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Hello to All

Welcome to our September Newsletter. We hope all of our subscribers have had a great summer, and for all of our young readers, we hope your return to school has been enjoyable so far.

What's NEWs.

The fall sports seasons have begun and we have begun our 3rd year of affiliation with AYSO 644 soccer, Weston Soccer Club, and our 2nd year of providing medical support for Weston Football. A note to coaches, players and parents: our schedule is VERY dynamic with our trainers, as is our staff- most certified trainers have obtained their certification as a stepping stone to higher educational levels/employment levels. As a result, all of our trainers we employ are part-time and are employed with us as a second job. Henceforth, we tend to have last minute changes to our schedule, based on the schedule suprises that our trainers may experience in their own personal/employment lives. We also tend to have many acquisitions/attritions to our staff- sometimes on a weekly and/or daily basis. We will continue to post our atheltic trainer scheule on our website, at http://www.southfloridasportsmedicine.com/atraining.asp
for your convenience.

Dr. Felton had a very captive audience at the New Coaches Clinic for AYSO 644 on August 24, 2002. Dr. Felton spoke on preventive medicine topics such as hydration and proper warm up and stretching. Many excellent questions from the coaches were fielded by Dr. Felton, and he looks forward to the next group of coaches.

Our Tamarac office continues to expand hours. As stated in our last newsletter, we have now expanded Podiatry and Physical Therapy hours to all day on Monday, Wednesday, and Friday, as well as Tuesday afternoons and Thursday Mornings. Dr Bodner, our physiatrist(physical medicine and rehabilitation) is now in our Tamarac office on Wednesday afternoons, and Dr. Haas(orthopaedics) will soon be expanding his current Monday and Wednesday afternoons to include Fridays as well- the determination is yet to be made as to whether or not it will be in the morning or afternoon.

Our newsletter this month focuses on an issue/condition that most of us have dealt with in one way or another- back pain. There are many conservative methods for dealing with back pain, but quite often there are strengthening exercises to help a painful back- what people tend to do is get tunnel vision and only think of the side of the body that the spine it on- the back side. They forget that on the front side of the body, there are muscles that help with trunk stability as well. This month's article is an exerpt from ADVANCE, a periodical for physical therapists. The article focuses on strengthening exercises to help lower back pain.

Crunching Away Lower Back Pain

Statistics show that over the course of their lifetimes, four out of five Americans will seek medical help for some sort of back condition or injury. Of these an astounding 85 percent cite the lower back as the primary source of their pain.

Despite numerous suggestions as to the primary reason for back pain, such as excessive weight, poor posture, improper sleeping positions, medical authorities feel that the most frequent cause of low-back pain is weak musculature- an imbalance of strength between the abdominal muscles people work so hard to condition, and the lower back muscles they neglect in the process.

Low-back injuries are one of the most common problems to haunt recreational athletes, and one of the main injuries people cite as a reason why they don't exercise.

There are back-strengthening exercises to perform in conjunction with abdominal workouts to achieve a productive balance in strength between the two muscle groups. For those fitness buffs fortunate enough to avoid low-back injury to this point, these exercises provide assurance that they will be able to maintain their good health.

Whether it be someone with no back problems or people with pre-existing back conditions caqn also benefit from lower-back exercises. Some people believe that a back condition precludes them from exercise altogether. The truth is, those with sciatica, joint problems, or herniated disks can benefit from exercise, particularly during stretching.

WEIGHT TRAINING EXERCISES
The amount of these exercises performed should be determined by a clinician, such as the physician or physical therapist.

GOOD MORNINGS
These exercises are done standing up with the feet about shoulder width apart. The patient should place a light bar- a broomstick handle is perfect-behind the neck, keeping both hands on the bar. Bending over at the waist, SLIGHTLY bending at the knees, the patient's body should come down and make a 90 degree angle, with the upper body being parallel to the ground. The head should be up, not looking down at the ground.

STIFF LEG DEAD LIFT
This exercise is very similar to the "bend over and touch your toes" exercise, but the differece is using a light barbell weight. An overhand grip is used on the bar and the patient bends down as far as comfortably possible before returning to the standing position. It is not necessary to go all the way down to the toes with this exercise.

TWISTS
It is best to do these seated. Place a light bar or broom handle behind your head and sit straight up. Twist as far to your right as comfortably possible, then do the same motion to your right.

NON WEIGHT RESISTANCE EXERCISES

PELVIC TILT
Lie on your back with the knees bent. Squeeze buttocks tightly together, then pull in your abdominal muscles. Once your feel your lower back go flat against the floor, hold for a count of five. Relax, and repeat as many times as appropriate. These can also be done in a standing position, against a wall. This is the most commonly recommended exercise for the lower back.

SINGLE LEG RAISE
Start on your back with one knee bent and the other leg straight on the floor. Hold yourself in the pelvic tilt position throughout the entire exercise, with the lower back flat against the ground. Raise the straight leg as far as possible without experiencing pain. Slowly lower the leg while keeping the lower back pressed flat against the ground. Repeat as many times as appropriate or pre-determined by your clinician, the switch to the opposite leg.

PARTIAL CURL-UPS
Start on your back on a soft or carpeted floor with the knees bent. Holding the pelvic tilt position, first raise your head, followed by the neck and finally the shoulders while extending your hands to your knees. Keeping your lower back on the floor, hold for a count of five. Repeat as many times as appropriate.

THE ABDOMINAL APPROACH
The final, and controversial, component of strengthening a weak or painful back is abdominal work . For years, there has been a debate among health care professionals as to the full value of abdominal work, but a fact that is accepted is that from a preventive standpoint, strong abdominals can reduce the risk of back injury by improving posture and helping to keep the spine straight.

Following are 3 types of abdominal exercises that have been used with patients recovering from back injuuries.

Lie on your back, with the knees bent and back flat on the floor. This position is used as the basis for alsmost all abdominal exercises. Raising one foot off the floor, bring the knee toward your chest. Using the abdominal muscles, gently pull the knee toward you, and hold it for a few seconds. Then slowly let the knee down and allow it to return to the floor. Repeat with the other leg.

Starting from the same position place your arms along the body with the palms facing down. Try pressing the small of your back flat against the floor while contracting your abdominals. Exhale. Hold this postion for a second or two and then inhale and relax the abdominals.

Starting from the same position, place your arms alongside your body with the palms facing up. Try pressing the small of your back flat against the floor while lowering your legs together as a pair down to the floor on the right side of your body, while turning your head to the left. Hold for a few seconds, then return the legs to the upright position. Repeat for the other side.

A combination program for the back and abdominal muscles can be a key component of helping to alleviate lower back pain.

We here at South Florida Institute of Sports medicine recommend that you always consult with your physician before engaging in any type of exercise program.

We hope everyone has a great beginning to their fall and you will hear from us again soon!

The Doctors and Staff of South Florida Institute of Sports Medicine

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