The stability ball as a chair for the back pain patient

I sit on a body ball at my desk everyday, and I have done so for years now. I am a healthy, fit and experienced body ball practitioner, with a strong core. Is sitting on the ball a good idea for people suffering from back pain? There is still a good deal of controversy among therapists, ergonomics experts and others about sitting on the ball at the office or at home. The controversy is due, in part, to lack of knowledge and experience with this application. I came across this interesting paper in the "Journal of the Canadian Chiropractic Association" dealing with this very subject. Are we helping our hurting our clients by promoting use of the body ball as their office chair?

The Stability Ball (body ball) has been used as an exercise tool for about 50 years, with great success. I use the body ball all the time with my clients, as do many trainers and therapists, in fitness programs and for injury rehabilitation and prevention. Recent research supports the theory of spinal stabilization and the role it plays in back pain. Panjabi, Diane Lee and others suggest that spinal stability is based on three subsystems: active (muscles), passive (structure) and control (neural).

Spinal stability can be greatly enhanced using the stability ball: they are safe and activate proprioception, balance, core and equilibrium control. However incorrect use, bad technique, overuse can lead to muscle fatigue, falling off the ball and potential injury for the stability ball user.

Two chiropractors, Larry Merritt and Celynne Merritt of Prince George, decided to study two of their clients, male and female, in their 50's, suffering from back pain - using the body ball in their treatment. In my next blogs I will present their story.

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
www.gaiaadventures.com

Stability Ball Workshop (basic 2 day) Calgary March 23, 24, Advanced Body Ball Workshop Calgary March 25, MTAA approved.
Stability Ball Workshop (basic 2 day) June 15, 16, Vancouver, July 13, 14 in Whistler, Foam Rolling Workshop (1 day) Whistler, July 15, CECs, BCRPA, MTABC

Exercises for Achilles Tendonitis

In my last blog I went over some of the basics of this common injury. A proper strength and stretching regime can work wonders to hasten recovery.

Exercises

Without a doubt, incorporation of appropriate exercises into your treatment regimen can help protect the Achilles tendon from further damage or progression.

In mild cases of acute tendinitis, conditioning may be maintained by modifying your exercises and activities. Cross training, swimming, biking and aqua jogging are recommended (Gottschlich et al., 2009). Again, make sure to avoid activities that require repetitive and forceful plantar flexion.

Include calf strengthening exercises into your exercise program. This is essential.

These exercises will not only provide better support to the Achilles tendon but they may also stimulate the production of type 1 collagen fibers, improving the tendon’s strength and endurance to stress.

After pain has subsided, calf stretches are recommended. These exercises should be done with the knee both in extension and flexion to stretch the gastrocnemius and soleus muscles, respectively.

Recommended Exercises for Achilles Tendonitis


There are many different ways to stretch your Achilles tendon, but here is a simple stretch you can do while standing.

. Stand about an arm's-length from a wall or another sturdy object.
. Lean forward and place both hands on the wall about shoulder width apart.
. Extend one foot (the side to be stretched) behind you with your knee bend and heel on the ground.
. Keep the other foot closer to the wall.
. Lean into wall slightly and bend the knee of the heel to be stretched (keeping the heel down) until you feel a stretch in the back of the lower leg (just above the heel).
. Sink down slowly with your hips to deepen the stretch.
. Hold this stretch for about 30 seconds and change sides.
This stretch is similar to the calf stretch, however by bending your knee you focus the stretch on the Achilles rather than the calf.

Achilles Tendon Calf Raise


How to Do the Calf Raise Exercise

. Warm up with gentle stationary cycling, walking, or marching in place for several minutes prior to performing any strengthening exercises.
. Stand on the balls of your feet on the edge of a sturdy box or step, keeping your heels free.
. Maintain control at all times and slowly lift up as high as you can on both toes for a count of three.
. Slowly lower yourself until your heels are just below the step.
. Repeat this exercise 10 to 15 times per leg.
. As it becomes easy, perform the calf raise on one foot at a time.
Add this to your general strengthening routine 2 to 3 times per week.


Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
www.gaiaadventures.com

Stability Ball Workshop (basic 2 day) Calgary March 23, 24, Advanced Body Ball Workshop Calgary March 25, MTAA approved.
Foam Rolling Workshop (1 day) Vancouver Feb 25 CECs

Achilles Tendonitis and Exercises

With the increasing number of individuals engaging in recreational and sporting activities, Achilles tendonitis has become one of the fastest rising musculoskeletal conditions, especially with those involved in running activities.

One of the most important discoveries is that the signs and symptoms of Achilles tendonitis are not exclusively caused by prostaglandins, the hormone-like substances that induce inflammation (Gottschlich et al, 2009). Interestingly, a landmark study found that its manifestations are mainly caused by degenerative changes in the Achilles tendon (Astrom & Rausing, 1995). Now that it is no longer strictly recognized as an inflammatory condition, the term Achilles tendonitis is replaced with Achilles tendinopathy or Achilles Tendonosis.

Today, experts and practitioners continuously explore and discover new information about Achilles tendinopathy to implement interventions that may effectively inhibit and alleviate its symptoms, which can be debilitating if left untreated. Simple exercises are effective preventive and protective interventions against this musculoskeletal condition. This will be further discussed in the Exercise section.


The Basics of Achilles Tendonitis

Achilles tendonitis was the term used to describe a spectrum of Achilles tendon injuries, ranging from signs of inflammation and tendon rupture to bone spur formation in the heel and swelling of the fluid-filled sac found at the back of the heel bone.

In 1995, a study published in Clinical Orthopaedics & Related Research indicated that degenerative changes, characterized by abnormal structure of tendon fibers, abnormal excess of cells and proliferation of blood vessels, were noted in 90% of biopsy specimens from symptomatic parts of the Achilles tendons of individuals with chronic Achilles tendonitis (Astron & Rausing, 1995).

Based on these findings, the pathology involving the Achilles tendon is grouped into three classifications: paratenonitis, tendinosis and paratenonitis with tendinosis.

Paratenonitis – It involves inflammation of the surrounding outer layer of the Achilles tendon, the paratenon, which nourishes the tendon. Partial or full tendon ruptures are usually the outcomes of end-stage paratenonitis.

Tendinosis – This degenerative condition of the Achilles tendon is usually caused by repetitive microtrauma or failed inappropriate healing response. When examined, the affected tendon does not demonstrate the presence of inflammatory cells.

Paratenonitis with tendinosis – This condition involves inflammation of the Achilles tendon with signs of degenerative changes. It is believed its occurrence is associated with disruption of blood flow (Buschbacher, Prahlow & Dave, 2009).

To be continued in my next blog

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
www.gaiaadventures.com

Stability Ball Workshop (basic 2 day) Calgary March 23, 24, Advanced Body Ball Workshop Calgary March 25, MTAA approved.
Foam Rolling Workshop (1 day) Vancouver Feb 25, Advanced Body Ball Workshop Vancouver (1 day) Feb 26. CECs

Overhead Squat Solutions

Overhead Squat Test is a very useful tool for therapists. The objective of the exercise is to test total kinetic-chain neuromuscular efficiency, integrated functional strength and dynamic flexibility.

The Exercise:

1. Have the patient place their feet hip-width to shoulder-width apart, toes pointing straight ahead, and arms raised above the head. They can hold something over their head such as a dowel rod, tubing or even a towel.
2. Instruct the patient to slowly squat down to a position that is comfortable for them, cueing them to go slow and controlled, squatting as deep as they can without letting the heels leave the ground. If they are unfamiliar with the squatting motion, use the analogy of sitting down in a chair.
3. Instruct them to squat under control for 5 to 10 repetitions. If the patient experiences too much pain, discontinue the evaluation and document location and intensity.

Observe the feet, alignment of the knees, low back movement, arm position, lateral shift: these could be indicators of weak core, pelvis dysfunction, tight lower body muscles and more.


Learn more about strength training at my Stability Ball Training workshops and Foam Rolling Workshop accredited for Massage Therapists and Personal Trainers across Canada http://www.gaiaadventures.com/Workshops.html

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
www.gaiaadventures.com

Stability Ball Workshop (basic 2 day) Calgary March 23, 24, Advanced Body Ball Workshop Calgary March 25, MTAA approved.
Foam Rolling Workshop (1 day) Vancouver Feb 25, Advanced Body Ball Workshop Vancouver (1 day) Feb 26. CECs