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.

Natural Remedies To Start Healing A Rotator Cuff Tear


Welcome to the Stay Healthy El Paso Podcast. I'm your host, Dr. David, specialist, physical therapist over at El Paso Manual Physical Therapy. And today we're going to be covering the top seven natural remedies for rotator cuff injuries. Now many people get rotator cuff injuries all the time. It's one of the most common shoulder injuries that we see here in the clinic. That I think plagues Americans unfortunately, and what a lot of people don't know that it is becoming more and more popular.

We even have scientific research to prove this. It's becoming more popular to not have surgery for rotator cuff problems and heal naturally we're discovering how to really do this. Well. Now here at our clinic, we feel like we have an excellent handle on helping people escape having a surgery, we have a track record, actually, for people that have been scheduled for rotator cuff surgery. And they call us as a second opinion. We get them in here and we honestly tell them hey, you know if you want to have your surgery, by all means go ahead. But I think that we can help you out.

We'll screen them out, and if we can't, we'll tell them. But if we tell them that we can help them, then we'll recommend that they start out with a few visits. And if it's getting better than they have an excellent shot at recovering naturally. And so far we've had 100% success rate where we get people that have had rotator cuff tears diagnosed by MRIs, and they're on a surgeon scheduled to go have it operated on, and then they end up postponing that appointment initially. While they start therapy with us and then canceling it because they get back to doing what they want to do and that shoulder stops bothering them.

We're really proud of that and so happy that our clients are avoiding surgery and really getting hugely confident. I don't mean they're just not in pain anymore. I mean, we get these clients lifting weights up overhead, returning to doing all the exercises in a very active things that they're doing.

One of the clients we finished recently loves to shoot. She's a handgun sharpshooter. And she's one of the best in the region actually, and just picking up her weapon to draw her weapon was killing her shoulder. She's also very active at home doing gardening, taking care of the house, she's a grandma has tons of grandkids and loves to bake and host them and be part of the family. And she was having trouble sleeping at night not being her usual self because of her shoulder issues.

She couldn’t pick up her arm up overhead at the beginning. And that woman did phenomenal shoes picking up 10 pounds over a head without pain just muscles getting tired. But that was part of a rehab in order to make sure that that rotator cuff tear is healed and isn't going to tear again. She's strengthening all the other tissues around it and safely strengthening the rotator cuff that was involved the part of the rotator cuff that was involved.

So, let’s get into the top seven remedies that you can try out at home or wherever you are so that you can begin the process of healing this rotator cuff.

Problem number one, you’ve got to get that inflammation under control by using ice and heat.

Now with ice and heat, you want to get something called an ice pack that you can purchase at the grocery store or even just get a bunch of ice cubes into a bag and put that on your shoulder and get back pain under control. And for some people, they don’t tolerate ice too well, it makes it hurt more. That’s cool, then it may just be that you’re more of a heat person then an ice person.

The research is unclear as to whether you should start out with ice or heat. I say just pick a place to start. Ice is usually the go-to for a lot of people. But if it’s not working out for you, then go to heat.

Now with both of these, when you try them out, put it put that ice or heat on for 15 to 20 minutes, get the ice to numb your skin. That’s how you know you’ve had it on long enough and take it off for 15 to 20 minutes. Then slap it back on and cycle like that three or four times.

If the ice is going to work for you, you should feel some numbness in the area and feel okay. Now if you go to pick up your arm, it’s still going to hurt because you still have the injury there. But at least it numbed the pain so that you might avoid taking that pain medication. Same with heat, it might feel like it just calms it down or after the goal of using ice and heat is to just calm the pain down so that you can sleep better so you can avoid taking pain medication and possibly even avoid visiting the doctor and just be a little happier for a little short period of time. And it’s a natural thing. It’s not taking pain medication.

But it’s not going to heal your rotator cuff problem though, it’s just going to bring down the inflammation to put you in a position to then begin to do things that are going to actually heal it. In some situations, people don’t respond to either heat or ice. If you find that you’re one of those people don’t be surprised or worried or shocked. That does happen. And it’s okay, there’s other things for you to try out.

Number two, this is a rarely implemented thing that I think has massive benefits is go get yourself a shoulder sling.

If you know what I’m talking about, it’s those things that you see that support your elbow and your forearm It’s usually just a piece of cloth that they might give you at a hospital or an urgent care place, if you hurt your shoulder arm. Just so that you can rest your arm in and it’s got a strap that goes behind your shoulder and around your neck on the opposite side and attaches to that same piece of cloth.

That kind of cradles your arm. Go get yourself one of those at a grocery stores, you can order them online there’s many places where you can find them and slap it on and tighten it up real good so that it shoves your elbow up. And the reason why you want to do that is because if you’ve got a rotator cuff injury, whether you suspect you have one or you know that you have one because you went and had an MRI or somebody checked you out and said that they really think that you got a rotator cuff injury.

Wear that sling, especially when you’re more busy, say you’re doing chores at home, or you’re out work or you’re out and about where people might bump into you or not know that you’re injured. And what it’s going to do is force you to not move so much that you don’t inadvertently use that rotator cuff muscle that’s got a tear in the tendon and potentially aggravated and it’s if you shove it up real high to make sure you tighten that strap down so that it shows it up. It brings the ball into the socket better so that it takes some of the tension and pressure off the rotator cuff.

You want to do that really for as long as it takes. I’ve had some people use it for a couple of weeks and get some immense relief from the pain. It doesn’t solve everything. It doesn’t make them all the way better where they can move their arm confidently and all that, but it brings that inflammation down and calms the rotator cuff injury down so they can begin to do some other stuff to help out that shoulder problem throughout the whole process of recovering it.

But that sling can make a huge difference. It’s super cheap, you can find one for probably definitely under $20 maybe even one first cheap as $10 and it’s well worth, it’ll cost you a bottle of pain medication, but it’s completely natural. And you don’t have to have it on 100% of the time. You can take it off obviously to shower and do things but when you’re more busy is the time to put it on.

Some people will sleep in them. It’s up to you when it comes to sleep get comfortable because you need to get quality sleep fine pillows to position yourself and whether or not you’re on your back or on your side. But you don’t necessarily have to put on this sling, but you might find that it works for you. Try it out and see what works best.

Tip number three easy rotation.

Let me explain this, it’s kind of an exercise, it’s kind of not, it’s just a very simple movement. Lie down on your back, you’ll get on a bed or a couch or even on the floor, and stick your arm out to the side, the involved arm. Let’s say it’s your right shoulder that’s hurting you and lift your elbow out to the side so that your shoulders at about 90 degrees from your body. Then bend your elbow about 90 degrees in really slowly and gently.

Let your hand move towards your head. You’re rotating through your shoulder and then let it go down towards your feet with your maintaining your shoulder joint at about 90 degrees outside from your body and just rotate to the available range of motion because you might get stuck or it might hurt to don’t push into pain are you going to do is real gently rotate back and forth like that, and do that for a minute or two. And how we do this frequently, I do this four or five, six times a day.

In some cases, especially if it’s real severe, I’d go to do this hourly. As you’re bringing that inflammation down, what you’re doing is you’re causing rotator cuff muscles to stabilize your joint during that motion. The ones that are not involved are typically to take over that motion, it shouldn’t be like otherwise, if you start to do it fast, or forcefully. Like when you rotate down this way or this way, down or up for your feet or your head. It can overactive your rotator cuff muscles and begin to aggravate that tear.

But if you do it real gently, it doesn’t hurt, do it slow, don’t force it into an enraged position, then you’re going to be able to use a rotator cuff muscles that need to work to compensate and offload the one that is injured.

Doing that exercise can make a huge difference to bring down that inflammation and get to where you’re not so painful and you are able to do some more advanced exercises as that rotator cuff tendon heals.

Number four, a shrugging exercise makes a world of a difference.

In addition to that rotation exercise, what you can do is just sitting down or standing up wherever you are, whether it’s at home, at work, in the car, just sit there and shrug your shoulders all the way up, just like so. Typically, this is really easy on the shoulder joint because you’re not moving the ball and socket, you’re just bringing those shoulder joints up towards your ears.

Just make sure with your neck, that you don’t put your chin up forward. Like a turtle. You want to maintain your chin down even a bit kind of like a double chin position, of a slight double chin position, as you shrug. That will activate the shrugging muscles, the ones that can connect your neck to your shoulders and begin to offload the rotator cuff tendon as well out in the shoulder joints.

You can do that just as frequently as that rotation exercise you might do an hourly and the way to do it, to hold that shrug for 10 seconds, and I’ll repeat that 10 times in a row. You can take little breaks, a few seconds here and there, it should be kind of tiring. Honestly, you might even start to break a sweat as simple as that exercise looks, it’s pretty challenging for people that have had that have shoulder problems. So don’t be surprised if that happens.

You might even get sore in those muscles. Just don’t do it so intensely or aggressively that your neck starts to hurt, or your shoulder starts to hurt, ease off on the intensity, and you might not hold for the full 10 seconds. Also, if you’re having that problem, you can hold for less but work your way up to 10 second holds as you get better at doing that shrug exercise.

Tip number five, pulley exercises.

I’ve got a pulley here. This is what I mean by this. This is a very commonly used physical therapy tool. And you can find these at pretty much any physical therapy offices. You can buy them off of Amazon, and they’re fantastic for calming down rotator cuff problems. It’s just a rope with some nice handles on it like this. Then it’s got this pulley so that the rope can freely move side to side here.

They typically have this kind of a strap with this, this thickening at the top of it. So if you’re listening to this right now, just go to, when you get a chance, I want you to Google shoulder pulley and you’ll find exactly what I’m talking about, you’ll probably find places to buy real cheap, these shouldn’t cost you more than $20. I think we find out for under $10 in some places, and they’re fantastic.

What we’ll do is put this pulley on a door, slide a chair right in front of it, and you’re going to grab one handle on each hand with your good side, with your hand and shoulder that isn’t hurting you. Use that hand to pull your other hand up. So, when you pull your good hand down, because you’re holding the handle on the other side that rope, you are going to use the pulley and lift your other arm and try to have your shoulder that hurts completely relaxed.

Just hold on to that handle and let your hand travel upwards, up to where you feel just a teeny bit of pain or stretch. And then come right back down. Real slow and just go up and down nice and easy up and down and allow your shoulder joint to move.

This is a nice way, on your own, to begin to get the ball and socket joint to move more freely. Now if you’re super irritated and your soldiers hurting you quite a bit, this might be tough to do at the beginning, but if you’ve done some of the other tips that I’ve already mentioned, then it should calm down a bit enough for you to do this shoulder pulley exercise successfully. And you should find that you’re better able to raise your arm and use your shoulder without as much discomfort.

Now how long to use a pulley? I would go for a minimum of five minutes continuously. You could take little breaks but sit there and pull your arm up and down for five and I would go to 10 minutes and I would do this three times a day. I sometimes recommend patients do 30 to 40 even 60 minutes.

If they’re really limited in shoulder motion, and they’re not quite where I want them to be, in preparation to begin to do more active exercises, even weightlifting exercises. So, you might need to be on this pulley for weeks sometimes I’ve even had a couple patients that go two months into using the pulley, but it’s well worth it to allow that tendon to heal.

The patients that had to go longer have typically been diabetic. The thing with diabetes is it just slows down tissue healing times and especially with tendons it can heal quite slow. So expect if you got diabetes and you’ve got a rotator cuff tear, it’s expected your recovery to just last longer, but it is still possible. As long as you got those sugars under control, it’s still possible for you to heal rotator cuff problem.

Tip number six massage.

Massage can make a world of a difference in a rotator cuff problem. Now you just have to be careful when you go see your massage therapist or if you’re getting a massage at home from a family member or a spouse that the that they’re laying off of tender spots because you’re obviously going to have some tender spots in your shoulder.

Also, some massage therapists like to stretch out shoulder joints and arms and all that. So just tell them as well that that they can do that, but you got to be very cautious and slow when going to that involved shoulder. But getting the neck muscles up here, the upper trap muscles, the neck itself, massage the back and even the arm muscles can make a tremendous difference in getting you some more mobility in your shoulder.

So, don’t be afraid to call up a massage therapist or you already got one tell them what’s going on and do a little bit of research to find a massage therapist that is familiar with handling shoulder problems. If you can do that, then I think you’re going to be a step ahead. It might cost you just a bit more, but I think it’ll be well worth it for you.

Go get a massage and have them get you to relax and do a full body massage as well while you’re there. That’ll be nice.

Tip number seven, get to an expert physical therapist.

Now what we do here in the clinic is we form a plan we make sure to diagnose the problem correctly before that, and build a timeline for when we expect this rotator cuff problem to fully heal and get people to the point where they’re overly strong and they’re tremendously confident to make sure that this rotator cuff problem isn’t going to come back in six months or a year or two years. So they can know with confidence that they’re going to avoid visiting the surgeon’s office and not going to have to get injections or take pain medications.

Most importantly, so that if they get a little bit of flare up coming back, they know what to do to make sure that it they are strengthen their shoulder, move through their shoulder exercises, do all the things that we’ve talked about in therapy, and make sure to stave off that pain from stopping them from enjoying their life. Working with an expert physical therapist will make sure to all the hands-on work, move the ball and socket joints and sends that joint is stuck and not moving well.

Sometimes there are shoulder blade issues that need to be addressed many times there’s a neck issues that are also contributing to the shoulder problems, and then we talk about movement issues that a person has with their exercises or their daily activities or their hobbies or chores they like to do at home. And we can get into the nitty gritty and in that allows us to form a very detailed plan in progressing this issue.

Now if you’re one that you’ve got a rotator cuff problem, you know it, you’ve been told that you have one. And you may even have considered having surgery or the doctors recommending that you have surgery. And I strongly encourage you to call a specialist physical therapist right away and get it looked at get it thoroughly assessed and get a plan if you can get their opinion on whether or not you can avoid having a surgery.

Because if you do have to have surgery for this, of course, there’s risks associated with that. It can end up worse in some cases, but you’re going to have to go through physical therapy anyway. Because you had the surgery, the shoulder is all stiff and tight. So you need to go through physical therapy to free up the shoulder. But what a lot of patients don’t realize it in the surgery, they think well I went through physical therapy should not have a shoulder problem again.

But the focus is different when getting physical therapy for a rotator cuff tear if you avoid surgery versus having the surgery. So if you’ve gone through a surgery for a rotator cuff tear, and then you go to the through the physical therapy after that, the focus is just on getting your motion back so you can begin to use your shoulder. It’s typically not on preventing a rotator cuff problem from happening again.

And sadly, we see that all too often that patients go get a rotator cuff surgery gets better, they go through physical therapy, and then it’s just a matter of a year or two after that before the shoulder starts to hurt them again, and they’ve returned. And the reason that that happens is because they never learned how to properly strengthen their muscles, how to move better, how to change little things in their life to make sure that that shoulder is moving well, and the rotator cuff tenant is not getting overly compressed. And that’s just not something that’s focused on when you’re you just had surgery in your learning to just get the most back in your shoulder.

Now somebody is coming in to see us before having surgery, we’re looking at prevention, not just treating all the limitations that happen after surgery.

Well, thanks for listening to this podcast, I hope that these seven tips were helpful for you. If you're dealing with a rotator cuff problem right now, I know that you probably have an excellent shot at avoiding surgery and making sure that this problem goes away for good so that you're not dealing with this and on a recurring basis.

If you're looking for some expert help, and you're in the El Paso area, give us a call our number is 915-503-1314. Or you can also visit our website to learn more about us at www.EPmanualpt.com and hit the cost and availability form once you get there, and you'll be able to leave us for details so that we can reach out to you and begin to learn more about your rotator cuff problem.

Also if you know anybody else that's dealing with a potential rotator cuff problem or they've already been told they have a rotator cuff issue or worse yet, they had rotator cuff surgery and it's coming back unfortunately. Please share this podcast with them and let them know of these tips so that you might brighten their day and help them out in avoiding the neck surgery or avoiding surgery altogether.

And one more thing if you can do me a huge favor, and whatever podcast platform you're listening to this on, please leave us a five-star review. And leave us some detailed information about how this was helpful for you or how we how this benefited you so that we might get more listen abilities, the more people can check out our podcasts and get helped out with all these tips and resources. Thanks so much for listening, and we'll talk soon again. Bye. Have a great day.

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