SOS: Building A Strong Core to Relieve Back Pain

The Spinal Column The Newsletter About Your Health And Caring For Your Body



I was diagnosed with scoliosis at the age of 15. I had a routine follow up with my GP and my dad had noticed I like to sit with one shoulder lower than the other and said I should mention in to my doctor. Thinking nothing of it I brought it up, had my doctor poke around my back, ask me to touch my toes, and next thing I knew I had an “osis”. Residents were being called in the room to look at my “interesting” back. My routine checkup was now scary and overwhelming. I was a competitive gymnast at the time and had no idea what scoliosis meant or what that would mean for me going forwards. Would I be able to compete? Would I need surgery? Would this change my activity levels going forwards? After seeing multiple specialists and being referred to Sick Kids, the time had come to have all of my questions answers. After what felt like dozens of x-rays, I was meeting with an orthopedic surgeon. I learned that scoliosis is a lateral curvature of the spine and that my curve was very severe. I have an “S” curvature that is 70 degrees in the thoracic spine and 38 in the lumbar spine (that is my real x-ray!). I was informed that I would have been made to wear a back brace had it been diagnosed earlier however, I had missed the window. My only options for treatment were surgery or conservative care. Surgery? I was only 15 years old, an athlete and had no pain. I was informed that surgery is often recommended in curves over 50 degrees however because of the involvement of almost my entire spine except for my neck, they would have to fuse virtually my entire spine. The thought of losing my mobility scared me much more than the thought of any future pain I may encounter.

I felt like a normal kid in every way except for my x-ray so I declined the surgery, not willing to accept the risk of the loss of mobility when I was experiencing virtually no pain. I went back to gymnastics and carried on. It was not until I quit gymnastics that I noticed an increase in back pain as I became less active. To my surprise the extreme ranges of motion I had been putting my spine through caused me less discomfort than losing the muscle mass and strength I needed to support my “crooked” spine. I now train in CrossFit 5 times a week. Finding a way to make rehab and strengthening fun has been the best decision I have ever made for my back. Whether it is weight lifting or walking on my hands there is nothing I cannot do. For now, I have some discomfort at the end of my work day (gravity is not my friend!) however nothing that a few stretches and rest can’t get rid of. My experience with back pain may change in the future as I age but I know I am in the right place if it does!

- Christine Ecclestone, PT

INSIDE: • Building A Strong Core To Relieve Back Pain • Four Core Activation Tips

• Exercise Essentials • My Patient Story • And More!



If you suffer from an aching back or even neck pain, weakness in your core muscles can be to blame. Do you have to sit for long periods at a computer, in the car, or are you just not that active anymore? All these positions can lead your core muscles to become weak. Even if you exercise regularly, unless you target your core muscles, you can cause an imbalance in your muscle strength, straining your back and putting you at risk for injury.

A prime example of how important core muscle strength is to protect against back pain was shown in a study with 443 firefighters that were put through core strengthening routines. Over a 12 month period, those firefighters had 62% less injuries than the group who did no core strengthening exercises.

When your core is strong, it means your spine is better protected against injury when you twist, lift or strain your body doing an activity.

Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355

Campus Clinic University of Waterloo Student Life Centre

Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767

Celebrating Over 25 Years of Healthcare Services!


1. Strengthening Perform specific strengthening exercises that engage all the layers of your abdominal wall, pelvic muscles and spinal muscles. Lying on your back, place your hands on your lower abdomen. Try to activate the transverse abdominis muscles beneath your hands drawing the muscles together towards your belly button. Keep breathing while you do this and hold for 10 second counts. Repeat 10 times and do 3-4 times a day, even while you stand! 2. Balance While keeping your abdomen tight in standing, try to stand on one foot. Stand close to a wall so you can keep your hand on it. Hold for 10 seconds each foot and repeat 5 times a day. Enhancing your balance engages the nerves that control the core muscles, helping everything work together. 3. Move Avoid sitting for prolonged periods and if you have to work, then break up the day with standing for 1-2 minute periods every 30 minutes. Keep working on tightening up your abdominal muscles in sitting, standing and lying down. Walk for 15-30 minutes a day, focusing on your posture and abdominal muscles. 4. After pregnancy Pregnancy severely stretches out the abdominal wall and many women can suffer from a condition called diastasis recti. Carefully strengthening your core muscles is essential for long term spinal rehabilitation after child birth. Talk to one of our physiotherapists today about having a complete recovery, even years after your last pregnancy.

Exercise Essentials

MODIFIED SIDE PLANK: The side plank is an excellent core strengthening exercise which generates more engagement of the obliques than the traditional plank. Strengthening the core in a static posture helps eliminate the risk of repetitive movements of the spine and is a great option for those with back pain. The obliques are strong contributors to movements with a rotational component (think shoveling) and are an excellent group to strengthen to prevent back injury.

To perform the side plank: Start laying on a firm surface with both knees bent 90 degrees and the elbow beneath the shoulder. Push the hips off of the ground, keeping the spine in a neutral line with equal pressure on the forearm and lower leg. Make sure the shoulders are both facing forwards and no rotation of the torso occurs. Hold for 30 seconds if able.


My Patient Story

Student Life At SOS:

“I came in for PT because I had pretty significant hip pain. On my worst days, it was difficult to climb stairs and my sleep also suffered because of the pain. I started thinking that I was going to have to hump up my skates, and I was worried that I wasn't going to be able to stay active and play with my kids. Adam fixed me! The treatment I received and the strengthening exercises I was provided with have significantly reduced the frequency and severity of the pain. I expect further improvements as I continue to work on strengthening my core. Thanks, Adam, and thanks SOS Physiotherapy." - Steve MacNeil (May 2019) Out In The Community FREE BACK PAIN AND SCIATICA WORKSHOP

“Hey! My name is Henry and I will be the physiotherapy student at SOS in Elmira for the rest of the summer. I am currently in my last year of physiotherapy school at Western University and this will be my last placement as a student before I get a chance to work full-time in September! I am excited to refine and enhance my clinical abilities with Melissa, Coco and the rest of the team at SOS. I look forward to hearing about how I can help you relieve your pain and live a healthier, more fulfilling life. - Henry

Staff Spotlight: Kymme

SOS is excited to welcome our newest staff member Kymme Kim. She is a Physiotherapy Assistant who will be working at our Belmont location come August. Kymme graduated from the OTA/PTA program at Conestoga. She had placements with WSM and Backworks and enjoyed the clinic atmosphere so she continued to work there after her placements ended. Kymme used to live in South Korea teaching English and is excited to be back in Canada growing roots in an area that is as great as Kitchener/Waterloo! She enjoy playing sports and getting to know how the body moves. Kymme stated "I look forward to getting to know the clients at SOS better so I can provide excellent client centered care and develop as a PTA under a knowledgeable and experienced team of Physiotherapists there" .


Once a month we offer a FREE back pain and sciatica workshop to educate members of our community about anatomy, the most common causes of back pain and what appropriate treatment looks like. Here is Adam teaching the group in the July workshop! You do not want to miss our August workshop. Come gain valuable insight into your injury. Knowledge is power! Spread the word and we hope to see you at our next workshop Wednesday, August 14th at 6:30pm!


Laser Therapy Is Now Available At Our Elmira Location! We debuted our class IV laser in Elmira with a huge success. Almost everybody who received a treatment had a decrease in pain, an increase in range of motion or strength in just one session! It has proven to be an excellent addition to physiotherapy treatment to treat at a cellular level which we are not able to do with our hands. We will be hosting another Laser Day in August. Spots will fill up so do not wait to reserve yours. Stay tuned for more information or contact our Elmira clinic for your free trial now!

Our next laser day will be held on Tuesday, August 20th in Elmira!

Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355

Campus Clinic University of Waterloo Student Life Centre

Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767


A common aggravating activity for people with back or hip pain are transition movements such as getting out of bed in the morning. Even if you need to spring out of bed to make it to the washroom, taking the short additional time to get out of bed correctly can help prevent exacerbation of low back symptoms! The log roll transition helps minimize torque and flexion of the spine and allows us to ease into our day without any sharp pangs of pain. Do’s: 1. Begin lying on the back with both knees bent 2. Reach across your body to the side of the bed, grabbing the mattress or grab bar for additional assistance if needed. Try to roll onto the side with the knees and shoulders moving as one unit, minimizing any twisting through the torso. 3. Allow the lower legs to come off the edge of the bed as the top arm pushes you into a seated position.

4. Sit for a couple of moments to prevent any dizziness while standing up!

Don’t’s: Going from lying on the back directly into a seated position puts a lot of load and compression on the spine when it has not been primed to do so after 8 hours of inactivity! Hopefully these tips help manage your morning pains and prevent flaring up symptoms so that you may begin your day more comfortably!

Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355

Campus Clinic University of Waterloo Student Life Centre

Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767

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