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A bum deal

by Ray Moore MCSP

Lower back and buttock pain, often accompanied by restriction of movement, is a frequent presenting symptom to GP’s and physiotherapists. It can occur in individuals with a sedentary life style, but more often presents in the “aging athlete”. Ray Moore, specialist physiotherapist at physio2go at York Lodge St. Albans discusses common causes of this injury and effective treatment strategies. Laszlo Szabo, personal trainer and qualified Pilates instructor at Sopwell House Country Club and Spa explores the role of general fitness and Pilates in the prevention of lower back injuries.

Causes of buttock pain

Pain in the lower back and buttock region is most often caused by minor injuries to the muscles and ligaments of the lower back. Causes include sports injuries, standing or sitting for prolonged periods, poor posture, lifting or twisting in awkward positions and a too sedentary life style! Disc injury to the lower back can put pressure on the spinal nerves causing buttock and leg pain (sciatica). Osteo-arthritis or more serious pathology in the spine can also cause referred pain into the buttocks and legs and should initially be assessed by your physician.

Initial assessment

Your GP or physiotherapist will first ascertain either an acute cause of the problem or question you to see if the pain has been developing over weeks or months. If the symptoms can not be explained as having a mechanical cause, or if other medical issues arise, your GP may order further investigations such as an X-ray, MRI, CT scan, bone densitometry or blood tests.

Acute Injury: Treatment Strategies

• Keep active! Try to lead as normal a life as possible; however, avoid sustained positions for long periods. Over the counter pain medication should be used if required. Gradually build up to more active pursuits over a period of time. Most back pain will improve within six weeks.
• Return to exercise? Generally, returning to moderate exercise is a good thing. Be sure that the exercise is well within your capability and that you avoid any impact or heavy lifting. Concentrate on mobility and stability training, increasing your training regime over a period of weeks under supervision.
• Role of physiotherapy. If your back pain persists, you should seek the expert advice of a chartered physiotherapist. The physiotherapist will be able to give you a thorough examination, and develop a treatment plan specific to your needs. This holistic approach may include manual therapy techniques, the use of electrotherapy, a specific exercise prescription and advice on posture and ergonomics.

Pilates and Prevention

It is important to prevent an acute injury from becoming a chronic condition! Pilates training can help to ensure long term strength and stability of the core and back muscles.

Laszlo Szabo, qualified Pilates instructor at Sopwell House Country Club and Spa is often the person called upon to initiate one-to-one personal training in this unique form of exercise. One-to-one training is highly recommended before joining an on-going exercise class.

Laszlo adds, “Pilates requires the individual to focus both mind and body on individual muscles. The strengthening and lengthening of specific muscle groups improves functional flexibility and posture. It has been shown to relieve pain, decrease stress and boost over all energy levels.

Pilates can give you a stronger toned body, a flatter stomach, leaner muscles, and improved posture. The Pilates technique has been modified over decades to be appropriate for all levels of fitness. Sedentary life styles can cause abdominal muscles to weaken, muscles in the back and legs to shorten, spines to slump and shoulders to rounds forward. All of these changes can lead to lower backache, chronic neck and shoulder pain. A well moving joint is a well lubricated joint. When your joint moves it releases synovial fluid which works like oil on a rusty hinge. When Pilates is done in a controlled manner synovial fluid production is increased and flexibility is improved. This may also help to prevent arthritic pain.

Pilates can help with stubborn back issues as it focuses on the ‘powerhouse muscles’ between the base of the ribs and the pelvic floor. Traditional abdominal exercises, focusing on the ‘six pack’ do not target the weaker deeper abdominal muscle group. In the Pilates system you will work from the inside out, starting with the deeper layers of muscle and moving towards the more superficial muscles. Focusing on core stabilization will help to support the lower back. This means strengthening your back, buttocks, hip flexors and pelvic floor. Pilates training will ensure that you learn safe and effective exercises for your level of fitness.

No Quick Fix

Remember, there is no such thing as a quick fix in any exercise regime. In 10 sessions, you will feel the difference, in 20 you will see the difference, and in 30 you will be delighted with the “new you”!

Pilates can provide a cardiovascular workout only at very advanced levels. Therefore, if you want to speed up weight loss, Pilates should be combined with a healthy diet and cardiovascular exercise. It is recommended to practise pilates approximately 3 times a week. Laszlo adds “I have been teaching Pilates since 2001. This training method can be practised by all ages, and is suitable for all levels of fitness. A qualified instructor can personalise an exercise programmes in response to an individual’s needs or medical condition. Although many of my classes are mostly attended by women I can highly recommend pilates for gentlemen with the frequent combination of a bad back and a beer belly!

Caution

If you have any kind of muscular-skeletal problem resulting from an injury or medical condition it is essential that you discuss taking up this programme with a doctor or a qualified Pilates teacher before you start.