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Grappling with back pain

10/12/2017

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Most of us have had some experience with lower back pain, whether it be severely debilitating where sitting or standing is already causing you excruciating pain, to just a niggle in the lower back that’s constantly there throughout your day. We can all agree that, YES, the pain is annoying and very frustrating, but it’s worse when it prevents us from doing what we love – for some it’s running or lifting weights, for myself it’s Brazilian Jiu-Jitsu (BJJ).
​
BJJ is a grappling martial art and combative sport, which involves controlling and submitting your opponent with pressure, chokes and joint locks, often this is happening on the ground with you crunching up and on your back. This position can lead to the front of your hips, abs, chest and neck muscles to become very tight, while back becomes stretched out and weak. This combined with the fact that a lot of us spend most of our day sitting, can lead to muscular imbalances in our bodies, which not only has a direct impact on our performance but can lead to issues like low back pain. 

What can I do about it?

To get relief and correct those muscular imbalances you want to stretch out the tight muscles at the front of your body and strengthen the muscles at the back.
Here are my THREE GO-TO stretches and exercises that I do in all my warm-ups.
  • Half Kneeling Hip Stretch
    • Chest up
    • Tail bone tucked under
    • Slightly push your hips forwards
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  • Cobra & Child’s Pose
    • Slowly alternate between the two positions
    • Spend 15 seconds in each position
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  • Superman Hold
    • Arms up over head or by your side
    • Lift your hands, elbows, knees and feet off the ground
    • 3 sets x 20 seconds holds
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It’s also important to off-set all that sitting we do at work, so every hour get up and spend 30-seconds on one of the follow stretches or exercises:
  • Half Kneeling Hip Stretch
  • Standing Ab Stretch
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  • Squats
    • Focus on keeping your trunk upright and chest up.
    • Keep your heels on the ground
    • Aim to get your hip crease below your knee level
​A good variation is to use a bar or weight on your chest which can help you maintain your centre of gravity forward and also give you feedback to keep your chest up.
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All of these stretches and exercises should be pain free. In addition to the above, if you have access to weights, try to front squat 3x a week to strengthen all those back muscles. Personally I prefer using the barbell as it encourages you to extend through the mid back which can get extremely stiff after prolonged sitting, which in turn had a significant effect on my ability to invert as I transitioned into different positions.
​
Give these exercises a try and watch your body and game thrive. Oss!
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Paul is a senior physiotherapist at Activ Therapy Casula
He trains at Absolute Fighting Arts and holds the rank of blue belt.
Paul's special interests are in recovery and perfomance for combat sports.
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October 10th, 2017

10/10/2017

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Happy Tuesday! Hopefully everyone’s enjoyed their October holiday break and none of us have come back feeling any worse for wear. Last weekend, I found myself at the 2017 Oceanic Championship Jiu Jitsu Tournament run by Events BJJ as both a physiotherapist assisting at the event and as a competitor.
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On the mats, it was a great day of competition and an interesting experience being the first tournament that I’ve participated in myself. Having previously worked at or spectated previous events, I’ve had some idea of what to expect from the competition watching from the sidelines. However, nothing quite prepares you for the mixture of nerves, anticipation and rush of adrenaline that you feel once you step out onto those mats.
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Unfortunately, at the end of the day, I didn’t quite get the result that I was after but it was a great learning experience which has helped to highlight some of the flaws in my technique and has identified areas in which I need to better prepare myself for in the future.
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It was also an interesting day on the table as the theme appeared to be upper limb and shoulder discomfort, mostly borne from posting out onto an outstretched arm, landing on the point of an elbow or from getting dumped onto the point of the shoulder. Now these aren’t particularly uncommon positions to find yourself in with most contact sports (think getting tackled in rugby) or everyday life (falling and protecting yourself with your arm) but it seemed to be an issue that was prevalent amongst jiu jitsu competitors due to the nature of the stand-up game.
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​One of the more common conditions I came across on the day was AC (acromio-clavicular) joint tenderness which is caused by shearing of the AC ligament as the head of the humerus gets jammed into the glenohumeral joint and causes movement of the acromion away from the clavicle. As a result, in most cases it becomes quite uncomfortable to actively flex or raise the arm overhead and positions involving rotation at the glenohumeral joint are often also quite uncomfortable. Thankfully for those involved on the day, the fix was relatively simple and a quick trigger point release of the upper trapezius, pectoralis minor and deltoid seemed to clear most things up.
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If you have found yourself in similar positions in that past, here are some quick easy stretches that you might be able to try out to help alleviate some of the symptoms. Of course, as with any injury if the symptoms persist it may be a good idea to contact your local physiotherapist to provide you with a proper assessment and rehabilitative program.
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  • Pectoralis Minor Release using Mobility Ball – 30 second hold, 2 reps, 3 times daily
​Start by feeling across your collar bone and towards the tip of your shoulder.
Just before the end, drop your fingers down you should feel a notch, this is your coracoid process which forms an attachment point for the pec minor.
Position the ball just below this point on the muscle and lean into the wall applying pressure against the ball.
Hold this position for up to 30 seconds or until desired effect is achieved, as the tissue may be tense this may feel quite sensitive.
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  • Upper trap stretch a/a
​Start by leaning head away from side you’re attempting to stretch.
With your opposite hand pull your head further across to intensify stretch.
Hold this position for up to 30 seconds or until desired effect is achieved, as the tissue may be tense this may feel quite sensitive.
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  • Deltoid Release using Mobility Ball – 30 second hold, 2 reps, 3 times daily
Start by feeling along the side of the shoulder for any thickened bands of tissue or knots in the muscle, if you dig in with your fingers it may feel a little tender.
Once you’ve found your spot, position the ball on point of the muscle and lean into the wall applying pressure against the ball.
Hold this position for up to 30 seconds or until desired effect is achieved, as the tissue may be tense this may feel quite sensitive.
​Brazilian Jiu Jitsu is a form of martial art and combat sport system that focuses upon grappling and ground fighting. The central theme of the sport is to utilise leverage and proper technique to control an opponent in ways that force them to submit via joint locks or chokes.
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Steve Ngo
Practice Principal at Activ Therapy Sans Souci
Physiotherapist for combat sports, martial artists and grappling athletes
Training at Kings Academy Moorebank
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How To Add 5-10kg On Your Squat or Deadlift WITHOUT Extra Training

10/8/2017

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Adding extra weight to the big lifts is always a good feeling...
 
For me it's an indicator that my training program is effective, my sleep and nutrition are going well, and that my time spent in the gym is actually paying off
 
In other words, I am getting results.
 
What if I could teach you how you can add an extra 5-10kg on your best squat or deadlift after reading this article - would that be worth your time?
 
Of course these results will differ from person to person and there are a lot of variables in play here, but using this strategy I have managed to help others hit personal records in their lifts. Not by coaching or training them, but by teaching their body how to move more effectively.
 
I will divide article into 3 areas to work on:
  • Core
  • Hips
  • Bracing

#1 Core

​The core refers to the deep stabilising muscles of your spine - their role is to control the spine under load and during movement
 
Under a heavy load like the deadlift or squat, the best and safest position of the spine will be in neutral. In other words, the spine should not bend or curve during these lifts.
 
Unfortunately a lot of people who get hurt in these lifts are unable to control their spine well enough under load and this stress is transferred into the back
 
The first step in our strategy is to teach the body how to find and maintain a neutral spine position
 
Find this in the quadraped position (on all-fours): first round the lower back as much as you can, then arch as much as you can, and then find the middle position
 
In this neutral spine position, we are going to control our arms and legs while maintaining full control of the spine. It's harder than it looks. What we're trying to do here is to differentiate between the spine, arms, and hips.
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#2 Get the hips working

​The gluteus maximus is essentially the engine of the body... having this guy not working is extremely detrimental to athletic performance and injury prevention
 
The gluteus medius controls the hips in the frontal plane (side-to-side movement) as well as the transverse plane (rotational movement) and therefore has a massive stabilising role to play
 
An easy way to get these muscles working is with the single-leg bridge and the clamshells in sidelying
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​Do a couple sets of these before you start with your lifts and feel the difference

#3 Bracing technique

Why do some people love lifting with belts and others don't?
 
It's all to do with creating intra-abdominal pressure, ie. creating stability in the spine through an effective bracing strategy.
 
I've seen many people over-extend (arch) through the lower back when they squat or deadlift, placing compressive forces on the facet joints, spinal erectors and posterior structures of the spine.
 
I've also seen people round and flex forwards at the lower back, putting themselves at risk of disc herniations and muscle strains.

The most ideal way to protect the spine during a heavy squat or deadlift is to learn how to actively recruit the core muscles and teach them how to stabilise the lumbopelvic region

The following cues may help achieve a good braced position:
  • Butt tucked in
  • Ribcage down
  • Fill belly 360 degrees with air
How did you go with these drills? Did they help you with your lifts?
​
If you liked this content and would like to find out more, follow us on Facebook @ActivTherapyCasula for the latest updates.
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About the Author:
Lawrence Khuu is a qualified Physiotherapist and Movement Specialist. His mission is to help motivated clients perform at their highest level through a combined hands-on treatment and exercise rehabilitation approach. He currently treats clients at Activ Therapy Casula.
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    Welcome the the Activ Therapy Blog.
    Find out about all things physiotherapy and chiropractic, covering health tips, self treatment advice, common conditions and latest updates in health.  Follow us on facebook to keep up to date with the latest.


    Author: Richard Kim

    rRichard has been a physiotherapist since 2003 working in public hospitals, workplace injury and gyms before establishing Activ Therapy.  He currently works with powerlifters, martial arts and crossfit athletes,

    View my profile on LinkedIn

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    • Conditions >
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      • Plantar Fasciitis
      • Anterior Hip Pain
      • Sleep Hygiene
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