Fast Fitness - New Understanding of Hyperlordosis and Disc Injury

Here is Friday Fast Fitness - a new possible contributor to vertebral disc injury, and how to avoid it:

1. In my previous studies, I found that overdoing the inward lower spine curve (hyperlordosis) pinches the lower spine like a soda straw. It forces the spine joints, called facets, backward against each other, eventually wearing them, 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.


2. Hyperlordosis was not previously thought of as a direct herniating force on discs. The major factor was and still is too much forward bending. Weighted flexion (bending forward bearing your body weight) opens the space between vertebrae in back, and over years of slouched sitting and bad bending and lifting forward, presses discs outward through that space creating herniated discs (an injury, not a disease). In my previous work I found that for someone with a disc already herniated, hyperlordosis pinches it, adding pain to the separate problem of the disc. Showing people how to stop standing in hyperlordosis greatly reduced their disc pain. In recent work, I found that hyperlordosis exacerbates, and possibly initiates disc herniation itself.


3. My new work is showing that hyperlordosis is a probable mechanism to directly shift disc position. I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness.

Hyperlordosis (overarching the lower spine) is a spine damaging posture. Hyperlordosis and the pain from it can be changed as easily as moving your spine to a smaller, healthier degree of arch (neutral spine). It is not tightening your abs, just moving your spine, as simply as bending your elbow. Links below tell more.

Related Fun Fitness Fixer:

• I wrote of this in May 2009 when I was on the way to present my work at a medical conference - Comments, A Medical Conference, New Findings on Discs
• How To Spot and Stop Damage from Hyperlordosis - Prevent Back Surgery
• Damage from the opposite problem of injuriously done forward bending - The Cause of Disc and Back Pain and Disc Pain - Not a Mystery, Easy to Fix

Random Fun Fitness Fixer:

• Down the Stairs

Labels: disc, facet joints, facets, fast fitness, fix pain, injury, lordosis, lower back, posture

Permalink and Comments | | Email Post

Comments, A Medical Conference, New Findings on Discs

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.

Related:

Neutral Spine or Not?
What is Neutral Spine and Why Does Sticking Out In Back Harm?
Friday Fast Fitness - Neutral Spine in 5 Seconds
Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine
Prevent Main Factor in Back Pain After Running and Walking
Back Pain From Running
Disc Pain - Not a Mystery, Easy to Fix

Our Travel to Another Conference Last Year:

The Coming Two Weeks

Story of Past Travel to Underwater Medicine Conference:

Hyperbaric and Aquatic Medicine On Travel

Photo is me, taken on the way on the way to a previous medical conference, out for some barefoot climbing.

Labels: disc, education, facet joints, facets, fix pain, lordosis, lower back

Permalink and Comments | | Email Post

Fixed Injuries, Got Strong, With Functional Exercise - Real Life

This fun note and great story came in from Robert Davis:

" I have tried to find a way to contact you for a while now!

"I have a story I thought I would share and I am so glad I had found your books and website.

" I had injured myself via weight lifting in late October. I had felt the warning signs before this, however I ignored them and continued to train full out. The result was I had hurt my lower back very badly. The pain was unbearable.

" Sitting hurt. Getting up and walking hurt. To top all this off, I was so adamant that one's "back" health is determined by how well you can stretch forward bending! So this became a discouraging struggle as the more I tested that, the worse I hurt! I had many bad habits besides that and will go into that in a moment.

" I kept training "thru" the pain and bad movement thru to about November 24th. I kept aggravating the area thru bad habits (while doing these exercises. Arched back, rounding etc). I finally went to the doctor and he just made me do some simple movements and the typical straight leg lift. He had decided for now that it was not something all that bad and said that we would do a MRI (or was it CAT scan?) if it did not get better.

I struggled for the next few weeks as I was told to simply rest. I realize the fallacy in this because "just taking it easy" had lead to muscle weakness. It was now a double edged sword by Christmas. I hurt in my back, but when I tried to exercise it it was so weak it hurt more.

I finally ran across your website just after Christmas and before the new year. I started to play around with the ideas at first. I was still stuck though on "better" meant no more pain bending forward. So for a week or two more I played back and forth with these ideas.

" Finally around the 15th or so after the new year I decided "what the heck" I will order some of your books. They seemed more promising then anything I had looked at and I realized in an "aha" moment that it was a form of exercise, which I so very much craved at the time as I simply love to exercise. This "resting" was driving me nuts..

I was watching a show on TV one night on beaches and shell collecting of all things and the biggest "aha" came to me in the form of a little girl. I watched adults picking things up and they bend right over without thought. This went on for a while. Then I saw a child pick up shells. She squatted every time! I said to myself "jeez these books are absolutely right, I am basing everything on bad habits!"..

" I immediately started becoming aware of everything I did during and after exercise. I took your book "fix your own pain" and have almost memorized every chapter and decided if I am going to do this I am going to balance my whole body.

" So after weeks of this (trial and error). I slowly got better. Things I learned along the way are this.. Bending over to pick stuff up is not healthy nor is it natural (that child in the show!).. I learned even after doing weight training for 2 years that my legs were still not as strong as I thought. I learned I had developed bad leg positions from unhealthy squatting (on the knee joints instead of behind). I had further learned that I was holding my feet outward and I think this had come from doing leg pressed with feet slightly out to try to target certain areas.

" I learned to strengthen my core much more effectively and better thru the ab revolution and fix your own pain. I was a 500 crunch type person. I am no longer doing sit ups crunches or whatnot. The stuff in your ab revolution is much more difficult to do and healthier.

I learned to strengthen my body thru its own weight, destroying the myth that you need "weights" for gains as I found these exercises to be just as challenging, if not more in some cases because of the added balance and flexibility required.

" I am now sitting here writing this and I tell you that compared to the initial injury and repeated re-injury (doing the same exercises with bad habits) to now, I am close to 100 percent.

" The funny thing is, I no longer have the desire to go back to weight training, which is odd because that was my life! I have discovered a whole new world of fitness with body weight alone. I am trying more challenging things by the day and I have realized that this is actually more fun the weight training for health and I am getting the same, and often better results (since I am not a body builder, just love exercise and looking fit). I had gone and bought a few things like pull up bars and planche devices and am currently working on mastering some very difficult moves that require body strength alone, but at the same time a mindful awareness of how I am doing it by using your techniques (keeping the back straight with slight tilt etc, no arching).

" It is fun working up to one arm pull-ups in good form. Jeez, to think you could bench press close to 300 a few months ago but doing a few of these exercises in your book were hard! I was surprised I could not do very many pull ups or hold these planks and whatnot.. I am set on a new adventure and I love it because it feels so "free" and balancing. I don't have to spend a huge fee to go to the gym. My gym is my body and functional movement.

" Thank you for your knowledge. Having my back back (sorry for that funny saying!) is great. I intend to keep it healthy now and have begun the correction process of all my body, all the way to my feet!

" I don't look at my injury as a mistake anymore. I look at it as a life changing experience and a chance to explore more functional and fun ways of living. I have passed this site and your books on (not my personal copies!) to a lot of friends into fitness. Some are already reporting healing knees and what not and even re-considering how they live and workout!

" PS I have also changed to a Vegan diet just to see what happens. I was very intrigued by the 72 year old body builder who is vegan.

"You are a godsend.
Robert Davis"

Great work Mr. Davis! Robert has been sending me many insightful updates with photos, to be posted with his ongoing success stories. His next story starts here:
Cardiovascular Cleanup.

Vegan Health:

• 72 year old body builder - Mr. America Urges Goodness and Responsibility
• Vegan bodybuilder and mixed martial arts fighter - World Vegan Day is November 1
• Reduce cancer and chronic disease, green the world with World Vegetarian Day
  
• Junk food can be vegan and vegetarian with unhealthful additives, dyes, refined processed sugar and flour. Click the label "Nutrition" under this post for all posts on how to get healthy fun sports food and Healthier Fitness by clicking the label "Green Fitness."

Weightlifting and Weightbearing With Lower Spine Overarching (Sticking out too much in back) Compresses Vertebral Facet Joints:

• What is Neutral Spine and Why Does Sticking Out In Back Harm?
• Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats
• Prevent Back Surgery

Ab Revolution - Learning and Using Neutral Spine to Prevent Spinal Compression:

• No More Crunches No More Back Pain - The Ab Revolution™
  
• If Better Abdominal Muscles Are Your New Year's Resolution, Try This
• Back Pain From Running

Spotting Spinal Rounding in Exercise:

• Are You Making Your Exercise Unhealthy?
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch

Rest Isn't The Answer:

• Exercise and Aging - Don't Limit the Patient to Limit the Pain

Lifestyle Functional Natural Fitness:

• Getting Stronger Without a Gym
• Don't Confuse Exercise With Real Fitness
• How Often Should You Be Healthy?
• What is "Fitness as a Lifestyle?"
• More Fun Squatting
  
• Parcours - Old Fun Is New Exercise

• 
  

Labels: abdominal muscles, facet joints, injury, lower back, neutral spine, nutrition, readers inspiring story, squat

Permalink and Comments | | Email Post

Overhead Lifting, Reaching, and Throwing Part II - Lower Back

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.

Fitness Fixer Posts on Related Topics:

• How to stop compressing your rotator cuff with your shoulder bone - Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury
• A reader tells how he identified the injury producing position in action in his yoga classes - Overhead Lifting, Reaching, and Throwing - More Part I
• Why hyperlordosis/overarching hurts the lower back - Innovation in Abdominal Muscles
• Watch two short movies to learn to restore neutral spine from an overarched position - Neutral Spine in 5 Seconds and How to Feel Change to Neutral Spine
• See the role of overarching in overhead lifts, Overlooked Ab Muscles in Overhead Lifts
• Learn to spot overarching during exercise - Prevent Back Surgery
• Coming on Friday Fast Fitness - How Abdominal Muscles Prevent Hyperlordosis When Carrying.

Labels: disc, facet joints, fix pain, injury, lordosis, lower back, posture

Permalink and Comments | | Email Post

Which Stretch Stops Back Pain by Making Neutral Spine Possible?

What can you do if you're too tight to stand and move in neutral spine? A common lower back pain occurs after long standing, walking, and upright activity. The most common cause is exaggerated inward curve in the lower spine - a bad posture called hyperlordosis or overarching which pinches the joints called facets and the surrounding soft tissue. An obvious treatment is to simply stop the cause, and restore neutral spine.

Which specific stretches relieve the tight muscles that make neutral spine difficult?

Usually the tight muscles are in the front of the hip (anterior hip muscles) called hip flexors. Several specific easy stretches restore resting length to the front hip. Several of my patients and readers find that posterior hip stretches also help quickly. Liz first wrote in with her success story, How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!

Liz continues her story:

"Dear Dr Bookspan,
"Just a few days ago I checked back to read your blog…since I posted my "Short history" which turned out to not be so short. I was particularly trying to share one thing that had happened to me, for which I couldn't find any specific help until I read your blog, which was back pain after bike riding.

"Even short walks hurt my back before I discovered your work, let alone the way my back felt after a bike ride, a future of pain, getting fat and depressed from lack of activity.

(trouble persists with getting photos to load - Liz' photo should be here and hopefully will soon)

"I thought I'd send at least one photo of me on my bike (I think I have mastered the dorky cyclist look) after a 12 km ride home from work and 12 kms to work that morning. If it hadn't been for you I would not have been able to do this, I would have not experienced the joy it gives me to use my muscles, feel my body doing what it was meant to do.

"I like being able to look after myself and not rely on an external source, like a chiropractor, to keep me well. Whenever I take out your book (Fix Your Own Pain) to refer to, my husband says, 'oh oh, what's wrong?' Mostly now it's just to refresh my memory of an exercise or principle you have written or to check I'm not doing something terrible to my knees. What a marvelous reference book it is.

"After I hurt my back during my first trial cycling to work, I read so many books and articles and web pages on back pain, and many on cycling and back pain. Mostly they were about pain caused by the racing position or impact injuries from bumps in the road. Then I read one of your blog entries where a readers/patient explained he had to give up cycling because of the pain he experienced in his lower back a while after he had been on a ride.

"This is what happened to me, in that blog you explained that a few specific stretches were useful for specific muscles. I checked many pictures of anatomy, which named the muscles that I seemed to be having trouble with, I went back to your book and read more about hips and how tight muscles in the hip area can cause lower back pain. It seems, sitting at a computer all day, then using my leg and hip muscles to propel myself up really steep hills was causing the muscles in my hips to tighten a great deal. That's why I tried your figure 4 stretch.

"It did precisely what I needed it to do, now if I don't do it regularly, I can feel my pelvis is tilting the wrong way, all by itself and my lower back starts to hurt. And when I lie on my back my front hip/pelvic bones (iliac crest) stick way out because of the extreme tilt. Then I do the lying figure 4 stretch and they go back into the right place. Now I know exactly what to do to end the pain and I wanted to make sure, should anyone be searching for help, that they will know there is an answer and your work is the source.

"Thank you for helping me find my joy."
Liz.

Neutral spine is pictured at left. Too much inward curve (hyperlordosis) is pictured in the middle and right drawings. Abs are too long, lower spine is pinched in back.

Habitually keeping too much inward curve (hyperlordosis) shortens and tightens lower back muscles. Tight lower back muscles pull the back of the pelvis upward, tilting it outward in back and forward in front. The tight area feels normal when held shortened (hyperlordotic) and resists lengthening enough to stand in neutral spine. Stretching the lower back allows neutral spine to become possible and feel normal.


I wrote back to Liz asking if she was using anterior hip (hip flexor) stretches too and if she felt the posterior hip stretches working to let her restore straight hip instead of tilting forward.


Liz replied:

"Yes, being a mostly sitting worker I do the hip flexor (anterior front hip) stretch too, I'm sure it helps my ability to voluntarily keep my hips tilted correctly all the time, I can feel with my hands when they 'flatten'. I do this stretch everyday, sometimes twice a day and it's very helpful. I have on occasion skipped this stretch and only done the posterior hip stretch and I've found I have had no trouble achieving neutral spine. But I do it anyway, it's got to be good for me!

"This is my description of the reason I do the posterior hip stretch, mostly on my bike ride days (though it's so good for me, now I do it twice a day) - Even though I am tilting my hips voluntarily to the best of my ability, if I have not done the posterior hip stretch I feel a sharp pinching in my lower back, where the 'dimples' are, sometimes only one side sometimes both. I feel my front hip bones with my hands and can tell my pelvis is not correctly angled, I can't tilt it correctly any further without starting to use muscle force. Not the gentle neutral spine you describe.

"When I lie down and try to gently straighten my spine to neutral, I find I can't and my front hip bones stick out quite a bit. It feels like a muscle somewhere is holding on to my pelvic bone so firmly I can't move it without force. So then I do the posterior hip stretch on both sides for 30 seconds or more if it's feeling wonderful. Often I feel one side is far tighter than the other. Then I test again by lying straight, feeling my front hip bones with my hands and gently moving into neutral spine and I find they are nice and flat, and stay that way. Also the pinching pain goes quite rapidly. Occasionally the pain doesn't go away for a few hours, a hot bath helps. If this happens I do the posterior hip stretch a few times over an hour or two and that also helps. I expect this means I may have done a wee bit of damage to the soft tissue, amazing how the body heals.

"I have discovered that even on non-biking days, if I do this stretch regularly, I rarely feel any pain in my back at all. I'm not 100% certain if it's the combination of stretches that I do, including the hip flexor stretch, but I feel this one is critical for the correction of some kind of internal postural muscle, that is not behaving in a natural way, through some unconscious action of mine."

Usually, no special exercises are needed to have neutral spine. Worse, a common scenario is someone doing exercises then walking away with the spine still arched, never applying the exercise to real life. They become stronger people with the same bad posture - the exercise was not used for function. Instead, just stop the bad position and deliberately move your spine to neutral. However, when the area is too tight to move to neutral, here are stretches. The stretches don't change your voluntary posture, you do that. They just can make it possible:

First, Don't Tighten:

• First make sure you don't tighten or clench abdominal or posterior hip and leg muscles. Tightening does not change posture, inhibits movement, and makes it hard to move to neutral spine.

Then, check if you just need a guide to help feel how to reduce the lower spine arch without pushing the hip forward, leaning back, or moving everything else:

• Fast Fitness - How to Feel Change to Neutral Spine

If you find you are still too tight, stretch the front of the hip (anterior) and back (posterior):

Anterior Hip Stretches:

• Until I make a post for this one, a relaxing start to stretch the front of the hip is to lie face up with knees bent and ankles crossed. Let knees separate to each side as far as comfortable. Keep lower legs next to each other, not one on top of the other. Do this without shoes, to fit your feet side by side without resting the lower leg on the foot. Experiment with pressing your lower back toward the floor. This stretches front and back at the same time, as needed for straighter standing. If this stretch is too much at first, start lying on your back with only one knee bent to the side, the other leg straight. Rest bottom of the foot of the bent leg at the knee of the straight leg.
• Use a comfortable lunge for bending for things around the house - Hip Stretch While You Strengthen Legs
• A short movie on how to position the Lunge Exercise to Neutral Spine
• A nice stretch over a bed or bench - Quick Relaxing Hip Stretch. If this one is too much, try it lying flat with a pillow under your hips. Gradually use a bigger pillow. Finally, lie with legs stretching down from the edge of the bed and no pillow.
• A big stretch - Relaxing Hip, Leg, and Groin Stretch. If the Relaxing Hip, Leg, and Groin Stretch is too much to start with, do it face up instead of face down (see the first stretch above).
• Push your knee away, instead of pulling it toward you during this posterior hip stretch to get an anterior hip stretch - Better Posterior Hip, Iliotibial, and Piriform Stretch

Lower Back, Posterior and Side Hip:

• Reader Steve demonstrates a different way to do the lying figure 4 hip stretch - Fast Fitness - Better Posterior Hip, Iliotibial, and Piriform Stretch
• Reader Mike demonstrates the seated figure 4 in A Whole Big Fix
• Fast Fitness - Great Hip, Side, Leg, and I.T. Stretch
• Increase your hip stretch (carefully) with Fast Fitness - Balance, Strength, Stretch, and Socks

Reader Success Stories fixing chronic lower back pain from overarching and tight hip:

• Ted's story - Back Pain From Running
• Nick's story - Prevent Main Factor in Back Pain After Running and Walking
• Mike's story with his photo of seated hip stretch - A Whole Big Fix
• Requested by reader Jean Christophe - Lower Back Pain and Golf

Liz's debut story - How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!


Books - all information in one place, illustrated, step-by-step - www.DrBookspan.com/books

• Fix Your Own Pain
• Health & Fitness In Plain English (THIRD edition), How to be Healthy Happy and Fit for the Rest of Your Life

Labels: facet joints, fix pain, hip stretch, lordosis, lower back, neutral spine, readers inspiring story

Permalink and Comments | | Email Post

Stop Lower Back Pain From Swimming and SCUBA Part II

Yesterday's post explained the most common hidden cause of lower backache after swimming and scuba diving. Swimmers and divers who get this chronic pain are often misdiagnosed with SI (sacroiliac) joint dysfunction, arthritis, disc injury or various "catch-all" terms for back pain with unknown origin. Scans may show damage to the facet joints, which can occur from spinal overarching. Injections and surgeries and various anti-inflammatories are often prescribed. No shots, medicines, or surgeries are needed. You do not need physical therapy or strengthening programs. All you need to do is stop overarching and maintain neutral spine when walking, running, swimming, and diving. It is easy, and is a healthy and normal spine position. You do not tighten any muscles to do it. It is just learning a normal posture.

Check yourself to see if you stand in hyperlordosis:

1. Stand up and look sideways in a mirror. Your belt should be level, as in the left drawing of neutral spine. The side seam in dress or trousers should be vertical from leg to waist, as in left drawing, not tilted forward at the hip (middle drawing).
   
   
2. Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first, it often is a good indicator that you lean the upper body backward (right drawing).
   
   
3. Stand with your back against a wall, with heels, hips, upper back and back of your head touching. There should be a small space between your lower back and the wall, but not a large space. Then raise both arms overhead to touch fingers to the wall behind you to simulate swimming with arms outstretched. See if the lumbar curve increases. You should be able to stand with the back of your head touching the wall without increasing your normal curve, and be able to raise your arms without increasing it.

If you have a large space between lower back and the wall, try this:

1. Press the lower back toward the wall to feel how to decrease the space. There is a short movie of this on Fast Fitness - How to Feel Change to Neutral Spine.
   
2. If you can't figure how to do that, put your hands on your hips, thumbs facing the back, and roll your hip under so that your thumbs come downward in back.
3. Feel the large space between lower back and the wall become a smaller space.

Lower back pain that is caused by hyperlordosis should ease right away. Learn how to easily, gently do this while walking, running, swimming, or whatever you do. This is done without tightening or clenching any muscles.

Keep the good new neutral spine when you walk away from the wall, and all the time. Apply it to when you are swimming and scuba diving.

Muscle Use is Not Automatic
The muscles that hold neutral spine are your abdominal muscles. They do not do this automatically, which is why strengthening programs do little to stop back pain. Someone may have strong abs but stand and swim in arched posture, with continuing lower back pain.

Heavy scuba tanks don't make you arch your back or have bad posture. Not using your ab muscles to counter the pull, and allowing your back to arch is the problem.

When you are standing up wearing tanks, straighten your body against the pull of the load and maintain neutral spine. Do not tighten your abs, just move your pelvis. If you notice yourself arching while wearing tanks, straighten your body as if starting to do a crunch but don't curl forward. Only straighten to neutral spine. Don't tuck so much that you lean back or push your hips forward.

No More Lower Back Pain From Overarching
Transfer this neutral spine skill to your daily life for carrying gear, putting cargo up on racks, heavy packages on counters, and whenever you lift and reach. Use neutral spine when standing, walking, running, reaching overhead, swimming, and scuba diving.


Related Fitness Fixer:

• Prevent Back Surgery
• What Does It Look Like to Not Use Abdominal Muscles?
• What is Neutral Spine and Why Does Sticking Out In Back Harm?
• Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
• Innovation in Abdominal Muscles

Labels: facet joints, lordosis, lower back, neutral spine, scuba, swimming

Permalink and Comments | | Email Post

Lower Back Pain From Swimming and SCUBA

Lifting and carrying heavy dive gear with good lifting mechanics is good and functional exercise. With bad lifting habits, it is a common and obvious cause of lower back pain in scuba divers. A second major cause of lower back pain after SCUBA and swimming is often overlooked and can occur after scuba diving and after swimming laps with no gear lifting.

Hyperlordosis
When swimming or finning face down and horizontally through the water, many divers allow their lower back to increase in arch. They look like they are face down in a hammock - shown by the figurine below:


A small inward curve belongs in the lower back. When you allow the normal inward curve, (normal lordosis) to increase, it becomes hyperlordosis or overarching (swayback).

For most people, hyperlordosis is most common when upright, such as standing, walking, and running. Swimmers and divers who allow their back to overarch when swimming face down often notice the pain after swims and dives:


How Hyperlordosis Causes Lower Back Pain
Hyperlordosis pinches the joints of the vertebrae called facets and the surrounding soft tissue. When swimming and diving in hyperlordosis, the fulcrum of the kick becomes the facets instead of the muscles of the abs and hip. When standing upright with a hyperlordotic lower spine instead of neutral spine, the weight of the upper body presses down on the overly pinched-backward lower back. Running in hyperlordosis causes more of the banging and pressing.

People with lower back pain from hyperlordosis usually feel they need to bend over forward, or sit, or raise one leg to relieve it. Often nothing shows up on x-rays and scans. Eventually, hyperlordosis can damage structures enough to show. Until then it just aches a great deal.

The cause of this kind of pain is often unrecognized and people may be told they have a condition called sacroiliac, or SI joint dysfunction, or nonspecific back pain, or other names.

Next - Part II, How to Stop Lower Back Pain From Swimming and SCUBA tells how to recognize it and what to do

Labels: facet joints, lordosis, lower back, neutral spine, scuba, swimming

Permalink and Comments | | Email Post

Kettlebells Without Spine Injury

Reader Dan wrote:

"Hello, I'm writing as someone who has incurred a training-related lower back injury and who has great interest in your words on hyperlordosis. I am hoping that you might shed some insight on how to achieve a neutral spine while doing "kettlebell swings." This is the exercise that has caused me back pain, and I would love to return to working out with kettlebells, but am not sure how to do so without creating too much lordosis. Any ideas? I appreciate any assistance you can provide and thank you for your contributions! Take care,
Dan L"

Throughout history, people have lifted and swung weights of all kinds of shapes. Kettle bells (also called kettle balls and many other names) are usually ball-shaped weights with a handle. A variety of sizes is shown in the photo, above, along with a medicine ball for comparison.

Kettle bells were long used in various martial arts and cultural festivals and contests before being rediscovered for modern weight lifting. In general, you lift, swing, and move them to do various weight lifting exercises. Kettle bells are weights. Benefits of kettlebells are the same as lifting and swinging other kinds of weights.

The photo above shows injurious lower spine posture of the person lifting or swinging overhead, called overarching, swayback or hyperlordosis. His upper body tilts backward relative to the lower spine. There is too much inward curve, pinching and compressing the lower spine. You can even see this pinched fold in his lower back. This poor posture is a common cause of lower back pain. People who chronically over-arch this way often feel they need to bend over forward to make the pain stop. However, using neutral spine and not allowing the slouch while lifting overhead would stop the cause in the first place - right photo below.

Recent kettlebell devotees have made a small set of lifts, and limit swings to mostly vertical swings up and down between the legs. However, a wider range of movement and more function can be trained. Great benefits are possible using weights with handles for functional core stability training, as below.

The photos above, of injurious overarched spine position (left) and healthy neutral (right) while swinging a heavy medicine ball overhead, are from the book Healthy Martial Arts. My black belt student Christopher demonstrates. This is a similar motion as swinging kettle bells overhead by the handle.

In the left photo, Christopher demonstrates the hyperlordosis posture that compresses the lower spine and is a major cause of lower back pain. He allows the hip (pelvis) to tilt forward in front and out in back, and his upper body tilts backward relative to the lower spine. In the right photo, he reduces the overarching to neutral spine. The belt line changes from tipped downward in front to level.

Keep neutral spine when lifting and swinging kettlebells and any weight overhead (right photo). Prevent the slouch of leaning your upper body backward and tilting the pelvis (left photo). Leaning backward and allowing the hip to tilt are often mistakenly done to "balance the weight" and make the lift easier. Leaning the upper body back and tilting the pelvis are not necessary to balance a load - your own muscles can hold the load, and in fact, that is the point of lifting the weights.

Overarching increases the small normal small inward curve (normal small lordosis) to a large curve (hyperlordosis). Hyperlordosis increases compression on the joints (facets) and soft tissue of the lower spine. The same overarching is the hidden cause of back pain in women who lean back and/or tilt the hip trying to offset the load of a pregnancy - Back Pain in Pregnancy - and Why Men Can Get It. Leaning backward and overarching are not helpful adaptations as sometime thought, are not unavoidable, and are not limited to pregnant women. Overarching (hyperlordosis) is a common bad posture, and an often missed source of back pain. It can be easily prevented by using your muscles to hold neutral spine. The post Prevent Back Surgery shows photos of hyperlordosis compared to neutral spine during many activities.

Bending over forward to swing kettlebells between the legs is another exercise where injury and back pain frequently occur. Good squatting technique reduces the problem. Often weight lifters spend much time learning and debating good squat posture, then bend over (injurious bad bending) to pick up and put down their kettlebells.

Neutral spine while exercising with kettle bells is the same as neutral spine during anything else - just hold your spine position. Neutral spine is not done by tightening or clenching any muscles. It is done by moving your hip and lower spine the same way you move your arm to scratch your nose - without tightening, just moving it to where you want it. Holding neutral spine is the same as not slouching your shoulders or not letting your mouth hang open - a voluntary use of your own muscles - built-in exercise.

Keep breathing, Have fun. You can swing weights of any kind in any variety of ways, to be stronger and healthier, without injury.

Learn neutral spine swinging kettlebells, babies, and all other fun weightlifting:

• Prevent Back Surgery
• Overlooked Ab Muscles in Overhead Lifts
• Neutral Spine in 5 Seconds
• Fast Fitness - How to Feel Change to Neutral Spine
• Back Pain in Pregnancy - and Why Men Can Get It
• Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine

Book:

• Healthy Martial Arts (www.DrBookspan.com/books) has a section on lifting and swinging kettlebells, medicine balls, and other weights.

Labels: exercise ball, facet joints, fix pain, kettlebells, lordosis, lower back, martial arts, neutral spine, performance enhancing modality, pregnancy, strength

Permalink and Comments | | Email Post

Fast Fitness - How to Feel Change to Neutral Spine

Here is Friday Fast Fitness - Use a wall to learn neutral spine while standing, to know how to stop a major source lower back pain during standing, walking, and running.

Many people learn pelvic tilts lying on their back in physical therapy or fitness classes. What does that do? Little. The purpose of learning the pelvic tilt is to know how to do it during real daily life so that you do not slouch and overarch your lower spine in to a swayback posture (hyperlordosis) which creates back pain. The tilts do not make your muscles prevent the slouch automatically, you use it to know how to do it yourself. My student Dennis, Olympic medalist in wrestling, demonstrates learning a functional pelvic tilt (he is holding his shirt away with hand so you can see better - you can relax your arms at your sides):

1. Stand with your back against a wall. Touch heels, hips, shoulders, and the back of your head.
2. If you allow a large arch in the lower spine there will be a large space between lower back and the wall. Press your lower back toward the wall.
3. Don't touch or force your lower back to the wall. Just learn how to tilt the hip so that the lower spine comes closer to it and reduces in arch.

Use a wall often to practice, then the idea is to hold neutral spine without the wall during the rest of your day.

Reducing a large arch back to neutral stops the painful lower spine compression on soft tissue and facet joints during standing activities (and bad pushups and handstands).

• Another short movie that shows the same idea, without the wall - Friday Fast Fitness - Neutral Spine in 5 Seconds
• Another short movie - changing hyperlordosis to neutral spine while holding a pushup position - Fast Fitness - Strengthen by Changing Your Plank
• Another short movie -changing hyperlordosis to neutral spine during handstands - Fast Fitness - Fixing Your Handstand to Neutral Spine
  
• Why hyperlordosis causes lower back pain - Neutral Spine or Not?
• How to spot and prevent damage from swayback - Prevent Back Surgery
• Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
  

Labels: facet joints, fast fitness, lordosis, lower back, neutral spine, video/movie

Permalink and Comments | | Email Post

Tax Preparation Health

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:

• Stretch upper body in your chair - Tax Stretch
• Stretch and relax upper body - Quick, Feel-Good Upper Back and Chest Stretch
• Stretch and relax lower body - Quick Relaxing Hip Stretch
• Stretch and relax your breathing - Do Breathing Exercises Work?
• Stretch and relax your spirit - Fast Fitness Friday - Strong Spirit.

Labels: disc, facet joints, fix pain, holiday, neck, posture, sitting, stress, upper back

Permalink and Comments | | Email Post

Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?

The post Innovation in Abdominal Muscles showed one of the most common, yet most overlooked cause of lower back pain during long standing walking, and running.

Readers sent excited letters stating they could finally see and feel why they had back pain, and could immediately feel the difference when they stopped standing with too much inward curve in the lower spine, and began standing and moving in neutral spine.

Readers asked for more photos so that they can see the difference between overarching (hyperlordosis) and neutral spine (normal lordosis) during running and walking. They wanted to see the overarch in action and what running in neutral spine looked like.

• In both photos, the hip tilts forward in front (and out in back) instead of holding vertical. The abdomen rounds outward.
• Note the red stripe on the runner's pants in the photo at left. The stripe tilts forward from the top of the leg to the middle of the hip. Compare to the red vertical line in the middle and right-hand drawing. The beltline tips downward in front. Compare to the red lines tilting downward in the drawings.
  
• The walker in the photo at right tilts the hip forward in front (and out in back), beltline tips downward. The upper body leans and sags backward.

The muscles that shorten to prevent the upper body tilting back and the hip tilting forward are your abdominal muscles. The abdominal muscles are too long when you allow overarching. Keep this in mind when you hear about exercise programs that claim to lengthen your abs.

Moving your spine to neutral spine for all daily life is how abdominal muscles help prevent back pain. It is not strengthening them that does this, and it is not tightening. Crunches and other forward bending exercises do not train you how to use your abs to hold neutral spine and they increase herniating pressure on your discs - click Good Life Works Better Than Bad Ab Exercise. Use your abdominal muscles, without tightening them, to position your lower spine during all you do, just like using any other muscles to move any other part the way you want. It is a free ab workout all day, and you will stop a major cause of back pain during standing, walking, and running.

• Click Overlooked Ab Muscles in Overhead Lifts to see more examples of overarching during lifting weights.
• Click Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain to see an example when reaching and lifting arms overhead
• Click Prevent Back Surgery to see why overarching can be so damaging to the joints of the vertebrae.
• Click my web site books page www.DrBookspan.com/books to see the training manual The Ab Revolution™. It shows several techniques to learn neutral spine as a normal habit, and how to use it to stop back pain from hyperlordosis, even if you don't exercise (Part 1) and how to use it for better core training if you want to incorporate it into exercises (Part 2), from simple to the hardest you can get.
  
  

Labels: abdominal muscles, facet joints, fix pain, lordosis, neutral spine, posture, running, walking

Permalink and Comments | | Email Post

A Reader Asks About Osteoporosis and Walking Lightly

One good question launched many answers. The post Walk Lightly - Shock Absorption for Happier Joints explained a light step prevents joint, soft tissue, and plantar fasciitis pain. In the comments, Carol asked if there were, "a connection between walking lightly and oesteopenia?" This is interesting, since osteopenia is lower than normal bone density, that lack of enough pulling or tension on the bones reduces bone density, and a certain amount of impact and loading keeps bones denser. The simple answer seems to be, that walking lightly should not be enough to reduce bone density, by itself.

Walking, running, and jumping lightly is good exercise to load the bones, while being better for your ankles, knees, hips, and spine than jarring with each step. The post Why So Many Aerobics Injuries? cited news accounts attributing joint pain and injury to high impact activities, with examples of popular aerobics personalities of the 1980s who now say they are too crippled to exercise. Their injuries were avoidable, but not by avoiding impact exercises. Impact activities can be done safely by not stomping down hard. Even repeated jumps from a height can be done with soft landings. Good athletes run, jump, and box with far less impact than most people walk, and have good strong bones. Exercise, done right, is crucial for your bones - Exercise is More Important Than Calcium Supplements for Bones.

When muscles pull your bones during walking, running, and other exercise, the pulling increases bone density. Adding external weight loads bones further. That is a major way weight-bearing and weight lifting exercise increases bone density. The effect of muscles contracting to provide good shock absorption when moving also pulls on the bones,which should be good. The post Forensic Anthropology and Bone Density looked at influencing the shape of our bones by how we move.

The reader went on to comment, "I have always been very light on my feet, and now in my 50s I have found out I have low bone density. I have a cousin who shakes the house when she walks who has been told that she doesn't ever have to worry about her bone mass." Walking lightly alone should not have caused the osteopenia. Questions would be, what other exercise the reader does, and what things might be decreasing her bone density? For the cousin, "shaking the house" by itself may not be enough bone stimulus that anyone could tell her that she "doesn't ever have to worry." Has the cousin taken a bone density test and was found to be high (for whatever reason)? Then you can say there is lowered risk of fracture. Is this cousin is very heavy, which helps load bone? Does this cousin do regular exercise to increase her bone density? It is not likely to be a valid prediction that someone never has to worry about bone density just because they walk badly.

The reader went on to ask, "I went to a bones for life class and was taught to do heel bouncing to stimulate bone growth. i.e. dropping repeatedly from toes onto heels while standing in proper alignment. Do you agree with that exercise?" I did a few searches on the bones for life class and found that the class uses many exercises, not bouncing on the heels alone. Bouncing for a few minutes would not be enough to undo an entire sedentary life style and the various things people do that actively take away from bone density. You need to do all the other exercises. How much the shock wave of the impact may additionally load or stimulate the bone is an interesting open possibility.

There are studies looking at effects of vibration and tapping on bone building. Mechanisms have been studied from the effect on cat bones of their purring, to various machines that bang or vibrate. Some advertising for vibration machines goes as far as making claims that they will increase bone density. So far, none have been found to have as much bone building effect as muscular activity (exercise). Too much occupational vibration, like jack-hammer, helicopter and similar environments produces joint pain, injuries to the spine, eyes, ear, nervous, and other systems. That was one of the topics I was looking into when I did aviation medicine research, explained in Indiana Jones Rocket Sled. A news article that came out on last year's fitness fad of vibration plates promising weight loss and fitness building, mentioned a few of the problems with too much vibration, and, ironically had an accompanying photograph showing severely hyperlordotic (overarched) lower spine positioning by a person listed as the trainer. Hyperlordotic spine posture, by itself, damages the facet joints of the spine over time. It seems safe to say that the jolting of the vertebral joints against each other in this overly arched position would only be worsened by vibration. The post Prevent Back Surgery shows examples of overarched lower spine and why it causes so many injuries in fitness.

It would be interesting to know if low levels of vibration and impact, through tap dancing, Flamenco dancing, pogo stick jumping, and similar activities, would change bone compared to the same amount of exercise without the impact. Some studies claim that swimmers or cyclists do not have as high bone density as runners, while others do not find that when they control for the direct muscle work applied to the area. There are even studies showing that Tai Chi, a most mild form movement with almost no foot-falls at all, can increase bone density in older people, just from the movement.

Along with walking or running, and weight lifting to build bone density, and using your muscles to stop stomping which can hurt the joints, you can prevent bone loss by avoiding things that reduce bone density:

• Smoking
• Drugs that are known to greatly increase risk of bone fracture: stomach acid drugs and steroid anti-inflammatory drugs, regular use of SSRI antidepressants such as Prozac and Paxil. Numerous medications used to treat different cancers may produce osteopenia (bone shortage) and osteoporosis in long-term cancer survivors. See Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Lack of sunlight. Calcium cannot be absorbed or do its job without enough sunlight
  
• High consumption of meat and dairy products
• Drinking alcohol too often
  
• Lack of fruit and vegetables, and vegetable calcium sources
• Eating wheat and related grains by people with celiac
  

Osteoporosis and osteopenia cause major problems for men, not only women. More on this to come. Move, walk, lift weights, stand on your hands, and jump for fun, exercise, and bone building. You do not need to ooze around on tiptoe to avoid impact injuries. Jump and dance and stamp your feet for fun, for bone building, and for all the refreshing good feeling it gives, without jarring your joints and retinas loose. Have fun.

Carol ended her comment to me with, "Thanks for your site - I've learned a lot about alignment, which has helped in many ways." Thank you Carol for writing so many helpful questions for our benefit.


More:

• Forensic Anthropology and Bone Density
• Exercise is More Important Than Calcium Supplements for Bones
• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Prescription Acid-Reducing Drugs Produce Heartburn and Dependency
• Exercise and Aging - Don't Limit the Patient to Limit the Pain
• Why So Many Aerobics Injuries?

Labels: aerospace, biking, facet joints, fibromyalgia, fix pain, impact, injury, osteoporosis, plantar fasciitis, sunlight, swimming

Permalink and Comments | | Email Post

Lower Back Pain and Golf

Lower back pain is a common problem for golf players. Pain is sometimes attributed to twisting the torso during the swing. The "twisting theory" seemed reasonable, since that is when many people feel the pain. However, the main problem is not twisting. Beside the bad forward bending that is common for picking up golf shots and equipment, a major overlooked source of lower back pain is overarching the spine during the swing.

If you increase the inward curve in the lower back, you increase normal lordosis to hyperlordosis. When you do this during the swing while letting your upper body weight press down on the area, it compresses the facet joints and surrounding soft tissue. It is the same pain that occurs from overarching during walking and running.

A golf pro attended my last workshop on fixing back, neck, and hip pain. I was able to check with her to make sure that what I found to stop lower back pain with golf would not interfere with a good swing.

She stated:

"I do not think arching is essential, but I can imagine the older golfers and what their swings might look like...there are some ugly ones that would arch WAY too much and that is the source of many problems on the score card, as well as the back!"

In the following photo examples, look for too much inward curve in the lower back. Too much curve is not a normal lordosis, it is overarching, called hyperlordosis. Overarching is the reason for much unidentified pain during standing activities.


In the next two drawings, the lower spine is overarched (hyperlordotic) on the left and neutral on the right. Neutral spine keeps a small inward curve, but not a large one:


In these photos, see how the lower back is overarched:


These photos show the lower spine from the back:



In these three photos, see how the lower back is held in neutral spine:

Preventing overarching and holding neutral spine does not mean that you do not get a full or strong swing. It is not the case that the only way to get full range of motion is by pivoting from the lower spine joints. By holding neutral spine you will shift the effort of the swing onto your abdominal muscles, giving you a more powerful swing.

Feel The Healthy Change For Yourself:

• To feel how to change from overarched to neutral spine, see Innovation in Abdominal Muscles.
• To understand how bad forward bending (opposite problem from hyperlordosis) contributes to back pain click The Cause of Disc and Back Pain.

Labels: abdominal muscles, facet joints, fix pain, golf, lordosis, lower back, neutral spine

Permalink and Comments | | Email Post