Staying safe in the garden

As a garden loving nation with the spring and summer months upon us, the longer daylight hours beckon us out into the garden. Always a great time for people like myself as we are usually very busy trying to deal with the sudden increase in patient numbers due to over exerted joints strained by being in awkward positions for too long.

A tulip from the clinic garden (thanks to the tender care of Neil)

Whilst gardening is a great way to keep physically active, it is worth noting that an estimated 3,900 people each week end up in hospital following accidents or injuries caused in the home or garden.  The main causes of injury are twisting awkwardly, stretching, and overuse of joints and ligaments in the spine causing pain, inflammation, and muscle spasm (rubbing my hands together).

Help is at hand! 

By following a few simple guidelines most injuries can be avoided and your passion can continue painlessly:

• Try to make sure that any materials are delivered as near to the area where they are to be used to avoid unnecessary lifting.  If you need to move them at any point always ask for assistance.
• When lifting heavy materials such as paving slabs, keep them close to your body with your knees bent, keeping the legs well parted and the back hollow with your buttocks sticking out.
• Avoid digging hard soil, it is better to wait until after rain when the soil  is softer
• Always kneel with one leg rather than two.  This avoids placing strain on the back.  If you have knee problems or find it difficult to stoop, use a gardening cushion or stool and try to keep the back hollow.
• Vary the tasks.  Change your activity after 20 minutes as different activities will use different muscles.  You can always return to an activity several times until it is complete.
• When mowing use a backwards and forwards motion and avoid swinging the mower side to side
• Keep warm – warm muscles work better and injure less!
• Avoid over reaching when pruning and weeding
• Do not ignore pain – stop if you begin to ache and if it continues see your chiropractor/osteopath/sports therapist/acupuncturist (we could carry on).
• Take regular breaks!

Warming Up

It is always important to do some warm up exercises before any exercise.  The best form of warming up is walking. The following gentle exercises to stretch and improve the flexibility in the muscles are a must and should be repeated before and after a period of gardening.

Knee to Chest Stretch

Lie on your back with your legs straight out in front of you.  Bring one knee up to the chest and grasp the back of your thigh.  Pull your knee towards your chest stretching your buttock muscle.  Repeat but this time; pull the knee to the opposite shoulder.  Repeat exercise with the other leg.

 

Stretching the Thigh

    

 

Stretching the Inside of the Thigh

Hold for 10 seconds and repeat 3 times.

 

Back Extension

Lie face down with your hands in the small of your back.  Slowly lift your head and shoulders off the floor just a couple of centimetres until you can feel your muscles working and hold for 5 seconds.  Repeat 5 times.  This exercise helps to strengthen the back muscles.

Cat Stretch

Kneeling on all fours, relax the back and let it go hollow.  Then arch the spine, effectively reversing the curve in the back.  Repeat 3-5 times.

Thigh Strengthening

Resting your back straight against a wall, move your feet out 12 inches.  Squat downwards slowly until your legs are at 45 degrees.  Hold for 10 seconds and repeat until your muscles feel worked.

For the Buttocks

With feet a few inches apart, tense the buttocks for 5 seconds and release and repeat 5 times.  This exercise can be done anywhere and should be practiced throughout the day.

Tensing your Stomach Muscles

Without taking a breath in, practice hollowing your stomach towards your spine by tensing your stomach muscles and hold for a least 5 seconds.  Repeat 5 times.  This exercise can be done anywhere and should be practiced throughout the day.  It is an excellent way of supporting your back during exertion.

Remember, prevention is better than cure – a regular exercise routine and stretching allows you to enjoy your activities even more!

Written by Anne French

Lower Cross Syndrome

A while ago I wrote a blog on Upper Cross Syndrome, complete with exercise videos on how to counter it. I said at the time that I would also write one for Lower Cross Syndrome – and finally – here it is!

I don’t want to repeat the same information so I suggest you look at the first blog here to get the full explanation as it’s good to understand why you are doing something(it means you are more likely to do it). The same rules apply – you need to stretch the hypertonic (tight) muscles first before you do the exercises to strengthen the hypotonic (weak) muscles. The stretches are really important, so don’t miss them out!

Here’s a picture to help you visualise the posture (or you could possibly look in the mirror).

As with Upper Cross Syndrome, certain muscles are tight (hypertonic) while others are weak causing a posture that is results in pain, looks unattractive and is very common if you start looking for it.

And here is the list of muscle involved with Lower Cross Syndrome.

Tonic Muscles Prone to Tightness or Shortness	Phasic Muscles Prone to Weakness or Inhibition
Gastroc-SoleusTibialis PosteriorHip Adductors Hamstrings Rectus Femoris Iliopsoas Tensor Fascia Lata Piriformis Thoraco-lumbar extensors Quadratus Lumborum	Peroneus Longus, BrevisTibialis AnteriorVastus Medialis, Lateralis Gluteus Maximus, Medius, Minimus Rectus Abdominus

These are very important, large postural muscles that are possibly functioning incorrectly but with the correct stretching and strengthening exercises these muscles can improve in function which will result in improved musculoskeletal function and pain reduction (if not pain elimination).

So – let’s start!

We are going to start with the foam roller on the IT Band.

You can use these rollers for most muscles groups to work out the knots so experiment. (And yes – it really should be that painful to start with but the pain recedes quickly if you keep doing it regularly). You can also use them for core strengthening exercises. We sell these at the clinic and quite honestly, I don’t know how I survived before I had one of these. They are very versatile and extremely effective. My advice would be – get one!

Now we are going to S-T-R-E-T-C-H.

We are starting with the calf muscles. Here is a simple stretch of the Gastroc and Soleus Muscles that you can do anywhere (you will also get the Tibialis Posterior slightly).

This next video demonstrates how to stretch the hip Adductors which are the large muscle group of the inner thigh.

Now for the Hamstrings.

And then the opposing muscle from the Quadratus group of muscles, the Rectus Femoris. Make sure you tuck your tail under for this one – then you will really feel it.

This next video demonstrates how to stretch the Iliopsoas and also the Tensor Fascia Lata. This last muscle goes into the IT Band so don’t forget to foam roll first.

Here are a couple of stretches for the Piriformis. Always a favourite!

And this video shows stretches for the Quadratus Lumborum and Thoraco-lumbar Extensors.

Okay – stretching done, now we can start strengthening the opposing muscles. We will start with the Tibialis Anterior (don’t want to confuse you with an exercise for the Peroneus muscles so we will stick with this one at the moment). You need a resistance band (which we sell at the clinic) or something that will add resistance to the muscle as you work it. As with any strengthening exercise you need to do sets of repartitions and increase the number of reps and/or sets as you get stronger e.g. start with 3 sets of 10 repetitions? Here’s how…

Now for the Gluteal muscles and here’s Rich demonstrating how.

And another…

And lastly, here is a good way to start working your abdominal muscles.

If you follow these recommendations you have the opportunity to have great posture, wonderful musculoskeletal function resulting in less chance of injury and pain.

You have a wealth of knowledge available to you from all the practitioners at Coast so take advantage of us. We are here to help you reach your goals, whatever they are.

Written by Anne French, Chiropractor

The Importance of Posture (Upper Cross Syndrome)

Posture – it is part of the first impression that you make to the outside world and it says so much about how you feel about yourself. Poor posture is highly prevalent in our society and one of the most common incorrect postures you will see if you start checking people out (or look in the mirror), is this -

Anterior Head Carriage

Now this famous woman is a perfect example of someone who carries her head before her body, also known as anterior head carriage. Many people walk around like this; it’s as if they are already somewhere else or trying to be, never actually present.

Ideally, a person’s ear should be in line with their shoulder and their shoulder should be in line with their hip. For every inch the head is forward from its natural position, it is twice as heavy and heads are really heavy to start with. This results in muscle imbalances as they strain to keep the head in position. In this posture, because the head is anterior, it naturally tilts forward resulting in the small muscles at the base of the neck, called the sub-occipitals to tighten, to enable the head to tilt up so that the person can see around them.

Upper Cross Syndrome

This is a further photo of the same woman showing another posture that commonly goes with anterior head carriage; here, unfortunately, she looks rather glamorous but the reality is her shoulders are forward and her scapula (shoulder blades) are winging (sticking out). This is due to hypertonic (too strong) muscles of the chest and hypotonic (weak) muscles of the back. This posture was first named by Dr. Vladimir Janda, a Czech neurologist and physiatrist, as Upper Cross Syndrome.

Janda’s approach is based on the function of the body rather than just the structure. Through observation and electromyography tests he concluded it was not just the strength of the muscle that was important but the sequence of the firing of muscle contraction, therefore an interdependence of the musculoskeletal and central nervous system, termed the ‘sensorimotor’ system, or lack of it, that was of great relevance and could predict injury patterns of a patient. Changes within one part of the system are reflected by compensations elsewhere within the system as the body tries to reach equilibrium (you’ve probably heard me say this one way or another, many times as I work on you). Janda noted that these changes in muscular tone create muscle imbalance, which leads to movement dysfunction that can result in pain elsewhere in the body and possible degeneration (wear and tear) of joints. Therefore, it is important to determine the cause of pain rather than just treat where it hurts.

I don’t want to bore you by getting into too much detail so hang in there, this is worth knowing.

The human body can reasonably be divided into two muscle type groups, Tonic and Phasic. The Tonic muscle group is made up of flexor muscles and this group is phylogenetically older and more dominant than the Phasic muscles. The Phasic group are extensor muscles that emerge shortly after birth and activate to resist the forces of gravity. Due to the dominance of the flexor muscles, they tend to tighten becoming shorter, whereas the extensor muscles are flaccid and therefore are weaker and have less tone. This can be observed when there is neurological damage e.g. a person with cerebral palsy or a cerebrovascular accident (stoke), the more dominant flexor muscles go into spasm producing a spastic posture.

Here is a table of Tonic and Phasic muscles.

Tonic muscles	Phasic muscles
Upper limb flexorsStenocleidomastoidScalenesLevator Scapulae Upper Trapezius Pectoralis major	Upper limb extensorsDeep neck flexorsRhomboidsSerratus Anterior Lower Trapezius

Now what this all really means is – many people have incorrect muscle patterns resulting in a combination of tight and weak muscles and commonly, in the upper body, the pattern of imbalance looks like this (I think a picture always helps):

Now you know what I’m talking about, don’t you? So what can be done about it?

Well, Janda determined that a tight, shortened muscle can inhibit its opposing muscle e.g. tight pectoral muscles will result in a weak serratus anterior muscle. And the good news; Janda also determined that many times just stretching the tight muscle allows the opposing muscle to function better. Therefore, the first step to counter Upper Cross Syndrome is to stretch the pectoral muscles.

Pectoralis stretch - In this video, Rich is demonstrating just that! You can also do this on a roller or on an exercise ball (haven’t got a video of those yet but will have soon.

Now how to strengthen the weak extensor muscles-:

Deep neck flexors – by doing this exercise, you are also stretching the tight sub-occipital muscles.

Wall Angel – stand with your back against a wall and your feet a shoes length away from the skirting board. Keep your spine, including your neck, against the wall. To do this you need to keep the ribcage/diaphragm down by activating the abdominal muscles and not let the ribcage lift as you put your arms into position. Many people can’t get into position, let alone do the exercise. Don’t give up, just keep doing it and you will improve. Here is Elke demonstrating the exercise.

Prone Angel – here Rich is demonstrating another way of doing the Wall Angel for those people that find it hard to get into Wall Angel position (but don’t give up on Wall Angel).

The Y exercise – it is important with this exercise not to lift your shoulders to your ears as you stretch out your arms. Don’t activate the Upper Trapezius muscles; keep those shoulders down. Here is Elke showing us how to do it.

Serratus Anterior – this is a difficult exercise to do correctly but it’s really important as the weakness of this muscle is usually the foundation of most shoulder problems. The biggest mistake people make is they just move their shoulder blades together and apart but the exercise is about moving the blades down and to the side. (It’s also difficult to explain) Here it is demonstrated really well by Rich.

Bruger Exercise – video coming soon.

Now obviously along with these exercises, body treatments such as Chiropractic, Osteopathy, Sports Therapy, Acupuncture and Massage really benefit to activate the sensorimotor system. Treatment and exercise, including Pilates, Yoga or Qi Gong, are the perfect combination to facilitate correct sensorimotor function and to improve your posture.

So that’s the top half of the body done. How about the bottom half? Watch this space…

Written by Anne French