Back pain is one of the highest reported reason for medical absence of work. Statistically speaking, if you picked a random group of people off the street to have a large enough sample and put them in an MRI scan, quite a high percentage of them, somewhere between 1/3 and 3/4 would have a clinically significant findings on the scan that the radiologist would consider worthy to report on but only a few of them would present with actual symptoms.
The most common spinal levels where the discs seem to wear out the most is at the L5/S1 and L4/5 in the lumbar spine and the C5/6 levels in the cervical.
This often results in the changed mechanics of the motion segment, with the disc impinging on the exiting nerve root, reduced disc height that changes facet joint mechanics etc. often resulting in pain and impaired function. There are various reasons why that is, couple of which are:
- We live a more sedentary lifestyle and lack of activities that conditions the tissues to be supported and more resilient to wear and tear -after all the body adapts to pressure and tension so lack of it poses a"de-conditioning" effect.
- From a biomechanical perspective L5/S1 is positioned like a wedge between the sacrum and the lumbar spine which carries and bears the weight of the superincumbent upper body, while the C5/6 is one of the first couple cervical segment where there is a transition between the relative "rigidity" of the upper thoracic spine and ribcage to the suddenly free neck. The movement in range most predominant in the cervical spine is flexion-extension which can be significantly exacerbated by today's text neck/forward head posture at the base of which sits C6 where the load exponentially increase with each extra centimeter of extra forward head carriage.
Therefore, I think it is worth having the presupposition when dealing with a new patient that they might have wear and tear in their spine, even if they don't report any symptoms.
While the patients concern is to become pain free as soon as possible, we as therapists have to do our best to address it as such to prevent the condition from becoming a chronic issue.
I find it important to look at how the body as a whole as well as its parts are being managed statically and dynamically relative to the centre of mass, as it shows where the weak points are, what segments get more stress, whether that extra stress is being dissipated and shared effectively between the joints of the kinetic chain and so on.
This often brings up the need for postural reprogramming to improve movement mechanics in order to learn to better manage it mass statically and dynamically movement mechanics
Among various manual soft tissue techniques and corrective exercise strengthening one very effective treatment, as well as preventative exercise tool that I teach all my patients, is the ELDOA™.
What is really ELDOA™? (and why you really need a qualified professional to learn it properly)
The ELDOA™ Method is a revolutionary exercise technique aimed to address postural dysfunctions, back pain, disc hernias, osteoarthritis and scoliosis. It works by self-induced myofascial tension where the subject engages in a very precise posture that solicits a specific fascial chain that is in link with the targeted joint segment making it the centre of separating forces. Each ELDOA™ posture is assigned to a joint segment and engages a different fascial plane. In fact, you can be very accurate with these exercises. By knowing the exact problem and its specific location, an experienced ELDOA™ practitioner should be able to isolate and address that body segment with a specific ELDOA™ exercise.
One thing is important to note here is that the reference value of an ELDOA™ posture is the deviation from the standard posture is very common based on a number of factors:
- Morphotype ( you have probably heard of the endomorph, mesomorph and the ectomorph types when it comes to discussing metabolism and resistance training. The difference in morphology shouldn't be overlooked when using the ELDOA™ either as connective tissue tension ( capsular, ligamentous, aponeurotic tension all affecting joint ROM), muscle fibre types and joint specific muscle composition can vary between the different morphotypes therefore adapting a general posture for a targeted segment will probably miss the point of the exercises, which is precise osteoarticular/joint opening.
- Flexibility - besides morphology, there are individual differences between joint range of motion, muscles length and connective tissue tension within the same morphotype. The same myofascial tension will be achieved at different parts of the joint range for a body builder and the hypermobile Yoga or Pilates instructor.
- Spinal curvatures - changes in spinal curvature have a big effect on fascial tension which need to be taken into account. The postures are modified differently for someone with a reversed curvature of the cervical spine following a whiplash car accident and an office worker with heavy forward head carriage.
- Body awareness, neuromuscular control - we all have different history in training and movement education therefore it would be unproductive to use a one size fits all approach like used in many fitness trends. The rate at which a person can learn and integrate a new movement vastly differs between a highly trained athlete and a sedentary individual who hasn't done much sports in their childhood. But there is a massive difference between a gymnast and a powerlifter or sprinter. What we need to understand that the joint opening promised by the ELDOA™ happens at peak myofascial tension. In order to achieve that peak tension the brain is being asked to simultaneous control different body parts (5-6 points at the same time) to maintain and gradually increase that tension in synch with each other while making continuous self corrections in the process. It is a serious act and it has to be layered properly so that the brain learns for it to become second nature.
Therefore the educational process to teach the body how to integrate all that the best and most efficient way, while following and progressing through a systematic model of learning and integrating, will look different for people as some has a deficiency in strength, flexibility, motor control or all the above.
Remember that ELDOA™ is an intelligent exercise. It awakens the body's innate wisdom to normalise itself. During the process of ELDOA™ training the body integrates the learned lessons which, when practiced frequently, will have a significant carry-over into your life, and not only in your posture!
If you want to reap the full benefit of these exercises go and seek out an ELDOA™ Trainer.
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