Does Your Tight Psoas Cause Your Lower Back Pain? – Ryno van den Berg –

There are various causes of low back pain, coming in different forms – some people experience a dull ache, while others have a sharp pain. Some experience pain that radiates into the back of the leg while others suffer the pain right into the foot. The back is made of various musculoskeletal components, and the role of these elements in various movements makes the back an important part of the whole body.

Regardless of the nature of the pain and how it makes you feel, one primary muscle that is involved in causing back pain is the Psoas, or perhaps more accurately – the Iliopsoas muscle. This muscle is shaped in the form of an “S” and runs down the five lowest spinal vertebrae, through your pelvic region ending in the femur bone. You have two of these muscles, one on either side of the body.

The psoas is involved in various movements, but one of the major tasks of this muscle is to stabilize your lower back whenever you lift the knee upwards. It is also critical for body balance, and you use it when executing basic body movements such as walking, bending forward and tilting to one side.

The muscle also helps you stand up from a sitting position, sit up from a lying down position and helps you to walk. It is vital in day-to-day life.

This muscle is responsible for your muscles’ and joints’ range of motion; therefore, if you have a psoas muscle that isn’t working correctly, you diminish your range of motion.

 

What Causes Injury to the Psoas Muscle?

A sedentary lifestyle and lack of activity can lead to contraction of the psoas muscle. When the muscle contracts, it leads to stiffness and consequent lack of mobility in your lower back or hip area.

You will also experience issues with the iliopsoas muscle due to strain, contracture, spasms, and tendinitis, which is an inflammatory condition that affects the muscle.

You also get a contracted psoas muscle if your back is misaligned. Misalignment causes the back to lean more to one side of the body as compared to the other. This can cause contraction of the muscle and result in other types of back pain as a result of sciatica and bulging discs.

 

The Symptoms of a Contracted Psoas

One of the major symptoms of back pain due to a contracted psoas muscle is back strain that doesn’t go away even with proper treatment. Instead of getting better, the condition even gets worse. The pain characteristically spreads from the lower back to the mid or upper areas, or it spreads to the surrounding regions of the anterior part of the hip.

The condition might also accompany various other conditions that affect the low back. It might even cause chronic low back pain that doesn’t go away easily.

This condition is more common in various professionals such as athletes and office workers who spend most of their times sitting. When it comes to sports, this condition is more prevalent in hockey, dance, and soccer.

When overworked or when it becomes too weak to handle the strain that is imposed on it, this muscle can go into spasm and tear. Tears in the muscle can heal but might lead to scarring that will cause weakness and pain. The surrounding muscles compensate and become painful and tight as well. When the muscles compensate, they can lead to herniation of the disc at levels L4 and L5.

This muscle is misunderstood by many people, and it makes it difficult for the patient to pinpoint the location of the pain. The patient also has a delay in achieving a fully erect posture when standing up.

In all these, the most characteristic feature of the pain is that of lower back pain that gets to spread to the rest of the back, the gluteal area, the hip regions and even the groin. You might experience initial pain when you rise from a seated position. Standing for some time might also result in pain. This pain doesn’t manifest itself when you lie down or when you walk unless it is severe.

Relief of the pain is experienced when you sit down. Extending the leg when driving makes the pain worse. The pain also gets worse when you twist at your waist without moving the feet.

Adopting any position that shortens the psoas muscle for more extended periods of the time can lead to spasm. This is possible when you sleep in a fetal position for long, sit for extended positions of time or when you work in a crouching or kneeling position.

A tear in the psoas muscle occurs when there is a forceful contraction. The damage can occur when you run up a steep slope, or perform an action such as kicking a ball or martial arts.

 

How Does a Contracted Psoas Muscle Cause Pain?

When the psoas muscle contracts, it shortens and pulls the spine into a condition called hyper lordosis and leads to an over-arched low back. This posture places a lot of strain on the spinal muscles, including an important muscle called the erector spinae. It also puts a strain on the vertebral joints, causing pain.

Low back pain also results when a tight psoas muscle leads to tension on the tendon that attaches the psoas muscle to the lumbar spine. While the tension occurs in the muscle, you feel the pain in the lower back. The tension can also affect the spinal nerve roots, which results in nerve pain. This is   why you feel the pain radiating to other areas of the body and lower body.

A contracted psoas muscle will pull and twist the vertebrae, which in turn causes compression of the vertebral joints and discs. The compression causes pain and gradual degeneration of these structures over time. This results in structural damage such as degenerative disc processes and potential herniation.

 

Treatment

It’s worth mentioning that education is key for most people when rehabilitating their back. A specialist back pain book can be worth it’s weight in gold and allow you to fully understand your treatment process and to avoid the injury recurring in future.

The location of the iliopsoas muscle and its roles in the back and hip make it hard for a doctor to get his hands on it during the examination. It is tricky to get to and reach manually; therefore treatment of any issue that results needs a qualified professional who can rule out any other conditions.

The aim of any treatment strategy is to correct lifestyle problems that might be causing the pain in the psoas muscle. If you are working at a job that requires you to sit for several hours, you need to get some time to stand up now and again to stretch the muscle. Or maybe you need to start improving your walking posture.

Secondly, you need to loosen up the psoas muscle by developing a daily habit that allows you to stretch this muscle, doing this consistently helps relax the muscle and loosen the tension that has built up over time.

You might also need to get to a medical professional for assessment and treatment of the condition. The qualified professional  will perform a physical examination and rule out any other conditions to make sure it is a condition affecting the psoas muscle.

You can also go natural when it comes to treating this low back pain. Combining natural remedies such as turmeric, cayenne pepper & CBD oil with stretching gives you the ability to get relief faster.

 

 

Active isolated stretching

Holding a stretch for 30 seconds and more is BAD !

A study done in Canada, once again showed us that holding your stretches for long periods (45 seconds) is not good for your athletic performance, and even impair your warm up.  If you like to exercise, please don’t warm up with long stretches.

The purpose of the study was to investigate the effect of an acute bout of lower limb static stretching on balance, proprioception, reaction, and movement time.

The conclusion was that an acute bout of static stretching impaired the warm-up effect achieved under control conditions with balance and reaction/movement time.

Methods: Sixteen subjects were tested before and after both a static stretching of the quadriceps, hamstrings, and plantar flexors or a similar duration

control condition. The stretching protocol involved a 5-min cycle warm-up followed by three stretches to the point of discomfort of 45 seconds each with 15-s rest periods for each muscle group. Measurements included maximal voluntary isometric contraction (MVC) force of the leg extensors, static balance using a computerized wobble board, reaction and movement time of the dominant lower limb, and the ability to match 30% and 50% MVC forces with and without visual feedback.

Results: There were no significant differences in the decrease in MVC between the stretch and control conditions or in the ability to match submaximal forces. However, there was a significant (P  0.009) decrease in balance scores with the stretch (2 9.2%) compared with the control (1 17.3%) condition. Similarly, decreases in reaction (5.8%) and movement (5.7%) time with the control condition differed significantly (P  0.01) from the stretch-induced increases of 4.0% and 1.9%, respectively.

Conclusion: In conclusion, it appears that an acute bout of static stretching impaired the warm-up effect achieved under control conditions with balance and reaction/movement time.

 

Effect of Acute Static Stretching on Force,
Balance, Reaction Time, and Movement Time
DAVID G. BEHM, ANDREW BAMBURY, FARRELL CAHILL, and KEVIN POWER
School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland, CANADA
ABSTRACT
BEHM, D. G., A. BAMBURY, F. CAHILL, and K. POWER. Effect of Acute Static Stretching on Force, Balance, Reaction Time, and
Movement Time. Med. Sci. Sports Exerc., Vol. 36, No. 8, pp. 1397–1402, 2004. Purpose: The purpose of the study was to investigate
the effect of an acute bout of lower limb static stretching on balance, proprioception, reaction, and movement time. Methods: Sixteen
subjects were tested before and after both a static stretching of the quadriceps, hamstrings, and plantar flexors or a similar duration
control condition. The stretching protocol involved a 5-min cycle warm-up followed by three stretches to the point of discomfort of
45 s each with 15-s rest periods for each muscle group. Measurements included maximal voluntary isometric contraction (MVC) force
of the leg extensors, static balance using a computerized wobble board, reaction and movement time of the dominant lower limb, and
the ability to match 30% and 50% MVC forces with and without visual feedback. Results: There were no significant differences in
the decrease in MVC between the stretch and control conditions or in the ability to match submaximal forces. However, there was a
significant (P  0.009) decrease in balance scores with the stretch (2 9.2%) compared with the control (1 17.3%) condition.
Similarly, decreases in reaction (5.8%) and movement (5.7%) time with the control condition differed significantly (P  0.01) from
the stretch-induced increases of 4.0% and 1.9%, respectively. Conclusion: In conclusion, it appears that an acute bout of stretching
impaired the warm-up effect achieved under control conditions with balance and reaction/movement time. Key Words: STABILITY,
ISOMETRIC FORCE, PROPRIOCEPTION, FLEXIBILITY
Stretching is commonly utilized to increase the range
of motion (ROM) around the joint (12,19) and theorized
to improve athletic performance (28). With the
exception of an increased ROM, recent studies have not
found substantial evidence to support the use of stretching
for improved performance. A number of studies report that
acute and prolonged stretching may actually reduce human
performance through decreases in force (4,14,15) and power
(11,40).
The stretch-induced decreases in force and power have
been attributed to impairments in neural output (2,4,13) as
well as changes to the musculo-tendinous unit (MTU)
(13,34). Fowles et al. (13) demonstrated an increase in
fascicle length of the soleus and lateral gastrocnemius of a
single subject with 30 min of stretching. Studies have reported
both decreases (24,35) and no change (23) in MTU
passive resistance or stiffness with stretching. MTU stiffness
incorporates the muscle, tendon, and other associated
connective tissue and can determine the effectiveness and
rapidity by which internal forces generated by the muscle
are transmitted to the skeletal system (38). Among the
functions of the intrafusal (includes stretch receptors) muscle
fibers, Golgi tendon organs and other proprioceptors is
to aid in the maintenance of balance (26) and detection of
the position of the body in space (proprioception) (8,10).
Acute changes in MTU length, stiffness, force output, and
muscle activation could alter the ability to detect (afferent
proprioception) and respond (efferent muscle activation) to
changes in the immediate environment. Stretch-induced impairments
might affect overall balance and stability or limb
proprioception. Furthermore, a more compliant MTU
(greater muscle and connective tissue slack) in conjunction
with a disturbed activation of the muscle could alter reaction
(RT) and movement (MT) times. There have been no studies
reporting on the effects of an acute bout of stretching on
balance, proprioception or reaction/movement time.
Balance involves the interaction of automatic postural
and voluntary motor commands of both the trunk and limb
musculature (6,30). Automatic postural responses are modulated
by both trunk and leg inputs (5), with the central
nervous system (CNS) performing anticipatory postural adjustments
when expecting self-inflicted postural perturbations
(1). Because under conditions of high instability the
CNS may suppress anticipatory postural adjustments, voluntary
responses of trunk and limb muscles to postural
challenges would play a prominent role. Stretch-induced
changes to either the afferent limb muscle responses (proprioception)
or the mechanical output would be expected to
affect the ability to adapt effectively to stability challenges.
At the elite sport level, where milliseconds can mean the
difference between winning and losing, even small changes
in RT, MT, and balance can have a dramatic impact. For
example, differences between the personal best times of the
Address for correspondence: David Behm, Ph.D., School of Human Kinetics
and Recreation, Memorial University of Newfoundland, St. John’s,
Newfoundland, Canada, A1C 5S7; E-mail: dbehm@mun.ca.
Submitted for publication December 2003.
Accepted for publication April 2004.
0195-9131/04/3608-1397
MEDICINE & SCIENCE IN SPORTS & EXERCISE®
Copyright © 2004 by the American College of Sports Medicine
DOI: 10.1249/01.MSS.0000135788.23012.5F
1397
top sprinters in the world can differ by approximately 1%
(i.e., Greene: 9.79 s, Bailey 9.84 s, Christie: 9.87 s, Cason
9.92 s). Thus, even minor changes in RT, MT, and balance
could have important implications for athletic endeavors.
The possibility of stretch-induced impairments to balance,
RT, and MT not only affects sport applications but the loss
of dynamic balance is also a risk factor for osteoporotic
fractures (27). The contributions of RT and MT to dynamic
balance could have implications not only for athletes and
fitness enthusiasts but also for rehabilitation professionals
who prescribe stretching.
The objective of the present study was to examine alterations
in static balance, proprioception, RT and MT, and
force. It was hypothesized based on previous studies that
demonstrated decreases in force and activation as well as
changes in MTU stiffness that all the dependent variables
would be adversely affected by an acute bout of static
stretching.
METHODOLOGY
Approach to the problem and experimental design.
Because a number of the previous studies investigating
stretch-induced force and power decrements used prolonged
stretching routines (15–30 min) of single muscle
groups (4,13) that were not representative of typical stretching
routines, the present study used a moderate volume of
stretching with three lower-limb muscle groups. Subjects
were tested before and after both an acute bout of static
stretching of the quadriceps, hamstrings, and plantar flexors
or a similar duration control condition. The stretching protocol
involved a 5-min cycle warm-up followed by three
stretches to the point of discomfort of 45 s each with 15-s
rest periods for each muscle group (independent variable).
Measurements were conducted over a 20-min period that
included maximal voluntary isometric contraction (MVC)
force of the leg extensors, static balance using a computerized
wobble board, reaction and movement time of the
dominant lower limb, and the ability to match 30% and 50%
MVC forces with and without visual feedback (dependent
variables).
Subjects. Sixteen healthy male university students (age
 24.1  7.4 yr, weight  71.5  15.4 kg, height  172.3
 6.5 cm) volunteered for the experiment. All participants
were verbally informed of the protocol, and read and signed
a consent form. Each participant also read and signed a
Physical Activity Participation Questionnaire (PAR-Q: Canadian
Society for Exercise Physiology) to ensure that their
health status was adequate for participation in the study. The
study was sanctioned by the Memorial University of Newfoundland
Human Investigations Committee.
Intervention. Before stretching of both legs, subjects
performed a warm-up procedure consisting of a 5-min cycle
on a cycle ergometer (Monark Ergomedic 828E) at 70 rpm
with 1-kp resistance. The order of quadriceps, hamstrings,
and plantar flexors stretching was randomized. Stretches
were held to the threshold of discomfort for a duration of
45 s with 15-s recovery periods between stretches. Each
type of stretch was repeated three times. Stretching of both
legs included a series of unilateral kneeling knee flexion
(quadriceps), hip flexion with extended leg while supine
(hamstrings), extended leg dorsiflexion while standing
(stretch of the plantar flexors with gastrocnemius emphasis),
and flexed knee dorsiflexion while standing (stretch of the
plantar flexors with soleus emphasis). Stretching was passive
for the quadriceps and hamstrings with the same researcher
controlling the change in the range of motion and
resistance for all subjects. The researcher would extend the
limb to the limits of the participant’s range of motion
without incurring injury. Subjects provided their own resistance
for the plantar flexors stretches with the instructions to
stretch the muscles to the point of discomfort.
For the control condition, subjects performed the 5-min
cycle warm-up and were allowed to rest for approximately
26 min between the pre- and posttesting periods. The 26-
min rest period provided similar pre- to posttest durations
for the stretching and control conditions. The order of control
and experimental stretch conditions was randomized.
Testing. An orientation session involving multiple attempts
(minimum three attempts) for all measures was organized
for all subjects 3–5 d before testing. The order of
testing was randomized. The stretching intervention commenced
2 min after the pretesting session. Postintervention
testing began within 1 min after the stretching routine. The
duration of pre- and posttesting was approximately 20 min
each.
For leg extension MVC force, subjects sat on a bench
with hips and knees flexed at 90°, and the upper leg and hips
restrained by two straps. The ankle was inserted into a
padded strap attached by a high-tension wire to a Wheatstone
bridge configuration strain gauge (Omega Engineering
Inc., LCCA 250). Prestretching, subjects performed two
leg extension MVC. If there was more than a 5% difference
in maximum force output, another MVC was performed.
Only two contractions were permitted poststretching to reduce
the chance of fatigue. Three-minute rest periods were
allocated between contractions. The day-to-day reliability of
the strength test using an intraclass correlation coefficient
(ICC) was determined to be 0.9, with a between test (single
session) reliability of 0.93.
All torques were detected by the strain gauge, amplified
(Biopac Systems Inc., DA 100, and analog to digital converter
MP100WSW) and monitored on computer (Sona
Phoenix PC). All data were stored on a computer at a
sampling rate of 2000 Hz. Data were recorded and analyzed
with a commercially designed software program (Acq-
Knowledge III, Biopac Systems Inc.).
The matching force task used the same set-up as the MVC
test. Once the MVC force was established, grid lines were
provided on the computer, which outlined 30% and 50% of
the MVC force. Subjects were asked to exert sufficient
isometric leg extension force over a 5-s period to match the
gridlines. Visual feedback was always given for the first
three trials of a particular relative force (30% or 50% MVC),
while the computer screen was obstructed from view for the
subsequent three trials. Two-minute rest periods were per-
1398 Official Journal of the American College of Sports Medicine http://www.acsm-msse.org
mitted between attempts. The order of the relative force
matching tasks was randomized. The day-to-day reliability
of the matching force test using an ICC was determined
to be 0.8, with a between test (single session) reliability
of 0.88.
A balance ratio (contact with floor to no contact time) was
calculated by a software program (Innervations, Muncie,
IN) from a 30-s wobble board test (Kinematic Measurement
Systems, Muncie, IN). A metal plate connected to the computer
hardware was placed under the wobble board. When
the perimeter of the wobble board made contact with the
metal plate, the duration and frequency (during the 30-s test)
of contact was recorded by the software. Subjects received
an orientation session for the balance board on a separate
day as well as one to two practice attempts on the day of
testing. The day-to-day reliability of the balance test using
an ICC was determined to be 0.81, with a between test
(single session) reliability of 0.86.
RT and MT were measured by an apparatus developed by
the Memorial University of Newfoundland Technical Services
(Electronics, Newfoundland, Canada). The testing apparatus
consisted of a stop clock (58007, Lafayette Instrument
Company, Lafayette, IN), an analog timer (L15–365/
099, Triton Electronics, UK), a stop clock latch (58027,
Lafayette Instrument Company) that connected the stop
clock and the analog timer, a custom-designed box (62 cm
(length)  15.5 cm (width)  9 cm (height)) with the
distance of 50 cm from center of start button to the center of
the stop button, and a trigger plate for the start of the task.
With the device situated on the floor, the task entailed
movement of the dominant foot in response to the illumination
of an incandescent light bulb. The subject would start
with the nondominant foot on the floor and the dominant
foot (ball of foot) placed on the start button. Upon illumination
of the light signal, the subject would release the start
button and move their foot forward to touch the stop button
(50 cm). RT was measured as the time between the illumination
of light stimulus and release of the start button. MT
was measured as the time between the initiation of movement
and the depressing of the stop button. The actions
involved hip flexion, knee extension and plantar flexion. In
order to move as quickly as possible, the quadriceps and
plantar flexors would initiate the movement, while the hamstrings
would aid with the deceleration of the leg to accurately
touch the stop button. Three trials of RT and MT were
performed with 30-s rest periods. The day-to-day reliability
of the RT and MT tests using an ICC was determined to be
0.60 and 0.89 respectively with no significant (P  0.05)
difference between values for test versus retest. Between
test (single session) ICC reliability measures of 0.79 and
0.93 were recorded for RT and MT, respectively.
Statistical analysis. Data were analyzed using a twoway
ANOVA repeated measures design. The factors included
condition (stretching vs control) and testing (pre- and
postcondition). An alpha level of P  0.05 was considered
statistically significant. If significant differences (P  0.05)
were detected, a Bonferroni-Dunn’s procedure was used to
identify the significant change. The means and SEM are
illustrated in Table 1. Reliability was assessed using an
alpha (Cronbach) model ICC (25) with all 16 subjects.
Repeated tests were conducted within 48–72 h.
RESULTS
Overall, significant differences from the control condition
due to the stretching protocol occurred with measures of
static balance, RT and MT.
Force. There was no significant difference between
stretching and control conditions in force output. The stretch
and control conditions experienced similar 6.9% and 5.6%
force decrements, respectively, from the pretest to the
posttest.
Perceived force. Whether visual feedback was or was
not provided, there were no significant differences in the
ability to match 30% and 50% MVC between control and
stretch conditions during the pretest or posttests. The control
condition demonstrated a nonsignificant 18.8% and 10.7%
greater accuracy for maintaining 30% and 50% MVC
posttest.
Balance. Balance scores moved in opposing directions
resulting in a significant change (P  0.009) for the pre- to
posttest differences between control and stretch conditions
(effect size  0.11: small). In comparison with the precontrol
sessions, the control condition demonstrated a significant
(P  0.05) 17.3% improvement in balance scores
postcontrol, whereas the stretch condition showed a nonsignificant
2.2% decrease in balance scores poststretching routine
(Table 1).
Reaction and movement time. Similar to balance
scores, reverse trends for the stretch and control conditions
resulted in significant change for the pre- to posttest differences
with both reaction (P  0.01, effect size  1.11:
TABLE 1. Balance, reaction and movement time data (means  SEM).
Pretest Control
Condition
Posttest Control
Condition
Pre- to Posttest
Difference
Pretest Stretch
Condition
Posttest Stretch
Condition
Pre- to Posttest
Difference
Wobble board contacts 10.8 8.9 1.9 8.8 9.0 0.2
(2.0) (1.5) 917.3%* (1.7) (1.8) 82.2%
Reaction time (RT) 294 ms 277 ms 17 ms 283 ms 294 ms 11 ms
(27.5) (10.7) 95.8% (16.6) (15.8) 84.0%
P  0.16
Movement time (MT) 427 ms 403 ms 24 ms 418 ms 426 ms 8 ms
(37.5) (30.2) 95.7% (32.6) (39.1) 81.9%
P  0.18
* Asterisk indicates a significant difference from the pre-test condition. Significant differences were detected in the pre- to posttest differences between control and stretch conditions
for balance (power: 50%), RT (power: 95%), and MT (power: 50%).
STRETCHING EFFECTS ON BALANCE AND MOVEMENT Medicine & Science in Sports & Exercise 1399
moderate-large) and movement (P  0.01, effect size 
0.65: moderate) time, respectively (Table 1). In reference to
the pretest control session, RT and MT improved (decreased)
by 5.8% (P  0.16) and 5.7% (P  0.18), respectively.
However, compared to the pretest stretch condition,
RT and MT were impaired (increased) by 4.0% and 1.9%
poststretch, respectively (nonsignificant).
DISCUSSION
The most important findings in this study were the impairments
in balance, RT and MT, due to prior stretching.
The control condition which involved a 5-min cycle warmup,
submaximal and maximal leg extension contractions,
three trials each of rapid leg movement (RT and MT), and
balance on a wobble board followed by a 26 min rest period
improved performance in the balance, RT and MT tests.
Inserting a stretching routine within the rest period not only
nullified the beneficial effects of the warm-up but also
produced small performance decrements in relation to the
pretest scores.
These decrements reflect impairments associated with
recent studies that have reported stretch-induced decreases
in force (4,13,14), power (11,40), and muscle activation
(2,4,13). Although isometric forces decreased 6.9% after
stretching in the present study, the decrement was not significantly
greater than the 5.6% impairment in the control
condition. The lack of a significant loss of isometric force
may be attributed to the moderate volume of stretching
imposed. In contrast to other similar studies that have
stretched a single muscle group for 15–30 min (4,13,14), the
present study involved only 135 s of intermittent stretching
for each of the three muscle groups.
Balance involves the interaction of automatic postural
and voluntary motor commands of both the trunk and limb
musculature (6,30). Balancing on a wobble board can involve
unanticipated perturbations to equilibrium that are
adjusted through contractions of both trunk and limb muscles.
Bloem and colleagues (6) speculated that lower leg
inputs act to modulate automatic postural responses. They
also found that the knees, hips, and trunk initiated movement
before the automatic postural responses. The CNS
performs anticipatory postural adjustments when expecting
self-inflicted postural perturbations (1). However, Aruin and
colleagues (1) suggested that under conditions of high instability
that the CNS may suppress anticipatory postural
adjustments as protection against their possible destabilizing
effects. Consequently, voluntary responses of trunk and
limb muscles to postural challenges would play a prominent
role. Shiratori and Latash (30) in a subsequent study from
the same laboratory reported that distal muscles (tibialis
anterior and soleus) cope with asymmetrical perturbations
and modulate the anticipatory postural adjustments in novel
situations (i.e., wobble board). Furthermore, Lipshits et al.
(22) described how perturbing balance by rapidly raising a
hand was initially counteracted by activation of lower limb
muscles. Therefore, it is apparent the important role that
lower limbs play in maintaining balance. Modifications to
either the afferent limb muscle responses or the mechanical
output would be expected to affect the ability of the peripheral
neuromuscular system to adapt effectively to stability
challenges.
Stretching has been reported to alter the length and stiffness
of the affected limb MTU. Although the exact mechanisms
responsible for increases in range of motion after
stretching are debatable, the increase is commonly attributed
to decreased MTU stiffness (37,39). Fowles et al. (13)
demonstrated an 8-mm increase in fascicle length of the
soleus and lateral gastrocnemius with 30 min of stretching.
Studies have reported both decreases (24,35) and no change
(23) in MTU passive resistance or stiffness with stretching.
Changes in MTU stiffness might be expected to affect the
transmission of forces, the rate of force transmission and the
rate at which changes in muscle length or tension are detected.
A more slack parallel and series elastic component
could increase the electromechanical delay by slowing the
period between myofilament crossbridge kinetics and the
exertion of tension by the MTU on the skeletal system. In
addition, the detection and monitoring of the muscle tension
by the Golgi tendon organs (GTO) would be delayed since
a more compliant tendon would not transmit the tension
information to the GTO as rapidly as a stiffer MTU. Furthermore,
increases in MTU length and decreases in MTU
stiffness could also alter the perception of the intrafusal
stretch receptors and thus perturb the afferent responses to
both changes in muscle length, rate of length change, and
tension (GTO). Therefore, stretch-induced changes in muscle
compliance might affect both the muscle afferent input
to the CNS and muscle output for counteracting unexpected
perturbations to balance.
Further evidence for the detrimental effect of an acute
bout of stretching on the CNS has been provided by Avela
et al. (2). They investigated the effects of passive stretching
of the triceps surae muscle on reflex sensitivity. After 1 h of
stretching, there were significant decreases in MVC
(23.2%), EMG (19.9%), stretch reflex peak-to-peak amplitude
(84.8%), and the ratio of H-reflex to muscle compound
action potential (M-wave) (43.8%). Although neural propagation
seemed unaffected (M-wave), afferent excitation of
the motoneuron pool (H-reflex) was impaired. They suggested
that the decrease in the excitation of the motoneuron
pool resulted from a reduction in excitatory drive from the
Ia afferents onto the -motoneurons, possibly due to decreased
resting discharge of the muscle spindles via increased
compliance of the MTU.
Stretch-induced impairments in RT and MT may be related
to similar mechanisms as the disturbance in balance.
As mentioned previously, a more compliant MTU could
compromise the rate of tension development. Although it is
highly unlikely that the visual detection of the light stimulus
and the subsequent initiation of CNS motor programs to
move the leg would be adversely affected by stretching, a
prolonged electromechanical delay could negatively affect
both RT and MT. Although not monitored in the present
study, other studies have reported decreases in muscle activation
after stretching (2,4,13). Increases in motoneuron
1400 Official Journal of the American College of Sports Medicine http://www.acsm-msse.org
inhibition are more likely to affect the high-threshold fastcontracting
motor units that could also play a role in stretchinduced
RT and MT impairments.
An interesting development in the present study was the
control condition’s improvements in balance scores, RT and
MT. This finding may provide support for the beneficial
effect of a short duration, combination of general (cycle
warm-up and leg extension contractions) and specific (pretest
wobble board, RT and MT tests) activities. However,
because there was no condition in which a cycle warm-up
was not included, the contribution of the cycling cannot be
precisely deduced from the present study.
Young and Behm (41) reported similar results in a study
where subjects participated in five different warm-ups in a
randomized order before the performance of two jumping
tests. The warm-ups were: a) control, b) 4-min run, c) static
stretch, d) run and static stretch, and e) run and static stretch
and practice jumps. Generally, the stretching warm-up produced
the lowest values and the run or run and stretch and
jumps warm-ups produced the highest values of explosive
force production. Thus, it should not be surprising that the
control condition’s dynamic warm-up and static leg extension
contractions facilitated subsequent performance.
Numerous studies have investigated the effects of actively
warming-up on subsequent performance, yielding
mixed results. Although the majority of the research has
demonstrated that an increase in temperature facilitates human
performance (9,29,32), other studies have shown inhibitory
effects (5,16) as well as no effect (7) of warming-up
on subsequent performance. These conflicting results may
be attributed to discrepancies in the type of exercise, intensity,
duration, or any combination of these variables utilized
in the warm-up procedure. Studies have demonstrated that
warming-up can result in increased nerve conduction velocity
(31). Increases in nerve conduction velocity could facilitate
the response speed to perturbation in balance as well as
contributing to the improvements in RT and MT.
Another mechanism that may help explain the control
condition’s improvement in RT, MT, and balance may be
the effect of postactivation potentiation (PAP). PAP can be
defined as an increase in the efficiency of the muscle to
produce submaximal force after a voluntary contraction.
PAP has been attributed to regulatory light chain (RLC)
phosphorylation (17,20,21,33), which increases the number
of force-producing crossbridges under conditions of suboptimal
Ca2 activation (33). Suboptimal Ca2 activation may
be present with lower-frequency stimulation such as the
lower-intensity contractions associated with static balance.
Potentiation also involves an increase in the rate constant of
crossbridge attachment (20). The increased rate constant
would allow a greater number of crossbridges to form during
a specific time period resulting in increased force and
rate of force development capabilities. Furthermore, at the
supraspinal level, motor-evoked potential facilitation has
been reported after different durations (5, 15, and 30 s) and
intensities (10%, 25%, and 50%) of thenar muscle voluntary
contractions (3). A number of studies have suggested that an
improved neuromuscular activation can occur after a few
MVC (18,40). Evidence of this postcontraction neural potentiation
is provided by increased H-reflex amplitudes (18)
that may persist for 10 min after the contractions (36). Thus,
pretest contractions in the control condition may have elicited
a PAP response providing both a facilitation of the
motoneuron excitation and RLC phosphorylation contributing
to the significant improvements in RT and MT. Indirectly,
the PAP-induced augmentation of RT and MT would
also benefit balance by allowing more rapid responses to the
perturbations of the unstable environment. The stretching
condition may have nullified the beneficial effects of PAP
contributing to the 2.2% decrement in balance scores.
ICC (reliability) for the dependent measures were all in
the good to excellent category (0.80–0.93) except for the
day-to-day reliability of RT that scored 0.60 (moderate). A
paired samples t-test was then conducted on the RT measures.
The lack of significant difference between the measures
suggested that the low RT ICC may be attributed to the
low between subject variability. Another contributing factor
for this less than optimal reliability may be due to the test
set-up. The RT test for the lower limb necessitated that the
individuals place most of their mass on the nondominant
limb creating a degree of instability. Even with an orientation
session, the lack of familiarity with this type of movement
and the greater instability may have led to a less
consistent action.
CONCLUSION
In summary, the findings of the present study demonstrate
that a moderate bout of stretching (three repetitions per
muscle group) held to the point of discomfort can adversely
affect performance on tests of static balance, RT and MT.
The stretch-induced impairments are hypothesized to be
related to changes in muscle compliance with the stretching
that may adversely affect the ability to detect and respond to
changes in muscle length, and rate of change in muscle
length and forces. Furthermore, it was found in the present
study that a warm-up consisting of general and specific
activities related to the tasks may improve performance
even after 20 min of recovery. Considering the minute
differences between winning and losing in both individual
and team sports as well as the precarious balance or stability
of the elderly, the low but significant percentage changes in
RT, MT, and balance could result in serious consequences.
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1402

Stay healthy this winter

The Winter season can be busy and exciting. We might not have thanks giving and a fairy tale white Christmas in winter time down here, but we still have plenty of distractions to keep us from focusing on our health and taking care of ourselves as we would normally.

Furthermore, once the April holiday season is over, many people experience a lull in their motivation to stay active. Some people begin to experience depression or feelings of anxiousness over expenses that accumulated throughout the holidays. Others let diet and healthy eating habits fall by the wayside. Often, given the weather, exercise is sacrificed for warm nights spent indoors on the couch.

With shorter days and colder weather, finding the motivation to stay healthy and fit can be difficult. And that can lay the foundation for a weakened immune system, posing a greater risk of developing illness or injury. No wonder they call it the winter blues. What’s more, the colder weather creates several safety risks to us and to those around us, and some of these we may not even be aware of.

Recognizing safety risks and patterns of illness or low energy ahead of time is key to preventing them — or at least to dealing with them as they arise. There are countless winter wellness tips and ideas available to ensure you have lots of ways to stay healthy, fit and safe this holiday season and beyond. These healthy winter habits will help you to recognize where your health falls short and what you can do to boost it during this time of year.

Diet and Exercise Tips

While the winter season might increase the risk for weather-related injury, the biggest risk to our overall health is a lack of attention to diet and exercise routines, the chilly and unpleasant weather can also make it very difficult to find the motivation to get to the gym or head outdoors for exercises. In tandem with this, the additional time spent indoors means many of us snack more than we would typically at other times of the year. This combination that can quickly add on the pounds and reduce our happiness and self-esteem over time.

  1. Calm Your Carb Cravings

The cold season tends to ignite our cravings for more carbs and comfort foods. Why? After you consume these delicious treats, your serotonin levels rise, making your brain think you are happier. And as the day wears on, your carb cravings get stronger and stronger.

To counter this, try eating a protein-packed breakfast to keep your energy levels up throughout the day. If by the time the afternoon rolls around you’re still craving sweets or carbs, be sure to have low-fat and healthy snacks on hand. However, if you can, finding a way to increase your serotonin levels without food is the best way to beat the carb cravings.

  1. Add Omega 3 Fatty Acids

Omega 3 fatty acids are a healthy type of fat that are naturally found in many food types including fish, plant seeds and nuts. Omega 3 fatty acids are great for reducing joint pain and stiffness as they are a natural anti-inflammatory. Studies have also shown that omega 3 fatty acids help lower levels of depression, which people commonly feel during the shorter days of winter.

Mushrooms Immune Benefits

  1. Cook with Mushrooms

There are several species of mushrooms that have immune-boosting health benefits. That’s because mushrooms have naturally-occurring antibiotics. This gives them medicinal properties, which helps us to fight off many types of illnesses. Next time you’re at the grocery store, be sure to stock up on varieties like white button or shitake mushrooms and add them to your meals this winter.

  1. Eat More Fiber

Soluble fiber found in apples, oats and nuts is an important way to decrease inflammation and boost immune system function. Soluble fiber also helps reduce cholesterol levels in the body and aids in weight loss and protection against diabetes. This is an especially important winter health tip for seniors who require a high-fiber diet to protect their digestive systems.

  1. Eat Greener and Orange Vegetables

Sticking primarily to vegetables and fruits that are dark green and orange is important in ensuring you’re getting healthy nutrients, sugars and fats. Spinach, kale, Swiss chard, squash, carrots and oranges are all delicious during the winter. There are plenty of recipes available to incorporate these items into your regular winter diet.

  1. Cook with Spices

Onions, garlic, ginger and cilantro are the perfect items to add flavour to your dishes. Not only do they make food taste great, but they’re also shown to help improve immune function. Turmeric is a spice traditionally used in Chinese and Indian medicine. Its main active ingredient is called curcumin, which gives curry its yellow colour. This spice helps to combat several conditions including inflammation and heart disease, and it acts as a powerful antioxidant.

  1. Plan Your Exercises a Week in Advance

Try to stick to a weekly exercise plan so you don’t put off your regular exercise activities. On Sunday night, write down your exercise schedule for the next seven days. Choose your exact workout routines, activities or exercises for each day and how long they will be. Knowing what you’re scheduled to do each day ahead of time makes it easier to stick to. If you can, line up your workout schedule with a friend to encourage each other to stick with it and stay motivated.

  1. Workout at Home

If you have no desire to head outdoors for your workout, then never fear. There are plenty of resources online that supply fun workout videos and exercises. These resources offer a variety of workouts including yoga, strength training, aerobics and other body-weight exercises. Check out Pinterest for tons of great resources so you can get fit in the comfort of your own living room.

These diet and exercises tips are great, specifically in the winter, but they can also be used year-round. By reminding yourself that spring will be here before you know it, you’ll stay motivated to provide proper attention to your body and health habits during the winter.

Mental Health and General Wellness Tips

Above and beyond the potential for personal injury and the decline in fitness and diet routines, winter time presents another threat to our health. This time of year, can cause an increase in depression, which may lead to a decline in overall mental health. Though many people may experience mild forms of depression or sadness due to lower levels of sunlight, there are an estimated nine million Americans chronically affected by the change in season. This is known as Seasonal Affective Disorder (SAD), and it is significantly more common in women than men.

 

When our mental well-being isn’t where it should be, we become even more susceptible to stress and illness. It is as important as ever in the winter to take a holistic approach to wellness, not only for our diets and physical exercise, but for our mental well-being, too.

Here are some mental health and general wellness tips for winter so you can stay healthy during the colder, darker season:

  1. Frequent Hand Washing

Though it sounds like a broken record, frequent handwashing throughout the day is an absolute must in maintaining your health during the winter. It not only helps protect your immune system and prevent you from developing flu and cold, but it protects others around you.

  1. Head to a Sauna or Steam Room

If you begin to feel yourself experiencing depression or higher levels of stress, steam rooms and saunas can help. They help tense muscles to relax which can alleviate feelings of stress. The high temperatures also get you working up a sweat, which is a great way to detoxify your body and your skin.

  1. Take Vitamin Supplements

Consuming lots of vitamin C during the winter will help your body to battle cold and flu symptoms if you do experience them. Vitamin D helps to supplement the lack of light experienced during winter, but it’s still important to get out in the sun whenever it does appear. Vitamin D helps to absorb other important vitamins like vitamin A, iron and calcium.

  1. Drink Herbal Teas

There are many types of herbal teas that can help you stay healthy. Herbal teas like lemon and chamomile can ease depression and anxiety by calming nerves and relaxing your body. They can also help you sleep better. Some herbal teas like green and Rooibos are great as antioxidants. For the most benefit, be sure to look for organic teas made from high-quality ingredients.

  1. Sleep Longer and Better

When the days get shorter, your body will naturally want to sleep longer and will adjust its rhythm to the hours of daylight. Use the longer evenings to wind down and begin relaxing before bed. Try to go to bed as early as possible to give your body enough rest during the times it craves it the most.

Many people choose to use light boxes that operate on a timer and turn on gradually when it’s time to wake up. This helps your body feel like it is morning. Using this method means that over time, it will be easier to wake up, even if it’s dark outside.

  1. Practice Meditation and Relaxation

When you start to feel the winter blues, anxiety and stress, it’s important to know how to manage it in a healthy way. Going for a walk outdoors whenever weather permits will drastically improve your stress levels, even if it’s just once around the block. You may also want to develop the habit of deep breathing whenever you feel anxiety mounting.

  1. Plan a Vacation

A winter vacation is a great way to shake off the winter blues and recharge yourself in a healthy way. Planning a getaway to a warmer climate will help lift your spirits and give you something to look forward to.

 

SOURCE : https://www.pinnaclehealth.org/wellness-library/how-to-stay-healthy-during-winter/

 

Back pain beyond the odd muscle spasm or two

Back pain beyond the odd muscle spasm or two.                    (By Hans de Wit – StretchingSA)

 

Back painIn some rare cases, we have found patients complaining about back pain, but it seems that the signs and symptoms are simply not adding up as a normal musculoskeletal problem. Muscle spasms and possible associated degenerative and musculoskeletal disorders are simply not just the only answer. Therefore, it is very important to have a specialist do a proper diagnosis on your back condition when you have one of those “chronic ailments” “no one” seems to be able to fix.

In this article I will attempt to bring you some alternative reasons for back pain, what can cause them, and what is the most likely outcome.  Also having said that, I will attempt to tell you which conditions CANNOT BE FIXED BY ANY FORM OF PHYSICAL THERAPY.  At StretchingSA we are very aware of this, and will not hesitate to send a patient to the right medical expert when it becomes clear that the outcome is not favourable for stretch therapy. We’ll call this CONTRAINDICATIONS to stretch therapy. In medicine, a contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a reason to use a certain treatment.

Possible contraindications are:

  1. Cauda Equina lesions

Low back pain is very common. It affects millions of people. In most cases, you don’t need surgery for low back pain. But in rare cases, severe back pain can be a sign of cauda equina syndrome (CES), a condition that usually requires urgent surgical treatment. People with cauda equina syndrome often are admitted to a hospital as a medical emergency. Here’s what you need to know about cauda equina syndrome.

What Is Cauda Equina Syndrome?

Cauda equina syndrome is a rare disorder that usually is a surgical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. You may need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs.

CES affects a bundle of nerve roots called cauda equina (Latin for horse’s tail). These nerves are located at the lower end of the spinal cord in the lumbosacral spine. They send and receive messages to and from your legs, feet, and pelvic organs.

Symptoms

It may be hard to diagnose cauda equina syndrome. Symptoms vary and may come on slowly. They also mimic other conditions. If you have any of these symptoms, see your doctor right away:

  • Severe low back pain.
  • Pain, numbness, or weakness in one or both legs that causes you to stumble or have trouble getting up from a chair.
  • Loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet that is severe or gets worse and worse. You may experience this as trouble feeling anything in the areas of your body that would sit in a saddle (called saddle anasthesia).
  • Recent problem with bladder or bowel function, such as trouble eliminating urine or waste (retention) or trouble holding it (incontinence).
  • Sexual dysfunction that has come on suddenly.

 

  1. Meningitis

The meninges are membranes that cover the brain and spinal cord. Meningitis is a condition involving the inflammation of these membranes. Meningitis can be caused by a virus or bacteria, with bacterial meningitis being much more severe. Symptoms of bacterial meningitis include high fever, headache, spinal stiffness, nausea, vomiting and even back pain, according to the Mayo Clinic. It is important to diagnose meningitis properly to ensure the appropriate treatment. For bacterial meningitis, antibiotics are an effective treatment and can help prevent the spread of the infection to others, according to the centres for Disease Control and Prevention.

  1. Bacterial Endocarditis

Bacterial endocarditis, also known as infective endocarditis, is an infection that attacks the inner lining of the heart, called the endocardium, and the heart valves. This infection is rare in people with normal hearts, but is a very real concern for anyone who has damaged heart valves or heart tissue. Bacteria that manage to enter the bloodstream lodges on damaged heart tissue and can further destroy the heart. Quick diagnosis and treatment are necessary to prevent severe damage. According to a 1977 study published in the journal Annals of Internal Medicine, bacterial endocarditis may manifest many musculoskeletal symptoms, including back pain.

  1. Tuberculosis

Tuberculosis is an infection that can attack any part of the body, but usually resides in the lungs. Once the infection lodges in the lungs, explains the British charity TB Alert, it causes symptoms of a pervasive cough that lasts for many weeks and gets worse over time, weight loss for no apparent reason, loss of appetite, night sweats, fatigue and fever. According to TBalert.org, all forms of tuberculosis are curable without lasting effects if they are diagnosed and treated early enough. Only tuberculosis of the lungs and throat are potentially infectious. A tuberculosis infection can travel to other parts of the body and can cause a variety of symptoms, including back pain.

  1. Urinary Tract Infection

The urinary tract includes structures such as the kidney, bladder, the ureters and the urethra. The function of the urinary tract is to eliminate waste. According to the National Kidney and Urological Disease Information Clearinghouse, or NKUDIC, urinary tract infections are the most common infection in human body. The NKUDIC also reports that when the infection reaches the kidneys, symptoms may include frequent urination, painful or burning urination, a feeling of fullness, a general feeling of weakness, back pain, nausea and vomiting.

  1. Bacterial infection

Antibiotics are being investigated as a new way to treat chronic lower back pain. It’s thought that up to one in four cases may actually be caused by infection and not by mechanical problems such as poor posture or improper lifting.

In a Danish study, more than half the patients were either cured or much improved after 90 days of daily antibiotics. A much larger trial is now under way, with results expected later this year.

Many patients improve within three months of this initial visit, but up to 50 per cent continue to suffer pain and disability. Carrying heavy items and sleeping on soft mattresses are common causes, but in many cases the problem is a herniated or slipped disc. The discs, which are slotted between each of the vertebrae, are made up of a hard, fibrous outer ring with a soft inner part called the nucleus. The discs can degenerate with wear and tear; the outer part then cracks, forcing the pulpy centre to bulge into the spinal canal. This can irritate the nerves running from the spinal cord down the leg, causing back pain and pins and needles down the leg. Conventional treatments range from lifestyle changes and physiotherapy to painkillers and surgery.

However, it’s thought bacteria may be implicated, after MRI scans of patients with herniated discs have shown key changes in the vertebrae – the bone itself around the affected area swells. The scans showed that this occurs in up to seven out of ten patients with a herniated disc. Patients with normal healthy discs do not develop these changes. In the pilot study, 29 patients with lower back pain and these bone changes were given the antibiotic amoxicillin-clavulanate for three months. Following treatment, 52 per cent of the patients reported that they were much better or cured and 24 per cent were moderately better. Nobody’s symptoms worsened, although symptoms had been getting more severe in the months before treatment. Researchers believe that when a disc becomes herniated, bacteria can enter and cause an infection. That results in an immune system response – the visible bone changes

  1. Neoplasms

Neoplasms commonly invades the spine. In addition to metastatic solid tumors, such as breast and prostate cancer, lymphomas and myeloma often involve vertebral bodies and produce back pain. Tumors arising from the spinal cord, nerve roots, or surrounding tissues are much less common. Some benign tumors, such as spinal meningioma’s and neurofibromas, also cause pain when they occur.

  1. Infections

Back pain can be caused by numerous types of infections. Bacteria can invade the vertebral bodies (osteomyelitis) or causes abscesses inside the spine. Chronic infections, such as Lyme disease, can involve the structures inside the spine. Viruses, such as the zoster virus causing shingles, can attach specific levels of the spine and cause back pain.

Sources: livestrong.com, webmd.com, Wikipedia.com, encyclopedia.com, dailymail.co.uk, healingchronicpain.org, tbalert.org

 

 

 

What is active isolated stretching?

Active Isolated Stretching

 

The Mattes Method:


What is Active Isolated Stretching?

Over the past two decades, many experts have advocated prolonged stretching up to 60 seconds. A prolonged stretch up to 60 seconds means that a person would move into a stretching position and keep it there for a longer period.

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