In the United States alone, at least 100 million adults suffer from common chronic pain conditions, which is more than the number of people who have diabetes, heart disease, and cancer combined. There are many factors that contribute to pain. However, one of the less obvious causes may be one of the most important – how we sleep.
We spend up to 1/3 of our lives asleep, and it plays a vital role in the overall health and function of our nervous system. Our bodies recover while sleeping and there is evidence to show sleep, pain, and inflammation relate to and interplay with each other. In recent studies, researchers have shown that losing sleep may disrupt the body’s pain signaling system, heightening sensitivity to painful stimuli. Another theory holds that losing sleep causes inflammation throughout the body. The average adult should sleep for at least eight hours each night, so there are many of us who may not be getting enough sleep, and our bodies are suffering because of it.
If you suffer from chronic pain or inflammation and are not getting a full, uninterrupted 8+ hours of sleep, here are simple suggestions to try:
- Take your lunch break outside. Melatonin is the hormone that makes you sleepy, and it is produced as a response to the day going from light to dark. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night, so this hormone response is more effective if you’re in bright sunlight during the day. If you work indoors, make a point to get outdoors for at least a total of 30-60 minutes during the brightest portion of the day.
- Leave the smart phone downstairs. These devices emit blue light, which tricks your brain into thinking it’s still daytime. Normally your brain starts secreting melatonin between 9 and 10 pm, and these devices emit light that may stifle that process.
- Sleep in total darkness. Even the slightest bit of light in your bedroom can disrupt your biological clock and your pineal gland’s melatonin production.
- Keep your cool. Keep the temperature in your bedroom at or below 70 degrees F. Studies show that the optimal room temperature for sleep is quite cool – between 60 to 68 degrees F.
Hopefully these tips will help you to get a better full night’s rest. If you still have problems with chronic pain that you think could be addressed by a physical therapist, contact your local Foothills clinic today.
Lange T, Dimitrov S, Born J. Effects of sleep and circadian rhythm on the human immune system.
Annals of the New York Academy Sciences. 2010;1193:48–59.
Our Gilbert physical therapy expert, Allen Gruver, is here to go in-depth about the link between your lower back pain and golf:
The golf swing is a highly integrated movement requiring tri-planar mobility and strength, especially across the hips and pelvis. There are approximately 23 ranges of motion in the body that are essential for an efficient swing—none more important than the hip joint, known as the acetabular-femoral (AF) joint. Rotation of the pelvis during the golf swing is a key movement, promoting stability and the transfer of power during both phases of a golf swing. When rotation of the hip joint is limited in one joint or both, rotational demands are transferred proximally to the lumbar spine and SI joints. This compensation affects the biomechanics of the swing and leads to mechanical breakdown in the lumbar spine region.
Research has shown a positive correlation between decreased lead hip rotation and lumbar range of motion with a prior history of low back pain in professional golfers. A study performed in 2004 by Dr. James Andrews and various authors showed that range of motion deficits in the lead hip rotation and lumbar spine extension are correlated with a history of low back pain in golfers. It was the author’s hypothesis that capsular tightening occurred due to lead hip external rotator hyper tonicity and inhibition of the corresponding internal rotators.3
Ron Hruska, MPT, PT of the Postural Restoration InstituteTM (PRI) in Lincoln, Nebraska describes a pattern of asymmetry across the lower extremity known as the Anterior Interior Chain (AIC). Hruska believes that the asymmetrical postural pattern occurs in some degree with all humans and the specific muscular imbalances occur on the left side. This is attributed to anatomical differences and a dominant right side motor pattern that we develop through our life. The left Anterior Interior muscle chain consists of the diaphragm, psoas major, tensor fascia latae, vastus lateralis, and the biceps femoris. When this muscle chain becomes unopposed and malpositioned a predictable pattern evolves, causing structural compensations throughout the entire body.2
The left anterior interior chain primarily affects the pelvic girdle and its corresponding joints. The left pelvic innominate is anteriorly tilted and forwardly rotated in relationship to the right innominate. The left femur is internally oriented within the acetabular-femoral joint (AF), promoting compensatory femoral-acetabular (FA) external rotation to reposition the left femur in a relative neutral state. This pelvic positional state produces hypertonicity of the left external rotators and posterior capsule tightening.
During a golf downswing, AF internal rotation is key for transfer of energy and acceleration through the impact of the golf ball. As weight is being transferred to the lead hip, the pelvis rotates over the femur producing AF internal rotation. This generation of torque is created in the lower body and transferred up through the body and through the club. According to Glenn Fleisig of the American Sports Medicine Institute, the majority of torque in a swing is generated by the lower body muscle groups of the glutes, hamstrings, quads, and core region (low back, abdominal, obliques).1
When a golfer presents with a Left AIC pattern and hip external rotatory hypertonicity and/or posterior capsular restriction is accompanied, the internal rotators of the hip and concomitant obliques are weakly positioned and cannot properly achieve adequate internal rotation during the downswing phase. The inability to rotate the acetabulum over the femur creates compensatory shearing forces in the SI joints and lumbar spine, where anatomical rotation is very minimal and undesirable. This rotational compensation will eventually lead to torque of SIJ and lumbar spine causing SIJ dysfunction/instability and mechanical low back pain.
Allen, and all of our physical therapy experts at Foothills Sports Medicine Physical Therapy have extensive knowledge about injuries and physical rehabilitation. If you have questions about your lower back pain or another golf-related injury, make an appointment today for a physical therapy consultation!
To learn more about Gilbert physical therapy at Foothills Sports Medicine Physical Therapy and what our certified physical therapists can do for you, check out the Foothills blog.
- Fleisig, Glenn MS: “The Biomechanics of Golf”
- Hruska, RJ. Myokinematic Restoration-An Integrated Approach to Treatment of Lower Half Musculoskeletal Dysfunction. Postural Restoration Institute Course Manual. 2008.
- Vad, V., Atul B., Basrai, D., Gebeh, A., Aspergren, D., Andrews, J. Low Back Pain in Professional Golfers. The Role of Associated Hip and Low Back Range of Motion Deficits. The American Journal of Sports Medicine 32: 494-497 (2004)
Hint: It has nothing to do with a gun.
A trigger point usually consists of a small band of muscle which feels knotty. It is sometimes painful when touched, but the pain is often referred to another area of the body. A trigger point in the shoulder, for example, might cause a headache.
What causes a trigger point? Acute trauma or repetitive micro-trauma may lead to the development of stress on muscle fibers and the formation of trigger points. Trigger points are thought to be due to an accumulation within deep muscle of the waste products of physical activity. This causes localized muscle tension and spasm which may make the points feel like small nodules.
Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles. These include muscles used to maintain body posture, such as those in the neck, shoulders, hip and pelvic girdle.
Trigger points may manifest as tension headache, jaw pain (TMJ), tinnitus (ringing in the ear), decreased range of motion in the legs, low back and neck pain. Trigger points have also been found to be related to shoulder pain, carpal tunnel, sciatica, hip/knee pain and foot/ankle pain. Usually, a physical therapist will ‘feel-out’ a hypersensitive bundle, or knot, of muscle fiber associated with a trigger point. Hands-on pressure of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain toward a zone of reference and a local twitch response.
Physical therapy has been shown to be one of the most effective treatments to inactivate trigger points and provide prompt relief of symptoms. Physical therapy treatment, such as the strain/counter-strain technique, ischemic compression, cupping, massage, myofascial release, active release techniques, electrical stimulation, ultrasound, joint mobilization therapy and corrective exercises, are used to ease the tension, numbness and pain associated with trigger points.
The key to success with trigger point symptoms is to be consistent with therapy and to know what caused the tightness in the first place so that you can avoid it in the future.