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Is your low back pain debilitating your life? Chronic back pain leaving you with a feeling of helplessness? Want to start a new endeavor like running, triathlons, Spartan racing, etc., but can’t seem to muster up the desire to do it because your back is limiting you? The key to unlocking your body’s ability to get rid of that chronic back pain may not be that far from your grasp.
At Complete Athlete, our fundamental approach to our body’s performance is found within our own control. Using the “joint-by-joint approach” founded by elite Performance Coach Mike Boyle and renowned therapist Gray Cook, we can look at the body in a way that allows us to not only decipher what parts of our bodies are causing the problem, but also how we can go about fixing the problem. In this continuum that we follow, pain associated in one area of the body is usually caused by a joint above or below the site of pain. In regards to low back pain, it is usually common to find that low back pain can be a result of some dysfunction in the hips.
In a study (1) done by therapists JB Ellison, SJ Rose, and SA Sahrmann; “Patterns of hip rotation range of motion: a comparison between healthy subjects and patients with low back pain”, they sought to determine the prevalence of passive hip rotation deficits in healthy subjects and those with low back pain. Their research suggested that there was an association between those with hip rotation range of motion (ROM) imbalance and the presence of low back pain. In accordance with this direction, we can surmise that if we increase range of motion in our hips, then we can start to alleviate some of the symptoms of chronic low back pain.
Another perspective we can approach our low back pain with is this; Is our low back (lumbar spine) performing compensatory movements that are dysfunctional elsewhere in our back? Is our low back doing the twisting, rotating, flexing, and bending that our upper back or “thoracic spine” should be doing? As stated, our thoracic spine is what is responsible for the multiple levels of movement necessary for healthy movement and not our lumbar spine.
Our lumbar, however, is built for stability. It is meant to support the weight of the body and any excessive weight added to our body. It is also meant to resist excessive rotation and twisting. Its stability characteristics are meant to act as a transfer point of power generated through the hips and then transferred to our mobile thoracic spine. Let me be clear here, I am not saying that the lower back shouldn’t move, I’m just stating that it is not meant to move greatly and instead meant to be solid and reliable.
At the hips, we want to make sure we can flex and extend, internally and externally rotate, and can abduct our hips to decrease strain on other structures like our knees and low back.
To mobilize the hips, intentional strategies must be implemented daily to try to regain the mobility that the hips need to allow for basic functional movement. Below are some mobility drills that you can start to implement right now to help facilitate more hip mobilization.
#1.) Seated hip external and internal rotation.
This exercise is an amazing two for one, bang for your buck movement that will address multiple facets of hip mobility. Leaning towards the front leg will address hip external rotation limitations. Leaning backwards, it will address external rotation issues as well as addressing hip internal limitations.
#2.) Rear foot elevated ½ kneeling hip extension.
To begin with, you will want to start off with a “neutral spine” position. This position is best described as “ribs down/towards your belt and tailbone or butt tucked under”.
Next, we activate/squeeze the butt cheek on the same side that the knee is down (or the hip that is being mobilized). This action makes sure that the pelvis is in a neutral position and can allow for a better stretch of the muscles of the hip and thigh.
Lastly push your hip forward and feel the rectus femoris, TFL, and hip flexor (PSOAS) being stretched.
#3.) Quadruped Hip Rock.
Now to address the adductors. The adductors can be either hip flexors or hip extensors. It all depends on what position our lower body is in. When we perform this exercise, make sure that you are maintaining a good neutral spine. Rocking back will target the end range of that squat or deadlift pattern. Rocking forward, it will target the adductors responsible for the end range of our hip extension.
Next, to alleviate compensatory movement of our lumbar (or low back), we must facilitate better movement of our t-spine (or upper back). This is generally where most of our extension and rotation of the back should occur.
#4.) Quadruped thoracic rotations.
In a quadruped, or all four position, place one hand on the back of your head. This will force a bit of thoracic extension. Then, rotate as far as possible towards the elevated arm. Focus on locking the hips and concentrate on just the upper back doing most of the rotation.
#5.) Seated thoracic rotations.
In a criss/cross applesauce seated position, place both arms behind your head as you would in a sit-up movement. Do your best to maintain a neutral spine. Next, rotate to your body to the right as far as you can and then to the left as far as you can. Again, make sure that it is the upper back that is doing the bulk of the moving.
By adding in these subtle movements into your daily exercise routine, you should start to feel that unwanted back pain minimizing and eventually gone. Remember, mobile hips, stable lumbar, and mobile upper back is the recipe we want to have for a pain free back.
1) Take control of your calories
How do you know if you’re eating too few or too many calories and what about those pesky macronutrients our trainer keeps talking about? Carbs, Proteins and Fats - who knew those were just as important as counting overall calorie count? When I talk about the importance of logging food, I’m not just talking about getting out a pen and paper and writing down breakfast, lunch and dinner. While this may give you insight into what you are eating it isn’t giving you clarity into the amount of calories and macros that you are ingesting on a daily basis. Chances are... you aren’t on track. It will only take a few days of logging to get the hang of how you should be eating so hang in there, I’m not asking you to do this your whole life long! Tip: Log all your food at the start of the day, check your calorie and macros on the summary of your tracking app to see how your day looks overall. This gives you a chance to adjust at the start of the day rather than the end when you all the sudden realize you still need to eat 80 grams of protein and oops, you overate 25 grams of fat. This takes pre-planning your meals for the day but it works.
2) Understand your sources of calories
Calories aren’t just about total calories, but about the breakdown of protein, carbohydrates, and fat, which are 3 nutrients that provide energy for your body. You’ll also keep track of alcohol you drink, which is the other element that provides calories to your body, but is not a nutrient. You may realize 70% of your calories are coming from carbohydrates, which is far higher than even what the USDA recommends (which is already high), or you might realize you only have 10% of your calories from protein despite being an active individual. Learning more about the calorie breakdowns in the foods I ate and each day as a whole was probably the second most helpful part that I found to keeping a food journal.
3) Get a feel for portion control
In your tracking app you will be forced to judge portion sizes, like TBSP, cups, scoops, etc. If you actually measured out that scoop of peanut butter that went into your smoothie what would it turn out to be? Your eyeballing it days are over if you want to be serious about your goals. Actually get your food scale and measurement devices out for a while until you get the look and feel of portion sizes down.
4) Identify situations where you give into temptation
I know I’m guilty of the snack attacks or left-overs from the kid’s uneaten portions or even the times when I full-on want to eat something I know I’m not supposed to just because it sounds good. Food logging can help with the temptations because you know you have to record it. You know it’s going to throw off your numbers so bad that it leaves you with no wiggle room for food later in the day when you know you’re going to be starving. Journaling will help you psychologically not sabotage your efforts just because you see it in black and white. Many times in our minds we will trick ourselves into believing we didn’t eat something, or we didn’t eat that much unhealthy food. When you have a written log, or journal, you will know exactly how you are eating and that objective feedback can help inspire change.
5) If you see a nutritionist, you would keep a food journal anyway
If you go see a health coach or nutritionist, one of the first tasks you will be assigned is keeping a food journal. This helps the coach analyze your eating habits so he/she can make suggestions as to how you can change them over time. If you are doing this on your own, you’re going to be analyzing your own eating habits on a less detailed level of course, but it’s still a very helpful exercise. Apps like My Fitness Pal allow you to have communities of friends to support your food logging efforts. You can even share your food diary with the world if that’s what it takes to stay accountable to your goals.
A lot of our habits are subconscious, so by making yourself conscious of how you eat by keeping a food journal, it makes changing your eating habits a whole lot easier.
Take some time over the following week to journal every single day for 7 days. It will be enlightening and I bet you will find out some very remarkable things about yourself and your habits. Don’t leave a single morsel undocumented!
Certified Nutritionist & Health Coach
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It's a New Year and with that comes resolutions to improve our eating habits and it can seem overwhelming and leave you wondering where to begin. We've compiled 5 steps to help take the guesswork out of your journey to better nutrition.
Step 1: Brainstorm and write down 3-5 nutrition-related goals that you would like to accomplish by the end of this year. These are your long-term goals. Need help? Schedule an appointment with our Registered Dietitian to assess your nutrition status and identify your individual nutritional needs for 2016!
• Example: “Eat more vegetables.” “Drink more water.” “Reduce my processed food intake.” “Increase my vegetable protein intake.” “Reduce my simple sugar intake.”
Step 2: Now that you have a variety of nutrition-related goals to choose from, select 1-3 goals that you are committed to achieving within the next 3 months. These are your mid-term goals.
• Example: “Eat more vegetables.”
Step 3: Transform your intentions into actions—and ultimately habits—by ensuring that the goals you set are SMART:
- SPECIFIC about the actions and behaviors that you will engage in to achieve success
- MEASURABLE to identify when success is achieved
- ACTIONABLE related to what you want to be doing consistently
- REALISTIC to promote your success
- TIME-ORIENTED to ensure that action is taken.
Write down each of your mid-term goals using the SMART goal format.
• Example: Rewrite your goal to “eat more vegetables” this year as “I will consume a minimum of 5 servings of vegetables per day on at least 3 days per week by March 31, 2016.”
Step 4: For each of your mid-term SMART goals, evaluate your motivation and commitment to achieving these goals by asking yourself:
- What is my primary motivation to complete this goal?
- What is my source of accountability to ensure this goal is completed?
- On a scale of 0 (low) – 10 (high), how important is completing this goal to me? Why did I select this rating?
- On a scale of 0 (low) – 10 (high), how confident am I in my ability to complete this goal? Why did I select this rating?
Write down your evaluative responses for each of your mid-term SMART goals.
- Primary motivation: Engaging in physical activities with my family will make me happy. Achieving my nutrition-related goals will promote my health and support my ability to participate in a variety of physical activities with my family.
- Source of accountability: I will meet with my dietitian 2 times per month for the next 3 months to achieve accountability and support in this process, and learn new ways to successfully increase my vegetable intake.
- Goal importance rating: 10/10; Achieving this goal to promote my health is a high priority for me at this time.
- Confidence rating: 8/10; My daily schedule and responsibilities present major obstacles to regular meal planning at this time, but I am committed to learning how to effectively plan my meals within my current schedule to meet this goal.
Step 5: Take manageable steps that set you up for success in achieving both your long-term and mid-term nutrition-related goals. Write down 1-2 SMART goals that you can accomplish this week that will promote your success in achieving your mid-term goals. Need help? Apply the same concepts from Steps 1-4 to your short-term goals!
• Example: “I will consume a minimum of 3 servings of vegetables on at least 4 days by [insert date 7 days from today]."
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