KRISTIN'S STORY

Kristin came to us when we first opened a few years ago. She’s a mother of two, bodybuilder, and overall awesome person. She had been through a lot already - several surgeries on her spine and lots of doctor’s appointments, imaging, and pills. She had suffered a previous disc injury in her low back which required surgery to get her out of pain - or so she was told. After her surgeries, she was still having low back pain with a little bit of leg pain, but not quite the typical sciatica pattern we see. Most importantly, she said that the pain she was experiencing now was very different than the pain which led to a surgery to fix her previous injuries.

Kristin had what’s called diastasis recti - an injury to the tendon in an abdominal muscle which was causing weakness in her core. Kristin kept going to the gym and training hard because she didn’t think much of it. Being the gritty person she is, she kept pushing through the pain even though squats and lunges were terribly painful because training hard and working to improve herself is a passion which can’t be stopped by a little pain - until one day it does. When she was working out her pain kept getting worse and lasting longer and longer after she was done. Eventually the pain was interfering with her most important job - caring for her twin boys. She ended up getting surgery again. Unfortunately, the although the surgery “fixed” the diastasis, she was not prescribed physical therapy afterwards which led to a further weakening of her abdominal muscles. She was still having pain and was at her wit’s end. Her doctors were starting to give up on her and telling her that her pain was all in her head.

THAT’S WHEN SHE FOUND US.

Video: Core Tests

We performed a very detailed assessment which included vitals, posture, a detailed movement assessment, and applicable orthopedic and neurological testing. Many of the tests we did were normal, which is a good sign. As part of our movement evaluation we did two tests which can help reveal a weakened core which may contribute to pain. It became pretty clear that her issue was due at least In part Check out the video below to see what those tests are. This test is simple and non-specific and just one of the several we did.

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Diastasis recti occurs when the rectus abdominis muscle (the 6-pack muscle) sustains a rip in the tendon that goes up and down the middle causing weakness and pain. This can occur for many reasons. The most common reason being pregnancy, but it can also happen in weightlifters, bodybuilders, and people who lift heavy things for a living such as construction workers. For some people, this weakness may go completely unnoticed or not interfere with anything, but for people who work out hard it can cause subtle changes in movement patterns. These changes can potentially load up the small muscles and joints in the low back. Small muscles and joints don’t like to do big work, so they start sending messages in the form of worsening pain.  We did not intend to “close” or fix the diastasis. Our goal was to instead strengthen everything around it and make her more resilient, stronger, and a better mover to lessen the impact of the injury on the overall system.

Quick disclaimer: “The core” has been subject to a lot of debate and is frequently blamed as a culprit for everything from low back pain to heel spurs. The details of that debate are outside the scope of this article. In this case I am relatively confident that’s what was causing Kristin’s pain. 

Kristin was very dedicated to getting well so that she can get back to doing what she loved. We love it when we see a patient with that level of determination!

We began a course of treatment which included gentle and specific chiropractic adjustments,advanced soft tissue treatments, and progressive rehab exercises. Since she had some unique considerations, we tailored the adjustments to fit her and not the other way around. Many of our exercises revolved around retraining how to activate her core and brace properly and we tweaked movement patterns for some of her main lifts such as squats, lunges, and deadlifts. The combination of the three treatments was a perfect 1-2-3 punch!

Here are two of the core stability exercises we did.

VIDEO - PALLOF PRESS

The Pallof press is a staple in many of our rehab programs. It trains a very important aspect of core stability called “anti-rotation” as well as how to brace while moving the arms. These skills are important while working out, but also when doing chores around the house. We want to use the big muscles to stabilize the spine rather than the small muscles and little joints.

VIDEO - PLANK PULL THROUGH

The plank pull through is a more advanced movement we use to train pretty much everything. The ability to generate full body tension while moving a heavy object is important. This is a great way to learn how to integrate a bunch of stuff at once!