A regular restriction that I see in clinic is difficulty extending the upper back when looking upwards. Typically, I will see this with patients who have had trauma around the head, neck or shoulder. As with any musculoskeletal injury, this makes sense. When you injure an area, that region goes through a protective phase of bracing. As healing progresses, and the unpleasant sensations one experiences begin to lessen, we can encourage return to pre-injury ranges. So why does the upper back seem to consistently come up as a restricted area? There are a few potential reasons.

Hip musculature changes are seen in those with hip pain pathologies (1,2). Atrophy of the gluteus medius has even been correlated with severity of hip osteoarthritis (OA) (2). How does hip abduction strength (sideways movements) relate here?

Long standing groin pain is common issue amongst athletes of all levels (1). It is one of the top five regions to be injured in multidirectional sports (1). It can be a tricky area for clinicians to assess and treat due to the complexity of the area. What is complex about it? Simply, there are many structures which can get injured (2,3). Read more to learn the solution!

This week's topic is about the skill of breathing. Specifically, how we can utilise three different aspects of the skill and mechanisms of breathing in an active and dynamic environment. These include breathing gears and anaerobic threshold, perfusion and breathing flexibility. I will not discuss specifics of breathing in a static environment. However, some of the topics can apply to all of the above. The skills are considered in a context of improving cardiovascular health and chronic low back pain populations.

Recently a study was published examining the metabolic effects of a novel prescription of a well known exercise, the soleus raise (1). The focus of the study, was to examine the potential effects of the what was coined the ‘soleus push up’ (SPU), during and afterwards, on markers of metabolic health e.g. resting blood glucose and lipid levels. Positively, they found that the SPU was very useful in improving these markers at the measured timepoints. However, on reading the study, I feel it is important to make a couple points before considering if it is useful for you.

Neck endurance can be compromised in people with persistent neck pain. Do the endurance tests to decide if you have this issue. Compare your results to the normative values. If it is less than the normative value, then improving your endurance may help improve your symptoms.

Exercises are planned, structured and repeated to help build the components needed for daily physical tasks. This enables us to be physically active. We must consider where each individual’s starting point is. Your starting point is an exercise that you can complete. What is the required technique?

A brief introduction to lower back pain, its contributing factors and the use of physical activity as a solution. Exercise or resistance training are introduced as the activity of choice. General principles for resistance training are introduced.

A short description of auto-regulated exercise and how to use it to manage your physical activity intensity.

I would argue it is better to train your primary breathing muscles to perform as breathing muscles and your secondary breathing muscles to do their primary jobs i.e. let your shoulder blade muscles do their shoulder blade movements. To achieve this, you will need to work on building stability around your abdomen and rib-cage so your diaphragm and intersotals can work solely as your breathing in muscles.

If you are in the 18-64 year old age group you only need to be doing 150 minutes of moderate intensity aerobic activity 5 days a week and 2 days a week of muscle strengthening to meet the World Health Organisation baseline recommendations. Have a read below to find some straightforward advice on how to achieve this.

Prolonged sitting is bad for our health. Given it takes a high intensity of exercise to negate these effects and that sitting is unavoidable, how can we turn this situation around? Floor life is a way to regain or improve joint and muscle mobility along with the added strength needed to transition from standing to the ground. Below are resting posture examples along with some ideas for how to train getting down to the floor and back up!

An informative post detailing why breath posture, flexibility and tolerance is important. Self-assessment and exercises are provided a long with rationale! (Image credit to: Complete Anatomy appliation).