Thank you for joining us for today’s livestream where we talked about specifically why younger people can experience back pain. Often if you go to the GP, it might be stated that your back pain is age-related wear and tear. In fact, we often associate back pain with getting older in general. So what are the causes of back pain during younger years?

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Technology & Younger Cases of Back Pain Young people grow up around technology. Very young children often accompany a parent coming in for back pain and they’re often kept busy with an iPad and they’re often sitting with it on their lap as they look continually down. When you’re that young, you don’t have spinal curves. These develop over time as we learn to crawl and walk. If we spend a lot of time at this point rounded over an iPad, this can lead to things developing not as effectively as they should. We often see young people in their late teens and twenties who come in with spines worse than their parents. There will be less degeneration there as that is the true age related change that can come from poor alignment, but the change in alignment will be present.  Studying For Further Years Nowadays it is more common that you’re spending many more years in education than the older generations alive today. There’s more scope and funding out there to stay in education well beyond the 16-18 age that older generations would have today. Using technology, video games and phones with children growing up, followed by years of studying: sitting reading books or on the laptop. There’s inappropriate muscle development, lack of strength in the core and back muscles, overly stretched muscles from sitting hunched and poor alignment in the spine. A lot of popular ‘memes’ online are shared about feeling old due to back pain in young age, this is because of a change in lifestyle.  What causes back pain? Sitting for long periods studying, texting and hunching over playing video games, we flatten the lumbar lordosis which can cause stiffness and stretching of the muscles. You maybe won’t understand what’s going on when you’re getting this stiffness unless you’re studying a subject related to your anatomy, so you might go ahead and try to stretch out more - which further perpetuates the problem. Sitting to rest the back further because you’re feeling sore will make the problem worse because you need movement to flush the area. Inactivity causes poor muscle control and movement patterns.

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Thank you for joining us for today’s livestream where we talked about how to manage a flare up of back pain. If you’re going through a relapse right now, or you have back pain that comes and goes, we’re here to talk to you about what you can do to ease the discomfort and get yourself in a position where you’re going to experience relapses less often.

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Why did it happen? Delayed onset of symptoms can confuse you as to how the problem started. Often it can feel like you just woke up with it when actually it’s probably caused by something you did the day or two days before. Maybe you went on a long walk, a bike ride, you’ve gone back to work etc. if these things are abnormal for you then you might get some back pain and your body might not tell you it’s been a problem until the next day.   What stage are you at? Phase 0-1: if you’re not in our back in shape yet, you’ve just injured your back or you’ve just started 

Phase 1. Use Phase 1 as a starting point as it teaches you how to engage your core and improve flexibility and mobility of the lower body. The stretches will help improve inflammation levels and tell you what you need to avoid on the daily basis. Anyone can access this for free.  

Phase 2: this is the area you’ll start to develop more control over your body, you’ll see further flexibility improvements because you’ve been doing the stretches for longer and you’ll be getting stronger. At this point, if you have a relapse, you’ll see that any relapse you might have will last for less time because you’re stronger than you were when you started. It can be very demoralising to go back to square one but you’re a different person now than you were then.  

Phase 3: the workouts here get a bit more fun as you can add resistance to the workouts. You should see that you’ve come a long way since beginning at phase 1.  Moving on with rehabilitation If you’ve relapsed at the beginning of phase 2, go back to phase 1 for a few days and be diligent with your icing and daily habits. After these few days, go back into phase 2 at about 75% of the effort you were at before. If you are at phase 3 at the relapse, stay mobile and revert to phase 1 for a couple of days again, then back to phase 3 at again 75% of the effort you were doing before. Build up over the next 5 days followed by a plateau of 7 days, then you can continue building from there.  If you’re going back to the gym in the next couple of weeks, don’t confuse delayed onset muscle soreness for a flare up, and don’t push it too hard straight away.

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Thank you for joining us for today’s livestream where we talked about if you should be starting rehabilitation straight away.

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We hear so often from people who think they need to wait until they’re out of pain to start rehabilitation. Having pain in your lower back is a sign that there is something wrong. The problem arises when you’ve had chronic pain that’s been and gone over a number of years, the signals may be unhelpful because it might make you anxious about doing exercise. Especially when exercises like knee hugs are recommended when they will likely make your problem worse. It’s so important to do the right rehab as soon as possible.  

You can get slipped discs, bulging or herniated discs, spondylolisthesis, spinal stenosis etc. and these injuries can cause inflammation to build in the lower back that spreads pain or symptoms into the legs. If you compress the nerve in your elbow, you’ll start to lose feeling in your hand - the solution is simple though - to take pressure off. Lack of movement in the evening can cause everything to cease up, which if you then take into account lack of movement during the day too that might make you worse.  Too much movement is not necessarily good but movement through walking is good. We often hear of patients unable to make it to their appointment because they’re in so much pain, but that when they decide to come in that they feel better because they’ve moved around to get here.  

Even in bad cases, it can be recommended to have painkillers. They’re not doing anything for your recovery but they are helping you to move around. The purpose of this is so that you can rehabilitate the problem. Painkillers are simply a plaster over a problem, just because you can’t feel it doesn’t mean the problem has gone. It’s not getting rid of it for you.  In Back In Shape, we have a phase 1 section that’s free where you can learn what stretches can make you more mobile and start engaging the core muscles. In phase 2 you’re introducing bodyweight exercises to strengthen your body and followed by phase 3 where we introduce added resistance. Do them with good technique rather than trying to hit the repetitions.

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Thank you for joining us for today’s livestream where we talked about a condition called spondylolisthesis. What they are, how they occur and the different variations. We’ll be going through some tips to manage the problem as well as what kind of rehabilitation you’ll need to do if you have this problem. 

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Some people have a spondylolisthesis and don’t perhaps understand exactly what it is, so we’re going to help you better understand this type of problem as well as the kind of movements you’ll need to avoid. We’ll also go through imaging and the condition’s relationship with bulging discs and spinal stenosis.  Also known as an anterolisthesis, a spondylolisthesis is where a vertebra slips forward. Retrolistehsis is where one slips backwards, but is usually in combination of one that has slipped forward. The way your spine is naturally aligned and the position of the facet joints, this prevents any vertebra slipping forwards, with the ligaments running along the spine they’re pretty stable.   

A spondylolisthesis can be graded between grade 1 and 4. It’s unlikely any of you will be anywhere between a grade 2-4, usually they’re grade 1. We’ve seen a few 3.5s over the years but usually this is as a result of a serious trauma, you know you’ve done it.  When you’re growing in your early years, we start off with a cartilage structure that later turns to bone, the facet and vertebra meet to form a pars interarticularis. 

If there’s a cartilage part of this that hasn’t developed into bone, this is a weakness that can later leave you more susceptible to shearing forces.  An MRI can be an un-useful version of imaging with this type of problem as a spondylolisthesis can actually slide back into its normal position when you’re lying down, which means it won’t be detected. Using upright X-ray imaging will detect this type of problem.   

What you need to avoid: any kind of backward bending like the cobra exercise will not be helpful, avoiding yoga for the meantime will be helpful when you’re first recovering. The towel exercise we frequently recommend can also be more challenging with this condition. Tentatively try it for around 20-30 seconds and build it up to the 3-5 minutes as it can be more uncomfortable at first. Avoid forward bending exercises like knee hugs.

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Welcome to today’s livestream where we talked about a roadmap to recovery after you’ve suffered with back pain. We hope this will give you a clear way forward to integrate exercise into your routine!

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You might have a goal of your own that you want to achieve, for example getting back into a sporting activity, being able to get through your work day without pain or getting back into the gym. You need to consider, what was injured? How did you find rehab? What activity are you looking to get back into?  A long standing injury we want to understand what has been injured. If you’re following our Back In Shape membership area exercises and you’re doing the core engagement for example, if this is taking you a week or two weeks to master then the road to recovery may be slower. If you can just do a couple of reps to begin with, this indicates there’s a long way to go in recovery. When it comes to returning to the activity, is the activity going to be simply going for a walk with your other half or is it returning to trampolining? 

Everything is possible but some will take longer than others.  Delayed reactions: back pain reaggravations usually occur the next day after you’ve done something. If you wake up with back pain it might be easy to put it down to how you slept, but the reaction was usually from something the day before as it takes time for the inflammation to build.  Replacing rehabilitation: once you’re able to bring in an activity you enjoy, don’t let it replace your rehabilitation. Whether that’s yoga, cycling or running, they’re not a replacement for rehab especially in the early stages.  Healing can be slow: healing can take time and may not be a linear process. 

We can’t see the injury which is why it can be more difficult but we can liken it to a cut on the hand. The pain stops before the injury has fully healed.  T.R.E.A.T: Test the activity on an easy day, Re-test: after a few days, probably not the next day but leave it a couple of days, Evaluate: how has it affected you, did you have any pain the next day? Adjust: See how it has affected you and make an adjustment accordingly, Test: Test the activity again to see whether it has affected the back.

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How To Engage Your Core Properly When Exercising

Thank you for joining us for today’s livestream where we talked about how to engage your core when exercising. Engaging your core is one of the most important first steps of rehabilitation, as all the exercises you’ll do require this skill.

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Not engaging your core is such a big mistake that a lot of people make when moving onto their rehab. This might play a role in why you perhaps haven’t been able to have an effective rehabilitation as well as why you might often be relapsing as well. 

If you’re thinking of moving into Phase 3 or you’re partway into Phase 2, this is especially for you. Those of you who have made progress, you’re probably not having too much back pain and you’re starting some of the more advanced exercises. Also if you exercise for fun and you’re not engaging your core, you should introduce this. Lack of proper control over the core can persist even if you go to the gym regularly and can catch you out, as it develops weaknesses.  

Why Do People Get Injured? A lack of proper control over your movement. This is exploited when you add resistance. It can be so common to increase the weight too quickly because you can’t ‘feel’ it. If you can’t even feel it without weight because you’re compensating with other muscles, you’re not going to be training the intended muscle. 

Deadbugs are another exercise where this can be more challenging once your muscles are properly engaged.  Abdominal Rotations This is an exercise we would normally do with a band. Imagine you’ve got a rod anchoring your body, and you’re just rotating from the midsection, keeping the upper body moving as one. Even without the weight if you’re engaging your core, you’ll notice it working and you might get a little cramping as the muscle works.

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Thank you for joining us for today’s livestream where we talked about why cholesterol is important! We’ll be going through some of the research and 3 things you can look into from home as to how you can make changes if you’re concerned about your cholesterol levels. Make sure to subscribe so you don’t miss out on the content!

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We’re not attempting to diagnose your condition here but sharing information that we think you’ll find interesting. You can then be able to be more informed, know where you can do further research and also use it as a talking point with your GP. If you have severe levels of cholesterol you may find the information helpful, but you should be consulting your physician to see if any of these things will help you.

First of all, if you’re concerned about anything to do with your health - get a blood test. There are plenty of companies online who offer broad spectrum blood tests.

Role of Diet From the research, it’s not possible for them to draw a link between high-fat diets and cholesterol levels. We can get into statins on another video, but our critique is unfortunately you see your GP for a short period of time and they don’t have the availability to discuss things you can do to reduce your cholesterol. This is why they may just suggest you come back in a few weeks to have the levels checked again. There is possibility to improve your cholesterol levels and lower long-term risk of mortality.

Ketogenic Diet This is a high-fat diet. The participants of the study were on a low-carb, high-fat diet for 56 weeks. Identifying the long-term consequences of a low-carb diet and impact on cholesterol levels. They were able to lower cholesterol and lower the BMI as well. This doesn’t give you a free pass to eat burgers and cheese, but there’s lots of scope to have a balanced diet. There has been a war on high-fat diets over the last few decades, but low-fat items can be replaced with sugar. There was a time when doctors endorsed smoking Camel cigarettes!

Exercise Low-grade aerobic exercise such as walking doesn’t have the same impact as resistance training. Slightly more intense exercise seems to have a much better effect in the long-run. The 10,000 steps a day is still important!

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Thank you for tuning in to today’s livestream where we talked about neck pain. Whether you’re getting neck pain that’s constant or coming and going, we’re going to talk more today about how you can help it from home. We need to have a look at what we’re doing on a daily basis and then some proactive ways of moving forward once you’ve established where you’re going wrong.

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How Are We Using Our Body On A Daily Basis Is it from daily life or was it a one-off trauma that caused your neck pain? If you’re getting stiffness and tension that’s built up over time into more constant pain, this may have happened over a number of months or years. You may have been diagnosed with facet issues or disc issues already. Someone who’s had a one off trauma we generally tend not to see as they tend to go to a hospital at the time, but we might see that person a few years later if they haven’t been through the necessary rehabilitation process.

How Is Our Neck Constructed? The human skeleton has been evolving for a long time. It’s designed very well with its three curves to help it function, and to support the weight of your body and a bowling ball weighted head on top of a delicate neck structure. Looking at erosion for example, smaller, sustained traumas can have a bigger impact over time than one off events. Are we doing things on a daily basis that’s not helpful. Are we laying in bed reading a book or on your phone with your head propped up on a pillow? Are we doing this watching TV? When we realign spines in the clinic using spinal remodelling, this is a process of 20 minutes a day for 3-4 months. If you can do that, you can definitely achieve a worsening of the posture in that time period as well in just 20 minutes. Most of us spend a lot more time than that with bad posture.

The Wrong Exercises With a reduced neck curve, you tend to get stiffness into the neck, shoulders and upper back. If you’re pulling the neck forwards to stretch the area, this is only perpetuating the problem - you need to stop doing that exercise. Your muscles will be working harder when you’re dealing with forward head posture because it accentuates the weight of your head, a little like holding your shopping bags in front of you away from the body - they feel heavy quickly.

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Thank you for joining us for today’s livestream where we talked about balance. As we age this is something that becomes increasingly important, in this video we discuss how you can improve your balance from home, how it relates to your back pain and why it is so important.

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Aging & Balance - The ability for your body to catch yourself when you fall off a pavement for example, diminishes as you age. This can often be the reason why someone in their older years might fall more regularly than someone of a younger age. It’s important we avoid this as much as possible because the consequences of falling over when you’re younger are not as severe as someone when they’re older, you’ve got more chance of fracturing or breaking a hip.

Exercise Choices - The choice of exercise as you age is generally changing to walking or gardening. Walking doesn’t quite do the same thing as other types of activity for your fast-twitch muscle fibres, the ones that will save you from falling. Resistance training is one of the best ways to build fast-twitch fibres and has a direct impact on your ability to balance. Slow-twitch fibres are not able to process information fast enough to save you, but are the ones maintained through walking.

Ankles - We have a lot of proprioception in our ankles. When you sprain your ankle you can lose some of those receptors, which is why it’s important to do the correct rehabilitation process to get that back.  Participants aged 72-98 choosing walking or swimming as low-impact activities, changing them onto a resistance training routine meant they were better able to do functional activities like climbing stairs, over a period of 10 weeks. So you can make big changes in a small amount of time.

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Thank you for joining us for today’s livestream where we talked about when the right time to exercise is when you have back pain. We’re going to give you some tips of how you can get started safely!

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When You Should Start - If you’re taking painkillers or you’re having injections, those ‘treatment’ methods are designed to relieve the pain so that you can effectively do your rehabilitation. A rehabilitation approach would not be knee hugs as there’s nothing strengthening about it. The Back In Shape membership area is designed to guide you through rehabilitation. 

What You Shouldn’t Do - Anything high impact is not going to be helpful right now. Running, tennis, trampolining, all of these exercises put a lot of stress on the back and should be avoided in the initial rehabilitation process.

What Should You Focus On - Strengthening exercises that challenge the core and lower body will be helpful to improve the health of your spine. You may find these quite difficult at first but it shows how much improvement you need to make.

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