Disc Pain - Not a Mystery, Easy to Fix
Friday, September 15, 2006
Healthline
Discs are tough cushions between your spine bones (left-hand drawing). They are living parts of your body. When you bend forward, the front of your vertebrae (back bones) squeeze closer together. The space between the back of each vertebrae opens. After many years of bad habits of sitting rounded forward, bad bending over forward, and stretching by bending over forward, the discs are forced backward, like squeezing the front of a water balloon (right drawing above). They begin to break down (degenerate) and move outward to the back, also called slip or herniate. Herniation can continue over years until it suddenly causes back pain with one more bad bend, until the disc moves backward enough to touch the nerves going down your leg causing sciatica and other nerve pain, or even press on your spinal cord. This is avoidable and easily reversed.
Discs can quickly heal without surgery, if you change your bending and sitting habits in simple, healthy ways:
1. Sitting. When you sit, don’t round your back. You don’t need an expensive ergonomic chair. No chair makes you sit right. You just use your own muscles to sit right. Make sure you don’t tighten and strain to sit straight. Pull your chair in closer to the desk, and lean your upper back against the seat back. Don’t round forward or push your lower back against the seat. Many seat backs are rounded so that you have to sit poorly if you rest your back against them. Don't let this happen. I will write more about healthy sitting in future posts.
2. Bending. The average person bends hundreds of times every day for daily activities like laundry, kitchen, pets, gardening, children, household chores, and everything else. Check to see if you are bending badly each time, hurting your discs. Check at the gym if you add more forward bending for toe-touches, weight lifting, and exercise class. The post Are You Making Your Exercise Unhealthy? shows some easily missed sources. The post Common Exercises Teach Bad Bending shows more. Bad bending puts herniating forces on your discs hundreds of times every day. No wonder your back hurts.
Here is one way to get healthy built-in leg exercise and stop back pain by bending well for every time you bend to reach things very day:
- Stand with feet side by side, comfortably apart.
- Bend both knees. Keep both heels down touching the floor.
- Keep your upper body upright, as if you don’t want something to fall out of your shirt pocket.
- As you bend lower and lower, peek down and make sure you can see your toes. If you can't, that means you are letting your knees come forward, which shifts your weight to your knees.
- Keep your knees back over your ankles to keep your weight on your leg muscles. Many people won't bend with their knees because it hurts their knees. This good bending stops knee pain too.
With healthy bending habits, you get free exercise hundreds of times a day, strengthen your legs, stop knee pain, and let your discs heal, all at the same time.
Many Fitness Fixer posts tell more about the large contribution of good daily bending, sitting, and moving habits to healthy lifestyle and stopping the source of disc injury. Click the links in this post for more examples and information. Click the labels under this post for all Fitness Fixer posts about that topic, for example, for good bending, click "squat" and "lunge," for healthy sitting, click the label "sitting." For all posts explaining discs or sciatica and how injury occurs and can heal, click those labels.
There is a large store of help and information right under this post in my replies to the many reader comments below this post. Before asking more questions, see if your answers are already here.
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Read 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 through DrBookspan.com/Academy. See Dr. Bookspan's Books.
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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 through DrBookspan.com/Academy. See Dr. Bookspan's Books.
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Drawings of discs and Backman!™ copyright © by Dr. Jolie Bookspan
Labels: disc, fix pain, injury, knee, lower back, lunge, sciatica, sitting, squat, strength, upper back
56 Comments:
At Saturday, September 23, 2006 2:37:00 PM, Anonymous said…
I've tried the knee-bending exercise and I don't know what I'm doing wrong. I feel I'm keeping my back straight but when I bend my knees they do move forward in front of my body and my toes do NOT show. Should I be facing my toes out to the side? Help!
At Monday, September 25, 2006 7:35:00 PM, Healthline said…
Good that you noticed your knees. That shows you actually tried it and are thinking it through.
The key is to keep your heels down and your weight back toward your heels. Don't just let your knees sink forward under your body weight. Physically pull your knees back over your heels. You will feel your leg muscles start to work. That's good. As you shift weight back, you may notice your back start to overarch again. Don't let it. There is no need to turn feet out. If you have to, that indicates a tight Achilles tendon. Good bending will be free Achilles stretching. It will feel good.
Your good question is so relevant to health for daily life for everyone, I will make it a post with more info and an illustration.
At Thursday, October 05, 2006 3:22:00 PM, Anonymous said…
Hi again! I tried your knee-bending suggestions (pulling my knees over my heels) and it works! It does feel a lot better, too, both on my knees and my heels. I do have an inflamed achilles tendon and this way of bending feels good on that heel.
Thanks!!!
At Friday, October 13, 2006 7:30:00 AM, Healthline said…
Kathy, you're right, it helps your Achilles too. Bending right gives a built-in stretch in the way you need to move for normal life (functional stretch). It should help.
Many people do the standard "lunge and lean" Achilles stretch for a few moments, an ineffective stretch that so many people seem to be taught. Then they go back to the other 23 hours a day of tightening the Achilles by never getting the normal stretch it needs from normal bending and walking. Next, check if you walk toe-out or straight. Walking toe-out (duck-foot), even slightly, reduces or eliminates the stretch on the bottom of your foot and back of the leg. Although we learned in school that toe-out is normal, it causes tightness and other problems. You're solving tightness with daily healthy movement. That's fitness as a lifestyle. Thanks for smart good work.
At Sunday, January 14, 2007 3:00:00 PM, Anonymous said…
bh
I can squat on the whole bottom of my foot. When I first learned to do that, I had to do it with my back supported by the bathtub wall, as I would lose my balance if I didn't.
Now I found your site, and am trying to squat with the weight more to the back, but i lose my balance! i cannot see my toes when I get halfway into the squat.
What to do?
Thank you.
At Wednesday, January 17, 2007 6:59:00 AM, Healthline said…
Hi bh, thank you for posting. Are you describing full squatting all the way to sit with your behind touching your heels? If you mean just bending knees to about 90 degrees (looks like sitting in a chair but without the chair) then follow the reply to kathyb about physically pulling your knees back. This will work better than leaning back. It's the knees that come back and you distribute your weight across your whole foot, instead of forward on the toes.
Sounds like you're on the right track in keeping your heels down and having practiced against the wall to stretch the Achilles tendons enough.
Don't worry about details - the point is to prevent herniating forces on the discs from bad bending and to prevent the knees from sliding forward to protect the knees too. You want to feel your weight on your muscles, not the knee joints. That makes it a leg stretch and strengthener, that is good rather than bad for the knees. You get free exercise just by bending for ordinary things around the house.
Let me know how this works. Send photos of your progress and I can post them.
At Thursday, May 31, 2007 6:56:00 PM, Anonymous said…
78 year male w/5 lumbar compression fracts & COPD seeks appropriate sustainable back exercises recovering from accidental back strain.
At Tuesday, June 05, 2007 11:36:00 AM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Reply to Anonymous with lumbar Fx-
ow, sorry to hear. Can you tell a bit of how you got the compression fractures?
Several posts cover low back strengthening in functional ways. That means you strengthen through healthy daily life instead of only stopping your life to do a few "exercises" then go back to injurious movement. Remember it is not exercises that restore an injury, it is stopping injurious motions during daily life and using healthy movement for everyday activities so it can heal. Exercises can't undo an injury if you go back to things that damage it.
(With your health care provider's guidance) start by clicking the label "lower back" in the label list under this post and looking at the posts that cover forward bending. That kind of bending is rough on your kind of injury. Use the good bending described for all bending, which strengthens in a healthier way. Check the same list of posts for those covering overarching the lower spine backward to see if you are doing that, which also compresses the spine. Straightening up also helps breathing. There is a post on breathing with some things to try.
Many posts have exercises to avoid, and why. There are also a few exercises to try (with your doc's permission). For now, avoid the full squat exercise and full squat Achilles stretch, and look at the other exercises. Click the label "sitting" to see how sitting can compress lumbar vertebrae, and how to sit in healthier ways. Click the label "disc" for another list of things to help. Check back as more posts are added to these topics. Let us know how it works.
At Saturday, June 23, 2007 3:52:00 PM, Anonymous said…
My wife has a compression fracture at the base of her back which makes it difficult for her to walk without pain. She has been told that their is a surgical medical procedure whereby "cement" is injected to fix or stabilize the problem area. Do you have any knowledge and or comment about this procedure?
At Tuesday, July 03, 2007 12:48:00 AM, Unknown said…
I am a 29 year old male and have been suffering from upper back pain for the past six months, centrally in between the shoulder blades. i wake in the night or after lying down for long periods(4 hours) the pain is almost unbearable and affects my breathing at its worse, heat applied to the area does seem to be benefitial however just sitting down or standing for an hour or so eleviates the pain.
I consulted my doctor who thought it was a muscle strain and gave me medication(SR Lodine). This did not work and was given other medication(dicloflex 50mg) and blood tests where taken. After a week this medication started relieving the pain, however my blood tests came back and showed i was animic. So came off the tablets and was refered to a back specialist, the diagnosis from him was that i had bad posture and was sent to physio. i had asked about the posibility of an mri but was told he didnt think it was neccasary as his diagnosis was correct, asked what if it wasnt correct he replied that i would then be refered back to him, which i found annoying. After seeing the physio and getting exercises to do, this improved the pain. however after a couple of weeks the pain started getting worse, to the point that it had returned to be as bad as it ever was.
on my next visit to the physio department i was seen by a different physio who diagnosed a problem with a upper thoratic disc, he tried manipulation and i was sent away with a different exercise to do. As yet there is no improvement. I have seen five people about this problem with no real continued success can you help? paul
At Friday, July 06, 2007 7:35:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Paul, what an awful, frustrating time you are going through. Hope we can sort it out simply.
1. If the pain is caused by "posture," it is easy to tell and fix:
- Try the wall stand test in the post Fixing Upper Back and Neck Pain and let me know the result. Is your head forward of the wall when you stand normally? Is it uncomfortable to stand with the back of your head touching the wall when you also touch your heels, backside, and upper back?
- When you stand normally, do your thumbs roll inward, explained in the post Thumbs Can Show Tightness That Leads to Upper Back Pain.
- What happens when you do the pectoral stretch in the first post Fixing Upper Back and Neck Pain? Can you then stand comfortably straight?
- What happens when you do the Nice Neck Stretch - it should feel better, and make the wall stand test work more easily, right away.
2. If the pain is from an upper back disc, that is also easy to tell (MRI or other test) and is often easy to resolve quickly:
- The post Disc Pain - Not a Mystery, Easy to Fix shows how discs are physically pushed backward by daily habits. It is easy to stop sitting and bending wrong- shown in the post The Cause of Disc and Back Pain. Then the disc can heal. Takes about a week. Don't worry.
- How does the Quick, Feel-Good Upper Back and Chest Stretch feel? It is good to help restore problems from both posture and disc.
3. SR Lodine and dicloflex are both anti-inflammatory drugs. We have to know the source of the problem to know if they will help. If it is postural, it is not inflammatory pain, so anti-inflammatories are not needed. Disc pain is quickly stopped by stopping the daily movements that are ruining the disc (described above) so also do not need long courses of these drugs.
4. Check to see if anyone suspects Scheuermann's disorder. It affects the upper back and can be managed with #1 and 2 above. It is not inflammatory. You do not need medication.
- Do you have a hard jutting lump on your back?
- Can you straighten out or is your upper back rigid?
- Can you lie back over a pillow (described above) and feel better?
Don't worry, Paul. Breath and feel hope. Keep me posted.
At Friday, July 06, 2007 8:15:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
To Anonymous, it has taken me a while to rewrite this in a short answer. Contact me directly if you want an ear-ful about these surgeries. In short, treatment (and preventing recurrence) depends why she has the compression. Is it from bad bending forward? Check the post The Cause of Disc and Back Pain and stop this cause of compression.
Is it from habitual overarching the lower spine, as in the left-hand photo in Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine and stop that source by repositioning as in the right-hand photo.
Is bone thinning from other medicines she is on? See the post Stomach Acid Drugs May Increase Osteoporosis and Fractures. Was it a sudden accident? Sorry you're going through this pain. Don't let anyone rush you into any procedure that you are not completely comfortable with. You don't have to trade more pain and limitation to fix the current one.
At Monday, July 09, 2007 12:54:00 PM, Jonathan said…
Jolie,
Is there any chance you could do a post specifically addressing Scheuermann's disease? For me, the location of the worst pain (in terms of height on the body) is the area from my belly button up through a little higher than the solar plexus. This seems to be an area that back pain books rarely cover -- it's just above low back pain, but not upper back pain. I am working long term on improving my posture and gait from your books but this area so far has been mostly unresponsive.
I do not have a very large kyphosis, Scheuermann's was diagnosed (along with a few 'small' thoracic herniations) mostly from multiple schmorl nodes on a scan. I have not had surgery but I have had worsening pain for over 5 years now (and intermittent back pain before that).
At Tuesday, July 10, 2007 2:31:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Jonathan, sorry to hear. Check the reply above to the reader named Paul. It is pretty much a post. Try each thing and let me know the answers. Then I can tell more about what to do next. Often the pain is set off or worsened by the same things as in people without Scheuermann's and can be relieved the same way.
At Monday, November 19, 2007 10:33:00 AM, Sloan said…
Sorry, newbie to blogging and such. Posted earlier but do not know if received.I was diagnosed with two bulging disc last year and have been dealing with so many issues especially on my right side. I have read your blog and have purchased your books and realized that I was doing all of the bad things to keep my back hurting. I was for sure a hyperextension person with rounded shoulders. I have been in pain for three years and have been to everyone. I had prolo/facet joint injection and felt immediate difference on my operated hip(hip scope)but my right side just is not responding especially after taking a day off from activities. I have been sleeping in all positions and before rising rolling over to my belly and doing the stretches and exercises. I have also been working on my gait and sitting positions. What am I missing? Sloan
At Tuesday, November 20, 2007 4:55:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Sloan, this is the first note from you that I have gotten.
Discs can heal. Usually takes a week or two. It does not have to be (and never should be) an ongoing lifelong "condition" any more than a broken arm. Pain can stop usually in days - if you stop injuring the discs with unhealthful movement. That does not mean giving up activity. With my method you can be far more active than before, if you want to be. You just move in healthful ways that put your body weight back on your muscles and off the discs in the way that pushes them outward (herniation).
You have done the first thing - understanding the bad movements that you have been doing for so long. That way you know it is not a disease or any mystery and that you can control if you hurt or not.
Bad bending when sitting, standing, and lifting is the major force to push discs. Standing in hyperextension usually affects the facet joints more. But if you also have discs protruding, the overly arched lower spine can press them, decrease disc space, and other things to aggravate the area. Injections are frequently given for facet pain, but they do not stop you from the overarching that continues the damage. Injections are almost always unnecessary. By changing how you stand to neutral spine, the pain should stop then and there from hyperextension - without injections - see Prevent Main Factor in Back Pain After Running and Walking. By changing bending, the herniating forces will stop and the disc can heal - Bending Right is Fitness as a Lifestyle. If you do them right you will notice pain reduce or stop right away. If not, check what you are doing. Use a mirror to tell better. Tell me what is the result of your wall stand? Can you do neutral spine too? How do you bend to get things from the floor? Can you adjust sitting to be healthy pain-free position? If not, change it. Send photos for me to see if you like (side view helpful for standing and bending). Come to a workshop. Let's get you fixed up quickly.
At Wednesday, November 21, 2007 11:38:00 AM, Sloan said…
Dear Dr, Jolie
Thanks sooo much for your quick reponse to my questions. I forgot to mentioned that I had a left hip scope for a torn labrum in 2005. Because of the traction from the surgery I had developed more problems in itself. I had developed knee, groin(adductors),ankle and glute pain. After not getting results from all my pts. I decided to become more informed. I truly believe that my right back and groin problems are also from compensation problems. After receiving the facet injections I used that window of oppertunity to strenghtend the left side. To my disbeleif I have been able to returned to the standard, traditional exercises such as knee extension and flexion, seated adduction and abduction and have been walking uphill and doing other various exercises that I could not do before. Granted I would be sore later I noticed a lot of improvements since. The standing lounge used to kill my knee to the back leg on the operated side, but that too is improving. Before reading your book, I was already doing the one legged reaches. I had to adjust my knee making sure it was over my heel. But apart from that I was doing it right. I even did a ten mile run yesterday making sure to land on heel and push off from toes. Yes I also have a left arch problem and have also concentrated on putting my weight on the outside of foot. My problem is the right side. As I speak I have the burning feeling on the inner hip. Could this be my SI joint. When I do the IT stretch it is so tight and sore. I sometimes roll and it feels better but it is right back the following day. I did the wall test and have to say everything matches up to your pictures. I do have a little arch in the low back. Lying down I do have a much bigger arch though and have concentrated on stretching anterior hip. You have given me hope and am so anxious to get this behind me.Your advice has helped me also with my clients since I am a personal trainer. One of the biggest info I have learn from you was the sticking out the butt one. I had competed in a few bodybuilding shows and had to stand in that position to be judge for long period of time. With your info I am now changing the way I train my clients and hopefully keep them from injuring themselves in the future. Respectfully Sloan
At Wednesday, December 05, 2007 12:36:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Ms. Sloan, great work. Facet injections! That is indication of the overarching problem. Injections are never needed. I am glad you are so smart and empowered that you noticed the overarching and are using the tuck-under to neutral spine. Then the facets will not be pressed and injured by the posture. You are right that you needed the anterior hip stretch to be able to lie face up without being pulled into hyperlordosis. Is that fixed now? "SI joint" problems are often misdiagnosed. Pain in that area is usually the overarching (hyperlordosis) problem again.
Can you help me know where is "the inner hip" you mention? What kind of rolling? What are one-legged reaches? Also which IT stretch? Different ones reach higher or lower on the long band. Keep fixing movement to healthful ones that you apply to daily movements, rather than only artificial isolated gym movements. Great work teaching your clients.
At Tuesday, January 08, 2008 10:53:00 PM, Sunnysideup said…
I have an active 18 year old, plays several contact sports, has complained of back pain for years. Just diagnosed w/possible Scheuermann's disease. In the literature I've found, he doesn't fit most info. He has excellent posture. The pain is in the lower back and the pediatrician said the lower spine had a rough appearance causing pain. Can anyone help. He's in college out of state and we hope to get into PT this week. He's concerned @ playing sports. Thanks -B
At Friday, January 18, 2008 9:43:00 AM, Sloan said…
Dear Dr Bookspan. First I want to apologized for not getting back to you. I kind of messed up sending my last comment. I thought it went through but it did not.
The stretching I do for the IT band is the one against the wall and the one lying on the floor crossing my leg over the other. I kind of do a moderation stretch to the one you have in your book. That stretch is sitting down and crossing leg with bent knee over the other and pulling on the leg that is on top. I do it lying down. It feels so much better on my back. The one legged reaches are just another name for the lounge. When I reach low I do that one making sure to keep the pencils in the pocket:)
Finally the rolling is a round styrofoam device that is about two to three feet long. I used it in my rehab for myofascia release. It is the next best thing to getting a massage.One of the biggest complication since my hip scope was tight hip flexors and internal rotators. Unfortunately a lot of issues were not addressed in my rehab. I do realized a lot of my backtracking had to do with the back. Since reading your book I am doing so much better. I do the exercises for my fallen arch and my knee and operated hip is so much better.
I am now seeing a physical therapist who told me that a lot of my issues on my right side are also from my SIjoint. They are not stable and with the weak back it does not help. So we are doing some back strenghteners.I feel so previleged to have read your book. You are an angel. I have had more result in two months than I have since this injury popped up in October 2005. I have also lost seven pounds and I see my six pack again.
My one question that I have is since I have an unalighned hip issue is it a good idea to do the static lounges still? Sloan
At Sunday, January 20, 2008 9:41:00 PM, Sloan said…
Dear Dr. Jolie. I made a mistake in my second message. I said I ran ten miles. I only ran two. Also I wanted to mension that before reading your book, I had an xray of my back that showed a small scroliosis. Since reading and having the prolo plus some specific back strenghtening exercises(extensions,abduction and adduction) It is gone. I am also doing bridges. lying on my back on the floor with my feet on a ball and lifting my butt to the ceiling. I was so weak.I feel so much stronger now. I have also cut out isolated ab work. I do realized that those were adding to my problem. My arches are also stronger and I do a few exercises for them also. It was such a pleasure to find a pt who agrees with your philosophy of how the body works. Thanks again. Sloan
At Sunday, January 20, 2008 11:29:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Becky, I just received your question, sorry for delay. Use all the info in all my replies to comments above about Scheuermann's. Often the diagnosis is not correct but the info is applicable either way. For lower back, follow all the posts about lower back. Probably the best starting place is to find a post with the label neutral spine and click that label. It will give info on fixing one of the most common and most missed causes of lower back pain. Sports can be helpful when done with good body mechanics. Keep me posted.
At Sunday, January 20, 2008 11:40:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Sloan, good work. Remember that "fallen arch" and "unaligned hip" are only the way you stand that moment, not a structural problem in your skeleton. Just stop pressing the arch down and standing crooked and that is all. Yes, the lunges are fine - they are not an exercise that fixes your posture, you yourself hold the right posture to do them - in that way you use them to retrain positioning. It is simple and something you control.
Next, the "SI" diagnosis is usually not the SI joint at all. Many people who are told they have "SI" usually are just standing in hyperlordosis. You just stop standing slouched like that and the issue is finished. Click the neutral spine label under posts and see how to stop pressuring the SI joint with hyperlordosis. The Fast Fitness post Friday Jan 18th 2008 has a visual and the labels to click. Stay great and be happy. Get some photos of what you are doing to send for your Reader Inspiring Success Story.
At Tuesday, January 22, 2008 10:07:00 PM, Anonymous said…
When I comes to postural issues as "paul" may in fact have, please consider Neuromuscular Therapy (NMT) by a qualified therapist. In similiar theory, Structural Integration, aka "Rolfing", is also excellent for realigning the body, correcting posture, and best used with Jolie Bookspan's wonderful exercises.
I have had many clients leave my office pain-free and with this website as their homework!
Michael LMT CNMT
At Thursday, January 24, 2008 12:57:00 PM, Sloan said…
Dear Dr Bookspan.
Hi again. I was just wondering if you had any info about lower back pain and the menstrual cycle. I know we are getting off the subject a little and that there are men on here that might not want to hear this. I am having a lot of right trunk pain and right side abdominal pain today. I have kept a diary and noticed that it starts occuring a week before the day of my cycle till the first day.I have also noticed it kind of fluctuate every other month. I have also been diagnosed with a tilted Uterus which gave me a hard time with both my children deliveries even though they are ten years apart. I have never been able to get a topical sonogram because of it. I do have a small cyst on my ovaries and a cyst on my Uterus. I guess I am trying to seperate my back pain from my other pain.
Now granted doctor I have been doing some strenghtening exercises for my hips and back(was diagnose with a strain hip and periformis syndrome before they found the l4 and l5 herniation a year ago).They do entail core work(engaging the abs)In the past I could not even lift my leg straight off the floor while laying on the back even engaging the abs. My right side is so weak. Like I said I have been doing side lying leg lifts, side lying knee raises with both feet touching each other and bent,bridges with a ball between the knee and one legged bridges keeping the extended leg off the floor the whole time. I have been increasing my reps and weight in the last couple of weeks from zero weight to now three lbs and 10 reps to thirty reps. I have been implementing all these exercises on the floor. I do not think it has to do with the cardio in the gym(elliptical,treadmill speed walk with elevation no higher than 3 and stairclimber low speed without holding on to rails) because I have been doing them with no problems. And I have been keeping aware of my posture alignment(no arching) through out. I know that I should not be pain free through the recovery process but it is disheartening to still have pain.My very good friend who had the same problem as I and who is now 100% pain free a year or so later said that is to be expected. Your advice has gotten me to be doing all of these pain free. I have lost 7 pounds throughout this and just want to make sure I am doing everything in my power to get better. As long as I know that I am doing good then I can bare the pain:) I just do not want to backslide. I am almost confident that I am not hurting myself because some of these exercises are demonstrated in your book. in your book. I guess doc that I just want to hear that from you that I am doing it right. I hope that all my issues are not confusing to you even though it can for me sometimes. Sloan
At Thursday, January 31, 2008 8:58:00 AM, Sloan said…
Dear Doctor.
I just wanted to give you an update on my condition.
I seem to have backslide since my last post. I am ready to give up. I have gotten ahead with your advice and implemented them into my everyday routine. I noticed that I feel so tight on my right but when I stretch the muscles I do not have any tightness where they insert. I am not sure what it is. I am hoping because it is almost my cycle(tomorrow)is causing me such pain. I had a massage yesterday and he told me that I was one of the worse he had seen. I had a lot of issues in my neck, scapula, IT band, and the calves and of course my whole hip/trunk area. It was popping when he would go into the muscles. It was so painful.He said that he was using no force hardly. I new I had issues in the lower body but I did not expect it from my upper. I cannot believe that all of this is from my back. The massage therapist said that my calves was like that because of my back issues.I thought I had a handle on this but it has seemed to have returned to the original pains I started out with. I did have my last series of injections two Saturdays ago to my surprize. I thought that I was only going for a follow up but he ended up doing another series even though I told him that I was doing and feeling so much better.Also to my dismay I began losing a lot of my hair right around the New Years and having a lot of facial heat flashes. I called the doctor and asked him If prolo causes those symptoms and he told me that he was using a very small dose of steriods. I was flabbergast because I was under the impression that he was using dextrose(main ingredient to prolo)I reminded him that I had told him that I did not want sterioed injections.He said in return that he was using such a small dosage that a baby can handle it. After all I was under the impression that he was doing prolo. My Aunt was the one that called me to tell me that she was receiving prolo injections from him and that she was feeling almost one hundred percent. I beleive he was very devious and gave her and I the impression that it was the prolo he was doing. I know that it is my fault that this happen because I was not proactive enugh to ask all the questions. I feel like I have been victimized by this doctor and have decided to stop seeing him. I do not know what to believe anymore and have just plain give up. I just wanted to thank you and your staff for taking the time to give me all your meaninful advice. It has helped me to be aware of my posture and bad movements.I will take all of the infomation with me always.
Sincerely Sloan
At Sunday, February 03, 2008 10:19:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Dear Sloan, don't worry and don't give up. We can figure this all out. It has gotten overcomplicated with many wrong PT exercises and "treatments." This is common and easy to remedy.
I wanted to write you another comment sooner, since I saw problems coming with all the artificial exercises you are doing from the PT. I am away in Asia with an expensive, slow connection that only occasionally connects. Please stop prolotherapy (I think you are already convinced). It can frequently cause many problems for many reasons. It also does not address or stop the cause of pain, so is a poor use of time and money.
It is time to start real movement not artificial segmented exercise "for body parts" which does not teach movement in the way your body really moves.
Can you come to my one-day April workshops? They are just north of Philadelphia. We already have people signed up from England, India, and California. It's a nice weekend. My web site page for classes; www.DrBookspan.com/classes gives details of the fix pain class.
Either way, e-mail me personally, scientist@erols.com, and we will get this simplified and straightened out quickly. Don't worry. Don't give up.
At Monday, April 28, 2008 12:43:00 PM, Anonymous said…
I'm a 42 year old male who practices yoga regularly. I have great flexibility in most parts of my body, but suffer from extreme inflexibility of my hamstrings and calves. I also have pretty bad toe-out. When I have to bend forward to try to touch my toes in yoga class, I am forces to bend my back forward a lot to get very far down. I know this puts a lot of stress on my lower back, and yes I have lower back problems. I take it that the forward bend you are recommending here is actually a half squat. I unfortunately do not have the flexibility to do even a quarter squat correctly. Yes, I do spend a great deal of time consistently on improving my hamstring flexibility. I used to be even more inflexible. I wish there was a way to get the hamstring flexibility I want without it taking ten years. Some experts say that I probably can never get good flexibility there; that there is a limit to how much gain someone can make. I'm acually thinking of getting the operation where they cut the femure bones in half to turn the toes pointing strait ahead then they bolt the bones back together twisted in the correct position. The experts say that it is a twisted femur bone that causes the duck footedness. Probably got them twisted wrong when my bones were soft as a baby. I know a Thai person. She says that no one in Thailand has toe out because moms stretch their baby's feet in or out whichever way they need to be corrected daily.
Anyway, was just wondering if you knew how I could solve my lower back problem by correcting my toe out and inflexibility quickly without resorting to surgery. Rolfing perhaups?
Thanks, Brian
At Tuesday, April 29, 2008 1:16:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Brian, if I understand right, you feel your back pain is from walking toe out, and want to fix the toe out. At the same time, you know that you bend forward to touch toes in a way that harms your lower back.
How about not forcing to "get very far down" and not "bending your back forward." The point of the stretch is not to "get very far down." The point is to get a nice stretch in your hamstrings. Bending your back takes away the stretch on the hamstrings - that is probably a large contributor to why they have not gained flexibility - you are not getting the stretch there, because of getting the movement from the back instead.
It is not true that you cannot improve flexibility there, especially if you have good flexibility elsewhere. It sounds like you have just not yet stretched in a way that stretches the hamstrings - Click Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch.
Common location to "toe-out" are from the knee, the ankle, and from the hip. Tight Achilles and calf contribute more common reasons to turn the foot outward when walking. In all those cases, cutting the femur is useless. Lie on your back and let your feet rotate outward. Then point your toes straight to the sky. Feel your muscles rotate your leg.
Good bending using a "quarter squat" for all the hundreds of times a day you need to bend will give you hundreds of small, needed, built-in stretches daily for the back of the lower leg. It is more effective to improve flexibility through normal healthy function throughout every day. Keep your heels down and get a nice stretch in the back of your lower legs each time. Small bends a day will lead to the flexibility you need for more. You will also stop putting painful forces on your lower back. Look to your bad stretching and bad bending habits and bending over to touch toes in yoga class as sources of your back pain and stop them.
At Thursday, May 29, 2008 9:53:00 AM, Anonymous said…
I had a disectomy December 2007 for herniated disc L5/S1. Main symptom was numbness in left leg and some
back pain. 5 months since surgery and still having terrible numbness. A new MRI showed I have a bulging disc
with annular tear at L4/L5. This numbness is driving me crazy! And worrying me at the same time. I tried
the exercises (knee to chest,seated lumbar flexion,etc.) from my PT but most just aggravate the numbness in my
leg. Any suggestions?
At Wednesday, June 04, 2008 11:32:00 AM, Lynn said…
I had an MRI which showed an enlarged S1 nerve root. Also, adjacent to the nerve root, some scar tissue from surgery. I have a great deal of numbness in my leg and foot. My doc says its nerve damage and its just something I have to live with. He did give me neurontin. I thought neurontin was more for nerve pain? Will neurontin help with the numbness and is there anything else I can do to help this?
At Wednesday, June 04, 2008 12:20:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Lynn sorry you are hurting and that you had surgery giving more problems. Keep hope. In this post that you replied to, read the part right after it says:
"This is avoidable and easily reversed.Discs can quickly heal without surgery, if you change your bending and sitting habits in simple, healthy ways:…"
It will explain many things to stop the cause of the problems so things can heal and stop hurting. Try each thing, gently, intelligently, if your health care providers know it's right for you. Click the "bad bending" link above in the post that says, "Bad bending puts herniating forces on your discs" to get more examples and try the post Bending Right is Fitness as a Lifestyle. Feel better!
At Wednesday, July 16, 2008 4:53:00 AM, Anonymous said…
I tried the knee-bending exercise and it seems to help stretch out my lower back. It's been about 5 months since the lower back pain came into the picture. X-ray is normal. Anti-inflammatory didn't help. W/O exercises, the pain is worst in the morning when I wake up. Especially if I tilt my chin toward the chest. Will this eventually go away?
At Wednesday, July 16, 2008 1:07:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Joycel, Keep hope. Good work reading and trying things mentioned. Remember that "the knee bending" is not just an exercise. It is a lifestyle of healthy bending that prevents one main cause of disc injury in the first place. Yes, discs heal. It can heal in days if you let it. One way it to use the healthy bending instead of bad bending, not just as an exercise to do then forget and then bend badly, injuring the discs all over.
Anti-inflammatories don't usually help because this is not usually an inflammatory problem. In this post that you replied to, read the part right after it says:
"This is avoidable and easily reversed. Discs can quickly heal without surgery, if you change your bending and sitting habits in simple, healthy ways…"
First thing in the morning, see if Fast Fitness - First Morning Stretch makes things better. See Fix Disc Pain Without Surgery and Studies Say Back Surgery Not Needed. They explain many things to stop the cause of the problems so things can heal and stop hurting. Try each thing, gently, intelligently, if your health care providers know it's right for you. Also click the labels for disc and reader inspiring stories to see exactly how other readers fixed their injured discs. It can be quickly fine. Don't let anyone pressure you into treatments you don't want. Disc injury can quickly heal.
At Saturday, July 26, 2008 12:26:00 AM, Anonymous said…
Hi about an year ago I fell on my right hip bone and it continued hurting for about two and a half weeks, after that it felt normal.
I am 14 now and I play sports and lift weights, when I overwork my lower back, run alot, or tackle very often it starts to hurt on every contact my foot has with the ground, but this happens only when I work out or run too much/often (three weeks of hard work outs and running) and other than that it is as if my back never hurt, I am worried this will end my football seasons and anything that I love. Please help!
At Monday, August 18, 2008 11:28:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Sam, there is a common source of lower back pain that is only felt when standing/walking/running, covered in the post Spotting Back Pain During Running and Walking. Check with your health providers for other sources.
At Monday, September 22, 2008 8:19:00 AM, Anonymous said…
I have a lot of SI pain and problems. I bought your book 'Stretching Smarter Stretching Healthier'. Are there any specific exercises in there to help SI pain or any exercises I should avoid?
At Monday, September 29, 2008 10:23:00 AM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Jenny, it depends what is causing your "SI" pain. Often what is called SI (sacro-iliac) pain comes from the pinching and compression of keeping too much inward curve in the lower spine, called hyperlordosis and swayback. Check if you overarch instead of neutral spine. An easy way to check is to look sideways at your body in a mirror. The post Innovation in Abdominal Muscles shows what it looks like and how to change it. Changing to neutral spine is a voluntary posture - Fixing Posture - No Exercise Needed.
Good that you have the stretch book. Check pages 65, 67, 75, 91, 92, 93, and others throughout, for how to avoid stretching and other habits that lead to overarching. The book teaches brain stretches to learn to move in healthy ways instead of doing a bunch of stretches then going back to unhealthful movement habits.
If the SI pain is from bad forward bending, instead of or in addition to overarching, the stretch book also covers that. See pages 28 and 58 for details and then use the principles throughout to change daily habits and how you exercise and stretch. See if you do any of the hurtful stretches explained, and stop those. It doesn't help to do stretches to fix a pain, then go back to the reason it hurt in the first place. Take a look at all the comments and replies to this post above for more specifics.
At Monday, December 15, 2008 12:48:00 PM, Unknown said…
Hi,
I played a game of tennis a couple of weeks back. I had difficulty sitting into and getting out of the car for about 3 days but no other symptons.
On the fourth day I began to get a twitch in my lower right calf and felt a bit of pain in my lower back. Since then, this has progressed to full twitching of all calf muscles on both legs and unbearably so at night, when I try to sleep. Last night was horrendous. I awoke at two with my right leg from the knee down in spasm. I have had a physical theraphist work on my back twice in the last fortnight. What do you think this is? Thanks for any help whatsoever.
At Tuesday, January 06, 2009 7:37:00 AM, Ms Frugal said…
Hi, my name is Tina and I have a herniated disc at my L4/L5. I have been managing it by doing strengtening exercises for the past 8 years that I had learned from my PT. I recently started following your instructions of how to fix the disc. However, there are several tasks that cause me to bend forward still and I haven't figured out the best way to do them. Not to sound silly but what is the best way to brush your teeth, wash your face, wipe your bottom, give your child a bath and pick up a lot of things on the floor such as a pile of marbles that are scattered. I find that all these tasks cause you to bend or be bent to do them. Thanks.
At Friday, February 06, 2009 10:06:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Tina (Ms. Frugal), a disc herniation is a simple injury that should not be allowed to persist 8 years. The idea is to stop the causes and let the disc heal, taking about a week. This post that you replied to explains the concepts and how to get started. Take a look at all the reader questions in the comments and all my answers.
For more ideas of healthy bending in real life, click Bending Right is Fitness as a Lifestyle. It is not silly to ask, but exactly the right mindset to ask. The idea is not to restrict your life or have strange rules, but have more exercise through daily good function.
For instructions and photos of the daily activities that you mention, click Household Fitness in the New Year.
Change to healthy movement so that your disc can quickly heal and you can have more pain-free fun life than before.
At Saturday, March 28, 2009 10:50:00 PM, Unknown said…
Hi,
I am 29 and recently had an MRI taken of my lower back and learned I have a torn L5-S1 (complete tear of the annulus) and 4 bulging, degenerative discs. I think I tore the disc seven years ago (this is when I had the most severe pain) but have probably been doing damage to it ever since (bad posture, continued playing basketball without strengthening the muscles, etc.). The pain in my back is only on the right side and does not go down my legs. I have very little arch in my lower back and have been working with my physical therapist to correct this by lifting up my hips and just getting my muscles to fire when I want them to. The most recent episodes of pain have occurred without me recognizing the motion or action that irritated my back...this is what has me extremely concerned that my condition is worsening (it used to just be when I played sports, etc.). I have a 2 year old daughter that I have not been able to pick up in months and I am starting to feel like my back pain is taking over my life. Any advice on excercise or posture to help me relieve my pain would be greatly appreciated. The best my back ever feels is after I swim.
Thanks!
At Saturday, May 30, 2009 11:50:00 PM, joe said…
exelent stuff do you do cources in australia or is there any one accetedin australia i could see ,or do you do on line cources ,or dvds thank you very much
At Thursday, June 11, 2009 1:01:00 PM, MICHAEL said…
what can i do for si joint pain? I am 57 and have been running since my late 20's until this injury forced me to the elliptical machine and stationery bike. I don't believe the problem is that the joint is hyper mobile. I belive muscle imbalance is causing this. My physical therapist is working with me to improve my hip range of motion which seems to be about a 3 on a scale of 1-10 with 10 being the best. I am also working on the hamstrings piriformis etc. I work the muscles on a foam roller (piriformis and hip)
At Friday, June 12, 2009 1:33:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
For Michael, "SI" pain is usually from standing with too much inward curve in the lower back - a bad posture that you simply stop and the pain stops with it. If you feel the ache after standing and running, or if bending forward seems to relieve or stretch out the pain, it is a simple postural change from large arch to normal arch that fixes it, on the spot.
Without seeing you, or more info, or x-ray vision, start with Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?.
For Arian, pe, and Michael (and everyone else), read the large amount of info in this post, and all the comments. The kinds of pain you describe should not take treatments and long periods of time to change - they should be corrected on the spot so that you do not continue the bad movement habits that cause them. Then you can go back to all your running and other athletics. Instead of doing little exercises and using pieces of foam, look for causes of these tightnesses in how you live and move - see " Exercise and Aging - Don't Limit the Patient to Limit the Pain.
For Joe (and everyone else) for class schedules, always go to my website CLASS page - DrBookspan.com/classes. People come from all over the world to learn.
At Monday, June 15, 2009 7:48:00 AM, MICHAEL said…
Thanks Dr. I performed the test where i stand with my back to the wall with head, heels and butt making contact with the wall. There is space between the back of my hand and my spine. I started walking and standing with my pelvis tucked under a bit as you mentioned. I am not tightening my abdomen in any way. This is just a subtle tuck under. I am trying to make this a regular habit with the hope that after a while i will not feel the ache at all. The ache seems to come and go now. Hopefully I can experience a single day where there is no ache at all and then i will try to get several days in a row with no symptoms. At this point I would attempt to run perhaps 5 minutes on the treadmill and see what happens.What else can I do besides the pelvic tilt change?
At Wednesday, June 24, 2009 9:16:00 AM, MICHAEL said…
the range of motion for my hips needs some work. i am doing 3 sets of 10 on each side maintaining neutral spine and keeping front knee over heel. I am also doing the hamstring stretch again maintaining neutral spine standing straight and keeping sole of foot flat on the wall. I also do 2 X 35 pushups with neutral spine. I also do the quad/hip stretch shown on pg 55 of the ab revolution (i set each side)I also peform the plank holding it for a minute although i can go longer. I also do the side plank for a minute on each side. Whenever I am standing or walking i strive to tuck the hips under. This is just a subtle tuck. I was doing the elliptical achine quite hard (30 minutes of interval work with 2 minute push and 30 second recovery throughout) I switched to the stationery bike because i thought this might be aggravating the si joint. I also do interval work on the bike setting the resistance relatively high. All i can say is the symptoms have noticeably improved although i am still experiencing some slight ache periodically throughout the day. I want to return to running if i can but not sure when i should try it.
At Wednesday, June 24, 2009 1:59:00 PM, MICHAEL said…
see
article from ny times
June 17, 2009, 11:00 am
Is Your Ab Workout Hurting Your Back?
By Gretchen Reynolds
supports Dr Bookspan
At Tuesday, November 03, 2009 10:07:00 PM, Unknown said…
Have pain in butt when sitting, and sometimes when standing. MRI & xrays don't show what is the cause. PT exercises for initial lower left back pain transformed the problem to what it is now and for last seven months. Two sessions of spinal decompression made it the worst so far. I don't know what to do - help!
At Wednesday, November 04, 2009 12:05:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
To psatre99, Sorry you are hurting. When you read the article above, and the 48 questions and answers already here above yours, do you see causes and solutions that apply to you? Let me know which you are trying and the results. Make sure to understand fully before trying anything so that you only apply safe movements that directly help your needs.
At Wednesday, November 04, 2009 1:56:00 PM, MICHAEL said…
Hello Dr. Bookspan it's Michael Devaney. I have several recent posts about si joint issues. I'm 57 year old Male and still having issues. I'm thinking of trying some physical therapy that deals with "active release" techniques. Any comments on this?
At Wednesday, November 04, 2009 10:05:00 PM, Unknown said…
Hello Dr. Bookspan, it is psatre99 (satre). I have scanned through all the posts and read many of the links. So far, I have tried sitting properly but my butt pain continues. It hurts less if I lean forward at my desk. I actually stand at my computer half the time, with raised monitors, keyboard & mouse. Is it better to stand than sit at computer? I have avoided bending forward for the last year for fear of making disc problem worse. I have yet to find another person experiencing butt pain from sitting. I have bought your book, Fix Your Own Pain without Drugs or Surgery, and hope it will have the answer unlike the doctors, surgeon, or chiropractors I have seen.
At Friday, November 06, 2009 11:57:00 AM, Jolie Bookspan, M.Ed, PhD, FAWM said…
To Michael Devaney, If the cause of the problem is addressed by those techniques, then chances improve. Time to be assessed for why - this is already written in earlier reply to Jenny and others. Otherwise, you can do those techniques, then return to causes. Get their assessment and direct questions to them. My next class may be in February or March. Occasional private appointments available. Then I can know what you are doing, and missing. People come from all over the world. My web site explains these options - links in original article, above.
---
To psatre99, Pain where you describe is common with sitting. Many reasons, some obvious like a hard chair, uncomfortable or lumpy chair, sitting crooked, for too long, or on a wallet. People sit poorly without knowing it, thinking they are right. Changing how you sit, (leaning as you mentioned) lessens it, so positioning seems involved. Avoiding all forward bending is not healthy. The idea is not to avoid all bending, but avoid spending the majority of time bent badly crushing and impinging structures, as many people seem to do. Your chair may accommodate you rounding too much. Your pulling forward may be fixing that. Without any specifics, photos, or being able to see you, there isn't enough to tell. The Fix Your Own Pain book has an entire illustrated chapter on sitting, plus answers to everyone's questions above, with more in Health&Fitness THIRD edition. Take some photos, look in a mirror, check for causes, see how healthy you are making the rest of your movements so that your back/hip/other aren't being damaged elsewhere,, and be able to change to healthy sitting. Good luck.
At Monday, November 09, 2009 9:14:00 PM, Satre said…
Dr. Bookspan,
What is your opinion of spinal decompression that seems to be the hot fad in treatment for lower back & butt pain? It sounds too good to be true.
Thanks,
Satre
At Friday, February 19, 2010 1:24:00 AM, Jordan said…
Hi Dr. Bookspan. I'm thrilled to find your site. I've been battling a lifting injury for about three years now (I was a hero in a battle against a tree trunk...the tree won). After lifting this big trunk abdominal pain presented several hours later. The docs thought it was a strain or maybe a small hernia but nothing showed up on cat scans and I won't let them look around with surgery. Over the next two years I felt good then would lift too much and the pain in the left lower ab would appear. Last April I was in a "healing" phase and able to lift about 30 pounds and pretty pain free. I lifted a 12 pound bike stand (outstretched in arm) and chatted with a friend about it's great uses, I walked into the living room and had shooting pain in my chest and lower ab. An MRI showed a 2.5 mm bulge between t8-t9. For the last 10 months I've been a core workout machine and the result is that I can lift about 15 pounds carefully (better than the 3 pounds I started with) and pain...well, I know it well. The docs say "It'll heal buddy, just give it time." Two years of kinda bad and 10 months of horrible seem enough.
I'm thrilled with your books (own them all and flipping pages like crazy) and I'm starting to use your methods. I also have a new baby coming in at 15 pounds (geez he's cute) I'm wondering:
1. Is there am amount of weight that should be avoided when healing a disk? Can I lift my kid?
2. Are there any tricks to healing a thoracic injury vs. lumbar or cervical?
3. When you injure a disk due to over lifting is it any different from the "overtime" injuries you talk about?
4. Anything other than a bulge I should look at. Ab (and lower back/hip at times) pain from something that high up I'm told is a bit odd.
Lastly, thank you for taking the time to talk details. My PT says "Stretch," your book says how.
Such Thanks for your wisdom and the new hope I have.
Jordan
PS: I'm a elementary teacher and this week we're learning "safe stretches." The kids think I'm a goof, but hey, it wakes them up!
At Tuesday, March 16, 2010 4:20:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…
Satre, Decompression can be done yourself without the cost and machinery, by following my work; Stop compressive slouching that causes disc protrusion so it can decompress during your daily life, and heal. In an office, you pay to be pulled for the moment. That's fine, just don't go back to the same movement habits that damaged you in the first place or you will wonder why you hurt again after paying money to be "fixed." Check first if you get medical decompression treatments, if nerves are entrapped. If they are pulled along with the bones, pain can increase.
For Jordan and all Readers, Jordan and I have been exchanging a flurry of productive e-mails. He has made great improvements and we are working on using his graphics talents to make helpful fun training materials.
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