Fast Fitness - New Understanding of Hyperlordosis and Disc Injury
Friday, January 22, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - a new possible contributor to vertebral disc injury, and how to avoid it:
In my previous studies, I found that overdoing the inward lower spine curve (hyperlordosis) pinches the lower spine like a soda straw. It forces the spine joints, called facets, backward against each other, eventually wearing them, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix.
Hyperlordosis was not previously thought of as a direct herniating force on discs. The major factor was and still is too much forward bending. Weighted flexion (bending forward bearing your body weight) opens the space between vertebrae in back, and over years of slouched sitting and bad bending and lifting forward, presses discs outward through that space creating herniated discs (an injury, not a disease). In my previous work I found that for someone with a disc already herniated, hyperlordosis pinches it, adding pain to the separate problem of the disc. Showing people how to stop standing in hyperlordosis greatly reduced their disc pain. In recent work, I found that hyperlordosis exacerbates, and possibly initiates disc herniation itself.
My new work is showing that hyperlordosis is a probable mechanism to directly shift disc position. I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness.
Above, Left and center - Drawings of two ways you can stand in hyperlordosis, and the results over time, on the discs. Above, Right - Actual MRI, comparable to center drawing, shows disc herniation and pinching between lower vertebrae.
Hyperlordosis in both walkers, easily seen at right. Damaging sloppy posture.
Hyperlordosis (overarching the lower spine) is a spine damaging posture. Hyperlordosis and the pain from it can be changed as easily as moving your spine to a smaller, healthier degree of arch (neutral spine). It is not tightening your abs, just moving your spine, as simply as bending your elbow. Links below tell more.
--- Read success stories of these methods and send your own. See if your answers are already here by clicking labels, links in posts, archives, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "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,DrBookspan.com/Academy. Get more in Dr. Bookspan's Books.
Here is Fast Friday Fitness - Fun rows to strengthen your back, chest, arms, grip, and torso muscles, without bending over or forward, using commonly available objects, no gym needed:
To start, leave both feet on the ground. Hold a low study pipe, branch, or overhead handle. Lean far back, body straight. Bend both elbows to pull up and lower down as many times as you can. Improve by increasing the number of times, and how fast you can pull up.
Once you can hold on and pull up, increase strength and balance by lifting your feet to the overhead support. Hold on whatever way you want that is safe. Pull up and down.
Hold your body straight, not rounded as pictured. You will work your muscles harder, involve core muscles, and train knowledge and use of healthier positioning.
Rows are great and useful exercise. Instead of standing or sitting bent over, you can strengthen the same and more muscles without loading the lumbar discs. These incline rows are fun and useful for climbing, and building ability to do pull-ups.
Readers send in your straightened photo to be featured as the Fix for this Fitness.
When you send me your photos of fixing this and other fun things, send a photo sharing link of web-size, not high resolution, instead of e-mailing photos to me. Blogger isn't letting me upload directly, and when on the road, I don't have programs to resize. Have fun.
--- 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, 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.
"Thanks so much for your help. "I wanted to let you know that I have had a herniated disk in my lower back for eight months. Had physical therapy & injections, but still needed medications-pain pills, etc. I never experienced so much pain in my life. I came across your website & articles & starting doing what you recommended, & within days I have been feeling great & have reduced the pain medicine because I don't need it.
"I know now that I was doing the wrong exercises in the past- too much bending forward & back. Didn't really know that this exercising technique (bending, stretching forward, arching) is incorrect. It sure is!!!!
"I really like the hamstring stretch - putting your leg on the wall. This is terrific. I feel so MUCH BETTER....
"Also, when you get copies of the Abs book, please let me know. "Have a great day Dr. Bookspan!!!! Laraine"
A herniated disc is an injury, not a condition or disease. It can heal. You do not have to live with it. You can go on to being able to do more not less.
Discs are living parts of your body, not like a tooth that once broken cannot heal. Most of the time, injured areas can heal, if you let them. Bulging areas can reduce. Dried discs can rehydrate. Each night as you sleep, discs replenish fluid. They plump back up a bit. That is part of why you are taller each morning, than in the evening. They can do all this if you stop the causes that injured them.
Doing surgery, adjustments, treatments, massage or yoga does not stop the cause of disc injury. Common exercises add to injury. Not all exercise is medicine. Then it is no surprise when pain does not stop, or stops but returns, or the next disc herniates after fixing the first one.
Changing unhealthy movement habits that degenerate discs and push them out of place means moving in healthy ways for all you do, not just for sets and reps in a gym. You can do all the "reps" of back exercises in the world. If you return to bending and standing in injurious ways all day around the house and workplace, it is no surprise that the exercises and treatments did not fix the pain.
Click the following for simple ways to stop causes of disc injury. Get the overall concepts, don't bog down on details. I see people in gyms following trivial, exacting "proper form" for exercising, while missing the whole point of healthy bending and lifting or how to apply it to general motion all day.
--- Read success storiesand contribute your own of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Comments, A Medical Conference, New Findings on Discs
Monday, May 25, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
By the time this post comes out, we should be halfway out West to a medical conference. I'm presenting a study, which took years to do, and which found something unexpected.
I am a medical researcher. I find out the things that doctors (with any luck) then learn and put into practice. A research career has all (and more) of the medical schooling, but without the burden of the medical salary. In previous studies, I found that chronically overdoing the inward lower spine curve pinches the lower spine. It forces the spine joints, called facets, backward against each other, eventually wearing them out, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix. In the work I am presenting, I found that although it is known that the main factor to injure vertebral discs is too much bending forward, that overarching backward can hurt discs too. This is a new proposed mechanism of disc injury.
There is supposed to be a small inward curve to the lower spine. With the (very) small normal inward curve, spine bones line up on top of each other like stacks of cups so that there is equal pressure on discs from front to back. That is called normal lordosis (inward curve). Chronic bending forward manages to unequally load the discs so that they push out in back. Overarching also unequally loads the area. It seems to pinch already protruded discs, and may even factor in the herniation process. I will be presenting on years of my work that lead to this finding.
I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness. The Healthline blog software is still not loading any new photos of my own. Stock photos or those from other people's sharing sites appear, but I the blogger is not letting us get my own diagrams and student photos to you, for now. I mailed the image to Healthline.com staffer Jerry, who said he could upload it for you. It should appear here, below this paragraph, so you can understand better why hyper-lordosis, although common, and often taught, it not neutral spine and can make unnecessary pain. The damage and pain can be quick to fix when you know how. Click the labels "facets" and "lordosis" for posts explaining this issue.
I have to pay the travel to get to the conference, pay the conference fee, essentially, pay to work. I have to bring a computer and projector to give my own presentation (or pay an AV fee to the conference) but won't have Internet access to see or answer questions. Leave fun comments but hold questions for the next two weeks.
Photo is me, taken on the way on the way to a previous medical conference, out for some barefoot climbing.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
Fast Fitness - Better Back and Leg Exercise When Vacuuming
Friday, January 30, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Prevent lumbar disc degeneration, and strengthen and stretch your legs without needing a gym, trainer, or exercise equipment, or even changing your clothes:
Notice if you bend wrong - pictured at right with red X. It may stretch and feel good, but over time pushes discs outward to the back (herniates them).
Stand upright and bend both knees in a lunge - pictured center with green check mark.
Instead of only doing lunges as an exercise 10 times and paying for a trainer or a gym (right) use it hundreds of times a day for real life bending. That is functional exercise.
Good bending will not hurt your knees. Keep front knee back over your ankle (left and middle photo with green check mark). Healthy positioning keeps your body weight on your muscles and off your knee joint.
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking labels below posts, links, and archives. Read success stories of these methods and send your own.
Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column.
Overhead Lifting, Reaching, and Throwing Part II - Lower Back
Wednesday, January 07, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Part I of this three part series, showed a major hidden cause of rotator cuff injury - jutting the neck and chin forward while raising arms. This post shows a major hidden cause of "mystery lower back pain."
Letting the head and neck hang forward is called a "forward head." The forward head puts the shoulder at a position of compression when the arm is raised, even when using a computer, a common cause of pain and numbness that radiates down the arm.
The forward head is a bad posture. It causes much upper back and neck pain. Usually people have a forward head because they do not know it is bad posture and do not prevent it. Occasionally they have used a forward position for so long that the muscles get tight and it feels familiar to jut forward and strange to hold the neck and head in upright healthier position. Click links below to Fitness Fixer articles that show how to spot and prevent the cause of the injurious positioning.
The photographer (red shirt) in the photo at left, several of the people in blue shirts, are leaning the upper body backward to raise the arms. Leaning back increases the inward arch of the lower back.
The resulting posture is called swayback, overarching, and hyperlordosis.
Hyperlordosis is a major cause of mystery lower back pain. The sharp angle presses on the lower spine, making it ache. Over time, the compression can injure the facet joints which are the joints of the vertebrae, discs, and soft tissue.
Reader David from Belgium has made us several helpful training videos. In the one below:
Click the arrow to watch as he reaches upward.
He first allows the beltline to tip downward, then mostly corrects it.
David left some of the arch to show readers.
I thank David for all his continuing great work. We are in the process of making more of these helpful topic segments.
Coming on Friday Fast Fitness - How Abdominal Muscles Prevent Hyperlordosis When Carrying.
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Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own. Have The Fitness Fixer e-mailed to you, free. Click "updates via e-mail" - Health Expert Updates (trumpet icon) upper right column. Find fun topics on the Fitness Fixer Index.
14,000 Miles on a Bike - Herniating and Fixing Discs
Monday, November 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Kristin S was run over by a hit-and-run driver while biking home from work. The car's trailer hitch crushed her face, nose, jaw, cheekbones, and eye sockets inward to her sinus cavities. After Kristin's reconstructive surgery, her step-mother, a student in my martial arts classes, asked me to make a house call to get Kristin back to physical activity. When I met Kristin, she had just had the wiring removed from her jaw, was moving slowly and painfully, and could barely open her mouth when she greeted me at the door.
We had a good session. I showed Kristin several of my rehab methods. She was a good listener and applied everything well. She rehabbed quickly and went back to biking, her socially conscious work, and her active life.
Kristin soon designed a bike trip called The EarthCycle Campaign to raise public awareness of ways to reduce common practices that waste and destroy world resources. Her trip extended 14,000 miles (22,530 kilometers) from Fairbanks, Alaska USA to Tierra Del Fuego, Antártida e islas del Atlántico Sur, Argentina.
I donated some of my books to Kristin to raffle along with her other fund raising activity for the trip, then off she went.
Along the 14,000 mile ride, Kristin stopped in villages and cities to exchange information about simple ways that we all can lower our impact on Earth's environment.
Months of biking passed. Kristin's back pain began.
Pain worsened as she rode mile after mile, through villages, open roads, and cities. She tried exercises she found on various web sites and doctors visited in cities she passed through. She did yoga. She stretched. The pain worsened. After one medical evaluation, the doctors told her results showed several herniated discs in her lower back. From there, she was told by every doctor that it was permanent and she had to stop biking. The rehab they gave her didn't help.
I received a short e-mail from somewhere on the road - "Help me, how do I fix this, they said I have to live with pain and have to stop the tour."
I chided her good-naturedly, "Kristin you should have read my books before selling them :-)" I e-mailed her back explaining the uncomplicated way that discs can be injured and also healed.
A herniated disc nearly always bulges (herniates/moves/slips/migrates/extrudes) toward the back of the spine, not the front. What pushes it to the back? You do.
Sitting with a rounded back physically angles the spine bones (vertebrae) closer in front and farther apart in back. The "opening" in back is often mistakenly written about as a positive way to make space for the nerves, but what is missed is that the bones pinching closer in front make unequal pressure, like squeezing a tube of toothpaste from one end. A little knowledge is a dangerous thing. Contents are squeezed outward to the other side. The discs are mashed and degenerated in front and pushed outward (herniated), little bit by bit, in back. At left (hopefully since we're still having graphics problems) is a graphic of the process from the post: Disc Pain - Not a Mystery, Easy to Fix. Two vertebrae are shown from a side view, as if you are sitting facing right. The right-hand drawing shows how sitting bent forward physically pushes discs (herniates them).
Sitting and standing straight would make space in a healthier way for the nerves.
Disc herniation is a process taking a few years, just like the damage of smoking or eating junk food accumulates until the heart is damaged enough to hurt.
I e-mailed Kristin telling her that a herniated disc is a simple injury, not a condition. It can heal if you understand and stop the bad postures that push the disc outward. In her case, it was sitting bent rounded over her bike, and unhealthful stretching and yoga. Here is what she did to understand and fix it all:
So was her yoga. If you already spend time bent forward and have the usually result of a flexion injury, you don't need more forward bending stretches - Getting the Right Yoga Medicine.
Questions come in by the hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives. Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
For someone with "foot drop," the front lower leg muscles are too weak to lift the foot upward at the ankle. The foot hangs downward instead of lifting upward to take each step. Gait is altered and the front of the foot may slap the ground with each step. Fixing foot drop involves fixing three things - stopping the original cause, strengthening the (several) secondary effects of the weakened and tightened muscles, and retraining gait to normal. Common treatment options of braces to hold the foot up, canes or walkers to steady walking, drugs for the pain of whatever is causing it, reductions in activity, and certain surgeries, may all interfere with recovery and create new, and even more serious problems. Healthy treatment can be done without surgery, drugs, inactivity, or bracing.
One common surgery fuses the ankle so that the foot can't hang down. The foot can't move any other way either, causing new gait disturbance, and limitations in moving for health or fun. When foot drop comes from a herniated disc reducing nerve conduction, surgeries may remove the disc. However, discs are needed for healthy spine dynamics. Surgical spine fusion, even more drastically limits healthful movement, and ultimately health itself.
Interchangeably called drop foot, it is not a disease by itself, but the result of something else. Foot drop can follow a herniated disc that presses on nerves that exit the lower spine. It may also come from an injury directly to the peroneal nerve behind the knee. Certain diseases of the nervous system such as multiple sclerosis, Parkinson's, and amyotrophic lateral sclerosis (ALS) may reduce signals to various nerves.
A disturbing and increasing number of foot drop cases come from back and knee surgery. Someone undergoing surgery for a herniated disc or a knee replacement may wake with foot drop when nearby nerves were damaged or accidentally cut during the surgery. Such "side effects" are regularly called unavoidable surgical risks. It is important to change understanding of medical practice so that it is understood that adding new problems is not healthy and so, isn't "health care." Tragically, surgery itself for disc trouble is nearly always unnecessary.
As foot drop continues, lack of stretching in back of the leg that would have naturally come with each step from lifting the foot results in Achilles tendon and other structural tightness. Tightness can increase until that alone restricts lifting the foot.
Reader Sylvia wrote me several notes of her success reversing the components of foot drop. She first wrote in August, after finding the post of Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. Her photos walking with a cane and needing to ride in a golf cart are above, left.
In Sylvia's case, her physician told her that a herniated disc was preventing the nerve down the leg from conducting enough to the front lower leg muscles (usually the tibialis anterior), which lifts the foot. Sylvia wrote,
"The specialist orthopedic surgeon I was referred to fortunately said he would not operate and my subsequent follow up visit has resulted in him telling me to go away as I am no longer in pain although I still have no dorsiflexion (upward lift of the foot). If in a year I still have drop foot I should discuss again with my doctor. Not very helpful…Thankyou for the wonderful work you have done putting this web-site together Best Wishes from England.
Sylvia"
When a disc is involved, the first thing to do is to stop the reasons for discs pressing outward, such as bad bending and sitting, and use good bending and sitting instead. If it is slouching so that you have too much inward curve of the lower spine, and that is pressing on the nerve, or it pushes the disc which then pushes the nerve, then you stop that habit, so it can heal. Stop the source. Surgery is not necessary. This is explained more in the post Cauda Equina - Result Not Cause. Then you exercise the shin muscles that have weakened, and stretch the calf and Achilles and bottom of the foot, which has tightened. You also need to practice balance and gait.
Reader Ivy began corresponding in the comments of the post to tell Sylvia her specific events to first stop the disc herniation, which was pressing and constricting nerve conduction.
By October, Sylvia has done much to reserve several causes and results. She was walking without a cane (right) and wrote,
"Hi Jolie and Ivy "I really appreciate your support and enthusiasm. My badly herniated disc obviously impinged on the nerve causing the nerve damage. I know this is from years of bad posture. I have come a long way already but not too far in the lunging and balance areas yet.
"At the weekend I was seen to be dancing at my son's wedding and I realised that non-one would believe I am usually slapping along.
"Instead of wearing my usual flat shoes or bare feet I had some new ankle strap 2 inch heel sandals for the event. The strap helps to keep the shoe on and the height of the heel was just right to keep me on my toes ! So I have decided to find a dance class to supplement my pool and land exercises as I have rediscovered I love dancing !
"I am going to Florida for a couple of months and should be able to find some dance action there. I'm going to try and toe walk on the sandy beach too.
"In the meantime I will keep on trying to change my bad postural habits! Best wishes. Sylvia"
Sylvia and I also corresponded. She send a photo of her happy and healthy at her son's wedding (below, right), with this update:
"Dear Dr Jolie, "I have received the books today... Now I have no excuse for not stretching and correctly at that !
"I can't wait to get back in the water and see how my ankles are - they are probably quite stiff so will need some work.
"I have printed the Inspirational Ivy page with the pictures of her exercising and keep it in my purse as a constant reminder that my condition will improve. Everyone here whom I haven't seen for two months whilst in the UK, is telling me how much better I'm walking. I tell them what I'm doing and if they have any problems refer them to your web page. Best wishes for now." Sylvia
We will be hearing more wonderful things from Sylvia.
Disc Pain - Not a Mystery, Easy to Fix - When you stop bending wrong many times each day, which pushes discs outward many times each day, damaging forces will stop, and can heal.
Read success stories of these methods and send your own. Questions come in by hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Have The Fitness Fixer e-mailed to you, free. Click updates via e-mail "Health Expert Updates" (trumpet icon) upper right column. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
In medicine, if someone wants to lose weight, they can do things to lose weight. It wouldn't work as well to "balance" the practice by doing things that both gain and lose. If someone has too high blood cholesterol, they may use foods, medicine, and exercise to lower it. It isn't helpful to do one thing to raise and another to lower the level. There's no need to "balance" the level by doing things to raise the level too.
In modern life, it is common to sit too much. The answer is not more sitting, or to bend forward more, but to get up and stretch the other way. The concept is not just mystic yoga, but common sense.
It is good yoga to omit moves that are not needed. Yoga has a long tradition to add or restrict specific movements and foods when you have too much or too little of something. Not all forward bending yoga moves are needed or useful to do in every class, and for many people, not at all.
It is not a mystery that several specific injuries come from too much time spent with the hip and spine bent forward. Hours a day, over months and years of sitting rounded forward, bring vertebrae together toward the front of the spinal column, slowly pressing the discs between them outward to the back, like squeezing the front of an old tube of toothpaste. Disc degeneration and herniation slowly result. The muscles that cross the front of the hip can become shortened until it is uncomfortable to stand or lie flat and straight. The front of the chest can round until round - posture feels normal and the rotator cuff rubs a little more raw with each lift of the arm. These are just three of several injuries from too much forward bending, also called flexion injury.
Someone with disc pain or other flexion injury doesn't need more flexion (forward bending). They need to reduce flexion and stretch the areas the other way. It is not unbalanced to give what is needed, not impose more of the cause of the problem. This becomes even more important with every passing year, as patterns and injuries become deep-rooted.
David Demets of Belgium has been invited to participate as a yoga teacher at a Global Mala event in Bruges. The event takes place September 21 and 22 at many places around the world. David will be one of four yoga teacher to lead people in 27 sun salutations on the 21st, to make a total of 108. The developers of the event say there are many approaches to leading a Yoga Mala and that they are open to any style of basic sun salutation.
One of many different parts of yoga is a short series of movements done in an order, like a dance, called a Salutation. Yoga has many different Salutations - moon salutations, wind salutations, sun salutations among others. They have different purposes, done at different times for different needs. Using all parts of one salutation for all students at all times, for people already loaded heavily with injury or pain from too much sitting does not serve the purpose of yoga.
David writes,
"I think this is a great opportunity to introduce yoga without (weighted) forward bending to a large group of people. So I'm working on an adapted sun salutation where I've left out the standing forward bend. I've made a video of this for my blog."
For forward range of motion without loading outward pressure on the discs, David retains the lunge with hands forward on the floor and the downward dog.
One year ago in October, David wrote me that he developed a yoga class that does not give more flexion to people with flexion injury. He wrote, "My mother follows this class as well. She says she hardly ever feels the hernia (herniated disc) in her back anymore since she started following (this new method). And I know she had really painful trouble with her back the past years. This is simply amazing! I'm very grateful."
Part II coming up - what happened when I explained this to one class that I teach.
Here is Friday Fast Fitness - rows to strengthen the upper body, practice balance and neutral spine, and avoid lower disc injury from bad forward bending.
Readers have been writing in, excited about doing handstands for the first time or improving the handstand they do to get whole body functional fun exercise. My student Danielle demonstrates:
Shift your weight to stand on one hand. Grasp a hand weight in the other hand
Do rows, and any variety of arm free-weight movements that you want to improve.
There is no need to bend over forward to do rows. It does not train functional posture, and unequally squeezes lower discs outward, which adds to degeneration and herniation forces that are common during bad daily sitting and unhealthy bending. You don't need more unhealthy things while exercising.
What Is The Difference Between A Leg Press and a Squat?
Monday, July 14, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Is a leg press the same as a squat upside down? Both the squat and leg press bend and straighten the legs against resistance. But something special makes opposite forces on the joints.
The post Exercising With A Friend - Partner Leg Press showed a fun leg press without equipment using a friend for resistance, balance, and teamwork. Reader Nina left the comment on the post: "This could being done another way. Sit on a bench or sumthing (sp) else back-to-back with your partner. Interlock arms sitting straight with your backs pressed together. Rise up and down, and feel the pressure on your leg muscles."
What Nina describes is called a squat or half-squat. The exercise in the post is a leg press. Standing on your feet changes it to a squat.
The squat has opposite joint and muscle dynamics to the leg press. In the kind of leg press described in this post, your body is fixed, and the feet move away. In the squat, the feet are fixed and the body moves. The difference in which end is stationary creates different forces on the muscles and joints.
My students Lily and Biji demonstrate one way to do a fun partner leg press. Hold your body (and head) stable.
To do half-squats with or without a partner, it is usually better exercise and balance training without the bench. There is no need for equipment. Instead, use your own muscles to hold up body weight, rather than sitting or touching down to a bench between each raise. The squat is functional - meaning it uses your body the way muscles need for real life. The key is using the half squat for healthy daily bending instead of "bending wrong." Bending over forward unequally weights the discs of the spine. Over years of bad bending, you can accumulate enough small pushes on the discs to begin to break them down and push them outward toward the back. This is the process of disc herniation. It is not a mysterious situation or a disease process. It is simple mechanics. The resulting disc damage, slippage, herniation, is an injury that can heal, usually easily and quickly when you stop the injury process of bad bending during standing, sitting, and lifting.
Your body needs to practice both kinds of leg resistance to be good at both. Have fun building functional squatting into daily life instead of dong artificial squats in a gym, then bending wrong hurting your discs the rest of your day. Have fun doing leg presses balancing friends and family that move and squirm, instead of ignoring real humans to interact only with artificial stationary gym equipment. Get real fitness with real life.
The new Indiana Jones movie came out this past weekend, the Kingdom of the Crystal Skull. It is set in 1957 with fun fitness and iconry of the era, for future blog posts. Today - the Rocket Sled.
In the early part of the movie, Indiana Jones and the Soviet Russians brawl through a US military testing base in Nevada. Jones and a Russian officer wind up on a rocket sled, which blasts them on a speed track into the desert.
Rocket sleds are one of several devices that create and test the effects of high acceleration on equipment and the people who use them. High acceleration forces occur when jets take off quickly, when launching a space flight, to eject from a hit (compromised) fighter jet, on roller coasters and spin and fall rides, when you fall from a height, and any time you change speed and/or direction quickly. Interesting changes occur in the body under acceleration. Acceleration is one of the areas of my study as a research physiologist and was my work for a time at two facilities testing air vehicle and human systems.
G-force is a measure of acceleration, not force, but the term g-force is also used for the reaction force that results from acceleration. More on meaning, spelling, and math of g and G in another post. Too much g-force can result in g-LOC (Loss of Consciousness), pronounced "jee-lock"in English, but just as meaningful when using the Cyrillic pronunciation of "loss." When piloting a multi-billion dollar property (the fighter jet) G-LOC is not a good thing for anyone. The pilot may convulse, called "doing an Elvis" because the flailing looks like playing an air guitar - a real air guitar. Then the pilot may "ding" (lose consciousness) and the vehicle may "descend below the level of the terrain" (crash) and "disperse energetically" (explode) and "value unfavorably" (be destroyed), and the crew and anyone they land on may "achieve a negative health status" (die).
So we test.
A rocket sled is a small platform. Rockets propel it on the ground on rails. It creates high onset g-forces for a time limited to the length of the track. When personnel or equipment riding it sit as in a car or plane, they experience acceleration pressing them from front to back (on an x-axis).
To measure the higher g-forces with short onset experienced in jet bail-out procedures, a vertical ejection tower can be used. A small seat is propelled quickly upward by a contained blast force under it (like lighting a bomb). If they are positioned to sit upright, the acceleration acts on them from head to foot, on their y-axis.
To experiment with varying accelerations over different amounts of time and onsets, one device used is a centrifuge. A long support arm swings around and around a center anchoring point -like swinging a ball on a string around your head. A container, often ball shaped, at the end of the support arm holds the equipment or personnel being tested. The ball can rotate to position the people inside at any angle to simulate the changing positioning of a cockpit during maneuvers, for example.
What happens to the people in these testing devices? Often they throw up all over my nice equipment. Some of my test subject pilots used to have contests who could eat the worst thing to redisplay on testing day. One ate plastic bugs just for the fun he was sure to cause - then he didn't throw up, no matter what we did to him. In vertical (y-axis) ejections, there is high impact and acceleration forces on the discs and spine. Back injury is a concern for ejection scenarios. Vibration, both during acceleration and non-acceleration situations, such as for helicopter and jack hammer operators seems to be a high contributor to back pain. It is not known if the various vibration devices sold as fitness devices are of the kind (vibration frequency or amplitude) that contribute to joint pain. G-LOC is another consideration. Why do we test it? To see how to prevent it, if we can screen for who is more likely to get it, if we can train those prone to it to be more resistant, and so on, in g-force tolerance improvement programs (g-TIP).
The set of photos at right is a well-known one of USAF Colonel John Paul Stapp, M.D., Ph.D., riding the rocket sled. He was a pioneer of acceleration study and is also known as the originator of the expression "Murphy's Law" for things that can go wrong. The effect on his face along the x-axis is not from his high speed, but the acceleration which is increasing in photos ii and iii, and decreasing in v and vi. Even though his speed is greatest in photo iv, speed is not increasing or decreasing much, so there is little effect.
More on the interesting effects of acceleration and environmental testing from roller coasters to jets to movies in posts to come.
Click labels under this post for more Fitness Fixer on each topic. For example, for all posts on fitness issues portrayed in the movies or other media, click movie/media fitness.
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Feeling Better Than She Ever Has Part II - Fixing Herniated Disk and Reclaiming Active Life
Tuesday, April 15, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Barbara lives in a little town of 300 people in Yukon Canada - map at right. Part I of Barbara's story last Wednesday described why it didn't take six weeks to fix Barbara's herniated discs and severe sciatic pain and numbness, but it was six weeks until the "light went on" and she did the things to stop the cause of the injury, so it could stop hurting and start to heal.
Here is an insider's peek behind the scenes week-by-week:
"Dear Dr. Bookspan, "This is a bit of a long one, and probably reaffirms everything you've ever received in hundred and hundreds of emails and stories, but I wanted to share this with you anyway. I can’t thank you enough for working hard and sharing all your knowledge. I am almost completely pain free!
"After 6 weeks of severe sciatic pain and numbness and weakness of my left leg and foot, something just clicked on Thursday night and I became more determined than ever that I could get rid of the pain. Through your website, the Fitness Fixer, and reading lots of personal stories (on your web site and book), I realized that I had to fix (the) causes. I know this might sound dramatic, but you’ve changed my way of life.
"Pre-sciatica lifestyle: "A cycle of: 1) a few months, everyday, of "power" exercising with all the unhealthful postures and movement habits you talk about, then sitting at the computer in all the unhealthy ways you talk about and drinking coffee and smoking, feeling like I’d accomplished something in my day; 2) followed by a few months of complete laziness (not even power exercising). Power exercising consisted of running (without stretching at all) with bad form, and Hatha Yoga (forcing myself into the stretches and tons of forward bending).
"Sciatica struck.
"First two weeks: "I did absolutely nothing about it. I read stuff on the internet and was convinced from the stories that I had some debilitating disease that would affect the rest of my life. I thought the cause was that I didn’t keep up with my "power" exercising. But, I continued to sit bent forward in a chair, hunched over, bending wrong, doing yoga forward bends, smoking and drinking coffee. I know, how sad."
How to avoid herniating forces on the lower back discs during yoga and fitness stretches for the hamstring:Healthier Hamstring Stretching
"Third week: "Had to go back to work in the morning, teaching 4 and 5 year olds in a kindergarten class; in the afternoon, teaching reading strategies to Grade 1 and 2's - sitting in a chair all afternoon. No longer could I hobble around the house holding my backside and leg - full on activity - and pain, tingling, numbness in my left foot, and total weakness in my left leg. Felt like I was walking around all day with a Charlie horse going down my entire left side. Amidst all my continued Internet searches, stumbled upon your website when a friend said that slight forward bending doing dishes and getting ready in the morning leaning over the sink might be a cause. Your website made so much sense to me - if a slight forward bend is a bad thing, how much more unhealthy would my Hatha yoga program be, with all its constant forward bends. I might add here that the two people at work who talk about slight forward bending being a bad thing continually hunch forward while sitting and exercise using forward bends. Just something I’ve begun to notice."
Major news stories quote physicians saying that back pain is often a mystery and that no one knows why stretching isn't working. My readers regularly report that once they understand the simple principles, they see the unhealthful positioning that causes pain frequently - at the gym, in fitness magazines, and in exercise videos and classes:
"I started with lying on the floor propped up, upper and lower back extensions, pec and trapezius stretches, isometric abs, being continually aware of my posture and not doing ANY bad forward bending. Tried to do the lunges and squats for daily good bending, but my muscles were so weak and I practiced them half-heartedly. I tried to apply them in daily life but life seemed so fast-paced at work and I was in so much pain constantly, that I would get _ way into it and then just try to lean to the side to pick things up - result, I was contorting my body in very odd ways! I ordered a support brace and special support backrest (now I know why I never needed them) and seat cushion for my chair from other web sites, but also ordered your book Fix Your Own Pain, along with a few of your other books."
"Fourth Week: "Limping and terrible pain, my boss told me to visit the nurses station -living in a town of 300 in the far north, we have one general store and a health centre, doctor visits once every two weeks - and take every afternoon off during this week to rest up. He still needed me at work in the mornings. Taking my new prescription of Naproxen and trying the lunges and squats and some stretches but not really trying to apply them to the rest of how I was moving and bending and sitting. I would be in quite a bit of pain coming home from my mornings at work. In the afternoons I would basically throw in some stretches, but generally read (sitting badly) and nap for an hour. A lot of the pain would dissipate after my stretches and a good nap - only to be set into full force the next morning at work.
"Your book came in on the Friday and I was very excited. I read through it and practiced the retraining stretches that show how to restore straighter positioning throughout the day. I felt much better by Sunday night with the stretching. Still only half-hearted attempts at lunges and squats."
"Fifth Week: "Decided to start my morning off by doing my full range of stretches instead of sitting in the computer chair smoking and drinking coffee. I felt pretty good when I left for work. People at work were starting to call me "feisty" saying that I seemed to be walking better (that was probably because of my better posture from applying your method instead of just doing stretches!) Sitting in a chair almost killed me - after 25 minutes in a chair the pain was almost unrecoverable - to be endured for the next hour and a half at work."
Barbara was getting the idea about healthy movement, but was sitting in the same way that causes discs to be pressured. She thought it was "taken care of" because she used a commercial lumbar support she purchased the first week. However she was still sitting in unhealthy ways, right over the support:
"I could manage the pain better with frequent relaxing on my stomach propped up on arms and stretching, but I never felt complete relief until I got home at night. I still didn't realize it was bad sitting position, so decided to get rid of my chair and stand to teach. This was better, but the pain still kicked in(especially in my left buttock!). Once my left buttock got hit with pain it went downhill - down my whole leg, followed by the numbness and severe tingling. Midway through the week I went to see our visiting doctor - quick visit and the prognosis that I had a herniated disc L5-S1. He said it would heal. I was feeling pretty positive about this, as it seemed to coincide with what you say about herniated discs. Meanwhile, the sciatica was taking it out of me. I felt I was always either in pain, or awaiting a painful episode. I made it through, relieved that the weekend was underway. I decided to trying walking - every couple of hours I'd walk on my treadmill for 20 minutes and then do my stretches. I did this two times in the day, and then went for a walk outside in the evening (-35 degree weather so I bundled up really well). My dog and I headed out for what was to be the most agonizing walk for me. Half hour into the walk I started to get that butt pain but I was only half way home. By the time I got home after an hour walk, I wanted to hit the roof and I although I could alleviate some of the pain through lying on my stomach propped up, and stretches, I could still barely sleep. I was also completely consumed by whether or not I had slacked in my posture somewhere along the line while I was walking, or whether I was too tight or loose (still missing the big picture)."
"Sixth Week: "Still determined. Began the week at an all-day staff meeting where I lay on a gym mat on my stomach, propped up on my elbows- all day. Stretching at lunch and a couple of other times I walked out of the meeting to stretch. It almost floored me to do a 20 minute standing stint that we had to do during our meeting. Followed by a 2 hour course via video-conferencing where I did the same thing. When I got home the pain was less and I didn’t want to "over-do" it again, so I gently did my stretches throughout the evening- I didn’t try to walk. Next day at work, the pain was pretty bad from the beginning, but it was -60 degrees F outside and not many kids came to school - more time out to stretch when I needed to. Wednesday - more of the same. I tried to walk at night but got discouraged when I couldn’t walk for more than about 10 minutes without pain. Thursday - same thing, but I almost ran out of the school at the end of the morning to go to the nurses station. (We both wrongly assumed that I had overdone walking, not just walked in injurious ways.) She prescribed more Naproxen and told me to make sure that I walked but more frequent intervals. She also told me to keep stretching, but that lunges and squats were simply out - don’t do them. I kept wondering about this advice as I reread Ivy’s story and looked at the pictures of her doing those amazing squats and lunges. I spent most of my evening on the internet reading and rereading stories."
Barbara was lying face down propped up on elbows for long periods in a way that hurt instead of help. Instead of letting the entire spine gently extend backward so that the upper back "unrounded," she was "folding" a crease at the lower back, increasing pinching in the lower back.
"Friday of the Sixth Week: True Awakening! "I took Friday off work and first thing in the morning while I was doing my usual morning stretch routine, it just hit me! I became so obsessed with my posture, thinking that stretches should magically make my pain disappear, but I wasn’t viewing my body as how I used it during regular activity; I was also very guilty of giving up on certain things when they got "too hard" (lunges, squats). My balance was bad (despite trying to practice it while putting on my socks and shoes), my walking gait was horrible, I wasn’t really trying to do anything that required some effort, and I was continuing my bad habits of resting for hours before I tried to get back up and stretch again. Having reread some of the personal stories, I worked on my walking: feet straight ahead, feet hip-distance apart, heel to ball of foot, using my whole foot to walk - I was so focused on posture that I was holding myself stiff while walking instead of walking naturally with a bit of rotation at the waist). When I thought I was using my muscles, I was really just tensing them right up instead of truly using them. Reading posts and walking also made me realize how tight my Achilles tendon, hamstrings, and hips are. I decided to work on this through my stretches too. Next hour I was back up and walking, and stretching those areas after (using a counter to hold onto while doing a full squat, doorway hamstring stretch, and stretching my hip sitting on a chair rather than lying on the floor). Every hour I walked and stretched, and every walking session was longer, every stretching session I could actually stretch farther! Halfway through the day - now it was time to really engage myself in those lunges and half-squats - just do them and do them properly - no excuses - I need them for everyday life and unless I go beyond what I think I can do, I’ll never get to that point. They’re definitely not just part of an exercise routine, but unless I could do them with strength and stability in my living room, I knew I couldn’t do them in a fast-paced setting when I needed them.
"Time to stop making excuses. I was up and about constantly all day, walking, lunges and squats, stretching. By the end of the day, I can’t even describe my feeling of elation when I went to bed completely pain free, with my left leg hardly stiff at all, and some of the numbness in my left foot gone! Actually having been rather lazy, and in fear of lunges and squats doing more damage, they turned out to be the best stretches and strengtheners...now why wouldn’t I want to use these in all situations to get a beautiful natural stretch during my day! The confidence and calmness that all using your principles, and truly using my muscles to engage in activities is giving me give is fabulous. Not to mention all the energy! This is a new way of life for me. And quitting smoking is not a different story...it’s the same story...and my next step is to look into my eating habits and to quit smoking. It’s my life and my body is a temple...I’m sick of mistreating this temple with lethargy and apathy. No more unhealthy exercises in "power" work-outs and yoga for me...strength, balance and flexibility will is every moment, every day. Now I'm ready for your Healthy Martial Arts book...
"Thank you! Thank you! You (and Ivy) are my inspiration! Wishing for you all joy and true happiness in life (which I know you already have :) ). "Fondly, Barbara
"I'm truly thankful for your hard work and great insight into pain and how to live healthy in every day life!!
"PS I was frightened when I was told I had a herniated disk at L5-S1, and this was great news to me as I know I'm healing and I won't need any physiotherapists, etc. to help me through this! Your book Fix Your Own Pain is amazing - I think I've almost memorized it; two people at work have borrowed it already (including my boss) - I think they're seeing how much it has helped me. I'm thinking about giving your book to people for Christmas."
Summary "take-home" message - Barbara found that she doesn't have to "do" any exercises. That is the difference with this method and others. Moving for daily activities using the retrained healthful positioning stops the source of the injury. At the same time, it just happens to give much built in functional healthful movement. That is how exercise is supposed to be - a natural part of your human life.
There is more good news to Barbara's story, but that's enough for now.
Here is Fast Friday Fitness - straighten out first thing in the morning and help your back feel good.
Instead of sitting on the bed first thing in the morning, which loads the discs, try this:
Before getting out of bed, turn face down propped gently on elbows
Hold briefly
Get out of bed without sitting.
Don't droop your head downward, jut your neck or chin forward, hunch your shoulders, or fold back sharply at the lower spine. Find a low gentle position that makes your whole back feel good. The idea is to feel better and straighter, not strain, force, or make your posture worse. That would be silly.
Also do this several times throughout the day. Feels good after long sitting and physical work.
For most people this stretch works well. If it hurts your lower back, go to a lower position. If you flatten completely straight and still feel pain or pinching in the lower back, then how can you stand up straight without the same problem? Don't use this First Morning Stretch until you find why it is not comfortable. One common reason is front hip tightness. Try the Quick Relaxing Hip Stretch.
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Hyperlordosis in both walkers, easily seen at right. Damaging sloppy posture.
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