Posts Tagged ‘lower back pain’

Dead Bug Variation to Regulate the Core

Wednesday, June 8th, 2022

The following is a Level B in the Pain-Free Movement Specialist Levels of Designation

The Dead Bug is a popular and effective core stabilization exercise. And although it is done supine on the floor, it has a level of difficulty that may be underestimated.

When working with chronic pain clients, particularly those with lower back related issues, the many common versions of the Dead Bug may actually be too challenging. With the version we share below, the degree of difficulty can be self regulated. This means the individual has a degree of control over the intensity of the exercise by way of the force that they apply with the upper body.

With this control, the client/patient has the ability to choose a level of difficulty within their capacity and reduce the sense of threat of further hurting themselves. They will also be able to better assess their success or lack their off with fewer moving parts to the exercise.

Scoring Your Wins and Beating Your Pain

Monday, April 11th, 2022

If I have had the pleasure of working with you, you have probably heard me speak of the need to score your “wins” as you move through the process of beating your pain. “Wins” are those smaller victories along the way to the ultimate goal of eliminating pain and doing all the things we physically want to do.

For so many of those challenged by chronic pain, their assessment of their pain is either they have it or they do not. This black and white view of the situation can be one of the most burdensome mindsets, hindering one’s progress. The reality is that there are many, many shades of grey in between.

If the view is black and white, there is no win unless the pain has been completely eliminated forever. Eliminating the pain forever is an achievable goal worth pursuing, but without a progress meter along the way, we do not know if the goal is right in front of us or 6 months or 6 years away.

Let us say that you have lower back pain and at its worst it is an 8 (on a scale of 1-10 with 10 being the worst). The back pain is an 8 whenever you stand too long. And when the pain reaches an 8, your back is aggravated for a couple of days afterwards. On average your pain is a 5/6 on most days if you take 400mg of Tylenol, twice a day.

You are frustrated and fed up and decide to begin a new program (Function First, chiropractic, physical therapy, acupuncture, etc.). At Function First, we would want to know more accurately what is “too long” for standing that gets you to an 8. Is it 5 minutes or 50 minutes? These are more objective time frames and easier to compare. We would also want to know more accurately how long afterward is your back pain aggravated? Is it 24, 36, 48 hours? If you do not know, this is a major reason why we ask you to track and journal your experiences. By journaling, you are not reflecting on a situation when you are in the throes of the emotions associated with the pain.

Scoring Wins

After two weeks of your new program, you still have pain that is an 8. In the black and white pain scenario, you are exactly where you were two weeks prior, minus the time and money you have spent. But in the finding wins on our way to the ultimate goal, progress is there if we look for it.

There are 3 fundamental ways we can gauge our progress. They might present individually or in combinations of two or more:

1. The overall level of pain is less. Your average pain of a 5/6 on most days is now a 2/3. Or your pain is still a 5/6 but you no longer need to take the Tylenol to control it. You still have pain but that is progress!

2. Your tolerance is greater. You could only stand for 15 minutes, and the pain was an 8. Now you can stand for 30 minutes, and the pain is an 8. Yes, the pain is still an 8, but you have increased your standing tolerance 100%. Another example might be your range of motion. You would squat to 45 degrees and your knee pain would be a 6. Now you can squat to 90 degrees before your knee pain is a 6.

3. Your recovery is faster. You stand for 15 minutes, and the pain is still an 8. However, you do your Function First exercises, and the pain is back down to a 5 within a couple of hours. You are no longer physically and emotionally burdened with the extended recovery time every time you push your body to stand. Or you love golf or tennis and could only play once a month, because your back needed that long to recover before you could play again. Now, your back still is painful after a round or a match, but because you are doing a strategic exercise program, you can now play once a week as your body gets more functional and stress is removed from the back.

As I share with all my clients, this is not something anyone should be convincing you of. It is simply recognizing progress (wins) that have occurred on your journey. This provides extremely valuable affirmation to the brain that you are on the right track and making progress. It provides hope and motivation to continue to strive for what is possible.

No one wants to be spinning their wheels hoping one day that magical door to a completely pain-free life will suddenly open. With the right intervention, supportive and educational coaching and acknowledging your wins, the path is clearer, and the goal is within reach.

Corrective Exercise Sitting Leg Extensions for Lumbar Stability

Wednesday, April 14th, 2021

Don’t be fooled. This exercise has nothing to do with strengthening the quads or the provocative slump test for neural tension. Both of those exercise look similar at first glance, but the nuances of this exercise give it a completely different objective.

Sitting Leg Extensions is an incredibly effective exercise to introduce a lumbar stability strategy that does not involved bracing or conventional core work.

The goal is not terminal knee extension. The goal is to generate enough internal tension from above and below the lower back, that the tensegrity forces help to de-rotate and stabilize the lumbo-sacral-region.

This is a self limiting exercise, meaning that the breakdown of the form and execution will be a result of the individual’s own internal force generation.

Give this one a try and let us know what you think.

Foam Rolling for Lower Back Pain

Friday, March 12th, 2021

For as long as foam rolling has been around, it still seems that people are doing 90% of the same areas of the body and with the same moves. Having had the good fortune to speak on many of the facets around the myofascial component, I’ve both seen and explored many interventions directed toward myofascial mobility. Since most people have or have access to a foam roller, I’d like to share this very effective application for the lower back that you may have never tried.

When I have participants experience this self-myofascial release application at a presentation, the “oohs” and “ahhs” fill the room. That’s because they are exploring a stimulus to

    this tissue that is brand new to them.

    This particular application does have some nuances and precautions, so be sure to watch the entire video.

    Leave your questions and comments below.

Lower Back Pain Relief

Friday, March 5th, 2021

This non-technical video is directed toward our clients and readers of The Pain-Free Program or anyone else looking for an accurate way to perform this familiar, lower back exercise exercise. Anthony gives you the nuances with the execution and the “why” behind the value (hint: It is probably not why you think it helps).

Anthony also suggests the best place to add to an existing lower back pain care exercise program.

Core-Tex Sit and Lower Back Pain

Wednesday, January 20th, 2021

Hi, this is Anthony Carey. For almost 30 years my professional mission has been to help those in chronic pain through strategic exercise and empowering knowledge around the pain experience.

As part of my journey, I started another company that produces exercise equipment based on our body’s need for variability in our environments. In other words, there is not enough variety in our movements, especially during the work ours.

Therefore, I have developed our second product that is geared toward both helping those with lower back, hip and pelvic floor issues AND making all the time that we spend sitting, more productive.

You can learn more about Core-Tex Sit at https://coretexfitness.com/products/core-tex-sit

The Haunted House Effect, Fear and Chronic Pain

Friday, October 30th, 2020


Photos are the property of Nightmares Fear Factory
This is an update from a post originally shared October 2015

The most current science on pain, tells us pain is an experience and not a sensation. Yes, we use words to describe our pain in terms of sensation (stabbing, aching, dull, throbbing, nagging, etc.), but there are many factors that contribute to just exactly how each of us get to the point where this pain is demanding our attention. Associated with this pain event are the many biological, psychological, and social elements that were present before, during and after the “experience”.

Many of you will be familiar by now with the bio-psycho-social paradigm used to better understand the pain experience. This video interview I did will help explain if you are not familiar.

The “Haunted House Effect” is a brilliant metaphor to add insight into our own experience.

We have all heard the saying “frozen with fear”. It is that brief but profound period of time where something is so shocking or terrifying that one cannot move. The body does not respond because the brain is overwhelmed with the danger or threat of danger at hand.

Similarly, consider what happens to your body and you mind the moment you have the fright of your life in a haunted house. The image above is from the web site Nightmares Fear Factory. They are hugely popular images on the internet of visitors caught at a moment in time inside the Nightmares Fear Factory’s haunted house.

If we got a little “sciencey” here and thought about all the things that happen to the body as this photo is taken and for the short time after, we would observe:

 A huge dump of stress hormones entering the blood stream (adrenaline, cortisol)
 The heart rate and blood pressure spike
 Blood vessels dilate
 Pupils dilate
 Breathing gets rapid and shallow
 Muscles all around the joints contract and stiffen the body
 Posture instinctively goes into a flexed protection mode
 Ensuing movement is guarded and apprehensive
 Language to express the experience are dramatic and emotionally charged

I purposely used boxes in the list above because I want you to think of “ticking the boxes”. In the haunted house examples, these are boxes that are “ticked” when an extreme scare has occurred. Now let us imagine these events happened within the first 5 minutes of a scheduled 30-minute tour through the haunted house. They still have 25 more minutes to take part in an experience where the tone has been clearly established as frighteningly intense.

So, what happens when they approach that next corner that they cannot see past? Are they relaxed and at ease? Absolutely not! Their body will reproduce the identical events it did from the first scare. Except all those responses will happen before they even get to the corner.

As they cautiously approach the blind corner, and their body is in full anticipation mode-anticipation of the next blood curling scare-they turn the corner to see a unicorn and rainbows.

No threat exists at this corner. Yet their body and mind went through all the same events as if the next big scare actually took place. That pattern continues through the remainder of the tour with each anticipation of the scares almost as physically and mentally real as a scare itself.

The source (which we cannot see) that created those responses in the photos is not the only part of that scare experience. Although likely not as obvious to those in the photos, the entire experience includes the people they are with, the smell of the room, the temperature of the room, the sounds and even how their clothes fit. And as the remainder of the tour continues, they all become part of the biological, psychological, and social contribution to that experience.

Now consider this scenario. After the first scare event, the participants get to put on full body armor and carry a 4-foot taser wand that can keep anyone or anything at least 4 feet away. Do you think this would increase their confidence and decrease the threat as they approached the ensuing corners? I would suggest it does make them safer and more confident. Perhaps they will have some fear, but not nearly as intense now that they have these protective “tools”.

So, what has this got to do with someone dealing with chronic pain? The scenarios can be almost identical except replace “scare” with “pain”. Let us say for example that after a long flight you felt a pop in your back as you lowered your carryon from the overhead bin. You begin to feel your back tighten up and you experience the pain ramping up as you exit the plane. Beginning with the “pop” you felt, you would begin to experience those same 7 traits listed earlier. And whether you realized it or not, the physical pain itself is not the only part of the experience. The people you are with, the smell of the airplane and then the terminal, the temperature, the sounds and even how your clothes fit all become part of the biological, psychological and social contribution to that pain experience.

These combined elements begin to form a neuro signature or neuro representation in your brain. Over the next couple of days as you are recovering from this episode, you experience those 9 traits (boxes to tick) any time you anticipate potential threat to your back. This could be something as familiar as putting on your socks. Some movements may in fact provoke pain, but others may not. Yet the net result is remarkably similar in terms of your physiological and mental response.

You can clearly see how patterns emerge that are counterproductive to your long-term goals. And the reality of this is that we can’t, and you can’t explain your way through process. Yes, you need an understanding, but your body and brain also need proof. This is where a strategic and structured corrective exercise plan can create the movement confidence you need to no longer anticipate a threat when the threat is not valid. The proper, strategic exercise program for you becomes your full body armor and 4-foot laser wand.

Pain is an extraordinarily complex experience for everyone. And many people will attempt to chase one aspect or another of their pain. The science now tells us that we must look at the entire bio-pyscho-social context from which chronic pain is experienced.

Don’t live your life waiting for the next ghost or goblin around the corner. Suit up, educate yourself and show your brain that you are not broken.

Happy Halloween!

Corrective Exercise Kneeling Aztec

Thursday, May 28th, 2020

Any exercise that requires you to match a force with a counter force to maintain stability, will be self regulating. In other words, you can only push or pull to a level that can be stabilized by your own internal force generation.

The opposite of this would be ground reaction forces (GRF). The limitations on force production would be strength issue because you can push through the ground. This is the case with most exercises when the force is moved vertically against gravity. But when the force applied is horizontally or perpendicular to the field of gravity, we don’t get the same benefits from the GRF that we get with a vertical load.

Instead, we must turn to our own internal stability from which to create an anchor point for force generation.

As such, this corrective exercise is an excellent core exercise predominantly for the sagittal plane that does just that. It’s also happens to have some great foot benefits too.

Leave your questions and comments below.

Corrective Exercise A-P Cat and Dog Rewind

Friday, October 4th, 2019

In one of our past newsletters where we talked about myofascial mobility with rhythm, timing and amplitude, we revisited the Anterior Posterior Cat and Dog as one of the examples of applying those principles.

In this exercise, we take the A-P Cat and Dog and progress it into a surprisingly challenging core exercise. We call it the A-P Cat and Dog Rewind.

You’ll see as the clients center of mass moves forward with the change and limits of base of support, the core has to switch on in a very novel way.

The beauty of this is that the response is reflexive with no feedforward response necessary by the client or patient.

This helps us move beyond the bracing and “keep your core tight” cues that are not part of our long term goals and authentic movement.

Try it, feel it and let us know what you think.

Corrective Exercise Wall Glute Bridge

Thursday, August 8th, 2019

This version of the glute bridge is a great corrective exercise for teaching the body the sequencing and synchronization from the ankle to the lumbar spine that is associated with triple flexion and squatting.

It will certainly challenge dorsi flexion in a pseudo closed chain environment as the knee moves over the toes. There is feedback from the wall and load placed into the wall, but no vertical forces acting on the joint.

The body gets comfortable with relative lumbar flexion in an unload position because it has to go through that motion to get the buttocks of the floor. The beauty is both the novelty and very limited load placed on the spine. So even those with lower back pain will find this a helpful exercise as it reduces the threat.

Additionally, it helps create some separation and distraction of the tissue at the thoraco-lumbar junction. The upper part of the body is fixed on the floor as the lower part moves away, creating the distraction.

Put it to good use and tell us how you did!