Home Exercise and Rehab
Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.
She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website: www.home-exercise-rehab.com
This month: Dealing with muscle weakness and stiffness
Weakness and stiffness in the muscles of the low back, hips and thighs, may contribute to long-term mobility problems. These often start with increasing difficulty in performing normal daily activities. It is not uncommon for the first symptoms to be experienced when getting out of bed or a chair, or after kneeling down for a period of time, such as with gardening.
The muscles which bend the hip joint, known as the ‘hip flexors’, connect to the lumbar spinal vertebrae as well as the spinal discs which are located between the vertebrae. Therefore, flexing the hip such as when getting out of a chair or when putting on shoes becomes difficult when the lumbar spine is affected by degenerative changes. Inflammation associated with spinal arthritis, which may also be termed ‘spondylitis’ or ‘spondylodiscitis’, leads to chronic stiffness or pain in the low back and hip region. Symptoms are usually worse first thing in the morning but improve with gentle movement or exercise. Commonly, pain can be referred from the spine to the outer hip area and front of the thigh via the nervous system.
Of course, muscle stiffness may simply be a consequence of being relatively inactive during the winter months. If the symptoms are not resolved by gentle exercises as described here, or by walking or swimming, it is prudent to visit your GP to determine any other cause of the problem. Anti-inflammatory drugs and gels are available on prescription and will to ease any inflammation in the lumbar spine which may be contributing to stiffness in the low back and hips. If you choose to avoid medications, an ice pack is a natural anti-inflammatory alternative and should be applied to the low back area on waking and in the evening. Apply the ice pack for 10 minutes, and repeat three times at 10-minute intervals. Also, it is inadvisable to remain sitting for long periods of time, i.e. more than 30 minutes, as inflammation tends to settle in one area, causing greater discomfort. It is therefore best to stand up and engage in gentle weight-bearing activities intermittently, for 10-15 minutes.
While gardening, you should kneel down on a pillow rather than squatting to avoid stiffness in the hips and thighs. Position yourself close enough to your target for pruning or planting etc. to be able to hold the knee joints at about a 90-degree angle, with your body upright. The more you incline to body forwards, the greater the strain on your low back and hips. Unfortunately, you will most definitely be aware of the fruits of your labours the next morning, in your low back!
Since the muscles at the front of the hips and thighs (the quadriceps) as well as those which attach behind the knees (the calves and hamstrings) must contract over a long period to provide postural support, some degree of stiffness may be inevitable. These muscles are powerful mobilizing muscles and function most efficiently with activities such as walking or swimming. They can provide postural support, but start to fatigue within 15-20 minutes. For this reason, it is advisable to stand up and engage in gentle weight-bearing activities for about 10 minutes intermittently, whenever you have to kneel down for longer than 20 minutes.
The following exercises for the low back, hips and thighs will help to avoid stiffness as well as help your mobility which practised regularly. It is advisable to repeat the exercises daily and after activities such as gardening.
Please send your questions for future columns, or feedback, by email to Gina John on firstname.lastname@example.org
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