Posts for tag: injury
How to Avoid Injury and Pain
What are the high-risk times and events for your lower back? Why can you get into more trouble doing something as simple as picking up a loaf of bread from the trunk of the car, rather than doing something more challenging? What simple steps can you take to avoid injury and pain? Let's get the answers to these questions and more.
Two Critical Moments
When it comes to your lower back and injury risk, there are two critical times when you need to be especially careful. One is first thing in the morning. Your back is actually swollen at that time. You are substantially taller, and the discs have extra fluid in them. A careless forward bend or twist first thing in the morning can do substantial damage to your discs or other back structures. It doesn't seem fair that such a simple thing, bending and twisting, something you have done thousands of times before, can suddenly cause big problems.
The other critical time is after you have been sitting. Long car drives or airplane trips are especially challenging. In this case, the culprit is something called "creep." This means that your ligaments and tendons lengthen into the position that you have been in. Think of sitting as a bent-forward position, as your legs are forward. The ligaments and tendons do not provide protection properly when they have been lengthened by creep. When you first get up from sitting, you are at risk. The longer you have been sitting, the higher the risk. If you sit more upright, with good lumbar support, you will have somewhat less risk.
Scenario #1: You didn't sleep well last night, perhaps from sleeping in an unfamiliar bed after travel, after sitting too long. You get up, feel stiff, but ignore it. You sit down in a soft chair to enjoy your morning hot drink. You get up and get a sudden sharp stab in the back.
Scenario #2: You get up from sleeping, and sit at your laptop, and get entranced by a video or article. You end up sitting far longer than you planned. You get up, and can't completely straighten up.
Scenario #3: You get up from sleeping, drink your morning coffee, which wakes up your gut, and you go to bathroom to empty your bowel. You are a bit constipated, and have to strain. When you get up from the toilet, your back spasms.
Overnight sleeping, even a good sleep on your favorite bed, leaves your back somewhat swollen. Swollen may be an exaggeration, but the reality is that there is extra fluid in all of your joints.
If you have a good back, none of this matters. If you have a vulnerable back, it all matters. Ideally, when you get up, you should do some kind of activity that warms up and "wrings out" the excessive fluids. A short walk, some simple movements, can make a real difference. Sitting down at the computer, sitting on the toilet, etc., can get you in trouble.
So, who has a good back versus a bad back? Unfortunately, most of us have bad backs, at least in the sense that they can be subject to injury and pain at any time. In fact, studies suggest that as many as eight in 10 people experience low back pain during their lifetime. That's a lot of back pain already happening or waiting to happen. And as you can tell from the above discussion, some of the scenarios whereby people experience back pain are all too common.
How to Avoid Injury and Pain
Don't bend over immediately after sitting. Sitting, even in good posture, puts you at risk. The longer you sit and the worse the seat, the more at risk you are. Airlines are very risky; it's hard to get up and move around because of the tight quarters, and the minute the plane stops, you bend over and get stuff from under the seat, or reach up, and twist and lift to get your bag from the overhead compartment. After a long sit, give yourself at least a few seconds of backward bending and/or moving around to reset your spine. Then you can carefully, using your hips rather than your back, bend over to pick up something.
When you sit, don't slump. Slumping reinforces the risks, makes it more likely for something bad to happen to your discs or joints or muscles. So, sit up straight, and keep your back in neutral. Neutral means that you keep a bit of a lordosis in your lower back, keep the lumbar spine from slumping forward, stay more upright. This simple action can make a huge difference. Like any habit, this will require you to "Just Do It" for a few weeks.
Talk to your doctor about these and other high-risk moments for your lower back and what you can do to relieve low back pain or avoid the pain altogether. And make sure to review "Self-Care for Back Pain" in the May 2010 issue, which provides information on exercises your doctor may prescribe if you are experiencing back pain.
Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore. He is a nationally recognized expert in treating tailbone, sacroiliac and lower back pain.
Cervical facet syndrome (CFS) is a form of osteoarthritis characterized by a structural deterioration of the vertebrae and joints of the neck. These vertebrae are connected to the spine and supported by a fluid-encapsulated, cartilage-coated hinge mechanism called a facet joint; this joint both stabilizes the spine and allows free movement of the neck and head. Like other joints, it experiences constant, repetitive motion, and can become worn or torn.
As the result of aging (and sometimes the result of trauma or injury such as whiplash), the cartilage that surrounds the facet joint can become worn, causing bone-to-bone contact. The facet joint then becomes inflamed, and may cause pain, stiffness, or soreness, both at the location of the joint and in other areas of the body. This area of the cervical spine is home to a number of pain generators, including the facet joint itself, the intervertebral discs, and the ligaments and muscles that support them. CFS can thus result in a range of symptoms including pain or tenderness near the joint itself, limited mobility of the neck and head, a chronically sore or stiff neck, and other symptoms that radiate to the shoulders, arms, upper back and upper legs. Some patients report pain that seems to originate in the back of the head, but which then radiates over the top of the head, sometimes extending into the region of the eyes and ears.
The pain of cervical facet syndrome is most commonly described as a dull, deep ache, which is often experienced as being worse in the mornings, because the inflammation and stiffness increases while they are asleep. As they begin to move around the pain may subside, but if their work or lifestyle requires them to sit at a desk all day, that may cause the pain to recur. Many patients report that the pain increases when they turn their heads, such as when they are trying to look behind them. The inflammation caused by CFS can also manifest as muscle spasms.
The majority of medical practitioners recommend initially treating cervical facet syndrome as conservatively and non-invasively as possible. Heat or ice packs and anti-inflammatory drugs such as ibuprofen can help. Chiropractic manipulation may be able to relieve many of the structural causes of CFS, and is often combined with deep tissue massage, electro-stimulation, and stretching exercises to relax affected muscles in the area, stimulating healing blood flow to the region, and increasing mobility. Recommendations for diet or lifestyle changes (including posture correction) can also help to promote faster healing and prevent recurrence of the syndrome and its distress.
Most everyone has experienced an injury of some sort that requires extra care in order to relieve pain, reduce inflammation and speed healing. Usually either ice or heat is recommended to help achieve these goals, but how do you know which to choose? Both heat and cold can be beneficial in certain circumstances, but each can also cause more harm than good if applied at the wrong time. Following are a few guidelines to help you decide on the best course of treatment.
The first general rule is to ice an acute injury and apply heat to a chronic injury. Swelling and inflammation is your body’s natural first response to injury - your blood vessels expand in order to rush more blood to the area to begin the healing process. So the best thing to do within the first 24 hours of an acute injury is to apply ice. This will allow the blood vessels to contract, reducing inflammation and bringing down the swelling, in addition to acting as a pain reliever by helping to calm irritated nerves.
Ice or cold packs should never be applied directly to the skin, as this may cause frostbite. They can be wrapped in a damp washcloth or towel, or even simpler is to use a bag of frozen peas. Ice should be applied to the injury for 10 to 20 minutes every two hours within the first 72 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours, unless it is used to aid recovery after a strenuous athletic workout.
Heat treatment is most useful for chronic injury, as it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. For example, sitting in a hot tub may feel good, however, the following day you will likely feel more pain and stiffness due to the increased inflammation it has caused. Heat can also reduce joint stiffness and muscle spasms.
Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm rather than hot treatments should be used to avoid the risk of burns, and heat should never be applied for an extended period of time or while you are sleeping. Heat treatment is also useful in cases of chronic injury, such as overuse injuries in athletes, shoulder impingement syndrome, bursitis and tendonitis.