Tag Archive for: c spine

Should you Rest when your Back Hurts?

Back pain is the most common type of problem we see here in our office. And the number one question I get from people who’ve hurt their back is, “should I rest until it feels better?” 

The short answer is “no.” 

But I understand why this is confusing. It’s scary to move, or know which exercise is best when something hurts, especially if it’s your back. We also get conflicting advice from the medical community. Many people suffering with back pain have been told they should rest, ice, lie down, and use their back muscles as little as possible until they recover. They’ve been told they should limit their movement and activity until their pain goes away.

Well what if I told you that for 80% of all back problems – movement is actually the BEST medicine.

Research even supports this. Most back pain falls into the category of what we call “mechanical low back pain” – and this type of back pain responds best to movement over anything else. It’s important to note that although movement is good when your back hurts, you want to pick the right type of movement. Generally speaking, early movement like walking is considered one of the best things you can do for your back, along with very specific mobility exercises in a direction designed to relieve your pain quickly. But you’ll want to avoid things like lifting heavy weights at first, or bending/stretching over excessively. If your back pain involves an irritated nerve, stretching forward, even though it might feel good, can often worsen your problem.

So what’s the big deal? Why is it so bad to rest until your back pain goes away?

Although most back pain will go away on its own with time, the problem with resting instead of moving is that it can prolong the time it takes to truly heal. And in some cases, rest can make your back problem worse. Too much rest leads to deconditioning of your muscles, and can even lead to biomechanical changes to the curves in your spine. Resting may take your back pain away, but it’s going to leave you feeling much stiffer and weaker, putting you at risk to just hurt your back all over again. One of the biggest problems I see with back injuries is a lack of mobility, sometimes due to weakness and sometimes due to not moving around enough. A flexible spine is a healthy spine. That’s why choosing activities like walking and corrective stretching exercises over rest will not only relieve your back pain, but will give you a better chance at keeping the pain gone over time.

Another issue with too much resting, especially lying down, is the impact on your discs.

Back problems frequently involve some variation of a bulging disc, and when you lie down, your disc changes in size. Lying down does relieve pressure from your disc, but also causes it to absorb more fluid, making it bigger. You won’t know this is happening until you go to get up. That enlarged disc will not feel good when it gets pinched. It’s why most people who are dealing with back pain feel worse first thing in the morning, just after getting out of bed. Their pain eases once they stand and start moving around a bit. When you walk around and move, you get natural compression of your disc, keeping the disc bulge smaller and thus, less of an irritant. A bulging disc in your spine is a pretty classic form of mechanical low back pain, and we already know that mechanical back pain responds best to movement.

Remember that the absence of back pain does not mean the absence of a back problem.

Back problems can be complicated and they love to linger under the surface until one day, a certain movement just tweaks you. The best way to figure out a back problem – and heal a back problem quickly – is with movement. As tempting as it is, don’t just rest to get rid of your back pain. Try walking, and even some easy stretching, and take note of what happens. You’ll either start to feel better the more you move or worse. If your pain is easing up with the movement you’ve chosen – you’re on the right track! If your pain is not responding or getting worse, then it’s a clue you need to see a professional. Either way, movement is your friend, because it’s going to tell you something. Rest won’t do that for you and if anything, potentially prolong the issue when you could have been doing something about it.

Neck stretches

Neck Pain During Crunches? Here’s Why & How to Avoid it

Abdominal crunches are one of the most popular “ab exercises” around. It’s a movement that emphasizes upper abdominal strength. You start by lying on your back, typically with your hands behind your head and knees bent. You then lift your head and chest off the floor, “crunching” your upper body into a C-shaped curve.

Over the years, many “experts” have dismissed this exercise, claiming it’s ineffective for core strengthening. While I agree that it shouldn’t be the ONLY core exercise you do — the crunch does have its place. I work on this a lot with my private clients, because it’s a functional move that when done correctly, will help you sit up from the floor with more ease and with less risk of injury. And of course you see variations on this movement all the time in Pilates, which is a key part of our practice and our efforts to help people recover from back pain.

I often hear that people don’t like crunches because they’re uncomfortable or hurt your neck. But when you’re doing a crunch, you want to make sure you’re feeling it in your abs… NOT in your our neck. Here are the biggest problems I see with crunches and how to tell if it’s a technique problem or a neck problem:

You’re not actually using your abs

This sounds pretty obvious, right? But a lot of people have trouble figuring this out. During our Pilates 101 class this week, one woman experiencing neck pain appeared to be doing the move correctly — but she couldn’t feel it in her abs, only in her neck.

It’s because she was using her neck and chest muscles to curl her upper body into the crunch instead of initiating the move from her belly (abs). My tips to correct this were to pull her lower belly in toward her spine and the front of her ribs down toward her belly button. Then, keeping this shape locked in, use her breath (exhale) to help her initiate and start the curl from her abs.

Sometimes people don’t have the abdominal strength yet to perform a crunch from lying flat. If that’s the case, you won’t be able to do this correctly no matter how well you follow my cues. If you think that’s your problem, place a small pillow under the back of your head. This gives you a head start into the curl. Once your abdominals get stronger, you can try doing the crunch with your head starting from the floor again.

Your neck is in the wrong position

When you’re doing a crunch, you want your neck to be slightly curled (chin toward chest). Most people either curl their neck too much, or not enough. If your chin is touching your chest, you’re curled too much. And if you feel your chin and neck jutting forward toward the ceiling, you’re not curled enough. Either of these positions could lead to neck problems down the line if not corrected.

The ideal position for your neck is to begin with a slight nod of the chin (like you’re nodding “yes”) and then keep it there. The rest of the curling motion will come from contracting your trunk and abs. As you curl up, I recommend keeping your eyes focused on your belly and keeping a tennis ball’s distance between your chin and your chest.

Sometimes your hand and arm position can be what causes your neck to be in the wrong place. If your hands are behind your head, be sure you’re not using them to pull your neck forward. Your head should be gently pressing into your hands and your elbows should be at a 45 degree angle from your body. Your abs do the rest.

You have an underlying neck problem

In our practice, we specialize in neck and back pain. When you’ve got an underlying neck problem, doing crunches isn’t a good idea until the underlying problem is resolved.

Let’s say you have a small bulging disc in your neck that you weren’t aware of or that you thought was fixed. The curled position of your neck during a crunch can exacerbate this problem, even if you are using your abs correctly and following every tip I just mentioned above.

Some clues that you might have an underlying neck problem could be pain that shoots into your shoulder blade or numbness and tingling down your arm. You might experience these symptoms during the movement, or even up to several hours after.

Either way, symptoms like this could be a sign that there is more to your neck pain than simply incorrect crunch-technique or weakness in your abs.

If this is happening, it’s a good idea to get it checked out by a movement/mechanical specialist like the physical therapists in our practice. The good news is that we can help your neck feel better even if you do have a problem like bulging discs — and you can get back to doing crunches again without any neck pain.

You can also check out our FREE guide to neck and shoulder pain right here!

It comes right to your email inbox and explores seven easy ways (plus a bonus section!) that are PROVEN to help you ease neck and shoulder pain quickly – without pain medication, procedures, or surgery.

If you have any additional questions or want a more personalized assessment, sign up for a FREE Discovery Session with us! It’s a quick, no-obligations opportunity for you to see if working with us could be the best decision for your health.

Carrie working on a client's shoulder

Shoulder Pain not Going Away? This could be why…

Whether it’s shoulder pain, neck pain, back pain, or knee pain that you’re dealing with — if you have a nagging pain or injury that just won’t go away no matter what you try, it’s a clue that you’re missing something.

We see this ALL the time in our office with shoulders.

Folks just like you come to us wondering why their shoulder still hurts after trying ice, heat, rest, physical therapy, massage, and every possible shoulder exercise you could imagine.

The pain either goes away temporarily, or sometimes it gets WORSE!

When it comes to shoulder pain, it’s critical that you know for certain if the pain is actually coming from your shoulder, or somewhere else. If not, you risk trying to fix the wrong problem… and that explains EXACTLY why your shoulder pain isn’t going away.

So… if your shoulder pain isn’t caused by your shoulder — where is it coming from?

The most common culprit is actually your NECK. Below are a few key signs to help you figure out if that’s the case…

(PS – we’re doing an online workshop on this topic in just a few weeks.)

Where is your pain?

When your pain is coming from your shoulder, the pain will always be localized to your shoulder alone. True shoulder pain is felt directly in front of your shoulder, directly on top, or in a more involved shoulder problem (like a rotator cuff injury) you might feel some achiness down the side of your arm… but it will never go below your elbow.

If the pain goes past your elbow and into your forearm or hand, or radiates above your shoulder into your neck (the upper trap area), or if you feel it deep inside of your shoulder blade in your mid-back, odds are pretty good that you’re dealing with a neck problem and not just a shoulder problem. This could be the reason why your shoulder pain isn’t going away.

Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening, it’s likely coming from your neck – and could be due to a bulging disc or a restricted/faulty movement pattern that is irritating nerve roots in your neck. An isolated shoulder problem typically does NOT involve nerve root compression or irritation. This is much more common in a problem related to your neck, and if that’s what’s happening, you will feel symptoms into your shoulder, shoulder blade, or even down into your arm. What’s particularly misleading is that it’s entirely possible to feel all these nerve symptoms and not actually feel anything localized to your neck. This is a big reason why shoulder pain caused by a neck issue gets missed by so many health practitioners.

Have you lost mobility or range of motion?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well and is pain free, but your shoulder is stiff and immobile, odds are good that the problem is actually in your shoulder and you just haven’t found the right treatment approach yet. BUT… if you have a stiff and painful neck, and you lack mobility in your shoulder, then it’s absolutely imperative that you investigate your neck. If your care provider only focuses on stretching and improving your shoulder mobility, and never bothers to look at your neck, it’s possible you could be missing a key component to full recovery… and that’s why your shoulder pain keeps coming back.