Most people know that sitting badly at your desk, as in the left-hand photo, is unhealthy.
It is easy to see that he is rounding his back forward.
He is not sitting up.
His ear is far forward of his shoulder (even with his shoulders so rounded that the shoulders are forward too).
He is jutting his head and chin forward.
The weight of his head is straining on the muscles and joints of his upper back.
The post Breasts Causing Upper Back Pain is a Myth explained how the bad body ergonomics of rounding forward is a common cause of upper back and neck pain, often mistaken for "stress," even contributing to pain down the arm as you slump the weight of your upper body on nerves that go down the arm, compressing them. The post Disc Pain - Not a Mystery, Easy to Fix showed how the forward bend to the spine squeezes your discs of your neck and lower back, gradually degenerating them and forcing them outward, which is called herniation.
Now look at the right hand photo of the bicyclist. The rounded forward positioning is the same. It does not magically become healthy because you are calling it an exercise. It is just as unhealthy whether you are at your desk, on a stationary or real bicycle, on an exercise ball, motorcycle, or in the car.
What to do instead is simple. Sit up. Don't round your back. Are you rounding forward reading this right now? In a chair at your desk:
Pull your chair in closer to the desk.
Put your hips all the way back against the seat back.
Lean your upper back against the seat back, not your lower back.
Gently bring shoulders and chin back.
Have your chair far enough in to rest your arms on the desk. Don't crane your wrists to type. I will write more about wrist pain. It should not come from keeping arms comfortably on the desk, which keeps the weight of your arms from hanging forward on your neck.
Don't push your lower back against the seatback. Many seat backs are rounded outward so that you have to sit bent forward if you rest your back against them. If the seat back is concave, put a small cushion (or loosely rolled towel or shirt) about as small as your forearm in the space between the seat back and your lower back. Do not press against the roll - that makes the useless to stop back pain.
Don't tighten and strain to sit straight. It is common to be so tight from a lifestyle of forward rounding that sitting straight is not comfortable. Do the pectoral stretch in Fixing Upper Back and Neck Pain, then use the wall test in the same article to check if the stretch worked. On a bike, unless you are in a high level race, straighten up. It is simple. Healthy.
Why exercise in unhealthy ways? Watch people at the gym and in life. Notice how often fitness publications ask you to practice being bent over forward. Instead, get free built-in back muscle exercise and prevent strain and pain just by sitting with healthy positioning.
More on lumbar rolls and how to make sitting comfortable:
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Thumbs Can Show Tightness That Leads to Upper Back Pain
Friday, October 27, 2006
Healthline
Healthy body position should be a natural easy part of daily life, not something you stop work to do as an exercise.
Unhealthy body positioning is more ingrained in daily life than many people realize. How can you tell your own positioning? Watch other people. See how many spend all day rounding their shoulders forward over their work and steering wheel, then further round their shoulders to stretch by bending forward, and do the unnecesary stretch of bringing one arm across the front of their body, then exercise by bending forward for crunches and leg lifts. The result of all this chronic forward bending is overstretching the back muscles and tightening your anterior (front) muscles. Many patients who come to see me, even those who can touch their toes and put one foot behind their head are so tight that they can't comfortably stand or sit straight. This is not just a problem of looking bad. It affects the health of your joints and muscles.
The post Breasts Causing Upper Back Pain is a Myth explained how overstretched back muscles and tight anterior muscles can promote the "forward head" and bent forward position that causes so much muscle strain and damage to the discs and joints of the back, shoulder, and neck. Many people "do neck exercises" never understanding that the exercises do not solve the problem of the chest muscles being too tight, and do not address how to hold healthy position. They stretch, believing that stretching prevents sports injuries, or that it is for doing contortions, but never know that the point of healthy stretching is to restore normal resting length just to stand and move in everyday life. They stretch in ways that exacerbates the problem they started with - rounding forward.
Try this to see if you round your shoulders:
Use the photo, upper left, for reference.
While standing with arms loosely at your sides, glance down at your hands.
Do your thumbs face each other, as in the photo, instead of facing forward? That shows that tightness in front of your chest has rotated your arms inward (round shoulders).
Does it feel awkward and unnatural to pull shoulders back so that your thumbs face forward? The point is to make it comfortable to be right, not force good positioning, which makes more strain.
To fix the problem, try this:
Check your thumb positioning while standing comfortably.
Right after doing the pectoral stretch, drop your arms loosely by your sides and glance down at your thumbs again.
If you did the pectoral stretch right, your thumbs should now be facing more forward because you fixed the tightness that rounds shoulders and rotates arms inward.
During the day, notice your thumbs when standing to see if you are rounding. Notice other people's thumbs. Watch their upper body positioning when they sit and stand and let it remind you to use healthy straight habits so that you do not get tight in the first place.
--- 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. For feedback take a Class. Top students may apply to certify through DrBookspan.com/Academy.
My Tuesday night martial arts class students continued transformation to healthy behaviour. Instead of chatting noisily, they sat quietly straight and relaxed. They sat down on the floor without needing to use their hands. Their equipment was neatly arranged. Instead of sitting glumly or chatting idly on cell phones about the usual annoyances from the day, they mentally put them away and were breathing calmly, focusing on what we were going to do in class. Last week we worked on elbow strikes, blocking, and double kicks. This week was triple kicks, faster footwork, and spinning backfist. Each week at the start of class we have a sitting Zen called the zesa or zazen. We kneel and concentrate on a story or parable, a historical lesson, or an inspiration to live life.
This week's story told the story of the black belt. Who wears one? Why? What does it mean? First, who doesn't wear one? Boxers don't. Kickboxers don't. Wrestlers don't. Chinese Kung Fu practitioners wear a black sash from the first lesson, not only when they become accomplished. Some aerobics instructors purchase one to wear like a chef's hat as a costume to look cool for boxaerobics. Anyone can buy one. What does it mean to earn one?
Color belts were not part of ancient martial arts. Dr. Jigoro Kano, founder of modern Judo, applied a system of belt colors in the early 1900's at his school, the Kodokan, in Tokyo. Some say that part of the inspiration was the ranking by color of swimmers in the Japanese military. Dr. Kano wanted to encourage and recognize his different rank martial arts students. The belt color system spread to other martial disciplines. Who wears belts now? Mostly the Japanese arts of Judo, Aikido, and Karate, the several Okinawan Karates, and the Korean Karates like Tae Kwon Do, Hapkido, Tang So Do, and others.
The symbolism for transforming from novice to black belt comes from starting white - blank - with nothing. In old Asia, you would not wear white to a wedding, but to a funeral. White is the emptiness. Black is the fullness. We all start with nothing, represented in our belt. As you work and learn and train, your belt turns yellow with sweat, red with blood, brown with your toil in the earth, and eventually black with the richness and fullness of your learning. Then you know enough to begin. You continue your dedication as your belt begins to fray and grey with age and wisdom, eventually turning white again, full circle. Zen.
I told my students that a black belt is much like a college degree. In many cases, it does not mean anything. It can show you passed time, but does it mean you learned? In some schools, some upper students bully instead of help those learning. They smoke and eat unhealthy food after class. In some schools, students advance belts by ritual exercises not sparring. In other schools, students fight continuously to subdue others, never taming their own mind.
The Founder of Aikido, Morihei Ueshiba, envisioned a martial art that would reject destruction and show strength through compassion. His revelation reversed thousands of years of harsh tradition. He named his art "Aikido," or "the art of peace." Honorably doing right is what all martial arts strive for, and is the true black belt.
I took the photo when we lived and trained in Japan. If you look, you can find Paul. See more photos and stories of how to change exercise to health in Healthy Martial Arts
--- Read and contribute your own success stories of Dr. Bookspan's Fitness Fixer methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. 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.
A customer in a bookstore asked the cashier, “Where's the self-help section?” She replied, "If I told you it would defeat the purpose."
Helping each other to do good is healthy. Thanks to Bob Coffield who helped us by gathering posts for this week's Grand Rounds. Grand Rounds collects helpful posts from many health blogs, and included my post The Stretch You Need The Least. Bob mentioned how changing to the healthier stretch in the post would help him after working to do Grand Rounds at his desk. Grand Rounds looks like a lot of work. Thank you Mr. Coffield.
Most people know junk food when they see it at Halloween, coming next week. Would you recognize it in disguise now? In gyms and fitness centers, I see people buying expensive exercise foods and drinks advertised for "health" and "energy" that are not healthful. Here are four things to check, with more in coming posts:
Many "energy" and workout foods are high calorie. The sport science definition of calories is energy. That does not mean calories make you energetic. If you are calorie deficient you will feel weaker. More calories than you need will not make you stronger or able to exercise more. A 400 calorie workout then eating a 200 calorie sports bar and a 200 calorie energy drink plus regular meals will result in weight gain not loss.
Next, many bars and drinks are little more than unhealthful candy - refined sugar, fillers, dyes, hydrolyzed proteins, unhealthy fats, and some synthetic vitamins. Eating them does not make you healthy just because they have the words "natural," "healthy," "vitamins," or "exercise" on the label. You would get more vitamins and health from eating a pear and some walnuts. Some that are labelled "low-carb" are high in unhealthy transfat and hydrogenated fat. Many products labelled "low-fat" or "no-fat" have much junk refined sugar. Junk fats and sugars damage your health over the long term. There is nothing you need to eat that has high fructose corn syrup. Both junk food and "health food" low carbohydrate products can have sugar substitutes like sorbital that can make you bloated and gassy.
Third, many powders, drinks, and bars have unfermented soy, which does not have the benefits of fermented soy, and in large amounts can slow the thyroid and may have estrogen-promoting qualities. People with tendency to estrogen-dependent tumors like fibroids, cystic ovary, and endometriosis probably want to avoid these products.
Fourth, watch for stimulants in exercise foods, often caffeine, guarana, ephedra, ginseng, ma huang and others. You don't need them to exercise or lose weight. Many exercisers take them, plus energy pills, diet pills, and their usual coffee and espresso. A cycle starts of needing them to avoid feeling weary and headachy. Nervousness, anxiety, inability to concentrate by day and sleep at night, and irregular heart beats can occur. Then over-the-counter or prescription medicines to try to stop those effects? That's not health.
Make healthier, less expensive sports drinks by putting an apple, banana, grapes, or other fruit, with nuts, a green pepper, and clean water in a blender, grinder, food processor, mixer, or just mash them in a bowl. Add any combination of unsweetened cocoa powder, cinnamon, cloves, ginger root, sesame seeds, and healthy items for flavor. When baking Halloween treats, there is no need to add any sugar. Use mashed fruit. Instead of shortening, use a cooked sweet potato and ground flax seeds or walnuts. Instead of icing, mash apples (no cooking needed) for a topping as sweet as any sugar or syrup, and a better habit for the long run. Get more ideas on our food blogger's Candy Free Halloween Treats (and Tricks) and on The NYTimes opinion page today for commentary on making the change to healthier food thinking.
Exercise your brain and be able to spot foods marketed for health and exercise that are unhealthy foods in disguise.
See an entire chapter on making good tasting, easy health food for exercise and a chapter on performance enhancing supplements, drugs, and food in the book Healthy Martial Arts.
Probably the most common stretch I see in gyms and fitness classes, beside hurting your discs by bending "wrong" to stretch hamstrings, is bringing one arm across your body in front, pictured at left. Although this posterior shoulder stretch is one of the most common stretches, it is one of the least necessary.
You probably already have over-stretched the back of your shoulders by slouching all day over your desk, steering wheel, and other work. Sitting and standing with rounded shoulders wears on the neck and shoulder joints and is a common source of upper back and neck pain. One of the most unnecessary things you can do is to further stretch the back of your already overstretched shoulder. Going to a gym to do it does not magically make it healthy.
The best way to stretch your shoulders for health is to skip the posterior shoulder stretch. Instead, stretch the front chest (pectoral) muscles, shown in Fixing Upper Back and Neck Pain to help straighten and "unround" your shoulders and upper back.
Here is a check for how well you can straighten your shoulder positioning for healthy standing and sitting:
Can you put your hands on your hips and bring your shoulders back?
You should be able to pull your shoulders back without tilting your shoulders forward, or arching your lower back, or jutting your head forward.
When you can pull your shoulders back easily with your hands on your hips, try pulling your shoulders back with your hands clasped together behind your back. Keep chin in and shoulders back.
Occasionally I give my cerebral palsy patients the posterior shoulder stretch (above left illustration) if they have an overly pulled-back position. More helpful to these patients is The Ab Revolution, a method I developed where you move your lower spine, changing too much inward curve in the lower back to the less arched position of neutral spine, reducing much back pain. The muscles that bend the spine forward are the abdominal muscles. You get a free abdominal workout just keeping healthy straighter spine position while going about your day. The post Fixing the Commonest Source of Mystery Lower Back Pain shows how easy this is.
It is rare to need the posterior shoulder stretch. Yet, notice how often you see it in fitness publications and gyms. Instead of doing stretches to practice rounded posture, use stretches like the pectoral stretch to restore healthy position. Then use the healthy positioning as a free built-in stretch for all you do so you don't get tight in the first place. That's fitness as a lifestyle.
"When someone does something good, applaud. You will make two people happy." - Samuel Goldwyn
Thank you to Emergiblog for hosting this week's Grand Rounds and including my post Breasts Causing Upper Back Pain is a Myth. On the web, Grand Rounds is a weekly compilation of selected blog posts from medical bloggers from around the world.
Tuesday night is martial arts class. It had rained all day. A few students were absent. They missed class on how to toughen body and spirit because of water? Next time it pours I think I should hold class outside. In fairness, the students who missed class responsibly contacted me that they would be out.
The rest of my students were sitting in two neat rows. They had gotten their equipment out of bins in healthy ways by bending their knees with body upright and heels down. Then they sat down in their rows on the floor without using their hands. Most were sitting up straight. The rest straightened when they saw me walk in.
Each week students practice preventing the bad habit of jutting their head forward of the center line of their body during stances and moves for exercise and sparring (left photo, above left). Healthy position keeps the chin in and the angle of the lower jaw over the center line of the shoulder (right photo).
A forward head is not healthy for daily life or exercise. It results in much neck, upper back, and shoulder pain. Jutting the head forward for kicking, lifting a weight, and other movement is commonly seen in exercise magazines and videos. Watch for it and let it remind you not to do that. The forward head doesn't look tough, it looks untrained and weak and is several inches closer to the opponent making your face easier to hit. It frequently leads to upper body pain, and in case of a blow to the head, a tilted forward angle of the neck in relation to the brain and skull is more likely to result in brain injury.
A forward head is not something you can't control. Just as you can move your arm or leg, you can easily move your neck in a relaxed way into the healthier chin-in position you want. The post Breasts Causing Upper Back Pain is a Myth gave a simple "wall test" to see if you keep your head forward - stand with your back against a wall and see if the back of your head also touches comfortably. If you have to arch your back or jut your chin forward or up to touch the back of your head, you are probably too tight to stand straight and are probably standing and moving all the time in an unhealthy bent-forward position that strains the neck, back, and other areas.
The post Fixing Upper Back and Neck Pain taught the pectoral stretch to restore muscle length to make healthy straight position comfortable. Use the pectoral stretch first thing in the morning and many times throughout the day. Then use your new ability to stand straight. The pectoral stretch (or any stretch) is not what fixes the problem. The stretch makes it possible for you to stand in the way that no longer strains and injures.
In the martial arts and in life, inviting a bad outcome is known as "leading with your chin." Letting your head and chin jut forward, as in the forward head, is inviting a bad health outcome. The martial arts teaches you to stop problems, not cause them. You can easily stop long-term damage through simple repositioning. You will look and feel better. That's using your head.
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The post Breasts Causing Upper Back Pain is a Myth explained that a tilted-forward position of the head and neck, called a forward head, is not the normal tilt to the neck. It is an avoidable slouch that causes much upper back, neck, and shoulder pain, and pressures the discs of the upper spine.
Do you have a forward head? Here is a test, called The Wall Test: If you can't put your back against a wall and comfortably touch the back of your head to the wall too without overarching your back or raising your chin, that usually indicates that the muscles in front of your chest are so tight that they restrict normal standing. The resulting bent-forward position of your neck creates large forces on the muscles and joints of your upper spine as it strains to hold the weight of your head forward of the supporting spine instead of above it.
Being too tight to stand and sit upright instead of slouching forward is common, even among people who stretch regularly. The reason is that they usually practice stretching forward, rarely stretching the front muscles by stretching back. In turn, holding your body bent forward instead of upright perpetuates tightness.
To lengthen the front chest (pectoral) area needed to stop the slouching-tightness cycle, use the photo above left for reference and try this:
Use the photo above as a guide. Stand facing a wall. Bend one elbow out to the side and put the inside surface of that arm against the wall, as in the left-hand photo.
Turn your whole body and feet away from the wall, letting the wall brace your bent arm behind you, as in the right-hand photo.
If you are doing this stretch right, you will feel a nice stretch in the front of your chest.
Keep your shoulders down and relaxed. Breathe. Smile.
Hold a few seconds, breathe in, change arms, and breathe out while stretching the other side for a few seconds.
Now drop both arms and turn to stand with your back against the wall again. If you did this pectoral stretch right, standing straight with the back of your head touching the wall should now feel more natural and comfortable and no longer a strain.
When you walk away from the wall don't slouch forward again out of habit. Hold the easy new healthy positioning for everything you do.
Remember that the wall test (checking if you are straight against a wall) is a test - it is not an exercise that fixes anything, it tells if you are doing the pectoral stretch and two more stretches to correctly restore anterior muscle resting length. This pectoral stretch is one of three techniques to stop upper body tightness that prevents standing and moving in healthy ways.
Three stretches together help more. After doing this pectoral stretch and seeing the results with the Wall Test, add the next two stretches to restore resting length to be able to stand comfortably:
After each stretch, check yourself again with the wall test to see if you did them in the way intended - to work. Then, remember that head and body position is voluntary. Hold your head up and shoulders back softly all the time. The stretches just make it possible YOU are the one to hold it there and retrain your body. No adjustments or bracing does that.
Do the pectoral stretch first thing every morning and several times every day to learn healthy positioning. Then check yourself with the wall test to see if you did it in a way that worked. Use this pectoral stretch and the two other stretches (nice trapezius stretch and better triceps stretch) instead of the stretch where you stand in a doorway or corner to stretch both arms at once, and instead of pulling your straight arm(s) behind you - what I call, The Stretch You Need The Least.
The three stretches will stop pain for the short term. In fact, if you don't feel improved right away, you're doing them wrong. Then for the fix, use them to allow you to hold healthy upright positioning. By not letting your head hang forward all day, you will no longer need constant pills, adjustments, or treatments for pain. You will stop the cause.
If You Have Questions:
Photo and details and complete sequence of restoring healthy body position, in the book Fix Your Own Pain Without Drugs or Surgery - What to do to fix many sources of pain and injury, step-by-step.
Click the labels under this post for all Fitness Fixer posts about that topic, for example, for posts about neck pain, click "neck," for healthy sitting, click the label "sitting." For all posts explaining discs or fixing pain, click those labels.
Even more information is in the replies to the many reader comments below this post.Before asking more questions, see if your answers are already here
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A Little Good Exercise, a Lot of Bad Food - Overweight Still No Mystery
Saturday, October 14, 2006
Healthline
A recent study in Great Britain found that exercise alone won't prevent childhood obesity. They concluded that changing unhealthy eating is needed too. The study has an important message, and, as one of my patients who works an engineer building spacecraft engines would say, "This isn't rocket science."
The children in the exercise group in the study didn't get as much exercise as recommended. They still received several health benefits of exercise plus important motor skills. They didn't lose weight because they were eating more calories than they burned.
More calories makes more weight. An easy way to improve weight and health at the same time is to stop eating junk. It is called junk for a reason. Don't give children soda or diet soda any more than you would give them cigarettes. People say, "You have to let them have a little fun," or, "If I don't let them have a little, they will want it more." Would you say the same about heroin? Antifreeze tastes sweet too but we teach children not to drink it because it is harmful. Talk to them. Teach them there is a better way. Set an example of exercising strength by putting away the cookies and shakes. Don't eat the 1000-calorie bag of chips. Do fun exercise with them like catch, skip rope, tumbling, and fun games you make yourself.
Remember that children can't wait to run away from the table to play, but are made to have the bad habit of sitting still and eating everything on their plate. Don't make them hold still when they can run. These common practices teach them to be sedentary overeaters who have too much pent up energy to concentrate in school or sleep at night. Let them jump and play after dinner instead of sitting in front of a television. Tell them how happy you are to be together. Sing and smile together while they help you around the house. That is fitness and health as a lifestyle.
Many people say they don't have money to eat healthful food, then spend the same money and more on junk food, supplements, "calming" drugs, and "energy" drinks. Put the money in a jar and exercise instead, and you can lose weight and feel calm plus feed the poor. Sports drinks with refined sugar and stimulant compounds are not healthy for everyday life or for exercise. Eat a banana instead. It is not more time consuming or difficult to steam or sauté in balsamic vinegar and spices instead of fry. You don't need to buy a steamer; use any pot. You can throw vegetables in the pot in the same time it takes you to heat a can of processed soup with too much salt, fillers, unhealthy fats, sweeteners, and little fibre or vitamins left after processing. Future posts will show how to make your own exercise drinks and bars, and how to have healthy exercise with kids (and elder parents). Fitness as a lifestyle means exercising your brain and sensibilities to live and move in happy, simple, uplifting ways for real health.
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Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs
Wednesday, October 11, 2006
Healthline
Tuesday night my martial arts students showed they had improved. When I came in they were waiting in two neat rows. I still had to cue them to sit up straight.
In the post Is Bad Martial Arts Good Exercise? I mentioned showing the class not to let their neck, back, and hip round forward when kicking. By straightening, strength and stretch are built into regular movement.
Several readers e-mailed me that they noticed for the first time that they let one leg pull forward when lifting the other (notice the standing leg in the left-hand photo, at left). They said they felt a good difference when they straightened (right photo).
If the front muscles of your hip are tight, when you lift one leg high you may find that you round your back and bend the other leg. Watch for this during kicks in martial arts and aerobics, when lying on your back raising one leg overhead to stretch the hamstrings, and ascending stairs. The common practice of allowing the other leg to bend forward perpetuates a tight anterior hip, which in turn, contributes to walking bent forward and back pain.
In martial arts, you don't want your standing leg completely straight. That is an invitation for your opponent to kick your knee, snapping it backward. But for both health and effective martial movement, you don't want to bend the leg more than a small amount. Bending the back, hip, and leg when kicking decreases force of the kick, pressures your discs, and reduces stretch on the hip and hamstrings. The rounded-under hip position keeps the hip tight, a hidden cause of groin pulls. It also looks weak and unskilled. For lying hamstring stretches with one leg overhead, it is often taught to keep the second leg bent to "protect the back." However, keeping the leg (and body) flat on the floor give a far better stretch and is healthier for your back. Even in slow easy motions of stair climbing, leaning forward and allowing the second leg to pull forward reduces the normal hamstring and hip stretch, decreases the exercise on your hip and leg muscles, and reduces the back muscle activation for holding the straight position you need for health and back pain prevention.
It is said the martial arts gives you discipline and strength. It won't if you practice unhealthy habits. When raising one leg, hold your neck and back upright. Prevent the other leg from pulling forward. You will get a built-in hip stretch, one of the places you need to stretch most. You will get back and hip exercise in the way you need to move in real life, and prevent tightness and weakness that leads to poor movement and pain. You will change from kicking like a bent over old lady to a young strong athlete. Exercise as a lifestyle is not something done "for body parts." It is built into your normal movement to make it healthy movement.
All Fitness Fixer about each topic by clicking labels, below.
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A news report in the MMD Newswire echoed a prevalent but luckily, false belief, that breasts must cause back pain. The good news is that means you do not have to be forced into back pain, and there are things that you can try quickly to relieve it yourself. You have choices.
Many of my patients who come to me with upper back pain say that their doctor or other health care practitioner told them the reason is the breasts. I show them how they can stop or reduce the pain.
One of the biggest mistakes in science is confusing correlation for cause and effect. There are so many people with back pain that it is easy to blame anything happening at the same time, like having breasts or a big belly in front, or carrying backpacks in back, or groceries on the side.
Men have the same or higher incidence of the same upper back pain.
Women who are smaller, or have had breast reduction and double mastectomies can have the same pain.
If straps are binding or cutting into your neck, that can obviously be uncomfortable, so check and fix that.
However, the specific cause is not the breasts, since men and smaller women can get the same kind of pain.
If you round your shoulders, spend time with the upper body bent or rounded forward, or have a forward head, the shifted weight is a common contributor to upper back pain.
Look at the photo, above left. Letting your neck tilt so that your ear is forward of your shoulder, as in the photo, is called a forward head. It is not the normal tilt to the neck. It is a weak and injurious bad posture. The angle of the jaw should rest comfortably above the center-shoulder. The forward head is the source of a surprisingly large percentage of upper back and neck pain. The classic distribution of this pain is across both shoulders, up the neck, down the upper back, sometimes causing numbness or tingling down the arm. Do you have a forward head? Here is a quick test:
Stand comfortably with your back against a wall or doorway.
Touch your heels, your behind, and your upper back against the wall.
Does the back of your head touch easily?
If your head is forward of the wall, it is likely that you have a forward head.
See if you have to crane your neck to bring your head back to the wall.
See if you round your shoulders
Check if you lean back to try to straighten up. Straightening should come from the upper body, not by increasing the inward curve of the lower back (hyperlordosis), which can hurt - Fixing the Commonest Source of Mystery Lower Back Pain.
If you have to force or crane your neck back to touch the back of your head to the wall, or you lean backward to try to straighten, you are too tight to be straight. That means you may walk around all day, and exercise, and sit, and do all you do with bent forward positioning, which can cause pain.
Often, people who think they "stand up straight" find that they are straining their beck and shoulder back, which causes upper body pain. The problem is that they are too tight to stand with healthful position. Strained straightening and the many postures that are mistaken for straight but are not will hurt as much as slouching.
If you did the wall test, see if you are slouching forward from the forward head, or from the upper body, or both. See if you have to lean backward to straighten up. See if it is an effort to stand roughly straight, instead of normal comfortable muscle length. Those are more causes of pain, mistaken for the size of the chest. In posts to come I show two quick techniques to lengthen the front chest muscles to let you stand straight easily and comfortably. Then you will not have a forward head or rounded shoulders:
Here is the first thing to try to restore resting muscle length to make standing straight possible and comfortable: Fixing Upper Back and Neck Pain.
Try those two gently, with the aim of restoring ability to straighten out comfortably, then use the straighter position, so bent forward position does not hang on your upper back muscles, making them hurt. The stretch does not fix the pain - using them to be able to straighten out during the rest of the day is the key.
The idea is, that no matter your size, use your own muscles to prevent uncomfortable positioning. By restoring healthier upper body positioning and use, you will get built-in back muscle exercise all day. Standing straight instead of allowing your upper spine to compress under your weight will stop your pain plus give free calorie burning exercise.
If you find that lifting your chest with your hands takes the strain away, then you can do the same with your upper body muscles. It is free exercise to use your muscles to prevent your own body weight from squashing you. Pull your chin inward and shoulders back in a relaxed way by unrounding the upper back. Then weight of your head and upper body will not pull forward on your upper back muscles, making them ache.
The same applies to carrying a grocery bag, a child, or any load. Don't slouch under the load, use muscles to keep healthy comfortable position.
"I am very large breasted and have always been. It's a very difficult thing to find a comfortable bra. For the past few months, I've been having upper back pain. I felt like I needed to "crack." Every night I complain, and nothing works!
"Except this. haha, you have NO IDEA how pleased I am that this "fixing upper back and neck pain" stretch works.
"Now, I'm not going to pretend that I think I'm perfect now because I've been sitting straight for about 10 mins and it is starting to get a little tiring. "But, I don't feel ANY pain. "I'm amazed.
"Was that it?? Really my DDDs have nothing to do with it???"
No exercise is more important for your joint health than holding up your own body weight, no matter what or where it may be. Your size does not force you to slouch. It does not require long or repeated treatments or sessions or teams of professionals.
I run classes for motivated, bright participants who want to empower themselves - see my web page for CLASSES - www.DrBookspan.com/classes.
There is specific helpful information in my replies already here to the many reader comments below this post.Before asking more, see if your answers are already here in the comments below.
--- 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 personal medical questions - Replies to Medical Questions. LimitedClass spaces for personal evaluation. Top students may apply to certify through DrBookspan.com/Academy. Learn more with Dr. Bookspan's Books.
The Health Matters HealthBlog Network consists of a dozen independent and unfiltered medical professionals blogging about the topics that matter to you. Each week, Healthline's Editors select the three top posts from the network to share with all of our readers in one convenient post. We hope you'll enjoy them!
Infertility Stress Reduction Tips If you, or someone you know, has struggled with infertility you know what a stressful time that can be. Visit The ART of Conception where expert Carl “Rusty” Herbert MD offers some tips for getting through these rough patches … read more
What Should Cancer Patients and Family Do About the Flu Vaccine? Vaccinations can be a lifesaver. Most vaccines contain inactive viruses, but others contain a small amount of a live virus. Tune into Cyndy King’s Cancer Treatment and Survivorship blog to learn what people undergoing cancer treatment that can compromise their immunity should do…read more.
Metabolism as you get older is not the culprit with much weight gain. Think of all the people who are eating more than in past years, exercising less, doing less, sitting around more, and eating junk food and soda. They gain weight and say the reason is that their metabolism slowed because they got older.
That fact that you burn fewer calories when you decrease activity can be twisted by clever product advertising as "slower metabolism." Don't fall for it. Find fun, healthy things you like to do and start them again to get the increase in metabolic calorie burning that comes with activity.
Don't fall for pills and supplements advertised to increase metabolism and therefore promote weight loss. Some contain stimulating compounds that increase heart rate or other functions. That is not helpful or healthy for your body. Many people feel stimulated and happy on these products, and don't notice the nervousness, anxiety, inability to focus, moodiness, difficulty falling asleep at night, and depression that also often occurs. A more serious cycle starts when people take other drugs to try to stop these symptoms. Then more drugs when the first drugs upset their stomach. Exercise will improve mood and increase your metabolism for weight loss more safely without the negative effects of stimulants and medicines.
Several devices, pills, and patches claim to burn calories or fat while you sleep or watch television. They can claim that because you always burn calories and fat when you sleep or watch television. That is how you stay alive. It is not because of the pill or the machine.
Eating food raises metabolism. The increase comes because your body has to do something extra – digestion. You still gain calories from the food and can gain weight if you eat more calories than you burn. Watch out for advertising that exploits the fact of the "thermogenic" (heat producing or calorie burning) effect of food. The effect is small compared to the calories you have eaten.
Some devices and pills claim to increase metabolism even after exercise ends. They can claim that because all exercise does that - with or without the device or pill. Exercise raises metabolic levels. It takes time after stopping exercise to return to resting level.
Live a healthy active life. Get outside and play. Move, bend properly (Disc Pain - Not a Mystery, Easy to Fix), and stretch as part of your everyday life (What is "Fitness as a Lifestyle?"). Get up now and walk away from the computer to take a break, breathe, stretch arms overhead, move, look up at the sky, and smile. The average amount of money spent on diet products that don't work is saddening. Every time you want to spend on them, put the money in a jar and go do something active instead, even if it is just dusting or gardening. Lift weights, including your own body, to regain the muscle you need for metabolic rate (How Good Would You Look From 400 Squats a Day - Just Stop Unhealthy Bending). Muscle loss from sitting around is often confused with aging. You will burn some calories, keep your joints moving, feel better, and save enough to give to the poor with enough left for a vacation.
--- 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.
---
Thank you to Paul & Aline for this photo from Creative Commons
Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique
Tuesday, October 03, 2006
Healthline
My Tuesday night martial arts students had another good class tonight. At the beginning of class, I showed them how to greatly strengthen their punch using a technique that also stops a common cause of lower back pain.
The reason both benefits occur from one technique is that it changes body positioning to shift the effort and leverage of the punch off your lower spine and onto the muscles of your abdomen and back. You can use this technique any time you punch, or push anything from a baby carriage to a piece of furniture to a car.
One of the commonest misconceptions in fitness is that you are supposed to stick your behind out in back. It is not cute or healthy. It is a major source of pressure on the joints and soft tissue of your lower spine.
There is supposed to be a small inward curve to the lower back for shock absorption and protection of the discs. (But only a small curve.) When people lose the needed small inward curve by rounded forward sitting, standing, and bending over wrong, it pressures the discs and eventually damages them (Disc Pain - Not a Mystery, Easy to Fix). The problem is that people hear they need a small inward curve, so they make a big one by tilting their hip and/or leaning their upper body backward - left photo above. This overarches their lower back, causing a swayback (hyperlordosis). You can see this silly-looking and unhealthy over-arching in many fitness classes, gyms, and fitness publications and videos.
By straightening your hip to vertical and your lower spine to neutral (right photo), you will have the healthy small curve without sticking your behind out in back. When standing, your hip should be vertical, not tilted, from the top of your upper leg bone to the middle-point of the crest of your hip.
To reduce the large lower back arch, tilt your hip under you as if you are starting an abdominal crunch while standing up. Do not push your hip forward, just straighten your back by changing the hip angle. This is called a pelvic tilt. This is what we did in class. Try this:
Look at the double photo above left, and stand facing a wall as in the photo, with one arm outstretched. Put the knuckles of your curled fist against the wall as if you had just punched the wall. Elbow slightly bent.
Stand badly, as shown in the left-hand photo. Stick your behind out in back. Let your lower back arch inward. Let your upper back lean backward. Press your fist hard into the wall. You will probably feel pressure in your lower back.
Now, keep pressing your fist hard but stop the bad positioning by tucking your hip under you, shown in the right-hand photo. The movement is like a hip thrust or a standing crunch. The arch in your lower back reduces.
The first thing you will notice if you do this right is your back stops hurting. You should also notice a stronger push against the wall and new strength in your arm and upper body. You will feel the muscles in your trunk and abdomen working.
I developed this technique and called it The Ab Revolution, because it uses your ab muscles all the time for real life. Don't tilt your hip to stick your behind out to lift weights, to exercise, or to stand and walk. Use your muscles to reposition your spine to neutral, so that your upperbody weight does not sag onto your lower back. You will get free built-in exercise and back pain prevention while doing all your normal activities. You will stop one of the commonest silly-looking mistakes in fitness. You will also be able to throw a surprisingly strong punch.
Learn this technique and high training for body and spirit in the book Healthy Martial Arts
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Grand Rounds is a review of the best medical articles (what they call "the best of the medical blogosphere") in the past week. To read this weeks’ favorite posts click here: RDoctor Medical
Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
Monday, October 02, 2006
Healthline
If you think that not having time to exercise is the problem, here is good news. Thinking that your life and your health are two separate things is the problem. You don't have to stop your life to get exercise.
Look at the drawings, above left. The left-hand drawing shows bad bending - letting weight rock forward, heels lifting, and overly arching the lower back. The right-hand drawing shows healthy bending - keeping weight back, heels down, and the lower back in healthy position, not rounded and not overly arched. Look at the right-hand drawing and try it:
Keep your upper body as upright as you can, instead of rounding over forward
Keep both heels down as you bend your knees (right drawing).
If you find you lift your heels, use your leg muscles to deliberately pull your knees back so that your weight shifts back over your heels. Shifting your weight back keeps your weight on your leg muscles and off your knee joints. There should be no knee pain with good bending.
Keep your knees back toward your ankles. If you just let your weight flop, the knees will come forward past your toes. Don't allow your knees to shift forward.
Don't overarch the lower spine (overly sticking your behind out in back). Keep neutral spine. If you overarch, tuck your hip (tailbone) under you just enough to prevent having a too large arch (inward curve) in your lower back. Although it is often taught in exercise and weight lifting classes to stick far out and overarch, increasing the arch increases pressure on the joints of your vertebrae, called facet joints, and the soft tissue of your lower back. Overarching is a major hidden cause of lower back pain and injury.
Use good bending every time you bend - even to look in the refrigerator and get in and out of your chair. Don't use your arms to lean on the arm rests to sit down and get up; use leg muscles. If you need to use your arms, or you lean your body forward to sit or rise, you need to improve balance, Achilles tendon stretch, and leg strength. Bending properly does all that for you. (Practice safely. Don't fall down.)
Have a friend (or a camera set on timer) take photos of you from the side as you stand and bend, showing how you fixed your bending from unhealthy to healthy during whatever you do all day for work and at home. Write a fun summary and e-mail your photos and stories to me. If you can, put the photos on a photo sharing site. That is easier for me to retrieve and post on Fitness Fixer. I can put the best photos and most fun stories up in lights.
Realize that a big part of your health is the way you move in real life. Make a conscious decision to change your idea of exercise, fitness, and health from stopping life to "do exercise" to how you live. Have fun - the best health.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
