Welcome to part two of our mini-series on sleep. You can read part one by clicking here. Sleep plays an essential role in maintaining good health and immunity, yet many people struggle to get a good nights sleep.

Researches claim that in first world countries many people are getting 1 -2 hours less sleep than they did 50 years ago. What has changed over the last 50 years?

How we fall asleep.

Lets take a look at how you fall asleep. Without getting too technical, we need to consider your circadian rhythm. This is your bodies’ natural body clock, which closely follows the day/ night cycle of the sun. All physiological processes that occur within your body are influenced by this circadian rhythm such as hunger, energy, body temperature and mood.

There are two processes which bring on sleep. First is the 24 hour cycle of your circadian rhythm. This rises and falls over the course of the day and is responsible for timing the release of hormones that make you feel alert and sleepy. One of these hormones is melatonin which is released soon after dusk and signals to the body that is dark and time to start commencing the event of sleep.

The second big process that brings on sleep is a chemical called adenosine. Adenosine is slowly released into the body over the course of the day and as it builds up, it causes what is known as sleep pressure. A combination of high adenosine levels and a declining circadian rhythm creates the strong desire to fall asleep. The level of adenosine starts to fall during the night and is removed from your brain. By the time morning arrives the combination of no adenosine and the rising of the activity from the circadian rhythm results in you waking up.

A hormone called cortisol, which is responsible for making you more active and alert. is now ready to take over. Cortisol levels continue to rise over the morning and naturally peak around an hour after you wake. After that, they start to fall and continue to decline over the course of the day while your adenosine levels rise and the cycle repeats itself.

How our lifestyle can upset this natural rhythm

There are a number of things that can happen during the day that can affect our circadian rhythm. Let us look at some of the factors that have the biggest influence.

Remember that hormone called cortisol. It naturally peaks an hour after we wake and then start to decline over the course of the day. Cortisol can also get stimulated by the fight or flight stress response. (if you want to learn more on this then click here). Basically, anything that places a stress on your body will result in the release of cortisol. Here are a few common examples in our everyday lives. The news, social media, work stress, diet, exercise, lack of exercise, an overdue bill, discussing household matters, a fight with your loved one.

An increase in cortisol can be fine early in the day but it can make sleep more difficult if it happens in the evening time, when your cortisol levels should naturally be declining. Hopefully you can see how checking your work emails before bed is not the best idea.

Artificial light can also upset your circadian rhythm. Blue light is emitted from LED bulbs, fluorescent bulbs and electronic devices such as televisions, phones, laptops and tablets. Blue light is also emitted by the sun. By staying up late at night watching TV or scrolling through your phone, we are exposing our bodies to a level of blue light that is not in line with the light / dark cycle of your circadian rhythm. This can upset the hormone balance in body and upset the quality of your sleep.

Another important compound in your body that can get influenced is Adenosine. Caffeine sticks to Adenosine and blocks the effect of it. This is fine in the morning when Adenosine levels are low but if we take in the afternoon or evening, when adenosine levels in your body are higher, it can make it difficult to fall asleep. It can take 5 – 7 hours for caffeine to lose 50% of its effects, so you can see how a cup of tea or coffee at 5pm can make it difficult to get to sleep. Your tolerance to caffeine can diminish with age so it good to get an idea of when your caffeine cut off point is.

Conclusion

There are more factors involved such as what time you go to bed and rise at in the morning and we could talk about how certain foods you eat can creasing your cortisol levels but they are beyond the scope of this particular blog.

I do hope that you now have more insight of how your daily lifestyle can be affecting your sleep.In the next blog I am going to give you some easy and manageable tips that you can start to implement immediately to help improve your sleep quality and help you to wake up with more energy and ready to face the day ahead.

Have you ever noticed how your back pain doesn’t seem as bad when you are on holidays or siiting out in the sun sipping on a nice glass of wine?

Why does this happen?

The level of pain you experience can, and often is, influenced by such things as where you are, who you are with, your thoughts and beliefs about what is going on, your previous experiences of pain, your emotions, your fears and any other stress that is going on in your life.

Pain is basically a protective response that occurs when your brain perceives that you are under threat. Messages are constantly being sent from the tissues in your body to your brain letting it know if they are been compressed, stretched or irritated in some way.

Your brain evaluates all these messages, decides if they are dangerous or not and can take one of the following actions. With a lot of messages, it will ignore them and not pay any attention to them. For others, it may respond by giving you a slight ache that causes you to change position to relieve the sensation, such as a shift in position when you have to sit down for an hour.

Finally, if it deems it necessary, it can also turn up this sensation to a sharp pain, stopping you in your tracks or causing you to move in a direction to relieve it

The longer someone has being suffering with back pain, the more influence that these messages that are been sent to your brain will have on your pain. The slightest movement or even the thought of a movement can result in pain.

This, for one minute, does not mean that the pain is not real or is just in ‘your head’.

The physical pain response you experience is very real, the aching muscles, the tenderness, discomfort and pain. All very real. But we must recognise that the mind and the body cannot be separated.

What affects the body affects the mind. And what affects the mind, affects the body and there is plenty of evidence to say that lifestyle, psychological and emotional factors are strong predictors of back pain.

So, in order to find an answer to why your long standing back pain has not gone away, we will need to look beyond your muscles and joints and understand the influence that your thoughts, beliefs, emotions, fears etc can have in your back pain.

This is often the key to get long lasting changes and help people feel good again on a regular basis, not just for a few hours.

All of this is taken into account in an initial assessment at out clinic. We want to know about the stresses that your body has been through and what stresses you face on a daily basis.

Combining this with a movement assessment gives us a great deal of information to allow us to come up with a plan to help you get back to living an enjoyable life with minimal back pain.

I will be discussing how we do this in the following two blogs in this series but if you are currently struggling with back pain, and are in need of some help,

Then call us at 09064 66761 and we will be happy to help.

As we move into the winter season it can be common for people to suffer more with aches and pains. Back pain, in particular, is a complaint that a lot of people come to see me in the clinic looking for help with, when the weather gets colder and the evenings get darker.

There can be a few reasons for this such as a reduced amount of daylight available which can make exercise harder to fit into your day. While it is still possible to get out and exercise at night, you don’t quite get that same feel good factor that you get during the day from the sun shining on your face.

If it’s cold and lashing rain in the evening it can also be a bit off putting and of course the damp weather in Ireland can affect people who suffer with arthritis.

Also, due to the current level 5 Covid restrictions, gyms, pools and attending classes in person are not allowed which takes that option of exercise away from people. All of this basically can mean that you may not be as active during the Winter months, which can lead to more back ache, pains and stiffness.

But is there a way to counteract this and keep yourself feeling free and mobile.

I believe there is and I have come up three tips to help you.

Since the Covid 19 restriction first began almost 12 months ago, working from home has been the norm for a lot of people and for many, it will continue to do so.

While there are some great aspects to it, there are also many challenges that it presents. Some people are fortunate to have a spare room to use as an office, and may have been supplied with a nice chair and monitor from their employers.

Others are not in the best same position and are working from a laptop on a kitchen table or a desk in their bedroom.

Throw in a few extra challenges such as the kids being off school, having to make the dinner, not having scheduled breaks, no friendly chats over a cup of coffee, and it can result in a full, busy and long day.

This can all result in a lot of stress on the body and at Midlands Physio & Back Pain Clinic we have had a lot of people come to us over the last 9 months with sometimes sharp, sometimes achy and often very uncomfortable neck pain.

And it’s often not just a pain in the neck itself,

It can be pain that runs into the shoulders, an ache between the shoulder blades, pain that runs down the arm, or a pain that leads to headaches …..

All of these can stem from problems in the neck area.

By themselves they can be very sore and uncomfortable, but, if your job requires you to sit in front of a laptop for large portions of the day, it can make it very difficult to focus on your work.

So, I have come with 3 practical tips that you can do to help prevent these problems from arising, allowing you to get your work done and still have energy and enthusiasm to be yourself afterwards.

I know how frustrating it can be.

When your back has been good for so long, you’ve been feeling good, feeling like you can do what you want,

And then you wake up sore and stiff and with the dreaded feeling of, ‘oh oh, I’m not sure if I can get out of bed’.

I’ve heard this type of story many times from people coming to the clinic,

And it is usually accompanied by not been able to work for a week or two, and been stuck to the bed or the couch.

It’s not much fun at all.

But is there a solution or a way of preventing things like this from happening?

Surely, if you are moving and have no pain then you 100%, right?

Well, if you have had back trouble before then unfortunately the answer is no.

Pain is not a good guideline of what shape you are in or how much you are able to do and a lot of people fall into this mistake.

‘Sure, I feel grand now, the pain has settled’, except it doesn’t mean the problem is fully gone..

Why does back pain like this come back at you with a vengeance.

How come you may feel great after a physio, chiropractor or massage treatment,

But then the following week the pain returns and you feel like you are back to square one?……

…Often when it seems like you haven’t done anything to aggravate it?

The answer can lie in something called the 80:20 principle .

This was a principle from Pareto who stated that 80% of your results come from 20% of your actions.

It works surprisingly well with most things, and I regularly follow it when helping patients in my clinic.

I use it by focusing ??% ?? my ????????? ?? addressing ??? ????? ?? ??? ??????? ??? ??% ?? my ????, ?? ??? ????????.

The reason for this is because more often than not, ongoing back pain is not an issue been caused by the back,

It is due to something elsewhere in your body not doing it’s job effectively,

This month is neck and shoulder pain awareness month at Midlands Physio & Back Pain Clinic and over the course of the month I am looking at some practical ways to help you sit at a computer, work from home and not end up with a stiff, sore and achy neck.

In part one, I looked at some strategies that you can implement straight away to help prevent neck and shoulder pain. In today’s post I am going to be looking at some specific movements that you can do at home to help prevent pain stiffness.

I’m not a great fan of sharing exercises without knowing some information about ones complaint, what they are struggling to do, their previous injuries and movement imbalances, and usually, I don’t do it. But I have shared some exercises in todays post as they are quite general and should be beneficial for the most people. However, if they are uncomfortable to do or cause pain, please do not continue to do them.

“Why do muscles get tight and achy?”

A question I often get asked by patients in the clinic is ‘why are my muscles so tight and sore?’

As with a lot of things with the human body, there is ‘no size fits all answer’ and it can depend on a number of things from the persons story, previous injuries and lifestyle factors. This is the value of an individual assessment as it allows to us to really understand your story and what you need to do to get back to moving with confidence and with pain free movement.

However, in general a muscle will ‘tighten’ and become sensitive and sore when it is being overworked, is not moving enough or it is too weak.

With the case of neck and shoulder related pain from sitting and working from home, it is often due to a combination of a repetitive posture and lack of movement resulting in muscle imbalances . Too much time in the same position will lead to a build up of waste products in muscles that don’t get an opportunity to get ‘flushed out’.

A group of muscles that can often have a part to play in neck pain are the sub occipital muscles, at the base of your skull.

Getting enough restorative sleep is vital in helping your body overcome pain. While many of my back pain patients often think that they get a great 8 or 9 hours of sleep, they can still be waking up feeling exhausted and in pain.

Studies in which they used heart rate monitors to measure sleep in people who had back pain have shown that many of them were still in a ‘fight or flight’ response when they slept. This can mean that they waking up feeling sore and stiff and find it a real effort to bend over and put their socks on.

In this post I am going to share with you a bedtime routine from my online back pain course that will help you get into rest and digest before bed and help your body naturally recover and replenish.

It combines mindfulness with our unique breathing strategy in positions that will help restore the lengthening and shortening ability of the pelvic floor and diaphragm. When we allow the diaphragm to lengthen, the abdominals activate naturally which helps to relax the lower back muscle.

This exercise should be done every morning and evening for at least a week in order for you to start feeling the benefits.

With all of our patients we like to use an outcome – skills – practices model when helping them achieve their outcome.

Here is an example.

Outcome: To get a better nights sleep

Skill: To be able to access rest and digest

Practices: Bedtime routine which I am about to share with you below

Here is how you do it:

To begin, sit on the side of your bed.

Step 1
Breathe lightly through your nose for at least 2 minutes, slowing the air as it travels through your nostrils. Focus on a calm and quiet breath as you do this.

STEP 2
Keep your tongue on the roof of your mouth at all times placed slightly behind your teeth. Keep your teeth slightly apart and lips gently pressed together to help open your airways and relax your jaw.

STEP 3
Think of a loving memory or a memory of feeling safe, one that makes you feel relaxed and happy. Continue to breathe lightly and only inhale 80% of a maximum breath, so you have a small hunger for air throughout your breathing.

Step 4
While focusing on a spot or something directly in front of you, instead of exhaling, hum for as long as possible for a total of three breaths until your ribcage is moving and you are beginning to feel relaxed. After three complete hums and when you are beginning to feel completely relaxed, revert back to breathing out through your nose and close your eyes, relaxing even further.

STEP 5
As you perform steps 1-4, check in on your body. If you are lying on your side, bring your knees to your chest so your hips are 90 degrees flexed. Just like relaxed sitting above, allow your low back to relax and your top shoulder to drop forward slightly to allow the low back muscles to relax.

By now your thoughts, emotions, and body (behaviour) should be on ‘useful’ things, in ‘rest and digest’ setting you up for a great night’s sleep or a great day ahead.

Be patient as it will take practice

It may take practice and time to get used to allowing your back to relax in bed so don’t worry if you struggle with this at first. In total I recommend aiming for 5 minutes of calm breathing at night, building it up to 10 minutes over the course of a few weeks. If you back is very sore you can also make this into a morning routine and allow some time to do some breathing in the morning time also.

Of course, there are other elements that you can add in to a bedtime routine that can begin up to 2 hours before you go to bed. If you want to learn more then click here to read our 7 tips to a better nights sleep post.

If you want more free help like this

If you are struggling to do your key everyday movements such as sitting, sleeping and standing then you can get free access to my 25 page guide that shows 5 key steps to help you do this with less back pain.

To access this free guide simply click the button below.