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This is your fast track to understanding what goes on with your back pain. Follow the posts and take advantage of her free education plus books, videos and aids that will support your recovery. Welcome!
Spinal fusions are much less readily performed these days and there's good reason for this: residual pain. The pain may be just as bad or worse after surgery (with or without sciatica) or the back may be passably okay for a few years but then starts to become problematic again.There are several reasons for lingering back pain after spinal fusion.1. The spinal fusion was done for the wrong reasons2. Post-operative scar tissue chokes the spinal nerves.3. The next level up above the fusion suffers excessive movement strain1. Modern Medicine is just as susceptible as many other disciplines to groupthink and fashionable mindsets of the day, otherwise known as zeitgeist. A recent zeitgeist in back world has been the diagnosing of spinal stenosis or vertebral stenosis (same thing) for rather murky looking radiology scans when in fact vertebral stenosis is quite rare and specifically related to difficulty (‘lead legs’) walking shorter and shorter distances; a previous fashion was ubiquitous diagnosis of ’slipped disc’ for almost any type of back pain (see https://www.simplebackpain.com/discectomy.html)). A recent fashion has been that a painful spine should be fused at a problem level, simply because that level is painful. In point of fact, a spinal level should only be fused if it has become loose, or or unstable. Spinal instability is rare and has distinct, easily recognisable features
The fancy neck pillows with a raised ridge along the front are also bad, although they do attempt to address one aspect of need - and that is support for the neck itself. Supporting the neck (as well as the head) is essential and much better brought about by tucking a pillow in around the neck to support the angle between shoulder and neck and this is critical to good neck relaxation. The best pillow-filling medium is feathers and it’s been that way for centuries! Why would we think that some modern material could do it any better? The best feather pillows are a combination of 80% feather 20% duck down although in their new state they’re almost over-stuffed. Before sleep you must punch a hole in the pillow with your fists to create an indentation that you nestle your head into, while the rest of the pillow bulk cradles around your neck. The neck MUST relax! At the other end of the spectrum, feather and down pillows lose their stuffing as they get old, so you literally have to plump them up from either end with your fists to get the support.
What happens as you get older is that you inadvertently forget to push off with the knee by bracing the knee back hard. Before you know it, you have lost this propelling forward function of the knee straightening. The vastus medialis muscle - the medial quadriceps muscle on the inner side of the thigh – wastes away and get weak incredibly quickly (this is why you have wobbly knees when you get up after spending a day or so in bed with the flu). After failing to walk by squeezing the knee back you find you can’t, because the inner quads muscle has wasted away. Not only does this give you a plodding, trudging walk typical of lack of propulsion, but the knee imperceptibly wobbles left to right as it fails to lock, which dramatically accelerates the knees wearing out. The good news is that you can regain a youthful walk easy as pie. It’s best to practice it on a seemingly endless flat pathway. As you relax and literally get into your stride, you will become aware at the sheer magic of it all. (Forget about the miracles of walking on water; he miracle is plain walking!). Focus but don't concentrate too hard – because if you do, everything will go clunky and discordant. All you have to think about is pushing the knee back straight as you push off. If you're doing it properly you will feel the inside of your thighs working hard to brace the knees back. Make sure to relax, let your shoulders down, let the arms swing, let the hips swing . . . . and enjoy the magic. To read more about exercises to keep the knees young see the video https://www.sarahkeyphysiotherapy.com/knee-arthritis.html#axzz3wtfxdvIC
So we're not talking about the upper body here (because what makes the old person look old in the upper body is being stooped forward like a boomerang – bottom at the back and head bent low at the front). Here we're talking about what it is in the leg department that characterises an old person’s walk. There are three joints to consider – the ankles, the knees and the hips. But in the modern era it is the knees that give us the most bother (and that wear out first). And believe it or not, in a typical case of chicken and egg, it's very much the way we walk as we get older that speeds up knee breakdown. Specifically, it's old people walking on bent knees that gives that incredibly old and decrepit look.To explain this further I have to go into the mechanics of walking. Walking is broken up into the weight-bearing and swing-through phases. As you swing the leg through and strike the ground with the heel, the knee should take your weight slightly bent. This is a good thing as it allows you to absorb shock coming up from the pavement. But then, as you go to push off in the weight-bearing phase that follows, it's really important that you push the leg back at the knee into a fully extended or locked-knee position. This action of the knee occurs simultaneously with the thrusting forward action of the gluteal muscles at the hip. So, strange as it seems, the knee going back fully straight, at the same time as the hip is thrusting forward gives you a duality of push off from both hip and knee of the same leg. See the video about Preventing Knee Arthritis https://www.sarahkeyphysiotherapy.com/knee-arthritis.html#axzz3wtfxdvIC
This video takes you carefully through self-treatment of one-sided back pain and sciatica
With so many injuries associated with them, the question has to be asked: are deadlifts bad for you.
But the main benefits of a night on the tiles are mechanical and this is why: dancing – particularly if you are a better than average dancer, light on your feet and twirling about in space - makes you inadvertently but nevertheless very effectively switch on the very muscles that have been switched off due to the bullying effects of the long spinal muscles. Moving and gliding over the floor means that you are deftly switching on your abdominal muscles, as you keep your abdominal torso braced (making you light on your feet so that you can lift and place your legs). This has the welcome effect of helping to switch off the muscles at the back thus lessening the compressive hold of the long spinal back muscles. At the same time, perhaps with a different sort of music, any shimmy-shaking of the hips similarly wakes up the deep spinal muscles that have an undulating-torso affect on the spinal segments moving in concert. This segmental spinal movement penetrates through the suffocating hold of the long spinal muscles and helps switch them off, while at the same time creating a delicious suck and squirt effect on the lumbar intervertebral discs – helping to squirt stale waste product out and suck fresh nutritional fluids in. Eliminating inflammatory toxins has an immediate and dramatic affect of easing discomfort from the very discs that have been flattened in the state of the perpetual lockdown for so long; another reason your back feels better at least in the short term after getting up and throwing yourself about. Of course, you may be a little stiff and sore the next day from the recent recruitment of muscles that have been out of action for a very long time but this is something to be stoical and philosophical about as all in a good cause. This is not a time to get anxious again and go rigid, as this will send you straight back to square one. Better to go for a walk - briskly, as you gird up your tummy and let your hips swing - and remember what a good time you had on that dance floor!See https://www.simplebackpain.com/back-muscles-anatomy.html
This goes to the very heart of what makes bad backs bad. The kernel of the problem is always a function fault, greater or lesser, at one of the spinal links. Whatever the cause, the automatic response is for the long spinal muscles is to go into protective mode automatically switching on to splint to the back – making it stiff – which wraps it up (should be) temporarily and takes it out of action. If it stays longterm there are a couple of unwanted consequences that make things worse, namely the reflex inhibition or switching off of two other important muscle groups – the deep spinal muscles of the lower back called 'multifidus' and at the same time 'abdominal muscles' at the front (this is why when your back is bad you find it harder to hold your tummy in). If the situation remains unchecked this can lead to a spiralling downturn with your lower back. It feels progressively more stiff and sore, more achy and then it eventually starts to grab on unguarded movement giving you screeching slices of pain that cobble you up in pain all the more. Eventually, you become locked in to an ever-more restricted frame of movement; so that can hardly make a move in any direction before the back lets you know again who's boss. Of course, this is made dramatically worse by you becoming more and more fretful and fearful of your back; afraid of the next painful move, dwelling on it all the time as you inexorably become more locked in and incapacitated.Strangely enough, or not so strangely, getting onto the dance floor can be just what the doctor ordered. Needless to say, it often coincides with carefree imbibition of alcohol which is no bad thing either (because it is a muscle relaxant, a slight sedative and creates that initial feeling of well-being).
Spinal fusions are much less readily performed these days and there's good reason for this: residual pain. The pain may be just as bad or worse after surgery (with or without sciatica) or the back may be passably okay for a few years but then starts to become problematic again.There are several reasons for lingering back pain after spinal fusion.1. The spinal fusion was done for the wrong reasons2. Post-operative scar tissue chokes the spinal nerves.3. The next level up above the fusion suffers excessive movement strain1. Modern Medicine is just as susceptible as many other disciplines to groupthink and fashionable mindsets of the day, otherwise known as zeitgeist. A recent zeitgeist in back world has been the diagnosing of spinal stenosis or vertebral stenosis (same thing) for rather murky looking radiology scans when in fact vertebral stenosis is quite rare and specifically related to difficulty (‘lead legs’) walking shorter and shorter distances (see https://www.simplebackpain.com/spinal-stenosis.html ); a previous fashion was ubiquitous diagnosis of ’slipped disc’ for almost any type of back pain (see https://www.simplebackpain.com/discectomy.html)). A recent fashion has been that a painful spine should be fused at a problem level, simply because that level is painful. In point of fact, a spinal level should only be fused if it has become loose, or or unstable. Spinal instability is rare and has distinct, easily recognisable features (see https://www.simplebackpain.com/lumbar-instability.html.) It is also quite common to see the wrong spinal level fused since surgeons are not particularly clever at deciding which segment is over-mobile (instability is best diagnosed manually with the hands through what is known as PIVM’S or passive intervertebral movement testing). Generally speaking, surgeons have a field day doing whatever procedure is the fashion of the day, or that they feel reasonably competent doing, and patients far too glibly prostrate themselves to oblige.
2. You can see from the photographs of a spinal fusion attached that this type of surgery uses screws and bolts not too dissimilar to that of a carpenter. The associated drilling and chopping of spinal bone and the dividing and cauterising of soft tissues and muscle in and around the spine causes massive bleeding and weeping at the operation ground zero. This must be dealt with by the surgeon before he closes up. The more careful surgeons quietly and patiently dab away at the tissues mopping up this traumatic exudate until it is virtually dry before sewing up each tissue layer on the way out. If this is not done - or if the procedure is unnecessarily traumatic and bloody- post-operative scar tissue proliferates as these fluids gradually thicken into sticky goo and then harden into stringy strands of fibrous scar tissue. It becomes like space occupying living junk that gets in the way, clogging the spinal machinery and clagging the spinal nerves. Excessive adhesions in the spine can cause back pain but more commonly causes chronic post-operative sciatica or leg pain, as they choke the nearby spinal nerve. 3. In cases where the spinal fusion has been done for the right reasons and there is not a problem with adhesions the results from spinal fusion can be excellent. The back feels as solid as a rock after the surgery (no longer prone to giving way or a ‘painful arc’ on bending). Typically unfortunately, there is a fair deal of attrition at the next mobile segment up, which suffers excessive movement strain in compensating for the obliterated movement at the fused level (see https://www.simplebackpain.com/back-fusion-surgery.html). This usually comes about approximately six years after the surgery and often manifest initially as discomfort in bed, particularly when turning over. You will see from the following pages of the book ‘Be Careful Of Back Surgery’ that the way to avoid this is to perform specific spinal intrinsic muscles exercises that keep the upper lumbar segment strong (see https://www.simplebackpain.com/E-book-on-Back-Surgery.html).BETTER TO READ THIS BOOK BEFORE EVEN THINKING OF BACK SURGERY!
For people with a painful neck, it's a peculiar type of debility. Perhaps because the neck is so close to the brain - where it’s quite possible that muscle tension chokes the blood supply to the brain - that a stiff and painful neck can be a totally all-consuming affair; distorting one’s consciousness and clouding one’s entire waking hours.
And this is why we see patients ever more desperately searching for magic miracle cures; anything from home traction gadgets, to micro-massaging machines, to trigger point guns.
Invariably, this odyssey includes trying all sorts of miracle cure pillows. The plain fact of the matter is that there’s nothing better for a neck than an old-fashioned feather-and-down pillow. The reason for this is simple: it supports the head so totally that the muscles of the neck relax.
On the other hand, pillows made of microfibre - or worse still rubber - mean the head never completely relaxes. It bounces minutely throughout the night with catastrophic effects of escalating muscle stiffness, swollen neck joints, crepitus (grating sounds on movement) head cloudiness, altered mental states, labile emotions - and that dreadful gnawing pain - not to mention headaches.
The fancy neck pillows with a raised ridge along the front are also bad, although they do attempt to address one aspect of need - and that is support for the neck itself. Supporting the neck (as well as the head) is essential and much better brought about by tucking a pillow in around the neck to support the angle between shoulder and neck and this is critical to good neck relaxation.
The best pillow-filling medium is feathers and it’s been that way for centuries! Why would we think that some modern material could do it any better?
The best feather pillows are a combination of 80% feather 20% duck down although in their new state they’re almost over-stuffed. Before sleep you must punch a hole in the pillow with your fists to create an indentation that you nestle your head into, while the rest of the pillow bulk cradles around your neck.
The neck MUST relax!
At the other end of the spectrum, feather and down pillows lose their stuffing as they get old, so you literally have to plump them up from either end with your fists to get the support.
AND TALKING OF NECK GADGETS . . . .
this one's a goody; The Ma Roller.
Although this page is about shearers' back pain, it is just as applicable to farriers, carpenters, plumbers, bricklayers, floor tilers and gardeners
Sarah Key recommends these 7 lower back exercises during pregnancy to relieve pain.
Sarah Key's Masterclass physiotherapy courses are designed to make graduate physiotherapists more confident treating back problems
World leading authority on back pain, Sarah Key, provides self-help for a bad back without surgery. Relief from back pain is now at your finger tips.
Meet Sarah Key, the back treating physiotherapist, in the game for over four decades. Information and advice from the guru of bad backs promises to be a life-altering experience
Learn about the two spinal conditions, lumbarisation and sacralisation, and what to do about them. Sarah Key describes the best treatment options. . . .
Lumbar facet syndrome is one-sided low back pain from an inflamed facet joint. It may also cause leg pain (sciatica), numbness, coldness, weakness and hypersensitivity as far down as the foot.
The best mattress for back pain depends how stiff your spine is.
These neck pain exercises from Sarah Key are specifically designed for using at home. Follow her video or on-page instructions to stop that pain in the neck!
The Complete Back Pain Relief Video Package from world acclaimed physiotherapist, Sarah Key will solve your back pain and related issues for good!
Upper Back Pain when breathing can be relieved and treated. Renowned expert Sarah Key explains the causes and what to do about it.
Sarah Key says "Of course bed rest for back pain has its place!" Find out why here . . . .
Learn what is causing your back pain and how to treat it yourself with Sarah Key's best-selling Back Sufferers' Bible
Here are Sarah Key's three best stretching exercises for back pain. They are all decompressing for the spine. Just doing these simple exercises each day will make your life worth living again.
Sarah Key explains all you need to know about sciatica symptoms and treatment
Just because you have adult scoliosis doesn't mean you're beyond help!
Many people are wary of back surgery, and rightly so. Here are Sarah Key's non-surgical options for spinal stenosis treatment
It's important to know the correct way to do deadlifts, simply because there are so many injuries due to bad technique.
Physical therapy for scoliosis consists of decompression, straightening and spinal strengthening exercises. Proper treatment can be highly effective.
Knowing something about the back muscles anatomy makes it easier to understand where you might be going wrong with an exercise regime for back pain.
Sarah Key's 7 best sciatica stretching exercises are tailored to coaxing the spinal nerve root free of its adhesions and then mopping up afterwards.
As well as masses of useful information, Sarah Key's sciatica treatment video shows you in real-time how to use the Ma Roller and BackBlock
Knowledge is power and, in this video, Sarah Key offers you the power of understanding the workings of the shoulder, and what could be causing your shoulder pain.
It could be the way you're moving your arms, or even neck pain that's contributing to pain in your shoulder.
Watch the video to understand more.
Exercises for posture start with the feet as it's essential to build on a firm and sustainable foundation
If you've lost the spring to your step and are experiencing painful feet, this one's for you.
Like most things skeletal,when feet become painful it's largely a matter of muscles gone awry; some weak some strong, some short, some long.
Follow the link to watch Sarah Key explain what's happening when you have painful feet, and demonstrate some simple ways you can mobilise and strengthen your arches to reduce foot pain. She particularly recommends the MaRoller in your exercises...
Knees giving you trouble? Knee pain is the greatest cause of visits to the GP!
Sarah Key's latest video on this subject, explains the different causes of knee pain and what you can do to prevent it developing into arthritis.
Check it out at the link below
Exercises for posture for the upper back are mandatory if you have pain, particularly if you are a sedentary worker, use a computer a lot, or work with your head down.
Sarah Key is one of the worlds leading experts and authors in the treatment of back pain.
The hips are a universally mobile but very stable joint, allowing them to bear massive loading and propel the body forward in walking and running. But, because they are such large weight bearing joints, minor deficiencies of movement can quickly translate to reduced maintenance and repair.
In this video, Sarah Key explains why hips break down when they lose end-of-range of movement - and what you can do to help prevent this happening.
Keeping the hip joints fully flexible and strong is vital to keeping the opposing cartilage surfaces slippery and compliant. Watch this video to understand important prevention and treatment for hip pain.
Thoracic kyphosis, also known as a hunched upper back, can lead to pain in the upper back, neck and shoulders, and can also cause our basic health to be compromised by limiting function of the ribs.
The link below takes you to Sarah Key's easy to understand video "Exercises for a Hunched Upper Back". In it, she outlines the impacts of thoracic kyphosis and the importance of doing regular, simple, upper back strengthening exercises. These release the upper back, return health and vitality to the body, and reduce general back pain.
Also available are links to her highly recommended BackBlock and home help videos
If you are suffering from lower back pain and feel you are endlessly searching for relief, the Ma Roller may end your search forever.
One of Sarah Key's best selling back pain products, the Ma Roller, uses gentle, convoluted, humps and hollows to mobilise thickened, inflamed facet joints either side of your spine.
By simply massaging this specifically designed 'wooden rolling pin' up and down your lower back, you will allow the spine to release through these inflamed structures, bringing greater ease of movement and relieving back pain.
Using the Ma Roller means business! It can be quite uncomfortable, but it is one of the most effective ways of mobilising painful facet joints, to help you on the path to greater health.
Watch the video to understand what is going on when you do this simple exercise at home, torelieve your lower back pain.
The spine is divided into three areas. At the top is the cervical spine (neck), followed by thoracic spine (middle back), the lumbar spine (lower back).
The Ma Roller is wonderfully effective on all areas for mobilising facet joints and relieving pain. In the thoracic spine the Ma Roller is particularly effective for mobilising the ribs as well, where problems can cause upper back pain when breathing.
Jump to this page for a step-by-step guide on using the Ma Roller to ease neck pain...
If you work in a job that requires long hours seated, often in front of a computer, you may experience lower back pain. Or, you may find that a simple act like sitting down for dinner is causing you discomfort.
Could there be a link between sitting and back pain?
You bet there is!
The spine has a natural S-Bend that helps support our heavy heads, allows us to walk upright and keeps our backs strong and healthy.
But, after sitting, our back often feels stiff and compressed and, over time, the natural function of the spine can become compromised if we’re not sitting correctly on a regular basis.
So what’s the problem with sitting?
If we’re not doing it correctly, we are forcing the spine into a position it is not designed to go.
The key to sitting well and minimising back pain can be very simple, and Sarah Key outlines core causes, solutions and exercises in this short video on this linked page...
Upper back strengthening exercises are key to fixing a hunched upper back (a thoracic kyphosis).
Sarah Key's video on spinal scoliosis treatment is a must-watch for anyone suffering from the spine disorder, no matter how mild or severe.
Yoga for stretching back muscles can zero in on a back problem and release it in ways you least expect.
This page 'beginner yoga for back pain' is he distilled wisdom from one of the pros in the field: Sarah Key's Beginner Yoga Routine for Back Pain Relief
See these pages for Sarah Key's collection of the best yoga for lower back pain
These exercises for back pain are specifically for tall people problems. But they're also good for pain in upper back from being hunched over a computer so much of the day.
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