Enthoven WT, Geuze J, Scheele J, et al. Prevalence and "Red Flags" Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma. BACK TO TEXT


When was the last time you got on your gym's abductor or adductor machine and got in a good workout? It's probably been a while. Both are machines that don't get a lot of use, and they are often the target of coaches' ridicule on those "useless gym moves we should all skip" lists. Perhaps rightly so, especially if you're hopping on those machines hoping for a slimming effect.
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful (especially in the early stages). For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!
The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to  postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.

Along with these exercises, it's also important to do some supplementary exercises to work your hip's supporting muscles. You've probably heard of your shoulder's rotator cuff. Well, your hip also has a cuff, or a group of muscles that help stabilize and support movement. For these exercises, you'll need a mini-band, a longer thera-band or tubing (both are sold at many sporting goods stores, or can be purchased online), and a cable-column unit.


To ease the pain and lower your odds of an injury, don’t try to do too much at once. “Start with just 10 minutes,” says Arina Garg, MD, a rheumatology fellow at The Center for Excellence for Arthritis and Rheumatology at the Louisiana University Health Sciences Center. “Every few days, increase that time by 5 to 10 minutes.” Your goal is to work up to 30 minutes of aerobic exercise, 5 days a week.
How to: Start with your left foot back behind your body, with feet flat on the ground and legs straight. With the back foot, take one step farther away from your body—engage the glutes as you do. Then reach overhead with the opposite arm and stretch through the side of your body. Return to starting position. That's one rep. Repeat eight times on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
An ischial apophysis avulsion is an injury to the sitting bone where the hamstring muscle meets the bony protrusion of the sitting bone or ischial tuberosity. An avulsion is an injury in which movement or injury results in a violent and sudden contraction of the hamstring which pulls a piece of the sitting bone with it. This injury typically affects young athletes, aged 13 to 25 years. Symptoms include ischial tuberosity pain, swelling and pain in the thigh area, muscle spasms, and muscle weakness in the legs. To heal the injury, extended rest and massage are typically in order as well as stretching exercises and gait work.
MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually aren’t a deal,2 most back pain goes away on its own,3 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.
But there are some pretty serious causes for back and hip pain as well. Lower back pain, in particular, can be a sign of various serious conditions such as advanced kidney infections or a condition called interstitial cystitis, which can cause inflammation of the tissues of the bladder. Sciatica causes lower back pain, pain in the back of the knee, pain in right buttock cheek, unilateral (one-sided) pain, thigh pain, pain behind the knee and calf, and muscle weakness in legs as well.
Grade II (moderate): A larger tear in your muscle that makes it difficult to move and causes a moderate amount of pain, especially when you move the affected muscle, swelling, and tenderness. You may have 5 percent to 50 percent loss of function and you may be limping. You can't go back to sporting activities until the tear is completely healed. These injuries can take anywhere from a couple weeks to a few months to heal, depending on how bad they are.
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