Free Your Upper Back And Shoulders

Stiffness in the upper back and shoulders can develop over time, especially if you have an office based job. This can lead to compensations and eventually pain in the muscles around the neck and lower back.

Below you'll find a short (less than 3 minutes) set of exercises - that you can do once or twice per day to keep your upper back and shoulders healthy and mobile 👇

This would be really helpful for anyone who spends time sitting in front of computer or driving around a lot.

Movement is Medicine!

We each have our own strengths and weaknesses, so getting a personal assessment / set of exercises from your Physio would be best, but this would be a pretty good start.

Let me know how you go in the comments and please tag anyone you know who might benefit 🙌

The exercises include:

• push-ups

• cat-cow with hands on foam roller

• childs pose lats stretch using foam roller

• thread the needle using a foam roller

• pecs stretch on the foam roller

• foam roller upper back

Get To Know Your Muscles: Upper Trapezius

Get To Know Your Muscles: Upper Trapezius

Upper trapezius trigger points are the primary muscles responsible for neck pain and headaches. The upper traps are also the most reactive muscles in your body to emotional stress.

This blog post discusses:

• how the traps gets overloaded

• symptoms of an overloaded upper traps

• self-care tips

• how Physio can help

QUICK ANATOMY REVIEW:

The traps is the most superficial muscle of the upper back and runs from the base of your skull, along to the tip of your shoulder, all the way down to the middle of your back, (see image below).

FUNCTION OF THE TRAPS:

The trapezius muscle consists of three parts that all have different functions:

• upper part helps raise the shoulder

• middle fibers retracts the scapula

• lower fibers lower the scapula

This blog post will focus on the upper traps.

HOW TRAPS BECOMES OVERLOADED:

The traps can become overloaded from the following situations:

• excessive sitting / computer use

• whiplash (car accident, falling on your head, or any sudden jerk of the head)

• tensing your shoulders

• constantly pulling the shoulders down attempting to have a ‘good posture’

• carrying small children around a lot

• sitting with a chair without armrests, or the armrests are too high

• extended car trips

• looking down constantly at your phone

• any profession or activity that requires you to look down for extended periods (i.e.. dentists/hygienists, architects/draftsmen, and secretaries/computer users)

• bra straps that are too tight (either the shoulder straps or the torso strap)

• a hand-bag or backpack that is too heavy

• anxiety

• recent surgery

• unresolved emotional trauma e.g. PTSD

SYMPTOMS:

The upper traps has an interesting referral pattern, as shown in red in the diagram below.

The upper traps is often the ‘key’ muscle that can trigger other areas such as jaw pain and headaches.

Symptoms of upper traps over-load include:

Upper Traps Referral Pattern (areas marked in red).

• severe neck pain

• a stiff neck

• facial, temple, or jaw pain

• pain behind the eye

• headaches on the temples / "tension" headaches

• dizziness or vertigo (in conjunction with the sternocleidomastoid muscle)

• intolerance to weight on your shoulders

• sinus pain
  
  
  
  

TREATMENT APPROACH:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your traps issue.

Some common manual therapy treatment approaches can include:

• joint mobilisation to the neck and upper back

• dry needling and massage to the traps to stimulate deep blood flow and release the tightness

• addressing any biomechanical issues with stretching, strengthening and foam rolling

SELF-CARE TIPS

• avoid extended periods of sitting

• Think about ‘time in the posture’ vs trying to find a perfect posture e.g. have a short break every 20 minutes

• consider a standing desk

• avoid constantly looking down at your phone

• apply heat to the traps 10 minutes each day to encourage blood flow

• ensure you are getting enough cardio-vascular exercise each day (30 mins minimum)

• take regular breaks on long car trips and consider using a pillow or support under your arm to take the strain off the traps

• learn to breathe through your diaphragm and manage your stress

• Wear bras that fit properly

• If you suffer with anxiety, seek help through your GP or a take a free online course

Some of the following exercises you may find useful:

Pecs stretch - feel the stretch at the front of the shoulder and hold 30 secs

Thoracic foam roller - release your upper back with a few rolls up and down

Upper traps stretch - hold gently 10-15 secs

Diaphragm breathing with legs at 90/90 - helps calm your nervous system

Building capacity in the upper body

Constantly focusing on relaxing and releasing the upper traps can be counter-productive because it isn’t always getting to the root cause.

Focusing on the pain and tightness can keep your body stuck in the ‘zone of stress’ (see picture below).

The only way to get better in the long term, is to gradually start building your physical capacity with a personalised program, so you can create a ‘zone of relaxation’ where you have the capacity to handle all of your daily life without the muscles becoming overloaded.

The trick is to build up gradually - step by step. As soon as you push too far you risk re-activating the tightness by over-loading the muscle.

In the beginning it is best to be conservative.

As your work with your body more, you will get to know and respect your bodies limits.

Some of the exercises you could include would be:

• push-ups

• bicep curls

• triceps

• bent over row

• lat pull downs

• core work

• increasing cardio fitness

Acknowledging underlying emotional issues in chronic pain

When your neck symptoms are chronic, one of the most concerning things is the ongoing pain, which can sometimes go on for months or years, despite seeing multiple health care practitioners and trying different medications.

Understandably, this can create a lot of fear and anxiety about the underlying cause of the symptoms which can keep you in a state of fight or flight (see picture below).

For some people, when they experience pain or injury it may be associated with anxiety and catastrophizing about the pain, like for example whether or not it will ever go away and if it will get worse if they move too much.

Some people become fearful of exercising and being active (known as ‘fear avoidance behaviour' and 'kinesiophobia') and might rely solely on passive treatment and resting, which can have some adverse effects and may lead to decreased function and a lower load threshold which could result in more pain.

As you can imagine, a downward spiral of fear, lack of movement, weakness and de-conditioning can result (see picture below) and become very difficult to break.

Examples of factors that may contribute to dysfunction in the upper trapezius Reference

You are not your scan !

Often there have been some scans showing some damage to a structure such as a disc or nerve issue.

Injuries and structural issues certainly do cause pain initially.

Unfortunately, sometimes the patient is not given a broader context in which to interpret the significance of the results.

The body has a tremendous capacity to heal, and generally tissue damage takes no more than six to twelve months to occur.

If you are still getting pain after this time (and you have been thoroughly investigated by your health care team), your pain is more likely to be coming from a sensitized nervous system (see picture below) than an damaged structural fault.

Maybe the most important picture to understand if you’ve had pain lasting more than six months.

Pain that lasts more than six months is generally related to an overly sensitive nervous system rather than a specific issue in the tissues

(Picture credit: Explain Pain - Butler & Mosely)

One thing is very clear with the recent research is that you can have structural abnormality and have no pain whatsoever (see picture below).

Degeneration, disc issues and arthritis are very common in asymptomatic individuals (i.e. who have no pain - see picture below).

Reference: Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine. 2015 Mar 15;40(6):392–8

The ongoing nature of the pain is more often to do with tight muscles with restricted and oxygen blood flow.

Just understanding this process can go along way to resolving your ongoing pain issues, but you will need an experienced GP and Physio to work with to help you diagnose and get you back on the fast track.

Get relief from your neck pain or headaches

We have a special interest in helping people overcome their neck pain / headaches and get back to what they love.

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

Psoas - Get To Know Your Muscles

Psoas - Get To Know Your Muscles

QUICK ANATOMY REVIEW:

The psoas (pronounced ‘so-az’) is one of the deepest core muscles in the body.

As you can see in the picture below, the psoas is a long muscle, attaching above to the upper part of the lower back as well as the intervertebral discs.

It then travels down through the abdomen and attaches to the inner part of the hip, making it one of only two muscles that attaches the spine to the lower limb.

FUNCTION:

The psoas has a number of diverse functions, making it a key factor in health.

There is still some controversy concerning it’s exact role in the body.

The psoas is partly a hip flexor - that helps bend your hip when you walk and run.

It also has an important role in stabilising the lower back and posteriorly tilts the pelvis.

HOW PSOAS BECOMES OVERLOADED:

The psoas can become tight from spending extended periods of time in the following positions:

• sitting

• sleeping in the fetal position

• standing with a swayed back and wearing high heels too often

• sitting in a kayak/canoe

The psoas becomes overloaded with repeated use in the following situations:

• driving

• kicking

• cycling

• excessive sit-ups

Visceral pain

As it passes through, and has some attachments to the internal organs, the psoas can also be activated when there is irritation internally, (in particular the colon).

Stress

The psoas tends to tighten in response to general life stress (activated during the fight / flight response). Think of the fetal position protective response - that is the psoas causing your spine to contract.

SYMPTOMS:

The psoas is known as the ‘Hidden Prankster’ due to it being responsible for a lot of lower back pain (especially related to disc pain), without many people being aware of it.

Pain from a tight psoas muscle may be projected in a vertical direction in a ‘gutter’ along either side of the lowerback as well as to the sacroiliac region and buttock (see red areas marked below).

Pain may be felt during sitting and walking.

Overload of the psoas can also lead to pain and tightness in the front of the hip. 

TREATMENT APPROACH:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your psoas issue.

Some common manual therapy treatment approaches include:

• joint mobilisation to the lower back

• dry needling to the psoas insertion point in the hip and upper attachment point in the back

• deep tissue and manual myofascial release on the mid-section of the muscle (pictured below). It is very difficult muscle to dry needle direclty due to its deep location and proximity to major organs.

SELF-CARE TIPS

• avoid extended periods of sitting. Think about ‘time in the posture’ vs trying to find a perfect posture

• consider a standing desk

• avoid walking and jogging uphills and on sloped surfaces in the short-term

• apply heat to the front of abdomen 10 minutes each day

• sleep on side with pillow between knees, avoiding the fetal position with the hip flexed right up

• use cruise control on long car trips to stretch the legs

• learn to breathe through your diaphragm and manage your stress

  Some of the following exercises you may find useful:

Psoas stretch - gently ease into it tucking the pelvis under as you lean forward (Picture credit: Fiona Melder Photography)

Bridge stretch - tuck your pelvis, squeeze your glutes but don’t overarch your back. Breathe! (Picture credit: Fiona Melder Photography)

Diaphragm breathing

As the psoas attaches to the diaphragm, when you breathe deeply you will naturally help decompress the psoas.

You can do this by putting your hands on the outside of your lower rib cage.

As you breathe in, expand the ribs from the sides, front and back - 360 degrees.

Aim for five seconds breathe in and five seconds breathe out for 1 minute.

Building capacity in the Psoas

Weakness in the psoas causes decreased ability to flex the hip joint.

It’s really important for runners to have adequate capacity in the psoas.

Try this marching exercise below with a theraloop to help build some capacity in your hip flexors.

Need some help with your lower back or hip pain?

We have a special interest in helping people overcome their pain and get back to what they love.

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

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Chronic Pain - The Myths

Chronic pain is a significant global health burden and low back pain causes more disability than any other condition.

Interpreting pain

People with negative beliefs about their pain report higher levels of pain intensity and disability.

People with musculoskeletal pain often view their body as being a fragile or a vulnerable structure which is easy to (re)injure.

Here are some common misconceptions about pain:

Credit: World Confederation of Physical Therapy

Some facts about pain

Acute pain alarms us about potential tissue damage and typically comes on suddenly as a result of a specific incident.

Chronic pain serves no biologic purpose as it is not related to actual tissue damage, but more the threat of tissue damage.

Sensitive Alarms

To understand chronic pain more simply, think of a house with a security alarm set up.

After the house was burgled a few months ago, the owners decided to set the alarm’s sensitivity to high.

So every time the wind blew, it would blow a lot of leaves and debris around - setting off the alarm system. The owners woke up to the alarm and prepared for a ‘fight-flight’ situation. But each time the alarm went off, they didn’t find anything wrong.

After an injury, the body is biologically wired to act like a sensitive alarm system - magnifying small normal niggles.

This is a normal and healthy protective response.

For some people though, while the original injury can heal (normally taking no longer than 3-6 months), this protective response (highly sensitive alarm system) can remain in place indefinitely.

This can lead to overwhelming sense of anxiety and fear, that can turn into a downward spiral of inactivity, de-conditioning and eventually more pain.

Maybe the most important picture to understand if you’ve had pain lasting more than six months.

Pain that lasts more than six months is generally related to an overly sensitive nervous system rather than a specific issue in the tissues

(Picture credit: Explain Pain - Butler & Mosely)

Consulting with a Physio who is specialised to treat chronic pain can help you discover if you have a sensitive nervous system and get you back on the fast track to living life again.

Physiotherapists will help you understand how chronic pain works.

They will help you reduce the fear attached to pain and explore long-term strategies to build confidence through engaging in activities that you once enjoyed.

Exercise and building capacity

People who have suffered chronic pain often have reduced physical capacity, that has dropped over a period of months or years.

This keeps them in the ‘zone of stress’ where everyday tasks can seem over-whelming and tiring.

The only way to get on top long term is to re-build your capacity, to create zone of relaxation, where you can easily handle the demands of everyday life.

A few tips:

1. Increase training or exercise loads gradually – our bodies don’t like surprises

2. Avoid changing too many training or exercise factors in one go

3. Participate in a program that focuses on whole body strength to ensure the body is tolerant to changes in exercise load

4. Pace yourself. Break bigger activities into smaller chunks.

Pain is normal - use this scale to guide your level of activity

Some people with chronic pain become overly sensitive at perceiving small normal niggles.

When you start to resume your activities., pain that is at a 0-5 level is considered ACCEPTABLE —> KEEP GOING.

Pain that increases to 5-10 means you are probably over-doing it and need to rest or modify your activity.

Pay attention to your pain during the activity as well as notice the 24 hour response e.g. the next day.

Need some help with getting you back to doing what you love?

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

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6 Minutes To A Supple Spine

There are many options out there for addressing back pain.

But the one approach that has the best scientific support is exercise ✅

We are taught early on how to care for our teeth to prevent tooth decay.

But no one ever told us how to take care of our spines 🤔

Unfortunately this can lead to ongoing spot fires 🔥 and niggles, as the underlying issues aren't being addressed.

Below you'll find a short 6 minute set of exercises - that you can do once or twice per day to keep your spine healthy, supple and strong 👇

We have our own strengths and weaknesses so getting a personal assessment / set of exercises from your Physio would be best, but this would be a pretty good start.

Let me know how you go in the comments and please tag anyone you know who might benefit 🙌

Prevention is better than cure!

Here’s an outline of the moves:

• Heel taps

• Bridge

• Single leg bridge

• Hip abduction, clams

• Side plank

• Plank

• Cat-cow

• Superman

• Child’s pose

• Pigeon pose

• Thoracic foam roller

• Hip flexor stretch

The solution to keeping your spine healthy lies in finding the balance of mobility and stability.

Each part of our body has a specific function (as the picture below shows).

This is know as the joint by joint approach.

Focusing on the giving what the body what it needs will lead to more efficient movement and a suppleness that you will leave you feeling energized and strong.

Research has showed that people who just focus only on stretching only had a higher incidence of lower back pain.

And people who focused only on strengthening (e.g machine based weights at the gym) had a higher incidence of back pain.

So this set of exercises has been specifically formulated to switch on the deep core stabilisers and creating mobility in the hips and back.

Doing this regularly will certainly help keep your spine supple and strong.

Let me know how you go in the comments.

Need some help with your lower back pain?

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813