Back & Neck EBook - US




Why Do My Back & Neck Hurt? Step 1: Improve Your Posture Step 2: Enhance Your Mobility Step 3: Improve Your Spine’s Strength and Stability Step 4: Enhance Your Spine’s Proprioception and Coordination Step 5: Lasting Results With Recovery of Function Why Physical Therapy Is The Right Choice Always consult your physical therapist before beginning any exercise program. This general information is not intended to diagnose any medical condition or replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. Stop and consult your healthcare provider if you experience any pain or difficulty with these tips. TABLE OF CONTENTS


Why Do My Back & Neck Hurt?


hen it comes to back or neck pain, the vast majority is caused by underlying mobility dysfunction (aka

mechanical pain) of the spine. This is often due to poor postural habits, faulty movement patterns, misalignment, lack of joint or tissue mobility, and weak spinal muscles. It’s important to know that pain is a symptom, not the source of the problem. Getting to the root of the problem is essential to finding lasting relief! Too often, people turn to over-the-counter medications or see their doctor for prescription medications to address the symptoms without identifying the root of the problem. Sadly, they never get the results they are hoping for. Physical therapists are movement experts and highly trained at identifying the root causes of back or neck pain and, more importantly, helping you find solutions for lasting relief!


Back pain is a mechanical problem and must be treated as such. Here are the leading causes of most back and neck pain: • Poor postural habits (i.e., slouched, awk - ward, and/or prolonged positions). • Lack of mobility in the joints and/or soft tissues. • Poor spinal joint stability and lack of core muscle strength. • Lack of proprioception and spinal coordi - nation. This book will teach you what we do to alleviate back pain, so you can improve your back and neck health and return to the activities you enjoy!




ack and neck pain can be acute or chronic, constant

or intermittent, mild or severe. No matter what type of back or neck pain you are experiencing, your body tells you something is wrong and needs to be addressed sooner rather than later. Addressing back and/or neck pain as soon as it starts is the key to avoiding more serious consequences. With the proper treatment, physical therapy can dramatically help back and neck problems such as degeneration, arthritis, stenosis, herniated discs, and sciatica. Take time to read and implement these back and neck pain relief strategies in this book. Your spine will thank you!


Why Choose Physical Therapy?



hysical therapists are highly trained; most have

doctorate degrees in medical sciences. As musculoskeletal experts licensed by the state, they evaluate orthopedic and neurological conditions that affect movement. Through a comprehensive evaluation of your joints, muscles, and neurological function, we can pinpoint the exact source of your spinal issues. Physical therapists are also experts in hands-on treatments such as therapeutic massage,


joint mobilization, and other soft tissue techniques. In addition, a physical therapy session also involves specific therapeutic exercises that target affected areas, rebuilding joint and soft tissue mobility strength, proprioception, and coordination. Finally, a physical therapist teaches you how to take care of your body independently with exercises, posture techniques, body mechanics, and restoring your functional capabilities for long-lasting results. If you want to know more about how we can help you alleviate your back pain for good, call us today to speak with one of our specialists.


STEP 1: Improve Your Posture


Every day, your spine encounters the relentless pull of gravity. Our ability to find, adjust and maintain our natural spine posture determines how well we withstand this force. Do you sit for long periods at work or home? Do you find yourself slouching during the day? Poor postural habits strain the muscles, tendons, ligaments, and connective tissues surrounding the joints. Prolonged postures can eventually lead to pain and cause spine areas to become stiff, weak, and more susceptible to injury. Ideally, the body’s center of gravity falls along the natural curves of your spine. Poor posture is essentially the loss of the spine’s normal curvature, which places strain on the different tissues of the back and neck.


How to Protect Your Spine With Better Posture One of the most effective ways to alleviate back and neck pain is to address bad posture and learn to find your ideal posture. Posture refers to the position(s) of a person's body in space. By properly aligning spine joints with one another, we can move more freely and perform daily activities comfortably. Our awareness of the postures we hold our body in is based on our nervous system's feedback and depends on our activities. This feedback helps us find and keep the alignment of the spinal joints over one another. Unfortunately, prolonged postures tend to dull these senses. The longer we stay in a position, the more our body becomes used to it, and the harder it is to get out of the offending position.


Postural control refers to maintaining posture against gravity and ensuring that the natural alignment is maintained. Unfortunately, getting into bad habits often doesn't cause pain in the beginning. By the time pain starts, our body has become accustomed to the unnatural postures. Sitting causes significant pressure on the spine and the tissues surrounding and supporting the spine. Research has shown that prolonged sitting has detrimental effects on the spine and your overall health. We must limit sitting in one position to 30-45 minutes at a time. It is important to note that if you sit a lot during the day, you should take extra care of your spine. Here are some simple tips to help you improve your posture while doing different tasks: • When sitting at a desk, ensure you are sitting tall with your feet flat on the floor. Sit tall or not at all. Lumbar support is often helpful in maintaining your natural alignment while sitting. Regardless of how you sit, limit any posture to 30-45 minutes and then change your posture or stand up and walk around. • Limit sitting at home on soft couches or in recliners for long periods. These surfaces cause abnormal/excessive slouching in your


lower spine and a severe forward head/neck posture in your cervical spine. • When standing or walking, start by lifting your breast bone (sternum) towards the sky to lift your spine into a tall posture with the vertebrae stacked over one another. Some people find similar effects by pretending that an invisible string pulls you up through the top of your head. The bottom line is that lifting the spine helps bring your body into better alignment. • When lifting objects, keeping your back straight is the key to success. Bending and/ or slouching makes you more susceptible to an injury. Keep what you're lifting close to your body and kneel or squat to pick up objects off the floor. Using your legs, not your spine, means your legs move while your spine stays straight and stable. • When sleeping, the most important position is the one you can sleep in. Rest is most important, and the actual position is the second most important. When you are experiencing pain, try to sleep on your back or side. Try using a pillow under your knees when lying on your back or between your knees when lying on your side.


How physical therapy helps your stride Physical therapists are experts in identifying your ideal posture and evaluating the alignment of your body. Our well- trained physical therapists have years of medical training in the musculoskeletal system. We can spot restrictions in your mobility, weaknesses, and compensatory movement patterns that help us identify your underlying problems. Proper posture helps reduce the strain on the spine throughout the day. Often pain in one area is due to compensation for poor posture and dysfunction in other areas. We use the symptoms to help us get to the root of your problems. By helping you restore your ideal posture, we can ensure your body functions normally and moves through pain- free ranges.


STEP 2: Enhance Your Mobility


Movement is the key to the health of your joints, especially in the spine.

Our bodies are designed to move, and our health and well-being rely on movement to function properly. More and more research shows that inactivity increases the likelihood of pain and dysfunction throughout the body. When it comes to the spine, there is no doubt. Inactivity and prolonged positions (i.e., sitting or standing) are associated with back and neck pain. The spine is made up of a series of interconnected joints. Each vertebra has four back-facing (posterior) joint surfaces that connect it to the vertebrae above and below. In addition, each vertebra has a specialized joint with a disc in between them. Finally, the spine is connected to other parts of the body. For example, the thoracic


spine connects your spine to the ribs, the sacrum to the pelvis, and the neck to the skull. In all, your spine has 364 joints! Movement is the key to the health of your joints, especially in the spine. Basic movements and more advanced activities help keep your joints strong and healthy. Our physical therapists can guide you through a safe and effective routine to ensure you keep your joints and body healthy so you can do what you love! Did you know? Your spine relies heavily on your hip joints and pelvis to function correctly. Most movement when you squat or bend down comes from your hips. When your hips lose their mobility, your body compensates and shifts the strain to your spine, causing pain and abnormal movement patterns that may lead to injury.


How to improve the mobility of your spine Always remember the slogan, “go-to pain, not through pain.” When it comes to improving your mobility, gentle, frequent, and consistent effort makes the most significant difference. Too often, people try to make up for neglecting their spine by trying to restore mobility and function overnight. The key to lasting results is persisting! Instead of forcing your body into pain or being aggressive, try taking your muscles and joints within a comfortable range and gradually ease into deeper ranges. Depending on your age and how long you have neglected the health of your spinal joints, the more frequently you should work on your mobility. Try connecting movement to things you do every day, like before you eat or after each time you use the restroom. Doing so can help you develop a consistent routine. Start with gentle stretches for the lower back, mid-back, and neck to help restore your natural posture and joint function to ensure the whole body's health. Another way to incorporate mobility into your daily routine is through active stretching (aka dynamic stretching): This form involves moving a limb through its full range of motion to the


end ranges, where tension/stretch is felt and repeated several times in a given time. Dynamic stretching is a very beneficial way to improve your mobility, coordination and re-educate the body on proper movement patterns. How physical therapy helps your mobility One of the core principles of physical therapy is helping people restore movement. A physical therapist improves the mobility of your spinal joints with targeted manual techniques like therapeutic massage, myofascial release techniques, and joint mobilizations/manipulations. These techniques specifically improve your soft tissue mobility and the mobility of your spinal joints. In addition, physical therapists focus on teaching you how to restore and prevent your problem from returning through specific exercises, postural corrections, and strengthening exercises.


Extension in Standing (Lumbar Extension) • Stand with feet about shoulder- width apart and hands in the small of the lower back. • Slowly bend backward as far as possible without forcing the movement. • Take a deep breath, exhale, and allow yourself to relax fully into the position. • Repeat 5-10 repetitions 3-5 times daily (more if desired). This is a movement, not a stretch, so go as far as possible but stay only 1-2 seconds maximum.


Cervical Retraction • Always start by sitting back

fully in the chair with your back comfortably resting against the back of the chair. • Slowly lean your chest and shoulders back while keeping your eyes forward. • Take a deep breath, exhale, and relax fully into the position. • Hold 1-2 seconds and return to neutral. • Repeat 5-10 repetitions 3-5 times a day (more if desired).


STEP 3: Improve Your Spine’s Strength and Stability


The spine is needed to perform the most basic to the most complex movements, with the coordination of muscles, joints, and nerves functioning simultaneously. This requires a complicated ballet of precision and timing. With an injury, or in some cases, a sedentary lifestyle, the coordination of the spinal muscles can become unbalanced. This places enormous pressure on key spots in the lower back, increasing the likelihood of dysfunction and pain.


Muscle weakness and instability are common issues for people with back and neck pain. The lower back, in particular, depends on the strength and stability of the core muscles. These include the abdominal, pelvic, and lower back muscles. They maintain the correct alignment and stability of the lower back and allow for proper function throughout the spine, including the neck. With injury and inactivity, your core muscles can weaken, resulting in compensations and faulty movement patterns that lead to pain and, in some cases, injury. This is especially common with a sedentary lifestyle or an occupation that

requires prolonged sitting or standing. Strength comes with consistency and

time. Identifying your areas of weakness or dysfunction can help ensure you perform the right exercises for your specific condition. In the beginning, you are far better off doing basic


Try this exercise to improve your spinal strength and stability. >> are incredibly complex, and unfortunately, inactivity and injury can impair this function. For some, pain and injury lead to dysfunction in the system. Many people don’t realize that strengthening involves your brain’s ability to connect with the right muscle groups. The timing and coordination of our muscles, joints, and nerves foundational spinal strengthening exercises. As you improve, it is important to continue progressing your program to achieve lasting results. The pelvic and hip muscles are as important as your abdominal and back muscles to ensure the health of your spine. Weakness in the pelvis and hip muscles will directly affect your spine and can lead to compensatory patterns that make your back more susceptible to pain and injury. Weakness in the core will change your posture and spinal movements, resulting in excessive strain on the spine.


Bridges • Lie on your back with your knees bent and feet flat on the floor. • Put your attention on your buttock muscles and press your heels into the ground. • Lift your hips off the floor until your hips are aligned with your knees and shoulders. • Hold for 3-5 seconds. • Repeat 5-10 repetitions - 3 times a week. If you feel cramping in your hamstring muscles (back of thighs), return to the starting position and focus on using your buttock muscles.


Planks • Lie on your stomach, bend your elbows, and rest your weight on your forearms and toes. • Put your attention on your core muscles and gently push up onto your elbows and hold yourself in a straight line (like a plank of wood). • Hold for 10-30 seconds. • Repeat 5-10 repetitions - 3 times a week.


How to improve your spinal strength

Strength comes from performing the right exercises with the right amount of control. You are far better off doing small, specific spinal strengthening exercises than trying to move large weights. It is safer, and you will achieve a better result. A lot of strengthening involves restoring your brain’s ability to connect with the right muscle groups. When you perform abdominal exercises, do them slowly, focusing on tightening your muscles and controlling the movement. The pelvic and hip muscles are an important part of strengthening your spine. Weak hip muscles fail to take the load when walking, change your posture and spinal


movement, and strain the spine. Performing leg lifts to the side and back helps to strengthen the hip musculature. Perform coordinated strengthening exercises. For example, doing mini squats while keeping your abdomen tight helps to engage the core, pelvic, and leg muscles together. How physical therapy helps your spinal strength Physical therapists have years of training in kinesiology, the study of human movement. Through proper evaluation of what muscles are weak in your spine, we pinpoint the area that needs strengthening. We then teach you specific exercises that target particular muscle groups. We naturally progress from very simple exercises to more complex coordinated exercises as our spinal muscles heal and begin to work together. You are empowered with the knowledge of keeping your spine strong and healthy. Try this exercise to improve your spinal strength and stability. >>


Beginners Dead Bug • Lie on your back with your knees bent and feet flat on the floor. • Press your lower back to the floor and maintain this contact throughout the exercise. • With your hands on your pelvis to ensure no movement, brace your abdominal muscles while simultaneously lifting one leg towards your chest. • Alternate legs using deliberate and controlled movements. • Repeat 10-15 repetitions per leg - 3 times a week.


Try this exercise to improve your spinal strength and stability.

Chair Squats • Stand in front of your chair, facing

away from it, with a tall posture. • Stick your buttock back while bending your knees (like you are going to sit down). • Gently tap the chair with your butt, but don't sit down. • Then return to the original position. • Repeat 5-10 repetitions and gradually increase until you can do 20-25 in a row. • When you can complete 20 repetitions, begin adding weight. • Hold a weight against your chest (aka goblet squat).


STEP 4: Enhance Your Spine’s Proprioception and Coordination


Enhance Your Spine’s Proprioception and Coordination

Our goal is to help relieve your pain quickly, and to make sure your spine stays healthy for the long run. One of the most important features of a healthy spine is the ability to coordinate your muscles, nerves, and joints. This provides long-term spine health and the capability to handle strenuous motions. Your spine is a complex system with bones, muscles, nerves, and joints that must move at the right time and sequence to make smooth, controlled movements. It’s no wonder things can go wrong when you have that many moving parts. With prolonged inactivity or injury, our joints and muscles can be negatively impacted, resulting in dysfunction throughout the spine. Often this leads


to changes in movement patterns and compensations that change how we move. These changes often lead to pain and, in some cases, injury. Research has shown that people with chronic back and/or neck pain do not use their muscles like those with no history of pain. Proprioception is a medical term used to describe the perception or awareness of the positions and movements of the body. Impairments in this system after injury or periods of inactivity will impair how our body coordinates actions, leaving us more susceptible to future injuries. The good news is that your coordination and proprioception can be vastly improved with the right exercises and treatment. This will help you learn about how your spine feels in certain positions. 1.While holding onto a steady surface, try to balance on one leg at a time. Tighten your abdominal muscles while doing this, and don’t let your hip/pelvis sink. 2.Perform alternating arm and leg lift exercises. Using multiple body parts causes rotation and activation of the smaller muscles in the spine.


Try this exercise to restore your spine’s mobility, natural alignment, and coordination. >> exact problem by examining your mobility, strength, and coordination. You are put through specific movement patterns that show where your spine lacks coordination and mobility that is affecting your function. With this knowledge, a complete plan is designed to restore your spine’s mobility, natural alignment, and coordination. 3.Work on controlling the tightening of your abdominal muscles, hips, and spine throughout the day. Practice this lying down, sitting, and standing to affect the abdominal muscles in different positions. 4.Perform core exercises such as modified planks How physical therapy helps your spinal coordination A physical therapist can pinpoint your


Quadruped Alternate Arm And Leg (Bird Dogs)

• Get onto your hands and knees. • With control, lift and reach your leg and opposite arm upwards. • Once your arm and leg are straight and fully out-stretched, pause for a 3-5 second count. (Work up to a 10-30 second hold). • Repeat 10-15 repetitions per arm-leg - 3 times a week.


Why Physical Therapy Is The Right Choice When you have to be careful about what you can or cannot do because your back or neck hurts, it’s time to do something about it. Medication and injections can sometimes help the symptoms but do not treat the underlying problem. Surgery is a last resort and should only be considered when all else has failed. For the vast majority of back pain and neck pain sufferers, physical therapy is the perfect solution that naturally restores spinal health. Physical therapists evaluate how your spine moves and functions to identify the root cause of your problem so you can find lasting results. Our evaluation process quickly pinpoints the root cause, which allows us to create a specific plan of gentle hands-on techniques and exercises. We will work to restore your spine’s mobility, strength, posture, and coordination. Imagine your sore muscles soothed, your joints moving freely, and feeling strong. Imagine easily bending down or lifting something without fear of hurting your back or neck. All this can happen by trying physical therapy first!


Request an appointment today to have your spine health assessed. Your body will thank you later!


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