SIT-UPS

Recently a patient said to me: “can you believe a friend of mine did his back doing sit-up’s?


"That’s right I think” he said when I asked if his mate did the sit-ups with his feet locked under underneath something.


Now abdominal crunches are one of the easiest and best postural strengthening exercises but if you lock your feet when you’re doing them it’s risky.


The reason is a muscle called Psoas major which makes your hip bend up but it’s also attached to the front of your lumber spine bones. So it also pulls your spine toward your hip if your feet are locked under something.


It’s a little hard to explain in words but hopefully my dodgy stick men below illustrate what I mean. (If you can't see them clearly in your browser, click on the box / link below). From the blue arrows you can see the abdominal muscles pulling the chest towards the pelvis in the first diagram (resulting in downward pressure (red) on the lower back while lying). In the second diagram you can see the Psoas muscle pulling the back towards a fixed leg (blue) resulting in upward force on the spine (red). Two opposing forces on the spine result in compression down the spine. If you’ve got an unstable spinal disc, there is potential to hurt you.



So don't stop your crunches (with bent knees) but keep your feet free!

SHOULDER BURSITIS

By Brendan Dax • October 27, 2025
Bursitis is one of the many causes of impingement pain of the shoulder, giving restriction and pain when lifting the arm. Bursae are small sacks of fluid and when inflamed in the shoulder, take up too much space, getting squashed when raising your arm causing painful pinching. Like all musculoskeletal problems, this is a problem of mechanics. Something doesn’t move properly. From a manual physiotherapy perspective, bursitis, like all shoulder impingement problems usually responds well to joint mobilisation. In all my years of treating shoulder impingement almost all presentations have associated neck/upper back spinal joint stiffness. Manual mobilisation (loosening up) of the neck/back and shoulder joints will always yield improvement, unless there is structural damage. Having seen 100s of acute onset (within the previous two days) shoulder problems in the industrial sector, I can assure you that most of them come in with chronic, stiff upper backs that they’ve had for ages. True bursitis usually responds as well to a guided Cortisone injection. Bear in mind if the neck and shoulder joints are still stiff the jab may not solve the problem. If you have shoulder pain that has not responded to injection and/or seeing a Physio who just uses machines and/or exercises, consider manual physiotherapy from someone like me, before we all retire!

SIDE HIP PAIN

July 1, 2025
Pain on the side of the hip from bursitis or gluteal tendon inflammation is an annoying problem often more so at night because lying on it frequently disturbs people’s sleep. It is a reasonably common problem for me to see. Tendons and bursae degenerate as we age and weakness in hip musculature can be a cause. But it can happen to anyone. Guided steroid injections can help, but most people respond well to soft tissue manipulation. The lower back should definitely be assessed and (usually) treated manually as related spinal joint stiffness frequently contributes to the issue. The hip joint should also be assessed and treated if necessary. Exercises can be helpful but need to match the pathology so an Ultrasound image might be needed give a diagnosis.