This post on running form is going to focus on the common injuries and biomechanical faults I see clinically.  There are multiple soft tissue and muscular-related damages that result anytime you push your body – we are speaking with running specifically in this instance, but it is by no means exclusive to that activity.  I’d like to start with arguably the most commonly injured muscle group, the hamstrings.  It can be somewhat complicated, but I am going to address it as straight-forward and general as I can and give some treatment ideas to address.

Let’s go back to touch on something I spoke about in a previous post:  Body shape, alignment, and inherent structure can all be so varied and it becomes even greater in its parody when in motion.  Look at these photos of people just standing. 

Knee, foot, pelvis, and spine all come into play.  Let’s go even further, what about general body type?  We all lean toward a certain “type” although we don’t generally fall into one perfectly.  Not to focus too much on these structural differences, but they are important to point out.  It continues to shed light on my opinion and experience that there is no one running technique or form that is truly ideal, because we are not all built “ideally” for running.        

So, is it structural or mechanical?  Remember, change the things you can and minimize the negative effects of the things you can’t change. We can absolutely make changes in muscle balance/stability/control, foot wear, technique & neuromuscular control. Even things like nutrition and chemical imbalances are relevant, but beyond my expertise.  Instead, I want to discuss how muscle dysfunction can be a huge component.  When a muscle group is working less than optimally OR overexerting that muscle group can become at greater risk for injury.  Beyond that, an underperforming (over/under active) muscle may ask a different muscle group to pick up its slack – for example, the glutes (butt muscles) are chronically under-worked and the hamstrings often bear the brunt.  In this example, the glutes are underactive and the hamstrings are overactive.  VERY common in the general population, but most notable in runners.

The gluteal muscles are primary hip extensors and are incredibly powerful.  Look at any power athlete and the size of their back side!  These muscles should be the driving force behind keeping us upright and propelling us forward.  When we reach out to stride, the hamstring muscles are stretched and are forced to control landing.  After landing, often the hamstrings are used to pull the leg through.  When the gluteal muscles are not the dominant muscle group in this cycle, tissues finally reach a breaking point that can lead to “strains” and “pulls”.  The hamstring muscle group is primarily a knee flexor (it’s main use is to bend the knee).  The hamstrings are secondary hip extensors…secondary! Use your butt muscles, not your hamstrings.

Here are some exercises to focus on hip strengthening that are centered around the entire glute complex – gluteus maximus, gluteus medius, gluteus minimus:

Bridge + T-Band

This first is a bridge + a thera-band knee separation.  Put a band around both of your knees.  First, squeeze your butt by clinching.  Next, lift your butt up off the ground. Then, separate your knees against the resistance of the band.  Hold this position 2-3 seconds then lower your butt back to the ground.  Repeat this 10-15x.

Let me start by welcoming Collin Trent to this site. I have known Collin for a long time and have always recognized him to be an active individual. He has played soccer for many years, been involved in weight training, exercise and overall wellness in general. Most recently, Collin has been a very consistent runner. He has posted some great times in half and full marathons and has experimented with his running style, form, and footwear. I’d like to thank Collin for helping write this guest post and answer some of my (and your) questions. Thank you, Collin.

I’d like to know your thoughts about running in general. Have you always been a “runner”?

Indy Mini Marathon

COLLIN: Before I begin, let me say I am by no means an expert. The following is simply based on my experience and is therefore my opinion. If you like what I have to say, great. If you disagree or think I’m a fool, no problem! Trust people like Joel who day-in and day-out work with clients from all populations and also have an extensive educational background in these fields.

But, to answer your question, I’ve always had a hard time considering myself a “runner” since I never ran competitively. I’ve come to the realization, though, that it’s not about speed, time, competing with others, etc. It’s about taking those first (and not always enjoyable) steps, making the effort, improving your physical fitness and overall quality of life.

When did you start competing in races?

COLLIN: My first competitive race was the 2006 Indianapolis Mini Marathon, or simply the “Indy Mini,” the country’s largest half marathon. I have run in multiple half marathons with a personal best time of 1:24:56 and 2 full marathons, the last of which was the Carmel Marathon where I posted a time of 3:01:26. This time qualified me for the Boston Marathon.

Tell us about your running form. How has it evolved over the years?

COLLIN: Well, I’ve been exploring the idea of “improving my running form” for slightly over a year now. After posting a time of 1:27:15 in the 2010 Indy Mini, I began taking myself more seriously as a “runner.” I began to think about form and mechanics much more than I ever had. My old mantra was basically, “Go out and run for as long and as fast as you can!” While this may not be all bad, making adjustments to improve your efficiency as a runner can be helpful as well. I was asking myself questions like, “Is my stride too long? Am I wasting energy in my arm swing? Am I in the right shoes?”

What brought on this line of questioning, when you seemed to be doing pretty well running just as you were?

COLLIN: I began reading Christopher McDougall’s controversial book Born To Run. This book isn’t controversial in the sense that it’s sparked religious or political debates, but it has sparked a lot of conversations and disputes over running form, and whether or not “minimalist running” is the best for all populations.

What is “minimalist running”?

Vibram 5 Finger Shoes

COLLIN: It’s a form/style of running that’s sweeping across the running community. The goal is to run more efficiently while decreasing and/or removing the risk of injury. This is achieved through smaller strides, focus on posture, etc. The most noticeable and popular result of minimalist running has been the evolution in footware (or lack thereof). Many “minimalists” are running barefoot, with a pair of Vibram’s Five Fingers, a pair of Nike Free or any other minimalist shoes…I do have to say, that regardless of your views or opinions on running form, or just running in general, Born To Run is a great book and I highly recommend it.

So, how did you start to change your style?

COLLIN: The first attempt at improving my form included incorporating barefoot running into my workouts. I got a lot of odd looks for running while holding a pair of shoes in my hands, but I would do this for no more than 1/4 – 1/2 miles at the end of runs. I also did this on grass, not pavement.

Did it hurt to run barefoot?

COLLIN: I did experience muscle soreness in the lower part of my calves and ankles at first, but nothing severe. I think the smaller, lesser-used muscle fibers in those areas had been caused to work harder than normal, hence the soreness.

Have you ever tried “minimalist” shoes?

COLLIN: I purchased a pair of Nike Free shoes for shorter runs and also to wear when weight training. Just as running barefoot or with minimalist shoes causes you to recruit new or lesser-used muscle fibers, the same can be said for weight training exercises when you’re on your feet. Try it for yourself: do a squat, with just your bodyweight, wearing the shoes you normally wear and then do it barefoot. I think you’ll notice a difference. I will admit that I tried-on a pair of Vibram Five Fingers, but my toes just didn’t jive with the “fingers.” I couldn’t imagine walking in them, let alone running. A lot of runners and walkers are wearing them, and even some ultra-runners, so I can’t say they’re “bad” shoes. They simply weren’t for me.

Have you ever been coached in your form to help improve your technique?

COLLIN:I attended a “Good Form Running Clinic” at the Runner’s Forum in Carmel, IN. In a nutshell, these clinics focus on four components of running: Posture, Midfoot, Lean, and Cadence. In my opinion, these components are very similar to minimalist or Chi running, if not the same. I can’t say that I walked away from this clinic as the “perfect runner,” but I do feel that my efficiency as a runner improved and I’ve also experienced less injury.

What has been your experience with running injuries?

Newton Running Shoes

COLLIN: Prior to attending the previously mentioned running clinic, I experienced a dull, yet steady soreness in my right hamstring. I’m not sure if it stemmed from my soccer-playing days, but my right leg always seemed to dominate my stride, like it was working much harder than my left. What I took away from the running clinic was that by focusing on my steps-per-minute, and trying to stay in the 170-180 range, it brought balance to my stride. My legs seemed to be “sharing the load” instead of my right working harder than my left. I do experience soreness from time-to-time, but it’s not near as severe as it used to be.

With this new style or form change of sorts, did you make a footwear change? If so, how has that affected your running?

COLLIN: I switched to Newton Running Shoes. I was skeptical of these at first as I thought they were a part of the “minimalist fad.” After hearing positive, first-hand accounts from my brother-in-law, a personal trainer and excellent du-athlete, as well as his good friend who’s a tri-athlete, I thought I’d give them a try. One of the most noticeable distinctions about Newtons is the four “lugs” that run under the midfoot. These are in place to help you land on your midfoot, and not your heel, and also to help propel you forward with each step. There’s a science and technology behind the design; read-up if you have a few minutes. I took the advice from the runners (employees) at the Runner’s Forum as well as the Newton website and eased my way into the shoe.

What are your thoughts on changing form and/or footwear for other runners out there?

COLLIN: As you mentioned in your previous post, focusing and/or changing your running form could be good, or it could be bad. For me, I experienced a positive change. I implemented smaller changes in hopes that it would improve my efficiency as well as prevent or decrease the risk of injury. I could argue that the changes I made in my form allowed me to endure the heavier mileage, and therefore better race times. That’s a hypothesis, though, and I can’t necessarily prove that. If you’re looking to make improvements in your running, I would first encourage you to go to a specialty running store, have them watch or film you run, and then get fitted for proper shoes. Minimalist shoes with next-to-nothing soles may not be a great for everyone. On the other hand, the latest pair of New Balances or Mizunos with 2-inch heel cushioning may not be great for everyone either. Find the right fit for you, recommended by someone that has experience with running, not a teenager at a general sports outfitting store.

What would you recommend to the readers and other recreational or competitive runners?

COLLIN: Whatever kind of changes you do (or don’t) implement, I applaud you for getting out there and running! Whether it’s a slow jog or a tempo run, I’m a big proponent of exercising and living a healthy lifestyle! Good luck as you focus on what works best for you. Thanks for your time. Happy running!

Great stuff, Collin! Thanks for taking time to give us your insight and hopefully learn from your knowledge and experience.

Next post I will get into common running injuries, imbalances, and what you can do for yourself.

A running cadence of 85-90 strides/minute (170-180 steps/minute) has been widely accepted to be ideal for runners – This is a pretty fast pace! The reason: Less time with your foot on the ground = less slowing down of your body. Contact time on the ground creates more friction which slows you down. Once in motion, running is a perpetual action that is only hindered by foot contact time. Sounds good, right? Makes sense, right? I would argue that ideally, this makes great sense.

In practice, though the vast majority of runners (from novice to elite) are heel strikers.  If your heel hits first then more of your foot has to contact the ground which, based on the understanding above, should slow you down.  So, why would anyone heel strike, let alone the majority of runners?

Where do we go from here?

This line of statements comes from a string of thoughts based on science, or lack thereof often, as well as anecdotal evidence I’ve discovered treating orthopedics the past several years. This is where I have landed on the issue.

Here is why heel strike is bad for running (while it is ideal for walking):

• When your heel accepts the force of your body weight, your foot is rigid (locked). This translates the shock out of your foot/ankle, but usually places it up to the knee and back.
• When your foot lands in front of your body, your IT band (a band that runs from your hip down the outside of your thigh to just under your knee) becomes overactive. This can result in generalized knee pain, also known as patella-femoral syndrome as well as hip bursitis.
• Tendency for longer strides, which are not natural and often don’t work for efficiency.
• Over-striding also typically leads to the overuse of the hamstring muscles with a heel strike.

Here is why forefoot landing is bad for distance running (but ideal for sprinting):

• Overuse of calf muscles which causes significant fatigue, as well as Achilles tendon issues, and often plantar fasciitis due to poor lower leg translation over the ankle joint.
• Landing on the forefoot puts significant increased stress on significantly small bones. Look at how thick and dense your heel is compared with the bones that make up our toes. This can quickly lead to stress fracture.

So, to say one style of running is “better” is not accurate – what makes sense on paper and in an ideal person doesn’t always pan out in reality. I ascribe to following the evidence and research whenever available. Midfoot landing with running makes the most sense, but cannot be generalized. It has flaws too. Trust me, this is not going to be a popular answer, but there is NO WAY – NO WAY to address proper running form in most persons, let alone to be able to say what the best technique is for all.

The science is simply not there, and I would argue that it may never be there. Have 20 people stand in front of you barefoot and look at how varied each person’s intrinsic foot structure appears, let alone their knee and hip alignment, bone density, muscle length and strength, tissue quality, or any other physical differences…and this is just with them in a static position! Imagine how much more complex it is when they begin to run.

Heel Strike

Now, does that mean we should throw our hands in the air just say, “we all run how we naturally run, and leave it at that?” Not even close. We can all use improvement. We shouldn’t focus on what is ideal for all or most, but what is ideal for you. We, as runners have the responsibility to alter what we can change and minimize the negative effects of what we can’t change. Identifying those limitations is key.

Ah, now we’re getting into what I am passionate about. What exactly are these limitations and imbalances? We will talk about some of the most common issues I see clinically and what you can do to help identify and address them. Stay tuned to continue this discussion on running form.  Next post I will have a guest blogger, Collin Trent.  Collin is someone that I truly respect as a seasoned runner, but even more so as an informed athlete always looking into the why and how of his craft.  Make sure to check back in later to hear what he has to say.  He is a very credible source!

References:

http://www.chirunning.com/

http://www.runnersworld.com/

This very question seems to be a hot button among runners.  If there is one group of athletes who are passionate about their trade, it is runners.  Running can be a grueling task that pushes the limits of human physical abilities as well as mental capacity to overcome stress, fatigue, weather, or even pain.  Often, runners run through pain to a fault, but we can discuss that in another post!  

With all of this passion for their sport, runners are always looking for:

• A competitive edge
• A way to run further and faster
• Or just a way to keep running without breakdown or injury. 

Now, I must admit that I am not an avid runner.  In fact, I usually only run 3-5 miles at a time.  I have recently studied running more in-depth, though, and as a physical therapist I have a solid background in biomechanics.  I also have treated dozens and dozens of runners with injuries ranging from knee pain, calf/hamstring/quad strains, stress fractures, shin splints, Achilles tendon issues to even back pain…all from just running. 

So it is with confidence that I can say OF COURSE form matters.  How could it not? Form matters in virtually everything that requires physical movement – swinging a bat/tennis racket/golf club, shooting a ball, kicking a ball, throwing a ball, jumping over a hurdle…heck, even bowling.  Yes, but is there an optimal form?  No way.  If there was, every person would adopt this optimal form.  I will concede that just adopting form is a gross oversimplification.  A great deal of practice, effort and time is required to make changes in technique, but what works for one person may not be ideal for another. Think of how many different types of golf and baseball swings exist.  I do, however, sincerely think there is an optimal form for each individual…here is the kicker, though:  Your optimal form is subject to change, just as you change. 

What does that mean? Well, there has been a recent outpouring of support for teaching optimal form.  Chi Running, Pose Running and other running styles and techniques have some great foundation and solid science behind what they are promoting.  I am not writing this series of posts to agree with or refute these approaches.  I am opening up this topic because I too have some thoughts about running, form, and the body’s response to this dynamic activity. I am also very confident that you cannot improve your form if you have asymmetries in your body. 

** This is where I come in as PT.  Bringing to light imbalances in the body is crucial before you should even begin to think about changing your form. Stay tuned to a series of follow up posts that will address such things as: stride length, foot/ankle mechanics, hamstring and gluteal imbalance, and the importance of cross training.

As far as strength exercises are concerned, we all know several exercises that work our shoulders but aren’t always sure which ones are the best.  Let me start with the exercises that I think should simply be avoided.  Any heavy overhead lifts, shoulder presses, front/lateral raises, deep bench press, or upright rows.  These generally are poorly performed, done with compensatory movements, and can be compressive to underlying structures.  This is not to say they are bad exercises…there are just more important things to focus on.  Throwers need stability & endurance-focused lifts that address scapular control + rotator cuff (RTC) musculature.

Side Lying ER

Shoulder "W"

• Side Lying External Rotation (ER) – while lying on your side, rotate your hand up/backward keeping your elbow tucked into your side.  You are trying to work the muscles on the back of your shoulder. Use 2-3# to and perform 2 sets of 10.
• Shoulder “W” (ER + scapular retraction) – Using an elastic band, pull it across your chest by squeezing your shoulder blades together while keeping your elbows close to your sides, forming a “W” with your arms and back (pictured right - image from http://mikereinold.com).  Use a light resistance band and perform 2 sets of 10.
• Horizontal Shoulder Abduction (“T”) with scapular retraction – Lying on your stomach with your arm off the edge of a table, lift your arm straight up (like half of a “T”) keeping your thumb up toward the ceiling. Use 2-3# and perform 2 sets of 10.

Horizontal Abduction "T"

The reason for the focus on these 3 specific exercises is to obtain strength and stability.  Prior to attempting something as forceful and dynamic as throwing a ball, this stability is required.  Improving strength with scapular retraction and depression (squeezing shoulder blades together & down), along with rotator cuff strength and endurance, helps keep the shoulder complex stabilized.  Adequate scapular/RTC strength is needed in order to violently move your arm overhead repetitively without damaging underlying structures.  Proper mobility and good muscle stabilization are the keys to a healthy and successful baseball/softball season!

References

1. Hal Townsend, F. J. (1991). Electormyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. The American Journal of Sports Medicine , 264-271.
2. Heiler, J. (n.d.). Retrieved May 3, 2010, from Physicaltherapist.com: http://physicaltherapist.com/articles/view/id/2
3. www.MikeReinold.com

Baseball and softball season are underway, and many athletes are now repeatedly stressing their arms, likely without regard to the condition of their shoulder.  I know I used to just get out there and start throwing once it was “baseball season” again.  The problem is that there are many things that should be considered when resuming any overhead activity after a period of inactivity.  For example:

1) If the athlete has pain

2) If their range of motion is limited

3) If strength/endurance are inadequate. 

First, if the athlete is currently having shoulder pain, please get it looked at.  If not, I have some basic things to help prepare and condition anyone’s upper extremity for the demands of repetitive overhead use. This post will focus on stretching – sounds simple enough, but it is often overlooked.  The primary mistakes I see are inadequate warm-up and not holding stretches long enough.

Proper warm-up and stretch quality cannot be overemphasized.  If you are either stressing cold tissues, or not moving throughout an appropriate range your shoulder complex (and possibly neck or back) will pay for it negatively.  In order to effectively “loosen up,” it is a good idea to get your entire cardiovascular system going:  Jumping jacks, light jogging, high skips, or grapevines, for example.  Next, move to arm circles with both forward/backward as well as small/large circles.  All of this will stimulate blood flow to the muscles and allow them to contract & relax more quickly, thus reducing the risk of injury.

Now, the body is ready to be stretched.  Stretching the entire shoulder complex is important and often overlooked, specifically the posterior capsule.  The pictures below demonstrate how to properly stretch the shoulder complex:

Sleeper Stretch

Cross Arm Stretch

Corner Stretch

Hold all stretches ~30 seconds and repeat.  Without the freedom to move through the necessary range of motion, stresses from this muscular imbalance can occur and result in an injury. Once warmed-up and stretched, now you can begin light tossing at close range.  Progress to throwing harder and increasing your distance as your shoulder gets “loose”.  Again, it sounds simple but this is often the first area breakdown can occur. 

Next post I will go into a greater depth of the overhead athlete and the complexity of shoulder mechanics (don’t worry, I’ll keep it basic enough…believe me, the amount of information out there can be very overwhelming).  I will be discussing shoulder stabilizing and strengthening exercises that address the primary muscles involved in throwing, thus the ones most often damaged and overused.  There is a ton of great content about the entire shoulder complex, and I am anxious to share it with you.  I’ll keep you posted!

Piriformis Stretch

Hamstring Stretch

When you think about pain in your “hip”, it seems people often call any pain that is off to the side in a general area ”hip pain”.  Ultimately, the actual hip joint itself is not often the source of the pain.  Pain that is NOT directly on the side could be coming from your pelvis, butt, back, or leg.  We can address these concerns in another post.  Pain that IS directly on the side is typically hip bursitis.  Hip bursitis is the most common source of pain in the hip.  Overuse from running or being on your feet for a while, recent change in activity level, muscle tightness, direct pressure on the hip, or muscle imbalance are often the root cause. 

IT Band Stretch

Some early tips for addressing bursitis (that pain that is directly on the side of your upper thigh) are:

• Ice
• Rest
• Over-the-counter anti-inflammatory medicines
• Avoid running, hills, stairs, and direct pressure on that hip (i.e. sleeping/lying down on that side).

These are good ways to minimize irritation. Sometimes that is enough to get rid of the pain.  Often, more needs to be done, though.  To help free up restricted surrounding soft tissues, see the video clip below.  I made it for knee pain, but ultimately it is designed to free up the IT band which can address hip pathology too – focus on the area closer to your hip in this case, instead of lower toward your knee.  Other helpful treatment options are stretching…hamstring, piriformis, IT Band, and the quadriceps muscles.  These can all improve mobility.  The most important part of the piriformis stretch is to pull your knee to the opposite shoulder.  You feel feel this in your buttock area.  Remember to hold all stretches 20-30 seconds and repeat 2-3 times. 

I say all of this to point out how often you bend your knee. So, if you are moving poorly, you could be overstraining the knee.  I am attaching a video to show you how you can assess the quality of knee bend.  It is called the lateral step down test.  It is pretty straight forward…if you can’t step down from a 4-6 inch box without 1) letting your knee cave inward 2) dropping your pelvis or 3) putting your other leg down for balance/stability than you likely have some sort of limitation. 

You could have some hip or leg weakness, ankle restrictions, calf/quad tightness, knee pathology, or some other discrepancy.  Also, if this causes pain you may want to see previous posts where I have referenced knee pain. It’s impossible to determine the underlying cause by one test you have seen on the internet; however, if you can’t complete this with the correct form or it causes discomfort you may want to see a healthcare professional.

Lower Trunk Rotation

Welcome back to the follow-up post on muscle strain & low back pain.  As stated in my last post, muscles are primarily response organs.  They react to the stresses placed upon them.  If you use them poorly with bad mechanics, if you overwork them, if they are weak and other surrounding muscles/joints/connective tissue has to compensate, your body WILL break down.  You hope you are not too severely injured and that it is the muscle that takes the brunt and is damaged.

Prayer Stretch

Muscles, because of their rich blood supply, have a tendency to heal quickly with prompt stretching, rest, and soft tissue work.  Conversely, overstretched ligaments, discs, nerves, and surrounding soft tissue do not heal as quickly.  So, if you think you have a muscle strain, please don’t just lie down and take some Tylenol in hopes that it will just “go away.”  By addressing the problematic tissue specifically and performing some guided movements and stretches, you can hopefully return to your normal activities quickly. 

Prayer Stretch Side-to-Side

These 3 stretches (pictured left & above) are all gentle ways to stretch and mobilize guarded muscles.  They should all be held for 20-30 seconds and repeated 2-3 times.  You can do these throughout the day to help yourself move around easier.  A GREAT adjunct to these stretches is soft tissue mobilization. 

Soft tissue mobilization, more commonly (but not necessarily more accurately) labeled massage, is the process of breaking down collagen cross-links (scar tissue).  By mobilizing and stretching connective tissue as well as muscle fibers that are bound down by this scar tissue, you allow your body to move more freely.  Scar tissue limits range of motion which often leads to pain.  I will often perform soft tissue mobilization with my hands or instrument-assisted via the Graston Technique®.  This technique uses stainless steel instruments to help mobilize restricted tissue in a manner similar to what a therapist’s hand can provide, but with reverberation when the instrument glides over restricted tissue(s). 

Foam Roller Back

Now, without specialized soft tissue treatment from a qulaified professional, you are left to try it yourself.  Again, nothing can take the place of a formal assessment and treatment by a PT, but here is something that may help many of you.  GET A FOAM ROLLER!  I have said this in multiple posts now, it is THE best thing you can get to help break up restrictions in your body.  Perform these rolls over the areas that you feel most restricted in - anywhere from 30 second to 3 minute intervals.  You can do these multiple times per day as well to help break down restrictions, minimize guarding, and eliminate pain.

This is the third consecutive post on Low Back Pain, and I will have a follow-up to this one in a couple of days.  Likely, more will be posted in the future too.  The reason for all of the attention is that back pain is by far one of the most common reasons people visit a medical professional. To name all of the underlying causes and possibilities of low back pain would be nearly impossible.  A list of the just the mechanical pathologies most often seen in PT can include:

• Overuse
• Weakness
• Inflexibility
• Instability
• Muscular imbalance
• Poor motor pattern
• Leg length discrepancies
• Pelvic asymmetries
• Hip pathology
• Poor biomechanics with walk/jog/run/exercise
• A number of foot or leg abnormalities that puts increased stresses up the kinetic chain…all the way to the low back. 

Of course there are underlying conditions that are not caused by (but can be influenced by) positioning and motion.  Some of these can include:

• Stenosis
• Sciatica
• Disc involvement – discussed in a previous post 

Internal tissues can also cause low back pain, but these are not my area of expertise, so when in doubt please seek medical guidance:

• Stomach pains
• Intestinal blockage
• Hernias
• Kidney infections
• Ulcers

Ok, that is a lengthy intro, but I wanted to first acknowledge the many mechanical possibilities.  Now, I only want focus on the top several incidences that I see as a physical therapist.  The purpose of this 2-part post is to assert that NOTHING can take the place of an examination from a medical professional; however, this blog series can help to serve as general guidelines. 

One of the primary examples of mechanical low back pain that I see and treat in the clinic is a muscle strain.  We have all felt like we “overdid it” at some point in time and our low backs bore the brunt of that blunder.  A muscle strain can range anywhere from feeling like a simple ache that is nagging – to an intense, sharp pain that is so great a person cannot move: walk, sit, bend, lie down.  Everything hurts and even feels “out of place.”  Patients are often very surprised at how much pain muscle tissue can actually produce.  It is amazing how readily this condition can be treated with guided stretches & soft tissue mobilization, instead of muscle relaxors and pain pills that never address the underlying problem in the first place.  Muscles are primarily response organs and react to the stresses each person places upon them.  As such, muscles can grab, spasm, and hold on causing intense pain.  Similarly, if a muscle can grab or spasm in response to too much strain, they can be relaxed with stretches and soft tissue mobilization to ease. 

Let me leave you with a stretch just to get moving and hopefully some early relief. 

Moving in the correct pattern, as the stretch seen here, is far superior to rest and immobilization for treating a muscle strain.

Stay tuned for a follow-up to this post, further addressing muscle strains and what you can do to get moving again.