Back Injury Chiropractor Oxford - Rebalance Chiropractic

Why does this matter?

As a first port of call, we do not prescribe exercises because we want to see how your body stabilizes naturally with the treatment we do. So, in between treatments, it is important to avoid doing things that you may have considered normal, but are actually adversely affecting your body mechanics. We call this SSS - Sitting, Standing, Sleeping.

Think about the fact that our body's yield and adapt to the environment we put them in. As a rule, we will always be either sitting, standing or laying down. So we want to ensure you don't create problems for your body in these three areas. Whilst this may sound unlikely, if you think about the fact that many of us develop pain, mobility issues or the like, but can't attribute a cause for it, then it is likely that the day-to-day routines of our lives are having an impact.

So, let’s break these three areas down to ensure we understand the things that help your body's mechanics, and those that hinder it.

SITTING Correctly

Many of us think that lumbar supports are the way to support your lower back. But let's rethink this. Fundamentally, your pelvis supports your spine as this is its foundation - like the foundations of a house. Therefore, ensuring that the pelvis is supported is imperative to supporting the spine. Our guidelines are:

1) sit with your hips higher than your knees.

2) sit with your pelvis slightly tilted forward. This can be achieved by using a seat wedge.

Tilting the pelvis forward will help prevent it rocking back when seated and this is what initiates the slumping process - not the lack of support for the lower back. A low flat chair, with lumbar support will still allow your pelvis to rock backwards and your spine will respond by slumping higher up in the spine. The image on the left shows how the body will rest on a flat low chair with lumbar support. The image on the right shows how the body rests using a chair wedge.

SLEEPING Correctly

We sleep for an average of 6-8 hours a day which is at least 25% of our day. Mattresses or pillows that do not support us in this period can leave you feeling stiff or uncomfortable, and slow down your rate of recovery, sometimes significantly.

Sleeping on your side is the ideal way to offer your spine neutral neutral support as there is less forward/backward movement.

Pillow too low

Shoulders roll forward

Pillow too high

Shoulders roll back

Pillow just right

Body stable and at rest

Your pillow should be supportively firm. Memory foam, feather or down pillows will not offer enough support. Contoured pillows (curved) are not necessary either.

For the majority of people, the alignment of the neck should be approximately level with the spine below but there is a degree of variation that we will discuss with you on your 3rd appointment. Bringing your pillow to this appointment would be helpful.

The key consideration to getting the correct pillow height is that your body is stable and at rest. If your pillow is too low, your shoulders will roll forward and if it’s too high they will roll backwards. If the body is at rest, you should also want to close your eyes more than to keep them open.

Similarly, your mattress needs to be made of a firm material. Memory foam once again is not appropriate as it’s too soft. Your pelvis is the heaviest part of your body, so a soft mattress will allow this to sink into the mattress deeper than the rest of your body.

Latex foam is what we recommend, but a good sprung mattress may work. You can always buy a latex foam topper if in doubt.

Sleeping on your front is never good for your spinal alignment, You will likely be arched backwards and with your neck rotated to one side.

Sleeping on your back can work, but you need a very firm mattress and either a very flat pillow or folded towel to put your head in neutral (i.e. your nose is pointing straight up - not back or forwards towards your chest).

We will advise you in clinic on what the best pillow set up for you is and (stock permitting) will be able to provide you with a pillow and chair wedge at a reasonable cost. We don’t look to profit on the resale of these products.

If interested in looking for yourself, we recommend LatexSense (latexsense.co.uk) or ABCE (https://abc-europe.org/shop/)

STANDING Correctly (good vs bad footware)

The market is flooded with shoes, boots and sandals that claim to support your feet. However, most of this has little to no scientific understanding of how the mechanics of the foot interact with the rest of your body.

Arch supports that many shoes purport to be helpful usually weaken the arch because the apex of the arch support does not match the natural medial arch of your foot. Furthermore, they are too high and therefore restrict the movement of the foot during locomotion - in effect bracing it.

Common shape of arch supports or orthotics - the True Apex of the medial arch is behind what most arch supports provide.

This creates problems that perpetuate up the body via your legs, hips, pelvis, and spine. The arches of your feet are not designed to be static like a bridge, but more like a spring that yields to pressure.

Now many of you may say “my feet get really sore if I don’t have soft insoles and arch supports”. If so, then the likelihood is that there is something higher up the chain causing the problem and if you don’t know about that problem yet, chances are you will do.

One of my clients always used to wear footwear like Birkenstock and Crocs because she had sore feet in anything else. She also had constant back pain and regular headaches. WIth ABC treatment her back pain is better and she now prefers neutral shoes. If she goes back to the ‘dark side’ of footwear, she gets back pain again!

So, what are neutral shoes?

Often they fall under the umbrella of barefoot shoes, but other shoes also tick the right boxes.

The key features are:

Little to no arch support
Zero heel drop - sometimes a slightly elevated heel improves foot function and body mechanics.
A relatively thin and flexible sole so your feet can feel the ground beneath them.
A wide toe-box so the forefoot can spread out and the toes not be constricted.

Over the past 10 years there has been a growth in the barefoot shoe market. Some options to consider are: