Posts Tagged ‘Rehab Techniques’

ACE – ProSource: October 2014 – Build Strong Glutes and a Pain-free Lower Back.

By Justin Price

There are two things many of our clients have in common: They want to have nice-looking buns and, at some point in their lives, they will experience lower-back pain. The good news is that developing strong, shapely glutes can contribute to a pain-free lower back. In this article, you’ll learn why deconditioned and/or dysfunctional gluteal muscles and lower-back pain often go hand-in-hand. You’ll also learn which exercises build strong glutes and can help keep lower-back pain at bay.

What Causes Back Pain

Many people mistakenly believe that lower-back pain is caused by a problem with their lower back. This is understandable given that movements of daily life, sports and most weight-bearing exercise modalities require the spine to move forward, backward, side to side and in rotation (McGill, 2002). When you lean forward, for example, the spine rounds/flexes. When walking and running, it moves from side to side as you transfer weight from one foot to the other. When performing sporting movements like golf, tennis and baseball, the spine must rotate to achieve the desired motion (Chasan, 2002).

However, all these movements of the spine require other parts of the body to work as well. When bending forward to pick a weight up from the ground, for example, the ankles, knees and hips should also bend to help lower the torso. Similarly, as the spine moves from side to side during walking, the legs and hips should also move from side to side (i.e., adduct and abduct) to help provide a good base of support for the spine as it moves. Rotational movements of the spine should be accompanied by rotational movements in the legs and hips so the tremendous force created by swinging a tennis racket or golf club, for example, is dissipated throughout the entire body. When actions of the spine are not accompanied by correct movement in the rest of the body, the spine and its surrounding muscles (e.g., the lower back) have to take up the slack and may become overworked and injured.

How Strong Glutes Can Help Prevent Back Pain

The gluteal complex of muscles (i.e., gluteus maximus, medius and minimus) plays a key role in helping take stress off the spine during multiplanar movements. That’s because these muscles help control movements of the torso, pelvis, hips and legs. When you bend forward or squat, for example, your hips should bend backward to counterbalance the forward motion of your upper body to help you stay upright (Figure 1). The gluteus maximus works to decelerate flexion of your hips to help counteract the downward pull of gravity and prevent your lumbar spine from over-rounding forward (Price and Bratcher, 2010). If your glutes are not strong enough to fully engage when your hips bend backward, your spine must round forward excessively to lower your arms to the ground (Figure 2).

Similarly, much of the rotational movement stress experienced by the spine during sporting activities is moderated by the gluteus maximus muscle. When the spine rotates over the leg on one side of the body (e.g., when taking a backswing or follow through in golf, tennis or baseball), the hip and leg should also rotate to take stress off the lower back (Figure 3). Because the gluteus maximus muscle attaches to the structures of spine and pelvis and to the leg, rotation of the hip and leg should engage and lengthen this muscle, thus helping to decelerate rotation of the torso (Golding and Golding, 2003). If the gluteus maximus muscle is not working properly, stress from rotational movements is instead transferred to the lumbar spine and may manifest as pain in the lower back.

Side-to-side movement stress to the spine is moderated by the smaller muscles of the gluteal complex—the gluteus medius and minimus (Dimon and Qualter, 2008). As the spine moves from left to right as a person takes alternating steps when walking and running, the pelvis should also move from side to side (Figure 4). This shifting motion of the pelvis with the torso is decelerated by the gluteus medius and minimus because of their attachments from the pelvis to the side of the hip and leg. When they are healthy and functional they act as a brake for the lumbar spine, protecting it from excessive movement and stress. If they are not working correctly, pain may manifest in the hips and lower back.

How to Build Strong Glutes and a Pain-free Lower Back

As you have seen, correct functioning of the gluteal complex of muscles can help protect the structures of the lumbar spine as it moves during multiple planes of motion. However, before you begin overloading these muscles in an attempt to build strong glutes and a pain-free back, it is extremely important to adequately prepare them so as not to injure your lower back (Price and Bratcher, 2010). The following “warm up and wake up” series of self-myofascial release exercises and neuromuscular activation techniques will help ensure your gluteal muscles are working correctly and can protect your lower back as you move through various ranges of motion in the glute-strengthening program that follows.

Warm-up Exercises

For gluteal muscles to be flexible enough to lengthen effectively and decelerate movements of the pelvis, hips and spine, have your clients perform some self-myofascial release techniques on the muscles of the glutes and lower back prior to exercising. This will ensure the tissues are warm and mobile and can move in all three planes of motion.

Tennis Ball on the Butt

Massaging the gluteal complex of muscles before working out can help promote better movement of the pelvis, hips and legs, and ensure you get the most out of the strengthening exercises that follow.

Have your client to lie on his or her back with the knees bent. Place a tennis ball under the right side of the butt and scoot the body up and down and from side to side to move the ball to any sore spots, from the base of the spine all the way out to the side of the leg. You can progress this exercise by coaching your client to place the right ankle on the left knee. Place a rolled-up towel under the left hip to help keep the pelvis level. Roll out each buttock for one to two minutes. While a tennis ball is the easiest piece of equipment to purchase and use, a foam roller can also be used to massage the gluteal complex.

Tennis Ball on Lower Back

The gluteus maximus muscle ties into the fascia of the lower back (i.e., thoracolumbar fascia). Therefore, massaging the muscles on either side of the lumbar spine is important before performing glute-strengthening exercises.

Instruct your client to lie on his or her back with the knees bent. Place a tennis ball under the right side of the lower back (away from the spine itself) and scoot the body to move the ball to any sore spots between the bottom of the rib cage and the top of the hip. (Note: Do not place the tennis ball directly under the bottom two ribs. These are “floating ribs,” which do not attach to the sternum at the front of the rib cage.) Massage the area on each side of the spine for one to two minutes.

Foam Roller on Side of Thigh

The iliotibial band on the side of the thigh attaches the gluteus maximus muscle to the lower leg. Increasing blood supply to this structure will encourage correct movement of the hip and leg.

Instruct your client to place a foam roller beneath and perpendicular to the right leg, which is extended, and to balance the body on the right elbow and the left foot. Roll the leg up and down over the roller and pause on any sore spots. If your client has shoulder problems, or finds it difficult to balance, instruct him or her to lie on the ground with the head supported by a pillow, and place a tennis ball under the outside of the thigh. Perform this exercise for one to two minutes on each side.

Wake-up Exercises

People with lower-back problems typically have difficulty activating their glutes correctly. The following isometric and/or single-joint neuromuscular-activation exercises for the gluteus maximus, minimus and medius ensure these muscles are receiving correct input from the nervous system before you load them up with dynamic, multiplanar strengthening exercises.

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Foam Rolling – The Basics

By Nicole Drummer

As a coach, I encourage all my athletes to utilize a foam roller in their training — the recovery part of training. Many of you have probably heard of foam rolling and have certainly seen these dense foam cylinders in your favorite running or cycling store, and perhaps also at the gym. This article will take a quick look at the purpose of foam rolling and how a triathlete can use it to aid in recovery. Let’s start with the basics:

What is a foam roller?
A foam roller is a foam cylinder, approximately 6 inches in diameter. They vary in length and density. They can be purchased online or at running/cycling/tri or other sport specialty stores.

Why do you want to foam roll?
Getting a regular massage is something a lot of us know we should do, but don’t. Foam rolling is an inexpensive way to provide self massage. It’s not as good as a “hands-on” massage from a  licensed massage therapist, but proper utilization of a foam roller to break up adhesions in the muscle tissue and/or fascia can help you recover faster and keep your muscles ready to train. In layman’s terms, breaking up the adhesions in the soft tissue aids in decreasing trigger points from forming and brings blood flow to the area. Increased blood flow will bring nutrients and assist in repairing damaged muscle that your last workout may have caused.

How do you foam roll?
There are several methods to foam rolling – you can find a trigger point (tight, painful spot) and just apply pressure there, or you can roll along the muscle (like the sweeping strokes of a massage therapist). You can also do a combination of the above. One thing to note — don’t foam roll joints or injured tissue.

How often should you foam roll?
Athletes training 5-6 times a week can probably foam roll daily, and right after a workout if possible. If you can spend 15-20 minutes foam rolling and 10-15 minutes stretching before bed, you’ll probably sleep better, feel better and recover faster, which means your next workout will be more effective. Note: foam rolling might be painful on chronic tight spots, but listen to your body as it shouldn’t feel like injury pain. If it does, go see a physical therapist!

Now that the basics are covered, here are some major muscle groups triathletes should consider foam rolling:

 

 

Glutes: One of the largest muscle groups and a primary driver in our sport, having a healthy gluteus maximus, minimums, medius is important.

This position helps isolate the piriformis.

 

 

 

IT Band: While Illiotibial band (a thick section of fascia from the hip to knee) issues usually stem from a muscle imbalance somewhere, keeping the ITB and the muscles around it loose is quite helpful to our running and cycling performance.

 

 

 

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