Understanding Our Philosophy at JADED a little further through back pain:
Why are back problems so difficult to treat? Well, they are not…For years, millions of highly trained chiropractors, physical therapists, trainers, medical doctors, massage therapists, and orthopedic surgeons have spent much of their focus and energy on one particular element of a person’s entire body: the back and spine. An orthopedic sports trainer focusing on strengthening a client’s back and core is not going to fix the problem; a physical therapist focusing on flexibility and posture is not going to fix the problem, and a psychologist focusing on the mind-body relationship is not going to fix the problem. It takes fine-tuning and a skillful manipulation of every one of these components to truly “fix” a person’s back.
For example, when a chiropractor adjusts a person’s spine, it may feel good temporarily as the endorphins released, the Type III mechanoreceptors cause the surrounding muscles to relax, and the facet joints begin to move smoothly. But if strength and conditioning, flexibility, alignment and posture, and the mind body perspective (four pillars in our hands-on physical therapy philosophy) aren’t addressed, the pressure of the tight hamstrings, piriformis, and glutes are going to slam pressure down on the spine. The weak abdominals and paraspinal muscles are going to fatigue, causing low back spasms and pressure on the discs and facet joints. The poor postural habits are going to drain the musculoskeletal system, and the insane stressors of work and life are going to create an endless downward spiral of chronic back pain. All of these things in congruence can cause you to feel that back pain that potentially plagues your everyday life.
Why do millions of people resort to seeing an orthopedic surgeon and allow them to slash through layers and layers of muscles, ligaments, and bone in an attempt to clean up and relieve pressure on a nerve? Because there are very few people in this world today that use an effective rehabilitation therapy philosophy, and utilize it correctly. Besides, our philosophy takes time, high-level training, and collaboration to accomplish what most facilities avoid. That brings us to our philosophy of the “Four Pillars.”
I: Strength/Conditioning/Activity Tolerance/Endurance:
Mechanical back braces were invented because there are far too many lazy and incompetent medical practitioners attempting to fix back pain today. It is true these braces work and, in some cases, are necessary. Back braces support the spine, and take pressure off a person’s ligaments, discs, facet joints, nerves, and muscles to relieve pain. But in terms of practicing an effective rehabilitative therapy technique, back braces are essentially a cop-out. Every one of us has a so-called “God given back brace.” We are all equipped with some very important muscles, apart of, or surrounding our back: multifidus, transverse abdominis, obliques, rectus abdominis, and all your low back paraspinal muscles. These muscle groups have the ability, if strong enough, to hug the spine and take a tremendous amount of pressure off irritated structures to relieve pain and improve function. When these muscle groups are weak, it will create a huge demand on a person’s ligaments, discs, and facet joints. This will eventually cause an increase in the degenerative process, causing excessive pressure on all low back spinal structures, and ultimately wear the spine away until the surrounding muscles go into an unrelenting protective spasm, shutting the back down.
To achieve some effective rehabilitation therapy, precise muscle groups must be educated, completely isolated and specifically trained in order to gain proper strength. Once the client can engage every one of these muscle groups in a hands-on physical therapy session, it is essential that they learn and sincerely understand the importance of adapting their newly gained abilities and strengths to function in the real world. This means they are engaging the core, and using the back while standing, walking, sitting at a desk, and while tying their shoes. It is our job to implement and coach this into our client’s lives and minds at all times.
It is possible to make a client’s spine their ‘strongest link,’ as opposed to their weakest link which is found in most people. People go from laying in soft beds to sitting in soft car seats to lounging on soft sofas and no longer use their backs. We are taught in society today, “don’t use your back, use your legs to lift.” Is it any surprise that when someone goes to use it one day, that it’s strength is no longer there for them? People use to work in fields and on farms, walk miles every day, ride horses, chop wood, and be building strength in their bodies and backs along the way. Today we have the tendency to sit in front of a computer or on our phones all day. Our JADED clinicians are specialists in locating dormant muscle fibers and bringing them back to life through hands-on physical therapy techniques, thereby stopping wear and tear on the spine and shifting the load to the more capable muscles.
II: Flexibility/ROM/Proper Movement Patterns/ Accessory Mobility: Improving flexibility of the muscles in the lower extremities is vital in achieving effective rehabilitation. The glutes, hamstrings, piriformis, IT bands and quadratus lumborum muscles all integrate into the pelvis and thoraco-lumbar fascia. If any one of these muscle groups has a shortened muscle length or an increase in muscle tone, they will wrench down on the low back spinal structures. These tight muscles can decrease spinal mobility, occlude vascular flow to surrounding nerves, amplify stress and strain on the lumbar discs and facet joints, and diminish the client’s functional movement potential. As soon as we begin to release the tight musculature, all these limitations begin to let go and allow the low back to be uninhibited. It is believed that a hamstring flexibility test is more diagnostic than an X-ray in determining back pain and future back pain. Rehabilitation therapy and restoring strength takes days and weeks providing little or no relief immediately, but restoring range of motion and function to tight, immobile muscles will offer immediate benefit and relief to a client.
III: Alignment/Body Mechanics/Ergonomics and Posture: Everyone in this world today has been told a time or two to sit up straight and have good posture, but what does that really mean? There is a chance that we may see an increased curve in the lumbar spine, or too flat of a low back, or forward shoulders and head posture, or scoliosis, or a rotated pelvis, or maybe a leg length discrepancy, or maybe even a combination of all of these. There are so many different postural impairments that a client may have, but it would be a novel in of itself to go into detail with those specifics. The overall point is that we as sports medicine practitioners must do our best to correct any significant variations that we discover in our client’s posture and spinal alignment. It is necessary to do this in order to distribute the pressures and forces of the body evenly over the spine and provide the physically therapeutic movements that maintain the life and vitality of the musculoskeletal system. Every single spinal segment needs to be moving evenly and appropriately. If there is instability, we must stabilize the area. If there is an irregular, stuck, or aberrant motion, we must mobilize the segment to free the movement. If the right ilium is rotated posteriorly, we must manipulate it anteriorly. Once we have pulled the shoulder back or adjusted the right L4/5 facet joint to get it moving properly the final step is to implant perfect posture into the mind and function of the client every single day. These are all just examples of returning alignment and posture to a client’s life, but the reality is that alignment and great posture is indispensable for applying effective hands-on physical therapy and achieving the freedom of back pain.
IV: Mind Body Relationship/Stress:
Dr. Sarno said, “The failure of medical practitioners to recognize and appropriately treat mind-body disorders has produced public health and economic problems of major proportion in the United States.” There is a very important interaction between the generally reasonable, rational, ethical, moral conscious mind and the repressed feelings of emotional pain, hurt, sadness, and anger characteristics of the unconscious mind. There are four very crucial sources of emotional reactions that can influence pain: anger, emotional pain, and sadness that can be traced back to childhood; anger stemming from the self-imposed pressures to be perfect and good; anger generated from the pressures of life and work; and miscellaneous things like guilt, shame, fear, insecurity, and vulnerability that also feed the reservoir of rage. Not only can these factors cause pain, tension, tightness and stress, but they can make the back more vulnerable to injury and cause prolonged episodes of suffering.
Furthermore, we must know that knowledge can cure. If a person is possibly suffering, or a person is in pain, it might not be possible to cure a person who is suffering, but you can heal one that is in pain. When a client is suffering it is either because they do not know why they are in pain, or their attempts to relieve this pain have failed. As soon as we can reproduce their pain and tell them why they are in pain in an educated and authentic manner, he or she can begin the physical therapy healing process. Additionally, there are three dimensions of pain that must be balanced for pain to be completely resolved: 1. Physical, 2. Emotional, 3. Rational. If any one of these dimensions is too dominant, they will overwhelm a client’s capacity to become pain free. For example, if a person is in an overwhelming amount of physical pain, it can block out most of the rational and emotional dimensions. At this point the client will not have the ability to rationalize why they have pain and will disconnect from the emotional factors of that pain all together. Likewise, if a client is so emotional about their pain, he/she won’t have the ability to rationalize about it or even feel the true quality of their pain. A similar concept can present itself, as we have seen numbers times while treating fellow medical practitioners. These clients have such a great ability to rationalize why they have pain that they over-analyze every single aspect of their symptoms and it blocks out the genuine emotional and physical components. However, these dimensions may present themselves, and it is our job as elite clinicians to bring them back into balance.
In the end, each patient and each case of back pain or physical pain is an individual issue that requires an individual level of care and support. The most important part of our physical therapy philosophy practice at JADED Body Wellness and Spine Institute is that we want to provide the best level of care for our clients and the issues they come to us with. Whether that's a schedule of cupping appointments, an extensive session of dry needling therapy, or just a simple Kinesio taping before a long hike, our team of clinicians wants to help you however we can. We offer a variety of rehabilitation therapy services and hands-on therapy techniques, designed to provide the physical therapy that your body and mind need. Contact us now, and schedule an appointment at our Girdwood or Wasilla locations today!