Could Sit Ups Make Your Back Worse?

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Hey, guys!

It’s Dr. David here at El Paso Manual Physical Therapy

We hear from clients all the time that they’ve been told by somebody somewhere down the line that sit-ups are bad for your back and they’ve probably felt pain when doing sit-ups or after doing sit-ups.

The thing is it’s not that sit-ups are bad for your back. Its that the way you might be doing sit-ups is bad for your back.

We want to clear it up for you guys.

Here is the right way, one of the best ways to do a sit up and it’s not the only way.

There are tons of ways.

An important thing to know about the way that you’re doing sit-ups is that there are three primary muscle groups that you use to accomplish a sit up or any type of ab exercise.

There’s upper abs, lower abs and then your hip flexors which are in the front of the hip here into the thigh a little bit.

You use all those muscles to perform that sit up motion.

But, when you’re trying to help your back problem by doing sit-ups, you usually need to get the lower ab stronger, the ones that are right below your belly button.

There’s a quick little trick that you can do that cleans up a lot of bad form on sit-ups.

Let me show you real quick.

This is the way that I like to do sit-ups.

You’re just going to lie flat, arms all the way up, feet flat just like so and here’s the trick.

You got to flatten out your low back so you got to push down right here.

Then once you hold that down, then come up from right there and you would do as many reps or sets as you desire to do.

But you got to focus on feeling your lower abdominals below the belly button work harder than anything else.

Now the reason why I don’t like you to have somebody hold down your feet or pin your feet under something is because that forces you to use your hip flexors more because you’re using your legs to stabilize and makes you cheat on using your lower abs so you miss using your lower abs because you’re using your hip flexors.

If you always train like that, you do your ab work like that, you’re actually training your hip flexors and it can definitely lead to a back problem.

Guys, if you’ve got a low back problem and you’re looking to do some ab exercises, some core exercises to treat the back problem, make sure you target those lower abs.

I hope this helps, guys.

Have a wonderful day.

How To Pick The Right Pillow For Neck & Shoulder Pain


Hey there, welcome to The Stay Healthy El Paso Podcast, I'm your host, Dr. David Middaugh, I'm a specialist physical therapist over at El Paso Manual Physical Therapy. And we're going to be answering the question today about how to choose the best pillow for a neck and shoulder pain problem.

We have so many clients here in the clinic that are wondering, they ask us all the time, what's the best pillow for me to have, should I get a polyester filled pillow, or feather pillow that I found this pillow online that cost $300 I found this other pillow at the store that cost 20 bucks. And we have all kinds of mixed answers and results.

The fact of the matter is, it's very confusing, there are so many options. And depending on what kind of neck and shoulder problem each individual has, you want to approach it differently. And it's more than just the pill of a pillow. It really is a tiny factor. But it is a factor and it can make a difference. So we want to talk about it in this podcast for you today.

Let’s break this down. The number one question you got to start with is what is your preferred sleeping position? Are you more of a side sleeper? Do you sleep on your back? Or do you tend to sleep on your stomach?

Now whenever I asked that question, the first answer I get is a little bit of everything. Sometimes I start on my side, and I end up on my back. I started on my stomach and then end up on my side. Or I started on my back and then end up on my stomach. We get all kinds of mixed things. And what I’ll go with is, where do you start usually? Where do you start to fall asleep? How do you get most comfortable? That is what I would look to optimize for.

So, if you’re a back sleeper, if you start sleeping on your back, then you have to consider whenever you lie on your back, how rounded is your back, how soft is your mattress, and how far up from the bed is your head. In other words, if your back is kind of flat, you have a flatter back and you lie down and your head’s kind of comfortable on the bed, then you might even be able to get away with no pillow or a thin pillow. You might not need the thickest pillow ever.

But if you have a rounded back because you’re naturally are kind of there. There are some people that are naturally there, and you’d like to sleep on your back then you’re going to need a thicker pillow, because what you’re looking to do is fill that space between your head and the bed whenever you lie down.

That’s the critical key component here, because what you need to do is rest your spine, rest your neck and upper back without letting your neck hang backwards, or putting excessive pressure through your spine, your upper back area. Whenever you lie back, you’re looking to fill that space between your head and the bed whenever you’re on your back.

It’s a similar concept for when you’re on your side. If you go lie down your side, now there’s a space between where your shoulder hits the bed and your head, there’s going to be that gap between either your head and the bed and it’s taken up by that space between your shoulder and your neck. So, you’re looking to get a pillow if you’re a side sleeper that fills that gap that tends to be a thicker pillow than if you’re a back sleeper.

You just have to consider the sizes of it and the thickness of the pillow and also how much it gives because some pillows are real thick, but you put your head on and then you sink down quite a bit so it ends up kind of being thin whenever you actually lie down on it. You have to just feel them whenever you go purchase a pillow and see what’s best for you.

If you’re a stomach sleeper, then it can get a little confusing because if you’re the type of stomach sleeper that you put your arm across your face and your heads turn to the side, then you probably don’t need the thickest pillow or maybe you want a pillow to hug, because some sleepers tend to not sleep completely flat, they’re kind of at an angle. So you need a pillow under your chest or shoulder and you’re going to be turned off to the side so you don’t need the thickest pillow for that situation.

Now some stomach sleepers are really more of a side sleeper but are towards their stomach. So that’s a situation where you might need an even thicker pillow. So you have to consider how far away your head is from the bed in this situation.

The next thing you want to consider is the filling of the pillow. You want to generally avoid the lumpy materials. The lumpy materials are going to be polyester and feathers or down is the other term that you’ll see on pillow labels. The reason for avoiding the lumpiness is because if you’re having a neck and shoulder problem, chances are you’re going to be tossing and turning at night, probably subconsciously. You’re not going to be even awake while you’re doing it.

And if you got this lumpy pillow that you’ve been able to manage whenever you’re not hurting because you can kind of just shove the pole together and get the all the polyester all the feathers together in one spot and put your head on there and you sleep through the night for the most part or if you wake up, you can do it again. But now you’ve got this neck and shoulder problem.

You want to get good quality rest so you want the entire pillow to be about the same cushion You want to avoid having those lumpy materials like down and polyester feathers, because when you roll around those lumps will be in position when you first start to go into sleep, but whenever you’re starting to wake up and move around because your neck and shoulders are hurting you, then you’re probably going to roll off those lumps and you’re not going to get the best quality sleep you want to make sure that the amount of cushion is evenly distributed, and not just a lump in one area where you started the night.

The third factor here is considered having multiple pillows for different sleeping positions, because you might start out on your back and you might need a thinner pillow in that instance, and mid in the middle of the night you might turn on your side and in now you need a thicker pillow because the gap between the bed in your head while you’re on your side from your shoulder is bigger than when you lie on your back.

A thicker pillow that sustains its thickness is the best thing at that point. The general idea is you want your spine to be straight. So if you lie on your side, you don’t want your head hanging down towards the bed and your neck bending sideways. That’s not going to be very good on your neck, especially if it’s irritated in the shoulder as well. It’s going to put more pressure on the shoulder and it’s going to stretch out the tissues on the opposite shoulder that’s up from the bed.

It’s just not a good situation to have your head hanging downwards. So get a thicker pillow and a thinner pillow. Now we here at the clinic have custom pillows, we have a special pillow called pillow wise. And they come in six different sizes, they have different colored trim on them to indicate the sizes and they’re shaped differently on each end. On one end, they’re thinner, and on the other end, they’re thicker. And they are made out of memory foam so that they can evenly distribute the weight of your head or your soldiers, whatever you’re resting on here.

They’re designed so that when you lie on your back, you can lie down on the thinner end and it’s not pushing your head up so much and pushing your neck out of alignment. Or if you lie on your side, you can flip the pillow around and lie on the thicker end, so that it fills that gap between your shoulder and your, between the bed and your head where your shoulders pushing your head away from the bed more.

And depending on how broad your shoulders are, depending on your genetics, your exact sleeping position, because if you’re not directly on your side, then you’re kind of more leaning towards your back or leaning towards the front than you you’re going to want a thinner pillow because your head’s going to be closer to the bed.

Here in the clinic, these pillows that we have, there are six sizes, and we custom fit each patient to them, each patient that needs to get a pillow. Based on measurements, we actually measure their neck circumference we measure the distance from their head to their shoulder. And then we take other factors into consideration as far as how they sleep. We ask them a lot of these questions that I’m talking through with you right now so that we can best fit them to the pillow, and we found amazing results.

And I just want to give you the caveats here. The results are great and that the patients are getting better quality sleep. But we’re not solving a neck and shoulder problem. Pillows don’t solve neck and shoulder problems, they merely allow you to get better sleep, which is critical if you’re dealing with a neck and shoulder problem. Because the more you sleep, the better you can heal. And of course, the less grumpy you are and the overall healthier. You’ll be on other ends of your health, not just your neck and shoulder problem your immune systems I’m getting at.

If you get good quality sleep, you’re putting yourself in a better position overall to fix the neck and shoulder problem. But if you’ve got a rotator cuff tear and arthritis problem, a pinched nerve, or other issues that can affect the neck and shoulder, then this pillow type that we offer here, the pillows that I’m describing that you might go find at the store are not going to solve it. There’s usually some underlying root cause problem of muscle imbalance, some joints that are stuck, some other issues that need to be addressed so that your sleep can get better at night.

Think of it this way, if you fell, and hopefully this doesn’t ever happen to you. But if you fell really bad and skinned your knee on concrete or road or something like that, and you just had this massive road rash, let’s say you have like a six inch circle of road rash on your knee. It would hurt tremendously. Obviously, it would hurt even if you stayed still, if you were just lying down in bed at night, and you just had Road Rash earlier that day. Your knee would probably throb and hurt. And that’s just how it’s going to happen.

That doesn’t mean that you need a special pillow for it necessarily. It’s healing right now. So you just need to give it time and it will heal as it scabs over, as it goes through the healing process and eventually develop a scar and your skin is fine and your knees fine. Then it’s not going to bother you anymore. You don’t have to worry about it. But while it’s healing, it’s going to kind of bother you.

People that have rotator cuff tears, or arthritis problems in their neck or pinched nerves, it’s kind of like they have a fresh injury like that Road Rash example that I’m telling you about. And it’s just going to hurt and throb no matter what at night. So what you’re looking for is getting in the most comfortable position possible so that you can get sleep. But what you have to be doing simultaneously is figuring out how to solve that pinched nerve, arthritis, rotator cuff tear or other neck and shoulder problem during the day so that it’s not getting so irritated during the day so that at night, you’re able to rest better.

It matters more what you do during the day to solve your neck and shoulder problems so that your sleeping can become better and better over time. I just want to make sure that you’re approaching this correctly, because we get patients in here all the time that swear, they need a better pillow or even a mattress and they even go spend quite a bit of money on it. Which is fine if you needed a mattress or pillow.

Anyway, I’m not stopping you from doing it. I just want you to do it for the right reason, make sure that you’re looking to get it fixed. I want you to be in a situation where you don’t have to have surgery and having to rely on medications to go to sleep at night, or pain medications to get through the night. It’s not a healthy thing for you to be doing. You need to solve that that problem, the root of the problem, and it’s usually done while you’re awake.

So that being said, choose your pills wisely. Make sure that you understand that you’re just looking at getting that extra hour or two of quality sleep. You’re not looking to solve the whole neck problem or the whole shoulder problem.

Thanks for listening to our podcast, guys. If you're interested in what our pillows are like, they're not on our website, we don't sell them online. And we can't really, the maker doesn't even sell them online to the public. They have to be purchased through a medical office like a physical therapist’s office like ours. So, if you're looking up our pillows, they're called pillowise. So you can just go to pillowise.com or Google pillowise and you'll find our pillows and kind of how they work and they're pretty nice, they're there.

They're pretty high-end phenomenal pillows, we love them all our patients that have bought them love them. When patients buy multiples, often just because they want to you know want in their RV, when they're at their home, when at their guests room for their spouse. Oftentimes spouses come in and buy one because they get to try it out as well. And they really like it and they want their size pillow because they're all custom fitted for each individual's sleeping preferences in size their neck and shoulder size.

So anyways, you can call our office at 915-503-1314 to set up a time to come in and get fitted for a pillow if you if you wanted to do that. Our staff has special training on how to fit you for the pillow. And then also what I recommend is getting a discovery visit during which physical therapists can check your neck and shoulder problem out to make sure that you have all the information necessary to properly address your neck and shoulder problem.

We're not talking about certain treatment at this point, just knowing what's going on with your shoulder and neck problems so that you can have a better expectation of how this pillow can help you out and how to properly use the pillow what to expect with the pillow regarding your neck and shoulder problem.

Anyways, if you found this podcast was helpful for you, please give us five stars on whatever platform you're listening to this on. That helps us get this podcast out to people that potentially need our help people that want to get better in their health and just are trying to figure this out and learn how. So you'd be helping them out. I could care less about it for my ego for my sake. I want the people to get the help they need so please give us five-star reviews so that they can get help. We'll talk soon again. Have a great day.

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