Paediatric Lower Back Pain

By | Body Balance Quarterly | No Comments

The Body Balance Quarterly

A newsletter designed for the patients of Body Balance Health & Physiotherapy Inc. that addresses current rehabilitative methods and addresses the current questions people may have regarding Physiotherapy related “HOT TOPICS”.

 

Paediatric Lower Back Pain

It’s that time of year! The kids are back in school and the scheduling of homework, sports and other activities are in full mode. Lower back pain is one of the most common ailments/disabilities that people suffer from and its not just an injury faced by adults. The incidence of lower back pain in the paediatric population and the effects of lower back issues early in life can have resounding impacts later in life.

In this issue of the BBQ we will look at some recent studies to investigate the incidence, causes and recommendations to help parents deal with lower back pain in children and adolescents.

 Potential Risk Factors

Currently, one of the most common talked about risk factors for Paediatric lower back pain is a sedentary lifestyle. Part of the reason for this trend may be due to the increasingly sedentary lifestyle choices young people make. Below are four explanations of how your children’s decisions can contribute to their lower back pain.

  1. Weaker Supporting Muscles

A general lack of regular exercise gradually weakens muscles that support the spine, including the abdominal and iliopsoas muscles and the obliques, or side muscles. Weaker supporting muscles can place added strain on the joints and bones of the spine and affect posture.

  1. Increased Susceptibility to Injury

Children are more likely to sustain an injury when muscles aren’t conditioned to absorb the impact. A study of more than 300 children with lower back pain found those who had some type of physical therapy reported a greater reduction in pain than those who did not receive therapy.

  1. Excess Weight

A sedentary lifestyle often means an increase in weight beyond what’s ideal for a child’s height. Excess weight also means added pressure on the spine, which can throw off posture and affect bone growth. As a result, some children may develop hyper-lordosis, a condition where a slight spinal arch forms.

  1. Unhealthy Eating Habits

Being consistently inactive tends to translate into making unhealthy eating choices. Children need to maintain an optimal balance of essential nutrients to promote muscle strength and spine health.

Most instances of back-related aches in younger patients are related to muscle strain. However, it is always important to seek the advice of a Medical practioner when concerns arise regarding pain in the lower back. Knowing what to do and how to exercise is very important for children as preventative measures can be as simple as encouraging kids to participate in some type of physical activity for at least an hour a day.

SOURCE:   http://www.laspine.com/sedentary-lifestyle-leads-to-back-pain-in-children/

Those Heavy Backpacks!!

“Students carrying heavier backpacks relative to their body weight were more likely to report back pain,” write the researchers in the March/April 2004 issue of the Journal of Pediatric Orthopedics.

How much is too much? Pain was associated with wearing a backpack weighing more than 20% of the student’s body weight, write the researchers.

How Kids’ Backs Respond to Backpacks

A backpack is a great way for children to carry schoolbooks and other items in a practical way by distributing the heavy load across the strong back and shoulder muscles. However, when the back pack is overloaded the risk is injury to the neck, shoulders and lower back.

By overloading a backpack, the following compensations in the back can occur:

  • Distort the natural curves in the middle and lower back, causing muscle strain and irritation to the spine joints and the rib cage
  • Lead to rounding of the shoulders
  • Cause a person to lean forward, reducing balance and making it easier to fall
  • Habitually carrying backpacks over one shoulder will make muscles strain to compensate for the uneven weight distribution. The spine leans to the opposite side, stressing the middle back, ribs, and lower back more on one side than the other. This type of muscle imbalance can cause muscle strain, muscle spasm, and back pain in the short term and speed the development of back problems later in life if not corrected.
  • A heavy backpack can pull on the neck muscles, contributing to headache, shoulder pain, lower back pain and/or neck and arm pain.

“Although there are very few studies and the medical literature does not agree on specific guidelines for backpack safety to avoid back pain, parents can use common sense to reduce the chance that their child or teen will suffer back pain due to carrying a backpack.”

The following back pack features may help in the prevention of back stress and strain.

  • Lightweight material (canvas as opposed to leather)
  • Two padded, wide (2-inches), adjustable shoulder straps on the backpack
  • Padded back
  • Individualized compartments
  • Hip strap, waist belt, or frame to redistribute the weight of the backpack from the shoulders and back to the pelvis
  • Wheels so that the backpack can be pulled rather than carried
  • Consider using a separate bag for the child’s laptop or other heavier electronic items

Habits are important as well so it becomes just as important to teach your child how to properly load and wear the backpack to avoid back pain:

  • Always use both shoulder straps and wear the backpack on the back rather than over one shoulder
  • Pack heaviest objects into the backpack first so they are carried lower and closest to the body
  • Fill compartments so that the load is evenly distributed throughout the backpack and items do not shift during movement
  • Pack sharp or bulky objects in the backpack so they do not contact the back
  • Adjust the straps to fit the backpack snugly to the child’s body, holding the bottom of the backpack 2 inches above the waist and keeping the top just below the base of the skull; do not carry the backpack low near the buttocks
  • Lift the backpack by using the leg muscles and keeping it close to the body, not by bending over with arms extended and arching through the back.
  • Do not lean forward when walking; if this is necessary, there is too much weight in the backpack

Source:

https://www.spine-health.com/wellness/ergonomics/tips-prevent-back-pain-kids-backpacks

Less Common Causes of Back Pain in Children

Recent reviews of common causes of lower back pain in children found that the common causes of pain most often included postural related muscle strain and acute occurrences of sport/activity related muscle strain and less commonly included mechanical pain from pre-existing conditions. However, pre-existing conditions may not be as common but they typically involve more specific care and follow-up. One condition that we would like to review in this edition of the BBQ is Idiopathic Scoliosis in children and adolescents. The following information was obtained from an article that was an overview of articles from the Pediatric Orthopaedic Association of North America and the Scoliosis Research Society.

What is Scoliosis

Scoliosis is a condition that causes the spine to curve sideways. There are several different types of scoliosis that affect children and adolescents. By far, the most common type is “idiopathic,” which means the exact cause is not known.

Most cases of idiopathic scoliosis occur between age 10 and the time a child is fully grown. Scoliosis is rarely painful—small curves often go unnoticed by children and their parents, and are first detected during a school screening or at a regular check-up with the pediatrician.

In many cases, scoliosis curves are small and do not require treatment. Children with larger curves may need to wear a brace or have surgery to restore normal posture.

Description

Scoliosis causes the bones of the spine to twist or rotate so that instead of a straight line down the middle of the back, the spine looks more like the letter “C” or “S.” Scoliosis curves most commonly occur in the upper and middle back (thoracic spine). They can also develop in the lower back, and occasionally, will occur in both the upper and lower parts of the spine.

Idiopathic scoliosis curves vary in size, and mild curves are more common than larger curves. If a child is still growing, a scoliosis curve can worsen rapidly during a growth spurt. Although it can develop in toddlers and young children, idiopathic scoliosis most often begins during puberty. Both boys and girls can be affected, however, girls are more likely to develop larger curves that require medical care.

Other less common types of scoliosis include:

  • Congenital scoliosis. Problems in the spine sometimes develop before a baby is born. Babies with congenital scoliosis may have spinal bones that are not fully formed or are fused together.
  • Neuromuscular scoliosis. Medical conditions that affect the nerves and muscles, such as muscular dystrophy or cerebral palsy, can lead to scoliosis. These types of neuromuscular conditions can cause imbalance and weakness in the muscles that support the spine.

Cause

Although doctors do not know the exact cause of idiopathic scoliosis, they do know that it is not related to specific behaviors or activities — like carrying a heavy backpack or having poor posture. Research shows that in some cases genetics plays a role in the development of scoliosis. Approximately 30% of patients with adolescent idiopathic scoliosis have a family history of the condition.

Symptoms

Small curves often go unnoticed until a child hits a growth spurt during puberty and there are more obvious signs, such as:

  • Tilted, uneven shoulders, with one shoulder blade protruding more than the other
  • Prominence of the ribs on one side
  • Uneven waistline
  • One hip higher than the other

If your Health Care Provider suspects scoliosis, he or she may refer you to a pediatric orthopaedic surgeon for a full evaluation and treatment plan.

Health & Wellness Edition

By | Body Balance Quarterly | No Comments

BODY BALANCE QUARTERLY (The BBQ)

GOLF! GARDENING! EVENING WALKS!

HOW CAN YOU KEEP ENJOYING THESE ACTIVITIES LONGTERM? THE HEALTH AND WELLNESS ISSUE

READ ON………

Health and Wellness are at the forefront of most of our lives. Nobody wants to have aches and pains, or lack the energy and stamina that get in the way of us doing what we want to do.

I think we all can agree that staying active leads to better health; but we thought we would take this opportunity to update you on some of the most recent research about the benefits of exercise that you might not even know about.

What does the research say about: Exercise and…..

Osteoporosis

Research shows that exercise helps to build bone density and prevent fractures. The other benefits of exercising with this diagnosis is that it improves strength and flexibility to help with balance to prevent falls and subsequent bone fractures. You must remember that weight bearing exercises are recommended (this means that the activity must include some form of ground reaction force) instead of something like swimming, where there is no contact from the feet and the ground. It is important to avoid high impact activities or sports that involve quick accelerations or ballistic movements such as running, jumping, golf and tennis as these activities predispose you to a greater risk of having a fracture.

Parkinsons

With Parkinsons being a progressive disease, the goal of exercise in this population is to maintain independence and overall physical performance. Recent research supports that people with Parkinsons disease who exercise consistently have improved performance and ability to fulfill their normal activities of daily living. It is believed that this is due to improved signalling efficiency of the affected brain areas and other neuroprotective effects that exercise has for people with Parkinsons. Structured exercise programs where individuals are challenged beyond their own pace (to work at a more intense level) have been shown to be more effective than self-paced or lower intensity exercise efforts. Spin classes have recently been directed toward the younger Parkinson population as offering an appropriate challenge for these individuals. Following vigorous intensity cycling programs improvements in balance, gait and resting tremor have been seen among individuals in this population.

Cancer

Physical activity has beneficial effects across all phases of cancer. Exercise plays a significant role in risk reduction and prevention of developing cancer in the first place. This is especially true for breast cancer, and colon cancer as exercise reduces your risk of developing these types of cancer by 20-40%. Recent research also shows that physical activity may have a similar effect in up to 10 other types of cancer including lung cancer, and prostate cancer! Exercising at a moderate intensity (able to carry a conversation while exercising) for 30 minutes each day is enough to achieve the benefits of exercise which will reduce your risk of developing cancer. Exercising for longer durations each day is shown to have even greater cancer risk reduction effects. While the specific percentage of risk reduction varies amongst sources, one thing is clear: By exercising regularly you can significantly reduce your risk of developing this life altering condition!

If you or a loved one has been diagnosed with cancer, you are likely aware of the impact it has on an individual’s overall energy levels. This can in part be related to the disease process itself, however, fatigue is also a side effect of common treatment methods such as chemotherapy. Exercise has recently been discovered as an effective fatigue reduction strategy in the cancer population. Exercise releases hormones which help to stimulate the appetite, improve mood, and improve sleep patterns. These all ultimately work together to improve an individuals energy stores. While in the past doctors directed patients towards rest and medication to battle fatigue, today research shows that exercising is more effective than any of these past strategies! How much exercise is required? The Canadian Physical Activity Guidelines recommends 150 minutes of moderate (see above paragraph) to vigorous physical activity each week, which is an adequate amount of activity to reduce fatigue levels in the cancer population. Cancer survivors have had good success with activities such as walking, cycling and yoga in helping to manage post chemotherapy fatigue. If you would like to read a bit more about this topic, take a look at these two articles below from the NBC News!

http://www.nbcnews.com/health/cancer/exercise-best-cure-fatigue-caused-cancer-study- n728241

http://www.nbcnews.com/nightly-news/video/exercise-is-best-cure-for-chemo-fatigue-new- analysis-suggests-888941123688

Diabetes

Exercise is one of the most effective treatment methods among people with diabetes. One of the more obvious benefits in this population is the role exercise plays in promoting weight loss. With obesity being a significant risk factor among those diagnosed with diabetes, controlling body weight is a relatively simple and important step for treating this condition. Another benefit that exercise has for individuals with diabetes is that it helps to regulate blood sugar levels by increasing its ability to be transported into the muscle cells and used. These benefits persist for hours after exercising! This prevents the spikes and valleys in one’s blood sugar levels and associated symptoms that arise from these large fluctuations.

The Canadian Diabetes Association recommends a minimum of 150 minutes of aerobic physical activity each week, with no more than two consecutive days without exercise. Examples of aerobic exercise that you may enjoy include brisk walking, cycling or swimming. At least two sessions of resistance exercise should be performed each week. If you are exercising with diabetes, here are some other tips that you should consider: Exercise at a consistent time each day. Pay attention to warning signs for low blood sugar such as dizziness, clumsiness, fatigue, and excessive hunger and sweating. Keep sugar rich snacks (such as granola bars and juices) on hand in case your sugar drops during or after exercise. If you require self insulin injections you should do this at least one hour before exercising.

Stroke

Exercise plays a role in both stroke prevention and rehabilitation. Exercise improves blood circulation throughout the body preventing plaque buildup within the vessels. This reduces the risk of this build-up being dislodged to the brain, causing a stroke. Generally, any type of exercise is beneficial in reducing an individual’s risk of having a stroke, whether it be playing your favourite sport, enjoying a yoga class, or going for a long bike ride.

Following a stroke, because of the many different areas that may be impacted, it is often difficult for people to do a rehabilitation program independently and may require assistance. Exercise and rehabilitation varies based on the location of the stroke. Exercises will likely involve core strengthening, sitting and standing balance and mobility training but will highly vary based on the body structures that were impacted. Lifestyle changes to accommodate safety considerations are very important as you may lack the balance or strength to do things safely that you did in the past. Many people have heard that the greatest recovery occurs within the first few months following a stroke. However, it is very important to know that individuals can continue to see life-long changes and improved function with continued exercise. Be persistent and continue to challenge yourself appropriately as you are able to do knew things to ensure you are getting all of the benefits that exercise can offer you!

Multiple Sclerosis (MS)

Staying active is an important part of healthy living with MS. People with MS often battle from chronic fatigue. Exercising helps to increase your “battery life” to allow you to do more throughout your day and also helps you to “re-charge” your daily energy stores. The Canadian Physical Activity Guidelines recommends two 30 minute bouts of cardiovascular activity each week for people with MS. Remember that you should be exercising at an intensity so that you can talk during exercise, while not exceeding this as you should not feel over heated or exhausted following exercise. These guidelines also recommend that low resistance strengthening should be done for all major muscle groups twice weekly. Exercise should focus on balance, core strengthening, and upper and lower body strengthening. Exercise should be performed in the morning, or times of the day when you have higher energy stores. Fatigue is generally worsened by heat among the MS population, so it is very important for you to avoid extreme temperatures and warm environments such as hot tubs, saunas, or sitting in the direct sunlight on hot summer days.

Other MS related complications have also been shown to improve with exercise including bowel and bladder function, levels of anxiety and depression, and improved function and mobility with daily tasks. Researchers have recently discovered a new “neurological factor” that is released by exercise. Although research has not confirmed this to date, it is believed that the presence of this in the body may have disease modifying affects among individuals with MS. To date this neurological factor has shown to improve nerve cell growth, increase the connections among nerves and may result in delayed or even decreased symptoms among this population. This is yet another reason why exercise is so important!

http://www.csep.ca/CMFiles/Guidelines/specialpops/CSEP_MS_PAGuidelines_adults_en.pdf

All of these above recommendations are general precautions for the above specific conditions. It is always important to make sure you check with your Doctor or Health Care Practitioner about your individual safety before starting any exercise program, especially if you have pre-existing conditions or a new medical diagnosis.

The take home message is that exercise and physical activity have a positive influence on many aspects of our lives. Unfortunately, some of us aren’t getting on board the activity train because of time, motivation, pain, etc.

If you are nervous about starting a program because of your pre-existing physical or health issues or just don’t know where to start, Body Balance Health has created some “starter programs” that may be right for you!

Programs include: Exercise for Beginners, Exercise and Osteoporosis (a 4 week program teaching you the basics about how to live with osteoporosis – the do’s and don’ts in day to day life, proper exercises to promote health and prevent injury, etc.), Corporate wellness programs, Weekend warrior, and more!!

For more information, visit our website or call our office at 519-541-9899 Remember: TAKE CONTROL OF YOUR HEALTH! BE ACTIVE! STAY HEALTHY!

“Find Your Path to Health and Wellness”

Running and Osteoarthritis: Does Recreational or Competitive Running Increase the Risk?

By | News | No Comments

Published: Journal of Orthopaedic & Sports Physical Therapy, 2017 Volume:47 Issue:6 Pages:391–391 DOI: 10.2519/jospt.2017.0505

Recreational runners had less chance of developing knee and hip arthritis compared to nonrunners/sedentary individuals and competitive runners. The researchers concluded that running at a recreational level for many years—up to 15 years and possibly more—may be safely recommended as a general health exercise, and benefits hip and knee joint health. Their findings indicate that remaining sedentary and forgoing exercise increases your rate of knee and hip arthritis, compared with regular recreational running. However, high-volume and high-intensity training also may increase your risk for arthritis. Other researchers who found a link between high-volume and -intensity runners with knee and hip arthritis defined high-volume running as running more than 57 miles (92 km) per week. The benefits of running are numerous. This study allows you to be confident that recreational running will not harm, and may improve, your hip or knee joint health.

 

New Location, Hydrotherapy & Keeping Children Active

By | Body Balance Quarterly | No Comments

logo-retina                                                                             

The Body Balance Quarterly

A newsletter designed for the patients of Body Balance Health & Physiotherapy Inc. that addresses current rehabilitative methods and addresses the current questions people may have regarding Physiotherapy related “HOT TOPICS”.

Well the weather in 2017 hasn’t been active but at Body Balance Health we have gone through many active changes including our name, logo and location. We are now located at 1315 Michigan Ave, next to the Goodwill. The changes have been positive and we are excited to present our new location during an open house on February 10th, 2017 from 2pm until 7pm. Our new location on Michigan Ave. is shared with Pure Powered by On Edge Fitness and because of this we are now in the process of developing new Integrated Health Programs. One of the programs we have initiated because of our new partnership is a hydrotherapy directed Physiotherapy treatment session. The benefits of Hydrotherapy are discussed further in this issue of the BBQ along with the rising concerns of reduced activity in the Paediatric population.

 The Benefits of Hydrotherapy

  1. Stimulating the immune system
  2. Improving circulation and digestion
  3. Encouraging the flow of blood
  4. Lessening the body’s sensitivity to pain.
  5. Patients can start rehabilitation earlier and recover faster
  6. Decreases joint stress
  7. Increases strength and range of movement
  8. Improves balance and coordination
  9. Reduces muscle spasms
  10. Increases the patient’s feeling of achievement even in the acute stages of rehabilitation

“Generally speaking, heat is used to quiet and soothe the body, and to slow down the activity of internal organs. Cold is used to stimulate and invigorate, increasing internal activity within the body. If you are experiencing tense muscles or anxiety, heat is recommended.”

“When submerged in a body of water such as a bath or a pool, there is a kind of weightlessness, as the water relieves your body of much of the effects of gravity. Water also has a hydrostatic effect and has a massage-like feeling as the water gently kneads your body. Water, when it is moving, stimulates the touch receptors on the skin, increasing blood circulation and releasing tight muscles.”

http://www.naturaltherapypages.com.au/article/hydrotherapy#ixzz4XAIhJcaZ

Who Benefits from Hydrotherapy

Conditions that may Benefit from Hydrotherapy

  • Arthritis
  • Osteoporosis
  • Sports Injuries/Rehabilitation
  • Post Orthopaedic surgery
  • Back pain and shoulder pain
  • Hip, knee, or ankle pain
  • Brain or spinal cord injuries
  • Fatigue/ Weakness or Prolonged inactivity/immobility
  • Fibromyalgia and other rheumatoid conditions
  • Neurological disorders, including stroke, multiple sclerosis, and Parkinson’s disease

A review on the effects of Hydrotherapy on various systems of the body is referenced below. The studies conclusion was basically that Hydrotherapy works but the science behind how it works needs to be further investigated. The literature review concluded that “Based on the available literature”, “hydrotherapy has a scientific evidence-based effect on various systems of the body.” These systems included; the cardiovascular system, the respiratory system, the musculoskeletal system, the nervous system and the gastrointestinal system. “Based on available literature, this review suggests that hydrotherapy was widely used to improve immunity and for the management of pain, asthma, Rheumatoid Arthritis, Osteoarthritis, Fibromyalgia, fatigue, anxiety, and obesity. It produces different effects on various systems of the body depending on the temperature of water.”

N Am J Med Sci. 2014 May; 6(5): 199–209.

Scientific Evidence-Based Effects of Hydrotherapy on Various Systems of the Body

A Mooventhan and L Nivethitha1

Potential Risks and Side Effects of Hydrotherapy

All forms of therapy can have both positive and negative impacts and Hydrotherapy is no different. It is recommended that you discuss Hydrotherapy as an option with your Health Care Provider prior to initiating a program. Along with the fact that some people have a fear of water here are some of the potential risks and side effects of Hydrotherapy:

  • Allergic reactions
  • Skin irritations
  • Overheating

 

Topic of interest – Keeping Children Active

“Can I play on the Wii?” “Can I watch Netflix?” “Can I play on the Ipad?”

These questions, along with many other similar questions are frequently asked by today’s children. While the use of some devices offers many opportunities to work on academic programs and the downtime of watching a program or reading a book is often necessary to slow the pace of constant day to day happenings; it is important to remember not to replace activity by answering yes to these questions all the time.

Obesity and physical activity in children

 Mia Pradinuk, MDJean-Pierre Chanoine, MD PhD and 

Ran D. Goldman, MD FRCPC

 

“Obesity has become a leading public health concern, particularly for Canadian youth, for whom rates of obesity have tripled during the past 25 years. Statistics Canada now estimates that 26% of our children and youth aged 2 to 17 years are overweight or obese”

“Interventions aimed at improving diet, increasing physical activity, and decreasing sedentary behaviour form the foundation of childhood obesity prevention and management.”

The article reports that “the beneficial role of physical activity in delaying or preventing metabolic complications such as type 2 diabetes, cardiovascular disease, and hypertension is well recognized.” It also states that “Physical activity has also been shown to improve bone mineral density, increase school performance, and have a positive effect on mental health.”

The article states that “The Canadian Paediatrics Society (CPS) released a position statement in 2002 providing recommendations on healthy living for children and youth. Physicians and health care professionals are advised to encourage “children and adolescents to increase the time that they spend on physical activities and sports by at least 30 min/day, with at least 10 min involving vigorous activities.” The goal being the achievement of 90 minutes of Physical activity in total.

 A recent report from Active Healthy Kids Canada suggests that 87% of children and youth are not meeting Canada’s physical activity guidelines of 90 minutes per day. Given the known health benefits of physical activity, current levels of inactivity are of concern.”

The article made the following conclusions regarding the promotion of Physical Activity. Worth noting in this article is the fact that Physical Activity does not have to come with a cost (dollar value). Physical activity can purely be the direct result of more time engaging with our children in the great outdoors.

 Excerpt from Article:

 Tackling barriers to physical activity

Recommendations to overcome barriers to physical activity

  • Recognize the problem. Measure height and weight, and plot body mass index on growth charts at each visit
  • Ask children and their families about physical activity patterns. Encourage the whole family to become involved in daily activity
  • Support progressive and well-defined steps. Limit sedentary behaviour
  • Encourage adherence to daily physical activity programs in schools
  • Support local community initiatives aimed at increasing activity
  • Advocate for safer and more accessible communities that are more conducive to increased activity

Please feel free to follow the link below which was written in May of 2014. Canada was given a grade of  D for overall activity in children.

http://www.cbc.ca/news/health/physical-inactivity-of-canadian-kids-blamed-on-culture-of-convenience-1.2648059

 

 

BIG NEWS!!!!!!!

By | News | No Comments

We are excited to announce that we will be moving to a new location on January 2nd, 2016. We will be joining “Pure” Powered by On Edge Fitness at theirs and our new location at 1315 Michigan Ave, next to the Goodwill. We are looking forward to the new opportunities that exist in this location and will continue to not just meet but exceed the expectations of the patients we treat.

We are Growing

By | News | No Comments

Body Balance Physiotherapy would like to welcome Larissa Moore, Physiotherapy Resident.  Larissa will be starting October 11th, 2016 and is looking forward to starting her professional career in Sarnia.

Celebration!

By | News | No Comments

Body Balance Physiotherapy are celebrating our 11th year in the Sarnia-Lambton community!  Join us for coffee and goodies all day long 🙂