Sit-to-Stand and Manual Therapy
*This article is written at a level so that everybody can understand it, but the content itself may be more technical.
***edit March 19, 2021: I was asked to write on this topic for my work at StudioD. I liked this version so much that I posted it here. My original blog post is archived below this one.
Spotlight on functional movements: sit-to-stand and manual therapy
By Dr. Giancarlo Carpino, DC
*Dr. Carpino published a scientific paper on this topic in January 2020. To see the complete work, including citations, see: https://chiromt.biomedcentral.com/articles/10.1186/s12998-019-0290-7
We’ve all taken something for granted in our lives.
In my case it was my back. I am prone to injuring my back. The most significant prognostic factor for injuring your back is, well, having hurt your back in the past. So, every now and then I overexert myself and I hurt my back. At least I was usually doing something that I liked in the process, like playing beach volleyball, flag football, etc…. I tell myself.
When your back, or any other body part for that matter is suddenly out of commission, you quickly find how important that body part was to you for your daily tasks. Try going for a walk if your knee hurts and you’ll see what I mean. Try getting out of bed when your back hurts, and you might just discover why I pursued the professional training that I did. Try sitting in and then standing up from a chair. Try having to crawl on your hands and knees around your house for a week because of the pain.
The average person performs the sit to stand motion 60 times per day (what this really means is that some people sit-to-stand 20 times per day and some people sit-to-stand 120 times per day, depending on what they do for a living). If your back is injured, you can imagine the difficulty doing something as simple as using the toilet, never mind working your 9-5pm job.
In the healthcare world, we’ve “known” that manual therapies (massage, Chiropractic, acupuncture, etc) helped people get over their pains faster and with less reduced function. But, when you search the literature for information on how they help, you may find yourself underwhelmed. There are many studies which show that X or Y intervention helps with Z issue, but the “why it helps” is often not laid out. This lack of descriptive mechanism was something that I found myself searching for regarding why manual therapy (from my Chiropractor) me get over my own back pain.
I investigated and published my study because while the efficacy of manual therapy on back pain is known to be good, I wanted to help lay the framework for why.
My paper titled: “Does manual therapy affect functional and biomechanical outcomes of a sit-to-stand task in a low back pain population: a preliminary analysis” analyzed how people move when they have low back pain, and what happened to how they move after receiving manual therapies to the painful area. I chose the to specifically investigate the sit-to-stand motion because, like we mentioned above, it’s so important in our everyday lives.
In brief, my findings help prove what we’ve “known” for many years- that manual therapy likely helps with your ability to perform a sit-to-stand when you have low back pain. We found that people with both recent onset and chronic low back pain were able to perform a functional sit-to-stand motion faster and using more of their low back range of motion after receiving manual therapy to the low back.
If you are a scientifically savvy person and read my paper in full including the limitations of the study, you’ll find that theses results are considered preliminary in the hierarchy of evidence world. But other studies have been published since which build off the concept that I’ve stated, and I’m excited to see where the evidence takes us.
The manual therapy interventions that I investigated were joint mobilisations and joint manipulations (like a Chiropractor would do), but I suspect that other therapies may prove similar results. Self stretching, stretching with the help of a trainer, foam rolling, acupuncture, and generally trying to move more tend to help with all pains and their related movement dysfunctions.
Can I say definitively that these other therapies help? No. Can I say definitively that the manual therapies I investigated help? Also no. But next time your back hurts and you can barely sit-to-stand, at least you have a place to start to find a solution. Despite the lacking evidence on the topic, people have known for hundreds of years that when your body is not working its best- go seek help, and you usually get better. The human body has an incredible power to heal itself. Sometimes it just needs a little help.
If you think that this brief blog is a “stand up” piece of work, and you want to talk with somebody about your health relating to our topic today, don’t hesitate to reach out. I hope that this will be your first step to achieving your goals, or getting back to doing the things that you love.
***below is the previous version of this blog post. It is a different style than above, so I thought it was still worth keeping around :)
Today I have the privilege of writing about a piece of work that I published a while back. I had been thinking about the best way to communicate the content of a niche scientific paper and had given up on the idea, to be honest.
You can imagine my pleasant surprise when I found out that a popular podcast had used my scientific paper as a topic, and yes- made it easy to understand! Here is the link to the podcast:
Okay… so maybe it’s only a popular podcast for Chiropractors who want to keep up to date with the latest clinical research. But hey that’s a big deal in my professional circle!
So, instead of me trying to explain the points of my research here, I can simply have you listen to this Podcaster for 10 minutes to get the gist of it :)
In brief:
-We perform the sit-to-stand task many times per day.
-When our low back hurts, performing this task can be uncomfortable and slow.
-By receiving some manual therapies (in this case, having your Chiropractor help your low back joints move) the participants in my study performed the sit-to-stand faster and with greater use of their low back range of motion.
-This study design isn’t definitive, but it’s good first data to help prove what we’ve seen in clinical practice for years- manual therapy helps with our ability to function when our low back hurts.
If you want to check out some of the details of the article itself, here is the link to the open-access paper:
https://chiromt.biomedcentral.com/articles/10.1186/s12998-019-0290-7
