BFS Skrev:
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> Mitt fleråriga ryggproblem "gick över" när jag
> började stretcha (baksida lår och stjärten). Och
> känner jag av ryggen, stretchar jag lite mer så
> går det över. Skönt att det inte var nåt
> diskbråck, vilket jag oroade mig för. Knivkänslan
> i ryggen är ju inget man blir varken glad eller
> lugn över. Det lustiga är att ingen (läkare,
> sjukgymnast eller kiropraktiker) lyckades lista ut
> hur jag skulle göra för att bli bättre...
vi cyklister kan åka på stora problem med höftböjarna
om du gått till en läkare, sjukgymnast eller kiropraktiker i cykelländerna så hade du nog fått hjälp direkt men här i norr så får vi inte den hjälp vi behöver.
har själv haft problem med ryggen i 3 år men med en kiropraktor och en finputsning av en sjukgymnast så är jag helt smärtfri och jobbar på att komma i bra form igen
saxade detta från cyclingnews.com:
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As someone that performs manipulative treatments, works closely with a number of chiropractors, and also does extensive work on development of stabilization musculature, I would like to provide a more scientific perspective on your symptoms to help you solve the root cause of your problems rather than 'band-aid' the symptoms.
Pain is typically a mechanical phenomenon - something places tension or compression on a pain-sensitive structure - a nerve root, a ligament, a joint - there are many different sources of pain. I will use an oversimplified analogy involving two ways that I look at the spine and how forces are transmitted through the spine.
First off, let's think of the spine (including the ligaments, disc, joint, etc) as a wire. We know that if we smoothly bend a wire it remains intact, but if we repetitively bend a wire at one point it will break at that point. Flexing forward on a bike involves 'flexing forward' through two separate areas - the pelvis, which rotates forward, and the lumbar vertebrae which glide upward (upper vertebra moving up and forward on the lower vertebra) causing trunk flexion. Very often, cyclists have extremely restricted lumbopelvic musculature (hamstrings, piriformis/hip external rotators/iliacus/psoas) which make the pelvis unable to rotate freely, and transmits the majority of flexion to the lumbar spine.
If, hypothetically, the pelvis should contribute 50 percent and the vertebra 50 percent of the motion necessary to flex forward to reach your handlebars, but the pelvis can only rotate for 20 percent of the motion, we have placed an excessive load on the lumbar spine. It will be forced into excessive flexion - approaching end range. The wire analogy is appropriate here because, the same way that a wire will break down the more severely it is bent, the spine will break down when forced to end range for prolonged duration. I have seen numerous cyclists bend forward and touch their toes thinking that they have nice long hamstrings, only to discover that they in reality have tight hamstrings and excessive motion present at the lumbar spine once their true hamstring motion is assessed.
The second way to think of the spine is as a stack of blocks. If we tilt this stack of blocks, the blocks usually will shear forward of the stack. If the vertebra are forced to end range, they too will shear (placing stress on the ligaments, disc and joints). Unlike the blocks, our spine has a system that will counter that shear and pull the spine back into alignment - the multifidus and transverse abdominals are the primary muscular stabilizers. Research shows that even one relatively small back injury will inhibit the small stabilizing muscles, and these muscles don't return unless they are specifically retrained - ab crunches and back extensions are not adequate to stabilize the spine and can actually contribute to the pathology present.
My problem with just getting a manipulation is that, yes, it does restore the joint position, but it does nothing to address how it was displaced to start with. Thus the cycle of needing repetitive manipulation to perform is started. Why is that joint moving out in the first place? If it is constantly under stress, how can we relieve the stress surrounding it? I am seeing one such patient right now. He was always getting short term relief from manipulation (approximately 15 treatments in 4 months) but noticing the interval necessary between manipulations was decreasing. He had extremely tight lumbopelvic musculature and a 50 percent deficit in his multifidus musculature. At his first two treatments, I initiated appropriate lower extremity stretching which he then progressed independently for two weeks. At two weeks symptoms were 50 percent improved. The next 6 treatments were spent regaining appropriate core stability with progression to a local Pilates program. I have performed one manipulative session in the last 6 weeks to help restore some lumbar extension and he reports symptoms as 95 percent improved.
I have recommended that he still see his chiropractor periodically, introduced him to a massage therapist, and he now has a flexibility and strengthening program with which he can maintain and promote the normal motion and stability of the joint segments.
Please understand that I find manipulative treatment to be very appropriate (one of two medical professionals I allow to work on me is an excellent chiropractor!) - but joint alignment is only one piece of the puzzle - flexibility, muscular stability, ligamentous stability, and neural activation patterns (how you move, how you are positioned on the bike) are all equally important components of the puzzle. In my opinion, good healthcare professionals should openly look at all components of movement.
My most sincere apologies to the editors here at cyclingnews.com for using 50GB of their memory for this column, but this truly is one of the most frequent issues that I deal with - both with cyclists and the less blessed bipeds as well.
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