily routine, you may start to see improvement in your back pain symptoms. 

The biggest key to performing these movements correctly is maintaining resistance throughout the entire range of motion – do not allow the targeted muscle to relax at all during the movement.  I use my hands to apply resistance in the video, but a resistance band or towel works as well.

Questions about how to implement these movements to your daily routine?  Please do not hesitate to reach out to me directly at [email protected].  My goal is to help you overcome back pain and get back to performing at your peak, whether it be at work, in the gym, or on the field.

The 5 exercise routine - perform each movement 10 times on each leg.  Click the name of each exercise to bring up a video that demonstrates the movement.

1.  Medial Hamstring Activation
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2.  Central Hamstring Activation

3.  Lateral Hamstring Activation

4.  Glutes & IT Band Activation

5.  Hip Flexors Activation


All the best,
Evan


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What are compensation patterns and how can they cause your back to hurt?

10/16/2017

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​One common term we like to throw around with members of the #PremierFamily is “compensation pattern.”    The term is used to describe an improper movement pattern that places more stress on parts of the body than normal (for example: for a number of reasons, bending over can put more stress on the back than it should).
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Before we dive into the technical side of compensation patterns in the body, let’s first look at a few types of “compensations” that we are more used to seeing in day to day life (unrelated to the human body or back pain).
  • If you’re working on a team at work, each team member has certain responsibilities.  If there’s a slacker on the team, someone else must take on his/her responsibilities.  In many cases, the person who takes on extra responsibility also takes on added stress, which can lead to burnout. 
  • If a pitcher is on the mound and the infield behind him makes multiple errors in an inning, the natural reaction for the pitcher is to overcompensate.  He puts the responsibility of getting people out on himself, and starts pressing to get strikeouts.  This leads to increased stress levels, and sometimes erratic control. 
  • Imagine you’re in a game of tug of war.  There are 4 members on each side of the rope, and it’s looking like a stalemate, but a member on your team decides to quit.  In order to continue holding the rope steady, all 3 remaining team members must exert more force on the rope, meaning more stress on their bodies,​
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In each of the above examples, there was a team responsible for completing a task.  When one team member stopped doing its job or did not perform adequately, it placed more stress on the remaining team members, leading to potential consequences.

The human body works in a similar way.  The nervous system and muscles in the body are the team responsible for creating movement. For instance, the act of putting a glass on the top shelf requires the nervous system to direct the muscles in the hand, arm, and shoulder to work together to complete the task.

 If nervous system is not performing optimally, a muscle is not activating properly, or a muscle is too weak to perform the task, the other muscles involved take on more stress than normally required.,

If that added stress is severe enough or happens over a long enough period of time, injuries and chronic pain can develop.

This may be exactly what’s going on with your back pain. Too often, we associate back pain with a damaged spine, which sounds irreparable.  It’s why we are so quick to believe painful surgeries and potentially addictive painkillers are the only solution (they’re not).
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In many cases, back pain is caused by compensation patterns that can be corrected without surgery or painkillers.  For a variety of reasons, muscles in the legs or back stop working correctly, we change our movement patterns accordingly to create compensation patterns, and more stress is put on the spine.  Over time, this added stress on the spine starts to become painful.

Relieving back pain is simply a matter of identifying the compensation patterns, what muscles caused the compensation patterns, and getting those muscle to activate properly again. When the entire team is working together again, the additional stress on the back is removed, and you get back to living the pain-free, active lifestyle you enjoyed before back pain.
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If you or someone you know is dealing with annoying back pain, here's 7 Quick & Easy Tips To Reduce Back Pain.  Just go here to get your free copy.

www.premierneurotherapy.com/back-pain

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Why stretching is not helping your back to feel better... and what to do about it.

10/11/2017

13 Comments

 
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​Every so often, I have a client that comes in looking for one thing – a few stretches to ease their back pain. “Evan, my back is just so tight.  I think if I just knew a few good stretches to do every day, I could loosen it up, and the back pain would go away.  What do you suggest?”

Unfortunately, there is no ‘magic bullet’ stretch to help with back pain.  In most cases, I am hesitant to recommend any stretches, as they often do more harm than good. 
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If you’ve tried stretching for back pain or tightness in the past, there is a scientific reason why you aren’t seeing results. That tightness you are feeling is not the result of ‘tight’ or ‘shortened’ muscles in the back.  And even if it was, it’s very unlikely that stretching the muscle would do anything to ‘lengthen’ it and help with what you’re feeling. In fact, in some cases, stretching can do more harm than good, as it puts undue stress on tendons and ligaments that are not meant to be stretched.

Instead, that tightness is actually a function of the nervous system.  For one reason or another, the nervous system is telling you that it does not feel comfortable going into the ranges of motion where you feel tightness.

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Sometimes, this nervous system becomes uncomfortable due to previous trauma or injuries.  When the body suffers a trauma, the nervous system acts to protect the affected area.  Often times, our bodies stay in this ‘protective’ state long after the injury has healed, leading to tightness and/or pain in the area.
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Other times, pain and tightness in the back might occur when the muscles are not used properly or there is a weakness elsewhere in the body (for example: the hamstrings or hip flexors) that puts the back at risk for injury.  The nervous system senses this risk, and puts it into that protective state, limiting the mobility of the back in order to protect it from future injury.  As a result, you feel tightness or pain in the back, when the cause of the issue is really in the hamstrings or hip flexors (in this example).

So if stretching’s not working, what’s the solution?  Convince the nervous system that it’s safe to take the back out of the ‘protective’ mode and put it back into ‘performance’ mode.  You can do this by starting to use the muscles that feel tight.  Find an exercise that strengthens the back.  Start with very light weight (or no weight at all), and start working the back through a slightly larger range of motion than you would normally feel comfortable.  Focus on activating the required muscles to control your body through the entire movement and maximize the neuromuscular effect of the exercise.

I also recommend incorporating a few leg exercises to your routine.   We find that the majority of back pain is caused by strength deficits in the legs. As I mentioned earlier, when the muscles in the legs become weak and stop doing their jobs properly, the nervous system senses the back is at greater risk for injury, and may put the muscles into that tight feeling, protective state.

In order to strengthen the back and legs, remember to start with light loads – don’t push too hard too fast.   The goal is to start feeling a little healthier each day, and adding too much weight too quickly may put that progress at risk. 
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The biggest takeaway?  Stop stretching and start strengthening to find back pain relief.

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If you or someone you know is dealing with annoying back pain, here's 7 Quick & Easy Tips To Reduce Back Pain.  Just go here to get your free copy.

www.premierneurotherapy.com/back-pain

or click here:
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    About the Author

    Evan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility.

    You might know Evan from his work with MLB, NFL, and NCAA players around the country.  After discovering the benefits of Neuro Therapy while playing football at Penn State University, he opened Premier Neuro Therapy in 2015.  Within just 6 months of opening, clients were so excited about Evan and his techniques that athletes from around the country began calling to request his services. Since then, he has been featured  by numerous publications and productions around the country including WEEI Boston Sports News, Jacksonville 1010XL The Drill With Dan Hicken And Jeff Prosser, and The Washington Post. 

    Today, Evan continues to strive towards his mission of bringing Neuro Therapy to as many people as possible.  This work begins in the Baltimore, MD area, where he looks forward to introducing you to Neuro Therapy and getting you back to the active lifestyle you love.

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    Download now: 7 Quick & Easy Tips To Reduce Back Pain (without painkillers,, injections, or seeing the doctor)!

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Premier Neuro Therapy specializes in helping people overcome nagging pains and injuries, avoid surgery and injections, and transform the body to a state of peak performance.
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