Low back pain and pregnancy
As your baby grows and your belly expands your center of gravity shifts forward. As a result the pelvis tilts forwards and the natural curve in the low back increases.
So why is the lower back such a common source of pain during pregnancy?
The answer is the connection to the uterus. The sacrum (tailbone) which is the triangle bone at the bottom of the spine is actually connected to the uterus by the uterosacral ligaments.
During pregnancy as the uterus expands it puts a significant amount of stress on these ligaments. You could think about them as guy wires suspending the uterus/baby within the belly. These ligaments get taut and essentially pull the sacrum forward. When the sacrum tips forward joints in lower back get stuck. The result is mild inflammation causing low back pain. The surrounding muscles get tight and short and pain can start to spread into the gluts and around to the side of the hips.
Women that come into the clinic with low back pain during pregnancy tend to respond the best to a care schedule that is very similar to the schedule they have with their OBGYN or midwife… 1x/month until 24 weeks, 2x/month until 36 weeks and then 1x/week till their due date. This helps keep moms comfortable and pain free throughout pregnancy and helps prepare the pelvis for optimal movement during delivery.
The adjustments are geared toward repositioning the sacrum so it sits in the right position, reducing inflammation and pain. In combination with adjustments, pregnancy specific exercises that are safe and helpful for recovery after birth are recommended. After baby comes, post-natal exercises, lifting and breastfeeding positioning tips are important to keep you healthy and comfortable so you can care for your new addition.
Dr. Gillian Smith, DC, Webster certified, trained in perinatal care and member of the of International Chiropractic Pediatric Association (ICPA)
Visit http://icpa4kids.org/ for more information.
New research offers hope for relief of neck pain
The January issue of Annals of Internal Medicine published new research comparing three common treatments for people experiencing neck pain.
Spinal Manipulative Therapy (SMT or Manual Therapy) and exercises that patients can learn to do at home are more effective than medication for relieving neck pain, both in the short and long term.
272 patients were randomly assigned to either the manual therapy group (SMT), medication group (MED) or the home exercise/advice group (HEA).
How did they do it?
The SMT was given by 5 different chiropractors. Medication was provided by licensed medical physicians, with a focus on prescription drugs. First line therapy was with NSAID’s (Non-steroidal anti-inflammatory drugs), acetaminophen, or both. Those patients who did not respond or could not tolerate the first line therapy drugs were given narcotic medication. Muscle relaxants were also used, and advice to stay active or modify activity as needed was also given.
The primary outcome measure was self-reported pain and disability. Secondary outcome measures included quality of life, general health status, adverse events and satisfaction with treatment.
Results
Results showed that spinal manipulation had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks, and that home exercise was superior to medication at 26 weeks. No important differences in pain were found between spinal manipulation therapy and home exercises at any time.
Patients who received spinal manipulation therapy or home exercises also reported similar improvements in self-reported disability, medication use, general health status, and adverse events. However, patients said they were more satisfied with spinal manipulation than with home exercise.
Adverse effects
With regard to adverse effects, 40% of the spinal manipulation group and 46% of the home exercise group reported adverse events. The most common was musculoskeletal pain, and less frequently they experienced paresthesia, stiffness, headache, and crepitus.
Among patients randomly assigned to the medication group, 60% reported adverse effects. The most common were gastrointestinal symptoms and drowsiness, followed by dry mouth, cognitive disturbances, rash, congestion, and disturbed sleep.
Commentary
I thought this was an interesting study, however from a practical point of view, it may not reflect how patients are commonly treated in an actual clinical setting.
There were 3 separate treatment groups: SMT, MED & HEA. The best benefit was seen in the patients receiving either manual therapy or home exercise and advice.
Typically, we would combine these two treatment approaches rather than just getting one or the other. Someone coming to the clinic seeking relief from neck pain or headaches may receive manual therapy (spinal manipulation, soft tissue therapy) and then be given home exercises and advice to complement the care they received in the clinic. It might be useful to see a future study which combines these two treatment groups to judge whether better results could be achieved.
Also, our experience has been that certain patients may not respond well to a generalized home based exercise program. For those people, a more customized, specific and supervised neck rehabilitation program may be necessary. To that end we developed a specific supervised treatment regime using the neck machine (Multicervical Unit or MCU).
The neck machine is a computerized piece of rehab equipment that allows us to measure and identify specifically where the weakness in your neck lies. This advanced approach then allows us to customize the supervised exercise program to specifically target the weaknesses and muscle imbalances.
Neck pain is surprisingly common and can dramatically interfere with your quality of life. Most people attribute ongoing neck pain to a history of trauma such as a motor vehicle collision or sports injury. Perhaps a more common cause of neck pain and headaches is related to the postural strain associated with sitting, working at a desk or in front of a computer.
No matter the cause of your neck pain, this new research shows that significant relief is possible.
How to prevent back pain when shovelling snow
Skiers and snow boarders are happy with the latest dump of snow but when I drove to work yesterday morning, it didn’t look like everyone had their happy shiny face on looking out at the 10-15 cm of new snow that arrived overnight.
When I was waiting at a light on 5th Avenue NW I looked over and saw a guy shovelling his walk and I immediately felt sorry for his lower back. If you were running a class on how NOT to shovel snow, this guy would have been the poster child. Straight legs, bent at the waist, lifting the full shovel up and then twisting to toss the snow away…You get the picture.
I was tempted to jump out of the car and do a snow shovelling intervention but the look on his face made me think he wasn’t that approachable. Instead, I thought I would provide a few tips and tricks that should go a long way to preventing a back injury when you are attempting to avoid the city bylaw guy’s fines for not clearing your walkway properly.
I seem to remember writing about this last year about this time (spot the trend?). As a chiropractor practising in Calgary, I see a lot of people that have hurt their back shovelling snow. Most of these injuries are preventable if you pay attention to a few simple things. This video shows some do’s and don’ts to prevent back pain and injury when performing this awesome task. Don’t forget that when faced with a whole driveway full of the wet stuff, ergonomics are important, but so is attitude…I find it helps if you hum a few christmas carols…whistle while you work as it were… 
Back pain from sitting on the job?
A lot of people were in this past week talking about the same thing. They have back pain that typically feels worse if they have to sit for prolonged periods. This is quite troubling because most people’s jobs involve sitting, working at a desk or in front of a computer.
I blogged about this last spring so you’ll have to bear with me if I’m sounding redundant but there were so many people saying the same thing this week, I thought it might be worth going over again.
Our bodies are meant to move so if we ask them to remain motionless for extended periods, stiffness and pain usually result. Probably the most common example of this is sitting at desks or in front of computers. There are a number of fancy biomechanics reasons for this, however suffice it to say, if you sit for quite a bit of your day, your body is going to start complaining.
There is a myth out there that improving your work station ergonomics will prevent back pain from sitting. I don’t believe this. Of course, changing your workstation around to better fit your body is a good idea. Any reduced stress or strain should translate into reducing pain and symptoms, however I don’t care how good your ergonomics are, if you’re going to sit there for 3 or 4 hours without a break, you’re going to hurt!
So what is the answer?
It may seem like common sense, but I think the answer is don’t sit there for 3 or 4 hours at a time!
No kidding, you say! But that isn’t very practical. I need to get this work done and I get so involved in tweaking that spread sheet that I lose track of time and the next thing I know, it is lunch time. If I’m up every 1/2 hour or so and wandering around, my boss will likely start recommending I consider taking a more permanent break from my job.
I get that so the key here is to balance out getting your work done, while at the same time building in enough small breaks to cut your body some slack. I’m not talking about getting up every 30 minutes and going to the bathroom or to the water cooler or to your co-worker’s office to bug them. Those methods are definately counterproductive.
People will tell me that their impression is they don’t sit for prolonged periods at a time. Their job has them getting up and down quite often but they still experience progressive back pain so what gives?.
I’m afraid just getting up and wandering down the hall to get another coffee, go to the washroom or visit a co-worker won’t cut it. That isn’t giving your body enough of a break to make much of a difference.
There are two types breaks I would recommend you build into your work day: Micro and Mini-breaks. I have two short videos that describe these breaks and show what you can do during them to alleviate the stress and strain. Check them out:
Micro-Breaks
Mini-Breaks
These two types of breaks should be easily built into your normal workday within reason. I understand it would look pretty weird if you are sitting in a 4 hour meeting with a bunch of other people and you are getting up every 30-45 minutes to do some callisthenics on the board room table. I’m not suggesting that.
The point here is that you need to become more conscious of your work habits and then use these tips and tricks to try and give your body a chance to recover from the stress and strain it endures from sitting too long (like what is happening right now from me writing this blog!).
The trick is to try and build movement and activity into your normal daily routine rather than considering it “exercise” which implies you need to dedicate some special time and energy to the activity.
I would like to hear from you on what you think of this advice. Feel free to comment if you think this is practical given your work day activities or if you have any other suggestions how we could change it up to make it more real world.
Is your pain all in your head?
I’m not sure if you have ever had the dismissive experience of being told your pain is all in your head, however if you have then you may want to read on.
In the past and perhaps to some extent right now, people experiencing pain that was out of proportion to their specific physical condition were dismissively treated by various health care professions. Traditionally, health care professionals separated the mind from the body so depending on where your pain was, the systematized approach to treatment was based on your specific diagnosis.
Without getting too complicated, our old approach to understanding pain was from the bottom up. This means that if you came in with back pain, all of our focus was spent trying to figure out what was going on in the back that might be causing pain. In addition to physical examinations, numerous expensive diagnostic tests have been created around this approach. This includes things like blood tests and advanced imaging techniques such as MRI. Unfortunately, the research is playing out that this approach hasn’t worked very well. Every clinician will tell you that they have seen patients with an inordinate amount of back pain and their MRI looks pretty normal. We also have studies demonstrating the opposite: Some people have horrible looking MRI’s but function quite normally and don’t have much in the way of back pain. We also know that pain can go on long past the time that we know the original injury has healed.
Let’s say that you injure your back lifting something. This is generally referred to as a sprain or a strain injury, indicating there has been some degree of tissue damage to your low back. Sport medicine research has now demonstrated that these tissues have very specific time frames they heal in. Often times, however patients come in months after the original injury still complaining of ongoing back pain. Now there may be mechanical problems that have continued on that keep re-injuring the local tissues in the back which can explain ongoing pain. If that is the case then logic would tell us that treatment plans should be structured around correction of mechanical problems to allow the tissues to heal properly.
Sometimes, however we see people whose pain does not fit with what we see going on in their low back. If, through various tests and examination procedures, it was felt that there wasn’t too much wrong locally in your back, then too often, the person was told that their pain must be in their head. Historically, the inference was made that because the back seems to be in pretty good working order, there must be some psychological problem that is to blame for ongoing pain. This approach was also typically accompanied by the usual negative connotations, such as an inference that the person is faking their pain. This is a difficult conundrum for many clinicians and patients to understand, however modern pain researchers have changed our understanding of pain, which is leading to new and improved treatment methods.
To illustrate this, I came across this video in YouTube awhile ago and thought it might be worth sharing.
It is a talk Professor Lorimer Moseley gave to a University Class in Australia which I feel is really worth watching if you have any interest in learning more about pain. Professor Moseley is one of the world’s foremost leading authorities on our current understanding of pain. His clinical expertise and research has revolutionized how we try and help people experiencing pain.
It is a pretty long video, however I think it is quite worthwhile.
In a nutshell, modern day understanding of pain shows that pain should be considered an “experience” rather than completely representative of only the local tissue damage. Pain is a protective mechanism for the body and it is a very complicated process that sees the coordination of many different systems in the body. In the past, traditional approaches to people with problems involving the musculoskeletal system (muscles, bones and joints) has largely tried to separate the mind from the body. Modern practices now understand that the mind and the body travel as a package and we must take that into account when trying to help people get out of pain.
Is your back pain a hardware or software problem?
For years now, the emphasis on treating back problems has been on the hardware, including the muscles, bones, joints, discs, etc. (anatomy). Research has shown that this approach may not be that effective so a new trend has emerged. This exciting new approach focuses on our software, which is all about how our brains control the function of the back. This new approach is yielding promising results.
Identifying software glitches means diagnosing how our brains control our movements. Functional movement pathology (problems) resulting from these software control issues create abnormal stress and strain on our muscles, bones and joints. This means that our normal, everyday movements may create harmful stress and strain on our bodies, which gradually, over time accumulate, resulting in pain and injury.
Is your hardware wearing out!
We know that sometimes, our backs develop problems in them that are painful and require a treatment to correct that local problem.
Examples of treatments designed to address hardware problems include things like:
- Surgery:
- remove that herniated disc or decompress that pinched nerve
- Spinal fusion to stabilize the spine and prevent movement in the joints
- Spinal injections
- reduce the inflammation in the joints or nerves
- heat up or cauterize the nerve to deaden it to block the transmission of pain signals
- Manual therapies
- Joint manipulation to restore normal movement to the spinal joints
- Soft tissue therapies to reduce tension and pain in tight, shortened muscles. Examples include:
- Massage therapy
- ART (Active release therapy)
- IMS (Intramuscular stimulation)
- Graston
- FAKTR-PM
- Myofascial release
Some or all of these treatments have been shown to be effective in the short term, however they all fall under the umbrella of what we call passive care. Researchers and health care experts now agree that passive care treatments may help in the short term, however they shouldn’t be relied upon for long term relief.
Expensive technologies such as MRI and PET scans have been trying desperately to identify problems with our anatomy that might explain your back pain. Diagnosis has focused on the fact you have a bulging or herniated disc, arthritis in your facet joints, spinal stenosis, pinched nerves, etc. Unfortunately, despite tremendous effort and very large expense, the research shows that this approach hasn’t helped much. Some, including famous Scottish orthopedic surgeon, Dr. Gordon Waddell, would argue that back pain represents a modern day medical mismanagement disaster.
Your software needs a reboot!
So if trying to fix the hardware hasn’t worked very well, what else can be done?
The emerging trend in treatment of back problems is showing us that the majority of back problems are a result of software glitches. A software glitch refers to a problem with how the central nervous system (our brains) controls the way we move. The science of biomechanics shows that our bodies will only put up with a certain amount of stress and strain. Too much strain results in over-stressing of the tissues leading to pain and injury.
You may be familiar with the saying “The straw that broke the camel’s back”. I assure you I’m not calling you a camel…I just like the metaphor to illustrate my point here. It speaks to the concept of the repetitive strain injury (RSI). Most back problems are the end result of repetitive strain. Small amounts of force are put on the joints and soft tissues on a repetitive basis due to the habits, movements and activities we do all day long. These small amounts of force accumulate over time, until finally it is too much for the body to take and the tissue gets injured. The onset of pain and symptoms is often the tip of the iceberg, however because the problem has been building for a very long time.
Well known and respected rehabilitation experts such as Craig Liebenson and Gray Cook support a model that looks at the body as a series of linkages. Certain areas of the body are supposed to be stable, while other areas mobile. If one area changes, say from mobile to stiff, the nervous system has to compensate for that by creating mobility in adjacent areas. If we introduce movement into an area that is supposed to be stable, this creates repetitive strain, which, over time, builds until the tissues in that area become injured.
Functional diagnosis examines these linkages through a series of tests that screen how we move. Moving inefficiently may not be painful, however it does create undo stress and strain, which, over time builds up resulting in pain and injury.
To illustrate my point, lets use our hips as an example. Our hips are supposed to be mobile (check out Elvis!). Above and below the hips are our low backs and knees, which are supposed to be stable (ever heard of core stability?).
A typical scenario that plays out in the clinic on a daily basis involves a person whose job requires prolonged sitting. Holding our bodies in certain positions for extended periods creates stiffness and muscle imbalance in our hips. In addition to local changes in the tissues around our hips, don’t forget that our nervous system adapts to whatever input is thrown at it. Our bodies are meant to move so lack of movement associated with prolonged sitting changes the feedback from the muscles, bones and joints back to the brain (what I refer to as input). The brain then responds to this input by changing the output, which are the signals it sends back down to tell the muscles how to work. Over time, this becomes a learned motor program. If this program is faulty (software problem) then the resulting movements set up repetitive strain on the various body parts.
The combination of the local hip tissue adaptation as well as the faulty software program results in stiffness and muscle imbalance in our hips. If we stiffen up our hips, then the body will have to create mobility in the adjacent areas such as at the knees or in the lumbar spine and pelvic joints. The muscle imbalance we often see that results from prolonged sitting is tight, shortened hip flexors and weak gluts. The motor control problem (ie. software glitch) that occurs is faulty hip extension. Instead of using our gluts to extend the hip when we walk or run, we overuse hamstring and back muscles. In the short term, we might get away with that, however if done repetitively (how many steps do you walk over the course of a year or two?), then the accumulated strain in the low back can injure the ligaments. To bring this full circle, examples of injured low back ligaments seen on an MRI include bulging or herniated discs, facet joint capsule thickening (part of the osteoarthritic process) and spinal misalignment.
So where am I going with all this?
The take home message here is that there are two different ways to look at back and neck problems:
- Pathoanatomic (hardware problems such as disc herniations, facet joint arthritis and spinal stenosis)
- Functional pathology (software problems including motor control problems and muscle imbalances)
These two approaches are not mutually exclusive. You may need both approaches combined if you want to get on top of your back or neck problem. Treatments that address both may be necessary in order to get out of pain and regain your mobility.
Stay tuned to future blog posts for specific examples of common functional movement problems as well as self-help advice on how to fix them.
Sore runner’s knees? It might be your hips!
Spring is here and the pathways are clear of snow (at least temporarily!). This means all of the runner’s are getting off their treadmills and getting outside. Resuming your running activities can see some of those nagging injuries start to rear their ugly head again.
Research has shown that almost half of runners will experience some sort of knee pain. If this sounds like you, it may not be just your knees that are the problem. Weakness in the hip muscles has been shown to contribute to knee pain in runners and some recent research coming out of the University of Calgary suggests that strengthening your hip muscles can dramatically reduce your knee pain. Here’s how it works:
Gluteus minimus and medius are located on the outside of the hip. Their main role is called hip abduction, which means when the limb is not weight-bearing, these muscles cause the leg to move outwards, away from midline. When we are weight-bearing on the leg, these muscles act to keep the pelvis level and our leg in proper alignment.
When these muscles are weak, a few things happen. The first is that when we come onto the leg, weakness allows us to sag into the hip too much, which creates unleveling of the pelvis as shown in this picture:
You can imagine that if this postural misalignment is allowed to occur repetitively, the stress and strain will build up to cause pain and injury. Common things we see clinically would be back pain and hip problems such as bursitis and tendinitis.
Not only do we see pelvic unleveling, but weakness in the glutes will result in misalignment in the leg. Kind of like in the song, “The hip bone’s connected to the…” The misalignment to watch for goes like this:
Weakness in the glutes allows the hip to adduct and internally rotate too much when we’re on the leg. This causes increased valgus angle at the knee (check out the picture for what increased valgus means). We also see pronation of the foot/ankle and collapse of the medial arch of the foot. You get the idea in this picture:
See how this person sags into the right hip, which results in unleveling of the pelvis and the angle from the hip to the knee increases, resulting in the knee pointing inwards too much (“valgus”).
This misalignment causes the knee cap to track incorrectly in it’s groove. It also creates inappropriate stress and strain on the inside and outside of the knee. All of this can result in knee pain.
Test yourself
Here is a simple test you can do to see if you have weak glutes:
Stand in front of a mirror and try to squat on one leg at a time. Watch the alignment of your hips and knees. Here is a picture of pretty good alignment:
Also, make a note of how easy it is to maintain your balance. Note if you tend to be tippy from side to side or if you have to bend at the waist and stick your butt out excessively to maintain your balance.
If maintaining your balance seems to be pretty easy, that is a good sign that your muscles are strong and your motor control is good. If you are wobbly, it is another clue that either your muscles are weak or you have poor coordinated control of those muscles. It is especially important to make note of side-to-side differences.
Here is a picture of poor alignment:
See how the knee tends to move to the inside and the foot rolls in (pronates)? This shows an increased valgus position. It is likely that this person also has a harder time balancing on this leg.
So what do you do about it?
If you have weak glut min/med, then you need to do some hip abduction strengthening exercises. There are many ways to go about doing this and having the correct technique is critical. Often I see well-meaning people trying to strengthen their glutes, however are unknowingly using their back muscles or their hip flexors to perform the movement instead of their glutes. This simply compounds the problem and can be quite frustrating.
Open chain vs. Closed kinetic chain exercises?
This is an age-old argument that rehab professionals go back and forth on as to which is a better approach. The answer is both can work if done properly. Personally, I’m a bigger fan of closed kinetic chain exercises, because I feel that the motor system thinks in terms of performing movements as opposed to recruiting individual muscles. There are sound arguments for both approaches so make sure you do your homework and figure out an approach that makes most sense to you.
Open chain
Most people are familiar with Clam exercises. If you are going to do them, make sure you don’t cheat by allowing your hips to roll backwards or excessively use your hip flexors. Click here to check out some videos demonstrating a progression of open chain exercises that are good for providing lateral stability to the hips, pelvis and low back
Closed chain
As mentioned, I don’t mind open chain exercises like the clam, however they may not translate into good stability when you are on the leg, which is what is termed a closed chain position. I prefer closed chain exercises. Here are some videos demonstrating a progression of closed chain hip abduction exercises that I like to incorporate into people’s rehab program.
Try it and see what you think. It is harder than it looks. Remember to make sure your pressure is directed down into the table/floor and you aren’t activating your hip flexors, which would result in your knee wanting to come closer towards your chest. As with most exercises, I recommend you get together with a trained health professional to get an exercise regime that is right for you and to ensure you are doing the movement correctly.
Office exercises – part 2
In a previous blog, I talked about taking micro breaks every 30-45 minutes and some simple exercises you can do to offset the stress and strain related to sitting for too long at your desk or in front of your computer.
The next step is to organize mini breaks, which should occur every 1.5-2 hours. These are a bit longer than the micro breaks. There are 5 simple exercises you can do to relieve the stress and tension that builds up in our bodies from prolonged sitting. I’ll describe each of the 5 exercises and then at the end of this blog, I have included a video demonstrating them.
1. Back of the leg stretch
Slide forward on your chair so your feet are firmly planted on the floor. Extend one leg and lean forward at the waist with a straight back so you feel a gentle stretch in the back of your thigh. Bend your ankle so that you bring your toes towards your shin. Hold that gentle stretch position for 15-20 seconds and then repeat on the other leg. You can do each side 2-3 times. Remember, no pain, only a gentle stretch should be felt.
2. Figure 4
While sitting forwards in your chair with your feet firmly planted on the ground, cross one leg over the other. Watch the video at the end of this blog for the correct stretch position. While holding the knee down, lean forward with a straight back until you feel a gentle stretch in the hip. Hold for 15-20 seconds and then repeat on the other leg. You can do each side 2-3 times. Again, no pain, only a gentle stretch should be felt.
3. McGill’s overhead reach
Stand up and gently reach your hands towards the ceiling while looking up. You can extend one arm at a time towards the ceiling, which will give a gentle stretch through your side and mid back. Hold each stretch position for 5-10 seconds.
4. Brugger’s relief position
This is a great exercise to reverse the slouched posture we tend to get into after sitting at a desk or in front of a computer for too long. While standing, roll your arms in so that your thumbs point towards your body (palms face backwards). While keeping your arms at your side, gently rotate your arms out so your thumbs point out (palms face forwards). You should feel your shoulder blades pinching together as you rotate your arms. Then imagine a string that is attached to your sternum that pulls your chest towards the ceiling while you look up. Hold this stretch position for 8-10 seconds and repeat 2-3 times.
5. Mad cat stretch
Stand in front of your desk with your feet shoulder width apart and your hands on the desk, shoulder width apart, supporting your weight. Roll your pelvis underneath you (tuck your tail in) while rounding your back and bringing your chin to your chest. Then gently reverse this position, where you roll your pelvis backwards (stick your butt out!), arch your back and look up at the ceiling. Slowly cycle through these positions 4-5 times while pausing for a few seconds at the end range of each position. Again, no pain should be felt, only a gentle stretch.
After going through these 5 simple exercises, you are ready to get back to work (with unabated enthusiasm, no doubt!)
Check out the video where I demonstrate how to do each of these 5 exercises. It should take about 5 minutes to do them, which means they shouldn’t significantly disrupt your workflow so your boss can’t get upset about you not getting your work done.
Office exercises-part 1
It is no secret that sitting too much leads to pain and injury. I have written about the negative effects of repetitive strain injury in previous blogs. Part of the solution is to ensure your workstation, including your chair and desk fits you properly to support your body.
Even if your workstation is adjusted to fit your body perfectly, however, it won’t offset the stress and strain of sitting for hours on end without a break. The constant stress and strain your body has to endure from prolonged sitting accumulates until finally it reaches a point where the tissues are damaged, causing pain.
It may seem like common sense, but a great way to prevent this is to schedule breaks into your workday. Human nature shows that we tend to get caught up in the task we are doing and lose track of time, so these breaks need to be planned and scheduled. You can set up your computer calendar warning as a regular reminder to take a break. Now practicality means that these breaks must be short so they don’t interrupt your normal workflow and take away from your productivity because that will likely irritate your boss. Here is a great way to do this:
Micro Breaks
The first type of break is called a micro break. It only takes 30 to 60 seconds, and should be done every 30-45 minutes. There are 4 simple things, including some stretches you can do during this quick break to offset the stress and strain. I have a video included at the bottom of this blog demonstrating these 4 things.
1. Visual break
The muscles that maintain the position and focus of the eye are no different than any other muscle. Prolonged work causes fatigue and discomfort. If you maintain focus on one thing for too long, like your computer screen or reading material, the eye muscles fatigue, resulting in eye strain. To prevent this, every 30 to 45 minutes, look away from your work and refocus on something that is at least 20 feet away. Look at a picture on the wall or out the window. Maintain that new focus for 10 to 15 seconds.
2. Neck range of motion stretches
After your visual break do the following neck movements:
- Look over your left shoulder
- Look over your right shoulder
- Bend your left ear down to your left shoulder
- Bend your right ear down to your right shoulder
There should be no pain while performing these movements. Simply move your neck as far as it wants to move in each direction without pain, and hold it and the end-range for a few seconds.
3. Shoulder rolls
After performing the neck range of motion stretches, a great way to relax the shoulders is to gently roll them in circles. Perform 5 – 8 rotations in each direction. Again, there should be no pain during any of these shoulder movements.
4. Forearm stretches
The muscles of the forearms can become tense, tight and sore from keyboarding or writing. The stretch to help this is a little hard to visualize so you might want to watch the video below for a demonstration.
Grasp your fingers with the palm up and gently bend the wrist and fingers towards the floor while extending your arm (straightening your elbow). Repeat on the other hand. Now reverse the position so your palm is towards the floor and you bend your wrist and fingers to the floor to stretch the top part of the forearm. Hold each position for 10-15 seconds. Again, you should not feel any pain, only gentle stretching.
Here is a video demonstrating these 4 things to do during these micro breaks.
Stay tuned where I will cover some more simple exercises you can do during longer breaks in your workflow that will help prevent pain and injury caused by sitting too long.