Fast Fitness - Hidden Source of Groin Pulls

An old sports medicine joke says that if you pull a groin muscle, make sure it is someone else's. Here is less known info for Friday Fast Fitness - do you stretch in a way that groin pulls are more likely to happen to you?

When you lift one leg to kick, stretch, or step up, you can get the needed range from the upper leg muscles, or you can just round your back. Many people round the spine and roll the hip under (tuck too much) to make the stretch easier. They don't get the stretch from the muscles high in the leg, leaving the area tight.

In event of large or sudden kick, step, or slip, high forces pull on tight groin muscles. Varying degrees of injury can occur, or the tight area yanks the standing leg out from under and the person falls backward suddenly - seen in aerobics and martial arts classes, and funny video shows. Then the person hobbles around saying they don't understand it since they do their stretching, and articles get published that stretching doesn't work and no one know why.

Being so tight that your other leg comes forward with the lifted one, comes from bad stretching habits that allow hip and pelvis to round and tuck under too much:

1. When you stand on one leg and lift the other, don't bend at the knee and hip, pictured at left. Straighten your back with chin loosely in, not rounded forward. Hold pelvis upright without letting it tilt and round under you, pictured right.
2. Keep the standing leg normally straight (not locked straight, but not bent more than normal standing). Stand straight and relaxed (both at once). Don't force or strain. Breathe.
3. Feel more stretch in the front thigh and groin of the standing leg.

Check your stretching, kicking, and stepping. Check if you round your back and hip when taking the stairs, stretching while standing, and stretching lying on your back.

When lying on your back to stretch by lifting one leg, keep the other leg flat on the floor, not bent at t he knee and hip. It is a myth that you must bend your knees when stretching legs to protect your back. If you must bend your knee to protect your back, how are you supposed to stand normally and move?


Prevent Stretch And Exercise Habits Promoting Tight Anterior Hip:

Fast Fitness - Don't Shorten Hip When Stretching Hamstring
Fast Fitness - Hip Stretch and Spine Stability Training When Stretching Legs
Is Bad Martial Arts Good Exercise?
Fast Fitness - Better Standing Hamstring, Achilles, and Inside Leg Stretch
Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs

Labels: fast fitness, fix pain, hip stretch, injury, leg stretch, martial arts

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Fast Fitness - Somebody Please Do My Personal Responsibility For Me!

A couple was buying a house. The real estate agent told them a problem with the house was that it was near the train, rumbling noisily by every night. It would take the first two weeks to be able to sleep through it. "No problem, said the couple, we'll spend the first two weeks in a hotel."

An opening line of last Friday's Fast Fitness was, "How long does it take to stop slouching, or stop herniating a disc, or stop paying money to eat food that is bad for your health? It takes as long as you want to continue injurious ways."

The letters came in. Some missed the whole point, hoping for magical externals to do it for them: " Can I use a posture brace until it works? … Is it until my shiatsu starts working? … My body worker says it takes 6 weeks for massage to make me aware of my body… My yoga teacher said the pain has to be worked through so I bend wrong to get used to it… OK, bending right does fix my pain, but every time I go back to bending wrong the pain comes back. I do the exercises 10 times. How long until the exercises work?... "

The "martyrs" blamed externals: " It is not possible to control how I stand or sit, I am fat/ weak/ large chested/ too thin to have muscles/ old/ young/ a person of privilege… You're wrong, the slouching just comes back by itself. … You're wrong I have gone to a chiropractor three times a week for years and I have to go or the pain comes back, that proves he is helping me and I can't change the pain…Another blog said to get a thousand dollar mattress and that will fix it… "

Some of the whining was comical: "You can't expect me to actually try to remember that… You're wrong, my body FORCES me to slouch… I have read all your posts and you didn't mention posture or answer readers when they asked (for new readers, you can fall over laughing at that)… Don't you know that it hurts my back to sit at a desk to read your book on fixing pain?..."

Excellent readers sent the brains: "You expect me to actually get free exercise using my muscles to make my own life better?? Congress will hear about this!… I can move my own body? Shocking!… Burn more calories, free, and be healthier and stop disc pain by sitting so that my back does not hurt? I won't, I won't, I WON'T!!!..."

1. The moment you bend right, you will stop injurious forces on the discs and knees. Keep good habits, and they can heal. Stop tensing your body and it will not be tight and tense any longer. Relax does not mean slouch. The moment you change to healthier sitting habits, you will be able to sit more comfortably.


2. No exercises, no séances, no pills, no mattresses make you bend right and stand in the kitchen preparing meals with healthful stance, breathing not grunting, shoulders back, not hunched, smiling and contented instead of poisoning your body with stress chemicals that you generate yourself through hurtful behaviors.


3. The method you choose to fix your injuries depends on your view. If you don't like to have it free, quickly, and in a way that uses your own body to get exercise as part of your life, then of course go to another method and comment there about your pain. It seems to be a 'sign of the times' to do pills and blame. Time for change to something healthier (if you want). This Fitness Fixer and all my other methods are for people who would be embarrassed to whine, and want direct, intelligent ways to get their own life back. Be prepared to have fun and use your brain.

Where to Start (if you want to, no one is making you):

• Read the Reader Inspiring Stories from real readers who used Fitness Fixer methods.
• Last Friday's article that was supposed to be a quick obvious mention of this topic, and that was all - Fast Fitness - Save Money, Fix Pain, Do More Exercise, Get Fit Faster - Strengthen Personal Responsibility
• Can you put down counterproductive behaviors - How Strong Is Your Arm? - Readers Find Out
• Secret To Get Better and Fitter
• All the More Reason To Try - Exercise to Overcome Each Difficulty

Fitness Myths:

• How Many Legs Does a Dog Have If You Call the Tail a Leg?
• Beware of Hype in Training Methods
• Gluteal Muscles Myth - Shaking The Dog's Paw

Helpful easy reminders to sit, bend, move well (you don't have to sit at a desk and read anything to use them):

• Dr. Bookspan's Backsavers

Get all information in one place:

• www.DrBookspan.com/books. Read the descriptions if you want the right book for your injury or life goals. Up to you.
  

Labels: fast fitness, fix pain, mind, posture

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Weak Hips on Purpose? Running Injury and Hip Strengthening

Who works their hips? Fitness Fixer success story Robert Davis wrote me several

notes that the weightlifters he knew didn't want to exercise their hip because they thought it would take away from the "V shape" they worked for.

Mr. Davis said that using my daily good bending and other functional exercise worked his hip greatly. He was pleased with reduction of stiffness and pain and increase in strength and mobility. No decrease in "V-shape."

The May/June 2009 issue of Sports Health: A Multidisciplinary Approach, published a study based on a literature review, concluding that running injuries to the lower leg may have more to do with weak hip muscles than how many miles run. Lead author Reed Ferber, Assistant Professor and Director of the Running Injury Clinic from the University of Calgary stated ”Hip muscle weakness especially appears to lead to atypical lower extremity mechanics and increases forces on knees and feet while running.” He also stated, "Based on a literature review, it appears that foot pronation (turning the arch and ankle flatter to the ground, and/or the knee inward) and inadequate hip muscle stabilization are the top categories for injury.”

From my own work in this area, I found that strengthening alone won't make you run with good mechanics, prevent pronating, or other injurious habits, you need to retrain them too. Not hard. Stopping your life to do rehab exercises then returning to bad daily movement also isn't so helpful. My work builds-in both strengthening and mechanics to daily life - functional exercise. Robert Davis has been sending in his successes fixing back and other injury using functional fitness.

Robert Davis writes:

"I had made a slight error in my story! I just wanted to let you know.. I had not ordered fix your own pain till only about 4 weeks ago cause I was looking at my expenses and the Amazon one came up!

"So to see how rapidly things change when you take up these habits is even more encouraging.

"Some things I noticed along the way (I did have some slight questions on this!). My hip muscles for one, started to get "sore". I believe this is because of over tightness and overall lack of use. My guess is like every other gym rat they avoid things to make obliques and lower back "too" big because it takes away from the V shape they are after. Everyone seems to fall for this but it is an un-healthy trap I now realize.

"Anyhow I had started to get really sore over the last few weeks in hip muscle areas and even upper buttocks from stretching these areas and working them (using your stuff). When I practiced going into full squats, this really seemed to stretch out areas that began to show signs of weakness/tightness. So it was like working out muscles and getting that "soreness" when your muscles start to adapt. I kinda figure it is as it is just as normal to workout a bicep and for it to "be sore" the next few days.

"The soreness goes away and with each passing week, it becomes more mild - kinda like the body getting used to biceps being sore and you don't get sore anymore.. They do not get sore like they did when I first started your stuff. I was just curious if you had seen this. I am sure it is normal, especially for a group of muscles not used to being used or stretched out.!

"Jeez I do not think most people realize just how tight and weak they can be in areas, mostly because they are never used or people are used to being tight there. People do not believe in the squat (I showed a few people to prove them wrong lol) because they are too tight. I realize how much I am glad I found this out early in life. I get stronger every day in the areas that were weak. I know I will have a much better core, lower back, complete back, and body then before I hurt myself :)

"I put together my "planche/pull up" setup for pictures and to start working on a full planche! That is difficult to do like you do it! Any suggestions? Just keeping trying? Heheh

"Thank you again! Thank you for posting my story."

Mr. Davis, thank you. You are well ahead of the fancy researchers :-)


Strengthen and stretch your hip functionally:

Bending Right is Fitness as a Lifestyle
How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending
Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
Cardiovascular Cleanup
Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches
Household Fitness in the New Year

Labels: fix pain, hip strength, hip stretch, knee, military fitness, pronation, readers inspiring story, running

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Fast Fitness - Built in Upper Body and Core Exercise Carrying Children

Here is Friday Fast Fitness - get better exercise and stop aching back and shoulders when carrying children (or anything else) in backpack carriers or by piggyback:

1. Put on the carrier (and baby for a fun practice ride or use groceries, etc). Look sideways in a mirror.


2. See if you round your upper and or lower back forward. See if you lean your upper body backward under the weight. Notice if you increase your lower spine inward curve, are tilting the hip out in back to hold up the carrier.


3. Straighten upper and lower body segments. You will feel a strong pull on your abdominal muscles when you reduce overarching in the lower spine and prevent leaning the upper body backward. You will feel an upper back workout when you don't lean or round forward.

Labels: abdominal muscles, children, fast fitness, fix pain, neck, partner exercise, perceived exertion, shoulder, upper back

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Knee Surgery - Arthroscopy Results No Better than Pretend Surgery

A study of arthroscopic knee surgery found that the surgery was no more successful than pretending to do the surgery.

Arthroscopic surgery for knee arthritis is performed in substantial numbers. Why? The patient's doctors said they needed it. Where did the doctors get that opinion? It is taught in medical school and repeated at medical conferences. Repeating things is not evidence-based medicine (which is key) but vehemence-based medicine. When highly paid people repeat things without even knowing if it is true, that is eminence-based medicine.

Studies are now following up the same patients who had the surgery. Numbers show that often the surgeries are not needed, and people can do as well without surgery, and with intelligent non-surgical rehab.

This is not new. In the 1930's, patients being prepared for the rigors of surgery through exercise, often found that by surgery time, they didn't need it. Other patients without receiving exercise went straight to surgery. They may have had continuing pain and damage after surgery or later in life, but patient tracking was not done. Doctors just reported that the surgery was done, the patient lived, and that was all, and on to the next paying job.

Then studies compared surgery to physical rehab without surgery. Improvement rates were found to be about the same.

Then came an even more interesting study in 2002 of 180 patients that compared knee arthroscopic surgery to cutting the patient but not doing the knee surgery. Sixty patients in the placebo group received skin incisions and underwent a simulated surgery without insertion of the arthroscope. Two other groups had one of two typical knee procedures: Sixty-one patients had arthroscopic lavage group, and 59 to had arthroscopic débridement.

Results showed, "At no point did either of the intervention groups report less pain or better function than the placebo group." Conclusions were, "In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure."



This does not mean that surgery does not "work" but that you do not have to have it or be rushed into it, if it is not right for you. There are other ways, often as quick, and less expensive and painful and without the limitations following. Take your time. Don't let anyone push you into something not right for you. Medical claims that you will get worse if you do not have immediate surgery have not turned out to be factual.


Related:

Surgery for Knee Arthritis, Meniscus, Unnecessary
What Works Better Than Knee Surgery?
Anterior Cruciate Ligament (ACL) Surgery Unnecessary
Hamstring to Quadriceps Ratios Not the Answer in Knee Injury

Labels: arthritis, fix pain, injury, knee, surgery

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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

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Pectoral (Chest) Stretch - The Most Common Mistake in the Best Shoulder Stretch

Mike Benson has sent several Fitness Fixer inspiring stories. In response to reader requests, he made us this photo set showing, "The most common mistake in the best stretch - How to not get any stretch from the pectoral stretch." I asked him to demonstrate this, because I see this mistake so often. People often "do" a stretch without "getting" a stretch.

Why is this stretch so good? Round-shouldered posture is a main contributor to neck and upper body pain and rotator cuff injury. Round-shouldered posture feels comfortable and natural when the front chest muscles are tight. A common mistake is to stretch the shoulder joint, which does not address this problem.

The purpose of the pectoral stretch is to lengthen chest muscles so that healthier positioning feels natural and comfortable. If you merely hold your elbow to the side, little lengthening can occur - shown in first photo:




Second photo below - changing the position to get the purpose - lengthening anterior (front) muscles that go across the chest. One way is to use a wall to help you press your elbow back.

• Turn your body and feet away from the wall.
• Your elbow is behind you, no longer out to the side.
• Raising the elbow higher or lower changes the stretch.
• Experiment until you only feel a stretch in the front chest and no pain or pinching anywhere in the shoulder:

• Keep shoulder down and relaxed
• Do not make any pain anywhere. The idea is to make things healthier, not to strain, push, force, tighten, grunt, and call that a health promotion activity.
• Understand the purpose first. The purpose of this stretch is to lengthen front chest muscles so that tightness does not pull you into feeling that round-shouldered position is the norm or that it is uncomfortable to straighten. Feel the stretch in the intended area.
  
• Use a mirror to help you connect what the position looks like with what it feels like.
• Use your brain.

Related:

Fix One Pain, Don't Cause Another
What Does Stretching Do?
The Stretch You Need The Least

More to Stretch the Anterior Chest:

Stretching With a Friend - Partner Pectoral Stretch
Pectoral Stretch was first introduced in Fixing Upper Back and Neck Pain
Quick, Feel-Good Upper Back and Chest Stretch

Mike Benson's Success Stories:

A Whole Big Fix
Fast Fitness - Core Hip & Body, Posture Strength & Balance
Flasher Exercises Not Best for Shoulder Pain
Healthy Youth Parties - Fun Exercise, No Junk Food

Labels: arm, chest, fix pain, posture, readers inspiring story, rotator cuff, shoulder, stretch

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How To Remember Good Kid Lifting and Carrying

Back pain from lifting and carrying babies and young children is common. Rehab and PT programs commonly have people spend time (away from their children and other important things they need to do) to lift weight to strengthen back muscles.

Here is an idea - if weight lifting helps, lift the kids. Just lift them right, so that you do not get the back pain in the first place. It is not the lifting that causes the pain.

Good Kid Lifting:

1. Prevents pain,
2. Strengthens your muscles,
3. Gives built in exercise (functional exercise the way your muscles work),
4. Increases contact with your young kids, important to their development,
5. Improves ability to keep time with your children fun, healthy, and happy.

Readers asked me to make reminders for them about how to lift and carry their young children.

I created several different reminders on good lifting, bending, carrying. Fun T-shirts for kids are available in several colors and fabrics. There are bibs, singlets, and shirts for babies, and fun Back and Neck Saver reminders for grownups too.

Related Post:
Mothers Day and New Parents Back and Neck Savers

Get the T-Shirt:
Click www.cafepress.com/AcademyGifts

Labels: children, education, fix pain, lower back, partner exercise, repetitive strain

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Headache From Head Position

Certain headaches can be initiated or aggravated by tense facial muscles (squinting, scowling, furrowing brow), and by tight, tense, overstretched muscles in back of the head, neck, and shoulders, common with letting the upper body slouch forward. Headaches from tight muscles were formerly categorized as tension headaches. A growing theory includes upper body muscle use among triggers of a different kind of headache, the migraine, previously thought of as only a vascular event.

The wide range of kinds of headache is not my major field of study. I had previously had results with patients retraining upper body position to stop tension headache. I was not aware my own research would be useful to people with other kinds of headache, so I am learning from my patients who frequently report stories just like this one recently in from engineer Johannes Ernst:

Dr. Ernst writes:

"Some mindblowing ideas one might come across by accident instantly convert you into a new missionary because they are so clearly and obviously true, no further check required. Your particular religion ;-) of fitness is one of them.

"I would summarize it as follows: if our ancestors, over 10's of thousands of years, had had as many ailments as we have today, the human race would have died out a long time ago. No ergonomic chairs but only rocks and logs to sit on? No exercise equipment? Not even one pill a day? Just leaves and furs instead of expensive mattresses and beds? Humans clearly had no chance.

"Well, but here we are nevertheless. So given how many ailments we have, something that we are doing these days must be much worse than what our ancestors did in the forests. Jolie's mindbogglingly straightforward answer: instead of using ever-more complicated medical and fitness tools and regimens, whose benefits, never mind costs, often are marginal or doubtful, what about we use our bodies how they were meant to be used? Duh!!

"The shameful thing is that medicine, as a profession, does not necessarily nudge anybody in that direction. Often, its leading practitioners seem totally oblivious to what should be a "Duh".

"What is wrong with this picture?

"In my case, over the course of 25 years of headaches, healthcare professionals on two continents, etc. etc., nobody, never, not once, suggested, that I could improve my posture. I got all the drugs, regardless of how expensive, few of which would make much difference other than to put me out cold.

"Last week, for the first time, about 6 weeks since I got a few of Jolie's books, I managed to extinguish an immobilizing headache through some rather simple exercises, completely without drugs. I totally expect that I will be able to do it again. (I did! This morning!)

"In case you ask, I do:

Pec stretch and trapezius stretch
Scapular mobilization exercise (in book Fix Your Own Pain Without Drugs or Surgery)
Upper and lower back extension (Fix Pain book)
Push-ups until I am sweating profusely or can't go any further; usually that happens at the same time ;-) (neutral spine for pushups covered in Fast Fitness - Strengthen by Changing Your Plank)
A concentrated effort to keep my shoulders back and down 24 hours a day, including at night, and my chin in.

"Not exactly hard, is it.

"Well, just had to get this off my chest.

"Cheer,
Johannes"

Dr. Ernst has more to report. To be continued in future posts.
I asked if he had a photo for us. He wrote:

"I didn't think I was quite bargaining for a photo. If you must, use this one, preferably unedited. It reflects my aspirations I think ;-)

"P.S. two out of three RSS/Atom feeds on your blog are broken."

Healthline tells me they are trying to fix the feeds, which continue to go down after each fix. Use the "subscribe by e-mail" option for convenience.

Related:

• Vertebral Artery Compression, Dizziness, Discs, and the Forward Head
• Is Your Drinking Hurting Your Neck?
• Gaze Perseid Meteors Without Neck Pain
• Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
• Easy posture reminders - BackSaver Gifts
  

Labels: fix pain, headache/migraine, neck, posture, readers inspiring story, repetitive strain

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Mothers Day and New Parents Back and Neck Savers

Readers, patients, and students have asked me for years to write down for them about good lifting and bending over babies and children. I wrote articles and books. I did experiments in the lab. They still said they couldn't remember. So I made something for all of you. You can give these to everyone in need for Mothers and Fathers days, coming up, and all year.

Here it is, quicker and easier than reading the books:


I designed singlets and one-piece suits for infants, T-shirts for toddlers and children, various sizes and colors.

One student had asked me to write down and hang the information around her neck so she would have an easy way to remember all the time. So I made a bib too - for the baby - so she could see it each time she bent to feed and lift.

I was surprised people wouldn't just remember on their own to live in a way so important to their health. But they kept coming back asking for me to tell them again. I am drawing the various concepts and putting them on daily items as funny reminders. I will show them in future posts if readers are interested.

Labels: children, education, fix pain, holiday, lower back, neck, partner exercise, posture, upper back

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Doctor Fakes Benefits in 21 Pain Pill Studies

A news report published in several publications including The Wall Street Journal stated that anesthesiologist Scott S. Reuben faked data so that it would seem that benefits occurred from painkillers like Vioxx and Celebrex. The studies had been published in several anesthesiology journals between 1996 and 2008.

Dr. Reuben had been a paid speaker for Pfizer, a powerful pharmaceutical company, and Pfizer paid for some of the research.

The journal Anesthesiology has retracted three of Dr. Reuben's articles. The journal Anesthesia & Analgesia has retracted 10 of Dr. Reuben's studies and posted a list of 11 of his studies published in other journals.

Jacques E. Chelly, head of acute interventional postoperative pain service at the University of Pittsburgh Medical Center, said that the situation has prompted his hospital to review the protocols it uses to treat patients for pain, because Dr. Reuben's work was so influential in establishing them.

Editor James C. Eisenach warned in an editorial in the journal Anesthesiology, stating:

"these retractions clearly raise the possibility that we might be heading in wrong directions or toward blind ends in attempts to improve pain therapy."

Other Problematic Drugs. Vioxx and Celebrex are not the only highly prescribed drugs that have been found less effective than advertised. Several major drugs prescribed for pain/fibromyalgia and headache were later ordered by the FDA to carry a Suicide Risk Warning:

• FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others

Where Does Some of the Information in Medical Books Come From?

• Fitness Myths - How Many Legs Does a Dog Have If You Call the Tail a Leg?
• Can We Teach Young Doctors to Be Healthy?
  
• What Medical Students Told Me About Nutrition

Healthy Ways To Stop Sources of Pain. Specific well-known medications and surgeries have found to be no more effective than less expensive and disruptive methods:

• Prevent Back Surgery
• Fix Disc Pain Without Surgery
• Studies Say Back Surgery Not Needed
• Surgery for Knee Arthritis, Meniscus, Unnecessary
• Anterior Cruciate Ligament (ACL) Surgery Unnecessary
• What Works Better Than Knee Surgery?
• Autumn Yard Work - Limiting the Person Instead of the Injury Again?

Labels: drugs, fix pain, surgery

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Fast Fitness - Better Legs and Pain Relief Comes From You Not The Exercise Ball

Here is Friday Fast Fitness - Be healthful when you do health activities. What a concept.

1. How fit is it to use fitness equipment in unhealthy ways?
2. When you pick up and put down an exercise ball, or any exercise equipment, how do you bend? Unhealthfully? During an activity you use to improve your health?
3. Robert Davis sent in this change of bad bending to good bending . Good bending shifts weight and leverage off lumbar discs and onto leg, hip, and back muscles.

Robert Davis wrote. "I had to use my cell phone on timer so the pictures are not the greatest quality."




Robert Davis was a weight lifter with a painful back injury from conventional lifting. He fixed his back pain with Fitness Fixer, intelligently applying principles of healthful movement for everything during exercise and also daily life. He wrote:

"I took a picture of what was causing "ouchy" because it is so normal in America *for adults!*.. (upper photo of forward bending). Then ouchy started to go away the more I did, 'ah much better' (squatting)... Pretty soon ouchy was gone from the bad forward bending.

"I am now doing a complete head to toe revision... Point was that my back stopped hurting, and as you said, heals when I let it, with better movement.

"I am glad there is someone out there like you who tells you how it is. It gives encouragement and hope. I have seen people my age already with a few surgeries (and they are in the 20s to 30s!). They were from injuries, and sadly they never had a chance to find that they didn't need it.

"I was encouraged by others' stories and with your statement, "don't let them scare you" because I was a bit scared. I have never been injured before with that much pain. But, I was more then willing to try this because I did not want limitation as I had seen in my friends who had surgery. Some multiple times. "

Mr. Davis has been sending in success stories one after then next. Here are some of his Inspiring Functional Fitness:

• Cardiovascular Cleanup
• Fixed Injuries, Got Strong, With Functional Exercise

Related Posts to Change Unhealthful Exercise

• Are You Making Your Exercise Unhealthy?
• The Cause of Disc and Back Pain
• How Often Should You Be Healthy?
• Common Exercises Teach Bad Bending
• Lung Training from the Exercise Ball
• Does an Exercise Ball Make You Sit Straight?

Labels: exercise ball, fast fitness, fix pain, lower back, readers inspiring story, squat, surgery

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Sunlight Eases Behavioral Problems of Dementia

Several studies have found that sunlight helped with depression and agitation in elderly people. It is likely that younger people benefit also.


Simple adjustments, not only in lighting, but scheduling daily outdoor activity and simple walks, may ease behavioral problems associated with dementia.

Click the label sunlight for ideas.

Labels: aging, depression, fix pain, sunlight

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Fast Fitness - Fixing Arches, Knock Knee, and Knee Pain Without Orthotics

Here is Fast Friday Fitness - Stop one major source of inward-turning knees (knock-knees). Click the movie arrow to run:

1. Look at your bare legs in a mirror with feet facing straight forward.
2. See if the knees turn inward to face more toward each other than forward.
3. Feel how the muscles can pull outward to gently move (not force) knee position. These muscles like to be used correctly, not left unused.

Often, knees turned inward are a simple case of letting body weight sag downward onto the inside of the leg and arch of the foot, not a case of unchanging anatomy. Pain often comes from letting the knees and ankles twist, rotate, and sag. Restoring neutral position can stop this source of pain.

Orthotics are hard inserts that hold your foot in a certain position. Orthotics are different from cushion inserts that make a softer landing for each step. You can control leg and foot position without orthotics. That doesn't mean orthotics don't work, just that you can do it without them. It's cheaper and you get a free leg muscle stability workout at the same time.

Remember, don't force. If it hurts, it's wrong. Creating new strain instead of restoring function is not health or good thinking. All you are doing is restoring muscle length and using that to learn how to stand neutral, not tilted so much that you compress your joints.

Labels: ankle, arches, fast fitness, fix pain, knee, orthotics, pronation, video/movie

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Your Muscles Are Your Orthotics for Arches, Knock Knee, and Knee Pain

David from Belgium has been a success story and valuable contributor. He frequently makes us photos and movies showing how to fix pain and unhealthful fitness using Fitness Fixer techniques. He first left a comment on a post in 2007:

"I'm training to be a yoga teacher and I'd love to teach the right things to my pupils such as good posture. Your insights are very inspirational. After struggling with minor but persistent knee pain for some years, I was diagnosed with seriously fallen arches recently. I'm not really flat-footed, but ankles that drop inwards too much. (I could clearly see that on the video my podiatrist made of me walking on bare feet). In a week I'll be getting new orthotics. Though, after reading a patient's testimony on your site I decided to try and use my feet differently. So now on my walks to and from my day job I'm trying to walk 'right'. Rolling on the entire foot, heel to toes, leaning more on the sides and using all five toes. It feels awkward though and I notice that I often forget it. I wonder if this will 'fix' my feet eventually? Anyway, thanks for sharing your knowledge!"

I replied that it "fixes" arch positioning as soon as you do it. It is natural to control how you stand and move - the whole intent of functioning in a healthy way in life, and the intent of yoga (supposedly). It seems at odds to say that yoga teaches body awareness, strength, or positioning, then let ankles slump without control, and purchase devices to do it for you. Once you understand the purpose, it will not be awkward. It is the same as any other good posture.

Since then, David has consistently made good use of these materials, and shared many success stories. He has fixed various pain producing habits for himself and his students, fixed his mother's herniated lumbar disc by showing her healthy bending around the house - Bending Right is Fitness as a Lifestyle, and developed a new yoga system of healthier movement - Getting the Right Yoga Medicine.

• Orthotics are rigid shaped devices, fitted by prescription, that specifically move and hold your foot in a certain position.
• Orthotics are different from over-the-counter shoe pads that can help by cushioning impact.
• Orthotics do not do anything you cannot do yourself using your own muscles and sense of positioning (kinesthetics).
  
• It is a myth that only a device can move your foot and leg leg. Click the label "myth" under this post for all Fitness Fixer posts on fitness myths.
  

Try these in relaxed way:

• Stand and see that you can raise your own arches back to normal, taught in the post Arch Support Is Not From Shoes. It takes only seconds.
• Understand more with Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Make sure you are also not pronating from higher up - Healthy Knees.
• Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints.
  
• The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.

During walking and running, a brief and small inward drop (slight pronation) occurs right after foot contact that creates part of the "spring" and propulsion. The idea is not to prevent all foot motion, but to not let the knee twist inward. You can do that with your own brain and muscles.

Check back tomorrow, Friday January 23 2009, for: Fast Fitness - Fixing Arches, Knock Knee, and Knee Pain Without Orthotics - with a short movie by David of restoring arches and knee position.

Labels: ankle, arches, feet, fix pain, knee, myths, orthotics, pronation, readers inspiring story, shoes, yoga

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Surgery for Knee Arthritis, Meniscus, Not Needed To Stop Pain, Restore Function

Good news. If you don't like or want knee surgery for most arthritis or meniscus injury, you don't have to have it. Lack of need for surgery has been demonstrated over many years in rehabilitation populations, and in a mostly ignored older clinical study. Recent studies confirm you can stop most pain and restore function just as well without surgery through good physical rehab.

Millions of Americans undergo arthroscopic surgery for knee pain every year. Over the last 30 years, arthroscopic surgery has been routinely accepted and prescribed for knee pain without undergoing rigorous evaluation.

Even when a 2002 study published in the New England Journal of Medicine (NEJM) found that results of arthroscopic surgery for knee osteoarthritis were no higher than medicine and physical therapy alone, the surgical community "remained unswayed."

Dr. Brian Feagan, co-author of a study in the Sept. 11 2008 issue of the NEJM stated, "It really didn't change practice that much. That's why this second [study] was really important."

Feagan's randomized, controlled trial involved 178 patients, average age 60. All had moderate-to-severe osteoarthritis of the knee. Half underwent arthroscopic surgery plus medical and physical therapy. The other half used medical and physical therapy alone. After two years, both groups' scores on a measure of arthritis severity were about the same.

A second study also published in the same journal issue, found that meniscal tears are common in the general population and, "may not, in fact, be responsible for painful symptoms." That means that if you have knee pain, and have scans and imaging which show a meniscus tear, it may not even be the tear that is causing the pain.

"There's going to be a swing in practice," said Dr. Feagan.

Study authors stated that meniscal tears detected on MRI may confuse matters and lead to unnecessary therapy. This is a similar finding to back pain where patients with pain are shown to have a herniated disc, stenosis, or other finding, but the pain is not from the anatomical finding, but the same bad movement habits, slouching, and lack of good movement that make anyone hurt. Discs also often appear herniated, and spines compressed by stenosis on scans of people with no back pain. Don't base your treatment and future on a picture. Scans are not tea leaves.

Poor knee stability increases risk of developing arthritis, and increases wear on the meniscus. Studies tracking results for years following surgery are finding that surgery "adds no benefit over rehabilitative training alone." That means you don't need the surgery to fix or prevent possible future arthritis.


You don't have to have surgery to stop knee pain:

• What Works Better Than Knee Surgery?
• Anterior Cruciate Ligament (ACL) Surgery Unnecessary

How to fix and prevent knee pain from arthritis and most meniscus injury:

• Healthy Knees
• Daughter's Love Saves Parent's Knees
• Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life
• You Can Fix Your Own Knees
• Prevent Knee Pain When Rowing
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Why So Many Aerobics Injuries?
• Walking Softly Benefits Olympic Wrestler
• Save Knees When Squatting
• Arch Support Is Not From Shoes
• Strengthen Legs Without Knee Pain - Standing Lunge
• Down the Stairs
• Better Exercise on the Stairs
• Most Helpful Olympic Advice So Far

Labels: anterior cruciate ligament/ACL, fix pain, injury, knee, martial arts, meniscus, repetitive strain, surgery

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Fast Fitness - Hip Stretch and Spine Stability Training When Stretching Legs

Here is Fast Friday Fitness - Retrain your standing leg stretches to hold your spine and hip in healthful position, get more stretch to the front of the hip, use your back muscles, practice balance, and learn functional stretching - the way your body needs to move in real life in a healthy way.

When you raise one leg to stretch when standing:

1. Keep your standing leg straight. Don't bend at the knee and hip, as pictured.
2. Don't round your back or let your pelvis and hip round under you, as pictured.
   
3. Stand straight. Relaxed. Don't force or strain. Breathe.

When stretching, remember function. Why practice a position that is rounded, tight, and detrimental to how you move in real life when you lift your legs. It would look silly and unhealthy to stand up that way. Why stretch that way?

Get functional stretch by lengthening your body enough to be able to straighten out. That is the purpose of the stretch.

Use the new length and your brain to stand straight. Transfer the positioning to real life when you are standing and lift one leg to take stairs, kick, dance, play sports, climb over things, and other life activities. Standing without being so tight that you round your body forward, or just round from habit, is healthier, better looking, burns more calories, and stops many sources of chronic aches and pains.

Send me your photos of fixing this stretch. Doing is the best learning. I will post the photos in a reader success story.


See how to retrain this same stretch lying down:

• Fast Fitness - Don't Shorten Hip When Stretching Hamstring

See photos of fixing this same stretch for kicking and stairs:

• Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs

Related posts:

• Improve Stretch and Strength With Better Kicking
• What Does Stretching Do?
• Are You Making Your Exercise Unhealthy?
• Better Achilles Tendon Stretch
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• Is Bad Martial Arts Good Exercise?
• The Cause of Disc and Back Pain
• Better Exercise on the Stairs
• Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs

Labels: balance, fast fitness, fix pain, hip, hip stretch, leg stretch, lower back, posture, stretch, upper back

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Logo Design Contest for New International Sports Medicine Academy

In November, we announced a new International Sports Medicine Academy.

The International Academy of Functional Sports Medicine was formed to provide:

• Evidence-based education in functional physical medicine, training, sports medicine including diving medicine, and rehabilitation,
• Internationally attended sports medicine congresses,
• Certifications for physicians, allied health, physical therapists, fitness instructors, massage professionals, and the public,
• Fellow advancement opportunities for physicians and researchers.

We are non-sectarian and dedicated to peace and health of all. We accept no advertising from unhealthful "health and sports" products. Part of course tuitions go to medical research, charity, and elderly help.

We are holding a contest to design the Academy logo. Winning logo will be seen internationally with credit to the designer. Logo designs should be simple, incorporate the concepts of brains and functional strength. Other concepts and ideas welcome.

If you are interested to help through your logo design submission, or other good ideas and talents, or be part of this organization, let me know. Be prepared to have fun and use your brain. To see how, the new Academy web site is www.DrBookspan.com/Academy.

Labels: education, fix pain, mind

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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

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New Years Resolutions for Fitness Success - Reader Hall of Fame

Happy New Year to readers on the Gregorian Calendar.

Happy day to the rest.

For your New Year's Resolutions, here are real stories from readers that appeared here on Fitness Fixer.

Readers tell how they used these methods for stronger, healthier, pain free, happy, more active life:

• Physical therapist George Nakhlé is assisting me to develop an entire new International Academy of Functional Sports Medicine using my methods.
  
• David of Belgium developed and teaches an improved new yoga system. He presented it at a world yoga congress. His system corrects for the widespread pain syndromes from flexion overuse, and reduces the cause instead of adhering to set ritual pose sequences - Getting the Right Yoga Medicine. He continues to translate my work into Dutch, create links for posts to reach world audiences, and make dozens of photos and videos for Fitness Fixer posts.
  
• Dr. Clara Hsu teaches Fitness Fixer methods to patients in her practice, prescribes my website, gives my books as presents around the world, and has offered her office space to hold workshops for our new International Academy - How Doctors Help Patients With Fitness Fixer and How Doctors Use The Wall Stand.
  
• Mr. America, Jim Morris, internationally encourages goodness and my Ab Revolution retraining technique - Mr. America Urges Goodness and Responsibility

• Leslie - Are You Stronger Than A 67 Year Old Lady?
• Ivy - Farm Work, Lifestyle Exercise, and Preventing Overuse Pain
• Ivy - Good Life Works Better Than Bad Ab Exercise
• Zoe - Don't Confuse Exercise With Real Fitness
• Mike demonstrates - Fast Fitness - Core Hip & Body, Posture Strength & Balance
• Terry Lee tries the handstand in the comments of Fast Fitness - Handstand Rows
• Liz Brown M.D. does her morning handstands in the comments of Thanksgiving Health
• Liz teaches how to overcome thinking that you can't do the handstand - Wall Handstand Success With Liz
  

• Sylvia - Fixing Foot Drop
• Ivy - Inspirational Ivy and Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier

• Rich T - Fix Neck, Play Hockey, Use Brain, Fun Life
• Bill - Freed From Pain, He Rides Again and Inspirational Update from Bill

• After 4 years and physical therapy didn't fix his pain, this "Big D" athlete tells how it is done - Fixing Posture - No Exercise Needed

• Mike - Flasher Exercises Not Best for Shoulder Pain
• Hanson stops shoulder pain caused by yoga - Overhead Lifting, Reaching, and Throwing - More Part I

• Kristin - 14,000 Miles on a Bike - Herniating and Fixing Discs
• Barb - Feeling Better Than She Ever Has Part I - Fixing Herniated Disk and Reclaiming Active Life and - Feeling Better Than She Ever Has Part II - Fixing Herniated Disk and Reclaiming Active Life

• Ted - Back Pain From Running
• Nick - Prevent Main Factor in Back Pain After Running and Walking
• Carina - How Much Inward Curve Space Should There Be In The Lower Back?
• Jean Christophe requested this post - Lower Back Pain and Golf
• Jeff - Fixing Pain and Golf Easier With Real Life Movement Than Isolated Exercises
• Liz - Which Stretch Stops Back Pain by Making Neutral Spine Possible?

• Bernie - Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I and Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II

• Zoe - Exercise and Cancer and Don't Confuse Exercise With Real Fitness

• Ivy - Is Healthy Living Less Expensive?
• Lily sends - Non-Plastic Non-Aluminum Sports and Fitness Food Carriers

• David from Belgium - Your Fitness Fixer Requests in the Works
• Jill - Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life
• MMLash - You Can Fix Your Own Knees
• Diana fixed her ankles, and demonstrates while I film her - Sprain Prevention and Rehab Training
• David from Belgium filmed himself demonstrating - Fix Flat Feet, Pronation, and Fallen Arches

• Kristin - 14,000 Miles on a Bike - Herniating and Fixing Discs
• Liz - Which Stretch Stops Back Pain by Making Neutral Spine Possible?

• Mike sent us - A Laugh at Sedentary Mindset

• Barb - ER Nurse To Her Own Rescue
• Liz - How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!
• Jean Christophe - Readers Count - Second Missed Cause of Back Pain With Golf
• Jeff - Fixing Pain and Golf Easier With Real Life Movement Than Isolated Exercises

• Ted - Runner Fixes More Pain With Straighter Push-Off
• Ivy - Getting More From a Hip Stretch

• My student Christopher fixed serious martial arts injuries and demonstrates - Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs
  
• David S demonstrates a different way to do the lying figure 4 hip stretch - Fast Fitness - Better Posterior Hip, Iliotibial, and Piriform Stretch
• Mike shows the seated figure 4 - A Whole Big Fix
• Bernie, who is 80 years old - Relaxing Hip, Leg, and Groin Stretch and Quick Relaxing Hip Stretch
• Pearl - Pearl is 97 (she will be turning 99 this coming February!)
  
• Dr. Ernie - Better Stretches for Swimming - Cook Strait Update
• Steve K demonstrates - Fast Fitness - Great Hip, Side, Leg, and I.T. Stretch
• I filmed a short movie of my student Ms. Han demonstrating how to sit on the floor and rise without hands - Functional Agility, Flexibility, Strength
• David of Belgium took time to make many movies for us to see methods better, this one to increase hip stretch (carefully) - Fast Fitness - Balance, Strength, Stretch, and Socks
• David of Belgium also took many photos to demonstrate fun ways to increase strength, balance, and stretch - Easy Handstand
• Ivy - Strengthen and Retrain Function With The Lunge
• Vikki, a Search and Rescue Paramedic demonstrates - Quick Hamstring Stretch At Work

• Mom V enrolled daughter - After School Trapeze Arts is Good Exercise

• Dr. Ernie swam it - Sixteen Miles of Cold Water and Getting Fitter in 50 Degrees

• Steve K - Fun Steve Loses Weight With Fitness Fixer
• Dr. Ernie - Nutrition for Endurance Swim Training
• Jill - Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life

• Marla - Fix Scoliosis and Arthritis Pain, Fix New Orleans

• Bill - Stronger Pain-Free Wrists When Biking
• Stephie fixed her knee pain by not letting her arches flatten when standing (see knee and arch links), and demonstrates - Prevent Wrist Pain During Pushups and Cooking

• Dean and Ivy - How Strong Is Your Arm? - Readers Find Out
• David reminds us - Health Can Occur on Weekends Too

• Bernie - Cauda Equina - Result Not Cause

• Rich T reminds - Fix Positioning by Watching Others

• Joe - Married 63 Years With Good Balance
• Bernie - Fast Fitness - Dynamic Partner Balance Challenge

• Katayon - Daughter's Love Saves Parent's Knees
• Ginger - Student Balances, Listens, Fixes Father's Back Pain
• Ivy - Each One Teach One
• Mike - changes school programs to be healthier - Healthy Youth Parties - Fun Exercise, No Junk Food
• An anonymous reader took time to find a neighborhood association with volunteers to shop and deliver a food order at no extra charge to the blind diabetic widow in - Thank You To Readers - Simple Gifts

• Mike - A Whole Big Fix
• Dennis fixed knee, ankle, foot, lower back pain - Walking Softly Benefits Olympic Wrestler
• Bernie - Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries.
  Ivy - Inspirational Ivy

Thank you everyone for using my methods for Good. Thank you for writing your stories for others to benefit. Congratulations on your great work.

Thank you readers Mim, Kate, Al, Kathy, Julia, PhatMac, Eddie, Carol, Dave, Tony, Anton, Terry Lee, Airchild, Teresa, Nina, Marina, Wondering Oriental, 9Volt Terry, Alberto (farioreo), Kip, Lee, Ness, Jayakrishnan, Michael LMT CNMT who gives his massage clients the Fitness Fixer and my professional website DrBookspan.com as their homework, and all the others who wrote their success stories in the comments of various posts.

Hundreds more, too shy to have their story online, mailed me the best thanks - that because of these methods, they had their lives back.

Labels: fix pain, holiday, readers inspiring story, spirit

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How Doctors Use The Wall Stand

A reader wrote in that he tried the "wall test" done by standing with your back against a wall. The wall test is a quick general assessment to see if you can comfortably stand up straight, and if not, where the tightness exists that prevents it. The reader said the test hurt. He was angry and wanted me to warn everyone not to do the wall test.

The point of the wall test is to see if you are generally standing upright, or have tightness preventing healthy stance, not to cause pain by forcing it. If you can't comfortably stand straight, it is likely that you are going about your day in a tight, crooked position that contributes to pain syndromes and gradual spine and disc damage. That is the point of doing the test - to determine the source of the problem right then. Then, see if it is just a bad habit of how you stand, if you don't know how to stand well, or if tightness prevents it. Specific functional stretches easily restore resting length to the area. Then you use the new ability to stand and move in healthy ways.


In the photo, Dr. Clara Hsu stands well while checking a patient. In the photo, the patient looks tight, both at the hip and the front of the shoulder. The patient seems to be straining to pull in her chin. She is lifting her ribs and overarching the lower back to try to get the upper body to the wall. These two compensatory moves are things to check for. Instead, pull neck and chin back loosely. Bring upper body upright by unroundng the upper back, not by leaning back, increasing the angle at the lower spine.

Dr. Clara Hsu was featured in a reader success story in How Doctors Help Patients With Fitness Fixer.

The wall test is a general test, not an exercise. It shows three things:

1. How you are standing at the moment, and perhaps as general habit
2. Where bad habit or tightness may be that prevents standing in healthy positioning, for example a forward head, bent or tight front hip where it meets the leg, or overarched lower back
3. The wall test is done a second time as immediate feedback after doing specific retraining stretches, to see how well you have achieved the purpose of the stretches to restore normal length of these areas.

The wall test is a general, not absolute measure. The assessment works for most body types. Many people who think that larger lower body prevents upright stance, may actually be standing bent forward at the hip.

Straining to stand straight is not healthy straight standing. Making it possible to be healthy is the point. Causing more pain would be silly, and counter to the point. Often it is just a matter of identifying what is straight stance using the wall test, and standing better from then on. If the wall stand is uncomfortable, or not possible, check your standing habits. If there is tightness, then stretch the hip, shoulder or wherever else is holding you in tight bent position.


To stretch front chest and hip to make straight standing comfortable:

• Fast Fitness - Quick Relaxing Hip Stretch
• Hip Stretch While You Strengthen Legs
• Fixing Upper Back and Neck Pain
• Nice Neck Stretch
• Friday Fast Fitness - Better Shoulder and Triceps Stretch

Posts to understand and fix compensatory movements:

• Breasts Causing Upper Back Pain is a Myth
• Fast Fitness - How to Feel Change to Neutral Spine
• Fix One Pain, Don't Cause Another

Coming soon, Dr. Clara Hsu asked me to tell the story of, "Class is always in session."

Labels: fix pain, hip, posture, readers inspiring story, stretch

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Anterior Cruciate Ligament (ACL) Surgery Unnecessary

After injury to the anterior cruciate ligament of the knee (ACL) it is common to be told that surgery is the only way to restore function. Is it?

Ninety percent of ACL injuries in the U.S. are treated with surgical reconstruction. A study reported in the Dec. 15 issue of Arthritis & Rheumatism found that, "Two to five years after treatment, patients had similar muscle strength and function whether they had training alone or with surgery." The study concludes, "Reconstructive surgery is not a prerequisite for restoring muscle function." That means you can have good results with good rehab and without surgery.

A second question is development of ostoarthritis following ACL injury. Poor knee stability increases risk of developing arthritis. Studies tracking results for years following the surgery are finding that surgery "adds no benefit over rehabilitative training alone" and that surgery is done, "despite an absence of evidence to suggest that reconstruction of the ACL prevents or reduces the rate of early-onset osteoarthritis." That means you don't need the surgery to prevent possible future arthritis.

Another common myth is that knee injury comes from "muscle imbalance" in the thigh from too much strength in the quadriceps muscles over the hamstring muscles. The strength of a muscle does not make you move it. That means you control whether you overstraighten a knee or not. It is a use issue, not a strength ratio. Future posts will cover the issue of quadriceps to hamstring ratios and injury to the ACL and other knee structures.

You don't have to have ACL surgery to rehab a knee injury.

Fitness Fixer Posts on Fixing Knee Pain Without Surgery:

• What Works Better Than Knee Surgery?
• Healthy Knees
• Daughter's Love Saves Parent's Knees
• Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life
• You Can Fix Your Own Knees
• Prevent Knee Pain When Rowing
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Why So Many Aerobics Injuries?
• Walking Softly Benefits Olympic Wrestler
• Save Knees When Squatting
• Arch Support Is Not From Shoes
• Strengthen Legs Without Knee Pain - Standing Lunge
• Down the Stairs
• Better Exercise on the Stairs
• Most Helpful Olympic Advice So Far

Meniscus. Coming Next:

• Surgery for meniscus repair found to be not needed to restore function or prevent later injury - Surgery for Knee Arthritis, Meniscus, Unnecessary.

Hamstring to Quadriceps Ratio:

• Hamstring to Quadriceps Ratios Not the Answer in Knee Injury

Helpful Books, available from my BOOKS page - www.DrBookspan.com/books:

• Fix Your Own Pain Without Drugs or Surgery
• Health&Fitness - How To Be Healthy Happy and Fit For The Rest of Your Life. THIRD edition.

Labels: anterior cruciate ligament/ACL, fix pain, injury, knee, leg strength, surgery

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Reader Successes Endure - Next Update From Bill

After being told he'd have to retire, have surgery, and live with pain forever, Coast Guard Lieutenant Bill S. attended my workshops and went to on return to marathon biking and new work flying cargo 747's around the world - with Captain's bars. Bill has contributed three previous success stories (links below). He keeps in touch and signs his updates "Free Man."

Bill wrote me two notes of thanks over Thanksgiving:

"Hi Dr. Jolie,
" I just wanted to say "thanks" for all the help. I would not be able to do my job or enjoy my strenuous activities if we had not done something about the pain. I have much to be thankful for. I cannot start the day without remembering you as I healthfully stretch on my elbows before rising from bed. I am well though my family thinks I'm nuts as I continue to enjoy my 10km runs, 50km hikes and 100km bike rides. The activity is healthy and gives me much to look forward to. I do something everyday I can as it clears the cobwebs from my head and chases the blues away!

" Still flying as 747 captain. I could not do it without the fitness I am maintaining. I am enjoying the job more than initially. My confidence is back.

" Hot new subject: teaching myself to weld and braze so I can design and build bicycles. I am no longer happy with buying frames made by others. Wish me luck. I hope I don't burn down my garage!

" Hope you are well and enjoying all things. Your blog is a frequent inspiration."
Take care, safe journeys,
your friend,
Freeman(really!)

We are still having trouble uploading photos, so imagine the photo of a happy fit Captain Bill standing at the: top of the steps in Liege, Belgium.

Related Post With Photo:

• Stretch on elbows before rising from bed - Fast Fitness - First Morning Stretch

Captain Bill's Success Stories:

• Inspirational Update from Bill
• Stronger Pain-Free Wrists When Biking
  
• Freed From Pain, He Rides Again

Labels: biking, fix pain, readers inspiring story

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FDA Orders Suicide Risk Warning for Common Back Pain and Migraine Drugs, and Others

The FDA issued a public health alert today based on their review of 199 clinical trials. Specific drugs for epilepsy and psychiatric disorders are often prescribed to patients with migraine, back and body pain. The FDA review was released last January, and showed that patients taking those drugs had "almost twice the risk of suicidal behavior or thoughts than patients taking a placebo."

One of the drugs on the warning list is Neurontin (Gabapentin). Patients with back and various nerve and diabetic pain are commonly prescribed this drug. More drugs on the list are frequently prescribed for fibromyalgia and other pain: Lyrica (Pregabalin), Topamax (Topiramate), Celontin (Methosuximide), Felbatol (Felbamate), Zarontin (Ethosuximide) and others.

Here is a list of the medications required to add the warning:

* Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
* Clonazepam (marketed as Klonopin)
* Clorazepate (marketed as Tranxene)
* Divalproex sodium (marketed as Depakote, Depakote ER, Depakene)
* Ethosuximide (marketed as Zarontin)
* Ethotoin (marketed as Peganone)
* Felbamate (marketed as Felbatol)
* Gabapentin (marketed as Neurontin)
* Lamotrigine (marketed as Lamictal)
* Lacosamide (marketed as Vimpat)
* Levetiracetam (marketed as Keppra)
* Mephenytoin (marketed as Mesantoin)
* Methosuximide (marketed as Celontin)
* Oxcarbazepine (marketed as Trileptal)
* Phenytoin (marketed as Dilantin Suspension)
* Pregabalin (marketed as Lyrica)
* Primidone (marketed as Mysoline)
* Tiagabine (marketed as Gabitril)
* Topiramate (marketed as Topamax)
* Trimethadione (marketed as Tridione)
* Zonisamide (marketed as Zonegran)
Some of these drugs are also sold generically.

I will be covering migraine and other headache in the future. Instead of drugs to mask back pain, neck pain and various musculoskeletal and nerve pain, fixing the cause is healthier than drugs. By no longer injuring the area, the pain will stop and the area can heal. It is not matter of choosing between pain and often worse problems from the treatment.

To stop common causes of pain, and the need for drugs, start with these:

• Disc Pain - Not a Mystery, Easy to Fix
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• The Cause of Disc and Back Pain
• Fix Disc Pain Without Surgery
• How Much Inward Curve Space Should There Be In The Lower Back?
• Fast Fitness - Prevent Back Pain When Rowing
• Fix Scoliosis and Arthritis Pain, Fix New Orleans
• Prevent Knee Pain When Rowing
• Prevent Main Factor in Back Pain After Running and Walking
• Prevent Back Surgery
• Gaze Perseid Meteors Without Neck Pain
• Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
• Upper Back Exercise and Neck Pain Prevention Too
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I
  
• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II
• Cauda Equina - Result Not Cause
• Healthy Mother's Day
• Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
  
  

Also recommended, available from my BOOKS page - www.DrBookspan.com/books:

• Fix Your Own Pain Without Drugs or Surgery
• Health&Fitness - How To Be Healthy Happy and Fit For The Rest of Your Life. THIRD edition.
• The Ab Revolution - No More Crunches No More Back Pain THIRD edition.

Labels: diabetes, drugs, fibromyalgia, fix pain, headache/migraine, injury, lower back, stenosis, upper back

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What Works Better Than Knee Surgery?

New studies have been making big health news. These studies conclude that knee surgery is not needed to rehabilitate after several kinds of knee injuries, and that "question the benefits of the surgery." This information is not new. How do I know this? Because of years of previous studies concluding that surgery "worked." Here is what those previous studies often meant:

About 10 years ago, I attended a sports medicine conference. A new line of knee surgeries had come out, and the surgeons and manufacturers of the products used were anxious to have their surgery accepted and endorsed. One of the clinical presentations of the conference was the results of a study that compared patient outcome after knee surgery to the outcome of physical rehabilitation without surgery.

The patient group receiving physical therapy had improvement of function and reduced pain over time. The sample undergoing surgery went through the risks of anesthesia and surgery, lost work and wages, pain controlling narcotics during surgery and recovery, reduced activity for a minimum of 2 months following surgery, and pain from the surgical area. They then underwent months of physical therapy to regain function lost from the surgery. Many had permanent reduction of knee range of motion, considered "standard and acceptable" for that surgery. The loss of range can reduce function of the area, and reduce ability to stretch the hip, which can cascade years later into further restrictions. The physical therapy group had improvements that started soon after beginning treatment. The surgical group initially had decreases in all measures of strength and function, then months of painful recovery, and further months of reduced physical condition while they worked to "get back in shape."

Patient outcomes of muscle strength and pain levels were compared after two years and found roughly equal. The conclusions of the study were that surgery was effective, since two years afterwards, patents in the surgical group had made gains equal to the therapy group. I raised the question to the presenters about the initial painful recovery, then months of recovery, which the therapy group never had to experience. They were angry that I could not see that the outcome measures were equal, so "all's well that ends well." They pointed out that their surgical patients often thank them because they, "wake up and the pain is gone." They omitted that post-surgical patients are on pain relieving drugs, often narcotics.

I do not judge my own patients to be fine, or a method to be worthwhile, if they have to endure loss of mobility and physical levels at all, let alone over two years.

What works better than knee surgery? Physical retraining of how you use your knees when walking, running, and other activities.

It is common to do exercises to strengthen the legs, then walk away from those same exercises allowing the knees to sag inward, slide, or twist in directions different from the line of the joint. The chronic unequal loading grinds, stretches, and wears at various bands of cartilage that connect upper and lower leg bone (ACL and PCL), meniscus cartilage, can grind the inside of the kneecap causing pattelo-femoral pain, and can even wear away at the shiny smooth cartilage covering bone ends (the articular surfaces), predisposing to arthritis.

You don't have to have surgery to stop pain. Here are Fitness Fixer posts on fixing knee pain without surgery:

• Healthy Knees
• Daughter's Love Saves Parent's Knees
• Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life
• You Can Fix Your Own Knees
• Prevent Knee Pain When Rowing
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Why So Many Aerobics Injuries?
• Walking Softly Benefits Olympic Wrestler
• Save Knees When Squatting
• Arch Support Is Not From Shoes
• Strengthen Legs Without Knee Pain - Standing Lunge
• Down the Stairs
• Better Exercise on the Stairs
  
  

Coming next Monday - Surgery for anterior cruciate ligament (ACL) repair found to be not needed to restore function or prevent later injury - Anterior Cruciate Ligament (ACL) Surgery Unnecessary.

Labels: anterior cruciate ligament/ACL, fix pain, injury, knee, meniscus, surgery

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Vertebral Artery Compression, Dizziness, Discs, and the Forward Head

I received an e-mail from Serbia. Miroslav had suffered eight years of dizziness from compression of the vasculature and nerves of his neck. Then he found how to prevent the bad position called "forward head" using my methods. Miroslav had previously read various sources promoting the often-repeated bad advice to bend the neck forward as a the way to make space for the nerves that exit the back of spine. A little knowledge is a dangerous thing. That kind of forward bending is not a healthy way over the long term.

Bending the spine forward pinches vertebrae closer in front and farther apart in back, creating unequal pressure that over time, wedges and squeezes discs rearward and outward, like squeezing a tube of toothpaste. A disc nearly always bulges (herniates/moves/slips/migrates/extrudes) toward the back of the spine out the enlarged space, from years of the bad posture of sitting and standing with a rounded/bent forward spine.

Sitting and standing straight would make more space for the nerves without the herniating force. Miroslav also had a forward head as a regular posture, also called "straightening the cervical lordosis." He had been flexing his neck (bending forward) trying to fix his various numbness and pain, and wound up compressing verves, blood vessels and other structures.

Miroslav wrote in one of his blog posts that he was practicing Alexander technique for the previous few weeks, "as specified in Richard Brennan's book /head up and forward." After getting worse and trying various doctors and cures, Miroslav found my web site. He wrote:

"Dear Dr Bookspan,
"I have found Your articles online and they have been extremely helpful. I just wanted to say that I appreciate Your work immensely. Few last articles I wrote on http://cvelee.blogspot.com/2008/11/quick-solutions.html regarding my problem and how You have helped me. If You have time, you can catch a glimpse of them.
"With respects,
"Miroslav Cvetinov"

Here is the post from his blog:

"Q u i c k s o l u t i o n s

"I am strong opponent to quick solutions to many of our everyday problem, whether money or health related. In such manner, I didn't expect my dizziness to disappear over night without trace.

"I had it since 2000. So 8 years before, they did everything necessary to rule out other diseases : EEG, Dopler, Blink reflexes, Evoked potentials... everything clean.

"In 2007. dizziness worsened so neurologist sent me to do endocranium MRI/MRA. Totally clean: no lesions whether white MS or atherosclerotic, balanced blood flow...

"2008. I have found article from Dr Jolie Bookspan, describing forward head posture and neurological deficits. I did have extremely straightened cervical lordosis, so I qualify for FHP. I started practicing healthy head postures : head back and FLEXION.

"I always thought that neck flexion was the key to healthy disc, because it opens neuroforamen, and that that degree of neck flexion wasn't possible without FHP. But, guys, I am physics scientist, I do not know how did it miss me : head-neck system has 5 degrees of freedom. I could pull it back, yet keep healthy degree of flexion. Just think of extending back of the neck while shortening front portion of it. That compulsive strengthening of SCM muscles I did, didn't do me any good, but...

"Anyway, MY TREMENDOUS DIZZINESS DISAPPEARED IN A MOMENT!! MOMENT, not day, not week, immediately. How? I do not know! I do not care! Thanks Dr Jolie.

"I can look over my shoulder while walking now. Easily without dizziness, loss of balance and lightheadedness. This it totally new.

"I have to give credit to 2 doctors more:
1. Dear ENT Vukoja Novak - he was the first one out of many doctors to tell me that if I consider it real, organic disease and not anxiety/panic related, I should check out carotid arteries on Doppler and cervical spine on roentgen. Latter revealed disk degeneration and straightened lordosis. He was the first to point to the spine.
2. Dr Mijanović - While doing EMG, he told me that tongue is clear except huge amount of hyperexcitability and asked me to check out something serious and real. I suggested left arm, with disesthesia running in C6 dermatome. He asked me about dizziness, I told him " I do have it, a lot of it, but dear doctor, I have panic disorder and somatoform disorder. It is due to this.". After poked me with a needle in left deltoid he immediately said "I can assure you, your dizziness are due to your spine."

"So, now I know. Not that it was spine, it can be cured in a moment:)"

Here is my web site post that Miroslav used: http://www.drbookspan.com/NeckPainArticle.html

These Fitness Fixer Posts explain more:

• Quick Fix?
• Fixing Upper Back and Neck Pain
• Overhead Lifting, Reaching, and Throwing - More Part I
• Disc Pain - Not a Mystery, Easy to Fix
• 14,000 Miles on a Bike - Herniating and Fixing Discs
• Breasts Causing Upper Back Pain is a Myth

Labels: dizziness, fix pain, impingement, injury, myths, neck, neutral spine, readers inspiring story, repetitive strain, upper back

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14,000 Miles on a Bike - Herniating and Fixing Discs

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:

• To understand and stop disc injury - The Cause of Disc and Back Pain
• To see the forces that herniate discs - Disc Pain Not a Mystery Easy to Fix
  
• The first thing to do - Fast Fitness - First Morning Stretch
• Then retrain healthy biking position by noticing bad rounding - Are You Making Your Exercise Unhealthy? and retrain good sitting in general with Long Sitting - Simple and More Comfortable
• The hamstring stretches Kristin was given were contributing to her herniated discs - Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• 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.
• She didn't need any surgery - Fix Disc Pain Without Surgery and Studies Say Back Surgery Not Needed
• Apply these principles to all your sitting sports - Prevent Back Pain When Rowing
• Apply these principles to all daily life - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending and How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending
• When should you use these principles? - How Often Should You Be Healthy?

Kristin followed the principles (above). She quickly recovered and went on with her bike tour, which lasted a full year.
Here is Kristin's web page about the ride: http://www.earthcycle.org/index.html
Click here to download her pamphlet: http://www.earthcycle.org/Pamphletengadult.pdf
Here is a page on her web site on easy healthy household tips: http://www.earthcycle.org/factsEnv.htm
Click the photo links below to see more phots of Kristin.

Labels: biking, disc, fix pain, hamstring, injury, readers inspiring story, spirit, yoga

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How Much Inward Curve Space Should There Be In The Lower Back?

Reader Carina asked a good question on the post Prevent Back Surgery about how much space there should be in the lower back inward curve. Comments were not accepted by the Blogger software for several weeks, and I could not reply in the comments. Her question is so good, it was chosen for this Fitness Fixer post.

Carina writes:

"Hello Jolie,
"Your information is so wonderful. Thanks for this stuff it's priceless.

I have been using the wall trick during the day when my back hurts (How to Feel Change to Neutral Spine). Wow it feels great. Only thing I can't STAY and walk like this. My knees are STUCK bent (or I go back to the big arch). I'd seriously look very odd walking around with bent knees. So here are my questions

"1) How much of my hand should go through when I am standing against the wall???
When I stand at the wall and do it naturally I can stick my whole arm to my elbow behind the arch.

"2) Besides these links you provided from a previous question
Fast Fitness - Quick Relaxing Hip
and
http://windowsxp-privacy.net/?id=198760105 "
(Note - the above link didn't come through in Carina's comment; I don't know which it is.)

"is there anything that helps me walk in neutral spine and not looking silly?
"Thanks for caring about our backs,
Carina"

Carina, great work. You have found that simply changing spinal angle (wall "trick") to reduce overarching works right away to reduce cause of pain. Next, here is how to retrain neutral spine into a normal natural stance:

1) Don't worry about "How much hand fits." It doesn't indicate amount of overarching. Lower spinal angle is what matters. Body proportions change the distance from wall - independent of spinal angle.

• If you have too much tilt to the pelvis or you lean the upper body backward, lower spinal angle increases. To reduce an arch that is large, press the lower back closer to the wall.


• The post Neutral Spine or Not? shows how to tell if your hip (pelvis) is tilted or straight, and/or if overarching (hyperlordosis/swayback) is coming from the upper body (leaning back). The wall maneuver shows you how to reduce the overarch. Don't press flat against the wall or you'll round like a beetle :-)


• While standing at the wall, see if you can do a small "crunch" movement without rounding your upper body forward, to reduce the overly large arch. Movement is just from the hip and mid-torso. Hopefully, you will feel that you easily move the body without bending your knees. That should produce reduced lower back arch. Send some photos if you like and I will take a look.

2) Next, you need to make it possible and comfortable:

• Check if you are tightening muscles. Don't tighten or clench backside or abdominal muscles. Tightening makes it harder to move to neutral - Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine.


• See the post for stretches to restore length to the areas needed - Which Stretch Stops Back Pain by Making Neutral Spine Possible?


• Check how you are standing. Don't try to touch the back of the legs to the wall. Just heels, backside, upper back, back of head.


• Thank you for already checking the other links and finding the relaxing-hip-stretch. I couldn't tell which other stretch you wrote, but most stretches that lengthen a tight front hip can help. One that is functional for daily bending that you need to do anyway is Hip Stretch While You Strengthen Legs.

Hope to hear more about your successes. Send photos and I can post your continuing success in Readers Inspiring Stories.

Labels: abdominal muscles, fix pain, hip, lordosis, lower back, neutral spine, posture, readers inspiring story, stretch

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Black Belt Hall of Fame 2008

This weekend, we will be at the International Black Belt Hall of Fame. Top martial artists and their students attend from all over the world.

I will teach a seminar on Stretching Smarter. Research is increasingly showing that conventional stretching is often not preventing or helping heal injuries. My seminar covers state of the art changes to stretch methods to restore function rather than doing artificial movements for arbitrary range of motion. Stretching Smarter workshops for the general public and medical personnel are planned for the Spring of 2009. Through cooperation of the International Academy of Functional Fitness, we hope to have certifications in place. See information on workshops on my website CLASS page.

Grandmaster Kanzler and Kim Harper and staff work tirelessly all year to make each year's Hall of Fame event. Photos are still not posting to show Hall of Fame training and the seminars. Hopefully will follow. For now, it's a martial arts visualization exercise. Paul and I were inducted into the Black Belt Hall of Fame several years ago and have been invited back each year as teachers. I am back in a white do-gi (karate training uniform). I left karate years ago to compete, train, and teach in other styles. This year, Paul reopened our karate dojo (training hall) after many years. I have returned to karate as his student. Check the CLASS page if you want to study karate with Paul at the new center. Scroll down to the karate class description.

I won't have e-mail for a few days to answer questions. Several posts are having technical trouble posting my replies to comments anyway, as part of overall temporary difficulties with the Blogger. Blogger needs a rest too, why not. I am preparing some of the reader questions as posts to come.

Until then, here are related posts:

• What Does Stretching Do?
• New International Academy Using Jolie Bookspan's Methods
• 2006 Black Belt Hall of Fame - Black Belts and Black Tie
• 2006 International Martial Arts Association Weekend
• 2007 Black Belt Hall of Fame

The Hall of Fame event is by invitation only. To attend or stop by and say hello this weekend, contact the International Headquarters of the International USA Martial Arts Association, 1-800-456-3872. Tell them I referred you.

Labels: fix pain, martial arts, stretch

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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:

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.

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

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Quick Fix?

When is "quick fix" not a bad thing? When something is not right, there are times to make it right, then and there.

The health, injury prevention, and physical rehabilitation methods I developed are designed to quickly identify and stop sources of injury and poor health. The idea is to begin the benefits right then. It doesn't mean to substitute another problem, but put good practices to work intelligently and quickly.

Ivy from New Zealand first found The Fitness Fixer a few years ago when looking for information to fix serious sciatica and drop foot. Click Inspirational Ivy to see how she quickly stopped the pain, and how her neighbor took the photos used for that post and the updates Ivy has been sending since then. She wrote:

" You can imagine my joy when after 2 days I was free of pain. I was so excited that I contacted Dr Jolie, who in turn, took time out from her busy schedule to e-mail me giving me further advice and exercises which I might add, I follow religiously"

In a recent e-mail to me, Ivy brought up the idea of people wanting quick fixes. I am all for it. If something is wrong or bad, don't leave it that way. Mistakes become habit over time. It is quick to stop much pain and poor health by simple actions.

If something is causing injury or poor health, it makes no sense to allow it to linger. When medicine and fitness aren't healthy, fix it.

Quick ideas to keep quick fixes healthy:

• Fix One Pain, Don't Cause Another
• Fixing Posture - No Exercise Needed
  
• All posts on Fast Fitness

Labels: fix pain, readers inspiring story

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Fixing Foot Drop

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.

Posts with specifics to try:

• Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
• Cauda Equina - Result Not Cause
• Fix Disc Pain Without Surgery
• Studies Say Back Surgery Not Needed
• The Cause of Disc and Back Pain
• 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.
• Changing Thai Massage to Be Healthier Part I - Avoid Pressuring Lower Back Discs

Labels: disc, fix pain, footdrop/dropfoot, gait, impingement, injury, Parkinson, readers inspiring story, surgery

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Physical Activity Guidelines for Americans

This morning, the United States Department of Health and Human Services (HHS) released "The Physical Activity Guidelines for Americans." The guidelines describe, "the types and amounts of physical activity that offer substantial health benefits." In summary, adults need 30 minutes of moderate-intensity daily physical activity five days a week, and children should run and play at least an hour every day.

Regular exercise lowers the risk of heart disease, many cancers, osteoporosis, diabetes, Alzheimer's disease, depression, and other diseases. Health and Human Services Secretary Michael Leavitt said in a telephone interview, "More than 59 percent of adults don't get enough physical activity and a quarter of adults aren't active at all in their leisure time."

Guidelines for ages 6–17:

• 1 hour (60 minutes) or more of physical activity every day.
• Most of the 1 hour or more a day should be either moderate- or vigorous-intensity aerobic physical activity.
• Vigorous-intensity activity on at least 3 days per week.
• Muscle-strengthening and bone-strengthening activity at least 3 days per week.

Guidelines for over age 18:

• 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes, preferably spread throughout the week.
• Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both.
• Muscle-strengthening activities that involve all major muscle groups performed on 2 or more days per week.

Barry A. Franklin, PhD, national American Heart Association spokesperson and Director of Cardiac Rehabilitation and Exercise Laboratories at William Beaumont Hospital in Michigan, stated, "Numerous studies now suggest that if we can simply move people out of the lowest levels of cardiorespiratory fitness, it can have a profound (and beneficial) impact on public health." More information and downloads of federal guidelines - www.health.gov/PAGuidelines.


Use this Fitness Fixer column to see how to get healthful activity as part of daily life. You don't need a gym, a trainer, or equipment. Click the articles and archives in the list at right, use the search box at top right, and the Fitness Fixer Index. Read success stories of these methods and send your own.

Labels: aerobic, aging, children, fix pain, strength

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How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!

Liz from New Zealand left a comment on the post Surfer's Myelopathy,

"Short history, I have hurt my lower back and neck several times previously through poor lifting technique and bad posture. My chiropractor did help, but it kept happening. I used to sit at a computer most of the day at work, then drive home, then go for a 30min walk with minimum stretching.

"Last year, when my back was ok, I decided to try riding my bike to work, three days a week, for the environment, the money, and for my fitness and weight. Each way is 12 kms, very hilly too in Auckland (New Zealand). After one week, my lower back was very badly hurt. I thought I'd never be able to ride to work again, that I'd have to get dressed sitting down for the rest of my life and I could barely walk. I felt like an old arthritic lady and I was only 38.

"I searched every book and website I could find, I had the idea it was my posture but I didn't know what to do about it. I found some information, but often what they recommended I couldn't do, they were too extreme or hurt me more or made no difference.

"Then I found your website www.drbookspan.com. Aha! I thought-this sounds good. And it was.


"I bought your book "Fix your own pain" and learn't more and got stronger and healthier, following your advice.

"But still my back hurt a bit, I would forget to tuck my pelvis, then it hurt and I'd remember. I would get up and move around more, I adjusted my chair and computer to help my posture at my desk, but would forget and slump and my back or neck would hurt and I'd then I'd remember.

"I can't believe how long it took me to "Click." When you say it's for every time you bend, you mean Every Single Time! Keep your pelvis gently tucked All The Time. Keep your back straight, heels down and knees over your ankles Every Single Time you bend.

"Then I started to remember alot more, and my back only hurt a little bit. Then just recently I decided to try cycling again.

"And my lower back hurt again. I went back to your book and read some more and thought. I read about the hip stretches and read your blog and thought.

"And I tried two stretches I hadn't tried before, the sitting figure-4 stretch and the stretch on your blog where you lay on your back to do the figure-4 stretch and gently lean to the side your foot is facing.

"What a difference they have made. I have to tell you just those two stretches have changed my life. Now I walk (pelvis gently tucked) with no pain, I sit (small lower back arch, chin in, relaxed) with no pain. Any little twinge and I do the seated figure-4 stretch and it's gone. After my bike ride I get down on the ground (in the changing rooms!) and do the stretch on my back.

"I found that I needed to lift my foot well up from the floor, keeping my hips level, and move both legs, still in the figure-4, over to the side my foot was facing, helped by holding my crossed ankle with my hands and keeping this stretch for about 30 seconds. This increased the stretch and felt sooooo gooood. And continued to feel good after the stretch.

"This is the first time I've added a comment to a blog, but I just had to let you know how grateful I am to you and your generosity in sharing your knowledge and I wanted to share with your readers about the increased stretch, I've learnt so much from reading their stories and your replies, I wanted to contribute a little bit too."

Many many thanks, Liz
Auckland, New Zealand"

Liz, thank you for great work applying the concepts, rather than just doing treatments and exercises, and taking time to write to inspire and teach other readers. Send updates and photos when you can.

Going to a chiropractor does not solve the cause of the pain. Something may be tight or "out" but that is the result, not the cause. Save a lot of money and time by spotting the cause and making simple changes to stop it from happening again, yourself:

• When Liz says "tuck the hip" it means straighten the lower spine to neutral position, not to round the back. Rounding is tucking too much. There is a difference. Here is a post with descriptions and drawings - Prevent Main Factor in Back Pain After Running and Walking

• Quick movie of how to tuck a too large curve to neutral - Friday Fast Fitness - Neutral Spine in 5 Seconds

• Good bending for legs with neutral spine - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending

• Aha! When to use good bending for legs and spine - How Often Should You Be Healthy?

• Hip stretch - Fast Fitness - Better Posterior Hip, Iliotibial, and Piriform Stretch

• Watch for this common mistake when stretching - Better Hip Stretch - Check Your Ankles

• 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

• Ivy's story - Getting More From a Hip Stretch

• Book - Fix Your Own Pain Without Drugs or Surgery.

Labels: biking, fix pain, injury, lordosis, lower back, readers inspiring story, squat, stretch

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Flasher Exercises Not Best for Shoulder Pain

In A Whole Big Fix Mike fixed several injuries and made the interesting statement, "I stopped cycling to improve my health."

Back in December, I asked Mike if he wanted to get back to cycling and about his shoulder. While we were working on his story, reader requests piled in by the hundreds. Stay with us and questions will be answered. If I only answer them in order, it will be hundreds more posts before I get to questions arriving today, so make your questions fun and helpful.

Mike wrote his update:

"The cycling didn't cause pain at the time, but created bad posture habits and muscle tightness (shoulder rounded forward after separating collarbone in a crash, tight psoas muscles and hamstrings) which led to pain later. I'm walking more human-like now. Also, the air and traffic around here has gotten worse because of the housing and population boom, so I was having horrible coughing fits. Now I don't, without the aid of any medicine and, I believe, by following your diet recommendations.


"Shoulder: The physical therapist had me doing the trench coat type exercises you've described in your books as not as effective or needed, in many different ways (pictured at right), especially the "closing of the trench coat" which didn't make sense to me because they said I was overly tight in the front and too flexible and weak in the back. The visits there didn't work.

"Instead, I used the two stretches shown by your husband - right angle elbow with hand in air in Fixing Upper Back and Neck Pain, and the hand in the opposite pocket behind the back while leaning sideways, in Nice Neck Stretch."

Standard physical therapy exercise for rotator cuff consists of keeping the elbow close to the waist and rotating the forearm inward and outward, like a flasher opening and closing a trench coat (photo). There are almost no daily activities that need this specific motion, not even opening a door. No one uses their muscles this way (unless you are a flasher I guess). People do these exercises then go back to daily bad overhead reaching and re-injure their shoulder, or wonder why it never heals.

The rationale for doing the trench coat exercise is that strengthening the rotator cuff will heal the injury. Strengthening is not the main issue in most shoulder injuries that I see. Misuse of the shoulder is the root cause. A common counterproductive scene is people "doing shoulder exercises" with their head and neck slouching forward, upper body rounded, which injures the shoulder with each arm lift.

Slouching the upper body forward when raising arms for any daily activity, stretch, yoga, or weightlifting will continue to injure the shoulder. What improvement are you making to your shoulder to do exercises in a way that will injure?

Mike wrote:

"I'm also concentrating on keeping my thumbs facing forward when arms are down in order to help prevent my shoulders from rolling forward. I'm feeling more upright and balanced when doing everyday activities."

I told Mike that the idea is not to hold thumbs forward. The idea is to get the purpose of the stretch so that the chest muscles lengthen enough so that the arm bone is not pulled into inward rotation. The post on this topic is listed at the end.

Mike was also "doing" one of the key stretches but not getting the stretch needed, so no benefit was occurring. He was going through a set of motions to achieve the set of motions instead of to achieve the purpose, which was to restore resting length to the chest muscles. Mike made us some photos of how he was originally doing the pectoral stretch and how he fixed the motion to get the purpose. I will post them soon so everyone can see the difference.

• It is common to stretch in ways that does not achieve the purpose, or are done in injurious ways. Then news stories report on studies that stretching doesn't improve physical performance or help prevent injuries, and no one knows why. It is not difficult to see why: What Does Stretching Do?

• What do thumbs have to do with shoulder and neck pain? - Thumbs Can Show Tightness That Leads to Upper Back Pain

• Notice upper body positioning when exercising: Are You Making Your Exercise Unhealthy?

• Avoid rotator cuff and shoulder impingement and injury when raising arms: Overhead Lifting, Reaching, and Throwing - More Part I, and Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.

• Avoid neck and shoulder pain when looking upward: Gaze Perseid Meteors Without Neck Pain

• Learn how to avoid injurious movement habits and how to have healthier daily life and exercise: Health & Fitness in Plain English new THIRD edition - How to be Healthy Happy and Fit for the Rest of Your Life.

Labels: biking, fix pain, impingement, injury, posture, readers inspiring story, rotator cuff, shoulder

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Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury

The photo at right shows one main contributor to shoulder and rotator cuff pain, and one for lower back pain. Can you see them? Can you see why the person in red is not getting as much stretch in the shoulder as they think?

I see patients for shoulder pain all the time. Their chart says, "normal range of motion at the shoulder," or the chart reads with a number of angle degrees corresponding to directly overhead reach. I ask the person, "Reach up for me please." They lean their upper body backward, increase the inward curve of the lower back, and their hand points directly overhead. Often they do this while tilting their neck and head forward, which puts the shoulder at a position of compression when the arm is raised. I show them how to straighten the upper body upright, reduce the lower back over-arch, and return to neutral spine. I ask them to reach up again. They can't. They shoulder is too tight to reach directly overhead. They were never stretching their shoulder when they thought they were. They were getting the motion from their lower back, not shoulder. They were only leaning backward, adding compressive load to their lower spine joints, called facets. This will be covered next in Part II.

In the photo, note that the head is forward, a major contributor to rotator cuff injury during overhead arm motion. Lifting your arm with the neck and head tilted forward mashes the upper arm bone against the shoulder bones. This compresses the soft tissue between them, including the rotator cuff and nerves that go down the arm. Each small pinch can eventually saw at the area until a rotator cuff tear begins.

Rotator cuff injury is common, even in people who do no overhead athletics, like pitching, martial arts, or kayaking. Reaching upward is common around the house and for exercise. Starting in the morning, you wash or comb hair (or polish a bald head). You pull clothing on and off overhead. You reach in cabinets, wave goodbye, shield your eyes from the sun, open car trunks and hatches, put things up on racks, shop for groceries and put them away in cabinets, lift children, clean curtains and tub walls, put work in overhead shelves - many reaches, all day, every day. At the gym there are overhead lifts, stretches, and arm motions.

Compressing the nerves that pass through the area and go down the arm sets is called impingement. Impingement is not a disease. Someone with a diagnosis of impingement does not have a real diagnosis. Impingement is not a cause of pain, it is a result. If you stop the mechanical cause, then you can stop the resulting impingement. No drugs or surgery or repeated therapies are needed.

• Notice your neck and head position when lifting overhead and don't let your head and neck sag or jut or tilt forward. To see if you have the health and flexibility just to stand straight, try seeing of you can stand comfortably with your back and back of your head against a wall. If not, try some posts on upper body flexibility, such as Fixing Upper Back and Neck Pain. Don't force. Breathe. Smile. Relax. It's all for health.

• When you lift arms upward, check if you lean the upper body backward (photo above) or tilt the pelvis out of neutral. To see how to prevent the resulting overarched lower spine and restore neutral spine, click Kettlebells Without Spine Injury, and to see short movies, see Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine and Friday Fast Fitness - Neutral Spine in 5 Seconds.
  

• For more on the forward head and how to fix it, click Breasts Causing Upper Back Pain is a Myth and the associated links.

• To see more on back and shoulder during reaching, click Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.

• For a post on overhead weight lifting, click Safer Overhead Military Press.

• For more photos and situations for safer daily and exercise overhead movement, click Overhead Lifting, Reaching, and Throwing - More Part I.
  

Labels: fix pain, impingement, injury, repetitive strain, rotator cuff, shoulder

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Down the Stairs

Readers Carol, Don, Teresa, AJ, and others asked about strength, and knee pain and placement when descending stairs.

Physical trainer Teresa wrote:

"Hello Dr. Bookspan,
"The post on "Better Exercise on the Stairs" from July 2007 contains the following statement: 'When descending stairs or hills, bend your knees when landing for soft shock absorption. Don't step down on a straight, locked, knee.'

"Some clients I work with have the habit of descending stairs on one leg because they can land straight-legged on the "weak" leg. Pain or fear of pain keep them from having the confidence to bend that "weak" leg sufficiently to support themselves for a soft landing on the other leg, but the "strong" leg will let them land softly on the "weak" one. When I get them to practice it, they find the proper motor pattern that is pain-free, but end up falling back on the old motor pattern that creates pain.

"Do you have any ideas on this one since descending usually requires more use of the toes than climbing the stairs does?

"I keep recommending your site to loads of people because you are sooo right. It's about motor patterns of moving our bodies, not just "exercise." Thank you for your time and assistance!"
Teresa Merrick, M.A.
ACSM HFI, NSCA-CPT/CSCS, NASM CPT
Master Trainer

Climbing stairs is a functional (real life) skill. Not having the strength to support your own body weight is serious weakness:

1. It is not healthy to land straight-legged with a locked knee on either a weak or strong leg. The functional life skill needed to descend the stairs is similar to what is needed for simple daily healthy bending (right drawing). Bending knees to retrieve and reach is something everyone needs to do many times a day. How many times a day do you think you bend for ordinary actions? Click How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending


2. Use the simple built-in life activity of healthy bending using the half squat (right drawing) to train your legs for the strength and mobility needed to descend stairs in a healthful way.


3. When you bend in the half squat, keep both heels down and your weight shifted back over the whole foot (right drawing), not just the toes (left-hand drawing). Pull back more to the heels if you slide forward.
   


4. No need to increase the inward curve, called hyperlordosis, or overarch (left). Hyperlordosis pinches the spine and can cause impingement and mystery back pain (Prevent Back Surgery). Overarching is sometimes taught to weightlifters because it shifts some of the effort onto the lower spine joints called facets, making the lift easier. It is healthier to keep the weight on the muscles and not overarch. Keep neutral spine (right drawing).
   


5. Keep heels down for bending using the half-squat, instead of lifting the heel. Keeping heels down shifts weight to the thigh and hip muscles and off the knee joint. Enjoy the free, built-in Achilles stretch with each bend. Specifics on this in the post Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending.
   


6. Descending the stairs should not be a toe-intensive maneuver. Your body weight belongs on the strong muscles of the thigh and hip.

Once you have the idea of the healthy bending you need for daily life bending, transfer that healthy movement to the stairs:

• Keep more weight on the leg on the upper stair, instead of flopping and stomping all weight down on the foot that is stepping down.
• Keep your weight back more toward the heel on the upper leg.
• Keep heel down longer on the upper leg, instead of lifting the heel right away. Get the free, built-in, functional Achilles stretch.
• Bend knee slightly upon stepping down instead of landing straight-kneed. Remember this is the same strength and skill that you need and have been developing (or should have) for ordinary daily bending, which totals many dozens every day.
• Use good shock absorption from the thigh muscles of the leg stepping down.

Instead of dong artificial leg exercises like leg raises, use legs for real life to get automatic built in exercise in the way you need to move. The movement gives built-in strengthening and stretch and movement patterns. The built-in strengthening and stretch and movement patterns directly improve daily function.

More will come in future posts. Have a real life of activity and fun, and enjoy.

Related:

Better Exercise on the Stairs
Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs
Click the label "stairs" under this post for all Fitness Fixer articles on stairs.

Labels: achilles stretch, fix pain, impact, knee, leg strength, leg stretch, lower back, squat, stairs

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Fixing Posture - No Exercises Needed

A widespread myth is that to fix posture you must strengthen sets of muscles.

After spending time and money on strengthening exercises, people often wind up as stronger people with the same poor body position. The fallacy is that strengthening does not create movement. You do that yourself.

A physician wrote me that he has hyperlordosis from surfing, and is "working" to fix it. He had spent much time waiting for the exercises to "work." What he missed is that surfing does not cause it, and how you stand can be fixed there and then by deliberately, volitionally changing how you stand. How? Try Friday Fast Fitness - Neutral Spine in 5 Seconds.


In the comments to the post Prevent Main Factor in Back Pain After Running and Walking, a Division I athlete wrote:

"Thank you. I am a D1 athlete and have been struggling with back pain/extreme tightness when lifting and playing in the same day. I have known I had bad posture while running/walking for about 4 years, went to physical therapy for it, and still haven't changed it. I kept waiting for a certain exercise to suddenly "fix" me. Duh, what fixes me is ME CHANGING IT. Shocking."

When certain muscles are tight, it can feel normal to stand badly. Even though it is popular to talk about tight hamstrings changing posture, that is mostly an issue when sitting. When standing, two tight areas are most common, chest and front hip:

• Tight front chest muscles make round-shouldered position feel normal. Round-shouldered positioning keeps the front muscles shortened, in a cycle of shortening and tightening. The upper back muscles over-lengthen. This is why the most common stretch of pulling an arm over the front of the body is usually counterproductive. To fix anterior (front) tightness start with understanding and doing the pectoral stretch, described in Fixing Upper Back and Neck Pain and stop promoting an already overstretched posterior shoulder with The Stretch You Need The Least.
  

• Tight front hip muscles make standing badly feel normal. The front of the hip is pulled downward, tipping the backside outward in back. The lower back increases in inward curve in a painful posture called swayback or hyperlordosis. Many people stand this way without knowing it because they think standing with the hip tilted forward in front is normal or "cute." Much of modern conventional "fitness" encourages this unhealthy, unattractive bad posture.

Hyperlordosis is a major hidden factor in lower back pain. People may undergo months, even years of treatments, adjustments, shots, medicines, therapies for discs, sciatica, facet pain, and other pain without knowing or changing the cause - allowing a too large an inward curve to the lower back.

The photo at right demonstrates an over-arch in the lower spine, the hip tilted forward in front, and a forward head while doing an activity supposed to be for health. It seems impractical to do "fitness" in unhealthy ways. Moreover, tilting the hip forward reduces the Achilles stretch and reinforces bad movement habits. For a more functional Achilles stretch try Better Achilles Tendon Stretch.

Hyperlordosis is not a medical condition or unchangeable anatomy. It is simple bad posture that you can allow or change right as you stand. Neutral spine is not pushing the hip forward, just moving it enough to make it level. See a short movie in the post Friday Fast Fitness - Neutral Spine in 5 Seconds. To stretch the front hip, try these:

1. Fast Fitness - Quick Relaxing Hip Stretch.
2. Change the common ineffective way to stretch the front of the thigh and hip with Instantly Better Hip and Quadriceps Stretch
3. and Stretch While You Strengthen Legs.
   

Watch other people when they exercise, walk, and run. See how often you can spot the unhealthy overarched lower spine. See what to look for in the post Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?

Remember that stretching the hip and shoulder, and anywhere else, will not automatically make you stand right. You do that yourself using your own muscles and brain. Free exercise. Free fix.

Labels: fix pain, lordosis, lower back, myths, posture, stretch

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Fast Fitness - NoCost Hand Strength and Rehab Equipment

Here is Fast Friday Fitness -hand exercise without rehabilitation equipment.

One of the exercises against repetitive strain syndrome is to exercise the muscles that open the hands. There are expensive commercial devices you can buy for this. One consists of a special glove with weights and pulleys to resist your ability to open your hand. Or you can:

1. Hold the fingers of one hand closed with your other hand
2. Open the hand against the resistance of the hand holding it closed
3. Do as many as comfortable. Repeat with the other hand. Vary intensity and number.

If you want to go high-tech, put a rubber band around the fingers instead of using your other hand. Push each finger in a variety of ways.

Labels: fast fitness, fix pain, hand, repetitive strain, strength

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Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine

Here is Fast Friday Fitness - quickly change your posture to change your luck on Friday the 13th. Hyperlordosis (swayback posture) seems to be unlucky - it causes lower back pain. You can do this in seconds to make a certain change to healthier spine for yoga or practicing the lunge. If you don't believe in luck, you're lucky. It's just good posture and simple anatomy.

Reader David from Belgium demonstrates in this 20 second movie that he made for us:

1. First ten seconds - he steps into a yoga pose called Warrior pose, but allows overly arched lower spine. He also demonstrates leaning more weight forward of center line, which is a different issue.
2. Note how the belt line tips downward in front and the lower spine overly curves inward - more than a normal curve.
3. At second 11 he levels the hip to bring the posture to neutral spine. Then he kindly demonstrates overarching when raising the arms further. Instead, hold neutral spine and raise the arms from the shoulder, not the lower back.

To prevent shoulder impingement when raising arms, keep shoulders down and back, don't just chin and neck forward, keep them gently in. A forward head posture compresses the rotator cuff when lifting arms. See Safer Overhead Military Press.

I never expected repeated requests to see how to do neutral spine in different activities. It is the same. Just apply the same neutral spine and that’s all. I thought one post would do it, but will post each activity readers ask about. I am aware that there are yoga and fitness places which teach to overarch the spine as part of the move. Teaching swayback does not seem to be as helpful as teaching neutral spine. Changing lunge and Warrior pose to neutral also improves the stretch to the front hip muscles of the back leg. Lucky.

Labels: fast fitness, fix pain, hip stretch, holiday, impingement, lordosis, neutral spine, posture, video/movie, yoga

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Simulation Suit To Feel the Pain of Osteoarthritis

A BBC news article reported on a suit that gives wearers a "real life" insight into the pain and impaired quality-of-life associated with osteoarthritis (OA). The suit costs £20,000 and was developed by Loughborough University. They wrote: "The JOINT Osteoarthritis Education Programme will be made available to GPs throughout the UK, providing advanced training on the diagnosis and management of the condition, including both drug-based and lifestyle approaches to help improve mobility and minimise pain."

How does this suit work? The specs for this particular suit are proprietary to the company (that means they are not telling). Similarly marketed suits to simulate arthritis use a simple principle to produce the painful feeling - they use straps and other restrictive designs to hold the body in bent positions that cause the rubbing and strain.

The suit would be useful for the kind of health care worker who tells people to live with their pain instead of fixing the cause to stop the pain. Most other people don't need an expensive suit to show them how to hunch over and hurt all over:

• The post Disc Pain - Not a Mystery, Easy to Fix shows how to understand the simple mechanics that damage discs. In my work, I have found it is one of the same mechanisms that increases wear and tear on the vertebrae contributing to spinal arthritis.
  
  
• The second main wear and tear injury adding to spinal arthritis is standing with the lower spine arched inward too much (lordosis) - Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine. The muscles you would use to simply move your spine to a less arched position and restore neutral spine are your abdominal muscles.

• Discs and vertebrae are living parts of your body. They can heal, when you stop hurting them, usually starting within days by stopping the harmful movements that aren't good for you anyway, and using healthy movement during daily life that gives you free exercise. Discs can heal without surgery, just like a sprained ankle. More on how to stop recurring ankle sprains is in How To Treat Ankle Sprains and Prevent Them and No More Ankle Sprains Part II.

• Post on changing bad positioning that increases wear and tear and risk of osteoarthritis on knees: You Can Fix Your Own Knees.
  
  
• Posts on changing positioning that increases wear and tear and risk of osteoarthritis on the neck: Is Your Drinking Hurting Your Neck? and Gaze Perseid Meteors Without Neck Pain.
  
  
• Post on changing positioning that increases wear and tear and risk of osteoarthritis on the shoulder: Upper Back Exercise and Neck Pain Prevention Too.
  
  
• Post on changing positioning that increases wear and tear and risk of osteoarthritis of the lower back: Prevent Back Surgery.

Use all the various posts on fixing injuries in The Fitness Fixer to see how to move in healthful positioning so that your exercise is healthy rather than injurious. You don't need to get treatments, or adjustments, or surgery, or shots, or medicines. It is a win-win situation where you do not have to give up favorite activities, and can become healthier than before. Just use healthy movement as part of normal daily life and get free exercise, better physical abilities, and stop the processes that cause injury, all at the same time.

For books, try Fix Your Own Pain Without Drugs or Surgery and Health & Fitness in Plain English Third Edition. The Fix Pain book concentrates on how to stop injury process in each area, with patient stories in each chapter. The Health & Fitness covers back and neck pain, plus living and exercising in healthy ways, nutrition, and health issues including measuring body fat tests, bone health, heart health, and other topics. Descriptions on my books page.

Labels: arthritis, fix pain, injury

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

A Reuters news item last week reports that "baby boomers" are accumulating wear and tear injuries, and they should consider cutting back on amount and type of exercise they get.

The article points out that contributors to injuries are biomechanics, poor flexibility, and "pounding" or stomping down unnecessarily hard when running, jumping, walking, etc. Even with that knowledge, the news report goes on to say the answer to reduce injuries is to cut back activity. In Sunday's Fitness Fixer post, Forearm, Upper Body and Hand Exercise, I wrote that it is not a healthful or useful solution to "limit the patient to limit the pain."

The Reuters article quoted a foot and ankle podiatrist saying, "It is really important that people continue to be physically active, but they need to think logically about how to remain active as they age… Probably when you start getting into your 40s and 50s, the half marathon is a great alternative (to full marathons). Or, if you did two or three marathons a year, cut it back to one a year or opt for 10K or 5K runs." The podiatrist himself is a marathoner. He stated, "Having run 25 marathons, it was hard for me to cut back."

I would suggest looking at biomechanics, poor flexibility, and "pounding" first, before telling someone to stop doing what they love:

• Biomechanics - Why So Many Aerobics Injuries?
• Flexibility - What Does Stretching Do?
• Pounding - Walk Lightly - Shock Absorption for Happier Joints

I have some exciting developments about getting you information on Exercise and Aging. Will announce soon.

Labels: aging, fix pain, impact, injury, myths, running

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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"

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 below, 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.

When lifting and swinging kettlebells (and any weights) overhead, don't lean your upper body backward (photo below left). Leaning backward is often mistakenly done to "balance the weight" and make the lift easier. Another common body movement to make lifting overhead easier is changing the tilt of the pelvis (hip) so that it juts forward in front and outward in back (same photo below left). 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. Not only are they not necessary, they increase the inward curve of the lower spine. Increasing the small normal small inward curve (lordosis) to a large curve (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.

The photos of spine position swinging the heavy medicine ball are from the book Healthy Martial Arts. My black belt student Christopher demonstrates. This is a similar overhead motion as swinging kettle bells by the handle. In the left photo, Christopher allows the hip to tilt forward in front (and out in back) and his upper body is tilting backward relative to the lower spine. In the right photo, he holds neutral spine. In the right hand photo you can see the change to reduce the overarching to neutral spine. The belt line changes from tipped downward in front to level.

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.

Neutral spine while exercising with kettle bells is the same as neutral spine during anything else - just hold your spine position. Holding neutral spine is the same as not slouching your shoulders or not letting your mouth hang open. You just voluntarily move to and hold desired 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.

Helpful posts to see and learn neutral spine while 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

The book Healthy Martial Arts (www.DrBookspan.com/books) has a section on lifting and swinging kettlebells, medicine balls, and other weights. Keep breathing, smiling, and have fun. You can swing weights to be stronger and healthier, without injury.

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

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ER Nurse To Her Own Rescue

Reader Barb wrote:

"Thanks for yet another great post. I am an ER nurse and see the horror of chronic back pain on a daily basis -- the disability, depression, and addiction that eliminates any quality of life for the sufferer and their family. Even after surgeries and pain clinic visits, I've yet to meet a patient who has managed to rehab well. Last year at age 52, after years of moving patients, some over 700 pounds, I injured my back while installing a patio and I couldn't breathe, let alone move without pain. If I hadn't been a devoted follower of yours, my career would have been over. I got your book, Fix Your Own Pain, did the exercises and went back to work four days later. I took a muscle relaxer to help me sleep the first three nights but have never taken any pain medication. The exercises actually relieved pain for me. I can't thank you enough.

Just a quick question, can you suggest proper form for climbing stairs, to prevent back and knee problems? I'm in a 3-story condo and don't want daily routine to do any harm to the old joints. Thanks so much Jolie!"

Barb, you have the intelligence, quick thinking, interest in learning, and empowerment that makes a quality ER nurse. Try Better Exercise on the Stairs.

Click this books link for the book Fix Your Own Pain and other resources.

Labels: fix pain, lower back, readers inspiring story, stairs

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Fixing Pain and Golf Easier With Real Life Movement Than Isolated Exercises

Jeff is a Silicon Valley executive, and coach of Next Stage. He found that a lifestyle of unhealthy exercise habits can accumulate, until one day of golf becomes "the Camel's Last Straw."

Jeff writes:

"There is life after back pain – even the kind where you can’t walk, sit, lie down, or sleep.

"The weekend before Thanksgiving (2007), I was out golfing, and I made a pretty bad swing at a ball that was buried in deep rough. My club got stopped by the deep grass, my back and arms kept going. I immediately felt a sharp pain in my lower back – so much in fact that I could no longer make a normal swing or even get down into a putting stance.

"I had to give it up after 6 holes and head home. I could still walk, but I couldn’t crouch and I had a hard time getting up out of a chair.

"Three days later feeling a little better, I headed out to the fitness center to do some treadmill running - NOT a good decision. After about 10 minutes, as I was cranking up the speed to a fast jog, I felt a searing pain in my lower back and down through my left thigh. From then on, I was toast.

"By the next morning I could barely walk. I had so much pain in my lower back and left leg I needed to support myself with a cane. I could barely walk or stand with the cane. There was no comfortable position for me, and I couldn’t sleep more than an hour at a time – even on pain killers and over the counter sleeping pills. Two trips to the chiropractor changed nothing.

"I did a web search, found Dr. Bookspan's web site, bought "Fix Your Own Pain Without Drugs or Surgery" and then even sent her an email telling what had happened. To my amazement, I got a personal answer (then another then another as I wrote with more questions and my progress). Dr. Bookspan referred me to the lower back pain part of her site, and I started doing the retraining exercises daily – and more importantly I started “living” the exercises, i.e., using them to get good body positioning and healthy movement into my day.

"In the beginning I could barely do the exercises, my pain was so extreme I couldn’t lie flat on my stomach or back without pain, not to mention doing upper or lower back extensions. (I wrote to Dr. Bookspan who found that I was overarching the lower back, when I was thinking I was straight. Wow! Consciously tucking the hip more reduced the pain significantly.)

"After a few days, things improved so I could perform the exercises better. I started to walk again – albeit with discomfort. (I wrote again and once again got the encouragement I needed, and realized the specific things I was not yet getting right. I was still overarching the lower back and that was preventing healthful motion.)

"Today, it is 5 weeks since worst of the pain. Thanks so much for your support. I am orders of magnitude better! I am walking without a limp – pretty much normal gait. I played 9 holes of golf this morning, walking a very hilly course, carrying my clubs. Yesterday I was on the treadmill doing some light jogging. All signs of discomfort are gone and I am gradually working myself back into shape. I am not taking any medications of any kind, and I am doing just great.

"I am working hard to incorporate the things I learned from Dr. Bookspan about movement, posture, and exercise into my daily life. It makes total sense to me that the positions you are in for most of the day have far more impact than 10 minutes of exercise. I feel like I have been to hell and back, and I definitely don’t want to make another visit."

Links used:

• Fix Your Own Pain without Drugs or Surgery
• Also recommended - Health & Fitness THIRD edition, How to be Healthy Happy and Fit for the Rest of your Life
• Understanding the hip tuck to neutral spine - Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine
• Fast Fitness - First Morning Stretch
• Lower Back Pain and Golf
• Web site Back Pain Article.

Labels: fix pain, golf, injury, lordosis, lower back, readers inspiring story, sciatica

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Replies to Medical Questions

Dr. Auerbach of the Wilderness Medicine blog wrote an important post for the many requests we get for personalized medical replies. It was so well said, I echo it here for readers of Fitness Fixer:

A fair number of comments from readers of this blog come in the form of clinical questions, in which someone asks for a response to a personal medical question. While I would like to be able to answer most of these, it is difficult to do that without more complete information, and in the absence of being able to examine the patient(s).

When a question or comment raises an issue or point of interest that is important for everyone, then I will try to address the topic in a separate post, rather than as an isolated answer to a question. In this way, more people can benefit.

Thanks for being a reader, and for your understanding.

Labels: education, fix pain

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Fix One Pain, Don't Cause Another

When you stretch and exercise, especially if you stretch and exercise to improve your health, remember that the purpose is not to recreate unhealthy movement habits.

Two similar letters came in recently.

Reader Tina wrote:

"Thanks so much for your posts on stopping upper back pain. I have stopped my upper back pain. But, when I pull my neck and shoulders back, I get pain in my lower back. Which stretches should I do to stop this pain?"

Alicia wrote:

"I recently stumbled upon your articles on the Internet about how to reduce back pain. Thanks so much for providing this information! I am experiencing less pain for sure already… but I have a question. When I am keeping my neck back and shoulders back and correcting the lower back arch, I get a pinching sensation in the middle of my back. What am I doing wrong?"

Tina was doing a common unhealthy movement habit. She didn't need stretches to fix the pain; she needed to stop old injurious movement habits. Tina was leaning her upper body backward thinking she was pulling her shoulders back. Leaning backward is not correcting rounded forward shoulders, even if it seems to move the shoulders rearward. The shoulders have not moved at all just stayed rounded while the upper body pinched backward at the lower spine.

The photo at left is a performer who had just finished a trapeze performance. All the exercise and stretching she did every day didn't change her bad positioning habits.

Leaning the upper body backward (shown in the photo, left) increases the inward curve of the lower back, making a sharper angle between the pelvis and the lower spine. That increases the normal lordosis (inward lumbar curve) to hyperlordosis (too much inward curve as in the photo), which put painful pinching compression on the area. Look at the strip on her leotard. It tilts forward at the front hip and back at the back of the hip. It should be straight up and down, which is part of holding neutral spine.

The photo also shows shoulders and upper back rounded forward, and the neck and head jutting forward.

Slipping into familiar unhealthy ways of moving may be habits that occur without thinking. You need to think a bit.

Alicia was just pulling back so tightly that she pinched the area between the shoulder blades. There are sources that say that you should squeeze shoulder blades as if holding a penny between them to fix posture, but of course, that is painful and too tight.

Alicia wrote back:

"Thanks! That helps actually. The pinching was in my upper back, but it's gone now! Thanks so much for responding to me. I look forward to your class in July.
Alicia"

Pinching back does not fix posture or stop upper back pain. Instead, stop the causes of the rounded shoulders and the pain.

These three posts help understand and fix the causes:

1. First read and try Fixing Upper Back and Neck Pain.
2. Then the second stretch is Nice Neck Stretch.
3. The third stretch to help restore upper body positioning is Friday Fast Fitness - Better Shoulder and Triceps Stretch.

Don't exercise one area and hurt the next:

• The post Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain shows a photo of the common bad habit of leaning the upper body backward when raising the arms.
• The post Prevent Back Surgery shows several photos of how people learn the upper body back or tilt the hip out in back during several common exercises, stretches, and daily activities. Both increase the pinching compression on the lumbar spine.

Remember to think and watch for causes instead of just *doing* exercises and stretches.

Labels: fix pain, lordosis, lower back, neutral spine, posture, shoulder, upper back

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Runner Fixes More Pain With Straighter Push-Off

Last year, reader Ted fixed back pain by learning to use neutral spine during running and daily life. This week he checked in to say the back is still fine, and that he went on to fix other painful sites.

Fixing pain and injuries by doing some exercises may temporarily ease symptoms. Instead, you can stop the source of injury by making movement habits healthy while exercising and moving through daily life, so that you can get exercise at the same time that the area can heal, and the pain not return.

Ted writes:

"Dr Bookspan, last summer, you helped me return to running, and did an article on me and how the neutral spine fixed my back problem with running.

"The back is a NON ISSUE. Thank you so much.

"Currently, I am working on hip/hammy/knee issues (probably due to over-training). Just thought I would share a thought on the ''Duck Foot'' issue you had talked about (I read the Fitness Fixer religiously). While running on the padded infield of the Stadium Football Field, I was still noticing pains in my hip (caught my foot on the ''upswing'' during a run, hip has hurt off and on since October).

"I focused on my feet, specifically, how I pushed off after the foot-strike (very soft, I often scare other runners because they can't hear me coming up on them). A straight push off after the foot-strike made the pain go away (probably because it aligned my foot/knee/hip during the movement). Also, when the knee pain flared, tensing my quads made it go away.

"I have enjoyed reading your ''Running Articles' please keep 'em coming.
AND
Thank you for fixing my Back.
Much Appreciated,
Ted H"

"Ps. I got your new book (Health & Fitness THIRD edition). VERY good info, I'm trying to use it everyday."

To fix the source of pain, it works best to understand healthful movement retraining and not just "do" a series of rules. One important example is keeping feet parallel or facing forward. The idea is to understand that a straight push-off comes from keeping all the joints in the kinetic chain from feet to hip and spine from twisting in unhealthful ways, not just straighten one segment by twisting another. Yanking or forcing the feet straight is not the point of good positioning.

Ted has more helpful stories to come in future posts. Click these posts for more:

• Back Pain From Running - Ted's story
• Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
• Walk Lightly - Shock Absorption for Happier Joints
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Plantar Fasciitis Part I
• Health & Fitness Third Edition at Last

Labels: feet, fix pain, impact, knee, readers inspiring story, running

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Plantar Fasciitis Part I

Raina and several other readers asked about plantar fasciitis.

On a house, a fascia is a flat horizontal surface just under the roof. In your body, a fascia is flat fibrous tissue that wraps your muscles and soft structures. You have fascia in several places. One is across the bottom of your feet. "Plantar” means the bottom of your foot that you "plant" on the ground. Your plantar fascia is the fascia on the bottom of your foot. Plantar fasciitis is an inflammation (-itis) of the fascia on the bottom of your foot.

Normal Plantar Fascia Action
When you walk or run with your feet facing straight ahead, the line of bending of the foot is straight from front to back. Each step gives you a nice, built-in small stretch across the bottom of your foot. As you walk, run, jump, and move, your plantar fascia transmits body weight across your foot. It is part of shock absorption for your entire leg.

How Bad Movement Mechanics Hurts
Several things can make the fascia tighten and hurt. Here are three. More to come in future posts:

1. When you walk or run with feet facing outward, the fascia loses the normal stretch. Over years of not getting its normal stretch, it becomes tight. Walking with feet facing outward also puts sideways forces on the fascia with each step instead of the needed stretch. Walking with poor shock absorption, banging down heavily with each step can amplify strain forces on a tight fascia. Every step you take on a tight fascia yanks on the heel where it attaches. Eventually the heel and bottom of the foot get irritated from the yanking and start to hurt. Irritation can eventually cause the bone to thicken to protect itself - a heel spur.

The tighter your Achilles and foot fascia, the more "normal" it feels to walk toe-out. In a circular problem, walking toe-outward is a common fascial tightener. It may be "natural" with tightness, but can increase tightness over time.

2. Letting ankles constantly sag into pronation (flattened arches) is another fascial strain. Keeping body weight more evenly around the sole of your foot, not pressing and downward on your arches, lifts the weight off the arch. Reader David from Belgium made us a great short video of easily changing from rolling in on the arches to holding straight in Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches.

3. Hard sole shoes and some fasciitis braces stop the sole from getting the normal lengthening while walking, stopping the pain from the stretch, giving the false impression that the injury is lessening. A negative cycle continues of shortening and continuing the source of the injury. Injections briefly make the area more prone to injury. Pain pills allow you to continue the injury process without pain telling you that it is wrong. Several kinds of anti-inflammatory and pain medicines interfere with healing. Wearing high heeled shoes raises the heel, shortening the length of the Achilles tendon, putting less stretch on the tendon, the lower leg muscles, and the fascia of the foot.

Fasciitis can be quickly stopped. It does not have to be chronic. "Doing" a few stretches does not undo a lifestyle of shortening, tightening, and straining. Forcing tight, artificially straight position instead of creating the length and use of the area that allows healthful motion, can create more pain in other segments. Use your brain and learn good body movement to allow it to heal and be functional.

Helpful links to move in healthy ways to stop plantar fasciitis:

• Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Arch Support Is Not From Shoes
• Better Achilles Tendon Stretch
• The book Fix Your Own Pain Without Drugs or Surgery has a section on fasciitis, the many unhealthful lifestyle contributors, and simple lifestyle fixes to build into daily life and your exercise classes.

Labels: achilles stretch, feet, fix pain, injury, plantar fasciitis, pronation, running, walking

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Junk Food Through Your Skin?

We live part of each year in Asia. For a few months, I was posting articles for you from various villages. The town shower of one is pictured at right - not the hut, the outdoor green post with hose. Imagine what the Internet café was like.

On the flights over, our only bag was lost. US transportation security required us to check our sole knapsack, since it had a small gift for friends containing liquid. It never reappeared. We don't need "things" and it was just as easy to make our own soap, comb, and toothbrushes as carry them.

In Western stores, I am astonished by the number of "personal care items." Not just shelves full, but aisles. Each promising better hair, skin, nails, and other parts, but with ingredients that are not healthy for your body, produced in ways that pollute the world, and packaged in plastics that are unhealthy to produce, pollute when discarded, and which apparently leak chemicals into the product that can be absorbed through your skin - see Green Water. A study commissioned by the Organic Consumers Association found that even shampoos, body washes, and lotions labeled "natural" and "organic" can contain unhealthful, even carcinogenic compounds.

I feel high maintenance just carrying a toothbrush. Then we arrived without even that. What freedom.

We made simple hand sanitizer from coarse salt, rubbed between the palms.


For body, face, and hair, we picked aloe leaves, squeezed out the gel inside, and rubbed directly on - see Fast Fitness - Aloe Inside and Out. It dries non-sticky, and makes your hair shiny, clean, and healthy. We used the rest of the gel in food and drink for healthy digestion.

Bamboo is easily made into cooking pots (photo above left). We also visit our favorite bean sprout PadThai restaurant - an outdoor wok on wheels run by a friend. Paul is always popular when we travel (photo at right). The others are not sitting; Paul is really that tall, and has to duck those umbrellas, doorways, and ceilings.

Baking soda and salt makes clean toothpaste. Even without them, a short branch called a neem stick with one end mashed until fibrous, makes a soft, effective bristled toothbrush. Neem extract is said to be a good antiseptic, and effective against various health ills and germs.

After a long day at work and after hard training, instead of hand lotion, you can rub sesame or other light healthy cooking oil onto your hands and feet. You can scent it with mint leaves, citrus peels, spices, and flowers. More ideas in Healthy Mother's Day.

I don't use sunblock, even in the tropics. I do use something to stop some of the unwanted effects of too much sun, but I do not want to block the Vitamin D and other helpful effects of sunlight. Vitamin D deficiency can lead to osteoporosis (thin, brittle bones) and osteomalacia (rubbery, demineralized bones). Vitamin D deficiency is associated with increased risk of a few types of cancer, including lung cancer. Studies find that people with low blood levels of vitamin D were more likely to have high blood pressure, cardiovascular disease, cystic ovary, and type 2 diabetes. Another study found that a number of patients with aches and weakness were vitamin D deficient and concluded, "A lot of 'fibromyalgia' may be D deficiency."

Instead of blocking or deflecting UV rays using chemical sunblocks that may contain chemicals that I am not sure are healthy, I mix my own, that I hope stops the oxidizing effects and makes my own body better able to stop skin cancer mechanisms. I mash together fresh coconut pulp, green tea, vegetable sprouts, mashed turmeric root, and aloe gel.

A study by Johns Hopkins researchers, reported in the Proceedings of the National Academy of Sciences (October 30, 2007, vol. 104, no. 44, 17500-17505) found that rubbing an extract made from broccoli sprouts on your skin may help prevent skin cancer from high levels of ultraviolet (UV) radiation. Broccoli, and the sprouts in particular, contain a chemical called sulphoraphane, which is found to activate cancer-fighting enzymes in your own cells throughout your body, not only skin cells.

Instead of chemical anti-mosquito products, we try various things. Marigold flowers rubbed on the skin seem to work for us. I don't seem to be "sweet," and mosquitoes often ignore me while going after Paul. We have heard various theories from locals. One is that he eats sweet rice while I eat more garlic. Various grasses rubbed on the skin also work well for us. There are vines growing in Thailand with beautiful purple flowers. When you rub them on wet hair, it leaves your hair soft and shiny and sweet smelling, but the bugs do not like it. There are other vines that, when mashed with water made effective gentle soap and mosquito control combined.

In Asia, martial arts training is often more rigorous and disciplined than is common in the states. After hard evenings of training, I would sit by a candle made from oil and tightly wrapped bamboo leaves, and rub salt and oil into my, and Paul's, tired feet. Bliss.

• You can exercise for your health. Why undo that by eating junk food - Is Your Health Food Unhealthful
• or by adding junk food to your brain through thinking unhealthful thoughts - Healthier Heart
• or with junk food directly through your skin.

The biggest worry for Paul is just ducking the doorways.

Labels: cancer, diabetes, digestion, drugs, fibromyalgia, fix pain, green fitness, nutrition, osteoporosis, sunlight

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Fast Fitness - Sprain Prevention and Rehab Training

Here is Fast Friday Fitness - feel how your own muscles work to hold ankle position, so that you can have stable ankles without artificial shoe supports or bracing, which weaken the supporting muscles from disuse:

1. Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
2. Rise to toe and hold
3. Keep body weight over big and second toe with straight ankle position as you remain on tip-toe. Don't let your weight shift over the small toes, allowing ankle to bend outward.

Click the arrow to see this short movie of my student Diana's feet, as she first allows rolling the ankle outward when rising to toe, then at second 3 in the movie, she uses ankle, foot and leg muscles to pull to straight neutral ankle position. She prevents outward rolling as she again rises to toes three more times.

Prevent rolling outward whenever you rise on toe or push off or land from a jump or step.

Developing positioning sense in the receptors of your ankles prevents the sprain-promoting position called inversion, and gains built-in foot and ankle muscle strength and stability. Nice foot stretch too. Practice balancing on tip-toe, and rising up and down without rolling outward every day.

Labels: ankle, balance, fast fitness, feet, fix pain, injury, sprain, toes, video/movie

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Feeling Better Than She Ever Has Part II - Fixing Herniated Disk and Reclaiming Active Life

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."

Here are posts and information Barbara used:

• Why bad forward bending is a major mechanism in disc degeneration and eventual bulging and herniation: Disc Pain - Not a Mystery, Easy to Fix
• Avoidable sources of bad bending that go unnoticed in common exercises: Common Exercises Teach Bad Bending
• 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:

• Fast Fitness - Fix Positioning by Watching Others
• What Does Stretching Do?
• Are You Making Your Exercise Unhealthy?

Barbara continues:

"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."

These are some techniques used above:

• Lie on floor propped on elbows - Fast Fitness - First Morning Stretch
• Pectoral stretch - Fixing Upper Back and Neck Pain
• Trapezius stretch - Nice Neck Stretch
• Lunge for daily good bending - Strengthen Legs Without Knee Pain - Standing Lunge
• Half squat for daily good bending - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending.

"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:

• The Cause of Disc and Back Pain
• Does an Exercise Ball Make You Sit Straight?

Barbara continues:

"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."

• Walking wasn't Barbara's problem. She was overarching the lower spine while walking, making a hidden problem - Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
• 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.
  
• Posts about how reader Ivy stopped the same sciatica problem: Inspirational Ivy and Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier

"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.

Labels: disc, fix pain, gait, hamstring, injury, lunge, readers inspiring story, sciatica, sitting, squat, walking

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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 posts 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

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Feeling Better Than She Ever Has Part I - Fixing Herniated Disk and Reclaiming Active Life

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:

• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
• Common Exercises Teach Bad Bending
• Bending Right is Fitness as a Lifestyle
• How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending
• Disc Pain - Not a Mystery, Easy to Fix
• How to bend using the lunge - Strengthen Legs Without Knee Pain - Standing Lunge
• How to bend using the half-squat - Free Exercise and Free Back and Knee Pain Prevention -Healthy Bending
• Neutral Spine or Not?
• Lying comfortably propped on elbows to unload discs - Fast Fitness - First Morning Stretch
  
• Inspirational Ivy
• Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier
• and the books.

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.

Labels: disc, fix pain, impingement, injury, lunge, readers inspiring story, sciatica, squat, stretch, yoga

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Fast Fitness - Fix Flat Feet, Pronation, and Fallen Arches

Here is Fast Friday Fitness - feel how your own muscles work to hold arch support, so that you can have healthy arches without artificial shoe arch supports or orthotics, which weaken the supporting muscles from disuse:

1. Stand with feet parallel and look in a mirror where you can see your feet, or just look down.
2. Pull outward until your arches rise and restore, and your ankles are straight.
   
3. Learn to feel this neutral position. Don't hold rigidly or roll outward. You gain built-in muscle strength and arch stability with each step you take.

Click the arrow to see the short movie made for us by reader David from Belgium. First he allows his weight to shirt inward, pushing his arch flatter toward the floor. Then at seconds 3 to 4 in the movie, he uses the outer muscles to pull to straight neutral ankle position. At seconds 8 to 9 he allows the arch to sag again, then simply restores and holds a healthy arch from second 13 onward. The "exercise" is not to roll back and forth. It is just to learn to feel what allowing sagging too much feels like, and how to stop.

Remember, don't force. If it hurts, it's wrong. All you are doing is standing neutral, not tilted so much that you compress your joints. The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.

During walking and running, there is a small natural inward drop (slight pronation) that is part of the spring and propulsion. Allowing exaggerated sagging is like rounding your shoulders too much. Legs and feet have posture that you can control yourself. Use your own muscles and get free built-in exercise and arch support all day, and stop painful poor positioning.

Labels: ankle, arches, fast fitness, feet, fix pain, posture, pronation, video/movie

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Walking Softly Benefits Olympic Wrestler

Reader Dennis is an Olympic Medalist in wrestling. He is the student who asked me how to walk without shocking his joints in the post Walk Lightly - Shock Absorption for Happier Joints.

Not long after, I saw Dennis running by at a fast clip, with beautiful neutral spine, good leg and foot alignment, and a light landing with each foot-fall. I asked him why he had asked about running lightly. He said he changed to running lightly after I worked with him on it. I asked if it made a difference and he laughed, "Of course. It used to hurt."

Dennis is muscular and squarely built. He used to leave an impression on the floor when he walked, and had knee, neck, and lower back pain after running.

Landing without jarring reduced pain. Dennis also did several things to stop injuring his joints during movement:

• Stopped keeping a large inward curve in the lower back while running. Changing to neutral spine decreased the compressive pinching and loading of the vertebral joints and soft tissue - Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?

• Stopped letting his arches flatten downward. Using his own leg and ankle muscles, Dennis held neutral foot position maintaining a good arch without needing any inserts or special running shoe - Arch Support Is Not From Shoes.
  
  
• Stopped letting the knees bend inward toward each other when running, and held neutral foot position - Healthy Knees.
  
  
• Held upright head and neck position instead of jutting the chin forward - Common Exercises Teach Upper Back and Neck Pain.

Using the information in my classes, Dennis fixed recurring ankle injuries, and various back neck and other joint pain and went on to win medals in wrestling. His stories and photos will follow in posts to come.

Labels: feet, fix pain, impact, readers inspiring story, running, walking

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Gluteal Muscles Myth - Shaking The Dog's Paw