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Core stability is an overused statement- pilates is the icing on the cake.

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Back pain

It's not very groovy, but most people at some time will experience symptoms.

Chronic, complex, ongoing, unremitting or just poorly managed, it shouldn't be like this. Here at SIX Physio we can give you the comfort, solution and explanation you deserve to manage your pain long term.

Last year we saw over 6,500 patients with back pain, more than any other clinic in London. That’s over 70% of all our new patients and 82% of our back pain patients have had symptoms for more than 4 months.

Surprisingly, 42% of patients have failed elsewhere to manage their back pain before they came to Six.

Over a 4-week period we can on average, get a 74% improvement in what you came to see us for.

This is all about you and your back.

It may not involve pushing or cracking the sore bits or core stability or stretching or strengthening your back.

What we do is not revolutionary; it’s just very good. We will keep moving better and show you functional, dynamic and out of this world rehab strategies. We do simple stuff well. Very well. We won’t hide behind complex explanations and we won’t treat you to death. If we can get you better, we will.

If you’re in your 2nd episode of recurrent back pain (1) and need to stretch your hamstrings or low back (2) to help relieve your pain or stiffness (3), you are not dealing with the cause of your symptoms. You may not get better, if that's what you want.

Feeling better is not the same as getting better.

We have to find out what is causing your problem (4). This is the tricky bit; it’s the bit we love.

We will have a look at your core stability (5), whatever that is. It’s a very misleading term that on its own means nothing. In conjunction with others muscles, it then starts to make sense. We use real time ultrasound machines to assess and retrain these stability muscles. This is our Gold Standard, which we know is not the norm - but it is at SIX Physio.

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1. What’s 2nd episode low back pain, compared to 1st episode low back pain?

80% of 1st episode back pain resolves in about 6 weeks. If treatment is sought it usually consists of some pretty classic low back stretching exercises, which may help - however, if your back pain returns its now classed as 2nd episode. The exercises that were used in the first instance have not done their job as the cause of your symptoms have not been recognised, hence the return. We really believe that a different approach needs to be employed, one which deals with the cause and not just the symptoms.

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2. We are not at all convinced that stretching solves very much long term.

If you think you’ve got tight hamstrings, there has to be a reason why. It’s an 'either or ' type of problem. Either it’s not your hamstrings, which are tight, but your sciatic nerve instructing your hamstring to tighten in order to protect the nerve (they make a roof over the nerve). Or, your hamstrings feel tight because you’ve altered the starting origin of the muscle, which is the bony bit of your bum. Changing your pelvic position will influence your hamstring length. If you can’t control your pelvic position when stretching your hamstring, then you won’t stretch your hamstring. You will stretch your lower back because you can’t keep your pelvis stable.

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3. Most back pain is due to excessive amounts of movement in your back.

Too much movement on its own is not always a problem, as long as you can control that movement. Lose control, then the problems start. Back 'stiffness' is not just that…Its not the joints which are stiff, but muscle stiffness which is trying to protect the mobile joints. Stretching these stiff muscles just stretches the underlying joints, and so the vicious cycle continues...

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4. Cause is more important than diagnosis.

No matter how good we think we are, it’s almost impossible to give you an empirically correct diagnosis for your back pain. That’s why mechanical or non-mechanical back pain seems to fit the bill. MRI scans are great, they (in most cases) help pinpoint what’s the anatomical problem, but they will not tell you, or us, why you’ve got it. Structural issues such as prolapsed discs may not be a problem if you function well. So a normal MRI, but with poor  function will give you symptoms.

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5. Core strength and stability for treating back pain.

On its own and in isolation Core stability does not and cannot do anything. However, when it’s utilised correctly with the correct activation of all the deepest surrounding muscles in a functional and dynamic fashion then, and only then, does it do what it says on the tin. Core strength is the misnomer. You need stability first with all the trimmings, and then you can start to explore the strength component. Strengthening your muscles will not give you stability- learning to stabilise your muscles will give you strength.

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Our Pilates class sizes are small but friendly, typically 3 patients to 1 physio.

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165 of our patients last month had been to see  us before- with a different injury of course!

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THE GURU on Twitter

GuruSixPhysio: Watch out - Susie asked The Guru for the following Physiotherapy Advice: Hi lovely Six Physio people. I have an http://t.co/aMk3aRwN
GuruSixPhysio: Scaling the dizzy heights with a dodgy wrist - Tom asked The Guru for the following Physiotherapy Advice: 15 months ... http://t.co/3q3pIsRX
GuruSixPhysio: Run like Billy Whizz - YeonJun asked The Guru for the following Physiotherapy Advice: Hello, I just wanted to ask yo... http://t.co/6Fvptbif
GuruSixPhysio: This is about you, not Joe Blogs and his back pain.... - Ryan asked The Guru for the following Physiotherapy Advice:... http://t.co/tlOT1LUi
GuruSixPhysio: Some wise words - Matthew asked The Guru for the following Physiotherapy Advice: I did a speed session last week and... http://t.co/5EwsS3S3
GuruSixPhysio: Undisplaced fracture of the radial head - Claire asked The Guru for the following Physiotherapy Advice: Back in Nove... http://t.co/1yspHXSE
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