Mal di schiena, infiammazioni, ernie e protusioni. Come comportarsi?
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Ognuno di noi ha sofferto o soffre di mal di schiena. Solitamente il dolore è localizzato nella zona lombare e questo ci fa pensare al peggio, ernie o compressione dei dischi, ma in verità nella maggior parte dei casi si parla di un problema muscolare. L’infiammazione della zona lombare, chiamata lombalgia, colpisce 8 persone su 10! Bisogna curarla subito per evitare che diventi cronica, ma senza allarmismi.
Molte volte sentiamo del dolore il giorno dopo aver fatto dello sport, o dopo una seduta in palestra con i sovraccarichi, ecco quelli sono semplicemente DOMS (dolori muscolare ad insorgenza ritardata) e passano dopo alcuni giorni senza ripercussioni.
Quando avvertiamo del dolore nella zona lombare è bene capire le cause scatenanti.
Le cause più comuni
–Sedentarietà. La mancanza di movimento è tra le prime cause di mal di schiena, i muscoli sono atrofizzati, deboli e poco elastici e questo causa fastidio, in pratica il nostro corpo ci sta implorando di metterci in moto!
–Lavori pesanti e ripetitivi. L’esatto opposto di prima, la schiena è sempre sotto sforzo e chiede riposo, la parte centrale del nostro corpo non è come il muscolo pettorale o il muscolo bicipite che possiamo tenerlo a riposo, stando in piedi e muovendoci è sempre attiva e questo se fatto in modo esasperato può portare grossi dolori, pensiamo al muratore che sta 8-9 ore al giorno a sgobbare senza sosta in posizioni anche scomode delle volte.
–Correre con scarpe inadatte o appoggio plantare alterato. Correre molto sollecita la schiena, e per questo bisogna farlo con scarpe adatte e comode, la suola deve essere morbida e la calzatura comoda. Un appoggio errato porterà tutto il corpo a lavorare in modo particolare, con pericolo infortunio per caviglie, ginocchia, bacino e zona lombare.
–Postura scorretta. Anche questa è una delle cause primarie insieme alla sedentarietà. Si stima che sia la causa dell’80% dei casi. Bisogna fare attenzione quando stiamo seduti, quando lavoriamo al pc, ma anche quando dormiamo il più delle volte assumiamo posizione strane e sbagliate. Ovviamente dormendo è difficile controllare la posizione che assumiamo, quello che possiamo fare è cercare di addormentarci nel modo più sano possibile.
–Movimenti bruschi o esercizi fatti male. Qua parliamo però di infortunio, un movimento fatto male o brusco può portare ad uno stiramento, ad una contrattura o nel peggior dei casi ad uno strappo muscolare. E’ possibile anche soffrire di ernia del disco o fratture vertebrali (più dovuto a caduta questo infortunio). Sono eventi rari ma comunque da non escludere.
–Debolezza muscolare. Come già citato prima nei sedentari avremo una debolezza ai muscoli della schiena soprattutto. La muscolatura lombare ma anche quella addominale faticano a sostenere il peso corporeo e gli sforzi giornalieri, la conseguenza è la creazione di contratture o infiammazioni.
– Curve disarmoniche. La colonna vertebrale è costruita in modo da sorreggere il peso corporeo e i carichi esterni. Una deformazione come può essere la scoliosi, la lordosi, oppure un appiattimento delle curve fisiologiche o la cifosi portano la schiena e soprattutto la zona lombare a faticare il doppio, con conseguente infiammazione.
–Sovrappeso. Abbiamo detto che la schiena deve sorreggere il nostro peso corporeo. Quindi un peso eccessivo porterà ad un lavoro straordinario i nostri muscoli e il rischio di infortunio sarà più alto.
–Disidratazione. I dischi intervertebrali sono costituiti da una grossa percentuale di acqua che permette loro di ammortizzare nel modo corretto. Quanto siamo disidratati i dischi si assottigliano lavorando di conseguenza male con il rischio di infortunio più alto. E’ importante quindi bere molta acqua anche per questo motivo.
–Problemi cronici dell’apparato osseo. Qua andiamo sul medico, osteoporosi, osteoartrite e artrosi sono problemi che colpiscono soprattutto i soggetti più anziani, con usura del corpo e acciacchi vari.
–Fattori psicologici. Ansia, stress, paura e depressione possono causare dolori alla schiena, è importante respirare bene e cercare di rilassarsi il più possibile.
Cosa bisogna fare per far passare il mal di schiena?
–Non restare fermo, fai sport e muoviti il più possibile entro i limiti. Fai stretching, posture, soprattutto ischiocrurali e glutei, vai a correre, vai in bici, insomma cerca di essere una persona attiva!
-Una volta sconfitta l’infiammazione rinforza addome e lombari con esercizi personalizzati.
–Correggi e rivedi la tua postura. Schiena dritta, spalle indietro e petto in fuori.
–Massaggi decontratturanti sono molto utili, sarebbe corretto farsi massaggiare ogni tanto, anche se non si hanno dolori al momento, meglio prevenire che curare.
–Non serve imbottirsi di antidolorifici! Abituare il corpo ad anti infiammatori non serve, anzi è dannoso per fegato e reni e a lungo andare il nostro corpo si abituerà e quando realmente ci servono non faranno effetto. Sopporta il dolore, fai stretching e posture. I medicinali solo quando è strettamente necessario.
-Se il dolore persiste affidatevi ad un bravo fisioterapista.
L’importanza del movimento anche qui è chiara, siamo nati per fare movimento, non per stare sdraiati o al pc. Forza! E’ ora di tornare in forma!
Posso allenarmi con ernie o protusioni?
Allenarsi con ernie e/o protusioni si può? Si può e anzi, si deve! Si deve perchè è necessario rinforzare la muscolatura e compensare ad una disfunzione più o meno grave. Possiamo dire che l’ernia è una polpa situata tra due vertebre che fuoriesce a causa di un movimento poco naturale. Questa polpa viene poi “mangiata” e tra le due vertebre rimane dunque poca sostanza morbida.
Sto semplificando palesemente l’argomento in quanto complesso a livello medico ma il senso rimane questo. Ovviamente non ci si allena in fase acuta con grande dolore e/o appena accaduto l’infortunio. Stiamo parlando di chi, avendo fastidi alla schiena, scopre di avere problemi alla colonna vertebrale tramite una risonanza. Con l’età è molto comune rilevare degenerazioni dei dischi intervertebrali, anche in chi non sente fastidi particolari.
Quando la schiena non è sana al 100 % bisogna fare molta attenzione a rinforzare la muscolatura ma senza compromettere ulteriormente la colonna vertebrale.Come allenarsi in caso di ernie o protusioni?
Bisogna almeno inizialmente evitare sovraccarichi sulla colonna come nel caso degli squat. Dico inizialmente perchè una volta che il cliente impara la tecnica corretta si può inserire gradualmente il sovraccarico. Non è un esercizio preciso a fare male alla colonna, è l’esercizio fatto male a fare danni! Bisogna allenarsi con la schiena sempre in sicurezza, dritta, in posizione di forza, quindi mai fare nulla con lordosi annullata. Dunque tutti gli esercizi vanno bene se fatti con la tecnica corretta.Se il caso è abbastanza complesso e grave allora si eviteranno tutti i carichi che gravano sulla colonna, si cercherà di rinforzare il più possibile a corpo libero e si eviteranno balzi, saltelli e movimenti bruschi.
Sia per i casi più semplici che per i casi più complessi si preferiscono gli esercizi in piedi, perchè attivando la muscolatura del core ci sarà più protezione alla colonna. Fondamentale rinforzare il core con esercizi statici, preferendo quindi i plank e i plank laterali, evitando quegli esercizi di rinforzo addominale più dinamici dove avremo un movimento della colonna (esempio crunch o sit up). Eliminare assolutamente le torsioni (ma questo a prescindere dalle problematiche alla colonna). Molto importante rinforzare i glutei, perchè glutei forti danno più stabilità.Sono da valutare tutti i singoli casi, non si può semplificare il tutto con un articolo. In questo articolo abbiamo parlato in modo molto generico, giusto per capire quale strada intraprendere. Spetta ad un professionista seguire il cliente e indirizzarlo al meglio per il suo benessere.
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