PAIN RELIEF AND ACTIVE FOR LIFE
An active approach focusing on the cause of the problems, not just the symptoms
Wonder about acupuncture and meridians? The scientific basis of acupuncture meridians by Dr. Alejandro Elorriaga Claraco...learned so much from this guy.
I remember the most intense athlete I ever tested in a maximal oxygen consumption test (VO2 max).
The year was 1996 and I was the Strength and Conditioning Consultant at Memorial University of Newfoundland. The athlete was a cyclist for the 1997 Newfoundland and Labrador Canada Games Team. That year I think we tested most of the Canada Games athletes from Newfoundland and Labrador. But this guy stood out.
So what made this guy stand out? His intensity. You could see it in his eyes. This guy got on the treadmill (yeah we tested these guys running instead of cycling but that's another story) and he killed it. He ran so hard that he literally went off the back of the treadmill. His coach caught him and I caught the $10,000 piece of equipment attached to his face. In the end he put out a VO2 max of over 80! That's over double the average Jane or Joe on the street.
In case you're wondering, a VO2 max test is performed by gradually making you work harder on a piece of equipment like a bike or treadmill while a mask and hose are on your face and collecting the gas that's going in and out of your mouth. The information from the test can be used as a measure of your cardiorespiratory fitness. Along with this it offers other interesting information that can be helpful in developing a "cardio" fitness program, which leads me this interesting study and why the results may be of interest to you if you're interested in improving your "cardio".
If you're investing time in training then it only makes sense that you want to see results right? I bet you also expect that if you do the work then you will see the results right? Not so it seems. The study mentioned above compared 2 groups of participants over a 12 week period. Both groups performed 150 minutes of "cardio" spread over 5 days a week (5 x 30 min.). However, Group 1 was given a workout program based on a heart rate formula (something like the 220-age formula) while the other group was given an individualized program based on the results of their VO2 max test. Want to know what happened?
Both groups improved their VO2 max. However, when the data was analyzed only 41% of Group 1 who followed the HR formula actually improved their results. In fact, some of the participants actually regressed! On the other hand, 100% of the participants in Group 2 who followed the individualized programs improved their VO2 max or "cardio" fitness!
The moral of the story here is that if you want to see results then you must individualize your training program based on you and not some formula. I've tested so many people over the years and very rarely do I see that the formulas actually match the person in front of me.
P.S. Another important take away from this story is to find a way to actually measure what it is that you're training to improve. I have seen many people that continue to train whether it's for health, a sport like running or even something like Crossfit group classes and they fail to improve their fitness because they don't measure or individualize their training needs.
P.S.S If you enjoyed the information in this post, I'm putting together a free little video to explain energy systems development (ESD) and how you can use this information to guide your training. If you're interested drop me a line at firstname.lastname@example.org and you'll be the first to know when it's ready.
Here's a summary of a review completed in 2006 of what was recommended for the relief of chronic low back pain and what was not recommended.
How does this compare to what provides you with relief? Do you find that you get relief from something on the not recommended list? What do you think of the list? I was surprised to see massage on the list as a number of people report relief from massage.
From another point of view, how does this compare to your experience with your health care provider? Does he or she use more from the recommended or not recommended list? This list is over 10 years old now, which means that the evidence has been available for some time and it generally has not changed. Unfortunately, a limitation of this review and other research on low back pain is the label of "non-specific" back pain but I'll comment on that at another time.
The following were not recommended for the treatment of chronic low back pain:
* We can now also add taping to that list.
So what was recommended? The following therapies were recommended for the treatment of chronic low back pain:
Airaksinen O et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;15 (Suppl. 2):192–300
So would you like to know if you're doing the best core exercise for you? Well you're in luck. In this post I'll review 4 core exercises and tell you what one gives the most bang for your buck. I'll also tell you what exercise has the highest cost on the spine in terms of health and give you some tips on how to go about choosing the best exercise for you. Hint: it isn't just about the exercise with the most muscle activity!
Why are folks still taping as a modality for the treatment of back pain or any pain for that matter? This systematic review is one many that demonstrates that taping doesn't provide a significant change or relief for any pain related condition. It's not said this finding is new or that there is some question of its efficacy. There are a lot of studies that pretty much say the same thing; taping is ineffective for the relief of back pain (or other pains).
What about muscle endurance? As I mentioned in this post, muscle endurance tends to be more protective of back pain than strength. So does taping result in greater muscle endurance? Again, the answer seems to be no; it does not result in greater muscle endurance.
So if you're thinking about taping or your therapist decides to use it, I would reconsider. You might even want to ask your therapist why they are using it given that it probably won't help you.
Nope, not according to the scientific research although you would never know it based on the number of articles written in the media on the need to strengthen your back or core to recover from back pain. Truth be told it seems to be a bit of a myth. How so you ask? Here are a few thoughts with a summary at the end.
Do you have back pain? If the answer is yes, then no, don't bother trying to get a flexible back. If the answer is no, then no don't bother stretching or doing silly exercises in an attempt to gain more range of motion. There appears to be no benefit to having a greater range of motion or flexibility of the trunk. There is some evidence to suggest that having less range of motion is actually more protective of back pain. So what's a guy or gal to do?
Seek good flexibility in your hips. The hip is a ball and socket joint and, therefore, by design has the capacity for a lot of range of motion.
There are many ways to train flexibility including stretching via contract/relax or holding positions for 30-120 sec, mobilizations or even core stability exercise. Yes even core stability exercises! A study a few years back found that people gained range of motion in the hip muscles by strengthening the core. I consistently see this using Redcord in practice.
Another thought - the knee to chest stretch for back pain - it may irritate a sensitive back as well depending on the particular type of sensitivity. People with flexion intolerance will not tolerate this stretch well.
- back pain? identify the postures, loads and motions that irritate your back
- greater range of motion is of no benefit to back pain or prevention
- core strengthening helps increase range of motion in the hips
What's your favourite activity for fitness? I love exercising outside this time of year.
Yesterday I did a short aerobic workout on the deck
3 sets of:
10 box jumps, 30-in. box
10 kettlebell swings, 36 kg
10 Redcord prone hip flexion
10 wall-ball shots, 30-lb. ball
Rest b/w each set same as work interval
Goal - same pace each set
Yes, energy system work can be done through gymnastics and weight training exercises.
I came up short on this one. Went out to hard. Learning pacing with mixed modal work. Looking forward to it!
Well it depends. In this study by Mcgill and Marshall they found reasonably low compression forces on the spine but higher shear forces at the last couple of lumbar vertebrae.
Compression forces are sort of like 2 vertebrae squeezing or pushing down upon one another. High compression forces are a risk factor for spinal fractures for folks living with conditions like osteoporosis. A common exercise with high compression forces is the sit-up (it can also irritate a spine that's sensitive to flexion).
As opposed to compression forces squeezing 2 vertebrae together, shearing forces are where one vertebra slides on top of the other. Spondylolisthesis is a low back condition often sensitive to shearing forces.
So in reference to the original question, kettlebell swings can be ok for people who may be sensitive to compressive forces but painful to those who may experience sensitivity to shear forces. On the other, you may be sensitive to spine flexion, in which case, I would ensure that you have the ability to hip hinge prior to initiating the kettlebell swing. The ability to hip hinge means that you can bend from the hip as opposed to flexing through the low back. This is important given that the way we move often changes in response to low back and generally requires some retraining if you wish to load that pattern (i.e. people who are sensitive to flexion frequently flex through the low back). Otherwise you will likely continue irritating the sensitive structures (nerves, disc, etc.).
Thanks for reading. Drop me a line if you require some clarification.
Q: I've been dealing with an injury (pain) now for a while and I can't seem to get back to the things I want to do. Any tips?
A: I put this question up as a broad stroke on how to get back to doing the things that you want to do. I work with a number of people that sustain injuries and are unable to do the things that they want to do whether it's running, Crossfit, lifting their grandkids, etc. When we experience pain we might try to push on for a while until it only seems to get worse and then, after no relief, remove the aggravating movements or activities with the hope that we can return to the activity later. That approach will work for acute injuries but, generally speaking, this approach leads to frustration and fails to deliver for persistent pain. Why is that?
Acute injuries are somewhat of a self-limiting thing. The pain is of an inflammatory nature directly related to a known cause (i.e.) fell down the stairs. In this case there is a relatively predictable response to the injury, which means that the painful response should resolve after a period of time and you should be able to get back to doing everything. However, in most of the cases that I'm referring to there is no direct injury and/or the pain extends beyond the predicted time frame. In these sort of cases the mechanisms are different and therefore the approach must differ as well.
So what can you do? A couple of things:
1. With persistent pain, contrary to common belief, as long as red flags are ruled out it usually doesn't mean that something is broken or damaged. It's more appropriate to think of it as being overly sensitive. With that in mind try approaching the problem from the perspective of gradually exposing the painful area to more work. This could be slowly increasing the load (weight or resistance) or range of motion (from less to more). In some cases simply thinking about moving the body or using a mirror can actually be the place to begin!
2. If there are specific ways of moving or limited range of motion address that as well. Range of motion in and of itself may not be telling but if it limits a performance objective then you're going to run into problems. For instance, if you lack the ability to bend forward to pick up your kids then you will need to address the strength or necessary range of motion. If you lack full shoulder flexion (arms overhead next to ears) and/or have a discrepancy from one side to the other then bilateral exercises like pull-ups, bench presses, barbell shoulder presses, etc are probably not on the menu. Shift the emphasis of your exercise to work on the required range of motion or strength. You could add in some stretching and foam rolling for mobility and things like planks for static shoulder stability.
3. Research in pain science informs us that pain changes the way we move and the patterns of muscle activity. Although the pain may go, the odd muscle activity and movement habits tend to hang around. In that case, introduce some low load drills that will "retrain" that movement.
I use Redcord Neurac for all of these issues as we can identify "weak links" and gradually exposure the muscles to greater load and range of motion with great results.
Have you cut back on some things because of pain or injury and struggling to get back at it? Try these things and let me know how it goes.
How this approach helps you get relief from pain
Get help with your pain or injury
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