Spinal manipulation endorsed as ‘best practice’ for back pain.
3rd leading disease burden in Australia with an estimated cost of over $9 Billion per year. The majority of sufferers will consult their GP seeking care in the first instance with half being prescribed medication as a first line treatment. In the past 5 years, prescription of pain relieving medication has increased from 5 million to 7 million prescriptions.
Paracetamol is the 4th most prescribed drug in Australia. The number of deaths from prescription pain medications – opioids – has increased 61% between 2004 – 2014. 58% of non–cancer pain medication prescriptions are for musculoskeletal issues The founder of Osteopathy, American Physician Dr Andrew Still, became disillusioned with the effectiveness of the medicines available to him in the 1800’s and developed an approach to health care to circumvent or at least complement drug prescription. Over a century later, after a relentless campaign to discredit the ‘hands on’ approach that Dr Still popularised, the American Medical Association has finally agreed with him and revised their best practice guidelines for managing back pain, endorsing spinal manipulation, massage and heat as first line treatments before medication is prescribed.
These recommendations are welcomed by Brisbane based Osteopath, Dr Giulian Di Venuto, who said ‘there seems to have been a ‘turf war’ for the back pain patient for a long time. Osteopaths have been advocating the use of spinal manipulation, massage, heat and exercise to help people with back pain since the 1800’s. It is good that the evidence base for what we do is starting to catch up and that eminent leaders in health care, such as the American Medical Association, are recommending with confidence that we are amongst the best people to assess and treat musculoskeletal pain such as back pain in the first instance.’ Osteopath, Dr. Di Venuto advises that most cases of back pain resolve within 6 weeks and whilst pain can be sever at times, it is best to try and keep moving.
‘People are vulnerable when they are in pain. They are often anxious and scared and believe that their pain will persist. I agree with drug therapy and the role it plays in pain medicine, but it is more important than ever that patients are referred to the most appropriate people for examination and treatment because the ‘quick fix’ is not working.
Medication dependency is real and so are the side effects. When there is evidence for interventions that are better and safer than medication, they should be used in preference and that is what the AMA is also saying. Osteopaths, physiotherapists and chiropractors have been advocating for a long time now that therapies such as spinal manipulation, massage and exercise, should be preferred to medication in the short and long term treatment of back pain.’
Osteopaths, Chiropractors and Physiotherapists are University trained, registered health care professionals, regulated by government agency, the Australian Health Practitioners Registration Authority (AHPRA) and specifically trained to assess, diagnose and manage musculoskeletal issues such as back and neck pain. Osteopaths and Chiropractors are trained in spinal manipulation during their undergraduate university training. If you are interested in seeking advice from a registered Osteopath, or you want to learn more about us you can learn more on our website or Osteopathy Australia.
1. Back pain from spinal joint sprains and strains
There are hundreds of joints extending from your neck to tailbone and rib cage. Movements during training that overstretch or overload joints can cause joint sprains and strains. These are common and can range from the mild irritation to debilitating pain. Most patients can make a complete recovery from most these when treated. Untreated they can remain problematic for long periods. Without treatment they can become areas of reoccurring injury and pain 2. Pelvic (Sacroiliac) joint sprain and strain
Like spinal joints, the two large joints either side of your tail bone in your pelvis can be sprained. The job of the sacroiliac joints can be very complex. They must bear weight and control movement. In my experience, they often become an area of repeated problems when left untreated. 3. Overuse injuries and tendonitis
As the name implies overuse and repetitive movements can cause injury almost any tendon. Repetitive use causes rubbing and irritation that can cause inflammation. In some cases this leads to bursitis which can easily become chronic. Tendonitis with bursitis almost always requires rest and specific rehabilitation. 4. Shoulder sprains and strains
The shoulder has a large range of motion but it generally not a very stable joint. This large range of motion makes it susceptible to chronic muscle strains, tendonitis’s, bursitis. These conditions in this area can often become chronic and can be difficult to manage. 5. Ankle sprains
These are a common traumatic sports injury. Rolling an ankle can be just bad luck but ankles need specific rehabilitation. Bad sprains can leave ankles week and susceptible to re-injury with simple activities. Many ankle strains over a period of time need specialized rehab.
6. Groin and hamstring strains
Are common sports complains and can often be the result of problems with form and technique. Tight and inflexible muscles, improper warm up can also be the cause. Overloaded weights training are another way these strains can occur. Simple examination and rehabilitation often gives excellent results. 7. Knee injuries
Poor techniques, physical trauma and overstrain of muscles around the knee can lead to many different knee injuries. Some such as patella (knee cap) tracking disorders can respond well to rehabilitation. More severe knee injuries need surgery and extensive rehabilitation to return to exercise. Knee injuries need thorough examination and investigation to be property diagnosed and treated.
So to avoid many of these common injuries we have put together a list of Our top tips for avoiding injury 1. Get professional advice
This is all about GOOD TECHNIQUE and knowing your body! As an Osteopath I have an excellent understanding of peoples individual body biomechanics. It is easy for us to see what is and what isn’t good for people to do. This combined with a trainer can put you in the best possible position train in the safest way possible way. This is when you can gain maximal results.
Knowing any limitations from previous injuries and concentrating on posture, technique and form. Getting advice from trainers no matter what your level is so important. Not only will it decrease your risk of injury but it also improves results. As you increase distance or weight you should be striving for improvement in technique. Not only does it present intrinsic challenges but it prevents injury.’ 2. Don’t do too much too fast.
Most of the time training is challenging yourself and pushing yourself harder. No matter what the challenge you need to allow your body time to get used to new movements or increased demand. Building things up steadily will always give you the best chance of avoiding injury. People become disheartened when they don’t see results from training sessions quickly
You would think this is most common to beginners but that is not always true. Sometimes more experienced exercisers misjudge where they are with strength and fitness. I often see very fit people underestimating the core strength required to get them to the next level in their training. Too much weight or distance too quickly can set you back severely. Overtraining and not allowing the body adequate rest periods can exhaust the body. Draining the body’s energy and not allowing time to recover and repair after can set you up for injury. 3. Warm up
Most people are guilty of not doing this one at some point. Warm up exercises are usually done with the aim of increasing the blood flow to the muscles. The increased blood flow makes them more “pliable” and adaptable to exercise without injury. Warm up exercises are generally high-rep, low-intensity – a light jog, cycle etc. Lifting weights without a warm up is putting you at a much higher risk of injury no matter how fit you are. 4. Don’t ignore pain
If it hurts, STOP! Pushing through pain (especially sharp or pain you have not had before) is not good. Pushing through fatigue for resistance training is how you progress. After an intense weights session a stretch or a foam roller can ease minor soft tissue strains. A good trainer can help you identify the difference between pushing yourself to the next level and pain due to tissues being injured. I often see patients who have been pushing through the pain not realising the damage they are doing. Continuing training with tendon injuries can cause tendonitis that can be difficult to rehabilitate. It is a similar story for stress fractures. Often the body has been trying to tell them for quite sometime that it cannot deal with the loads being applied. These injuries are far more common than people realise. If identified early they have much better outcomes. 5. Stretch
Ok so there’s lots of different schools of thought on this one. One minute it’s essential before and after all exercise. Next minute a researcher will claim there are no beneficial outcomes. What I do know from years of treating injuries is that not stretching at all will not help your performance. Not Stretching at all will probably put you at a much greater risk of hurting yourself.
Properly performed, a stretch helps to elongate, increase circulation and warm up a muscle. Warmed up muscles are more pliable and ‘alert’. in my experience this makes it far more injury-resistant. Post exercise muscle soreness is reported less when muscles are stretched after a workout.
Yep I’ve come across body builders that don’t stretch ….. like ever!! I often find not only do they have injuries but they can be very unbalanced with their strength and flexibility. They may be able to lift very heavy weights but some simple activities can easily cause strain in them. In my experience, the best performing bodies have a perfect combination of strength and flexibility. These bodies tend to recover well from injuries.
Make sure you get advice and guidance from a trained professional on what stretches are best for you and how to do them properly before you start. 6. Optimal nutrition
Ive seen countless people wanting to lose weight who consume too little or the wrong type of food. They continue to try to train hard and frequently. This is a great way to get injured. If you want to perform better or gain muscle bulk diet is important. Getting advice from a sports nutritionalist on what to eat is worthwhile. You need to provide your body with the best fuel possible if you want it to perform well. If you are doing resistance training you need to ‘feed’ your muscles. Optimal nutrition can feed your muscles and help them recover from a work-out.
Get the right advice from the beginning. Have a team around you to know exactly what your body can (and probably should not) do and how to do it correctly. At the first sign of injury get it assessed and treated. Follow the proper management from the beginning to avoid injuries setting you back.
A serious problem in your hip joint – like damage to your cartilage. It’s not that common particularly in young people and it is usually painful.
Tight tendons or muscles ‘snapping’ ‘flicking’ and ‘clicking’ over the boney parts of your hip joint. – This is really common and is often painless. The two biggest offenders are your psoas muscle in your groin or your ITB (illiotibial band) on the outside of your hip.
So is it bad?
If you have a serious problem in your hip joint then yes the reparative ‘clicking’ could be bad and causing further damage. If it is caused by ‘tight’ muscles snapping over boney bits ….. while it’s not that bad or necessary painful, it can lead to inflammation, bursitis and other problems at the hip in some people
The people who get “snapping hip syndrome’ the most are often dancers, athletes and people doing a lot of exercise or people that are using their hip flexors a lot in some way.
To know exactly what is going on in your hip and the cause of the ‘snap’ you need your hip properly assessed and diagnosed. Once we have examined your hip then we can work out exactly what is casing it and what to do about it.
In the majority of cases that we see the ‘clicking’ or ‘snapping’ is being caused by tight muscles. Osteopathy takes a global look at your body and movement to see how and why certain muscles have become this way …. Is it a repetitive movement you’re doing? Is it to do with your posture at work or when you are exercising?. Has your psoas become overly tight due to stiffness in your lower back? And so on…
Once we figure out how and why your muscles have become this way be can work out the best way to treat it.
We might release the tension in the muscles and use techniques to improve range of motion in parts of your body that are being affected by the increased tension in these muscles.
We will often prescribe you specific stretches or techniques designed to release tension in the problematic muscles. Foam rollers and massage balls can be very helpful with this
Help you understand and improve your technique or posture with a particular exercise or activity that you are doing
Sometimes no matter what the patient does they will never get rid of it. So long as they have had it investigated and ensure that there is no damage being caused to their joints by the activity that they are doing then they continue to move and ‘clunk’ ‘snap’ and ‘click’ their way through a yoga class. Have you got a snapping hip? Or know someone who does? If you need to be moving better then come see us and we’ll get you moving again! Call one of our clinics for an appointment
We all know movement and exercise helps to keeps us fit and healthy and keep pain and injury at bay. When done correctly simple squats are a great exercise for most people, but if done incorrectly they can have the potential to cause or provoke injury which we have seen many times! For most fit and healthy people squats are a great all-round exercise that can work many major muscle groups including your core muscles and generally benefit a lot of people. You don’t have to be young, super fit or already have strength to do them. They can pretty much be done anywhere without too much fancy equipment. So what are the benefits of doing squats?
Squats can strengthen and tone your legs
Squats use your quadriceps, hamstrings, calf muscles, which helps to tone and strengthen the legs. Moving slowly through the squat can make it a much more intense and effective exercise.
Squats can give you a better butt (and who doesn’t want that!)
Doing squats gives the glutes a good workout, helping to strengthen and tighten your glute muscles.
Squats can give you a total body workout
Doing squats with slowly increasing weights in your hands or above your head can engage the muscles of the upper body giving you a full body workout in one exercise.
Squats can strengthen your Core
When done correctly squats can engage your core muscles. Abdominal and back muscles are needed to keep balance during the movement.
Squats can improve your balance and co-ordination
By strengthening muscles and core muscle activation, you may wobble at first …. but the more you practice the better you’ll get
Squats can increase and maintain bone density
weight bearing exercises are excellent and increasing and maintaing bone density
Increases Flexibility
When done properly squats increases joint flexibility in the ankles, knees, hips and lower back are all being used. Upper
SO what are the tips for doing a perfect squat so i don’t hurt myself?
It’s especially important to maintain good technique doing squats especially when using weights. Always follow the steps below. Ask your Osteopath if squats are something that you may benefit from and ask them to go through the movement with you to make sure you are doing them correctly. Seek their advice on if, when and how much weight to add to doing squats to get the best outcomes for you. Doing squats in-front of a mirror can be especially useful to keep and eye on your technique. Here are the basic tips for good squats.
Stand with your feet hip width apart.
Tighten and engage your abdominal muscles.
Lower your body dropping your bottom and bending your knees as if you were going to sit in a chair. Keep the motion slow and steady.
Stop when your legs are parallel with the ground.
Stay in this position for a few seconds.
Now slowly press back up keeping your feet flat on the floor.
Repeat the exercise for a total of 2 to 3 sets of 8 to 12 reps.
Be sure to rest for 60 to 90 seconds between sets.
Once you’re good at doing squats (with no shaky wobble), you can increase the difficulty and effectiveness of the exercise by doing it with weights. Try holding hand weights in each hand at shoulder level or use a bar across your shoulders, (at the gym you’ll usually see people doing it like this in the ‘smith machine’). You can also just hold one weight (with both hands) or a medicine ball in front of you while you do the squat.
This month we asked trainer Matt from “The Results Room” in Newstead to give us some insight into how to keep up with your fitness goals even if you have an injury. An injury, pains, niggles and other ailments can really derail our focus and commitment to regular exercise and training. It can happen to anyone from high-level athletes to office workers to stay-at-home mums. If this is you, I want you to know that it’s not the end of the world or the end of your health and fitness goals, but a mere setback to learn from and overcome. Sometimes these things can take a long time to manage and frustrations can set in, but if you ensure there is a plan in place to fix it, perseverance is the key to seeing it through and coming out millhouse!
The following are a few strategies that you can implement in your training to keep you on track:
Train the uninjured body parts
If you injure your ankle for example, you still have all of your upper body that you can train and the other leg! Don’t be scared of creating an imbalance, as you will get a cross-education effect to the injured side that will help maintain the strength you do have and help to speed recovery.
Do your rehab exercises!
It helps your injury if you do these every day in most cases, they help to keep the injured limb mobile and provide some stimulus for either a healing or strengthening adaptation to occur. If you train with a trainer, get them to work with your clinician to monitor and coach you through your rehab exercises.
Prevention is better than a cure
Some injuries are clearly unavoidable; in those cases implementing the first two points will keep you on track. However, many injuries come about for a variety of reasons and can be avoided. To ensure you stay injury free find yourself a reputable coach who can give you a structured plan to fit your needs, knows and coaches you to perform exemplary form on big multi-joint exercises and has a working knowledge of exercise modifications should you need to change something to suit you better. If you have an injury, check with your Osteopath and seek their advice on training. If you have any questions or are interested in some more information about training feel free to pop in and Matt at The Results Room or send him an email to matt@theresultsroom.com.au.
