Healthline blog posts have a new helpful tool to find posts on the topic you want. Look below each post to find a list marked "labels: "
Each label is a keyword for a topic that appears in that post. Click any of the labels in the list to get (hopefully) all posts that cover that topic by that blogger.
The addition of labels is a great tool to get more from posts. I've been working with hardworking behind-the-scenes Healthline staff Carrie and Leigh to get all Fitness Fixer posts labeled. Leave a comment if we left out any appropriate labels.
This post wouldn't ordinarily have a label for you to see and experiment with, since it is not about a health topic, so I put one. Since I'm at a sports medicine conference right now presenting on how arching the lower spine too much (stick out your behind far in back when squatting, for example) can cause back injury, I put the label "neutral spine" on this post. Click it to see all the posts that explain why overarching harms and how to get good exercise without this kind of injury. Each of those posts will have their own links. Enjoy.
Thank you to MedSkool for including my post What Does Stretching Do? in this week's Grand Rounds. Grand Rounds is a weekly selection of notable medical posts of the week.
The previous post mentioned I am writing from the meeting of the American College of Sports Medicine (ACSM). Yesterday the ACSM ran a blood drive at the conference center. At a blood drive, volunteers donate a small amount of (their own) blood; only a pint. Giving blood is a helpful simple thing to do. Your body will quickly make more and replace the small amount you give.
You can give as often as every two months. Seventy-nine-year-old Lillian Bloodworth from Florida has given 160 times, spread over 40 years. Just giving one time in your life still makes you a hero. The single pint you give can be used to save several sick, even dying, people of any age.
Before donating, donors are screened through questions to make sure they have not engaged in practices that make them more likely to have diseases spread through blood. These practices can be sexual, injecting drugs for recreation or bodybuilding, even receiving tattoos or piercings. A small blood screening is done to assure that you have enough blood iron to make donation safe for you. Then you lie down comfortably while they take the blood from a vein in the inside of your elbow. A good phlebotomist (venipuncturist, blood donation taker) makes the process painless. A common topic in sports medicine is low iron. Medical texts devote much attention to populations with lowered iron levels, considering it a bad thing. Just as important to consider is high blood iron level, which is one intriguing risk factor for cardiovascular disease. High iron levels have also been associated with unusual fatigue, and perhaps cancer. One, of many, reasons to cut back (or eliminate) red meat is high iron content. Conversely, premenopausal women who lose small monthly amounts of iron, and vegetarians and athletes have lower incidence of heart disease than the rest of the population. One of the factors is that these populations often maintain lower iron levels.
High iron is not only an issue with extreme levels, or a genetic disorder of iron metabolism, such as hemachromatosis. Raised iron level from dietary sources may raise cardiac risk, particularly in men who don't have the benefit of monthly blood loss. Understandably, people with iron levels that are too low are turned away from blood donation. Other people donate to benefit their own health by lowering blood iron.
Either way, it can be healthy and kind to donate blood. Need for blood donations rises in the summer and holidays. Check with your Red Cross.
--- Read success stories of these methods and send your own. See if your answers are already here by clicking post labels, links, archives at right, and Index. 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. Get more in Dr. Bookspan's Books.
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Bloodmobile license plate photo by tellumo Blood donation photo by noricum
Hello from the annual meeting of the American College of Sports Medicine (ACSM), held this year in New Orleans. The meeting is attended by thousands of researchers, physicians, allied health, trainers, educators, scientists, and others.
Sports medicine is more than studying and treating movement-related injuries, or using movement to repair injuries. It includes chronic diseases, physical challenges, nutrition, and extreme environments. The College states its goal as "Advancing health through science, education and medicine."
I'm at the conference to learn all I can from others, and present some of my research on identifying lumbar hyperlordosis (too much lower spine arching) and how it produces lower back injury. A few posts describe some work from past years:
and others. Click the label "neutral spine" following this post to bring up a screen with most past posts on the topic.
I will try to get to Internet cafes over the next week to post some of the interesting studies and presentations at this conference from researchers and practitioners from all over the world.
During and after the conference week, a group of ACSM members will assist the Association of Community Organizations for Reform Now (ACORN) to gut homes and prepare for rebuilding to help reconstruct New Orleans. Work is scheduled June 2 - 6, 7:30 a.m.- 2:30 p.m. Kristine Clark, Director of Sports Nutrition at Penn State U is coordinating the mobilization. To participate, e-mail or phone (814) 863-8107.
--- Read success stories of these methods and send your own. 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, 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.
A new first aid training course has been developed by NAUI. The National Association of Underwater Instructors (NAUI) is one of several scuba diving training and certifying organizations. The first aid course is open to divers and nondivers.
I was one of three reviewers to develop the new course text and fact-check each page and entry. NAUI did a nice job of keeping it clear and simple.
Each of the different scuba training agencies has different approaches and philosophy. NAUI stresses "Safety through Education." Similar to discussions on which university or car is best, there are spirited exchanges by divers from different organizations on which scuba organization is "best." I did my training to become a scuba instructor with NAUI and have been active to help develop some of their textbooks and training courses.
The new First Aid Training course includes all standard first aid, plus first aid for aquatic life and diving injuries, CPR (including professional rescuer), defibrillators, blood-borne pathogens, and emergency oxygen administration.
The NAUI First Aid course meets International Liaison Committee on Resuscitation (ILCOR) recommendations. Effective June 1, 2007, the course also meets acceptance of the United States Coast Guard. We received a letter from their Training and Assessment Division stating our course "meets or exceeds the standards of the American Red Cross Standard First Aid and Emergency Care or Multimedia Standard First Aid and will satisfy the first aid training requirements of 46 CFR 10.205(h)(1)(iii) for a merchant mariner license."
NAUI Vice President Jed Livingstone said, "For the first time in the emergency responder training market there exists an international consensus on what constitutes effective CPR and First Aid skills and the training methods and content needed to educate the general public and professional rescuer communities."
NAUI offers several diving courses from skin diver (using no air tanks) to scuba instructor, and specialty courses such as rescue, Nitrox, and technical diving. Their certification is accepted internationally.
Related:
Frequently Asked Questions (FAQ) list for the first aid course
Regular physical exercise is documented to reduce risk of cancer. Exercise has also been found to increase survival in those with existing cancer, (JAMA and J Clin Oncol.) improving both number of years and quality of life.
Until recently (sometimes currently), cancer patients, along with heart patients and back pain sufferers were told to rest and stop activity. Inactivity creates new health problems and worsens existing health problems. Lack of regular exercise decreases strength, endurance, energy, blood sugar regulation, cellular repair (lengthy list here) and increases fatigue. Cancer treatments of radiation and chemotherapy do the same, and worse. This is called iatrogenic harm, which means injury or illness brought on by medical treatment. One medical report found that debilitating tiredness and loss of energy from cancer treatments can be more disruptive to the patient than the original pain of cancer. Another report called fatigue, "The most important consideration for the patient with cancer." Cancer fatigue can be a problem for months, even years, after treatments end.
Reader Dr. Zoe E., cancer survivor with personal experience writes:
"I don't think I'm quite ready for prime-time yet - but if I can be a source of encouragement to those trashed by chemo, I'm happy to be displayed.
"Yes, exercise helps if you can do it. Lots of people are lucky to experience low toxicity during chemo and are able to keep up their exercise programs or active life through treatment. Others are laid low and must stop treatment or are just trying to recover enough between treatments to continue them.
"While the Lance Armstrongs and Tony Snows of the world are inspirational, it would be a bad thing if the general population thought that people should be able to work and function during cancer treatment. Many, maybe most, can't and they shouldn't feel bad about it. Chemotherapy is as close to killing you as modern medicine gets."
Dr Zoe sent an update the day before yesterday:
"I did the Relay for Life on Saturday (a fund raiser for the American Cancer Society). It's a 12-hour team event where you keep one person on the track for the full time. I did the Survivor's Lap and several more with lots of rest stops. I managed to hang out there for 4 hours before I got too pooped. No photos though, I'm even more camera shy than blog shy! You can draw a picture if you want."
One of the benefits of exercise is that your body produces more of an interesting compound called heat shock protein. Heat shock proteins (HSP) are families of proteins that do several things including accompanying and helping other proteins under stress (called chaperoning). Heat shock chaperones keep the other proteins neatly folded when they are being deformed by stress factors such as infection, ultraviolet light, starvation, heat, and other harsh conditions. Heat shock proteins help cell survival and are thought to mobilize immune function against infections and diseases. One of the big stressors of focus in heat shock study is cancer. Heat shock proteins have been investigated for their role in activating immune response to cancer, and in cancer vaccine research.
Molecular physiology isn't my research area, so I haven't done any work in it personally. I just read the work of others. Heat shock proteins are intensely fascinating to me for their role in exercise, in increasing tolerance to hot environments (interestingly, cold too), and other extreme challenges to the body. I hope to post more about it from the sports medicine meeting next week.
Getting enough exercise to improve strength and quality of life doesn't only mean exhausting yourself or stopping your day to change clothes and go "do exercises." Get exercise that is healthy and fun, and as a normal part of how you bend and position your body in healthful ways during your day.
The new expanded third edition is now available of the training manual, The Ab Revolution™ No More Crunches No More Back Pain.
The Ab Revolution™ is a groundbreaking core training method. It has two components. The first is to learn how to consciously use your core to reposition your spine away from injurious positioning and into healthful position for back pain control during everything you do. The second component uses the new healthy positioning during innovative exercises for fun, healthy, exercise that works your muscles more than conventional core training and works them in functional ways - training them in the way they need to work in real life.
The Ab Revolution™ uses no forward bending which pressures discs and reinforces the rounded upper spine that contributes to pain syndromes.
I rearched the method over many years in the lab and in real life with several thousands of students, patients, and participants, testing combinations of established and proven sports medicine rehabilitation techniques and physical training methods, then integrating them into real activities. I will present some of the research next week at the meeting of the American College of Sports Medicine (ACSM). The Ab Revolution™ is in use around the world at top spine centers and by athletes and military. SEAL teams say, "We use it - (we can't tell you our names, we'd have to kill you with our bare abs)."
Stretching has been shown in some studies to prevent injuries or pain, or improve athletic performance. Based on this, gyms are filled with people stretching - often in tight, unhealthy ways that re-emphasize the rounded forward postures that caused the pain and injuries in the first place. Other studies cast doubt on benefits of stretching for injury reduction, or indicate that stretching reduces muscle tensile contraction. Based on that, there are athletes who say they won't stretch at all. This is where I wind up back in the lab for more years to find out where the discrepancies lie and what to do about them.
The problem seems to be how people stretch, then how they then go exercise and incur their injuries. Another key issue is how they go about their real life outside of the gym and their stretching routine.
For many, stretching means producing a greater range of motion for any given joint, and bending forward to touch the toes. Many of these same people don't have the flexibility to comfortably lie flat without a pillow under head or knees, or stand with their back against a wall with the back of their head touching the wall without craning their neck or lower back. Their back and shoulders are too rounded forward. Their hip is too tight in front. Tight chest, shoulders, and anterior hip contributes to round-shouldered, bent forward posture. The average person is often too tight to just stand up straight. Consequently, they stand, walk, and do all activities at joint angles that impinge, grind, rub, and stress. This is functional tightness.
It is not a mystery when populations don't become more flexible or prevent injuries through conventional stretching routines. The idea of stretching needs to be reframed as specific retraining to restore healthy length to your muscles, so that you no longer stand, sit, and move with strained unhealthful positioning.
Stretching needs reform.
Several posts have introduced how ingrained unhealthful stretching is in popular fitness. Start with the following, plus the links I put in each, to see how to retrain your muscles and brain to stretch in ways that restores and retrains healthy positioning, rather than distort it:
--- Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified with DrBookspan.com/Academy.
Reuters News India reported that yesterday in the eastern state of Bihar, the driver of a stalled electric train asked passengers to help get it moving again. We call this a G.O.P. car (get out and push).
The train had stopped in an electrically neutral area between wires. Hundreds of passengers pushed for more than half an hour to move the train until it connected with the electric contact overhead to supply power again (different distances, time, and why the electric connection to overhead wires was lost, according to different news sources).
In the 1970s and 80s, I often worked as a scuba instructor and dive guide in the Caribbean Islands and Mexico. There were strange tides one day, and the boatman accidentally ran the old wooden dive boat (with no radio) aground, far from shore. It seemed reasonable enough (to me) to put everyone out in the waist deep water, decreasing the weight and draft (distance from the waterline to the bottom of the hull). All the paying passengers and I got to enjoy a yo-heave-ho of functional exercise in the water pushing the boat free under the shining sun. The boatman stayed onboard to steer. I also put the two children on the trip with us off the boat to help, although the shorter one rode on my shoulders, excitedly pushing with both hands and feet.
For many years, it has been an interesting question whether exercise will increase or decrease risk of decompression sickness after scuba diving. Exercise seems to affect evolution and dissolution of bubbles from the dissolved nitrogen absorbed and released during and after scuba dives. It is turning out that exercise can both increase and decrease risk, depending on the timing of the exercise, to be covered in future posts. It is a topic for divers from military operations to vacationers trying to adjust their risk factors, and divemasters and scuba instructors who haul anchors, gear, and passengers up and down boat ladders (and G.O.P. boats).
Going back to trains, at least 30 years ago, my mother and I came up with the idea that in addition to dining cars, rail lines should have an exercise car, instead of passengers being confined to long sitting. We envisioned stationary bicycles and other simulators hooked up to generators that would run lights (or television), or record the distance traveled, with windows or screens showing passing scenery like a nice bike trip or race. Participants could race with or against each other. (Originally, Mom thought the cyclists could power the entire train.) Ideas flowed, like having proceeds help set up exercise and health programs that develop body and spirit in poor neighborhoods passed though. We came up with several names like "Training" and other variations, and thought it would be a new exercise craze and sure-sell for the rail industry. We made inquiries and didn't hear much back. You heard it here first - now date-stamped in this blog as our fun idea.
I was one of the first people to develop fitness on cruise ships, back when cruises were thought of as only deck chairs and buffets - one story is in Parcours - Old Fun Is New Exercise.
Let me know if you want stories (or to set up a Fitness Fixer cruise).
Rail lines, are you interested? I will develop it for you as a fun fitness "Training™" program.
--- 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.
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Photo (unrelated to the Bihar train this week) by Prince Roy
Sitting in full squat with heels down can be healthful and useful. Squatting for daily life is a built-in Achilles stretch, more effective and functional than the standard "lunge and lean stretch" against the wall, or lowering one heel from a step or ledge. Better Achilles Tendon Stretch shows one Achilles tendon stretch that is effective and quick. Sitting in a full squat is another. Rising from the squat adds functional leg muscle strengthening and balance.
I took the photo, above left, in an airport in Asia. The man was easily sitting to work on his laptop during the hour before boarding. Others were similarly sitting with laptops and mobile devices to get work done. Elders squatted that way to rest.
Achilles Stretch in the Bathroom introduced the full squat as a functional normal daily action used in many countries for resting, washing, gardening, working, washing, toileting, chatting on the phone, and other activities, and gave an idea of how to try it. Save Knees When Squatting explains how keeping the heels down rather than lifting heels to rest on the ball of the foot is safer for the knees. Reader Mim supplied a wonderful link in the comments for a great little film of the Asia squat. More Fun Squatting tells a funny squatting story. People new to squatting may find their Achilles tendons are too tight to bend in this normal manner. Reader Ivy of New Zealand offered to demonstrate one easy way to practice this stretch in a safe way, and sent the photo at right.
Keep both heels down while holding something sturdy in front. Straighten your arms and lean back to shift weight away from the knee joints.
Squatting can be a nice stretch for your lower back too. I have been working, off and on, for some years on the interesting finding that slight forward spine rounding when just sitting on your heels in the squat (no weights) does not load the spine to the extent of sitting on your behind in a chair.
Be smart about trying it or not if you already have damaged knees. When rising, make sure to keep knees back over your feet, not sliding forward, which loads the knee joint, or inward at an angle (narrower than your feet), which can twist the joint. Either action can grind against the meniscus and cartilage.
Done properly, it should feel good on the Achilles and calf, lower back, be good exercise, not hurt the knees, and become an option for a functional stretch and even normal sitting ability.
Neolithic groups (stone age) worshiped the mother. Ancient Germans worshipped the virgin Hertha holding her child. Scandinavians worshipped virgin Disa holding her child. In ancient Egypt it was Isis with infant Osiris. In India, Devaki had Krishna (also by virgin birth). In Asia, Cybele and Deoius. Chinese holy mother Shing Moo held her child in arms. Christian missionaries to Tibet, China, and Japan found that holy mothers depicted with splendid light around their head and holding a divine child had been worshiped long before they got there.
In Rome, the goddess was Demeter, meaning Earth Mother, wearing wreathes of braided corn in her hair. In ancient Greece, Demeter was called Ceres, the great mother with baby at breast. From her name "Ceres," we get the word "cereal" (grains), "which made man different from wild animals."
In the spring in ancient Greece, celebrations were held in honor of Rhea, the Mother of the Gods. Christian Europe celebrated the spring festival of "Mother Church" who (they believed) would protect them from harm. During the 1600's, England celebrated "Mothering Sunday" on the 4th Sunday of Lent, honoring the mothers of England. All cultures worshiped the divine, the Mother, who gives life and food, compassion and love.
So. How to celebrate this Sunday on Mother's Day? I'm in favor of some goddess worship, probably involving some rocks and food and chocolates and compassion and love. Not so original, but time tested and universal:
Visit Mom (or a Mom) and give her a massage (if she wants one). Neck, hands, feet, back. Good for circulation for giver and receiver. Touch can be healthy. Ask her stories.
Make her (and you) something healthy to eat. For light teas, try cinnamon, cloves, grated orange peel, or ginger in hot water.
For a cold treat without unhealthy junk food, mash a frozen banana with crushed raw walnuts or flax seeds. Use a food grinder or get free exercise by mashing them yourself in a bowl. It will taste like creamy ice cream. Flax seeds and walnuts have been found to be effective to help bone health as vegetarian sources of omega-3 (n-3) fatty acids. Raw walnuts (as part of a general low fat and cholesterol diet) have also been found to have a beneficial effect to decrease cardiovascular disease risk, among other benefits. This treat has fiber and is non dairy, both associated with lower breast cancer risk.
Goddess worship often is helped with chocolate. The primary chemical in chocolate is theobromine. "Theo-" means God and "broma" comes from a word meaning food. The theobromine in chocolate was named for "food of the gods." Theobromine is an antioxidant, weak diuretic, stimulant, and mood booster, opens breathing airways, and relieves coughing. Dark chocolate has more theobromine than lighter chocolate, with flavonoids and phenolics, plant substances that are good for the heart. People who get a kind of vascular headache called migraine do better not to eat chocolate. For others, get plain cocoa, unsweetened, not junked up with sugar. Add the unsweetened cocoa to the frozen mashed banana and walnuts for a healthy sweet wonderful treat that tastes better than you would expect. For exotic flavor and more health benefit, add fresh grated ginger root.
Sit outside in the air and sun to have your tea and frozen banana. Warnings on the dangers of overtanning are important for preventing skin cancer for people who work outdoors, who over-tan for cosmetic purposes, and a few other populations. Another group to consider is those spending too little time outdoors. Sunlight exposure and the Vitamin D it makes your skin produce, is increasingly documented as crucial to bone density, healthy immune function, positive mood, sound sleep at night, relief of symptoms of rheumatoid arthritis, fibromyalgia, MS, Parkinsons, polycystic ovary, diabetes, and other health issues. A nice massage and tea and chocolate outside in the sunlight could be made into a wonderful Mother's Day. Nice excuse to buy a hat.
Make Mom (or a Mom) some homemade healthy skin lotion. Commercial products have preservatives, dyes, and chemicals. Try combinations of grape seed oil, tea tree oil (very small amount), vitamins C and E, ginger, honey, tea, fresh aloe, and fragrances from oils, fruit, flowers like lavender, or leaves like mint. (Don't wear citrus oils like lime out in the sun.)
Help out at a woman and child shelter. Or help at a men's shelter to help the guys get back on their feet to help their own families.
Celebrate Mother Earth - go out and pick up litter. It's good exercise. Bend right.
Make a trip to look around a home improvement center to see about some do it yourself solar projects, even if only to replace a few lights.
Reader Bill Slabonik had sports injuries, motorcycle and bicycling accidents. He was a good exerciser and hard worker, doing all the conventional exercises and ways of lifting during his regular workouts, long hours sitting as a pilot, and vigorous work in the Coast Guard. I know these things because I've seen his x-ray and MRI reports.
Bill writes:
"After two years of waking every couple hours with extreme pain in my shoulders and both hands completely numb, I sought relief from the medical community. Thinking that something was wrong with my shoulders, I was very surprised to find out that I had degenerative disc disease in my neck and spine. I was scheduled for epidural injections and advised that if they did not help, surgery was the only alternative. I was advised that I might consider disability retirement.
Not being pleased with my choices, I was able to get a script from my family doctor for physical therapy. Two months of therapy gave encouraging if small improvements. Back spasms stopped and pain diminished somewhat. Encouraged by this I continued to search online for neck and back pain fixes until I was fortunate to find a website maintained by Dr. Jolie Bookspan. The articles made logical sense to me and I soon ordered her book "Fix Your Own Pain." I noticed rapid improvement as soon as I began to practice her methods. Encouraged by these results I chose to attend one of her clinics held at Temple U.
I have returned to an active, athletic life. Waking due to pain is a thing of the past. I am setting and achieving physical goals that seemed impossible only a year ago. I am hiking farther and riding faster than I could have dreamed of. I am using post-it notes in my car, at my desk and on my flight kit for the airplane as reminders to maintain good position.
The photo is my neighbor Ken and myself taking a break from the year's Pennsylvania State Police Memorial century ride. He is also putting your principals into good use. We rode 50 miles that Saturday morning without pain or discomfort. Ken is 61 years old and I'm 55. The amazing part is that I had over 180 miles for the week without pain. Ken and I have made a goal of riding together on each of our birthdays, the number of miles matching our age, i.e., a 62 mile ride this fall for Ken's birthday. Oh, the ride was from Hershey, PA to Mount Gretna, PA and back. A nice loop through the central PA farmlands. Thanks again for your encouragement and books. I am feeling fantastic today!
Your work has not only provided hope but is putting life into my years. I want people to know that there is help.
I normally shy away from putting myself out on display like this, but if it encourages others to fix their pain then it was worth it. Thanks again Doc. I'm out mowing the lawn by hand.. two hours..no pain...riding my bike to work tomorrow 42 mile round trip.. I'm not going to stop."
Sincerely, LT William M. Slabonik US Coast Guard (Retired)
Fun note: the surname Slabonik means "Free Man." Bill now signs his e-mail updates to me as Free Man
--- Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Take classes, get certified - DrBookspan.com/Academy. ---
Bending over from a stand to touch the toes may "work" to stretch the hamstrings, but puts degenerative forces on the discs, whether you keep your back straight or rounded. It is also not a functional way to stretch. It is not done in the manner your body moves in regular life and does not train healthful movement.
One of my students, Vikki, demonstrates a nice, quick, and effective hamstring stretch, done standing straight, photo at right, that you can easily do during your regular day:
Stand facing a wall (or tree as in the photo) just about arm's length away.
Make sure both feet are facing forward, not turned out.
Lift one foot to press the heel against the wall at about hip height.
Peek down to see if your standing foot is straight, and has not rotated outward, not even a small amount.
Lift your upper body to stand straight.
Don't let your hip curl under or your back round.
Smile and breathe.
Hold a few seconds and switch legs.
Vikki and co-worker Cindy are State Paramedics. Cindy is the Director of Services and Vikki is in charge of Search and Rescue. They support firefighting crews in the field. When there is a large fire in their service area, they are posted at strategic spots near the fires, and might treat 1-2 firefighters a day with various injuries, dehydration, hyperthermia, and difficulty breathing due to smoke inhalation. During the rest of their daily work, they do a lot of heavy lifting and carrying.
Cindy and Vikki use the back pain reduction techniques, and the exercises and stretches of this blog and my classes for their work.
The Cook Strait, separating the north and south islands of New Zealand, is cold. Reader Dr. Ernie, 52 years old, is training to swim the 26 kilometers across the strait next February. Sixteen Miles of Cold Water started telling about it.
Cold water can be uncomfortable, even incapacitating. Scuba divers wear wet suits in cold water, and dry suits in very cold water, not only for comfort, but safety. According to International Swimming Federation rules (Fédération Internationale de Natation (FINA), marathon swimmers cannot use wet suits to stay warm. English Channel swimmer Ted Erikson is reported to have said that "wearing a wet suit in a marathon swim is like completing the Tour de France on a moped."
Unofficial swimmers can wear whatever they want, but the idea of training in the cold is to improve your fitness by training several body systems so you can generate more heat and better prevent heat loss. The process of increasing resistance to cold injury through regular cold exposure during real conditions is called cold acclimatization. The International Union of Physiological Sciences distinguishes acclimatization in actual conditions, from acclimation, which is change produced in a laboratory.
To be able to swim in the cold, you need to train in the cold water, not just swim in a pool. The idea is not supposed to be to make yourself sick and weak from cold, but to train to become healthier. Dr. Ernie writes:
"Last Saturday I did an 8 km swim: two and a half hours total, out to Somes Island in the middle of the harbour, fortunately dodging the big and small ships with the help of friends in an accompanying dinghy. It was a most gorgeous day. And though tired on the following Sunday, I felt ready to start up again on Monday. It was a tremendous confidence and stamina builder. Today (Sat) after about half an hour in the pool I ventured out and swam about 40 minutes -- water colder, rainy.... but exhilarating. Pretty much a sprint all the way (I have to stay warm enough). We are in our autumn here and will be easing into winter in a few months.
"I feel as if my best chance to make it across Cook Strait is not going to involve miles and miles in the pool, but lots of time in the ocean, hence I'm trying to maximize that, trying to become more and more familiar with its changing moods. I love it and am reaching a tremendous comfort with it even in rough conditions (as this past week). I'd really like to keep up sea swimming through winter without a wetsuit -- the water might get as low as 10 Celsius (50 degrees F).... we'll see."
In school, we were taught about the "unavoidable lordosis of pregnancy." Lordosis (technically, hyperlordosis) is when you allow too much inward arching in the lower spine - Drawing 1 at right.
Over-arching causes one kind of lower back pain. It was taught as something that "just happens" to the spine during pregnancy. I asked the professors why women could also get it before and after pregnancy, and why men got the same kind of compressive force on the joints of the spine, called facet joints. It became a focus of study in my lab with lifters for many years.
The post Neutral Spine or Not? and What is Neutral Spine and Why Does Sticking Out In Back Harm? show how slouching so that you increase the inward curve in the lower spine (increase the lordosis so that it is no longer neutral spine) pinches the lower back under the weight of the upper body. Both also show what neutral spine looks like compared to lordotic.
The upper body should be upright (vertical) and the hip level to be in neutral spine. Drawing 2, with x-ray, shows what hyperlordosis looks like when the front of the hip tilts down and the upper body leans backward. This is not the normal curve - it is too much. The back of the spine gets pinched and pressured.
I found that hyperlordosis is not caused by a pregnant belly or beer belly or carrying groceries or backpacks. The over-arching (hyperlordosis) is not unchangeable anatomy. It is leaning back to offset the load in front.
Note the same over-arching occurring with the overhead lift in drawing 3, below left.
Overarched spine position is something that you can decide whether to allow or not. You can easily use your muscles to prevent hyperlordosis and hold you in healthy upright position.
Try it for yourself:
Stand up and pick up your chair (bend right to pick it up for more exercise and back injury prevention).
Hold the chair like any package in front, or on your hip, and notice if you lean back to shift the weight off your muscles (make it easier). Where does the weight shift to? On to your lower spine.
Instead, stand straight. You will get free, built-in healthful exercise that protects your spine.
When carrying or lifting any load in front, from groceries, to a chair, to a pregnancy, or a baby on your hip, don't lean back to offset the load. To stop the arching and the lower back pain that results, tuck your hips under you as if doing a small abdominal crunch standing up until you are straight, without rounding forward. Don't over-tuck, tighten up, round your shoulders, or lean forward or backward. Just stand straight. When you tuck properly by moving your spine (not by tightening anything) the too-large arch will lessen to normal, and pressure in your lower back from the arching should immediately disappear.
The pelvic tilt to tuck the spine to restore an overly arched lower back to neutral spine was introduced in Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique and Healthier Carrying - Get Free Ab Exercise and Stop Pain. Don't overarch or lean the upper body backward while you stand and carry - center and right-hand figures in the drawing at left. That is the missing link. Stand upright in neutral spine - left hand figure. There is a small lower spine curve, not a large one, and the lower spine is not pinched and folding backward, which squashes the soft tissue, discs, and vertebral joints called facets.
I have heard argument that nine months is too long to expect someone to think about their spine, and the muscles get tired. As they say in computers, "that's not a bug, that's a feature." It's good news that you get a free core muscle workout and free back pain prevention. Pregnancy (and any weight lifting) is a key time to have that.
--- Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Thank you MyThreeShrinks for hosting Grand Rounds 3.32 this week at their site Shrinkwrap, and for including my post Exercise Your Sense of Humor. They also produced a podcast.
The Internet version of Grand Rounds is a weekly medical web post that recommends notable medical posts of the week.
A physician in New Zealand wrote that he is preparing to swim Cook Strait, the body of water separating the north and south islands of New Zealand, next February. The Strait is 26 km wide (16 statute miles). It may take him anywhere from 8 to 15 hours to swim, depending on tides and other factors. Temperatures range from 14 to 19 degrees Celsius (52-66 F). Body grease is allowed for the crossing, but no wetsuit, just a regular bathing suit. He asked me to call him "Ernie."
Dr. Ernie is 6'2", approx. 190 lbs, on the lean side. He shivers easily. He asked for suggestions about acclimatizing to cold water swimming.
Cold acclimatization means increasing your ability to tolerate cold. Cold acclimatization occurs through regular exposure to cold. People developing cold acclimatization don't need to shiver so soon, and generate more heat without shivering. They may develop ability to both increase and decrease skin temperatures. In some circumstances, skin blood flow increases to keep extremities warm. In other cases, it decreases to reduce heat loss.
Tolerance to cold improves with physical conditioning. A fit person can tolerate a colder external environment and lower internal body temperature than an unfit person before shivering begins, and they can generate more internal heat through shivering. Increased muscle through physical training increases their ability to produce and store heat. Being physically fitter allows you to exercise at a higher intensity to generate more heat. Cold tolerance increases more with exercise in the cold than from exercise alone. For that reason, you need to get out and exercise in the cold.
Dr. Ernie writes, "I've kept up my schedule of working on technique in the pool and have been in Wellington Harbour at least 4 times weekly for 30 minute swims: the temp is about 14-15 Celsius and I can feel myself slowly able to tolerate the cold better -- much less shivering after I'm finished."
A nice fat layer helps maintain warmth and buoyancy for cold water swims. You don't want so much fat that you are slower or unhealthy. I mentioned to Dr. Ernie, that maybe he can stay lean to make the training more effective (difficult) now, then gain the fat closer to time of the crossing when he will want an easier ride.
Readers, you are all great people. Feel good about yourselves. I appreciate all the e-mails how you're using the ideas in this blog, my website, and classes to stop years of pain, get back to doing fun things, or try healthy fun for the first time. You all can do extraordinary things even if you don't know it or think you are doing anything right now.
Some of you have written me about your lives. I have notes from people biking across continents and crossing the arctic using my training info. Notes from soldiers stationed in harm's way who stopped their back pain while carrying packs and during operations. Astronauts. Circus performers. Olympic wrestlers. Ultramarathoners. Competitive lifters who went on to increase personal records after being told by top physicians to give up lifting because of shoulder, elbow, back, and knee injuries. Concert musicians. Survivors of cancer and abuse. A runaway who went back to school because of the blog. A student who quit an unhealthy job. A man who could not lift his own children because of obesity, who used fitness as a lifestyle of bending and playing with his children to get to healthier weight. Readers Ivy and Zoe and MMLash let me tell a bit of their triumphs on the blog. Mim, Kate, Kathy, Julia, PhatMac, Eddie, and a few others helped with their success stories in the comments. The rest - too shy to post their stories? I understand that this blog attracts an independent intelligent bunch. It's not boasting, but educating and inspiring and helping others when you write. If you are not sure what to write, just e-mail me telling me what you tried, how it's helping, and we'll develop it.
You don't have to climb a mountain to be featured. Just getting out of bed is an Olympic sport some days. Stopping pain, making your daily life healthy movement, feeling good again (or for the first time), and having your life back *is* climbing the highest mountain.
