Baltimore - Reduce Lower Back Pain Today
Hi, this is James with Pioneer PT. Day in and day out I get asked about lower back pain. It is the most common thing that people get. About 80% of people get debilitating lower back pain at least once in their lives. So, I wanted to come out with a video to show a few of the easiest exercises that people can start with. These are universal and most anyone with lower back pain can benefit from these. One of the hardest ones to teach is called a pelvic tilt. I want to go into more detail on that first.
While lying on your back, I want you to pull your pelvis up. I want you to think about pulling your belly button up and in and flattening your back to the bed. Think about your tailbone, your tailbone should be dropping towards your feet while your belly button pulls up. If you want feedback, with your hands wrapped around your hips; when you tighten up pulling your belly button up and in you should feel the abdominal muscles right underneath your fingers become tense. Hold this one for a good 10 second count and get at least 10 of those to help strengthen your core.
Next one, a nice easy stretch you can do is called a lower trunk rotation. Stretch from side to side, nice and easy, helping to gap the lower back. Get a good hold as you go side to side (10-30 seconds)
Lastly, I would recommend a piriformis stretch, to stretch out those tight glutes. With your ankle resting on your opposite knee, grab your knee (closest to the joint), and pull up and across getting a good stretch through your glutes. If you prefer more of an intense stretch, you can grab under your opposite leg and pull up. This will also target down on the glute. in the piriformis. Try to hold a good 30 seconds to a minute, and relax.
To review, the 3 universal exercises you can do for lower back pain include, pelvic tilts, lower trunk rotations, and piriformis stretching. If you have any severe aches or pains, especially burning, tingling, or numbness increasing, please contact your physical therapist. Take care, and best of luck!
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For most distance runners foot strike is irrelevant to performance (1). Naturally foot strike occurs through a continuum, depending on speed. Sprinters benefit from forefoot running to maintain explosive quick movements. Frequent short strides are taken to get moving quicker and propel forward faster. However, healthy long distance runners show no clear benefit from the type of initial contact, and most runners have a rear foot strike (1). It is normal to have a heel strike as stride length increases.
When would mid-forefoot strike be beneficial? One study suggests that a 6:25 pace per mile is the transition point where mid/forefoot striking may be more efficient (2). However, this may be best for elite runners that choose a mid foot initial contact and are biomechanically sound. The majority of long distance runners chose heel strike, and it is not necessarily wrong (3). As with any type of training it is not recommended to suddenly increase or change training habits. Changing habits too quickly can result in injury.
Force with each running style is almost identical, however it is spread differently to the body. Forefoot runners absorb more vertical force in their foot and ankle, while heel strike runners absorb more force up the chain specifically in their knees (4).
In a 2017 study, Hamill suggests that changing style of contact is not beneficial for most runners, as it can result in injury, however changing style of running may be beneficial for some (1).
Chronic lower extremity pain including achilles tendonitis, plantar fasciitis, and patellofemoral pain may be taken into consideration. Runners with chronic anterior knee pain and clicking at the patellofemoral joint may benefit from slowly transitioning to more of a mid foot style running to decrease knee joint forces. This should be done gradually. Other biomechanics should be considered as well, such as achilles flexibility and arch type. Decreased ankle dorsiflexion and high arches may result in achilles tendonitis, plantar fasciitis, or metatarsal stress fractures, especially if the transition occurs too quickly. Individuals with high arches may also be succeptible to ankle sprains with this running style. On the other hand if you are an elite runner who typically runs with mid foot strike, transition towards heel strike may be beneficial if you are struggling with achilles tendonitis.
Bottom line, for most, heel strike running is sufficient. However, the above considerations may be beneficial with certain conditions. It is best to consult with a professional to help answer these questions as everyone is unique and if your body is in pain, it is telling you to back off.
1.) Hamill J, Allison G. Is changing foot strike pattern beneficial to runners. Journal of Sprite and Health Science. Vol. 6, issue 2, June 2017, Pages 146-153
2.) Ogueta-Alday A, Rodriguez-Marroyo JA, Garcia-Lopez J. Rearfoot Striking Runners Are More Economical than Midfoot Strikers. Med Sci-Fi Sports Exerc. 2013 Aug 30
3.) M.O. de Almeida, B.T. Saragiotto, T.P. Yamato, A.D. Lopes. Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners? Phys Ther Sport, 16 (2015), pp. 29-33
4.) Hamill J, Allison H. Derrick G, et al. Lower extremity joint stiffness characteristics during running with different footfall patterns. European J Sports Sci. Oct 15, 2012.
Hey Baltimore this is James with Pioneer PT. I wanted to talk with you guys about walking on the ice. We have some slippery conditions coming this evening. Unfortunately we are in the area of the country where we are at the rain, snow, sleet line. You have to be careful when you are out and about walking in the winter.
When you are walking on the ice, first thing I would recommend is some good shoes. Good shoes with good tread, with nice raised bumps on the bottom of the shoe is ideal. With a flat soled shoe you will end up slipping and falling. As for body mechanics there are quite a few things you can do. First off, you want to think about widening your base of support a little bit more than usual when you are walking, that way you are wider and more stable. Also, when you are walking, try not to land with your heel. If you land with your heel first, you tend to slip back and fall on your rear. Instead, I recommend landing flat footed or slightly towards your toe first. That way you are landing soft and you are not going to tend to slip backwards. So wide base of support, land with a flat foot, and lower your center of gravity by bending your knees and hips bringing you closer to the ground. You are a little bit more stable. You can also use your arms a little bit wider to maintain nice center of gravity. So you are walking a little bit more gingerly on the ice. Be careful out there, enjoy the winter, and take care!
James Dulkerian, DPT
Active outdoorsman with an honest soul and a passion for health.