We are in Malaysia for the Thaipusam. At the first full moon of the Tamil month named "Thai" when the Pusam star is highest in the sky, the Tamil community and others celebrate the festival of Thaipusam.
People fast, wash, pray, and give thanks by various acts of devotion. Simple acts of loyalty and care are to carry pots of milk. Others seek to purify themselves further with the self-imposed discipline and hardship of piercing their skin, tongue, body, or face with skewers.
Men carry altars called kavadis, attached to their bodies with skewers piercing their skin all over their bodies and faces. Fruit are hung from the skin with hooks. The kvadis pulled by pure human devotion range in size up to the enormous vel kavadi, attached by 108 vels pierced through the chest and back.
Some of the extreme piercing practices have been pointed out to be unhealthy and contrary to the intention of the Hinduism and non-Hindu beliefs that wanted to create a spirit of positive blessing to the festival.
There are claims that devotees enter a trance, feel no pain, do not bleed, leave no scars, and suffer no infection. That is why we are here to study. We will let you know what we find - click here for Thaipusam- Exercise of Body and Spirit.
We are on the long trip south to Malaysia. The next posts will tell the interesting story of why. The previous post Unhealthy Yoga Ankles showed how you can reduce the good stretch on the hip and increase a bad stretch on the ankles by letting your ankle bend inward instead of keeping the ankle joint straight when sitting cross legged.
Look at the photo, at left, of the good positioning of the people, sitting to chat, in the morning of the overnight train ride. Besides their good upright sitting positioning, note the straight ankle position. They do not turn the outside of ankle, but get the needed stretch to sit with knees out, from the hip - a better stretch.
Good positioning is common in people of all ages here in Asia. People of all ages, even aged people, sit easily this way to eat, travel, or read the paper. Fitness as a lifestyle is not difficult and does not require exercise machines or gyms or trainers.
Just as there are foods that are bad for you, and just as some common medicines have side effects to make you sicker instead of better, there are several yoga moves that injure directly or predispose you to later injury. This is true, not just for people who overdo the pose, or who are inexperienced, but because the move itself is inherently unhealthy.
When you sit cross-legged, don't let your ankles turn upward, left photo, above left. By turning the ankle, you diminish the stretch on your hip and inner leg muscles, and put an unhealthy stretch force on the outside of your ankle. The outside of the ankle is not supposed to stretch much; it is supposed to hold your ankle straight so that it does not turn when you stumble. Overstretching the outside of your ankle is one of a few bad habits that predispose you to ankle sprains. Future posts will cover more on stopping ankle pain and sprains, and will give fun ways to strengthen your ankles. For now, try this when sitting cross legged:
Straighten your ankles, as in the right-hand photo above. Preventing the bending will stop overstretching the outer ligaments and you will get more and better stretch in your hip. The hip stretch is better because the turning of the leg has to come from the hip, instead of keeping the hip raised and tight, but bending up from the ankle.
Sit upright and straight. Don't round your back, not even a small amount.
Lift your chest to sit straight instead of sitting rounded.
If your hip is so tight that you cannot comfortably sit upright and straight, put both hands behind you to lean your weight on your hands and push yourself upright (right photo, above).
You will feel more stretch, and practice better habits by sitting up straight than by leaning forward with your back and shoulders rounded.
If you get recurring ankle sprains, check to see if you are ensuring that your problem continues through the bad habit of overlengthening the outside of your ankle. Check if you sit poorly to do this stretch with your back rounded and hip curled under because you are too tight to sit in a healthful position. Sitting rounded puts huge herniating force on the lumbar (lower back) discs. Putting your hands behind you to straighten you takes weight off your lower back discs, and gives you a good hip stretch as you regain straight positioning.
As more people try to fix their health problems through medical exercise programs and yoga classes, it is good to make sure not to do things that make new health problems and perpetuate old ones.
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Don't forget to stretch your toes. You need mobile toes for balance, healthy walking mechanics, and foot health.
Every day, take your feet in your hands and stretch your toes apart side to side, easily and comfortably. Make sure all your toes can move apart from each other, and that each one moves up and down. It is not healthy for your toes to remain stuck together and not moving. Check if you sit straight while stretching your toes and feet. It makes no sense to sit in unhealthful ways to do a health activity.
Sitting in various ways can be a built-in stretch for the toes. If you sit on your heels, as in the photo at left, or kneel on your hands and knees with toes curled under you, or when you are sitting in your chair right now, see if you can bend your foot behind you and still touch all your toes to the floor - even your little toes. Don't force toes to bend, just gently see if they all reach the floor. After stretching your toes back (toward the top of your foot) bend them all down toward the bottom of your foot. Many people, particularly people who wear heeled shoes wind up with toes that are bent upward all the time. The tendons on the top of the foot can shorten from keeping the toes bent up, and the toes can get stuck in a pulled-up position. Future posts will cover more on stretching your feet for mobility, pain control, and health.
When you sit, as in the photo above, see if you can rise to a stand without pushing off the floor with your hands or bracing your hands against your leg or knee. Use your leg muscles and get a strength and balance exercise while you get a nice stretch on the bottom of your feet.
The photo was taken when I studied a field medicine course in Cambodia. Before and after classes, you practice respect, concentration, and self-discipline. While you do this, you get a lot of physical exercise. It is commonplace for people of any age to kneel without using hands, except to hold the candles, flowers, and incense, and to rise the same way. The photo was taken in the middle of bowing, so I am not fully straightened yet. The nun is laughing. My Cambodian is so bad that I made her laugh. I think that is good exercise and good medicine too.
American baseball catchers have the occupational risk of meniscus tears in their knees. Yoga practitioners of certain squatting moves like "the eagle" and the hindu squat are more likely to get the same meniscus cartilage tears and early joint wear and tear. Asians who routinely squat for so many activities of daily life don't get these injuries. The difference is keeping your heels down and your feet facing in the same direction as your knees.
Sitting in a full squat with your heels down and your weight back does not pressure the knees the way squatting with heels up does. Keep both heels down and keep your weight back on your heels.
People who are not accustomed to squatting often find that they are too tight in the Achilles tendon to sit all the way down. Many of these same people do Achilles tendon stretches every day, or at least they do a motion commonly taught as an Achilles stretch, but which barely stretches the Achilles. The "lunge and lean," is the least effective Achilles stretch. The post Better Achilles Tendon Stretch tells why and gives a better stretch to do instead. The squat is another good Achilles tendon stretch. It is a lifestyle stretch for the Achilles and lower back, and a hip, leg, and shin muscle strengthener. You get healthful natural exercise from regular daily life. Even if you can't get down to full sit, bend properly with both heels down for daily bending and you will get a free Achilles tendon stretch every time you bend, which is many many times a day. Holiday Leg and Abdominal Exercise tells more on this.
The trains here in Thailand have the luxury of a bathroom, including a squatting bowl. You can tell new tourists here. They are afraid of the bathroom. When we lived in Japan, even the gleaming modern Bullet train, the Shinkansen, had a spotlessly clean squat fixture. Train bathroomsgive you balance practice too, swaying with the train as it takes you to the next adventure.
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There is more in the replies already here to many reader comments below this Fitness Fixer. Before asking more, see if your answers are already below or in the Fitness Fixer labels, links, archives, andIndex.
The next post will be in a few days (or I will send it for someone to post for me). We won't have internet access. We will be in a remote northern mountain area near the Thai-Burmese border where the monks of the Archa Tong forest monastery ride horseback.
The abbot is a former Muay Thai kick boxing champion. He leads the young monks and villagers to fight opium trafficking with rightness instead of rifles. Many of the young monks have come to the monastery having seen drug henchmen murder their parents and family. Abbot "Khru Ba" teaches the novice monks discipline, horsemanship, monastic ways, peace, humanity, and Thai boxing.
The previous post, Achilles Stretch in the Bathroom, explains how and why the squat is a functional lifestyle exercise, good to stretch the Achilles tendon and get strong, shapely leg muscles. By keeping both heels down and your weight off the front of your foot, it can be safe for the knees. The large amount of built-in leg exercise you get from routinely sitting and rising from sitting this way strengthens the hip, thigh, and knees.
At the left is a photo of a sign that is common here in Asia. The sign instructs people who are accustomed to squatting how to use the strange seat. The drawing marked with an X shows someone standing with both feet on the seat and squatting over the bowl. That is marked as incorrect use. The user is instructed to sit touching the seat. I asked some of the locals what they thought of the "sit and touch the seat" method. They shuddered, pointing out how silly that was.
Beside strengthening and stretching the legs, squatting is a cleaner way to sit, since only your feet touch the surface. It is common to see people waiting for a bus at the street curb, sitting, not with their behind on the curb, but sitting in a squat so that only their feet touch.
Squat toilets vary, but are often clean. You leave your shoes outside and wear bath shoes. Even some public toilets have public rubber shoes thoughtfully provided.
Western sit-down fixtures are becomming more common, as more wealthy tourists demand them and locals adopt less physical lifestyles. Our friends living here told us the story of a family who decided to convert their shining clean indoor squat facility to Western plumbing. They purchased a standard raised bowl and seat. They left on a short tip while a workman installed it. When they returned, the man was proud of his installation. He excitedly told the people it had been strange at first, but he did a fine job. He led the people to his finished work and said that at first he was puzzled by the height of it, but figured out to dig a deep hole. He buried the new, shiny toilet exactly up to the seat to become the familiar floor level.
In the airport, an obvious tourist arriving here in Asia proudly waved a travel pack of toilet seat covers and claimed to be ready for the germs of travel. Another tourist nearby announced that it was a problem for him that women couldn't go to the bathroom outdoors. I asked him why he thought they couldn't. He said it was because they can't stand up to go, and someone needed to invent a tray so that they could. I asked him if men sat to pass their bowels. He seemed surprised when he realized that everyone does natural things the same way. Both men and women have been sitting to "go" for thousands of years before plumbing and raised seats were invented.
All over Asia, Africa, India, the South Sea continents and islands, and even in places in Europe and the Americas, men, women, and children routinely and easily sit in full squat to eat, wait, talk on the phone, rest, relax, wash, and do other activities of life. The tourist with her seat covers may quickly find that squatting is cleaner than touching a seat. Many people who first encounter Western sit-down plumbing think it is unclean and barbaric. The squat is a functional and excellent leg strengthener and Achilles tendon stretch. People in their 80s and older who routinely squat have strong legs and healthy good knees, and can easily rise from the floor.
Would you like to try the squat? (Use your brain to be safe to try things or not, if you have damaged knees):
Keep both heels down (right drawing) as you bend both knees, which protects your knees.
One way to practice the squat if your Achilles tendons are too tight, is to hold something in front of you, like a counter or sink, and bend both knees as much as you can with both heels down.
While holding the support in front of you, lean back with both arms straight so that your weight stays over your whole foot and heels, which moves your weight off your knee joints and back onto your leg muscles.
Try to balance and sit without holding on. If you find yourself falling backward, or if your heels come up (left drawing), it is likely that your Achilles tendons are too tight for this normal activity. Put one or both hands behind you to lean on (not in the squat bathroom but just to practice).
Every time you bend around the house, use a small squat with both heels down, described in Bending Right is Fitness as a Lifestyle and Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending. You will strengthen your thighs and hip, develop healthful bending that stops knee pain, strengthen your shins, and stretch your Achilles tendons each time. As this routing bending strengthens and stretches your legs, progress to lower and lower bending until you can comfortably sit in a squat. Have fun.
Last weekend we visited the Siriraj Forensic Science museum in Bangkok (pronounced Silly-lot). Forensics is the science of crime. Why are we here?
I am the science officer for the Vidocq Society (pronounced Vee-doc), an international forensic think-tank for solving cold case murders. The Vidocq Society is named after the eighteenth century French detective Eugène François Vidocq, who is considered the founder of modern criminology. Vidocq was a former fugitive and police informant, and expert in surveillance and disguise. In his career-reversal, working in crime prevention, Vidocq was the first to make plaster casts of foot and shoe impressions, and introduced record-keeping and the study of ballistics into police work.
The Vidocq Society allows 82 members by invitation only. As the science officer for the Vidocq Society, my job is to make sense of some of the physiology and facts about the body used (and often not used) in forensic investigations. Real forensics is not like television forensics and often techniques shown on television are exaggerated, applied incorrectly, interpreted badly, or just false. Part of my job is to learn enough to help make sure we don’t do the same in real life.
It is important to check things, even if accepted as fact. For example it is not true that you can tell when someone died from their body temperature or stiffness. You can’t just check the books. Many of the most held old fallacies, were things we learned in school and from forensic books. Health and fitness is like that too. We just need to look a little further to learn how things really work.
What Does It Look Like to Not Use Abdominal Muscles?
Sunday, January 21, 2007
Healthline
Readers have been e-mailing asking for more photos of what "the plank" and other exercises, or even daily life looks like if done in a way that doesn’t use the abdominal muscles as intended.
In the top photo at left, you can see the badly arched lower back at the junction of the t-shirt and beltline. Her back is sagging and "hammocking" under body weight. The hip tilts up in back. If she used her abdominal muscles to tilt her hip under, the spine would be held straight and prevented from sagging. The lower back would no longer pinch backward and compress under her weight. The joints that hold the vertebrae (spine) together are called the facet joints. They get hurt from overarching. Injections are not the answer. To stop the cause of the injury, you simply stop bashing your facet joints together by preventing overarching.
The lower photo shows not using abdominal muscles while standing and reaching overhead to learn how to twirl fire sticks, a common beach activity here in Southeast Asia. The lower arrow over the hip shows how the hip is tilting instead of straight. The hip tilts down in front and up in back.
Another way to understand the movement of tilting the hip under (pelvic tilt or tuck) to bring the spine into healthy straight position is to try this:
Stand with your heels, backside, shoulders, and the back of your head against a wall. Gently try to press the space in the lower back toward the wall.
You don't have to touch the wall, in fact, that is too much tilt. Just learn how to move the hip with a slight curl-under, so that the arch lessens until your hip is straight and no longer tilted forward and down in front.
Don't bring your head forward away from the wall.
Gently hold the tilt as you walk away from the wall.
Keep breathing. Don't tighten your abs. That is not how to use them for real life. Just use your muscles to reposition your spine, like moving your arm or leg - simply and easily and in relaxed manner.
The tilt is not an exercise to do 10 times. It is something you do once, the use, for better health, better use of abs, and better looks. Send in your own photos of your own successes. Have fun.
Read inspiring success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Abdominal Muscle Exercise - Better, Different, Not What You Think
Friday, January 19, 2007
Healthline
Many medical fitness programs, health and exercise classes, and kickboxing and martial arts practices have a complicated and ritualized belief structure that the abdominal muscles have some magic or central function. They try to fix back pain or improve posture through abdominal strengthening programs. Usually these strengthening programs use the same unhealthful rounding forward motions that cause high pressure on your lumbar discs, practice unhealthful bent-forward posture, and perpetuate several common pain syndromes.
Here in Thailand, the Muay Thai kick-boxers and training camps do not have any beliefs about the torng, or abdomen. Even so, the Thai boxers are among the world's best-conditioned fighters. You can swing a bat at their abdomen and it would not faze them. In fact, that is part of training in many training camps. Today I have an abdominal muscle training exercise for you that is more fun than that:
The post Change Common Exercises to Get Better Ab Exercise and Stop Back Pain showed how the pushup, or just holding a pushup position, called The Plank is often done allowing the lower back to overly arch and sag under body weight, as in the upper photo at left. This extra arching, called hyper-lordosis, pressures the lower back and means that you are not getting exercise because you are just resting your body weight on the joints of your lower back instead of holding up your body weight in a straighter, healthier position, shown in the lower photo. Try this:
As soon as you tuck the hip, you will immediately feel the load shift off your lower back and onto your abdominal muscles.
Once you can hold a good flat plank position, add lifting one arm as shown in the lower photo. Do not allow your lower back to sag, shown in the upper photo. Do not hunch or round your upper body, also shown in the upper photo. Rounding the upper body will get in the way of your shoulder joint being able to lift your arm.
"Unround" your upper back and lift your chest to straighten your back. This makes room for your shoulder to allow your arm to straighten in line with your body.
Once you can lift your arm, also lift your opposite leg (not the leg on the same side but the other one). You will feel your abdominal muscles working strongly.
Hold as long as you can.
Keep relaxed but straight, and keep breathing.
Work up to being able to jump to switch the arm and leg that is lifted.
This fun abdominal exercise trains you how to hold your body in the same straight neutral spine position you need for standing and walking and reaching overhead without arching the lower back. That means it is functional abdominal exercise. Many people who do hundreds of crunches a day cannot do this exercise at all because they have never trained their abdominal muscles in the way they really need to work – to hold your spine straight without sagging inward (overly arching).
Crunches are not functional, and train unhealthful, forward-bent posture, which you don't need after a day of sitting at your desk or over the steering wheel.
Instead of crunches, this is one of many fun abdominal-building exercise. You will get better more effective abdominal exercise in the way your body, and abs, work for real.
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
"Anybody can write the first line of a poem, but is a very difficult task to make the second line rhyme with the first" - Mark Twain
This week Kerri at Six Until Me hosted Grand Rounds, not only finding and posting medical blogs from the past week that focus on the needed humanity in medicine, but did it all in rhyme.
Thank you Kerri for your work reminding medicine that true healthcare means, and needs, kindness, and for concluding the entire Grand Rounds my post Thank You To Readers - Simple Gifts.
Western boxers and students of many martial arts are often taught to hunch their shoulders and lower their head to protect their neck. Box-aerobics students (and teachers) also often jut their head forward thinking it looks tough, or more authentic. It doesn't protect the neck as hoped, and conversely produces neck and shoulder problems, some immediately, others over time. It also reduces effectiveness of the punching exercise, and to people who know martial arts, it doesn't look tough, it looks weak.
Look at the photo at left. The student on the right is holding his head severely forward (orange arrow). The teacher at right in the foreground is holding his neck and head properly, relaxed and upright (white arrow). The teacher and student in the background also are holding their neck in position that is healthy for the neck and shoulder, and makes punching more effective.
What are some of the problems of forward head angle and hunched shoulder?
Keeping your head forward brings it closer to your opponent, easier to hit.
In case of a head strike, a tilted angle of the neck to the brain and skull is more likely to result in brain injury.
Hunching the shoulder can injure the neck and shoulder muscles
Hunching results in tight, aching neck and shoulders.
When you keep your head and shoulders forward, it rotates the shoulder bone forward. When you raise your arm with your neck forward, the soft tissue of the rotator cuff gets pinched between the arm bone and the shoulder bone. Eventually the bones can saw away at the rotator cuff muscles trapped between them, enough to get a tear.
The same pinching between shoulder and arm bone can compress the nerve(s) that go down your arm, resulting in tingling, pain, numbness, weakness.
All the above problems can easily stop and reverse when you stop the cause - the forward head angle and hunched shoulder. Start with the post Fixing Upper Back and Neck Pain.
The muscles you use to hold your head and neck upright instead of forward are your upper back and posterior shoulder muscles. It is a free upper back and posterior deltoid and shoulder workout by standing relaxed but straight, and exercising that way too.
When you watch movies of Mohammed Ali fighting, watch for his healthy, straight, graceful neck positioning. For doing martial arts and boxing aerobics, you can protect your chin and brace your neck without hunching and injuring your neck and shoulder. For exercise classes and just moving around the house you get more upper back exercise and stop injuring your neck and shoulder all at the same time by using your muscles to hold yourself upright instead of sagging. Stop neck injury from exercise. Exercise is supposed to be healthy.
--- 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.
Thai boxing (Muay Thai) kicks are among the most devastating and effective kicks in the world. Thai fighters spend hours a day kicking heavy bags and posts, and years toughening their legs and shins for kicks and blocks by bashing them with pipes and against coconut trees. A blow from a Muay Thai fighter's leg is like a blow from a club.
When you practice moves that lift the leg for martial arts training, for self-defense, for dancing, or for exercise in an aerobics class, watch for several bad habits that increase strain on muscles and joints, and reduce effectiveness of the kick. It is not the point to kick someone else and wind up injuring yourself.
1. Look at the photo, above left. The teacher is holding his hip and neck straight. The blocking student is not. The orange arrow at the student's leg shows how, when the student lifts the left leg, the right leg pulls forward instead of remaining straight at the hip. This is a sign of tightness at the hip and poor technique. He needs to stretch the front of his hip and retrain kicking and blocking technique to prevent this common bad habit. Read more on this in the posts, Is Bad Martial Arts Good Exercise? and Common Exercises Teach Hip Tightness When Kicking, Stretching, and on the Stairs.
2. Next, check the white arrow at the student's belt line. It is tilting up in front. The teacher's hip remains level as the leg is raised. Curling the back and letting the hip roll under, as shown by the white middle arrow is another sign of tight hip muscles in the front and back of the hip, and poor movement habits. When you raise one leg to kick, block, prepare to kick, do a knee strike (whatever), check if you curl your hip or round your back. Hold your back straight and upright for more exercise, a built-in hip stretch, and more effective technique.
3. Third, note the black arrow showing how the student rounds the upper back and neck forward, instead of holding straight. With practice, the student will learn to hold the neck straight as the teacher is doing.
For all the exercise you do (kick, block, ascending stairs, whatever is done raising one leg), keep healthful positioning. Yes, rounding the back is taught, and done for fighting, but you will be beating yourself up in the long run. You can still be an effective fighter and at the same time, prevent hurting yourself with common strains from unhealthful technique, plus get more exercise with healthier ways.
See all martial arts articles, or other topics that interest you, by clicking labels under this post.
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Meet your new training partner. This is not box-aerobics. This is Muay Thai, which means Thai boxing. Muay Thai is the national sport of Thailand. It is the devastating "Art of eight limbs" using two fists, two feet, two elbows, and two knees. Muay Thai is considered one of the most physical, strenuous, and directly effective of the martial arts styles. Thai boxers are among the most highly conditioned of all athletes.
We are home in Thailand now, and back to training with the Masters. The government coup continues peacefully and respectfully, as is the Thai way. In Thailand, respect and self-discipline are highly prized and practiced. It follows that their national martial art is not just hitting and kicking. Muay Thai comes from a long tradition of hard work and spiritual values. Typical training in Muay Thai involves not only long hours of physical conditioning and practice kicking and striking heavy bags, practice pads, and sparring partners, but practicing self control, strength of mind, and compassion.
Jai yen, or "cool heart" is part of Muay Thai boxing training. Some people think that martial arts means angrily destroying furniture and retaliating for real or perceived insult. Dramatic movies depict a trainer goading a student into releasing an angry "warrior." But that is not the Thai warrior spirit. Jai yen prevents making anger a negative force or becoming agitated or unkind. It illustrates the mind/body set of the experienced warrior. Jai yen is also central to Thai social and business interaction. It is a good and healthy exercise.
In Thai martial arts, respecting teachers and elders is foremost. The "Wai Khru" (bow or pray to the teacher) is a mark of respect done at every greeting to a teacher and before every training session and fight. Each fight begins with rituals of honoring the teachers, and the Ram Muay, a spirit dance to show respect and thanks, and ask blessings from the teachers - the Kruu Muay Thai, from the ancestors, and the four directions. Thankfulness and respect are strengthening to your own spirit.
Many people come to Thailand to train in Muay Thai. Some are tourists who just want to try it, or say they did it, or as a stunt, or for some exericse. Others study seriously for long periods. This post tells of some of the metal exercise to strengthen the way you live. The next posts will give some of the physical training and how to stay healthy while practicing.
"To win one hundred victories in one hundred battles is not the highest skill. To subdue the enemy without fighting is the highest skill." - Sun Tsu, The Art of War
Healthier Carrying - Get Free Ab Exercise and Stop Pain
Sunday, January 14, 2007
Healthline
Do you overly arch your lower back when you carry things in front of you, as in the photo at left? Arching your lower back and leaning back to carry anterior loads is common source of pressure and loading on your lower back, whether you are carrying a dog, a chair, a baby in arms, a child on your hip, packages, or grocery bags. It is the same contributor to the mystery back pain from carrying backpacks, explained in the previous post, and after long standing, walking, and running explained in Fixing the Commonest Source of Mystery Lower Back Pain.
Look at the photo, at left.
1. The upper arrow shows how her upper body is tilting backward instead of being straight and upright from mid-hip to shoulder.
2. The lower arrow shows how the hip is tilting forward in front and sticking out in back, instead of being vertical from mid-hip to the top of the leg bone.
3. Between the two arrows, her lower back is overly-arched and pinched. There is supposed to be a small inward curve, not a large one, pinched back like bending a drinking straw.
Leaning back offsets the weight and makes things easier to carry. The reason it is easier is that you shift the weight of the load away from your arm and torso muscles onto your lower back. This squashes your lower back under the weight of your upper body and the things you carry as it pinches backward.
Leaning back makes a swayback - right-hand figure in drawing. It is one of several overly arched slouching postures that are a common source of lower back pain. Pain from slouching keeps coming back, even after pills and treatments. The reason the pain keeps coming back is that you haven't stopped the cause. In the right-hand drawing, the hip is neutral, but the upper body leans back, producing a swayback. The photo above is even worse - the hip tips forward too, a second kind of swayback. In my work I have identified three kinds of swayback slouches (hyperlordosis - explained in other articles here on Fitness Fixer). All are just bad postures, easy to fix by standing and moving in neutral spine instead.
Leaning the upper body backward and/or tilting the hip forward when holding a load is common during standing, walking, running, reaching and carrying around the house, and while exercising. It is not necessary to slouch to offset the weight. Let your muscles do that for you, not your aching lower spine.
To feel reducing the lower spine arch and getting the upper body more upright, stand with your back against a wall. Touch heels, backside, and upper back to the wall. See if you have a large space between lower back and the wall, or if you have to increase the space to bring your shoulders and head to straight position. Press the lower back space lightly, gently, toward (not touching) the wall to feel how to reduce a too-large arch. If you do it right, pain should stop right then. Short movie of this on - Fast Fitness - How to Feel Change to Neutral Spine.
Click the label "neutral spine" (and other labels that interest you) for more on each topic.
The muscles that pull your spine forward to neutral are your abdominal muscles. You get free, built-in exercise for your abdominal and back muscles in the way they are supposed to work for real life. That is called functional exercise.
Standing neutral when carrying things without overarching the lower back is better, healthier, and more functional exercise than lying on the floor and rounding your back to do crunches.
Use the arch-reducing technique in this article to learn neutral spine for a healthier back and built-in back and abdominal muscle exercise all the time during everything you do.
--- Read success stories and send your own. See if your answers are already here - click Fitness Fixer labels, links, archives, andIndex. Subscribe free - "updates via e-mail" upper right. For personal medical questions - Replies to Medical Questions. Limited Class space for personal feedback. Top students may earn certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain
Saturday, January 13, 2007
Healthline
Frequent news items report that wearing backpacks causes back pain in children and adults. Some of the usual theories proposed for why backpacks cause pain is "overstuffing them" or carrying them too high or low. Complicated and expensive packs are developed as remedies. Another of the often-repeated theories is that carrying things on your back makes you arch your back. However, none of these are the reason for back pain when carrying packs. It is not the pack that causes the pain or the arching. It is a very simple matter of allowing your back to arch and slouch backward instead of standing straight against the load.
In the photo, above left, of the backpacker, the upper arrow shows his upper body tilting backward instead of straight from mid-hip to shoulder. The lower arrow shows the lower body (the hip) tilting forward in front and out in back, instead of straight from mid-hip to the top of the leg bone. Between the two arrows, his lower back is overly arched and pinched (not neutral spine, but overly arched). The other hiker without the backpack standing near the sign is also overly arching the lower back.
The weight of his upper back plus the weight of his pack is pressing downward on the joints and soft tissue of the lower back (left drawing of x-ray image). This is how overarching causes lower back pain. It is not the backpack, but the body position while carrying it.
Lower back arching (hyperlordosis) when standing may seem "natural" but it is not healthy. Wetting your pants is natural too, but you have to learn to control it.
To reduce unhealthy overarching (hyperlordosis), use your muscles to move your spine to neutral. Try this:
To feel the problem of overarching, stand, lift your ribs, allow your upper body to lean backward. Allow your hip to tilt down in front and out in back. You may feel a familiar pressure in the lower back (left drawing).
Straighten your upper body by bringing ribs back down to level. Do not slouch or round forward; just stand straight without lifting your ribs.
Straighten your lower spine by bringing your "tailbone" under you until your hip is straight from the top of the upper leg bone to the middle of the crest of the hip bone, not tilted.
The motion of tucking the hip and pulling the upper body straight is like doing an abdominal crunch standing up.
The too-large inward curve of the lower back becomes the small inward curve of neutral spine (right x-ray drawing).
Whenever you carry a backpack, stand, walk, run, or exercise, use the same hip tilt to normalize your spine position and prevent overarching. Overarching is not healthy and is poor body ergonomics to walk around or exercise with your behind stuck out in back. The muscles you use to hold your spine from overarching are your abdominal muscles. You get free built-in abdominal muscle exercise just by standing in healthful position.
--- Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy. ---
Thank you Dr. John LaPuma for Grand Rounds 3.16 this week on his website, Let Food Be Your Medicine.
Dr. LaPuma featured my post Stomach Acid Drugs Increase Osteoporosis and Hip Fractures. The post offers several good foods which work better than stomach acid drugs to control stomach pain and acid problems, and several strategies not to need the stomach acid drugs in the first place.
Grand Rounds is a lot of work to do. Dr. John did much work to find and promote important information on how much food influences health.
We have just gotten home to Thailand after over 40 hours of flights. It would have taken longer to walk here, so we are happy. We unfolded husband Paul, just under seven feet tall, from the seat. During the next month and a half we will travel on 14-hour overnight trains and ferries to places we need to be. Paul will practice good bending almost everywhere as he tries to fit under low Asian doorways, roofs, and bus ceilings, bow lower than the old people, and stand and sit with his head lower than the head of the monks, as is respectful.
Most people sit a great deal even without long travel. Sitting puts higher pressure on the back and spine than standing. Long sitting pressures the back far more. Sitting also means keeping the hip bent forward at the crease of the leg. The muscles in front of the hip shorten and tighten. When most people exercise, their exercise is usually more bending forward. The result for most people is that the hip stays bent almost all the time. Much tightness results that prevents normal hip function, and reinforces the same tight, bent positioning that is so hard on the spine.
Long airline flights sometimes provide a video or printed message encouraging in-seat exercise and stretching. Often the advice is forward bending. That is the last thing most people needs. Instead, try the following:
Stretch your back and shoulders backward, not forward. Pull your chin in while pushing your upper back backward against the seat back. Stretch arms overhead. Breathe.
Lean the back of your head and upper back against the seat, press your feet on the floor, and raise your hips, trying to straighten your hip at the "crease" of the leg. Don't bend your neck forward; leep it straight. You will feel your thigh and hip muscles working to do this.
Turn in your seat to each side to brace your elbow against the seat back for the pectoral stretch, shown in Fixing Upper Back and Neck Pain.
Stretch the back of your legs by straightening your knees and pulling your toes back using your shin muscles.
Increase leg circulation by pressing both feet against each other, then cross your ankles and pull both feet outward against each other, then cross your ankles the other way and repeat. Try it again with both legs out in fron, as in the stretch above.
Get out of your seat as often as you can. Restore length to the front of your hip with the hip-tilt quadriceps stretch shown in Instantly Better Hip and Quadriceps Stretch.
With one foot far in front of you and the other in back (lunge position) tip your hip under you to stretch the front of your hip. As soon as you tilt your hip under, you will feel the difference. While holding the hip tilt, bend both knees to dip straight down almost to the floor, then up. Do many, then switch legs and do many more.
It is easy and unobtrusive to do wall stretches while waiting for the rest room: Rest your head, heels, hip, and upper back against the wall, described in the post Breasts Causing Upper Back Pain is a Myth. Bring both arms overhead, hands touching the wall. Lean your body far to one side then the other. Keep both hands touching the wall. When Paul does this one, his head is often either against the ceiling or he can't stand up fully at all, depending on the type of aircraft. He bends knees and grasps each elbow overhead, keeping elbows touching the wall behind him. For other people short enough to fit standing up, just stand straight.
Then stand a step away from the wall and stretch arms overhead and back to touch the wall, fingers pointing downward. Straighten elbows as much as comfortable and keep the stretch coming from your upper back, not lower back.
Tomorrow in the early morning, we leave to go home to Asia.
For the next two months I will be posting on healthy exercise for long flights, better stretches for long sitting and travel, the training exercises of Thailand's national sport Muay Thai, the wonderful stretches of Thai massage, lifting and carrying backpacks and travel bags, the social morning exercise done in parks every morning all over Asia that keep the aging populations mobile and independent, answering your fitness and health questions, plus some surprises.
Keep sending in your comments to the blog posts, and requests for happier healthier ways to move, bend, stretch, reach, exercise, and live.
Several readers have e-mailed me saying they have stopped long-standing pain and gotten fitter than from their gym programs by using Fitness Fixer posts. They say they can now exercise where before they were held down by pain and medical treatment. Now they have mobility and fun and hope. Thank you all for being brave and empowered to try.
One reader read the earlier blog post An Exercise in Helping People Get Healthy about the blind woman in Madison Wisconsin who just wanted some fruit and vegetables but there was no public transport to the market, only a bus to the store that sells junk food.
The kind reader, asking to remain anonymous, did a Google search to find a Madison neighborhood association with volunteers from the Regent Market Co-op who will shop and deliver a food order at no extra charge. She e-mailed the information to me and said, "I hope she'll be feeling better soon. Fresh fruits and vegetables may help with that!"
I thank this brave reader for the link to people who will be there, above just a package. We have found that the box of food that we bought here and shipped to her, delivered a week ago Friday, has sat unopened in our friend's house. She has been too sick to open it. This reader may be the one to save this lady's life. The reader replied, "It was a very simple thing for me to do."
Today 37 new students were waiting when I came in to teach yoga. I was their New Year's Resolution. Most were sitting bent over forward, rounding their back to stretch. When I walked through the gym to get to the teaching room, I walked past a gym full of New Year's Resolutions, all bent over forward straining to stretch, bent over their stair machine and bent over their treadmill. They were lying on the floor face-up rounding forward and they were standing bent over, face-down. Many were doing The Stretch You Need The Least. Everyone looked like the same unhealthful, bent-over posture that you already know causes back pain if you do it over your computer and steering wheel. I mentioned that bending over forward to stretch and exercise, although popular, and ingrained, and dogmatically and almost universally taught, is not what they needed.
What is needed is to get used to holding the body in healthful straighter ways during daily life and during exercise and stretching. In the post Better Achilles Tendon Stretch I showed how to get a better leg stretch without bending forward. Following is a nice upper spine stretch you can do while lying down to relax. Try this:
Lie on your back over a pillow or an article of clothing comfortably placed under your upper back between your shoulder blades. Start with your hands by your sides.
If this hurts, stop and see what to do in the following three paragraphs.
Don't put the pillow under your head or neck, just your upper back.
Let your upper back drop backward toward the floor.
Notice the feeling of the upper spine no longer rounding forward.
Relax and breathe. The stretch should feel good.
To increase the stretch, bring both arms by your ears. You should be able to raise your arms without arching your lower back or feeling pinching in the shoulder.
If you are not able to lie on your back without lower back pain, the usual reason is tightness in the front hip muscles. Do the Instantly Better Hip and Quadriceps Stretch on each leg to loosen the front of the hip.
If you are not able to lie on your back without upper back or neck pain, the usual reason is tightness in the front chest muscles and over rounding in the upper back. Do the pectoral (chest muscle) stretch described in Fixing Upper Back and Neck Pain.
If you have osteoporosis check with your doctor before doing the pillow stretch. One of the intended benefits of this stretch is to help prevent the rounding that contributes to the tendency to fracture already thin bones.
Many people spend so much of their life rounding forward, that their spine loses the mobility to bend backward, or even, in many cases to straighten enough to just lie flat and stand straight. The point of this stretch is to "unround" the upper spine and get it to relax and extend backward (arch safely) in the other direction. This stretch helps to "undo" the constant forward rounding that tightens the upper body and contributes to many pain syndromes. It is important to regain the normal flexibility to be able to straighten the upper spine enough to stand and sit and exercise in healthful straight position.
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Many people are taking down Christmas trees even as the Russian and other Eastern Orthodox families are putting theirs up for Christmas, coming this Saturday Jan 6th. The Russian Snow Girl (Snegurushka), and DedushMoros (Father Frost) have already come to visit. S nastupaiushchim Novym godom i s Rozhdestvom Khristovym - Happy New Year!
Here are two lifestyle strengtheners (and a free Achilles tendon stretch) to build into your fitness as a lifestyle for 2007:
If you would like to get strong legs for the New Year, don't bend over wrong to lift things (upper drawing, left). From now on, make all your bending the way that strengthens your thighs and at the same time prevents back and knee pain (upper drawing, right). Keep your upper body upright and bend your knees. Prevent knee pain and get better use of your leg muscles by keeping both knees down and back over your heels. Each time you keep both heels down while doing healthy bending, you will also get a built-in Achilles tendon stretch. The post How Often Should You Be Healthy? tells more on good bending.
If you want to stop "mystery" lower back pain for the New Year, check to see if you lean backward when you reach upward (lower drawing, left), carry things, or when you are just standing. Leaning back creates overarching of the lower back called hyperlordosis, which pinches and pressures the soft tissue and joints of your spine. People with this kind of pain feel they need to lean over forward or sit to relieve the pain. Instead of doing remedies for pain, it is smarter and healthier to stop the cause of the pain.
The "hip tuck" or "pelvic tilt" to reduce overarching and straighten the spine (lower drawing, right) is described in the post Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique. The muscles you use to move your spine out of unhealthy overly arched position and into straighter position are your abdominal muscles. By simply standing and moving with a healthier spine position, you get free exercise for your abdominal muscles. "Tightening" the abs is not what exercises the abs or prevents back pain. Tightening also does not let you breath or move properly. Tightening is not how to have healthy abdominal function. Instead, use the abdominal muscles to stop overarching and maintain healthy position while going about your daily life and exercise. The post, If Better Abdominal Muscles Are Your New Year's Resolution, Try This, shows how.
If your New Year's Resolution is to have a healthier low back, Achilles tendons, and abdominal muscles, you can do that all at once during your regular daily activities.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
Healthful eating is not difficult or expensive. It is cheaper to stop buying junk and convenience food, and it is easier to eat a piece of fruit than to fry food.
Over the holidays, we called a friend in Madison Wisconsin. She is a visually-impaired diabetic widow. She is cheery and fun and wants to be healthy. She can't drive of course. The only available public transportation can get her to a department store that stocks junk food. There is nothing that goes to a supermarket so she can get fruit and vegetables. We checked on cab rates and it will cost more than $30 round trip to get to a supermarket. The local Meals on Wheels turned out not to be healthful food. The services for the blind, paratransit, and various other social services have not worked out to get her to a grocery store. All she wants is some fruit and vegetables. How hard could that be?
Paul and I went to the market and filled a box with nuts, apples, pears, zucchini, cucumbers, berries, broccoli, red peppers, yellow peppers, celery, some other vegetables, some mung beans for her to sprout, tomatoes (that we wrapped in bubble wrap), and a pair warm fuzzy socks, and shipped it to her.
If readers would like to send her broccoli and simple healthful fruit and vegetables, or if anyone lives in the Madison, Wisconsin area and wants to take her to a market so she can purchase her own, e-mail me for her information. It would be fun and in keeping with the spirit of being healthy for the New Year.
