Unspecified Lower Back Pain

Have you ever felt low back pain? A tiny pinch, stretch, strain or something that just did not feel ‘right.’

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If not yourself, at least one of us knows a friend, a family member, or a co - worker who has complained of low back pain that is chronic or acute in nature.

Chronic low back pain is the second leading cause of disability worldwide and the most common musculoskeletal condition affecting the adult population. Statistical evidence has shown a continuously increasing pattern of incidence and prevalence, supporting the significant impact this condition has on the contemporary world. There are many implications and burdens that may manifest from low back pain, ranging from reduced functional capacity, increased difficulty to complete activities of daily living, ongoing absence from work, and increased stress.

Low back pain can have a diversity of pathophysiological streams that have led to the presentation of pain. However, we will primarily focus on low back pain from a mechanical perspective to address the modern seated office worker or the self - professed gym rat.

Low back pain is commonly treated with analgesic medication, rehabilitation and ongoing rest. This is a paradox, as the individual resumes the same lack of inactivity that led to mechanical dysfunction and potentially even more sedentary activity.  Exercise is slowly emerging as a widely recognized appropriate and effective treatment modality.

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The spine has 4 compartments, the cervical, thoracic, lumbar, and coccyx / sacral vertebrae. Each compartment is uniquely designed for a specific function. Low back pain occurs along the lumbar spine. A region of the area with 5 vertebrae ( consider these as hinges). 

The lumbar spine is specifically meant to engage in flexion, extension and  minimal rotation.  Our ongoing sedentary activity, leads to the loss of our functional capacity to complete these basic movements. Our body creates specific adaptations to specific demands. If we do not train our capacity in these ranges of motion and suddenly add load (either a 20kg box, or a 20kg barbell), dysfunction and damage will ensue.  An unstable spine is intolerant to spinal flexion along the sagittal plane and compressive forces. In addition, the lack of thoracic mobility, hip stability, and hip mobility with an unstable lumbar spine is the perfect recipe for low back pain. Remember, you also have to be careful on the selection of the chair you choose for your desk job. Especially for seniors. Here a couple of chair exercises for seniors that will help them strengthen their lower backs.

In order to address the low back pain in a progressive and pro - active way; it is key to address the core and develop the ability to control and brace the spine. The ability to engage the brace the spine will help improve your mobility and the body to generate force. When you can assume a braced spinal position instinctively and be able to handle imposed demands of varying loads, you are able to reduce re injury or recurrence of low back pain. Exercise that increases your functional capacity to handle activities of daily living will ensure that you live your life pain free and at optimum peak. 

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Ernest Manalo is a trainer with a high knowledge in kinesiology at Your House Clinic. Inquire here for an assessment on back related issues with one of our experienced personal trainers or kinesiologists.

Don't Run Into Problems

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Identifying and Knowing Runner’s Knee

Runner’s Knee, the term most typically used describe Patellofemoral Pain Syndrome (PFPS), frequently occurs with fitness enthusiasts who are avid distance runners . With this condition, the patella or kneecap doesn't track correctly during knee flexion and extension, resulting in various forces to imbalance the joint and cause ongoing discomfort.

How the patella rests on the femur is extremely important, as there are various pressure points within its groove, meaning it can cause an abundance of complications. Runners knee can become a problem for this very reason. Runner’s Knee can trigger very fast, feeling very acute and resulting in a lot of trauma. Mild cases of PFPS can become more surprisingly problematic, as they can cause more chronic issues with the severity of the pain silently increasing over time. The sooner the issue is identified by a physician, the process of recovery becomes more irreversible.

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The Signs and Symptoms Of PFPS

The most frequent complaint is pain around the knee cap, rather than its focal point. The origin of the pain will feel like its directly behind the knee, with the discomfort moving to the sides of the patella.

If suffering from runners knee, the individual may feel emotionally scared in participating in activity, as one of the main symptoms is the knee feeling like its going to ''collapse'' or suddenly lose full function.

Aggravation in the joint can be spurred by prolonged flexion of the knee, such as sitting, weight bearing exercises, such as lunges or squats, or constant repetitions against an unlevel service, such as running uphill or downhill.


How is Runner's Knee Caused?



A direct hit to the knee cap can shift the knee cap out of place

Imbalanced Agonist and Antagonist Muscles

The patella relies on strong and functional thigh muscles (quadriceps) to keep the patella aligned. Weak hamstrings can also cause a muscular imbalance that will eventually affect the knee joint.

Overuse Or Overtrained

Any repeated movement or non-movement can chronically cause the issue. Prolonged sitting, such as working a desk job, followed by more inactivity, can cause the knee to become less functional with the surrounding muscles becoming tight and weaker. Excess lunging or squatting can put a lot of stress on the knee cap and could overload the joint.

Poor Biomechanics

Sometimes genetic make up and anatomy are simply a natural cause. Examples could be incorrect bone structure on one side at the hips, in the thigh bone or in the ankles. On one side, the knee cap could be larger in size to its opposite, causing the tracking on the femoral groove to become more impaired. Seeing a physiotherapist in the is case would be a good idea. The physician could design a program to help achieve balance on bot sides and reduce risk of chronic knee injury.


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Correct Your Personal Training Program

Modern exercise is proving more everyday how important it is to train correctly for running activities. Incorrect training programs can lead to large array of problems, including damaged bone structure, imbalanced muscles leading to weak joints, bad posture and spine issues, and can even affect internal organs over time. When natural biomechanics are not to blame, it’s most likely that the quadriceps are not strong enough to keep the patella aligned with the femur.

As mentioned previously, the quadriceps and hamstrings must be equally trained, so that either muscle group does not overcompensate each other, adding extra pressure to the knee joint's function.

Strengthening the inner quadriceps is essential when maintaining the alignment of the patella. The inner quads (pulls knee can towards your body) and outer quads (away from your body) will pull the knee cap in opposite directions. The inner quadriceps tend to get progressively weak if not trained regularly. The outer quads can then compensate too much and pull harder on the patella, shifting it out of center alignment.

Last but not least, it is not all about training your quadriceps and hamstrings. Training all your muscles from the hips down are all equally as important. Every compartment supports each other when coming to knee health.


Tight IT Band

The Illiotibial Band originates from the side of your hip and runs down the side of your leg and beneath the knee cap. Runners who experience a tight IT Band will tend to feel the irritation on and off. The later stages of IT Band Syndrome can also cause a clicking noise in the knee cap, due to further instability of the knee cap. The main function of this fibrous tissue is to strengthen the placement of your glutes, TFL and patella itself, meaning its a primary stabilizer. Avid runners who now how to condition and warm down after a workout, will foam roll on their side (from the hip to the knee) to ensure the band does not become too tight over time.

Click here to read more about foam rolling.


Correct Running Shoes

All sport specific or training needs require the right shoes as a platform. If there is an arched gap between your foot and the terrain where the sole of your itself should land, then most physicians will recommend orthotics to close the gap. If your foot is not fully landed on the floor, the forces impacted will directly affect your knee joint, rather than being absorbed by the muscles that support the patella.


Train Gluteus Maximus & Medius

Activating your Glute Medius can be a lot more tricky and less straight forward then training your Glute Maximus. This particular muscle is important absorption as the foot strikes the ground while running and keeping the pelvis in steady position. It also helps the function of the inner quads and prevents knee adduction as stated before. Many exercises can be done for the glute medius:

  • Zig Zag Squats

  • Bridges (Using a theraband)

  • Plank Steps (Using a theraband on lateral steps)

  • Step Ups (Coming in from a lateral position)

  • Seated Clam Shells

 Consult a personal trainer or kinesiologist at Your House Clinic for more advice.



In any form of training, it's always best to listen to your body. If you sense overload to your joints or its supporting muscles, take a rest day or activate recovery through stretching and foam rolling on all lower extremities. If there are any signs of swelling, inflammation or prolonged pain, practice the RICE method: Rest, Ice, Compression, Elevation. Also, swimming is another low impact/recovery activity should try. Or, do what I do, on my recovery day I'll usually ride the stationary bike for 30 minutes while listening to faithfully lyrics, followed up by 1 hour of restorative yoga.

Sore after a workout? Read about the benefits of CBD Oil can provide you.


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Looking to bring your running game to the next level or train for an event. Ask one of our personal trainers or kinesiologists for a gait analysis and assess your form.

Hydration & Cellular Activity

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Hydration & Cellular Activity

Water is the most important nutrient for humans.  While we can be deficient in many aspects of health and stay alive for sometimes months, the human body will only survive days without water.  Even if someone goes a full 24 hours without water, there will be dramatic side effects.  A human is mainly composed of water, almost two-thirds of the body, and is vital to the many cellular processes that occur.  From cell structure, to energy mobilization, and even vital organs, all human lives need water to make us, well, function!  Our joints and spine rely on water for fluid to provide lubrication, as well as our eyes for vision, and of course it is vital to maintain and regulate body temperature.

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Hydration is very important especially for those who exercise regularly.  While normal humans should try to consume at least 4L of water daily, people who are very physically active need to increase their intake of water above minimum standards (Sizer, et. al. 2015).  Proper hydration is especially important for individuals who compete in endurance events, perform long bouts of exercise, or who work outdoors in hot temperatures. 


Consuming water regularly is vital to maintaining proper bodily functions.  While we might not feel thirsty, we can still become dehydrated.  Some mild effects can be weakness, lack of energy, light-headedness, but serious symptoms like seizures, irregular heart rate, and coma can occur and can be fatal (Sizer, et al. 2015).  Make sure to have at least 500mL 1-2 hours before your training or work regimen, and keep taking small sips every 10-15 minutes or more frequently if you are still thirsty (Sizer, et al. 2015). 


Research has shown that dehydration can cause significant impairment and decreased performance in endurance events, such as cycling (Adams et. al. 2018).  What is also important is to maintain hydration levels not just before your training or event, but also during training and after.  There is evidence to support that regular hydration reduces fluid loss, maintains and helps blood plasma (VonDuvillard et. al. 2004), and prevents potential serious side-effects, such as elevated temperatures and vision problems (Ikemura et. al. 2018)

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There are many foods that are rich in water and can help to contribute to your total daily intake.  Most vegetables are over 90% water, so having a large amount of vegetables daily is a great way to ensure you are staying hydrated.  Green vegetables such as lettuce, cabbage, kale, and cucumber are almost entirely water, as well as other vegetables such as carrots, squash, tomato, being over 90% water (Sizer, et al. 2015). 


Always remember to drink water, even if you are sedentary.  We all need to have water regularly, and many individuals simply forget to do so.  Try to limit your coffee to 2-3 cups daily and also remember to drink water alongside your coffee.  Individuals who drink water regularly are half as likely to develop potential cancers as those who don’t (Sizer, et al. 2015).  Remember, WATER IS LIFE, and there is truly no better substitute to keep your body hydrated.  Your body and mind both depend on it!

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Ask one of our experienced kinesiologists or personal trainers at Your House Clinic for more advice about hydration and sports performance.