The Stenosis Diagnosis

July 29, 2018

If walking on land creates weakness in the legs, striding back and forth across a pool can be the perfect strategy to increase heart and respiration rate, without the risk of falling.

May 27, 2018

Some of us believe the best way to protect the spine is to move like a robot. We walk around like a robot (holding in our abs). We lift things like a robot (back straight, knees shoulder-width apart). We make love like a robot, and so on. But the fact is, human beings are not robots. It's normal for us to move in multiple planes, diagonals, and spirals. We need rotation in our spines when we walk to promote healthy circulation and normal tissue elasticity.

Those of us with spinal stenosis should avoid extreme rotational or repetitive large twisting movements--but we shouldn't tense up and stop moving as our bodies are designed to move. Keep moving like a person--let those arms and shoulders swing when you walk! Breathe deeply and try to stay relaxed. 

April 23, 2018


Tai Chi for Spinal Stenosis? Yes, absolutely! If you have trouble standing, I recommend Tai Chi in a tall-sitting position, such as sitting on the arm or back of a couch or on high stool or bed. Some of my patients report dramatic post-surgical recovery breakthroughs after practicing just a few Tai Chi warm-up moves several times throughout their day.

One reason for this may be that many conservative (and post op) back exercises are about stabilization and strengthening in these very linear planes. People can be taught inadvertently by conventional PT exercises, to move around like robots.

Tai Chi helps you learn to move your whole body, not just one part at a time, so you move more efficiently, effortlessly, and with less stress on the joints.

July 22, 2017

Pliability, circulation, and joint lubrication are as important as the ability to generate force with our muscles. Even the way we breathe can have a huge effect on the spine.

Physical therapists and athletic trainers are well-versed in ways to strengthen different muscles. You may be told by these professionals that certain muscles need to be stronger to support certain injured joints. If you have strong leg muscles or butt muscles, your knees will be well-supported. If you have strong abs or back muscles, your spine will be more "stable." This is the conventional way we think of exercise: Your spine is a ship mast, supported by ropes and pulleys (muscles). Strengthen the ropes and pulleys and your spine will be better supported. Well, to some degree, this is true. But this is by no means the only reason to do--or way to think of--strengthening.

Let me state the obvious: Your spine is not a ship mast.

When we think of the spine as a ship mast, it helps us to understand muscles from a mec...

July 2, 2017

Occasionally, clients with lumbar spinal stenosis ask me about rowing machines. Are they good? Are they bad? What muscles do they work?

Rowing provides a work out for several large muscle groups (gluteals, quads, abs, lats), some that directly attach to the spine. Working muscles that attach to the spine improves circulation to the spine, which can be very advantageous for someone with spinal stenosis. Rowing also allows you to get a low impact aerobic workout, without having to be on your feet for long periods. Still, as with any new exercise, you'll want to proceed with caution. It's best to try out a rowing machine for a few minutes first, see how you feel the next day, and progress from there. Also, you'll want to start with small arcs of movement and low low resistance.

Advantages: 1) rowing specifically targets back muscles 2) it can be tailored quite easily to fit your fitness and strength level 3) is excellent for more fit individuals 3) involves exercising in a sitting position,...

June 11, 2017

Strategic exercise is smart exercise--exercise designed to provide the best chance for success. All you need to do is keep to a few basic principles:

  • Choose just one or two exercises at a time and a realistic goal.

  • Use gradual progression (just...go...slow).

  • Should you have a flare-up--make adjustments rather than just ditching the whole program.

Let's take a look at the exercise strategies of Kyle and Bill:

Kyle is told by his doctor to exercise for his spinal stenosis and to "get out and walk." The next day, he hits the sidewalk! His goal is to walk 3 miles per day until he starts feeling better. He doesn't use any kind of cane or walker because, "That'll just make me weak!" At about 500 feet, his legs are wobbly, but he keeps on going, determined to meet his goal. Finally, his legs give out from under him. Undeterred, Kyle drags himself to his feet and continues his walk. Then, he falls and breaks his hip. (You see, he literally did hit the sidewalk!) For the next 8 we...

May 15, 2017

The following information was presented in a lecture at the Golden Future 50+ Expo in Pasadena, California on May 13th, 2017:

Intro:

My name is Terri Night. I’ve been a physical therapist since 1988—so, coming up I’ll be going on 30 years. Boy, did that fly by! In my career, I’ve worked all up and down the West Coast, including the Cedars Sinai Institute of Spinal Disorders, and with some of the best spine surgeons in the country.

Like the many of you, I have my own “back” story. When I was 25, I had what I like to call my "jackass injury." I was taking classes in a Brazilian martial art called Capoeira, and was in the best shape of my life. I was walking down the sidewalk one day and, for some reason, thought it would be a good idea to take a running, leaping kick. I planned to do this kick as I sailed past a speed-limit sign, and (a la Singing in the Rain meets Rush Hour II) grab the sign pole and twirl around. This turned out to not be such a good idea. As I flew past the sign, I grabb...

May 15, 2017

1. Spinal stenosis always gets worse over time. 

FALSE: Studies have shown that some people with spinal stenosis show a decrease in spinal stenosis over time. (Who are these people, and what do they know?)

2. You should force yourself to stand up straight to lessen the symptoms of stenosis. 

FALSE: Forcing yourself (or someone else) to stand up straight can create more pressure on the spinal cord and lead to increased weakness in the legs. It’s better to allow yourself to stand as straight as you are comfortable standing, and if you start to stoop more than usual, it may be time to take a rest.

3. Short of surgery, there is nothing you can do to reduce spinal stenosis.

FALSE: Studies have shown that the number one factor in reducing spinal stenosis is to improve one’s overall physical health.

4. Spinal stenosis is a rapidly progressing arthritic condition.

FALSE: Spinal stenosis is a very slowly progressing condition. (You have time to try to improve your health.)

5. Disc bulges, herniations,...

March 2, 2017

Elastic Lumbar Corset

  1. Ride an exercise bike. Work out while decreasing pressure on the spinal cord and nerves. A great alternative to walking.

  2. Stop forcing yourself to stand up straight. If you’re comfortable standing up straight, great. But if standing up straight is making your legs feel rubbery or your low back feel like it’s going to cave in, you’re better off finding a nice place to sit down.

  3. Use an elastic lumbar corset. Helps limit large movements. Helps if you’re going to be on your feet a little longer than usual. Wear it while you sleep to reduce awful morning wake-up pain. 

  4. Use ice. Slows down the nerve’s ability to conduct pain signals and increases circulation to your spine. Ice also causes deep muscle relaxation. 

  5. Use a walker with a seat. A walker with fold-down seat lets you to sit down whenever you need to and is great for preventing falls. Especially useful if you have trouble walking or standing for long periods. 

  6. Use a Nu-Step machine. I...

February 18, 2017

The word stenosis is defined as an abnormal narrowing of any opening in the body.

You can have aortic valve stenosis (narrowing at the valve to the major artery of the heart), bronchial stenosis (narrowing of the bronchial tube of the lung), or intestinal stenosis, which is, well, just…very unpleasant.

The term spinal stenosis relates to an abnormal narrowing of either...

  1. The spinal cord canal or

  2. The nerve openings

Think of a piece of Swiss cheese. Swiss cheese has holes big enough for spinal nerves to pass through. Change that cheese to a baby Swiss, suddenly the holes aren’t big enough—and, it’s kind of like this in your spine:

(This is not meant in any way to disparage baby Swiss cheese, which is

a fine cheese for sandwiches or even just a snack.)

Symptoms of Spinal Stenosis

When the holes in the spine are narrowed like this, people can experience:

  • Severe low back pain

  • Feelings of heaviness or pressure in the low back

  • Weakness or cramping in the legs 

  • Difficult...

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TERRI NIGHT, MSPT

© 2017 by Terri Night, MSPT

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