Low Back Pain Exercises

lower back pain exercises physical therapy

These first set of exercises are designed to treat Lumbar Derangement Syndrome, which occurs when disc material in the spine compresses nerve tissue causing pain that radiates into buttock and sometimes into the leg. Start with the first exercise and only progress to the next if you can perform without any pain in your back, buttock or leg. Stop these exercises and consult a Therapydia physical therapist if your pain worsens.

Exercises for Lumbar Derangement Syndrome

Try to perform these exercises 3-5 times per day. We’re looking for the pain in your back, leg and buttock to lessen and resolve.

Prone on Elbows

Prone on elbows helps to strengthen your lower back and neck as well as works to improve your posture.

• Prop on your elbows for 30 seconds.
• Then lower until you are lying flat.
• Repeat for 5-10 repetitions.

Prone Lying

Prone lying helps to strengthen and stretch your lower back and neck as well as works to improve your posture.

• Use a pillow under your abdomen and lay prone for 5-10 minutes.

Prone Press Ups

This is a passive exercise for your legs and buttocks. You want to see the pain centralize, or move, out of the leg.

• Relax your lower body and use your arms to press yourself up to end range.
• Try to keep your hips on the table as you press up.
• Perform this exercise for 10 reps.

Exercises for Lumbar Dysfunction Syndrome

Lumbar dysfunction syndrome occurs when tissues shorten and cause loss of mobility and increased back pain. The goal of these exercises is to lengthen the shortened tissues and increase mobility. Start with the first exercise and only progress to the next if you can perform without any pain in your buttock or leg. Stop these exercises and consult a Therapydia physical therapist if your pain worsens.

Flexion in Lying

Back pain can be caused by a lack of flexibility. This exercise helps with flexibility, muscular pain and general stiffness.

• Lie on your back, knees bent and pull your knees to your chest and hold for 5 seconds.
• Return to lying position.
• Do 10 repetitions of this exercise.

Flexion in Sitting

This exercise helps to improve range of motion and flexibility which can be a source of low back pain.

• Sit on the edge of a chair with your feet on the floor.
• Bend forward as far as you can comfortably and hold for 5-10 seconds.
• Hold the legs of the chair for extra stretch.
• Return to upright sitting position.
• Perform 10 repetitions of this exercise.

Flexion in Standing

This exercise helps with low back pain and flexibility.

• Stand with your feet hip distance apart and slowly bend forward as far as you comfortably can.
• Hold this position for 5-10 seconds and slowly return to standing position.
• Repeat this exercise for 10 repetitions.

Any pain or discomfort produced by stretching should stop shortly once you release the stretch. Contact a Therapydia physical therapist if your pain worsens with any of these exercises.

Patient Recovery Story: Getting Back to the Box

crossfit injury recovery new orleans

When Kristin Mann first started CrossFit nearly five years ago, she did so at CrossFit Roux in New Orleans. The advantages of CrossFit were massive. Being diabetic, Kristin was able to keep her health in check by working out consistently and it wasn’t long before the exercise regimen became one of her favorite hobbies and a huge part of her life. “I found something that I was pretty good at. I was enjoying it and also seeing growth,” she described. Over the next few years, Kristin began going to CrossFit about 4-5 times per week. “I love the atmosphere and the people. It’s a very supportive environment.”

Cut to May, 2017: One Saturday morning, Kristin woke up in a lot of pain. Her arm was completely numb and she had lost full range of motion in her head and neck. “At first I thought I was having a heart attack,” she explains. “My arm wasn’t moving and my head was sort of stuck. If I moved it out of a certain position, it hurt a lot. It was weird to think that I didn’t have control over a part of my body. No matter how hard I tried, I couldn’t move my arm.” After a few unnerving minutes, Kristin’s fiance asked if she needed to go to the emergency room. “I don’t know, let me text Jonathan,” she replied.

Kristin was referring to Jonathan Burke, physical therapist and Clinic Director at Therapydia NOLA. Kristin had seen Jonathan a couple of times over the years for little things here and there and she knew him well as a trainer at CrossFit Roux. Despite it being a holiday weekend and although he was away attending a seminar, Jonathan quickly replied, asking Kristin to send him a few videos demonstrating her mobility. Thankfully, he was able to give her enough advice and instruction to get her through the weekend.

“I sent Jonathan a video, he sent me one back. He gave me some basic movements so I could stretch my arm out a little bit. He ended up coming in to work at 5AM the following Monday morning so he could help me.”

It turned out that Kristin had a herniated disc in her cervical spine. One of the scarier elements of the injury was that it wasn’t as if she had been mid-workout and felt something tweak, leading to the numbness and pain. The day prior to waking up with pain, she had gone about her business as usual: she did her workout, went out to dinner, saw friends and then went to bed. Nothing out of the ordinary.

Recovery Process

The beginning of her recovery was tough. Kristin spent the first month basically confined to her couch. Once the pain began to subside, she was able to start moving again and with Jonathan’s help, she worked her way up from slow movements to walking to eventually coming back to the gym. Her physical therapy treatment consisted of a lot of exercises, trigger point dry needling and manual therapy. “Eventually I was able to go back to CrossFit but I was modifying everything a whole lot.” As a CrossFit trainer, Jonathan was able to help her out to make sure she didn’t aggravate any of the progress that she had been making during her recovery.

“Jonathan was very persistent that I needed patience and that it would take time and that I would recover.” Kristin was able to put a lot of faith in his word and believed that through doing her exercises, she would get there. “But there were also times that I struggled with it and thought: how long could this take?”

Kristin was incredibly surprised just how difficult it was to come back. With CrossFit being such a huge part of her life, she found that she wasn’t able to lift or perform the exercises that she was used to do doing for so long. That wasn’t going to work for her. With Jonathan’s help and her own resolve, Kristin powered through her recovery even when it was really difficult. For her health and her own personal well-being, Kristin admitted that there were things that she wouldn’t be able to do but she was determined to figure out the things that she could.


Progress Report: Where is she now?

Almost a year later, Kristin has mostly recovered. Not only has she gotten back the full movement of her arm but she’s also been able to gain a little perspective on life and CrossFit:

“Prior to my injury, I wasn’t competing with myself, I was competing with other people. The injury allowed me to take a step back and say, okay, why am I doing this? I’m doing it because I want fitness. It helped me re-prioritize why I was doing CrossFit.”

Kristin is back in action doing CrossFit and finally lifting heavier weights. She just recently started lifting over her head again and still sees Jonathan about once a month to monitor her recovery and to check-in. “I’m so psyched that I’m better.” Kristin is currently planning a week-long bike ride this summer from Germany to Austria. “I told Jonathan: you need to get me in tiptop shape.”

As she continues to progress in her recovery, Kristin maintains an extremely healthy outlook: “At the end of the day, I know that there are things that are way worse that could happen and the fact that I have been able to recover so much, I’m just so grateful for that.”



Have a story you’d like for us to share? Email us at Hello@TherapydiaNOLA.com!

Running Cadence: What’s Your Number?

running shoes runner's world runner's knee physical therapy metairie

Up to 80% of recreational runners experience a running related injury (RRI) every year. The most common RRIs occur at the knee and below in areas such as the leg, shin, ankle and foot. Increasing one’s cadence while running can reduce the load to these regions of the body that are most frequently injured.

Your run cadence, or step rate, is the number of foot contacts made per minute while you run. Most recreational runners fall between 140-180 steps per min. Cadence is affected by multiple factors and will differ between runners.

How do I calculate my running cadence and what should it be?

After a quick warm up, start running and count the number of times your right foot hits the ground for one minute.
Multiply this number by two to get calculate your step rate.

If you fall on the low end of the cadence spectrum or are experiencing some discomfort while running, try increasing your running cadence by at least 5% with a goal of 10% at your preferred speed. Find your current step rate and multiply it by 1.05 and 1.10 to establish your 5-10% window.

Current Step Rate x 1.05 = 5% Window
Current Step Rate x 1.10 = 10% Window

Why should I increase my cadence?

Increasing your cadence by 5% above your preferred rate, while maintaining the same preferred running speed/velocity, will reduce the energy absorption (or load) by up to 20% at the knee joint, which is the most commonly injured area of the body in runners. Another advantage of a higher cadence includes a wider step width. This will help reduce strain to the iliotibial band (IT band), the most prevalent cause of lateral knee pain. “Shin splints” or medial tibial stress syndrome is also affected by an increase in step rate as runners typically adopt a flatter foot strike affecting load to the lower leg. These are just some of the benefits that may occur with a cadence change.

How do I increase my cadence?

An easy way to start to alter your cadence is to run to a beat. Set an audible metronome to your desired step rate and match your foot speed to the beat. Metronomes are found in apps on smartphones and are available on some running watches. RUNCADENCE is an app that can help to identify your current cadence and determine your new cadence window. It is also equipped with a metronome to use while training. Another way to affect your step rate is to increase your arm swing while running. This should cause a reciprocal increase in foot speed.

How do I start?

Practice your goal cadence during your run workouts. Remember, if you run a 9 minute mile pace, keep your 9 minute mile pace, just increase the steps you take per minute—think of “turning your feet over faster”. Start with a 5% increase above your preferred step rate. Practice your new step rate for 30 second intervals and work up to 1, 2, 3 minute bouts over a training session. Give yourself at least 6 weeks to master this task!

Increasing your step rate while maintaining your preferred running speed has been shown in the research to reduce loads to the areas of the body most often injured with running. Cadence alteration is just one of many tools that can be incorporated into a running treatment plan. Learn more about how to improve your run form with a one-on-one Run Assessment.

Why Do I Pee When I Cough, Laugh or Sneeze?

pelvic health pee when i cough laugh sneeze physical therapy

One common question we hear from our Women’s Health Physical Therapy patients is: why do I pee when I cough, laugh or sneeze? Is this normal? While this occurrence may be common, it’s not something you should have to accept and learn to live with. Urinary incontinence, or the loss of control of your bladder, is a condition that may be a sign of weakened muscles in the core and pelvic floor.

urinary incontinence physical therapy pelvic floor dysfunction

When we cough, laugh or sneeze, there is an increase in intra-abdominal pressure which causes our diaphragm to contract down into the area of our bladder. If the bladder can’t withstand that pressure, it causes you to urinate unintentionally, aka “leakage”. We tend to over-utilize our abdominal muscles to compensate for weakened pelvic floor muscles. The good news in all of this is that physical therapy can actually help to strengthen the core and pelvic floor muscles that are responsible for holding up the bladder, thus, preventing leaks.

For patients suffering from urinary incontinence or other symptoms related to weakened core and pelvic floor muscles, physical therapy provides minimally invasive, one-on-one treatments to help strengthen those muscles and address any functional limitations. Just like any other condition treated by physical therapy, we can address the unique musculoskeletal problems of this region and also provide preventative services to keep this issue from ever coming back.

If you’re experiencing symptoms of urinary incontinence or any other issues associated with the pelvic floor, contact one of our physical therapists today.

Why Every New Mom Should See a Physical Therapist

mother physical therapy baby postpartum

After a new mother has her child, issues with stretching, back stiffness and weakened muscles in the core and pelvic floor require attention to ensure that the body returns to a state in which it can function normally and without pain. Our physical therapists work with postpartum women to strengthen pelvic floor muscles and develop custom therapeutic exercise programs to repair and restore these areas that have undergone so much change.

When pregnant, stiffness in the thoracic spine, or upper back area, may occur as a result of the anterior movement of the baby essentially pulling you forward. Stretching in the abdomen and pelvic floor can also result in weakened muscles in the pelvic floor though luckily these issues can be resolved with physical therapy. Your PT will work with you to improve the strength and stability of these muscles to repair stretching and ensure that you’re not at risk for back pain.

Common pelvic floor conditions for new moms can include incontinence and prolapse (which occurs when an organ in the body slips forward or down). Your PT can help to build your pelvic floor back up and restore the foundation of your body so you can resume life healthy as ever. Visit our Women’s Health Physical Therapy page to learn more about our pre- and post-partum services and to understand how we can help you address your unique pelvic musculoskeletal issues to improve your quality of life.

March Madness

marching drills runner run training running

As triathletes, we spend time in the water doing endless drills to help improve our swim technique. We also prioritize single leg drills while cycling to enhance our pedal stroke efficiency. But what about running?

Running requires coordination, balance, motor control, rhythm and timing. Just like swimming and cycling, our running form is worthy of attention. Try this marching drill with these key factors in mind:

1. Maintain tall, upright posture
2. Perform reciprocal arm swing
3. Land with soft, flat foot
4. Do not grip floor with toes
5. Avoid excessive wobbling

Perform marching drill 1 to 3 minutes before and after your run sessions. To increase the challenge and progress this drill, keep your step rate in line with a metronome. Utilizing an external cue with varying beats can challenge coordination and movement adaptation. Metronome apps are available and easy to use on a smartphone. Start at 30 beats per minute (bpm) and increase by 15 bpm at a time. Spend 1-2 minutes at 3-4 different speeds at least twice a week.

30 Beats Per Minute:


45 Beats Per Minute:


60 Beats Per Minute:



Your running technique can benefit from drills that help foster improvements in single leg balance, control, and coordination of movement. Join March Madness and start incorporating some marching drills into your weekly routine.

4 Exercises for Neck and Upper Back Pain

neck-pain-back-pain-relief-posture-workplace-exercises

Neck and upper back pain are commonly reported medical conditions in the United States caused by a variety of factors that affect the muscles and ligaments around the base of the skull. The pain can be quite limiting and can cause considerable stress on the muscles in this area. For sedentary workers, poor posture in the workplace can be a big contributor to these pain symptoms and is often a tough habit to break.

Take a few minutes each day to fight back with these neck and upper back exercises:

Upper Trap Stretch

The Upper Trap Stretch helps to stretch and relax the muscle between your shoulder and neck. When tight, this muscle can cause pain and limited range of motion.

1. Slowly tilt your head to one side and hold for 5-10 seconds.
2. Repeat on the opposite side.

Levator Scapulae Stretch

The levator scapula runs along the back and side of the neck and attaches to the shoulder. It functions primarily to help the head and neck rotate and bend to the side.

1. Gently turn your head to a 45 degree angle. Bring your nose to your armpit.
2. Repeat on the opposite side.

Chin Tuck

The Chin Tuck is an effective exercise for combatting neck pain as it helps to strengthen the muscles that pull the head back into alignment over the shoulders. It can also help you to develop good postural habits.

1. Tuck your chin for 2 seconds and then relax.
2. Repeat 8-10 times.

Wall Angels

Wall Angels help to keep poor posture at bay by combatting muscle tightness and weakness.

1. Stand up straight, making sure that your shoulder, elbows, and bottom are touching a wall.
2. Keep your shoulders back as you use your arms to mimic the motion of a “snow angel”.

For more information, visit our pages on Neck Pain Physical Therapy and Back Pain Physical Therapy

Urge Incontinence & Bladder Irritants

bladder-urgency-overactive-bladder-irritants-urge-incontinence

Urge Incontinence is a problem with the bladder that causes you to feel like you have to go to the bathroom suddenly, when really you don’t need to. But why does this occur?

While it could be based on a number of factors, one of the big things that we consider are bladder irritants—certain foods and beverages that can actually contribute to the irritation of the bladder lining, which normally protects the bladder from toxic contents in urine. “The Four Cs” is a helpful rule to remember when considering bladder irritants.

The Four Cs
• Citrus: Fruits like oranges and limes contain high amounts of citric acid which can worsen bladder control.
• Caffeine: Beverages like coffee and tea can increase bladder activity and contribute to higher urgency and frequency of urination.
• Cocktails: Any type of alcoholic beverage will irritate the bladder and also act as a diuretic, increasing urinary frequency.
• Carbonation: Beverages like soda (which often also contains caffeine) has been shown to worsen incontinence symptoms.

Pay attention when you have these things and if you notice an increased urge following, take note of that and consider making changes to your diet.

Visit our Women’s Health Physical Therapy page for more information.

Office Ergonomics: Simple Tips to Keep Moving Throughout the Day

sitting-office-neck-pain-back-pain-shoulder-pain

For those who work at an office job, sitting at a desk all day is pretty unavoidable. As most people come to find out, long periods of inactivity day after day isn’t the best thing for our joints and can lead to neck pain, shoulder pain and back pain. Therapydia physical therapist Michelle Fell, PT, offers a few simple tips to keep us all moving throughout the day.

• Park far away from your building to get a brisk walk in before and after work
• Take the stairs instead of the elevator
• Bring a water bottle to work and make yourself get up throughout the day to fill it up at the water fountain. Hydration and movement, great!
• Set a timer to remind yourself to stand up throughout the day and move around!

Visit our Resources page for more information on how to avoid neck pain, shoulder pain and back pain.

Female Bladder Urgency: What’s Normal?

female-bladder-overactive-urinary-urgency

At Therapydia NOLA, our physical therapists address the unique musculoskeletal problems of the pelvic region to help and treat any functional limitations and also offer preventative services. As part of our Women’s Health Physical Therapy services, we field a lot of questions surrounding bathroom norms, urinary urgency and overactive bladders. Below are just a few things to remember when it comes to daily bathroom use:

When it comes to voiding, how many times should I be using the bathroom in a day?
Normally, you should use the restroom around 5-8 times per day.

How much water should I drink in a day?
To figure out how much fluid you should intake each day, take your body weight and divide that number by two. This amount of water in ounces that you should aim to intake each day.

For example: If you weigh 150 pounds: 150/2=75. You should be drinking at least 75 ounces of water per day.

For women, remember to always sit and to never push when voiding.
The pelvic floor is a group of muscles. Everything exits through here. We want these muscles to be relaxed in order to promote healthy habits.

Never “just in case” pee.
Everyone has a different tolerance within their bladders as far as how much it stretches. If you use the bathroom all the time throughout the day, this “just in case peeing” is teaching your bladder to tell you that you need to urinate when really you don’t need to.

For more about our Women’s Health Physical Therapy services, visit: Women’s Health Pelvic Floor Therapy