Tag: core stability

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Why a Strong Core Can Help Reduce Low Back Pain @ClevelandClinic #healthaware #physiotherapy

cleveland back pain a physical therapist

Cleveland Clinic
@ClevelandClinic

Back pain is a complex problem, but can strengthening core muscles with targeted exercise provide some relief?

If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? Physical therapist Patti Mariano Kopasakis, PT, DPT, SCS, answers common questions about what we should know about strengthening your core muscle group.

Q: What is your core?

When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.

Your core includes:

  • Front abdominal muscles — the rectus abdominis.
  • Muscles along the side of your body — the internal and external obliques.
  • A deep muscle that wraps around the front — the transverse abdominal.
  • Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi.

Your core also includes your diaphragm, muscles of the pelvic floor, hip flexors, and gluteal muscles.

Q: What is the relationship between core strength and back pain?

Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures for stability, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs which lie between the spinal bones. This can cause pain.

But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.

Q: What are some exercises for the core that can help with back pain?

Here are my top five:

  •  Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
  • Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
  • Bird dog — Kneel  on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
  • Marches — Lie on your back with knees bent. Take a deep breath in and as you breathe out draw your belly muscles in as if tightening a belt. As you do this lift one leg a few inches from the floor. Return to starting position and switch sides. Repeat for 8-10 repetitions on each side. 3 sets.
  • Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.

For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.

Q: Can you injure your back by trying to strengthen your core?

Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.

Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.

The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.

Q: When should you talk to a doctor about your back pain?

If any of the following is going on you should consult with your doctor:

  • Your pain has been going on for longer than a month, despite resting from activities that make it worse.
  • Your pain is getting worse.
  • Your pain wakes you from sleep.
  • Your pain is in your low back but also is going down one or both of your legs.
  • You notice that one leg is becoming weaker than the other.

Q: Where should you turn if you want help in creating a plan to address back pain?

Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.

Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely. The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.

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Strong core muscles help you maintain good posture. Why a strong core is important + exercises to try. @ClevelandClinic

cleveland evrything starts wit your core

If you’re planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.

“The core muscles provide stability for the entire body as it moves,” says Smith. “These muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.”

Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.

Getting started with your core

To get your core muscles in shape, you need to exercise.

“Our bodies were made to move, so any physical activity is really important,” says Smith.

She recommends these specific core-strengthening exercises below.

The first one engages the deep muscles in the abdomen, called the transverse abdominis. “These muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,” says Smith.

“The more you work on these muscles, the more it will become second nature to hold these muscles tight when you’re lifting grocery bags, doing yard work or any other kind of physical activity,” says Smith. This will help support your body.

Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.

Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. “It’s better to take your time, maybe do fewer reps, but with better quality,” she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.

Move on from the core

Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.

Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.

With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. “You don’t have to be in pain to make gains,” she says.

Beginner exercises for core strength

For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.

Abdominal bracing

Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.

Bridge

Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.

Clamshell

Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Don’t let your pelvis roll back during the lifting movement. Hold for 5 seconds.

https://health.clevelandclinic.org/planning-to-start-exercising-start-with-your-core-first/?utm_medium=social&utm_source=twitter&utm_campaign=cc+tweets

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Starting a Workout Routine – Tips to start moving and grooving @ClevelandClinic


Exercise is a vital part of a healthy lifestyle. But if you’ve gotten out of the habit of being active — or have never found an exercise routine that works — it might feel like an impossible task to get started.
Luckily, it’s never too late to figure out a workout routine. Here’s how to start exercising — and tips to stay motivated when all you want to do is hang out on the couch instead.
What should I include in my exercise program?
Every exercise session should include a warm-up, a conditioning phase and a cool-down phase.
The warm-up
In a nutshell, a warm-up helps your body adjust slowly from rest to exercise. Making this part of your routine reduces the stress on your heart and muscles, and slowly increases your breathing, circulation (heart rate) and body temperature. A warm-up can also help improve your flexibility and reduce muscle soreness.
The best warm-up includes stretching, range of motion activities and beginning the activity at a low-intensity level.
Conditioning phase
The conditioning phase follows the warm-up and is the time when you’re burning calories and moving and grooving.
During the conditioning phase, you should monitor the intensity of your activity. The intensity is how hard you’re exercising, which can be measured by checking your heart rate.
Over time, you can work on increasing the duration of the activity. The duration is how long you exercise during one session.
Cool-down phase
The cool-down phase is the last phase of your exercise session. It allows your body to gradually recover from the conditioning phase. Your heart rate and blood pressure will return to near-resting values.
However, a cool down does not mean to sit down. In fact, for safety reasons, don’t sit, stand still or lie down right after exercise. This might cause you to feel dizzy, lightheaded or have heart palpitations (fluttering in your chest).
The best cool down is to slowly decrease the intensity of your activity. You might also do some of the same stretching activities you did in the warm up.
General exercise guidelines
In general, experts recommend doing a five-minute warm up, including stretching exercises, before any aerobic activity, and include a five- to 10-minute cool down after the activity. Stretching can be done while standing or sitting.
Here are some other things to keep in mind when starting a workout routine:
Determine the best exercise routine for your lifestyle
Not everybody likes to hop out of bed in the morning and go for a run. Figuring out a routine that fits your lifestyle can help you be more successful.
Here are some questions you can think about before choosing a routine:
What physical activities do I enjoy?
Do I prefer group or individual activities?
What programs best fit my schedule?
Do I have physical conditions that limit my choice of exercise?
What goals do I have in mind?
(These might include losing weight, strengthening muscles or improving flexibility, for example.)
Don’t try and exercise too much too fast
Gradually increase your activity level, especially if you haven’t been exercising regularly. Guidelines around how often to exercise also differ depending on your age, any health conditions you have and your fitness history.
Set big and small goals — and be specific
If you’re looking to reach a particular goal, exercise specialist Ben Kuharik suggests setting mini goals to achieve along the way. This ensures your motivation stays strong over the long haul.
Setting a specific goal is also important. “For example, if you want to lose some weight, it’s hard to be motivated or stick to a plan,” he says. “That’s because you don’t have the excitement in knowing you are getting closer to achieving it.”
Having smaller goals or milestones to reach in between the big ones keeps you on track. “If you want to lose 8 pounds in two months — and you set a mini goal of losing 1 pound a week in the process — you get the sense of accomplishment that reaffirms your efforts,” Kuharik says. “And this can snowball into achieving even greater goals.”
This also applies if you fall short of your goal. “If you only lose 7 pounds in two months, you’re still 7 pounds down than when you started,” Kuharik affirms. “You’ll feel great about the progress you’ve already made.”
Schedule exercise into your daily routine
Plan to exercise at the same time every day, such as in the mornings when you have more energy or right after work. Add a variety of exercises so you don’t get bored.
Where exercise is concerned, something is also always better than nothing. “Not every day will go as planned,” Kuharik notes. “If you unexpectedly have a tight schedule or are even just having an off day, doing half of your planned workout that day is much more rewarding and beneficial than skipping it altogether.”
Exercise at a steady pace
Keep a pace that allows you to still talk during the activity. Be sure not to overdo it! You can measure the intensity of your exercise using the Rated Perceived Exertion (RPE) scale. The RPE scale runs from 0 to 10 and rates how easy or difficult you find an activity.
For example, 0 (nothing at all) would be how you feel when sitting in a chair; 10 (very, very heavy) is how you feel at the end of an exercise stress test or after a very difficult activity. In most cases, you should exercise at a level that feels 3 (moderate) to 4 (somewhat heavy).
Keep an exercise record
Keep a record of how much and when you exercise. This can help you look at goal-setting, as well as get a sense of how much activity you’re doing in a given week.
Time your eating and drinking properly
Wait at least one and a half hours after eating a meal before exercising. When drinking liquids during exercise, remember to follow any fluid restriction guidelines you might have.
Only buy what you need
Exercise doesn’t have to put a strain on your wallet. Avoid buying expensive equipment or health club memberships unless you’re sure you’ll use them regularly. But you’ll want to dress for the weather (if working out outside) and wear protective footwear. Sneakers are the one thing you should prioritize, as you want to make sure your feet are protected.
Stick with it
If you exercise regularly, it’ll soon become part of your lifestyle. Make exercise a lifetime commitment. Finding an exercise “buddy” can also help you stay motivated.
Don’t forget to have fun
Exercising should be fun and not feel like a chore. “Consistency is key — but to do something consistently, it’s important to find a way to enjoy it,” Kuharik says.
So, above all, choose an activity you enjoy! You’ll be more likely to stick with an exercise program if you don’t dread working out.
“Try to look at exercise as an opportunity to get away from stress, clear your mind and leave nagging thoughts at the door,” Kuharik encourages. “With this in mind, over time, you will look forward to giving your mind a break and feeling good after a great workout session!”
Exercise: Where To Start
You should always talk to your doctor before starting an exercise routine. Together, you can figure out a plan to ease into regular physical activity.
And walking and climbing stairs are two easy ways to start an exercise program.
Walking guidelines
Start with a short walk. See how far you can go before you become breathless. Stop and rest whenever you’re short of breath.
Count the number of steps you take while you inhale. Then exhale for twice as many steps. For example, if you inhale while taking two steps, exhale through pursed lips while taking the next four steps. Learn to walk so breathing in and exhaling out become a habit once you find a comfortable breathing rate.
Try to increase your walking distance. When setting specific goals, you might find you can go farther every day. Many people find that an increase of 10 feet a day is a good goal.
Set reasonable goals. Don’t walk so far that you can’t get back to your starting point without difficulty breathing. Remember, if you’re short of breath after limited walking, stop and rest.
Never overdo it. Always stop and rest for two or three minutes when you start to become short of breath.
Stair climbing
Hold the handrail lightly to keep your balance and help yourself climb.
Take your time.
Step up while exhaling or breathing out with pursed lips. Place your whole foot flat on each step. Go up two steps with each exhalation.
Inhale or breathe in while taking a rest before the next step.
Going downstairs is much easier. Hold the handrail and place each foot flat on the step. Count the number of steps you take while inhaling, and take twice as many steps while exhaling.
Whichever activity you choose, remember, even a little exercise is better than none!

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