by Jason Nenzel | May 31, 2023 | news
Understanding The Care Path Through Physiotherapy And What It Means For You. How can Physiotherapy help with a torn rotator cuff problem?
Physiotherapy plays a crucial role in the rehabilitation of rotator cuff tears, helping individuals regain strength, restore range of motion, and improve shoulder function. Shoulder injuries account for a large portion of physiotherapy visits and a rotator cuff tear may be the reason for your appointment. Causes of rotator cuff injuries include sudden and unexpected loads above the supply of the cuff (generally happens in a younger population) or repetitive overload (a common cause in older populations). Symptoms of rotator cuff tears may include: pain, limited range of motion, a reduced ability to lift and accomplish activities of daily living, and more. In this blog post, we will explore the typical care path in physiotherapy specifically tailored to rotator cuff injuries. By understanding the stages of treatment, the techniques utilized, and the importance of evidence-based practices – you can have a clear roadmap towards optimal recovery.
Initial Assessment and Evaluation
The first step in the physiotherapy care pathway for rotator cuff tears is the initial assessment and evaluation. A rotator cuff tear may be confirmed with an MRI and the quality of this tear (whether partial tear or complete) can be visualized with the use of imaging. This is more relevant if the condition may require surgery. However, data suggests that conservative care for partial thickness tears can be equally as effective as surgical management. Either way a physiotherapist will conduct a comprehensive evaluation to gather information about your injury, medical history, symptoms, and functional limitations. This assessment helps in developing an individualized treatment plan.
The assessment may involve physical exam, range of motion testing, strength assessment, shoulder stability evaluation, and special tests specific to rotator cuff tears. The physiotherapist may also use subjective questionnaires and outcome measures to assess pain and disability levels, functional abilities, and overall well-being.
This thorough assessment helps identify common symptoms, determine the severity and specific characteristics of the torn tendon, identify contributing factors, and establish baseline measurements for tracking progress throughout the treatment.
Goal Setting and Treatment Planning
Once the assessment is complete, the physiotherapist collaborates with you to set goals and develop an individualized treatment plan. The treatment plan outlines the best treatment options including: specific interventions, techniques, and exercises that will be used to address your injury and achieve the desired outcomes.
The goals set during this stage typically include reducing pain, improving range of motion, restoring strength and stability, and returning to functional activities. These goals should be centred around your joy and provide a clear direction for your recovery.
Treatment options may involve a combination of evidence-based interventions, including therapeutic exercises, manual therapy techniques, and education regarding self-management strategies.
Active Rehabilitation and Therapeutic Exercises
Active rehabilitation through therapeutic exercises is a cornerstone of physiotherapy for rotator cuff tendon injuries including a tear of the rotator cuff. These exercises aim to restore strength, flexibility, and stability in the shoulder joint, promote tissue healing, and return to activities of daily living.
The rotator cuff is a group of four muscles and tendons that hold the humerus (upper arm bone) centred in the joint; working together to provide stability while you move the shoulder. Injuries to the tendons and muscles of the rotator cuff are common shoulder complaints, however partial or complete tears are relatively uncommon with a rate of 4% in patients under 50. This increases to 25% over the age of 60. When one suffers partial-thickness tears, full-thickness tear or a complete rotator cuff tear your physiotherapist will guide you through a series of exercises tailored to your specific goals and present limitations. Whether a partial or complete tear, this group of muscles and tendons responds quite favourably to progressive exercise. Initially, the focus may be on pain management, gentle range of motion exercises, and scapular (shoulder blade) stabilization. As your condition progresses, the exercises will gradually advance to include strengthening exercises targeting the rotator cuff muscles and the surrounding shoulder girdle muscles.
Therapeutic exercises for shoulder injuries may include external and internal rotation exercises, shoulder abduction and adduction exercises, scapular retraction exercises, and shoulder stabilization exercises. As you improve, these can progress to compound lifts such as: the bench press, overhead press, power clean and pull-ups. The physiotherapist will provide detailed instructions on the correct technique, frequency, and intensity of each exercise. They will also monitor your progress, provide feedback, and modify the exercises as needed to ensure ongoing improvement.
Research consistently supports the effectiveness of therapeutic exercises in the management of rotator cuff tears. A systematic review published in the Journal of Orthopaedic & Sports Physical Therapy concluded that exercise-based interventions, including specific rotator cuff exercises, can lead to improved pain, function, and strength in individuals with rotator cuff tears.
Manual Therapy Techniques
Manual therapy techniques are an integral part of physiotherapy for shoulder pain, post rotator cuff surgery or in the acute stages of a torn rotator cuff. These techniques aim to reduce pain, improve joint mobility, and optimize tissue healing.
Our Victoria based physiotherapists may employ various manual therapy techniques, including:
- Soft tissue mobilization: This technique involves applying pressure and gentle movements to the soft tissues around the shoulder, such as muscles, tendons, and ligaments, to reduce muscle tension, alleviate pain, and improve tissue flexibility.
- Joint mobilization: This technique focuses on restoring normal joint mechanics and mobility by applying controlled movements to the shoulder joint. It can help reduce stiffness, improve range of motion, and enhance shoulder function.
- Manual stretching: The physiotherapist may move your shoulder to perform specific manual stretching techniques to target tight shoulder muscles and tendons of the rotator cuff and improve flexibility. These stretches aim to maintain or restore the optimal length-tension relationship of the muscles around the shoulder joint.
The use of manual therapy techniques should be individualized based on your specific condition, preferences, and response to treatment.
Gradual Return to Functional Activities
As you progress through the care path, your physiotherapist will guide you towards a gradual return to functional activities. This stage focuses on restoring the strength, stability, and mobility required for your specific daily and recreational activities.
Our physiotherapists at South Island Physiotherapy will design a personalized exercise program that mimics the demands of your functional activities, such as reaching, lifting, and overhead movements. This program may include sport-specific exercises, work-specific movements, and activities aimed at improving proprioception and coordination of the arm and shoulder.
Your physiotherapist will provide guidance on proper body mechanics, ergonomic modifications, and strategies to prevent re-injury. They will also emphasize the importance of ongoing self-management strategies, such as home exercises, stretching routines, and maintaining a healthy lifestyle to improve recovery time and make a full recovery without surgery.
Conclusion
Physiotherapy for rotator cuff tears involves a systematic approach tailored to your specific needs. Through initial assessment and evaluation, goal setting, active rehabilitation exercises, manual therapy techniques, and a gradual return to functional activities, physiotherapy aims to reduce pain, restore mobility, resolve shoulder weakness, and restore overall shoulder movements and function, getting you back to your best life.
It is essential to work closely with a qualified physiotherapist like the ones at South Island Physiotherapy who utilizes evidence-based practices to ensure optimal, and durable outcomes. By actively participating in your treatment plan and following the guidance of your physiotherapist, you can pave the way towards a successful and durable recovery.
Rotator Cuff Tear FAQs
What is a rotator cuff tear?
A rotator cuff tear is a tear of the rotator cuff tendon, which is a group of muscles and tendons that connect the shoulder blade to the arm bone.
What causes a rotator cuff tear?
A rotator cuff tear may be caused by injury, degeneration of the tendon due to aging, or repetitive overhead activities such as pitching or throwing. It is a common cause of shoulder pain.
What are the symptoms of a rotator cuff tear?
The symptoms of a rotator cuff tear may include pain in the shoulder, weakness in the arm, and difficulty with range of motion of the shoulder. A partial tear may not cause as much pain or weakness as a full-thickness tear.
How is a rotator cuff tear diagnosed?
A rotator cuff tear may be diagnosed through a physical exam and an MRI to confirm the diagnosis.
What are the treatment options for a rotator cuff tear?
The treatment for a rotator cuff tear may depend on the severity of the tear. Research has consistently shown that most rotator cuff injuries respond well to conservative care such as physiotherapy.
Do all rotator cuff tears need surgery?
No, not all rotator cuff tears need surgery. The majority of rotator cuff injuries have been shown to improve through conservative management such as physiotherapy.
How long does it take to recover from a rotator cuff injury
The timelines for recovering from a rotator cuff injury are specific to the individual. Following an initial assessment, your physiotherapist should be able to provide you with an expected timeline for healing and recovery.
by Jason Nenzel | May 5, 2023 | news
From Shoulder Tendinopathy to Achilles Tendinopathy: What You Need to Know
Tendon pain and injury can be a confusing topic, particularly when you’re the one suffering. With various ‘quick fix’ options being advertised, as well as online fitness gurus proclaiming one approach over another, we find that patients are often left perplexed. This blog post is meant to simplify the complex topic of tendon pain, injury, and rehabilitation.
So what is a tendon? Simply put, a tendon is the structure that attaches your muscle to bone. It helps to transmit force produced by your muscle(s), to your bone(s), so that you can move. Dig a little deeper and you’ll find that tendons are composed of type 1 collagen and proteoglycan, which enable them to store and release energy, stretch, and adapt to stress.
What is Tendinopathy?
Tendinopathy is a fancy five-syllable word we use to define tendon pain and/or injury. It occurs when the tendon is exposed to an unfamiliar amount of activity without being given an appropriate amount of time to adapt or due to sudden compression (a hard fall). When one or both of these situations arise, the tendon will communicate its displeasure through the medium of pain and perhaps swelling.
What are the Different Tendon Conditions?
Though tendinopathy is a broad term used to define tendon pain and/or injury, we do have more specific categorizations for determining the severity of tendon injury. These categories help to make sense of terms like tendonitis, tendinosis, tendon pathology and degeneration, and other materials focused on tendon healing. These include having a normal tendon, reactive tendon, tendon in dysrepair, and degenerative tendon. To determine what stage of tendinopathy you might be suffering from, continue reading.
Normal Tendon
A normal tendon is optimal. It has been given enough time to adapt to a given training volume or level of physical activity. It has upregulated its ability to store and release energy so that you can engage in the activities you love. We all want normal tendons. They aren’t at risk for injury, inflammation or tendon rupture.
Reaction Tendon
A reactive tendon is the first step in developing acute tendon-related pain. It’s usually a product of abrupt overload but can also occur due to sudden compression (i.e., falling on your knee or elbow). The tendon experiences a non-inflammatory cell response and an increase in water content. There is a short-term adaption which thickens and stiffens the tendon to reduce stress or protect the tendon from further irritation. You’ll likely experience pain and a restriction in pain-free movements.
Tendon in Dysrepair
A tendon in dysrepair is another step away from having a normal tendon. It’s usually a product of chronic tendon overload. This is common in endurance athletes that suffer through training blocks despite having received multiple signals from their tendon(s) to reduce training volume. A tendon in dysrepair has attempted to heal, but the demands placed on it have interrupted the tendon repair process. During this phase, there is tendon tissue matrix breakdown, collagen separation/ disorganization, and possible vascular and neuronal ingrowth (things we don’t want to happen). At this point, the tendon may appear swollen and thick. It will be painful and limiting.
Degenerative Tendon
A degenerative tendon is the final stage of tendinopathy. It’s characterized by the progression of collagen matrix breakdown and intracellular changes (more of what we don’t want to happen). At this stage, cell death has occurred within the tendon and there’s an increased risk of rupture (try not to YouTube achilles tendon or patellar tendon rupture). Those with a degenerative tendon usually have a history of repeated bouts of tendon pain that reduces along with load management (slowing down from the activities that cause pain). Though this might provide intermittent relief, it’s not an optimal approach for the treatment or management of tendinopathy.
So what do we do about tendinopathy (particularly during the later stages)? First, it’s important to know that regardless of your stage of tendon injury, you can always progress towards having a normal tendon. Second, you want to make sure that you’re progressing into activities gradually. Enthusiasm is great, but we want to avoid overuse injury. Third, if you’re experiencing tendon related pain or injury, you should contact an experienced healthcare practitioner. At South Island Physiotherapy, our team of Physical Therapists, Massage Therapists, and Kinesiologists specialize in the treatment of tendinopathy or tendinopathies.
Tendinopathy FAQs
Where does tendinopathy occur?
Tendinopathy can occur in various parts of the body where tendons attach muscles to bones, such as the shoulders, elbows, wrists, hips, knees, and ankles. Examples include rotator cuff tendinopathy, tennis elbow, golfer’s elbow, achilles tendinopathy, patellar tendinopathy, gluteal tendinopathy, and so many more.
Can tendinopathy be permanent?
Yes, tendinopathy can be permanent if it is not properly treated or if it has been present for a long time. Chronic tendinopathy can lead to degenerative changes in the tendon and result in permanent damage. However, with appropriate management, such as rest, physical therapy, and medication, it is possible to improve symptoms and reduce the risk of long-term damage.
How to prevent tendinopathy?
1. Gradual Progression: Gradually increase your exercise program or activity level at a slow and steady pace.
- Proper Equipment and Form: Make sure that you use the proper equipment, including shoes, and maintain proper form while exercising.
- Warm-up and Cool-down: Always perform a proper warm-up and cool-down before and after any activity or exercise.
- Rest and Recovery: Take adequate rest and recovery time between workouts to allow your body to recover fully.
- Proper Nutrition: Ensure that you maintain a balanced and healthy diet, including sufficient amounts of vitamins and minerals.
- Adapt to Age: Adapting your activity/program to your age is very essential.
- Strength Training: Engage in strength training programs to build up your muscles and tendons.
- Appropriate Exercises: Choose exercises that are appropriate for your fitness level, age, and overall health.
- Seek medical advice: If you have pain or discomfort in your tendons, seek medical advice to prevent further injury.
If you’re suffering from tendon pain or injury, don’t let the confusion and conflicting advice leave you feeling helpless. Take control of your recovery by understanding tendinopathy and the treatment options available to you. At South Island Physiotherapy, our team of experienced healthcare practitioners specialize in the treatment of tendinopathy. Contact us today to learn more about how we can help you progress towards having a normal tendon and get back to doing the activities you love. Feel free to book an appointment online or you can find us here.
by Jason Nenzel | Apr 19, 2023 | news
What You Need to Know About Shoulder Impingement Syndrome
Shoulder impingement syndrome is one of the most common complaints we see in the clinic. It’s also one of the most misunderstood by patients. Impingement suggests that something is pinching, and it is commonly explained this way. This may be true in some cases but we need to ask a bigger question:
Why is the tendon pinching in the first place and how relevant is this?
If we look at the condition as a symptom rather than a cause, it opens up a myriad of possibilities for treatment that may produce more durable results. So without further ado, let’s have a look at 3 categories of shoulder dysfunction, how shoulder impingement may manifest in each, and how to begin the process of recovering from the shoulder pain.
3 Types of Shoulder Pain
- The Stiff and Painful Shoulder
Limited shoulder motion due to joint changes causes a stiff and painful shoulder. Physical examination will often show the shoulder’s inability to move freely and fully; both by the patient and the therapist. This inability to fully move the shoulder is often found with conditions like Frozen Shoulder (Adhesive Capsulitis) or Osteoarthritis.Both types of shoulder conditions create changes in the joint and tissues that can limit the range of the shoulder joint and consequently cause the scapula (shoulder blade) to rotate early. Over time, this inefficient arm movement can irritate structures in the shoulder (like a tendon or bursa), which can cause pain.To treat the cause of shoulder pain in this category of conditions, our focus is to improve the quality of shoulder mobility and use exercises to strengthen the supporting muscles.In the long term addressing the underlying causes of disease states like arthritis should be of interest for injury reduction….. but that’s a post for another time.
- The Weak and Painful Shoulder
This category of shoulder pain is the broadest. It includes everything from rotator cuff injuries (which is a broad category in itself) to bursitis, ligament sprains or any other trauma that may reduce the shoulder’s ability to produce or tolerate force. In this presentation of shoulder impingement, physical exam often reveals that full passive movement can be achieved, but active cannot.Your physiotherapist will perform specific testing for shoulder function to target exercise strategies and customize pain relief efforts. The structural diagnosis doesn’t have a significant effect on the treatment plan in this category unless surgical intervention is a possibility. People with shoulder impingement in this category do best with a focus on pain relief followed by a customized and progressive exercise strategy.One of the most important indications of impingement is the “Cuff Strength Ratio,” used to assess the relative strength of the rotator cuff muscles. Cuff strength needs to be 1:1 internal to external rotation, meaning the patient must have equal parts strength in these ranges of movement. If not, the shoulder cannot centre in the joint properly which can cause mechanical compression in the subacromial region (the area underneath the acromion), and shoulder impingement occurs. Dedicated retraining exercises to resolve this deficit can greatly improve persistent symptoms.
- The Unstable and Painful Shoulder
This injury carries the most trauma but isn’t necessarily the most complicated. Injuries in this category are represented by shoulder dislocations, subluxations or anatomical anomalies that may present a higher risk for instability of the shoulder. Common symptoms with these types of injuries often include fear, pain, and a sense of instability that can lead to guarding behaviours which manifest as impingement syndrome of the shoulder.The clinical term for this is “scapular dyskinesia,” which means abnormal movement or positioning of the shoulder blade during movement. It presents as shoulder shrugging and lifting the upper arm to achieve the desired motion. Unfortunately, this movement pattern can cause irritation to a rotator cuff tendon and create pain in the shoulder. The treatment for shoulder impingement here is to restore confidence in movement through gentle exercises to explore ranges of motion, followed by progressive strengthening exercises to get the shoulder more stable in its socket.Shoulders are one of the most common injuries we see in our line of work, and understandably so. They are the most mobile joint in the body, and tendons of the rotator cuff undergo many forms of stress. They need to be prepared to meet the demands of their life and although the injury process is complicated, the treatment plan doesn’t have to be!
Shoulder Impingement Syndrome FAQs
Does shoulder impingement go away on its own?
It is possible for shoulder impingement to go away on its own, but it depends on the severity and cause of the impingement. In many cases, reducing or modifying irritable activities for a period of time then strategically re-introducing them can help resolve symptoms. In rare cases, impingement symptoms may need further medical support and a physical therapist is perfectly equipped to help determine if this is required.
Does shoulder impingement require surgery?
It is rare for shoulder impingement to require surgery. Treatment options for shoulder impingement can include activity modification, physical therapy, anti-inflammatory medications, and corticosteroid injections. In some cases where conservative treatment does not improve symptoms, surgery may be indicated but this is a last resort. The decision to have surgery will depend on the severity of the impingement and the individual patient’s needs and goals.
Will shoulder impingement show on MRI?
Shoulder impingement does not show up on an MRI as it is the consequence of movement. MRIs take pictures while the patient is still. MRIs can visualize soft tissues such as tendons, muscles, and ligaments and can detect potential abnormalities in these structures that may influence impingement. Having said that, MRIs do now show pain and the findings must be taken into account with patient experience to determine their relevance. A clinical exam by a physical therapist is usually the first step in diagnosing shoulder impingement, and an MRI may be ordered to confirm or further evaluate the diagnosis.
We hope you have gained a better understanding of shoulder impingement syndrome and how it can be effectively managed. At South Island Physio, we offer a wide range of treatment options for shoulder impingement syndrome, including physical therapy, manual therapy, Shockwave Therapy, IMS/dry needling and exercise programs tailored to your specific needs. If you are experiencing shoulder pain or discomfort, we encourage you to book an appointment with one of our experienced therapists today. Our team is here to help you get back to doing the things you love, pain-free.
Your best days are ahead of you! Make your move and let’s get your shoulder serving you and your joy!
by Jason Nenzel | Mar 9, 2023 | news
Top Five Reasons To Visit A Physical Therapist:
We’ve been in this game for a long time and one of the questions we often ask patients is, “how would you describe physio to a friend?” The responses often range from an “I don’t actually know” to a “ you’ll show me some exercises and perform some treatments to fix me.” At first, these responses were surprising and confusing as you wouldn’t invest your time and money into something you didn’t fully understand. You wouldn’t go buy a car without knowing how to drive and you shouldn’t place your trust in a professional without understanding the nature of how they can help. So let’s take a moment and briefly go over the top 5 reasons to visit a physical therapist.
1. Recovery is taking longer than you expected
Most musculoskeletal conditions that are minor and don’t require guiding the body back to full recovery take around 2-4 weeks depending on severity. If your injury is lasting longer than these timelines then getting an opinion or assistance to guide the recovery process back to thoughtless, careless, fearless movement may be indicated.
2. Your recovery requires a targeted adaptive outcome
There are many benefits to physiotherapy but one of our favourites is manipulating the body through adaptive stress to achieve a desired outcome. The body can produce 9 total adaptions to a well dosed physical stress. These outcomes include: strength, flexibility, power, skill acquisition to name a few. Knowing which one to target can be essential for both performance and injury reduction as you make your way through your recovery.
3. You find your pain experience is unpredictable or unmanageable
Pain is confusing. Sometimes we don’t understand why we have it, where it came from and how to get ride of it. Our job is to teach and guide you through this relationship with both hands on care and education so that pain becomes more of a teacher rather than a disciplinarian.
4. Your own effort results in re-injury or re-aggravation
In our experience there are two types of patients who struggle with recovery. Those who fear and avoid pain and those who disrespect it. To put it another way, we all operate the most complicated piece of technology to ever exist on this earth (the human body). Let us help you read the user’s manual.
5. You want to move forward in your recovery but you’re unsure of how to do it safely
One of the primary reasons people seek our help is because they lack structure. They know where they are, they know where they want to go, but creating an actionable plan to get there safely and successfully can sometimes feel out of reach. An initial assessment is designed for this purpose. Come equipped with your biggest dreams and a curious mind and watch what physio can do for you! If you’re looking for physiotherapy in Victoria, you can book an appointment with our team online here.
by Jason Nenzel | Dec 20, 2022 | news
Osteoarthritis Myths
At South Island Physiotherapy, we educate patients regarding Osteoarthritis every single day. Over the past 11 years two things have become clear: 1. Osteoarthritis scares the heck out of people and 2. It is often highly misunderstood and/or carelessly diagnosed. The following post is meant to dispel some of the most common Osteoarthritis (OA) myths and misconceptions we see around this complicated condition. If you’re looking for a physiotherapist that specializes in the management of OA – book here.
Myth #1: OA is a consequence of getting older
This is a particularly pernicious myth influenced by joint changes reflected in the findings of medical images (X-ray, MRI, CT scan, etc). Though the changes are real, they are often influenced by a combination of the aging process and lifestyle behaviours. Research has determined that there is not a strong relationship between these findings and OA symptoms. For example, some people have medical images revealing a lot of joint change, but they experience very few symptoms. This myth buster is a reminder that you aren’t your medical image. Ready to improve the health of your joints? Book with one of our Physiotherapists that specialize in the management of OA.
Myth #2: OA is the result of “wear and tear” on the joint(s)
This myth is so common that it’s found what appears to be a permanent home in our vernacular. We find that this myth results in people restricting their participation in the activities they love in order to avoid ‘wear and tear’. It’s important for everyone to know that OA is not caused by a joint ‘wearing out’. OA is an inflammatory disease that interferes with how the cartilage in your joint(s) repairs itself. OA is not inevitable and not everyone will develop it as they age. So go ahead, participate in the things you love. Make sure to do so progressively and consistently with the help of a Registered Physiotherapist.
Myth #3: Exercise will damage my joint(s) further
This myth is related to the idea that joints suffer ‘wear and tear’. When is comes to the notion that exercise will advance OA, it’s important to know that the opposite is true. Exercise and general movement are the best defence against OA. Exercise avoidance results in stiff, deconditioned joints. Engaging in progressive, consistent exercise keeps joints lubricated, mobile, and resilient. Be safe and find a Physiotherapist specialized in the management of OA.
Myth #4: Pain during exercise means I’m causing damage to my joint(s)
Ironically, this myth results in activity avoidance, deconditioning, and the progression of OA. Though the pain experience is complicated, we do know that it is independent from tissue health. This means that pain is not directly related to the structural changes of your joint. Pain is influenced by stress, sleep quality, dietary fluctuations, and a host of other variables independent from the structure of your joint. Experiencing joint related pain? Our Registered Physiotherapist’s can help you navigate pain and injury.
Myth #5: My OA is doomed to get worse
This myth results in people feeling defeated by their diagnosis of OA. There are plenty of positive, active things you can do to help with the pain associated with OA. Strength training, balance exercise, walking, and progressive exercise can stimulate tissue adaption. This can result in better lubricated, more mobile, and resilient joints. Interested in creating a more resilient joint? Find a Physiotherapist that specializes in the management of OA.
So there you have it – OA is a complicated, misunderstood disease that often limits and restricts the lives of those with a diagnosis. This blog post is meant to dispel some common Osteoarthritis myths so that you can move towards the things you love with a bit more assurance. South Island Physiotherapy is here to help those with OA navigate the process of creating healthier, more resilient joints.
Make your move.
by Jason Nenzel | Dec 1, 2022 | news
10 Back Pain Secrets
Have you ever wondered what causes Back Pain (BP)? It’s a big topic and there are plenty of opinions enjoying mass circulation. For instance, you might have heard about slipped discs, pinched nerves, wear and tear, misalignment, and postural dysfunction. Perhaps you’ve been informed that the back is particularly susceptible to injury and you should avoid using or lifting with it. In either case, the word on the street seems to be that there’s something unique about our backs.
But is this true? Is our back somehow separate and different from the other tissues and joints of our body? If it’s not, then why is BP a leading cause of global disability? This blog post is meant to share with you 10 Back Pain secrets that are supported by research. These facts can help us better understand the phenomenon that is BP.
Fact #1: Persistent back pain can be scary, but it’s rarely dangerous
Persistent BP can be distressing and disabling, but it’s rarely serious and you’re likely to recover with the right approach to physical rehabilitation.
Fact #2: Getting older is not a cause of low back pain
Although this is a widely accepted concern and belief, research does not support the idea that age causes BP. Evidence-based physical therapy can help at any age.
Fact #3: Persistent back pain is rarely associated with serious tissue damage
Backs are strong and resilient. If you’ve experienced an injury, tissue healing occurs within three months. Pain persisting beyond this time frame is likely influenced by other contributing factors. These include sleep quality, stress levels, activity levels, and diet (just to name a few).
Fact #4: Scans rarely show the cause of back pain
Plenty of scary-sounding things can be found on medical scans. These include disc bulges, protrusions, degeneration, arthritis, etc. Interestingly enough, research shows that these findings are common in people without BP or injury. Therefore, medical scans are only helpful in a minority of cases.
Fact #5: Pain with exercise and movement doesn’t mean you are doing harm
When pain becomes persistent, the spine and surrounding structures can become sensitive to movement. It’s likely that the pain you’re feeling during activity is a reflection of how sensitive these structures have become – not how damaged they are. Therefore, it’s normal to feel some degree of pain or discomfort as we participate in physical rehabilitation. Your Physical Therapist will place structure around your recovery to ensure that you’re stimulating tissue adaption through appropriate challenge and that pain will reduce in a timely manner.
Fact # 6: Back pain is not caused by poor posture
How we sit, stand, and bend does not cause BP, though too much of any one thing can lead to discomfort. Your spine is meant to move and you should allow it to enjoy a variety of positions throughout your day.
Fact #7: Back pain is not caused by a ‘weak core’
Weak core muscles do not cause BP. In fact, individuals with BP often clench their core muscles as a protective response, which can exacerbate the situation. Imagine clenching your fist. The first two minutes are fine, but eight hours later you’re moaning in agony.
Fact #8: Backs do not wear out with everyday bending and loading
The same way lifting weights makes muscles stronger, moving and loading the spine makes it more resilient and healthy. Activities like lifting, running, twisting, and bending are safe so long as you progress gradually and practice regularly.
Fact #9: Pain flare-ups don’t mean you’re damaging yourself
While pain flare-ups can be disabling and scary, they are not often related to tissue damage. Common triggers include poor sleep, stress, tension, dietary fluctuations, and inactivity. Controlling these variables can reduce the likelihood of pain flare-ups. When they do happen try to relax, stay calm, and keep moving.
Fact # 10: Injections, surgery, and strong drugs aren’t a cure
Spine injections, surgery, and strong medications aren’t very effective for persistent BP in the long term. They also come with risks and side effects. A strong physical rehabilitation protocol involving activity pacing, progressive exercise, and pain management techniques is the safest and most effective way to recover from BP.
So there you have it. Your back is stronger, healthier, and more resilient than often advertised. It’s meant to lift, bend, twist, and move! If you’re struggling with BP, we recommend finding a Physical Therapist that inspires hope, provides challenge, and offers guidance along the way. We ought to acknowledge Peter O’Sullivan for dedicating his time and energy towards debunking common misconceptions about BP. Without his work the 10 secrets that you just read wouldn’t exist. We also want to acknowledge Dr. Stuart McGill who has dedicated his career towards understanding spinal injury. Though biomechanics is on the ebb, his contributions to the field shouldn’t go unnoticed.
If you’re suffering from BP, we have a a number of Physical Therapist that can help through evidence-based care. Book here.
