Posts Tagged ‘lower back pain’

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!

How Accurate Are Your MRI Findings?

Monday, July 15th, 2019

We all want the best, most accurate information we can get regarding our health. And when the doctors and therapists are not getting the results everybody wants, they will typically order imaging studies to gather more information and an “accurate” look at what is going on.

Many in the general public consider the MRI as the gold standard or best possible diagnostic available. What we must realize, however is that an MRI (magnetic resonance imaging) is an image or picture. And as such, its interpretation relies on the individual reading the image. This is generally a radiologist but may also be another medical doctor that is treating you.

The technology behind an MRI is quite amazing and is not in question. What is of concern is the accuracy of the conclusions reached and therefore the ensuing treatment plan, costs and expected outcome(s)that follow.
lumbar mri
A 2017 study in The Spine Journal, wanted to look at just how accurate and consistent MRI findings would be across 10 different MRI centers. A 63-year-old women with a history of lower back pain and nerve pain down her leg received 10 MRI’s at 10 different locations over the course of 3 weeks.

What they found were very large differences in what was reported as the findings on the MRI in both false positives and false negatives (see chart from study below). Using disc herniation for example, 47.5% had a false negative or miss rate. Meaning the herniated disc was there but missed by the radiologist.

For those of us that work with a population determined to overcome their pain, the MRI is a double-edged sword. Because, as you may know from some of my past posts, the findings on an MRI do not have a one-to-one correlation with pain. There are people who have MRI’s that looked like they have been hit by a bus and have no pain. And there are people who have no clear findings on an MRI and may have significant pain. The bio-psycho-social factors that contribute to the pain experience are numerous.

What Can We Do?

Most importantly be informed and question everything. Even if you are sure the MRI findings are accurate, they don’t equate to surgery. In the absence of any medical emergency (significant muscle weakness, bowel or bladder problems), conservative treatment has shown to be as good as surgery and in several studies having even better outcomes.

At Function First, we are not doctors or physical therapists. We are exercise and movement professionals who understand the pain experience and how important it is to provide exercises that remove mechanical stress from the body and restore movement confidence through a very systematic process of program design and coaching.

When you seek help from a practitioner, you always want to be the head coach. And appreciate that passive treatments (hands on therapy, modalities) and medications may be necessary to progress you to the next step. But a comprehensive exercise program is ultimately what translates to the real-life functions you seek to participate in and enjoy.
mri variability study

Corrective Exercise-Half Frog

Thursday, July 11th, 2019

This simple exercise can be quite challenging for those with a history of lower back pain, as well as the deconditioned client. The ability to disassociate the hip motion from the movement of the lower back and pelvis can be very helpful in removing stress from the lower back.

This “Level B” exercise from the PFMS is both a corrective and assessment opportunity. You will be able to see, and the client will be able to feel any control and/or range of motion differences between the two sides.

The Half Frog is also an exercise, that as a Level B allows for more intrinsic focus of attention for motor learning purposes. The client is able to concentrate on what muscles are engaging and the sensory feedback of those contractions.