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I have recently followed a bodybuilding program. The routine include the exercises Squats, OHP, Romanian Deadlift, Front Squats and Bench Press. Due to these exercises I have felt nerve pain in my left foot just from sitting, and I can’t point out what the reason can be. I have met a physiotherapist and he checked me out, but he said that I have to stretch my nerves but I think I could have a piriformis syndrome. Why I believe so is because the nerve pain occurs when sitting and not walking. What should I do, and what exercises should I cut out of my routine?

For the time being I would recommend you cut out any exercise that makes your pain worse. You could try the same exercises with only body weight, doing them very slowing and watching your form carefully. If any of them continue to cause pain, stop doing them for the time being until you have addressed the issue. Nerve pain in your foot could be caused by the nerve being under pressure in your foot, or anywhere further up your leg into your gluts, or even from your back. You could try stretching well prior to exercise, and if you have reason to believe it is piriformis syndrome you could try self massage of the glut region. To do this you could sit on a tennis ball and roll it around the muscles around your sit bone until you find an area that is especially tight.

Generally it is not recommended to stretch nerves, as they are not designed to be stretched and do not need to be stretched because they do not contract and get short. I recommend you ask your physiotherapist questions regarding you diagnosis and if they think you have piriformis syndrome. I would also ask your physiotherapist or general practitioner to make sure you do not have a problem with a disc in your low back, or a problem with your sacroiliac joints. Both of these things are also common causes of symptoms such as yours, but do depend on many things such as your age and flexibility.

You could call and book with one of the physiotherapists at North Shore Sports Medicine at 604-973-0242 for a complete assessment and diagnosis to help speed you along to get back to the gym routine you would like to be doing. Best of luck in your recovery!

I have pain in the upper right side of my back for the last couple of days; no apparent reason; it’s comes from inside (not surface) muscles; location near centre upper right back; moving arm or not. When idle or lying down I am usually fine. Did do some weeding a few times in recent week; otherwise normal household chores; never have had this kind of pain before. If it is muscle related, what might be some movements I can try to alleviate it?

Without an assessment it is difficult to identify what might be causing your pain and to prescribe exercises that may be useful. If there are specific movements that increase your pain, these should be avoided. With that said, it is recommended you continue to move your arm, neck and back in the range that does not cause pain. Back pain in the location you describe could be coming from your neck, your shoulder, the muscles between your ribs or those running up your back.

A physiotherapist can perform a full assessment to determine the cause of your pain and would use a combination of manual therapy and exercise to get you back gardening pain free.

Give us a call at North Shore Sports Medicine to start working with a physiotherapist to start working towards recovery

I’ve been having this issue for a while now, which shows in a number of exercises. The problem seems to only be on the left side of my back. For instance, I have trouble doing bicep dumbbell curls with my left arm, and I feel that the left side of my back really has to work to get the dumbbell up, where as with my right it’s not an issue. Also, for dumbbell shoulder pressing, it’s A LOT harder to lift the weights with my left arm, and I can only do about half the weight that I can do with my right. I tried to solve this by doing barbell shoulder press instead, but it eventually got to a point where I wasn’t making progress anymore because my left side is much weaker. I also felt my upper back working a lot when doing the overhead press. Furthermore, I noticed my upper back tends to round very easily when dead lifting, which I’m assuming is for the same reason. My guess is that it is some kind of tightness issue with the upper traps on my left side, probably stemming from a lot of sitting still in front of the computer with bad posture. I’ve also been a stomach sleeper all my life, but have recently shifted to sleeping on my side instead, even though I find myself waking up on my stomach a lot anyways, as I can’t control what my body does when I’m unconscious. Any idea what the issue could be, and if so, how I can treat it?

You have identified that it might be important to pay attention to the way you sleep and ensure good posture throughout the day. Do your exercises in front of a mirror and make sure you aren’t leaning or compensating in another way in an attempt to lift your weight. I would recommend backing off the weight and focusing on good form, lifting only what you can comfortable lift on your left side for both sides (that is, don’t lift more on your right as you don’t want to increase the discrepancy in strength).

A physiotherapist could do a full assessment, identify the source of your weakness/tightness and use manual therapy, exercise prescription and other modalities to help even things out a bit. Give us a call at North Shore Sports Medicine to start working with a physiotherapist to start working towards recovery.

My son is 11 in June this year, He is a gymnast, in the gym the coach makes all kids his age carry a 6kg dumbbell when he is on his stomach on the pommel horse, upper torso in the air face down legs in the air other kid hang on the leg for balance. The movement is the back and head folds towards the ground and raise up this is done with lifting the 6kg, this exercise really is concerning for the well being of his back and spine, what’s your opinion?

Thank you for your question. I think the exercise you are describing are weighted back extensions over a pommel horse. As a gymnast it is important that your son have a strong low back – often gymnasts are very flexible through their backs and lack strength, while they have very strong abdominals. With that said, it is important that this exercise be done with proper form and no pain at all. Specifically, it is important that your son does not over arch his back throughout this extension and he keeps his back in a neutral position.

To make sure this is the case this exercise should be closely supervised. If he is not yet strong enough to do this exercise with good form (without over arching his back) he should work less weight or without a weight until he has developed the strength to maintain good form.

He could also do back extensions lying on his stomach on the ground, which would put less stress on his low back. I hope your son is happy and successful in his gymnastics training.

I have pain in upper right side of my back the last couple of days; no apparent reason; it’s comes from inside (not surface) muscles; location near centre upper right back; moving arm or not. When idle or lying down usually fine. Did do some weeding a few times in recent week; otherwise normal household chores; never have had this kind of pain before. If it is muscle related, what might be some movements I can try to alleviate it?

Without an assessment it is difficult to identify what might be causing your pain and to prescribe exercises that may be useful. If there are specific movements that increase your pain, these should be avoided. With that said, it is recommended you continue to move your arm, neck and back in the range that does not cause pain.

Back pain in the location you describe could be coming from your neck, your shoulder, the muscles between your ribs or those running up your back. A physiotherapist can perform a full assessment to determine the cause of your pain and would use a combination of manual therapy and exercise to get you back gardening pain free.

Give us a call at North Shore Sports Medicine to start working with a physiotherapist to start working towards recovery.

I am 30 years old, healthy weight and fairly active. I just finished a third round of PT that lasted 10 months to help the chronic lower back pain and sciatic pain/SI joint pain that I’ve had since 18 when I ruptured l4, l5. Ever since my lower back “goes out” at least once a year. I’ve seen 3 different PTs and it had gotten somewhat better on a day to day basis but when I stand with my feet straight pointing forward, my pelvis and torso twists to the right. The lower right side is the side that goes out. I finally went 2 years instead of 1 without an episode and lo and behold it went out 4 days ago despite religiously doing my exercises and frequent dry needling of the QL muscles. My PT didn’t have an answer as to why this would still happen. What are your thoughts? Is my QL just too scarred up and beyond help? Is that what is causing my rotated torso and pelvis? What should I do from here?

I am sorry to hear about your low back struggles. I would like to encourage you to have hope that there is an answer to your low back pain, and believe that your QL is in better shape than you picture it to be! It is difficult to say what might be causing your pain without a full assessment. There are many structures in the low back and hips that could be contributing to your current situation and it is also possible that something further up or down the chain is the main driver. Many muscles insert to your vertebrate and pelvis that could result in your rotation or the rotation could be skeletal in nature.

To help answer this question a physiotherapist could assess the length, strength and tone of your QL, as well as your erector spinae, your hip flexors, your transverse abdominis and other deep core muscles, you glut muscles, quads and hamstrings. They could examine the mobility of your SI joints, and look up the chain at your thoracic spine. Often a fresh set of eyes can catch something that someone else hasn’t seen as everyone has a different perspective.

Here at North Shore Sports Medicine, we can perform a full assessment to determine the cause of your discomfort and use a range of treatments including manual therapy, exercise prescription and other modalities to help ensure the best possible healing.

Call us at 604 973 0242 and one of our healthcare coordinators can help you set up an appointment.

My spouse was recently in a bike accident (hit by a car) and has 3 broken ribs. What kind of therapy or treatment do you recommend for him?

I am sorry to hear about your spouse’s accident. Fractured bones (that are not displaced) usually take between 6 and 8 weeks to heal. Physiotherapy can help throughout the course of healing ensuring the injury heals as quickly as possible and minimising the risk of any long lasting impact. Immediately following the injury a physiotherapist can assess your spouse to check for any other possible injuries associated with the accident that wouldn’t be captured by x-rays (soft tissue injury), they would teach your spouse what is and is not safe given their current state of injury and work to reduce inflammation and control pain.

As the ribs heal and a boney callus forms a physiotherapist would progress exercises to ensure the ribs are moving well and the muscles that attached to the ribs regain strength. Here at North Shore Sports Medicine, we can perform a full assessment and use a range of treatments including manual therapy, exercise prescription and other modalities to help ensure the best possible healing.

Call us at 604 973 0242 and one of our healthcare coordinators can help you set up an appointment.

I have a bulge on my lower back right on top of buttocks in the middle. It disappears if I tighten my gluts. If I flex the gluts or contract them hard to bring the buttocks cheeks together the bulge completely goes away. I’m very skinny so the bump is apparent. Like a hill. Soft and doesn’t have edges like a tumour. Can you help me find out what it is or tell me how i can go about diagnosing it. Note: I have back pain but nothing serious it’s usually brought on by carrying something or bad posture.

Your pain which seem to be unrelated to each other according to your note. Questions that will help determine the cause of your pain and possibly the bulge include: Did the onset of the pain and appearance of the bulge coincide? Did the pain come on acutely or has it been slowly getting worse with time? Is the bulge painful to palpate? How long ago did the pain and the bulge appear?

A physiotherapist will look at your muscle function, joints and nerves to diagnose your injury and set you on a path to recovery using a combination of manual therapy and exercise prescription if the bulge and pain are related to your musculoskeletal system. However, it is quite possible that you need to see a physician to have further investigations to diagnose the bulge.

Give us a call at North Shore Sports Medicine (604) 973-0242 today to set up an appointment and we can certainly ascertain if there is a musculoskeletal origin of your bulge and your pain.

I’m working in a Nursing home but had back surgery two years ago and haven’t worked since. I’m on a sick leave. I had and have no benefits to get physiotherapy. Is it possible to return back the job requires heavy lifting and twisting. I have improved physically a little. Is it too risky I do so?

There are many factors that will influence your ability to perform you work. Questions I have included: what type of surgery did you have? What was your previous and what is current physical fitness level? Also, what are your specific job duties? Often duties can be modified to protect ones back; you can be taught appropriate bending and lifting techniques as well as exercises to strengthen your core and leg muscles.

Physiotherapy is often covered by extended benefits – have you looked into this possibility? Also, depending on your level of income MSP can cover some of the cost. A third thing for you to look in to is if the company or organization covering your sick leave will cover rehabilitation services of any sort. You could use an extended return to work protocol to help you ease back into the work place. In the meantime, often getting into a pool for exercise can be good for someone with a history of back injury. However, without specifics it is difficult to make exercise recommendations.

Give us a call at North Shore Sports Medicine at 604-973-0242 and we can help you explore your options for getting the help
you need.

I’ve been having this issue for a while now, which shows in a number of exercises. The problem seems to only be on the left side of my back. For instance, I have trouble doing bicep dumbbell curls with my left arm, and I feel that the left side of my back really has to work to get the dumbbell up, where as with my right it’s not an issue. Also, for dumbbell shoulder pressing, it’s A LOT harder to lift the weights with my left arm, and I can only do about half the weight that I can do with my right. I tried to solve this by doing barbell shoulder press instead, but it eventually got to a point where I wasn’t making progress anymore because my left side is much weaker. I also felt my upper back working a lot when doing the overhead press. Furthermore, i noticed my upper back tends to round very easily when dead lifting, which I’m assuming is for the same reason. My guess is that it is some kind of tightness issue with the upper traps on my left side, probably stemming from a lot of sitting still in front of the computer with bad posture. I’ve also been a stomach sleeper all my life, but have recently shifted to sleeping on my side instead, even though I find myself waking up on my stomach a lot anyways, as I can’t control what my body does when I’m unconscious Any idea what the issue could be, and if so, how I can treat it?

It is difficult to determine what might be causing your issue without a full assessment of your neck, back and shoulder. Some questions that might help you narrow down the cause of this imbalance include: how old are you? Do you have any other health issues? Do you have any history of shoulder, neck or back injury? Do you play/participate in a single side dominate sport (rowing or baseball for example)? What limits your ability to do the curls/shoulder presses – pain or a feeling of weakness? Do you notice a difference in the flexibility of your shoulders from side to side (raising hands over head, behind back)? Is there a pattern to your pain in terms of time of day, or other activities outside of lifting that you notice it in? There are multiple possible causes of your problem from musculoskeletal to other systemic possibilities.

You have identified that it might be important to pay attention to the way you sleep and ensure good posture throughout the day. Do your exercises in front of a mirror and make sure you aren’t leaning or compensating in another way in an attempt to lift your weight. I would recommend backing off the weight and focusing on good form, lifting only what you can comfortable lift on your left side for both sides (that is, don’t lift more on your right as you don’t want to increase the discrepancy in strength).

A physiotherapist could do a full assessment, identify the source of your weakness/tightness and use manual therapy, exercise prescription and other modalities to help even things out a bit

My lower back feels tight after I play hockey. What can I do before I play to help?

As a recreational hockey player I often find myself rushing to get to the rink and have only 5 min or less of warm up. That on ice time should be used to warm up stick and puck skills, not getting the core and legs warmed up. Warming up your core and legs is the most important thing you can do to protect your back by priming the core muscles.

It can start at home or at the rink but you must make it a part of your pregame ritual. Two foot squats, jumping jacks or light jogging for 10 minutes will start to warm up the core and legs. Both forward and side planks are great way to activate the core muscles. Finally while you are waiting for the zamboni gates to close stand on 1 skate and swing your leg in each direction ten times, then put you stick over your shoulders and twist side to side. Keeping active and having fun are all important components of preventing lower back problems.

Remember pain is not normal no matter what your age. Please consult a physiotherapist for more information or if you are having pain.

I recently got diagnosed with back problem namely: mild scolootic deformity, L5/S1 mild difuse disc bulge, L3/4 mild posterior annular relaxation. I was told not to lift heavy weight or put excess pressure on my back. I used to exercise regularly and perform squats and deadlifts to target my legs and glutes. I now need new ways to target the gluts and was looking into weighted cable kickbacks. I wanted to know if this exercise will be safe for my back and will not cause further damage. Do you have any ideas?

It would be find as long as your core is stable, preventing any arching through the lumbar spine (low back). A way to prevent that would be to do smaller backward movements of the leg. Stop if it aggravates your low back, and start with light resistance, slowly progressing over time. The other thing would be to have higher repetitions, 2 or 3 sets of 30 reps to start. Having said this, without proper assessment, it can be difficulty to prescribe an exercise without first reviewing movement patterns and previous injuries.

If you have any questions, or want to ensure that the exercises are being done correctly, please feel free to call and book an appointment with any of our registered physiotherapists

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