better movement

Standing Firm - Why it sometimes hurts to stand from sitting?

The sit-to-stand (STS) is a test used to measure lower-limb strength in older people or those with significant weakness (1). 

It is considered an easy, quick and fairly valid measure, which involves measuring the time taken to stand from a seated position a certain number of times, or recording the number of repetitions you can do in a given period (2).

The findings of recent studies suggest performance in this test is influenced not just by factors associated with strength, but also balance and mobility, and a vast array of psychological factors (1).

But what about when sit-to-stand hurts?

Low back pain can reduce spine, hip and pelvic floor motion due to conscious or unconscious guarding associated with pain (3). 

Multiple studies have shown there are changes in how energy is transferred between bone and soft tissue in the spine, pelvis, and legs associated with pain (4).  And that inefficient energy flow or transfer then places more demand from everything.  A cycle of back pain-altered biomechanics can start, creating more back pain. With all the changes in energy transfer and muscle power, everyday activities such as standing up from a sitting position can become difficult.  

Muscle coordination, balance and mobility are affected, and psychological factors start to play in and effect our beliefs and so the cycle continues (1).

Stopping the cycle can be easy. 

You just bypass your traditional route to standing and try something different altogether. 

Try these simple tips.  You may not need all of them:

RELAX before you start

WIDER STANCE - think SUMO wrestler

SLOW DOWN (TIMING) - move more slowly

HANDS ON KNEES

BREATHE OUT - this is a big one.  The less compression in the container of the torso the better. 


Many people are surprised they can suddenly sit-to-stand with no pain after weeks or months experiencing twinges and outright muscle spasms when trying to stand after sitting.  


After a few days of pain free sit-to-stand, you can try heading back to your old ways as there is rarely a “right” way to do something.  You can get up and down any way you choose, each one of them equally valid. 


As a lot of research shows, the way you do something does start to matter. If you always get up and down via your arm on the desk, leaning forward to create momentum, it means the strengths necessary to do it another way are waning. 

Can this help if I have pain elsewhere?


This can also break the cycle if you experience pain in hips, knees and feet.


references


1. J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M539-43. Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. Lord SR1, Murray SM, Chapman K, Munro B, Tiedemann A.


2. Exp Gerontol. 2018 Oct 2;112:38-43. doi: 10.1016/j.exger.2018.08.006. Epub 2018 Sep 1. The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people. Alcazar J1, Losa-Reyna J2, Rodriguez-Lopez C1, Alfaro-Acha A3, Rodriguez-Mañas L4, Ara I1, García-García FJ5, Alegre LM6. 

3. Explain Pain Supercharged G. Lorimer Moseley and David S.
Butler. Adelaide City West: NOI Group Publishers, 2017. ISBN: 978-0-6480227-0-1

4. Gary L. Shum, PhD, et al. Energy Transfer Across the Lumbosacral and Lower-Extremity Joints in Patients with Low Back Pain During Sit-to-Stand. In Archives of Physical Medicine and Rehabilitation. January 2009. Vol. 90. No. 1. Pp. 127-135.

Morning, I'm Broken!

We all know we feel better physically, emotionally and psychologically if we’ve taken the time to exercise in the morning but how do we reduce the general ache and stiffness that many of us feel before we even get out of bed?

The main thing people consult an osteopath for is pain.  Pain in their low back, between their shoulder blades and in their neck.

But a frequent complaint in practice is people reporting a general feeling of stiffness or ache in all sorts of places when they try to leave their beds of a morning. So while the good news is you aren’t woken with pain in the night, the moans and groans start when you haul yourself out of bed. And it can be enough to wake your partner, or the dog.

Is there any research on this?

There was nothing focused in the literature about whether stiffness improves with exercise, and certainly nothing as specific as morning stiffness. Although this may be because no one asked the question in an original study (i.e. it wasn’t set as a specific outcome for the population being studied).      

An educated guess…

Waking with stiffness would be due mostly to your body trying to adapt to new behaviours or resting postures you’d get out of given the chance if you were awake.

Examples of the types of things that might cause stiffness in your neck:

Stomach sleeping

Bingeing on Netflix in bed with a laptop

Long long hours at a computer

Long drives on straight roads

 

Examples of the types of things that might cause stiffness in your low back:

See above

 

Examples of the types of things that might cause stiffness in your feet and achilles:

Standing for long periods (cooking, ironing, gallery walking)

New exercises or an increase to new exercises (skipping, golfing, new shoes)

Or just good old DOMS the day or two after a workout at the gym

What exactly will you be mobilising? 

There is no exactly about it….you’ll be mobilising nerves, muscles, tubes, connective tissue, all manner of fluids including sparking up your brain juices.

A word of caution in the mornings.

Your nervous system is a bit protective of itself when we first wake up, as anyone who has ever done yoga before 6am will attest. That burning tightness behind your knees is not your hamstrings it’s actually your sciatic nerve letting you know it does not appreciate being pulled quite so aggressively before the sun has even risen.

Give it a fortnight.

It might take a while to tell if your body is going to love a new regime but in the meantime you can reward your mornings with these mobilisations:

 

ACHILLES and FEET stiff when you stand on them in the mornings? 

Prancing with straight legs

Heel to toe

Holding onto the door frame squat

 

If your low back stiff in the mornings?

Try this series of movements: 

LB twist 

 

Knees to chest

 

Cat/Camel

Child Pose with Lateral Flexion 

 

 

UPPER BACK and NECK stiffness in the mornings?

Sidelying bow and arrow

Neck slider/shoulder shrugs

 

 

 

All our mobilisations will be available on our BLOG this month. 

So make yourself a morning routine that suits you.

Share these tips and tricks to put some spring in someone else’s step this August.  

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