Here is Friday Fast Fitness - how do abs help your back? Only when you use them to:
Abdominal muscles don't help your back by themselves. Support is not automatic. They don't fix your back pain by being stronger. Strengthening abdominal muscles doesn't make you hold neutral position (support you). Holding neutral strengthens your abs.
In the post Fast Fitness - Strengthen by Changing Your Plank Reader David from Belgium showed changing the plank from overarched lower spine to neutral spine. He pushes up from the floor into an arched position, then fixes it. Readers asked to see how to push up from the floor (or from the bottom of a pushup) with neutral spine.
David made us another video. Click the > arrow to see the first 20 seconds show holding neutral - green check mark. Next 15 seconds repeat the same push up, but with over-arched spine, marked with a red X. Then he corrects spine angle until the end - green check again. Can you see the difference? Can you do the difference?
Letting your lower spine cave inward (hyperextend) under your body weight means you are not using core muscles to prevent it. Hyper-extension, is also called hyperlordosis (too much lordosis) and swayback. Hyperlordosis bangs and abrades the joints, called facets, of the spine. Hyperlordosis can also pinch a disc that is already degenerating or bulging, making disc pain worse.
Get the T-shirt - Abs only support your back when you use them to. Shows ab use for carrying load on the back, in front, and standing.
--- Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
As kids become pre-teens, the slight normal inward curve of the lower spine often increases too much. Large degree of hyper-lordosis (swayback) is often written in medical textbooks as normal development, however, my physician colleagues who see patients at Children's hospitals report much back pain in these kids.
Teaching kids they don't have to ooze into any slouch that just happens, is part of regular training in manners, looking both ways before crossing the street, brushing teeth, and physical habits. Changing from overly-sagging inward at the lower spine to more neutral spine, stops much lower back pain in these populations.
Here is a charming, well-made video by reader James J., age 14, showing keeping stable in all planes and with a smile:
James' dad Paul J. says this is a fun reminder or a way to get kids interested in neutral spine. He wrote, "Plastic Man has a plastic shirt, so you won't be able to see the slight curve that is neutral lower spine. You can put a plastic man on your desk as a reminder."
Enjoy the video as a wonderful reader contribution, for a smile, and to keep going. The way to get strong enough for a plank or handstand or all you do, is to do them and keep good spirit.
--- Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Fast Fitness - Straighten and Stretch Hip While Strengthening Core, Arms, Legs, and Balance
Friday, March 27, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Increase strength and muscular endurance of your body working as a whole, and learn to keep neutral spine and good hip position against resistance.
From a pushup position, turn to the side, raising one arm overhead, holding legs and body straight.
Raise your top leg. Notice if you increase the inward curve of your lower back (overarch to hyperlordosis) and if you bring the leg forward - demonstrated in the upper photo.
Instead, hold straight. To feel position, practice against a wall - demonstrated in the lower photo. Bring the back of the raised leg against the wall. Press your lower back closer toward the wall instead of letting it overarch from the weight of your leg pulling the spine.
The idea is to use the wall as a guide to learn positioning, then use your muscles and sense of positioning to hold straight without the wall from then onward.
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from selected ones. Before asking, see if your answers are already here by clicking labels under posts, links in posts, and archives at right.
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Fixed Injuries, Got Strong, With Functional Exercise - Real Life
Wednesday, March 04, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
This fun note and great story came in from Robert Davis:
" I have tried to find a way to contact you for a while now!
"I have a story I thought I would share and I am so glad I had found your books and website.
" I had injured myself via weight lifting in late October. I had felt the warning signs before this, however I ignored them and continued to train full out. The result was I had hurt my lower back very badly. The pain was unbearable.
" Sitting hurt. Getting up and walking hurt. To top all this off, I was so adamant that one's "back" health is determined by how well you can stretch forward bending! So this became a discouraging struggle as the more I tested that, the worse I hurt! I had many bad habits besides that and will go into that in a moment.
" I kept training "thru" the pain and bad movement thru to about November 24th. I kept aggravating the area thru bad habits (while doing these exercises. Arched back, rounding etc). I finally went to the doctor and he just made me do some simple movements and the typical straight leg lift. He had decided for now that it was not something all that bad and said that we would do a MRI (or was it CAT scan?) if it did not get better.
I struggled for the next few weeks as I was told to simply rest. I realize the fallacy in this because "just taking it easy" had lead to muscle weakness. It was now a double edged sword by Christmas. I hurt in my back, but when I tried to exercise it it was so weak it hurt more.
I finally ran across your website just after Christmas and before the new year. I started to play around with the ideas at first. I was still stuck though on "better" meant no more pain bending forward. So for a week or two more I played back and forth with these ideas.
" Finally around the 15th or so after the new year I decided "what the heck" I will order some of your books. They seemed more promising then anything I had looked at and I realized in an "aha" moment that it was a form of exercise, which I so very much craved at the time as I simply love to exercise. This "resting" was driving me nuts..
I was watching a show on TV one night on beaches and shell collecting of all things and the biggest "aha" came to me in the form of a little girl. I watched adults picking things up and they bend right over without thought. This went on for a while. Then I saw a child pick up shells. She squatted every time! I said to myself "jeez these books are absolutely right, I am basing everything on bad habits!"..
" I immediately started becoming aware of everything I did during and after exercise. I took your book "fix your own pain" and have almost memorized every chapter and decided if I am going to do this I am going to balance my whole body.
" So after weeks of this (trial and error). I slowly got better. Things I learned along the way are this.. Bending over to pick stuff up is not healthy nor is it natural (that child in the show!).. I learned even after doing weight training for 2 years that my legs were still not as strong as I thought. I learned I had developed bad leg positions from unhealthy squatting (on the knee joints instead of behind). I had further learned that I was holding my feet outward and I think this had come from doing leg pressed with feet slightly out to try to target certain areas.
" I learned to strengthen my core much more effectively and better thru the ab revolution and fix your own pain. I was a 500 crunch type person. I am no longer doing sit ups crunches or whatnot. The stuff in your ab revolution is much more difficult to do and healthier.
I learned to strengthen my body thru its own weight, destroying the myth that you need "weights" for gains as I found these exercises to be just as challenging, if not more in some cases because of the added balance and flexibility required.
" I am now sitting here writing this and I tell you that compared to the initial injury and repeated re-injury (doing the same exercises with bad habits) to now, I am close to 100 percent.
" The funny thing is, I no longer have the desire to go back to weight training, which is odd because that was my life! I have discovered a whole new world of fitness with body weight alone. I am trying more challenging things by the day and I have realized that this is actually more fun the weight training for health and I am getting the same, and often better results (since I am not a body builder, just love exercise and looking fit). I had gone and bought a few things like pull up bars and planche devices and am currently working on mastering some very difficult moves that require body strength alone, but at the same time a mindful awareness of how I am doing it by using your techniques (keeping the back straight with slight tilt etc, no arching).
" It is fun working up to one arm pull-ups in good form. Jeez, to think you could bench press close to 300 a few months ago but doing a few of these exercises in your book were hard! I was surprised I could not do very many pull ups or hold these planks and whatnot.. I am set on a new adventure and I love it because it feels so "free" and balancing. I don't have to spend a huge fee to go to the gym. My gym is my body and functional movement.
" Thank you for your knowledge. Having my back back (sorry for that funny saying!) is great. I intend to keep it healthy now and have begun the correction process of all my body, all the way to my feet!
" I don't look at my injury as a mistake anymore. I look at it as a life changing experience and a chance to explore more functional and fun ways of living. I have passed this site and your books on (not my personal copies!) to a lot of friends into fitness. Some are already reporting healing knees and what not and even re-considering how they live and workout!
" PS I have also changed to a Vegan diet just to see what happens. I was very intrigued by the 72 year old body builder who is vegan.
"You are a godsend. Robert Davis"
Great work Mr. Davis! Robert has been sending me many insightful updates with photos, to be posted with his ongoing success stories. His next story starts here: Cardiovascular Cleanup.
Junk food can be vegan and vegetarian with unhealthful additives, dyes, refined processed sugar and flour. Click the label "Nutrition" under this post for all posts on how to get healthy fun sports food and Healthier Fitness by clicking the label "Green Fitness."
Weightlifting and Weightbearing With Lower Spine Overarching (Sticking out too much in back) Compresses Vertebral Facet Joints:
Read success stories of these methods and send in your own. Questions come in by the hundreds. I make posts from selected ones. Before asking, see if your answers are already here by clicking labels under posts, links in posts, and archives at right.
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Here is Friday Fast Fitness - learn how to use your abdominal muscles for what they need to do in real life - hold your spine in neutral position, even against resistance:
Lie flat, face up. Legs out straight, as if standing up. Hold a weight a few inches above the floor with arms outstretched, elbows by your ears.
Lift the weight a few inches up and down, using your abdominal muscles to prevent your ribs from lifting up and to keep your back from leaving neutral position.
Keep your lower back close to the floor. This is the key to making this into an effective and functional abdominal retraining exercise. Also prevent the weight from touching the floor (don't drop baby on head).
This video was made by David from Belgium with his baby Aiko, born one year ago today, Feb 27th 2008. Happy Birthday Aiko!
Click the arrow to run. If the video does not load, here is the URL: http://www.youtube.com/watch?v=8k4zDwce7bE
Watch how David bends well with heels down and upright body to pick up baby Aiko, and gets up again without using hands.
Press your lower back toward the floor and feel your abdominal muscles working strongly. The point of this retraining drill is to have fun learning to hold your spine stable against resistance, learn how to reduce an overly large lower back arch using the floor as a guide, then transfer that knowledge to standing and lifting overhead. This is how your abs are supposed to work in daily life when standing - to prevent the spine from overarching (overextending backward).
For more on using neutral spine in real life see the third expanded edition of The Ab Revolution™.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Partner 1 (white uniform) does biceps curls and other lifts using partner 2's weight.
Partner 2 uses core and whole body strength and endurance to hold straight positioning. Partner 2 can face up, down or sideways, in each case using appropriate muscles to maintain straight position. Breathe normally.
This Fast Fitness can be done with willing friends, children, pets, and furniture.
Partner 1 uses core and abdominal muscles to stand with neutral spine rather than leaning backward, and whole body strength to support weight of partner 2.
It is a myth that you must lean back to offset a carried load. You get intense and functional abdominal muscle workout by using them to pull you forward to neutral standing position.
I once used this exercise of holding straight horizontal position (partner 2's part) while helping out a friend who is a stage magician. I filled in for his absent assistant for the floating lady illusion. I was too tall for the apparatus. It usually holds your body out flat using struts reaching from head to thigh. It reached only to my midback. I wound up holding my weight myself, from hips to feet - high above the stage - while trying to look hypnotized. More on this, someday, in another post.
I make posts from fun mail. Before asking more questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Fast Friday - Functional Oblique Abdominal Muscle Practice - Holding Straight
Friday, February 06, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - use your oblique abdominal muscles functionally - to hold yourself straight against resistance:
Stretch out on the floor. Turn to the side, standing on one hand and one foot
Hold straight as long as you can. Don't sag. Feel how to hold yourself straight and relaxed.
For more, raise the top leg. Keep body straight, instead of bending forward at the hip. Don't increase the inward curve at the lower spine when you raise the leg. Keep neutral spine.
Photo is of one of my students, Dr. Hanley Owen, a physician from Fairbanks Alaska, who took a workshop with me at the Wilderness Medical Society meeting 2008. Check my web site CLASS page for workshops this summer - DrBookspan.com/classes.
Instead of curling forward and sideways to exercise abdominal muscles, this drill retrains oblique abdominal the way you need them in real life - to keep you straight instead of slouching to the front or side when carrying shoulder bags and other loads, including yourself.
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Fast Fitness - How Abdominal Muscles Prevent Hyperlordosis When Carrying
Friday, January 09, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - How to use your abdominal muscles to maintain neutral spine when carrying babies, and other things held and carried.
When you hold loads in front, notice if you lean your upper body backward - right-hand photo marked with red X. Leaning backward from the waist increases lumbar lordosis (hyperlordosis) which pinches the lower spine, causing aching after long standing.
Instead, stand upright - middle and left photo. The muscles that pull your spine forward to straight position against the load are your abdominal muscles. Upper spine angle will be a little more upright than pictured (center).
It is a myth that you must lean back to offset a carried load. You get a free abdominal muscle workout and increase abdominal muscles endurance by using them (not tightening) to change from painful to healthful standing position. Breathe normally.
David from Belgium is pictured at left. David has made many contributions to Fitness Fixer through photos, movies, success stories fixing his own pain and of his yoga students, translated many of my articles into Dutch, and has developed a healthier yoga style which he premiered at a world yoga congress last year
He did all this during the time he and wife (pictured center and right above) were expecting their first baby, arriving early last February. Thank you David and family from all of us.
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
Vertebral Artery Compression, Dizziness, Discs, and the Forward Head
Tuesday, December 02, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
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:)"
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
How Much Inward Curve Space Should There Be In The Lower Back?
Wednesday, November 19, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Reader Carina asked a good question on the post Prevent Back Surgery about how much space there should be in the lower back inward curve. Comments were not accepted by the Blogger software for several weeks, and I could not reply in the comments. Her question is so good, it was chosen for this Fitness Fixer post.
Carina writes:
"Hello Jolie, "Your information is so wonderful. Thanks for this stuff it's priceless.
I have been using the wall trick during the day when my back hurts (How to Feel Change to Neutral Spine). Wow it feels great. Only thing I can't STAY and walk like this. My knees are STUCK bent (or I go back to the big arch). I'd seriously look very odd walking around with bent knees. So here are my questions
"1) How much of my hand should go through when I am standing against the wall??? When I stand at the wall and do it naturally I can stick my whole arm to my elbow behind the arch.
"2) Besides these links you provided from a previous question Fast Fitness - Quick Relaxing Hip and http://windowsxp-privacy.net/?id=198760105 " (Note - the above link didn't come through in Carina's comment; I don't know which it is.)
"is there anything that helps me walk in neutral spine and not looking silly? "Thanks for caring about our backs, Carina"
Carina, great work. You have found that simply changing spinal angle (wall "trick") to reduce overarching works right away to reduce cause of pain. Next, here is how to retrain neutral spine into a normal natural stance:
1) Don't worry about "How much hand fits." It doesn't indicate amount of overarching. Lower spinal angle is what matters. Body proportions change the distance from wall - independent of spinal angle.
If you have too much tilt to the pelvis or you lean the upper body backward, lower spinal angle increases. To reduce an arch that is large, press the lower back closer to the wall.
The post Neutral Spine or Not? shows how to tell if your hip (pelvis) is tilted or straight, and/or if overarching (hyperlordosis/swayback) is coming from the upper body (leaning back). The wall maneuver shows you how to reduce the overarch. Don't press flat against the wall or you'll round like a beetle :-)
While standing at the wall, see if you can do a small "crunch" movement without rounding your upper body forward, to reduce the overly large arch. Movement is just from the hip and mid-torso. Hopefully, you will feel that you easily move the body without bending your knees. That should produce reduced lower back arch. Send some photos if you like and I will take a look.
2) Next, you need to make it possible and comfortable:
Check how you are standing. Don't try to touch the back of the legs to the wall. Just heels, backside, upper back, back of head.
Thank you for already checking the other links and finding the relaxing-hip-stretch. I couldn't tell which other stretch you wrote, but most stretches that lengthen a tight front hip can help. One that is functional for daily bending that you need to do anyway is Hip Stretch While You Strengthen Legs.
Hope to hear more about your successes. Send photos and I can post your continuing success in Readers Inspiring Stories.
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Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
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Which Stretch Stops Back Pain by Making Neutral Spine Possible?
Monday, November 10, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
What can you do if you're too tight to stand and move in neutral spine? A common lower back pain occurs after long standing, walking, and upright activity. The most common cause is exaggerated inward curve in the lower spine - a bad posture called hyperlordosis or overarching which pinches the joints called facets and the surrounding soft tissue. An obvious treatment is to simply stop the cause, and restore neutral spine.
Which specific stretches relieve the tight muscles that make neutral spine difficult?
Usually the tight muscles are in the front of the hip (anterior hip muscles) called hip flexors. Several specific easy stretches restore resting length to the front hip. Several of my patients and readers find that posterior hip stretches also help quickly. Liz first wrote in with her success story, How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!
Liz continues her story:
"Dear Dr Bookspan, "Just a few days ago I checked back to read your blog…since I posted my "Short history" which turned out to not be so short. I was particularly trying to share one thing that had happened to me, for which I couldn't find any specific help until I read your blog, which was back pain after bike riding.
"Even short walks hurt my back before I discovered your work, let alone the way my back felt after a bike ride, a future of pain, getting fat and depressed from lack of activity.
(trouble persists with getting photos to load - Liz' photo should be here and hopefully will soon)
"I thought I'd send at least one photo of me on my bike (I think I have mastered the dorky cyclist look) after a 12 km ride home from work and 12 kms to work that morning. If it hadn't been for you I would not have been able to do this, I would have not experienced the joy it gives me to use my muscles, feel my body doing what it was meant to do.
"I like being able to look after myself and not rely on an external source, like a chiropractor, to keep me well. Whenever I take out your book (Fix Your Own Pain) to refer to, my husband says, 'oh oh, what's wrong?' Mostly now it's just to refresh my memory of an exercise or principle you have written or to check I'm not doing something terrible to my knees. What a marvelous reference book it is.
"After I hurt my back during my first trial cycling to work, I read so many books and articles and web pages on back pain, and many on cycling and back pain. Mostly they were about pain caused by the racing position or impact injuries from bumps in the road. Then I read one of your blog entries where a readers/patient explained he had to give up cycling because of the pain he experienced in his lower back a while after he had been on a ride.
"This is what happened to me, in that blog you explained that a few specific stretches were useful for specific muscles. I checked many pictures of anatomy, which named the muscles that I seemed to be having trouble with, I went back to your book and read more about hips and how tight muscles in the hip area can cause lower back pain. It seems, sitting at a computer all day, then using my leg and hip muscles to propel myself up really steep hills was causing the muscles in my hips to tighten a great deal. That's why I tried your figure 4 stretch.
"It did precisely what I needed it to do, now if I don't do it regularly, I can feel my pelvis is tilting the wrong way, all by itself and my lower back starts to hurt. And when I lie on my back my front hip/pelvic bones (iliac crest) stick way out because of the extreme tilt. Then I do the lying figure 4 stretch and they go back into the right place. Now I know exactly what to do to end the pain and I wanted to make sure, should anyone be searching for help, that they will know there is an answer and your work is the source.
"Thank you for helping me find my joy." Liz.
Neutral spine is pictured at left. Too much inward curve (hyperlordosis) is pictured in the middle and right drawings. Abs are too long, lower spine is pinched in back.
Habitually keeping too much inward curve (hyperlordosis) shortens and tightens lower back muscles. Tight lower back muscles pull the back of the pelvis upward, tilting it outward in back and forward in front. The tight area feels normal when held shortened (hyperlordotic) and resists lengthening enough to stand in neutral spine. Stretching the lower back allows neutral spine to become possible and feel normal.
I wrote back to Liz asking if she was using anterior hip (hip flexor) stretches too and if she felt the posterior hip stretches working to let her restore straight hip instead of tilting forward.
Liz replied:
"Yes, being a mostly sitting worker I do the hip flexor (anterior front hip) stretch too, I'm sure it helps my ability to voluntarily keep my hips tilted correctly all the time, I can feel with my hands when they 'flatten'. I do this stretch everyday, sometimes twice a day and it's very helpful. I have on occasion skipped this stretch and only done the posterior hip stretch and I've found I have had no trouble achieving neutral spine. But I do it anyway, it's got to be good for me!
"This is my description of the reason I do the posterior hip stretch, mostly on my bike ride days (though it's so good for me, now I do it twice a day) - Even though I am tilting my hips voluntarily to the best of my ability, if I have not done the posterior hip stretch I feel a sharp pinching in my lower back, where the 'dimples' are, sometimes only one side sometimes both. I feel my front hip bones with my hands and can tell my pelvis is not correctly angled, I can't tilt it correctly any further without starting to use muscle force. Not the gentle neutral spine you describe.
"When I lie down and try to gently straighten my spine to neutral, I find I can't and my front hip bones stick out quite a bit. It feels like a muscle somewhere is holding on to my pelvic bone so firmly I can't move it without force. So then I do the posterior hip stretch on both sides for 30 seconds or more if it's feeling wonderful. Often I feel one side is far tighter than the other. Then I test again by lying straight, feeling my front hip bones with my hands and gently moving into neutral spine and I find they are nice and flat, and stay that way. Also the pinching pain goes quite rapidly. Occasionally the pain doesn't go away for a few hours, a hot bath helps. If this happens I do the posterior hip stretch a few times over an hour or two and that also helps. I expect this means I may have done a wee bit of damage to the soft tissue, amazing how the body heals.
"I have discovered that even on non-biking days, if I do this stretch regularly, I rarely feel any pain in my back at all. I'm not 100% certain if it's the combination of stretches that I do, including the hip flexor stretch, but I feel this one is critical for the correction of some kind of internal postural muscle, that is not behaving in a natural way, through some unconscious action of mine."
Usually, no special exercises are needed to have neutral spine. Worse, a common scenario is someone doing exercises then walking away with the spine still arched, never applying the exercise to real life. They become stronger people with the same bad posture - the exercise was not used for function. Instead, just stop the bad position and deliberately move your spine to neutral. However, when the area is too tight to move to neutral, here are stretches. The stretches don't change your voluntary posture, you do that. They just can make it possible:
First, Don't Tighten:
First make sure you don't tighten or clench abdominal or posterior hip and leg muscles. Tightening does not change posture, inhibits movement, and makes it hard to move to neutral spine.
Then, check if you just need a guide to help feel how to reduce the lower spine arch without pushing the hip forward, leaning back, or moving everything else:
If you find you are still too tight, stretch the front of the hip (anterior) and back (posterior):
Anterior Hip Stretches:
Until I make a post for this one, a relaxing start to stretch the front of the hip is to lie face up with knees bent and ankles crossed. Let knees separate to each side as far as comfortable. Keep lower legs next to each other, not one on top of the other. Do this without shoes, to fit your feet side by side without resting the lower leg on the foot. Experiment with pressing your lower back toward the floor. This stretches front and back at the same time, as needed for straighter standing. If this stretch is too much at first, start lying on your back with only one knee bent to the side, the other leg straight. Rest bottom of the foot of the bent leg at the knee of the straight leg.
A nice stretch over a bed or bench - Quick Relaxing Hip Stretch. If this one is too much, try it lying flat with a pillow under your hips. Gradually use a bigger pillow. Finally, lie with legs stretching down from the edge of the bed and no pillow.
A big stretch - Relaxing Hip, Leg, and Groin Stretch. If the Relaxing Hip, Leg, and Groin Stretch is too much to start with, do it face up instead of face down (see the first stretch above).
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
I have received urgent inquires from physicians and reporters after an ABC news report came out on surfer's myelopathy - lower body paralysis occurring shortly after surfing.
The main suspected mechanism is standing or lying for long periods with the lower back so overarched that it interferes with blood flow to the spine below it, causing a "stroke in the spine."
Overarching is a topic of my laboratory research as it relates to compression of soft tissue and the joints of the lower vertebrae leading to chronic mystery back pain.
Overarching the lower spine is an avoidable bad posture. It is simply and quickly changed by holding the pelvis level in what is commonly called neutral spine. Compression which impedes blood flow is a different, serious effect. Until I can post separately on it, to understand and avoid one main mechanism, check:
Holding neutral spine is not just an exercise to do then stop and return to overarching during life activity. Neutral spine is a healthy normal position to maintain comfortably, not rigidly, during ordinary activities and exercise. To see some of the issues of neutral spine, click:
Stop Lower Back Pain From Swimming and SCUBA Part II
Tuesday, June 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Yesterday's post explained the most common hidden cause of lower backache after swimming and scuba diving. Swimmers and divers who get this chronic pain are often misdiagnosed with SI (sacroiliac) joint dysfunction, arthritis, disc injury or various "catch-all" terms for back pain with unknown origin. Scans may show damage to the facet joints, which can occur from spinal overarching. Injections and surgeries and various anti-inflammatories are often prescribed. No shots, medicines, or surgeries are needed. You do not need physical therapy or strengthening programs. All you need to do is stop overarching and maintain neutral spine when walking, running, swimming, and diving. It is easy, and is a healthy and normal spine position. You do not tighten any muscles to do it. It is just learning a normal posture.
Check yourself to see if you stand in hyperlordosis:
Stand up and look sideways in a mirror. Your belt should be level, as in the left drawing of neutral spine. The side seam in dress or trousers should be vertical from leg to waist, as in left drawing, not tilted forward at the hip (middle drawing).
Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first, it often is a good indicator that you lean the upper body backward (right drawing).
Stand with your back against a wall, with heels, hips, upper back and back of your head touching. There should be a small space between your lower back and the wall, but not a large space. Then raise both arms overhead to touch fingers to the wall behind you to simulate swimming with arms outstretched. See if the lumbar curve increases. You should be able to stand with the back of your head touching the wall without increasing your normal curve, and be able to raise your arms without increasing it.
If you have a large space between lower back and the wall, try this:
If you can't figure how to do that, put your hands on your hips, thumbs facing the back, and roll your hip under so that your thumbs come downward in back.
Feel the large space between lower back and the wall become a smaller space.
Lower back pain that is caused by hyperlordosis should ease right away. Learn how to easily, gently do this while walking, running, swimming, or whatever you do. This is done without tightening or clenching any muscles.
Keep the good new neutral spine when you walk away from the wall, and all the time. Apply it to when you are swimming and scuba diving.
Muscle Use is Not Automatic The muscles that hold neutral spine are your abdominal muscles. They do not do this automatically, which is why strengthening programs do little to stop back pain. Someone may have strong abs but stand and swim in arched posture, with continuing lower back pain.
Heavy scuba tanks don't make you arch your back or have bad posture. Not using your ab muscles to counter the pull, and allowing your back to arch is the problem.
When you are standing up wearing tanks, straighten your body against the pull of the load and maintain neutral spine. Do not tighten your abs, just move your pelvis. If you notice yourself arching while wearing tanks, straighten your body as if starting to do a crunch but don't curl forward. Only straighten to neutral spine. Don't tuck so much that you lean back or push your hips forward.
No More Lower Back Pain From Overarching Transfer this neutral spine skill to your daily life for carrying gear, putting cargo up on racks, heavy packages on counters, and whenever you lift and reach. Use neutral spine when standing, walking, running, reaching overhead, swimming, and scuba diving.
Lifting and carrying heavy dive gear with good lifting mechanics is good and functional exercise. With bad lifting habits, it is a common and obvious cause of lower back pain in scuba divers. A second major cause of lower back pain after SCUBA and swimming is often overlooked and can occur after scuba diving and after swimming laps with no gear lifting.
Hyperlordosis When swimming or finning face down and horizontally through the water, many divers allow their lower back to increase in arch. They look like they are face down in a hammock - shown by the figurine below:
A small inward curve belongs in the lower back. When you allow the normal inward curve, (normal lordosis) to increase, it becomes hyperlordosis or overarching (swayback).
For most people, hyperlordosis is most common when upright, such as standing, walking, and running. Swimmers and divers who allow their back to overarch when swimming face down often notice the pain after swims and dives:
How Hyperlordosis Causes Lower Back Pain Hyperlordosis pinches the joints of the vertebrae called facets and the surrounding soft tissue. When swimming and diving in hyperlordosis, the fulcrum of the kick becomes the facets instead of the muscles of the abs and hip. When standing upright with a hyperlordotic lower spine instead of neutral spine, the weight of the upper body presses down on the overly pinched-backward lower back. Running in hyperlordosis causes more of the banging and pressing.
People with lower back pain from hyperlordosis usually feel they need to bend over forward, or sit, or raise one leg to relieve it. Often nothing shows up on x-rays and scans. Eventually, hyperlordosis can damage structures enough to show. Until then it just aches a great deal.
The cause of this kind of pain is often unrecognized and people may be told they have a condition called sacroiliac, or SI joint dysfunction, or nonspecific back pain, or other names.
Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine
Friday, June 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - quickly change your posture to change your luck on Friday the 13th. Hyperlordosis (swayback posture) seems to be unlucky - it causes lower back pain. You can do this in seconds to make a certain change to healthier spine for yoga or practicing the lunge. If you don't believe in luck, you're lucky. It's just good posture and simple anatomy.
Reader David from Belgium demonstrates in this 20 second movie that he made for us:
First ten seconds - he steps into a yoga pose called Warrior pose, but allows overly arched lower spine. He also demonstrates leaning more weight forward of center line, which is a different issue.
Note how the belt line tips downward in front and the lower spine overly curves inward - more than a normal curve.
At second 11 he levels the hip to bring the posture to neutral spine. Then he kindly demonstrates overarching when raising the arms further. Instead, hold neutral spine and raise the arms from the shoulder, not the lower back.
To prevent shoulder impingement when raising arms, keep shoulders down and back, don't just chin and neck forward, keep them gently in. A forward head posture compresses the rotator cuff when lifting arms. See Safer Overhead Military Press.
I never expected repeated requests to see how to do neutral spine in different activities. It is the same. Just apply the same neutral spine and that’s all. I thought one post would do it, but will post each activity readers ask about. I am aware that there are yoga and fitness places which teach to overarch the spine as part of the move. Teaching swayback does not seem to be as helpful as teaching neutral spine. Changing lunge and Warrior pose to neutral also improves the stretch to the front hip muscles of the back leg. Lucky.
Students Balances, Listens, Fixes Father's Back Pain
Tuesday, June 03, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
My student Ginger sent the photo at right taken on her recent camping trip. Don't try this at home. It takes balance training, concentration, and a few changes to standard back bend technique.
Ginger is distributing the stretch along the spine so that no one area is compressed at an unfavorable angle, and is contributing most of the leg extension from the hip, not lower spine. More safe back extension stretch and strengthening methods will come in future posts.
Ginger is a good student who makes good use of my classes. Last week, while visiting her parents, she was out walking with her father. She told me that her father said that his back hurt from the walking. She looked, and saw that her father was standing and walking with too much inward curve to the lower back - hyperlordosis (swayback). Standing with the lower spine overarched is a slouch that compresses the spine unevenly downward, pinching the joints and soft tissue at the back of the lower vertebrae. Overarching is a large hidden cause of lower back ache during walking and running. This slouch is not fixed in the bone, it is a posture that is easily corrected. It does not require strengthening the back or core muscles, just using the ones you have. In moments, Ginger showed her father what I taught in class - how to change a slouching overarch to neutral spine. Ginger's father said the ache disappeared right there, and that was all there was to it.
The article Innovation in Abdominal Muscles gives an overview, and the comments give a link to another post with a short movie showing the concept.
If you want a whole book showing the concept, several techniques to achieve and use neutral spine, and examples of use in all daily life, try the book The Ab Revolution™ Third edition expanded. Part I of the book shows daily use without needing any exercises. Part II shows how to exercise using neutral spine to get more exercise, healthier exercise, and use abdominal muscles functionally to stop unattractive and damaging overarching.
"Hello, I'm writing as someone who has incurred a training-related lower back injury and who has great interest in your words on hyperlordosis. I am hoping that you might shed some insight on how to achieve a neutral spine while doing "kettlebell swings." This is the exercise that has caused me back pain, and I would love to return to working out with kettlebells, but am not sure how to do so without creating too much lordosis. Any ideas? I appreciate any assistance you can provide and thank you for your contributions! Take care, Dan L"
Kettle bells (also called kettle balls and many other names) are usually ball-shaped weights with a handle. A variety of sizes is shown in the photo below, along with a medicine ball for comparison. Kettle bells were long used in various martial arts and cultural festivals and contests before being rediscovered for modern weight lifting. In general, you lift, swing, and move them to do various weight lifting exercises.
When lifting and swinging kettlebells (and any weights) overhead, don't lean your upper body backward (photo below left). Leaning backward is often mistakenly done to "balance the weight" and make the lift easier. Another common body movement to make lifting overhead easier is changing the tilt of the pelvis (hip) so that it juts forward in front and outward in back (same photo below left). Leaning the upper body back and tilting the pelvis are not necessary to balance a load - your own muscles can hold the load, and in fact, that is the point of lifting the weights. Not only are they not necessary, they increase the inward curve of the lower spine. Increasing the small normal small inward curve (lordosis) to a large curve (hyperlordosis) increases compression on the joints (facets) and soft tissue of the lower spine. The same overarching is the hidden cause of back pain in women who lean back and/or tilt the hip trying to offset the load of a pregnancy - Back Pain in Pregnancy - and Why Men Can Get It.
The photos of spine position swinging the heavy medicine ball are from the book Healthy Martial Arts. My black belt student Christopher demonstrates. This is a similar overhead motion as swinging kettle bells by the handle. In the left photo, Christopher allows the hip to tilt forward in front (and out in back) and his upper body is tilting backward relative to the lower spine. In the right photo, he holds neutral spine. In the right hand photo you can see the change to reduce the overarching to neutral spine. The belt line changes from tipped downward in front to level.
Leaning backward and overarching are not helpful adaptations as sometime thought, are not unavoidable, and are not limited to pregnant women. Overarching (hyperlordosis) is a common bad posture, and an often missed source of back pain. It can be easily prevented by using your muscles to hold neutral spine. The post Prevent Back Surgery shows photos of hyperlordosis compared to neutral spine during many activities.
Neutral spine while exercising with kettle bells is the same as neutral spine during anything else - just hold your spine position. Holding neutral spine is the same as not slouching your shoulders or not letting your mouth hang open. You just voluntarily move to and hold desired position.
Neutral spine is not done by tightening or clenching any muscles. It is done by moving your hip and lower spine the same way you move your arm to scratch your nose - without tightening, just moving it to where you want it.
Helpful posts to see and learn neutral spine while swinging kettlebells, babies, and all other fun weightlifting:
The book Healthy Martial Arts (www.DrBookspan.com/books) has a section on lifting and swinging kettlebells, medicine balls, and other weights. Keep breathing, smiling, and have fun. You can swing weights to be stronger and healthier, without injury.
Fast Fitness - Fixing Your Handstand to Neutral Spine
Friday, May 16, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Last week's Fast Fitness showed a movie of how to step up into an easy handstand and get back down. This week shows a common pitfall - letting your lower spine sag under gravity - and how to fix it and hold neutral spine.
My student Dennis, Olympic medalist in wrestling, demonstrates:
Step your foot up behind you high onto a wall, then the other.
For the first 5 seconds of the movie, Dennis allows the lower spine to overarch (increase the inward curve) under the pull of gravity, a bad posture called hyperlordosis. It is not the normal inward curve, it is an easily changed bad posture.
At second 5 he changes the tilt of the hip and lower spine back to neutral spine. The action is like doing an abdominal crunch to bring the spine and torso just forward enough to be straight.
This technique practices the muscles and positioning for straight standing, making it better than just a handstand. If you want to gain abdominal strength, using neutral spine uses those muscles. An important difference in Fitness Fixer exercises is that they are not only exercises alone. All the techniques I developed are supposed to be used to train muscle function and positioning for when you stand up and walk away.
Use neutral spine, not only for handstands, but all you do. Examples are in Prevent Back Surgery.
When you stretch and exercise, especially if you stretch and exercise to improve your health, remember that the purpose is not to recreate unhealthy movement habits.
Two similar letters came in recently.
Reader Tina wrote:
"Thanks so much for your posts on stopping upper back pain. I have stopped my upper back pain. But, when I pull my neck and shoulders back, I get pain in my lower back. Which stretches should I do to stop this pain?"
Alicia wrote:
"I recently stumbled upon your articles on the Internet about how to reduce back pain. Thanks so much for providing this information! I am experiencing less pain for sure already… but I have a question. When I am keeping my neck back and shoulders back and correcting the lower back arch, I get a pinching sensation in the middle of my back. What am I doing wrong?"
Tina was doing a common unhealthy movement habit. She didn't need stretches to fix the pain; she needed to stop old injurious movement habits. Tina was leaning her upper body backward thinking she was pulling her shoulders back. Leaning backward is not correcting rounded forward shoulders, even if it seems to move the shoulders rearward. The shoulders have not moved at all just stayed rounded while the upper body pinched backward at the lower spine.
The photo at left is a performer who had just finished a trapeze performance. All the exercise and stretching she did every day didn't change her bad positioning habits.
Leaning the upper body backward (shown in the photo, left) increases the inward curve of the lower back, making a sharper angle between the pelvis and the lower spine. That increases the normal lordosis (inward lumbar curve) to hyperlordosis (too much inward curve as in the photo), which put painful pinching compression on the area. Look at the strip on her leotard. It tilts forward at the front hip and back at the back of the hip. It should be straight up and down, which is part of holding neutral spine.
The photo also shows shoulders and upper back rounded forward, and the neck and head jutting forward.
Slipping into familiar unhealthy ways of moving may be habits that occur without thinking. You need to think a bit.
Alicia was just pulling back so tightly that she pinched the area between the shoulder blades. There are sources that say that you should squeeze shoulder blades as if holding a penny between them to fix posture, but of course, that is painful and too tight.
Alicia wrote back:
"Thanks! That helps actually. The pinching was in my upper back, but it's gone now! Thanks so much for responding to me. I look forward to your class in July. Alicia"
Pinching back does not fix posture or stop upper back pain. Instead, stop the causes of the rounded shoulders and the pain.
These three posts help understand and fix the causes:
The post Prevent Back Surgery shows several photos of how people learn the upper body back or tilt the hip out in back during several common exercises, stretches, and daily activities. Both increase the pinching compression on the lumbar spine.
Remember to think and watch for causes instead of just *doing* exercises and stretches.
Fast Fitness - How to Feel Change to Neutral Spine
Friday, May 02, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Use a wall to learn neutral spine while standing, to know how to stop a major source lower back pain during standing, walking, and running.
Many people learn pelvic tilts lying on their back in physical therapy or fitness classes. What does that do? Little. The purpose of learning the pelvic tilt is to know how to do it during real daily life so that you do not overarch (hyperlordosis) and create back pain. My student Dennis, Olympic medalist in wrestling, demonstrates learning a functional pelvic tilt (he is holding his shirt away with hand so you can see better - you can relax your arms at your sides):
Stand with your back against a wall. Touch heels, hips, shoulders, and the back of your head.
If you allow a large arch in the lower spine there will be a large space between lower back and the wall. Press your lower back toward the wall.
Don't touch or force your lower back to the wall. Just learn how to tilt the hip so that the lower spine comes closer to it and reduces in arch.
Use a wall often to practice, then the idea is to hold neutral spine without the wall during the rest of your day.
Reducing a large arch back to neutral stops the painful lower spine compression on soft tissue and facet joints during standing activities (and bad pushups and handstands).
The post Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It? showed the common and painful bad posture of standing with too much inward curve in the lower back, called swayback and hyperlordosis. A reader mailed me an article about gluteal muscles and asked what gluteal muscles have to do with it. The article shows one kind of hyperlordosis, with the hip pushed forward. The drawing at right shows that hip-forward hyperlordosis position (right figure) compared to neutral spine (left figure). The article stated that the hip-forward posture was due to weak gluteal muscles, and that strengthening the muscles would fix the bad posture. The article gave a strengthening exercise of lying on your back and squeezing the "cheeks" of the backside together as if squeezing a coin between them.
Knowing muscle action will help you know why it doesn't work that way:
Your gluteal muscles are muscles of your backside. One function is to pull your upper leg backward, for example, when walking, to pull each leg behind you. The distance between the back of your hip and the back of your upper leg shortens.
If you use your gluteal muscles while standing (not tighten them, just use them to bring about movement) your hip will push forward. That is the opposite of correcting a hip that is forward in bad posture.
Squeezing the "cheeks" of the gluteal muscles together is training a different movement direction than either pushing your hip and leg forward or back.
Another fallacy is that tight gluteal muscles pull the hip so that it pushes forward into bad posture. It is true that tight hip muscles in front will change the tilt of your hip. People with anterior tightness cannot easily bring the leg behind them, which hurts stance and gait. Gluteal muscles cannot get that tight unless you have tetanus. Gluteal tight enough to push the hip forward a few inches would be so tight that you would not be able to sit down. You would tear your backside like splitting your pants.
The key point is that strengthening a muscle does not make it move your body or change your position. If you strengthen your arm, for example, your arm does not automatically wave around or raise over your head. Your arm only moves when you make it move. Strengthening your gluteal muscles will not move your hip for you. Even if strengthening did make any body part move on its own, gluteal muscles would cause a forward hip, not correct it.
Think of asking a dog to shake hands with you. If you want the dog to move his paw up to shake your hand, you do not strengthen his leg and paw. You train the movement and the voluntary desire to bring about the action.
Standing, walking, and running in hyperlordosis is a major cause of lower back pain. Some people stick the backside out in back and others tilt the upper body back with the hip thrust forward. Both increase the inward curve of the lower back and painfully pinch the lower back structures. Although some fitness information and advertisements represent overarching as attractive, even something to deliberately do, it is an unhealthy and weak posture, making it unattractive and undesirable.
Strengthening muscles is good and helpful and fun and healthy, and so on. Strengthening gluteal muscles or any other muscles will not automatically make you stand in healthful position. Stronger muscles do not make you move. You can change to healthful position right now without strengthening. These posts show how:
When you hear that you need various strengthening exercises to correct posture, think of shaking a dog's paw.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
Thursday, March 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
The post Innovation in Abdominal Muscles showed one of the most common, yet most overlooked cause of lower back pain during long standing walking, and running.
Readers sent excited letters stating they could finally see and feel why they had back pain, and could immediately feel the difference when they stopped standing with too much inward curve in the lower spine, and began standing and moving in neutral spine.
Neutral spine at left. The line from the top of the leg up to the middle of the hip is vertical. The beltline (line from front to back through the crest of the hipbone) is horizontal.
Middle drawing shows tilting the hip forward in front and out in back.
Right drawing shows tilting the hip forward, and also leaning the upper body backward.
Readers asked for more photos so that they can see the difference between overarching (hyperlordosis) and neutral spine (normal lordosis) during running and walking. They wanted to see the overarch in action and what running in neutral spine looked like.
The two photos above show allowing hyperlordosis, or too much inward curve (arch) in the lower spine. It is not a normal curve. The angle increases where the back of the vertebrae come together. It does not look fit or healthy.
In both photos, the hip tilts forward in front (and out in back) instead of holding vertical. The abdomen rounds outward.
Note the red stripe on the runner's pants in the photo at left. The stripe tilts forward from the top of the leg to the middle of the hip. Compare to the red vertical line in the middle and right-hand drawing. The beltline tips downward in front. Compare to the red lines tilting downward in the drawings.
The walker in the photo at right tilts the hip forward in front (and out in back), beltline tips downward. The upper body leans and sags backward.
Neutral spine.
The muscles that shorten to prevent the upper body tilting back and the hip tilting forward are your abdominal muscles. The abdominal muscles are too long when you allow overarching. Keep this in mind when you hear about exercise programs that claim to lengthen your abs.
Moving your spine to neutral spine for all daily life is how abdominal muscles help prevent back pain. It is not strengthening them that does this, and it is not tightening. Crunches and other forward bending exercises do not train you how to use your abs to hold neutral spine and they increase herniating pressure on your discs - click Good Life Works Better Than Bad Ab Exercise. Use your abdominal muscles, without tightening them, to position your lower spine during all you do, just like using any other muscles to move any other part the way you want. It is a free ab workout all day, and you will stop a major cause of back pain during standing, walking, and running.
Click Prevent Back Surgery to see why overarching can be so damaging to the joints of the vertebrae.
Click my web site books page www.DrBookspan.com/books to see the training manual The Ab Revolution™. It shows several techniques to learn neutral spine as a normal habit, and how to use it to stop back pain from hyperlordosis, even if you don't exercise (Part 1) and how to use it for better core training if you want to incorporate it into exercises (Part 2), from simple to the hardest you can get.
My student Leslie is 67 years old. She has been working with me for several years. Click the arrow of this 30 second movie to watch her knock off 30 pushups.
At around the 25 second mark of this short movie, enjoy the reaction of the student who will appear at right.
Leslie holds straight neutral spine position. She does not let her lower spine sag, or her head and neck sag downward. To see a movie to practice how to change overarched hyperlordotic sagging spine to neutral spine for pushups, click Fast Fitness - Strengthen by Changing Your Plank.
Leslie says hello to all the readers and that she is strong with such great positioning due to my classes and emphasis on being able to hold up your own body weight in healthful positioning for regular daily life. I hope to post more of Leslie's and other students' happiness and strength.
Bookmark this post. Open it every day and do your 30 pushups with Leslie.
Lower back pain is a common problem for golf players. Pain is sometimes attributed to twisting the torso during the swing. The "twisting theory" seemed reasonable, since that is when many people feel the pain. However, the main problem is not twisting. Beside the bad forward bending that is common for picking up golf shots and equipment, a major overlooked source of lower back pain is overarching the spine during the swing.
If you increase the inward curve in the lower back, you increase normal lordosis to hyperlordosis. When you do this during the swing while letting your upper body weight press down on the area, it compresses the facet joints and surrounding soft tissue. It is the same pain that occurs from overarching during walking and running.
A golf pro attended my last workshop on fixing back, neck, and hip pain. I was able to check with her to make sure that what I found to stop lower back pain with golf would not interfere with a good swing.
She stated:
"I do not think arching is essential, but I can imagine the older golfers and what their swings might look like...there are some ugly ones that would arch WAY too much and that is the source of many problems on the score card, as well as the back!"
In the following photo examples, look for too much inward curve in the lower back. Too much curve is not a normal lordosis, it is overarching, called hyperlordosis. Overarching is the reason for much unidentified pain during standing activities.
In the next two drawings, the lower spine is overarched (hyperlordotic) on the left and neutral on the right. Neutral spine keeps a small inward curve, but not a large one:
In these photos, see how the lower back is overarched:
These photos show the lower spine from the back:
In these three photos, see how the lower back is held in neutral spine: Preventing overarching and holding neutral spine does not mean that you do not get a full or strong swing. It is not the case that the only way to get full range of motion is by pivoting from the lower spine joints. By holding neutral spine you will shift the effort of the swing onto your abdominal muscles, giving you a more powerful swing.
To understand how bad forward bending (opposite problem from hyperlordosis) contributes to back pain click The Cause of Disc and Back Pain.
Golf cartoons by subscription to Clipart.com Golf arched 1 photo by jarrod job Golf arched 2 photo by subscription to ClipArt.com Golf arched 3 photo by MattFM Arched swing from the back photo by digital_image_fan Neutral swing from the back photo by mahalie Golf neutral 1 photo by dospaz Golf neutral 2 photo by minds-eye Golf neutral 3 photo by Jayel Aheram
Fast Fitness - Core Hip & Body, Posture Strength & Balance
Saturday, January 26, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - training and challenging abdominal muscles to hold neutral spine. Use this, not as an exercise to "do," but to use to retrain neutral spine. Reader Mike, who did a A Whole Big Fix sent this photo to illustrate:
Hold a plank.
Lift one arm straight in front.
Figure out which is the opposite leg and lift that one. Keep straight spine
Mike writes:
"Here's some more feedback on your exercises: it seems the more planks I do with opposite arm/leg extended, the less my hip pops, so I'm doing those every morning for about 4 sets of 10 sec. holds on each side, along with the side planks. Those seem to set my posture off right for the rest of the day. I'm using my hand and wrist muscles to take weight off the bones, as you've said, and my wrists, are getting stronger.
"BTW: my daughter's badminton coach has a PhD in exercise physiology and she's also a big fan of your site."
Here is Friday Fast Fitness - fixing painful swayback to neutral spine.
If you have lower back pain after standing, walking, or running, or feel that you need to bend forward or lift one leg to relieve lower back pain, you may stand with too large an inward curve in your lower back (hyperlordosis).
Stand with hands on hips, thumbs in back
Roll hip under so that thumbs and the back of the hip come downward (not forward)
Use the neutral spine position for normal posture.
Reader David from Belgium made us this short video of correcting overarching (hyperlordosis). At first he is standing with the front of the hip tilted forward and the upper body leaning backward. Both actions increase the lower back curve. Then he tucks the bottom of the hip under to neutral position, correcting the hyperlordosis.
Don't tighten your abs to do this. Just use them to move your lower spine out of unhealthful arching to neutral spine. Breathe.
Fast Fitness - Stabilization During Speed and Directional Change
Friday, December 14, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - a fun, real-body skill to improve stabilizing your spine, knee, ankle, and foot (and hopefully everywhere else with good positioning) while having fun. Have a pillow fight standing on one foot:
When one partner has to touch down, change feet.
When the other loses balance, game over.
Swing fully without letting your lower back arch on the swing. Keep neutral spine.
No score, just the big desire to practice again and improve functional balance, stabilization, and have fun from movement.
To practice this solo, swing a pillow on your own. Use a progressively heavy object, such as a ball on a rope, dumbbell, kettlebell, and any household item. Breathe. Have fun.
Fast Fitness - Upper Back, Shoulder, Triceps, Arm, Wrist, and Hand Stretch
Friday, December 07, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - nice stretch for hands, upper back, and everything in between.
Stand with your back about a foot from a solid surface
Reach upward and backward to place both hands on the wall, all fingers facing downward
Press, lifting upward, keeping the stretch in your chest and upper body.
Vary the stretch by straightening elbows more.
Do not pinch your spine backward like a soda straw at the lower back, which increases lordosis (causes hyperlordosis). Tuck hip to neutral to stop compressive pain in the lower back. Here is how.
Breathe. Smile. Feel good stretching your upper back out of forward-rounded posture.
Here is Friday Fast Fitness - fix your plank (hold pushup position) to strengthen core and wrists, and train standing neutral spine posture. In yoga the plank is done in high and low positions called chaturunga.
A sagging inward curve to the lower back is not the normal curve, it is too much curve - pictured at the start of the MPEG movie below. Holding a plank with a sagging (overarched, hyperlordotic) lower spine "hammocks" body weight onto your spine joints called facets, adding to lower back pain, and does not use your core muscles. It is counterproductive as an exercise. Instead:
Hold a pushup position
Change sagging lower back to neutral by tucking the hip. Head up, neck as straight as standing.
Don't flop all weight on wrists. Press with hand and fingers, and use forearm muscles to reduce wrist compression and shift weight to surrounding muscles - see Stronger Pain-Free Wrists When Biking for ideas.
Reader David D. from Belgium sent this excellent movie. He pushes up into plank. You can also can start on hands and feet without pushing up. He first demonstrates badly overarched lower back, then changes to neutral spine in seconds 8-11 of the movie, then holds. When you do this you will immediately feel the effort shift to your abs. Use this instead of crunches for functional core training. If you push up from the floor, hold tucked neutral spine, not lifting upper body first.
(The exercise is not to do overarching and change to neutral - it is to hold neutral throughout.)
The 2006 Sylvester Stallone movie Rocky Balboa featured a scene where a computer simulation estimates the outcome of a hypothetical fight. Stallone's character Rocky is a retired heavyweight boxer. While watching ESPN news, Rocky is startled by a broadcast. It features a computer simulation depicting a fantasy fight, and predicts the outcome of how he would have fought in his prime against the movie's present-day heavyweight champion Mason Dixon. A real pro boxer plays Mason Dixon's character. Antonio "Magic Man" Tarver is a southpaw from Florida, and former light heavyweight world champion.
Computer generated fights that generate real probable outcomes in real time 3-D are not yet possible outside the movie industry.
An actual "fantasy fight" computer simulation was done in 1970. It was the SuperFight between Muhammad Ali and Rocky Marciano. Rocky (Rocco) Marciano was heavyweight champion of the world from 1952 to 1956. Muhammad Ali was three-time World Heavyweight Champion in the 1970s. Marciano and Ali fought in different eras and never fought an actual bout.
To make the SuperFight, probability formulas were entered into a computer. No drawings, just numbers. Ali and Marciano met in real life on a filmset to film numerous short segments showing possible parts of a fight. Marciano was already retired 13 years and wore a toupee. The short segments were then spliced together to match the already done computer outcome to make a movie that looked like a real fight or computer-generation of one, but was not. The predicted outcome had already been generated by computer, but the fighters and movie were the real people, not computer generated. The outcome may or may not have reflected actual ability of the fighters or the real outcome.
In the mid 1980s, I was investigating which differences in human movement determined injury potential and athletic performance. In one study, I wanted to know what made the difference between the punch of a black belt martial artist and the same punch by an athletic person without training.
In present day, a camera can be hooked directly to a computer, which picks up the locations of the person's joints at each point in time, generating a computer image of the person as they move in real time. Software automatically calculates, draws, and records the image on the screen. When I started, we didn't have any of that. I did it all manually.
I filmed two subjects using 16mm high speed filming. An athletic man who had never done martial arts was subject #1. My husband Paul, who had earned his black belt a few years before that, volunteered as subject #2. I put markers over the center points of their major joints, and bands around joints which initially faced the camera but would rotate during the punch, so that the joint center would still be determined. Both executed a front reverse punch with their dominant arm. (Paul had to use traditional hyperlordotic position to match the untrained subject, rather than healthier neutral spine position, just for this comparison. We have done other studies comparing my neutral spine adjustment and found it to be a stronger punch - try it here.)
After waiting a week for film developing, I went into a darkened lab and used a film projector to throw the image of each of the thousands of frames, one by one, against a large computer digitizing tablet hung on a wall. I then digitized each joint point of each projected image, in each frame, of both subjects, frame by frame, with a digitizing Graf-pen. I sent data points from each frame by (300 baud acoustic coupling) modem to a text editor on a mainframe in another building at the University's new computer center. I wrote my own FORTRAN programs to generate data summaries and used packaged International Mathematical and Statistical Libraries (IMSL) cubic spline programs and subroutines for data smoothing. This was all to get each knee, hip, ankle, shoulder, wrist, elbow, neck and other filmed joint points into a computer to see exactly where and how fast they moved. Projecting each frame against the wall also allowed me to trace the subjects' outlines to make series of line drawings of their punch, and to make stick figures showing joint center placement. Here are some data and the actual drawings I made:
The untrained subject is at left. Paul is on the right. Paul is left handed so I had to reverse the images to make exact comparisons.
Below are comparisons of the angular velocity (left) and acceleration (right) of each subjects wrist, elbow, shoulder, and hip
Below are some center of gravity calculations
Not long after, with improvements in automating this process, action video games were flourishing. I was invited to a computer-generated imagery (CGI) development studio to be their "movement representation figure." They put the dots on my joint centers and filmed me using high-speed 3D computer graphics modeling as I did martial arts and tumbling moves. Not just one punch, painstakingly done, but jumping, spinning, flying all over the studio, and up and down walls.
The software automatically generated a mathematical, "wireframe" 2-D representation of my three-dimensional form. From it they animated a wild female warrior action figure for their fighting/mission genre arcade and video gameplay. They also used skeletal animation for when I would morph (on-screen) into various animal forms. I never got royalties but it was fun.
This is a big fun topic. For more, click the label "martial arts" under this article. I can write more about motion capture analysis of various sports if anyone is interested. The Great Muhammad Ali has been diagnosed with "Pugilistic Parkinson's syndrome" of tremors, muscle rigidity and slowness - with the possibility, still not fully determined, if due from the damage of a boxing career. See Rocky IV and Head Injury.
--- Read and contribute your own success stories using Fitness Fixer methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply to get certifiedDrBookspan.com/Academy. Learn more with Dr. Bookspan's Books.
Fast Fitness - Strength, Abs, Balance, and Ankle and Leg Stabilization
Friday, November 09, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - quickly increase functional stabilization of the knee, leg, and ankle while increasing overall strength and balance.
Anyone can lift weights, but can you do it balancing on a basketball? Get started by standing on one foot:
Do your regular lifts, curls, presses while standing on one foot (and then the other). Breathe.
Notice the leg you stand on. Don't let the arch of your foot flatten toward the floor, or knee roll inward toward the other leg. Hold knee, ankle, arch inline, using your muscles. See Arch Support Is Not From Shoes.
It reduces exercise to sit, even on a fitness ball. It is more exercise, more functional, and better balance training to stand on one foot than to sit. You sit all day already.
Be safe, be excited about having fun doing functional movement, be happy.
Prevent Main Factor in Back Pain After Running and Walking
Thursday, October 11, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
One of our readers, Nick, wrote me that he had had slowly increasing lower back pain despite exercising regularly. He ran, he stretched, he did abdominal exercises. Nick's doctor told Nick to give up running and take up low impact activity. Giving up running made Nick miserable but he did it. The pain came and went, but overall did not change. One day during a walk, his pain had spread into the back of his hip and was unendurable. He didn't feel able to make it back home, and wound up in the emergency room.
His x-rays were inconclusive and he was sent home with anti-inflammatory medicines, instructions to stretch his hamstrings, and rest or try other non-impact activity. This is a common story that readers mail me. It is unfortunate because:
The real cause of the pain was missed.
You do not need to give up running.
This kind of back pain is not inflammatory so does not benefit by anti-inflammatory medicine, which often causes its own problems.
Impact is not the problem. With a little common sense you can see if you clomp instead of walking or running lightly. Use leg muscles to step lightly instead of bashing down with no control. You should be able to run and jump with little impact. Many people walk with higher impact than a good runner lands during running. Future posts will cover this.
Most important was the missed cause - lower back pain during and following running, walking, lifting, and other upright activity is usually from allowing the lower spine to over arch. This hyperlordosis is not caused by an anatomic problem "condition." It is a bad posture, which is easily correctable. Hyperlordosis is one of the most commonly missed causes of lower back pain. Left drawing shows neutral spine. Right drawing shows one kind of hyperlordosis.
In the left neutral spine figure, the hip is level and horizontal from front (ASIS) to back (PSIS). The hip is also vertical from the top of the leg (greater trochanter) to the center crest of the hip. The right drawing shows allowing the front of the hip (pelvis) to tilt forward, which increases the lower spine angle. A small inward curve in the lower back is necessary for disc health and shock absorption. A high angle is as painful as any other pinching and pressuring of an area.
This is what I had Nick do. You can try it too. Check yourself these two ways to see if you stand in hyperlordosis:
Stand up and look sideways in a mirror. Your belt should be level-green line in left neutral drawing. The side seam in dress or trousers should be vertical from leg to waist - black arrow in left drawing, not tilted forward at the hip
Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first it is usually a good indicator that you lean the upper body backward, which increases a second kind of hyperlordosis. See Neutral Spine or Not? for more.
Here is how to reduce an overly large arch:
Stand with your back against a wall, with heels, hips, upper back and back of your head touching.
Put your hands on your hips, thumbs facing the back.
Roll your hip under so that your thumbs come downward in back.
Feel the large space between lower back and the wall become a smaller space.
Keep your heels, hips, upper back and the back of your head touching the wall and stand tall and straight. Lower back pain that is caused by hyperlordosis should ease right away.
Keep the good new neutral spine when you walkaway from the wall, and all the time.
More step-by-step instructions and photos in the Ab Revolution manual.
Check back often. I am working on the next part of this post: Another Common Cause of Back Pain With Running.
Nick was quickly able to return to running by stopping hyperlordosis. So was Ted - Back Pain From Running. Recognize hyperlordosis. It will save office visits, even emergency room visits, tests, time, money, stress, and worry. Reduce hyperlordosis to neutral spine with a simple repositioning technique to stop and prevent much pain.
--- Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here in the several replies to questions already here under this post. Get all posts on this topic by licking labels under posts and links in posts. Also check archives at right, the Fitness Fixer Index, and all the success stories of Fitness Fixer methods.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. See class schedules, get certified - DrBookspan.com/Academy. ---
One of my areas of injury research for both Army and Navy aeromedical systems was preventing back pain from running. Disease Non-Battle Injuries (DNBI) from exercising in the gym and doing PT is a huge military issue - grounding far more personnel than combat casualty.
I ran several studies and found that overarching (hyperlordosis) is a major overlooked cause of lower back pain - some examples are shown in the post Prevent Back Surgery.
I developed a simple method for people with this kind of back pain to understand and reverse the cause of pain themselves, with simple repositioning to neutral spine instead of overarching. It was unexpected news to some groups who have been taught to overarch, and who deliberately tilt the backside far out in back for exercise. But it was welcome relief for my guys who liked to joke that they were my STRACguys - combat slang for 'stupid troops running around in circles.'
I wrote a little training manual that went through several improvements to become the book, The Ab Revolution™ No More Crunches No More Back Pain. The book has two parts. The first shows how to stop back pain during various standing activity in daily life, both non-active and active, including running. The second part gives ways to exercise core muscles in healthier ways.
Reader Ted found the book and put it to immediate use to stop years of disabling back pain and return to running. Ted wrote:
"I am 57 years old and have weighed 175-lbs for the last 10-years (which drives my doctor nuts). I discovered running in 1969, after gaining weight when I entered college. The track at the University was fenced in, so we'd slide under the fence to run it. I jogged for six years, then raced for another ten years. I wasn't a fast runner, but I hit the legendary ''Second Wind'' on many occasions - you feel like you could Run Forever.......No Time....No Distance.....Just You and the Road.........it is a Mystical Experience....
"I tore out my ankle ligaments in 1980, and had to rehab for a year 'til I could start running again. I have run carrying 2 1/2-lb hand weights for the last 22 years. In 1989, I tore my back. It hurt, then the pain subsided, but flared up every so often."
The only way Ted had then to "cure the pain" was to stop running. Ted continued:
"In 2005 I REALLY hurt it, went into spasms (my wife had taken me shopping for eight hours, and I still blame this on being taken shopping), and the pain made me look back fondly on the Ligament Tear of 1980. After that, it was an All the Time Thing. Running dropped to twice a week (if that) and the slightest thing would trigger a back spasm. I accidentally came upon Dr Bookspan's ''Ab Revolution'' and 'mistakenly' bought it as an exercise book. It's more of a Way of Life, just like running.
"I have been pain-free (amazing) for 12-weeks and counting. I have increased my running to 4-5 days a week. Not having my back killing me is more than I could have hoped for. I thought my running days were over, and I would have missed them.......A LOT.
"The funny part was, I had gotten so used to the pain, it took about three DAYS for me to realize it WASN'T hurting. I cannot recommend the techniques in this book enough to other runners, If you can do The Thing You Love, why WOULDN'T you try this?"
What specifically did Ted do to fix the pain? He writes:
"The two techniques (in the book) I got the results from were the Standing Beginning Crunch with the hands facing each other, and the Where is My Belt Pointing? technique."
I will ask Ted what's going on with his knee in the photo he sent for this post, and what we can do to fix that up next. I will cover more on back pain after running, and also hope to post some other interesting work I did on the military running chants called jody calls or jodies, and their effect on perceived exertion during running. Check back often.
Friday Fast Fitness - Better Shoulder and Triceps Stretch
Friday, September 28, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Quick shoulder and triceps stretch, without adding new bad positioning. Use this instead of the usual stretch of pulling elbow overhead with the other hand, which usually results in leaning the head forward and arching the lower back. Instead:
Stand diagonally in front of a wall.
Raise elbow (the one closest to the wall). Lean arm, armpit, and body against the wall
Breathe. Relax. Smile. Switch sides.
Do not arch the lower back or tighten any part, or it will hurt and not be right or healthy. That would be silly.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Farm Work, Lifestyle Exercise, and Preventing Overuse Pain
Tuesday, September 25, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Reader Ivy from New Zealand wrote me that she was house-sitting for friends on their farm. When you read her note, remember that Ivy is a great-grandmother,
"You were very much on my mind yesterday. My friends had arranged for someone to come onto the property to feed the stock. By 5pm no one had turned up so I decided that I would have to do it myself.
"Picture me pushing wheelbarrow loads of hay - carrying buckets of water to fill the troughs and so the list goes on. The paddocks were muddy so had to wear gumboots. I was terrified of falling over. Chickens to be fed, eggs to fetch, pony to be fed plus the sheep and cows. Two of the water troughs had to be filled by hand hence the buckets. I tried to crawl (yes crawl) through the bush to get the hose through to no avail. I can laugh now, however, it wasn't funny at the time.
"This is where you come in - I kept repeating these words to myself the whole time "Now do what Dr Jolie has taught you, use your abs, tuck your hip" (to neutral spine so that the lower spine does not overarch) - "Squat, Ivy, squat - don't bend over."
"The whole thing took me 2 hours - I really thought I would have back ache and that the sciatica would rear its ugly head, but no, I am fine (Jolie's note: Ivy stopped previous sciatica using these healthy techniques). My evening meal consisted of a slice of bread and some fruit - I was too tired to even think of cooking. After a hot shower, I fell into bed exhausted and slept through until 6.30am. I don't have any aches or pain.
"That was my day."
I mailed Ivy a few days later to check how she was feeling. Ivy was still great and wrote,
"The neighbours arrived to check the sheep which are ready to drop their lambs. Needless to say Dr Jolie, I am hoping that they hold off until Harriet and family arrive back home on Monday."
We will see if there will be a post about Ivy using good bending and sitting mechanics to tend birthing sheep and baby lambs.
Related Fitness Fixer articles to learn the skills Ivy used:
Readers have asked for posts on wrist strength and stopping wrist pain with use and exercise. It is in the works. I am also still working on the post I started with, where Ivy wrote of success doing a hip stretch, coming soon.
Readers, feel inspired, get out of the gym and have some fun lifestyle exercise, have fun taking photos, and send in your own success stories.
A standard recommendation for back pain is to stand with one foot up, or in front of the other. Why? Pubs often have a foot rail to put your foot up. Why? This post shows 1. A major missed cause of the pain, 2. An innovative relief, 3. The missing link of what abdominal muscles actually do.
1. The Cause If you stand with your behind tilted out in back (middle) and/or lean the upper body backward (right), you increase the normal inward arch in the lower spine.
Overarching produces a mystery ache after long standing, walking, running, and lifting overhead. People who do this feel they must bend forward or sit to relieve this pain, or put one foot up. These movements reduce the painful arch. The pain reduces, and may later return when the person returns to injurious bad slouching (standing in hyperlordosis).
Often no injury shows on x-rays or scans. The person may be told nothing is wrong. Or that they have a back "condition." They many be told to strengthen their muscles, or improve endurance, or given pain suppressing medicine. Those do not stop the source of the injury. Over years, the facet joints (joints of the vertebrae) may finally wear out. Sometimes other things show on x-rays and the patient is treated for the scan results, the pain masked with drugs or returning mysteriously because this cause went unaddressed. Injections and surgery are frequently prescribed, but not necessary. Why not?
2. The Relief The latest "buzz-phrase" in fitness is that back and abdominal muscle endurance, more than strength, is important in solving back pain. However, that still leaves out the key - improving endurance with conventional core training does not train you to stand without overarching. It is not automatic.
The innovation is not a new pill, device, or footrest, or to improve strength or endurance with crunches (not good for your back anyway), or to work on one particular muscle, for example the overrated multifidus. The innovation is to stop the source of the pain then and there, by reducing the over-arch to normal, small inward curve called neutral spine, with simple spine repositioning.
The left photo shows overarching. It is not the normal curve to the lower spine. The silhouette of the lower back is hidden by the arm, but you can see the beltline tilted downward in front and the hip tilted forward in front and out in back. The length of the abs is roughly marked by distance between the hands.
The right photo shows reducing hyperlordosis to neutral spine. Try it yourself by standing with your hands on the bottom of your ribs and center hipbone. Straighten your torso, as if doing a slight crunch standing up. Hands draw closer. The belt line levels. This is normal, straight, relaxed standing position.
The post Prevent Back Surgery showed overarching in action, and gave another quick method to learn neutral spine.
3. How Abs "Support" The muscles that you happen to use to tuck the hip under until you reach neutral spine are your abdominal muscles, including obliques. That is the innovation. You stop the source of pain and get free built-in abdominal muscle exercise at the same time. No tightening, just functional use as a lifestyle. That is what abdominal muscles do. They prevent overarching - but only when you use them.
To direct treatment to fixing the source of pain, and to replace conventional core training with something that applies better to real life, I developed an innovative technique that specifically trains core muscles functionally - which means maintaining healthy spine during daily use. It is called The Ab Revolution™ and has two parts. The first details how to get comfortable neutral spine to stop pain during daily life, no special or strenuous exercises needed. The second part is for people who want healthier exercise. Exercises range from simple to high. Students using the book asked for more illustrations, so Part I of the newest edition has 49 illustrations. Part II on functional strengthening has 65 illustrations, both with step-by-step instructions. If you use the book, use the newest third edition, expanded. Here is the link to my BOOKS page to see it - www.DrBookspan.com/books.
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.
I received an invitation to take a course to learn a new back surgery for damage to the facets. Facets are the joints at the back of each vertebrae (spine bone). The surgery was advertised as a good revenue producer.
In the surgery, the facet joint is cut off and replaced by "lumbar position preservation hardware" rigidly attached so that the area can no longer bend or arch backward. At right is an X-ray of the lower spine with surgically implanted hardware. The person is standing sideways facing to the right. Surgical facet rigid fixation surgery is considered innovative because it replaces the more drastic spine fusion. It also replaces repeated injections into the painful area. The seminar would teach me the surgery with a cocktail reception following.
Why does the surgery want to prevent arching the lower spine? The facets are in the back of the vertebrae. Chronically letting your spine arch (too much inward curve) squashes the facets in back. According to work I've done over years in the lab, the overarching, called hyperlordosis (or slouching backward), is a chief factor in damage and pain to the facets and surrounding soft tissue. That means that you can stop this yourself without the surgery.
Notice if you allow overarching when carrying things in back (1. left) and in front (2. right). The pictured overarching is not the normal curve of the spine. It is too much:
The drawing at right is from Back Pain in Pregnancy - and Why Men Can Get It. Imagine lifting your baby overhead (or any weight) and allowing your spine to pinch backward on the facet joints instead of standing upright and holding neutral spine.
You can stop overarching, thereby preventing crushing force on the facets, and instead, distribute the weight through the core muscles. It is a simple positional adjustment that takes seconds (shown below). It is a healthier approach than surgery over both the short and long term.
Following rigid fixation surgery, you will no longer be able to stretch your lower spine as far backward, even when you want to stretch for range of motion and better disc health. You will still be able to slouch your body weight backward - onto the implants. They may eventually wear, along with adjacent bone, from the chronic crushing. Because the surgically fixed area can no longer overarch, increased forces occur on the joints above and below which have to bend more. If you thought the spine in the x-ray above still looked overly arched, not neutral, you are right. The areas above and below the implanted devices are over-arching backward, and the backside is tilting out in back (hip axis is tilted anteriorly). After years, those facets may be next to break down. It is no surprise "when the pain comes back." The cause of the pain was never removed.
Instead of allowing your spine to be pulled into damaging position, use your muscles to hold neutral spine. Here is one easy way to learn to feel it:
Stand with your back against a wall. Touch heels, backside, shoulders, and head. Do you feel a large arch in the lower back making a large space?
Put your hands on your hips. Thumbs in back. Fingers in front.
Roll your hip so that thumbs roll down in back.
The large space between lower back and wall becomes a smaller space. Do not flatten against the wall or round your back. Just feel the strain come off the lower back. Use the new neutral for daily positioning. Simple. Check the photo at right (spine positioning is shown standing sideways, not with back to wall). Left is arching. Right is neutral. A small inward curve remains with neutral spine (right). Neutral spine does not mean rounding the back (which pressures the discs). Make the belt line level, not tilting down in front. The photo is from the post Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine. Click for additional ideas.
The muscles used to maintain neutral spine are your abdominal and core muscles. It is not strengthening ab muscles that stops pain or teaches you neutral spine. It is using them to prevent damaging spine position. You get built-in core muscle exercise through the same repositioning technique that allows you to avoid back surgery.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Strengthen Legs Without Knee Pain - Standing Lunge
Thursday, August 02, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Many people know they need to bend "right" but don't because it hurts their knees.
Bending right will not hurt knees. It will help fix one of the things that has been injuring them - bad bending habits which pressure and grind the joint.
Good bending will also give your knees the exercise they (and you) need.
Some knee patients are told to never "bend right" with a half-squat or lunge because it is bad for the knee. There are specific things about bending and straightening the knee that can increase certain kinds of pain, to be covered in future posts. Use your brain and try the following gently and safely. Done right, it should reduce knee pressure, not increase it.
How To Lunge:
Stand with one foot far in front of the other. Both feet face forward. (Left photo.)
Feet remain normal width from side-to-side, not directly in line front-to-back.
Lift your back heel. Don't turn the back toes outward. Look at your back foot and check.
Tuck your hip under (click "neutral spine" label for posts explaining how). You will feel a far better stretch and strengthener.
Bend both knees to lower straight downward. Don't touch back knee to the floor. Use leg muscles. Watch your front knee and keep it over your front heel, not sliding forward. (Right photo.)
Don't let your front knee sway inward.
Keep upper body upright and straight. (Right photo.)
Lower and rise several times, then switch legs. Keep feet still, not stepping forward and back.
Tips:
To keep healthy knee positioning for the front knee, peek downward to see your front knee and foot.
You should be able to see your front toes all the way through the bend.
If your knee slides forward covering your toes, you are shifting weight to your knee joint and off your leg muscles. This is one of two common ways to increase knee pain while bending. Letting the front knee sway inward is another.
Keep front knee steady over your front ankle, not sliding forward or inward. You will strengthen and stabilize your knees and legs instead of hurt them. You will feel more muscle use when you keep healthful positioning.
Lunge is a Lifestyle, not an Exercise to "do" 10 Times:
No need to go to a gym to do lunges. Use the lunge for daily bending around the house. It will add up to many lunges every day, built-in as fitness as a lifestyle. The posts How Often Should You Be Healthy? and Bending Right is Fitness as a Lifestyle give ideas of how to use healthy bending for normal daily life.
Benefits of the Standing Lunge:
Strengthen leg muscles
Strengthen the knee
Stop harmful forces on the knees from bad bending
Stretch the front of the hip of the rear leg
Stretch the Achilles tendon and foot of the back leg
Learn knee stabilization
Practice balance
Retrain healthful bending for daily life - transferring to function instead of just being an arbitrary exercise - free exercise all day
Retrain straight upper body position for bending - more functional exercise
Provide beneficial general exercise, warming which makes further movement easier, and healthful body movement.
Have fun practicing this now. You will need the standing lunge for tomorrow's Fast Fitness - Quick Warm Up. Enjoy.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
The cheerleaders in the photo at right are letting their lower spine overarch.
Their hip tilts forward in front and sticks out in back.
It is an unhealthy, pain-producing spine position.
Can you see it?
Can you see it better now with arrows showing the tilt of the hip?
Sticking the hip out in back creates a higher angle than normal in the normal inward curve of the lower spine.
It is an unhealthy spinal position called hyperlordosis, swayback, and overarching, among other terms.
Letting the lower spine overly-arch presses the weight of the upper body, plus the weight being lifted, downward onto the lower back, folding it backward and compressing it unevenly. Over years, the joints of the vertebrae, called facets, can degenerate under the compression. The surrounding soft tissue aches. The photographer of the photo labeled it "Ouch" in the Creative Commons collection where I found it.
Overarching and sticking out in back is unhealthy for the spine, and is a major overlooked cause of ongoing lower back pain after long standing and ambulating (walking and running, for example).
If the cheerleaders were standing in neutral spine, the yellow arrows would be vertical. In the drawing at right, the left drawing shows neutral spine, the right shows tilting the hip so that it sticks out in back.
Tucking the hip until neutral spine does not mean curling the spine forward (rounding the back), which can pressure the discs. In neutral spine, a small inward curve remains in the lower back, but not a big one, and the hip does not tilt outward in back.
Some exercisers are accustomed to stick far out in back when lifting weight overhead. It is now known that it is healthier over the long run to maintain neutral spine, not sticking out in back, when lifting overhead.
Another bonus of neutral spine is that the muscles that pull the spine away from overly arched position and into neutral position, are the abdominal muscles. Keeping neutral spine is a free, built-in abdominal exercise. There is no tightening of the abdomen to hold neutral spine - you should be able to inhale easily. It should be no great effort to move your spine from unhealthy to healthy position. Just move the spine, the same as moving your arm to scratch your head.
Click the label "neutral spine" below this post for all related posts. Neutral spine is fun, and looks healthier, stronger, and fitter. Enjoy.
--- Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Healthline blog posts have a new helpful tool to find posts on the topic you want. Look below each post to find a list marked "labels: "
Each label is a keyword for a topic that appears in that post. Click any of the labels in the list to get (hopefully) all posts that cover that topic by that blogger.
The addition of labels is a great tool to get more from posts. I've been working with hardworking behind-the-scenes Healthline staff Carrie and Leigh to get all Fitness Fixer posts labeled. Leave a comment if we left out any appropriate labels.
This post wouldn't ordinarily have a label for you to see and experiment with, since it is not about a health topic, so I put one. Since I'm at a sports medicine conference right now presenting on how arching the lower spine too much (stick out your behind far in back when squatting, for example) can cause back injury, I put the label "neutral spine" on this post. Click it to see all the posts that explain why overarching harms and how to get good exercise without this kind of injury. Each of those posts will have their own links. Enjoy.
Hello from the annual meeting of the American College of Sports Medicine (ACSM), held this year in New Orleans. The meeting is attended by thousands of researchers, physicians, allied health, trainers, educators, scientists, and others.
Sports medicine is more than studying and treating movement-related injuries, or using movement to repair injuries. It includes chronic diseases, physical challenges, nutrition, and extreme environments. The College states its goal as "Advancing health through science, education and medicine."
I'm at the conference to learn all I can from others, and present some of my research on identifying lumbar hyperlordosis (too much lower spine arching) and how it produces lower back injury. A few posts describe some work from past years:
and others. Click the label "neutral spine" following this post to bring up a screen with most past posts on the topic.
I will try to get to Internet cafes over the next week to post some of the interesting studies and presentations at this conference from researchers and practitioners from all over the world.
During and after the conference week, a group of ACSM members will assist the Association of Community Organizations for Reform Now (ACORN) to gut homes and prepare for rebuilding to help reconstruct New Orleans. Work is scheduled June 2 - 6, 7:30 a.m.- 2:30 p.m. Kristine Clark, Director of Sports Nutrition at Penn State U is coordinating the mobilization. To participate, e-mail or phone (814) 863-8107.
The new expanded third edition is now available of the training manual, The Ab Revolution™ No More Crunches No More Back Pain.
The Ab Revolution™ is a groundbreaking core training method. It has two components. The first is to learn how to consciously use your core to reposition your spine away from injurious positioning and into healthful position for back pain control during everything you do. The second component uses the new healthy positioning during innovative exercises for fun, healthy, exercise that works your muscles more than conventional core training and works them in functional ways - training them in the way they need to work in real life.
The Ab Revolution™ uses no forward bending which pressures discs and reinforces the rounded upper spine that contributes to pain syndromes.
I rearched the method over many years in the lab and in real life with several thousands of students, patients, and participants, testing combinations of established and proven sports medicine rehabilitation techniques and physical training methods, then integrating them into real activities. I will present some of the research next week at the meeting of the American College of Sports Medicine (ACSM). The Ab Revolution™ is in use around the world at top spine centers and by athletes and military. SEAL teams say, "We use it - (we can't tell you our names, we'd have to kill you with our bare abs)."
In school, we were taught about the "unavoidable lordosis of pregnancy." Lordosis (technically, hyperlordosis) is when you allow too much inward arching in the lower spine - Drawing 1 at right.
Over-arching causes one kind of lower back pain. It was taught as something that "just happens" to the spine during pregnancy. I asked the professors why women could also get it before and after pregnancy, and why men got the same kind of compressive force on the joints of the spine, called facet joints. It became a focus of study in my lab with lifters for many years.
The post Neutral Spine or Not? and What is Neutral Spine and Why Does Sticking Out In Back Harm? show how slouching so that you increase the inward curve in the lower spine (increase the lordosis so that it is no longer neutral spine) pinches the lower back under the weight of the upper body. Both also show what neutral spine looks like compared to lordotic.
The upper body should be upright (vertical) and the hip level to be in neutral spine. Drawing 2, with x-ray, shows what hyperlordosis looks like when the front of the hip tilts down and the upper body leans backward. This is not the normal curve - it is too much. The back of the spine gets pinched and pressured.
I found that hyperlordosis is not caused by a pregnant belly or beer belly or carrying groceries or backpacks. The over-arching (hyperlordosis) is not unchangeable anatomy. It is leaning back to offset the load in front.
Note the same over-arching occurring with the overhead lift in drawing 3, below left.
Overarched spine position is something that you can decide whether to allow or not. You can easily use your muscles to prevent hyperlordosis and hold you in healthy upright position.
Try it for yourself:
Stand up and pick up your chair (bend right to pick it up for more exercise and back injury prevention).
Hold the chair like any package in front, or on your hip, and notice if you lean back to shift the weight off your muscles (make it easier). Where does the weight shift to? On to your lower spine.
Instead, stand straight. You will get free, built-in healthful exercise that protects your spine.
When carrying or lifting any load in front, from groceries, to a chair, to a pregnancy, or a baby on your hip, don't lean back to offset the load. To stop the arching and the lower back pain that results, tuck your hips under you as if doing a small abdominal crunch standing up until you are straight, without rounding forward. Don't over-tuck, tighten up, round your shoulders, or lean forward or backward. Just stand straight. When you tuck properly by moving your spine (not by tightening anything) the too-large arch will lessen to normal, and pressure in your lower back from the arching should immediately disappear.
The pelvic tilt to tuck the spine to restore an overly arched lower back to neutral spine was introduced in Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique and Healthier Carrying - Get Free Ab Exercise and Stop Pain. Don't overarch or lean the upper body backward while you stand and carry - center and right-hand figures in the drawing at left. That is the missing link. Stand upright in neutral spine - left hand figure. There is a small lower spine curve, not a large one, and the lower spine is not pinched and folding backward, which squashes the soft tissue, discs, and vertebral joints called facets.
I have heard argument that nine months is too long to expect someone to think about their spine, and the muscles get tired. As they say in computers, "that's not a bug, that's a feature." It's good news that you get a free core muscle workout and free back pain prevention. Pregnancy (and any weight lifting) is a key time to have that.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
A small inward curve belongs in your lower back (left-hand figure of the three in the drawing). You can slouch your spine in a few ways to increase the small inward curve resulting in over-arching, also called hyper-lordosis (two ways shown in the middle and right figures). Hyperlordosis can pinch and compress the lower spine joints called facet joints, and surrounding soft tissue.
I have done several studies trying to see why hyperlordosis hurts. One study that I will present at the American College of Sports Medicine meeting this May, identified and measured three kinds of hyperlordosis and their relation to lower back injury. It turns out that, historically, it has been tricky to measure overly-arched spinal angles in relation to the hip (middle drawing). It is even more demanding to figure how the lower spine angle relates to the upper body in hyperlordosis (right drawing). The middle drawing above, and left figure in the photo at right, show one kind of lordosis from tilting the hip downward in front so that the backside sticks out in back, explained in the previous post What is Neutral Spine and Why Does Sticking Out In Back Harm? An earlier post introduced how this kind of overarching can injure - Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
The right-hand figure in both the drawing and photo show a second kind of hyperlordosis. The hip may be fine and level, but if you slouch and lean your upper body backward, you overarch the lower spine and pinch it under your upper body weight. Watch for this kind of overarching when standing, lifting arms overhead, and carrying loads in front.
The muscles that hold your torso and hip straight are your abdominal muscles. But abs do not do this automatically - you have to voluntarily, consciously use them, the same as moving your arm or leg. If you don't deliberately use abs to position your spine, you may fall into whatever bad positioning habit you are used to - sticking out in back, or leaning upper body back, or both at once.
Strengthening abs and tightening them through conventional exercises also does not automatically make your abs do anything to position your spine - Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine. That is why I spent more years in the lab to develop exercises that do train your abs to hold your spine right while you go about your daily life and while you exercise. We named the new system The Ab Revolution because it is a different way of understanding and using abs, and because we couldn't think of a better name. Ideas welcome.
I will be giving a fast, fun, workshop on The Ab Revolution™ in downtown Philadelphia in May. If you can't make it, follow this blog or try the book The Ab Revolution™. It tells all about fixing the pain of hyperlordosis and how to get effective abdominal exercise.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
What is Neutral Spine and Why Does Sticking Out In Back Harm?
Wednesday, April 25, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
"Neutral spine" is an often-used phrase in exercise and back pain rehab. What does your spine have to do to be neutral? What does it matter?
In general, (this interesting topic can be involved) think of a line through the crest of your hipbone from back to front. The line from the top bump in back (medical abbreviation is PSIS) to the top bump in front (ASIS) should be approximately horizontal (left-hand figure in the drawing).
If you let your spine slouch so that the front of the hip (ASIS) drops downward and the back of the hip tilts outward in back, the small normal inward curve of the lower back increases (drawn figure on right). The spine is no longer neutral. It is over-arched.
Another way to see the anterior hip tilt when the spine is over-arched is to check the line from the ASIS to where the pelvic bones meet in front, called the symphysis pubis (PS). When you hold your spine in neutral, the line from ASIS to PS will be vertical (left drawing). When the ASIS tilts forward and the behind sticks out in back (right drawing and photo), this is an anterior tilt to the hip. The spine is no longer neutral. It is arched - hyperlordotic. The anterior tilt is easy to see when people stand arched. It is a little harder to measure. Since some experimental subjects are disconcerted to have measuring devices put on their symphysis pubis (PS), the line can, instead, be drawn from the top of the leg bone to the center of the crest of the hipbone. The blue line in the left drawing is vertical, showing the hip is straight and level. When this line tilts forward in front and back at the bottom, that is an anterior tilt to the hip. Note the arrow drawn onto the photo showing the abdomen sticking out in front and the behind pushed out in back. The photo shows standing with pronounced hyperlordosis - too much arch or inward curve to the lower back.
In my laboratory work, I have identified three ways the spine can become hyperlordotic. The anterior hip tilt is one. Hyperlordosis pinches and compresses the lower spine. By any name - overarching, anterior hip tilt, swayback, hollowback, sticking out in back - hyperlordosis is a common contributor to lower back pain. The area may ache after long standing, walking, running, or lifting overhead. Eventually, (over years) overarching can damage the spine joints called facets and nearby structures.
Holding the hip and spine in neutral and not letting the hip tilt forward happens to use a particular set of muscles - your abdominal muscles. Strengthening the abs does not automatically keep the spine neutral. Tightening the abs also does not move the spine to neutral. Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine explains more of why. Simply moving your own spine on purpose and holding healthful position as you go about your activities is how you keep your spine neutral and not sinking into injurious overarching.
Hyperlordosis during daily movement and exercise, and how to prevent the injuries it causes, have been an area of my laboratory investigations for years. I have done several interesting experimental studies (interesting to me, anyway). Upcoming posts will tell a bit about them.
Book:
Fixing the pain of hyperlordosis and how to get more effective abdominal exercise - The Ab Revolution™
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class space for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.
Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats?
Monday, March 12, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
A commonly repeated phrase in fitness training and programs is "neutral spine" and "tuck the tail" for healthier lower spine posture. Many people know this, repeat this, teach this, write articles about it, then jut their hip too far out in back and overly-arch their lower spine, doing just the opposite, when they squat, bend to pick things up, sit in a chair, and exercise (photo at left).
Tilting the hip too far outward in back overly-arches and hyperextends the lower spine - photo at left and left drawing below.
Hyperextrending the spine, creating too much lordosis (hyperlordosis) can result in unhealthful compression on the spine joints called facets, and on surrounding soft tissue.
Overarching shifts your body weight onto the spine joints and compresses them in a bent-backward position, eventually increasing back pain and joint damage.
Another issue is that if you cannot squat without sticking out in back or leaning your upper body far forward, it is a sign that your thighs are weak, your Achilles tendons are tight, you are not using your ab muscles, your balance is poor, or all four.
Why do so many programs teach to stick far out in back? It is well known that the opposite problem of tucking too much and rounding forward (lumbar flexion) contributes to back pain. People hear this and assume that the opposite, over-arching backward, will counteract that. They exaggerate the arch.
Overarching often initially seems to "work" because you can lift more since you shift some of the work from the muscles onto the lower spine (and sometimes knees).
The muscles do less, so it seems easier. Competition lifters use it to lift more, regardless of the pain and injuries it causes later on.
It is trend-breaking news to say don't stick your backside out too much to squat, and instead use neutral spine, shown in the right-hand drawing. I know. It goes against what fitness organizations and pop-science exercise books teach. I know. Try this to see for yourself:
Stand upright with feet side-by-side, comfortably apart.
Face both feet in the same direction as your knees.
Bend both knees, keeping both heels down on the floor and over your feet, not sinking inward or bowing outward.
Look down and see if your knees cover the sight of your toes.
If you can't see your toes because your knees are forward blocking the view, pull your knees back (keeping them bent) until you are still squatting but can see your toes.
Keep your upper body as upright as you can.
Now, here is the point about the lower back - notice if you tilt too far out in back, pinching your lower spine backward like a straw. Overarching may be habit, or that you don't have the leg strength or balance, or your Achilles tendon is so tight that your heels come up from the floor. Instead, tuck the bottom of the hip under, just enough to bring the spine to "neutral." A small inward curve remains when you have neutral spine, but not a large one - Right-hand drawing.
Raise your upper body to be more vertical, while staying in the squat.
Notice how you have to use far more leg and hip muscle, and the pressure of holding your body weight comes off the lower back and knee joints.
Use healthy bending for all bending. Neutral spine helps squats for exercise, to pick up clothes from the floor, to get pet dishes, look in the refrigerator, get the laundry, pick up the kids, to sit down in a chair, and so on. You will get a far better workout for your thighs, keep weight off the joints of your knees and spine. It is healthier to squat upright than bending over forward to pick things up. It is not healthier to cause the opposite problem by overly-arching and pinching the spine back (increasing swayback).
Another point in spine health and exercise is not to "tighten" or clench your abdominal muscles to squat or lift. It is not healthy or useful to tighten muscles for movement. It is trend-breaking news to say "don't tighten." I know. It goes against what fitness organizations and pop-science exercise books have been teaching. I know. Tightening is not what supports your back. Moving your spine out of unhealthy over-arched position, explained in this post, to a more neutral position is what "supports" (you hold your spine in place) preventing pain and injury. Using the muscles to stop unhealthy position, and hold healthful position is how you support your back - not by tightening.
Have fun being part of this big and healthy change in fitness.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine
Thursday, March 08, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Tighten your neck! Sound comfortable? Tighten your legs and walk around! Sound sensible? Yet, many popular exercise programs have insisted on the erroneous practice of tightening abs. I have written articles, posts, and books on why this is not beneficial and what works your abs better. At last, it is making headline news. The biggest name in spine research, Dr. Stuart McGill, has published that "drawing in" the abdominal muscles, also described as "press the navel to spine" is detrimental to health of the lower back, and that tightening the abs impedes normal movement. In Arch Phys Med Rehabil. 2007 Jan;88(1):54-62, authors Grenier and McGill conclude, "There seems to be no mechanical rationale for using an abdominal hollow, or the transversus abdominis, to enhance stability."
This week the headline news of British newspaper "The Daily Mail" followed up with inquiry into the incidence of back pain and injuries using the "drawing in" technique: Is Pilates bad for your back? (A minor note - they accompanied the otherwise good article with an incorrect photo depicting the opposite concept of back extension, not the unnecessary contracted abdominal tightening, which was the point of the article.) Pressing and tightening the abdominals has been an incorrect assumption made into ritual in the fitness industry for many years. However it is not the way your abdominal muscles work to do anything helpful to you.
When you bend your arm, you don't tighten your muscles to do it. In fact, you shouldn't want to. You just move your arm bones using your arm muscles. Abdominal muscles work the same way. You use them to move the body parts they attach to. Voluntarily. Strengthening or tightening won't make them move automatically. You may have a strong arm, but it isn't held up in the air automatically - only when you move it there. Strong, or even tight, abs will not automatically support your back. Moving your spine into healthful position will:
Abs attach from hips to ribs. When you don't use your abs, your ribs lift up and the front of your hip sinks down increasing the inward curve or arch in your lower spine (left-hand photo of the pair). This inward curve is called lordosis and also hyperlordosis and swayback.
Note how the belt line tips down in front (left-hand photo).
The lower back aches after long standing because you are letting the weight of your upper body slump down on your lower back. People with the bad habit of overarching often feel they need to lean over forward or sit to relieve the pain.
Instead, to correct the source of the pain, tuck the hip under (not push it forward) to lift up the beltline in front (right-hand photo). Lower the ribs to level. The action is like a thrust or pelvic tilt or crunch standing up just enough to straighten, not round forward.
The muscles that move the ribs and hip to healthier position happen to be your abdominal muscles. Standing properly (right drawing) gives a free built-in ab workout, with no tightening and no forward bending; just functional use of the abs to hold your spine in position during all you do.
Using your abdominal muscles to move your spine out of injurious over-arched position and hold healthy neutral position during ordinary daily life and during all the exercise you do is good exercise - without tightening. The book that started the sea-change in understanding abdominal use and functional exercise is The Ab Revolution™, No More Crunches No More Back Pain.
-- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels, links and replies in the articles, archives at right, and the Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy. ---
Abdominal Muscle Exercise - Better, Different, Not What You Think
Friday, January 19, 2007
Healthline
Many medical fitness programs, health and exercise classes, and kickboxing and martial arts practices have a complicated and ritualized belief structure that the abdominal muscles have some magic or central function. They try to fix back pain or improve posture through abdominal strengthening programs. Usually these strengthening programs use the same unhealthful rounding forward motions that cause high pressure on your lumbar discs, practice unhealthful bent-forward posture, and perpetuate several common pain syndromes.
Here in Thailand, the Muay Thai kick-boxers and training camps do not have any beliefs about the torng, or abdomen. Even so, the Thai boxers are among the world's best-conditioned fighters. You can swing a bat at their abdomen and it would not faze them. In fact, that is part of training in many training camps. Today I have an abdominal muscle training exercise for you that is more fun than that:
The post Change Common Exercises to Get Better Ab Exercise and Stop Back Pain showed how the pushup, or just holding a pushup position, called The Plank is often done allowing the lower back to overly arch and sag under body weight, as in the upper photo at left. This extra arching, called hyper-lordosis, pressures the lower back and means that you are not getting exercise because you are just resting your body weight on the joints of your lower back instead of holding up your body weight in a straighter, healthier position, shown in the lower photo. Try this:
As soon as you tuck the hip, you will immediately feel the load shift off your lower back and onto your abdominal muscles.
Once you can hold a good flat plank position, add lifting one arm as shown in the lower photo. Do not allow your lower back to sag, shown in the upper photo. Do not hunch or round your upper body, also shown in the upper photo. Rounding the upper body will get in the way of your shoulder joint being able to lift your arm.
"Unround" your upper back and lift your chest to straighten your back. This makes room for your shoulder to allow your arm to straighten in line with your body.
Once you can lift your arm, also lift your opposite leg (not the leg on the same side but the other one). You will feel your abdominal muscles working strongly.
Hold as long as you can.
Keep relaxed but straight, and keep breathing.
Work up to being able to jump to switch the arm and leg that is lifted.
This fun abdominal exercise trains you how to hold your body in the same straight neutral spine position you need for standing and walking and reaching overhead without arching the lower back. That means it is functional abdominal exercise. Many people who do hundreds of crunches a day cannot do this exercise at all because they have never trained their abdominal muscles in the way they really need to work – to hold your spine straight without sagging inward (overly arching).
Crunches are not functional, and train unhealthful, forward-bent posture, which you don't need after a day of sitting at your desk or over the steering wheel.
Instead of crunches, this is one of many fun abdominal-building exercise. You will get better more effective abdominal exercise in the way your body, and abs, work for real.
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Healthier Carrying - Get Free Ab Exercise and Stop Pain
Sunday, January 14, 2007
Healthline
Do you overly arch your lower back when you carry things in front of you, as in the photo at left? Arching your lower back and leaning back to carry anterior loads is common source of pressure and loading on your lower back, whether you are carrying a dog, a chair, a baby in arms, a child on your hip, packages, or grocery bags. It is the same contributor to the mystery back pain from carrying backpacks, explained in the previous post, and after long standing, walking, and running explained in Fixing the Commonest Source of Mystery Lower Back Pain.
Look at the photo, at left.
1. The upper arrow shows how her upper body is tilting backward instead of being straight and upright from mid-hip to shoulder.
2. The lower arrow shows how the hip is tilting forward in front and sticking out in back, instead of being vertical from mid-hip to the top of the leg bone.
3. Between the two arrows, her lower back is overly-arched and pinched. There is supposed to be a small inward curve, not a large one, pinched back like bending a drinking straw.
Leaning back offsets the weight and makes things easier to carry. The reason it is easier is that you shift the weight from your arm and torso muscles onto your lower back. This squashes your lower back under the weight of your upper body and the things you carry. It is a common source of lower back pain that keeps coming back, even after pills and treatments. The reason the pain keeps coming back is that you haven't stopped the cause.
Leaning the upper body backward to hold something in front of you is common during standing, walking, running, reaching and carrying around the house, and while exercising. To stop the pain:
To feel reducing the lower spine arch and getting the upper body more upright, stand with your back against a wall. Touch heels, backside, and upper back to the wall. See if you have a large space between lower back and the wall, or if you have to increase the space to bring your shoulders and head to straight position. Press the lower back space lightly, gently, toward (not touching) the wall to feel how to reduce a too-large arch. Pain should stop right then.
Click the label "neutral spine" (and other labels that interest you) for more on each topic.
The muscles that straighten your spine are your abdominal muscles. You get free, built-in exercise for your abdominal and back muscles in the way they are supposed to work for real life. That is called functional exercise.
Standing without overarching the lower back when carrying things, whether in front or back, is better, healthier, and more functional exercise than lying on the floor and rounding your back to do crunches.
Use the arch-reducing technique in this post to learn neutral spine for a healthier back and built-in back and abdominal muscle exercise all the time during everything you do.
Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain
Saturday, January 13, 2007
Healthline
Frequent news items report that wearing backpacks causes back pain in children and adults. Some of the usual theories proposed for why backpacks cause pain is "overstuffing them" or carrying them too high or low. Complicated and expensive packs are developed as remedies. Another of the often-repeated theories is that carrying things on your back makes you arch your back. However, none of these are the reason for back pain when carrying packs. It is not the pack that causes the pain or the arching. It is a very simple matter of allowing your back to arch and slouch backward instead of standing straight against the load.
In the photo, above left, of the backpacker, the upper arrow shows his upper body tilting backward instead of straight from mid-hip to shoulder. The lower arrow shows the lower body (the hip) tilting forward in front and out in back, instead of straight from mid-hip to the top of the leg bone. Between the two arrows, his lower back is overly arched and pinched (not neutral spine, but overly arched). The other hiker without the backpack standing near the sign is also overly arching the lower back.
The weight of his upper back plus the weight of his pack is pressing downward on the joints and soft tissue of the lower back (left drawing of x-ray image). This is how overarching causes lower back pain. It is not the backpack, but the body position while carrying it.
Lower back arching (hyperlordosis) when standing may seem "natural" but it is not healthy. Wetting your pants is natural too, but you have to learn to control it.
To reduce unhealthy overarching (hyperlordosis), use your muscles to move your spine to neutral. Try this:
To feel the problem of overarching, stand, lift your ribs, allow your upper body to lean backward. Allow your hip to tilt down in front and out in back. You may feel a familiar pressure in the lower back (left drawing).
Straighten your upper body by bringing ribs back down to level. Do not slouch or round forward; just stand straight without lifting your ribs.
Straighten your lower spine by bringing your "tailbone" under you until your hip is straight from the top of the upper leg bone to the middle of the crest of the hip bone, not tilted.
The motion of tucking the hip and pulling the upper body straight is like doing an abdominal crunch standing up.
The too-large inward curve of the lower back becomes the small inward curve of neutral spine (right x-ray drawing).
Whenever you carry a backpack, stand, walk, run, or exercise, use the same hip tilt to normalize your spine position and prevent overarching. Overarching is not healthy and is poor body ergonomics to walk around or exercise with your behind stuck out in back. The muscles you use to hold your spine from overarching are your abdominal muscles. You get free built-in abdominal muscle exercise just by standing in healthful position.
--- Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy. ---
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.
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:
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.
The purpose of the quadriceps stretch is to lengthen the front hip muscles. It is often done in ways that do not stretch the front muscles. The standing quadriceps is done by bending one knee to clasp the foot in your hand behind you (or rest it on a chair if you can't reach). If you increase the lower back arch and keep the leg bent forward at the front of the hip (top drawing at left), not much stretch occurs, and the purpose of the stretch is lost.
Instead of "doing" a stretch, get the purpose of the stretch. Try this:
Look at the top drawing, then the second drawing at left.
Stand and begin the stretch.
Tuck your hip under to reduce the lower back arch, as if you are starting an "abdominal crunch."
Don't curl your upper body forward; just tuck the lower body at the hip.
When you tuck the hip correctly, you will immediately feel the stretch move to your thigh.
Straighten your arm away from your body and push your knee downward and backward.
Allow your lower back to arch again, and you will immediately notice the stretch will lesson or stop.
Tuck your hip under again and you will feel the stretch return to the front of your thigh.
I have seen a poster hanging in various gyms of "dos and don'ts for exercise and stretch." The poster shows this quadriceps stretch and says you should not pull your foot away from your body in back because that makes you arch your back. However, it is not pulling your foot away that makes you arch. You allow the arching if you do not tuck your hip - using your muscles to straighten your spine. The post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique shows how to reposition your spine using the tucking technique. Then you can pull your foot away to increase the stretch all you want. You can control whether you arch or not.
Many people start this stretch by lifting their leg forward at the hip, bending over forward to reach their foot, then pulling the foot behind them. The point of the stretch is to lengthen the front of your hip, not bend it. Instead of bending forward to reach your foot, stand straight, lift your foot behind you, and reach back. If you are too tight to reach your foot, place it on a chair or bench behind you. Work up from there. If your balance is too poor to do this stretch, stand near something for safety, but do not hold on. You will quickly improve balance by simply practicing it. You will not improve balance by holding on.
Remember - don't "do a stretch" - do the purpose of the stretch. Use this stretch with your upper body upright and straight. Keep your hip tucked under, your shoulders down, and get a nice stretch and balance exercise in one.
--- I make posts from fun mail and success stories. Read success stories of these methods and send your own. Click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy. ---
Fitness and Health as a Lifestyle for Thanksgiving
Tuesday, November 21, 2006
Healthline
If you think you won't have time to exercise over the Thanksgiving holiday, here is good news. This post will show you how to move in healthy ways so that you have healthy exercise built-in to all the cooking, shopping, furniture moving, and social interactions. Here is more good news. You don't have to go to a gym to work off the stress and eating too much of the Thanksgiving holiday. Life is not supposed to be a poison that you deliberately take, then need an antidote to offset.
Here are four of the healthiest, quickest ways to make your Thanksgiving into fitness and health as a lifestyle:
To pick up chairs, babies, and grocery bags, to move furniture, and for lifting things from the floor, bend your knees, keeping your weight back toward your heels, and your body upright.
To carry chairs, babies, grocery bags, furniture, and any loads in front of you, don't lean back. It is a common bad habit to lean the upper body backward, increasing the lower back arch. Leaning backward shifts the weight of the load off your core and arm muscles and onto your lower spine. Get free, built-in exercise for your abs and arms and save your back by standing straight. Don't lean and arch backward to carry things.
Notice all the times you round and hang forward over things that you can easily reach by standing upright. Check your upper back positioning when standing over counters, sinks, grocery bins, vacuum cleaners, cribs and baby-changing tables, and when setting food tables. Don't let your body weight hang over and forward. Stand upright, chin in, and just tilt your head downward in relaxed manner to see what you are doing. Relax shoulders downward. Smile. Breathe.
Preparations and family interactions are no excuse to do unhealthy behaviors out of habit like smoking, overeating, and arguing, then blame it on stress. The bad habits are even more stress on body and mind. If something is wrong, see about fixing it in a good way. Don't suffer in silence with people telling you that you have to be happy just because of a holiday. Make your home healthy for yourself. There is no place it matters more:
Get exercise cleaning the house of junk and clutter. Take the extra clothing, toys, and household items to a shelter. Carry the bags with healthy positioning to the people who need it.
Make a healthy meal with family or alone, without television or phone. Carry the meals to shut-ins and isolated elderly in your neighborhood, and the homeless on the street.
Volunteer at a soup kitchen. Do grocery shopping, cooking, and vacuuming for those who are too sick or disabled or alone to do it for themselves. If you think you don't have time because you have young children, take them with you to help carry things and to teach them healthy ideals, and how thankful they can be for the home you provide.
Don't smoke, drink soda (diet soda is just as unhealthy) eat junk food (even if it has marketing words like "organic" on the label), or undo the health benefits of fruit and vegetables by junking them with cream, sugar, and cornstarch. Add up all you spend on cigarettes and junk food that take a healthy body and give it health problems. Take the money and give to the poor. With what you save on prescriptions and treatments for all the pain and jitters you cause yourself, you can feed a village and still take a vacation.
When you eat the Thanksgiving meal, say thankful things. Taste your food. Turn down seconds. Breathe. Smile. Help clean up. Shoulders back. Enjoy the roof over your head. That is health as a lifestyle.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique
Tuesday, October 03, 2006
Healthline
My Tuesday night martial arts students had another good class tonight. At the beginning of class, I showed them how to greatly strengthen their punch using a technique that also stops a common cause of lower back pain. The reason both benefits occur from one technique is that it changes body positioning to shift the effort and leverage of the punch off your lower back and onto the muscles of your abdomen and back. You can use this technique any time you punch, or push anything from a baby carriage to a piece of furniture to a car.
One of the commonest misconceptions in fitness is that you are supposed to stick your behind out in back. It is not cute or healthy. It is a major source of pressure on the joints and soft tissue of your lower spine.
There is supposed to be a small inward curve to the lower back for shock absorption and protection of the discs. (But only a small curve.) When people lose the needed small inward curve by rounded forward sitting, standing, and bending over wrong, it pressures the discs and eventually damages them (Disc Pain - Not a Mystery, Easy to Fix). The problem is that people hear they need a small inward curve, so they make a big one by tilting their hip and/or leaning their upper body backward. This overarches their lower back. You can see this silly-looking and unhealthy over-arching in many fitness classes and gyms, and fitness publications and videos.
By straightening your hip, you will have the healthy small curve without sticking your behind out in back. When standing, your hip should be vertical, not tilted, from the top of your upper leg bone to the middle-point of the crest of your hip. To reduce the large lower back arch, tilt your hip under you as if you are starting an abdominal crunch while standing up. Do not push your hip forward, just straighten your back by changing the hip angle. This is called a pelvic tilt. This is what we did in class. Try this:
Look at the double photo above left, and stand facing a wall as in the photo, with one arm outstretched. Put the knuckles of your curled fist against the wall as if you had just punched the wall. Elbow slightly bent.
Stand badly, as shown in the left-hand photo. Stick your behind out in back. Let your lower back arch inward. Let your upper back lean backward. Press your fist hard into the wall. You will probably feel pressure in your lower back.
Now, keep pressing your fist hard but stop the bad positioning by tucking your hip under you, shown in the right-hand photo. The movement is like a hip thrust or a standing crunch. The arch in your lower back reduces.
The first thing you will notice if you do this right is your back stops hurting. You should also notice a stronger push against the wall and new strength in your arm and upper body. You will feel the muscles in your trunk and abdomen working.
I developed this technique and called it The Ab Revolution, because it uses your ab muscles all the time for real life. Don't stick your behind out to lift weights, to exercise, or to stand and walk. Use your muscles to position your spine so that your weight does not sag on your lower back. You will get free built-in exercise and back pain prevention while doing all your normal activities. You will stop one of the commonest silly-looking mistakes in fitness. You will also be able to throw a surprisingly strong punch.
Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
Monday, October 02, 2006
Healthline
If you think that not having time to exercise is the problem, here is good news. Thinking that your life and your health are two separate things is the problem. You don't have to stop your life to get exercise.
Look at the drawings, above left. The left-hand drawing shows bad bending - letting weight rock forward, heels lifting, and overly arching the lower back. The right-hand drawing shows healthy bending - keeping weight back, heels down, and the lower back in healthy position, not rounded and not overly arched. Look at the right-hand drawing and try it:
Keep your upper body as upright as you can, instead of rounding over forward
Keep both heels down as you bend your knees (right drawing).
If you find you lift your heels, use your leg muscles to deliberately pull your knees back so that your weight shifts back over your heels. Shifting your weight back keeps your weight on your leg muscles and off your knee joints. There should be no knee pain with good bending.
Keep your knees back toward your ankles. If you just let your weight flop, the knees will come forward past your toes. Don't allow your knees to shift forward.
Don't overarch the lower spine (overly sticking your behind out in back). Keep neutral spine. If you overarch, tuck your hip (tailbone) under you just enough to prevent having a too large arch (inward curve) in your lower back. Although it is often taught in exercise and weight lifting classes to stick far out and overarch, increasing the arch increases pressure on the joints of your vertebrae, called facet joints, and the soft tissue of your lower back. Overarching is a major hidden cause of lower back pain and injury.
Use good bending every time you bend - even to look in the refrigerator and get in and out of your chair. Don't use your arms to lean on the arm rests to sit down and get up; use leg muscles. If you need to use your arms, or you lean your body forward to sit or rise, you need to improve balance, Achilles tendon stretch, and leg strength. Bending properly does all that for you. (Practice safely. Don't fall down.)
Have a friend (or a camera set on timer) take photos of you from the side as you stand and bend, showing how you fixed your bending from unhealthy to healthy during whatever you do all day for work and at home. Write a fun summary and e-mail your photos and stories to me. If you can, put the photos on a photo sharing site. That is easier for me to retrieve and post on Fitness Fixer. I can put the best photos and most fun stories up in lights.
Realize that a big part of your health is the way you move in real life. Make a conscious decision to change your idea of exercise, fitness, and health from stopping life to "do exercise" to how you live. Have fun - the best health.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Change Common Exercises to Get Better Ab Exercise and Stop Back Pain
Saturday, September 23, 2006
Healthline
Holding a straight pushup position is sometimes called "the plank." Holding a plank is often done in a way that reduces the exercise benefit, trains unhealthy habits, and increases compression on your spine.
Look at the photo at left. The first boy on the left is letting his lower back (and neck) sink and bow under his weight. So is the third and fourth from the left. This sagging is not healthy and is not a normal curve. The bad overarching makes the plank easier to do. That means you get far less exercise. More seriously, allowing your weight to “hammock” shifts your body weight off your muscles and onto your lower back, causing compressive force and bad positioning habits.
The second boy from the front (and left) is holding straight.
A major, often overlooked purpose of the plank is to train your muscles how to hold your back in straighter healthier position under the weight of your own body. If you can’t hold up your own body weight in a plank for a few moments without sagging, it is no wonder your spine sags painfully during the day. No matter how many planks or pushups you do, if you let your spine sag into an arch, you are missing the best benefit of the exercise - to train positioning habits for real life once you get back off the floor.
Holding a plank has so many benefits that even if you are not athletic this exercise is one to choose. To do it in a healthy way that is useful to your real life, move your spine posture to be straighter(second from left in the photo). To reduce an overly large arch while holding the plank, tuck your hip under you as if you were starting an abdominal crunch or thrusting movement. The muscles you use to reduce the inward curve (arch) are your abdominal muscles. As soon as you reduce the arch to straighten your spine, you will feel your abdominal muscles working strongly.
Use the plank as a functional exercise. That means to use it to train how to use (not tighten) your abdominal muscles during daily activity. Once you understand the hip tuck to reduce an overly large arch, use it during the day when standing to exercise your abs the way they are meant to be used – for real life to keep you standing in healthy ways.
I will teach a workshop this coming Saturday on The Ab Revolution™, the method of holding healthy spine position for life, and having fun while exercising. See the class schedule on my web site.
If you miss the workshop, you can get the Ab Revolution™ training manual. Make sure to get the current edition, presently Third expanded edition.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class space for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.
What Abdominal Muscles Don't Do - The Missing Link
Thursday, September 21, 2006
Healthline
Did you know that your abdominal muscles have the most important function when you are standing?
The person in the photo is not using abdominal muscles to prevent a common overlooked cause of lower back pain. The upper body is leaning and sagging backward. The inward curve of the lower spine is exaggerated. It is not neutral spine, but overly arched in a bad posture called hyperlordosis.
Tightening abs does not fix the problem - using the abdominal muscles to change lower spine angle does.
Abdominal muscles connect your ribs to your hips along your front and sides. When you use your abs, they pull your ribs and hip closer in front, bending your spine forward. If you don't use your abdominal muscles when you are standing up, your ribs and hip can pull away from each under the weight of your upper body. Your lower back will arch. You can see the over arch in photo upper left, and the drawing below. Leaning back also shows not using upper back muscles, to be covered soon. The weight of your upper body arching backward presses on your lower back, making it ache after long standing and walking. That is how not using your abdominal muscles contributes to back pain. The answer is not in strengthening the abdominal muscles. Many muscular people stand arched. Just look at fitness magazines, where the weak, arched posture that causes so much back pain is common.
The answer is just to *use* your abdominal muscles to pull your spine enough forward to reduce the arch and stand upright - first figure in the drawing at left. Tuck your hip under just enough to reduce a too large arch, and pull your upper body forward to straighter position, like starting an abdominal crunch or pelvic tilt standing up. Don't round your upper body, just pull it to an upright position.
Don't "suck in" or tighten your abs. Just move your spine like moving any other body part. When you reduce the arch, your body weight shifts to your abdominal muscles and off your lower back.
Watch how other people stand and move, particularly in the gym. Are they using their abs to stand right when they get back off the floor from doing "abdominal exercise?" All the crunches in the world will not stop back pain if you do not know you need to voluntarily use your abs when standing so that you don't sag into a sloppy arch. That is the missing link - your abdominal muscles do not automatically support your back. You have to use them to move out of unhealthy position.
If you use your abdominal muscles to prevent your lower back from sagging into an arch, you will stop pain and get built-in, all-day, free abdominal exercise from all your standing, walking, and activities in an ordinary day.
Photos and descriptions of how and why preventing hyperlordosis prevents injury - Prevent Back Surgery.
Get all the information in one handy training manual - The Ab Revolution.
Send in your photos and success stories of how you corrected your spine positioning and stopped pain in daily life and in the gym. I post them in Fitness Fixer Reader Inspiring Stories. Prizes for the best ones.
Fixing the Commonest Source of Mystery Lower Back Pain
Wednesday, September 20, 2006
Healthline
Many people let their lower back curve inward (arch) too much when they stand, walk, exercise, and carry things (drawing on left). This is commonly called sway back, hollowback, arching, lordosis, or hyperlordosis. People who overarch this way get back pain after long standing and walking. They often feel they need to bend forward or sit to relieve it.
The pain is from overarching, which tilts the weight of your upper body downward onto your lower back, arching and pinching it inward (drawing on left). Think of the foot-rests in bars. The reason putting one foot up on the low foot-rest reduces back pain is that you unwittingly reduce the large lower back arch that so many people allow when standing.
It is not normal or "neutral spine" to have a large inward curve. A large curve is not "just the way you are made." Sticking your behind out is not cute or healthy, whether in daily life or exercise. It does not protect your back. It is bad posture that hurts, and that you can easily change. You don't need pills or injections or treatments for the pain. All you need to stop the pain forever is to stop allowing your back to sag, and simply move your back to straighter position while you go about ordinary life (drawing on right). Here is how:
Check yourself - Stand up and reach your arms high overhead. Do you lift your ribs, arch your back, or lean backward? Did the front of your belt or hip tilt downward? These are all indirect pointers to different kinds of hyperlordosis (drawing on left).
To reduce the arch, tuck your hip under you (drawing on right), like doing an abdominal crunch or pelvic tilt while standing. Don't round your upper body or hunch forward. Imagine wearing a belt buckle and tilting your hip to lift the buckle upward, closer to your ribs instead of hanging downward.
Reach up again and hold your straighter spine position. Your belt line should be level. Your ribs do not lift upward. Your upper body does not lean backward. Now the reach has to come from your shoulder where it belongs, not your lower back, an additional benefit. The post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique shows more on how to do the tilt to correct the overarching. Future posts will show more about problems from overarching in exercises and daily life.
Yes, this is different from what we learned in the gym and in school, including medical school. It is simply stopping the source of this pain - stop pain from arching by voluntarily moving your back, like moving any other body part, so that you reduce arching.
I developed this method, called The Ab Revolution™ that you can apply to all your daily life to stop pain, and to get more abdominal exercise than through conventional methods. Posts to come will show more. I will teach The Ab Revolution™ in downtown Philadelphia, Saturday morning, September 30th, and a workshop on how to fix your own back pain will run Oct 7 & 14th. Info on my site, www.DrBookspan.com
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
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