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Jolie Bookspan, M.Ed, PhD, FAWMExercise and Fitness
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Upper Body Built in Functional Fitness

Jolie Bookspan, M.Ed, PhD, FAWM
Reader Vietanh asks:
"I enjoy the all day exercises using squat and lunge for my daily activities. Thank you for sharing your philosophy.

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

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

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

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

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

Apply upper body muscle use for function in daily life:
Prevent Neck Pain and Get Upper Back Exercise Carrying Backpacks
Upper Back Exercise and Neck Pain Prevention Too
Common Exercises Teach Upper Back and Neck Pain
Fast Fitness - Prevent Back Pain When Rowing
Overhead Lifting, Reaching, and Throwing - More Part I
Fast Fitness - Built in Upper Body and Core Exercise Carrying Children


Use arm and hand muscles instead of compressing wrist joints:
Fast Fitness - Prevent Wrist Pain During Pushups and Cooking
Forearm, Upper Body and Hand Exercise


Have daily active upper body fun:

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

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

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

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Read success stories of these methods and send your own.
Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.

Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
See Dr. Bookspan's Books. Get certified
- DrBookspan.com/Academy.
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Photo by djwhelan

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Feeling Better Than She Ever Has Part II - Fixing Herniated Disk and Reclaiming Active Life

Jolie Bookspan, M.Ed, PhD, FAWM

Barbara lives in a little town of 300 people in Yukon Canada - map at right. Part I of Barbara's story last Wednesday described why it didn't take six weeks to fix Barbara's herniated discs and severe sciatic pain and numbness, but it was six weeks until the "light went on" and she did the things to stop the cause of the injury, so it could stop hurting and start to heal.

Here is an insider's peek behind the scenes week-by-week:
"Dear Dr. Bookspan,
"This is a bit of a long one, and probably reaffirms everything you've ever received in hundred and hundreds of emails and stories, but I wanted to share this with you anyway. I can’t thank you enough for working hard and sharing all your knowledge. I am almost completely pain free!

"After 6 weeks of severe sciatic pain and numbness and weakness of my left leg and foot, something just clicked on Thursday night and I became more determined than ever that I could get rid of the pain. Through your website, the Fitness Fixer, and reading lots of personal stories (on your web site and book), I realized that I had to fix (the) causes. I know this might sound dramatic, but you’ve changed my way of life.

"Pre-sciatica lifestyle:
"A cycle of: 1) a few months, everyday, of "power" exercising with all the unhealthful postures and movement habits you talk about, then sitting at the computer in all the unhealthy ways you talk about and drinking coffee and smoking, feeling like I’d accomplished something in my day; 2) followed by a few months of complete laziness (not even power exercising). Power exercising consisted of running (without stretching at all) with bad form, and Hatha Yoga (forcing myself into the stretches and tons of forward bending).

"Sciatica struck.

"First two weeks:
"I did absolutely nothing about it. I read stuff on the internet and was convinced from the stories that I had some debilitating disease that would affect the rest of my life. I thought the cause was that I didn’t keep up with my "power" exercising. But, I continued to sit bent forward in a chair, hunched over, bending wrong, doing yoga forward bends, smoking and drinking coffee. I know, how sad."


Here are posts and information Barbara used:

"Third week:
"
Had to go back to work in the morning, teaching 4 and 5 year olds in a kindergarten class; in the afternoon, teaching reading strategies to Grade 1 and 2's - sitting in a chair all afternoon. No longer could I hobble around the house holding my backside and leg - full on activity - and pain, tingling, numbness in my left foot, and total weakness in my left leg. Felt like I was walking around all day with a Charlie horse going down my entire left side. Amidst all my continued Internet searches, stumbled upon your website when a friend said that slight forward bending doing dishes and getting ready in the morning leaning over the sink might be a cause. Your website made so much sense to me - if a slight forward bend is a bad thing, how much more unhealthy would my Hatha yoga program be, with all its constant forward bends. I might add here that the two people at work who talk about slight forward bending being a bad thing continually hunch forward while sitting and exercise using forward bends. Just something I’ve begun to notice."

Major news stories quote physicians saying that back pain is often a mystery and that no one knows why stretching isn't working. My readers regularly report that once they understand the simple principles, they see the unhealthful positioning that causes pain frequently - at the gym, in fitness magazines, and in exercise videos and classes:

Barbara continues:
"I started with lying on the floor propped up, upper and lower back extensions, pec and trapezius stretches, isometric abs, being continually aware of my posture and not doing ANY bad forward bending. Tried to do the lunges and squats for daily good bending, but my muscles were so weak and I practiced them half-heartedly. I tried to apply them in daily life but life seemed so fast-paced at work and I was in so much pain constantly, that I would get _ way into it and then just try to lean to the side to pick things up - result, I was contorting my body in very odd ways! I ordered a support brace and special support backrest (now I know why I never needed them) and seat cushion for my chair from other web sites, but also ordered your book Fix Your Own Pain, along with a few of your other books."

These are some techniques used above:

"Fourth Week:

"Limping and terrible pain, my boss told me to visit the nurses station -living in a town of 300 in the far north, we have one general store and a health centre, doctor visits once every two weeks - and take every afternoon off during this week to rest up. He still needed me at work in the mornings. Taking my new prescription of Naproxen and trying the lunges and squats and some stretches but not really trying to apply them to the rest of how I was moving and bending and sitting. I would be in quite a bit of pain coming home from my mornings at work. In the afternoons I would basically throw in some stretches, but generally read (sitting badly) and nap for an hour. A lot of the pain would dissipate after my stretches and a good nap - only to be set into full force the next morning at work.

"Your book came in on the Friday and I was very excited. I read through it and practiced the retraining stretches that show how to restore straighter positioning throughout the day. I felt much better by Sunday night with the stretching. Still only half-hearted attempts at lunges and squats."
"Fifth Week:
"Decided to start my morning off by doing my full range of stretches instead of sitting in the computer chair smoking and drinking coffee. I felt pretty good when I left for work. People at work were starting to call me "feisty" saying that I seemed to be walking better (that was probably because of my better posture from applying your method instead of just doing stretches!) Sitting in a chair almost killed me - after 25 minutes in a chair the pain was almost unrecoverable - to be endured for the next hour and a half at work."

Barbara was getting the idea about healthy movement, but was sitting in the same way that causes discs to be pressured. She thought it was "taken care of" because she used a commercial lumbar support she purchased the first week. However she was still sitting in unhealthy ways, right over the support:
Barbara continues:
"I could manage the pain better with frequent relaxing on my stomach propped up on arms and stretching, but I never felt complete relief until I got home at night. I still didn't realize it was bad sitting position, so decided to get rid of my chair and stand to teach. This was better, but the pain still kicked in(especially in my left buttock!). Once my left buttock got hit with pain it went downhill - down my whole leg, followed by the numbness and severe tingling. Midway through the week I went to see our visiting doctor - quick visit and the prognosis that I had a herniated disc L5-S1. He said it would heal. I was feeling pretty positive about this, as it seemed to coincide with what you say about herniated discs. Meanwhile, the sciatica was taking it out of me. I felt I was always either in pain, or awaiting a painful episode. I made it through, relieved that the weekend was underway. I decided to trying walking - every couple of hours I'd walk on my treadmill for 20 minutes and then do my stretches. I did this two times in the day, and then went for a walk outside in the evening (-35 degree weather so I bundled up really well). My dog and I headed out for what was to be the most agonizing walk for me. Half hour into the walk I started to get that butt pain but I was only half way home. By the time I got home after an hour walk, I wanted to hit the roof and I although I could alleviate some of the pain through lying on my stomach propped up, and stretches, I could still barely sleep. I was also completely consumed by whether or not I had slacked in my posture somewhere along the line while I was walking, or whether I was too tight or loose (still missing the big picture)."

"Sixth Week:
"Still determined. Began the week at an all-day staff meeting where I lay on a gym mat on my stomach, propped up on my elbows- all day. Stretching at lunch and a couple of other times I walked out of the meeting to stretch. It almost floored me to do a 20 minute standing stint that we had to do during our meeting. Followed by a 2 hour course via video-conferencing where I did the same thing. When I got home the pain was less and I didn’t want to "over-do" it again, so I gently did my stretches throughout the evening- I didn’t try to walk. Next day at work, the pain was pretty bad from the beginning, but it was -60 degrees F outside and not many kids came to school - more time out to stretch when I needed to. Wednesday - more of the same. I tried to walk at night but got discouraged when I couldn’t walk for more than about 10 minutes without pain. Thursday - same thing, but I almost ran out of the school at the end of the morning to go to the nurses station. (We both wrongly assumed that I had overdone walking, not just walked in injurious ways.) She prescribed more Naproxen and told me to make sure that I walked but more frequent intervals. She also told me to keep stretching, but that lunges and squats were simply out - don’t do them. I kept wondering about this advice as I reread Ivy’s story and looked at the pictures of her doing those amazing squats and lunges. I spent most of my evening on the internet reading and rereading stories."


"Friday of the Sixth Week: True Awakening!
"I took Friday off work and first thing in the morning while I was doing my usual morning stretch routine, it just hit me! I became so obsessed with my posture, thinking that stretches should magically make my pain disappear, but I wasn’t viewing my body as how I used it during regular activity; I was also very guilty of giving up on certain things when they got "too hard" (lunges, squats). My balance was bad (despite trying to practice it while putting on my socks and shoes), my walking gait was horrible, I wasn’t really trying to do anything that required some effort, and I was continuing my bad habits of resting for hours before I tried to get back up and stretch again. Having reread some of the personal stories, I worked on my walking: feet straight ahead, feet hip-distance apart, heel to ball of foot, using my whole foot to walk - I was so focused on posture that I was holding myself stiff while walking instead of walking naturally with a bit of rotation at the waist). When I thought I was using my muscles, I was really just tensing them right up instead of truly using them. Reading posts and walking also made me realize how tight my Achilles tendon, hamstrings, and hips are. I decided to work on this through my stretches too. Next hour I was back up and walking, and stretching those areas after (using a counter to hold onto while doing a full squat, doorway hamstring stretch, and stretching my hip sitting on a chair rather than lying on the floor). Every hour I walked and stretched, and every walking session was longer, every stretching session I could actually stretch farther! Halfway through the day - now it was time to really engage myself in those lunges and half-squats - just do them and do them properly - no excuses - I need them for everyday life and unless I go beyond what I think I can do, I’ll never get to that point. They’re definitely not just part of an exercise routine, but unless I could do them with strength and stability in my living room, I knew I couldn’t do them in a fast-paced setting when I needed them.

"Time to stop making excuses. I was up and about constantly all day, walking, lunges and squats, stretching. By the end of the day, I can’t even describe my feeling of elation when I went to bed completely pain free, with my left leg hardly stiff at all, and some of the numbness in my left foot gone! Actually having been rather lazy, and in fear of lunges and squats doing more damage, they turned out to be the best stretches and strengtheners...now why wouldn’t I want to use these in all situations to get a beautiful natural stretch during my day! The confidence and calmness that all using your principles, and truly using my muscles to engage in activities is giving me give is fabulous. Not to mention all the energy! This is a new way of life for me. And quitting smoking is not a different story...it’s the same story...and my next step is to look into my eating habits and to quit smoking. It’s my life and my body is a temple...I’m sick of mistreating this temple with lethargy and apathy. No more unhealthy exercises in "power" work-outs and yoga for me...strength, balance and flexibility will is every moment, every day. Now I'm ready for your Healthy Martial Arts book...

"Thank you! Thank you! You (and Ivy) are my inspiration!
Wishing for you all joy and true happiness in life (which I know you already have :) ).
"Fondly, Barbara

"I'm truly thankful for your hard work and great insight into pain and how to live healthy in every day life!!

"PS I was frightened when I was told I had a herniated disk at L5-S1, and this was great news to me as I know I'm healing and I won't need any physiotherapists, etc. to help me through this! Your book Fix Your Own Pain is amazing - I think I've almost memorized it; two people at work have borrowed it already (including my boss) - I think they're seeing how much it has helped me. I'm thinking about giving your book to people for Christmas."
Summary "take-home" message - Barbara found that she doesn't have to "do" any exercises. That is the difference with this method and others. Moving for daily activities using the retrained healthful positioning stops the source of the injury. At the same time, it just happens to give much built in functional healthful movement. That is how exercise is supposed to be - a natural part of your human life.

There is more good news to Barbara's story, but that's enough for now.


Barbara's book source www.DrBookspan.com/books

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Tax Preparation Health

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

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

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

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

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

More posts with quick techniques to feel better during desk work:


Forward head photo 1 by Kevin K. Luu
Forward head silhouette photo 2 by äÁǻǵ
Forward head writing at desk photo 3 by My Hobo Soul
Straight good cooking posture photo by Presta

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Can We Teach Young Doctors to Be Healthy?

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

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

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

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

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

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

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

Photo by CJ Sorg

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Long Sitting - Simple and More Comfortable

Jolie Bookspan, M.Ed, PhD, FAWM
As you read this, we will have been on several days of flights and trains.

Sitting for long periods does not have to be uncomfortable, whether at the desk, on a flight, when driving. Most lists of instructions for sitting without hurting your back tell you to sit in exact ways at exact angles. This is not needed. Instead, it's better to understand the concepts of how and why strain and injury occur when sitting. Then you can sit in healthy ways that are comfortable, easy, and healthy.

Many desk chairs, even expensive ergonomic chairs are made so that you sit with your spine rounded forward. Sitting rounded eventually creates herniating forces on your discs, explained in The Cause of Disc and Back Pain and Are You Making Your Exercise Unhealthy?

Commercial airline, bus, and train seats often have a concave seat back, encouraging prolonged, enforced rounding. So do many car seat backs, even those saying they have lumbar support.

  • If your seat back is too concave, pad the space with a small cushion.
  • Use a pad about the size of your own forearm.
  • Place the pad in the small inward curve of your lower back.
  • Don't remain sitting rounding forward against the lumbar pad out of habit. A lumbar roll will not make you sit right.
  • Lean your upper back against the chair. Don't press your lower back against the pad.
  • If your lumbar roll hurts, it is not right. It should not be a hard material that hurts you. See if you have it positioned in the right place.
  • At a desk, move your seat in closer so that you do not round or lean forward to reach or see the computer.

Future posts will cover more about lumbar roll use and misuse.

If the seat is very concave, you may need two pillows, one for the small inward curve of your low back, and the second above that one for your upper back, in the space still left by the rounded seat. The upper back has a small outward curve, however sitting with a large outward curve creates upper back pain.

Get up frequently to move. Here is the link to last year's travel sitting post on Exercise and Stretch for Long Travel Sitting.

Drawing © copyright by Jolie from the book Fix Your Own Pain Without Drugs or Surgery


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Household Fitness in the New Year

Jolie Bookspan, M.Ed, PhD, FAWM
Start off the new year with fitness as a lifestyle. Use healthy movement and body positioning as you go about all your daily activities.

David from Belgium trains balance first thing



Ivy from New Zealand uses a half squat to functionally strengthen her legs and prevent back pain while making the bed.






See - Bending Right is Fitness as a Lifestyle.




Feeding the dog.
How often do you bend around the house in a day?
See - How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending

Vacuuming with a good half-squat.
See - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending




and full squat, see - Save Knees When Squatting



good lunge with front knee over foot.
See - Strengthen Legs Without Knee Pain - Standing Lunge



full squat for chores with feet facing the same direction as knees, and both heels down



A Thai villager sits straight, getting nice hip stretch, and keeps ankles straight
- see Unhealthy Yoga Ankles











Our friend MomPon is relative to the abbot of the Muay Thai Monks on Horseback near the border of Myanmar (Burma). We stayed with her during the time we spent at the monastery. She sits straight and comfortably in full squat to get things for dinner from her garden, then to wash dishes in her kitchen. We do the same when we help. She stands straight with chin in to reach overhead to get tamarind fruit from her tree, see - Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.



Our friends, the elder Thai ladies, sit straight while they watch a parade - Healthy Sitting



A hill tribe mother stands straight without rounding forward or leaning backward from the weight of her baby -
Healthier Carrying - Get Free Ab Exercise and Stop Pain
and
Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain


A villager takes his children for a fun ride, while sitting straight. See how a reader fixed upper body pain from biking in Freed From Pain, He Rides Again


Sitting straight to wash the kids.

I gave these villagers soap bubbles for their baby. They played for hours.
Enjoy life, laugh, and share good times.

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Fast Fitness - Functional Agility, Flexibility, Strength

Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - build balance, leg and hip strength, and flexibility as a lifestyle.

Lightly sit down on the floor and get up again without your hands.

Being able to rise from the floor is natural lifestyle movement, done in many places in the world by people up to the oldest years. My martial arts student Ms. Han demonstrates in the short mpeg movie. Click the arrow to run the video:


video


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Fix Neck, Play Hockey, Use Brain, Fun Life

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

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

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

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

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

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

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

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

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

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

I wrote Rich to congratulate him on his initiative and great work, and thank him for his story. He replied:
"Just when I've corrected the forward head problem, I'm going to need those neck exercises to treat "swelled head syndrome."

Smile and laugh. It's healthy too.

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

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:

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

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

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

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

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

Photo by Lazy_Lightning

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Pearl is 97

Jolie Bookspan, M.Ed, PhD, FAWM

After reading about success with exercise and stretching over various posts including Monday's Getting More From a Hip Stretch, reader Dr. Alan, sent this photo at right of his mother Pearl, age 97, stretching her hip. The straighter upright you sit, and the farther toward the ankle the leg is placed over opposite knee, the greater the stretch. If you are at your desk, try putting ankle over opposite knee, keeping the lifted knee under the desk. More stretch when low desk height keeps your knee down. Pearl also does the "ankle over knee" hip stretch while standing.

Pearl gets regular leg exercise through good bending as she goes about her busy days - she bends well with one foot in front of the other - the lunge, and with feet side by side - the half-squat. This post tells why this kind of bending gives better exercise, maintains mobility, and prevents various knee problems.

Thank you Pearl!

Photo by Dr. Alan

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Back to School - Healthy Sitting

Jolie Bookspan, M.Ed, PhD, FAWM

The mind can only absorb what the tushy can endure. Better sitting can make better work along with better health. If your back or neck hurt from sitting, here is how to change it.

You don't need special or ergonomic chairs, keyboards, or desks.
You can sit well on a bucket. You can sit poorly and have pain
from an expensive posture chair. Many people do.

Myths of how to sit "right" involve strange rules - to keep thighs parallel to the floor, for example,
or feet at certain angles, or hips at 90 degree angles to the body.
None of these are necessary.

The photo of sitting, at right, shows sitting poorly. No mystery. The spine is rounding forward. Body weight presses on the lower back discs. The upper back is overstretched. The head is held at an angle that pulls on the muscles at the top of the shoulder. The post Don't Fall for "Don't Sit Up Straight" explained about a research study that found there is less pressure while leaning back against a seat, than when sitting vertically. That does not mean not to "sit straight" as the headlines said. With or without a seat back, sitting straight is still healthier than rounding.




The HealthLine team sent the photo (left) of one example of healthy straight sitting,

and a parody of exaggerated, strained, rigidly straight sitting, (right).

Anyone trying it would soon find that sitting straight like that is not worth the strain, with good reason.












To try better sitting now:
  1. Move your backside right against the chair back.
  2. Move your chair in closer to the desk.
  3. Lean your upper back against the seat back, not your lower back. Do not press or round against the lower back.
  4. Chin in loosely, not jutting or tilting forward over the desk.

What is a good way to remember to sit without rounding forward? Watch other people sitting, driving, at the desk, and when exercising and stretching. Their bad positioning will remind you not to do that to your own spine.

Many chairs, even expensive ergonomic "back posture" chairs advertised to have built in lumbar support, are built in a way that makes you round forward when you sit against the seat back. The next post on sitting will cover fixing a bad chair.

The body needs movement for health. Get up from the chair often to straighten and move. The post Exercise and Stretch for Long Travel Sitting will get you started. When sitting, use your brain and your muscles to get free, natural, upper back use by not slumping. Make the idea of good sitting about understanding healthy body use and positioning instead of memorization without comprehension. Make healthy body use enjoyable and interesting. This is the kind of learning that is in the best spirit of "Back to School."

Good sitting should not cause pain.

Posts with more healthy Back-to-School:

Photo 1 by Terry Bain
Desk photos 2 and 3 by Healthline staff

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Inspirational Ivy

Jolie Bookspan, M.Ed, PhD, FAWM
Last October, Ivy from New Zealand left a comment on Fitness Fixer how she first found me while looking for relief from severe sciatica with foot drop. For 11 months, she had tried treatment and an exercise regimen from a chiropractor. Last week, she e-mailed me a funny update of improving mobility and health from a new stretch. I started writing this post just to tell of Ivy's stretch and how readers can have the same success.

I looked over my file of Ivy's comments on Fitness Fixer and her e-mails to me over the last two years - each story weaving to the next - of improving health, mobility, and joy of life for herself and people in her community. Reading them again was like sitting by a stream that sparkled over rocks on its way by, inspiring and lovely. Some are private, some I have her permission to tell.

Last October, Ivy wrote:
Ivy wrote, "I knew I should be feeling better than I was. During those months I was continually surfing the net looking for answers, then in November 2005, I discovered Dr Jolie Bookspan's "How to fix your own pain without drugs or surgery." Everything she described was ME, 69 years of bad habits had finally caught up with me.
"So began my journey to good health and freedom from pain. I began with the pec stretch, trapezius stretch, wall stand, sitting correctly at the computer without sticking out my chin, hamstring stretch, isometric abs (no more crunches), squats and lunges instead of bad bending.
You can imagine my joy when after 2 days I was free of pain. I was so excited that I contacted Dr Jolie, who in turn, took time out from her busy schedule to e-mail me giving me further advice and exercises which I might add, I follow religiously along with a daily 30 minute walk (weather permitting).
"Some months ago, I decided to follow a vegetarian diet. I feel so well and happy, in fact, I have loads of energy. I turn 70 at the end of this month (Oct 2006) and am looking forward to the next stage of my life feeling healthy and free of pain."
This year Ivy followed up when we were corresponding on making sure of healthy nutrition:
"This is the second winter that I have not had either a cold or 'flu. For someone who was always getting the 'flu, that is really something. I put it down to my healthy vegetarian diet."
Ivy used my free web site summary sheets on fixing pain, my books, and Fitness Fixer posts. Here are links to posts Ivy used:
The posts on lunges, Doorway Hamstring Stretch, and Functional Achilles Stretch, feature photos that Ivy sent me. I had written Ivy earlier this year asking if she could send me photos demonstrating what she is doing. She invited a neighbor to visit and take the photos, had them developed, then mailed a pack of them to me from New Zealand. Ivy writes:
"My dear 86 year old friend took them and we certainly had a lot of fun doing what I will call a "photo shoot." Bear in mind her age when I tell you that while I was trying to hold the pose, she would press the incorrect button and would have to start all over again. I would lose what I would call the correct form and so it would go on... I can now sympathize with models who have to hold poses for what seems an eternity."
In February 2007 Ivy sent an update, signing it:
"I shudder to think where I would be if I had not found your web site over 15 months ago. I mean it when I say "Thank you for helping me get my life back." I am fit, I am healthy, what more can one want in this life. I have passion about what I do something that I haven't had in a very long time."
What about her e-mail and the new stretch? We're out of room. Click for the next post- Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier.

Photos of Ivy by her neighbor Joan Cleveland

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Forensic Anthropology and Bone Density

Jolie Bookspan, M.Ed, PhD, FAWM

A few weeks ago, I attended a lecture on forensic anthropology. In general, this is the study of things you can tell from human bones in a crime setting. How old was the person? Were they male or female? How big were they? What was their probable race or ancestry?

Why was I there when my work is with the living? Two main reasons. I am the science officer for the Vidocq Society, an international forensic society. I might evaluate data, for example in an aviation disaster, whether someone might have been conscious at each point when undergoing G-forces or different temperatures and amounts of oxygen after a depressurization at various altitudes. In a scuba death, I might advise on physical changes that occur with different situations. The second reason was to learn more about bones. Bones are remarkable. Your bones know a lot about you. What was your health like? Were you active? What kind of activity did you do? When I was small, I read about an archaeological dig in ancient Rome. The bones of a girl were recovered. The account stated they could tell she carried loads too heavy for her, and was therefore (in conjunction with other evidence) probably a servant or slave. I was riveted. How could they know that? I spent years after that learning more about telling how someone moved from looking at their bones.

Throughout your entire life, when you exercise you stimulate growth of new bone cells. The physical pull of muscles thickens your bones where the muscles attach. Using your arm muscles thickens arm bones. Using your legs strengthens leg bones, and so on. This is a main mechanism of how exercise prevents osteoporosis. Without exercise, you don't stimulate enough new cells to counter the normal loss as old ones break down. Your bones thin no matter how much calcium you eat. The post Exercise is More Important Than Calcium Supplements for Bones tells more about this. Bone demineralization is rapid and serious in astronauts in microgravity (Collapsing Astronaut Gives Healthy Reminder).

How you use your muscles causes them to pull differently, giving evidence about the kind of habitual motion. More interesting is that when you are active, your bones grow and shape themselves to facilitate your motion. An example of interest to readers following the posts on squatting is that people who habitually sit for normal daily life in full squat grow "squatting facets" on their lower leg bones. These are small areas on the bone that quickly grow to make squatting more comfortable. At one point, it was a debate in anthropology that squatting facets were a marker of someone of Asian ancestry, until it was found that others who squat also grow them, and that squatting facets disappear when the person adopts a Western sitting habit of chairs and no longer squats. Babies of all races can have them.

Someone who habitually slouches can change the shape of their bones, eventually deforming them. This can occur in the spine, knees, hips, ankles, shoulders, feet, toes - everywhere you pressure your bones. Changing positioning habits to healthier ones can, in many cases, reshape the bones back to healthier shape. Think of braces on your teeth. It's human bonsai. In cases of extreme dystrophies of the muscles, someone who sits without function of their trunk muscles to hold the spine upright, can eventually deform their spine until their ribs sit on their hip bones. How are you sitting right now? The recent post What Does Stretching Do? explained a bit of why stretching isn't reducing injuries. People are stretching, then exercising and going about daily life in bent over positions that rub and grind the joints and soft tissue.

You literally shape your own health. Use the posts throughout this Fitness Fixer blog to do healthy exercise in healthful positioning so that your bones will only tell good tales about you.


Photo by Dioboss

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Functional Achilles Stretch

Jolie Bookspan, M.Ed, PhD, FAWM

Sitting in full squat with heels down can be healthful and useful. Squatting for daily life is a built-in Achilles stretch, more effective and functional than the standard "lunge and lean stretch" against the wall, or lowering one heel from a step or ledge. Better Achilles Tendon Stretch shows one Achilles tendon stretch that is effective and quick. Sitting in a full squat is another. Rising from the squat adds functional leg muscle strengthening and balance.

I took the photo, above left, in an airport in Asia. The man was easily sitting to work on his laptop during the hour before boarding. Others were similarly sitting with laptops and mobile devices to get work done. Elders squatted that way to rest.

Achilles Stretch in the Bathroom introduced the full squat as a functional normal daily action used in many countries for resting, washing, gardening, working, washing, toileting, chatting on the phone, and other activities, and gave an idea of how to try it. Save Knees When Squatting explains how keeping the heels down rather than lifting heels to rest on the ball of the foot is safer for the knees. Reader Mim supplied a wonderful link in the comments for a great little film of the Asia squat. More Fun Squatting tells a funny squatting story.

People new to squatting may find their Achilles tendons are too tight to bend in this normal manner. Reader Ivy of New Zealand offered to demonstrate one easy way to practice this stretch in a safe way, and sent the photo at right.

Keep both heels down while holding something sturdy in front. Straighten your arms and lean back to shift weight away from the knee joints.

Squatting can be a nice stretch for your lower back too. I have been working, off and on, for some years on the interesting finding that slight forward spine rounding when just sitting on your heels in the squat (no weights) does not load the spine to the extent of sitting on your behind in a chair. Be smart about trying it or not if you already have damaged knees. When rising, make sure to keep knees back over your feet, not sliding forward, which loads the knee joint, or inward at an angle (narrower than your feet), which can twist the joint. Either action can grind against the meniscus and cartilage.

Done properly, it should feel good on the Achilles and calf, lower back, be good exercise, not hurt the knees, and become an option for a functional stretch and even normal sitting ability.

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Does an Exercise Ball Make You Sit Straight?

Jolie Bookspan, M.Ed, PhD, FAWM

Healthline staff helpfully sent in photos of sitting at work on an exercise ball. Both photos show obvious slouching and forward rounding.

A ball does not make you sit upright or prevent unhealthful, uncomfortable sitting position. You can sit upright or not. It is not the ball, but you, that determines what you do with your own body.




A ball that is too high will even prevent you from sitting close enough to the desk, so that you have to lean over forward to reach the surface.


Use common sense and your own muscles for simple, comfortable, healthful habits.




Photos courtesy of Healthine.com. Please do not try these bad postures at home. Healthline staff are trained professionals.

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Get Better Exercise From Your Chair

Jolie Bookspan, M.Ed, PhD, FAWM

How many times do you get in and out of a chair everyday? It could be enough for a fair amount of exercise, if you use muscles instead of leaning forward (photo shows terrible sitting) and flopping down.

At a medical conference last year, a speaker droned endlessly about back surgery (even though Studies Say Back Surgery Not Needed, and you can Fix Disc Pain Without Surgery) and the usual tedious exercises that people must do three times a week (then they do unhealthy movement all day that causes the pain in the first place, or do their exercises in back damaging ways - Common Exercises Teach Bad Bending). An obese physician arriving late plodded to a chair next to me. She laboriously bent over, bending wrong to put her bag on the floor. She slowly bent over forward, bending wrong again to retrieve two cushions from the bag. She bent over wrong again to place one cushion on the chair seat, then again for the second cushion for the chair back. She turned her back to the chair, bent far forward, bent her knees a small amount, so slowly, then slammed her backside down to the chair with a WHUMP. She sat rounded for the rest of the lecture about surgery for disc herniation. Sitting and bending rounded forward is the major cause of disc "disease." To easily avoid disc pain and surgery see Disc Pain - Not a Mystery, Easy to Fix.

What to do instead? Any time you start to sit, check if you lean forward and stick your backside out. You shouldn't need to lean far forward to sit, or rise from sitting. If you have to lean, it is usually a sign of weak legs. If your heels come up as you bend your knees, your Achilles tendons are tight (or you have functional bad Achilles habits). You shouldn't (ordinarily) need to use your hands to sit or rise. Your balance and legs should do the work. Do you sit down heavily, not using leg and hip muscles to decelerate? Why jolt your spine and give up free calorie burning at the same time? Try this now to see:

Stand up, ready to sit -
  1. Start to sit, keeping both heels down on the floor.
  2. Don't lean forward. If you lean, correct it by tilting your hip under and raising your upper body to be straighter.
  3. Keep both knees back over your heels. Don't let knees slide forward.
  4. Keep knees parallel over your heels. Don't let knees sway inward.
  5. 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.
  6. Notice if you reach for the arm rests, or other support, out of habit. Use your leg muscles instead.
  7. Sit down lightly.

Start to rise from sitting -
  1. Notice if you lean far forward or raise your heels or jut your chin forward.
  2. Notice if you need to push off your hands.
  3. Notice if your knees comes together. Don't let them.
  4. Change how you rise to put both heels down on the floor, push off your whole foot including heels, and use your leg muscles to rise while holding your upper body more upright without jutting your neck and chin forward.
This is not a bunch of strange rules for sitting, or a weird, contrived exercise, it is just basic concepts for normal healthful daily movement.

The previous post explains why it is not healthy for your back or the best exercise to lean and stick out in back - Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats? It covered good knee placement too, so check that if you avoid healthy movement because of knee pain.

Exercise is still thought of as something you go and "do" instead of moving in real life. It's silly to do 10 squats in a gym or using your chair and then go back to unhealthy movement each time you sit or bend during the day. Have comfortable healthful movement all day. Sit and rise easily. That is exercise as a lifestyle.


Photo by butterbits

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When Did Health Become Thinking Out Of The Box?

Jolie Bookspan, M.Ed, PhD, FAWM

We're just back from teaching the medical school elective in wilderness medicine. Same food as last year. But the creek was thinly iced - good for ice swimming.

Before lecturing, I worried that my information on health - stand up straight, eat right, exercise, "and all that," would be so known and obvious to the bright young medical students that it would bore them. Instead, it was called, "Out of the box." When did health become out of the box?

I spent years of my career in a lab as a serious, intensely number-checking research scientist. I worked to ensure that we knew what truly worked, and what was hype, unrelated, or just wrong. I made certain that what I discovered and developed for patients was squarely right, practical, and in the best interest of the patient (and fun too, which is health). All I pursued was The Truth. Matt Cartmill once said, "As a youth I craved factual certainty, and I thirsted for a meaningful vision of human life. So I became a scientist. This is like becoming an archbishop so you can meet women."

Why is bypass surgery, angioplasty, stents, obesity, diabetes, and medications with uncomfortable, unhealthful side effects considered normal, while eating a vegetarian diet is labeled wacky and extreme when it is medically documented to stop and prevent heart disease, diabetes, high blood pressure, and other prevalent conditions that rob people of joy in life?

In my diving medicine lectures, I wanted students to see how the information worked and how it relates to many things in and out of diving, not just dictate lists of conditions to memorize. I showed slides, asking them to identify why an accident would happen on the way down versus up and why. I told them that if they understood, they would not have to memorize. I just wanted them to think. As my father once enlightened me, "Jolie, you're asking a lot!"

In the orthopedic lectures, I taught the same principles I tell in this Fitness Fixer blog of gaining great physical improvements without making pain and injury in the first place. After one of my lectures, students scattered for personal time, while a few stayed in the lecture hall, bent over laptops. They sat hunched, rubbing sore shoulders. Eventually one nudged the other, "Get the doc, she's right here." After some indecision, one student asked me to give him stretches to fix the pain of working at the computer. I told him you can sit and work without getting pain in the first place, and why didn't I show him that, instead of a stretch as an "antidote." He protested that the computer made his neck hurt. I agreed that the way he was sitting would do that, and repeated that you can easily sit and work in a way that doesn't cause the pain in the first place. More protests came, that as students they had to work on the computer long hours.

Medicine is not supposed to consist of allowing bad things to happen so that you can do a cool procedure to try to reverse it. Readers, do you want to try what I showed him and get a free house-call right now?
  • I moved his chair in close to the table where he was working. Move yours in close now.
  • Standing behind him with my hands on his shoulders, I gently pulled his upper body up and back to rest against the chair back. At home you can feel me guide your shoulders and upper body back.
  • Next, keep the chin gently in, not jutting forward.
  • We moved his computer back from the front edge of the table to make room to rest his forearms while using the keyboard. If you use a "below-desk" keyboard tray, it is often better to move the keyboard back to the desk. Don't crane your wrists, making a new problem. Relax and breathe.
  • I told them that at my own desks, I raise computer on a shelf, block, or book about 10 inches higher than desk level, and use a cheap external keyboard. Even without these helpful changes, you don't have to round forward over a laptop.
  • The seat back of the lecture chairs were concave - shaped to curve like the letter "C" so that you sat rounded forward. This is a common problem in many chairs, even some called ergonomic chairs. Another of the students mentioned he had a commercial lumbar roll at home. It was expensive and he didn't use it much because it was uncomfortable. I showed them how to use a small soft roll, which can be your gloves or light sweater, nothing fancy or expensive. Nestle it in the small inward curve of the lower back, then press your upper back, not lower back, against the chair back so that you can sit straight and lean back, instead of rounding forward. Pressing the lower back against the lumbar roll is a common way to make it useless and uncomfortable.
  • See these posts to see how you may be doing unhealthy sitting without realizing it, during work, play, and exercise:
Are You Making Your Exercise Unhealthy?
Disc Pain - Not a Mystery, Easy to Fix
Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.
It turned out that most of the young, active, outdoorsy, academically talented medical students had muscle and joint pain. So did many of the top ranked physician faculty. Several told me they thought their pain was normal from their activities, from studying, their fallen arches, or body structure. They regularly took anti-inflammatory medicines and thought they needed special shoes. The posts Arch Support Is Not From Shoes and Which Shoes Help Exercise, Fall Prevention, and Ankles? show how you can simply use your own muscles to have healthy foot and ankle mechanics and no pain, and Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain shows how it is not the backpack, but mostly how you carry them that makes or stops back pain.

You probably heard not to slouch since you were a child. That easy medicine hasn't changed. You heard to eat vegetables for health and an apple a day to keep the doctor away. I think a lot of the kids I was teaching caught on and will help many with what they learned. It's easy. It's true. Who is the one who is out of the box?


Photo by fischerhuder

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On The Way

Jolie Bookspan, M.Ed, PhD, FAWM

We are on our way to the United States. It will be several days of trains, ferries, buses, and flights. I won’t have phone, mail, or internet to be able to post for a few days, but I will keep trying the drumming, magic spells, and carrier pigeons that have delivered some of my posts over the past month to Carrie, wonderful Healthline Staff member, who got them uploaded for you. Thank you Carrie.

Enjoy the photo, at left, of young tourists on the ferry. I will post soon on comfortable, healthful sitting for long travel. Until then, start with

Continue posting your comments, questions, and ideas, and keep e-mailing me your stories and photos for posting. You have all been writing great things that I will reply to as soon as I can.

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

Jolie Bookspan, M.Ed, PhD, FAWM

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

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

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

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

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

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

Previously:
What is Thai Massage?

Drawing copyright by Dr. Jolie Bookspan

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Better Hip Stretch - Check Your Ankles

Healthline

We are on the long trip south to Malaysia. The next posts will tell the interesting story of why. The previous post Unhealthy Yoga Ankles showed how you can reduce the good stretch on the hip and increase a bad stretch on the ankles by letting your ankle bend inward instead of keeping the ankle joint straight when sitting cross legged.

Look at the photo, at left, of the good positioning of the people, sitting to chat, in the morning of the overnight train ride. Besides their good upright sitting positioning, note the straight ankle position. Good positioning is common in people of all ages here in Asia. People of all ages, even aged people, sit easily this way to eat, travel, or read the paper. Fitness as a lifestyle is not difficult and does not require exercise machines or gyms or trainers.

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Unhealthy Yoga Ankles

Healthline
Just as there are foods that are bad for you, and just as some common medicines have side effects to make you sicker instead of better, there are several yoga moves that injure directly or predispose you to later injury. This is true, not just for people who overdo the pose, or who are inexperienced, but because the move itself is inherently unhealthy.

When you sit cross-legged, don't let your ankles turn upward, as in the left-side photo, above left. By turning the ankle, you diminish the stretch on your hip and inner leg muscles, and put an unhealthy stretch force on the outside of your ankle. The outside of the ankle is not supposed to stretch much; it is supposed to hold your ankle straight so that it does not turn when you stumble. Overstretching the outside of your ankle is one of a few bad habits that predispose you to ankle sprains. Future posts will cover more on stopping ankle pain and sprains, and will give fun ways to strengthen your ankles. For now, try this when sitting cross legged:

  • Straighten your ankles, as in the right-hand photo above. Preventing the bending will stop overstretching the outer ligaments and you will get more and better stretch in your hip. The hip stretch is better because the turning of the leg has to come from the hip, instead of keeping the hip raised and tight, but bending up from the ankle.
  • Sit upright and straight. Don't round your back, not even a small amount.
  • Lift your chest to sit straight instead of sitting rounded.
  • If your hip is so tight that you cannot comfortably sit upright and straight, put both hands behind you to lean your weight on your hands and push yourself upright (right photo, above).
  • You will feel more stretch, and practice better habits by sitting up straight than by leaning forward with your back and shoulders rounded.

If you get recurring ankle sprains, check to see if you are ensuring that your problem continues through the bad habit of overlengthening the outside of your ankle. Check if you sit poorly to do this stretch with your back rounded and hip curled under because you are too tight to sit in a healthful position. Sitting rounded puts huge herniating force on the lumbar (lower back) discs. Putting your hands behind you to straighten you takes weight off your lower back discs, and gives you a good hip stretch as you regain straight positioning.

As more people try to fix their health problems through medical exercise programs and yoga classes, it is good to make sure not to do things that make new health problems and perpetuate old ones.


Photos from the book Healthy Martial Arts

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Exercise and Stretch for Long Travel Sitting

Healthline

We have just gotten home to Thailand after over 40 hours of flights. It would have taken longer to walk here, so we are happy. We unfolded husband Paul, just under seven feet tall, from the seat. During the next month and a half we will travel on 14-hour overnight trains and ferries to places we need to be. Paul will practice good bending almost everywhere as he tries to fit under low Asian doorways, roofs, and bus ceilings, bow lower than the old people, and stand and sit with his head lower than the head of the monks, as is respectful.

Most people sit a great deal even without long travel. Sitting puts higher pressure on the back and spine than standing. Long sitting pressures the back far more. Sitting also means keeping the hip bent forward at the crease of the leg. The muscles in front of the hip shorten and tighten. When most people exercise, their exercise is usually more bending forward. The result for most people is that the hip stays bent almost all the time. Much tightness results that prevents normal hip function, and reinforces the same tight, bent positioning that is so hard on the spine.

Long airline flights sometimes provide a video or printed message encouraging in-seat exercise and stretching. Often the advice is forward bending. That is the last thing most people needs. Instead, try the following:

  • Stretch your back and shoulders backward, not forward. Pull your chin in while pushing your upper back backward against the seat back. Stretch arms overhead. Breathe.
  • Lean the back of your head and upper back against the seat, press your feet on the floor, and raise your hips, trying to straighten your hip at the "crease" of the leg. Don't bend your neck forward; leep it straight. You will feel your thigh and hip muscles working to do this.
  • Turn in your seat to each side to brace your elbow against the seat back for the pectoral stretch, shown in Fixing Upper Back and Neck Pain.
  • Stretch the back of your legs by straightening your knees and pulling your toes back using your shin muscles.
  • Increase leg circulation by pressing both feet against each other, then cross your ankles and pull both feet outward against each other, then cross your ankles the other way and repeat. Try it again with both legs out in fron, as in the stretch above.
  • Get out of your seat as often as you can. Restore length to the front of your hip with the hip-tilt quadriceps stretch shown in Instantly Better Hip and Quadriceps Stretch.
  • With one foot far in front of you and the other in back (lunge position) tip your hip under you to stretch the front of your hip. As soon as you tilt your hip under, you will feel the difference. While holding the hip tilt, bend both knees to dip straight down almost to the floor, then up. Do many, then switch legs and do many more.
  • It is easy and unobtrusive to do wall stretches while waiting for the rest room: Rest your head, heels, hip, and upper back against the wall, described in the post Breasts Causing Upper Back Pain is a Myth. Bring both arms overhead, hands touching the wall. Lean your body far to one side then the other. Keep both hands touching the wall. When Paul does this one, his head is often either against the ceiling or he can't stand up fully at all, depending on the type of aircraft. He bends knees and grasps each elbow overhead, keeping elbows touching the wall behind him. For other people short enough to fit standing up, just stand straight.
  • Then stand a step away from the wall and stretch arms overhead and back to touch the wall, fingers pointing downward. Straighten elbows as much as comfortable and keep the stretch coming from your upper back, not lower back.

Click labels under this post for more on each topic.
More stretches in the book Stretching Smarter Stretching Healthier.

Photo by Orin Optiglot's photos

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Don't Fall for "Don't Sit Up Straight"

Healthline

An article getting much attention in news and blogs carries the headline, "Don't sit up straight." Many people have been overjoyed to read this. The news articles state that recent studies say not to sit up straight due to the pressure it puts on the spine. But this is misleading.

The studies don't mean, "don't sit up straight." They mean, "don't sit up vertically." They say that leaning back reduces pressure on the spine. The posts I have written about healthy sitting are in line with these studies, and say to lean slightly back. However, you still need to prevent rounding your back when leaning back. This bad rounding of the lower back is shown in the drawing at left. All my posts on sitting have mentioned to lean your upper back against the chair to lean back and reduce pressure, but not to also round your lower back.

It is not "being straight" that is the major problem. My post Disc Pain - Not a Mystery, Easy to Fix shows how rounding the spine forward mechanically opens space between the back of your vertebrae, and pushes your discs outward, over years, into this space. The post says to, "Pull your chair in closer to the desk, and lean your upper back against the seat back." That way you can lean back without rounding. That is how to sit straight (sit with your spine not rounded forward) and still not be vertical (by leaning back).

The post The Cause of Disc and Back Pain shows a photo of someone sitting vertically - head is above hips - but they are rounding the spine forward, putting unhealthy pressure on the discs and soft tissues. They need to straighten their sitting to reduce the outward force on the discs and the overstretch on the muscles and supporting tissue.

This study, and subsequent reports of it, missed that you have less vector force on your spine while sitting vertically at 90 degrees if you don't also round your spine, than if you lean back as they say but round your back. You can lean back and still pressure your spine by rounding. Look at the drawing, above left. The person is leaning back, as the study reports you should do, but the person is also rounding the lower back. This is one of the most common slouching there is. It is more pressure and more unhealthy than sitting vertically but not rounding.

Healthy sitting is simple when you understand, not just memorize a bunch of strange rules. More posts about healthy sitting to come. Until then, straighten your spine by not rounding forward. Move your chair in closer, and lift your upper body up to lean your upper back against the seat back. Yes, that does make your spine straighter - in a healthy way.



Drawing copyright from the book Fix Your Own Pain Without Drugs or Surgery.

For more on healthy sitting see the book and the free web site article - Sitting For Planes, Trains, Exercise, Computers, and TV

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Fix Disc Pain Without Surgery

Healthline

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

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

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

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

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

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

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

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


Photo by subscription to clipart.com

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Studies Say Back Surgery Not Needed

Healthline

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

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

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

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

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

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

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

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

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



Photo by akeg.

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Quick and Easy Strength and Balance Exercise

Healthline

Several readers sent e-mails about the last post, asking about being able to sit on the floor. Many said they are so tight and weak that it is hard for them to get down, and not comfortable to sit comfortably and straight, as in the photo at left. Others wrote applauding that I am getting the message out that sitting comfortably on the floor is a normal ability, not strange or extreme.

First, don't be shy about posting replies and comments on this blog instead of e-mailing me privately. Next, sitting comfortably on the ground or floor is not an advanced athletic contortion. It is an entry-level physical ability that is crucial for normal physical function of your body.

If you don't have the stretch, strength, and balance to do this most basic of movements, you have severe weakness and tightness. It is not just people who don't exercise. I have seen aerobics instructors and personal trainers who cannot sit comfortably straight on the floor. Their hip is so tight from all the forward bending exercises they do that their hip rolls and rounds under them, which shifts their body weight to their discs and lower back. They may do artificial gym exercises, but cannot easily get down to the floor without using their hands because they have not trained movement that is useful to daily life, called functional exercise.

For a quick exercise to improve strength and balance, try this:
  1. Stand up.
  2. Easily and lightly, sit down on the floor without using your hands to get down.
  3. Sit by crossing your ankles and lowering into a cross-legged sit, or by squatting straight down, or lightly and softly kneeling on one knee then sitting. Experiment until you can do all three ways.
  4. Don't thump down hard on the floor. Use your leg muscles to lower softly with shock absorption.
  5. Sit straight without rounding your back forward or curling your hip under you.
  6. Stand up again without using your hands to get up.
Do this "sit and rise" exercise several times in a row. It is more useful and effective than doing little leg raises or presses in a gym. Don't be put off if you can't do this right away. Practice (safely) and you will quickly get stronger and more flexible, with better balance. When your strength improves so much from practicing sitting and rising from the floor that your body weight is not enough to give you exercise, sit and rise from the floor holding children or packages.

You can sit and rise from the floor ten times a day as an isolated exercise then spend the rest of your day sitting in a chair, but it makes more sense to sit and rise from the floor for real life. Sitting on the floor is not a strange or rare thing only done in poor villages far away. It is done in a great part of the world's countries, even in developed cities, and in our home. When you come to eat with us, you will sit at a low table on the floor by the fire. It's nice.

Sitting and rising from the floor is one of the many ways that much of the world gets built-in leg exercise and protects their hip joints from stiffening, arthritis, and bone loss. You will see grandparents easily lifting grandchildren, and other loads. They get bone-building strength, flexibility, and balance every day through their real life, and don't need to buy little machines or go to trainers to do ten little repetitions of an artificial movement. So can you.


Photo by Tupinamba, CreativeCommons

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Conference on Aging Dec 2, 2006 in Midtown New York

Healthline

The Greater New York Chapter of the American College of Sports Medicine (ACSM) will hold a conference on aging on Saturday, December 2nd, 2006 at the Flatotel, 135 W. 52nd Street between 6th & 7th Avenue, in New York City.

In one fast moving day, there will be nine lectures by authorities on metabolic changes of aging, cardiovascular changes and the benefits of exercise, exercise in older patients with heart failure, neuromuscular training for the older population, psychosocial aspects, physical training for older clients with special conditions, and nutritional needs of older populations. I will be giving a lecture called "Three Quick Techniques for Three Musculoskeletal Problems Confused for Aging."

Many of the declines that come with doing less are often confused with aging. A stiff and rounded upper back, for example, is not necessarily aging, but practice. Are you sitting rounded forward reading this right now? Do you spend your day rounding over your desk and steering wheel, then go to the gym and bend forward for crunches, leg lifts, Pilates, and toe touches? Do you bend your neck down to do biceps curls? No wonder it's hard for you to straighten out. How long will you practice unhealthy bent forward position before you get stuck that way? There is no need to exercise in the very way that is not healthy when you do it sitting at your desk. There are better ways.

Much of the loss of strength and balance over the years is from disuse not aging. Many people do not use their legs for the hundreds of times each day they need to bend. They bend wrong, throwing their weight on their spine. Their back hurts and their legs and hips tighten and weaken. Eventually they find they are unable to sit comfortably on the floor, and more worryingly, cannot rise from the floor, or even from their chair without using their hands. This is debilitating weakness, and a dangerously unhealthy cycle of use or lose. It is not aging. In cultures where sitting and rising from the floor is a daily activity, people of 90 have the strength and balance to do it. They do not suffer the rates of falls, osteoporosis, arthritis, and cardiovascular disease of less active populations.

My lecture will cover three easy techniques to maintain and improve spine health and muscle strength. Come say hello. The meeting is designed for allied health practitioners, but is open to the public, with reduced registration fees for members of the American College of Sports Medicine (ACSM) New York Chapter. Contact Felicia D. Stoler, MS, RD (732) 946-4436, or e-mail fstoler@att.net

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The Cause of Disc and Back Pain

Healthline

A UK Times article featured a physician musing that as medical students they were not taught in school to identify the cause of medical problems, but to treat symptoms (and give electric shocks to decerebrate frogs). The cause of the problem would still remain.

He mentioned how you may go to the doctor with painful tonsils, and be given a "diagnosis" of tonsillitis. He educates the reader that "Tonsillitis, for example, is not a disease but a symptom - of something else that caused the tonsils to be infected." He continued with how you may go to the doctor with pain down your leg, and be given back a "diagnosis" of sciatica, which just means "pain down the leg" but not what is causing the sciatica. A disc may be pressing on the nerve, but what is making the disc press? The sciatica and the bad disc are the symptoms. They are not the cause. Unfortunately, he stopped there, and for treatment said to go back to your activities with light rest. Nothing about what caused the disc to degenerate (break down) or protrude (herniate or slip) in the first place.

Understand The Causes:
  1. Bad sitting and bending are main causes of disc degeneration and herniation.
  2. Rounded sitting (photo on left) compresses the space between vertebrae in front and opens the space between them in back and squeezes the disc gradually backward into that space.
  3. Bad bending (right) levers the weight of your upper body plus whatever you are lifting onto your lower back discs, whether you keep your back straight or rounded.
Strengthening your back will not stop you from sitting and bending wrong. Stretches or massage that feel good for the moment will not stop you from sitting and bending in the way that rounds the spine forward, pushing and squeezing the discs until, finally, give break down and squeeze out to the back (herniate).

A bad disc is not the diagnosis. It is not the cause of the problem. It is the result of what is causing the disc go bad.

You can treat the disc pain with pills, exercises, massage, and shots, but not remove the cause. When you continue the cause, the pain often comes back. You can undergo surgery to remove the disc, but of you do not remove the cause and continue injurious sitting, lifting, and bending, you continue harming your other discs.

What to Do:

It is easy to prevent and heal back pain when you simply stop the cause.


Photos: Thanks to HealthLine staff who posed pretending to sit and bend wrong to help others.
No readers were hurt in the photographing of this post.


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Are You Making Your Exercise Unhealthy?

Healthline

Most people know that sitting badly at your desk, as in the left-hand photo, is unhealthy.
  • It is easy to see that he is rounding his back forward.
  • He is not sitting up.
  • His ear is far forward of his shoulder (even with his shoulders so rounded that the shoulders are forward too).
  • He is jutting his head and chin forward.
  • The weight of his head is straining on the muscles and joints of his upper back.
The post Breasts Causing Upper Back Pain is a Myth explained how the bad body ergonomics of rounding forward is a common cause of upper back and neck pain, often mistaken for "stress," even contributing to pain down the arm as you slump the weight of your upper body on nerves that go down the arm, compressing them. The post Disc Pain - Not a Mystery, Easy to Fix showed how the forward bend to the spine squeezes your discs of your neck and lower back, gradually degenerating them and forcing them outward, which is called herniation.

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

What to do instead is simple. Sit up. Don't round your back. Are you rounding forward reading this right now? In a chair at your desk:
  • Pull your chair in closer to the desk.
  • Put your hips all the way back against the seat back.
  • Lean your upper back against the seat back, not your lower back.
  • Gently bring shoulders and chin back.
  • Have your chair far enough in to rest your arms on the desk. Don't crane your wrists to type. I will write more about wrist pain. It should not come from keeping arms comfortably on the desk, which keeps the weight of your arms from hanging forward on your neck.
  • Don't push your lower back against the seatback. Many seat backs are rounded outward so that you have to sit bent forward if you rest your back against them. If the seat back is concave, put a small cushion (or loosely rolled towel or shirt) about as small as your forearm in the space between the seat back and your lower back. Do not press against the roll - that makes the useless to stop back pain.
Don't tighten and strain to sit straight. It is common to be so tight from a lifestyle of forward rounding that sitting straight is not comfortable. Do the pectoral stretch in Fixing Upper Back and Neck Pain, then use the wall test in the same article to check if the stretch worked. On a bike, unless you are in a high level race, straighten up. It is simple. Healthy.

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


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

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The Story of the Black Belt

Healthline

My Tuesday night martial arts class students continued transformation to healthy behaviour. Instead of chatting noisily, they sat quietly straight and relaxed. They sat down on the floor without needing to use their hands. Their equipment was neatly arranged. Instead of sitting glumly or chatting idly on cell phones about the usual annoyances from the day, they mentally put them away and were breathing calmly, focusing on what we were going to do in class. Last week we worked on elbow strikes, blocking, and double kicks. This week was triple kicks, faster footwork, and spinning backfist. Each week at the start of class we have a sitting Zen called the zesa or zazen. We kneel and concentrate on a story or parable, a historical lesson, or an inspiration to live life.

This week's story told the story of the black belt. Who wears one? Why? What does it mean? First, who doesn't wear one? Boxers don't. Kickboxers don't. Wrestlers don't. Chinese Kung Fu practitioners wear a black sash from the first lesson, not only when they become accomplished. Some aerobics instructors purchase one to wear like a chef's hat as a costume to look cool for boxaerobics. Anyone can buy one. What does it mean to earn one?

Color belts were not part of ancient martial arts. Dr. Jigoro Kano, founder of modern Judo, applied a system of belt colors in the early 1900's at his school, the Kodokan, in Tokyo. Some say that part of the inspiration was the ranking by color of swimmers in the Japanese military. Dr. Kano wanted to encourage and recognize his different rank martial arts students. The belt color system spread to other martial disciplines. Who wears belts now? Mostly the Japanese arts of Judo, Aikido, and Karate, the several Okinawan Karates, and the Korean Karates like Tae Kwon Do, Hapkido, Tang So Do, and others.

The symbolism for transforming from novice to black belt comes from starting white - blank - with nothing. In old Asia, you would not wear white to a wedding, but to a funeral. White is the emptiness. Black is the fullness. We all start with nothing, represented in our belt. As you work and learn and train, your belt turns yellow with sweat, red with blood, brown with your toil in the earth, and eventually black with the richness and fullness of your learning. Then you know enough to begin. You continue your dedication as your belt begins to fray and grey with age and wisdom, eventually turning white again, full circle. Zen.

I told my students that a black belt is much like a college degree. In many cases, it does not mean anything. It can show you passed time, but does it mean you learned? In some schools, some upper students bully instead of help those learning. They smoke and eat unhealthy food after class. In some schools, students advance belts by ritual exercises not sparring. In other schools, students fight continuously to subdue others, never taming their own mind.

The Founder of Aikido, Morihei Ueshiba, envisioned a martial art that would reject destruction and show strength through compassion. His revelation reversed thousands of years of harsh tradition. He named his art "Aikido," or "the art of peace." Honorably doing right is what all martial arts strive for, and is the true black belt.



Photo from when we lived and trained in Japan. See more photos and stories of how to change exercise to health in Healthy Martial Arts

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The Stretch You Need The Least

Healthline

Probably the most common stretch I see in gyms and fitness classes, beside hurting your discs by bending "wrong" to stretch hamstrings, is bringing one arm across your body in front, pictured at left. Although this posterior shoulder stretch is one of the most common stretches, it is one of the least necessary.

You probably already have over-stretched the back of your shoulders by slouching all day over your desk, steering wheel, and other work. Sitting and standing with rounded shoulders wears on the neck and shoulder joints and is a common source of upper back and neck pain. One of the most unnecessary things you can do is to further stretch the back of your already overstretched shoulder. Going to a gym to do it does not magically make it healthy.

The best way to stretch your shoulders for health is to skip the posterior shoulder stretch. Instead, stretch the front chest (pectoral) muscles, shown in Fixing Upper Back and Neck Pain to help straighten and "unround" your shoulders and upper back.

Here is a check for how well you can straighten your shoulder positioning for healthy standing and sitting:
  • Can you put your hands on your hips and bring your shoulders back?
  • You should be able to pull your shoulders back without tilting your shoulders forward, or arching your lower back, or jutting your head forward.
  • When you can pull your shoulders back easily with your hands on your hips, try pulling your shoulders back with your hands clasped together behind your back. Keep chin in and shoulders back.
Occasionally I give my cerebral palsy patients the posterior shoulder stretch (above left illustration) if they have an overly pulled-back position. More helpful to these patients is The Ab Revolution, a method I developed where you move your spine from an overly arched lower back, so common in many people, to a less arched position, reducing much back pain. The muscles that bring the lower spine forward are the abdominal muscles so you get a free ab workout going about your day just keeping healthy straighter spine position. The post Fixing the Commonest Source of Mystery Lower Back Pain shows how easy this is.

It is rare to need the posterior shoulder stretch. Yet, notice how often you see it in fitness publications and gyms. Instead of doing stretches to practice rounded posture, use stretches like the pectoral stretch to restore healthy position. Then use the healthy positioning as a free built-in stretch for all you do so you don't get tight in the first place. That's fitness as a lifestyle.


Illustration and more ways to change stretches to be healthy are found in the book Stretching Smarter Stretching Healthier

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Common Exercises Teach Upper Back and Neck Pain

Healthline

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

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

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

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

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

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

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


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

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Fixing Upper Back and Neck Pain

Healthline

The post Breasts Causing Upper Back Pain is a Myth explained that a tilted-forward position of the head and neck, called a forward head, is not the normal tilt to the neck. It is an avoidable slouch that causes much upper back, neck, and shoulder pain, and pressures the discs of the upper spine. Do you have a forward head? If you can't put your back against a wall and comfortably touch the back of your head to the wall too without overarching your back or raising your chin, that usually indicates that the muscles in front of your chest are so tight that they restrict normal standing. The resulting bent-forward position of your neck creates large forces on the muscles and joints of your upper spine as it strains to hold the weight of your head forward of the supporting spine instead of above it.

Being too tight to stand and sit upright instead of slouching forward is common, even among people who stretch regularly. The reason is that they usually practice stretching forward, rarely stretching the front muscles by stretching back. In turn, holding your body bent forward instead of upright perpetuates tightness. To get the stretch in the front chest (pectoral) muscles that you need to stop the slouching-tightness cycle, use the photo above left for reference and try this:
  • Stand facing a wall. Bend one elbow out to the side and put the inside surface of that arm against the wall, as in the left-hand photo.
  • Turn your whole body and feet away from the wall, letting the wall brace your bent arm behind you, as in the right-hand photo.
  • If you are doing this stretch right, you will feel a nice stretch in the front of your chest.
  • Keep your shoulders down and relaxed. Breathe. Smile.
  • Hold a few seconds, breathe in, change arms, and breathe out while stretching the other side for a few seconds.
  • Now drop both arms and turn to stand with your back against the wall again. If you did this pectoral stretch right, standing straight with the back of your head touching the wall should now feel more natural and comfortable and no longer a strain.
  • When you walk away from the wall don't slouch forward again out of habit. Hold the easy new healthy positioning for everything you do.
Do the wall test and the pectoral stretch first thing every morning and several times every day to learn healthy positioning. Use this pectoral stretch instead of the stretch where you stand in a doorway or corner to stretch both arms at once, and instead of pulling your straight arm(s) behind you.

This pectoral stretch is one of two techniques to stop upper body tightness that prevents standing and moving in healthy ways. I will cover the second soon. Remember that head and body position is voluntary. Hold your head up and shoulders back softly. By not letting your head hang forward all day, you will no longer need constant pills, adjustments, or treatments for pain. You will stop the cause.

Thank you to photo subject Paul Plevakas, shown from the book Fix Your Own Pain Without Drugs or Surgery - What to do to fix many sources of pain and injury, step-by-step.

Post with helpful info to get the purpose of this pectoral stretch - Pectoral (Chest) Stretch - The Most Common Mistake in the Best Shoulder Stretch

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

Click the labels under this post for all Fitness Fixer posts about that topic, for example, for posts about neck pain, click "neck," for healthy sitting, click the label "sitting." For all posts explaining discs or fixing pain, click those labels.

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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.

Find your topics on the Fitness Fixer Index, and see Jolie's books on her website.
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Disc Pain - Not a Mystery, Easy to Fix

Healthline

Discs are tough cushions between your spine bones (left-hand drawing). They are living parts of your body. When you bend forward, the front of your vertebrae (back bones) squeeze closer together. The space between the back of each vertebrae opens. After many years of bad habits of sitting rounded forward, bad bending over forward, and stretching by bending over forward, the discs are forced backward, like squeezing the front of a water balloon (right drawing above). They begin to break down (degenerate) and move outward to the back, also called slip or herniate. Herniation can continue over years until it suddenly causes back pain with one more bad bend, until the disc moves backward enough to touch the nerves going down your leg causing sciatica and other nerve pain, or even press on your spinal cord. This is avoidable and easily reversed.

Discs can quickly heal without surgery, if you change your bending and sitting habits in simple, healthy ways:

1. Sitting. When you sit, don’t round your back. You don’t need an expensive ergonomic chair. No chair makes you sit right. You just use your own muscles to sit right. Make sure you don’t tighten and strain to sit straight. Pull your chair in closer to the desk, and lean your upper back against the seat back. Don’t round forward or push your lower back against the seat. Many seat backs are rounded so that you have to sit poorly if you rest your back against them. Don't let this happen. I will write more about healthy sitting in future posts.

2. Bending. The average person bends hundreds of times every day for daily activities like laundry, kitchen, pets, gardening, children, household chores, and everything else. Check to see if you are bending badly each time, hurting your discs. Check at the gym if you add more forward bending for toe-touches, weight lifting, and exercise class. The post Are You Making Your Exercise Unhealthy? shows some easily missed sources. The post Common Exercises Teach Bad Bending shows more. Bad bending puts herniating forces on your discs hundreds of times every day. No wonder your back hurts.

Here is one way to get healthy built-in leg exercise and stop back pain by bending well for every time you bend to reach things very day:
  • Stand with feet side by side, comfortably apart.
  • Bend both knees. Keep both heels down touching the floor.
  • Keep your upper body upright, as if you don’t want something to fall out of your shirt pocket.
  • As you bend lower and lower, peek down and make sure you can see your toes. If you can't, that means you are letting your knees come forward, which shifts your weight to your knees.
  • Keep your knees back over your ankles to keep your weight on your leg muscles. Many people won't bend with their knees because it hurts their knees. This good bending stops knee pain too.

With healthy bending habits, you get free exercise hundreds of times a day, strengthen your legs, stop knee pain, and let your discs heal, all at the same time.

Many Fitness Fixer posts tell more about the large contribution of good daily bending, sitting, and moving habits to healthy lifestyle and stopping the source of disc injury. Click the links in this post for more examples and information. Click the labels under this post for all Fitness Fixer posts about that topic, for example, for good bending, click "squat" and "lunge," for healthy sitting, click the label "sitting." For all posts explaining discs or sciatica and how injury occurs and can heal, click those labels.

There is a large store of help and information right under this post in my replies to the many reader comments below this post. Before asking more questions, see if your answers are already here.


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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.

Find your topics on the Fitness Fixer Index, and see Jolie's books on her website.
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Drawing copyright by Dr. Jolie Bookspan

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Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch

Healthline

You already know that sitting bent over your desk, steering wheel, and computer is unhealthy for your back. Then you go to the gym and sit bent over to touch your toes to stretch. It is the same bad bending. It is not magically different or healthy because it is called a stretch.

Sitting and leaning forward to touch toes, even with your back straight, is a common contributor to lower back pain. It may stretch your back and legs, but sitting, especially sitting bent forward puts high forces on the discs of your lower back.

The sitting hamstring stretch also practices the same bad bent forward posture that you already are probably overdoing at your computer, desk, and other daily activities. Modern lifestyle predominantly favors being bent forward, overstretching your back and tightening the front of your body until it becomes natural to slouch forward and uncomfortable to stand straight. Lower back discs become increasingly squashed and pressed outward from all the forward bending. It starts feeling “normal” to stand and move with your back rounded in unhealthy position.

Sitting and bending forward is not even the most effective way to stretch your hamstrings, even though it is a common stretch, and has been done for many years. Many things that are common and traditional are also not healthy, like smoking and hostility. Use healthy ways instead. The previous post Healthier Hamstring Stretching shows one easy effective hamstring stretch. Posts to come will show many more.Check back often.

Every day in my Sports Medicine practice, I see patients who are instructors of yoga, Pilates, and aerobics with ongoing back pain from doing bad stretches. They say they need the stretch because their back hurts. Then they learn that much of their pain is from the stretch. When they realize this, they smile, stop the bent over stretches, both sitting and standing. I show them more effective hamstring stretches to do instead. They quickly become more flexible from the better stretches, and the pain stops that they were getting from pressuring their discs and lower back with sitting bent forward. Have fun using your brain for stretching, and putting health back into fitness.

Example photo and drawing from the book Healthy Martial Arts by Jolie Bookspan

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What is "Fitness as a Lifestyle?"

Healthline

To many people, fitness means stopping your "real life," changing clothes, driving somewhere else, and doing uncomfortable things without similarity to movement in daily life. Then they go back to "real life" - slouching, bending wrong, walking heavily, sitting rounded, leaning back to carry packages, taking elevators, and avoiding movement.

At the gym, people do squats with a trainer, paying to learn proper form and upright back, then bend over wrong to put the weight down when they’re finished. They do proper lunges for their legs in exercise class, then bend over wrong without using their legs to pick up their things when they leave. They work with weights to isolate arms but never learn how their entire body stabilizes a weight, then hurt their back opening a window at home. They work on a treadmill or elliptical trainer but sprain their ankle when out walking because they haven't trained balance and stabilization. They sit hunched in bad posture waiting for exercise class to start. In modern life, exercise is something you go and specially "do," then destroy and ignore your health the other 23 hours a day. Fitness has become “fast food” – stripped of value, sweetened up, and mass produced, even when unhealthy.

Changing your real life into healthy movement is a big and inspiring area of rethinking and retraining. Instead of sitting slouched then stopping to stretch because your back hurts, sit and stand well so that you do not get stiff and sore in the first place. Instead of lifting packages, babies, groceries, laundry, and everything else wrong all day, then stopping to do back exercises because your back hurts, lift properly. I will show you exactly how in posts to come. You will get built-in exercise, strengthen your knees, and save your back. You don’t need to go to a gym; move, balance, and reach in healthy ways in order to do your real life. Instead of thinking you must stop your life to get health and exercise, fill your life with built-in healthy movement.

Photo: National Cancer Institute, Linda Bartlett (photographer)

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