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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Indiana Jones Rocket Sled

The new Indiana Jones movie came out this past weekend, the Kingdom of the Crystal Skull. It is set in 1957 with fun fitness and iconry of the era, for future blog posts. Today - the Rocket Sled.

In the early part of the movie, Indiana Jones and the Soviet Russians brawl through a US military testing base in Nevada. Jones and a Russian officer wind up on a rocket sled, which blasts them on a speed track into the desert.

Rocket sleds are one of several devices that create and test the effects of high acceleration on equipment and the people who use them. High acceleration forces occur when jets take off quickly, when launching a space flight, to eject from a hit (compromised) fighter jet, on roller coasters and spin and fall rides, when you fall from a height, and any time you change speed and/or direction quickly. Interesting changes occur in the body under acceleration. Acceleration is one of the areas of my study as a research physiologist and was my work for a time at two facilities testing air vehicle and human systems.

G-force is a measure of acceleration, not force, but the term g-force is also used for the reaction force that results from acceleration. More on meaning, spelling, and math of g and G in another post. Too much g-force can result in g-LOC (Loss of Consciousness), pronounced "jee-lock"in English, but just as meaningful when using the Cyrillic pronunciation of "loss." When piloting a multi-billion dollar property (the fighter jet) G-LOC is not a good thing for anyone. The pilot may convulse, called "doing an Elvis" because the flailing looks like playing an air guitar - a real air guitar. Then the pilot may "ding" (lose consciousness) and the vehicle may "descend below the level of the terrain" (crash) and "disperse energetically" (explode) and "value unfavorably" (be destroyed), and the crew and anyone they land on may "achieve a negative health status" (die).

So we test.

A rocket sled is a small platform. Rockets propel it on the ground on rails. It creates high onset g-forces for a time limited to the length of the track. When personnel or equipment riding it sit as in a car or plane, they experience acceleration pressing them from front to back (on an x-axis).

To measure the higher g-forces with short onset experienced in jet bail-out procedures, a vertical ejection tower can be used. A small seat is propelled quickly upward by a contained blast force under it (like lighting a bomb). If they are positioned to sit upright, the acceleration acts on them from head to foot, on their y-axis.

To experiment with varying accelerations over different amounts of time and onsets, one device used is a centrifuge. A long support arm swings around and around a center anchoring point -like swinging a ball on a string around your head. A container, often ball shaped, at the end of the support arm holds the equipment or personnel being tested. The ball can rotate to position the people inside at any angle to simulate the changing positioning of a cockpit during maneuvers, for example.

What happens to the people in these testing devices? Often they throw up all over my nice equipment. Some of my test subject pilots used to have contests who could eat the worst thing to redisplay on testing day. One ate plastic bugs just for the fun he was sure to cause - then he didn't throw up, no matter what we did to him. In vertical (y-axis) ejections, there is high impact and acceleration forces on the discs and spine. Back injury is a concern for ejection scenarios. Vibration, both during acceleration and non-acceleration situations, such as for helicopter and jack hammer operators seems to be a high contributor to back pain. It is not known if the various vibration devices sold as fitness devices are of the kind (vibration frequency or amplitude) that contribute to joint pain. G-LOC is another consideration. Why do we test it? To see how to prevent it, if we can screen for who is more likely to get it, if we can train those prone to it to be more resistant, and so on, in g-force tolerance improvement programs (g-TIP).

The set of photos at right is a well-known one of USAF Colonel John Paul Stapp, M.D., Ph.D., riding the rocket sled. He was a pioneer of acceleration study and is also known as the originator of the expression "Murphy's Law" for things that can go wrong. The effect on his face along the x-axis is not from his high speed, but the acceleration which is increasing in photos ii and iii, and decreasing in v and vi. Even though his speed is greatest in photo iv, speed is not increasing or decreasing much, so there is little effect.

More on the interesting effects of acceleration and environmental testing from roller coasters to jets to movies in posts to come.

Labels: aerospace, circulation, disc, g-force, injury, lower back, performance enhancing modality

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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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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. Over years, your foot can get strained. 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.

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 pronate (arches flatten) is another fascial strain. Keep your body weight evenly around the sole of your foot, not sagging inward on your arches, pressing them downward. Reader David from Belgium has 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, therefore stopping the pain from the stretch, giving the false impression that the injury is lessening. It is a negative cycle 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. Use good body movement for all 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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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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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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Readers Ask About Watching Body Positioning

How many of you caught that the photo in the Fast Fitness post - Fix Positioning by Watching Others is of terrible body positioning that is a common source of upper body pain and injury?

I received letters asking about the photo. Several readers did not catch that the reason for the photo was that both people were standing in terrible rounded forward posture. Some readers thought the photo was not of bad posture, but showed people with interest in the game or that they way they were standing was a needed position to see the ball.


The rounded and tilted forward position of the upper back, neck and head is a bad positioning that is a major cause of:

• Upper back pain sometimes called Upper crossed syndrome
• Herniated neck disc
• Numb fingers
• Shoulder pain and rotator cuff injury

Here are short posts to show you how to spot the cause of upper back and neck pain and what to do:
Breasts Causing Upper Back Pain is a Myth
Fixing Upper Back and Neck Pain The Cause of Disc and Back Pain
Disc Pain - Not a Mystery, Easy to Fix

One way to tell is to check your arm rotation, shown in
Thumbs Can Show Tightness That Leads to Upper Back Pain

Crunches, many common Pilates exercises and many other exercises done every day done for "health" are in rounded forward or bent forward positions. They are counterproductive to health, to posture, and to strengthening:
Are You Making Your Exercise Unhealthy?
Common Exercises Teach Upper Back and Neck Pain
and The Stretch You Need The Least


Look in your fitness magazines and videos and look around during fitness classes and the gym to see if you can see the forward head and a rounded upper body. It's a handy reminder that it is not healthy, and to exercise in better, healthier ways.

Labels: arm, disc, fix pain, impingement, injury, neck, upper back

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A Reader Asks About Osteoporosis and Walking Lightly

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

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

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

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

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

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

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

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

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

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

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

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

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Cauda Equina - Result Not Cause

Bernie, age 80, promised in December he would dance at his daughter's upcoming wedding in
Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I.

Part II of Bernie's story looked behind the scenes of how we fixed the source of the pain, step-by-step.

The promised dance is at right.

The point of the two posts was that the key is to fix the source of pain and injury, not just have surgery, take medications, and do some exercises. The posts also showed things to do to fix the causes so that readers could do it too.

A reader wrote an opinion in the comments of Part II, that Bernie's signs and symptoms were of Cauda Equina Syndrome (CES), and felt cauda equina was important for readers to know about.

The problem is that cauda equina is not the cause of the collection of back and leg pain and numbness problems, but the result. The cauda equina is a group of nerve roots of your lower spine that go down toward your feet. The bundle of stringy nerves looks like the tail (cauda) of a horse (equina). If something hurts or presses on the area, pain and numbness can result. It is just saying something wrong has resulted in that location. The key is finding and stopping the cause of what is hurting or pressing on the area, not taking medicines or having treatments.

It is like saying someone has stomach pain, and prescribing pain medicines and support groups. The pain could be worms, a pregnancy, a lack of enough stomach acid to digest food. You need to know the cause to do the right treatment.

For example, if a herniated disc is compressing the cauda equina, you need to stop pushing your disc out of place, described in Disc Pain - Not a Mystery, Easy to Fix and use daily simple good body mechanics instead of the bad bending that gradually push discs outward - The Cause of Disc and Back Pain. Then the disc and nerves can heal and the pain will stop without drugs or back surgery.

The reader asked me to review a web site. The web site they recommended lists treatments of drugs such as narcotics and antidepressants, and epidural injections. It mentions exercise to maintaining muscle strength in leg areas that have weakness from nerves that are compressed. This is like trying to catch blood loss in a bucket instead of stopping the blood loss at the source. The web site says sufferers with foot drop can use a brace. Instead of using a brace, which can cause more atrophy, it is better to stop the cause of the foot drop, where possible.

Fitness Fixer reader Ivy from New Zealand had foot drop from nerve compression. She stopped the cause, detailed in Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. By stopping the cause of the nerve compression, Ivy did not need the brace or cane. It is not healthy to allow nerve compression to continue. Muscles and nerves become more damaged over time. A brace or cane does not restore function. They can further cause bad gait and body mechanics.

Bernie had many injuries from the surgeries he had undergone for the purpose of relieving back pain. In addition, the back surgery deliberately resulted in some reduced movement of the spine. Many back surgeries do this on the premise that reducing movement will reduce pain. The reduced movement meant reduced function and mobility, resulting in more pain.

The cauda equina web site says, "We live with CES every day." The approach of The Fitness Fixer is not to live with an injury or take unhealthful drugs, but to find the cause and stop the cause so that you do not have to live with pain and drugs.

Labels: fix pain, injury, lower back, sciatica, surgery

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Can We Teach Young Doctors to Be Healthy?

We have been traveling for the past 2 months in Asia and are on the way to the chilly Smokey Mountains of Tennessee USA to teach medical students for a week during their rotation elective in Wilderness Medicine. This is the third year I will teach there.

I will teach the entire curriculum of diving medicine and physiology, plus a workshop on why commonly prescribed stretches are not healthful, and what to do instead. Several members of the Knox County Sheriff's Office from Knoxville TN have requested to attend my lectures, and several readers made the effort to find the class information on my web site and make arrangements to travel to the camp to attend.

As a physiologist, I design the techniques that physicians use. I spent many years as a military and university researcher in environmental physiology, which is how the body functions in the heat and cold, at altitude and underwater, breathing different mixtures of gases, doing different forms and intensities of exercise. It's important to understand why things work. If you don't understand, then you can't think for yourself, and all you can do is repeat the mistakes of the generation before you, who also were just repeating what they learned in a book from teachers who just were repeating what they had heard.

This problem occurs with some of the exercises and stretches given as physical therapy. An introduction to the problem is in the post What Does Stretching Do? In the past two years teaching at the camp, we encountered young students who were not interested to change bad stretches, and made a point of showing me after my lectures that they will keep doing their rounded bent forward toe touches, since "everyone knows" that is how it is done. However, Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.

The problem occurs with nutrition. The medical school food at the wilderness camp is not healthy, and students have defended eating candy and junk food as reasonable, even saying that what they eat is not unhealthful - What Medical Students Told Me About Nutrition and When Did Health Become Thinking Out Of The Box?

The problem can occur with medical treatments that are in the books, even though wrong. In my diving physiology lectures, I try to show that if you understand the physiology, you will know why certain treatments do not work or are not needed. Immersion in water, for example, creates many interesting effects such as distributing blood volume more out of the limbs to the body. This is similar to the effect that occurs in space, described in Collapsing Astronaut Gives Healthy Reminder. Recently, during our travels, Paul wound up in the hospital with a swollen leg. The doctor who was Chief of Medicine of the hospital, announced that the treatment was bed rest. Paul was told he must lie flat in bed for at least three to fours days with the leg elevated to drain the fluid. We understand that bed rest is often listed in books as a treatment for this, but it is wrong. I asked the doctor if going in the water could help. The doctor said that standing in the water meant the leg would be "hanging down" and the leg needed to be elevated to drain. If you understand immersion, then you know why immersion can more effectively treat limb edema and water retention than medicines and lying in bed. Extended bed rest is unhealthy, and reduces muscle and bone health so much that it is used to study the damage to the body from floating around during space travel. We escaped the medical care and went into the water. I will post more on immersion, edema, and health soon.

I will not have Internet access for the next week to read or reply to comments. Enjoy the posts. Start taking and sending in fun photos of your successes using all the fun techniques.

Labels: education, injury, scuba, swimming

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Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II

In Part I of this post on Monday, photographer Bernie tells of fixing years of pain that doctors told him only surgery would fix, even after three surgeries. Here is a look "behind the scenes."

10 March 2005, Bernie e-mailed me:

"I've had this persistent paresthesias for 4+ years. I just learned about you yesterday. Where are your back & spine classes held. Tomorrow, I'm having lumbar myelogram & CT at (top name deleted here) Hospital. Before I consider anything else, I want to learn about your methods."

I wrote back with class information. I had two classes coming up. One was the next month. The second would be in early May and only a few blocks from where he lived. I told how we work to see change in pain right in class. I asked him to let me know the test results and that I hoped to see him in class.

20 March 2005 he wrote back:

"Thanks for asking, I never expected you to keep in touch. The myelogram and CT showed moderate central spinal stenosis at L4-L5. Severe facet joint arthropy & hypertrophy of ligamentum flaxa causing compression of the lateral recesses stenosis of L5 on both sides, kinking of L5 nerve root sleeves on both sides. I have a copy of the xray, showing the "hourglass" at L4-L5

"(name deleted) is the attending, 3-B Orthopaedics. He said the next step is surgery, by ( ), at ( ) Hosp. I asked if strengthening of my upper body would help support my spine. He said "try it" so I'll be at physical therapy next week to start.

"I have a commitment for the weekend of April 2-3 so can't attend that class, much as I'd like to. Since I live at (close to) your class at Temple CC is my best chance of attending. Cordially, Bernie Cleff"

I checked back in to make sure he was signed up for the May class and to ask what he was doing in Physical therapy. He wrote:

29March 2005
"The phys therapy that I'm getting concentrates on my core muscles. Thanks for gett