Neck, Shoulder Pain & Headaches.

Kieran has treated thousands of achy, stiff, tense neck and shoulders and associated headaches over the years and often gets quick results. It’s not uncommon for Kieran to see someone who has seen several other health professionals with minimal results and only after a few treatments with Kieran finally got the relief they needed. The number one reason why most people don’t respond to most treatments is because the postural muscles haven’t been released. A 10 minute chiropractic treatment may provide relief in the short term but the postural muscles that attach to spine inevitably tighten again and you have to go back for months on end.

I cannot over emphasise the role of the muscles when it comes to chronic neck and shoulder pain and headaches. Have a look at the ‘shopping list’ of muscles below and notice how the muscles are attaching directly onto the spine. These muscles get tight and restrict movement and compress the sensitive spinal joints. This is why Kieran always does a comprehensive muscle and massage treatment prior to chiropractic, adjustments are only as effective as the muscle work done prior.

A good way to test this yourself is to run you fingers across the muscles on either side of your neck, do they feel “gristly” and “crunchy” as your fingers flick over the tense muscles like a guitar string. What about the the muscles on top of your shoulders, do they feel soft and relaxed or like concrete? Is there a big knot or lump on top of your shoulder blade? Roll your shoulder back and down and forward in a circular motion, can you hear the tight muscles as they flick over your shoulder blades?

Also be wary of so called “posture experts” who don’t treat the postural muscles. In my experience professionals who treat posture use it more as a marketing tool similar to getting “realigned”, people are more likely to pay $80-$100 for a 10 minute treatment under the guise of having their posture corrected. Most “posture experts” couldn’t tell you what muscles cause poor posture yet alone how to treat them, it takes a lot more than 10 minutes.

Click on the image to get more detail on specific muscles, take note on where they attach onto the spine, how they are aggravated, common associated pain patterns and headaches and effect on forward head posture (FHP). The body compensates by distributing tension across many postural/spinal muscles, It would rather be generally tight everywhere rather than extremely tight in isolation. You’ll have a greater understanding on your own muscle anatomy and how it relates to your pain than most chiropractors, physiotherapist, GP’s etc…

Trapezius or “traps”

Levator scapula

Splenius capitis

 Sub occipitals (FHP)

Sternocleidomastoid (FHP)

 

Erector spinae

 

Pec minor and front deltoid. (Muscle that causes forward shoulder posture)

If you’re looking for an effective treatment for neck and shoulder pain book online and claim your initial appointment offer today.

kieranfNeck, Shoulder Pain & Headaches.
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Low Back Pain

Where low back pain is typically felt

Causes Of Low Back Pain

“Shopping List” of Important Back Pain Muscles.

Success Stories

Low back pain is typically described as tension, stiffness, an ache etc… Most people can’t attribute their back pain to one specific incident but rather a general and accumulating sense of discomfort and tension, that comes and goes over years and then may begin to experience it on a more consistent and day-to-day basis, many back pain sufferers will often put it down to just “getting old”. On occasion their might be a sudden and extremely painful episode where the person is unable to move or function without significant pain, this can be a result of a mundane movement such as picking something light off the floor, coughing, house work, an exercise at the gym etc…

Where Low back Pain Is typically Located

Do you feel your pain similar to any of these images? Pain is often felt around the joints of the lower spine. There are several key postural muscles that attach directly on to the spine and may compress and aggravate the sensitive spinal joints and why chiropractors who don’t treat the muscles typically only produce short term relief. Click on image(s) below to get more detail on location of pain.

Causes & Aggravating Factors

Back pain sufferer’s may feel their pain first thing in the morning, typically they have a hot shower and then move around and the pain and tension usually eases. Similarly, people who sit for extended periods of time may feel tension and discomfort in the postural muscles of the spine, once they get up and change postures the pain and tension will usually subside for the short term. Certain exercises, especially weighted ones may also aggravate back pain, sitting on soft/unsupportive couches or seats where the hips are lower than the knees such as driving, or they do something their not accustom to such as extra walking while on holiday, gardening, moving house etc…

“Shopping List” of Important Back Pain Muscles.

There are usually several key postural muscles associated with back pain, once chronic the body will distribute the tension to the muscles of the hips, low back and may aggravate the spine. This is why Kieran always performs extensive muscle and massage therapy prior to chiropractic. The adjustments are only as effective as the muscle work before it.

Quadratus Lumborum

Psoas

Erector Spinae (ES)

Thoracolumbar fascia (TLF)

Multifidus

Glute medius

Success Stories

These are just a fraction of reviews taken from over 180, Sydney Chiropractic & Massage and previous location in Waterloo (closed down). There was no need for x-rays, scare tactics or corrective care plans (scams). Just a comprehensive hands on muscle and spine approach, evidence based and wholistic. Click to see reviews.

If you’re looking for effective treatment for low back and hip pain book online and claim your initial appointment offer today.

kieranfLow Back Pain
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The Truth About Scoliosis

Most people develop a scoliosis during adolescents and is often referred to adolescent idiopathic (unknown origin) scoliosis. I have a theory it may develop if one side (unilateral) of the spinal muscles are relatively tight compared to the other side especially during a growth spurt, in particular the I use the analogy of tying a rope to a bamboo tree on one side, it will inevitably grow/curve to that direction. In this diagram you can see the “ropes” that are attaching to the spine.

The problem is not the scoliosis or misalignment itself but potentially the original muscle problem that set up the misalignment in the first place, for a number of people the muscles that set up the scoliosis aren’t always going to be causing any pain either, there are many factors involved. However, for those who’s muscles are causing pain once you get rid of the underlying muscle problem, imbalance, tension, the associated back pain will often subside, although the alignment of the spine won’t actually change. Once you get to adulthood the shape of the bones will tend to change shape based off wolfs law which states bones will adapt/remodel due to the mechanical pressure placed on them, this typically cannot be reversed even after months of these scam “corrective care programs” designed to realign the spine. You can take an x-ray before and after months of treatment and the only difference will be in your bank account.

It’s not a coincidence that people who supposedly get their spine “realigned” have to keep going back regularly for “realignment“.

Back pain sufferer’s may feel their pain first thing in the morning, typically they have a hot shower and then move around and the pain and tension usually eases, that’s not because your spine magically realigned itself after having a hot shower, it’s because the heat and movement stimulated blood to the muscles. Similarly, people who sit for extended periods of time may feel tension and discomfort in the postural muscles, get up and change postures and tension typically eases, this has nothing to do with your spine going back in to alignment. Similarly people who have high levels of stress may experience pain and tension due to the ‘fight or flight’ part of the nervous system and the effect on muscle tension, being relaxed or stressed doesn’t determine whether your spine is misaligned or not.

If you have been told your back pain is because of a scoliosis, misalignment or your hips are out more than likely that’s not the case. If you’re looking for an evidenced based and logical approach to back pain book online today and get an initial appointment discount.

Tired of living with neck and shoulder pain? Click here to see how I can help.

Is low back pain preventing you from enjoying life? There is an answer, click here to find out more.

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kieranfThe Truth About Scoliosis
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How To Avoid These Treatment Scams

I have treated many people over the years who had been to other chiropractors and would have to go back for weekly treatments for months on end sometimes the treatment would be so ineffective & symptomatic they would have to go back multiple times a week! When ever I ask them why they kept going, the answer is always the same. They thought it was normal based the information described below and the chiropractor seemed like a really nice and kind person. That’s no different to getting a plumber to fix a simple leak and then have them come back every week for months to keep fixing their own shoddy work because they seemed nice and then getting charged a small fortune for it! It’s not uncommon for me to resolve someone’s pain and tension in only a few treatments despite getting treatment somewhere else for months.

By keeping the things listed below in mind when looking for a chiropractor hopefully you get a chiropractor that genuinely wants to help you. So you can experience the benefits of chiropractic without all the pseudoscience and scams.

Payment Upfront & “Corrective Care Plans”

X-Rays & Scare Tactics

Cookie Cutter Treatments

Subluxations, Misalignments & “Pinched Nerves”

How To Avoid Getting Scammed

Payment Upfront & “Corrective Care Plans”

Upfront payment plans and long term ”corrective care plans” seem to be business plans more than anything else. They often require multiple visits a week for months on end, a car salesy pitch is often used where excessive treatments are paid for upfront at a “reduced rate”. Ultimately they would be hundreds of dollars worse off by getting a years worth of symptomatic treatment in only a couple of months. A years worth of health fund is also used very quickly so they end up paying more out of pocket.

A treatment plan is different and usually involves an accurate and evidence-based diagnosis and prognosis, educating the patient especially on how to avoid or modify aggravating factors. I typically only need to see you 2 or 3 times over a 3-4 week period, as you move into more of a self-management/active care situation and getting treatment as needed. Reassurance and empowering the back pain sufferer is vital for best outcomes.

X-Rays & Scare Tactics

If you’re told you need x-rays, run and don’t look back! There are decades of research showing the vast majority of things found on x-rays have nothing to do with pain and are more just age related ‘wear and tear’, you can take x-rays of people who don’t have back pain vs with back pain and they will be almost identical. Often, x-rays are taken on the first visit (some will even have measurements/lines for greater effect), the patient is told they have a scoliosis, the hip is out by a certain amount of millimeters, their spine has arthritis and/or lost the curve in the neck.

Pain can be confusing at the best of times, to then tell someone who may be feeling a bit anxious or worried about their back pain that it is a result of their spine being broken, out of alignment or degenerated usually serves one purpose, to create more fear and vulnerability so the patient becomes dependent on treatment and much more likely to sign up for a corrective care or payment up front plans. Most people would be hesitant in paying money for a 10 minute treatment if it wasn’t to have their spine realigned, posture corrected etc..

X-rays should only be used when underlying medical conditions are suspected which is about 5% of people.

Short 10-15 treatments, where you get the same treatment every time you go and the same treatment everybody else gets. It usually involves the same two adjustments on the low back, mid back and neck or a slight variation of this . It may include a 5 or 10 minute massage which is pointless considering the amount of chronic tension people hold in their muscles. As well as being a chiropractor, I am a massage and muscle therapist with over 15 years experience, despite this I still need 30-45 minutes to make long term changes to the muscles, what can someone who has minimal training/experience in treating muscles achieve in 10 minutes?

The ironic thing is, the same chiropractor that claims pain is due to these ‘significant” findings on x-rays will also give a 10 minute, cookie cutter treatment that addresses nothing actually found on the x-rays.

Subluxations, Misalignments & “Pinched Nerves”

Some chiropractors will claim that misalignments in the spine will put pressure or “pinch” the nerves and cause pain and/or reduced function. which is where the nerve exists the spine, is relatively larger than the exiting nerves, in order for two adjacent vertebra to be compressing the nerves there needs to be a serious structural deformity and would require emergency spinal surgery.

The misalignments seen on x-rays are just normal wear and tear and actually cannot be reversed, you can see on this x-ray the shape of the bones have formed a wedge shape

Some will even take it a step further and claim these misalignments cause’s where the nerve innervates leading to decreased function to that organ, causing things such as digestive problems, asthma etc… and even poor immunity.

How To Avoid Getting Scammed

If you have any doubt or queries it’s usually best to call in advance and ask if x-rays are usually required, they may say that it depends on a case by case basis which is usually means yes. Check and see how long a typical appointment is and if it’s mainly just adjustments or is it a multidisciplinary approach. On the first appointment ask generally how many treatments will be required, I typically see someone 2 or 3 times then as needed there after, what I do isn’t magic I just use a multidisciplinary and patient focused approach. Avoid chiropractors who use terms like misalignments or subluxations their understanding of the spine, nervous system and pain is rudimentary at best.

Click to book online and save $20 off your initial appointment.

Tired of living with neck and shoulder pain? Click here to see how I can help.

Is low back pain preventing you from enjoying life? Click here to see how I can help.

intervertarabal foreman
decreased organ function
kieranfHow To Avoid These Treatment Scams
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Why X-rays Are So Damaging.

X-rays are often used as a marketing tool to capitalise on peoples fear about their alignment & back pain.

Unfortunately there are still some health professionals who routinely x-ray people with back pain, this is despite the national governing bodies that represent chiropractic, medicine, physical therapy all strongly recommend against it. Studies show 90%-95% of back pain has no medical underlying cause, x-rays are notoriously bad at diagnosing the vast majority of back pain, and do more harm than good (see research below)

Some clinics will have on-site x-rays and rather than x-raying approximately 5% as clinically needed they will x-ray almost 100% of back pain sufferers with an obvious financial incentive for the clinic. With the cost of living, I’m sure most people would prefer not waste their hard earned money on x-rays that are not only useless but potentially harmful and prolong recovery leading to more unnecessary costs.

Most things seen on x-rays are just normal wear and tear giving the appearance of bones been misaligned or out. Only a snake oil treatment can claim that bones can magically be put back in or treating “misalignments” somehow takes pressure off nerves. You can take x-rays before treatments that supposedly realign the spine and after and they will be identical to each other. In my experience “fixing alignment” has more to do with justifying charging $80-$90 for a 10 minute treatment or excessive treatment plans that would otherwise only take 2 or 3 visits.

Some professionals will also claim a bone is out and ‘putting pressure on the nerves’ causing muscle tension, headaches, general back pain, poor posture and even poor health conditions such as digestive problems, which is anatomically impossible. When you consider the hole or space where the nerve exits the spine is almost 4 times larger than the nerve itself, there would have to be a major spinal deformity for a bone to be impinging a nerve and is usually associated with severe pain, pins and needles, numbness and weakness of the legs and arms where nerves supply sensation and movement. Treatments claiming a bone is out and can magically be put back in offer nothing more than an expensive placebo. 

X-ray findings between people with back pain and without back pain are almost identical, they do not improve outcomes and do more harm than good!

Researchers found no evidence that the use of routine x-rays to assess the function or structure of the spine, improves clinical outcomes and benefits patients.

Researchers in another study concluded; in most cases the potential benefits from routine imaging, including spinal X-rays, do not outweigh the potential harms. The use of spinal X-rays should not be routinely performed in chiropractic practice. (Jenkins 2018)

Another study found routine imaging does not seem to improve clinical outcomes and exposes patients to unnecessary harms & the overuse of imaging also contributes to the high and growing costs associated with low back pain (Chou 2011).

A study published in American Journal of Neuroradiology found many imaging-based degenerative features (arthritis/misalignments) are likely part of normal aging and unassociated with pain. (Brinjiki 2018)

A 2019 study: Imaging in LBP may be associated with higher medical costs, increased healthcare utilization and more absence from work”. (Lemmers 2019)

Another study published in the British Medical Journal found “Imaging may do more harm than good when serious conditions are not suspected and is likely to prolong recovery in patients with non-specific low back pain”. (Hall 2021)

There are dozens of research done over two decades that all have similar findings.

How X-Rays Are Used.

1. Someone with simple back pain, usually muscular gets an x-ray

2. Report of findings: The practitioner tells the back pain sufferer they have lost the curve in their neck, too much curve in their low back, spine is misaligned, hips are out, spine has degenerated etc… Everyone gets told a variation of this.

3. The patient is also told this is what’s causing their pain (it’s not) and several months of treatment is needed some will offer to sell several months of treatment upfront at a reduced cost. With proper treatment most people only need two or three treatments before moving to a more active or self management phase.

4. Revolving door, 5-15 minute treatments with everyone getting the same cookie cutter treatment; two adjustments of the low back/hip, mid back and neck or a slight variation of this.

5. Symptomatic scheduling: 2 treatments a week for 4-6 weeks, one treatment a week for another 4 weeks. When I ask people who get this done why they kept going back when the results were so poor they would often tell me they believed it was normal and they were worried it would get worse if they didn’t.

The irony is the things that actually determine posture or where the body/bones are positioned in space are the muscles and are often seen as incidental.

References

W. Brinjikji,a P.H. Luetmer,a B. Comstock,b,c B.W. Bresnahan,c L.E. Chen,c R.A. Deyo,f S. Halabi,g J.A. Turner,d A.L. Avins,h,i K. James,c J.T. Wald,a D.F. Kallmes,a and J.G. Jarvikc,e Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

Roger Chou, Amir Qaseem, Douglas K Owens, Paul Shekelle, Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians Ann Intern Med  2011 Feb 1;154(3):181-9.

Amanda M Hall, Kris Aubrey-Bassler, Bradley Thorne, Chris G Maher. Do not routinely offer imaging for uncomplicated low back pain BMJ 2021 Feb 12;372:n291

Hazel J Jenkins , Aron S Downie, Craig S Moore , Simon D French  Current evidence for spinal X-ray use in the chiropractic profession: a narrative review Chiropr Man Therap 2018 Nov.

G P G Lemmers, W van Lankveld, G P Westert, P J Van der Wees, J B Staal. Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work. Eur Spine J. 2019 May;28(5):937-950.

kieranfWhy X-rays Are So Damaging.
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Work From Home Survival Guide

With our daily and work lives changing so rapidly and more people working from home, I’m sure many of you have experienced an increase in work related pain and discomfort, fortunately by implementing some healthy spinal habits throughout the day and without needing expensive or specialised ergonomic chairs this can be avoided. The main culprit is not moving or static postures, if you were to sit for an extended period of time with perfect posture you are still likely to feel pain, likewise if you were to stand all day and limit movement, it would also lead to pain and discomfort.

The best antidote to pain is movement.

With the nature of working from home, incidental movement such as walking to and from the home/office, public transport, between meetings and appointments, access to gyms/exercises classes have all been limited, it’s becoming more imperative now than ever people create an artificial demand for movement in our lives. A good way to make use of the time saved on commuting to work can be used to go for a brisk 30-45 minute walk or jog prior to settling into the home office.

Everyone has a different stress capacity or tolerance when it comes to sitting, for some it can be as little as 30-60 minutes for others it could longer, a relaxed muscle with good blood and oxygen supply will have a higher capacity, if a muscle is tense, it gets fatigued much quicker, lactic acid develops and tension & discomfort usually follows. Similar to holding a tight fist, it doesn’t take too long before tension and discomfort is felt in the hand and forearm muscles, compared to a relaxed hand.

Make a note how long you sit for before the muscles feel tense and uncomfortable and try to get roughly 5-10 minutes of exercise just prior to the onset of pain; things such as air squats, hip and shoulder rotations, push ups, body weight lunges can all be used to great effect, do these at regular intervals as needed throughout the day.

Try have a couple of alternate setups, it could be as simple as changing from an office chair to an excise ball, or a couch and using that for 15 minutes to shift certain stress points to other locations on the body & spine. For the vast majority of people these will be more effective than just “sitting up straight”.

When I am treating someone with back pain, specifically associated with not moving (sitting) I make sure to release the main affected postural muscles. For low back pain; the hamstrings, glute and spinal muscles, for mid/upper back and neck pain; spinal, shoulder and arm muscles, combined with the advice described above, and self treatment techniques to effectively target and release to problem muscles for fast results.

kieranfWork From Home Survival Guide
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When to Worry About Back Pain.

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The bark of most back pain is worse than the bite, even when the pain levels are quite bad or even debilitating its usually nothing serious. Although for small percent of back pain suffers will have an underlying pathology or medical issue which is less than 3%. Without trying to oversimplify things most back pain felt stem from the soft tissues namely the muscles, although these are very often overlooked as a major contributor.

Things like MRI’s & x-rays a notoriously bad at diagnosing back pain when it comes bulging discs, arthritis, “alignment” etc… which were all previously associated with back pain in the past and often misleading. However, when I am treating someone for the first time or even over an extended period of time I always have in the back of mind and on the look out for anything that may indicate a more serious cause of their pain, such as autoimmune diseases particularly rheumatoid arthritis or other autoimmune arthritis, cancer, infections, fractures and several other culprits which may be a more serious cause of back pain.

This article is just to give you a very brief background in how to discern the difference between common musculoskeletal back pain and a more serious cause of your back pain. If you have any concerns its always best to see you GP or health practitioner such as a chiropractor or physiotherapist for a detailed assessment. It’s worth mentioning even more serious causes of back pain may not be painful and may fly under the radar at least at the beginning but usually becomes more apparent as time goes on. The level or intensity of pain overall is not a good indicator, but the type of pain and when it is or isn’t felt is often noteworthy. On the flip side you can have extreme back pain and it may be nothing more than a muscle spasm, I usually explain it to my patients it’s similar to having a calf cramp which is very painful but the cramp involves the muscles around your spine and can’t just be stretched out like a normal cramp.

Two symptoms or situations that require urgent medical attention is numbness around groin and buttocks with or without loss of bowel/bladder control. Or when you have experienced force from a fall or accident sufficient to cause a fracture, this may be falling of a ladder (even a low one), off a bike etc… even if pain levels are that high.

Three signs that need to be investigated further but not considered medical emergencies like the two example above.

  1. You have felt back pain for more than 6 weeks.
  2. If the pain has stayed the same or actually gotten worse.

(Both if these are even more important if you have been getting treatment.)

  • There is at least one coinciding “red flag from the list below”.

List of “ red flags” which are signs and symptoms of a more serious cause of back pain.

History of corticoid steroid use (especially important for fracture(s)

General signs of illness such as fever, chills

Unexplained weight loss

Family history of autoimmune disease, gradual but progressive increase of pain particularly before the age of 40 and unresponsive to treatment, significant low back stiffness in the morning, rashes etc..

“sciatic” like symptoms pain and needles and numbness in both legs, less of a concern if located in one leg.

Current or previous history of cancer.

So if you are experiencing back pain and you fit the description for potential serious cause of back pain it may be a good idea to book in to see your GP.

kieranfWhen to Worry About Back Pain.
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Do You Suffer From Morning Back Pain?

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Back pain and stiffness in the morning is a common complaint I see in my practice, most people will state they wake up with pain and stiffness, get moving and have a hot shower then it will subside and then by the end of the day the pain and stiffness will return, it may also be the case it specifically is only felt for the first 30-60 minutes then completely fine for the rest of the day until the next morning. There are two main reasons why back pain first thing in the morning occurs, a more serious but less common cause and a less serious but much more common cause.

Serious But Less Common Cause

Inflammatory back pain (IBP) which is usually a result of auto-immune arthritis (not to be confused with osteo-arthritis) such as rheumatoid arthritis can include symptom of morning back pain and stiffness. This type of pain will usually wake the person up rather than feeling pain and stiffness once you are up and moving. The reason why pain is felt in the morning is not very clear but may have something to do with the body’s natural inflammatory circadian rhythm.

Other indications of IBP include more widespread pain in other joints such as hands, wrist feet, a family history of auto-immune arthritis, a recent infection and respond well to anti-inflammatories. Imaging such as x-rays, MRI and blood tests are required to confirm.

Not Serious but Much More Common

Myofascial or muscle pain is by far the most common reason for morning back pain and stiffness. It is usually a result of deep tightness and trigger points that run a good portion of the lower and lower mid back namely the erector spinae muscles. Typically the is no pain until you actually get up and start moving and putting on your shoe’s and socks can be a chore and it usually settles down fairly quickly, especially after having a hot shower as this increases blood circulation which allows the muscles to relax. Typically the trigger points are still there so as the muscles are being used throughout the day they can fatigue and tire quicker and the stiffness and tension will return later in the day.

I have treated hundreds of these over the years and assuming it hasn’t become too chronic or the muscles are not too deconditioned it is a very easy fix and usually only takes a couple of sessions. As the trigger points can be quite deep in the muscles a strong, deep tissue massage to the erector spinae muscles is what is usually required. Also doing self treatment/trigger point release using a tennis or lacrosse ball will greatly speed up the process and make sure it doesn’t come back anytime soon.

kieranfDo You Suffer From Morning Back Pain?
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Your Best Chiropractor in Sydney CBD – Why I Don’t Do Ten Minute Treatments

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Patients who have experienced this sort of 10-minute treatment before they come to me frequently state that they got the impression the practitioner was focused more on treating them quickly and having them come back frequently,often requiring treatment several times a week (which is absolutely not needed) or experienced little in the way of relief even though they’ve had 3 treatments.

Its highly unlikely to be able to provide quick & fast relief of chronic pain in just 10 minutes and not possible to correct posture without addressing the muscles as its the muscles which are responsible for holding the skeleton in an upright position and not the other way around. In fact, in my opinion the idea of fixing posture it is often used as marketing ploy to justify charging up to $70 and leaving people more willing to pay for such a short amount of time. 

Being a chiropractor myself, its sad to say that there seems to be a particular problem with other chiropractors putting profits before patients; it’s deeply frustrating to read research demonstrating that chiropractors on average see patients 4.5 times more often than an osteopath and 2.5 times more than physiotherapists. This research was undertaken in Australia, by chiropractors themselves, employing health fund data.

I believe that chiropractic treatment is the most effective when properly employed. However, 10-minute sessions, inevitably offering the same treatment independent of what the patient actually needs, treating six patients per hour and possibly more than 50 each day and geared towards the greatest profit.

 
 
 
kieranfYour Best Chiropractor in Sydney CBD – Why I Don’t Do Ten Minute Treatments
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Weak Core, Pilates and Back Pain.

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There is usually not a week goes by where I am seeing a back pain client for the first time and they tell me they think their pain is because of a “weak core”. The fact is, the whole concept of a weak core and its relationship to back pain is dubious to say the least. It mainly stems from research done in the 1990’s by Australian physiotherapists which showed a delayed onset to the firing of the core muscles namely the transverse abdominus (Tra) in people with low back pain. This has spawned a massive industry of mainly physiotherapists, Pilates instructors, personal trainers telling their clients to brace their core by, “pulling the belly button towards the spine”, or “sucking the stomach in”, in an attempt to prevent or relieve back pain.

The idea of the core being a corset of muscles that stabalise the spine is anatomically incorrect, as the body is integrated with a 3D movement system that involves a large variety of muscles and connective tissue that span many parts of the body to control movement of the spine. The biggest issue with the idea of bracing or tensing the spine is the vast majority of people I treat already have quite tense/overworked back muscles, stiff spines, poor movement patterns and heightened fear avoidance behaviors I’m not sure what the goal of bracing the spine actually is. Stuart McGill a Canadian world leader in spinal biomechanics research say’s pulling the stomach in/hollowing may actually weaken the spine.

Another thing to note is most people feel back pain and stiffness first thing in the morning or when sitting for extended periods of time. There is no reason why a weak core would cause back pain under these circumstances as there is very little force on the spine, whether a core is strong or weak is not an issue. Also sitting while bracing your core would feel extremely unnatural and potentially aggravate the problem.

More than likely the delayed onset of firing of the core muscles found in the research the original research has more to do with the response of pain as a neurological coping mechanism to avoid low back pain rather than the other way around. Pilates is probably the biggest proponent of bracing the core or sucking in the stomach with instructors and physiotherapist a like charging exorbitant fee’s for classes when in fact you would more likely benefit just as much if not more from general exercise such as resistance training, swimming, yoga etc… With a recent systematic review finding; There is low- to moderate-quality evidence that Pilates is more effective than minimal intervention with most of the effect sizes being considered medium. However, there is no conclusive evidence that Pilates is superior to other forms of exercises. When you consider you can do other forms of exercise for free or comparably at very low costs with similar if not better results for lower back pain, pilates or doing endless plank exercises may not be the best choice.

kieranfWeak Core, Pilates and Back Pain.
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