Preventing Back Pain: Tips for New Moms

Complaints of back pain by pregnant women are common. Usually, the pain diminishes within two weeks after delivery. But back pain may return as you begin lifting and carrying the infant on a daily basis. As the infant grows, the weight load increases and back pain can result.

Caring for an infant puts stress on your back. Initially, you may be lifting the 7- to 10-pound baby up to 50 times a day. By the time the child is a year old, you are lifting and carrying 17 pounds. Two years later, you will be lifting a 25- to 30-pound child.

Here are ten ways that new mothers can help reduce their risk of injury and back pain. Many of these tips also work well with new fathers!

Begin exercising soon after delivery to restore muscle tone to the abdominal and back muscles. While the baby is napping, take 10 minutes to do stretching exercises on the floor each day. This will help restore hip and back flexibility.

• Try to return to your normal weight within six weeks after giving birth.
• Do not stretch your arms out to pick up the baby. Bring the baby close to your chest before lifting. Avoid twisting your body.
• To pick up a child from the floor, bend at your knees-not at your waist. Squat down, tighten your stomach muscles and lift with your legs.
• Remove the high chair tray when you are trying to put the baby in or take the baby out of the high chair.
• When lifting the child up out of the crib, put the crib side down and pull the child toward you. Do not bend over the crib side and lift the baby over the top.
• Consider using a "front pack" to carry the baby when you are walking.
• Do not carry a child on your hip; this overloads the back muscles.
• To avoid upper back pain from breastfeeding, bring the baby to your breast, rather than bending over the baby. While you are nursing, sit in an upright chair rather than a soft couch.
• Do not stand outside the car and try to place the child in the car seat. Kneel on the back seat as you place the baby into the car seat. Consider trading in your sporty two-door model for a four-door vehicle, which will make it easier for you to place the child in the car seat.
• If you had a Caesarian-section (C-section) delivery, wait six weeks or until you get the permission of your obstetrician before you begin exercising. Additionally, the risk of back pain is greater among young, overweight women.

Created by: Melissa Rachiele (Action Sport Physio West Island)

Sweet Dreams

The following article is an excerpt from our Spring newsletter, which you can read here.

The frantic deadlines and crazy schedules of modern life make it difficult to unwind and relax. This can affect your sleep patterns. We spend a third of our lives sleeping, and sleep is the more restorative of all activities, yet it's among the most neglected.

Take a moment to evaluate your sleep habits and ask yourself the following questions. Do you:

• Go to bed at different times every night

• Have difficulty falling asleep

• Depend on alcohol, medicines or sedatives to fall asleep?

• Snore loudly

• Experience sleep interruptions, tossing and turning

• Wake up tired and restless, possibly with a headache

• Doze off at work

Some of the symptoms above may indicate sleep apnea (breathing that is blocked or partly blocked during sleep). Obstructive sleep apnea is largely undiagnosed (and potentially dangerous) because most individuals don't even realize they have a sleep disorder (unlike an insomniac who stays up all night). According to the Public Health Agency of Canada, over one in four Canadian adults (26%) was at high risk for having obstructive sleep apnea.

The Hidden Link Between Metabolic Syndrome and Sleep

Researchers at the University of Pittsburgh have discovered a link between sleep and metabolic syndrome, which is a combination of factors that includes heart disease, diabetes, and stroke. If you have a sleep disorder, it is likely that your body is producing higher levels of stress hormones, which can cause high blood pressure, high blood sugar, low "good" cholesterol, high triglycerides, and excess belly fat.

How much sleep do you really need?
There's no set number, but most adults need seven to nine hours a night; others manage just fine with six to seven. It's even possible to get too much sleep, because spending too much time sleeping may indicate depression or chronic fatigue syndrome.

Problems with the quantity or the quality of your sleep may not be obvious, but will silently take their toll on your body. A key indicator of good sleep is your willingness to get out of bed (do you wake up alert and refreshed?) along with your energy level (are you irritable, sleepy or tired?) during the day.

Sleep Strategy

• Gentle, restorative stretching and controlled breathing as instructed by your physical therapist can help you relax and reduce muscle tension. This will put you in a better state of mind before you go to bed.

• Excess weight may contribute to sleep disorders. A physical therapist can also assist you with a safe, effective weight loss program and a regular exercise program designed to relieve muscle tightness and increase flexibility, which will assist you to sleep better.
• Eliminate caffeine and soda before bed time (the earlier in the day you can cut these out, the better). Depending on your caffeine fix, you may need to eliminate them around lunch time.

• Avoid heavy meals before bed time. A combination of healthy carbohydrates and protein during dinner team containing tryptophan, an amino acid that converts to sleep-promoting serotonin in the body is beneficial. You may want to consider whole wheat pasta, fresh vegetables and parmesan cheese, yogurt sprinkled with cereal, milk and graham crackers etc. For best results, consult a nutritionist for advice about which foods can facilitate (and may adversely affect) your sleep habits.

• Your body needs to cool to a certain temperature to reach a sound state of sleep, so if you tend to take a hot bath right before bed time, you may want to do it sooner (right after you get home from work). Cooling your bedroom before bedtime is also a good step.

• Your bedroom must be as quiet as possible. Consider soothing music, ear plugs to buffer unwelcome sounds.

• Switch off all lights in your bedroom. Dim the lights before bedtime if possible, since this is a biological trigger to 'wind down'. It's unlikely that you will go from the bright lights of a computer or the television to sound sleep since your body is in a 'daytime' mode. Installing dimmers in your bedroom and other rooms is valuable because your body needs darkness to unwind and relax.

• Leave all thoughts of work and all to-do lists outside the bedroom. Ban televisions, computers and cellphones from your bedroom, since your body is cued to respond to these devices even if they are in vibrate/silent mode. Resist the urge to use your cellphone as an alarm clock (you may want to switch it off completely) and get an alarm clock with a soothing, relaxing wake up reminder.

Consult your doctor if you want to reduce your dependence on sedatives and alcohol to fall asleep. Contact your physical therapists to help you with a stretching routine, deep breathing exercises and weight loss programs.

The following article is an excerpt from our winter newsletter, which you can read here.

It's the New Year, and it's also time for a flurry of resolutions. You're probably thinking about how you can become healthier, be more pain-free, and move better than you do right now.

Great thought! To help you along, here are 15 tips to get you healthy this year:

1. A gradual, personalized exercise program that takes into account your anatomy and physiology is important. Your physical therapist can conduct an evaluation and assist with this.

2. Make yourself accountable to someone other than yourself. Log your exercises (either at home or at the gym) in a journal and inform your physical therapist about your progress.

3. Self-confidence is critical. Believe in yourself and your ability to become stronger, healthier and more functional. If you think you can, then you CAN!

4. Visualize yourself as being stronger, with increase energy, as if you already achieved your goals. Positive expectations of health, vitality and energy are helpful to improve your health and well being.

5. Drink plenty of water. Hydration is important for your blood, kidney, and joints.

6. Always seek qualified help. Expert supervision provided by a physical therapist is important, especially if you are recovering from injuries or medical conditions.

7. Be aware of what you eat. Fat has twice the caloric density of carbohydrates and protein. So limit your fat intake and consume a balanced diet containing lean protein, whole grains, fruits and vegetables.

8. Get into the habit of reading nutrition labels at the grocery store. Not all foods are created equal. Make a conscious decision to shop for natural foods and increase the variety of foods you consume. Most individuals have the same food habits. Deviate from your 'regular diet' and experience a world of fruits, vegetables, herbs and lean protein.

9. Never skip meals, especially breakfast. It is the most important meal of the day, so start your day right - with a healthy breakfast. It will get your metabolism going, and keep your appetite and blood sugar in check as the day progresses.

10. Find an exercise partner to help you stay consistent with your exercise regime.

11. Consistency is key - exercise at least 3-4 times a week.

12. Challenge yourself each week - gradual progression the only way to improve. Stay within the limits of pain. When in doubt, ask your physical therapist.

13. Make sure a 5-10 minute warm-up and a 5-10 minute cool-down are part of your home exercise routine. Don't forget to include stretching in the warm-up and cool-down to reduce the risk of injury.

14. Set specific goals for yourself (consult your physical therapist) and resolve to meet them.

15. Reward yourself for small victories, they are important milestones towards your 'larger goal'. Positive reinforcement is the best way to stay on track and reach your health and wellness goals.

New Year Resolution Mistakes To Avoid

Most individuals make some health-related New Year Resolutions (I will start exercising, lose weight, quit smoking, reduce alcohol intake, etc). Most people also face the same roadblocks. The good news is that all of these can be easily remedied.

There are three main reasons for failed New Year Resolutions and this is something we can help you with:

1. Absence of a structured plan of action (a firm, focused routine will help overcome this)

2. Low self-confidence (we help you by setting small, progressive goals and encouraging you with positive reinforcement and accountability)

3. Poor time management (we empower you to make the best use of your time, with a program personalized for your health and fitness needs)

Most Resolutions Fail Unless...
Did you know that a majority of New Year Resolutions end in failure? Manage your expectations. Remember that the road to health is a marathon, not a sprint to the finish line. Be patient and take progressive, sustainable steps towards your goal. Some examples for you to consider:

1. If you are planning to run a marathon, make sure you set a short term goal - walking/running 3-4 times a week.

2. If your resolution was to lose 15 lbs, a good first step is to avoid the morning bagel, cream cheese and coffee and opt for fruit and green tea instead.

3. Instead of depriving yourself from your favorite foods, resolve to eat a healthy combination of fruits, vegetables and lean meats, allowing yourself to indulge in your favorite foods once every other week.

4. Instead of "going to the gym to exercise", call health professionals like us and ask for an evaluation, so you can start a structured exercise program under the supervision of a physical therapist.

If one of your resolutions is to improve your health and wellness this year, then we look forward to serving you as your trusted physical therapists. We will set reasonable goals, hold you accountable and empower you with confidence by designing a structured, personalized exercise program. Such a program is engineered to improve your muscle strength, flexibility and endurance.

We look forward to working with you this year and will do everything we can to improve your health and well-being.

How Can a Chair Save Your spine?

The following article is an excerpt from our fall newsletter, which you can read here.

In a 21st century office, work typically involves a lot of sitting in an office chair (usually in front of a computer).

Did you know that sitting actually puts more stress on your spine than standing?
To avoid developing lower back problems, it's critical to use an office chair that's ergonomically designed. What does ergonomics mean? It is the applied science of equipment design (in the workplace) intended to maximize productivity by reducing an individual's fatigue and discomfort. An ergonomic chair, for example, is one that supports your lower back and helps maintain good posture.

The big question is - How do we identify the ideal ergonomic office chair?

All ergonomic chairs are not built the same. Since every individual is built differently, it is best to look for a chair that can be easily adjusted in terms of chair height, armrest height and back inclination. There are many types of office chairs and no single chair is the best, but a few simple tips can save your joints a lot of discomfort. You are about to avoid the biggest mistakes most individuals make with chair selection. If you have any doubts, always speak with your physical therapist to help you find the right chair for your specific needs.

Five key factors to consider while choosing an ergonomic chair:
• Seat height. This should be adjustable. Depending on your height, this should be between 16 to 21 inches from the floor. When sitting, your feet should be flat on the floor and your thighs horizontal (or parallel) to the floor.

• Seat width and depth. Standard seat width is 17-20 inches. The depth (from the front to the back of the seat) needs to be enough so that you can sit with your back against the backrest with about 2-4 inches between the back of the knees and the seat of the chair. The forward or backward tilt of the seat should be adjustable because the right inclination can significantly reduce the strain on your lower back (call us to learn more)

• Backrest. The ideal backrest should be 12 to 19 inches wide. It should be able to support the natural curve of the spine. The more we sit, the more we tend to slouch. Therefore, proper lumbar support provided by your chair’s backrest is very important to help support your spine.

• Armrests. Office chair armrests should be adjustable. They should allow your arms to rest comfortably and shoulders to be relaxed. The elbows and lower arms should rest lightly, which means the armrests should neither be too high nor too low.

• Swivel. This allows you to easily rotate to reach different areas of your desk without straining your spine.

Picking the right office chair can help you avoid the agony of low back pain or neck pain associated with full-time desk jobs. Too much time at the computer or several hours a day on the phone can also put your spine at risk. To learn more about ergonomics and correct body mechanics, give us a call right away.

Here are some quick tips to help protect your spine while sitting on a chair:
• The backrest should support the curve of your spine and provide good lumbar support.

• The seat should be comfortable and allow your feet to rest flat on the floor or footrest.

• The armrests of your chair should be soft, allow your shoulders to relax and your elbows to stay close to your body.

• The chair should have a five-leg base with casters that allow easy movement along the floor.

Remember to take breaks when sitting for long periods at at time. Follow the 50-10 rule. For every 50 minutes of sitting at your desk, take a 10-minute break. Activities that involve standing or walking are always a good idea. Also, be sure to include some stretching exercises for your muscles. To determine the best stretches for you, talk to one of our physical therapists.

If you experience any discomfort from your current chair, take precautions to prevent serious injury. The following warning signs often result from extensive computer use or prolonged sitting at your desk and should never be ignored:

• Numbness, tingling or weakness in the arm, hands or wrist

• Shoulder pain

• Neck pain

• Headaches

• Low back pain

• Numbness, tingling or weakness in your legs

If you experience any of the symptoms mentioned above, talk to your doctor. As they say, prevention is better than cure and that's where we come in. Contact us today to learn about the most ergonomically designed seating options and protect your spine. We are here to help you determine the best seating options. The right chair can indeed save your spine.

And our winner is...



The winner of our "Be Our Back to Life Star!" contest is Mrs. Réjeanne Scullion, a patient at the Action Sport Physio West Island clinic.

"Alain, thanks to you and your wonderful team, I'm painlessly swinging like a 40 year old! Who says age is a handicap?"

Mrs. Scullion wins a $50 Action Sport Physio gift card.

Contest

Send us a short testimonial with a photo showing an accomplishment or a challenge you took up following your treatments. You could win an Action Sport Physio gift card.

We will also publish the big winner's picture and text in our Action-Reaction newsletter in the fall.

To participate, simply email us your photo and text to info@actionsportphysio.com before July 31st, 2011.

Q & A on Running with Éric Boucher

The following article is an excerpt from our summer newsletter, which you can read here.



What is the most important thing to keep in mind when someone starts to run?

The most important thing is to start running gradually. It is important to not rely solely on your cardiovascular capacities, but to also quantify the mechanical stress on the lower extremities. If your body is not already adapted to this stress (impact) and you progress too quickly, the risk of injury increases.

How long before an important run should you begin training?

This all depends on one’s cardiovascular capacities and lower limb tissue adaptation regarding the repeated impact against the ground. So, depending on the adaptation of the lower limb, it can take between 3 to 8 weeks before being able to run 30 minutes non-stop without the risk of injury. Furthermore, it is important to know the distance you are going to run at the event. That’s why with a gradual progression of a maximum of 10% of the total volume of running per week, it may take 20 to 24 weeks of training before being able to run a marathon (if the person had not started running beforehand).

What should you eat the day before a run?

It’s good to eat plenty of carbohydrates the day before the event. However, since we are likely to experience stress on the eve of a run, you should not overeat so as to digest well. Also, this is a bad time to try new foods which you are not used to digesting and it’s best to avoid alcohol to not get dehydrated.

How much water should one drink on the day of the run?

You must start drinking the week prior to the run to already be well hydrated the day of the event. On the day of the run, you must drink sufficiently and regularly, especially if the run will last more than an hour. However, one must beware of hyponatremia (overhydratation). Research has shown that most marathon runners are more likely to suffer from hyponatremia than from dehydration! In conclusion, the level of hydration depends on the individual (people who sweat a lot, or who are very thin or very tall, etc. will all drink water in different ways), so it is important to know ourselves well before the ultimate run!


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Éric Boucher is a physiotherapist and co-owner of the Vaudreuil-Dorion and the Valleyfield Action Sport Physio clinics.