"Thanks so much for your help. "I wanted to let you know that I have had a herniated disk in my lower back for eight months. Had physical therapy & injections, but still needed medications-pain pills, etc. I never experienced so much pain in my life. I came across your website & articles & starting doing what you recommended, & within days I have been feeling great & have reduced the pain medicine because I don't need it.
"I know now that I was doing the wrong exercises in the past- too much bending forward & back. Didn't really know that this exercising technique (bending, stretching forward, arching) is incorrect. It sure is!!!!
"I really like the hamstring stretch - putting your leg on the wall. This is terrific. I feel so MUCH BETTER....
"Also, when you get copies of the Abs book, please let me know. "Have a great day Dr. Bookspan!!!! Laraine"
A herniated disc is an injury, not a condition or disease. It can heal. You do not have to live with it. You can go on to being able to do more not less.
Discs are living parts of your body, not like a tooth that once broken cannot heal. Most of the time, injured areas can heal, if you let them. Bulging areas can reduce. Dried discs can rehydrate. Each night as you sleep, discs replenish fluid. They plump back up a bit. That is part of why you are taller each morning, than in the evening. They can do all this if you stop the causes that injured them.
Doing surgery, adjustments, treatments, massage or yoga does not stop the cause of disc injury. Common exercises add to injury. Not all exercise is medicine. Then it is no surprise when pain does not stop, or stops but returns, or the next disc herniates after fixing the first one.
Changing unhealthy movement habits that degenerate discs and push them out of place means moving in healthy ways for all you do, not just for sets and reps in a gym. You can do all the "reps" of back exercises in the world. If you return to bending and standing in injurious ways all day around the house and workplace, it is no surprise that the exercises and treatments did not fix the pain.
Click the following for simple ways to stop causes of disc injury. Get the overall concepts, don't bog down on details. I see people in gyms following trivial, exacting "proper form" for exercising, while missing the whole point of healthy bending and lifting or how to apply it to general motion all day.
--- Read success storiesand contribute your own of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Comments, A Medical Conference, New Findings on Discs
Monday, May 25, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
By the time this post comes out, we should be halfway out West to a medical conference. I'm presenting a study, which took years to do, and which found something unexpected.
I am a medical researcher. I find out the things that doctors (with any luck) then learn and put into practice. A research career has all (and more) of the medical schooling, but without the burden of the medical salary. In previous studies, I found that chronically overdoing the inward lower spine curve pinches the lower spine. It forces the spine joints, called facets, backward against each other, eventually wearing them out, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix. In the work I am presenting, I found that although it is known that the main factor to injure vertebral discs is too much bending forward, that overarching backward can hurt discs too. This is a new proposed mechanism of disc injury.
There is supposed to be a small inward curve to the lower spine. With the (very) small normal inward curve, spine bones line up on top of each other like stacks of cups so that there is equal pressure on discs from front to back. That is called normal lordosis (inward curve). Chronic bending forward manages to unequally load the discs so that they push out in back. Overarching also unequally loads the area. It seems to pinch already protruded discs, and may even factor in the herniation process. I will be presenting on years of my work that lead to this finding.
I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness. The Healthline blog software is still not loading any new photos of my own. Stock photos or those from other people's sharing sites appear, but I the blogger is not letting us get my own diagrams and student photos to you, for now. I mailed the image to Healthline.com staffer Jerry, who said he could upload it for you. It should appear here, below this paragraph, so you can understand better why hyper-lordosis, although common, and often taught, it not neutral spine and can make unnecessary pain. The damage and pain can be quick to fix when you know how. Click the labels "facets" and "lordosis" for posts explaining this issue.
I have to pay the travel to get to the conference, pay the conference fee, essentially, pay to work. I have to bring a computer and projector to give my own presentation (or pay an AV fee to the conference) but won't have Internet access to see or answer questions. Leave fun comments but hold questions for the next two weeks.
Photo is me, taken on the way on the way to a previous medical conference, out for some barefoot climbing.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Fast Fitness - Better Back and Leg Exercise When Vacuuming
Friday, January 30, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Prevent lumbar disc degeneration, and strengthen and stretch your legs without needing a gym, trainer, or exercise equipment, or even changing your clothes:
Notice if you bend wrong - pictured at right with red X. It may stretch and feel good, but over time pushes discs outward to the back (herniates them).
Stand upright and bend both knees in a lunge - pictured center with green check mark.
Instead of only doing lunges as an exercise 10 times and paying for a trainer or a gym (right) use it hundreds of times a day for real life bending. That is functional exercise.
Good bending will not hurt your knees. Keep front knee back over your ankle (left and middle photo with green check mark). Healthy positioning keeps your body weight on your muscles and off your knee joint.
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking labels below posts, links, and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
Overhead Lifting, Reaching, and Throwing Part II - Lower Back
Wednesday, January 07, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Part I of this three part series, showed a major hidden cause of rotator cuff injury - jutting the neck and chin forward while raising arms. This post shows a major hidden cause of "mystery lower back pain."
Letting the head and neck hang forward is called a "forward head." The forward head puts the shoulder at a position of compression when the arm is raised, even when using a computer, a common cause of pain and numbness that radiates down the arm.
The forward head is a bad posture. It causes much upper back and neck pain. Usually people have a forward head because they do not know it is bad posture and do not prevent it. Occasionally they have used a forward position for so long that the muscles get tight and it feels familiar to jut forward and strange to hold the neck and head in upright healthier position. Click links below to Fitness Fixer articles that show how to spot and prevent the cause of the injurious positioning.
The photographer (red shirt) in the photo at left, several of the people in blue shirts, are leaning the upper body backward to raise the arms. Leaning back increases the inward arch of the lower back.
The resulting posture is called swayback, overarching, and hyperlordosis.
Hyperlordosis is a major cause of mystery lower back pain. The sharp angle presses on the lower spine, making it ache. Over time, the compression can injure the facet joints which are the joints of the vertebrae, discs, and soft tissue.
Reader David from Belgium has made us several helpful training videos. In the one below:
Click the arrow to watch as he reaches upward.
He first allows the beltline to tip downward, then mostly corrects it.
David left some of the arch to show readers.
I thank David for all his continuing great work. We are in the process of making more of these helpful topic segments.
Coming on Friday Fast Fitness - How Abdominal Muscles Prevent Hyperlordosis When Carrying.
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Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own. Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column. Find fun topics on the Fitness Fixer Index.
14,000 Miles on a Bike - Herniating and Fixing Discs
Monday, November 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Kristin S was run over by a hit-and-run driver while biking home from work. The car's trailer hitch crushed her face, nose, jaw, cheekbones, and eye sockets inward to her sinus cavities. After Kristin's reconstructive surgery, her step-mother, a student in my martial arts classes, asked me to make a house call to get Kristin back to physical activity. When I met Kristin, she had just had the wiring removed from her jaw, was moving slowly and painfully, and could barely open her mouth when she greeted me at the door.
We had a good session. I showed Kristin several of my rehab methods. She was a good listener and applied everything well. She rehabbed quickly and went back to biking, her socially conscious work, and her active life.
Kristin soon designed a bike trip called The EarthCycle Campaign to raise public awareness of ways to reduce common practices that waste and destroy world resources. Her trip extended 14,000 miles (22,530 kilometers) from Fairbanks, Alaska USA to Tierra Del Fuego, Antártida e islas del Atlántico Sur, Argentina.
I donated some of my books to Kristin to raffle along with her other fund raising activity for the trip, then off she went.
Along the 14,000 mile ride, Kristin stopped in villages and cities to exchange information about simple ways that we all can lower our impact on Earth's environment.
Months of biking passed. Kristin's back pain began.
Pain worsened as she rode mile after mile, through villages, open roads, and cities. She tried exercises she found on various web sites and doctors visited in cities she passed through. She did yoga. She stretched. The pain worsened. After one medical evaluation, the doctors told her results showed several herniated discs in her lower back. From there, she was told by every doctor that it was permanent and she had to stop biking. The rehab they gave her didn't help.
I received a short e-mail from somewhere on the road - "Help me, how do I fix this, they said I have to live with pain and have to stop the tour."
I chided her good-naturedly, "Kristin you should have read my books before selling them :-)" I e-mailed her back explaining the uncomplicated way that discs can be injured and also healed.
A herniated disc nearly always bulges (herniates/moves/slips/migrates/extrudes) toward the back of the spine, not the front. What pushes it to the back? You do.
Sitting with a rounded back physically angles the spine bones (vertebrae) closer in front and farther apart in back. The "opening" in back is often mistakenly written about as a positive way to make space for the nerves, but what is missed is that the bones pinching closer in front make unequal pressure, like squeezing a tube of toothpaste from one end. A little knowledge is a dangerous thing. Contents are squeezed outward to the other side. The discs are mashed and degenerated in front and pushed outward (herniated), little bit by bit, in back. At left (hopefully since we're still having graphics problems) is a graphic of the process from the post: Disc Pain - Not a Mystery, Easy to Fix. Two vertebrae are shown from a side view, as if you are sitting facing right. The right-hand drawing shows how sitting bent forward physically pushes discs (herniates them).
Sitting and standing straight would make space in a healthier way for the nerves.
Disc herniation is a process taking a few years, just like the damage of smoking or eating junk food accumulates until the heart is damaged enough to hurt.
I e-mailed Kristin telling her that a herniated disc is a simple injury, not a condition. It can heal if you understand and stop the bad postures that push the disc outward. In her case, it was sitting bent rounded over her bike, and unhealthful stretching and yoga. Here is what she did to understand and fix it all:
So was her yoga. If you already spend time bent forward and have the usually result of a flexion injury, you don't need more forward bending stretches - Getting the Right Yoga Medicine.
Questions come in by the hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
For someone with "foot drop," the front lower leg muscles are too weak to lift the foot upward at the ankle. The foot hangs downward instead of lifting upward to take each step. Gait is altered and the front of the foot may slap the ground with each step. Fixing foot drop involves fixing three things - stopping the original cause, strengthening the (several) secondary effects of the weakened and tightened muscles, and retraining gait to normal. Common treatment options of braces to hold the foot up, canes or walkers to steady walking, drugs for the pain of whatever is causing it, reductions in activity, and certain surgeries, may all interfere with recovery and create new, and even more serious problems. Healthy treatment can be done without surgery, drugs, inactivity, or bracing.
One common surgery fuses the ankle so that the foot can't hang down. The foot can't move any other way either, causing new gait disturbance, and limitations in moving for health or fun. When foot drop comes from a herniated disc reducing nerve conduction, surgeries may remove the disc. However, discs are needed for healthy spine dynamics. Surgical spine fusion, even more drastically limits healthful movement, and ultimately health itself.
Interchangeably called drop foot, it is not a disease by itself, but the result of something else. Foot drop can follow a herniated disc that presses on nerves that exit the lower spine. It may also come from an injury directly to the peroneal nerve behind the knee. Certain diseases of the nervous system such as multiple sclerosis, Parkinson's, and amyotrophic lateral sclerosis (ALS) may reduce signals to various nerves.
A disturbing and increasing number of foot drop cases come from back and knee surgery. Someone undergoing surgery for a herniated disc or a knee replacement may wake with foot drop when nearby nerves were damaged or accidentally cut during the surgery. Such "side effects" are regularly called unavoidable surgical risks. It is important to change understanding of medical practice so that it is understood that adding new problems is not healthy and so, isn't "health care." Tragically, surgery itself for disc trouble is nearly always unnecessary.
As foot drop continues, lack of stretching in back of the leg that would have naturally come with each step from lifting the foot results in Achilles tendon and other structural tightness. Tightness can increase until that alone restricts lifting the foot.
Reader Sylvia wrote me several notes of her success reversing the components of foot drop. She first wrote in August, after finding the post of Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. Her photos walking with a cane and needing to ride in a golf cart are above, left.
In Sylvia's case, her physician told her that a herniated disc was preventing the nerve down the leg from conducting enough to the front lower leg muscles (usually the tibialis anterior), which lifts the foot. Sylvia wrote,
"The specialist orthopedic surgeon I was referred to fortunately said he would not operate and my subsequent follow up visit has resulted in him telling me to go away as I am no longer in pain although I still have no dorsiflexion (upward lift of the foot). If in a year I still have drop foot I should discuss again with my doctor. Not very helpful…Thankyou for the wonderful work you have done putting this web-site together Best Wishes from England.
Sylvia"
When a disc is involved, the first thing to do is to stop the reasons for discs pressing outward, such as bad bending and sitting, and use good bending and sitting instead. If it is slouching so that you have too much inward curve of the lower spine, and that is pressing on the nerve, or it pushes the disc which then pushes the nerve, then you stop that habit, so it can heal. Stop the source. Surgery is not necessary. This is explained more in the post Cauda Equina - Result Not Cause. Then you exercise the shin muscles that have weakened, and stretch the calf and Achilles and bottom of the foot, which has tightened. You also need to practice balance and gait.
Reader Ivy began corresponding in the comments of the post to tell Sylvia her specific events to first stop the disc herniation, which was pressing and constricting nerve conduction.
By October, Sylvia has done much to reserve several causes and results. She was walking without a cane (right) and wrote,
"Hi Jolie and Ivy "I really appreciate your support and enthusiasm. My badly herniated disc obviously impinged on the nerve causing the nerve damage. I know this is from years of bad posture. I have come a long way already but not too far in the lunging and balance areas yet.
"At the weekend I was seen to be dancing at my son's wedding and I realised that non-one would believe I am usually slapping along.
"Instead of wearing my usual flat shoes or bare feet I had some new ankle strap 2 inch heel sandals for the event. The strap helps to keep the shoe on and the height of the heel was just right to keep me on my toes ! So I have decided to find a dance class to supplement my pool and land exercises as I have rediscovered I love dancing !
"I am going to Florida for a couple of months and should be able to find some dance action there. I'm going to try and toe walk on the sandy beach too.
"In the meantime I will keep on trying to change my bad postural habits! Best wishes. Sylvia"
Sylvia and I also corresponded. She send a photo of her happy and healthy at her son's wedding (below, right), with this update:
"Dear Dr Jolie, "I have received the books today... Now I have no excuse for not stretching and correctly at that !
"I can't wait to get back in the water and see how my ankles are - they are probably quite stiff so will need some work.
"I have printed the Inspirational Ivy page with the pictures of her exercising and keep it in my purse as a constant reminder that my condition will improve. Everyone here whom I haven't seen for two months whilst in the UK, is telling me how much better I'm walking. I tell them what I'm doing and if they have any problems refer them to your web page. Best wishes for now." Sylvia
We will be hearing more wonderful things from Sylvia.
Disc Pain - Not a Mystery, Easy to Fix - When you stop bending wrong many times each day, which pushes discs outward many times each day, damaging forces will stop, and can heal.
Read success stories of these methods and send your own. Questions come in by hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Have The Fitness Fixer e-mailed to you, free. Click updates via e-mail "Health Expert Updates" (trumpet icon) upper right column. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Here is Friday Fast Fitness - rows to strengthen the upper body, practice balance and neutral spine, and avoid lower disc injury from bad forward bending.
Readers have been writing in, excited about doing handstands for the first time or improving the handstand they do to get whole body functional fun exercise. My student Danielle demonstrates:
Shift your weight to stand on one hand. Grasp a hand weight in the other hand
Do rows, and any variety of arm free-weight movements that you want to improve.
There is no need to bend over forward to do rows. It does not train functional posture, and unequally squeezes lower discs outward, which adds to degeneration and herniation forces that are common during bad daily sitting and unhealthy bending. You don't need more unhealthy things while exercising.
What Is The Difference Between A Leg Press and a Squat?
Monday, July 14, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Is a leg press the same as a squat upside down? Both the squat and leg press bend and straighten the legs against resistance. But something special makes opposite forces on the joints.
The post Exercising With A Friend - Partner Leg Press showed a fun leg press without equipment using a friend for resistance, balance, and teamwork. Reader Nina left the comment on the post: "This could being done another way. Sit on a bench or sumthing (sp) else back-to-back with your partner. Interlock arms sitting straight with your backs pressed together. Rise up and down, and feel the pressure on your leg muscles."
What Nina describes is called a squat or half-squat. The exercise in the post is a leg press. Standing on your feet changes it to a squat.
The squat has opposite joint and muscle dynamics to the leg press. In the kind of leg press described in this post, your body is fixed, and the feet move away. In the squat, the feet are fixed and the body moves. The difference in which end is stationary creates different forces on the muscles and joints.
My students Lily and Biji demonstrate one way to do a fun partner leg press. Hold your body (and head) stable.
To do half-squats with or without a partner, it is usually better exercise and balance training without the bench. There is no need for equipment. Instead, use your own muscles to hold up body weight, rather than sitting or touching down to a bench between each raise. The squat is functional - meaning it uses your body the way muscles need for real life. The key is using the half squat for healthy daily bending instead of "bending wrong." Bending over forward unequally weights the discs of the spine. Over years of bad bending, you can accumulate enough small pushes on the discs to begin to break them down and push them outward toward the back. This is the process of disc herniation. It is not a mysterious situation or a disease process. It is simple mechanics. The resulting disc damage, slippage, herniation, is an injury that can heal, usually easily and quickly when you stop the injury process of bad bending during standing, sitting, and lifting.
Your body needs to practice both kinds of leg resistance to be good at both. Have fun building functional squatting into daily life instead of dong artificial squats in a gym, then bending wrong hurting your discs the rest of your day. Have fun doing leg presses balancing friends and family that move and squirm, instead of ignoring real humans to interact only with artificial stationary gym equipment. Get real fitness with real life.
The new Indiana Jones movie came out this past weekend, the Kingdom of the Crystal Skull. It is set in 1957 with fun fitness and iconry of the era, for future blog posts. Today - the Rocket Sled.
In the early part of the movie, Indiana Jones and the Soviet Russians brawl through a US military testing base in Nevada. Jones and a Russian officer wind up on a rocket sled, which blasts them on a speed track into the desert.
Rocket sleds are one of several devices that create and test the effects of high acceleration on equipment and the people who use them. High acceleration forces occur when jets take off quickly, when launching a space flight, to eject from a hit (compromised) fighter jet, on roller coasters and spin and fall rides, when you fall from a height, and any time you change speed and/or direction quickly. Interesting changes occur in the body under acceleration. Acceleration is one of the areas of my study as a research physiologist and was my work for a time at two facilities testing air vehicle and human systems.
G-force is a measure of acceleration, not force, but the term g-force is also used for the reaction force that results from acceleration. More on meaning, spelling, and math of g and G in another post. Too much g-force can result in g-LOC (Loss of Consciousness), pronounced "jee-lock"in English, but just as meaningful when using the Cyrillic pronunciation of "loss." When piloting a multi-billion dollar property (the fighter jet) G-LOC is not a good thing for anyone. The pilot may convulse, called "doing an Elvis" because the flailing looks like playing an air guitar - a real air guitar. Then the pilot may "ding" (lose consciousness) and the vehicle may "descend below the level of the terrain" (crash) and "disperse energetically" (explode) and "value unfavorably" (be destroyed), and the crew and anyone they land on may "achieve a negative health status" (die).
So we test.
A rocket sled is a small platform. Rockets propel it on the ground on rails. It creates high onset g-forces for a time limited to the length of the track. When personnel or equipment riding it sit as in a car or plane, they experience acceleration pressing them from front to back (on an x-axis).
To measure the higher g-forces with short onset experienced in jet bail-out procedures, a vertical ejection tower can be used. A small seat is propelled quickly upward by a contained blast force under it (like lighting a bomb). If they are positioned to sit upright, the acceleration acts on them from head to foot, on their y-axis.
To experiment with varying accelerations over different amounts of time and onsets, one device used is a centrifuge. A long support arm swings around and around a center anchoring point -like swinging a ball on a string around your head. A container, often ball shaped, at the end of the support arm holds the equipment or personnel being tested. The ball can rotate to position the people inside at any angle to simulate the changing positioning of a cockpit during maneuvers, for example.
What happens to the people in these testing devices? Often they throw up all over my nice equipment. Some of my test subject pilots used to have contests who could eat the worst thing to redisplay on testing day. One ate plastic bugs just for the fun he was sure to cause - then he didn't throw up, no matter what we did to him. In vertical (y-axis) ejections, there is high impact and acceleration forces on the discs and spine. Back injury is a concern for ejection scenarios. Vibration, both during acceleration and non-acceleration situations, such as for helicopter and jack hammer operators seems to be a high contributor to back pain. It is not known if the various vibration devices sold as fitness devices are of the kind (vibration frequency or amplitude) that contribute to joint pain. G-LOC is another consideration. Why do we test it? To see how to prevent it, if we can screen for who is more likely to get it, if we can train those prone to it to be more resistant, and so on, in g-force tolerance improvement programs (g-TIP).
The set of photos at right is a well-known one of USAF Colonel John Paul Stapp, M.D., Ph.D., riding the rocket sled. He was a pioneer of acceleration study and is also known as the originator of the expression "Murphy's Law" for things that can go wrong. The effect on his face along the x-axis is not from his high speed, but the acceleration which is increasing in photos ii and iii, and decreasing in v and vi. Even though his speed is greatest in photo iv, speed is not increasing or decreasing much, so there is little effect.
More on the interesting effects of acceleration and environmental testing from roller coasters to jets to movies in posts to come.
Click labels under this post for more Fitness Fixer on each topic. For example, for all posts on fitness issues portrayed in the movies or other media, click movie/media fitness.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Feeling Better Than She Ever Has Part II - Fixing Herniated Disk and Reclaiming Active Life
Tuesday, April 15, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Barbara lives in a little town of 300 people in Yukon Canada - map at right. Part I of Barbara's story last Wednesday described why it didn't take six weeks to fix Barbara's herniated discs and severe sciatic pain and numbness, but it was six weeks until the "light went on" and she did the things to stop the cause of the injury, so it could stop hurting and start to heal.
Here is an insider's peek behind the scenes week-by-week:
"Dear Dr. Bookspan, "This is a bit of a long one, and probably reaffirms everything you've ever received in hundred and hundreds of emails and stories, but I wanted to share this with you anyway. I can’t thank you enough for working hard and sharing all your knowledge. I am almost completely pain free!
"After 6 weeks of severe sciatic pain and numbness and weakness of my left leg and foot, something just clicked on Thursday night and I became more determined than ever that I could get rid of the pain. Through your website, the Fitness Fixer, and reading lots of personal stories (on your web site and book), I realized that I had to fix (the) causes. I know this might sound dramatic, but you’ve changed my way of life.
"Pre-sciatica lifestyle: "A cycle of: 1) a few months, everyday, of "power" exercising with all the unhealthful postures and movement habits you talk about, then sitting at the computer in all the unhealthy ways you talk about and drinking coffee and smoking, feeling like I’d accomplished something in my day; 2) followed by a few months of complete laziness (not even power exercising). Power exercising consisted of running (without stretching at all) with bad form, and Hatha Yoga (forcing myself into the stretches and tons of forward bending).
"Sciatica struck.
"First two weeks: "I did absolutely nothing about it. I read stuff on the internet and was convinced from the stories that I had some debilitating disease that would affect the rest of my life. I thought the cause was that I didn’t keep up with my "power" exercising. But, I continued to sit bent forward in a chair, hunched over, bending wrong, doing yoga forward bends, smoking and drinking coffee. I know, how sad."
How to avoid herniating forces on the lower back discs during yoga and fitness stretches for the hamstring:Healthier Hamstring Stretching
"Third week: "Had to go back to work in the morning, teaching 4 and 5 year olds in a kindergarten class; in the afternoon, teaching reading strategies to Grade 1 and 2's - sitting in a chair all afternoon. No longer could I hobble around the house holding my backside and leg - full on activity - and pain, tingling, numbness in my left foot, and total weakness in my left leg. Felt like I was walking around all day with a Charlie horse going down my entire left side. Amidst all my continued Internet searches, stumbled upon your website when a friend said that slight forward bending doing dishes and getting ready in the morning leaning over the sink might be a cause. Your website made so much sense to me - if a slight forward bend is a bad thing, how much more unhealthy would my Hatha yoga program be, with all its constant forward bends. I might add here that the two people at work who talk about slight forward bending being a bad thing continually hunch forward while sitting and exercise using forward bends. Just something I’ve begun to notice."
Major news stories quote physicians saying that back pain is often a mystery and that no one knows why stretching isn't working. My readers regularly report that once they understand the simple principles, they see the unhealthful positioning that causes pain frequently - at the gym, in fitness magazines, and in exercise videos and classes:
"I started with lying on the floor propped up, upper and lower back extensions, pec and trapezius stretches, isometric abs, being continually aware of my posture and not doing ANY bad forward bending. Tried to do the lunges and squats for daily good bending, but my muscles were so weak and I practiced them half-heartedly. I tried to apply them in daily life but life seemed so fast-paced at work and I was in so much pain constantly, that I would get _ way into it and then just try to lean to the side to pick things up - result, I was contorting my body in very odd ways! I ordered a support brace and special support backrest (now I know why I never needed them) and seat cushion for my chair from other web sites, but also ordered your book Fix Your Own Pain, along with a few of your other books."
"Fourth Week: "Limping and terrible pain, my boss told me to visit the nurses station -living in a town of 300 in the far north, we have one general store and a health centre, doctor visits once every two weeks - and take every afternoon off during this week to rest up. He still needed me at work in the mornings. Taking my new prescription of Naproxen and trying the lunges and squats and some stretches but not really trying to apply them to the rest of how I was moving and bending and sitting. I would be in quite a bit of pain coming home from my mornings at work. In the afternoons I would basically throw in some stretches, but generally read (sitting badly) and nap for an hour. A lot of the pain would dissipate after my stretches and a good nap - only to be set into full force the next morning at work.
"Your book came in on the Friday and I was very excited. I read through it and practiced the retraining stretches that show how to restore straighter positioning throughout the day. I felt much better by Sunday night with the stretching. Still only half-hearted attempts at lunges and squats."
"Fifth Week: "Decided to start my morning off by doing my full range of stretches instead of sitting in the computer chair smoking and drinking coffee. I felt pretty good when I left for work. People at work were starting to call me "feisty" saying that I seemed to be walking better (that was probably because of my better posture from applying your method instead of just doing stretches!) Sitting in a chair almost killed me - after 25 minutes in a chair the pain was almost unrecoverable - to be endured for the next hour and a half at work."
Barbara was getting the idea about healthy movement, but was sitting in the same way that causes discs to be pressured. She thought it was "taken care of" because she used a commercial lumbar support she purchased the first week. However she was still sitting in unhealthy ways, right over the support:
"I could manage the pain better with frequent relaxing on my stomach propped up on arms and stretching, but I never felt complete relief until I got home at night. I still didn't realize it was bad sitting position, so decided to get rid of my chair and stand to teach. This was better, but the pain still kicked in(especially in my left buttock!). Once my left buttock got hit with pain it went downhill - down my whole leg, followed by the numbness and severe tingling. Midway through the week I went to see our visiting doctor - quick visit and the prognosis that I had a herniated disc L5-S1. He said it would heal. I was feeling pretty positive about this, as it seemed to coincide with what you say about herniated discs. Meanwhile, the sciatica was taking it out of me. I felt I was always either in pain, or awaiting a painful episode. I made it through, relieved that the weekend was underway. I decided to trying walking - every couple of hours I'd walk on my treadmill for 20 minutes and then do my stretches. I did this two times in the day, and then went for a walk outside in the evening (-35 degree weather so I bundled up really well). My dog and I headed out for what was to be the most agonizing walk for me. Half hour into the walk I started to get that butt pain but I was only half way home. By the time I got home after an hour walk, I wanted to hit the roof and I although I could alleviate some of the pain through lying on my stomach propped up, and stretches, I could still barely sleep. I was also completely consumed by whether or not I had slacked in my posture somewhere along the line while I was walking, or whether I was too tight or loose (still missing the big picture)."
"Sixth Week: "Still determined. Began the week at an all-day staff meeting where I lay on a gym mat on my stomach, propped up on my elbows- all day. Stretching at lunch and a couple of other times I walked out of the meeting to stretch. It almost floored me to do a 20 minute standing stint that we had to do during our meeting. Followed by a 2 hour course via video-conferencing where I did the same thing. When I got home the pain was less and I didn’t want to "over-do" it again, so I gently did my stretches throughout the evening- I didn’t try to walk. Next day at work, the pain was pretty bad from the beginning, but it was -60 degrees F outside and not many kids came to school - more time out to stretch when I needed to. Wednesday - more of the same. I tried to walk at night but got discouraged when I couldn’t walk for more than about 10 minutes without pain. Thursday - same thing, but I almost ran out of the school at the end of the morning to go to the nurses station. (We both wrongly assumed that I had overdone walking, not just walked in injurious ways.) She prescribed more Naproxen and told me to make sure that I walked but more frequent intervals. She also told me to keep stretching, but that lunges and squats were simply out - don’t do them. I kept wondering about this advice as I reread Ivy’s story and looked at the pictures of her doing those amazing squats and lunges. I spent most of my evening on the internet reading and rereading stories."
Barbara was lying face down propped up on elbows for long periods in a way that hurt instead of help. Instead of letting the entire spine gently extend backward so that the upper back "unrounded," she was "folding" a crease at the lower back, increasing pinching in the lower back.
"Friday of the Sixth Week: True Awakening! "I took Friday off work and first thing in the morning while I was doing my usual morning stretch routine, it just hit me! I became so obsessed with my posture, thinking that stretches should magically make my pain disappear, but I wasn’t viewing my body as how I used it during regular activity; I was also very guilty of giving up on certain things when they got "too hard" (lunges, squats). My balance was bad (despite trying to practice it while putting on my socks and shoes), my walking gait was horrible, I wasn’t really trying to do anything that required some effort, and I was continuing my bad habits of resting for hours before I tried to get back up and stretch again. Having reread some of the personal stories, I worked on my walking: feet straight ahead, feet hip-distance apart, heel to ball of foot, using my whole foot to walk - I was so focused on posture that I was holding myself stiff while walking instead of walking naturally with a bit of rotation at the waist). When I thought I was using my muscles, I was really just tensing them right up instead of truly using them. Reading posts and walking also made me realize how tight my Achilles tendon, hamstrings, and hips are. I decided to work on this through my stretches too. Next hour I was back up and walking, and stretching those areas after (using a counter to hold onto while doing a full squat, doorway hamstring stretch, and stretching my hip sitting on a chair rather than lying on the floor). Every hour I walked and stretched, and every walking session was longer, every stretching session I could actually stretch farther! Halfway through the day - now it was time to really engage myself in those lunges and half-squats - just do them and do them properly - no excuses - I need them for everyday life and unless I go beyond what I think I can do, I’ll never get to that point. They’re definitely not just part of an exercise routine, but unless I could do them with strength and stability in my living room, I knew I couldn’t do them in a fast-paced setting when I needed them.
"Time to stop making excuses. I was up and about constantly all day, walking, lunges and squats, stretching. By the end of the day, I can’t even describe my feeling of elation when I went to bed completely pain free, with my left leg hardly stiff at all, and some of the numbness in my left foot gone! Actually having been rather lazy, and in fear of lunges and squats doing more damage, they turned out to be the best stretches and strengtheners...now why wouldn’t I want to use these in all situations to get a beautiful natural stretch during my day! The confidence and calmness that all using your principles, and truly using my muscles to engage in activities is giving me give is fabulous. Not to mention all the energy! This is a new way of life for me. And quitting smoking is not a different story...it’s the same story...and my next step is to look into my eating habits and to quit smoking. It’s my life and my body is a temple...I’m sick of mistreating this temple with lethargy and apathy. No more unhealthy exercises in "power" work-outs and yoga for me...strength, balance and flexibility will is every moment, every day. Now I'm ready for your Healthy Martial Arts book...
"Thank you! Thank you! You (and Ivy) are my inspiration! Wishing for you all joy and true happiness in life (which I know you already have :) ). "Fondly, Barbara
"I'm truly thankful for your hard work and great insight into pain and how to live healthy in every day life!!
"PS I was frightened when I was told I had a herniated disk at L5-S1, and this was great news to me as I know I'm healing and I won't need any physiotherapists, etc. to help me through this! Your book Fix Your Own Pain is amazing - I think I've almost memorized it; two people at work have borrowed it already (including my boss) - I think they're seeing how much it has helped me. I'm thinking about giving your book to people for Christmas."
Summary "take-home" message - Barbara found that she doesn't have to "do" any exercises. That is the difference with this method and others. Moving for daily activities using the retrained healthful positioning stops the source of the injury. At the same time, it just happens to give much built in functional healthful movement. That is how exercise is supposed to be - a natural part of your human life.
There is more good news to Barbara's story, but that's enough for now.
Here is Fast Friday Fitness - straighten out first thing in the morning and help your back feel good.
Instead of sitting on the bed first thing in the morning, which loads the discs, try this:
Before getting out of bed, turn face down propped gently on elbows
Hold briefly
Get out of bed without sitting.
Don't droop your head downward, jut your neck or chin forward, hunch your shoulders, or fold back sharply at the lower spine. Find a low gentle position that makes your whole back feel good. The idea is to feel better and straighter, not strain, force, or make your posture worse. That would be silly.
Also do this several times throughout the day. Feels good after long sitting and physical work.
For most people this stretch works well. If it hurts your lower back, go to a lower position. If you flatten completely straight and still feel pain or pinching in the lower back, then how can you stand up straight without the same problem? Don't use this First Morning Stretch until you find why it is not comfortable. One common reason is front hip tightness. Try the Quick Relaxing Hip Stretch.
--- Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
RSS feeds still down - Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy. ---
Taxes are due April 15th. Piles of papers, forms, schedules, receipts. Readers have asked how to be healthier while working at the desk, and how to keep their cool during tax preparation.
Several readers asked how to stop neck pain when looking down over deskwork. Reader John M, specifically asked "How do you suggest someone look down (to look at a chart etc at work) without pushing the (herniated neck) disc out more (or aggravating symptoms)?
Three photos above show tilting the neck forward and/or jutting the chin forward. Holding the head forward of the neck and body is a major source of upper back and neck pain. The "forward head" is hard on the soft tissues, the joints of the vertebrae called facets, and the discs of the neck, and is a major overlooked cause of "upper crossed syndrome." The forward head is just a bad posture, and easy to stop. It is not necessary to jut the neck or chin forward to look downward.
Check how you are sitting right now. Are you letting your neck hang forward, are you jutting your chin forward, or are you pushing or rounding your neck and upper body forward? Instead, keep chin in, loosely and gently. If needed, bring your chair closer in closer to the desk and lean the upper body back instead of rounding your lower back against the chair back and leaning the upper body forwad.
To look down comfortably - tip chin down in relaxed straight position instead of jutting the head and neck forward. That is healthy positioning for everyone - injured or not. No need to lean or hang the head or neck forward, or round your upper back to look downward.
More Fitness Fixer with quick techniques to feel better during desk work:
Read inspiring success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
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Forward head photo 1 by Kevin K. Luu Forward head silhouette photo 2 by äÁǻǵ Forward head writing at desk photo 3 by My Hobo Soul Straight good cooking posture photo by Presta
Feeling Better Than She Ever Has Part I - Fixing Herniated Disk and Reclaiming Active Life
Wednesday, April 09, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Barbara's story came in over several weeks. Barbara thought she was healthy and active, and had done years of yoga. She had years of lower back pain, then a sudden onset of severe pain, leg weakness, and numbness. She couldn't push off effectively with her left foot, or stand on tiptoe. The heel of her left foot was completely numb, as well as the left side of that foot.
Barbara lives six hours from the nearest big town (there are 300 people in her little town in the Yukon and one general store).
Her doctor found that she had a herniated disc in her lower back, put her on anti-inflammatories. She was in continuing pain, and fearful of her future of pain and reduced activity, which would mean getting more out of shape and feeling worse. She was frightened that she had some "debilitating disease."
Barbara found my web site and this Fitness Fixer column with free information of how discs become pushed outward (herniated) through bad sitting and bending habits, and began trying some of the information. She wrote me excitedly the first week,
"I decided, after reading one of the many great patient stories you included in your book showing what to do, to lie on the floor on my stomach propped on my elbows to read your book. This felt amazing and when I got up again I could walk straight!"
Another e-mail followed that she was feeling worse again after that. I asked if she had gone back to all the injurious habits that cause the pain. She was surprised to realize that she had. Bad forward bending puts outward and eventually herniating forces on the discs. Barbara was bending badly all day at work when she need to pick things up, bending badly at home over the sink, counters, and while doing housework, then going to yoga class and spending much time bending over forward. Even in a yoga class, herniating forces occur from chronic forward bending, both sitting and standing bent over. It isn't magically good for the discs by calling it a stretch. Barbara also had been told by her health care providers not to do any lunges or squats. She later realized they were just the healthy bending she needed to do normal daily reaching and bending at work and around the house. Without them, she would only be doing the same bad bending that was contributing to the original problem.
Barbara wrote,
"I realized that part of my problem all week was that I had been half-heartedly doing "exercises" then going back to wrong bending while getting completely frustrated because it would seem things would start to feel better in the morning, but I'd feel like garbage by night. I wouldn't do all the things you recommended first thing in the morning, and I would get halfway through a lunge or squat to bend or pick something up and then bend forward out of frustration. So, I pampered myself yesterday - really, truly practicing and applying how to move in real life, especially concentrating on those lunges and squats when I needed to get something. It also finally clicked with me that while I was trying to concentrate on tucking the hip to neutral spine to walk, I was totally ignoring the forward bend of my upper back while standing and walking all week. I was walking all stooped over and feeling like an invalid."
I wish I could write that Barbara followed everything I said and was better the first day. What actually occurred was that it was six weeks until the "light bulb went on" and Barbara realized that "doing" a stretch or exercise doesn't magically erase the injury. Stopping the injurious bad movement habits that harms the disc is needed to let it heal. Using healthy movement in daily life for daily bending and reaching would improve strength and balance. Barbara said that reading the Fitness Fixer stories from Ivy sparked her "turning point" to understand. She then started feeling relief.
Barbara wrote.
"In short, I’ve come from having pain, and muscles completely unaccustomed to healthy movement lifestyle, to feeling stronger, more flexible and agile, pain free, along with a new attitude to everyday life and health, with fresh energy and a renewal of love of life. I know this might sound dramatic, but you’ve changed my way of life.
"Your website has been a godsend actually; especially when I surf the net and see "surgery" splattered everywhere.
"PS My principal just ordered your book - he borrowed Fix Your Own Pain for a week (I didn't think I'd get it back) and would like his own copy. That's saying a lot - he's doesn't take well to other people's advice."
It was six weeks of half-way recovery and recurring pain until Barbara got the idea that "doing exercises" doesn't heal an injury if you go back to bad movement habits the rest of the day. She also noticed how some of the most common exercises contribute to the original problem. Here are links to the information Barbara used:
Barbara generously wrote up her story to help readers see that they can fix pain sooner, rather than waiting six weeks. Coming next, Feeling Better Than She Ever Has Part II - a look behind the scenes.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
How many of you caught that the photo in the Fast Fitness post - Fix Positioning by Watching Others is of terrible body positioning that is a common source of upper body pain and injury?
I received letters asking about the photo. Several readers did not catch that the reason for the photo was that both people were standing in terrible rounded forward posture. Some readers thought the photo was not of bad posture, but showed people with interest in the game or that they way they were standing was a needed position to see the ball.
It is a harmful body position called forward head and round shoulders.
The rounded and tilted forward position of the upper back, neck and head is a bad positioning that is a major cause of:
Upper back pain sometimes called Upper crossed syndrome
Look in your fitness magazines and videos and look around during fitness classes and the gym to see if you can see the forward head and a rounded upper body. It's a handy reminder that it is not healthy, and to exercise in better, healthier ways.
Here is Friday Fast Fitness - make rowing good exercise, not bad sitting:
Don't round your spine forward (left). Rounding pushes discs outward. Left drawing shows disc pushing outward by bending the vertebrae to that they open in back. Rounded sitting with chin forward shown in 1st and 3rd rower in left photo.
Chin in.
Stay straight during the pull (right drawing and photo).
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
As you read this, we will have been on several days of flights and trains.
Sitting for long periods does not have to be uncomfortable, whether at the desk, on a flight, when driving. Most lists of instructions for sitting without hurting your back tell you to sit in exact ways at exact angles. This is not needed. Instead, it's better to understand the concepts of how and why strain and injury occur when sitting. Then you can sit in healthy ways that are comfortable, easy, and healthy.
Commercial airline, bus, and train seats often have a concave seat back, encouraging prolonged, enforced rounding. So do many car seat backs, even those saying they have lumbar support.
If your seat back is too concave, pad the space with a small cushion.
Use a pad about the size of your own forearm.
Place the pad in the small inward curve of your lower back.
Don't remain sitting rounding forward against the lumbar pad out of habit. A lumbar roll will not make you sit right.
Lean your upper back against the chair. Don't press your lower back against the pad.
If your lumbar roll hurts, it is not right. It should not be a hard material that hurts you. See if you have it positioned in the right place.
At a desk, move your seat in closer so that you do not round or lean forward to reach or see the computer.
Future posts will cover more about lumbar roll use and misuse.
If the seat is very concave, you may need two pillows, one for the small inward curve of your low back, and the second above that one for your upper back, in the space still left by the rounded seat. The upper back has a small outward curve, however sitting with a large outward curve creates upper back pain.
Rich Tarpinian, IT systems engineer, musician, hockey coach, and vegan, fixed grinding neck pain, back spasms, disc pain, and tension-type headaches. He had not been comfortable sleeping in any position. Rich said the neck grinding and discomfort, "felt like it was never going to go away."
Rich writes:
"Thanks again for your help! Here's my update. I stopped cranking my neck around and the grinding stopped within the 2 weeks or so that you had indicated.
"I am controlling my body positioning, more aware, and have eliminated lots of neck tension even though I work at a computer all day. The anxiety I was having about disc problems, etc., has mostly been replaced with good knowledge, a feeling of control, and an ability to heal.
"Every morning (instead of sitting on the bed) I get out of bed the way you have recommended - why? because it makes sense. I don't sit on the bed and then try to straighten my body as I start to walk. I get up from the face down position in the already standing position.
"I've always had an interest in the mechanical aspect of how the body moves and what the sources of problems can be which is why, when I was pouring over information on the internet, your information regarding cause/effect relationships instantly caught and held my attention.
"I eat a pretty good diet - vegan with a good amount of raw foods, but had not paid much attention to posture and movement. I will now.
"As a side note, I coached hockey for about 8 years and played up until about 4 years ago. I had an opportunity to get back into some coaching recently but was really worried about the neck issues that I had been having for weeks. I also used to get a lot of back spasms when I played/coached. After experiencing the progress from your recommendations, which came just in time, I stepped confidently back on the ice a couple of weeks ago and have felt good given some expected muscle soreness that is now gone. The hardest thing was lacing up the skates but, once I was on the ice, I felt great.
"What you have done effectively is to empower people with the knowledge of how to find and return to the correct answers in order to maintain their own bodies. You've done that by providing reasons where needed, presenting conflicting information to show contrast, and using repetition to help solidify the important concepts."
"The key is that I now understand the causes of the problem and can, for the most part, manage the process when things start going wrong. As I cruised the internet looking at information, my anxiety meter kept rising - until I found your article on fixing the neck grinding problem which prompted me to read your other articles on sitting, lifting, etc. The article was immediately positive with a no strings attached approach to fixing and preventing the problem. My overcoming the neck issues is directly attributable to you."
Rich first fixed his pain using my web site summary sheets. These Fitness Fixer posts also describe techniques used:
Two important stretches to do first thing in the morning and throughout the day to restore ability to sit, move, and stand without unhealthful neck position - Fixing Upper Back and Neck Pain and Nice Neck Stretch
Having muscles soreness is not bad, it means you're out having fun. Make sure there is no pain or soreness in the joint. That is the difference. See Teen Dies After Using Muscle Soreness Rub
I wrote Rich to congratulate him on his initiative and great work, and thank him for his story. He replied:
"Just when I've corrected the forward head problem, I'm going to need those neck exercises to treat "swelled head syndrome."
Smile and laugh. It's healthy too.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
Wednesday, August 29, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Ivy had serious sciatica with foot drop. She had knee and other injuries. She was in awful pain. In this kind of foot drop, the nerve cannot serve the muscles enough to lift the foot to walk normally. The toes drag. The foot hangs limply and slaps the ground with each step.
Commonly, someone with foot drop is put in a leg brace for life. One surgery done for foot-drop fuses the ankle so the foot is rigid and doesn't hang. Other problems come over years from changes in walking mechanics. For the terrible pain, patients are often directed to drugs and surgery. These are not healthy.
We changed that:
Monday's post Inspirational Ivy told the essentials of stopping the cause of the sciatic pain and nerve impingement, rather than treat the results with unhealthy means. Links to specific methods are there.
Sciatica, disc damage, facet pain, and impingement are results, not the cause of pain. They are not a diagnosis. When you have them, find what is causing them. Then you can reverse the cause: The Cause of Disc and Back Pain
Ivy followed my directions exactly and used her brain to understand how to get the intended results, not just "do a bunch of exercises." When she first began, she wrote,
"Over the past few days, I have been very conscious of my movements and, hey presto, I have not experienced any tingling or pain. I have to take total responsibility for every movement I make. I am constantly telling myself 'Think before you go to the fridge or need to pick up something off the floor - think lunges.'"
I gave her simple gait retraining. Ivy quickly discarded the cane she had used for nearly 7 months.
Ivy went on to teach several neighbors in her community how to fix their own pain. One story is posted in Each One Teach One.
In April 2006, Ivy wrote,
"It is nearly 5 months since I started your wonderful programme so I thought it was time that I gave you an update. I am fit and well, the sciatica has disappeared, if I get a little niggle in that area, I ask myself as to what have I done wrong, my left knee (IT Band) is no longer a problem, my balance has improved immensely and the "dropped" foot is great, in fact, when I go for my daily walk, I no longer hear the plop, plop of which I hated. I can also now wear "normal" shoes.
"Without your help and support and putting me on the right road so to speak, I would still be in constant pain plus making the chiropractor richer. Please note, I no longer go to him for treatment - I DON'T NEED HIM."
At age 70, Ivy is steadily improving strength and range of motion using healthy movement for daily life. She is eating healthful vegetarian food. January 2007 brought this note:
"The reason for this e-mail being that I feel somewhat excited re a remark made by the son of one of my fellow villagers. His very words being, "How did you become the woman that you are now. I have watched you over the past couple of years - when I first met you, you were obviously in a lot of pain, what is your secret?"
"I also sent the photos to my son and daughter-in-law who live in the US, they too, could see the improvement - they thought I looked great. Mind you, over that 2 year period, I gradually lost 20 lbs."
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
This weekend in the Northern Hemisphere, the moon will be new, and the night dark, and the skies filled with the shooting stars of the Perseid Meteor shower.
Every 130 years or so, the Swift-Tuttle comet circles the Sun, streaming icy, dusty debris the size of sand and peas. Every mid-August, the Earth passes the orbit of Swift-Tuttle, raining fiery remains through the atmosphere. Igniting against the air's intense friction, they "shoot" across the sky. Books by people who study these things say they fly about 37 miles per second (60 kps), most burning away far above the ground.
The Perseid showers are seen in the sky around the constellation of Perseus the Hero, giving the name. Early Greeks explained that the god Zeus, father of Perseus, visited Perseus' mortal mother Danae in a shower of brightness. Later the event was renamed (or reborn) as "The Tears of St. Lawrence" for their appearance during the August festival of Saint Laurentius. Chinese, Japanese, and Korean writings of Perseid showers date from the 8th century. I grew up on Russian childhood social-utopian folk bedtime stories of comets, mixed with my Grandmother's whispers of fiery conflagration, later determined from an unknown comet or part bursting over Tunguska Krasnoyarsk Siberia around 1908, devastating the forest (later politically reinvented as a nuclear event, and editorially as UFOs for Russian science fiction writing and American television).
What about your neck? When watching meteor showers standing or sitting, don't martyr your neck. If you crane your neck and push the chin forward when looking upward, you put destructive force on the neck, shown in three examples that follow:
Three images above show craning the neck and jutting the chin. Injurious compression builds in vertebrae, discs, and surrounding soft tissue.
The left and middle images show leaning the upper body backward. Thoracic lean overly arches the lower back (hyperlordosis), adding weighted compression to the joints called facets and soft tissue of the lower spine.
The right photo shows unhealthy craning with the chin forward, common in some yoga and exercise classes. It adds sizeable compressive loading on the back of neck vertebrae plus shearing force on the discs. When raising arms upward, it contributes to rotator cuff compression and injury. Click Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.
I understand that jutting the chin far forward is often taught as proper form. I have taken yoga classes in India with major names and those unknown to the outside world. One teacher told me pushing the neck and chin forward protects the discs. It unfortunately doesn't. Shearing force on the discs is severe when you jut the chin forward then raise it. Shear is a structural strain when one layer shifts sideways (or front to back) in relation to the other. Damage may take years to accrue until visible on x-ray. Don't jut your chin forward, especially not when looking upward.
Photo 3 above shows tilting the neck forward when looking through binoculars (left figure with yellow arrow). The chin is not forward, but the forward head still creates painful forces on the upper back contributing to upper crossed syndrome, disc trouble, and muscle strain in the classic diamond and hangar shape across the upper back. The pain is easily stopped. Keep neck vertical and chin in (right green arrow).
You can look directly upward for all you need in healthful position. Here are ways:
Keep your chin in, loosely and relaxed.
Shoulders back.
The back of your head lifts loosely upward without strain.
Straighten the rounded-forward curve of the upper spine - get more upward gaze range from your upper back.
Don't yank or force the head and chin back, or the corners of your neck will ache.
Don't lean back by arching your lower back.
Healthy upward gazing is a nice good-feeling stretch and exercise for the upper back and neck without injury. Use it for all overhead needs, photo 4 of Amsterdam policeman at right.
The time where we pass through the Perseid shower is long, from about July 15 through August 25. The highest activity is predicted over the Northern Hemisphere this coming weekend. Look up on Saturday, 11 August before dawn, Sunday morning the 12th, late Sunday night through Monday early dawn.
Because of the tilt to Swift-Tuttle's orbit, its fiery dust falls almost entirely on Earth's northern hemisphere. Southern hemisphere friends see few Perseids. The next good Southern hemisphere meteor shower is hoped to be the Geminid showers in December.
The constellation where meteors appear to come from is called the radiant. The Perseid meteor shower radiant is the constellation Perseus. The Leonid shower is hoped to peak this 18 November. Look toward the constellation Leo. The Geminid shower radiant is the Gemini constellation. Watch in mid-December with the evening crescent of the moon.
In photo 5 at left of looking up through the telescope, the neck is a bit more forward than needs to be.
Experiment on your own. Use a mirror and send in your photos of remaking healthful fun overhead gazing activities.
The cheerleaders in the photo at right are letting their lower spine overarch.
Their hip tilts forward in front and sticks out in back.
It is an unhealthy, pain-producing spine position.
Can you see it?
Can you see it better now with arrows showing the tilt of the hip?
Sticking the hip out in back creates a higher angle than normal in the normal inward curve of the lower spine.
It is an unhealthy spinal position called hyperlordosis, swayback, and overarching, among other terms.
Letting the lower spine overly-arch presses the weight of the upper body, plus the weight being lifted, downward onto the lower back, folding it backward and compressing it unevenly. Over years, the joints of the vertebrae, called facets, can degenerate under the compression. The surrounding soft tissue aches. The photographer of the photo labeled it "Ouch" in the Creative Commons collection where I found it.
Overarching and sticking out in back is unhealthy for the spine, and is a major overlooked cause of ongoing lower back pain after long standing and ambulating (walking and running, for example).
If the cheerleaders were standing in neutral spine, the yellow arrows would be vertical. In the drawing at right, the left drawing shows neutral spine, the right shows tilting the hip so that it sticks out in back.
Tucking the hip until neutral spine does not mean curling the spine forward (rounding the back), which can pressure the discs. In neutral spine, a small inward curve remains in the lower back, but not a big one, and the hip does not tilt outward in back.
Some exercisers are accustomed to stick far out in back when lifting weight overhead. It is now known that it is healthier over the long run to maintain neutral spine, not sticking out in back, when lifting overhead.
Another bonus of neutral spine is that the muscles that pull the spine away from overly arched position and into neutral position, are the abdominal muscles. Keeping neutral spine is a free, built-in abdominal exercise. There is no tightening of the abdomen to hold neutral spine - you should be able to inhale easily. It should be no great effort to move your spine from unhealthy to healthy position. Just move the spine, the same as moving your arm to scratch your head.
Click the label "neutral spine" below this post for all related posts. Neutral spine is fun, and looks healthier, stronger, and fitter. Enjoy.
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To get a better lunge stretch and stop pressure on the medial knee (the side facing the other leg), don't turn your back leg outward (left photo). Turn your back foot parallel, and face forward (right photo)
The previous post Hip Stretch While You Strengthen Legs shows a key move to position the hip to get a great stretch on the front of the hip and feel a better strengthener for the legs as you lower and rise in standing lunges.
One of my students, Lily, demonstrates good hip and leg position for the lunge (second photo at right). Instead of tilting the hip forward in front and out in back, you tuck the bottom of the hip to maintain it vertical from the top of the leg (hip joint) to the middle of the waist. Note the stripe of the side of the pants compared to the vertical line in the wall behind her. On occasion, Lily makes me a wonderful bean dish and brings it to class in a glass container. The glass is a thoughtful healthy touch to avoid whatever may leach out of plastics into food. My students and I try to do this with food and drinks carried to work and class. Here is her recipe. Just throw it all in a bowl:
Lily's Wonderful Beans
Cup or two of cooked black beans Cup or two of corn 1 jalapeño pepper, diced 1 red onion, chopped 1 red pepper, chopped 2 tablespoons cumin powder 1 bunch fresh cilantro, chopped salt and pepper to taste sprinkle of olive oil, just enough to blend ingredients squeeze 1 fresh lime over the top
Some people with celiac omit the corn. Celiac causes various discomforts after eating wheat and related products.
Good bending gives free exercise and stops a major cause of several chronic pain syndromes (muscle strain, disc degeneration, disc herniation, and sciatica) at the same time. Click the labels under this post for related posts. If you use the lunge and squat around the house for all the things you need to bend for instead of bad bending, you will stop a major source of back pain back, and get hundreds of free leg exercises a day. Enjoy healthy eating and healthy lunging.
Leg Exercise That Helps Your Back - Why The Lunge?
Monday, June 25, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
I receive the question often, "What exercises should I do to stop my back pain?" I stress that that the exercises you need to do are to simply change away from all the injurious movements that are causing all the pain in the first place (left drawing) and use good movement instead (right drawing). Then your back can heal. The pain will stop.
I see patients all the time who come to me after going through back pain exercise programs. They went through their eight or ten week program, then their pain came back. Every day they did their exercises, then bent over wrong to put down their weights (left drawing), bend over wrong to pick up their gym bag (same left), sat badly on the way home, then hunched over their computer to record their exercise session. It is no mystery.
The post Disc Pain - Not a Mystery, Easy to Fix shows the mechanism of how bad bending and sitting damages the spine and discs. It is a simple injury, not a disease or condition. You can easily stop the process yourself.
A lot of dollars are spent on the common assumption that you need to strengthen or stabilize the back or exercise a particular muscle set, for example the multifidus. That does not fix the source of the damage. At the gym I see trainers, students, and yoga and Pilates teachers doing their exercise classes week after week, saying they come because they have to because of their back pain. Even the exercises they are doing were contributing to the problem. Many things that are bad for you feel good at the time. The post Common Exercises Teach Bad Bending gives examples so that you can avoid this pitfall. The post Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch shows how the most common stretches done, even in back pain programs are contributing to the problem, and what to do instead.
The answer is easy. The post Bending Right is Fitness as a Lifestyle showed one of the most important exercises you need to do to stop back pain. It introduced the squat, which is not an exercise to do for 10 repetitions, but to use instead of bad bending for the hundreds of times every day you bend for things. Instead of hurting your back hundreds of times every day, you prevent hurting your back hundreds of times a day. Instead of hurting your back hundreds of times every day, you strengthen your legs hundreds of times a day. It is not the exercise of squatting that fixes your pain by strengthening, but by preventing the damage in the first place.
This post introduces the lunge as a second wonderful "exercise" to stop back pain. It is not something you do as an exercise for a number of repetitions. Instead, you use it, along with the squat, for the many times a day you need to bend for all the daily things around the house and workplace - the laundry, the pets, the things on the floor, the kids, the dishwasher and refrigerator, and everything else, all day, every day:
Stand upright with one foot far in front of the other (right drawing).
Feet apart comfortably, both facing ahead, not turned outward (right drawing).
Bend both knees
Don't let your front knee come forward. Keep it over the front ankle (right drawing).
Lower straight down.
Your back heel comes up. Keep the front heel down for better knee health. It's a free, built-in Achilles stretch too.
Don't touch your back knee to the floor.
Don't hold your hands on your front knee. Although common, you get better balance and strength without it.
Done properly, the lunge should not hurt your knees. If you are too weak to lower enough to pick up the mail on the floor and get back up, that is serious weakness. You need functional strength to do ordinary daily life. This isn't walking miles over rocks to the river and returning with heavy water jugs over your back just to cook with. This is getting the mail.
Bending right with the lunge burns more calories than bending over wrong. Good bending helps a weight loss program.
Click the labels under this post to see more on these topics. The next post Strengthen and Retrain Function With The Lunge shows a reader making good use of the lunge. Posts to come will cover more about how wonderful the lunge is to transform your life from weakness and pain into easy function. This is fitness as a lifestyle.
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The new expanded third edition is now available of the training manual, The Ab Revolution™ No More Crunches No More Back Pain.
The Ab Revolution™ is a groundbreaking core training method. It has two components. The first is to learn how to consciously use your core to reposition your spine away from injurious positioning and into healthful position for back pain control during everything you do. The second component uses the new healthy positioning during innovative exercises for fun, healthy, exercise that works your muscles more than conventional core training and works them in functional ways - training them in the way they need to work in real life.
The Ab Revolution™ uses no forward bending which pressures discs and reinforces the rounded upper spine that contributes to pain syndromes.
I rearched the method over many years in the lab and in real life with several thousands of students, patients, and participants, testing combinations of established and proven sports medicine rehabilitation techniques and physical training methods, then integrating them into real activities. I will present some of the research next week at the meeting of the American College of Sports Medicine (ACSM). The Ab Revolution™ is in use around the world at top spine centers and by athletes and military. SEAL teams say, "We use it - (we can't tell you our names, we'd have to kill you with our bare abs)."
Reader Bill Slabonik had sports injuries, motorcycle and bicycling accidents. He was a good exerciser and hard worker, doing all the conventional exercises and ways of lifting during his regular workouts, long hours sitting as a pilot, and vigorous work in the Coast Guard. I know these things because I've seen his x-ray and MRI reports.
Bill writes:
"After two years of waking every couple hours with extreme pain in my shoulders and both hands completely numb, I sought relief from the medical community. Thinking that something was wrong with my shoulders, I was very surprised to find out that I had degenerative disc disease in my neck and spine. I was scheduled for epidural injections and advised that if they did not help, surgery was the only alternative. I was advised that I might consider disability retirement.
Not being pleased with my choices, I was able to get a script from my family doctor for physical therapy. Two months of therapy gave encouraging if small improvements. Back spasms stopped and pain diminished somewhat. Encouraged by this I continued to search online for neck and back pain fixes until I was fortunate to find a website maintained by Dr. Jolie Bookspan. The articles made logical sense to me and I soon ordered her book "Fix Your Own Pain." I noticed rapid improvement as soon as I began to practice her methods. Encouraged by these results I chose to attend one of her clinics held at Temple U.
I have returned to an active, athletic life. Waking due to pain is a thing of the past. I am setting and achieving physical goals that seemed impossible only a year ago. I am hiking farther and riding faster than I could have dreamed of. I am using post-it notes in my car, at my desk and on my flight kit for the airplane as reminders to maintain good position.
The photo is my neighbor Ken and myself taking a break from the year's Pennsylvania State Police Memorial century ride. He is also putting your principals into good use. We rode 50 miles that Saturday morning without pain or discomfort. Ken is 61 years old and I'm 55. The amazing part is that I had over 180 miles for the week without pain. Ken and I have made a goal of riding together on each of our birthdays, the number of miles matching our age, i.e., a 62 mile ride this fall for Ken's birthday. Oh, the ride was from Hershey, PA to Mount Gretna, PA and back. A nice loop through the central PA farmlands. Thanks again for your encouragement and books. I am feeling fantastic today!
Your work has not only provided hope but is putting life into my years. I want people to know that there is help.
I normally shy away from putting myself out on display like this, but if it encourages others to fix their pain then it was worth it. Thanks again Doc. I'm out mowing the lawn by hand.. two hours..no pain...riding my bike to work tomorrow 42 mile round trip.. I'm not going to stop."
Sincerely, LT William M. Slabonik US Coast Guard (Retired)
Fun note: the surname Slabonik means "Free Man." Bill now signs his e-mail updates to me as Free Man
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Bending over from a stand to touch the toes may "work" to stretch the hamstrings, but puts degenerative forces on the discs, whether you keep your back straight or rounded. It is also not a functional way to stretch. It is not done in the manner your body moves in regular life and does not train healthful movement.
One of my students, Vikki, demonstrates a nice, quick, and effective hamstring stretch, done standing straight, photo at right, that you can easily do during your regular day:
Stand facing a wall (or tree as in the photo) just about arm's length away.
Make sure both feet are facing forward, not turned out.
Lift one foot to press the heel against the wall at about hip height.
Peek down to see if your standing foot is straight, and has not rotated outward, not even a small amount.
Lift your upper body to stand straight.
Don't let your hip curl under or your back round.
Smile and breathe.
Hold a few seconds and switch legs.
Vikki and co-worker Cindy are State Paramedics. Cindy is the Director of Services and Vikki is in charge of Search and Rescue. They support firefighting crews in the field. When there is a large fire in their service area, they are posted at strategic spots near the fires, and might treat 1-2 firefighters a day with various injuries, dehydration, hyperthermia, and difficulty breathing due to smoke inhalation. During the rest of their daily work, they do a lot of heavy lifting and carrying.
Cindy and Vikki use the back pain reduction techniques, and the exercises and stretches of this blog and my classes for their work.
In school, we were taught about the "unavoidable lordosis of pregnancy." Lordosis (technically, hyperlordosis) is when you allow too much inward arching in the lower spine - Drawing 1 at right.
Over-arching causes one kind of lower back pain. It was taught as something that "just happens" to the spine during pregnancy. I asked the professors why women could also get it before and after pregnancy, and why men got the same kind of compressive force on the joints of the spine, called facet joints. It became a focus of study in my lab with lifters for many years.
The post Neutral Spine or Not? and What is Neutral Spine and Why Does Sticking Out In Back Harm? show how slouching so that you increase the inward curve in the lower spine (increase the lordosis so that it is no longer neutral spine) pinches the lower back under the weight of the upper body. Both also show what neutral spine looks like compared to lordotic.
The upper body should be upright (vertical) and the hip level to be in neutral spine. Drawing 2, with x-ray, shows what hyperlordosis looks like when the front of the hip tilts down and the upper body leans backward. This is not the normal curve - it is too much. The back of the spine gets pinched and pressured.
I found that hyperlordosis is not caused by a pregnant belly or beer belly or carrying groceries or backpacks. The over-arching (hyperlordosis) is not unchangeable anatomy. It is leaning back to offset the load in front.
Note the same over-arching occurring with the overhead lift in drawing 3, below left.
Overarched spine position is something that you can decide whether to allow or not. You can easily use your muscles to prevent hyperlordosis and hold you in healthy upright position.
Try it for yourself:
Stand up and pick up your chair (bend right to pick it up for more exercise and back injury prevention).
Hold the chair like any package in front, or on your hip, and notice if you lean back to shift the weight off your muscles (make it easier). Where does the weight shift to? On to your lower spine.
Instead, stand straight. You will get free, built-in healthful exercise that protects your spine.
When carrying or lifting any load in front, from groceries, to a chair, to a pregnancy, or a baby on your hip, don't lean back to offset the load. To stop the arching and the lower back pain that results, tuck your hips under you as if doing a small abdominal crunch standing up until you are straight, without rounding forward. Don't over-tuck, tighten up, round your shoulders, or lean forward or backward. Just stand straight. When you tuck properly by moving your spine (not by tightening anything) the too-large arch will lessen to normal, and pressure in your lower back from the arching should immediately disappear.
The pelvic tilt to tuck the spine to restore an overly arched lower back to neutral spine was introduced in Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique and Healthier Carrying - Get Free Ab Exercise and Stop Pain. Don't overarch or lean the upper body backward while you stand and carry - center and right-hand figures in the drawing at left. That is the missing link. Stand upright in neutral spine - left hand figure. There is a small lower spine curve, not a large one, and the lower spine is not pinched and folding backward, which squashes the soft tissue, discs, and vertebral joints called facets.
I have heard argument that nine months is too long to expect someone to think about their spine, and the muscles get tired. As they say in computers, "that's not a bug, that's a feature." It's good news that you get a free core muscle workout and free back pain prevention. Pregnancy (and any weight lifting) is a key time to have that.
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Here is a hamstring stretch that is relaxing to do, more effective than bending over to touch toes, and doesn't pressure the lower back or neck discs. The doorway hamstring stretch trains healthful positioning that makes straighter posture feel natural in daily life when standing up and gives a better stretch while lying down. Reader Ivy from New Zealand sent in the photo at right of doing this stretch so well. Thank you Ivy.
Lie face up in a doorway.
Lift one leg up to rest against the wall or doorjamb.
Keep your body, shoulders, head, and other leg relaxed comfortably flat on the floor.
Keep both hips flat on the floor. Don't let your hips round under you. Don't let the leg on the floor get lifted upward along with the leg you are stretching. If it raises, that often indicates a tight hip. Gently keeping the leg down on the floor stretches the hip, giving additional benefit.
Relax and breathe. Smile. Hold for a few seconds, then switch legs using the other side of the door or wall.
For more stretch, move your whole body further into the doorway.
To add stretch for the back of your calf and bottom of your foot, pull your toes back and downward, using your shin muscles, a towel, or your hand if you can reach.
It is not the case that you must bend the other knee to protect your back or prevent muscle strain. It is not harmful to keep the leg on the floor comfortably straight and stretched flat against the floor. Keeping the leg down makes the stretch more functional and transferable to daily life movement. Several Fitness Fixer articles cover why - here is one, Fast Fitness - Don't Shorten Hip When Stretching Hamstring. Relax and enjoy this stretch.
Readers, send me your photos and success stories showing healthy movement during real life. Don't be shy.
Read more success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
How many times do you get in and out of a chair everyday? It could be enough for a fair amount of exercise, if you use muscles instead of leaning forward (photo shows terrible sitting) and flopping down.
At a medical conference last year, a speaker droned endlessly about back surgery (even though Studies Say Back Surgery Not Needed, and you can Fix Disc Pain Without Surgery) and the usual tedious exercises that people must do three times a week (then they do unhealthy movement all day that causes the pain in the first place, or do their exercises in back damaging ways - Common Exercises Teach Bad Bending). An obese physician arriving late plodded to a chair next to me. She laboriously bent over, bending wrong to put her bag on the floor. She slowly bent over forward, bending wrong again to retrieve two cushions from the bag. She bent over wrong again to place one cushion on the chair seat, then again for the second cushion for the chair back. She turned her back to the chair, bent far forward, bent her knees a small amount, so slowly, then slammed her backside down to the chair with a WHUMP. She sat rounded for the rest of the lecture about surgery for disc herniation. Sitting and bending rounded forward is the major cause of disc "disease." To easily avoid disc pain and surgery see Disc Pain - Not a Mystery, Easy to Fix.
What to do instead? Any time you start to sit, check if you lean forward and stick your backside out. You shouldn't need to lean far forward to sit, or rise from sitting. If you have to lean, it is usually a sign of weak legs. If your heels come up as you bend your knees, your Achilles tendons are tight (or you have functional bad Achilles habits). You shouldn't (ordinarily) need to use your hands to sit or rise. Your balance and legs should do the work. Do you sit down heavily, not using leg and hip muscles to decelerate? Why jolt your spine and give up free calorie burning at the same time? Try this now to see:
Stand up, ready to sit -
Start to sit, keeping both heels down on the floor.
Don't lean forward. If you lean, correct it by tilting your hip under and raising your upper body to be straighter.
Keep both knees back over your heels. Don't let knees slide forward.
Keep knees parallel over your heels. Don't let knees sway inward.
Notice how you have to use far more leg and hip muscle, and the pressure of holding your body weight comes off the lower back and knee joints.
Notice if you reach for the arm rests, or other support, out of habit. Use your leg muscles instead.
Sit down lightly.
Start to rise from sitting -
Notice if you lean far forward or raise your heels or jut your chin forward.
Notice if you need to push off your hands.
Notice if your knees comes together. Don't let them.
Change how you rise to put both heels down on the floor, push off your whole foot including heels, and use your leg muscles to rise while holding your upper body more upright without jutting your neck and chin forward.
This is not a bunch of strange rules for sitting, or a weird, contrived exercise, it is just basic concepts for normal healthful daily movement.
The previous post explains why it is not healthy for your back or the best exercise to lean and stick out in back - Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats? It covered good knee placement too, so check that if you avoid healthy movement because of knee pain.
Exercise is still thought of as something you go and "do" instead of moving in real life. It's silly to do 10 squats in a gym or using your chair and then go back to unhealthy movement each time you sit or bend during the day. Have comfortable healthful movement all day. Sit and rise easily. That is exercise as a lifestyle.
A recent New York Times article quotes aerobics teachers and devotees saying they now have painful, chronic injuries from years of aerobics classes. Why did this happen?
I receive frequent e-mails from aerobics instructors, many only in their 20s and 30s, saying they are too old to continue teaching because of pain and injuries from teaching. I am older than their parents. At the schools and clubs where I teach classes, teachers and trainers are often absent, or replaced, because of herniated discs.
The Times article quotes major aerobics spokespeople, attributing the injuries to jumping on "concrete floors in bad tennis shoes," and related how former well-known-names in the aerobics industry now teach low impact classes. The article continued, "A lot of people doing aerobics back then can no longer do any jumping whatsoever. They have problems with their backs, feet and hips."
Conventional "impact activities" are not the problem.
In the years I spent in the lab studying injuries, seeing patients, and teaching students, I have found that the problem is not that impact must be avoided. I see patients who are instructors of Pilates, stretch, yoga, rowing, martial arts, and Alexander technique for degenerating joints. It is simple misuse.
It is not that people are doing the exercises "wrong" but the movements themselves.
If you saw someone bend over at the waist or hips to hoist a suitcase or child, you know it is bad bending and it hurts the back. The same people will bend over the same way to lift weights in a gym or do yoga stretches. It is the same disc-injuring bending in all cases.
The post CommonExercises Teach Bad Bending gives interesting examples from a class that is "low-impact." Wear occurs on the lower back and neck discs regardless of how expensive and engineered the aerobics shoes.
The post Are You Making Your Exercise Unhealthy? shows you how to put the knowledge of bad positioning together in your mind with how people are exercising, to realize it is not rocket science when people have pain, even though they "do their exercises."
You can run, jump, walk without jarring impact
Many people walk with higher impact than a good martial artist will kickbox.
Many people are unnecessarily restricted from favorite sports and told to walk instead, based on the fallacy that running or tennis is necessarily higher impact, instead of looking at how heavily they clomp around letting spine, hips, knees, and ankles sag and grind.
Many of my obese patients with knee pain stand and walk with their knees in sagging positions. This is not a consequence of their body weight.
When I show them to simply hold their knee from knocking inward (or outward) by using their own muscles to hold straight, the pain quickly goes away. They say that they can then, for the first time, *do* any real exercise to lose weight.
Lightweight people can have the same knee and other pain. They may move heavily without good shock absorption or hold joints in angled painful ways.
The post When Did Health Become Thinking Out of The Box? explains more of why you don't have to have pain from exercising or even long sitting while studying (or watching TV). I don't take people away from their favorite activities when injured. I even use their sport as rehab, showing them how to do it in healthier ways so that they can do more, lift more, and run more than before, not less. Health care should not be "Limit to the patient to limit the pain."
Read Inspiring Patient Stories on my web site - how patients fixed their own pain and could do more than before.
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Changing Thai Massage to Be Healthier Part I - Avoid Pressuring Lower Back Discs
Sunday, February 04, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
In the previous post, What is Thai Massage? I explained that many moves in Thai massage are beneficial, with a few to avoid. One of these less than healthy moves involves the practitioner pushing your back and neck forward into a stretch.
The post Disc Pain - Not a Mystery, Easy to Fix explains why sitting and bending over eventually breaks down the discs of your lower back. In one of the pushing stretches, the practitioner sits behind you to push your back forward, leaning their weight to assist your forward movement, as in the drawing at left.
In another move they add putting their arm under your arm and around the back of your neck. In wrestling, this move is called a half-Nelson. This move is used to bend your neck forward. From there, they push your back and neck forward, leaning their weight to assist your forward movement
Don't let people push your back or neck to round forward, whether to stretch or to make a cracking noise. Avoid treatments that include manipulation to the neck, which has been found to sometimes tear the blood vessels leading to the brain. There have been deaths and even Western chiropractors have been cautioned not to crack the neck with these moves.
A second assisted stretch to avoid is similar to the move above. The practitioner may sit behind you or to the side, and put one or both of their arms under your arms then around the back of your neck, in a move that in the West are called a "half Nelson" and "full-Nelson." From there they may swing you slightly to the side, then again with a wider swing, then a third time with force. This sometimes makes a cracking noise in your back. Anatomically, the greatest force you can put on your discs and low back is bending forward with a twist. Politely decline anyone who would do this to you.
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Thai boxing (Muay Thai) kicks are among the most devastating and effective kicks in the world. Thai fighters spend hours a day kicking heavy bags and posts, and years toughening their legs and shins for kicks and blocks by bashing them with pipes and against coconut trees. A blow from a Muay Thai fighter's leg is like a blow from a club.
When you practice moves that lift the leg for martial arts training, for self-defense, for dancing, or for exercise in an aerobics class, watch for several bad habits that increase strain on muscles and joints, and reduce effectiveness of the kick. It is not the point to kick someone else and wind up injuring yourself.
1. Look at the photo, above left. The teacher is holding his hip and neck straight. The blocking student is not. The orange arrow at the student's leg shows how, when the student lifts the left leg, the right leg pulls forward instead of remaining straight at the hip. This is a sign of tightness at the hip and poor technique. He needs to stretch the front of his hip and retrain kicking and blocking technique to prevent this common bad habit. Read more on this in the posts, Is Bad Martial Arts Good Exercise? and Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs.
2. Next, check the white arrow at the student's belt line. It is tilting up in front. The teacher's hip remains level as the leg is raised. Curling the back and letting the hip roll under, as shown by the white middle arrow is another sign of tight hip muscles in the front and back of the hip, and poor movement habits. When you raise one leg to kick, block, prepare to kick, do a knee strike (whatever), check if you curl your hip or round your back. Hold your back straight and upright for more exercise, a built-in hip stretch, and more effective technique.
3. Third, note the black arrow showing how the student rounds the upper back and neck forward, instead of holding straight. With practice, the student will learn to hold the neck straight as the teacher is doing.
For all the exercise you do (kick, block, ascending stairs, whatever is done raising one leg), keep healthful positioning. Yes, rounding the back is taught, and done for fighting, but you will be beating yourself up in the long run. You can still be an effective fighter and at the same time, prevent hurting yourself with common strains from unhealthful technique, plus get more exercise with healthier ways.
See all martial arts articles, or other topics that interest you, by clicking labels under this post.
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Many people are taking down Christmas trees even as the Russian and other Eastern Orthodox families are putting theirs up for Christmas, coming this Saturday Jan 6th. The Russian Snow Girl (Snegurushka), and DedushMoros (Father Frost) have already come to visit. S nastupaiushchim Novym godom i s Rozhdestvom Khristovym - Happy New Year!
Here are two lifestyle strengtheners (and a free Achilles tendon stretch) to build into your fitness as a lifestyle for 2007:
If you would like to get strong legs for the New Year, don't bend over wrong to lift things (upper drawing, left). From now on, make all your bending the way that strengthens your thighs and at the same time prevents back and knee pain (upper drawing, right). Keep your upper body upright and bend your knees. Prevent knee pain and get better use of your leg muscles by keeping both knees down and back over your heels. Each time you keep both heels down while doing healthy bending, you will also get a built-in Achilles tendon stretch. The post How Often Should You Be Healthy? tells more on good bending.
If you want to stop "mystery" lower back pain for the New Year, check to see if you lean backward when you reach upward (lower drawing, left), carry things, or when you are just standing. Leaning back creates overarching of the lower back called hyperlordosis, which pinches and pressures the soft tissue and joints of your spine. People with this kind of pain feel they need to lean over forward or sit to relieve the pain. Instead of doing remedies for pain, it is smarter and healthier to stop the cause of the pain.
The "hip tuck" or "pelvic tilt" to reduce overarching and straighten the spine (lower drawing, right) is described in the post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique. The muscles you use to move your spine out of unhealthy overly arched position and into straighter position are your abdominal muscles. By simply standing and moving with a healthier spine position, you get free exercise for your abdominal muscles. "Tightening" the abs is not what exercises the abs or prevents back pain. Tightening also does not let you breath or move properly. Tightening is not how to have healthy abdominal function. Instead, use the abdominal muscles to stop overarching and maintain healthy position while going about your daily life and exercise. The post, If Better Abdominal Muscles Are Your New Year's Resolution, Try This, shows how.
If your New Year's Resolution is to have a healthier low back, Achilles tendons, and abdominal muscles, you can do that all at once during your regular daily activities.
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This spring I will be offering two opportunities to learn breakthrough techniques in person to fix pain, and get stronger and more flexible. People come from all over and have a fun time.
The spring workshops are "Fix Your Own Back Pain - Medical Breakthroughs in Non-Surgical Treatment" and "Stretches That Help, Stretches That Harm."
In the fun, active back pain workshop, learn to get rid of neck, back, and hip pain and keep it from coming back. You will fix the causes of neck pain, back pain, sciatica, herniated and degenerating discs, stenosis, lordosis, facet pain and other problems right in class. In the stretch workshop you will learn about the many common stretches that harm your joints or don't improve flexibility, and innovative stretches to do instead. You will learn how to not get stiff and sore in the first place:
On April 21 2007, we will run both workshops in one full, fast-moving day at Temple University Ambler/Ft Washington campus in Ambler, Pennsylvania. Fix Your Back Pain will run 9:30am to 2pm, and "Stretches That Harm" will run from 2:30 to 4:30pm. Contact Rhonda Geyer, Director, by email or phone (215) 283-1304. Out-of-towners can have a fun Saturday in class and stay to visit Philadelphia on Sunday. Tourist info at www.goPhila.com.
For a slower pace, come to Temple University at the Center City campus in downtown Philadelphia to attend just the Back pain workshop, held over two Saturdays March 3 and 10, 2007. Each class is held from 9am-11:30am. This is one class divided over two sessions. Plan to attend both days. To register e-mail Kevin Wood Director, or call (215) 204-6565.
Links to register for both classes on-line plus more class info are on my web site page for CLASSES. Both workshops are a combination of fun and fast-moving audiovisual lecture and non-strenuous physical practice. Both classes are suitable for the out-of-shape as well as the athlete. Wear comfortable ordinary clothing. If you have to change your clothes to fix pain and move and stretch in healthy ways during normal life, how are you supposed to have an ongoing normal life without pain?
The days are becoming longer and light is returning in the Northern Hemisphere. Native Americans, Shinto, Iranian Zorastrians, Buddhists, Christians, and non-faith based traditions all celebrate the winter return of light and life and enlightenment with trees, and lights, and cleaning the house, and giving presents, and lifting things.
In many of these traditions, is written that pain and darkness is high before the return of the light. The upper photo shows pain - unhealthy bending. The lower photo shows "seeing the light" - healthy bending.
For healthy holidays, check your bending for all the cleaning and lifting you do. Don't lean over. Keep your body upright and bend your knees. This bending gives healthful exercise and prevents straining back muscles and herniating (slipping) your lower back discs. Many people think that lifting bent over strengthens back muscles. The problem is that, over years, it also degenerates your discs. Bend right to strengthen without also damaging. Other people refuse to bend right because it hurts their knees. But, done properly with both knees back over your heels, and your weight back over your heels, not toes, you shift body weight off your knee joints and back to your thigh and hip muscles. You will feel the difference as soon as you try it. Healthy leg and hip strengthening without back or knee pain.
For all my friend readers in the Northern and Southern Hemispheres, make healthy bending a New Year's Resolution and part of your healthy holidays and stronger New Year.
Bad bending photo by subscription to Clipart.com Good Lifting photo (without halo) by iwona_kellie
An article getting much attention in news and blogs carries the headline, "Don't sit up straight." Many people have been overjoyed to read this. The news articles state that recent studies say not to sit up straight due to the pressure it puts on the spine. But this is misleading.
The studies don't mean, "don't sit up straight." They mean, "don't sit vertically." They say that leaning back reduces compression on the spine. The articles I have written about healthy sitting are in line with these studies, and say to lean the upper body slightly back - less vertical vector, means less direct axial loading. You still need to prevent rounding your back when leaning back, shown in the drawing at left.
It is not "sitting straight" that is the problem. My article Disc Pain - Not a Mystery, Easy to Fix shows how rounding the spine forward under your body weight mechanically opens space between the back of your vertebrae, and pushes your discs outward, over years, into this space. The article reminds:"Pull your chair in closer to the desk, and lean your upper back against the seat back." That way you can lean back without rounding. You don't need to be vertical to be straight rather than rounded.
The article The Cause of Disc and Back Pain shows a photo of someone sitting vertically - head is above hips - but they are rounding the spine forward, putting unhealthy pressure on the discs and soft tissues. They need to straighten their sitting to reduce the outward force on the discs and the overstretch on the muscles and supporting tissue.
The "Don't Sit Straight" study, and subsequent reports of it, missed that you have less vector force on your spine while sitting vertically at 90 degrees if you don't also round your spine, than if you lean back as they say but round your back. You can lean back and still pressure your spine by rounding. Look at the drawing, above left. The person is leaning back, as the study reports you should do, but the person is also rounding the lower back. This is one of the most common slouching there is. It is more pressure and more unhealthy than sitting vertically but not rounding.
Healthy sitting is simple when you understand, not just memorize a bunch of strange rules. More posts about healthy sitting to come. Until then, straighten your spine by not rounding forward. Move your chair in closer, and lift your upper body up to lean your upper back against the seat back. Yes, that does make your spine straighter - in a healthy way.
Read inspiring success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
A physician contacted me, saying he had three successful disc surgeries and had slipped another disc. He wanted a consult with me before his fourth surgery. I told him it was like having three successful tonsillectomies. That is not a successful surgery. He had never stopped the reason he was pushing his discs out of place, one after the next.
Surgery for back pain and sciatica is considered by some as a solution, but an alarming number of people have pain that continues after surgery, or their pain stops initially while on pain medications and rehab following surgery, but then returns. The reason is that, except for unusual situations like bullet wounds or tumors, surgery does not stop the root cause of back pain. Because the cause continues, you continue doing harm to your back until it hurts again.
Degenerating or slipping discs are not from aging, or fate, or heredity, or a disease. The term "degenerative disc disease" is a misnomer. It is not a disease process, or a germ, or inherent factor or weakness that makes discs unhealthy. There are external factors, like smoking cigarettes, which contributes to disc degeneration. However, the majority of damage to discs and the soft tissue of the back and neck is usually chronic forward bending that physically pushes the disc outward until it presses on nearby soft tissue and nerves.
Disc damage occurs daily from avoidable bad bending in daily life, unhealthy sitting position, and many common exercises and stretches. Just as not all food is healthy, not all exercises and stretches are healthy, even some of the most common ones in gyms and yoga and fitness studios. The daily harm to your back is usually painless and something you are not aware of doing, until it accumulates, like smoking for years, until one day you get symptoms. The pain may come on suddenly, but was developing over years.
The physician who had the three surgeries, and three discs already removed, had gone back to all his bad bending, lifting, and sitting, and pushed out another disc. If he had stopped the injurious mechanics, he could have let the disc heal. Pain can often stop within days using this method. He probably never needed the first three surgeries. Having a fourth disc surgery will not stop him from going back to the injurious habits that caused the discs to break down and push out of place.
Removing discs, even part of them, means that the cushion and shock absorption between your vertebrae is reduced. This predisposes to early arthritis. A worse situation follows fusion surgery. It is a belief that stopping motion in a joint via fusion surgery will stop pain. But it also stops function. If you want an active life, it is setting you up for more problems. Even if you do not value being active, because fused back bones cannot move when you bend and sit and move, the vertebrae above and below the fused site must move more than usual, squeezing the discs and bones more than they are designed for. Fusion surgery is often a predisposing factor to forcing people into future back surgeries.
I sent the physician my free articles showing, step-by-step, how to stop disc pain. I sent him several of my books for his own use and for his waiting room. I called to follow-up on several occasions, urging him to simply stop the cause of disc injury so that he would not need the surgery. He told me he was not interested and had decided to go for his fourth back surgery. I hope his luck in avoiding surgical complications holds out as well as his good insurance.
The post Common Exercises Teach Bad Bending will get you started understanding common exercises that harm. There are far better exercises to do instead that give you fun, healthy movement without harm to discs. I am not in favor of doing less to avoid pain. I want my patients to have their life back and more. You can do this in fun ways and without surgery.
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Many back pain patients who come to me say the same thing; that they have gone for several opinions and were told each time that surgery was the only answer. However back pain, even chronic pain, sciatica and disc pain, are simple to stop with quick and non-surgical methods.
News articles are now reporting that back surgery is not more effective than non-surgical methods.
Patients are often told that if they don't have the surgery, they might become paralyzed. A recent New York Times article stated, "Many surgeons had long feared that waiting would cause severe harm, but those fears were proved unfounded." The Times article quoted Dr. Steven R. Garfin, chairman of the department of orthopedic surgery at the University of California, San Diego, "I think this will have an impact. It says you don't have to rush in for surgery."
More important to your health is what is not being reported. The Times article said, "No one who waited had serious consequences, and no one who had surgery had a disastrous result." It is important to know what is meant by, "no one who had surgery had a disastrous result." It is not considered "a disastrous result" if you go through the pain and fear of surgery and still have back pain, or are worse after surgery. It is not considered "a disastrous result" if you lose your job because of the time lost to surgery and recovery, and your family won't talk to you because they think you're a complainer. It is not considered a "disastrous result" if the medicines given during and after surgery cause problems you didn't have before, or worsen existing problems, and then you are given more medicines to counteract the first ones, each with their small (or large) health drawbacks. It is not considered a "disastrous result" if you get far more out of shape and gain large amounts of weight because you could do less after your surgery, and your overall health declines from it.
There is no national database where people who have the same or worse pain after surgery are counted. There is no clearinghouse where people who get new problems because of the surgery are counted or helped. Often, there is no way for surgeons to know that their patients still have pain years later.
Patients may be referred to physical therapy but as their pain, disability, and misery grow, they "are lost to follow-up." I hear these things every day because these patients show up in my office and e-mail me everyday saying they have no money left and will I please help them. They are at the end of what they can endure.
Exercise programs for back pain often fail because they do not stop the cause of pain. Personal trainers and Pilates instructors come to me all the time as patients with herniated discs because they do unhealthy bending and stretches for their exercise. There are far better exercises and stretches you can do instead. Some of my patients are doctors. Their own doctors said there is nothing else to do but live with pain. People often tell me, "You don't understand, I *HAD* to have the surgery, because of the pain." I do understand, and you can stop the pain without surgery, often better and faster.
Use The Fitness Fixer every day to change your idea of exercise from a bunch of artificial moves, to real health that is built-in to your daily life. You don't have to have back pain, and you can be stronger and healthier than before - without surgery.
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Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Conference on Aging Dec 2, 2006 in Midtown New York
Friday, November 24, 2006
Healthline
The Greater New York Chapter of the American College of Sports Medicine (ACSM) will hold a conference on aging on Saturday, December 2nd, 2006 at the Flatotel, 135 W. 52nd Street between 6th & 7th Avenue, in New York City.
In one fast moving day, there will be nine lectures by authorities on metabolic changes of aging, cardiovascular changes and the benefits of exercise, exercise in older patients with heart failure, neuromuscular training for the older population, psychosocial aspects, physical training for older clients with special conditions, and nutritional needs of older populations. I will be giving a lecture called "Three Quick Techniques for Three Musculoskeletal Problems Confused for Aging."
Many of the declines that come with doing less are often confused with aging. A stiff and rounded upper back, for example, is not necessarily aging, but practice. Are you sitting rounded forward reading this right now? Do you spend your day rounding over your desk and steering wheel, then go to the gym and bend forward for crunches, leg lifts, Pilates, and toe touches? Do you bend your neck down to do biceps curls? No wonder it's hard for you to straighten out. How long will you practice unhealthy bent forward position before you get stuck that way? There is no need to exercise in the very way that is not healthy when you do it sitting at your desk. There are better ways.
Much of the loss of strength and balance over the years is from disuse not aging. Many people do not use their legs for the hundreds of times each day they need to bend. They bend wrong, throwing their weight on their spine. Their back hurts and their legs and hips tighten and weaken. Eventually they find they are unable to sit comfortably on the floor, and more worryingly, cannot rise from the floor, or even from their chair without using their hands. This is debilitating weakness, and a dangerously unhealthy cycle of use or lose. It is not aging. In cultures where sitting and rising from the floor is a daily activity, people of 90 have the strength and balance to do it. They do not suffer the rates of falls, osteoporosis, arthritis, and cardiovascular disease of less active populations.
My lecture will cover three easy techniques to maintain and improve spine health and muscle strength. Come say hello. The meeting is designed for allied health practitioners, but is open to the public, with reduced registration fees for members of the American College of Sports Medicine (ACSM) New York Chapter. Contact Felicia D. Stoler, MS, RD (732) 946-4436, or e-mail fstoler@att.net
Fitness and Health as a Lifestyle for Thanksgiving
Tuesday, November 21, 2006
Healthline
If you think you won't have time to exercise over the Thanksgiving holiday, here is good news. This post will show you how to move in healthy ways so that you have healthy exercise built-in to all the cooking, shopping, furniture moving, and social interactions. Here is more good news. You don't have to go to a gym to work off the stress and eating too much of the Thanksgiving holiday. Life is not supposed to be a poison that you deliberately take, then need an antidote to offset.
Here are four of the healthiest, quickest ways to make your Thanksgiving into fitness and health as a lifestyle:
To pick up chairs, babies, and grocery bags, to move furniture, and for lifting things from the floor, bend your knees, keeping your weight back toward your heels, and your body upright.
To carry chairs, babies, grocery bags, furniture, and any loads in front of you, don't lean back. It is a common bad habit to lean the upper body backward, increasing the lower back arch. Leaning backward shifts the weight of the load off your core and arm muscles and onto your lower spine. Get free, built-in exercise for your abs and arms and save your back by standing straight. Don't lean and arch backward to carry things.
Notice all the times you round and hang forward over things that you can easily reach by standing upright. Check your upper back positioning when standing over counters, sinks, grocery bins, vacuum cleaners, cribs and baby-changing tables, and when setting food tables. Don't let your body weight hang over and forward. Stand upright, chin in, and just tilt your head downward in relaxed manner to see what you are doing. Relax shoulders downward. Smile. Breathe.
Preparations and family interactions are no excuse to do unhealthy behaviors out of habit like smoking, overeating, and arguing, then blame it on stress. The bad habits are even more stress on body and mind. If something is wrong, see about fixing it in a good way. Don't suffer in silence with people telling you that you have to be happy just because of a holiday. Make your home healthy for yourself. There is no place it matters more:
Get exercise cleaning the house of junk and clutter. Take the extra clothing, toys, and household items to a shelter. Carry the bags with healthy positioning to the people who need it.
Make a healthy meal with family or alone, without television or phone. Carry the meals to shut-ins and isolated elderly in your neighborhood, and the homeless on the street.
Volunteer at a soup kitchen. Do grocery shopping, cooking, and vacuuming for those who are too sick or disabled or alone to do it for themselves. If you think you don't have time because you have young children, take them with you to help carry things and to teach them healthy ideals, and how thankful they can be for the home you provide.
Don't smoke, drink soda (diet soda is just as unhealthy) eat junk food (even if it has marketing words like "organic" on the label), or undo the health benefits of fruit and vegetables by junking them with cream, sugar, and cornstarch. Add up all you spend on cigarettes and junk food that take a healthy body and give it health problems. Take the money and give to the poor. With what you save on prescriptions and treatments for all the pain and jitters you cause yourself, you can feed a village and still take a vacation.
When you eat the Thanksgiving meal, say thankful things. Taste your food. Turn down seconds. Breathe. Smile. Help clean up. Shoulders back. Enjoy the roof over your head. That is health as a lifestyle.
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Readers asked for more pictures of healthy bending around the house and workplace during daily life. They've been getting excited about the idea that daily life is the way to physical ability and health, instead of stopping life to do a bunch of exercises. People spend time and money for endless treatments and gadgets for back and knee pain and tight Achilles tendon. Healthy bending prevents the commonest sources of all of these.
A major predisposing factor of knee and hip arthritis is weak thighs.
A major risk factor of hip osteoporosis is lack of weight bearing exercise.
A major risk factor of falls is weak legs and poor balance.
The Achilles tendon gets a natural stretch with each time you bend right with heels down, and loses this constant normal source of stretch without good bending.
The most important contributor to making a lumbar disc degenerate, or slip out of place (herniate), and press on nerves causing sciatica, is bad bending forward.
The biggest contributor to upper back and neck pain is keeping the upper body rounded and bent over forward.
If you would like to reduce risk of falls, osteoporosis, bad discs, sciatica, achy upper back, and arthritis, get a built-in Achilles tendon stretch, and get strong shapely legs all at the same time, just use your legs with good body position for daily healthy bending.
Why go to the gym or to physical therapy to do knee bends to strengthen your legs, then spend your "real life" weakening your legs and degenerating your lower back discs with bad bending, and say, "I don't have time to exercise."
You will get free built-in exercise just moving in life. My friends and family in Asia are astonished when I tell them I teach Americans how to bend to look in the refrigerator, and that Americans tell me it is too much work to bend right to load dishes in a machine that washes for them. Then they pay money to go to a gym or buy equipment to exercise their legs.
Here is a fun way to change mindset to exercise as a lifestyle:
Count how many times a day you bend and how many times you can choose to harm yourself or help yourself.
If you would like to try "fitness as a lifestyle," this is the best place to start. Think of it:
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Carrying Schoolbooks Is Not the Cause of Back Pain
Wednesday, November 15, 2006
Healthline
A recent BBC news article echoed the common idea that children are getting back pain from carrying their books. However, carrying books is not the cause of the pain.
The article continued how children often require "physiotherapy" for their pain. Common programs in physical therapy involve strengthening. An important thing to understand is that carrying your own things would be more strengthening than lifting little weights that often weigh less than the books.
The article mentioned how one of the schools is trying to raise money for more lockers so that children will not have to carry their books between home and school. While physical educations programs are being increasingly cut, and children are getting less exercise, fewer physical skills, and are gaining weight, people still think it is too much exercise for children to carry books.
It is not the backpacks that hurt the back. It is carrying them with poor positioning that pressures the spine. Carrying books, even heavy books, with good positioning would be healthy and good exercise, not a cause of pain. By contrast, pulling a rolling carrier or bag on wheels while bent over in unhealthy ways can cause the same kind of pain.
One common poor positioning when wearing a backpack is rounding the upper body forward or slouching to the side to offset the weight of the pack. These poor positions are the same that create pain when sitting poorly at a desk, which is another source of the children's pain. If you stop hunching forward or sideways when carrying a backpack or other loads, and stand straight, the pressure on the spine shifts from the spine to the core muscles. It is free exercise.
The second major pain producing bad habit when carrying a backpack is leaning or arching backward - allowing the lower back to increase the inward curve (overarch). Backpacks do not make you arch your back. It is you who allow yourself to be pulled backward by the weight. If you straighten yourself and not slouch backward, the compression on the lower back stops. The muscles that pull your spine forward to reduce the backward lean are your abdominal muscles. You would have a free abdominal muscle workout. The action of pulling yourself straight instead of arching backward is the same movement as described in Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.
Posts to come will show how to easily carry loads, books, and backpacks so that instead of compressing and hurting your back under the weight, you get free exercise that makes you stronger and healthier. The answer is not to stop carrying books, then go to a gym or physical therapy center to lift weights. It is fitness as a lifestyle to move and get healthy exercise from your daily life, including carrying your own things in healthy ways.
A reader thoughtfully sent in the photos at left to help readers recognize unhealthy bending, and asked, "What is your advice when someone is having to bend to put dishes in the dishwasher? It just seems so uncommon to think to squat while loading the dishes."
There is no better time to bend in healthy ways than your real life. The whole point of fitness as a lifestyle is that your daily life is healthy movement - not to change clothes to do squats at a gym three times a week, then change clothes again, go home, and bend wrong all day. Healthy bending is for every time you bend. How often is that? The post How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending showed how we estimated that you bend an average of 400 times every day for ordinary activities. Why harm your back and miss free exercise for your legs hundreds of times a day? Most people know and repeat, "bend your knees" if you quiz them on healthy bending. Bending knees slightly, as in the above photos, does not make bad bending healthy. Bending over forward pressures your lower back discs, whether your back is rounded (photo above left) or straighter (above right). You are still bending over and the leverage point is your lower spine. Bending right is simple:
With feet side-by-side, comfortably apart, bend knees, keeping your torso fairly upright - as if not wanting something to fall from a shirt pocket (right drawing).
Keep both heels down and shift your weight back to your heels.
Pull your knees back over your heels. Don't let them droop forward under your body weight. When you shift your knees back, you will feel the effort shift away from your knee joint to your thigh muscles.
Don't stick your backside out or exaggerate the lower back arch.
Unless you are moving in healthy ways for your real life, it is not a lifestyle and it is not healthy. Healthy bending is easy and life changing. It is free exercise and injury prevention. When should you do it? Each time you want your daily life to be healthy.
More photos and description of bad sitting and bending that causes back and disc damage and what to do instead - The Cause of Disc and Back Pain
Check the exercises you do for the same body positioning that would be recognized unhealthy if they were not renamed "exercise" - Are You Making Your Exercise Unhealthy?
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A frequently seen stretch for the calf muscles and Achilles tendon is the "lunge and lean" pictured at right. It is one of the least effective ways to stretch your calf and Achilles. Although many people spend much time doing this stretch, they often get little or no stretch:
Bending over forward reduces the stretch and trains the same bent forward position that you already know is poor posture when you sit like that at your desk or steering wheel.
Sticking your hips out in back reduces the stretch on the Achilles tendon.
Turning your back foot outward, even a small amount, reduces, and often eliminates the stretch completely.
The "lunge and lean" is not highly effective, even when done "well," and is often done in the ineffective ways listed above. This is one reason why Achilles tendon stretching doesn't seem to be cutting down on injuries as hoped. Instead of the "lunge and lean," following is a quick, effective way to stretch your calf and Achilles tendon:
Stand facing a wall at about arm's length away.
Stand with both feet facing straight ahead - parallel - not turned out, even a small amount.
Put one foot on the wall at knee height. Press that heel toward the wall.
Look down and see if the foot you are standing on is facing directly ahead. Make that standing foot straight, not turned out; not even a little.
Do not lean toward the wall. Lift your chest until you are standing straight.
Don't let your hip curl under or your standing knee or hip bend.
Smile, relax shoulders, and breathe.
Hold a few seconds and switch legs.
Many people are so tight, that as soon as they raise one leg against the wall, their standing foot turns out without their even noticing it, and they round their back. Don't stretch wrong, allowing the tightness to perpetuate.
The closer you press your heel toward the wall, the more stretch. If you are tight, you will get substantial stretch just getting close. The purpose of this move is not to touch the wall by any means possible, but to get a functional stretch and not automatically go to unhealthful positioning. Do the purpose of the stretch - to retrain the same healthy positioning you need for real life.
Stretching is supposed to be healthy. When you stretch, don't practice bad bent over posture habits. Stretch in ways to make your daily life healthier.
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Most people know that sitting badly at your desk, as in the left-hand photo, is unhealthy.
It is easy to see that he is rounding his back forward.
He is not sitting up.
His ear is far forward of his shoulder (even with his shoulders so rounded that the shoulders are forward too).
He is jutting his head and chin forward.
The weight of his head is straining on the muscles and joints of his upper back.
The post Breasts Causing Upper Back Pain is a Myth explained how the bad body ergonomics of rounding forward is a common cause of upper back and neck pain, often mistaken for "stress," even contributing to pain down the arm as you slump the weight of your upper body on nerves that go down the arm, compressing them. The post Disc Pain - Not a Mystery, Easy to Fix showed how the forward bend to the spine squeezes your discs of your neck and lower back, gradually degenerating them and forcing them outward, which is called herniation.
Now look at the right hand photo of the bicyclist. The rounded forward positioning is the same. It does not magically become healthy because you are calling it an exercise. It is just as unhealthy whether you are at your desk, on a stationary or real bicycle, on an exercise ball, motorcycle, or in the car.
What to do instead is simple. Sit up. Don't round your back. Are you rounding forward reading this right now? In a chair at your desk:
Pull your chair in closer to the desk.
Put your hips all the way back against the seat back.
Lean your upper back against the seat back, not your lower back.
Gently bring shoulders and chin back.
Have your chair far enough in to rest your arms on the desk. Don't crane your wrists to type. I will write more about wrist pain. It should not come from keeping arms comfortably on the desk, which keeps the weight of your arms from hanging forward on your neck.
Don't push your lower back against the seatback. Many seat backs are rounded outward so that you have to sit bent forward if you rest your back against them. If the seat back is concave, put a small cushion (or loosely rolled towel or shirt) about as small as your forearm in the space between the seat back and your lower back. Do not press against the roll - that makes the useless to stop back pain.
Don't tighten and strain to sit straight. It is common to be so tight from a lifestyle of forward rounding that sitting straight is not comfortable. Do the pectoral stretch in Fixing Upper Back and Neck Pain, then use the wall test in the same article to check if the stretch worked. On a bike, unless you are in a high level race, straighten up. It is simple. Healthy.
Why exercise in unhealthy ways? Watch people at the gym and in life. Notice how often fitness publications ask you to practice being bent over forward. Instead, get free built-in back muscle exercise and prevent strain and pain just by sitting with healthy positioning.
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Thumbs Can Show Tightness That Leads to Upper Back Pain
Friday, October 27, 2006
Healthline
Healthy body position should be a natural easy part of daily life, not something you stop work to do as an exercise.
Unhealthy body positioning is more ingrained in daily life than many people realize. How can you tell your own positioning? Watch other people. See how many spend all day rounding their shoulders forward over their work and steering wheel, then further round their shoulders to stretch by bending forward, and do the unnecesary stretch of bringing one arm across the front of their body, then exercise by bending forward for crunches and leg lifts. The result of all this chronic forward bending is overstretching the back muscles and tightening your anterior (front) muscles. Many patients who come to see me, even those who can touch their toes and put one foot behind their head are so tight that they can't comfortably stand or sit straight. This is not just a problem of looking bad. It affects the health of your joints and muscles.
The post Breasts Causing Upper Back Pain is a Myth explained how overstretched back muscles and tight anterior muscles can promote the "forward head" and bent forward position that causes so much muscle strain and damage to the discs and joints of the back, shoulder, and neck. Many people "do neck exercises" never understanding that the exercises do not solve the problem of the chest muscles being too tight, and do not address how to hold healthy position. They stretch, believing that stretching prevents sports injuries, or that it is for doing contortions, but never know that the point of healthy stretching is to restore normal resting length just to stand and move in everyday life. They stretch in ways that exacerbates the problem they started with - rounding forward.
Try this to see if you round your shoulders:
Use the photo, upper left, for reference.
While standing with arms loosely at your sides, glance down at your hands.
Do your thumbs face each other, as in the photo, instead of facing forward? That shows that tightness in front of your chest has rotated your arms inward (round shoulders).
Does it feel awkward and unnatural to pull shoulders back so that your thumbs face forward? The point is to make it comfortable to be right, not force good positioning, which makes more strain.
To fix the problem, try this:
Check your thumb positioning while standing comfortably.
Right after doing the pectoral stretch, drop your arms loosely by your sides and glance down at your thumbs again.
If you did the pectoral stretch right, your thumbs should now be facing more forward because you fixed the tightness that rounds shoulders and rotates arms inward.
During the day, notice your thumbs when standing to see if you are rounding. Notice other people's thumbs. Watch their upper body positioning when they sit and stand and let it remind you to use healthy straight habits so that you do not get tight in the first place.
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The post Breasts Causing Upper Back Pain is a Myth explained that a tilted-forward position of the head and neck, called a forward head, is not the normal tilt to the neck. It is an avoidable slouch that causes much upper back, neck, and shoulder pain, and pressures the discs of the upper spine.
Do you have a forward head? Here is a test, called The Wall Test: If you can't put your back against a wall and comfortably touch the back of your head to the wall too without overarching your back or raising your chin, that usually indicates that the muscles in front of your chest are so tight that they restrict normal standing. The resulting bent-forward position of your neck creates large forces on the muscles and joints of your upper spine as it strains to hold the weight of your head forward of the supporting spine instead of above it.
Being too tight to stand and sit upright instead of slouching forward is common, even among people who stretch regularly. The reason is that they usually practice stretching forward, rarely stretching the front muscles by stretching back. In turn, holding your body bent forward instead of upright perpetuates tightness.
To lengthen the front chest (pectoral) area needed to stop the slouching-tightness cycle, use the photo above left for reference and try this:
Use the photo above as a guide. Stand facing a wall. Bend one elbow out to the side and put the inside surface of that arm against the wall, as in the left-hand photo.
Turn your whole body and feet away from the wall, letting the wall brace your bent arm behind you, as in the right-hand photo.
If you are doing this stretch right, you will feel a nice stretch in the front of your chest.
Keep your shoulders down and relaxed. Breathe. Smile.
Hold a few seconds, breathe in, change arms, and breathe out while stretching the other side for a few seconds.
Now drop both arms and turn to stand with your back against the wall again. If you did this pectoral stretch right, standing straight with the back of your head touching the wall should now feel more natural and comfortable and no longer a strain.
When you walk away from the wall don't slouch forward again out of habit. Hold the easy new healthy positioning for everything you do.
Remember that the wall test (checking if you are straight against a wall) is a test - it is not an exercise that fixes anything, it tells if you are doing the pectoral stretch and two more stretches to correctly restore anterior muscle resting length. This pectoral stretch is one of three techniques to stop upper body tightness that prevents standing and moving in healthy ways.
Three stretches together help more. After doing this pectoral stretch and seeing the results with the Wall Test, add the next two stretches to restore resting length to be able to stand comfortably:
After each stretch, check yourself again with the wall test to see if you did them in the way intended - to work. Then, remember that head and body position is voluntary. Hold your head up and shoulders back softly all the time. The stretches just make it possible YOU are the one to hold it there and retrain your body. No adjustments or bracing does that.
Do the pectoral stretch first thing every morning and several times every day to learn healthy positioning. Then check yourself with the wall test to see if you did it in a way that worked. Use this pectoral stretch and the two other stretches (nice trapezius stretch and better triceps stretch) instead of the stretch where you stand in a doorway or corner to stretch both arms at once, and instead of pulling your straight arm(s) behind you - what I call, The Stretch You Need The Least.
The three stretches will stop pain for the short term. In fact, if you don't feel improved right away, you're doing them wrong. Then for the fix, use them to allow you to hold healthy upright positioning. By not letting your head hang forward all day, you will no longer need constant pills, adjustments, or treatments for pain. You will stop the cause.
If You Have Questions:
Photo and details and complete sequence of restoring healthy body position, in the book Fix Your Own Pain Without Drugs or Surgery - What to do to fix many sources of pain and injury, step-by-step.
Click the labels under this post for all Fitness Fixer posts about that topic, for example, for posts about neck pain, click "neck," for healthy sitting, click the label "sitting." For all posts explaining discs or fixing pain, click those labels.
Even more information is in the replies to the many reader comments below this post.Before asking more questions, see if your answers are already here
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Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs
Wednesday, October 11, 2006
Healthline
Tuesday night my martial arts students showed they had improved. When I came in they were waiting in two neat rows. I still had to cue them to sit up straight.
In the post Is Bad Martial Arts Good Exercise? I mentioned showing the class not to let their neck, back, and hip round forward when kicking. By straightening, strength and stretch are built into regular movement.
Several readers e-mailed me that they noticed for the first time that they let one leg pull forward when lifting the other (notice the standing leg in the left-hand photo, at left). They said they felt a good difference when they straightened (right photo).
If the front muscles of your hip are tight, when you lift one leg high you may find that you round your back and bend the other leg. Watch for this during kicks in martial arts and aerobics, when lying on your back raising one leg overhead to stretch the hamstrings, and ascending stairs. The common practice of allowing the other leg to bend forward perpetuates a tight anterior hip, which in turn, contributes to walking bent forward and back pain.
In martial arts, you don't want your standing leg completely straight. That is an invitation for your opponent to kick your knee, snapping it backward. But for both health and effective martial movement, you don't want to bend the leg more than a small amount. Bending the back, hip, and leg when kicking decreases force of the kick, pressures your discs, and reduces stretch on the hip and hamstrings. The rounded-under hip position keeps the hip tight, a hidden cause of groin pulls. It also looks weak and unskilled. For lying hamstring stretches with one leg overhead, it is often taught to keep the second leg bent to "protect the back." However, keeping the leg (and body) flat on the floor give a far better stretch and is healthier for your back. Even in slow easy motions of stair climbing, leaning forward and allowing the second leg to pull forward reduces the normal hamstring and hip stretch, decreases the exercise on your hip and leg muscles, and reduces the back muscle activation for holding the straight position you need for health and back pain prevention.
It is said the martial arts gives you discipline and strength. It won't if you practice unhealthy habits. When raising one leg, hold your neck and back upright. Prevent the other leg from pulling forward. You will get a built-in hip stretch, one of the places you need to stretch most. You will get back and hip exercise in the way you need to move in real life, and prevent tightness and weakness that leads to poor movement and pain. You will change from kicking like a bent over old lady to a young strong athlete. Exercise as a lifestyle is not something done "for body parts." It is built into your normal movement to make it healthy movement.
Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
Monday, October 02, 2006
Healthline
If you think that not having time to exercise is the problem, here is good news. Thinking that your life and your health are two separate things is the problem. You don't have to stop your life to get exercise.
Look at the drawings, above left. The left-hand drawing shows bad bending - letting weight rock forward, heels lifting, and overly arching the lower back. The right-hand drawing shows healthy bending - keeping weight back, heels down, and the lower back in healthy position, not rounded and not overly arched. Look at the right-hand drawing and try it:
Keep your upper body as upright as you can, instead of rounding over forward
Keep both heels down as you bend your knees (right drawing).
If you find you lift your heels, use your leg muscles to deliberately pull your knees back so that your weight shifts back over your heels. Shifting your weight back keeps your weight on your leg muscles and off your knee joints. There should be no knee pain with good bending.
Keep your knees back toward your ankles. If you just let your weight flop, the knees will come forward past your toes. Don't allow your knees to shift forward.
Don't overarch the lower spine (overly sticking your behind out in back). Keep neutral spine. If you overarch, tuck your hip (tailbone) under you just enough to prevent having a too large arch (inward curve) in your lower back. Although it is often taught in exercise and weight lifting classes to stick far out and overarch, increasing the arch increases pressure on the joints of your vertebrae, called facet joints, and the soft tissue of your lower back. Overarching is a major hidden cause of lower back pain and injury.
Use good bending every time you bend - even to look in the refrigerator and get in and out of your chair. Don't use your arms to lean on the arm rests to sit down and get up; use leg muscles. If you need to use your arms, or you lean your body forward to sit or rise, you need to improve balance, Achilles tendon stretch, and leg strength. Bending properly does all that for you. (Practice safely. Don't fall down.)
Have a friend (or a camera set on timer) take photos of you from the side as you stand and bend, showing how you fixed your bending from unhealthy to healthy during whatever you do all day for work and at home. Write a fun summary and e-mail your photos and stories to me. If you can, put the photos on a photo sharing site. That is easier for me to retrieve and post on Fitness Fixer. I can put the best photos and most fun stories up in lights.
Realize that a big part of your health is the way you move in real life. Make a conscious decision to change your idea of exercise, fitness, and health from stopping life to "do exercise" to how you live. Have fun - the best health.
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I teach martial arts, yoga, and other classes at gyms on evenings and Saturdays. This morning I watched the class before mine. The music was loud. I remembered the saying "If it's too loud, you're too old."
When you read the following, remember that you already know it injures to bend "wrong," as in the photo at left, with your upper body bent over instead of upright. You know not to pick up a suitcase or child like that. Previous posts explain how that gradually hurts your lower back and discs.
The class ran a circuit:
They bent wrong to pick up a barbell for ten deadlifts, staying bent over while lifting.
They put the barbell down wrong (bending over) and ran to do ten toe touches - more bad bending over.
They ran to do abdominal crunches, rounding their back forward over and over.
They got up and kicked a target baffle, rounding their back and pushing their chin forward like a pigeon with each kick so that each impact transmitted to their spine.
They ran across the room, each footfall landing heavily so that each impact transmitted to their knees, hip, and spine.
Then leg lifts, bending forward at the hip over and over.
Back to bent-over deadlifts, then alternate toe-touches - bending over and twisting side to side (more pressure on discs than just bending over), then sitting and bringing knees to chest, then deadlifts.
They bent over wrong to get dumbbells for bent over triceps curls (healthier when done standing upright.)
Then standing squats by bending the hip forward over and over. The instructor coached them to stick their behind far out in back. This pinches the lower back adding to a second kind of back pain. Posts coming soon will tell more.
They reclined with feet up, putting body weight on their rounded shoulders to bicycle their legs in the air, and so on, rounding, bending, and pressuring discs and lower back structures for the 45-minute class.
They bridged up on shoulder and feet, to "stretch the other way" even though it bent their neck forward.
They ended by hanging forward to stretch and bringing each arm across the front of their body to stretch the back of the shoulder. This is counter-productive. Most people are already round-shouldered from sitting and bending forward all day. The personal trainer outside the room was doing similar exercises.
One of the students said she comes to the class to strengthen because of back pain. The trainer said he also had back pain and that is why he exercises. Hopefully you can now see part of why.
I'm not just an Ivory-tower egghead who wants you to reduce activity, never lift heavy things, or never move quickly or through a full range of motion. Just the opposite. I'm a former full contact kickboxer (undefeated) in the US, the Netherlands, and Thailand. I want to show you how to have a healthier, more fun and active life, where you stop pain and injuries and do more. The exercises I learned in over 30 years of martial arts were all the usual but injurious ones. Many students dropped out with injuries. It was not the martial arts but some of the exercises. But which? I went back to the lab to study until I found why the injuries were occurring and what will train you better than what we were using. If it works better, I want to know and do it.
Watch other people exercising. It will remind you of many things to avoid. Start your way back to healthy movement by noticing what your exercises are really doing.
--- Read and contribute your own success stories of fixing pain with these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class spaces for personal feedback. Top students may apply to get certifiedDrBookspan.com/Academy.
Discs are tough cushions between your spine bones (left-hand drawing). They are living parts of your body. When you bend forward, the front of your vertebrae (back bones) squeeze closer together. The space between the back of each vertebrae opens. After many years of bad habits of sitting rounded forward, bad bending over forward, and stretching by bending over forward, the discs are forced backward, like squeezing the front of a water balloon (right drawing above). They begin to break down (degenerate) and move outward to the back, also called slip or herniate. Herniation can continue over years until it suddenly causes back pain with one more bad bend, until the disc moves backward enough to touch the nerves going down your leg causing sciatica and other nerve pain, or even press on your spinal cord. This is avoidable and easily reversed. Discs can quickly heal without surgery, if you change your bending and sitting habits in simple, healthy ways:
1. Sitting. When you sit, don’t round your back. You don’t need an expensive ergonomic chair. No chair makes you sit right. You just use your own muscles to sit right. Make sure you don’t tighten and strain to sit straight. Pull your chair in closer to the desk, and lean your upper back against the seat back. Don’t round forward or push your lower back against the seat. Many seat backs are rounded so that you have to sit poorly if you rest your back against them. Don't let this happen. I will write more about healthy sitting in future posts.
2. Bending. The average person bends hundreds of times every day for daily activities like laundry, kitchen, pets, gardening, children, household chores, and everything else. Check to see if you are bending badly each time, hurting your discs. Check at the gym if you add more forward bending for toe-touches, weight lifting, and exercise class. The post Are You Making Your Exercise Unhealthy? shows some easily missed sources. The post Common Exercises Teach Bad Bending shows more. Bad bending puts herniating forces on your discs hundreds of times every day. No wonder your back hurts.
Here is one way to get healthy built-in leg exercise and stop back pain by bending well for every time you bend to reach things very day:
Stand with feet side by side, comfortably apart.
Bend both knees. Keep both heels down touching the floor.
Keep your upper body upright, as if you don’t want something to fall out of your shirt pocket.
As you bend lower and lower, peek down and make sure you can see your toes. If you can't, that means you are letting your knees come forward, which shifts your weight to your knees.
Keep your knees back over your ankles to keep your weight on your leg muscles. Many people won't bend with their knees because it hurts their knees. This good bending stops knee pain too.
With healthy bending habits, you get free exercise hundreds of times a day, strengthen your legs, stop knee pain, and let your discs heal, all at the same time.
Many Fitness Fixer posts tell more about the large contribution of good daily bending, sitting, and moving habits to healthy lifestyle and stopping the source of disc injury. Click the links in this post for more examples and information. Click the labels under this post for all Fitness Fixer posts about that topic, for example, for good bending, click "squat" and "lunge," for healthy sitting, click the label "sitting." For all posts explaining discs or sciatica and how injury occurs and can heal, click those labels.
There is a large store of help and information right under this post in my replies to the many reader comments below this post. Before asking more questions, see if your answers are already here.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
Wednesday, September 13, 2006
Healthline
You already know that sitting bent over your desk, steering wheel, and computer is unhealthy for your back. Then you go to the gym and sit bent over to touch your toes to stretch. It is the same bad bending. It is not magically different or healthy because it is called a stretch.
Sitting and leaning forward to touch toes, even with your back straight, is a common contributor to lower back pain. It may stretch your back and legs, but sitting, especially sitting bent forward puts high forces on the discs of your lower back.
The sitting hamstring stretch also practices the same bad bent forward posture that you already are probably overdoing at your computer, desk, and other daily activities. Modern lifestyle predominantly favors being bent forward, overstretching your back and tightening the front of your body until it becomes natural to slouch forward and uncomfortable to stand straight. Lower back discs become increasingly squashed and pressed outward from all the forward bending. It starts feeling “normal” to stand and move with your back rounded in unhealthy position.
Sitting and bending forward is not even the most effective way to stretch your hamstrings, even though it is a common stretch, and has been done for many years. Many things that are common and traditional are also not healthy, like smoking and hostility. Use healthy ways instead. The previous post Healthier Hamstring Stretching shows one easy effective hamstring stretch. Posts to come will show many more.Check back often.
Every day in my Sports Medicine practice, I see patients who are instructors of yoga, Pilates, and aerobics with ongoing back pain from doing bad stretches. They say they need the stretch because their back hurts. Then they learn that much of their pain is from the stretch. When they realize this, they smile, stop the bent over stretches, both sitting and standing. I show them more effective hamstring stretches to do instead. They quickly become more flexible from the better stretches, and the pain stops that they were getting from pressuring their discs and lower back with sitting bent forward. Have fun using your brain for stretching, and putting health back into fitness.
Healthy Martial Arts - for all athletes, not just martial artists. Healthier smarter training for everyone.
---
Read success stories of Fitness Fixer methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right.Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
One of the most common stretches for the hamstrings is bending over from a stand to touch the toes. You already know that bending over with straight legs to pick up a package is unhealthy for your back. Bending over to stretch is just as unhealthy. Forward bending puts large forces on the discs of your lower back, and is not even a highly effective stretch for your hamstrings. Bending over to touch toes is a common contributor to back pain, whether you keep your back rounded or straight. I will show you more about exactly why in future posts.
Instead of bending over to stretch, or standing with one foot propped up on a bench or chair, an effective way to stretch the hamstring is to stand facing a wall and press one heel against the wall at about hip height.
Keep your standing foot straight, not turned out; not even a small amount.
Look down and see if your standing foot is facing straight ahead.
Move your foot so that it is straight, or you will lose the stretch. As soon as you turn your standing foot straight, you will feel the stretch improve.
Lift your chest and stand straight.
Don't let your hip curl under.
Smile and breathe.
Hold a few seconds and switch legs.
Stretching is supposed to be healthy. When you stretch, don't practice bad posture habits by rounding your back, and don't practice things you know aren't healthy like bending over so that your body weight hinges on your lower back.
Stretch in ways to make your life healthier.
--- Find more information in the replies already here to reader comments below this and other articles. Before asking more, see if your answers are already here. Click labels, links in posts, archives at right and the Fitness Fixer Index. Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. SeeDr. Bookspan's books and learn how to get certified in functional exercise medicine. ---
A recent injury survey by US military revealed that 62% of American injuries in Iraq are occurring in the gym. The same is happening at home. How can this be? Several things are happening. Just as not every medicine is healthy, not all exercises and stretches are healthy.
Just as smoking "works" for weight loss, but is not a smart or healthy way to do it, many exercises "work" for cosmetic results, but result in long-term injury, and promote bad movement habits. Other common exercises don't work your body the way you need to move in real life, resulting in strains and injuries when going about daily activities.
This Fitness Fixer blog will show you hundreds of simple ways to change your exercises, stretches, and daily movement, to make them fun, healthy, and the way you really need to move for healthier daily life. In my laboratory research in human physiology, and my sports medicine clinical practice, I see patients every day who are hurting and unhappy, despite all the exercise and fitness they do. Many of my patients are yoga teachers and Pilates teachers with back pain, hip pain, and neck pain. I see personal trainers with herniated discs and knee pain. I see body builders with back pain, despite all the abdominal exercises they do. I see patients, including fitness instructors, who aren't getting more flexible no matter how much stretching they do. I see people who are stressed, tired, achy, and not in shape, even though they spend hundreds of dollars a month on supplements and pills, gizmos, equipment, trainers, and classes. The answers are simple, and this regular column will cover many easy changes you can make so that your fitness becomes not only more effective, but fun and healthy.
Photo by Jolieof Paul who does real life not gym exercise
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