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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Fast Fitness - Leap for Balance on Leap Year

Here is Friday Fast Fitness for the intercalary year (Leap Year) - Leap to develop ankle and knee stability, leg power, and balance.

1. Leap forward, landing on the other foot with soft shock absorption. Don't land hard, which jars joints.
2. "Stick" your landing, without wobbling or setting the first foot down.
3. Leap backward to the original foot and place. Hold your landing steady. Try several leaps forward and backward, then change the leading leg and repeat.

When landing, keep ankle stable by preventing your foot from rolling to the outside. Info in the post No More Ankle Sprains Part II.
Train knee and hip stability by preventing your knee from swaying inward upon landing - Healthy Knees.

Labels: ankle, balance, fast fitness, feet, hip, holiday, impact, knee, leg strength, sprain

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Walk Lightly - Shock Absorption for Happier Joints

"Your tread must be light and sure
as though your path were upon rice paper

"This rice paper is the test
Fragile as the wings of the dragonfly

"Clinging as the cocoon of the silkworm
When you can walk its length and leave no trace
You will have learned"
- Master Khan to Grasshopper in the 70's TV series Kung Fu

Walk, run, jump, and move lightly.

Banging down with each step is not good for your body. It increases risk of joint pain and plantar fasciitis.

I tell my students to stop banging and stomping when they walk and move and jump. One day, a student asked me "How?" Here are some things to try:

1. I asked the student to stomp his foot.
Then I asked him to place his foot down lightly. That is how.

2. Use an analog bathroom scale. Step on heavily and see the numbers go up high. Then step on again lightly and see that the last number reached is a lower number. In sports medicine, we use force plates to measure ground forces when an athlete jumps or runs by.

3. While walking, try not to make noise. It doesn't mean to tip-toe, but to walk with regular heel to toe gait, but lightly.

4. Try walking with a full-to-the-brim cup of hot coffee or any liquid. Don't tip-toe, just walk softly without spilling any.

5. Practice jumping in the air and landing softly. Bend your knees when landing. Increase the height of the jump, maintain soft landing. Work up to jumping down from increasing heights without making a sound, or much sound.

Labels: arthritis, feet, impact, knee, leg strength, martial arts, plantar fasciitis, running, walking

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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 getting in touch...very kind of you."

I wrote back saying that conventional core exercises were not the best thing. Usually they are forward bending actions that will further compress the discs, the nerves, and also do not retrain the abdominal muscles in the way they work when you go about daily life. Strengthening does not automatically support the spine. I wanted to make sure that he had my Ab Revolution book, which was then out in a training manual version. He said he had it with him for PT. (I found out two years later that they had the book, but they were not using it, and were doing traditional forward bending abdominal exercises.)

10 May 2005, the day after the Fix Your Own Back Pain workshop was held, Bernie wrote me,

"Hello, I did sign-up for your class at TUCC on Monday 5/9, but I was too tired to attend. On top of that, I am scheduled for spine surgery at ( ) on Wed 5/11/05, with ( ). After having 2 epidurals and physical therapy I decided to go for the surgery. My nerve that is pinched is in the shape of an hourglass (at L4- L5) and (the doctors told him) that no body position or exercise changes are going to help at this time. Both legs are numb and I am walking like a drunk. It is kind of you to keep in touch. I hope to meet you at your fall class."

Days later, Bernie had the surgery. He tells about it, and his next two years, in Part I of this story. The doctors all considered his surgery a "complete success." They said the surgery went completely according to plan, with no complications. His recovery was in line with expected results. The fact that his pain returned, was worse, and complicated by limited movement from his plates and screws and other surgical hardware not a factor to them. They felt the limited movement was beneficial and a goal of the surgery. The commonly held idea is to stop motion in the area to stop the pain.

In late October of 2007 arrived to teach the Fix Your Own Back and Neck Pain Workshop. I had 16 people waiting for me. One was Mr. Bernie Cleff, a funny white-haired muscular man of 80, who was in much pain.

We had a fun, energetic class. One of the students was a young man from India. He sat unsmiling as I mentioned various yoga poses that can injure discs in the neck. I tried to ease the class explaining that I am not against all yoga, and studied years to become a teacher myself. He sat unsmiling. We did three specific techniques to stop the neck pain process and a beautiful smile radiated from the young man from India. He had three herniated discs in his neck, most likely from his yoga practice of the specific moves I had mentioned, together with sitting badly at a computer for his work. He already knew those yoga moves hurt his neck. He had just been worried the pain would never stop. When it did, right there in class, he smiled.

Another of the students was a golf pro. Who I consulted with afterward to test out my work on lower back pain and golf. More on this to come.

Mr. Cleff did great in the first class. This class was done over two weeks. I gave the class things to try over the week before the second and last class.

Oct 25 2007 he wrote me:

"Today (Thursday) is my class day at The Clay Studio, working over the wheel for 5 hours. I felt good with very little noticeable pain. Usually after walking the 5 blocks from my home to the studio both my legs would tingle badly and I would stop to rest halfway. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to check-up. You are one hellova person and I'm thankful that I've met you.

"I've had my spine problems with the pinched nerves for a long time - roughly 4-5 years- and I'm slowly getting better since you came into my life. There is no other way to say it. Thanks Jolie."

He was improved in one class, and he felt that he was "slowly" getting better. I like an empowered student who does not want to dawdle to get better. The day after the second of the two sessions, Bernie wrote:

28 Oct 2007

"Last night, I walked about 7 blocks to restaurant AQUA (great value, low cost & delicious) and back home another 7 blocks.

"Upper back extension causes no pain, lower back does. I can do plank on elbows, holding for 60 seconds now, no pain.

"If you want to make photos of a geriatric doing your things, it's OK with me. as you've seen, I'm not bashful or delicate. I will work at getting better, my daughter is getting married January 5 and I want to be able to dance with her and my wife."

Bernie went back to his doctors about the small amount of pain remaining. They told him he should have more surgery, and gave him prescriptions. He wrote to ask me:

"On Nov. 2 I have a follow up with the spine surgeon (same guy) and on Nov 14 a consult with a Neurologist ( ). Do you have any suggestions about a pain med FENTANYL ,which was suggested by a doc at the V.A."

I wrote back that Fentanyl is a surgical grade narcotic. It is used "off-label" for back pain and there have been deaths. I asked him to tell me more about what hurt, and when, so we could stop it without any harmful medicine, and also what the neurologist said.

14 Nov 2007 he wrote:

"I had an office visit with the neurologist at ( ), he said my twisted nerve at L5 will never get better and I will always have pain."

They told him to have another spine surgery and take the Fentanyl. (Then why did they put him though all that surgery?)

He wrote:

"Hello, I still have some tingling in both knees...but much better than 2 weeks ago! There has always been pain in my left flank between spine & hip, never told you because the knees were my greatest problem… The lower back pain persists, but only left side. When I do the trap stretch leaning to left--puts much pressure on that pain. Leaning to the right feels like a good stretch. Any additional suggestions?"

I found that that he was still doing "their" exercises. Conventional exercises of bending forward to stretch the hamstrings are often prescribed for back pain. The assumption is that tight hamstrings have (something) to do with back pain. However, bending forward is one major contributor of this kind of back pain. I changed how he stretched his hamstrings to one of the ways we did in class.

He was also continuing to overarch his lower back when walking, which was a large source of the tingling pain. When he used the Trapezius stretch, he was also overarching, which makes pain when bending to that side. This kind of pain is often confused for spinal stenosis. One classic sign of stenosis is pain when bending toward one side. But the narrowing is not true stenosis, but just overarching which narrows and pinches the area. For someone who has stenosis, not pinching the area further with overarching is frequently enough to stop pain.

What was complicating everything was his surgeries. They were considered "completely successful." The two knee replacements were "completely rehabbed" meaning he could bend his knees enough to sit in a chair. He could no longer stretch the front of his hip enough to prevent the kind of tightness that encourages standing and moving in overarched position. The back surgery put a plate in his back to prevent much movement. That meant that even small overarching movements were enough to pressure the newly immovable area. The back hurt, and the tight back and hip were compressing nerves going down both legs.

He wrote two mails:

"Jolie You hit on the spot. I will keep at it gently."

and

"Jolie, a quick note to tell you today I walked 12 blocks, stopping to stretch hamstrings.. often on steps or fireplug....as you suggested...also lunge stretch. I will dance at my daughter's wedding. Much thanks.

"There will not ever be more surgery on my body."

For the flank pain, he had been for many tests, and was even scheduled for a kidney evaluation. The muscles in the area were so tight, that I biked over to his home to do a sports medicine technique to stretch it out for him, and checked his other stretches. I went over how to stretch the front of the hip without overarching his lower back. His sweet funny wife made me lunch. We got some fun photos of things as gifts for you, of fun stretches and activities.

He wrote

"I've had x-rays, MRI, bloodwork, surgery, injections, no Dr. had any solution.
YOU HAD THE ANSWER. No wonder so many people have thanked you."

He did the work and gave me the credit. That's a good man.

Labels: facet joints, fix pain, hamstring, impingement, injury, knee, lordosis, lower back, neck, readers inspiring story, side, stenosis, stretch, surgery, yoga

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

In this post, Bernie, an 80 year old retired photographer tells how he was signed up to take my "fix your back pain" workshop in 2005, but was convinced by his doctors that nothing but surgery would help. After "completely successful" surgery, his pain returned and worsened. He returned two years later to me. December 2007, Bernie wrote:

"I was a professional photographer for over 53 years-freelance-meaning go any place, any where- for many varied clients and I am now 80 years old and retired from photography.

"Much of the time I carried a 40-pound camera bag on my shoulder when climbing a 75 ft radio tower, walking on railroad construction sites or climbing The Great Wall in China.

"When I was at my vacation home, I climbed ladders to paint, replace cedar shingles and install new windows.

"Both my knee joints were replaced (5/93 & 6/01). Sometime in 2003 I was aware of tingling in both of my lower limbs from the knees downward. That started my medical testing with EMG’s, MRI, CT Scan and X-rays. The diagnosis was spinal stenosis caused by age-related changes in my spine. Physical therapy was started and I had an epidural, which helped for about a year. Then a second epidural lasted for only 3 months.

"I had been volunteering in an E.R. for 7 years helping patients and I had to stop as it was impossible to walk or stand on my feet because of the strong tingling in both limbs. Then I was told that spine surgery was the answer, but continue P.T. with some changes of the therapy. So, two years later, with some relief… but not enough to continue, I stopped the P.T., had an MRI scan which showed further degeneration of L4 & L5 with kinking of nerve roots. All along there was a pain in my left flank, but that was overshadowed by the strong tingling in the knees. There had been suspicion of kidney stones or liver function but x-rays & all blood work proved negative. I was hurting more in both knees.

"The spring passed at my vacation home near Barnegat Bay with much pain and with me looking at my kayak that had remained in storage. I called for surgery to be scheduled.

"The lumbar myelogram & CT was done at Pennsylvania Hospital and surgery date was set.

"On March 10,2005 I found the website of Jolie Bookspan and e-mailed her with my “story” of pain. Her class to fix back pain was going to be held soon a few blocks from where I lived. She asked me to try the class first, (it was being held a week before the schedule surgery) but I told her that both legs are numb and I am walking like a drunk, the doctors said no amount of exercise or body mechanics would fix such structural problems, and am going thru with the surgery on May 11, 2005.

"Post-op recovery was hell. The summer was hell with pain killers and sleeping pills. At the follow-up exams, I was told “the surgery went well, no infection, you’ll be better in 6 to 8 months”. The laminectomy used a metal plate & 4 screws and a bone graft from my hip for the fusion of L4 & L5. The pain in my left flank remained throughout 77 physical therapy treatments. The surgeon prescribed Elavil and when I took it, I felt like a zombie. After I told him, I was told to try a half tablet. That made me feel like a half-zombie.

"No doctor had a solution except “try Tylenol, Advil, Fentanyl, and more”…a consult with a neurologist said that my twisted nerve would never get better. (So why all the surgery?) The pain in my left flank remained.

"Then I took Jolie's class on October 20, 2007 and she had the answer. My left flank pain was not a medical condition (I was put through every test including kidney function), but a muscle in spasm. I was doing the wrong exercises that I had learned in PT and they were making it worse. She taught me to do the exercises the correct way as shown in her books and articles in her websites.

"Five days later I reported to Jolie that I had been working at The Clay Studio, throwing clay on a wheel making pottery for 4 hours and felt good. Usually after walking the 5 blocks from my home to the studio both legs would tingle badly and I had to stop halfway to rest. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to checkup. You are one hellova person and I’m thankful that I’ve met you.

"I’ve had my back problems with the muscle spasm and damaged nerve for a long time…roughly 4-5 years…and I’m getting better since you came into my life. There is no other way to say it. Thanks Dr. Jolie for your passion for helping others.

"On your questionnaire in the first class I wrote that I wanted to be able to dance with my daughter at her wedding in January 2008. You have made it happen for me.

"I will dance."

Next - Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II - a look behind the scenes.

Follow-up Note - the wedding on the 4th of January was great and Bernie danced and danced. Here is a photo.

Labels: fix pain, impingement, knee, lower back, readers inspiring story, side, stenosis, surgery

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Fast Fitness - Strength, Abs, Balance, and Ankle and Leg Stabilization

Here is Friday Fast Fitness - quickly increase functional stabilization of the knee, leg, and ankle while increasing overall strength and balance.

Anyone can lift weights, but can you do it balancing on a basketball? Get started by standing on one foot:

1. Do your regular lifts, curls, presses while standing on one foot (and then the other). Breathe.


2. Notice the leg you stand on. Don't let the arch of your foot flatten toward the floor, or knee roll inward toward the other leg. Hold knee, ankle, arch inline, using your muscles. See Arch Support Is Not From Shoes.
   


3. Don't lean your upper body backward (increasing lower back arch) when lifting arms up - a hidden source of back pain. See Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.

It reduces exercise to sit, even on a fitness ball. It is more exercise, more functional, and better balance training to stand on one foot than to sit. You sit all day already.

Be safe, be excited about having fun doing functional movement, be happy.

Labels: abdominal muscles, ankle, arches, arm, balance, exercise ball, fast fitness, hip strength, knee, leg strength, neutral spine, pronation, sitting, strength

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Daughter's Love Saves Parent's Knees

A special story came in. I had been corresponding with someone who wrote me to ask how to stop her mother's knee pain, and later with questions to help her father. I was charmed by this good daughter who wanted to help her parents. She faithfully taught her mother everything I wrote her, and she wrote back with results. I didn't know where she was from, and didn't ask. In the weeks of letters back and forth, she caringly scanned and e-mailed me copies of lab reports and pharmacy prescriptions. She asked good questions about the medicines and tests and how they could help her parents. The tests and prescriptions had notes in Arabic and distinctive generic names. I wondered if I might wind up on a watch list of people who correspond with people from certain countries. In one reply that I wrote, I headed the instructions on knee pain with, "To whoever else may read this, please use it to stop your knee pain too, for more peace and less pain in the world."

Here is the story of Katayon:

"I belong to Afghanistan and I am very grateful to Dr. Jolie Bookspan. My mother’s knees pain was my biggest concern for a long time. She went to more than six best doctors here in Pakistan. But all she got was medicine for relieving her pain which not always helped her. She was also told not to walk a lot and rather sit on the chair most of the time. My mom is young and still it’s very soon for her to spend her life just sitting. Doctors said the cartilage inside her kneecap has dried and can never be recovered and she will always have the pain. And that the only way is to always use those tablets. This really bothered me to think of her feeling pain all her life.

"After trying the doctors in the city, I selected the option of getting support through the internet. That is where I fortunately found Dr Jolie Bookspan who always keeps telling me that medicine is not the only option. But rather we have to adopt healthy movements. In the first stage, this knowing this thing encouraged and cheered me a lot. She also introduced me to the free articles- exercises related to knee pain and back pain, on her website. I have checked almost a lot of those useful links and currently I am following a lot of those helpful movements, exercises and directions mostly for knee pain. Currently I am also suffering from knee pain which is due to weakness of my muscles as the doctors here have told me. Dr Jolie has been a great help for me and my mother.

"And now I and my mother are feeling much better. I learned not to use knee-bands (bracing) because it further weakens the joints instead of strengthening them. I have shared all what I leaned with my whole family. So we are all blessed with an opportunity of adopting healthy joints movements. Besides a lot of other very useful guidance, I learned these important things: climbing the stairs putting full flat foot on the ground avoiding knees coming forward, so overall moving the knees in a healthy way which should not create pain while walking – I am practically doing this and I really see how useful and pain free it is; while picking something from the ground, trying to avoid knees coming forward and instead making it like sitting on a chair. So all in all, we are following all of the guidance and tips which really are pain free and help my knee joints get strengthened. I and my mother regularly every morning and anytime during the day we find time do the squat and lunge exercise which are very much helpful. Not only this, but I have also shared this exercise and all of the other healthy tips with my office colleagues who are suffering from knee pain.

"I never thought of a way out but only as the doctor said that the only option is to have medicine for whole life, whereas Dr. Jolie changed the whole thing for me encouraging me to have fun and keep walking pain free. I feel very fortunate to have found her. And I appreciate all of her time and efforts that she makes to help the world live without pain. I and my mother are deeply inspired by what she is doing to help the people. And we wish her best of luck and lots of energy to keep on her good job."
Katayon Q – Afghanistan

Posts to learn the techniques Katayon used:

• Strengthen and Retrain Function With The Lunge
• Strengthen Legs Without Knee Pain - Standing Lunge
  
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Why this kind of bending gives better exercise and prevents pain and injury
• Reduce Knee Pain on the Stairs
• My free web site Sports Medicine page

Why is there a picture of a flower with this story? A personal photo was not the right thing. I asked Katayon what photo she thought would represent her story and country. She wrote:

"With this email I am sending a picture to go with my story. I was thinking of something to show relief and happiness as a result of being healthy. And I came up with the idea of selecting flower picture for my story. To me, a flower presents every positive thing."

Labels: fix pain, injury, knee, leg strength, lunge, readers inspiring story, spirit, squat

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

Ivy had serious sciatica with foot drop. She had knee and other injuries. She was in awful pain. In this kind of foot drop, the nerve cannot serve the muscles enough to lift the foot to walk normally. The toes drag. The foot hangs limply and slaps the ground with each step.

Commonly, someone with foot drop is put in a leg brace for life. One surgery done for foot-drop fuses the ankle so the foot is rigid and doesn't hang. Other problems come over years from changes in walking mechanics. For the terrible pain, patients are often directed to drugs and surgery.

We changed that:

1. Monday's post Inspirational Ivy told the essentials of stopping the cause of the sciatic pain and nerve impingement, rather than treat the results with unhealthy means. Links to specific methods are there.
2. Sciatica, disc damage, facet pain, and impingement are results, not the cause of pain. They are not a diagnosis. When you have them, find what is causing them. Then you can reverse the cause: The Cause of Disc and Back Pain
3. The post How Often Should You Be Healthy? explains when and how to apply it.

Ivy followed my directions exactly and used her brain to understand how to get the intended results, not just "do a bunch of exercises." When she first began, she wrote,

"Over the past few days, I have been very conscious of my movements and, hey presto, I have not experienced any tingling or pain. I have to take total responsibility for every movement I make. I am constantly telling myself 'Think before you go to the fridge or need to pick up something off the floor - think lunges.'"

I gave her simple gait retraining. Ivy quickly discarded the cane she had used for nearly 7 months.

Ivy went on to teach several neighbors in her community how to fix their own pain. One story is posted in Each One Teach One.

In April 2006, Ivy wrote,

"It is nearly 5 months since I started your wonderful programme so I thought it was time that I gave you an update. I am fit and well, the sciatica has disappeared, if I get a little niggle in that area, I ask myself as to what have I done wrong, my left knee (IT Band) is no longer a problem, my balance has improved immensely and the "dropped" foot is great, in fact, when I go for my daily walk, I no longer hear the plop, plop of which I hated. I can also now wear "normal" shoes.

"Without your help and support and putting me on the right road so to speak, I would still be in constant pain plus making the chiropractor richer. Please note, I no longer go to him for treatment - I DON'T NEED HIM."

At age 70, Ivy is steadily improving strength and range of motion using healthy movement for daily life. She is eating healthful vegetarian food. January 2007 brought this note:

"The reason for this e-mail being that I feel somewhat excited re a remark made by the son of one of my fellow villagers. His very words being, "How did you become the woman that you are now. I have watched you over the past couple of years - when I first met you, you were obviously in a lot of pain, what is your secret?"

"I also sent the photos to my son and daughter-in-law who live in the US, they too, could see the improvement - they thought I looked great. Mind you, over that 2 year period, I gradually lost 20 lbs."

What about Ivy's e-mail that I mentioned in the last post about the new hip stretch? I'm out of room again. Watch for the next post.

Labels: disc, facet joints, feet, fix pain, iliotibial band, injury, knee, lunge, nutrition, readers inspiring story, sciatica, shoes, spirit, squat

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Inspiring Update from Jill - Celiac, Knees, Fasciitis, and Restoring Happy Life

Reader Jill hasn't sent a photo yet, but her words are a beautiful picture. Her story can help many readers stop pain and improve strength and function for happier daily life.

In the post Lunges and Beans Jill commented on Celiac disorder, an immune reaction to foods with the gluten protein - principally wheat plus a few others. Symptoms can be baffling until identified as coming from gluten.

Jill writes: "I had bad and steadily worsening joint problems, especially in the knees, for ten years before I found out about my gluten sensitivity. By that time my legs were extremely weak from having been unable to put weight on a bent knee for so long.

"I let the knees heal without doing anything special for them until I hit a plateau, then started doing isometric exercise for the quads (the classic wall chair), then six months after that started running slowly on an elliptical trainer. Weightlifting exercises for quads, though, still left me hobbling.

"That's where I was when I found your blog, and since then I've been doing squats at every opportunity, which was very hard at first and got much easier. Along with the foot stretch you gave, the Achilles tendon stretch in the squats also caused tremendous improvement in my plantar fasciitis.

"After a few weeks of that you posted the stair climbing posts and now I'm having far less trouble on the large numbers of stairs I climb every day. I am shying away from lunges from long associating them with pain, but plan to get over that soon and try them (gently) according to your detailed suggestions.

"Your blog has given me an enormous number of ideas to help in rehabilitating my knees from the years of gluten, which has made an enormous improvement in my quality of life. Thank you for the care and skill you put into it."

Jill, thank you for your care and skill to write things that will help many, and to do empowered good work to shine again. I put the posts with their links. Everyone, add your favorites:

• Foot stretch - Healthy Toe Stretches
• Achilles stretch - Better Achilles Tendon Stretch
• Achilles stretch built into daily bending with half-squats - Bending Right is Fitness as a Lifestyle and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Happy knees during stair climbing - Better Exercise on the Stairs
• Plantar fasciitis - see the comments in Why So Many Aerobics Injuries?
  
• Lunges - Strengthen Legs Without Knee Pain - Standing Lunge and Strengthen and Retrain Function With The Lunge
• All posts helping knees

To stop pain and regain your life, you don't have to "do exercises" - use movement for healthy life. Have fun. Shine!

Labels: achilles stretch, celiac, feet, fix pain, knee, lunge, planter fasciitis, readers inspiring story, squat

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Strengthen Legs Without Knee Pain - Standing Lunge

Many people know they need to bend "right" but don't because it hurts their knees.

Bending right will not hurt knees. It will help fix one of the things that has been injuring them - bad bending habits which pressure and grind the joint.

Good bending will also give your knees the exercise they (and you) need.

Some knee patients are told to never "bend right" with a half-squat or lunge because it is bad for the knee. There are specific things about bending and straightening the knee that can increase certain kinds of pain, to be covered in future posts. Use your brain and try the following gently and safely. Done right, it should reduce knee pressure, not increase it.


How To Lunge:

1. Stand with one foot far in front of the other. Both feet face forward. (Left photo.)
2. Feet remain normal width from side-to-side, not directly in line front-to-back.
   
3. Lift your back heel. Don't turn the back toes outward. Look at your back foot and check.
4. Tuck your hip under (click "neutral spine" label for posts explaining how). You will feel a far better stretch and strengthener.
5. Bend both knees to lower straight downward. Don't touch back knee to the floor. Use leg muscles. Watch your front knee and keep it over your front heel, not sliding forward. (Right photo.)
6. Don't let your front knee sway inward.
   
7. Keep upper body upright and straight. (Right photo.)
8. Lower and rise several times, then switch legs. Keep feet still, not stepping forward and back.
   

Tips:

• To keep healthy knee positioning for the front knee, peek downward to see your front knee and foot.
• You should be able to see your front toes all the way through the bend.
• If your knee slides forward covering your toes, you are shifting weight to your knee joint and off your leg muscles. This is one of two common ways to increase knee pain while bending. Letting the front knee sway inward is another.
  
• Keep front knee steady over your front ankle, not sliding forward or inward. You will strengthen and stabilize your knees and legs instead of hurt them. You will feel more muscle use when you keep healthful positioning.

Fitness as a Lifestyle:

No need to go to a gym to do lunges. Use the lunge for daily bending around the house. It will add up to many lunges every day, built-in as fitness as a lifestyle. The posts How Often Should You Be Healthy? and Bending Right is Fitness as a Lifestyle give ideas of how to use healthy bending for normal daily life.

Benefits of the Standing Lunge:

• Strengthen leg muscles
• Strengthen the knee
• Stop harmful forces on the knees from bad bending
• Stretch the front of the hip of the rear leg
• Stretch the Achilles tendon and foot of the back leg
• Learn knee stabilization
• Practice balance
  
• Retrain healthful bending for daily life - transferring to function instead of just being an arbitrary exercise - free exercise all day
• Retrain straight upper body position for bending - more functional exercise
• Provide beneficial general exercise, warming which makes further movement easier, and healthful body movement.

Have fun practicing this now. You will need the standing lunge for tomorrow's Fast Fitness - Quick Warm Up. Enjoy.

Labels: achilles stretch, feet, knee, leg strength, leg stretch, lunge, neutral spine, squat, strength

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Better Exercise on the Stairs

Old woman: Come upstairs and we'll make love.

Old man: I can NOT do both.

If you would like to strengthen legs and reduce knee pain while going up stairs:

• Don't lean forward (photo 1 above)
• Stand upright (photo 2 below)
• Keep your heel down on the foot that steps up.
• Push off the whole foot, feeling the push-off through the heel. Do not push off the ball of the foot.
• When you raise one leg to step up, don't let the other leg pull and bend forward. Keep the standing leg straight (not locked straight).

Many patients who come to me, previously unable to step up a curb without pain, can climb flights without knee pain using this repositioning. Stairs become not only accessible, but a source of the exercise their legs need to strengthen and regain function.

Keep your weight back toward your heel to use leg muscles instead of putting your weight on the front of your knee. You will get knee pain relief and a built-in Achilles tendon stretch with each step. Done right, you will feel a more muscular and strong push off, making stairs easier to climb and better leg exercise. Even if you have big feet and your heel is off the step, keep your heel down instead of going up "tip-toe."

Notice if you bend forward. Instead, stand straight. The post Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs explains how hip tightness increases bent forward posture when raising one leg for kicks and activities like stairs, and shows how to hold straight body position instead, to stop tightness, and get a built-in hip and body stretch.

When descending stairs or hills, bend your knees when landing for soft shock absorption. Don't step down on a straight, locked, knee. Future posts will cover more about stairs. Have fun improving leg strength and knee function by taking the stairs during daily life in a healthy way. Send photos of your successes.

Labels: achilles stretch, fix pain, hip strength, knee, leg strength, stairs

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Strengthen and Retrain Function With The Lunge

The previous post Leg Exercise That Helps Your Back introduced the lunge. The lunge can be a quick effective fitness and health enhancer when you understand that you use it for real life bending, not just as an exercise to do for a set number of "reps."

The idea is to use the lunge in a healthy way instead of bending over "wrong" for all the hundreds of times you bend around the house and workplace. Then you stop one of the major sources of back (and knee) pain and degeneration while you get free built-in exercise, calorie burning, and leg and hip stretch and strengthening. The post How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending shows just how many times every day you need to know this.

Reader Ivy from New Zealand sent in the photo above right showing a great way to bend for some of the many times you need to bend to reach and get things - the standing lunge:

• Upright torso
• Bending straight downward, not forward
• Front shin pretty much vertical
• Front knee over the foot
• Front knee does not sway inward. This is key in retraining knee stability during real life bending, stairs, and other movement.
  
• Back foot facing ahead, not turned out
• Front heel down. Better for knee and gives built-in Achilles stretch
• Feet nicely spaced
• Hands free, not on front leg
• The side-seam of the jeans from hip to waist-band is vertical, not tilting forward. It is somewhat hidden by Ivy's arm, I know. But the idea is important - do not tilt your hip forward to stick the backside out in back. Keeping the side seam vertical does several important things to strengthen and stretch, and keep neutral spine that I will cover in future posts on lunging.
• Looks comfortable and doable.

When using the lunge, do not bog down in "rules" over placement. The idea is to move in simple, healthy positioning, not hold yourself rigidly.

The post The Cause of Disc and Back Pain shows more on why healthy bending is key to fitness as a lifestyle, and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending introduces the half-squat as one of several fit and healthy normal ways to bend for every day activities.

Going to a gym three times a week is not fitness as a lifestyle. Instead of "doing" exercise, lift, and bend, and move in healthy ways all the time for real fitness as a lifestyle. Give it a try and send in your success stories.

Labels: achilles stretch, hip, knee, leg strength, lunge, stretch

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Leg Exercise That Helps Your Back - Why The Lunge?

I receive the question often, "What exercises should I do to stop my back pain?" I stress that that the exercises you need to do are to simply change away from all the injurious movements that are causing all the pain in the first place (left drawing) and use good movement instead (right drawing). Then your back can heal. The pain will stop.

I see patients all the time who come to me after going through back pain exercise programs. They went through their eight or ten week program, then their pain came back. Every day they did their exercises, then bent over wrong to put down their weights (left drawing), bend over wrong to pick up their gym bag (same left), sat badly on the way home, then hunched over their computer to record their exercise session. It is no mystery.

The post Disc Pain - Not a Mystery, Easy to Fix shows the mechanism of how bad bending and sitting damages the spine and discs. It is a simple injury, not a disease or condition. You can easily stop the process yourself.

A lot of dollars are spent on the common assumption that you need to strengthen or stabilize the back or exercise a particular muscle set, for example the multifidus. That does not fix the source of the damage. At the gym I see trainers, students, and yoga and Pilates teachers doing their exercise classes week after week, saying they come because they have to because of their back pain. Even the exercises they are doing were contributing to the problem. Many things that are bad for you feel good at the time. The post Common Exercises Teach Bad Bending gives examples so that you can avoid this pitfall. The post Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch shows how the most common stretches done, even in back pain programs are contributing to the problem, and what to do instead.

The answer is easy. The post Bending Right is Fitness as a Lifestyle showed one of the most important exercises you need to do to stop back pain. It introduced the squat, which is not an exercise to do for 10 repetitions, but to use instead of bad bending for the hundreds of times every day you bend for things. Instead of hurting your back hundreds of times every day, you prevent hurting your back hundreds of times a day. Instead of hurting your back hundreds of times every day, you strengthen your legs hundreds of times a day. It is not the exercise of squatting that fixes your pain by strengthening, but by preventing the damage in the first place.

This post introduces the lunge as a second wonderful "exercise" to stop back pain. It is not something you do as an exercise for a number of repetitions. Instead, you use it, along with the squat, for the many times a day you need to bend for all the daily things around the house and workplace - the laundry, the pets, the things on the floor, the kids, the dishwasher and refrigerator, and everything else, all day, every day:

1. Stand upright with one foot far in front of the other (right drawing).
2. Feet apart comfortably, both facing ahead, not turned outward (right drawing).
3. Bend both knees
4. Don't let your front knee come forward. Keep it over the front ankle (right drawing).
5. Lower straight down.
6. Your back heel comes up. Keep the front heel down for better knee health. It's a free, built-in Achilles stretch too.
7. Don't touch your back knee to the floor.
8. Don't hold your hands on your front knee. Although common, you get better balance and strength without it.

Done properly, the lunge should not hurt your knees. If you are too weak to lower enough to pick up the mail on the floor and get back up, that is serious weakness. You need functional strength to do ordinary daily life. This isn't walking miles over rocks to the river and returning with heavy water jugs over your back just to cook with. This is getting the mail.

Bending right with the lunge burns more calories than bending over wrong. Good bending helps a weight loss program.

Click the labels under this post to see more on these topics. The next post Strengthen and Retrain Function With The Lunge shows a reader making good use of the lunge. Posts to come will cover more about how wonderful the lunge is to transform your life from weakness and pain into easy function. This is fitness as a lifestyle.

Labels: disc, knee, leg strength, lower back, lunge, strength, weight loss

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Calories Burned in Prayer

Last week at the sports medicine conference, I talked to a researcher from Kuwait University. Dr. Jasem Ramadan presented a lovely little study called Bioenergetics of Islamic Prayers, measuring the amount of oxygen and calories the physical movements of the prayers burned.

Five standard prayers (Salat) are mandatory every day for every adult male and female Muslim. Each prayer has a continuous sequence of body movements (Rakkas) consisting of standing, bowing, kneeling and sitting. Each Rakka lasts between 3 and 6 minutes. Dr. Ramadan looked at the energy cost of two and four Rakka prayers in thirty-two male and female adults. He found that Salats have a positive effect on metabolic function. For an 80 kg person, energy cost of daily prayers was about 80 calories a day, and could be considered a form of physical activity that enhances fitness.

Dr. Ramadan told me, "The prayers have been done for thousands of years and no one thinks about it as physical exercise." I told him I think that often. I told him that Russian Orthodox prayer was pretty physical. A liturgy lasts hours, done standing and continuously crossing yourself from the floor in a squat to high overhead. Everyone including the oldest people do this, up and down, and up and down, and up and down, stretching and squatting, reaching and bending. I always thought it was group community health activity, probably found long ago to be protective against many ailments (and attributed divinely). The original yogas were the same, reaching upward to exalt the heavens, bowing, kneeling, prostrating, rising, over and over.

I told Dr. Ramadan that many Westerners aren't comfortably able to do the kneeling Rakka shown in Healthy Toe Stretches or rise to a stand without using their hands, as in the post Quick and Easy Strength and Balance Exercise, not only the elderly, but the rest of the population too.

He seemed surprised and interested. I told him I believed that this lack of basic human movement for real daily life was a major contributor to the epidemic numbers of people who are too weak and unstable to get up unassisted, to walk without canes and walkers, have trouble taking stairs, have poor balance, and for much knee and hip pain and degeneration. Dr. Ramadan said that elders in his country do not suffer knee and hip arthritis in high numbers, and can easily rise from the floor into their old age. I told him that many Westerners are familiar with a device that is worn, with a button to press for help if they cannot get up from the floor or chair. At this point, he was sure I was kidding.

If you cannot get up from the floor or low chair easily without using your hands, you likely have dangerously decreased leg strength and balance. Use good bending to strengthen your legs and knees many times a day and improve your fitness, explained in the post How Often Should You Be Healthy? Use healthy movement every day to sit, rise, bend right, clean, garden, give thanks, stretch, take stairs, and play to get healthy functional exercise, and prevent common joint pain. That is fitness as a lifestyle.

Labels: aging, arthritis, balance, fix pain, hip, knee, leg strength, leg stretch, strength, stretch, weight loss, yoga

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Fixing More Fitness Myths

On April 1st, I covered some fun fitness myths and how to change myth into healthier exercise. Today continues with more fun ways to get more exercise and reduce injury at the same time:


Heart Health

Myth - Anger has no health effects. Instead, turn contempt and anger for others to healthy dialog with:
Healthier Heart.

Understanding How "Sticking Out in Back" Isn't Neutral Spine:

Start with this one to see what overarching the lower back means, and how correcting it lets you do more in healthier ways:
Fixing the Commonest Source of Mystery Lower Back Pain

Then try Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine to visualize how you simply tuck enough to make the belt line level when standing, not tilted. A small inward curve in the lower back remains when you shift to neutral spine, but not large enough to cause degenerative pinching on the facet joints, the joints of the lower spine.

Then feel the difference of tucking until neutral: Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique

and Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain

Here is how to try it during squats: Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending

Here are some abdominal exercises using these principles: Change Common Exercises to Get Better Ab Exercise and Stop Back Pain

Here is what it looks like not to use abs:
What Abdominal Muscles Don't Do - The Missing Link
What Does It Look Like to Not Use Abdominal Muscles?
and Healthier Carrying - Get Free Ab Exercise and Stop Pain.

Abs and Tightening:

Myth - Pressing navel inwards to tighten abs is the way to strengthen your abs or fix your posture. Fact - tightening will not move your spine out of unhealthy position and it impedes normal fluid motion:
Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine.

Exercise Injuries

Myth - Exercise injuries are usually overuse and aging.
Fact - Simple misuse is easily fixed: Why So Many Aerobics Injuries? and What is "Fitness as a Lifestyle?"
A recent injury survey by US military revealed that 62% of American injuries in Iraq are occurring in the gym. Welcome to the Fitness Fixer tells more.
Some top docs say the military press should be avoided. I think it is a functional exercise and can be done in ways without upper body injury: Safer Overhead Military Press.

Dispelling Myths about Circulation and Massage:

Keeping Thai Massage Healthy Part III - Should You Do "The Blood Stop?"
Making Thai Massage Healthier Part II - Avoid Snapping Elbows or Knees Backward
Changing Thai Massage to Be Healthier Part I - Avoid Pressuring Lower Back Discs.

Sitting and Rising:

Myth - The way to sit and rise from a chair is to lean forward and stick out in back. Here is a way that uses muscles more:
Get Better Exercise From Your Chair
and
Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?