"Thanks so much for your help. "I wanted to let you know that I have had a herniated disk in my lower back for eight months. Had physical therapy & injections, but still needed medications-pain pills, etc. I never experienced so much pain in my life. I came across your website & articles & starting doing what you recommended, & within days I have been feeling great & have reduced the pain medicine because I don't need it.
"I know now that I was doing the wrong exercises in the past- too much bending forward & back. Didn't really know that this exercising technique (bending, stretching forward, arching) is incorrect. It sure is!!!!
"I really like the hamstring stretch - putting your leg on the wall. This is terrific. I feel so MUCH BETTER....
"Also, when you get copies of the Abs book, please let me know. "Have a great day Dr. Bookspan!!!! Laraine"
A herniated disc is an injury, not a condition or disease. It can heal. You do not have to live with it. You can go on to being able to do more not less.
Discs are living parts of your body, not like a tooth that once broken cannot heal. Most of the time, injured areas can heal, if you let them. Bulging areas can reduce. Dried discs can rehydrate. Each night as you sleep, discs replenish fluid. They plump back up a bit. That is part of why you are taller each morning, than in the evening. They can do all this if you stop the causes that injured them.
Doing surgery, adjustments, treatments, massage or yoga does not stop the cause of disc injury. Common exercises add to injury. Not all exercise is medicine. Then it is no surprise when pain does not stop, or stops but returns, or the next disc herniates after fixing the first one.
Changing unhealthy movement habits that degenerate discs and push them out of place means moving in healthy ways for all you do, not just for sets and reps in a gym. You can do all the "reps" of back exercises in the world. If you return to bending and standing in injurious ways all day around the house and workplace, it is no surprise that the exercises and treatments did not fix the pain.
Click the following for simple ways to stop causes of disc injury. Get the overall concepts, don't bog down on details. I see people in gyms following trivial, exacting "proper form" for exercising, while missing the whole point of healthy bending and lifting or how to apply it to general motion all day.
--- Read success storiesand contribute your own of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Don't let the vast potential of children go unmet. Go to the playground with them. Hang with them. Tumble with them. Play movement games with them. It's gaining priceless skills and health and the best aspects that childhood offers, not losing any aspect of childhood. Ask them to show you things.
Babies have a grasp reflex that allows them to hang with their fingers, with grip equal to world class climbers. Children have the brain elasticity to easily learn many languages without an accent, to move with strength and ability.
Don't strap children into the equivalent of wheel chairs (strollers) while you lift little hand weights. Lift the kids.
I teach many of the moves in this video in my yoga and other classes. Beginners can start them with good success, if they work and try. I have had yoga instructors who come my classes, curse and storm out at the first effort, whining that it is "haaaaaaaaaarrrrrd." They claim yoga makes them strong and loving, then throw tantrums, but that is for another story.
Click the labels children and partner exercise below this post, for Fitness Fixer ideas you can try (using your brain) so that children grow with all the joy, discipline, and strength of real health.
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Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Fast Fitness - Better Standing Hamstring, Achilles, and Inside Leg Stretch
Friday, June 12, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - get a better stretch for the hamstring of the standing leg when stretching the other leg to the side:
When you stand with one leg stretching to the side, notice the leg you are standing on. It is common to stand with the foot turned outward and the hip rounded under you.
Instead, turn the standing leg to face directly ahead. Knee and toes straight forward. Not turned out, not even a small amount. Stand straight.
Notice the stretch move to the back of your leg.
My student Leslie is pictured above at age 68. I snapped this shot of her while she was waiting for one of my classes. The position of the foot on the standing leg isn't visible, but she is straight ahead. I had to snap the photo quickly before the club manager told us to stop.
Stand straight without leaning over, rounding your upper body, or letting your hip round under you. This is different from the way most people are used to.
The straighter you stand, the more stretch, while training the function of healthy posture - a functional stretch. You need to be able to lift one leg without being so tight that your back rounds and your hip rolls under. Think of stairs, kicks for dancing, aerobics, martial arts, stepping over things, stairs, much real life. If you are not only using bad mechanics for daily life, but training unhealthful tight mechanics with conventional bent over stretching, what are you accomplishing?
If you can't stand straight, lower your leg to where you can. There is little point stretching for health while practicing unhealthful ways.
What has happened in a year? She can now do 40 push-ups. We just don't have a video camera. While we get one, click the link to do your push-ups with her each morning while it is still only 30.
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.
Fast Fitness - Develop Ankle Stability Sense While Stretching
Friday, June 05, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - prevent a common source of overstretched lateral ankle ligament, which is one contributor to repeated sprains - turning the ankle when stretching:
When you stretch your hip and legs, or sit cross legged or in yoga poses, notice if you allow the foot to turn, increasing stretch on the outside ligaments of the ankle - too much supination. Reader Liz demonstrates in photo 1 below.
Straighten your ankle, Liz photo 2, below.
You may notice you get more good stretch from your hip to make up for the motion you were getting by turning your ankle. Holding straight gives better stretch in the hip, and better ankle stability training.
Avoid turning ankle, overstretching outer ligament, demonstrated by Liz in photo 1 above /\
Then remember to use the sense and knowledge of ankle straightening when you stand, run, take stairs. Lying down to stretch will not train stable ankles. The idea of this post is not to make ankles worse with your stretches. Not all things are good to stretch. Avoid the unhealthful practice of lengthening the side ankle ligaments, shown again in the photo below:
Ligaments are like a briefcase latch. They attach the top bone to the bone below it. Like a latch, a ligament is not supposed to stretch, but hold position, so that the briefcase hinge (your ankle joint) does not rattle and the briefcase does not pop open (side of your ankle sprain). While sitting cross legged, straighten the ankle so that it does not turn up.
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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Healthy photos thanks to Liz of New Zealand Ligament stretch yoga ankles by Than Tan
Your Muscles Are Your Orthotics for Arches, Knock Knee, and Knee Pain
Thursday, January 22, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
David from Belgium has been a success story and valuable contributor. He frequently makes us photos and movies showing how to fix pain and unhealthful fitness using Fitness Fixer techniques. He first left a comment on a post in 2007:
"I'm training to be a yoga teacher and I'd love to teach the right things to my pupils such as good posture. Your insights are very inspirational. After struggling with minor but persistent knee pain for some years, I was diagnosed with seriously fallen arches recently. I'm not really flat-footed, but ankles that drop inwards too much. (I could clearly see that on the video my podiatrist made of me walking on bare feet). In a week I'll be getting new orthotics. Though, after reading a patient's testimony on your site I decided to try and use my feet differently. So now on my walks to and from my day job I'm trying to walk 'right'. Rolling on the entire foot, heel to toes, leaning more on the sides and using all five toes. It feels awkward though and I notice that I often forget it. I wonder if this will 'fix' my feet eventually? Anyway, thanks for sharing your knowledge!"
I replied that it "fixes" arch positioning as soon as you do it. It is natural to control how you stand and move - the whole intent of functioning in a healthy way in life, and the intent of yoga (supposedly). It seems at odds to say that yoga teaches body awareness, strength, or positioning, then let ankles slump without control, and purchase devices to do it for you. Once you understand the purpose, it will not be awkward. It is the same as any other good posture.
Since then, David has consistently made good use of these materials, and shared many success stories. He has fixed various pain producing habits for himself and his students, fixed his mother's herniated lumbar disc by showing her healthy bending around the house - Bending Right is Fitness as a Lifestyle, and developed a new yoga system of healthier movement - Getting the Right Yoga Medicine.
Orthotics are rigid shaped devices, fitted by prescription, that specifically move and hold your foot in a certain position.
Orthotics are different from over-the-counter shoe pads that can help by cushioning impact.
Orthotics do not do anything you cannot do yourself using your own muscles and sense of positioning (kinesthetics).
It is a myth that only a device can move your foot and leg leg. Click the label "myth" under this post for all Fitness Fixer posts on fitness myths.
Try these in relaxed way:
Stand and see that you can raise your own arches back to normal, taught in the post Arch Support Is Not From Shoes. It takes only seconds.
Make sure you are also not pronating from higher up - Healthy Knees.
Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints.
The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.
During walking and running, a brief and small inward drop (slight pronation) occurs right after foot contact that creates part of the "spring" and propulsion. The idea is not to prevent all foot motion, but to not let the knee twist inward. You can do that with your own brain and muscles.
See if your answers are already here by clicking links, labels under posts, archives, and the Fitness Fixer Index. Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer - Click "updates via e-mail" - (trumpet icon) upper right. Find fun topics on See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
14,000 Miles on a Bike - Herniating and Fixing Discs
Monday, November 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Kristin S was run over by a hit-and-run driver while biking home from work. The car's trailer hitch crushed her face, nose, jaw, cheekbones, and eye sockets inward to her sinus cavities. After Kristin's reconstructive surgery, her step-mother, a student in my martial arts classes, asked me to make a house call to get Kristin back to physical activity. When I met Kristin, she had just had the wiring removed from her jaw, was moving slowly and painfully, and could barely open her mouth when she greeted me at the door.
We had a good session. I showed Kristin several of my rehab methods. She was a good listener and applied everything well. She rehabbed quickly and went back to biking, her socially conscious work, and her active life.
Kristin soon designed a bike trip called The EarthCycle Campaign to raise public awareness of ways to reduce common practices that waste and destroy world resources. Her trip extended 14,000 miles (22,530 kilometers) from Fairbanks, Alaska USA to Tierra Del Fuego, Antártida e islas del Atlántico Sur, Argentina.
I donated some of my books to Kristin to raffle along with her other fund raising activity for the trip, then off she went.
Along the 14,000 mile ride, Kristin stopped in villages and cities to exchange information about simple ways that we all can lower our impact on Earth's environment.
Months of biking passed. Kristin's back pain began.
Pain worsened as she rode mile after mile, through villages, open roads, and cities. She tried exercises she found on various web sites and doctors visited in cities she passed through. She did yoga. She stretched. The pain worsened. After one medical evaluation, the doctors told her results showed several herniated discs in her lower back. From there, she was told by every doctor that it was permanent and she had to stop biking. The rehab they gave her didn't help.
I received a short e-mail from somewhere on the road - "Help me, how do I fix this, they said I have to live with pain and have to stop the tour."
I chided her good-naturedly, "Kristin you should have read my books before selling them :-)" I e-mailed her back explaining the uncomplicated way that discs can be injured and also healed.
A herniated disc nearly always bulges (herniates/moves/slips/migrates/extrudes) toward the back of the spine, not the front. What pushes it to the back? You do.
Sitting with a rounded back physically angles the spine bones (vertebrae) closer in front and farther apart in back. The "opening" in back is often mistakenly written about as a positive way to make space for the nerves, but what is missed is that the bones pinching closer in front make unequal pressure, like squeezing a tube of toothpaste from one end. A little knowledge is a dangerous thing. Contents are squeezed outward to the other side. The discs are mashed and degenerated in front and pushed outward (herniated), little bit by bit, in back. At left (hopefully since we're still having graphics problems) is a graphic of the process from the post: Disc Pain - Not a Mystery, Easy to Fix. Two vertebrae are shown from a side view, as if you are sitting facing right. The right-hand drawing shows how sitting bent forward physically pushes discs (herniates them).
Sitting and standing straight would make space in a healthier way for the nerves.
Disc herniation is a process taking a few years, just like the damage of smoking or eating junk food accumulates until the heart is damaged enough to hurt.
I e-mailed Kristin telling her that a herniated disc is a simple injury, not a condition. It can heal if you understand and stop the bad postures that push the disc outward. In her case, it was sitting bent rounded over her bike, and unhealthful stretching and yoga. Here is what she did to understand and fix it all:
So was her yoga. If you already spend time bent forward and have the usually result of a flexion injury, you don't need more forward bending stretches - Getting the Right Yoga Medicine.
Questions come in by the hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Overhead Lifting, Reaching, and Throwing - More Part I
Wednesday, August 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Nice e-mails and requests came in after Part I last Monday about the overlooked training habit which slowly impinges and tears the rotator cuff. Here is one that covers the points from all received so far.
Reader Hanson writes:
"Thank you Dr. Bookspan for exactly the missing link. I had been attending months of expensive private yoga lessons at [well known studio name deleted] for my shoulder woes without much relief, and maybe have worsened my circumstances. I thought becoming worse with yoga was preferable to surgery that my orthopedic surgeon at [top California facility name deleted] said was required. The yoga directress said more months were necessary (for her wallet?) and I must learn to cool my mind (before I questioned why I wasn't getting better?). I sure didn't question when she wore that little outfit. She showed me yoga poses to "awaken" the area and other fuzzy yoga talk. Poses were raising arms overhead, leaning over with arms overhead, sitting with arms up, and so on. My shoulders burned, she said it was "awakenening." Now I discovered from you it was "impinging." No one said anything about a forward head when I raised arms. I did the same as the directress did. She had this bad posture too. She said do it slowly if it burns. So I burned up my shoulders slowly. Instead of paying the yoga directress for another private session of self-injury raising my arms with head forward I printed your blog and held it overhead to read it. I didn't lean myself back and didn't tilt my head forward. The shoulder is already better. I found all those yoga lessons never prepared me to stand up straight. They told me yoga gives you posture, but it didn't give me anything except a worse shoulder. The "awakening" came from your blog saying use this for life not just exercise. I can lift arms without pain now. I keep my head straight, not forward. Can you put more pictures up of what to look for and can you tell people about your blog?"
Left (pink), upper body leaning backward (explained in Part I). Tilting unevenly compresses the lower spine by increasing the inward curve under load, and fools some into thinking the arm is stretching fully. Center, hunched (raised) shoulders and forward head. Hunching compresses the area. Keep shoulders down when raising arms. Don't raise arms and shoulder together. Right (yellow), leaning upper body backward and forward head. Can you detect the forward head camouflaged by the upper body lean back?
Head forward when raising arm. Shoulders rounded, further compressing the area when lifting the arm.
Head forward when raising arm, shoulders rounded. Also pictured - lower back rounded, tilting the hip (pelvis) too far under. Shifts weight to the lumbar discs (click The Cause of Disc and Back Pain).
Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine
Friday, June 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - quickly change your posture to change your luck on Friday the 13th. Hyperlordosis (swayback posture) seems to be unlucky - it causes lower back pain. You can do this in seconds to make a certain change to healthier spine for yoga or practicing the lunge. If you don't believe in luck, you're lucky. It's just good posture and simple anatomy.
Reader David from Belgium demonstrates in this 20 second movie that he made for us:
First ten seconds - he steps into a yoga pose called Warrior pose, but allows overly arched lower spine. He also demonstrates leaning more weight forward of center line, which is a different issue.
Note how the belt line tips downward in front and the lower spine overly curves inward - more than a normal curve.
At second 11 he levels the hip to bring the posture to neutral spine. Then he kindly demonstrates overarching when raising the arms further. Instead, hold neutral spine and raise the arms from the shoulder, not the lower back.
To prevent shoulder impingement when raising arms, keep shoulders down and back, don't just chin and neck forward, keep them gently in. A forward head posture compresses the rotator cuff when lifting arms. See Safer Overhead Military Press.
I never expected repeated requests to see how to do neutral spine in different activities. It is the same. Just apply the same neutral spine and that’s all. I thought one post would do it, but will post each activity readers ask about. I am aware that there are yoga and fitness places which teach to overarch the spine as part of the move. Teaching swayback does not seem to be as helpful as teaching neutral spine. Changing lunge and Warrior pose to neutral also improves the stretch to the front hip muscles of the back leg. Lucky.
"My Yoga teachers uses that, but you hold you legs at a right degree angle to the floor. It forces your back to be straight. Seems to me it sets you up for more shoulder action. I don't think I'll ever be able to do a handstand without the wall."
The handstand against the wall can be done with legs straight or bent as Ginger describes, or a variety of other stretches. However bending the legs at right angle, or any angle, does not "force" a straight back. Rounded back can still occur. Many people with tight hamstrings wind up rounding the back doing this stretch as Ginger describes because the back is the only place they can get the stretch from and they do not know how to transfer the stretch to the hamstrings. The shoulders also can be in any posture or level of "action" from good to bad depending on how much you know about posture and allow to happen.
The photo at right shows five of my students demonstrating the easy wall handstand in both positions. First at right in the foreground is Diana who hold straight good neutral spine. Next, also in good neutral spine is 67 year old Leslie who starred in the post Are You Stronger Than A 67 Year Old Lady? Click the post to do your pushups with her every day. Third in the middle, Johanna demonstrates right angle (photo taken just before reaching parallel to floor). This can be a fun stretch for hamstrings without loading the lower back.
Most important, use a straight handstand position in neutral spine to train straight body position against resistance, then transfer that knowledge to daily life. If you use the right-angle pose alone you do not learn that.
All my exercises are developed to be more than exercise alone. Instead of just "doing a move" or "holding a pose" use them to train how to move out of bad positioning into healthy position for everything you do.
The post Fast Fitness - Fixing Your Handstand to Neutral Spine shows a short movie of letting spine sag in the handstand and how to fix it so that you can train what to do when you are walking around, running, lifting weights, and just enjoying life. Instead of "doing" exercise, restore real life.
For doing handstands without the wall, it’s just real life balance and stretch training - a post soon will cover how.
Feeling Better Than She Ever Has Part I - Fixing Herniated Disk and Reclaiming Active Life
Wednesday, April 09, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Barbara's story came in over several weeks. Barbara thought she was healthy and active, and had done years of yoga. She had years of lower back pain, then a sudden onset of severe pain, leg weakness, and numbness. She couldn't push off effectively with her left foot, or stand on tiptoe. The heel of her left foot was completely numb, as well as the left side of that foot.
Barbara lives six hours from the nearest big town (there are 300 people in her little town in the Yukon and one general store).
Her doctor found that she had a herniated disc in her lower back, put her on anti-inflammatories. She was in continuing pain, and fearful of her future of pain and reduced activity, which would mean getting more out of shape and feeling worse. She was frightened that she had some "debilitating disease."
Barbara found my web site and this Fitness Fixer column with free information of how discs become pushed outward (herniated) through bad sitting and bending habits, and began trying some of the information. She wrote me excitedly the first week,
"I decided, after reading one of the many great patient stories you included in your book showing what to do, to lie on the floor on my stomach propped on my elbows to read your book. This felt amazing and when I got up again I could walk straight!"
Another e-mail followed that she was feeling worse again after that. I asked if she had gone back to all the injurious habits that cause the pain. She was surprised to realize that she had. Bad forward bending puts outward and eventually herniating forces on the discs. Barbara was bending badly all day at work when she need to pick things up, bending badly at home over the sink, counters, and while doing housework, then going to yoga class and spending much time bending over forward. Even in a yoga class, herniating forces occur from chronic forward bending, both sitting and standing bent over. It isn't magically good for the discs by calling it a stretch. Barbara also had been told by her health care providers not to do any lunges or squats. She later realized they were just the healthy bending she needed to do normal daily reaching and bending at work and around the house. Without them, she would only be doing the same bad bending that was contributing to the original problem.
Barbara wrote,
"I realized that part of my problem all week was that I had been half-heartedly doing "exercises" then going back to wrong bending while getting completely frustrated because it would seem things would start to feel better in the morning, but I'd feel like garbage by night. I wouldn't do all the things you recommended first thing in the morning, and I would get halfway through a lunge or squat to bend or pick something up and then bend forward out of frustration. So, I pampered myself yesterday - really, truly practicing and applying how to move in real life, especially concentrating on those lunges and squats when I needed to get something. It also finally clicked with me that while I was trying to concentrate on tucking the hip to neutral spine to walk, I was totally ignoring the forward bend of my upper back while standing and walking all week. I was walking all stooped over and feeling like an invalid."
I wish I could write that Barbara followed everything I said and was better the first day. What actually occurred was that it was six weeks until the "light bulb went on" and Barbara realized that "doing" a stretch or exercise doesn't magically erase the injury. Stopping the injurious bad movement habits that harms the disc is needed to let it heal. Using healthy movement in daily life for daily bending and reaching would improve strength and balance. Barbara said that reading the Fitness Fixer stories from Ivy sparked her "turning point" to understand. She then started feeling relief.
Barbara wrote.
"In short, I’ve come from having pain, and muscles completely unaccustomed to healthy movement lifestyle, to feeling stronger, more flexible and agile, pain free, along with a new attitude to everyday life and health, with fresh energy and a renewal of love of life. I know this might sound dramatic, but you’ve changed my way of life.
"Your website has been a godsend actually; especially when I surf the net and see "surgery" splattered everywhere.
"PS My principal just ordered your book - he borrowed Fix Your Own Pain for a week (I didn't think I'd get it back) and would like his own copy. That's saying a lot - he's doesn't take well to other people's advice."
It was six weeks of half-way recovery and recurring pain until Barbara got the idea that "doing exercises" doesn't heal an injury if you go back to bad movement habits the rest of the day. She also noticed how some of the most common exercises contribute to the original problem. Here are links to the information Barbara used:
Barbara generously wrote up her story to help readers see that they can fix pain sooner, rather than waiting six weeks. Coming next, Feeling Better Than She Ever Has Part II - a look behind the scenes.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Fast Fitness - Prevent Wrist Pain During Pushups and Cooking
Friday, February 08, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Learn to use strength and good joint positioning instead of compressing the wrist joint during activities that put weight on a bent wrist.
Good positioning and strength is more effective than splinting wrists straight and restricting activity:
While sitting or standing, press your right wrist and hand backward strongly using your left hand. Feel the right wrist compress under the weight of the other hand.
Now use your right hand and forearm muscles to press forward against the left hand. You should feel the compression come off the right wrist.
Hold a pushup position. Use this technique so that, regardless of your weight, instead of letting your weight compress your wrists, you use your hand and forearm muscles. Keep weight distributed across your hand, not just on the heel of the hand.
Use this whenever you use your wrists - for weightlifting, for standing on your hands, for typing, driving, biking, playing piano, and during cooking and cleaning.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
"I would like to take this opportunity to tell you that after suffering for many years from back (scoliosis) and neck (arthritis) pain, it was my good fortune to happen upon your website. I read every word, tried the movements and postures and found an immediate measure of relief from the pain that no doctor, chiropractor, physical therapist or massage therapist has been able to help (I am 56). I immediately ordered a number of your books, read them from cover to cover, gave them to my daughter and son-in-law and then ordered more for my son.
"I took your books with me to New Orleans, where I worked for 10 days as a volunteer building houses, and am happy to report the exercises and stretches allowed me to climb ladders, wield heavy loads and hammer nails without further consequence to my back and neck.
"As mentioned by most people, I found instant relief upon simply correcting the positions of my neck and back. I took the books to New Orleans with me and did most of the stretches, especially the side bending, back extension, hip and hamstring ones. I also took great care with my positioning with the construction work and lifting. "Before I found you, because I was in so much pain, I had stepped up my go-to stretching routine gleaned from years of aerobics and some yoga, which always included toe touching with straight knees and plow and all those exercises you say not to do. I thought it was good that I could touch my toes on the floor behind my head in a plow or my palms to the floor bending forward. Ouch!
"I've also been doing many of the strength-building exercises, trying to work up from the elementary to the more difficult. It's fun stuff and it feels SO GOOD!
"Thank you for putting so much information out there for the long-suffering public! Sincerely, Marla Black"
"PS - my daughter is a triathlete and she and her husband have been doing all the bad stretching and wrong postures. Her neck and back were starting to hurt. I gave them the books and they are already onboard and feeling the difference!"
Fast Fitness - Core Hip & Body, Posture Strength & Balance
Saturday, January 26, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - training and challenging abdominal muscles to hold neutral spine. Use this, not as an exercise to "do," but to use to retrain neutral spine. Reader Mike, who did a A Whole Big Fix sent this photo to illustrate:
Hold a plank.
Lift one arm straight in front.
Figure out which is the opposite leg and lift that one. Keep straight spine
Mike writes:
"Here's some more feedback on your exercises: it seems the more planks I do with opposite arm/leg extended, the less my hip pops, so I'm doing those every morning for about 4 sets of 10 sec. holds on each side, along with the side planks. Those seem to set my posture off right for the rest of the day. I'm using my hand and wrist muscles to take weight off the bones, as you've said, and my wrists, are getting stronger.
"BTW: my daughter's badminton coach has a PhD in exercise physiology and she's also a big fan of your site."
Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II
Thursday, January 17, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
In Part I of this post on Monday, photographer Bernie tells of fixing years of pain that doctors told him only surgery would fix, even after three surgeries. Here is a look "behind the scenes."
10 March 2005, Bernie e-mailed me:
"I've had this persistent paresthesias for 4+ years. I just learned about you yesterday. Where are your back & spine classes held. Tomorrow, I'm having lumbar myelogram & CT at (top name deleted here) Hospital. Before I consider anything else, I want to learn about your methods."
I wrote back with class information. I had two classes coming up. One was the next month. The second would be in early May and only a few blocks from where he lived. I told how we work to see change in pain right in class. I asked him to let me know the test results and that I hoped to see him in class.
20 March 2005 he wrote back:
"Thanks for asking, I never expected you to keep in touch. The myelogram and CT showed moderate central spinal stenosis at L4-L5. Severe facet joint arthropy & hypertrophy of ligamentum flaxa causing compression of the lateral recesses stenosis of L5 on both sides, kinking of L5 nerve root sleeves on both sides. I have a copy of the xray, showing the "hourglass" at L4-L5
"(name deleted) is the attending, 3-B Orthopaedics. He said the next step is surgery, by ( ), at ( ) Hosp. I asked if strengthening of my upper body would help support my spine. He said "try it" so I'll be at physical therapy next week to start.
"I have a commitment for the weekend of April 2-3 so can't attend that class, much as I'd like to. Since I live at (close to) your class at Temple CC is my best chance of attending. Cordially, Bernie Cleff"
I checked back in to make sure he was signed up for the May class and to ask what he was doing in Physical therapy. He wrote:
29March 2005 "The phys therapy that I'm getting concentrates on my core muscles. Thanks for getting in touch...very kind of you."
I wrote back saying that conventional core exercises were not the best thing. Usually they are forward bending actions that will further compress the discs, the nerves, and also do not retrain the abdominal muscles in the way they work when you go about daily life. Strengthening does not automatically support the spine. I wanted to make sure that he had my Ab Revolution book, which was then out in a training manual version. He said he had it with him for PT. (I found out two years later that they had the book, but they were not using it, and were doing traditional forward bending abdominal exercises.)
10 May 2005, the day after the Fix Your Own Back Pain workshop was held, Bernie wrote me,
"Hello, I did sign-up for your class at TUCC on Monday 5/9, but I was too tired to attend. On top of that, I am scheduled for spine surgery at ( ) on Wed 5/11/05, with ( ). After having 2 epidurals and physical therapy I decided to go for the surgery. My nerve that is pinched is in the shape of an hourglass (at L4- L5) and (the doctors told him) that no body position or exercise changes are going to help at this time. Both legs are numb and I am walking like a drunk. It is kind of you to keep in touch. I hope to meet you at your fall class."
Days later, Bernie had the surgery. He tells about it, and his next two years, in Part I of this story. The doctors all considered his surgery a "complete success." They said the surgery went completely according to plan, with no complications. His recovery was in line with expected results. The fact that his pain returned, was worse, and complicated by limited movement from his plates and screws and other surgical hardware not a factor to them. They felt the limited movement was beneficial and a goal of the surgery. The commonly held idea is to stop motion in the area to stop the pain.
In late October of 2007 arrived to teach the Fix Your Own Back and Neck Pain Workshop. I had 16 people waiting for me. One was Mr. Bernie Cleff, a funny white-haired muscular man of 80, who was in much pain.
We had a fun, energetic class. One of the students was a young man from India. He sat unsmiling as I mentioned various yoga poses that can injure discs in the neck. I tried to ease the class explaining that I am not against all yoga, and studied years to become a teacher myself. He sat unsmiling. We did three specific techniques to stop the neck pain process and a beautiful smile radiated from the young man from India. He had three herniated discs in his neck, most likely from his yoga practice of the specific moves I had mentioned, together with sitting badly at a computer for his work. He already knew those yoga moves hurt his neck. He had just been worried the pain would never stop. When it did, right there in class, he smiled.
Another of the students was a golf pro. Who I consulted with afterward to test out my work on lower back pain and golf. More on this to come.
Mr. Cleff did great in the first class. This class was done over two weeks. I gave the class things to try over the week before the second and last class.
Oct 25 2007 he wrote me:
"Today (Thursday) is my class day at The Clay Studio, working over the wheel for 5 hours. I felt good with very little noticeable pain. Usually after walking the 5 blocks from my home to the studio both my legs would tingle badly and I would stop to rest halfway. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to check-up. You are one hellova person and I'm thankful that I've met you.
"I've had my spine problems with the pinched nerves for a long time - roughly 4-5 years- and I'm slowly getting better since you came into my life. There is no other way to say it. Thanks Jolie."
He was improved in one class, and he felt that he was "slowly" getting better. I like an empowered student who does not want to dawdle to get better. The day after the second of the two sessions, Bernie wrote:
28 Oct 2007
"Last night, I walked about 7 blocks to restaurant AQUA (great value, low cost & delicious) and back home another 7 blocks.
"Upper back extension causes no pain, lower back does. I can do plank on elbows, holding for 60 seconds now, no pain.
"If you want to make photos of a geriatric doing your things, it's OK with me. as you've seen, I'm not bashful or delicate. I will work at getting better, my daughter is getting married January 5 and I want to be able to dance with her and my wife."
Bernie went back to his doctors about the small amount of pain remaining. They told him he should have more surgery, and gave him prescriptions. He wrote to ask me:
"On Nov. 2 I have a follow up with the spine surgeon (same guy) and on Nov 14 a consult with a Neurologist ( ). Do you have any suggestions about a pain med FENTANYL ,which was suggested by a doc at the V.A."
I wrote back that Fentanyl is a surgical grade narcotic. It is used "off-label" for back pain and there have been deaths. I asked him to tell me more about what hurt, and when, so we could stop it without any harmful medicine, and also what the neurologist said.
14 Nov 2007 he wrote:
"I had an office visit with the neurologist at ( ), he said my twisted nerve at L5 will never get better and I will always have pain."
They told him to have another spine surgery and take the Fentanyl. (Then why did they put him though all that surgery?)
He wrote:
"Hello, I still have some tingling in both knees...but much better than 2 weeks ago! There has always been pain in my left flank between spine & hip, never told you because the knees were my greatest problem… The lower back pain persists, but only left side. When I do the trap stretch leaning to left--puts much pressure on that pain. Leaning to the right feels like a good stretch. Any additional suggestions?"
I found that that he was still doing "their" exercises. Conventional exercises of bending forward to stretch the hamstrings are often prescribed for back pain. The assumption is that tight hamstrings have (something) to do with back pain. However, bending forward is one major contributor of this kind of back pain. I changed how he stretched his hamstrings to one of the ways we did in class.
He was also continuing to overarch his lower back when walking, which was a large source of the tingling pain. When he used the Trapezius stretch, he was also overarching, which makes pain when bending to that side. This kind of pain is often confused for spinal stenosis. One classic sign of stenosis is pain when bending toward one side. But the narrowing is not true stenosis, but just overarching which narrows and pinches the area. For someone who has stenosis, not pinching the area further with overarching is frequently enough to stop pain.
What was complicating everything was his surgeries. They were considered "completely successful." The two knee replacements were "completely rehabbed" meaning he could bend his knees enough to sit in a chair. He could no longer stretch the front of his hip enough to prevent the kind of tightness that encourages standing and moving in overarched position. The back surgery put a plate in his back to prevent much movement. That meant that even small overarching movements were enough to pressure the newly immovable area. The back hurt, and the tight back and hip were compressing nerves going down both legs.
He wrote two mails:
"Jolie You hit on the spot. I will keep at it gently."
and
"Jolie, a quick note to tell you today I walked 12 blocks, stopping to stretch hamstrings.. often on steps or fireplug....as you suggested...also lunge stretch. I will dance at my daughter's wedding. Much thanks.
"There will not ever be more surgery on my body."
For the flank pain, he had been for many tests, and was even scheduled for a kidney evaluation. The muscles in the area were so tight, that I biked over to his home to do a sports medicine technique to stretch it out for him, and checked his other stretches. I went over how to stretch the front of the hip without overarching his lower back. His sweet funny wife made me lunch. We got some fun photos of things as gifts for you, of fun stretches and activities.
He wrote
"I've had x-rays, MRI, bloodwork, surgery, injections, no Dr. had any solution. YOU HAD THE ANSWER. No wonder so many people have thanked you."
He did the work and gave me the credit. That's a good man.
Like a Bonsai Tree Your terrible posture at My dinner table
The photo above shows an injurious positioning called "a forward head." A forward head position presses cervical (neck) discs outward, causes upper back and neck pain often called "upper crossed" syndrome, and can press the nerve going down the arm, leading to arm pain and hand/finger numbness. Jutting the chin upward with the neck forward can, over time, create a spondylolisthesis (vertebral shifting). Raising the arm with the shoulder rounded and the neck forward adds to shoulder and rotator cuff injury.
Check yourself for a forward head position when eating and drinking (and on the phone):
Corner of the jaw is far forward of the shoulder
Neck tilts forward
Jaw juts forward
Neck pinches backward, with high compressive force
Shoulder rounded
Don't round your back or jut your chin forward. Instead, keep chin in when you eat and drink and talk on the phone. To look upward, get the upward motion more from straightening your upper back, and not from one joint in your neck. The neck is not a hinge joint.
Don't rely on, "Keep ear over shoulder" thinking that is straight posture. You can see in the photo that the ear is over the shoulder, but the neck is craned badly.
Use healthful positioning for built-in upper body muscle exercise and easy pain prevention. Check yourself sideways in a mirror. Watch other people eating and drinking for an easy reminder. Happy Holidays.
Here is Friday Fast Fitness - fix your plank (hold pushup position) to strengthen core and wrists, and train standing neutral spine posture. In yoga the plank is done in high and low positions called chaturunga.
A sagging inward curve to the lower back is not the normal curve, it is too much curve - pictured at the start of the MPEG movie below. Holding a plank with a sagging (overarched, hyperlordotic) lower spine "hammocks" body weight onto your spine joints called facets, adding to lower back pain, and does not use your core muscles. It is counterproductive as an exercise. Instead:
Hold a pushup position
Change sagging lower back to neutral by tucking the hip. Head up, neck as straight as standing.
Don't flop all weight on wrists. Press with hand and fingers, and use forearm muscles to reduce wrist compression and shift weight to surrounding muscles - see Stronger Pain-Free Wrists When Biking for ideas.
Reader David D. from Belgium sent this excellent movie. He pushes up into plank. You can also can start on hands and feet without pushing up. He first demonstrates badly overarched lower back, then changes to neutral spine in seconds 8-11 of the movie, then holds. When you do this you will immediately feel the effort shift to your abs. Use this instead of crunches for functional core training. If you push up from the floor, hold tucked neutral spine, not lifting upper body first.
(The exercise is not to do overarching and change to neutral - it is to hold neutral throughout.)
Grunting in the gym made recent news. A member was forcibly removed from a gym when others complained. The article told of factions arguing who was right if grunting and other loud vocalizations when exerting for exercise were helpful or needless annoyance.
Exercise is supposed to be healthy and build discipline of mind and body. Antagonism and disputes are not healthy for mind or body. Moreover, both sides have missed the point.
Breathing out, either quickly or slowly in coordination with effort can help. It can be done silently - by exhaling without vocalizing. You can have both, the exhale and the peace. This quiet but forceful exhalation practice is used in many high exertion fields from martial arts to warfare to meditation.
Fighting ninjas were legendary for both focused effort and silent tactics. No sense making a war cry until it was needed for its better purpose - to increase tendency to submission by the other party on the receiving end of the cry. In other words, to be scary.
For exercise, focused exhalation can increase acceleration at specific points of the move to increase power. For heavy moves, it can help lessen increases of pressure in the chest cavity and blood vessels, depending how it is done. Sometimes, people put so much pressure into the exhalation that they increase internal pressure instead of prevent problems. Done either quickly or slowly, it can be used to strengthen the move by including expiratory muscles. Often in martial arts and yoga classes, we (teachers) use noisy breathing just to remind students to breathe at all. It is a cue until they remember to breathe on their own (quietly) instead of holding their breath.
In the war dances and drumming in many countries, in martial arts, and in meditation arts, a concentrated exhalation coordinated with effort is variously called kiah, kiai, hihap, battle cry, and other terms. Each school is certain that their own different translation and beliefs about these terms is the "right one." The exhalation can be vocalized in a short yell, a loud breath, or silent. In group efforts, from martial arts to hauling sheets on tall ships, to chain gangs, to exercise classes, it helps unify mood or keep cadence. Done without coordinating effort, it is called yelling, and sometimes it is just vocalizing in corny ways.
More about breathing, the kiai exhalation, and exercise for any sport are in the book Healthy Martial Arts.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Thank you for the many e-mails. I am sorting through the piles. Readers are sending success stories, long and short, of improving their lives and fixing injuries and the moves that produced them. They changed their mindset so that exercise is not something you change clothes and go "do" - if you can make time - but all the ways you sit, bend, reach, lift, and move all day in real life, using muscles to hold the positioning that prevents body aches and joint wear and tear, and comfortable easy movement. They are now getting fresh air, sunshine, balance, and real exercise going to work or grocery shopping on a real bike or walking on real ground, instead of driving then rushing home or to the gym to "do" exercise, illogically spending money on an artificial machine, exercise cycle, or treadmill. Instead of thinking they have to lose weight first to try things, they are using daily movement to be able to exercise for the first time without injury. They are saving money and health, eating real food instead of processed unhealthful "sports food."
Yoga instructor David from Belgium first asked about fixing knee pain and fallen arches in the comments of the post Thank You Grand Rounds 3.51. Since then, he quickly applied the posts I recommended and fixed his pain, no longer needed shoe orthotics, sent photos of new progress, asked about other injuries from yoga, changed how he teaches yoga, given his students my techniques, started making short mpeg movies for us (see the first here), and is translating my work into Dutch for his web site and students. I look forward to more collaboration. Watch for wonderful posts to come.
There have been a small number of e-mails from readers applying techniques in ways so "unclear on the concept," that some posts may turn out to be Readers Inspiring Stories of What Not To Do. All for the greater good, learning, and health.
If I can't get to everything in the comments I will make posts for you, don't worry. I read and want to get to them all. The top number of requests for posts, so far, are how to stop shoulder injury from swimming, baseball and weight lifting; low back pain from swimming, baseball, and golf; separating truth from advertising in orthotics and shoe inserts; more healthy sports food; rowing; sports drugs; hamstring injuries (often from the usual bad stretches); plantar fasciitis; knee pain from rowing, yoga, and walking; wrist pain from pushups and handstands; healthy sitting; and many requests for martial arts and self defense for body and mind. If you have other requests, let me know. Until I post each specifically, start with:
Shoulder - use for all overhead reaching and lifting
Lower back - learn the concept and apply to all sports
Fitness has become unhealthy. Healthful natural, comfortable body movement has become foreign as more people think that exercise means artificial sets of repetitions on a machine or using equipment. How are you sitting right now reading this? Pull chin comfortably in, instead of jutting forward or down. Stand up, breathe a grateful breath, and walk away from the computer for a few minutes contemplating a new, healthy fun life of natural movement. Print out a post of something that will make your own situation happier. Lie face down on a comfortable surface, propped slightly on elbows to read it. If you can't lie comfortably that way, that signals tightness that makes daily movement unhealthy and uncomfortable. I will post about that too.
The third harvest is here in the Northern Hemisphere. The Hunter's Moon is bright in the sky.
The last harvest of fall is a time of endings and beginnings. More than a commercial holiday of destruction and gruesome death, the approaching winter was historically a time to reverently mark departure of the living and life-giving fields, and be thankful for the harvests they gave. Revering of elders was observed in analogy.
The first and most important precept of thousands of years of yoga and martial arts is ahimsa. Ahimsa means non-violence, non-harm, non-destruction. Ahimsa was reaffirmed in recent times by the Mahatma Gandhi, and in the West by Martin Luther King, Jr. In all the classes I teach, I remind the students that ahimsa is something you incorporate in all your actions. Don't harm yourself by sitting in injury-producing bad slouching. Don't harm yourself with bad exercise. Don't harm yourself by destructive thoughts and actions. Don't harm yourself with unhealthful food and drink. Don't harm yourself by hunching your shoulders to stress through preparing meals, when you can relax your shoulders, straighten your back, breathe, and use each stoke of washing, cutting, and preparing food as beautiful meditation in the same amount of time. Don't harm others with spiteful words, deeds, and thoughts. Don't cause others fear or pain. Don't cause yourself fear and pain.
In many of the countries where we have traveled and lived, lovely short public service announcements occur daily with kind messages of doing good. Television and radio commercials are paid for with no other purpose than to give specific positive examples of helping each other for a better world. Where we have lived in the US, continuous messages of spiteful and worse behavior are common as entertainment.
Several centers in your brain process self-control. They need exercise like anything else. Studies of imaging these brain centers in people who overeat, showed that with retraining, the centers changed in level of activity when pictures of food were viewed. "Exercising self-control" is more than an expression.
Children, and even adults, need consistent positive examples. It is good and crucial exercise. It is easy to destroy, and takes (but also gives) energy to be good. Instead of "Mischief Night" tonight, do good. Instead of spending money on destroying property with thrown eggs and toilet paper, have fun learning a healthful recipe that you can enjoy for years to come. Learn to stand on your hands safely. Paint or draw a picture of a good wish. Talk about how it can come true. Design and construct inspired homemade costumes. Help the community. Volunteer at a shelter. Exercise your spirit. Develop a fun, beautiful positive public service announcement for your home, or a commercial project, that reminds to uplift spirit and behavior. Teach a child something. Don't wait until they are already doing bad. Teach them consistently, before they know to do either, so that they will more often know to choose good and why.
The average American spends nearly $15 on Halloween candy - more than $1 billion total on unhealthful refined sugar and hydrogenated fat candy - just for Halloween. This is not parental love. It is the same as giving them cigarettes or addictive drugs. Change that. Parental love is giving them beautifully functioning self-control brain centers. Halloween story and ideas in Exercise Common Sense Discipline - Turn Down Halloween Junk Food.
Positive behavior is too important to leave up to only the schools, the entertainment industry, the government, the Internet, the home. We all add ahimsa.
Many chapters of ideas for happy bountiful living are in the book Healthy Martial Arts.
Photos of Paul Creating Good on Halloween. Can you find Jolie in the photos?
This weekend in the Northern Hemisphere, the moon will be new, and the night dark, and the skies filled with the shooting stars of the Perseid Meteor shower.
Every 130 years or so, the Swift-Tuttle comet circles the Sun, streaming icy, dusty debris the size of sand and peas. Every mid-August, the Earth passes the orbit of Swift-Tuttle, raining fiery remains through the atmosphere. Igniting against the air's intense friction, they "shoot" across the sky. Books by people who study these things say they fly about 37 miles per second (60 kps), most burning away far above the ground.
The Perseid showers are seen in the sky around the constellation of Perseus the Hero, giving the name. Early Greeks explained that the god Zeus, father of Perseus, visited Perseus' mortal mother Danae in a shower of brightness. Later the event was renamed (or reborn) as "The Tears of St. Lawrence" for their appearance during the August festival of Saint Laurentius. Chinese, Japanese, and Korean writings of Perseid showers date from the 8th century. I grew up on Russian childhood social-utopian folk bedtime stories of comets, mixed with my Grandmother's whispers of fiery conflagration, later determined from an unknown comet or part bursting over Tunguska Krasnoyarsk Siberia around 1908, devastating the forest (later politically reinvented as a nuclear event, and editorially as UFOs for Russian science fiction writing and American television).
What about your neck? When watching meteor showers standing or sitting, don't martyr your neck. If you crane your neck and push the chin forward when looking upward, you put destructive force on the neck, shown in three examples that follow:
Three images above show craning the neck and jutting the chin. Injurious compression builds in vertebrae, discs, and surrounding soft tissue.
The left and middle images show leaning the upper body backward. Thoracic lean overly arches the lower back (hyperlordosis), adding weighted compression to the joints called facets and soft tissue of the lower spine.
The right photo shows unhealthy craning with the chin forward, common in some yoga and exercise classes. It adds sizeable compressive loading on the back of neck vertebrae plus shearing force on the discs. When raising arms upward, it contributes to rotator cuff compression and injury. Click Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.
I understand that jutting the chin far forward is often taught as proper form. I have taken yoga classes in India with major names and those unknown to the outside world. One teacher told me pushing the neck and chin forward protects the discs. It unfortunately doesn't. Shearing force on the discs is severe when you jut the chin forward then raise it. Shear is a structural strain when one layer shifts sideways (or front to back) in relation to the other. Damage may take years to accrue until visible on x-ray. Don't jut your chin forward, especially not when looking upward.
Photo 3 above shows tilting the neck forward when looking through binoculars (left figure with yellow arrow). The chin is not forward, but the forward head still creates painful forces on the upper back contributing to upper crossed syndrome, disc trouble, and muscle strain in the classic diamond and hangar shape across the upper back. The pain is easily stopped. Keep neck vertical and chin in (right green arrow).
You can look directly upward for all you need in healthful position. Here are ways:
Keep your chin in, loosely and relaxed.
Shoulders back.
The back of your head lifts loosely upward without strain.
Straighten the rounded-forward curve of the upper spine - get more upward gaze range from your upper back.
Don't yank or force the head and chin back, or the corners of your neck will ache.
Don't lean back by arching your lower back.
Healthy upward gazing is a nice good-feeling stretch and exercise for the upper back and neck without injury. Use it for all overhead needs, photo 4 of Amsterdam policeman at right.
The time where we pass through the Perseid shower is long, from about July 15 through August 25. The highest activity is predicted over the Northern Hemisphere this coming weekend. Look up on Saturday, 11 August before dawn, Sunday morning the 12th, late Sunday night through Monday early dawn.
Because of the tilt to Swift-Tuttle's orbit, its fiery dust falls almost entirely on Earth's northern hemisphere. Southern hemisphere friends see few Perseids. The next good Southern hemisphere meteor shower is hoped to be the Geminid showers in December.
The constellation where meteors appear to come from is called the radiant. The Perseid meteor shower radiant is the constellation Perseus. The Leonid shower is hoped to peak this 18 November. Look toward the constellation Leo. The Geminid shower radiant is the Gemini constellation. Watch in mid-December with the evening crescent of the moon.
In photo 5 at left of looking up through the telescope, the neck is a bit more forward than needs to be.
Experiment on your own. Use a mirror and send in your photos of remaking healthful fun overhead gazing activities.
The week before I left to teach at the Wilderness conference, I taught my University yoga class entirely on an exercise ball. I will post about functional movement on a ball in weeks to come.
We don't use three of the most ineffective things you can do on a ball - crunches, sitting on the ball (for almost anything), and arching the lower back over the ball. These seem to be three of the more common things done on the ball in fitness classes, but they are not fit or effective.
Another myth is that an exercise ball will magically make you sit straight. You can sit with as faulty positioning as on any other surface.
Most of my students brought in an owned or borrowed exercise ball. I brought in three more for students without access. Some of the students pin-balled cheerfully through the narrow doorway with a large inflated exercise ball. One came in on the subway holding hers. I managed a comic, calorie-burning commute with three on a bicycle. A few students brought theirs uninflated. Wow, such an idea.
They asked me if I had a pump.
I told them, "Yes, your lungs, blow it up."
They sat politely waiting for the other students who brought a pump to finish with theirs.
I chided them that people talk all about yoga and breathing but here was opportunity in the tangible. They sat politely waiting for the pump. I demonstrated - "fffooooooooou."
I told them that when I was small, I was transfixed when my father, a Russian ice swimmer, blew up a beach ball in one breath. I decided then and there that I wanted to do that. I experimented with bags. I'd inflate to all my capacity and compare the bag to my little chest. I later practiced this in my swimming career until I was measured by scientists who came one day to test our whole team. My lung volume (not counting residual that you cannot breathe out) came in close to 6 liters. They called me a sports car. I didn't know what that was and hoped they were not flunking me. Who knows how much was from my 35 to 40 mile a week swimming training, or inherited, or just lung size relative to height. Still, a "big engine" can be trained and added to the mix. Click the label "breathing" under this post for entries about training breathing and exercise capacity.
My students took a chance on believing me that breathing and yoga and health had something to do with real life, and took a big breath to the ball. Bigger, bigger, full. Then quick hands to cap it off. They laughed. Laughing is good for breathing too. Then we started class.
Take a nice full breath in right now. Let your lower abdomen come outward. Exhale normally.
Breathe when you cook, clean, and do daily life. Don't hold your breath or gasp.
Blow up balloons, pool floats, air cushions, enormous inflatable beach toys. Don't overbreathe and get dizzy.
Exercise until you have to breathe a lot. Don't let yourself get so out of shape that it ever becomes unhealthy to try fun exercise.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Photo - from the world's strongest lungs competition
Last week at the sports medicine conference, I talked to a researcher from Kuwait University. Dr. Jasem Ramadan presented a lovely little study called Bioenergetics of Islamic Prayers, measuring the amount of oxygen and calories the physical movements of the prayers burned.
Five standard prayers (Salat) are mandatory every day for every adult male and female Muslim. Each prayer has a continuous sequence of body movements (Rakkas) consisting of standing, bowing, kneeling and sitting. Each Rakka lasts between 3 and 6 minutes. Dr. Ramadan looked at the energy cost of two and four Rakka prayers in thirty-two male and female adults. He found that Salats have a positive effect on metabolic function. For an 80 kg person, energy cost of daily prayers was about 80 calories a day, and could be considered a form of physical activity that enhances fitness.
Dr. Ramadan told me, "The prayers have been done for thousands of years and no one thinks about it as physical exercise." I told him I think that often. I told him that Russian Orthodox prayer was pretty physical. A liturgy lasts hours, done standing and continuously crossing yourself from the floor in a squat to high overhead. Everyone including the oldest people do this, up and down, and up and down, and up and down, stretching and squatting, reaching and bending. I always thought it was group community health activity, probably found long ago to be protective against many ailments (and attributed divinely). The original yogas were the same, reaching upward to exalt the heavens, bowing, kneeling, prostrating, rising, over and over.
I told Dr. Ramadan that many Westerners aren't comfortably able to do the kneeling Rakka shown in Healthy Toe Stretches or rise to a stand without using their hands, as in the post Quick and Easy Strength and Balance Exercise, not only the elderly, but the rest of the population too.
He seemed surprised and interested. I told him I believed that this lack of basic human movement for real daily life was a major contributor to the epidemic numbers of people who are too weak and unstable to get up unassisted, to walk without canes and walkers, have trouble taking stairs, have poor balance, and for much knee and hip pain and degeneration. Dr. Ramadan said that elders in his country do not suffer knee and hip arthritis in high numbers, and can easily rise from the floor into their old age. I told him that many Westerners are familiar with a device that is worn, with a button to press for help if they cannot get up from the floor or chair. At this point, he was sure I was kidding.
If you cannot get up from the floor or low chair easily without using your hands, you likely have dangerously decreased leg strength and balance. Use good bending to strengthen your legs and knees many times a day and improve your fitness, explained in the post How Often Should You Be Healthy? Use healthy movement every day to sit, rise, bend right, clean, garden, give thanks, stretch, take stairs, and play to get healthy functional exercise, and prevent common joint pain. That is fitness as a lifestyle.
"The public has an insatiable curiosity to know everything, except which is worth knowing." - Oscar Wild
April 1 seems to be a day to notice, more than usual, if things in the news are not facts but April Fool. On other days, urban legends and other stories are still popular, sometimes more popular than what is really going on.
The observation that the Earth is flat seemed obviously true at one time until we had more information. It used to be a taught as a medical fact that the cause of epilepsy was masturbation. When I was in school, one of my medical books stated that you don't need to eat calcium since you can "get all you need from your bones." It is true that you pull calcium from your bones when you don't eat enough, although with unhealthy results.
The post Forensic Science told of two crime-science myths, often still taught in forensic books and popularized in television shows, which were never true. Following are more posts hoping to replace myth with information, so that you can get stronger and do more, without the injuries or restrictions in activity that are part of many fitness or injury rehab practices.
The previous post How To Treat Ankle Sprains and Prevent Them promised another effective technique on the missing link in preventing and rehabbing ankle sprains in today's post. It follows below. First, it made news yesterday that a well known name in spine research, Stuart McGill, found what I have been saying for nearly 30 years of my research career - that tightening the abs and "sucking them in" inhibits healthful movement, and using the popular "draw in the abs" technique is making yoga and Pilates classes the sources of more back pain and problems. The post What Abdominal Muscles Don't Do - The Missing Link shows why crunches and Pilates are not the best exercises for core muscles, and the comment replies to Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain give more links on how abs really work. The next post will cover the news from Dr. McGill and my years of research of what works the abdominal muscles in healthier ways instead.
So today you get two breakthrough fitness posts in one. Now the promised second fun thing to do for more stable ankles. Maybe you never sprained your ankle but wear supportive shoes thinking that will keep you from sprains. Maybe you've sprained your ankle in the past, and rested it and keep it braced during activity thinking that will help, and did ankle exercises, usually consisting of "spelling the alphabet" in the air with your foot or using resistance bands. The "exercises" often do not prevent repeat sprains, leading people to think that exercise will not help and only bracing will "support" an ankle. Rest and bracing often make things worse - the numbers show many repeat sprains in people following this method. Why?
The missing link is receptors in your ankle that sense if you are standing straight on your ankle or if your ankle is bending outward, a movement called inversion. In an inversion sprain, the bottom of your foot turns toward the other leg and your ankle bends too much, overstretching or tearing the connective ligaments. Inversion is the most common source of sprains. There are two common beliefs in medicine - that strengthening will help prevent sprains, and that strengthening will not help. Both points of view are missing that preventing sprains requires something else - training the receptors that tell you if you are about to invert. This sense is called proprioception. Without it, the ankle does not send signals to your leg muscles to prevent you from turning it. With proprioception training, you learn how to sense ankle position and balance to keep it from inverting. Allowing inversion when stepping up or down is surprisingly common, even in people who exercise frequently. No wonder they get sprains. The last post showed the interesting proprioception drill of rising to toes while not allowing your ankle to invert. Try that first, then try this next step:
Rise to tiptoe and lower to full foot, keeping your ankles straight without allowing your weight to shift over your small toes. Keep weight over your big and second toe. Repeat at least 10 times.
Work up to rising to toe and lowering on just one foot (good for balance).
Work up to careful jumps, first coming down on both feet, then on one foot. Each time, land with your weight centered over your big and second toe, not turning your ankle outward, then roll gently down until the whole foot is one the floor.
Use the above stabilization technique each time you step up or down from anything, including stairs and curbs.
With this practice, you can train your ankles to deliberately hold healthy position with each foot-fall, reducing your risk of sprains, instead of letting the ankle turn outward.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
A recent New York Times article quotes aerobics teachers and devotees saying they now have painful, chronic injuries from years of aerobics classes. Why did this happen?
I receive frequent e-mails from aerobics instructors, many only in their 20s and 30s, saying they are too old to continue teaching because of pain and injuries from teaching. I am older than their parents. At the schools and clubs where I teach classes, teachers and trainers are often absent, or replaced, because of herniated discs.
The Times article quotes major aerobics spokespeople, attributing the injuries to jumping on "concrete floors in bad tennis shoes," and related how former well-known-names in the aerobics industry now teach low impact classes. The article continued, "A lot of people doing aerobics back then can no longer do any jumping whatsoever. They have problems with their backs, feet and hips."
Conventional "impact activities" are not the problem.
In the years I spent in the lab studying injuries, seeing patients, and teaching students, I have found that the problem is not that impact must be avoided. I see patients who are instructors of Pilates, stretch, yoga, rowing, martial arts, and Alexander technique for degenerating joints. It is simple misuse.
It is not that people are doing the exercises "wrong" but the movements themselves.
If you saw someone bend over at the waist or hips to hoist a suitcase or child, you know it is bad bending and it hurts the back. The same people will bend over the same way to lift weights in a gym or do yoga stretches. It is the same disc-injuring bending in all cases.
The post CommonExercises Teach Bad Bending gives interesting examples from a class that is "low-impact." Wear occurs on the lower back and neck discs regardless of how expensive and engineered the aerobics shoes.
The post Are You Making Your Exercise Unhealthy? shows you how to put the knowledge of bad positioning together in your mind with how people are exercising, to realize it is not rocket science when people have pain, even though they "do their exercises."
You can run, jump, walk without jarring impact
Many people walk with higher impact than a good martial artist will kickbox.
Many people are unnecessarily restricted from favorite sports and told to walk instead, based on the fallacy that running or tennis is necessarily higher impact, instead of looking at how heavily they clomp around letting spine, hips, knees, and ankles sag and grind.
Many of my obese patients with knee pain stand and walk with their knees in sagging positions. This is not a consequence of their body weight.
When I show them to simply hold their knee from knocking inward (or outward) by using their own muscles to hold straight, the pain quickly goes away. They say that they can then, for the first time, *do* any real exercise to lose weight.
Lightweight people can have the same knee and other pain. They may move heavily without good shock absorption or hold joints in angled painful ways.
The post When Did Health Become Thinking Out of The Box? explains more of why you don't have to have pain from exercising or even long sitting while studying (or watching TV). I don't take people away from their favorite activities when injured. I even use their sport as rehab, showing them how to do it in healthier ways so that they can do more, lift more, and run more than before, not less. Health care should not be "Limit to the patient to limit the pain."
Read Inspiring Patient Stories on my web site - how patients fixed their own pain and could do more than before.
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There are many claims for massage, some real and some exaggerated or false. I searched for methods that provide real benefit. I studied sports massage in India and Nepal, and in certification programs of Shiatsu in Japan, TuiNa in China, and Nuad Borarn, (which is Thai for "ancient massage") in programs in the United States and Thailand. We are here in Thailand now, working on many projects.
Thai massage has been called "Yoga Done For You." You rest comfortably on the floor on a soft mat, clothed, except for bare feet. There is no rubbing as in Swedish massage, but pressing and wonderful stretches.
The person associated with founding or codifying Thai Massage was Shivaga (or Jivaka) Komalaboat. Some practitioners in the United States call him Dr. Zhivago, like the main character Yuri Andreyevich Zhivago in the Russian epic by Boris Pasternak. But that is just a funny mispronunciation.
The "Father Doctor" or "Hermit Doctor" Jivaka is reported to have been born in northern India, and became a doctor of traditional medicine. According to some sources, he was a contemporary, even advisor, of The Buddha and great kings. He moved to what is now Tibet. His teachings came to Thailand and Burma over a thousand years ago. Father Jivaka is so important to traditional medicine throughout all these areas that he is also called the "Thrice Crowned King of Tibetan medicine." Drawings and statues of him, many with small shrines, are common in massage and medicine schools and pharmacies.
Many Thai massage stretches and movements are used in traditional Western sports medicine to reset resting muscle length, and find and relieve unhealthy muscle and joint tensions. I learned these techniques in school in the United States when I studied orthopedics. When I first came to Thailand to train and compete in martial arts, I was surprised to find they were established techniques for massage, and helpful for boxers recovering from injuries and strenuous training and matches. The photo, to the left, shows a nice stretch for the front of the hip. Several past posts explained how important it is to stretch the anterior hip. Most people keep the hip bent forward in a shortened position all day for sitting, then only bend forward more to exercise with crunches, pilates moves, toe touches, and others. A tight, shortened anterior hip contributes to many pain syndromes, and results in not being able to use hip and leg muscles properly when walking and exercising.
Many Thai massage moves are helpful. There are a few Thai massage moves that can be unhealthy. When I give or teachThai massage, I omit the unhealthy moves. When I get Thai massage at home in Thailand, it is an art to politely manage to stop the tiny practitioners from holding you in an iron grip to calmly apply these moves. I will cover what is beneficial in Thai massage and what to avoid in posts to come. If you want to come study Thai massage with me in the States, see my web site.
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.
American baseball catchers have the occupational risk of meniscus tears in their knees. Yoga practitioners of certain squatting moves like "the eagle" and the hindu squat are more likely to get the same meniscus cartilage tears and early joint wear and tear. Asians who routinely squat for so many activities of daily life don't get these injuries. The difference is keeping your heels down and your feet facing in the same direction as your knees.
Sitting in a full squat with your heels down and your weight back does not pressure the knees the way squatting with heels up does. Keep both heels down and keep your weight back on your heels.
People who are not accustomed to squatting often find that they are too tight in the Achilles tendon to sit all the way down. Many of these same people do Achilles tendon stretches every day, or at least they do a motion commonly taught as an Achilles stretch, but which barely stretches the Achilles. The "lunge and lean," is the least effective Achilles stretch. The post Better Achilles Tendon Stretch tells why and gives a better stretch to do instead. The squat is another good Achilles tendon stretch. It is a lifestyle stretch for the Achilles and lower back, and a hip, leg, and shin muscle strengthener. You get healthful natural exercise from regular daily life. Even if you can't get down to full sit, bend properly with both heels down for daily bending and you will get a free Achilles tendon stretch every time you bend, which is many many times a day. Holiday Leg and Abdominal Exercise tells more on this.
The trains here in Thailand have the luxury of a bathroom, including a squatting bowl. You can tell new tourists here. They are afraid of the bathroom. When we lived in Japan, even the gleaming modern Bullet train, the Shinkansen, had a spotlessly clean squat fixture. Train bathroomsgive you balance practice too, swaying with the train as it takes you to the next adventure.
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Today 37 new students were waiting when I came in to teach yoga. I was their New Year's Resolution. Most were sitting bent over forward, rounding their back to stretch. When I walked through the gym to get to the teaching room, I walked past a gym full of New Year's Resolutions, all bent over forward straining to stretch, bent over their stair machine and bent over their treadmill. They were lying on the floor face-up rounding forward and they were standing bent over, face-down. Many were doing The Stretch You Need The Least. Everyone looked like the same unhealthful, bent-over posture that you already know causes back pain if you do it over your computer and steering wheel. I mentioned that bending over forward to stretch and exercise, although popular, and ingrained, and dogmatically and almost universally taught, is not what they needed.
What is needed is to get used to holding the body in healthful straighter ways during daily life and during exercise and stretching. In the post Better Achilles Tendon Stretch I showed how to get a better leg stretch without bending forward. Following is a nice upper spine stretch you can do while lying down to relax. Try this:
Lie on your back over a pillow or an article of clothing comfortably placed under your upper back between your shoulder blades. Start with your hands by your sides.
If this hurts, stop and see what to do in the following three paragraphs.
Don't put the pillow under your head or neck, just your upper back.
Let your upper back drop backward toward the floor.
Notice the feeling of the upper spine no longer rounding forward.
Relax and breathe. The stretch should feel good.
To increase the stretch, bring both arms by your ears. You should be able to raise your arms without arching your lower back or feeling pinching in the shoulder.
If you are not able to lie on your back without lower back pain, the usual reason is tightness in the front hip muscles. Do the Instantly Better Hip and Quadriceps Stretch on each leg to loosen the front of the hip.
If you are not able to lie on your back without upper back or neck pain, the usual reason is tightness in the front chest muscles and over rounding in the upper back. Do the pectoral (chest muscle) stretch described in Fixing Upper Back and Neck Pain.
If you have osteoporosis check with your doctor before doing the pillow stretch. One of the intended benefits of this stretch is to help prevent the rounding that contributes to the tendency to fracture already thin bones.
Many people spend so much of their life rounding forward, that their spine loses the mobility to bend backward, or even, in many cases to straighten enough to just lie flat and stand straight. The point of this stretch is to "unround" the upper spine and get it to relax and extend backward (arch safely) in the other direction. This stretch helps to "undo" the constant forward rounding that tightens the upper body and contributes to many pain syndromes. It is important to regain the normal flexibility to be able to straighten the upper spine enough to stand and sit and exercise in healthful straight position.
Readers have been asking what happened to the weekly reports of my martial arts classes. Others wanted to hear about my other classes including yoga. My martial arts students continued becoming skilled and disciplined. Next semester I will post some of the fun drills they do to build natural strength, discipline, and flexibility using themselves and each other instead of weights and equipment. In my yoga classes we learn that the poses themselves are not what gives good posture and focus. We learn what healthy positioning is, then apply it to how to move for daily life after walking out of the class.
In my sports medicine practice, I regularly see yoga teachers as patients for back, knee, and neck pain. That is because several yoga moves are not good for anyone - just as not all food is healthful. Many moves are fine, but other traditional poses injure joints, even when done "right" (or especially when done right), like bending over from a stand or a sitting position, whether the back is rounded or straight. We omit those moves and use others that are better stretches without the degenerating forces on the lower back and neck discs, for example, Healthier Hamstring Stretching. You don't have to injure yourself to get exercise. Fitness is supposed to be healthy.
This week in yoga we did a fun, effective hip stretch. We stood on one foot and reached for the other ankle crossed over the bent standing knee (drawing at left). When we do this, we practice the daily healthy position of keeping the upper body upright and straight, with the chin in, not craned forward. One new student was not happy with my class. She was used to sitting on the floor in classes she ordinarily took. She was peeved that we did so much standing. Although people call yoga "mind and body," she didn't like that we used the body. Although people frequently say that yoga is about understanding and light, she whined and complained and cursed me under her breath for most of the class. She wanted to know why I was making everyone do an extreme and bizarre movement.
I told the class it was healthy and happy to do this move every day. I pointed to my crossed foot and spoke the name of this ancient move - "Putting on shoe."
I hope you will try this too, to get a normal and healthy hip stretch and better balance everyday. Remember that most of the world stands to dress - the ones lucky enough to have shoes. Stand up now and try it. You will get free balance, healthy hip stretch, and leg strengthening every day from daily life. When you get good at this fun move, keep your ankle crossed and bend the standing leg enough for you to reach to the floor to retrieve your other shoe or sock. Keep your chest up and your back straight to prevent practicing unhealthful rounded position. Even though this one bends over, it does not transfer the pivot force to the lower discs for several reasons.
Have fun adding new healthy movement to your New Year. Write your stories and take photos of how you make your life better by fixing your fitness to be functional and healthy. Send link to your photo sharing site of your examples, and I can put you up in lights as a role model for healthier life.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
A physician contacted me, saying he had three successful disc surgeries and had slipped another disc. He wanted a consult with me before his fourth surgery. I told him it was like having three successful tonsillectomies. That is not a successful surgery. He had never stopped the reason he was pushing his discs out of place, one after the next.
Surgery for back pain and sciatica is considered by some as a solution, but an alarming number of people have pain that continues after surgery, or their pain stops initially while on pain medications and rehab following surgery, but then returns. The reason is that, except for unusual situations like bullet wounds or tumors, surgery does not stop the root cause of back pain. Because the cause continues, you continue doing harm to your back until it hurts again.
Degenerating or slipping discs are not from aging, or fate, or heredity, or a disease. The term "degenerative disc disease" is a misnomer. It is not a disease process, or a germ, or inherent factor or weakness that makes discs unhealthy. There are external factors, like smoking cigarettes, which contributes to disc degeneration. However, the majority of damage to discs and the soft tissue of the back and neck is usually chronic forward bending that physically pushes the disc outward until it presses on nearby soft tissue and nerves.
Disc damage occurs daily from avoidable bad bending in daily life, unhealthy sitting position, and many common exercises and stretches. Just as not all food is healthy, not all exercises and stretches are healthy, even some of the most common ones in gyms and yoga and fitness studios. The daily harm to your back is usually painless and something you are not aware of doing, until it accumulates, like smoking for years, until one day you get symptoms. The pain may come on suddenly, but was developing over years.
The physician who had the three surgeries, and three discs already removed, had gone back to all his bad bending, lifting, and sitting, and pushed out another disc. If he had stopped the injurious mechanics, he could have let the disc heal. Pain can often stop within days using this method. He probably never needed the first three surgeries. Having a fourth disc surgery will not stop him from going back to the injurious habits that caused the discs to break down and push out of place.
Removing discs, even part of them, means that the cushion and shock absorption between your vertebrae is reduced. This predisposes to early arthritis. A worse situation follows fusion surgery. It is a belief that stopping motion in a joint via fusion surgery will stop pain. But it also stops function. If you want an active life, it is setting you up for more problems. Even if you do not value being active, because fused back bones cannot move when you bend and sit and move, the vertebrae above and below the fused site must move more than usual, squeezing the discs and bones more than they are designed for. Fusion surgery is often a predisposing factor to forcing people into future back surgeries.
I sent the physician my free articles showing, step-by-step, how to stop disc pain. I sent him several of my books for his own use and for his waiting room. I called to follow-up on several occasions, urging him to simply stop the cause of disc injury so that he would not need the surgery. He told me he was not interested and had decided to go for his fourth back surgery. I hope his luck in avoiding surgical complications holds out as well as his good insurance.
The post Common Exercises Teach Bad Bending will get you started understanding common exercises that harm. There are far better exercises to do instead that give you fun, healthy movement without harm to discs. I am not in favor of doing less to avoid pain. I want my patients to have their life back and more. You can do this in fun ways and without surgery.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
I heard a radio program about yoga for senior citizens. The yoga program directors made the usual statements about yoga helping strength and balance. Then they said something that seemed at odds with their goal. They said, "If your balance is poor, do the moves sitting down or hold on to the wall." The very thing that you need to improve your balance is to practice standing and (safely) not holding the wall. If you sit and hold on, you prevent practicing balance.
Balance that helps your normal daily life is easy to improve at any age. All you need is to stand up and balance. Balance is quickly lost with sitting and disuse.
How does balance practice help you? You have receptors in all your joints that sense positioning. They can tell if you are about to fall. They tell your body to send signals to your muscles to steady you. If you don't use your balance sensors with balance practice, they become slow and unable to sense positioning well. You may tip over far enough to fall before your receptors sense it and can tell your muscles to pull you to upright position. Balance practice also improves your muscles. Without balance practice, your muscles become too slow and weak to prevent you from tipping over and falling. If you have let yourself become tight, brittle, and weak from lack of general exercise, you may strain, tear, or break something from a fall that would not have otherwise caused any harm.
Years ago when I left working in the hospital to go into private practice in sports medicine, I found that by making house calls you learn the reasons for people's pain and injuries that you will never see in a hospital or clinic exam setting. It was the first time I ever saw anyone have to sit to put on or take off their shoes. Here are a few quick, functional (real life) ways to improve balance:
Stand up when you put on your socks or hosiery.
Stand up to put on your pants. Lift one leg in front of you, keep your upper body comfortably straight and upright, and slide on each pant leg.
Stand up to put on your shoes. Try two ways: holding the foot in the air front of you to place the shoe, and by crossing the ankle on the opposite knee.
For more balance, after putting on one sock or shoe, remain standing on one foot and do a small squat on one leg to reach the other sock or shoe on the floor.
If you can't stand to dress yourself, and you have at least one working leg, you may be too tight and weak and unsteady for healthy normal life. To get started:
Practice standing on one foot without holding on to anything. If balance is poor stand near a wall for safety to get started and have a skilled friend help. Practice standing for 10 counts without holding on. Increase how long you can balance.
Stand on one foot and swing the other forward and back, side to side, without holding on or touching down. Safely.
If you use a cane, practice walking holding it off the ground. Use your brain to do this intelligently and safely to improve balance and reduce dependence on the cane.
Balance is "use or lose" and can be quickly improved with safe smart practice. You don't need to go to a gym or "do exercises." Use balance skills as part of your daily life.
Reader Dr. Zoe Eppley e-mailed, "I have been trying to apply your "bending right" approach to my daily activities. I find my tight leg and hip muscles seriously limit my ability to squat. Could you please recommend some stretches that will help?"
I receive this inquiry often. People are realizing that they are too tight to move in healthy ways for normal everyday life. I hear it from instructors of aerobics, yoga, Plates, personal trainers, and many others. This is an important epiphany. If you are too tight to move in healthy ways, then it is likely that you spend every day of your life moving in tight ways that create pain and perpetuate tightness.
The good news is you do not need to "do" stretches and exercises. Keep bending right and you will get exactly the stretch and strengthening you need. My most important message that I stress in all my work about exercise is not to "do exercises" but get crucial, functional, effective exercise by moving in healthy ways during normal everyday life.
People spend fortunes on treatments for pain, gadgets, potions, pills, prescriptions, adjustments, and ongoing medical scans and tests. Tightness and body pain is often made to be a mystery because it persists even after surgery and exercise programs. The reason is that they don't stop the cause. My successful techniques for fixing pain, even the most resistant back, neck, knee, and other musculoskeletal pain, emphasizes that you don't "do exercises" but simply stop the source of the injury by stopping unhealthy injurious movement patterns, and using healthy ones. Many people do ten repetitions of an exercise and hold each stretch for 30 seconds, then go back to unhealthy moving, sitting, bending, walking, exercising, and everything else that caused their pain and tightness in the first place.
If you are too tight to use your legs to bend down and get back up without using your hands or getting help, you need the hard realization that you lack normal function. It may be common in Western society to not be able to lift your own body, but it is dangerously unhealthy weakness.
Dr. Zoe e-mailed me a second time and mentioned watching an Indi-pop movie. She noticed the healthy posture and flexibility of the actors and how easily they squatted. She wisely reflected that she had probably lost much flexibility by not using normal bending and from "spending my life in chairs."
Keep bending right with your heels down, knees back, and your body upright. You will stretch your Achilles tendon and hip, and strengthen your thighs and knees hundreds of times a day - every time you bend.
One fun way to greatly help your bending is not a specific stretch or exercise but another normal daily activity: apply the same healthy positioning to ascending any set of stairs. I will post more about stairs, as it is interesting and enlightening. Until then, any time you go up stairs, notice if you tilt forward and let your heels lift. Instead:
keep your heel down as you step up,
keep your knee back over your ankle as you step up, instead of sliding your knee forward,
keep your body upright.
Use healthy positioning for both bending and stairs and you will quickly gain functional and healthy strength and flexibility.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Read success stories of these methods and send your own. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Which Ancient Exercise Gives Focus and Concentration?
Thursday, September 28, 2006
Healthline
People often meditate by staring at a candle but tense their shoulders preparing dinner and driving, hold their breath to lift things, and are easily distressed when someone cuts in front of them.
My husband Paul and I studied martial arts in several training centers, and in temples and monasteries in Asia. The monks told us a secret. Sitting quietly, starting at something, or nothing, or counting, is the first five minutes of the first lesson. After this simple start, you are supposed to *use* the concentration and focus to do everything else. The fact that some people take years to master the first five minutes, or spend their life doing only this minor introductory part is another story.
Sometimes students come to my classes talking all about how yoga and martial arts gives you discipline, but can't seem to organize themselves to get their paperwork filled out or their things put away off the floor. They claim the Arts give you patience and awareness, then get angry when someone's cell phone goes off during class and when I show them how to bend and sit in a way that helps rather than harms their health. People use the catch phrase "mind-body" then sit in poor posture not using their body, and losing their mind.
Long ago, only the rich and subsidized could sit idly to meditate. The rest had chores to do and families to raise. There are stories of ancient monks who sat and meditated unmoving for years, then got up and ran marathons. Those turned out to be folk tales and fables. The monks actually soon found they had trouble concentrating, trouble sleeping, and that their joints hurt. They needed exercise. They developed systems of using their body while practicing concentrating because they had to defend the temple and their emperor. When bad guys attacked they couldn't say, "Oh I can't work under pressure." They had to unfalteringly see and do frightening things to win bloody defenses. They had to be able to lie down that night and sleep, not lie awake saying, "Oh I'll have such nightmares. How could he yell at me? I am so ruined by what I saw and what happened to me." They had to practice being mentally strong while they practiced fighting. Their meditation was done raking leaves from monastery paths, preparing dinner, chopping wood, and during all their strenuous training.
All exercise is supposed to train focus and concentration. All household chores too. Work too. Use meditative action for all you do. Can you stay healthy and keep your blood pressure from rising in real life when the phone is ringing and the babies (of all kinds) are screaming? Or when nothing is happening externally to make you focus and get things done. Instead of only practicing meditation sitting, get up and get healthy by turning away negative thoughts, staying on track, and breathing easily when doing housework, during interactions with others, and all exercise you do.
I teach martial arts, yoga, and other classes at gyms on evenings and Saturdays. This morning I watched the class before mine. The music was loud. I remembered the saying "If it's too loud, you're too old."
When you read the following, remember that you already know it injures to bend "wrong," as in the photo at left, with your upper body bent over instead of upright. You know not to pick up a suitcase or child like that. Previous posts explain how that gradually hurts your lower back and discs.
The class ran a circuit:
They bent wrong to pick up a barbell for ten deadlifts, staying bent over while lifting.
They put the barbell down wrong (bending over) and ran to do ten toe touches - more bad bending over.
They ran to do abdominal crunches, rounding their back forward over and over.
They got up and kicked a target baffle, rounding their back and pushing their chin forward like a pigeon with each kick so that each impact transmitted to their spine.
They ran across the room, each footfall landing heavily so that each impact transmitted to their knees, hip, and spine.
Then leg lifts, bending forward at the hip over and over.
Back to bent-over deadlifts, then alternate toe-touches - bending over and twisting side to side (more pressure on discs than just bending over), then sitting and bringing knees to chest, then deadlifts.
They bent over wrong to get dumbbells for bent over triceps curls (healthier when done standing upright.)
Then standing squats by bending the hip forward over and over. The instructor coached them to stick their behind far out in back. This pinches the lower back adding to a second kind of back pain. Posts coming soon will tell more.
They reclined with feet up, putting body weight on their rounded shoulders to bicycle their legs in the air, and so on, rounding, bending, and pressuring discs and lower back structures for the 45-minute class.
They bridged up on shoulder and feet, to "stretch the other way" even though it bent their neck forward.
They ended by hanging forward to stretch and bringing each arm across the front of their body to stretch the back of the shoulder. This is counter-productive. Most people are already round-shouldered from sitting and bending forward all day. The personal trainer outside the room was doing similar exercises.
One of the students said she comes to the class to strengthen because of back pain. The trainer said he also had back pain and that is why he exercises. Hopefully you can now see part of why.
I'm not just an Ivory-tower egghead who wants you to reduce activity, never lift heavy things, or never move quickly or through a full range of motion. Just the opposite. I'm a former full contact kickboxer (undefeated) in the US, the Netherlands, and Thailand. I want to show you how to have a healthier, more fun and active life, where you stop pain and injuries and do more. The exercises I learned in over 30 years of martial arts were all the usual but injurious ones. Many students dropped out with injuries. It was not the martial arts but some of the exercises. But which? I went back to the lab to study until I found why the injuries were occurring and what will train you better than what we were using. If it works better, I want to know and do it.
Watch other people exercising. It will remind you of many things to avoid. Start your way back to healthy movement by noticing what your exercises are really doing.
--- Read and contribute your own success stories of fixing pain with these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Limited Class spaces for personal feedback. Top students may apply to get certifiedDrBookspan.com/Academy.
Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch
Wednesday, September 13, 2006
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.
Healthy Martial Arts - for all athletes, not just martial artists. Healthier smarter training for everyone.
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Read success stories of Fitness Fixer methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right.Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
A recent injury survey by US military revealed that 62% of American injuries in Iraq are occurring in the gym. The same is happening at home. How can this be? Several things are happening. Just as not every medicine is healthy, not all exercises and stretches are healthy.
Just as smoking "works" for weight loss, but is not a smart or healthy way to do it, many exercises "work" for cosmetic results, but result in long-term injury, and promote bad movement habits. Other common exercises don't work your body the way you need to move in real life, resulting in strains and injuries when going about daily activities.
This Fitness Fixer blog will show you hundreds of simple ways to change your exercises, stretches, and daily movement, to make them fun, healthy, and the way you really need to move for healthier daily life. In my laboratory research in human physiology, and my sports medicine clinical practice, I see patients every day who are hurting and unhappy, despite all the exercise and fitness they do. Many of my patients are yoga teachers and Pilates teachers with back pain, hip pain, and neck pain. I see personal trainers with herniated discs and knee pain. I see body builders with back pain, despite all the abdominal exercises they do. I see patients, including fitness instructors, who aren't getting more flexible no matter how much stretching they do. I see people who are stressed, tired, achy, and not in shape, even though they spend hundreds of dollars a month on supplements and pills, gizmos, equipment, trainers, and classes. The answers are simple, and this regular column will cover many easy changes you can make so that your fitness becomes not only more effective, but fun and healthy.
Photo by Jolieof Paul who does real life not gym exercise
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