Q&A, Soreness/Pain

Q&A: Low Back Pain

lowbackQ:  I was standing and praying all day in Synagogue for Yom Kippur – at least 3-4 hours at a stretch and I had a long walk there from my house, too.  My low back is aching.  Is yours?  Do you have any exercises I should do?  I hear that I should strengthen my abs but my stomach is strong already.  Please don’t use my name in your blog post. I don’t want people to think I am unhealthy.  It just came up because I was standing so long on Yom Kippur and not something that happens to me all the time.

(Achy Back, Some Synagogue in America–Name withheld upon request)

A:  Dear Achy Back,

Don’t worry. Nobody will figure out who you are!  80% (some experts even say 90%) of Americans suffer from low back pain at some point. The majority of folks suffering are between the ages of 25 and 60.

Most cases are due to poor body mechanics – posture/muscle imbalances and not from things like cancer, arthritis, or fractures, bone loss or kidney stones etc.  Though those things can also cause back pain.   Before simply pointing you in the direction of some good core strengthening exercises (as opposed to ab exercises like situps/crunches), the better more complete approach would be to do a postural assessment to see if any muscle imbalances might be causing your discomfort.

A few postural deviations which can lead to low back pain include lordosis (sway back/overly arched lumbar spine and an anterior pelvic tilt), kyposis (hunch back, rounded shoulders and perhaps a forward jutting head) or hip and shoulder height discrepancies which might indicate a spinal curviture/scoliosis.

For those who tend toward lordosis and have an anterior pelvic tilt, I would strengthen the abdominals and stretch the iliospoas and erector spinae muscles.  For those with kyposis, I would strengthen the mid-trapezius and rhomboids and stretch the chest – the pectoralis major and the anterior deltoids.

Performing traditional ab exercises without proper lumbo-pelvic-hip stabilization has been shown to increase pressure on the discs and compressive forces in the lumbar spine actually.   So I think it would be more prudent to work on core stability before building you some abs.

  1. The drawing-in maneuver:   Get on your hands and knees on the floor like a dog.  Make sure your hands are under the shoulders and your ears are in line with your shoulders and there’s a straight line – ears, shoulders and hips.  Knees are directly under the hips.  Maintaining this neutral spinal position, now pull the region just below your belly button toward your spine.
  2. You can also lie on your back with your knees bent, feet on the floor, toes pointing straight ahead, arms and palms down at your sides and lift one leg at a time marching.
  3. Floor bridge.  Staying on your back with knees bent, feet shoulder width apart, arms by your sides, palms down, push though your heels and raise your hips off the floor as you draw your navel in and activate your butt muscles.  Raise your hips until your knees, hips and shoulders are in a straight line.  Slowly lower to the floor.
  4. Floor prone cobra:  Lie on your tummy on the floor, arms at your sides, palms facing the ground.  Draw your navel in, activate your butt muscles, pinch your shoulder blades together as you raise your head and chest off the floor.  (Keep legs and hips on the floor.) Hold for 1-2 seconds and slowly return to the floor keeping your chin tucked.
  5. Plank.  Lie with your belly facing the floor, feet together, elbows under shoulders and forearms on the ground.  Draw your abs in and activate your butt muscles.  Lift your whole body off the ground.  The only parts touching the floor are the balls of your feet and toes, and your elbow and forearm and fist/hand.  (If this is too difficult, you could do it in a modified push-up position – knees and hands on the floor)

Once your core is stable, we could build you some abs and strengthen your low back more to further improve your kinetic chain and prevent the low back pain.  Remember not to hold your breath during these exercises!!

Here are a few other tips to prevent low back pain: maintain a healthy weight, stay active, lift with your thighs by bending at the knee instead of the waist when lifting heavy objects and avoid twisting while lifting. Wear low-heeled shoes.

Exercise, Injuries, Soreness/Pain

Pain in the heel…Plantar Fasciitis

How can I get a good cardio work out?  I have pain in my heel and I can’t jump around because it makes it so much worse?plantar

Plantar Fasciitis is a painful inflammation of the plantar fascia. The plantar fascia is a thick fibrous band of connective tissue that originates at the heel bone and runs the entire length of the sole. It helps maintain the arch system of the foot and plays a role in your balance and phases of your gait.

A classic symptom is pain in the heel when getting out of bed

It can be an over-use injury, it can also result from flat arches.

Its common among runners, and women who are overweight, pregnant, and wear flats and other footwear without proper arch support.  A significant number of my clients have this condition.

Once it starts, it can get worse with continued impact activity.  Pain is your body’s way of telling you something is wrong and it is time to stop. If you know you have plantar fasciitis, you probably don’t even want to start activities with impact because you know it can hurt—so don’t.

There are a number of ways I get around this problem while working with clients.

We don’t do things like jogging or stair climbing, which are impact activities that can aggravate the condition. Instead, we do low or non-impact cardio alternatives like aqua jogging, swimming, shadow boxing, and recumbent biking with weights.

If a client’s condition is mild, we might attempt such activities as elliptical, rowing machine, or cycling/spin class.

In addition, there are a number of physical therapies which can help relieve some of the pain, such as stretching to the gastrocnemius and soleus (the calf).

We also make sure that worn-out shoes are replaced with shoes with excellent support that accommodate an orthotic, when needed.

Yet the plantar fascia could even be inflamed after even this non-or low-impact exercise. Icing it for 20 minutes after physical activity can help alleviate some of this discomfort.  (Some clients may need to discuss other more in

tensive forms of relief with their physician.)  Using the forms of cardiovascular exercise we just discussed is almost always possible for clients with this condition and typically, no discomfort results.  So don’t let plantar fasciitis get in the way of your health and fitness goals. Don’t just work out hard. Work out smart!

For more information on booking personal training sessions with Kayla, please see our Personal Training page and contact us via our Facebook page.


How to Prevent and Treat Delayed Onset Muscle Soreness

(Originally posted January 19, 2012)

OK, the ugly truth is if you do not ever want to experience DOMS (delayed onset muscle soreness), the surefire way to do that is keep being a fat, sedentary blob. You could also exercise, but never to the point at which your muscles are actually challenged to grow though. This, of course, means you won’t experience the health benefits of exercise such as improved cardio vascular fitness (increased HDL for instance), decreased blood pressure, or any of its protective effects against breast, colon, endometrial, lung and prostate cancer.(1,2) You also won’t be experiencing any of its protective effects against osteoporosis and other ill effects of aging. Assuming you’re willing to put up with some temporary discomfort for long-term gain of increased health and vitality, let’s talk about what to do to prevent and treat DOMS.

Kayla’s Top 4 Tips for Preventing DOMS:

  1. Warm up before working out in order to increase body temperature, get the blood and oxygen flowing and prepare your muscles for the workout itself. Movement rehearsal and light cardio are good ways to do this.
  2. Stretch gently after the warm up/cardio to prepare the muscles for work.  (Do not stretch cold muscles)
  3. Progress slowly when you begin a new exercise activity. If it’s a new kickboxing class for instance, do a little less than you think you’re capable of while still getting a good workout. You can judge how sore you were after the first class to know how hard to push yourself the next time when you’re not too sore to have a next time.  Use a lower percentage of your 1 rep maximum on weights…so if you have been working at 80% maybe try 70-75% or less and work up slowly (listen to your body).
  4. Consume some protein within the hour after you finish your workout paired with a little carbohydrate. Examples include peanut butter on Ezekiel bread, or a whey protein shake, slices of turkey and an apple, eggs etc.

Kayla’s Tips for Treating DOMS:

  1. Have a bath with Epsom salts. I like to put in a cup of Epsom salts into the hot/warm bath water and soak for at least 20 minutes if I’m sore. The heat from the water relaxes the muscle and its thought that the Magnesium (the key ingredient in Epsom salts ) gets into the skin to reduce the inflammation in the muscle.  It also delivers sulfates, which can ease joints. For more information on Epsom salts and its many uses go to http://www.epsomsaltcouncil.org.
  2. Ibuprofen won’t make you heal any faster but can take the edge off.
  3. Take a day or more off from training that particular muscle. If it’s the bicep that’s sore, focus on the quadriceps or hamstrings or rhomboids for instance and move back to the biceps or upper body when it’s not so sore.
  4. Do light cardio. As the blood circulates, it can help ease the muscle. We’re talking a walk or light jog.
  5. Stretch the muscle. Use a foam roller.
  6. Get a massage.
  7. If its very severe and the Epsom salt bath didn’t do it, you might try drinking a small amount of aloe juice (we’re talking a teaspoon or two) mixed in apple juice to disguise the taste.

If you are sore more than two days, you may have a slight injury or muscle strain. is the case, rest and give that muscle time to heal before training it again.


(1) Courneya,K.S. & Friedenreich, C.M.(1997)Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. Journal of Alternative and Complimentary Medicine, 3, 15-216

(2)  Friedenreich, C. M. (2001) .  Physical activity and cancer prevention from observational to interventional research. Cancer Epidemiological Biomarkers Prevention, 10, 287-301


Delayed Onset Muscle Soreness

(Originally posted January 14, 2012)

Delayed Onset Muscle Soreness (DOMS) is what you feel 24-48 hours after a workout. What causes this condition is still the subject of controversy but in general, its thought that there’s tearing and inflammation that occurs in the muscle during a workout. It can also be a sign of lactic acid building in the muscle. One opinion is that the micro-trauma caused in the muscle causes the body to repair it in a way that’s stronger and denser than it previously was.

The good news is that once you get past this period of soreness-(which can last up to 72 hours as your body works to repair the muscle), that same activity shouldn’t make you that sore or sore at all because they should have adapted to that level of overload—You have gotten stronger.

Keep reading to find out how to prevent and treat DOMS.


Muscle Soreness / Muscle Pain

(Originally posted January 9, 2012)

So you started your workout plan and you’re feeling proud but your muscles are telling you they want to quit even though you just started. Yesterday it was a bicep curl and today it hurts to lift your toothbrush and you’re losing motivation right out of the gate…First of all, mild sore muscles or mild muscle discomfort is simply a symptom of using your muscles and placing stresses on them that are leading to adaptations to make them stronger and better able to perform the task the next time. As your body adapts, there should be less muscle soreness until you challenge your body in ways its unaccustomed to being challenged. Anyone and everyone from weekend warriors to elite athletes get muscle soreness. On the other hand, a very uncomfortable sharp or intense pain in muscle, joint or bone is different. That’s an unhealthy pain, and not just muscle soreness. If you experience sudden pain, severe pain, swelling, extreme tenderness, extreme weakness in a limb, inability to place weight on a leg or foot, inability to move a joint through its full range of motion, visible dislocation or broken bone, numbness or tingling you should see a healthcare professional right away.

Keep reading the blog this week to learn about the different types of muscle soreness, what to do about it after it happens, and how to best prevent it.