Best shoes for back pain

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Often when we think of back pain we think about “where” we feel it. The challenge is identifying what might be contributing to it. Our feet are our foundations for our posture. They help maintain proper spinal alignment when standing, provide shock absorption from ground forces, and they provide stability. If you feet hurt or are improperly supported they can increase back pain or make you more susceptible to injury. So what are the best shoes for back pain?

First, let’s consider what footwear is not good for back pain. Sandals can be some of the worst footwear when it comes to back pain. Sandals are the most basic of footwear, and only provide a barrier between your foot and the ground. They are often designed to be “carried” by the foot and require the foot to activate more muscles to help carry them along. Most have little or no arch support and are highly unstable. These types of shoes should be avoided, especially when experiencing back pain.

Women’s high heels are also poor footwear when it comes to back pain. High heels put the foot in an unnatural position, compromising its ability to provide stability. It also requires the wearer to constantly engage their hip and back muscles in order to maintain balance. This constant tension can increase back pain.

Old shoes are also a culprit. Shoes are like tires on a car, when worn out, replace them. Every individual has their own foot strike pattern, which over time wears out the shoe and can lead to decreased stability and support. Replace heavily worn shoes about every 3 months, even if sole wear is not visible. The wear may be inside the shoe where it is not visible.

So what does a proper shoe look like? Well, first the shoe needs to fit the activity you are doing. The key component in buying any shoe is knowing what its intended use is. If you are hiking, does the shoe have good grip on unstable surfaces and proper ankle support? If you are a runner, is it light weight and have proper cushioning and support for your type of foot strike? A runner wouldn’t wear a hiking shoe, and a hiker wouldn’t wear a running shoe. Start here when considering a shoe.

Find the right fit. The design of a good shoe requires a proper fit. Our foot size doesn’t stop changing after our teen years. While our foot might stop growing, the foot anatomy can start to change by flattening. This flattening can increase your shoe size and affect what you thought was a good width. Check your shoe size periodically to see if there are any changes. Even the best shoes won’t work for you if the fit isn’t right. Be aware, sizes between brands can be different to so always try a pair on first and don’t be afraid to return a shoe if it ends up not being the right fit. Check a stores return policies so you don’t get stuck with a pair of ill-fitting shoes.

Get foot orthotics to properly fit your foot. Shoe manufacturers design their shoes to meet a general populations’ needs. The orthotics built into the shoe, don’t always address your specific needs. You can often get orthotics fitted for you by a Podiatrist or Chiropractor/Physical Therapist.

So the best shoes for back pain are shoes that provide proper protection, support, and stability for the activity you are doing. Be prepared to invest into good footwear if you have back pain, it can dramatically improve your quality of life!

How Athletes Recover from Back Pain

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When most people think of back pain and an athlete, they think of Tiger Woods. His recovery is a well documented long dedicated process. In 2018, his return stunned the golf world as many sports writers had written his career as over. He is now back this week starting his 2019 season. So what can we learn from how athletes recover from back pain?

First, Tiger Woods began his process taking the most conservative route to recovery, physical therapy. He understood that once surgery takes place, the success rate and outcomes begins to diminish. Athletes are highly motivated to return to their optimal performance and are willing to put the hard work and consistency of treatment that is required in physical therapy. The challenge with the athlete is listening to their body through the process and not pushing themselves, which can set them back. Tiger Woods experienced this.

The next phase is going through less invasive treatments that help relieve pain temporarily to help in the recovery process. This can include nerve blocks and steroid injections. For an athlete this can help them address the pain and discomfort while they progress in their physical therapy.

Finally comes the surgical options. If the physical therapy and injections do not help the athlete they begin the surgical route. Tiger Woods surgical journey began in 2014. He had choices, do I take the more aggressive surgical route, which would limit his ability to return to golf, or do the more conservative surgeries. He knew the conservative route would mean the potential for multiple surgeries and multiple rehabilitation programs before he could “potentially” return to competitive golf. The same drive and determination that made him the #1 golfer in the world, helped him choose the more difficult path.

Over the next 3 years he dealt with setbacks and disappointments. He had the sports community saying he was done. He even let the possibility of him not ever golfing again to creep into his thoughts. But, when he returned last year, he shocked everyone, even himself and found success at the end of the road by winning the Tour Championship.

The athlete mindset is what we all need when dealing with back pain. There are no quick fixes, no magical surgery, no pill to get you through it. It takes hard work, a tough mentality, willingness to commit to the process.

3 Great Stretches at Desk for Back Pain

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Sitting at a desk all day can be a real pain in the back and really hurt productivity. In the past we have covered how to properly set up your workstation, but static postures for 8 hours a day can really do a number on your back. Here are 3 great stretches at desk for back pain. Perform 3-4 times daily.

Seated Twist

Seated Twist Stretch – Crossing your legs, place the opposite hand on the knee on top and twist towards the top leg’s side. Stretch should be gentle and held for 3 seconds. Reverse to the other direction. Perform 3 times.

Seated Side Bends

Seated Side Bends – Place your hands behind your head with elbows pointed out, while seated. Gently bend side to side in a slow controlled movement repeat 5 times each side.

Seated Pirformis Stretch

Seated Piriformis Stretch – While seated raise your leg and place the outside of your ankle/foot on the opposite knee. Place hand on foot and ankle, keeping back straight and bend forward up until you feel a stretch, hold for 30 seconds. Perform once per side.

You should feel no pain after performing these stretches. Consult with your physician before starting any stretch program.

Headaches are a pain in the neck!

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Headaches and Migraines

Are your headaches a pain in your neck?

Did you know that your headache can be caused by what is going on in your neck?  This type of headache is called a Cervogenic Headache and can often be overlooked and results in re-occurring headaches. Nearly 25% of all headaches can be related to this condition.  In other words your headache is caused by a pain in the neck!

The good news is that once you identify this as the cause, treating your headaches are as easy as treating your neck.  Your neck headache can originate from a variety of musculoskeletal and neurovascular structures in your upper neck; including the upper three neck joints, C2/3 disc, spinal cord coverings and neck muscles. A dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).

How do you identify a Neck Headache?

Typically people with a neck headache will have tenderness in the upper part of the neck just below the head.  They also experience a reduction in range of motion due to stiffness.  Often sufferers will experience a headache that radiates from the back of the head to the front.  They will also experience some relief when adjusting their head/neck position.

Treating a Neck Headache

The good news once identified as the cause has been identified, treating the condition in your neck can result in immediate pain relief.  Physical therapy and chiropractic care can immediately address the neck dysfunction and patients will typically leave the clinic with instant relief from your headache.  While treating the headache is the first step, the expertise of a physical therapist and chiropractor is to help identify what may be causing the neck pain and help educate the patient to help them avoid future occurences.

It is important to note that sometimes a neck headache is combined with other conditions that also need to be treated.  Contact our office and schedule a consultation if you suspect you suffer from a neck headache.

Top Low Back Stretches: Prayer Stretch

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Top Low Back Stretches: Prayer Stretch

The prayer stretch is a great stretch that primarily targets the extensor muscles of the back.  The prayer stretch is excellent because it limits the loading placed on the low back while performing the stretch and allows you to fully relax, letting gravity do the work for you. The prayer stretch is one of the best stretches you can do to protect yourself from a low back injury and to help relieve pain during the rehabilitation from a low back injury.  When people injure their low back, the muscles surrounding the area of the injury will tighten to guard the area from further injury.  The problem is that this constant tension in these muscle groups, can increase pain when a nerve is involved and decreases blood flow to this area.  Decreased blood flow increases the time for healing.  So stretching the muscles in this area help break this cycle and allow for the body to heal.

Prayer Stretch

To perform the prayer stretch first consider the surface you are performing it on.  Due to your knees making direct contact with the surface you will probably want to perform this stretch on some form of padded surface. Also if you have knee pain you may want to place a pillow between the backs of your thighs and calves when you are kneeling.

Prayer stretchprayer stretch 2







-On your hands and knees, sit back so your buttocks is resting on your heels.

-Reach your hands forward to lengthen your spine and feel a stretch in your middle back.

-You can reach your hands to either side to focus the stretch on the opposite side of your spine.

-Hold for 10-30 seconds and perform 2-3 repetitions.

When should I perform the prayer stretch?

The prayer stretch can be performed prior to or after any workout program, especially with back loading is involved.  This will help prevent injury.  Performing this stretch after injury will help expedite the healing process.

When should I avoid performing the prayer stretch?

The prayer stretch needs to be approached with caution if you are dealing with back pain.  Some people with severe knee pain will have difficulty performing the stretch.  If you feel an increase in pain or numbness, stop and contact your doctor.


Top Neck and Shoulder Stretches: Trapezius Stretch

John Naumann Neck Pain, Uncategorized Leave a comment  

Here are the top neck and shoulder stretches everyone should be doing.  Neck pain can have many different causes and almost all of them included muscle tightness and muscle guarding.  Breaking up the tension in you neck and shoulders is one of the key elements to recovery.  It is important that when performing stretches in the neck that the individual does not have pain or numbness, but a mild stretching sensation in the muscles of the targeted area.  Please consult with a doctor if you have any questions about this exercise.  This week we start our series off with the Trapezius Stretch or commonly called the Trap Stretch.

upper trap stretchTrapezius Stretch

– Place the back of one hand on your lower back making sure you are keeping that sides shoulder down

– Place the other hand gently across the top of your head, while the head is looking straight forward

– Apply gentle pressure to your head pulling your head towards the hand on head side until you feel a good stretch, no pain. (Do not push down)

– Hold the stretch for 20-30 seconds and perform for both sides 3 times


When should I perform Trapezius Stretches?

Whenever you have limited range of motion in neck or have tightness in shoulders.  Perform at least 2-3 times daily.  If you are working at a computer workstation, perform 1 time per hour.

When should I avoid performing Trapezius Stretches?

If you experience an increase in localized pain during and prolongs after stretch, numbness, dizziness, or radiating pain during stretch, discontinue stretch and consult a doctor.


Best Type of Pillow for Neck Pain

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Have you ever woken up with a stiff neck and wondered if your pillow is causing your neck pain?  Well you could be right.  Your pillow is very important in maintaining proper neck posture while you sleep.  So what are the best types of pillows for neck pain?

Pillows are very individual so it is important to find one that bests fits you.  But here are some of the best available options to meet your needs.

For side sleepers, use a pillow with a bulge/contour under the neck to help support proper spinal alignment.

  • Sleep Innovations Memory Foam Contour Pillow
  • Brookstone Biosense Shoulder Pillow
  • Leesa Reversible Hybrid Pillow
  • Classic Brands Cool Sleep Advanced Contour Cool Gel Memory Foam Pillow


For back sleepers, use a pillow that provides a firmer head support.  Avoid too big or too thin.

  • Classic Brands Cool Sleep
  • My Pillow Premium
  • Sahara Nights
  • Best Cervical Orthopedic
  • ISHOWStore Therapeutic & Ergonomic
  • Bamboo Pillow


Pillows wear out faster than mattresses, so look to replace them every one to two years.  Here is to a better night sleep with less back pain!



Healthy Holiday Tips!

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The holiday season is upon us and so are busy schedules and poor eating habits.  Here are a few tips on how to have a healthy holiday season!

  1. Plan for holiday events that involve a lot of sweet and high calorie food
    1. Eat healthy before the holiday event so that you don’t overeat
    2. Limit sampling to bite size, not serving size
    3. Avoid high calorie drinks, go for the one for one strategy.  For every high calorie drink, follow with the same volume of water
  2. Get plenty of sleep
    1. Stick to your normal sleep schedule.  People who sleep less eat more, exercise less, and have less energy
  3. Stick to an exercise regime
    1. You may not be able to maintain your normal workout schedule but plan your exercise schedule in advance so you can keep to it.
    2. Lower your workout expectations.  If you are in a time crunch, try HIIT (High Intensity Interval Training) for an effective shorter workout.
  4. Don’t overbook yourself
    1. Make time for yourself to decompress and relax.

Most importantly, remember the goal of the holiday season is to celebrate and enjoy friends and family.  Happy holiday’s from The Center for Total Back Care Team!

Arms fall asleep at night? Check the Scalenes!

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The numbness in your arms, could be your scalenes

Have you ever woken up in the middle of the night and one or both of your arms are asleep? This can be not only uncomfortable, but also very scary.

What might be causing this?

While there are many potential issues that might be contributing to this, the problem can be located in your neck. In particular, this may be an issue with your scalene muscles.

Scalenes and nerves

What are the scalenes?

The scalene muscles are a pair of muscles located in the front of your neck on either side down to your first two ribs. Each side is divided into three separate sections, anterior, posterior and middle, that perform different functions. They bend the head side to side, flex the neck forwards and lift the first two ribs when breathing. The picture above represents the brachial plexus, which includes the subclavian artery and ulnar and medial nerve, in which innervates the scalene muscles. The subclavian artery provides the blood supply for the entire arm. The ulnar and medial nerves are major nerves for the arm.

How do the scalenes cause arm pain when I sleep?

There are a couple of causes for the arm pain related to the scalenes. First, everyone’s physical makeup can be a little different and the position the nerves innervate the scalenes can increase the potential for impingement on the nerves and blood supply. For the purpose of this topic we focus our attention on your sleeping posture but work posture, and overuse injuries.

The sleeping position can be the most significant contributor to your arms falling asleep. Sleeping on your stomach is the worst position for your neck and arms. Laying on your stomach shortens the scalenes and increases pressure on the brachial plexus, leading to blood flow constriction and nerve impingement. Stomach sleeping encourages you to put your hands above your head and maintaining your neck in a static rotated position. Many stomach sleepers will experience numbness and pain in both arms at the same time. Side lying positions can cause the arm on the side you are sleeping on to fall asleep because you are putting all the pressure on one shoulder causing the scalene muscles to shorten on that side. Plus the weight of your body applies pressure on the brachial plexus. Typically side lying people will experience arm pain and numbness on the side they are laying on. Back sleeping is overall the best position to sleep, as long as your arms stay at chest level or lower. If you place your hands above your head you will potentially experience pain in both arms.

How do you reduce the occurrence of your arms going to sleep?

The first thing to do is to improve your sleeping posture. Laying on your back or side is preferable to stomach sleeping, which should be avoided. If you are a side sleeper, make sure your head is properly supported. Finding the right amount of pillow support will help keep the neck in better alignment, reducing side lying curvature. Using a body billow will help keep the arms separated and supported. For back sleeping the important thing is to keep your hands from going higher than the shoulder.

Make sure you perform the upper trapezius stretch and chin tuck periodically throughout the day to alleviate the tension built up in the scalenes.

Lastly, if the issues are persistent seek medical assistance. Chiropractic, physical therapy, and massage therapy helps target the specific issues and can help address the issues originating in the neck and help you get a better night sleep and alleviate your arm pain and numbness.

AN EDUCATION IN EXERCISE-Get The Most Out Of Your Workout

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Lesson 1
Before starting an exercise program, you and your health professional need to understand what your immediate goals are. Are you trying to lose weight? Increase strength? Train for a particular sport? Do you have any swelling? Pain? Weakness? Are your joints stiff? Once you know what you want to accomplish, it’s a lot easier to figure out where to start. Research shows that immediate results usually motivate people to continue what they are doing. If your goal is to decrease joint stiffness through stretching, but then you decide to start with strengthening exercises that don’t address the stiffness you could lose motivation. If you’re trying to lose weight, but don’t do any fat-burning exercises, you won’t get the results you want (certainly not in the time frame you want). Always remember to have short-term goals and work from there.

Lesson 2
Exercise should consist of three clear phases. Begin with five to 10 minutes of warm-ups. Keep in mind that a “warm-up” is not the same thing as stretching. Warming up means doing low-intensity range-of-motion exercises that increase your body temperature. This increase in body temperature heats up the joints and muscles, preparing them to handle the rigors of exercise. Warm-ups can include such things as simply walking back and forth, moving the arms and legs in pain free ranges of motion, or a slow and steady ride on a bicycle. It’s really just about getting your body moving and getting heat to your muscles.

The second phase is the exercise itself. It can be strengthening, aerobic training, strength training, etc. The third phase is a cool-down phase, which can include stretching since the muscles are warmed up enough to be stretched. Never stretch a cold muscle. Research shows that overstretching in the beginning without a proper warm-up can actually cause further injury.

Lesson 3
The type of exercise is just as important as the three exercise phases. Try to incorporate different types of programs, such as strengthening, strength training, balance training, and aerobic conditioning. Each of these affects the joints and body in different ways. By using all of them, you’ll be able to make better gains in your health.

Most guidelines recommend 20 to 30 minutes of moderate-intensity activity per day. However, if you are not able to do this, then break it up into five minute bouts of exercise several times a day. Research suggests that doing smaller bouts of exercise throughout the day is just as beneficial as one continuous session.

Source: to your Health –By: Jasper Sidhu, BSc, DC

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