Postural muscles become short when stressed (overused, misused or abused) and require gentle, safe stretching methods as a rule (yoga type) to normalise them plus reeducation as to elimination of causes wherever possible. If strengthening is indicated isometric exercises are best. However when muscles become chronically shortened they will weaken their antagonists (so that tight low back muscles produce weak abdominals for example) and no strengthening of these weak muscles can occur until shortness and tightness has been effectively corrected. Imbalances such as this (hypertonic group inhibiting weak antagonist group) result in mal-coordination and functional problems, often preceding pathology such as disc herniation by many years. Chronically tight postural muscles affect tendinous structures and influence crowding of joint spaces in time.
2. Techniques Which Can Be Used When Pain is Present Include:
Rest, support, hydrotherapy (including ice), massage, exercise, manipulation, pain killing injections or medication, electrotherapy (including TENS), acupuncture, sclerosing injections for hypo-mobile structures, surgery.
All may benefit from re-education employing stretching exercises, relaxation exercises, stress reducing measures etc.
The safest self-help measures include:
- a/ Muscle energy techniques
- b/ Strain/counterstrain techniques
- c/ Acupressure or neuromuscular techniques
These will be all demonstrated and are described in detail in Osteopathic Self Treatment (published by HarperCollins)
3. Good Habits for the Back (Prevention):
- Postural integrity and use of self is main preventive measure. Stand tall as Head/neck relationship is primary (Alexander approach will explain this further)
- Avoid one-legged standing for any length of time.
- Avoid bending from waist, use hips and knees to raise and lower body and weights.
- Try to organise working heights ergonomically (height of tables, desks, working surfaces etc)
Correct height for work surface is judged by standing alongside it wit h arms relaxed. If worktop height is correct it will match level of wrist. Better high than low.
- Sit well back into chair, with adequate support. Ensure that when seated for any length of time knees are at least on same level as hips. If not use small support for feet.
Swedish designed 'Balans' chairs in which individual kneels are best, but expensive.
- WHEN LIFTING HAVE WEIGHT CLOSE TO TRUNK, ARMS CLOSE TO SIDES, AND BACK AS STRAIGHT AS POSSIBLE.
- Avoid lifting and twisting at same time especially when back is bent.
- Arch back when sneezing and coughing.
- Try to balance carrying such as shopping bags or suitcases to avoid one sided stress.
- When lifting avoid heavy objects, rather try to lift more frequently with lesser loads each time.
- When placing items into boot of car use knees and hips, and/or spread legs to lower yourself to correct height, all the while keeping back straight. Same for bed making. Better to kneel for this than bend.
- When gardening ensure long-handled tools to avoid stooping action. Use kneeling stool with arms to help getting up and down for lengthy jobs such as weeding.
- Reduce stress levels so that what is being done with muscular action does not involve excessive effort. In other words avoid overuse.
- Sleep on firm surface, sidelying best (face down is harmful to neck and back) using one medium cushion to support space between neck and shoulders.