Technorati Tags: hoola hooping, Lower Back Exercises, lower back pain

‘I am suffering from right lower back pain. I thought it was sciatica, but it seems that hooping is agitating my back and hip. Could it be my sacroiliac joint (SI joint)?’

Let me start by saying, the body is so complex, so it is always best to get a licensed practitioner to put their hands on you and evaluate you individually. But, it is important that you are educated so you can understand how to help heal your body and continue your daily life without pain and of course, hoop to your heart’s delight!

From my experience as a physical therapist, it is always important to check the SI join’s alignment. The pelvis is the foundation of your body. If your pelvis is out of alignment, then the rest of the spine has to stack itself accordingly.

What is the SI joint? Place your hands on the top of your hips on each side of your body and wrap your thumbs along your back. Where your palms rest is your ilium and about where your thumbs reach is where the ilium meets the triangular bone of the sacrum. This is loosely where the SI joint is.

The SI joint is held together by strong ligaments. There are no per say muscles that directly attach to the SI joint. BUT, there are muscles that influence the SI joint. It is important to stabilize the SI joint via its ligaments and the muscles that influence the joint. It is important to keep in mind that both males and females are affected. Although, it is noted that females do experience more SI joint dysfunction than males. This is due to the female pelvis having less contact at the actual joint than males. Also, since ligaments primarily stabilize this joint, during a female menstrual cycle, a female may experience more laxity in her ligaments. During this period for females, the SI joint may be more unstable. It may be a time to not perform activities that stress this joint. I will speak further on this later in this article

The three muscles that effects the SI join are the gluts, transverse abdominus and ‘lats’. It is important to stabilize your SIJ using these muscles. One excellent exercise that achieves this goal is bridging with a ‘lat’ pull down. Lie a foot away from a safely closed door and a theraband safely placed on the door handle. While lifting your hips in neutral spine and pelvis during the bridge, pull down on the theraband with arms and wrist straight. Pull down your arms towards your thighs with enough tension in theraband to stimulate your ‘lat’ muscles. Make sure your shoulder blades glide down your rib cage for correct alignment.

At the beginning, it is important to do exercises and activities that do not stress the SI joint. Therefore, do exercises and activities that require both arms and/or legs simultaneously. These exercises are referred to as ‘bilateral symmetrical’ movements. As you progress your exercise program, it may be safe to perform exercises that are one-sided. These exercises are referred to as ‘unilateral asymmetrical’ movements.

Another example of a ‘bilateral symmetrical’ exercise would be and ‘isometric adduction’. This exercise can be done several times throughout the day. Lie down on your back with your knees bent and feet flat on the floor. Place a plastic ball or folded pillow between your knees and gently squeeze your knees towards each other for 5-10 seconds. Be sure to breathe. You can perform this exercise 6x each time 4-5x a day.

An example of a ‘unilateral assymetrical’ exercise would be bridging with one leg. Notice, I have given exercises with the spine supported in the lying down, ‘supine’ position. As you progress with exercises, you may perform exercises in the unsupported position of sitting and standing.

Nutrition can also play a role in the health of your SI joint. You may want to ask your health care practitioner about taking manganese for a short period of time. Manganese, not magnesium, can help ‘tighten’ your ligaments. Also, sugar, caffeine and alcohol can increase your perception of pain.

If you are really unstable, it is beyond the scope of being managed without the assistance of a professional. You may need to be fitted with an SI belt or referred to prolotherapy. This article is to help educate you and help direct you whether you need further assistance.

Jodi Jainchill PT, CFMT

Technorati Tags: best lower back exercise, exercise for lower back, hip pain, hula hooping, sacroiliac dysfunction, SI joint pain

‘ really want to exercise and I love to hoop. When can I start hooping again?’ This is a question I often get from people who have experienced back pain at some point in their life. First, let me start by saying you should consult your practitioner for clearance to exercise. Next, I would like to educate you on three different stages of recovery from back pain. Once you understand these three stages of recovery from back pain, it may help you and your practitioner decide when you are ready to start an exercise program.

After a back injury or exacerbation of an old injury, you are considered to be in the acute phase. The acute phase usually lasts about two weeks. It is important to consult your practitioner to rule out any organic factors that may be referring pain. I highly recommend this especially if you do not know how you hurt your back. Also, if you feel pain, tingling or numbness down your leg. The main goals during the acute phase is to decrease inflammation and find a position of comfort. You can decrease inflammation with ice or an anti-inflammatory prescribed by your practitioner. You may also need to take pain medication and muscle relaxers in order to break your pain cycle. Next, your position of comfort should be in neutral alignment. This will allow for space for your spine to heal without increasing stress on the spine’s structures. At this point, stabilizing exercises that are in neutral and supported are beneficial. Therefore, at this time, hooping would not be recommended during this pain stage.

The second stage of recovery is called the sub-acute stage. This stage generally lasts from two to four/six weeks. During this stage you are still vulnerable to re-injury. This is a time to progress your spine’s stabilization. You may slowly progress from supported to unsupported exercises. Depending on the severity of your injury, you may still want to maintain a neutral spine with your exercises. This is also an important time to use correct body mechanics with your functional daily activities. You should also avoid repetitive activities as well as any aggravating movements. Therefore, you must learn to set your limits during this stage. You may still want to ice after any irritating movements to prevent further inflammation. Therefore, depending on your extent of your injury in this phase, you may be able to start hooping for short periods of time if you are relatively pain free. This means you have minimal pain and hooping does not increase your pain during hooping for one to two days thereafter. If not, hold off until you are more pain free and stable.

After six weeks from your injury or exacerbation, you are now in the chronic phase of recovery. During this stage, your goal is to return to your normal activities of daily living. In doing so, it is important to have good body mechanics. It is also time to progress your exercise program to unsupported articulating positions. Yes, this means you may start hooping if you are relatively pain free. I usually have a patient start with only five minutes a day of waist hooping without any increase in back pain. After a few days, I progress my patient to ten minutes daily without any increase of pain. Then I recommend to increase their time slowly in increments of five minutes for a cardio workout. It is important to not have any increase in pain during or after your exercise program. You may benefit from ice after you exercise as well.

Some times there will be set backs during your recovery. If this happens, please be patient and set your limits to continue your recovery. You must find a balance with the help of your practitioner. It is important to get movement and stability for your spine to help heal. But at the same time, you do not want to exacerbate the injury. If you are not getting better, this is a ‘red flag’. It would be important to consult with your practitioner for further testing. You must also remember there are other factors to consider for your healing. These include your age, back and health history, eating habits and digestion, pain tolerance, personality, athletic background and daily activities. Also, only add one new activity or exercise at a time. This way you can easily identify any one activity that may cause any new onset of pain or aggravation while returning to your normal daily exercise program and activities. There are so many variables to an injury as well as the process of healing for each individual. Be sure to consider your individual situation rather than comparing yourself to others and their healing process as you return to your hooping and exercise goals.

Jodi Jainchill PT, CFMT`

-red flag if not getting better`

Technorati Tags: best lower back exercise, exercise for lower back, exercise for lower back pain, hoola hooping, strengthen lower back exercise

I often am told that my body moves so easily when I hoop. I call this ‘effortless movement’. I explain that usually when you first start hooping, it requires a lot of effort. In this case, your movement is less subtle. As your spine becomes more supple, your movement will become smoother and less jerky.

When the spine and pelvis move like a slithering snake, then each segment of the spine and the pelvis are contributing to the movement. In other words, if a segment is stiff, then other segments have to move more to make up for it. This dysfunction can be diagnostic. It could tell me that there may be an instability at the segment where there is too much movement. This instability is where core stabilization is helpful. It also could indicate that there is a restriction where there is no or little movement at a segment. I find hula hooping to be what pioneer Physical Therapist, Gregg Johnson, terms as an excellent ‘functional movement pattern.’ A series of movements that helps evaluate and treat the body’s dysfunctions in a functional way.

I have also noticed that personality types and emotions can play a role in how well someone starts hooping. I find it interesting when someone who seems to be ‘uptight’, ‘insecure’ or has experienced a traumatic event can hoop like a champion. Often this is not the case. And this works both ways. I also notice and find it interesting when someone who seems quite ‘laid back’ or ’secure’ gets really stiff when they hoop. Again, this is not always the case. I feel like hooping could also tap into the psychology diagnostic world as well.

But, what I love most is the energy shifts I see after someone hoops. I know what it is like, since I experience this transformation myself with hooping. It does not matter if the person was very successful or just a little successful with their first attempts at hooping. Regardless, there is a smile. And when someone is smiling, their energy is flowing up. And when energy is flowing, it feels delightful.

I love how hula hooping is so much fun and yet diagnostic and transforming. Hooping can help the spine loosen up and strengthen core muscles to help prevent possible injuries. It also seems that it can help change your state of emotional being. This can help a person feel better about themselves. Yet, there are still many other additional benefits including losing weight and improving posture. Wow, pretty amazing for a plastic circle.

Jodi Jainchill PT, CFMT

Technorati Tags: exercise for lower back, hula hooping, lower back pain exercises, strengthen lower back exercise

In the previous articles in this series ‘What Do I Need To Stretch For My Lower Back Exercise Program?’, we discussed the hip flexors, hamstrings, and ‘chest’ muscles. Now, are you ready to learn about the buttocks muscles? There are several large and small buttocks muscles that are very powerful. These muscles help extend the leg as well as rotate the hip. Here we will discuss the gluteus maximus and gluteus medius. We will discuss why the buttocks muscles are important to be included in your lower back exercise program in a Q & A format. Let’s begin.

Q: Where are the buttocks muscles?
A: The gluteus maximus originates from the posterior ilium, sacrum & coccyx as well as posterior fascia and ligament. It inserts into the lateral fascia or the thigh (’IT’ band) and upper posterior thigh. The gluteus medius is a deeper and smaller muscle than the gluteus maximus. The gluteus medius originates on the posterior ilium and inserts into the upper lateral thigh.

Q: Why should the buttocks muscles be stretched?
A: The gluteus muscles play an important role for the flexibility of the hips. The mobility of the hips effects the position of the pelvis. The position of the pelvis plays a primary role for the position of the lower back. The position of the lower back is important because an arched or flexed lower spine can compress structures in the spine. Compression of the spine can lead to pain and dysfunction.

Q: How should the buttocks muscles be stretched?
A: The buttocks muscles can be stretched in many directions. This is because the buttocks muscles help move your hip in both directions of rotation as well as extension.

Q: What are some examples of buttocks muscle stretches?
A: There are many variations and positions. I will discuss some starting with the positions that are easiest to perform correctly.
1. Single Knee to Chest
Lie on your back with your knees bent and feet flat on the floor. Bring one knee towards your same side shoulder. Use both hands to supprt leg up. Then you can progress the stretch by gently bringing your knee gently towards the opposite shoulder. Repeat this exercise on the other leg.

Single Knee to Chest

2. Crossed Knees to Chest
Lie on your back with your knees bent and feet flat on the floor. Cross one leg over the other knee. Gently bring both knees to your chest with your hands clasped around your shins. Repeat exercise on the other side.

Crossed Knees to Chest

3. Figure 4 Hip Stretch
Lie on your back with your knees bent and feet flat on the floor. Cross one ankle over the other knee. Gently push the crossed knee away from your body. Repeat exercise on the other side.

Figure 4 Hip Stretch

4. Standing Hip Rotator Stretch (modified pigeon)
Place your leg bent and knee turned out on a medium-height surface (can use firm bed). Bend your standing leg. Make sure both hips are facing forward. Try to turn out the bent knee for a deeper stretch. You can also deepen the stretch by leaning forward. Be sure to keep your back in neutral (not rounded). Reach your tailbone back when leaning forward to help maintain alignment.

Standing Hip Rotator Stretch (modified pigeon)

Q: How often and how many times should I stretch my buttocks muscles?
A: If you do not experience sharp pain in your hip, you can hold the position for 30-60 seconds 1-2 times in the a.m. then 1-2 times in the p.m. to help build length in your muscles. Be sure not to ‘bounce’ in the stretch. If you feel sharp pain, you may want to consult your medical doctor for further evaluation.

Q: What should I be careful of when stretching my buttocks muscles?
A: Sometimes you may feel a ‘pinch’ deep in your hip when stretching your buttocks muscles. Do not push yourself into a deep stretch, which may cause more harm. Be patient and be sure to stretch all the muscle groups I talk about in this series of articles to help improve your hip flexibility and decrease the ‘pinch’ sensation.

Q: What are some helpful hints and tips about the buttocks muscles?
A: If you feel a ‘pinch’ in your hip, try placing a small towel roll in the crease where your thigh meets your trunk. Do this technique for exercises #1 and #2. It will also help to increase your stabilizing muscles in your pelvis after doing these stretches. One fun exercise would be to hoola hoop on one leg. That will ‘wake up’ your buttocks stabilizing muscles!

I hope this helps you have a better understanding of your buttocks muscles. It is important to understand why you are stretching a particular muscle group. When you understand more about your body, it helps to do your exercises safe and correct. In the next and final article for this series, I will address the lower back muscles. The lower back muscles also play an important role for the pelvis along with the hip flexors, hamstrings, ‘chest’, and buttocks muscles. This will be discussed in great detail in Part V of “What Do I Need To Stretch For My Lower Back Exercise Program?”

Jodi Jainchill PT, CFMT

Technorati Tags: best lower back exercise, exercise for lower back, exercise for lower back pain, hoola hooping, lower back stretching exercises

Ready to learn about the second group of muscles that helps you when you have lower back muscle tightness and aches? In the first article of this fiver part series, “What Do I Need To Stretch For My Lower Back Exercise Program?”, I discussed the hip flexors. In this article, I will discuss the hamstrings in the same Q & A format. Let’s begin.

Q: Where are the hamstring muscles?
A: These long muscles start at your sit bones and attach to behind your knee. They include semitendinosis, semimembrinosis, and biceps femoris. Yes, the hamstrings are a set of three different muscles.

Q: Why should the hamstring muscles be stretch?
A: When they are tight, they pull on your pelvis causing your lower back to get rounded. This causes compression to your spine. Compression can lead to tightness, aches and eventually lower back pain and problems

Q: How should the hamstrings be stretched?
A: They should be stretched with your tail bone pushed out, not tucked in. But, make sure your lower back is not ‘locked’ in an arched position. Also, your knees should be straight.

Q: What are some examples of hamstring stretches?
A: There are many variations and positions. I will discuss some starting with the positions that are easiest to perform correctly.
1. Lie on your back with your buttock near a wall. Place one heel on the wall and the other foot flat on the floor with knee bent. Slide your heel along the wall until you can straighten your knee gently. Bring your buttocks closer to the wall for a further stretch. If you cannot straighten your knee all the way, move your buttocks back from the wall until you can and still feel and gentle stretch.

2. When you are comfortable with the first example position, you can do the same exercise using a towel, sheet or ring around your heel for support, instead of the wall. For a further stretch, you can flex your foot and turn your toes either inward or outward.

3. An advanced position would be in standing. Place your heel on a low table or chair. Make sure your tail bone is pushed out gently. Next, bend forward coming from the hips. Make sure your back is not rounded but in ‘neutral’.

4. Another advanced position is the standing forward bend. Often, people ’round’ their back from bending at the lower spine. It is important to bend from the hips and keep the tailbone out without arching your back. Also, keep your knees straight. (same principles apply to the hamstring stretch performed in sitting with your legs straight)

Q: How often and how many times should I stretch my hamstrings?
A: If you do not experience sharp pain, which I talk about below, you can hold the position for 30-60 seconds 1-2 times in the a.m. then 1-2 times in the p.m. to help build length in your muscles. Be sure not to ‘bounce’ in the stretch. Alternatively, you can oscillate in and out of the stretch gently 10 times 1-2 times in the a.m. and 1-2 times in the p.m.

Q: What should I be careful of when stretching my hamstrings?
A: You should not force a deep stretch cause you can irritate your sciatic nerve. If you feel a sharp pain, you are probably irritating the sciatic nerve. It is best to use the oscillating technique mentioned above. In this case,do not go into a deep stretch.

Q: What are some helpful hints and tips about the hamstring muscles?
A: If you are doing these stretches and everyday you have the same amount of tightness, it may not just be the length of the muscles. It could be the ability of the muscles to move from left to right. Certain massaging techniques that moves the muscles left to right may help with this. Also, be aware you may have more of a nerve issue rather than a muscle tightness. Furthermore, If you have a muscle tear, it would be wise to be under the supervision of a doctor or physical therapist. Often, muscle tears do not like to be stretched until enough healing has taken place.

I hope this helps you have a better understanding of your hamstrings. It is important to understand why you are stretching a particular muscle group. When you understand more about your body, it helps to do your exercises safe and correct. In the next article, I will address the chest muscles in detail. The chest muscles, like the hamstrings and hip flexors, play an important role on the pelvis which affects the lower back. This will be discussed in great detail in Part III of ” What Do I Need To Stretch For My Lower Back Exercise Program?”

Jodi Jainchill PT, CFMT

Technorati Tags: best lower back exercise, exercise for lower back, exercise for lower back pain

“I stretch my back out every morning, but it still gets tight and achy. What do I need to do?”
This is often one of the most common questions people ask about for lower back tightness and aches. Although stretching your back feels like the right muscles to stretch, it is usually not the only muscle group that needs to be stretched. The lower back may already be over-stretched and may not even need to be stretched.

First thing to realize is that there are about 32 muscles that attach to the pelvis. The position of the pelvis effects how your back may feel. Therefore, there are a lot of muscles to consider relating to your lower back. There are five major muscle groups to consider to stretch for your lower back. These include:

•     Hip Flexors (Iliopsoas)
•     Hamstrings
•     Chest (increase upper back extension)
•     Buttocks
•     Lower Back

I am going to talk about each muscle group in detail. Therefore, I have broken this article into four parts. I will address a muscle group in each article. I will explain this information in a Q&A format. I will first discuss the hip flexors and in particular the iliopsoas muscle.

Q: Where are the iliopsoas muscles?
A: The iliopsoas start in your lower back and attaches to the front of your hip (yes, from back to front).

Q: Why should the iliopsoas muscles be stretch?
A: When your hip flexors get tight, they make your back arch and cause compression on your spine.

Q: How should the iliopsoas be stretched?
A: They can be stretched in several positions. I will discuss some examples in the next question, but the most important techniques to consider is that you ‘tuck your tailbone under’ and keep your toes facing forward.

Q: What are some examples of stretchs?
A:  There are many variations. All are great when done correctly. I will begin with the easier positions.

1. Stand with one leg in front of the other at hip width apart (stride position). You’ll be stretching the back hip flexor. Bend both knees slightly. Tuck tailbone under.

2. You can also stretch at the end of the table when lying on your back. Have your buttocks to the very edge of the table. Bring both knees to your chest. Keep one knee to your chest and then let the other leg drop off the edge of the table.

3. More advanced, you can do a “runner’s stretch”. Lie on your side and bring both knees to your chest. Grab the top ankle. Tuck your tailbone under. Bring the ankle back towards your buttocks.

4. Another advanced hip flexor stretch is in ‘half kneeling’. Kneel on one knee in a stride. Tuck your tailbone under and shift your weight forward. Make sure your front knee is  above or behind your ankle.

5. You can also get a hip flexor stretch while hooping with one leg in front of the other (stride stance). Be sure your back foot toes are facing forward. There is a tendency for the toes to go outward. You may notice that the hooping stretch is performed in a functional position. This stretch while hooping is similar the stretch the hhip flexors get during walking.

Q: How often and how many times should I stretch my iliopsoas?
A: You can hold these positions for 30-60 seconds or move in and out of the stretch slowly and gently. Do not ‘bounce’. Do 1-2 sets in the a.m. and then again in the p.m. It is best to spread out your stretches to allow the muscle fibers to maintain their new length and keep it. For the hooping stretch, you can do the movement for 30-60 seconds in the a.m. and p.m. as well.

Q: What should I be careful of when stretching my iliopsoas?
A: You should not force a deep stretch so you can maintain correct spine and pelvic position for safety.

Q: What are some helpful hints and tips about the iliopsoas muscles?
A: It is good if you can have your iliopsoas released by a trained professional. It would also be good to get releases done to your quadricep muscles.

It is important to understand why you are stretching a particular muscle group. This understanding helps you do the exercise safe and correct. In the next article, I will address the hamstrings in further detail. The hamstrings, like the hip flexors, play an important role on the pelvis which affects the lower back. This will be discussed in great detail in Part II of ” What Do I Need To Stretch For My Lower Back Exercise Program?”

Jodi Jainchill PT, CFMT

“I am looking for an exercise program that is fun, but works to keep my back strong.” Although both Pilates and hoola hooping have been around for some time, let me tell you why these exercise programs are great for lower back and general exercise programs.

When performing Pilates exercises, it is important to perform them using the principles of movement. These principles includes breathing, body alignment, activating your core, elongation of the spine, spine articulation (spine moving wave-like), and integrating movement. Just by hoola hooping, all these principles get incorporated.

Both Pilates and hoola hooping focuses on movement. In particular, correct body movement. When performing both these methods, you learn to improve your body awareness. You learn to ‘feel’ where your body is in space. You also improve body posture. As you lengthen your spine, you align your body better. Also, you tap into your core muscles. This is important to stabilize your spine for safe movement. You also increase your body balance and symmetry on your left and right side. Finally, you lose weight because it is fun and you keep moving and burning calories.

It is ideal to have an exercise program that your are motivated to do and have fun doing. Both Pilates and hoola hooping help release endorphins to give you a euphoric feeling. You no longer have to dread exercising, but look forward to your workout time.

Jodi Jainchill PT, CFMT

Technorati Tags: best lower back exercise, exercise for lower back, exercise for lower back pain

There are so many lower back exercises and approaches to exercises, how do you know which are best for you? Once you gain an understanding that you are trying to strengthen your core muscles, your choices become simpler.

Be sure you understand that it is important not only to work core muscles, but how you do the exercises. Once you gain an understanding that core muscles stabilize the spine all day, it makes sense that you want to do exercises that hold for a long period of time. Holding the exercise for the core will train the muscles correctly to do their job. Yes, there job is to make your spine stable day and night!

One of the most fun and beneficial exercise that works the core is hoola hooping. Once you get the ’spin’ going, you tap into the core muscles. You ‘wake’ them up. And because hooping is so much fun, you can build up spinning the hoop for longer periods of time. In this exercise, you actually perform a ‘functional’ exercise.

A ‘functional’ exercise is when you are performing movement that looks like a daily activity. For example, when you are hooping in stride position, it works a position you go through in your walking cycle. Also, in this position, it stretches your hip flexor muscles. The hip flexors are often a culprit of lower back pain. This position also replicates the movement you do when you reach up for an object. And this is with only basic hooping.

As you progress with hooping exercises,, you can challenge your core in other functional positions like squatting. The more you can find exercises in functional positions, the more benefit you will get out of the exercise. On the other hand, a non-functional exercise may get that muscle stronger, but not necessarily be stronger when doing an activity. For example, one exercise for your quadriceps is in sitting. You sit on a machine with your leg bent and push a weight up to straighten your leg. Where would you realistically need to do that daily? See my point? So, it is best to find ‘functional’ lower back exercises.

Some other ideas include bridging while squeezing a ball between your knees. Once you build up your stamina and hold the exercise for longer periods of time, you are waking up the core muscles in another functional position. Another functional core exercise would be on your hands and knees. This position is known as quadraped. In this exercise, you reach with your arms and/or legs in different variations. It is important to do this exercise trying to make yourself long with each reach. You want to make sure your spine maintains a ‘neutral’ posture. This really wakes up the core muscles along your upper and lower back and abdomen. This exercise helps stabilize your spine for activities you may do on your hands and knees like scrubbing the floor or playing with your children.

Using these examples may further help you decide if an exercise will tap into your core and help you in a functional way. Remember, once you understand what you are trying to achieve in an exercise, you can modify and change the exercise to fit your needs and be safe.

Jodi Jainchill PT, CFMT

Technorati Tags: best lower back exercise, exercise for lower back, exercise for lower back pain