• Physical Therapy Blog

Free-Weight Lifting helps a LOT for Low Back Pain

Free-Weight Lifting helps a LOT for Low Back Pain

The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. Welch N, Moran K, Antony J, Richter C, Marshall B, Coyle J, Falvey...

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Chad Reilly December 14, 2017 2 Comments

Pain in the Butt, Sacroiliac Pain as Tendinopathy?

Pain in the Butt, Sacroiliac Pain as Tendinopathy?

I recently finished the 3rd edition Stuart McGill’s “Low Back Disorders.” I’ve followed his work since reading edition 2 and bulk of my back pain treatments are based on, or consistent with it and his more recent research. For those...

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Chad Reilly March 9, 2017 8 Comments

EMS, High-Frequency Fatigue and Pain, Particularly Headaches & Back Pain

EMS, High-Frequency Fatigue and Pain, Particularly Headaches & Back Pain

I needed a break from fasting papers and, while I’m a big, BIG fan of EMS, and to a substantially lesser extent TENS, I am underwhelmed by high “kilohertz-frequency” alternating type currents as is commonly used in Russian stimulation for...

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Chad Reilly April 8, 2016 1 Comment

Dry Needling Collapses Lung, on Video

Dry Needling Collapses Lung, on Video

I had a physical therapist stop by my office last week and try and sell me on dry needling. I said heard all about dry needling and that I thought that like the force, it can have a strong influence...

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Chad Reilly December 31, 2015 8 Comments

Neutral Spine Protects Against Axial Compression

Neutral Spine Protects Against Axial Compression

Lumbar spine endplate fractures: Biomechanical evaluation and clinical considerations through experimental induction of injury. Curry WH, Pintar FA, Doan NB, Nguyen HS, Eckardt G, Baisden JL, Maiman DJ Paskoff GR, Shender BS, Stemper BD, J Orthop Res. 2015 Nov 26. Abstract...

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Chad Reilly December 28, 2015 No Comments

Retired Weightlifters, Wrestlers, DDD, and Back Pain

Retired Weightlifters, Wrestlers, DDD, and Back Pain

Low back pain among retired wrestlers and heavyweight lifters. Granhed H, Morelli B. Am J Sports Med. 1988 Sep-Oct;16(5):530-3. [FREE FULL TEXT] Abstract The lifetime incidence and prevalence of low back pain among 32 retired wrestlers (ages 39 to 62 years)...

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Chad Reilly December 14, 2015 2 Comments

Massive Herniated Discs and Low Back Pain, the Good News

Massive Herniated Discs and Low Back Pain, the Good News

Conservatively treated massive prolapsed discs: a 7-year follow-up. Benson RT, Tavares SP, Robertson SC, Sharp R, Marshall RW. Ann R Coll Surg Engl. 2010 Mar;92(2):147-53. Abstract INTRODUCTION: The natural history of a lumbar hernia of the nucleus pulposus (HNP) is...

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Chad Reilly November 5, 2015 13 Comments

Low Back Pain & Reverse Ergonomics: Fit the Person to the Job?

Low Back Pain & Reverse Ergonomics: Fit the Person to the Job?

Evolving ergonomics? McGill SM. Ergonomics. 2009 Jan;52(1):80-6. Abstract The theme developed in this position paper follows the current evolution of injury prevention in the backs of workers. Job change or 'fitting the task to the person' has come far, but...

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Chad Reilly August 7, 2015 No Comments

Traction, Low Back Pain, Research Suggests it Doesn’t Work

Traction, Low Back Pain, Research Suggests it Doesn’t Work

Traction for low-back pain with or without sciatica. Wegner I, Widyahening IS, van Tulder MW, Blomberg SE, de Vet HC, Brønfort G, Bouter LM, van der Heijden GJ. Cochrane Database Syst Rev. 2013 Aug 19;8 Quotes from abstract (but I read...

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Chad Reilly August 6, 2015 4 Comments

Spinal Manipulation in Physical Therapy, Death Throes in Research

Spinal Manipulation in Physical Therapy, Death Throes in Research

Basis for spinal manipulative therapy: a physical therapist perspective. Bialosky JE, Simon CB, Bishop MD, George SZ. J Electromyogr Kinesiol. 2012 Oct;22(5):643-7. [Free Full Text] My comments: This paper has an extremely well referenced number of facts seemingly leading to...

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Chad Reilly June 18, 2015 4 Comments

Chiropractor Debunks Manipulation/Manual Therapy for Low Back Pain

Chiropractor Debunks Manipulation/Manual Therapy for Low Back Pain

Do manual therapies help low back pain? A comparative effectiveness meta-analysis. Menke JM. Spine (Phila Pa 1976). 2014 Apr 1;39(7) :E463-72. Abstract STUDY DESIGN: Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain....

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Chad Reilly June 7, 2015 3 Comments

Manipulation & Mobilization for Chronic Low Back Pain, Not Worth the Effort

Manipulation & Mobilization for Chronic Low Back Pain, Not Worth the Effort

Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review. Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spine (Phila Pa 1976). 2011 Jun;36(13) Abstract STUDY DESIGN: Systematic review of interventions. OBJECTIVE:...

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Chad Reilly May 21, 2015 2 Comments

Manipulation vs Mobilization for Acute Low Back Pain, Neither Work

Manipulation vs Mobilization for Acute Low Back Pain, Neither Work

Spinal manipulative therapy for acute low-back pain. Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW. Cochrane Database Syst Rev. 2012 Sep 12;9 Abstract BACKGROUND: Many therapies exist for the treatment of low-back pain including spinal manipulative therapy...

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Chad Reilly May 20, 2015 3 Comments

McKenzie Method as Lackluster as Back School for Back Pain

McKenzie Method as Lackluster as Back School for Back Pain

Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Garcia AN, Costa Lda C, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, Costa LO. Physical Therapy. 2013 Jun;93(6):729-47. Abstract...

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Chad Reilly April 25, 2015 No Comments

Vertebral Fractures after Yoga in Women with Osteopenia

Vertebral Fractures after Yoga in Women with Osteopenia

Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: case series. Sinaki M. Pain Pract. 2013 Jan;13(1):68-75. [FREE FULL TEXT with good pics] Abstract OBJECTIVE: The objective of this report is to raise awareness of...

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Chad Reilly March 30, 2015 3 Comments

Emetophobia and the Biopsychosocial Model of Low Back, Neck Pain

Emetophobia and the Biopsychosocial Model of Low Back, Neck Pain

Exposure therapy for emetophobia: a case study with three-year follow-up. J Anxiety Disord. 2013 Jun;27(5):527-34. Maack DJ, Deacon BJ, Zhao M. Abstract Emetophobia, also referred to as a specific phobia of vomiting, is a largely under-researched and poorly understood disorder...

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Chad Reilly December 11, 2014 No Comments

Low Hip Strength Associated with Increased Spine Motion

Low Hip Strength Associated with Increased Spine Motion

Relationship between hip strength and trunk motion in college cross-country runners. Med Sci Sports Exerc. 2013 Jun;45(6):1125-30. Ford KR, Taylor-Haas JA, Genthe K, Hugentobler J. Abstract PURPOSE: Hip strength may directly relate to abnormal running mechanics and contribute to the...

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Chad Reilly November 14, 2014 No Comments

Physical Therapy After Vertebroplasty and Kyphoplasty

Physical Therapy After Vertebroplasty and Kyphoplasty

Significantly fewer refractures after vertebroplasty in patients who engage in back-extensor-strengthening exercises. Huntoon EA, Schmidt CK, Sinaki M. Mayo Clin Proc. 2008 Jan;83(1):54-7. Abstract OBJECTIVE: To determine whether patients with osteoporotic compression fractures would have decreased fracture recurrence or a...

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Chad Reilly October 30, 2014 2 Comments

So Called “Trunk Stabilization” Exercises are Anything But…

So Called “Trunk Stabilization” Exercises are Anything But…

Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Physical Therapy. 2005 Mar;85(3):209-25. Koumantakis GA1, Watson PJ, Oldham JA. Abstract BACKGROUND AND PURPOSE: The purpose of this randomized...

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Chad Reilly October 22, 2014 No Comments

Kinesio Tape Sure Smells Like Placebo

Kinesio Tape Sure Smells Like Placebo

Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014 Mar;60(1):31-9. Parreira Pdo C, Costa Lda C, Hespanhol Junior LC, Lopes AD, Costa LO. Abstract Questions: Is Kinesio Taping more effective than...

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Chad Reilly September 15, 2014 No Comments

Low Back Pain, Hip Strength, and IT Band Tightness

Low Back Pain, Hip Strength, and IT Band Tightness

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & Osteopathy. 2010 Jan 13;18:1. Arab AM, Nourbakhsh MR. Abstract BACKGROUND: Shortening of the iliotibial band (ITB) has been considered to be...

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Chad Reilly August 27, 2014 2 Comments

Decreasing Low Back Pain While Driving

Decreasing Low Back Pain While Driving

Seat inclination, use of lumbar support and low-back pain of taxi drivers. Scand J Work Environ Health. 2005 Aug;31(4):258-65. Chen JC, Dennerlein JT, Chang CC, Chang WR, Christiani DC. Abstract OBJECTIVES: Epidemiologic evidence supporting optimal seating is limited and inconsistent....

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Chad Reilly August 26, 2014 No Comments

Reversing Disc Protrusions, McKenzie Mostly Correct in Theory

Reversing Disc Protrusions, McKenzie Mostly Correct in Theory

Disc prolapse: evidence of reversal with repeated extension. Scannell JP, McGill SM. Spine (Phila Pa 1976). 2009 Feb 15;34(4):344-50. Abstract STUDY DESIGN: A basic science study that used a porcine cervical spine model to produce disc prolapse subsequently exposed to an...

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Chad Reilly August 20, 2014 2 Comments

How to Herniate a Disc, and How Not to

How to Herniate a Disc, and How Not to

  Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech (Bristol, Avon). 2001 Jan;16(1):28-37. Callaghan JP, McGill SM. Abstract OBJECTIVE: To determine whether repeated motion with low magnitude joint forces,...

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Chad Reilly August 18, 2014 2 Comments

Central Sensitization and Chronic Pain

Central Sensitization and Chronic Pain

Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. Woolf CJ. [FREE FULL TEXT] Abstract Nociceptor inputs can trigger a prolonged but reversible increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways,...

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Chad Reilly July 26, 2014 No Comments

McKenzie Method, Diagnosis No Better Than Treatment

McKenzie Method, Diagnosis No Better Than Treatment

McKenzie lumbar classification: inter-rater agreement by physical therapists with different levels of formal McKenzie postgraduate training. Spine (Phila Pa 1976). 2014 Feb 1;39(3):E182-90.  Werneke MW, Deutscher D, Hart DL, Stratford P, Ladin J, Weinberg J, Herbowy S, Resnik L. Abstract...

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Chad Reilly July 1, 2014 8 Comments

Muscle Spasms and Low Back Pain

Muscle Spasms and Low Back Pain

This was a pair of studies by the same authors that have some great, real world implications with regards to prevention and physical therapy treatment of low back pain and neck pain. Short rest periods after static lumbar flexion are...

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Chad Reilly May 31, 2014 2 Comments

Abdominal Hollowing, Core / Spine Stabilization, and Low Back Pain

Abdominal Hollowing, Core / Spine Stabilization, and Low Back Pain

This study explains a lot with regards to differential, and failure to differentiate exercise outcomes in people with low back pain. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr...

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Chad Reilly May 21, 2014 No Comments

Not Just Strength but Also Neuromuscular Exercise and Counseling Decreases Low Back Pain.

Not Just Strength but Also Neuromuscular Exercise and Counseling Decreases Low Back Pain.

Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study.   Spine (Phila Pa 1976). 2013 Mar 1;38(5):375-84.   Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki...

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Chad Reilly May 20, 2014 No Comments

Preventing Low Back Pain on Airline Flights

Preventing Low Back Pain on Airline Flights

Lessons from this study make up what I think is about a third of the solution to effectively treating low back pain preventing future episodes of back pain.  That is, to avoid prolonged damaging posture particularly in spine flexion. Using a...

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Chad Reilly May 20, 2014 No Comments

Periodized Resistance Training Works Better than Aerobic Training for Chronic Low Back Pain

Periodized Resistance Training Works Better than Aerobic Training for Chronic Low Back Pain

A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res. 2009 Mar;23(2):513-23. Kell RT, Asmundson GJ. From the study: Abstract The purpose of this study was to determine...

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Chad Reilly May 15, 2014 No Comments

Periodized Resistance Training: Strength, Function and Low Back Pain.

Periodized Resistance Training: Strength, Function and Low Back Pain.

The influence of periodized resistance training on recreationally active males with chronic nonspecific low back pain. J Strength Cond Res. 2011 Jan;25(1):242-51. Jackson JK, Shepherd TR, Kell RT. From the study: Abstract The most common musculoskeletal health issue is chronic...

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Chad Reilly May 15, 2014 3 Comments

Hard Times for McKenzie Method, Low Back Pain

Hard Times for McKenzie Method, Low Back Pain

The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach. Spine. 2006 Apr 20;31(9) Machado LA, de Souza Mv, Ferreira PH, Ferreira ML. From the study: “Eleven trials of mostly high quality were...

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Chad Reilly May 14, 2014 188 Comments

Low Back Pain: Use of Biopsychosocial Model Does Not Improve Outcomes

Low Back Pain: Use of Biopsychosocial Model Does Not Improve Outcomes

Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2118-23. From the review: "The...

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Chad Reilly May 6, 2014 No Comments

Rotation Stretch Increases Low Back Pain and Decreases Spine Stability

Rotation Stretch Increases Low Back Pain and Decreases Spine Stability

Low back pain development response to sustained trunk axial twisting. Eur Spine J. 2013 Sep;22(9):1972-8. From the study: METHODS: Sixteen male pain-free university students volunteered for this study. The trunk axial twisting was created by a torsion moment of 50...

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Chad Reilly May 5, 2014 No Comments

Low Back Pain: Cyclic and Static Spine Flexion Both Bad for the Back

Low Back Pain: Cyclic and Static Spine Flexion Both Bad for the Back

Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Ann Biomed Eng. 2005 Mar;33(3):391-401. From the study: Abstract There is a high incidence of low back pain (LBP) associated with occupations requiring...

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Chad Reilly May 5, 2014 2 Comments

EMS Decreases Back Pain, Increases Core Strength, Endurance

EMS Decreases Back Pain, Increases Core Strength, Endurance

“Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.” Right now this is my favorite electric muscle stimulation...

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Chad Reilly April 16, 2014 21 Comments

Low Back Pain. Free Weights Good, Weight Machines and Stretching Bad — It’s Science.

Low Back Pain. Free Weights Good, Weight Machines and Stretching Bad — It’s Science.

Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain? J Sci Med Sport. 2013 Aug 8 The researchers followed 4610 adults and compared their exercise program and incidence of low back pain over an...

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Chad Reilly April 9, 2014 2 Comments