Sarah Key Method - Back Block

Posted by Nell Mead at 14:00 on 9 Mar 2011

Time to get back to backs!

This exercise is another of Sarah Key's, and is great for stretching your low back.  You'll need what Sarah calls a back block; they're also known as yoga bricks.  Roughly the size of a house brick, they come in a variety of materials including wood, bamboo, cork and foam - I usually use one made of solid foam, though in an emergency I have also been known to use a hardback copy of a Harry Potter book!

When we spend all day with our spines in an upright position (sitting, standing, walking, running), gravity combined with our bodyweight squashes our spinal discs, and over the course of the day they flatten out a bit.  It's not unusual to be 2cm shorter at the end of the day than you were at the start.  Generally, the discs rehydrate and plump up again overnight when you're lying flat, but over time - with age, or particularly with injury - the flattening starts to have a greater effect than the rehydration, and you develop stiff spinal segments.

Sarah's theory is that this process is reversible if you regularly take steps to decompress your spine, and this is where the back block - coupled with the appeasing exercise I described before - comes in.

• Lie on your back on a firm surface such as the floor, knees bent so that your feet are on the floor, and feet and knees together.
• Squeeze your knees and buttocks together. Keeping them squeezed, roll up your spine, curling your bottom off the ground first, and - bone by bone - then your low back, mid back and upper back, until your weight is on your feet and shoulders.
• Bone by bone, roll your way back down again, trying to make the space between each bone as long as possible, and making sure that when you reach your pelvis, the left and right sides hit the ground at the same time.
• Make sure your knees and buttocks are squeezed together, and roll all the way up to your shoulders again, bone by bone.
• This time when you are at the top, slide your back block underneath your pelvis (NOT under your low back) and roll your bottom down onto it.  The block should be horizontally aligned and on its shallowest side.
• Slide (don't lift) one foot along the ground and away from you, and then the other.  Allow your ankles to relax and roll outwards.  Relax your calves, then your knees, then your thighs, buttocks, low back...
• Let your arms roll outwards so that your palms face the ceiling, and relax completely for a minute.
• Then slide one foot back up towards you, and then the other.
• Squeeze your knees and buttocks together, and roll your way up off the block (at first this may be sore; don't worry, this is quite normal and it does get better!)
• Slide the block out from underneath your bottom, and roll down just as you did before.
• Now do 30 seconds of the appeasing exercise, and repeat the whole thing three times.

NB - any discomfort you feel on curling up off the block should fade quickly and should improve over the first few days of practising this exercise.  If it is too painful, or remains significant for more than a week of doing this, you should discontinue the exercise and get your back assessed.  (Of course, I'd recommend that you see a Sarah Key-trained physiotherapist...)

Thanks to the lovely Graeme Marsh for posing for these pictures at The Foundry.

Sarah Key Method - Appeasing exercise

Posted by Nell Mead at 16:00 on 31 Jan 2011

Moving on from last week's diversion - back to the back pain!

This exercise from legendary Australian physiotherapist Sarah Key is suitable for virtually anyone's back, and is the first exercise I teach my patients who have low back problems.  The key is to be very subtle with your movements - in this instance, less is definitely more.  The idea is to gently appease the low back muscles and coax them out of spasm, muscle spasm being the body's natural - but in this situation unhelpful - response to pain.

If you jerk or move too forcefully while doing this exercise, you are likely to stimulate the stretch receptors in the muscles, which could potentially make the spasm worse.  But if you can keep your movements smooth, and "under the radar" of the stretch receptors, then it will really help to soothe your back pain.

• The first step is to lie on your back on a firm surface - a folded blanket on the floor is fine, or in my therapy rooms I use a yoga mat.

• Pull your tummy in gently, as this supports your spine, and bring one knee up to your chest.  Hold the knee in the same hand - i.e. if you have lifted your right knee, hold it in your right hand.

• Keeping your tummy pulled in, bring the other knee up to join the first, and hold it in the other hand.

• Cross your ankles, and drop your knees apart, still holding them in your hands.  Let your tummy relax.

• Producing the movement with your hands, move your knees gently back and forth, left and right, until you find that your weight is over the sore part of your back.  This is where the muscles need to let go.  Oscillate your knees gently and repeatedly over this area - I describe this to my patients as "ironing the spine" - for a minute or two until the muscle relaxes and the pain subsides.
• After a minute or two, use your hands to bring your knees back to the middle, pull your tummy in gently, and then lower first one foot to the floor and then the other.  Rest for a minute or two and then repeat twice more.  
• On the second and third repetition of the exercise, you may find that the sorest spot in your back has moved a bit.  Hunt around until you find it; but remember to keep the movements subtle and gentle.

If your back is really sore, you may need to do this exercise very regularly, perhaps as often as every hour at first.  Some people also find that heat is helpful, so you may also want to try using a hot water bottle on your back (obviously, all the usual precautions apply here: please don't burn or scald yourself!)

If you can't relieve your pain by yourself, then of course please do e-mail me for an appointment.  I am at the Foundry on Mondays and Tuesdays, and at the Back Shop on Wednesdays and Thursdays.

Thanks to my lovely model Graeme at The Foundry - the cheque's in the post!