Tag Archives: strength

Low back pain

Biokinetics for low back pain

Low back pain is becoming more common among individuals of all ages, gender and activity levels. The most common cause of non-specific low back pain is weak core stabilising muscles and poor posture ².

The spine is made up of 33 individual bones called vertebra: 7 cervical vertebra of the neck. 12 thoracic vertebra of the trunk, 5 lumbar vertebra of the lower back and 9 fused vertebrae of the sacrum ¹. The vertebrae form a protective tunnel around the spinal cord from the brain down to the sacrum. Nerves exit the side of each vertebra to innervate specific areas of the body; these nerves can be found next to bone, muscle and ligaments ¹.

Spine anatomy

Structures of the spine

Vertebral discs are located in between each of the vertebra of the spine to act as shock absorbers during the force distribution the body experiences while we move about. There are also many ligaments and muscles running along the spine to support it and keep it aligned correctly ¹.

If there is an injury to any of the joints in the vertebrae or inflammation, this creates dysfunction – an interruption in the correct function of each muscle and joint in the spine. Most often this translates into muscle spasm and pain; because of this pain we tend to try avoiding using the affected muscle which in turn leads to disuse atrophy ³. The affected muscle becomes deactivated and unable to fulfil its function correctly, which in turn puts even more pressure on the other muscles and structures of the spine leading to further pain and dysfunction ³.

Biokinetics use the science of movement and exercise to find exactly which muscles need to be strengthened and which stretched in order to prescribe an exercise program to target these muscles and create a better balance between supporting muscles (the core) and the rest of the body. Exercises include flexibility work: stretching hamstrings, gluteals, quadriceps, muscles along the spine. Flexibility will improve the muscles’ ability to move more and thus allow the joints on either side to move better as well. Better movement leads to less pain and inflammation ². Strength work usually begins with self-awareness: being able to locate the deep core muscles, these include the pelvic floor muscles (Kegal exercises), the erector spinae and multifidi muscle groups alongside the spine and the gluteal muscles. Teaching the brain to activate these muscles is the first step in improving spinal stability so that all other movements have a strong foundation to work from ².

Most individuals feel a significant improvement within a few sessions of starting biokinetics if there are no other underlying conditions (these will be discussed in more detail in other posts).
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References used in this article

  1. Hamilton, N. & Luttgens, K. (2002). Kinesiology. Scientific Basis of Human Motion. [10th ed.] McGraw Hill.
  2. Houglam, P.A. (2005). Therapeutic Exercise for Muscoluskeletal Injuries [2nd ed.] Human Kinetics.
  3. Ulrich, P.F. (n.d.). Back Muscles and Low Back Pain. Retrieved on 5 January 2016 from http://www.spine-health.com/conditions/spine-anatomy/back-muscles-and-low-back-pain.

Good body alignment during squats and lunges

Correct exercise technique is important not just for optimum fitness results but also to keep your body safe and thus (hopefully) injury-free. A very common error, most often because of lack of knowledge, people do not squat or lunge correctly. There are a myriad of factors that influence a person’s ability to do either one of these such as leg strength, familiarity, pelvic stability and body awareness, so it is important to get as many of these (ideally all) as correct as possible to reduce injury risk.

Exercise type: squat

How to do a squat

A basic squat involves keeping your feet about shoulder-width apart, spine upright, chest up then pushing the hips backwards and bending the knees as in the image below. The position of the arms can assist in balance if needed.

A basic lunge involves stepping forward, bending the knees to go downwards while maintain an upright spine and level hips, then pushing upwards again to reverse the motion and step back to the starting position.

Exercise type: lunge

How to do a lunge

So to achieve a healthy body alignment in either of these exercises it is important to be aware of what your body is doing throughout the movement – using a mirror and a spotter is a great way to achieve this. Traditionally “knees behind the toes” is a good general cue to help with alignment: one should always aim to keep the knee joint behind the toes, even over the ankle joint itself of possible, to keep the shear forces going through the knee at a minimum (these forces may lead to overuse of the cartilage in the knee and increase the chances of an injury). Another great way of getting this alignment right is to keep your knee over the second toe of the foot. Therefore, you should still be able to see your toes when performing a squat or alunge as in the picture here.20150901_132102Also important to remember is to check on whether your knee is caving inwards which often happens if the foot is over-pronated upsetting the biomechanics of all the bones in the ankle, shin, knee, thigh and pelvis. This next picture shows an example of this which I found on https://www.silversurfers.com in an article called The Strength of Strength.

Correct alignment

Body alignment when lunging

Because we all have different body types and are at varying stages of strength and ability when exercising some people may find it more difficult to achieve the ideal alignment, but as long as you aim to get most of these alignments right, with practice, lunges and squats will become easier to do which will also make it easier to find and correct any issues. However, if you are in doubt or need extra help then get some more professional help with your exercise techniques.