Fixing Posture - No Exercises Needed

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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Stop Lower Back Pain From Swimming and SCUBA Part II

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

Check yourself to see if you stand in hyperlordosis:

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

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

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

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

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

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

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

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

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

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

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Lower Back Pain From Swimming and SCUBA

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

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


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

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


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

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

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

Next - Part II, How to Stop Lower Back Pain From Swimming and SCUBA

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

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

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

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

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

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

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

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

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Kettlebells Without Spine Injury

Reader Dan wrote:

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

Kettle bells (also called kettle balls and many other names) are usually ball-shaped weights with a handle. A variety of sizes is shown in the photo below, along with a medicine ball for comparison. Kettle bells were long used in various martial arts and cultural festivals and contests before being rediscovered for modern weight lifting. In general, you lift, swing, and move them to do various weight lifting exercises.

When lifting and swinging kettlebells (and any weights) overhead, don't lean your upper body backward (photo below left). Leaning backward is often mistakenly done to "balance the weight" and make the lift easier. Another common body movement to make lifting overhead easier is changing the tilt of the pelvis (hip) so that it juts forward in front and outward in back (same photo below left). Leaning the upper body back and tilting the pelvis are not necessary to balance a load - your own muscles can hold the load, and in fact, that is the point of lifting the weights. Not only are they not necessary, they increase the inward curve of the lower spine. Increasing the small normal small inward curve (lordosis) to a large curve (hyperlordosis) increases compression on the joints (facets) and soft tissue of the lower spine. The same overarching is the hidden cause of back pain in women who lean back and/or tilt the hip trying to offset the load of a pregnancy - Back Pain in Pregnancy - and Why Men Can Get It.

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

Leaning backward and overarching are not helpful adaptations as sometime thought, are not unavoidable, and are not limited to pregnant women. Overarching (hyperlordosis) is a common bad posture, and an often missed source of back pain. It can be easily prevented by using your muscles to hold neutral spine. The post Prevent Back Surgery shows photos of hyperlordosis compared to neutral spine during many activities.

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

Neutral spine is not done by tightening or clenching any muscles. It is done by moving your hip and lower spine the same way you move your arm to scratch your nose - without tightening, just moving it to where you want it.

Helpful posts to see and learn neutral spine while swinging kettlebells, babies, and all other fun weightlifting:

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

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

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

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Fast Fitness - Fixing Your Handstand to Neutral Spine

Last week's Fast Fitness showed a movie of how to step up into an easy handstand and get back down. This week shows a common pitfall - letting your lower spine sag under gravity - and how to fix it and hold neutral spine.

My student Dennis, Olympic medalist in wrestling, demonstrates:

1. Step your foot up behind you high onto a wall, then the other.
2. For the first 5 seconds of the movie, Dennis allows the lower spine to overarch (increase the inward curve) under the pull of gravity, a bad posture called hyperlordosis. It is not the normal inward curve, it is an easily changed bad posture.
3. At second 5 he changes the tilt of the hip and lower spine back to neutral spine. The action is like doing an abdominal crunch to bring the spine and torso just forward enough to be straight.

This technique practices the muscles and positioning for straight standing, making it better than just a handstand. If you want to gain abdominal strength, using neutral spine uses those muscles. An important difference in Fitness Fixer exercises is that they are not only exercises alone. All the techniques I developed are supposed to be used to train muscle function and positioning for when you stand up and walk away.

Use neutral spine, not only for handstands, but all you do. Examples are in Prevent Back Surgery.

Labels: abdominal muscles, arm, fast fitness, lordosis, lower back, neutral spine, posture, strength, video/movie

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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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Fix One Pain, Don't Cause Another

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

Two similar letters came in recently.

Reader Tina wrote:

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

Alicia wrote:

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

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

Leaning the upper body backward increases the inward curve of the lower back, making a sharper angle between the pelvis and the lower spine. That increases the normal lordosis (inward lumbar curve) to hyperlordosis, which put painful pinching compression on the area. The shoulders may even still be rounded forward, as in the photo at left. The two segments are different. The photo is a performer who had just finished a trapeze performance. All the exercise and stretching she did every day didn't change her bad positioning habits.

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

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

Alicia wrote back:

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

Pinching back does not fix posture or stop upper back pain. Instead, stop the causes of the rounded shoulders and the pain. These three posts help understand and fix the causes: First read and try Fixing Upper Back and Neck Pain. Then the second stretch is Nice Neck Stretch. The third stretch to help restore upper body positioning is Friday Fast Fitness - Better Shoulder and Triceps Stretch.

Don't exercise one area and hurt the next:

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

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

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

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Fast Fitness - How to Feel Change to Neutral Spine

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

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

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

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

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

• Another short movie that shows the same idea, without the wall - Friday Fast Fitness - Neutral Spine in 5 Seconds
• Another short movie - changing hyperlordosis to neutral spine while holding a pushup position - Fast Fitness - Strengthen by Changing Your Plank
• To learn why hyperlordosis causes lower back pain - Neutral Spine or Not?
  
• Still to come - changing hyperlordosis to neutral spine during handstands.

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

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Gluteal Muscles Myth - Shaking The Dog's Paw

The post Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It? showed the common and painful bad posture of standing with too much inward curve in the lower back, called swayback and hyperlordosis. A reader mailed me an article about gluteal muscles and asked what gluteal muscles have to do with it.

The article shows one kind of hyperlordosis, with the hip pushed forward. The drawing at right shows that hip-forward hyperlordosis position (right figure) compared to neutral spine (left figure). The article stated that the hip-forward posture was due to weak gluteal muscles, and that strengthening the muscles would fix the bad posture. The article gave a strengthening exercise of lying on your back and squeezing the "cheeks" of the backside together as if squeezing a coin between them.

Knowing muscle action will help you know why it doesn't work that way:

1. Your gluteal muscles are muscles of your backside. One function is to pull your upper leg backward, for example, when walking, to pull each leg behind you. The distance between the back of your hip and the back of your upper leg shortens.
2. If you use your gluteal muscles while standing (not tighten them, just use them to bring about movement) your hip will push forward. That is the opposite of correcting a hip that is forward in bad posture.
3. Squeezing the "cheeks" of the gluteal muscles together is training a different movement direction than either pushing your hip and leg forward or back.
4. Another fallacy is that tight gluteal muscles pull the hip so that it pushes forward into bad posture. It is true that tight hip muscles in front will change the tilt of your hip. People with anterior tightness cannot easily bring the leg behind them, which hurts stance and gait. Gluteal muscles cannot get that tight unless you have tetanus. Gluteal tight enough to push the hip forward a few inches would be so tight that you would not be able to sit down. You would tear your backside like splitting your pants.

The key point is that strengthening a muscle does not make it move your body or change your position. If you strengthen your arm, for example, your arm does not automatically wave around or raise over your head. Your arm only moves when you make it move. Strengthening your gluteal muscles will not move your hip for you. Even if strengthening did make any body part move on its own, gluteal muscles would cause a forward hip, not correct it.

Think of asking a dog to shake hands with you. If you want the dog to move his paw up to shake your hand, you do not strengthen his leg and paw. You train the movement and the voluntary desire to bring about the action.

Standing, walking, and running in hyperlordosis is a major cause of lower back pain. Some people stick the backside out in back and others tilt the upper body back with the hip thrust forward. Both increase the inward curve of the lower back and painfully pinch the lower back structures. Although some fitness information and advertisements represent overarching as attractive, even something to deliberately do, it is an unhealthy and weak posture, making it unattractive and undesirable.

Strengthening muscles is good and helpful and fun and healthy, and so on. Strengthening gluteal muscles or any other muscles will not automatically make you stand in healthful position. Stronger muscles do not make you move. You can change to healthful position right now without strengthening. These posts show how:

• The post Friday Fast Fitness - Neutral Spine in 5 Seconds shows a quick movie.
• Prevent Back Surgery shows places to look for overarching and why it is so important to prevent it.
  
• Neutral Spine or Not? shows two kinds of hyperlordosis to watch for, with links to photos how to stand in neutral spine.
  
• For a stretch for the anterior hip: standing - Hip Stretch While You Strengthen Legs and lying down - Fast Fitness - Quick Relaxing Hip Stretch
  

When you hear that you need various strengthening exercises to correct posture, think of shaking a dog's paw.

Labels: abdominal muscles, fix pain, lordosis, lower back, myths, neutral spine, posture, running, strength, walking

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

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

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

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

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

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

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

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

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

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Lower Back Pain and Golf

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

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

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

She stated:

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

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


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


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


These photos show the lower spine from the back:



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

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

To feel how to change from overarched to neutral spine, see Innovation in Abdominal Muscles.

To understand how bad forward bending (opposite problem from hyperlordosis) contributes to back pain click The Cause of Disc and Back Pain.

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

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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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Fast Fitness - Upper Back, Shoulder, Triceps, Arm, Wrist, and Hand Stretch

Here is Friday Fast Fitness - nice stretch for hands, upper back, and everything in between.

1. Stand with your back about a foot from a solid surface


2. Reach upward and backward to place both hands on the wall, all fingers facing downward


3. Press, lifting upward, keeping the stretch in your chest and