Thank You Grand Rounds 6.8 Health Insurance Colorado

Thank you Louise Norris for hosting Grand Rounds Vol. 6 No. 8 this week from the blog Health Insurance Colorado and including my article Fourth Group Functional Training Exercise, Functional Upper Back Stretch among the best medical writings of the week.

Louise writes:

"Jolie Bookspan, the Fitness Fixer, brings us a detailed post about how to look upward without placing strain on our necks. I like the part about how our necks are not Pez dispensers – good visual image. The article is a good reminder that we need to use proper form in all of our daily activities, not just while we’re at the gym."

On the web, Grand Rounds is a collection of the best on-line medical posts from the past week. A different host works hard each week to find and list the articles. This is different from the Grand Rounds in a hospital, which is a lecture for doctors about a patient or topic.

Thank you to this week's host for doing the hard work of collecting and featuring our information.

Labels: Grand Rounds, neck, upper back

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Fast Fitness - Stop Neck Pain From Biking

Here is Friday Fast Fitness - Save your neck while biking, while drinking from a water bottle while biking, and get a needed upper back stretch at the same time:

1. Main concept - your neck is not a Pez dispenser. Don't tip and pinch back at the neck to look upward to drink or look forward while riding.


2. Notice if you jut your chin forward and upward to drink or ride.


3. Instead, extend upward through your entire upper back. Keep your chin fairly still and see how much upward range you can get from your upper back. Instead of rounding the upper back forward, you get a nice straightening stretch.

Craning the neck (pinching backward at one joint) and pushing the chin forward, pinches and compresses your discs, joints of the neck bones, the soft tissue, and nerves.

To help remember good biking form, I put a reminder on a healthy water bottle. Keep your exercise healthy. Click AcademyGifts or the image to order.

Related:

• Is Your Drinking Hurting Your Neck?
• Are You Making Your Exercise Unhealthy?
• Gaze Perseid Meteors Without Neck Pain

Labels: biking, fast fitness, fix pain, green fitness, neck, upper back

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Upper Body Built in Functional Fitness

Reader Vietanh asks:

"I enjoy the all day exercises using squat and lunge for my daily activities. Thank you for sharing your philosophy.

"However, those exercises are mainly for lower body. I would like to ask if there are good all day exercises for upper body parts i.e., shoulder, neck.

"I found some stretches for shoulder and neck that you introduced.

"Thank you and best regards,
Vietanh"

This is a great question and understanding that fitness is something that you do during real life. In gyms and health centers, even therapy settings where people are going there for the purpose of fixing and increasing function, they sit waiting in terrible unhealthful positioning - photo at right - waiting for a class or activity for health.

I have read fitness books saying the posterior shoulder is "difficult to target." Hold your shoulders straight, rather than letting them slump forward. You will get built in upper body functional exercise. Apply this to exercise, to lifting, sitting, sewing, all you do.

Look at your many hours each day of real life - when you prevent round shoulders with retraction to neutral, you are getting upper back extension exercise. When you sit and bend and lift right instead of rounding forward, you get healthful, functional upper and mid range back extension. When you use neutral spine to walk, run, kick, and jump, by extending at the hip instead of allowing the lower spine to increase in arch passively into hyperlordosis, you get healthful lower back extension and abdominal exercise at the same time. It is the abdominal muscles that will flex you forward to straight, rather than overarched. They only do this when you deliberately use them. Strengthening alone does not create movement to healthful position. Healthful positioning strengthens and gives exercise. Look at the photo above again and see that how you really live, not a gym, is your exercise and health.

Apply upper body muscle use for function in daily life:

Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
Upper Back Exercise and Neck Pain Prevention Too
Common Exercises Teach Upper Back and Neck Pain
Fast Fitness - Prevent Back Pain When Rowing
Overhead Lifting, Reaching, and Throwing - More Part I
Fast Fitness - Built in Upper Body and Core Exercise Carrying Children

Use arm and hand muscles instead of compressing wrist joints:

Fast Fitness - Prevent Wrist Pain During Pushups and Cooking
Forearm, Upper Body and Hand Exercise

Have daily active upper body fun:

Fast Fitness - Make Your Own Device to Strengthen Arms, Upper Body, Balance, and Core Stability
Fast Fitness - Easy Handstand for Balance, Upper Body Strength -The Movie
Pushups and rows at the same time - Strengthen Many Places at Once
Handstand and rows at the same time - Fast Fitness - Handstand Rows

Using upper back muscles to prevent rounding forward in round shoulders gives continuous built in exercise. This is not forcing, just mobile, comfortable muscle use. How are you sitting while reading this?

There is more to this excellent question. Will come in future posts.

Labels: arm, endurance, neck, posture, shoulder, sitting, strength, upper back

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

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

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


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


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

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

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Headache From Head Position

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

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

Dr. Ernst writes:

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

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

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

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

"What is wrong with this picture?

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

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

"In case you ask, I do:

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

"Not exactly hard, is it.

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

"Cheer,
Johannes"

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

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

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

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

Related:

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

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

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Mothers Day and New Parents Back and Neck Savers

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

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


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

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

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

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

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

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

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

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

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

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

Here is the post from his blog:

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

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

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

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

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

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

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

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

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

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

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

These Fitness Fixer Posts explain more:

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

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

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Overhead Lifting, Reaching, and Throwing - More Part I

Nice e-mails and requests came in after Part I last Monday about the overlooked training habit which slowly impinges and tears the rotator cuff. Here is one that covers the points from all received so far.

Reader Hanson writes:

"Thank you Dr. Bookspan for exactly the missing link. I had been attending months of expensive private yoga lessons at [well known studio name deleted] for my shoulder woes without much relief, and maybe have worsened my circumstances. I thought becoming worse with yoga was preferable to surgery that my orthopedic surgeon at [top California facility name deleted] said was required. The yoga directress said more months were necessary (for her wallet?) and I must learn to cool my mind (before I questioned why I wasn't getting better?). I sure didn't question when she wore that little outfit. She showed me yoga poses to "awaken" the area and other fuzzy yoga talk. Poses were raising arms overhead, leaning over with arms overhead, sitting with arms up, and so on. My shoulders burned, she said it was "awakenening." Now I discovered from you it was "impinging." No one said anything about a forward head when I raised arms. I did the same as the directress did. She had this bad posture too. She said do it slowly if it burns. So I burned up my shoulders slowly. Instead of paying the yoga directress for another private session of self-injury raising my arms with head forward I printed your blog and held it overhead to read it. I didn't lean myself back and didn't tilt my head forward. The shoulder is already better. I found all those yoga lessons never prepared me to stand up straight. They told me yoga gives you posture, but it didn't give me anything except a worse shoulder. The "awakening" came from your blog saying use this for life not just exercise. I can lift arms without pain now. I keep my head straight, not forward. Can you put more pictures up of what to look for and can you tell people about your blog?"

• How to avoid neck and shoulder injury when raising arms: Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury
  
• Avoid neck and shoulder pain and herniated neck discs from the forward head in activities without arms raised: Gaze Perseid Meteors Without Neck Pain
• Detect and change a forward head: Breasts Causing Upper Back Pain is a Myth
• Stretch triceps without forward head: Friday Fast Fitness - Better Shoulder and Triceps Stretch.

Click the labels under this post for more Fitness Fixer posts on each topic.

See if your other questions are already here: Click and bookmark the new Fitness Fixer Index.

Labels: impingement, injury, neck, readers inspiring story, repetitive strain, rotator cuff, yoga

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Tax Preparation Health

Taxes are due April 15th. Piles of papers, forms, schedules, receipts. Readers have asked how to be healthier while working at the desk, and how to keep their cool during tax preparation.

Several readers asked how to stop neck pain when looking down over deskwork. Reader John M, specifically asked "How do you suggest someone look down (to look at a chart etc at work) without pushing the (herniated neck) disc out more (or aggravating symptoms)?

Three photos above show tilting the neck forward and/or jutting the chin forward. Holding the head forward of the neck and body is a major source of upper back and neck pain. The "forward head" is hard on the soft tissues, the joints of the vertebrae called facets, and the discs of the neck, and is a major overlooked cause of "upper crossed syndrome." The forward head is just a bad posture, and easy to stop. It is not necessary to jut the neck or chin forward to look downward.

Check how you are sitting right now. Are you letting your neck hang forward, are you jutting your chin forward, or are you pushing or rounding your neck and upper body forward? Instead, keep chin in, loosely and gently. If needed, bring your chair closer in closer to the desk and lean the upper body back instead of rounding your lower back against the chair back and leaning the upper body forwad.

To look down comfortably - tip chin down in relaxed straight position instead of jutting the head and neck forward. That is healthy positioning for everyone - injured or not. No need to lean or hang the head or neck forward, or round your upper back to look downward.

More Fitness Fixer with quick techniques to feel better during desk work:

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

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

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Sinus and Head Colds

Several readers asked what else they can do for painful head and sinus congestion, because after two+ weeks of medicines and doctor visits, they were no better, or were worse. Common treatments do not work as claimed, including decongestants and sprays, and can cause sinus pain to continue and recur.

What Are Sinuses?
The sinuses in your head are eight spaces in your skull behind your eyes and nose. They produce mucus, and that is good. Mucus produces antiseptics, and traps and filters germs and particles that you don't want to pass into your respiratory system and the rest of your body. Sinusitis occurs when one or more of your sinus cavities become inflamed.

Inflamed by Inhaling Things
Sinuses can become inflamed without any germs causing it, for example from inhaling particles, allergens, or liquids up the nose. If you have ever "gotten water up your nose" in a pool, you have felt the results. The practice of irrigating the nose and sinuses with salt-water sprays is often prescribed for sinus congestion, and even for preventive "maintenance," but it removes important protective mucus layers and natural disease-fighting compounds, and is irritating in itself. Some people regularly spray the sinuses using a variety of squeeze bottles, or a device called a neti pot. It is an unnecessary practice, and does not prevent the underlying cause of sinus pain. It sets up an addictive cycle of rebound congestion and irritation, and increased risk of infections and discomfort to follow.

Another contributor to rebound congestion is regular use of camphor inhalers. Sniffing camphor is a widespread practice throughout Asia, where decorative camphor containers shaped to fit the nose are sold in most grocery, pharmacy, and convenience stores. Camphor irritates mucus membranes causing a cycle of irritation, more camphor inhalation, and more congestion. Some people develop a habit of inhaling camphor, thinking it is for their congestion, not realizing they have a substance inhalation addiction called "huffing."

Decongestants
Decongestants are a big money item in drug store sales. They are not the best treatment for sinus pain and congestion. You are already too clogged up. You do not want more "drying out." The clogged areas would do better becoming more dilute by drinking hot liquids, not by becoming more gummy and concentrated with the "drying out" of a decongestant. After the decongestant wears off, a rebound can occur of more congestion. Taking more decongestant perpetuates a negative cycle, and can raise blood pressure. Cough syrups and pills that contain dexomethorphan (DXM) to block coughing are not as effective for coughs as hoped, but are popularly abused by kids looking for a cheap, easily available "high" ("rhobotripping") with unhealthy physical and psychoactive effects.

Infections and Antibiotics
Sometimes sinuses fill with bacterial or viral fluid. Antibiotic do not help against sinusitis, even the kinds colonized by bacteria. Antibiotics can kill your body's good "bugs" or weaken them, leaving you susceptible to stronger bad bugs, who learn how to live and multiply in your body. Antibiotics taken orally reduce the needed numbers of beneficial flora that normally live in your GI tract. The nutritional and immunogenic products that they normally make in your body are not made, and the organisms responsible for several illnesses can rapidly reproduce and get out of control. An example is antibiotic-associated Clostridium difficile (C. difficile) colitis, an infection of the colon that occurs primarily among patients exposed to antibiotics. More than three million C. difficile infections occur in hospitals in the U.S. each year. He number is growing. An estimated 20,000 C. difficile infections occur each year in the U.S. outside the hospital - directly caused by taking antibiotics.

Healthier Ways to Decongest and Sooth:

• Hot steamy showers and baths.
• Hot facial compresses.
• No need for fancy vaporizers with chemicals (more camphor or other irritants to inhale). Put on a kettle or any pot of water and heat until steaming. Stand at a distance where you feel the warm steam, without standing close enough for any chance of burns. No need to bend over as in the photo at right. Stand in healthy comfortable position for your back and neck.
• Eat spicy foods that you like, such as wasabi or chili peppers.
• Drink hot peppermint tea, or other warm, aromatic teas with lemon.
• Reduce irritating particles (rugs, cats, junk piles, cigarettes, or whatever concentrates trigger irritants).
• A walk outdoors in fresh air and sunshine helps clear breathing and pain.
• Do any fun exercise to heat your body. Increasing body temperature loosens clogging secretions and generates heat shock proteins that have been found to be pretty good for you. The post Exercise and Cancer touches on the basics of heat shock proteins.
• The post Fast Fitness - Quick Warm Up gives a quick method to increase body temperature to warm up.
• The post Regular Exercise Reduces Cold and Flu Incidence lists good practices to lower risk and increase resistance to infectious diseases.

More information on preventing and resolving sinus problems, things to know about antibiotic use, and other infectious topics are in the book Healthy Martial Arts.

Labels: breathing, children, colds/flu/infectious, drugs, heat, neck, nutrition, smoking, warmup

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Readers Ask About Watching Body Positioning

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

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


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

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

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

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

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


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

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

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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 explained 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 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 the pain stopped 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 students things to try during the week before the second (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 to ask about a small amount of remaining pain. 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. However, 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.

After we fixed these issues 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.



Next:

• Bernie dances at his daughter's wedding in Cauda Equina - Result Not Cause.

Related:

• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I
• Overhead Lifting, Reaching, and Throwing - More Part I
• Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
  
• Prevent Back Surgery
  

See Mr. Cleff Demonstrate:

• Fast Fitness - Quick Relaxing Hip Stretch
• Fast Fitness - Relaxing Hip, Leg, and Groin Stretch
• and Dynamic Partner Balance Challenge.
  
  

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

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Is Your Drinking Hurting Your Neck?

A reader sent me this Hauku:


The photo above shows an injurious positioning called "a forward head." A forward head position presses cervical (neck) discs outward, causes upper back and neck pain often called "upper crossed" syndrome, and can press the nerve going down the arm, leading to arm pain and hand/finger numbness. Jutting the chin upward with the neck forward can, over time, create a spondylolisthesis (vertebral shifting). Raising the arm with the shoulder rounded and the neck forward adds to shoulder and rotator cuff injury.

Check yourself for a forward head position when eating and drinking (and on the phone):

• Corner of the jaw is far forward of the shoulder
• Neck tilts forward
• Jaw juts forward
• Neck pinches backward, with high compressive force
• Shoulder rounded

Don't round your back or jut your chin forward. Instead, keep chin in when you eat and drink and talk on the phone. To look upward, get the upward motion more from straightening your upper back, and not from one joint in your neck. The neck is not a hinge joint.

Don't rely on, "Keep ear over shoulder" thinking that is straight posture. You can see in the photo that the ear is over the shoulder, but the neck is craned badly.

Use healthful positioning for built-in upper body muscle exercise and easy pain prevention. Check yourself sideways in a mirror. Watch other people eating and drinking for an easy reminder. Happy Holidays.

For More Healthy Neck Motion:

• For looking upward, click Gaze Perseid Meteors Without Neck Pain.
• For neck and upper back health looking downward over desk, click Tax Preparation Health.
• For drinking and biking, with drawings of fixing neck and upper back while looking up, click Fast Fitness - Stop Neck Pain From Biking

Labels: fix pain, impingement, injury, neck, rotator cuff, shoulder, upper back, yoga

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Fix Neck, Play Hockey, Use Brain, Fun Life

Rich Tarpinian, IT systems engineer, musician, hockey coach, and vegan, fixed grinding neck pain, back spasms, disc pain, and tension-type headaches. He had not been comfortable sleeping in any position. Rich said the neck grinding and discomfort, "felt like it was never going to go away."

Rich writes:

"Thanks again for your help! Here's my update. I stopped cranking my neck around and the grinding stopped within the 2 weeks or so that you had indicated.

"I am controlling my body positioning, more aware, and have eliminated lots of neck tension even though I work at a computer all day. The anxiety I was having about disc problems, etc., has mostly been replaced with good knowledge, a feeling of control, and an ability to heal.

"Every morning (instead of sitting on the bed) I get out of bed the way you have recommended - why? because it makes sense. I don't sit on the bed and then try to straighten my body as I start to walk. I get up from the face down position in the already standing position.

"I've always had an interest in the mechanical aspect of how the body moves and what the sources of problems can be which is why, when I was pouring over information on the internet, your information regarding cause/effect relationships instantly caught and held my attention.

"I eat a pretty good diet - vegan with a good amount of raw foods, but had not paid much attention to posture and movement. I will now.

"As a side note, I coached hockey for about 8 years and played up until about 4 years ago. I had an opportunity to get back into some coaching recently but was really worried about the neck issues that I had been having for weeks. I also used to get a lot of back spasms when I played/coached. After experiencing the progress from your recommendations, which came just in time, I stepped confidently back on the ice a couple of weeks ago and have felt good given some expected muscle soreness that is now gone. The hardest thing was lacing up the skates but, once I was on the ice, I felt great.

"What you have done effectively is to empower people with the knowledge of how to find and return to the correct answers in order to maintain their own bodies. You've done that by providing reasons where needed, presenting conflicting information to show contrast, and using repetition to help solidify the important concepts."

"The key is that I now understand the causes of the problem and can, for the most part, manage the process when things start going wrong. As I cruised the internet looking at information, my anxiety meter kept rising - until I found your article on fixing the neck grinding problem which prompted me to read your other articles on sitting, lifting, etc. The article was immediately positive with a no strings attached approach to fixing and preventing the problem. My overcoming the neck issues is directly attributable to you."

Rich first fixed his pain using my web site summary sheets.
These Fitness Fixer posts also describe techniques used:

• To understand and spot the injury and pain from unhealthful head and neck position - Upper Back Exercise and Neck Pain Prevention Too
• Spot and prevent upper body pain when carrying a backpack - Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
• Two important stretches to do first thing in the morning and throughout the day to restore ability to sit, move, and stand without unhealthful neck position - Fixing Upper Back and Neck Pain and Nice Neck Stretch
• Looking upward with good neck mechanics - Gaze Perseid Meteors Without Neck Pain
• Two nice upper back stretches to relax - Tax Stretch and Quick, Feel-Good Upper Back and Chest Stretch
• Stopping neck pain from sitting - Are You Making Your Exercise Unhealthy?
• Stopping neck pain from exercise - Common Exercises Teach Upper Back and Neck Pain
• Photo of healthful neck position when cooking - Fast Fitness - Homemade Sports Food
• The Wall Test checks for unhealthful neck positioning - How Doctors Use The Wall Stand
  
• Having muscles soreness is not bad, it means you're out having fun. Make sure there is no pain or soreness in the joint. That is the difference. See Teen Dies After Using Muscle Soreness Rub
• November is Vegan month. More on vegetarian and vegan eating - World Vegetarian Day.

I wrote Rich to congratulate him on his initiative and great work, and thank him for his story. He replied:

"Just when I've corrected the forward head problem, I'm going to need those neck exercises to treat "swelled head syndrome."

Smile and laugh. It's healthy too.

Labels: disc, headache/migraine, hockey, lower back, neck, nutrition, readers inspiring story, sitting, sleep, upper back

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Inspirational Update from Bill

In May, blog reader Bill (Lieutenant William Slabonik) sent an inspiring story - Freed From Pain, He Rides Again. Bill had been told by several sources that surgery and disability retirement were his only options. He used Fitness Fixer information to change a future as damaged as x-rays of his spine, to the active life he loves, without pain. He used information from the upper back and shoulder posts, among others, to learn how neck discs, upper back muscles, and other structures are damaged with mal-positioning, and how to employ healthy muscle use so the discs can heal and arm numbness stops, even riding long bike trips, lifting heavy gear, and in his demanding work as a pilot. He fixed low back chronic pain with the simple neutral spine repositioning away from a hyperlordotic (over-arched lower spine) when standing, shown in Prevent Back Surgery and all the posts on neutral spine.

In the May update, Bill told how he fixed the injuries and rode the Pennsylvania State Police Memorial century ride. Last week Bill reported in:

"My goal of riding the 200 km night ride down the Jersey shore was a success. I rode from 10pm 'til 9am with no problems covering the distance of 125 miles. I actually felt like I could go on a lot further. I have also completed a 2-day 200-mile ride to visit my brother-in-law in Maryland. I now can get on my bike on any day and reasonably crank out a hundred mile ride. No serious pain or discomfort noted. Only the usual slight soreness in the rear end and hands and elbows that seems to come with any long ride. The neck, shoulders and back did incredibly well, - I constantly checked my position while on the bike and did some "Healthy Stretching" whenever I was off the bike. Mission accomplished."

Note to readers - I will cover hand and arm soreness with biking in posts to come. I already worked with Bill to prevent local hand numbness from compressive leaning on the wrists, which Bill put to immediate use. I asked Bill to take photos for you of his simple changes in biking positioning to change damaging neck, shoulder, arm, and hand use to healthy ones.

Bill says,

"My son has promised to help me with the photos. I must ride herd on this project and get back to you soon.

"My confidence and health have skyrocketed. My daughters are leaving for college and I am looking forward to an empty house soon. They have thanked me for being there when they needed me and asked me why I just don't go and do something I would love to do. I am applying for retirement this morning and have completed an interview for a job flying in mainland China. I have two other airlines trying to get me to interview. Wish me luck on my next amazing adventure. And thanks for your help and encouragement."

Bill - Free Man

Bill, all hats off to you. Keep flying high. More good things are still to come. Keep us posted.


More from Bill:
Bill demonstrates wrists for biking - Stronger Pain-Free Wrists When Biking
Next update, with Captain's bars - Reader Successes Endure.

More inspiring stories coming next from readers Jill and Ivy.

Labels: biking, hand, neck, neutral spine, readers inspiring story, shoulder, spirit, upper back, wrist

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Gaze Perseid Meteors Without Neck Pain

This weekend in the Northern Hemisphere, the moon will be new, and the night dark, and the skies filled with the shooting stars of the Perseid Meteor shower.

Every 130 years or so, the Swift-Tuttle comet circles the Sun, streaming icy, dusty debris the size of sand and peas. Every mid-August, the Earth passes the orbit of Swift-Tuttle, raining fiery remains through the atmosphere. Igniting against the air's intense friction, they "shoot" across the sky. Books by people who study these things say they fly about 37 miles per second (60 kps), most burning away far above the ground.

The Perseid showers are seen in the sky around the constellation of Perseus the Hero, giving the name. Early Greeks explained that the god Zeus, father of Perseus, visited Perseus' mortal mother Danae in a shower of brightness. Later the event was renamed (or reborn) as "The Tears of St. Lawrence" for their appearance during the August festival of Saint Laurentius. Chinese, Japanese, and Korean writings of Perseid showers date from the 8th century. I grew up on Russian childhood social-utopian folk bedtime stories of comets, mixed with my Grandmother's whispers of fiery conflagration, later determined from an unknown comet or part bursting over Tunguska Krasnoyarsk Siberia around 1908, devastating the forest (later politically reinvented as a nuclear event, and editorially as UFOs for Russian science fiction writing and American television).

What about your neck?
When watching meteor showers standing or sitting, don't martyr your neck. If you crane your neck and push the chin forward when looking upward, you put destructive force on the neck, shown in three examples that follow:

• Three images above show craning the neck and jutting the chin. Injurious compression builds in vertebrae, discs, and surrounding soft tissue.
• The left and middle images show leaning the upper body backward. Thoracic lean overly arches the lower back (hyperlordosis), adding weighted compression to the joints called facets and soft tissue of the lower spine.
• The right photo shows unhealthy craning with the chin forward, common in some yoga and exercise classes. It adds sizeable compressive loading on the back of neck vertebrae plus shearing force on the discs. When raising arms upward, it contributes to rotator cuff compression and injury. Click Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.
  

I understand that jutting the chin far forward is often taught as proper form. I have taken yoga classes in India with major names and those unknown to the outside world. One teacher told me pushing the neck and chin forward protects the discs. It unfortunately doesn't. Shearing force on the discs is severe when you jut the chin forward then raise it. Shear is a structural strain when one layer shifts sideways (or front to back) in relation to the other. Damage may take years to accrue until visible on x-ray. Don't jut your chin forward, especially not when looking upward.

Photo 3 above shows tilting the neck forward when looking through binoculars (left figure with yellow arrow). The chin is not forward, but the forward head still creates painful forces on the upper back contributing to upper crossed syndrome, disc trouble, and muscle strain in the classic diamond and hangar shape across the upper back. The pain is easily stopped. Keep neck vertical and chin in (right green arrow).

You can look directly upward for all you need in healthful position. Here are ways:

• Keep your chin in, loosely and relaxed.
• Shoulders back.
  
• The back of your head lifts loosely upward without strain.
  
• Straighten the rounded-forward curve of the upper spine - get more upward gaze range from your upper back.
  
• Don't yank or force the head and chin back, or the corners of your neck will ache.
• Don't lean back by arching your lower back.

Healthy upward gazing is a nice good-feeling stretch and exercise for the upper back and neck without injury. Use it for all overhead needs, photo 4 of Amsterdam policeman at right.

The time where we pass through the Perseid shower is long, from about July 15 through August 25. The highest activity is predicted over the Northern Hemisphere this coming weekend. Look up on Saturday, 11 August before dawn, Sunday morning the 12th, late Sunday night through Monday early dawn.

Because of the tilt to Swift-Tuttle's orbit, its fiery dust falls almost entirely on Earth's northern hemisphere. Southern hemisphere friends see few Perseids. The next good Southern hemisphere meteor shower is hoped to be the Geminid showers in December.

The constellation where meteors appear to come from is called the radiant. The Perseid meteor shower radiant is the constellation Perseus. The Leonid shower is hoped to peak this 18 November. Look toward the constellation Leo. The Geminid shower radiant is the Gemini constellation. Watch in mid-December with the evening crescent of the moon.

In photo 5 at left of looking up through the telescope, the neck is a bit more forward than needs to be.

Experiment on your own. Use a mirror and send in your photos of remaking healthful fun overhead gazing activities.

Labels: aerospace, disc, facet joints, fix pain, holiday, lordosis, lower back, neck, upper back, yoga

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Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks

Tilting or leaning your neck forward (left photo) instead of keeping ear over shoulder (right photo) is called a "forward head."

A forward head hangs the weight of your head on the muscles of the neck and upper back, making them hurt. Keeping the head forward tightens the front chest and shoulder muscles. The forward head also interferes with healthy motion of the shoulder and can contribute to shoulder injury.

The resulting upper body tightness and pain is often given a fancy name of "upper crossed syndrome." It is not a disease, but an injury from simple mal-positioning, and often a simple matter to fix.

The backpacker in the left-hand photo is standing with a forward head. The photo on the right shows bringing the chin in - without strain, without arching the lower back, or making any new problems, just relaxed, straight body positioning.

When you carry packs or handbags, or any loads, see if you tilt or lean your neck forward or jut your chin out. It is a common source of "hanger-shaped" pain across the shoulders. This pain is also common when sitting at the desk, and is usually caused by the same forward head positioning.

More about how the forward head positioning causes so much upper back strain is in: Breasts Causing Upper Back Pain is a Myth.

Check for common activities when you use unhealthy neck positioning for exercise: Common Exercises Teach Upper Back and Neck Pain and Safer Overhead Military Press.

Don't add to the same round-shouldered positioning that promotes pain: The Stretch You Need The Least.

Fixing Upper Back and Neck Pain shows how to stretch the tight chest muscles that prevent bringing the chin inward comfortably - many people are too tight to stand straight. They get more pain trying to hold straight position in strained unhealthy ways.

You can easily stop the bad positioning and the pain. Don't yank or force. Forcing straight position when you are too tight causes as much pain as bad positioning. Keeping comfortable straight head position gives free upper back and posterior shoulder muscle workout. Easy fitness as a lifestyle.

Labels: fix pain, neck, upper back

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Independence Day for Fitness

Today is Independence Day in the United States. The Declaration of Independence was drafted in June of 1776. Signing began by July. The paper itself didn't grant independence - work continued until independence came a few years later. After getting the idea to do something, the next thing is to take action. Here are ideas for a life free from things that are unhealthy - pain, unhealthful food, and exercises that reinforce bad habits:

Freedom from junk food:

Instead of soda, put a red sweet pepper in a food grinder. Cut about an inch of fresh ginger root and add through the grinder. In about 30 seconds preparation time you will have a sweet, cool, red, slushy drink with an exotic tang of ginger. Healthy and good tasting.

Instead of refined sugar sports drinks, put a peeled whole cucumber into the food grinder or low speed blender with a whole kiwi fruit. It will make a sweet, cool, slushy, green drink.

Instead of processed peanut butter and refined sugar jelly, put fresh raw nuts and apple slices into a grinder, mill, or chopper. In less than a minute of preparation time, you have a sweet nut butter that you can spread on fruit slices, carrots, and other good foods. Try walnuts, almonds, other fresh raw nuts, and experiment with different fruit combination to make different sweet creamy fresh nut butters.

For more recipes, Healthy Martial Arts has an entire chapter on nutrition.

Freedom from overeating

Just as you can't go through red lights every time you just feel like it, or hit someone any time you just feel like it, you don't just eat anything you feel like it at any time. That is unhealthy. Some people say any denial is unhealthy. That is like saying you can just wet your pants when you feel like it. Self-control is cleaner in body and spirit:
Exercise Common Sense Discipline - Turn Down Halloween Junk Food
A Little Good Exercise, a Lot of Bad Food - Overweight Still No Mystery

Freedom from unhealthy drugs and medicines:

Masses of products crowding store shelves claim to fix this and cure that. Millions of dollars are spent. The products seem dazzling, but much is hype and many produce unhealthy effects. Then more dollars are spent on more pills and products for the new problems caused by the medicines. Many prescribed medicines cause new problems that can be avoided. Stop the cycle and save yourself time, money, and unhappiness. If it is not healthy, it is not health care:
Teen Dies After Using Muscle Soreness Rub
Human Growth Hormone
Is Your Health Food Unhealthful?
Stomach Acid Drugs Increase Osteoporosis and Hip Fractures

Freedom from physical pain and injuries:

At the Special Operations Medical Association conference two years ago, it was released that 62% of our American injuries in Iraq are "Disease Non-Battle Injuries"(DNBI) - not from combat or supporting operations, but occurring in the gym. At the ACSM conference last month, a research study reported that their American military units had 17% DNBI injuries. I asked them how they kept their numbers so low. They replied that the number was for evacuations - injuries so serious they required removal from the base. Some of the most common exercise and stretching practices are not healthy. It is not that they are not good for some people or that they are overuse or done "wrong" - they are inherently bad movements. The same high injury rate is happening to fitness and yoga and Pilates instructors and students. I wrote about this in Welcome to the Fitness Fixer. Here are some specifics on why and what to do instead:
Why So Many Aerobics Injuries?
The Stretch You Need The Least
Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
Safer Overhead Military Press
Are You Making Your Exercise Unhealthy?

Freedom from neck pain:

Fixing Upper Back and Neck Pain
Nice Neck Stretch
Breasts Causing Upper Back Pain is a Myth

Freedom from mental pain:

Healthier Heart
Exercise Your Sense of Humor
Which Ancient Exercise Gives Focus and Concentration?

Freedom from crunches:

Abdominal crunches are a popular exercise, but they are not healthy. This is new and different information, I know. Crunches "work" your abdominal muscles, but not in a healthful or beneficial way, whether done sitting or standing or using a machine. Crunches also train rounded bad posture that you know is unneeded and unhealthy when sitting or standing that way in real life.

The idea that strengthening the abdominal muscles stops back pain is a myth. Many muscular people have pain. They do their crunches, then stand and move in the overly-arched spinal posture that is the hallmark sign that the abs are not even being used, and which creates one major kind of chronic pain: Fixing the Commonest Source of Mystery Lower Back Pain

Crunches do not automatically make you use your abdominal muscles to position your spine to support your back. You do that on your own: What Abdominal Muscles Don't Do - The Missing Link.

Neutral spine has a small inward curve to the lower spine, just not a large one:
What is Neutral Spine and Why Does Sticking Out In Back Harm?
Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?

The simple act of standing and doing all your activities and exercise without letting your lower spine overly arch, and instead keeping neutral spine, uses more abdominal muscle involvement than doing crunches: Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine.

Functional abdominal exercises use no forward bending: Abdominal Muscle Exercise - Better, Different, Not What You Think

The book No More Crunches No More Back Pain The Ab Revolution explains a healthier better way to use and exercise your abs (114 illustrations 124 pages). I have a number of copies of the new 3rd edition expanded to give to military personnel as gifts. Contact me to send one (free) to someone you know, to keep our guys healthy.

Independence is Healthy:
This post included links to a few past posts about being free of unhealthy things. Click the labels below each post for more related posts. Keep the things you do, eat, and think healthy. If a medicine is not healthy, it is not health care. If an exercise trains injurious body mechanics, use the time for healthier exercises that are more fun. There are better, healthier ways. Be free.

Labels: abdominal muscles, drugs, fix pain, holiday, injury, military fitness, neck, nutrition, performance enhancing modality, spirit, stress, upper back, weight loss

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Tax Stretch

The tax filing date is coming in a few days in the United States. Bending forward over a desk is a common source of sore neck and upper back.

A nice stretch for the upper back is to stretch back.

Stretching back reduces pressure on (unloads) the discs. A little about why bending forward loads the discs is in Disc Pain - Not a Mystery, Easy to Fix and Are You Making Your Exercise Unhealthy? Stretching back also is nice for the muscles.

Keep it simple. Breathe. Don't stress.

Labels: fix pain, holiday, neck, stress, stretch, upper back

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Nice Neck Stretch

Here is a quick stretch, helpful after long sitting or working. It stretches the neck, upper body, and side of the body, helping restore muscle length to tight muscles.

• Put one hand behind you, as if in an opposite back pocket (photo at right).
• Slide the other hand down your leg toward your knee. Breathe.
• Tilt your head toward your shoulder, gently stretching the entire side of your neck and body.
• For best stretch to the side of the neck, look forward, rather than up or down.
• Don't lean your head or body forward or you will lose the stretch. Stand straight.
• Hold for a few seconds.
• Change sides and repeat on the other side. Smile. Keep breathing.

To tell if you are standing straight, do the stretch with your back against a wall. Keep the back of your head against the wall for the entire stretch. If it is not comfortable to stand against a wall with your shoulders, backside, and the back of your head all touching at once, do the pectoral stretch in Fixing Upper Back and Neck Pain. You can check for the upper body tightness that makes it uncomfortable to stand straight - Thumbs Can Show Tightness That Leads to Upper Back Pain.

Use this stretch, called the trapezius stretch, along with the pectoral stretch to restore healthy positioning to the upper body. Rounded upper body position while lifting contributes to shoulder trouble, explained in Upper Back Exercise and Neck Pain Prevention Too.

With good positioning you can lift more and avoid injury.

More good, quick stretches in the book Stretching Smarter Stretching Healthier.

Labels: fix pain, neck, posture, side, stretch, upper back

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Changing Thai Massage to Be Healthier Part I - Avoid Pressuring Lower Back Discs

In the previous post, What is Thai Massage? I explained that many moves in Thai massage are beneficial, with a few to avoid. One of these less than healthy moves involves the practitioner pushing your back and neck forward into a stretch.

The post Disc Pain - Not a Mystery, Easy to Fix explains why sitting and bending over eventually breaks down the discs of your lower back. In one of the pushing stretches, the practitioner sits behind you to push your back forward, leaning their weight to assist your forward movement, as in the drawing at left.

In another move they add putting their arm under your arm and around the back of your neck. In wrestling, this move is called a half-Nelson. This move is used to bend your neck forward. From there, they push your back and neck forward, leaning their weight to assist your forward movement

Don't let people push your back or neck to round forward, whether to stretch or to make a cracking noise. Avoid treatments that include manipulation to the neck, which has been found to sometimes tear the blood vessels leading to the brain. There have been deaths and even Western chiropractors have been cautioned not to crack the neck with these moves.

A second assisted stretch to avoid is similar to the move above. The practitioner may sit behind you or to the side, and put one or both of their arms under your arms then around the back of your neck, in a move that in the West are called a "half Nelson" and "full-Nelson." From there they may swing you slightly to the side, then again with a wider swing, then a third time with force. This sometimes makes a cracking noise in your back. Anatomically, the greatest force you can put on your discs and low back is bending forward with a twist. Politely decline anyone who would do this to you.

Coming Next:
Making Thai Massage Healthier Part II - Avoid Snapping Elbows or Knees Backward
Keeping Thai Massage Healthy Part III - Should You Do "The Blood Stop?"

Previously:
What is Thai Massage?

Labels: disc, lower back, massage, neck, sitting, upper back

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Upper Back Exercise and Neck Pain Prevention Too

Western boxers and students of many martial arts are often taught to hunch their shoulders and lower their head to protect their neck. Box-aerobics students (and teachers) also often jut their head forward thinking it looks tough, or more authentic. It doesn't protect the neck as hoped, and conversely produces neck and shoulder problems, some immediately, others over time. It also reduces effectiveness of the punching exercise, and to people who know martial arts, it doesn't look tough, it looks weak.

Look at the photo at left. The student on the right is holding his head severely forward (orange arrow). The teacher at right in the foreground is holding his neck and head properly, relaxed and upright (white arrow). The teacher and student in the background also are holding their neck in position that is healthy for the neck and shoulder, and makes punching more effective.

What are some of the problems of forward head angle and hunched shoulder?

• Keeping your head forward brings it closer to your opponent, easier to hit.
• In case of a head strike, a tilted angle of the neck to the brain and skull is more likely to result in brain injury.
• Hunching the shoulder can injure the neck and shoulder muscles
• Hunching results in tight, aching neck and shoulders.
• When you keep your head and shoulders forward, it rotates the shoulder bone forward. When you raise your arm with your neck forward, the soft tissue of the rotator cuff gets pinched between the arm bone and the shoulder bone. Eventually the bones can saw away at the rotator cuff muscles trapped between them, enough to get a tear.
• The same pinching between shoulder and arm bone can compress the nerve(s) that go down your arm, resulting in tingling, pain, numbness, weakness.
  

All the above problems can easily stop and reverse when you stop the cause - the forward head angle and hunched shoulder. Start with the post Fixing Upper Back and Neck Pain.

The muscles you use to hold your head and neck upright instead of forward are your upper back and posterior shoulder muscles. It is a free upper back and posterior deltoid and shoulder workout by standing relaxed but straight, and exercising that way too.

When you watch movies of Mohammed Ali fighting, watch for his healthy, straight, graceful neck positioning. For doing martial arts and boxing aerobics, you can protect your chin and brace your neck without hunching and injuring your neck and shoulder. For exercise classes and just moving around the house you get more upper back exercise and stop injuring your neck and shoulder all at the same time by using your muscles to hold yourself upright instead of sagging. Stop neck injury from exercise. Exercise is supposed to be healthy.

More From Fitness Fixer:

• Is Bad Martial Arts Good Exercise?
• Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique
• Improve Stretch and Strength With Better Kicking
• Muay Thai in Her 90's
• Muay Thai Monks on Horseback
• Rocky Movie Computer Fight Simulation
• Rocky IV and Head Injury
  
• 2006 Black Belt Hall of Fame - Black Belts and Black Tie
• 2006 International Martial Arts Association Weekend
• 2007 Black Belt Hall of Fame

Labels: fix pain, injury, martial arts, neck, partner exercise, posture, shoulder, spirit, upper back

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Improve Stretch and Strength With Better Kicking

Thai boxing (Muay Thai) kicks are among the most devastating and effective kicks in the world. Thai fighters spend hours a day kicking heavy bags and posts, and years toughening their legs and shins for kicks and blocks by bashing them with pipes and against coconut trees. A blow from a Muay Thai fighter's leg is like a blow from a club.

When you practice moves that lift the leg for martial arts training, for self-defense, for dancing, or for exercise in an aerobics class, watch for several bad habits that increase strain on muscles and joints, and reduce effectiveness of the kick. It is not the point to kick someone else and wind up injuring yourself.

1. Look at the photo, above left. The teacher is holding his hip and neck straight. The blocking student is not. The orange arrow at the student's leg shows how, when the student lifts the left leg, the right leg pulls forward instead of remaining straight at the hip. This is a sign of tightness at the hip and poor technique. He needs to stretch the front of his hip and retrain kicking and blocking technique to prevent this common bad habit. Read more on this in the posts, Is Bad Martial Arts Good Exercise? and Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs.

2. Next, check the white arrow at the student's belt line. It is tilting up in front. The teacher's hip remains level as the leg is raised. Curling the back and letting the hip roll under, as shown by the white middle arrow is another sign of tight hip muscles in the front and back of the hip, and poor movement habits. When you raise one leg to kick, block, prepare to kick, do a knee strike (whatever), check if you curl your hip or round your back. Hold your back straight and upright for more exercise, a built-in hip stretch, and more effective technique.

3. Third, note the black arrow showing how the student rounds the upper back and neck forward, instead of holding straight. With practice, the student will learn to hold the neck straight as the teacher is doing.

For all the exercise you do (kick, block, ascending stairs, whatever is done raising one leg), keep healthful positioning. Yes, rounding the back is taught, and done for fighting, but you will be beating yourself up in the long run. You can still be an effective fighter and at the same time, prevent hurting yourself with common strains from unhealthful technique, plus get more exercise with healthier ways.

Previously:

• Thai Boxing

Related Fitness Fixer:

• Fast Fitness - Hidden Source of Groin Pulls
• Fast Fitness - Don't Shorten Hip When Stretching Hamstring
• Black Belt Hall of Fame - Black Belts and Black Tie
  
• Muay Thai Monks on Horseback
  
  

Labels: disc, fix pain, hamstring, hip, injury, knee, leg strength, leg stretch, lower back, martial arts, neck, partner exercise, posture, shoulder, spirit, upper back

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Quick, Feel-Good Upper Back and Chest Stretch

Today 37 new students were waiting when I came in to teach yoga. I was their New Year's Resolution. Most were sitting bent over forward, rounding their back to stretch. When I walked through the gym to get to the teaching room, I walked past a gym full of New Year's Resolutions, all bent over forward straining to stretch, bent over their stair machine and bent over their treadmill. They were lying on the floor face-up rounding forward and they were standing bent over, face-down. Many were doing The Stretch You Need The Least. Everyone looked like the same unhealthful, bent-over posture that you already know causes back pain if you do it over your computer and steering wheel. I mentioned that bending over forward to stretch and exercise, although popular, and ingrained, and dogmatically and almost universally taught, is not what they needed.

Previous posts have shown how this bending does not give the best exercise or stretch: Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch and Common Exercises Teach Bad Bending, and is not healthy during daily life: How Often Should You Be Healthy? and promotes the same bad bent forward habits you started with that cause pain: Breasts Causing Upper Back Pain is a Myth.

What is needed is to get used to holding the body in healthful straighter ways during daily life and during exercise and stretching. In the post Better Achilles Tendon Stretch I showed how to get a better leg stretch without bending forward. Following is a nice upper spine stretch you can do while lying down to relax. Try this:

• Lie on your back over a pillow or an article of clothing comfortably placed under your upper back between your shoulder blades. Start with your hands by your sides.
• If this hurts, stop and see what to do in the following three paragraphs.
• Don't put the pillow under your head or neck, just your upper back.
  
• Let your upper back drop backward toward the floor.
• Notice the feeling of the upper spine no longer rounding forward.
• Relax and breathe. The stretch should feel good.
• To increase the stretch, bring both arms by your ears. You should be able to raise your arms without arching your lower back or feeling pinching in the shoulder.

If you are not able to lie on your back without lower back pain, the usual reason is tightness in the front hip muscles. Do the Instantly Better Hip and Quadriceps Stretch on each leg to loosen the front of the hip.

If you are not able to lie on your back without upper back or neck pain, the usual reason is tightness in the front chest muscles and over rounding in the upper back. Do the pectoral (chest muscle) stretch described in Fixing Upper Back and Neck Pain.

If you have osteoporosis check with your doctor before doing the pillow stretch. One of the intended benefits of this stretch is to help prevent the rounding that contributes to the tendency to fracture already thin bones.

Many people spend so much of their life rounding forward, that their spine loses the mobility to bend backward, or even, in many cases to straighten enough to just lie flat and stand straight. The point of this stretch is to "unround" the upper spine and get it to relax and extend backward (arch safely) in the other direction. This stretch helps to "undo" the constant forward rounding that tightens the upper body and contributes to many pain syndromes. It is important to regain the normal flexibility to be able to straighten the upper spine enough to stand and sit and exercise in healthful straight position.

Drawing copyright from the book Stretching Smarter Stretching Healthier

Labels: chest, fix pain, neck, shoulder, stretch, upper back, yoga

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Safer Overhead Military Press

Two weekends ago we were in Virginia on a medical consult with colleagues. One of the docs is an osteopath and collegiate team doc who really knows his orthopedics. I enjoy our discussions of the best techniques to retrain healthy muscle use. He mentioned that he discourages his team members from the overhead military press (lifting weight directly overhead with both arms). He mentioned the frequent, serious shoulder and neck injuries this exercise often produces. The numbers show that he is correct.

I asked his opinion on my view that these injuries usually only occur when allowing mal-positioning, such as the forward head and rounded shoulders, and overarching the lower back. Read how these positions produce injury in the posts Breasts Causing Upper Back Pain is a Myth and Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.

My colleague reminded me that the military press is not usually functional, which means that except in cases like my carpenter husband Paul who lifts substantial objects overhead all day at work, people do not lift overhead for daily life. Given the large number of injuries the overhead press causes, he'd rather people strengthen in other, more functional ways.

It is true that most lifting overhead is not directly over the shoulder, as in the military press. However, most people need to lift things overhead as part of daily life, and often use the overhead press during recreation, as in the photo, at right.

Here is how to do the overhead press in ways that I believe can keep it healthy, and how to transfer that healthy positioning to lifting laundry, groceries, babies, and other daily weights:

1. Before doing lifting, use the quick check in Thumbs Can Show Tightness That Leads to Upper Back Pain.
2. Do the pectoral stretch described in Fixing Upper Back and Neck Pain.
3. Make sure not to arch your lower back to lift your arms, as explained in Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain

Keep your shoulders down and your chin in, then lift. By keeping head and shoulder position from drooping forward, you will prevent the shoulder bone from squashing your rotator cuff and other soft tissue when you lift your arm. Use the healthy shoulder, neck, and lower back, positioning in #1,2, and 3 (above) for every overhead lift, from pulling off a shirt, to putting away groceries, to lifting children, putting things on shelves or overhead racks, to lifting weights. You will get better exercise and prevent injury.

Labels: arm, injury, lordosis, lower back, neck, neutral spine, shoulder, strength, upper back

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Fix Disc Pain Without Surgery

A physician contacted me, saying he had three successful disc surgeries and had slipped another disc. He wanted a consult with me before his fourth surgery. I told him it was like having three successful tonsillectomies. That is not a successful surgery. He had never stopped the reason he was pushing his discs out of place, one after the next.

Surgery for back pain and sciatica is considered by some as a solution, but an alarming number of people have pain that continues after surgery, or their pain stops initially while on pain medications and rehab following surgery, but then returns. The reason is that, except for unusual situations like bullet wounds or tumors, surgery does not stop the root cause of back pain. Because the cause continues, you continue doing harm to your back until it hurts again.

Degenerating or slipping discs are not from aging, or fate, or heredity, or a disease. The term "degenerative disc disease" is a misnomer. It is not a disease process, or a germ, or inherent factor or weakness that makes discs unhealthy. There are external factors, like smoking cigarettes, which contributes to disc degeneration. However, the majority of damage to discs and the soft tissue of the back and neck is usually chronic forward bending that physically pushes the disc outward until it presses on nearby soft tissue and nerves.

Disc damage occurs daily from avoidable bad bending in daily life, unhealthy sitting position, and many common exercises and stretches. Just as not all food is healthy, not all exercises and stretches are healthy, even some of the most common ones in gyms and yoga and fitness studios. The daily harm to your back is usually painless and something you are not aware of doing, until it accumulates, like smoking for years, until one day you get symptoms. The pain may come on suddenly, but was developing over years.

The physician who had the three surgeries, and three discs already removed, had gone back to all his bad bending, lifting, and sitting, and pushed out another disc. If he had stopped the injurious mechanics, he could have let the disc heal. Pain can often stop within days using this method. He probably never needed the first three surgeries. Having a fourth disc surgery will not stop him from going back to the injurious habits that caused the discs to break down and push out of place.

Removing discs, even part of them, means that the cushion and shock absorption between your vertebrae is reduced. This predisposes to early arthritis. A worse situation follows fusion surgery. It is a belief that stopping motion in a joint via fusion surgery will stop pain. But it also stops function. If you want an active life, it is setting you up for more problems. Even if you do not value being active, because fused back bones cannot move when you bend and sit and move, the vertebrae above and below the fused site must move more than usual, squeezing the discs and bones more than they are designed for. Fusion surgery is often a predisposing factor to forcing people into future back surgeries.

I sent the physician my free articles showing, step-by-step, how to stop disc pain. I sent him several of my books for his own use and for his waiting room. I called to follow-up on several occasions, urging him to simply stop the cause of disc injury so that he would not need the surgery. He told me he was not interested and had decided to go for his fourth back surgery. I hope his luck in avoiding surgical complications holds out as well as his good insurance.

The post Common Exercises Teach Bad Bending will get you started understanding common exercises that harm. There are far better exercises to do instead that give you fun, healthy movement without harm to discs. I am not in favor of doing less to avoid pain. I want my patients to have their life back and more. You can do this in fun ways and without surgery.

Labels: disc, fix pain, injury, lower back, neck, practice of medicine, sciatica, sitting, surgery, upper back, yoga

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Studies Say Back Surgery Not Needed

Many back pain patients who come to me say the same thing; that they have gone for several opinions and were told each time that surgery was the only answer. However back pain, even chronic pain, sciatica and disc pain, are simple to stop with quick and non-surgical methods.

News articles are now reporting that back surgery is not more effective than non-surgical methods.

Patients are often told that if they don't have the surgery, they might become paralyzed. A recent New York Times article stated, "Many surgeons had long feared that waiting would cause severe harm, but those fears were proved unfounded." The Times article quoted Dr. Steven R. Garfin, chairman of the department of orthopedic surgery at the University of California, San Diego, "I think this will have an impact. It says you don't have to rush in for surgery."

More important to your health is what is not being reported. The Times article said, "No one who waited had serious consequences, and no one who had surgery had a disastrous result." It is important to know what is meant by, "no one who had surgery had a disastrous result." It is not considered "a disastrous result" if you go through the pain and fear of surgery and still have back pain, or are worse after surgery. It is not considered "a disastrous result" if you lose your job because of the time lost to surgery and recovery, and your family won't talk to you because they think you're a complainer. It is not considered a "disastrous result" if the medicines given during and after surgery cause problems you didn't have before, or worsen existing problems, and then you are given more medicines to counteract the first ones, each with their small (or large) health drawbacks. It is not considered a "disastrous result" if you get far more out of shape and gain large amounts of weight because you could do less after your surgery, and your overall health declines from it.

There is no national database where people who have the same or worse pain after surgery are counted. There is no clearinghouse where people who get new problems because of the surgery are counted or helped. Often, there is no way for surgeons to know that their patients still have pain years later.

Patients may be referred to physical therapy but as their pain, disability, and misery grow, they "are lost to follow-up." I hear these things every day because these patients show up in my office and e-mail me everyday saying they have no money left and will I please help them. They are at the end of what they can endure.

Exercise programs for back pain often fail because they do not stop the cause of pain. Personal trainers and Pilates instructors come to me all the time as patients with herniated discs because they do unhealthy bending and stretches for their exercise. There are far better exercises and stretches you can do instead. Some of my patients are doctors. Their own doctors said there is nothing else to do but live with pain. People often tell me, "You don't understand, I *HAD* to have the surgery, because of the pain." I do understand, and you can stop the pain without surgery, often better and faster.

1. My posts The Cause of Disc and Back Pain and Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch show you how easy it is to avoid and fix pain from bad discs and sciatica, and give better exercises to do instead.
2. Understand how to stop the root causes of pain in the posts Breasts Causing Upper Back Pain is a Myth and Disc Pain - Not a Mystery, Easy to Fix.
3. Learn why it is not a matter of just strengthening abdominal muscles and realize what abs really do to help your back in What Abdominal Muscles Don't Do - The Missing Link and Change Common Exercises to Get Better Ab Exercise and Stop Back Pain.
4. Read real stories of exactly how my patients fixed pain without surgery.
5. Fix your back pain by Christmas - read Fix Your Own Pain Without Drugs or Surgery

Use The Fitness Fixer every day to change your idea of exercise from a bunch of artificial moves, to real health that is built-in to your daily life. You don't have to have back pain, and you can be stronger and healthier than before - without surgery.

Labels: disc, fix pain, hamstring, injury, lower back, neck, practice of medicine, sciatica, sitting, surgery, upper back

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Are You Making Your Exercise Unhealthy?

Most people know that sitting badly at your desk, as in the left-hand photo, is unhealthy.

• It is easy to see that he is rounding his back forward.
• He is not sitting up.
• His ear is far forward of his shoulder (even with his shoulders so rounded that the shoulders are forward too).
• He is jutting his head and chin forward.
• The weight of his head is straining on the muscles and joints of his upper back.

The post Breasts Causing Upper Back Pain is a Myth explained how the bad body ergonomics of rounding forward is a common cause of upper back and neck pain, often mistaken for "stress," even contributing to pain down the arm as you slump the weight of your upper body on nerves that go down the arm, compressing them. The post Disc Pain - Not a Mystery, Easy to Fix showed how the forward bend to the spine squeezes your discs of your neck and lower back, gradually degenerating them and forcing them outward, which is called herniation.

Now look at the right hand photo of the bicyclist. The rounded forward positioning is the same. It does not magically become healthy because you are calling it an exercise. It is just as unhealthy whether you are at your desk, on a stationary or real bicycle, on an exercise ball, motorcycle, or in the car.

What to do instead is simple. Sit up. Don't round your back. Are you rounding forward reading this right now? In a chair at your desk:

• Pull your chair in closer to the desk.
• Put your hips all the way back against the seat back.
• Lean your upper back against the seat back, not your lower back.
• Gently bring shoulders and chin back.
• Have your chair far enough in to rest your arms on the desk. Don't crane your wrists to type. I will write more about wrist pain. It should not come from keeping arms comfortably on the desk, which keeps the weight of your arms from hanging forward on your neck.
• Don't push your lower back against the seatback. Many seat backs are rounded outward so that you have to sit bent forward if you rest your back against them. If the seat back is concave, put a small cushion (or loosely rolled towel or shirt) about as small as your forearm in the space between the seat back and your lower back. Do not press against the roll - that makes the useless to stop back pain.
  

Don't tighten and strain to sit straight. It is common to be so tight from a lifestyle of forward rounding that sitting straight is not comfortable. Do the pectoral stretch in Fixing Upper Back and Neck Pain, then use the wall test in the same article to check if the stretch worked. On a bike, unless you are in a high level race, straighten up. It is simple. Healthy.

Why exercise in unhealthy ways? Watch people at the gym and in life. Notice how often fitness publications ask you to practice being bent over forward. Instead, get free built-in back muscle exercise and prevent strain and pain just by sitting with healthy positioning.


More on lumbar rolls and how to make sitting comfortable, in the book Fix Your Own Pain Without Drugs or Surgery

Labels: disc, hip, lower back, neck, posture, practice of medicine, shoulder, sitting, upper back, wrist

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Thumbs Can Show Tightness That Leads to Upper Back Pain

Healthy body position should be a natural easy part of daily life, not something you stop work to do as an exercise.

Unhealthy body positioning is more ingrained in daily life than many people realize. How can you tell your own positioning? Watch other people. See how many spend all day rounding their shoulders forward over their work and steering wheel, then further round their shoulders to stretch by bending forward, and do the unnecesary stretch of bringing one arm across the front of their body, then exercise by bending forward for crunches and leg lifts. The result of all this chronic forward bending is overstretching the back muscles and tightening your anterior (front) muscles. Many patients who come to see me, even those who can touch their toes and put one foot behind their head are so tight that they can't comfortably stand or sit straight. This is not just a problem of looking bad. It affects the health of your joints and muscles.

The post Breasts Causing Upper Back Pain is a Myth explained how overstretched back muscles and tight anterior muscles can promote the "forward head" and bent forward position that causes so much muscle strain and damage to the discs and joints of the back, shoulder, and neck. Many people "do neck exercises" never understanding that the exercises do not solve the problem of the chest muscles being too tight, and do not address how to hold healthy position. They stretch, believing that stretching prevents sports injuries, or that it is for doing contortions, but never know that the point of healthy stretching is to restore normal resting length just to stand and move in everyday life. They stretch in ways that exacerbates the problem they started with - rounding forward.

Try this to see if you round your shoulders:

• Use the photo, upper left, for reference.
• While standing with arms loosely at your sides, glance down at your hands.
• Do your thumbs face each other, as in the photo, instead of facing forward? That shows that tightness in front of your chest has rotated your arms inward (round shoulders).
• Does it feel awkward and unnatural to pull shoulders back so that your thumbs face forward? The point is to make it comfortable to be right, not force good positioning, which makes more strain.

To fix the problem, try this:

• Check your thumb positioning while standing comfortably.
• Do the pectoral stretch, taught in the post Fixing Upper Back and Neck Pain.
• Right after doing the pectoral stretch, drop your arms loosely by your sides and glance down at your thumbs again.
• If you did the pectoral stretch right, your thumbs should now be facing more forward because you fixed the tightness that rounds shoulders and rotates arms inward.

During the day, notice your thumbs when standing to see if you are rounding. Notice other people's thumbs. Watch their upper body positioning when they sit and stand and let it remind you to use healthy straight habits so that you do not get tight in the first place.

Recommended Book:

• Fix Your Own Pain Without Drugs or Surgery

Related Fitness Fixer:

• How Doctors Use The Wall Stand
• Nice Neck Stretch
• Fixing Upper Back and Neck Pain
• Quick, Feel-Good Upper Back and Chest Stretch
  
• What Does Stretching Do?

Labels: arm, chest, disc, fix pain, hand, neck, posture, shoulder, stretch, upper back

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Common Exercises Teach Upper Back and Neck Pain

Tuesday night is martial arts class. It had rained all day. A few students were absent. They missed class on how to toughen body and spirit because of water? Next time it pours I think I should hold class outside. In fairness, the students who missed class responsibly contacted me that they would be out.

The rest of my students were sitting in two neat rows. They had gotten their equipment out of bins in healthy ways by bending their knees with body upright and heels down. Then they sat down in their rows on the floor without using their hands. Most were sitting up straight. The rest straightened when they saw me walk in.

Each week students practice preventing the bad habit of jutting their head forward of the center line of their body during stances and moves for exercise and sparring (left photo, above left). Healthy position keeps the chin in and the angle of the lower jaw over the center line of the shoulder (right photo).

A forward head is not healthy for daily life or exercise. It results in much neck, upper back, and shoulder pain. Jutting the head forward for kicking, lifting a weight, and other movement is commonly seen in exercise magazines and videos. Watch for it and let it remind you not to do that. The forward head doesn't look tough, it looks untrained and weak and is several inches closer to the opponent making your face easier to hit. It frequently leads to upper body pain, and in case of a blow to the head, a tilted forward angle of the neck in relation to the brain and skull is more likely to result in brain injury.

A forward head is not something you can't control. Just as you can move your arm or leg, you can easily move your neck in a relaxed way into the healthier chin-in position you want. The post Breasts Causing Upper Back Pain is a Myth gave a simple "wall test" to see if you keep your head forward - stand with your back against a wall and see if the back of your head also touches comfortably. If you have to arch your back or jut your chin forward or up to touch the back of your head, you are probably too tight to stand straight and are probably standing and moving all the time in an unhealthy bent-forward position that strains the neck, back, and other areas.

The post Fixing Upper Back and Neck Pain taught the pectoral stretch to restore muscle length to make healthy straight position comfortable. Use the pectoral stretch first thing in the morning and many times throughout the day. Then use your new ability to stand straight. The pectoral stretch (or any stretch) is not what fixes the problem. The stretch makes it possible for you to stand in the way that no longer strains and injures.

In the martial arts and in life, inviting a bad outcome is known as "leading with your chin." Letting your head and chin jut forward, as in the forward head, is inviting a bad health outcome. The martial arts teaches you to stop problems, not cause them. You can easily stop long-term damage through simple repositioning. You will look and feel better. That's using your head.


Photo and more on this and related topics in the book Healthy Martial Arts

Labels: chest, fix pain, martial arts, neck, posture, practice of medicine, sitting, stretch, upper back

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Fixing Upper Back and Neck Pain

The post Breasts Causing Upper Back Pain is a Myth explained that a tilted-forward position of the head and neck, called a forward head, is not the normal tilt to the neck. It is an avoidable slouch that causes much upper back, neck, and shoulder pain, and pressures the discs of the upper spine.

Do you have a forward head? Here is a test, called The Wall Test:
If you can't put your back against a wall and comfortably touch the back of your head to the wall too without overarching your back or raising your chin, that usually indicates that the muscles in front of your chest are so tight that they restrict normal standing. The resulting bent-forward position of your neck creates large forces on the muscles and joints of your upper spine as it strains to hold the weight of your head forward of the supporting spine instead of above it.

Being too tight to stand and sit upright instead of slouching forward is common, even among people who stretch regularly. The reason is that they usually practice stretching forward, rarely stretching the front muscles by stretching back. In turn, holding your body bent forward instead of upright perpetuates tightness.

To lengthen the front chest (pectoral) area needed to stop the slouching-tightness cycle, use the photo above left for reference and try this:

• Use the photo above as a guide. Stand facing a wall. Bend one elbow out to the side and put the inside surface of that arm against the wall, as in the left-hand photo.
• Turn your whole body and feet away from the wall, letting the wall brace your bent arm behind you, as in the right-hand photo.
• If you are doing this stretch right, you will feel a nice stretch in the front of your chest.
• Keep your shoulders down and relaxed. Breathe. Smile.
• Hold a few seconds, breathe in, change arms, and breathe out while stretching the other side for a few seconds.
• Now drop both arms and turn to stand with your back against the wall again. If you did this pectoral stretch right, standing straight with the back of your head touching the wall should now feel more natural and comfortable and no longer a strain.
• When you walk away from the wall don't slouch forward again out of habit. Hold the easy new healthy positioning for everything you do.

Remember that the wall test (checking if you are straight against a wall) is a test - it is not an exercise that fixes anything, it tells if you are doing the pectoral stretch and two more stretches to correctly restore anterior muscle resting length. This pectoral stretch is one of three techniques to stop upper body tightness that prevents standing and moving in healthy ways.

Three stretches together help more. After doing this pectoral stretch and seeing the results with the Wall Test, add the next two stretches to restore resting length to be able to stand comfortably:

2. Nice Neck Stretch - trapezius stretch
3. Friday Fast Fitness - Better Shoulder and Triceps Stretch

After each stretch, check yourself again with the wall test to see if you did them in the way intended - to work. Then, remember that head and body position is voluntary. Hold your head up and shoulders back softly all the time. The stretches just make it possible YOU are the one to hold it there and retrain your body. No adjustments or bracing does that.

Do the pectoral stretch first thing every morning and several times every day to learn healthy positioning. Then check yourself with the wall test to see if you did it in a way that worked. Use this pectoral stretch and the two other stretches (nice trapezius stretch and better triceps stretch) instead of the stretch where you stand in a doorway or corner to stretch both arms at once, and instead of pulling your straight arm(s) behind you - what I call, The Stretch You Need The Least.

The three stretches will stop pain for the short term. In fact, if you don't feel improved right away, you're doing them wrong. Then for the fix, use them to allow you to hold healthy upright positioning. By not letting your head hang forward all day, you will no longer need constant pills, adjustments, or treatments for pain. You will stop the cause.

If You Have Questions:

• Photo and details and complete sequence of restoring healthy body position, in the book Fix Your Own Pain Without Drugs or Surgery - What to do to fix many sources of pain and injury, step-by-step.
• Post to get the purpose of this pectoral stretch - Pectoral (Chest) Stretch - The Most Common Mistake in the Best Shoulder Stretch
• How Doctors Use The Wall Stand Test
  
• Click the labels under this post for all Fitness Fixer posts about that topic, for example, for posts about neck pain, click "neck," for healthy sitting, click the label "sitting." For all posts explaining discs or fixing pain, click those labels.
• Even more information is in the replies to the many reader comments below this post.Before asking more questions, see if your answers are already here
  

Labels: chest, disc, fix pain, neck, posture, shoulder, sitting, stretch, upper back

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

Tuesday night my martial arts students showed they had improved. When I came in they were waiting in two neat rows. I still had to cue them to sit up straight.

In the post Is Bad Martial Arts Good Exercise? I mentioned showing the class not to let their neck, back, and hip round forward when kicking. By straightening, strength and stretch are built into regular movement.

Several readers e-mailed me that they noticed for the first time that they let one leg pull forward when lifting the other (notice the standing leg in the left-hand photo, at left). They said they felt a good difference when they straightened (right photo).

If the front muscles of your hip are tight, when you lift one leg high you may find that you round your back and bend the other leg. Watch for this during kicks in martial arts and aerobics, when lying on your back raising one leg overhead to stretch the hamstrings, and ascending stairs. The common practice of allowing the other leg to bend forward perpetuates a tight anterior hip, which in turn, contributes to walking bent forward and back pain.

In martial arts, you don't want your standing leg completely straight. That is an invitation for your opponent to kick your knee, snapping it backward. But for both health and effective martial movement, you don't want to bend the leg more than a small amount. Bending the back, hip, and leg when kicking decreases force of the kick, pressures your discs, and reduces stretch on the hip and hamstrings. The rounded-under hip position keeps the hip tight, a hidden cause of groin pulls. It also looks weak and unskilled. For lying hamstring stretches with one leg overhead, it is often taught to keep the second leg bent to "protect the back." However, keeping the leg (and body) flat on the floor give a far better stretch and is healthier for your back. Even in slow easy motions of stair climbing, leaning forward and allowing the second leg to pull forward reduces the normal hamstring and hip stretch, decreases the exercise on your hip and leg muscles, and reduces the back muscle activation for holding the straight position you need for health and back pain prevention.

It is said the martial arts gives you discipline and strength. It won't if you practice unhealthy habits. When raising one leg, hold your neck and back upright. Prevent the other leg from pulling forward. You will get a built-in hip stretch, one of the places you need to stretch most. You will get back and hip exercise in the way you need to move in real life, and prevent tightness and weakness that leads to poor movement and pain. You will change from kicking like a bent over old lady to a young strong athlete. Exercise as a lifestyle is not something done "for body parts." It is built into your normal movement to make it healthy movement.


Photo (and more healthy techniques) from the book Healthy Martial Arts

Labels: achilles stretch, balance, chest, disc, hamstring, hip, hip stretch, knee, leg strength, leg stretch, lower back, martial arts, neck, posture, stairs, strength, stretch, upper back

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Breasts Causing Upper Back Pain is a Myth

A news report in the MMD Newswire echoed a prevalent but luckily, false belief, that breasts cause back pain. The good news is that means you do not have to be forced into back pain, and there are things that you can try quickly to relieve it yourself.

Many of my patients who come to me with upper back pain say that their doctor or other health care practitioner told them the reason is the weight of their breasts. I show them how they can stop the pain by checking and correcting other factors that are the real underlying cause.

One of the biggest mistakes in science is confusing correlation for cause and effect. There are so many people with back pain that it is easy to blame anything happening at the same time, like having breasts or a big belly in front, or carrying backpacks in back, or groceries on the side.

1. Men have the same or higher incidence of the same upper back pain.
2. Women who are smaller, or have had breast reduction and double mastectomies can have the same pain.
3. If straps are binding or cutting into your neck, that can obviously be uncomfortable, so check and fix that.
4. However, the specific cause is not the breasts, since men and smaller women can get the same kind of pain.
5. If you round your shoulders, spend time with the upper body bent or rounded forward, or have a forward head, the shifted weight is a common contributor to upper back pain.

Look at the photo, above left. Letting your neck tilt so that your ear is forward of your shoulder, as in the photo, is called a forward head. It is not the normal tilt to the neck. It is a weak and injurious bad posture. The angle of the jaw should rest comfortably above the center-shoulder. The forward head is the source of a surprisingly large percentage of upper back and neck pain. The classic distribution of this pain is across both shoulders, up the neck, down the upper back, sometimes causing numbness or tingling down the arm. Do you have a forward head? Here is a quick test:

• Stand comfortably with your back against a wall or doorway.
• Touch your heels, your behind, and your upper back against the wall.
• Does the back of your head touch easily?
• If your head is forward of the wall, it is likely that you have a forward head.
• See if you have to crane your neck to bring your head back to the wall.
• See if you round your shoulders
• Check if you lean back to try to straighten up. Straightening should come from the upper body, not by increasing the inward curve of the lower back (hyperlordosis), which can hurt - Fixing the Commonest Source of Mystery Lower Back Pain.
  

If you have to force or crane your neck back to touch the back of your head to the wall, or you lean backward to try to straighten, you are too tight to be straight. That means you may walk around all day, and exercise, and sit, and do all you do with bent forward positioning, which can cause pain.

Often, people who think they "stand up straight" find that they are straining their beck and shoulder back, which causes upper body pain. The problem is that they are too tight to stand with healthful position. Strained straightening and the many postures that are mistaken for straight but are not will hurt as much as slouching.

If you did the wall test, see if you are slouching forward from the forward head, or from the upper body, or both. See if you have to lean backward to straighten up. See if it is an effort to stand roughly straight, instead of normal comfortable muscle length. Those are more causes of pain, mistaken for the size of the chest. In posts to come I show two quick techniques to lengthen the front chest muscles to let you stand straight easily and comfortably. Then you will not have a forward head or rounded shoulders:

1. Here is the first thing to try to restore resting muscle length to make standing straight possible and comfortable: Fixing Upper Back and Neck Pain.
2. Here is the second - Nice Neck Stretch
3. Try those two gently, with the aim of restoring ability to straighten out comfortably, then use the straighter position, so bent forward position does not hang on your upper back muscles, making them hurt. The stretch does not fix the pain - using them to be able to straighten out during the rest of the day is the key.
4. To help unround a rounded tight upper back, gently experiment with Fast Fitness - First Morning Stretch and Quick, Feel-Good Upper Back and Chest Stretch
5. Check if you spend much time rounding or bent forward - Are You Making Your Exercise Unhealthy?
   
6. Check to see if you lean back instead of straightening - Neutral Spine or Not?

The idea is, that no matter your size, use your own muscles to prevent uncomfortable positioning. By restoring healthier upper body positioning and use, you will get built-in back muscle exercise all day. Standing straight instead of allowing your upper spine to compress under your weight will stop your pain plus give free calorie burning exercise.

If you find that lifting your chest with your hands takes the strain away, then you can do the same with your upper body muscles. It is free exercise to use your muscles to prevent your own body weight from squashing you. Pull your chin inward and shoulders back in a relaxed way by unrounding the upper back. Then weight of your head and upper body will not pull forward on your upper back muscles, making them ache.

The same applies to carrying a grocery bag, a child, or any load. Don't slouch under the load, use muscles to keep healthy comfortable position.

Fitness Fixer reader Ness left a comment on the post Fixing Upper Back and Neck Pain:

"I am very large breasted and have always been. It's a very difficult thing to find a comfortable bra. For the past few months, I've been having upper back pain. I felt like I needed to "crack." Every night I complain, and nothing works!

"Except this. haha, you have NO IDEA how pleased I am that this "fixing upper back and neck pain" stretch works.

"Now, I'm not going to pretend that I think I'm perfect now because I've been sitting straight for about 10 mins and it is starting to get a little tiring.
"But, I don't feel ANY pain.
"I'm amazed.

"Was that it?? Really my DDDs have nothing to do with it???"

See the wall test - How Doctors Use The Wall Stand.

No exercise is more important for your joint health than holding up your own body weight, no matter what or where it may be. Your size does not force you to slouch. It does not require long or repeated treatments or sessions or teams of professionals.

I run classes for motivated, bright participants who want to empower themselves - see my web page for CLASSES - www.DrBookspan.com/classes.

There is specific helpful information in my replies already here to the many reader comments below this post. Before asking more, see if your answers are already here in the comments below.

Labels: chest, fix pain, myths, neck, posture, shoulder, upper back

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Is Bad Martial Arts Good Exercise?

This week marked several beginnings. The equinox began the journey of the sun away from the northern hemisphere bringing longer nights. The festivals of Ramadan, St. Sophia, Navarati and others celebrate origins and understanding. The university semester began, including the full-to-capacity martial arts class I teach on Tuesday nights at Temple U's Center City campus.

When I arrived, students were sitting on the floor waiting. Some sat in bad rounded posture that you know is unhealthy at your desk. They straightened when I asked them to. In past semesters there were students who refused. Once, one stormed out shouting she didn't understand why she had to sit straight when class hadn't started yet. She didn't know that class is always in session.

Students got their equipment - bending wrong to yank weights out of bins. I told them, "Healthy bending. This class is for health." Some didn't understand the connection. Others tapped those still bending wrong, "Teacher says bend your legs." Several looked surprised. One said, "I'm getting leg exercise before class even begins." I told her that class is always in session. I reminded students to use healthy bending at home and work for every time they bend (Disc Pain - Not a Mystery, Easy to Fix). I showed them how to get more exercise by helping others who came in late.

We began stances. Students sometimes have a stereotyped idea, sometimes learned from aerobic boxing classes. They stand with shoulders hunched up, upper back rounded, head and chin jutting forward, and their behind tilted out in back. I mimicked them. They giggled at how bad it looks. I told them, "You don't look tough. You look ninety." It's true that you use shoulders to block some strikes, but you are not supposed to hunch. Don't do things to harm your neck in order to protect your neck. Overarching your lower back so that your behind tilts out in back is a frequent cause of back pain in daily life (Fixing the Commonest Source of "Mystery" Lower Back Pain) and injury when giving or receiving a blow. It's silly to go to boxing class and beat up yourself.

Look at the photo above. It shows terrible positioning that injures, and perpetuates the tightness that causes more troubles. When you lift one leg to kick (or stretch or take the stairs), notice if your other leg pulls forward. That shows tightness in the front of your hip. Instead, stand straight and keep the standing leg from pulling forward. Don't round your body to lift your leg. You will get built-in anterior hip stretch, one of the places you need to stretch most, and prevent several problems that I will cover soon.

The point of exercise is to improve life. It is missing the point to exercise in unhealthy ways, training unhealthy habits. If you are interested in learning how to retrain healthy movement in martial arts or aerobic boxing classes that you transfer to daily life, let me know and I will post more on what my students learn.

Book:

• Healthy Martial Arts - www.DrBookspan.com/books. Winner of the Black Belt Hall of Fame Readers Choice Award.

Labels: hamstring, hip, injury, knee, leg strength, leg stretch, lower back, martial arts, neck, posture, shoulder, strength, stretch, upper back

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