Low back pain is extremely common and in most cases is mild. At any given time, approximately 25% of people in the U.S. report having experienced low back pain within the past 3 months. For some people, back pain is recurrent or becomes chronic which eventually leads to a decreased quality of life.
Low back pain varies and may be experienced as dully, achy, burning, or sharp. It can be very localized or generalized over a larger area. You can sometimes experience muscle spasms or stiffness which may be worse at different points of the day. Many people also experience symptoms into one or both legs. **IF your low back pain is accompanied by loss of bowel or bladder control or numbness in the groin or inner thigh, you need to visit your local emergency department immediately** How does a physical therapist diagnose your back pain? How can physical therapy help? A physical therapist will take you through a very thorough evaluation which includes a review of your health history and specific questions in regards to your symptoms, an examination to assess functional movement patterns, quality of movement, strength, range of motion, etc. and assessment of how you use your body at work, home, or during your certain recreational or leisure activities. For the majority of cases of low back pain, imaging such as an x-ray or MRI is unnecessary as the first line of care. If your physical therapist suspects your low back pain might be caused by another serious health condition, they will refer you to the proper health provider for further assessment and evaluation. A recently published study compared patients who received an MRI first versus physical therapy first for low back pain and those that received an MRI first spent on average $4793 more! Your physical therapist will help determine the appropriate treatment plan for you based on examination findings as most treatment needs to be individualized to the person for low back pain! Some treatments may include:
Why A Physical Therapist First? A recent study published in 2018 compared differences in opioid prescription, health care utilization, and costs among low back pain patients who saw a physical therapist at the first point of care, any time during the episode, or not at all. The main finding was that patients who saw a PT first had lower probability of having an opioid prescription, any advanced imaging services, and an Emergency Department visit. These patients also had lower out-of-pocket costs, thus there was lower utilization of high-cost medical services and lower use of opioids! Do you suffer with back pain or leg pain when you stand or walk? Do you have pain when you sit for long periods or drive? Does your back ever “go out” if you move the wrong way? Are you afraid your pain will get worse if you don’t do anything about it? Do you experience pain, numbness, or tingling into your butt, groin, or down your leg? **If you answered YES to any of the above questions → You need to see a physical therapist to help you with your symptoms!** Call or Email to Schedule Today or Set Up a FREE, 15-minute phone discovery consultation to ask questions and determine the proper plan for you : ) Phone: 614-437-9002 Email: [email protected] References
0 Comments
Are You Glute Dominant OR Hamstring Dominant?!
WHY does it matter?? Let’s start out by talking a little bit about the glutes and hamstrings. Both the gluteus maximus and the hamstring muscles are hip extensors meaning they work to extend the hip (think bringing your leg back behind you in a glute kickback exercise or returning to the start position in a deadlift). These muscles are active in bridge variations, deadlifts, step-ups, running, etc. It is very important that both the glutes and hamstrings are working and working properly, especially if you have any hip pain or if you have tight hamstrings! The Hamstrings attach from the ischial tuberosities on the pelvis (sit bones) distal to cross the knee joint and attach to the lower leg. Thus, they have a long lever arm (Hello Physics!). When they are overactive (‘tight’), due to this long lever arm, every time the hip goes into extension the femur (thigh bone) gets shoved forward in the hip socket. This can lead to significant irritation and pain at the front of the hip, which can thus influence the hip flexors at the front of the hip causing pain there as well. The Glute Max on the other hand has a short lever arm as it attaches from the iliac crest on the pelvis to the femur and iliotibial band tract. Thus, when the glutes are activating properly and prior to the hamstrings during hip extension, there is proper roll and glide within the hip joint. So by changing activation by getting the glutes to fire first rather than the hamstrings can help with hamstring tightness from overworking as well as with hip pain. What I’m not saying is we don’t want the hamstrings working. We DO want the hamstrings working and strong as they can play a huge role in stabilization of the knee/pelvis and injury prevention. We just don’t want them overworking or working prior to the glutes! That is when we begin to see issues occur within the hip joint or tendinopathy/tendon pain of the hamstring tendons! Here is a link to a great video by Dr. Sarah Duvall, PT on how to solve hamstring tightness by changing activation: https://www.youtube.com/watch?v=Df7b8_MB4Jw ^^ This assessment in the video above is a perfect way to figure out if your hamstring is overworking/firing before the glute (i.e. hamstring dominant) OR if you’ve got it down already and your glutes fire first without even thinking about it (i.e. glute dominant). I love the tip she gives in the video to retrain yourself and help get the glute to fire first by externally rotating the leg to give the glute an advantage! Try the test and see if you are glute or hamstring dominant & start working on getting those glutes activating properly to help your hip pain and reduce hamstring tightness!! As always, make sure you see a physical therapist to help you decrease your pain, move better, and improve your overall function through a guided program individualized for you!! Call 614-437-9002 OR Email [email protected] to schedule :) Kaitlin Hartley, PT, DPT What is it?
Diastasis Recti (DR) is a thinning or separating of the linea alba, which is the connective tissue/fascia that connects the two sides of the rectus abdominis (6-pack) muscles. The connective tissue is what thins or separates, not the actual muscles. You can have a diastasis in different places such as above the belly button, just above the belly button, below the belly button, or completely open. To be considered a diastasis, there needs to be greater than a 2 finger width separation OR softness/squishiness under the diastasis. The softness/squishiness is actually MORE important than the finger width gap because that is a signal to us that the deep inner core system is not working properly! What it should feel like underneath the linea alba/connective tissue is firm like a trampoline! Is it normal? During pregnancy, some natural stretching and diastasis formation occur and is completely normal! One study by Mota et al. in 2014 showed that 100% of women had some diastasis formation in their 3rd trimester. However, the wrong exercises or improper form or poor movement patterns can cause a DR to get worse. This is where we want to take caution! The linea alba that connects the two sides of the rectus abdominis helps transfer load through your trunk. So, if the gap is too large or too squishy, it can be an ineffective point for load transfer, which could lead to issues such as pelvic floor dysfunction, low back pain, or SIJ pain. Women who have not had a baby as well as men can also have a diastasis, thus reinforcing the theory that diastasis correlates with function of the abdominal canister meaning your diaphragm function, core, and pelvic floor function! How do you check for a diastasis? It’s as simple as lying on your back with your knees bent and feeling with your fingers at different areas along the linea alba. Then, simply lift your head off the ground and assess again. You are feeling for gap (# of finger widths) and for depth (squishiness/fingers sinking in). Remember, DEPTH is more important than the GAP!! We want it to feel firm like a trampoline, not soft and squishy! What should I do about it? A postpartum or pelvic floor physical therapist can help you assess for a diastasis recti & guide you in the proper exercise program for you! Like I said before, it can be a sign that the deep inner core system is not working properly and we need to figure out what’s not working to create balance in the system so you can effectively transfer load through your trunk! In general, I recommend to anyone with a DR to assess it in any position as you are doing exercise to ensure there is no worsening or bulging in the diastasis. If there is, you likely need to modify the exercise you are doing! ALWAYS check your DR in front loading exercises like planks or roll-ups, indirect front loading exercises such as pull-ups or standing arm work, transitions in yoga, and even things like running and swimming! Something that may be fine for one person to do may not be the best thing for you! It’s not that you can’t do it, we may just need to modify it for you for a period of time to meet you where you are at and help you safely get that system working properly so that down the road you can do everything and anything you want without having to worry! Do you think you have a diastasis? Are you having trouble getting your core to fire after having a baby? Do you have difficulty controlling your breath during movements? Call 614-437-9002 OR Email [email protected] today!! I would love to help you heal your diastasis and get your entire system working so you can be at your optimal function!! Kaitlin Hartley, PT, DPT |
AuthorKaitlin Hartley, PT, DPT Archives
January 2020
Categories |