Lower Back Pain Treatment: Fulcrum Exercises & the "Big Three"

Foam Fulcrum

Lower back pain is among the most common injuries; effecting 80-90% of adults. Many patients ask what they can do at home to decrease the re-occurrence of lower back pain. Back pain is often caused by irritation of the disc, spinal joints, nerves and muscles. The spine is designed to have a backwards curvature (lordosis) of 35-45 degrees. Many patients with lower back pain have either completely lost the curve of the lower back or it is highly concentrated between L4,L5 and the sacrum. This spinal position places a lot of increased stress on the disc, joints and tissues of the lower back. Restoring spinal curvature and increasing stability and endurance of the lower back tissues are essential in decreasing and preventing lower back pain.


 Pettibon Spinal Molding & Fulcrum Exercises are the exercises that I have found to be the most effective in restoring the normal curve of the lower back. The Fulcrum is a piece of high density foam that is specifically made to keep the spine in its ideal curve and position. While lying on the floor, the peak of the fulcrum is placed under the T12/L1 area, the transition of the mid and lower back . A series of specific exercises are performed while on the fulcrum to increase the endurance and strength of lower back spinal stabilizer muscles and ligaments. The patient is taken through a series of exercises from Beginner to Intermediate to Advanced. Depending on the level, there are 2 to 3 exercises that are performed for 10 repetitions on each side (usually taking about 5 minutes).  The Spinal Molding is done after the exercises by lying on the foam for a total of 20 minutes (including exercise time) on the fulcrum.

In addition to the Fulcrum Exercises, a series of Spinal Stabilization Exercises researched and developed by Stuart McGill, professor of spinal biomechanics at the University of Waterloo, Ontario, called " The Big Three" should be added. These exercises have been shown to put the least amount of unwanted compression on the low back and provide the most benefit.

The Big Three:
1. Modified Curl-Up                    
2. Side Bridge                           
3. Bird-Dog

Bird-Dog

Modified Curl-Up

Side Bridge

The Fulcrum Exercises and the Big Three should be done with perfect form; spending more time on the quality of movement that the quantity of repetitions. To learn more about the Fulcrum Exercises and the most effective Lower Back Rehab Exercises contact me at (403) 265-9730 at Nielsen Homeopathic & Integrative Clinics.

Improve your Posture Endurance with this Exercise!

Slouching forwards on your computer all day can leave you feeling sore, tired and in a lot of pain.
It can lead to reduced lung, heart and intestinal function, headaches and jaw, neck and back pain. Over time your body structurally changes and adapts to these habits making the problem even worse.

PRONE COBRA 

                                       

                                              START

FINISH

Start position: Lying face down on a mat with arms resting to your sides

1. Lift feet slightly off the ground by engaging glutes and hamstrings
2. Lift upper chest, shoulders and arms slightly off floor by squeezing muscles between shoulder blades
3. Rotate arms and shoulders first until the thumbs are point towards ceiling by contract muscles behind shoulder.
4. Relax head and neck until head is in-line with body. Press tongue to the roof of the mouth to engage deep stabilizing muscles of the neck.
5. Draw belly-button towards the spine to stabilize the lower back and prevent excessive arching of low back muscles.
6. Do not hold your breath-- breath naturally.
7. There should be no pain! The goal is not to lift the legs and arms high off the floor- only enough to engage muscles. Lifting the legs and body too high causes compression in the low back.

** Start with 6 sets of 20sec hold with 10-20sec break in between. When the length of time becomes easy, increase hold to 6 sets of 30sec hold.
If you have any questions please send email to drjesshiebert@gmail.com

What Does YOUR posture look like??

 Forward Head Posture (FHP) describes a dysfunctional posture pattern where the head is carried forward as compared with the centre of the shoulder. This posture pattern can be caused by a multitude of factors some of which are: sitting for long periods of time at the computer, prolonged reading with your head down, driving with your head forwards away from the headrest, trauma and injury, changes in body weight distribution (pregnancy, large breasts, large tummy).

Forward Head Posture

With every inch that the head is positioned forwards from ideal, it can increase the weight on the spine by an additional 10 pounds (Kapankdji, Physiology of Joints).

This causes increased stress on the spine, compensatory curves or straightening of the spine, stretching of important stabilizing muscles and ligaments and overuse of other muscles causing trigger points and pain.

Posture does not only affect the structure of the spine, but also alters function of the nervous, muscular and organ systems!

Ideal Posture

Ideal posture

From the Front: the eyes, shoulders, hips and knees are all level.

From the Side: The centre mass of the head (one inch in front of the ear), shoulder, hip and knee are all in line; you could draw a line connecting all of those points.

Spinal Curves: A healthy spine has a forward curve of the neck, backward curve of the upper back and a forward curve in the lower back.

Health Implications of Forward Head Posture

• Decreased Lung Capacity: up to 30% loss of total lung capacity due to the loss of cervical curve --decreasing the ability of the hyoid muscles to lift the 1^st rib during inhalation.
• Reduced blood and lymph flow: may lead to blood pressure & heart rate abnormalities
• Gastrointestinal dysfunction: decreased peristalsis (movement) of the bowel
• Mood disorders due to changes in endocrine system function
• Decreased ability to concentrate and think
• Chronic low back and neck pain, headaches and stress related illnesses due to the abnormal strain on muscles, ligaments, bones and fascia—causing a flattened cervical curve
• Jaw Pain & TMJ: as the head moves forward away from the body increased pressures and forces are placed upon the TMJ (jaw).
• Increased pain perception: Regulation of the body’s pain controlling chemical (endorphins) is greatly decreased with decreased movement of the first four cervical vertebrae (found with forward head posture).
• Tingling, numbness & weakness of the arms & hands: shortened neck and pectoral muscles as well as degeneration and immobility of the spinal joints cause irritation of the nerves going from the neck to the arms and hands (Thoracic Outlet Syndrome).
• Accelerated Arthritis of Spine aging of the spinal joints resulting in degenerative joint disease and osteoarthritis due to abnormal biomechanical stress on the spine.
• Decreased balance & stability due to dysfunction of the mechanoreceptors and the coordination  with  the inner ear’s vestibular balance system
• Alignment Problems: up to 30lb of abnormal leverage on the cervical spine – ability to pull the entire spine out of alignment
• Ligament laxity: prolonged stretching of the ligaments (as found in forward head posture) predisposes the spine to future injury

Correcting Forward Head Posture and restoring the normal cervical, thoracic and lumbar curves can be done with specific rehab protocols. The most important part about correcting posture is to start at the top—at the cervical spine.

Rene Cailliet M.D., former director of the department of physical medicine and rehabilitation at the University of Southern California wrote:

"Most attempts to correct posture are directed toward the spine, shoulders and pelvis. All are important, but, head position takes precedence over all others. The body follows the head. Therefore, the entire body is best aligned by first restoring proper functional alignment to the head"

Posture Correction Rehabilitation Program :

• The Pettibon Head-weighting System: to re-set the neurological posture pattern by activating the body`s righting reflexes- causing the body to reposition forward under the weighted head. 
• Repetitive Cervical Traction: Aids in the correction of cervical, upper back and low back problems due to its effect on cervical and lumbar spine curves. Warms-up the ligaments and muscles of the spine to aid in posture correction and relieves pressure off the spinal joints and nerves.
• Spinal Molding: Lying over the cervical and lumbar fulcrums to restore the ideal spinal curves that are necessary for spinal stability as well as stretch shortened muscles and ligaments.
• Cervical and Lumbar Fulcrums: Exercises done over the fulcrums strengthen ligaments and stabilizer muscles of the spine as well as increase mobility and flexibility.
• Specific Chiropractic Adjustments: to mobilize the spinal joints and ensure that proper movement is restored to allow the correction of forward head posture and restore nerve, blood and lymph flow
• Active Release Technique (ART): to restore length and function to the soft tissues

Spinal Molding

Active Release Technique

Fulcrum Exercise

Make an appointment today to have a Postural Assessment and learn how you can correct your posture! Call (403) 454-1861 or visit www.PerformanceSpinal.com