There are so many physical therapies out there, and trying to keep track of each one and what they do can get really confusing. You might be asking yourself, “why bother?” when it comes to looking at rehabilitation specialities.
You’ve heard about physiotherapy, chiropractic care, massage therapy, and acupuncture, but you’ve recently visited your GP and they recommended seeing a kinesiologist.
There are many reasons for a GP to refer to a kinesiologist, but for this article I’ll use the example of lower back pain. Now you’re wondering, what would I actually do with a kinesiologist to treat lower back pain, and is it a long-term solution?
Kinesiologists are health-care practitioners with an undergrad in kinesiology and years of experience that use evidenced-based techniques to help you achieve your health and fitness goals. Kinesiology is simply a physical activity plan prescribed for recovery from any condition designated by a health professional. Kinesiologists use resistance training, cardiovascular training, postural assessments, balance training, range of motion training and health coaching to help their clients.
Let’s go back to your low back pain:
Kinesiologists have multiple tools that they can use to help reduce your low back pain and get you moving again. These are:
1. Resistance training
Kinesiologists use resistance training to improve muscular fitness by exerting external force to a muscle or muscle group. When we talk about an external force, this can be using dumbbells, cables, resistance bands, your own body weight, or even water!
Resistance training is great for increasing bone density, making healthier muscles, tendons, and ligaments, and reducing potential for common musculoskeletal injury.
Strengthening the muscles stabilizing the pelvis and spine with resistance training helps your low back, which is usually very flexible/mobile, be able to tolerate more load before getting injured.
2. Cardiovascular training
You may know this as ‘cardio’ for short-this is a type of exercise that gets your heart and breathing rate up. It’s also called aerobic exercise, think Jane Fonda and Richard Simmons, or your neighbour who gets up to swim in the mornings. Cardiovascular exercise is used for increasing muscle endurance, weight loss, and reducing risk of cardiovascular disease, to name a few.
A common technique in athletic training, cardiovascular training Includes repetitive movements such as walking, biking, rowing, elliptical, treadmill, stationary bike, swimming, and running. Not only does it put good stress on your heart making it stronger (you’ll more easily sprint for the bus if you need to), it also has a detox effect. Cardio lubricates your joints and brings blood flow to all parts of your body, clearing waste products and encouraging repair.
How can cardio help with your lower back pain? Repetitive motions involving your legs creates small movements at the pelvis and low back which helps release tight muscles that are surrounding the spine, leading to a reduction in low back irritation.
The best part about cardio is that it can be done at any intensity and can be adapted for any level-from professional athletes to folks with reduced mobility. Based on objective measures like your endurance level, your kinesiologist will choose an intensity, duration, and type of cardiovascular exercise that best suits your needs and goals.
3. Postural Assessments
Kinesiologists are trained in identifying and treating muscle imbalances that may be causing pain or dysfunction (i.e. a limitation in your movement). With an in-depth assessment, they look at the curvature of the spine, how your hips are rotated, and if the shoulders are sitting forward or back. They compare your left and right sides to locate any length differences that may be caused by strong or weak muscles. These observations are simple but foundational and make postural assessments very effective.
Postural assessments are important because they provide information about your body that helps the kinesiologist better create a cohesive and effective exercise program. For example, an arched low back can indicate weakness in your hip flexor muscles, which can be adding unwanted forces to the low back in sitting and standing. A postural assessment allows the kinesiologist to identify these weaknesses so they can program exercises that target the hip flexor muscles to strengthen them and therefore reduce pain.
4. Balance training
Balance is a critical component of everyday movement. Kinesiologists use unstable surfaces to help you increase your body awareness and to decrease your risk of re-injury. Unstable surfaces are a variable stimulus, meaning they challenge your body in multiple positions. This develops balance capacity so you can respond to changes in the environment in real life like walking on an icy patch of sidewalk in the winter or stepping on rocks at the beach.
Can balance be trained?
Yes! Balance exercises can be functional movements, such as step-ups onto risers (think step class), balancing on small wobbly surfaces like a half exercise ball or foam pad, or shifting your weight while standing on one leg.
Balance exercises strengthen muscles that surround the bones of the hips, legs, and spine. They also train the body to recruit muscles surrounding the spine in unstable (yet controlled) environments. When you encounter an unexpected perturbation outside of the studio (like a sudden drop off of a curb you didn’t see), you’ll be able to confidently regain balance without straining your back.
5. Range of motion
Our range of motion starts at our joints. It's not just physiotherapists who are concerned about joints, kinesiologists pay close attention to these complex structures because they are integral to movement. Range of motion is affected by the shape of the joint, the elasticity of tissue, the structure of ligaments, and the normal tension of surrounding muscles.
Kinesiologists use static (long holds), dynamic (movement through your full range) and trainer-assisted (Proprioceptive Neuromuscular Facilitation) stretching techniques to help you get more movement at your target joint. More movement means working towards being able to touch your toes or reach your arms overhead.
Increasing your mobility doesn’t only happen with stretching techniques. Using tools like foam rollers, massage balls and dowels also help with increasing the length of your muscles and the surrounding tissue. Your kinesiologist will show you the best ways to use these tools to target the muscles around your injury.
A common stretch that is used for low back pain is the ‘figure four’. This stretch involves lying on your back and crossing one leg over the other, in a shape of a four looking down from above, and lacing both hands to hold the bottom thigh.
6. Health Coaching
Health coaching isn't just the realm of personal trainers or nutritionists. The work of kinesiologists doesn’t stop at movement techniques, proper movement and activity often involves a lifestyle shift, they are also an accountability partner for making healthy choices. They provide general diet advice and planning, as well as guide you with motivational interviewing (MI).
Motivational interviewing is a guiding type of conversation that allows the kinesiologist to combine both active listening (following) and giving information/advice (leading). The kinesiologist might ask open-ended questions about your ideas, behaviors, and experiences, and then guide the conversation to reflection on how a change may be meaningful or beneficial (Miller & Rollnick, 2013).
For example, you may discuss with your kinesiologist how sitting long hours at work may be affecting your back pain. Reflecting on the changes you have already made (working to strengthen your muscles) and planning some simple changes to your work routine might provide additional momentum for facilitating healing and recovery.
Ready to see for yourself?
Hopefully reading this you now have a much better understanding of what a kinesiologist does (for more on why to chose a kinesiologist, click here). Having a kinesiologist in your arsenal can make a huge difference in the time it takes to recover from a low back injury. Kinesiologists are here to help you in a holistic and in-depth manner and provide support and guidance that will help you manage not only your current pain but also prevent future injuries.
Find our more about how to choose a kinesiologist.
3. Miller, W.R.& Rollnick, S. (2013) Motivational Interviewing: Helping people to change (3rd Edition). Guilford Press. 1.