Pool Spine Workout

By Amy Price PhD

Chronic pain and balance can be improved with water exercise. Exercise releases feel good chemicals in the brain that are powerful mood booster and pain fighters. These neurochemicals help balance mood swings and the other benefits are looking better and having a body that burns fat more effectively. Many spinal patients can’t get the exercise they need because they find exercise painful torture so they lied down on the couch with a snack until feelings (mostly guilt) about exercise go away. This perpetuates the cycle as muscles and joint get stiff and lose flexibility, loss of muscle means less fat is burned and guilt and low energy levels steal that feel good feeling.  

Water provides a safe medium for joints and working in water improves balance. Be sure to choose a warm place for your water workout to avoid muscle spasms.  Afterwards a hot bath with a couple of cups of epsom salts included can provides an inexpensive muscle soothing experience. The NCPAD  has some great information on how to get started and exercise in water safely. Here are more aquatic exercises   . If you are a swimmer add some power to your water workout with swim fins for the feet and  hands.  

The buoyancy of water reduces the “weight” of a person by about 90%, (at least while in the water!) which means that the stress on weight bearing joints, bones and muscles is lessened. That’s why aqua exercies are good for people with arthritis or back problems. You still get a great work out, it just doesn’t hurt! Water exercise can encompass all of the components of fitness: cardiovascular fitness, muscular strength and endurance, and flexibility. And, when done regularly, water exercise can help reduce body fat 

Need some help with diet too? Check out this information on diet for pain relief and clear thinking here 

Nerve Glides can help relieve chronic spinal pain

Amy Price PhD

Nerve Glides can help release a lot of the pain that comes from trauma and even arthritis. A lot of the pain may be originating from the nerves in a cascading effect which inflames surrounding soft tissue. The peripheral nerves in your arms and legs are mobile structures  that can stretch when elongated. Injury and scar tissues can trap them but you can do special stretches called nerve glides to release these areas.

To see how your nerves move try this.  Take your finger and touch your nose.  Then bring your hand all the way out to your side and stretch it out as far as it will go.  Next tilt your head away from your outstretched hand (if it’s your left hand, bend your head right).  You will likely notice a pulling sensation in your hand and arm with your head bent.   Now try to bring the head towards the hand, does it go away?  This is a demonstration of  nerve tension. 

 There is no muscle that goes  all the way from your neck to the hand.   Since bending your head away from the hand tightens the nerves that go from your neck to your hand, you feel pulling. If you feel pain, numbness and tingling, this is a problem you should tell your doctor about. Nerve glides can be used in multiple body areas not just the hand and neck. Nerve pain is referred to other body areas and you can get an idea of the patterns  by looking at a dermatome map

Another example  is that the nerve when inflamed looks like a thick lumpy rubberband, but as you stretch and glide the nerves, they thin out making an easier passage through the channels they move theough. If you stretch a rubber band it “thins” out.

The nerves in your body have a normal range of motion like the joints.   Nerve glides are stretches that help get back that normal movement.  Nerve glides must be done gently and should never increase pain. The goal is to  free the area up and not to inflame it so in this case pain is not gain.  Technique is critical. It is best to have an occupational therapist that specializes in neural education who can show you how to do these nerve glides. They will give you a sheet with the instructions on how to do these right and you can watch as you perform the nerve glides in the mirror to make sure your form is correct. Nerve glides are also known as nerve flossing or nerve stretching.

Detailed Treatment Strategies for the Prevention
and Treatment of Piriformis Syndrome

If you suffer from piriformis syndrome or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, making stretching a part of your fitness regime will have a significant impact.

What is the Piriformis?
The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum (lower region of the spine) to the top of the femur (thigh bone) and aids in external rotation (turning out) of the hip joint.

Piriformis

As you can see from the diagram to the right, there are many muscles and tendons that make up the hip and buttocks region. The diagram shows the posterior (rear) view of the buttock. The piriformis is the horizontal muscle in the center of the picture running over the top of the sciatic nerve.

What Causes Piriformis Syndrome?
Piriformis syndrome is predominantly caused by a shortening or tightening of the piriformis muscle, and while many things can be attributed to this, they can all be categorized into two main groups: Overload (or training errors); and Biomechanical Inefficiencies.

Overload (or training errors): Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. However, piriformis syndrome is not only found in athletes. In fact, a large proportion of reported cases occur in people who lead a sedentary lifestyle. Other overload causes include:

• Exercising on hard surfaces, like concrete;
• Exercising on uneven ground;
• Beginning an exercise program after a long lay-off period;
• Increasing exercise intensity or duration too quickly;
• Exercising in worn out or ill fitting shoes; and
• Sitting for long periods of time.

Biomechanical Inefficiencies: The major biomechanical inefficiencies contributing to piriformis syndrome are faulty foot and body mechanics, gait disturbances and poor posture or sitting habits. Other causes can include spinal problems like herniated discs and spinal stenosis. Other biomechanical causes include:

• Poor running or walking mechanics;
• Tight, stiff muscles in the lower back, hips and buttocks;
• Running or walking with your toes pointed out.

Symptoms
Pain (or a dull ache) is the most common and obvious symptom associated with piriformis syndrome. This is most often experienced deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.

Weakness, stiffness and a general restriction of movement are also quite common in sufferers of piriformis syndrome. Even tingling and numbness in the legs can be experienced.

Treatment
Piriformis syndrome is a soft tissue injury of the piriformis muscle and therefore should be treated like any other soft tissue injury. Immediately following an injury, or at the onset of pain, the R.I.C.E.R. regime should be employed. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis.

It is critical that the R.I.C.E.R. regime be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery.

The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy techniques. The application of heat and massage is one of the most effective treatments for removing scar tissue and speeding up the healing process of the muscles and tendons.

Once most of the pain has been reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase is to regain the strength, power, endurance and flexibility of the muscles and tendons that have been injured.

Prevention
Prevention is the key when it comes to piriformis syndrome. The more you can do to prevent it, the better off you’ll be. There are a number of preventative techniques that will help to prevent piriformis syndrome, including modifying equipment or sitting positions, taking extended rests and even learning new routines for repetitive activities. However, there are four preventative measures that I feel are far more important and effective.

First, a thorough and correct warm up will help to prepare the muscles and tendons for any activity to come. Without a proper warm up the muscles and tendons will be tight and stiff. There will be limited blood flow to the hip area, which will result in a lack of oxygen and nutrients for the muscles. This is a sure-fire recipe for a muscle or tendon injury.

Before any activity be sure to thoroughly warm up all the muscles and tendons that will be used during your sport or activity.

Second, rest and recovery are extremely important; especially for athletes or individuals whose lifestyle involves strenuous physical activity. Be sure to let your muscles rest and recover after heavy physical activity.

Third, strengthening and conditioning the muscles of the hips, buttocks and lower back will also help to prevent piriformis syndrome.

Fourth, (and most importantly) flexible muscles and tendons are extremely important in the prevention of most strain or sprain injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. When this happens, strains, sprains, and pulled muscles occur.

To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine. I’ve included two effective piriformis stretches below.

	Sit with one leg straight out in front. Hold onto the ankle of your other leg and pull it directly towards your chest.
	Lie face down and bend one leg under your stomach, then lean towards the ground.

Stretching is one of the most under-utilized techniques for improving athletic performance and getting rid of those annoying sports injuries. Don’t make the mistake of thinking that something as simple as stretching won’t be effective

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Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit
The Stretching Institute.
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