Posts Tagged ‘low back pain’

Pelvic Bridge Vs. Pelvic Tilt

by Kristin Stromberg, ATC

When a person comes into the office as either a new patient or as a wellness visit, I usually ask if they perform any type of exercise at home. Some answer no because they are too busy or do not have the equipment at home. Others will say that they go to the gym and the rest will say they try and work on exercising at home. My next question is if they know what a pelvic tilt is. If the person takes a yoga class or has had some sort of physical therapy in the past this is familiar to them. Some will go into a bridge position and rest give me a blank stare. This lead me to start thinking how many people are doing a bridge instead of a pelvic tilt.

 

So what is a pelvic tilt? A pelvic tilt is an exercise comprised of very subtle spinal movements that strengthen the support muscles around the low back, particularly the abdominals. They are a good preliminary exercise for those seeking low back pain relief or to help improve your posture. They can be done lying on the floor or standing with the back to a wall. For performing them on your back, lie on your back with the knees bent and the soles of the feet on the floor. This is your Neutral Spine* with the natural curve of the lumbar spine causing the low back to be slightly elevated from the floor. On an exhale, gently rock your hips towards your face. Your butt will not actually leave the floor, but you will feel your low back press into the floor. You are essentially taking the curve out of the low back. Think of the pelvis as a bowl of water. When you do the pelvic tilt, the water would be spilling towards your belly. After a few seconds, inhale and return to your neutral position. Repeat this movement 5 to 20 times.

 

When working on pelvic tilts you are trying to achieve a *neutral spine. Neutral spine is the natural position of the spine when all 3 curves of the spine; cervical (neck), thoracic (middle) and lumbar (lower) are present and in good alignment. This is the strongest position for the spine when we are standing or sitting.

                      

Pelvic Tilt

Pelvic tilts are a basic exercise that needs to be mastered before challenging yourself with harder exercises. If keeping a pelvic tilt is difficult then performing harder exercises will cause discomfort and maybe even pain in the low back area. There is no rush into progressing with exercises. If a patient has acute low back pain, pelvic tilts are great for relieving tension in the back. Bridges would come later into the rehab protocol once the pelvic tilts technique is acquired.

 

 

Pelvic Bridge

A pelvic bridge is a great exercise that works on glutes, hamstrings, core muscles such as rectus abdominis and erector spinae. Bridges can be modified to increase the level of difficulty by adding a swiss ball, Bosu ball, single leg movement and other variations. At the beginning of a rehab routine we usually wait to perform any type of bridging for low back patients due to the possibility of the low back not responding well due to poor core strength. By going into a bridge, it is putting your back into extension and patients that come in with low back issues have a hard time with extension. Before going into a bridge I always make sure that the body is in a pelvic tilt so there is no extra tension in the low back. Lie face up on the floor, with your knees bent and feet flat on the ground. Keep your arms at your side with your palms down or up. Lift your hips off the ground until your knees, hips and shoulders form a straight line. Squeeze those glutes hard and keep your abs drawn in so you do not overextend your back during the exercise. Hold for three to five seconds and then bring your hips back down to the floor. Repeat for two sets of ten reps. After a few days of trying bridges and there are no residual effects then we will progress with the exercise.

                        

If you would like to learn more about performing pelvic tilts and bridges, please call the office for a FREE CONSULTATION at 847-362-4476 with Dr. Jordan or Dr. Jade to see how we can help you!!

Muscle of the Month : The Piriformis

by Kristin Stromberg, ATC

When patients come into our office with low back pain or symptoms resembling sciatica one of the muscles we check in on is the piriformis. During the examination we will check on range of motion and strength of different muscles to see if we can narrow down where the pain/discomfort is coming from. It is usually not just one muscle that is tight or restricting but the piriformis is tight in most if not all in our patients.

The piriformis  is a flat, pyramid-shaped muscle that lies parallel to (in line with) the gluteus medius and underneath the gluteus maximus muscle in the hip area.The muscle passes through the greater sciatic foramen (a space in the pelvic bones, on each side of the center) and to the upper part of the greater trochanter (a bone ridge near the top of the femur, or thigh bone). It takes up the most area in the greater sciatic foramen.

It is a small muscle when compared to other muscles of the region. The piriformis helps rotate the hip and works with other rotators. It will rotate the thigh while extended and will abduct, or pull inward, the thigh when flexed.

The close nature of the piriformis muscle to the sciatic nerve, which is the largest nerve in the human body, can cause pain in some individuals. This known as piriformis syndrome.  This pain can run from the buttocks to the lower back and in some cases down the leg into the ankle. The more joints the nerve passes thru with pain the longer the recovery. This condition can happen to anyone and can worsen with prolonged sitting, sedentary lifestyle, other muscles not working or “firing” correctly and if the problem is not addressed as soon as possible.

Treatment to help reduce the pain in the piriformis

  • Physical therapy to increase range of motion and to help strengthen the low back, core etc.
  • Chiropractic care to make sure there are no subluxations and that the body is in proper alignment.
  • Massage therapy to help relax the muscles from spasming
  • Low Level Light Therapy (Cold Laser) to reduce any inflammation that is being caused in the body.

Pictured below is a great stretch to help loosen the piriformis.  For more information on how to stretch, visit here.

If you are not sure if you are experiencing any of these symptoms mentioned above and are not sure what to do we are offering a free consultation with one of our doctors to see if we can help. Please call the office at 847-362-4476 so we can stop it in its tracks!!