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Rehabilitation

The Shoulder

About 12.3 million people went to the doctor's office in 2002 for a shoulder problem, including 4.2 million visits for shoulder and upper arm sprains and strains.

Shoulder injuries can be caused by sports activities that involve excessive overhead motion like swimming, tennis, pitching and weightlifting. People involved in everyday activities like washing walls, hanging curtains, and gardening also can get shoulder injuries due to excessive overhead arm motion.

Athletes are especially susceptible to shoulder problems. A shoulder problem can develop slowly in athletes through repetitive, intensive training routines.

 

Low Back Pain

The lower back is an elegant construction of bone, muscle, and ligament. Because the lower back is the hinge between the upper and lower body, it is especially vulnerable to injury when you are lifting, reaching, or twisting. When low back pain strikes, we become acutely aware of just how much we rely on a flexible, strong back. Ironically, most of us don't think of the importance of keeping our back and stomach muscles strong until we have back trouble.

See an illustration of the lower back (lumbosacral region of the spine)

Spine_Lumbosacral Region

Up to 85% of all people have low back pain at one time or another. Each year, about 2% of American workers are compensated for disability caused by back pain.1 Low back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine. Less commonly, low back pain is caused by illness or spinal deformity.

 

Exercise, Return to Activity Helps Back Pain

By Salynn Boyles
WebMD Medical News
Reviewed By Michael Smith, MD

Got Back Pain? Assess Your Options

Low Back Pain Shouldn't Sideline You

Sign Up for the Chronic Pain Newsletter

June 9, 2005 -- Low back pain is one of the most common and difficult-to-treat medical complaints among adults. Treatment often includes physical therapy, but new research shows that a hands-off educational and behavioral approach to pain management works just as well.

Researchers say people in the study who suffered from short-duration low back pain responded well to counseling programs that explored their attitudes toward pain and urged them to exercise and resume routine activities despite their discomfort.

 

Relieving Low-Back Pain With Exercise

Brian Shiple, DO; Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE

If you suffer from low-back pain, the most important part of your treatment is something only you can give yourself: exercise. Regular workouts make pain go away faster. By strengthening the muscles that support your back and improving your back's flexibility, exercise reduces the chances of another acute attack.

A full program has two parts. The first component is aerobic exercise to get your whole body in good condition (aerobic exercise like walking or biking uses large muscles and gets your heart and breathing rates up). The second component is specific exercises designed to strengthen your back muscles and increase or maintain flexibility. Your doctor will tell you when to begin each type of exercise.

 

How to Save Your Back

Always try to maintain the natural curves in your back.

These curves provide strength and support for your back. This is especially important when lifting or when sitting for long periods.

Hinge at your hips and bend your knees when lifting.

You should be doing most of the work with your legs rather than with your back! Placing your feet shoulder-width apart will help you stay balanced. A wider stance can also help if you have difficulty bending your knees.

Tighten your stomach muscles before you lift.

They help support and stabilize your back when you lift.

 

Rehab Equals Surgery for Low Back Pain

HealthDay News -- British researchers have found no clear evidence that spinal fusion surgery for chronic low back pain is better than intensive rehabilitation in relieving discomfort.

What's more, these surgeries may not be as cost-effective as other interventions, the researchers added.

Published online May 23 in the British Medical Journal, the study included 349 people with chronic low back pain, defined as pain lasting more than a year. Patients were divided into two groups: 176 underwent spinal fusion surgery and 173 were enrolled in an intensive rehabilitation program that involved daily exercises and cognitive (mental) behavior therapy.

 

Efficacy of Ergonomics

Historically, Ergonomics was another name for Human Factors. Today, Ergonomics commonly refers to designing work environments for maximizing safety and efficiency. Biometrics and Anthropometrics play a key role in this use of the word Ergonomics. Engineering Psychology often has a specialty dealing with Workplace or Occupational Ergonomics.

Companies once thought that there was a bottom-line tradeoff between safety and efficiency. Now they embrace ergonomics because they have learned that designing a safe work environment can also result in greater efficiency and productivity. Recently, U.S. laws requiring a safe work environment have stimulated great interest in Workplace Ergonomics - from ergonomic furniture to ergonomic training. But it is in the design of the workplace as a whole where the greatest impact can be seen for both safety and efficiency.

 

How "Core Stability" can protect your back

Modern life for most of us has meant a steady reduction in physical activity and an increasing sedentary lifestyle. This has been due to a decrease in manual labour, the increase in labour-saving devices and the rise of more passive entertainments such as computer games and television. Unfortunately this means that once strong muscle systems that helped us maintain good posture and movement while helping us avoid injury have grown weak through lack of use and exercise. In short we have reduced our "core stability".

What is "core stability"?

Core stability and sports

 

Low Back Pain Exercise Guide

Regular exercises to restore the strength of your back and a gradual return to everyday activities are important for your full recovery. Your orthopaedic surgeon and physical therapist may recommend that you exercise 10 to 30 minutes a day one to three times a day during your early recovery. They may suggest some of the following exercises. This guide can help you better understand your exercise and activity program, supervised by your therapist and orthopaedic surgeon.

Initial Exercise Program

Ankle Pumps - Lie on your back. Move ankles up and down.
Repeat 10 times.

Heel Slides - Lie on your back. Slowly bend and straighten knee.

 

Back pain at work: Strategies to prevent aches, pains and injuries

By Mayo Clinic staff

Whether it's dull and annoying or screaming for attention, back pain can make it hard to concentrate on your job.

Many occupations — such as nursing, construction or factory work — place significant demands on your back. Even routine office work can worsen back pain if you fall into risky habits.

But you can avoid back pain and injuries by paying attention to what causes them and focusing on prevention.

What causes back injuries?

Doctors and scientists aren't sure about all of the causes of back injury. In fact, most back problems are probably the result of a combination of factors. Some factors, such as family history, aren't preventable. Other factors, such as weight, fitness and flexibility, can be controlled by changing your lifestyle. Still other factors are work related, and you may or may not be able to modify these to prevent injury.