Broken bones are common injuries. Because children’s bones grow rapidly, they have increased flexibility. When injuries, specifically fractures, occur, they do not always break cleanly across the bone or into pieces. What type of fracture is this, and how are they treated?
Greenstick Fracture
A greenstick fracture is a partial break in a bone that occurs when a bone bends and cracks instead of breaking into separate pieces. (Wolfe J. A. et al., 2019) The term is based on a young green branch that bends and splinters but does not break into pieces when bent. Only one side of the bone is broken, while the other side gets bent. Many children experience at least one fracture during their growing years. This is one of multiple fracture types seen in children. They can happen in adults but are uncommon.
Causes
Greenstick fractures mostly occur in infants or toddlers, sometimes in children during their early adolescent and pre-adolescent years. They are partial-thickness fractures (a break in a bone that doesn’t completely break it) characterized by a break on one side and a bend on the other. Buckle fractures and bow fractures are different types of partial-thickness fractures. Greenstick fractures commonly occur:
In children under 10 years old
Occurs when a child reaches out to break a fall
During motor vehicle collisions
Sports
Direct impacts
Non-accidental trauma
It is more common in long bones, including:
Radius
Ulna
Humerus
Fibula
Tibia
Clavicle
The fracture pattern often indicates a limb’s bending or contortion.
Deformity, such as the affected body part looking crooked or out of alignment.
Treatment
If the bone is not significantly bent out of alignment, a splint or cast may be all that is necessary to treat the break. If the bone is visibly out of alignment, it must be manually straightened before the limb is put into a cast. If the break is severe, surgery may be required. Fortunately, a growing skeleton can remodel bone, so fractured bones can often realign themselves over time with minimal intervention. Healing depends on various factors, including:
Sometimes, the fracture must be bent back and repositioned in a fracture reduction procedure. An anesthetic may be used as the doctor manually realigns the bone into the correct position. After the reduction, a cast or splint will stabilize the bone and maintain proper alignment. Depending on how quickly the bone heals, a cast may be necessary for a few weeks, months, or longer, depending on the patient and/or underlying conditions.
Healing
Healing involves specialized cells that gradually rebuild and fine-tune the new bone.
The average time for a greenstick fracture to heal completely may take four weeks.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Building a Stronger Body
References
Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early Pediatric Fractures in a Universally Insured Population within the United States. BMC pediatrics, 19(1), 343. https://doi.org/10.1186/s12887-019-1725-y
Atanelov, Z., & Bentley, T. P. (2025). Greenstick Fracture. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30020651
Pountos, I., Clegg, J., & Siddiqui, A. (2010). Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single-blind study. Journal of children’s orthopaedics, 4(4), 321–326. https://doi.org/10.1007/s11832-010-0269-3
Can walking backward on a treadmill aid in treating conditions and injuries, improving strength, gait, and mobility in the lower extremities and knee, hip, and ankle range of motion (ROM)?
Walking Backward On A Treadmill
Walking backward is often used in physical therapy to treat multiple conditions and injuries and help improve strength, gait, balance, and mobility in the lower extremities. It is also used to improve knee, hip, and ankle range of motion and lower back pain and burn calories.
The Difference Backward vs. Forward
The difference from forward walking is that certain motions are normal gait characteristics.
First, the leg swings through the air, and the heel lands on the ground.
Then, the straight knee bends slightly as you roll from heel to toe.
As this occurs, the opposite leg rolls from the toes and up into the air.
This heel-to-toe motion repeats, and normal walking takes place.
Reverse walking creates the opposite gait process.
The leg swings through the air and reaches backward with a bent knee.
The toes contact the ground, and the bent knee straightens as you roll from toe to heel.
Then, the heel leaves the ground with the knee straight, repeating the process.
Reverse walking can help increase knee extension range of motion. (Zhang M. et al., 2022)
Individuals with knee injuries, surgeries, or arthritis may lose their knee extension or the knee’s ability to straighten.
The bent knee straightens fully when walking backward, moving from the toes onto the heel.
This helps to improve the range of motion into knee extension.
Quadriceps Function
Reverse walking can improve the function of the quadriceps muscles in the upper thighs. (Alghadir A. H. et al., 2019)
The quads are active when straightening the knee.
Exercises like quad sets, short arc quads, and straight leg raises increase quad strength.
Hamstring Flexibility
The hamstrings are located in the back of the upper thighs and work to bend the knees and extend the hips.
For individuals with tight hamstrings, a therapist may have you walk backward on the treadmill to improve the flexibility of the muscle group. (BBC, 2023)
When walking backward, the hamstring contracts to bend the knee as it swings through the air.
Then, the hamstring is stretched from the toe to heel movement, and the knee straightens.
Walking backward can help reset one’s gait and improve one’s ability to walk forward.
A study on stroke patients found that backward walking training was superior to standing balance training for improving balance and walking speed. (Rose, D. K. et al., 2018)
Burns Calories
Backward walking has been found to burn more calories than forward walking.
As a result, it improves heart and lung health better.
Conditions That Benefit
Individuals with a lower extremity impairment that results in loss of normal walking mobility may benefit from reverse walking. Common conditions that may help include: (BBC, 2023) (DelMastro H. M. et al., 2023)
Hamstring strain
Sciatica with tightness in hamstrings
Hip, knee or ankle surgery
Lower extremity fracture
Cerebral palsy
Multiple sclerosis
Parkinson’s disease
Stroke
A physical therapist will decide if an individual’s condition warrants reverse walking as part of a rehabilitation program.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Control Foot Motion and Posture
References
Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science, 28(6), 1901–1903. https://doi.org/10.1589/jpts.28.1901
Zhang, M., Pang, J., Lu, J., Kang, M., Chen, B., Jones, R. K., Zhan, H., & Liu, A. (2022). The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals. Journal of Healthcare Engineering, 2022, 4232990. https://doi.org/10.1155/2022/4232990
Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC musculoskeletal disorders, 20(1), 159. https://doi.org/10.1186/s12891-019-2537-9
BBC. (2023). Why walking backwards can be good for your health and brain. https://www.bbc.com/future/article/20231110-why-walking-backwards-can-be-good-for-your-health-and-brain
Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2019). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation, 33(2), 171–182. https://doi.org/10.1177/0269215518801430
Rose, D. K., DeMark, L., Fox, E. J., Clark, D. J., & Wludyka, P. (2018). A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial. Journal of Neurologic Physical Therapy: JNPT, 42(1), 12–21. https://doi.org/10.1097/NPT.0000000000000210
Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait & posture, 65, 20–25. https://doi.org/10.1016/j.gaitpost.2018.06.168
DelMastro, H. M., Ruiz, J. A., Simaitis, L. B., Gromisch, E. S., Neto, L. O., Cohen, E. T., Wong, E., Krug, R. J., & Lo, A. C. (2023). Effect of Backward and Forward Walking on Lower Limb Strength, Balance, and Gait in Multiple Sclerosis: A Randomized Feasibility Trial. International journal of MS care, 25(2), 45–50. https://doi.org/10.7224/1537-2073.2022-010
Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?
Outcome Measurement Tests
Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.
The physical therapist may use other functional outcome measurements to help assess physical therapy progress.
They may measure your strength and range of motion.
Balance and posture may be evaluated.
Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.
Common Outcome Measurement Tests Used
Common functional outcome measurement tools that a physical therapist may use include:
The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues.
The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability.
The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.
Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Understanding The Effects of Personal Injury
References
American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement
Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf
Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z
Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282
Can knowing how to stretch your back help reduce pain and improve your range of motion?
Stretch Your Back
Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:
When stretching, don’t try to push past your pain limit.
Listen to your body, which leads to a calmer nervous system.
Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.
Warm Up
Stretching cold muscles can lead to injury. Always warm up first.
Do between five and 10 minutes of mild activity, such as walking.
Apply heat for 15 to 20 minutes before stretching.
Knees-to-Chest Back Stretch
To perform:
Lie on your back with your feet flat on the floor.
Bring your legs toward your chest With your knees bent.
Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
Pull until there is a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Do a total of 10 reps.
Supine Twist Back Stretch
To perform:
Lie on your back with your knees bent and feet flat on the floor.
Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
Hold for 15 seconds.
Return to the starting position.
Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.
Prone Bridging Back Stretch
To perform:
Lie on your stomach.
Prop yourself up on your elbows.
Extend your back.
Start straightening your elbows, further extending the back.
Continue straightening the elbows until the stretch is felt.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.
Supine Butt Lift Back Stretch
To perform:
Lie on your back with your knees bent and feet flat on the floor.
Push down through the feet as you slowly raise yourself off the floor.
Hold for 10 seconds.
Return to starting position.
Repeat for nine reps.
Seated Forward Curl Back Stretch
To perform:
Sit in a chair with your feet flat on the ground.
Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
Hold for 10 seconds.
Return to the starting position.
Repeat for nine reps.
Side Stretch
To perform:
Stand up straight with your arms at your sides and feet shoulder-width apart.
Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
Hold for 10 seconds.
Return to the starting position.
Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
Hold for 10 seconds.
Repeat for nine reps.
Other Treatments to Loosen a Tight Back
Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)
Acupuncture
Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.
Stretching Benefits
References
Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. https://doi.org/10.1089/acu.2020.1499
Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. https://doi.org/10.1089/acu.2023.0054
U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from https://media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF
Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?
Planes of Motion
The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)
Sagittal plane -Divides the body into right and left sides.
Frontal plane – Divides the body into front and back.
Transverse plane – Divides the body into top and bottom sections.
To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.
Sagittal Plane
Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane. Several eating mechanics occur in the sagittal plane. Movements include:
Flexion – A bending movement that decreases the angle at a joint.
Extension – An extending movement that increases the angle at a joint.
Hyperextension – Extending the angle at a joint beyond neutral.
Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin.
Plantarflexion – Pushing the foot down and away from the body.
Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.
Frontal Plane
The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:
Abduction – Moving the body or a limb laterally and away from the body’s midline.
Adduction – Moving the body or a limb towards the body’s midline.
Elevation – Moving the shoulder blades up.
Depression – Moving the shoulder blades down.
Eversion – Rolling the foot towards the inside/medial side.
Inversion – Rolling the foot towards the outside/lateral side.
Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.
Transverse Plane
The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:
Rotation – Moving the torso or a limb around its vertical axis.
Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.
Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.
Training Within the Planes of Motion Benefits
Training in all three planes can help with movement in several ways, providing greater ease in life and sports.
Prepares Body for Daily Tasks
Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.
In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.
Prepares Body for Sports and Physical Activities
Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.
Encourages Variation For Full Body Strengthening
Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.
Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.
Injury Medical Chiropractic and Functional Medicine Clinic
Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
The Difference of Using Custom Foot Orthotics
References
National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. https://blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES
Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000
For individuals dealing with newly formed or chronic lower back pain, can making daily walks a part of a weekly routine help relieve pain and discomfort symptoms and prevent strains and injuries?
Walking For Low Back Pain Relief
Walking is recommended to treat and prevent chronic or recurrent lower back pain. A study found that a personalized and progressive weekly walking program that builds up to 130 minutes of moderate intensity can significantly relieve severe lower back pain and prevent future flare-ups. (Pocovi N. C. et al., 2024) Walking is a cost-effective and easily accessible way to relieve lower back pain and prevent recurring or future injuries. It strengthens the back muscles, improves posture, and stabilizes the spine. (Suh JH, et al., 2019) Other benefits include improved overall physical health, posture, and circulation.
How Walking Helps
Walking for low back pain relief and general movement is better than not engaging in physical activities for individuals with recurrent lower back pain. Being sedentary can worsen back pain symptoms. (National Library of Medicine. 2019) Walking is second nature and is easy to incorporate into a weekly routine to help relieve back pain and improve overall health (Macquarie University, 2024)
Increases Spinal Flexibility
Walking and gentle movements increase the lower back’s functional range of motion, improve spinal flexibility, and reduce stiffness. (Smith J. A. et al., 2022)
Stabilizes Lumbar/Low Back Muscles
Walking builds muscle endurance and strength in the paraspinal muscles, increasing lumbar spinal stabilization. (Suh JH, et al., 2019)
Strengthens Core Muscles
Walking increases the body load and strengthens core muscles like the transversus abdominis, which lowers the risk of chronic lower back pain. (Lee J. S. and Kang S. J. 2016)
Improves Posture
Movement of the legs during walking enhances bodily awareness and helps correct posture.(Henry M. and Baudry S. 2019)
Increases Blood Circulation
Walking increases blood circulation to the muscles, supplying essential nutrients to spinal discs. It also reduces the frequency and severity of lower back muscle spasms. (Sitthipornvorakul E. et al., 2018)
Lubricates Spinal joints
Low-impact walking improves synovial fluid production and circulation, lubricating the lumbar spine’s facet joints and other joints that tend to get achy, such as the knees. (Zhang S. L. et al., 2013)
Relieves Inflammation
Walking helps reduce the presence of pro-inflammatory cytokines, like (IL-8 and TNF-alpha) associated with chronic lower back pain. (Slouma M. et al., 2023)
Promotes Weight Loss
Walking and a healthy diet can help individuals lose excess fat, which puts added strain on the lower back and correlates with lumbar intervertebral disc degeneration. (Wang M. et al., 2024)
Stress Relief
Regular walking can reduce mental stress associated with chronic lower back pain. (Choi S. et al., 2021)
Releases Endorphins
Moderate to vigorous physical activity, like walking at about 3 miles per hour for a half-hour daily, stimulates the release of endorphins, the body’s natural pain relievers. (Bruehl S. et al., 2020)
Walking Correctly
To get all the benefits of walking for low back pain relief, it is recommended to practice the following (Macquarie University, 2024)
Start slowly.
Gradually build intensity.
Stay consistent with the walking program.
Track progress to maintain motivation.
Healthcare Provider Consultation
Walking is a low-risk, low-impact activity well-tolerated by most individuals with nonspecific low back pain. (Pocovi N. C. et al., 2022) Because it doesn’t involve twisting or vigorous movements, it is considered a safe exercise for individuals with back pain symptoms (Gordon R. and Bloxham S. 2016). However, individuals experiencing severe lower back pain due to a traumatic injury or medical condition should consult a healthcare provider before starting a regular walking program.
Limit High Impact Activities
High-impact activities like running on hard surfaces or playing sports can exacerbate chronic lower back pain. If there is chronic lower back pain, it is recommended to limit activities that involve: (Al-Otaibi S. T. 2015)
Heavy lifting
Repetitive bending
Twisting motions
Injury Medical Chiropractic and Functional Medicine Clinic
Walking for low back pain relief. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Movement as Medicine
References
Pocovi, N. C., Lin, C. C., French, S. D., Graham, P. L., van Dongen, J. M., Latimer, J., Merom, D., Tiedemann, A., Maher, C. G., Clavisi, O., Tong, S. Y. K., & Hancock, M. J. (2024). Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. Lancet (London, England), 404(10448), 134–144. https://doi.org/10.1016/S0140-6736(24)00755-4
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173
National Library of Medicine., & InformedHealth.org [Internet]. Cologne, G. I. f. Q. a. E. i. H. C. I. (2022). Low back pain: Learn More – Why movement is so important for back pain. https://www.ncbi.nlm.nih.gov/books/NBK284944/
Macquarie University. (2024). Macquarie University. Walking to combat back pain: world-first study shows dramatic improvement. https://lighthouse.mq.edu.au/article/june-2024/walking-away-from-pain-world-first-study-shows-dramatic-improvement-in-lower-back-trouble
Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. Journal of sport and health science, 11(4), 450–465. https://doi.org/10.1016/j.jshs.2022.02.001
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173
Lee, J. S., & Kang, S. J. (2016). The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. Journal of exercise rehabilitation, 12(5), 463–470. https://doi.org/10.12965/jer.1632650.325
Henry, M., & Baudry, S. (2019). Age-related changes in leg proprioception: implications for postural control. Journal of neurophysiology, 122(2), 525–538. https://doi.org/10.1152/jn.00067.2019
Sitthipornvorakul, E., Klinsophon, T., Sihawong, R., & Janwantanakul, P. (2018). The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskeletal science & practice, 34, 38–46. https://doi.org/10.1016/j.msksp.2017.12.003
Zhang, S. L., Liu, H. Q., Xu, X. Z., Zhi, J., Geng, J. J., & Chen, J. (2013). Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis. Molecular medicine reports, 7(1), 183–186. https://doi.org/10.3892/mmr.2012.1168
Slouma, M., Kharrat, L., Tezegdenti, A., Metoui, L., Ghazouani, E., Dhahri, R., Gharsallah, I., & Louzir, B. (2023). Pro-inflammatory cytokines in patients with low back pain: A comparative study. Reumatologia clinica, 19(5), 244–248. https://doi.org/10.1016/j.reumae.2022.07.002
Wang, M., Yuan, H., Lei, F., Zhang, S., Jiang, L., Yan, J., & Feng, D. (2024). Abdominal Fat is a Reliable Indicator of Lumbar Intervertebral Disc Degeneration than Body Mass Index. World neurosurgery, 182, e171–e177. https://doi.org/10.1016/j.wneu.2023.11.066
Choi, S., Nah, S., Jang, H. D., Moon, J. E., & Han, S. (2021). Association between chronic low back pain and degree of stress: a nationwide cross-sectional study. Scientific reports, 11(1), 14549. https://doi.org/10.1038/s41598-021-94001-1
Bruehl, S., Burns, J. W., Koltyn, K., Gupta, R., Buvanendran, A., Edwards, D., Chont, M., Wu, Y. H., Qu’d, D., & Stone, A. (2020). Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial. Pain, 161(12), 2887–2897. https://doi.org/10.1097/j.pain.0000000000001969
Pocovi, N. C., de Campos, T. F., Christine Lin, C. W., Merom, D., Tiedemann, A., & Hancock, M. J. (2022). Walking, Cycling, and Swimming for Nonspecific Low Back Pain: A Systematic Review With Meta-analysis. The Journal of orthopaedic and sports physical therapy, 52(2), 85–99. https://doi.org/10.2519/jospt.2022.10612
Gordon, R., & Bloxham, S. (2016). A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel, Switzerland), 4(2), 22. https://doi.org/10.3390/healthcare4020022
Al-Otaibi S. T. (2015). Prevention of occupational Back Pain. Journal of family & community medicine, 22(2), 73–77. https://doi.org/10.4103/2230-8229.155370
For athletes and individuals who want to engage in physical and sports activities, can focusing on health-related fitness components improve overall fitness and conditioning so that they can participate in various sports and other forms of exercise?
Fitness Components For Improved Physical and Sports Performance
Improving cardiovascular fitness, muscular strength and endurance, and flexibility will enhance athletes’ abilities and the daily lives of individuals who exercise and play sports. When enhancing performance in a specific activity, skill-related fitness training that focuses on that activity will be most beneficial. For instance, cardiovascular endurance and flexibility are necessary to play sports that require a lot of running, jumping, and changing positions quickly and to be able to play for the entire time, along with various skills that need to be practiced for agility, power, speed, and hand-eye coordination. Activity-related skills can differentiate two areas of fitness.
Getting In Shape and Improving Performance
Health-related fitness components are important for everyone in all walks of life, regardless of competition in or performing physical activities at an optimum level. These are:
Cardiovascular endurance
Flexibility
Muscle endurance
Muscle strength
Body composition
When improving cardiovascular endurance, the risk of heart disease is reduced. When improving flexibility, a healthy range of motion is maintained, enhancing the ability to perform activities of daily living, like household chores and tasks. These fitness components are crucial for physical health and contribute to positive lifestyle outcomes. (Garber C. E. et al., and American College of Sports Medicine 2011) The American College of Sports Medicine recommends:
Moderate-intensity Cardio
30 minutes a day, five days a week for a total of 150 minutes/week or
Vigorous-intensity Cardio
For 20 minutes a day, three days a week, or
A Combination
Moderate- and vigorous-intensity exercise, plus
Resistance Training
Two to three days a week, along with
Flexibility Training
Two days a week
Skill Related Components
Skill-related fitness components are:
Agility
Balance
Coordination – hand-eye and/or foot-eye
Power
Reaction time
Speed
The skill-related fitness components can help those who want more training for a specific fitness-related goal.(Zemková E. and Hamar D. 2018) For example, while everyone can benefit from daily walks, weightlifters can focus most of their effort on power, balance, and strength.
Power
Power combines speed and strength, which is how fast maximal force can be generated. Athletes exert maximum strength in short, all-out efforts. Jumping requires leg power, while jumping and striking involve a combination of upper- and lower-body power. Power can be improved by combining resistance and speed with fast-paced strength-training exercises that include:
Kettlebell swings
Clean lifts
Jerk lifts
Plyometric box jumps
Pushing a weighted sled
Sprinting
Speed
Athletes train differently but with a similar goal: to become faster in their sport. Speed training will differ based on the sport being trained for. High-intensity interval training, or HIIT, is one of the best ways to improve speed. Training involves working at an all-out or near all-out effort for set periods, followed by set rest periods. (Alansare A. et al., 2018) It repeatedly challenges the aerobic and anaerobic systems, teaching the muscles, heart, and lungs to grow accustomed to working at higher intensity levels. Depending on the sport, the length and intensity of the intervals will be longer or shorter, less challenging, or more difficult. Runners can try these example HIIT speed drills:
Marathon Training
Mile repeats – a style of interval training where the runner goes all-out for a full mile before resting and doing it again.
Sprint Training
Focuses on shorter, more intense intervals.
Ranging from 40 to 400 meters, running all out and resting before repeating.
These same concepts apply to other sports as well.
Agility
Agility is the ability to move and change direction quickly and easily. For example, soccer, basketball, football, and tennis players are incredibly agile and have to move in every direction, jumping, sliding, twisting, and backpedaling in quick response to the ball’s movement and other players. Their bodies must be trained to respond and change course. Agility drills commonly involve exercises that develop foot speed and direction change, that include:
Ladder Drills
Using an agility ladder can help develop quick and specific foot placement.
Cone Drills
Set up cones in a T shape, then sprint, slide, backpedal, or change direction depending on the cone.
Coordination
Sports and physical activities require well-honed hand-eye and foot coordination. They require seeing an external object and responding precisely with the hands and/or feet. Think of hitting a ball, running and catching a ball, throwing a frisbee, or blocking a shot. To improve coordination, try skill-related fitness exercises like:
Playing catch
Jumping rope
Dribbling a ball
Throwing or hitting balls or specific sports objects at targets
Balance
Balance refers to the ability to adjust the body position to remain upright. It involves proprioception, or knowing where the body is in space and being able to adjust position as the center of gravity changes during movement. (Aman J. E. et al., 2015) Sports and daily physical activities require balance for performance and safety. Jumping on a trampoline or rebounder, for example, can help individuals better sense where their bodies are as they move. To improve balance, try these exercises:
Practice standing on one foot.
Practice standing yoga poses.
BOSU balance ball workouts.
Use balance discs to perform squats, lunges, and push-ups.
Reaction Time
Reaction time refers to how quickly one responds to an external stimulus and focuses on the mind-body connection. The eyes see a stimulus, the mind interprets the stimulus, and the body reacts to that interpretation. This mind-body reaction relates to knowledge of the sport or activity and enables individuals to respond more quickly and accurately to the stimulus. Reaction-time training tends to be sport-specific, but skill-related fitness activities can help and include:
Using tools like reaction balls
Fielding a ball
Protecting a goal as other players try to score
Playing table tennis
Playing hacky sack
Injury Medical Chiropractic and Functional Medicine Clinic
Ask a qualified fitness coach or personal trainer if you are unsure where to begin. Other athletes, local teams, gyms, athletic clubs, and healthcare organizations can direct individuals in the right direction. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain, restore function, and prevent injury. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Improving Athletic Performance Through Chiropractic
References
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., Nieman, D. C., Swain, D. P., & American College of Sports Medicine (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and science in sports and exercise, 43(7), 1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb
Zemková, E., & Hamar, D. (2018). Sport-Specific Assessment of the Effectiveness of Neuromuscular Training in Young Athletes. Frontiers in physiology, 9, 264. https://doi.org/10.3389/fphys.2018.00264
Alansare, A., Alford, K., Lee, S., Church, T., & Jung, H. C. (2018). The Effects of High-Intensity Interval Training vs. Moderate-Intensity Continuous Training on Heart Rate Variability in Physically Inactive Adults. International journal of environmental research and public health, 15(7), 1508. https://doi.org/10.3390/ijerph15071508
Aman, J. E., Elangovan, N., Yeh, I. L., & Konczak, J. (2015). The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in human neuroscience, 8, 1075. https://doi.org/10.3389/fnhum.2014.01075
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