By David De La Fuente
Gardening and tending to our yards are common activities this time of year, which require a lot of sustained postures and repetitive movements, such as forward bending and the twisting of our spine.
Poor posture and body mechanics can lead to pain due to muscle strains, herniated discs, facet impingements, which can lead to the development of spinal stenosis. With any one of these conditions, there will be distinct symptoms present. Muscle strains, for example, occur due to overloading tissue in a way that it is not designed to handle, resulting in achiness, soreness, and tenderness along the muscles affected.
With a muscle strain, the long, but thin erector spinae muscles become overloaded, resulting in pain and inflammation. The misconception most people have when they come to my practice is that their “back muscles” are weak. The truth of the matter is that these muscles are not designed for strength, rather they are designed for endurance. The erector spinae are known as anti-gravity muscles, and their only job is to keep us upright rather than to lift heavy loads. When lifting heavy loads, such as bags of soil or even plants, we should be using our hips and knees, but never using our backs. The same is true when bending to plant flowers and vegetables, or to weed gardens and flower beds. Most people bend fully at their spine, keeping their knees and hips locked into extension. However, it would be a better option to either kneel, which puts less stress on your lumbar spines, or even sit on a low stool. Our hips and knees are the powerhouses of our body and are designed to take on high loads. When lifting something from the ground to our waist, one needs to bend their hips and knees, while maintaining a neutral spinal position.
A herniated disc can present with centralized, or localized pain at the level of the spine where the herniation occurred. A herniated disc can also peripheralize, known as radiculopathy, which is when the symptoms radiate anywhere along the nerve distribution where the disc is herniated. The symptoms with a herniated disc are commonly described as achiness, sharp, burning, and tingling, especially when peripheralization has occurred. Herniated discs are commonly developed due to poor posture, and poor body mechanics.
The disc is made of two components: the annulus, which are the outer rings of cartilage, and the nucleus propolsus, which is the thick inner fluid. When a disc is bulging or herniated, one develops a tear in the cartilage and the nucleus propolsus leaks out. As the fluid leaks out, it can place pressure on the nerve roots exiting the spine, causing radiculopathy, or pain away from the source. Facet impingement presents with a localized left or right sided symptom, and commonly described as pinching. The facet is the joint that articulates one vertebrae to another, therefore is where our spinal movement originates from. The facet joint is wrapped in tissue known as the capsule, and for various reasons gets trapped or pinched with the joint, resulting in inflammation and pain. As we age, the facet joint can become tight and restricted. Due to tight and restricted facet joints, the levels of the spine above and below the restriction become hypermobile, or develop excessive movement to compensate for loss of movement elsewhere. As the hypermobility develops, the capsule becomes overstretched or loose, and has the risk of getting pinched within the joint space, resulting in pain.
Spinal stenosis, which tends to develop as we age can present with symptoms radiating down both legs and stiffness of the lower back region. As the stenosis progresses, it also becomes difficult to straighten up, or stand with erect posture.
If you are experiencing difficulty performing certain activities that you enjoy such as gardening, or have developed symptoms after performing sustained or repetitive activities, and would like to discuss successful, conservative treatment options, come and see your local physical therapist at Cornerstone Physical Therapy Health and Wellness Center, conveniently located on 77 Brant Avenue, Suite 101 in Clark.
If you have any questions in regard to any injury or condition, and possible treatment options in a relaxing and convenient environment, give us a call at 732-499-4540. We specialize in many facets of physical therapy, focusing on complete patient satisfaction, and patient results. We also guarantee that each individual will be seen within 48 hours, open 6 days per week, making ourselves available for our patient’s hectic lifestyles and accept all insurances. Let us help you enjoy your life, without worrying about uneasy pain.
David De La Fuente, PT, DPT, CSCS, Doctor of Physical Therapy, Cornerstone Physical Therapy Health and Wellness Center, PC.