Ted loves to run. We previously fixed his back pain from running. We kept in touch about all his successes with pain free running. A few years later he wrote, worried that his hip x-rays showed severe hip arthritis and an old hip injury hurt. We again got him back to pain free running. That is what we do at Fitness Fixer. In the New York Times, an article quoted a physician who always had pain after running and said he "had no idea why." More about that follows with what Ted and I did to fix his hip pain from running.
Four years ago, Ted came to me with back pain from running. He had been running with too much inward curve in the lower back, which is a common cause of lower back pain while standing, walking, and running. We stopped his back pain from running by teaching him to reduce the too-large inward curve to neutral spine during running and daily life - Back Pain From Running.
A year later, he wrote back saying that since his back pain was completely gone (plus a few other things we fixed in the interim), he noticed some hip pain. He had been running with the foot turned out (duck-foot) and wrote, "A straight push off after the foot-strike made the pain go away - Runner Fixes More Pain With Straighter Push-Off.
Earlier this year Ted wrote that his doctor said his x-rays showed arthritis in both hips. I told Ted not to let doctors scare him into anything rash (surgery, giving up running, taking medicines that cause other problems, and so on). Often the arthritis or other abnormality that shows up on an x-ray is not the cause, or only cause, of pain.
The New York Times recently ran an article quoting the President of the American College of Sports Medicine (ACSM) as saying he (the president) "Has no idea why his knees are sore after each time he runs." The article also quoted several prominent physicians saying, "Most folks should not go (to doctors), because most general doctors don’t know a lot about running injuries. Most docs, often even the good sports docs, will just tell you to stop running anyway, so the first thing is to stop running yourself. In fact, because you probably will have to make a co-payment if you see a doctor, you will be adding insult -the fee - to your injury."
In a study reported at a recent meeting of the American Orthopedic Society, Dr. Matthew Silvis did MRI scans of the hips of 21 professional hockey players and 21 college players. Results showed 70 percent of the athletes had abnormalities, More than half had labral tears, which are scary looking rips in the cartilage that holds the leg in place in the hip bone. None had pain, or only minimal discomfort that did not affect their playing. The same is true for rotator-cuff tears. Studies have demonstrated that about half of all middle-age people with no shoulder pain have these rotator-cuff tears that show on scans but they have no pain or symptoms.
I wrote to Ted with several things for him to check and fix about his body mechanics. He replied:
"I used your ''Better Exercise on Stairs'' article to go Pain Free up stairs (which I had not been able to do for 8-months)
"Thus Encouraged, I ''flattened'' it out, and used the Same Mechanics to do AN EXTREMELY Slow Jog on my 20-min Sunday Walk/Jogs. which have been PAIN FREE.
"The doc looked at my x-rays, told me he had NO idea how I could run on my arthritic hips, had me demonstrate the Flattened Better Exercise on Stairs Method, I explained my 41 year Love of Running....and he said ''You've already figured it out, keep doing what works and YOU call ME if you need to come back.''"
Ted didn't need to go back to the Doc, but he did write to me:
"Sorry to bother you Dr. Bookspan, "In my running you helped me with my back, then you helped me with my knee, (and shoulder).
"I may be pushing my luck here, But NOW my hip flexor (psoas) is inflamed and essentially my thigh is swollen. By paying attention, I found the pain in the hip is in front, about where a tendon would attach to the hip (not the ball joint as I had feared).
"QUESTION--is there an isolation exercise for this tendon??? assuming there is one (I didn't pay much attention to Anatomy in Pharmacy School). What would be some good re-hab exercise/stretches?? This is an old injury from catching my foot on the upswing while running across a tarp spread over the track."
I gave him a nice stretch for the front of the hip where the leg meets the body (anterior hip).
Ted wrote: "Thanks for the quick response
"I went out this morning and did 40-minutes (ohboyohboy) PainFree
"I'm game for any other techniques (and am reading all your web site info…)
"This has added literally YEARS to my running starting 4 years ago when you helped me fix my Back Pain."
Then Ted went walking around downtown on concrete surfaces. He wrote that he was in pain again. I sent him to all the anterior stretches in my book Stretching Smarter Stretching Healthier. Ted replied:
"Dr Bookspan,
"......WOW.....
".....I just got the book last night, "was hurting from a lousy 20-min run, "looked up ''quad'' and ''hip flexor'' stretches and was Pain Free this morning.
"Like I told my running buddy this is like a CookBook for Pain Relief,,,,,,,
"I cannot wait to go out and hurt something else."
Here is Fast Friday Fitness - learn healthy floor-sitting, mobilize your pelvis, and use your core muscles and brains at the same time to move out of painful position to healthy comfortable sitting.
Here is a technique to identify if you sit in a way that is associated with lower back pain, and a technique to move out of unhealthful position:
1. Sit on the floor cross legged. 2. Notice your pelvis. Does it tilt backward at the top, so that the lower back rounds outward. This is too much tuck, demonstrated by my student Yash in photo 1 below:
3. Put your hands on the floor right behind your hips. Push against your hands to lift your back upright. Can you feel your hip tilt forward to upright position demonstrated in photo 2 below?
(In the photo above, hands are not behind the hip, to provide unobstructed view of the hip/pelvis corrected from tilted back to vertical)
Sit well and you can sit without back pain.
If your hip is too tight to move out of unhealthful tilted position, then it is likely that you are sitting with your back in painful rounded position.
If you are tight, or do not know how to move your pelvis while sitting, it is often easier to learn to mobilize your pelvis standing or lying down. The pelvic tilt is misused in therapy settings. It is mistakenly thought of as a strengthener or a back pain fix. The muscle work (to strengthen) is minimal. The idea is to learn *how* to move the pelvis so that you can voluntarily move to the needed position, then hold it.
Here is Friday Fast Fitness - a stretch to help relieve the ache of menstrual cramps and the same pain from uterine cramping after sexual relations:
Person with cramping lies on back, knees bent, feet flat on the floor or bed.
Partner sits at their feet, facing their knees, and gently cups the front of both thighs near the knees.
Partner leans backward, pulling the top of both thighs with them (yellow arrows in photo). Cramping person should feel a pleasant relief stretch in the lower abdomen (red arrow in photo). Repeat as needed.
The partner doing the cramp release can either sit closely, securing the cramping person's feet with their knees (as pictured), or sit further back. It is preference for how you can best and most comfortably do the stretch.
The cramping person's feet can be moved closer to their body to add a nice Achilles tendon stretch, or if the partner applying the stretch is not strong enough to easily pull back. This stretch works extra well on a soft bed when the feet can sink into the soft surface. Apply it slowly to not overdo.
See how this works for you and send your suggestions.
--- I make posts from fun mail and success stories. 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. 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 certifiedDrBookspan.com/Academy.
An old sports medicine joke says that if you pull a groin muscle, make sure it is someone else's. Here is less known info for Friday Fast Fitness - do you stretch in a way that groin pulls are more likely to happen to you?
When you lift one leg to kick, stretch, or step up, you can get the needed range from the upper leg muscles, or you can just round your back. Many people round the spine and roll the hip under (tuck too much) to make the stretch easier. They don't get the stretch from the muscles high in the leg, leaving the area tight.
In event of large or sudden kick, step, or slip, high forces pull on tight groin muscles. Varying degrees of injury can occur, or the tight area yanks the standing leg out from under and the person falls backward suddenly - seen in aerobics and martial arts classes, and funny video shows. Then the person hobbles around saying they don't understand it since they do their stretching, and articles get published that stretching doesn't work and no one know why.
Being so tight that your other leg comes forward with the lifted one, comes from bad stretching habits that allow hip and pelvis to round and tuck under too much:
When you stand on one leg and lift the other, don't bend at the knee and hip, pictured at left. Straighten your back with chin loosely in, not rounded forward. Hold pelvis upright without letting it tilt and round under you, pictured right.
Keep the standing leg normally straight (not locked straight, but not bent more than normal standing). Stand straight and relaxed (both at once). Don't force or strain. Breathe.
Feel more stretch in the front thigh and groin of the standing leg.
Check your stretching, kicking, and stepping. Check if you round your back and hip when taking the stairs, stretching while standing, and stretching lying on your back.
When lying on your back to stretch by lifting one leg, keep the other leg flat on the floor, not bent at the knee and hip. It is a myth that you must bend your knees when stretching legs to protect your back. If you must bend your knees to protect your back, how are you supposed to stand normally and move?
Prevent Stretch And Exercise Habits Promoting Tight Anterior Hip:
--- Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking for 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 read and learn, 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 - DrBookspan.com/Academy.
Fast Fitness - Better Standing Hamstring, Achilles, and Inside Leg Stretch
Friday, June 12, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - get a better stretch for the hamstring of the standing leg when stretching the other leg to the side:
When you stand with one leg stretching to the side, notice the leg you are standing on. It is common to stand with the foot turned outward and the hip rounded under you.
Instead, turn the standing leg to face directly ahead. Knee and toes straight forward. Not turned out, not even a small amount. Stand straight.
Notice the stretch move to the back of your leg.
My student Leslie is pictured above at age 68. I snapped this shot of her while she was waiting for one of my classes. The position of the foot on the standing leg isn't visible, but she is straight ahead. I had to snap the photo quickly before the club manager told us to stop.
Stand straight without leaning over, rounding your upper body, or letting your hip round under you. This is different from the way most people are used to.
The straighter you stand, the more stretch, while training the function of healthy posture - a functional stretch. You need to be able to lift one leg without being so tight that your back rounds and your hip rolls under. Think of stairs, kicks for dancing, aerobics, martial arts, stepping over things, stairs, much real life. If you are not only using bad mechanics for daily life, but training unhealthful tight mechanics with conventional bent over stretching, what are you accomplishing?
If you can't stand straight, lower your leg to where you can. There is little point stretching for health while practicing unhealthful ways.
What has happened in a year? She can now do 40 push-ups. We just don't have a video camera. While we get one, click the link to do your push-ups with her each morning while it is still only 30.
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. Get certified - DrBookspan.com/Academy.
Fast Fitness - Develop Ankle Stability Sense While Stretching
Friday, June 05, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - prevent a common source of overstretched lateral ankle ligament, which is one contributor to repeated sprains - turning the ankle when stretching:
When you stretch your hip and legs, or sit cross legged or in yoga poses, notice if you allow the foot to turn, increasing stretch on the outside ligaments of the ankle - too much supination. Reader Liz demonstrates in photo 1 below.
Straighten your ankle, Liz photo 2, below.
You may notice you get more good stretch from your hip to make up for the motion you were getting by turning your ankle. Holding straight gives better stretch in the hip, and better ankle stability training.
Avoid turning ankle, overstretching outer ligament, demonstrated by Liz in photo 1 above /\
Then remember to use the sense and knowledge of ankle straightening when you stand, run, take stairs. Lying down to stretch will not train stable ankles. The idea of this post is not to make ankles worse with your stretches. Not all things are good to stretch. Avoid the unhealthful practice of lengthening the side ankle ligaments, shown again in the photo below:
Ligaments are like a briefcase latch. They attach the top bone to the bone below it. Like a latch, a ligament is not supposed to stretch, but hold position, so that the briefcase hinge (your ankle joint) does not rattle and the briefcase does not pop open (side of your ankle sprain). While sitting cross legged, straighten the ankle so that it does not turn up.
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. Get certified - DrBookspan.com/Academy.
---
Healthy photos thanks to Liz of New Zealand Ligament stretch yoga ankles by Than Tan
Weak Hips on Purpose? Running Injury and Hip Strengthening
Wednesday, June 03, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Who works their hips? Fitness Fixer success story Robert Davis wrote me several
notes that the weightlifters he knew didn't want to exercise their hip because they thought it would take away from the "V shape" they worked for.
Mr. Davis said that using my daily good bending and other functional exercise worked his hip greatly. He was pleased with reduction of stiffness and pain and increase in strength and mobility. No decrease in "V-shape."
The May/June 2009 issue of Sports Health: A Multidisciplinary Approach, published a study based on a literature review, concluding that running injuries to the lower leg may have more to do with weak hip muscles than how many miles run. Lead author Reed Ferber, Assistant Professor and Director of the Running Injury Clinic from the University of Calgary stated ”Hip muscle weakness especially appears to lead to atypical lower extremity mechanics and increases forces on knees and feet while running.” He also stated, "Based on a literature review, it appears that foot pronation (turning the arch and ankle flatter to the ground, and/or the knee inward) and inadequate hip muscle stabilization are the top categories for injury.”
From my own work in this area, I found that strengthening alone won't make you run with good mechanics, prevent pronating, or other injurious habits, you need to retrain them too. Not hard. Stopping your life to do rehab exercises then returning to bad daily movement also isn't so helpful. My work builds-in both strengthening and mechanics to daily life - functional exercise. Robert Davis has been sending in his successes fixing back and other injury using functional fitness.
Robert Davis writes:
"I had made a slight error in my story! I just wanted to let you know.. I had not ordered fix your own pain till only about 4 weeks ago cause I was looking at my expenses and the Amazon one came up!
"So to see how rapidly things change when you take up these habits is even more encouraging.
"Some things I noticed along the way (I did have some slight questions on this!). My hip muscles for one, started to get "sore". I believe this is because of over tightness and overall lack of use. My guess is like every other gym rat they avoid things to make obliques and lower back "too" big because it takes away from the V shape they are after. Everyone seems to fall for this but it is an un-healthy trap I now realize.
"Anyhow I had started to get really sore over the last few weeks in hip muscle areas and even upper buttocks from stretching these areas and working them (using your stuff). When I practiced going into full squats, this really seemed to stretch out areas that began to show signs of weakness/tightness. So it was like working out muscles and getting that "soreness" when your muscles start to adapt. I kinda figure it is as it is just as normal to workout a bicep and for it to "be sore" the next few days.
"The soreness goes away and with each passing week, it becomes more mild - kinda like the body getting used to biceps being sore and you don't get sore anymore.. They do not get sore like they did when I first started your stuff. I was just curious if you had seen this. I am sure it is normal, especially for a group of muscles not used to being used or stretched out.!
"Jeez I do not think most people realize just how tight and weak they can be in areas, mostly because they are never used or people are used to being tight there. People do not believe in the squat (I showed a few people to prove them wrong lol) because they are too tight. I realize how much I am glad I found this out early in life. I get stronger every day in the areas that were weak. I know I will have a much better core, lower back, complete back, and body then before I hurt myself :)
"I put together my "planche/pull up" setup for pictures and to start working on a full planche! That is difficult to do like you do it! Any suggestions? Just keeping trying? Heheh
"Thank you again! Thank you for posting my story."
Mr. Davis, thank you. You are well ahead of the fancy researchers :-)
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.
The RSS feed may still be down. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Fast Fitness - Straighten and Stretch Hip While Strengthening Core, Arms, Legs, and Balance
Friday, March 27, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - Increase strength and muscular endurance of your body working as a whole, and learn to keep neutral spine and good hip position against resistance.
From a pushup position, turn to the side, raising one arm overhead, holding legs and body straight.
Raise your top leg. Notice if you increase the inward curve of your lower back (overarch to hyperlordosis) and if you bring the leg forward - demonstrated in the upper photo.
Instead, hold straight. To feel position, practice against a wall - demonstrated in the lower photo. Bring the back of the raised leg against the wall. Press your lower back closer toward the wall instead of letting it overarch from the weight of your leg pulling the spine.
The idea is to use the wall as a guide to learn positioning, then use your muscles and sense of positioning to hold straight without the wall from then onward.
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from selected ones. Before asking, see if your answers are already here by clicking labels under posts, links in posts, and archives at right.
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Fast Fitness - Even More Core With No Forward Bending
Friday, March 13, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - build on a previous Fast Fitness for increased strength of body and core. Strengthen almost everything with this fun move.
Questions come in by the hundreds. I make posts from fun ones. 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. Read inspiring success stories of these methods and send your own.For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. For personal evaluation take a Class. For top students, certification throughDrBookspan.com/Academy.
Fast Fitness - Hip Stretch and Spine Stability Training When Stretching Legs
Friday, January 16, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - Retrain your standing leg stretches to hold your spine and hip in healthful position, get more stretch to the front of the hip, use your back muscles, practice balance, and learn functional stretching - the way your body needs to move in real life in a healthy way.
When you raise one leg to stretch when standing:
Keep your standing leg straight. Don't bend at the knee and hip, as pictured.
Don't round your back or let your pelvis and hip round under you, as pictured.
Stand straight. Relaxed. Don't force or strain. Breathe.
When stretching, remember function. Why practice a position that is rounded, tight, and detrimental to how you move in real life when you lift your legs. It would look silly and unhealthy to stand up that way. Why stretch that way?
Get functional stretch by lengthening your body enough to be able to straighten out. That is the purpose of the stretch.
Use the new length and your brain to stand straight. Transfer the positioning to real life when you are standing and lift one leg to take stairs, kick, dance, play sports, climb over things, and other life activities. Standing without being so tight that you round your body forward, or just round from habit, is healthier, better looking, burns more calories, and stops many sources of chronic aches and pains.
Send me your photos of fixing this stretch. Doing is the best learning. I will post the photos in a reader success story.
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking labels below posts, and links and archives. Read success stories of these methods and send your own.
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Fast Fitness - Don't Shorten Hip When Stretching Hamstring
Friday, December 19, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - Get a more functional hamstring stretch, and a built-in posturally helpful functional stretch to the front of the hip at the same time.
When lying on your back to stretch your hamstrings by lifting one leg:
Lie flat. Keep the leg you are not lifting flat on the ground, not bent at the knee and hip, or with upper body curled and neck craned, as pictured.
Don't let your pelvis and hip round under you. Don't let your backside curl up off the floor.
Keep your hip, leg, back, shoulders, and head relaxed, flat, straight, touching the ground.
It is a myth that you must bend your knee to protect your back. If you must bend your knee to protect your back, how are you supposed to stand on one leg and lift the other in real life to climb stairs, kick, and even run and walk, without curling into bent over, old-looking, tight, injury-producing position?
When stretching your hamstrings, remember function. Why practice a position that is rounded, tightening, and detrimental to how you move when you stand and extend your legs. Get stretch by lengthening you body enough to be able to straighten out.
Send me your photos of fixing this stretch. Doing is the best learning. I will publish the photos in a reader success post to come.
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.
Which Stretch Stops Back Pain by Making Neutral Spine Possible?
Monday, November 10, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
What can you do if you're too tight to stand and move in neutral spine? A common lower back pain occurs after long standing, walking, and upright activity. The most common cause is exaggerated inward curve in the lower spine - a bad posture called hyperlordosis or overarching which pinches the joints called facets and the surrounding soft tissue. An obvious treatment is to simply stop the cause, and restore neutral spine.
Which specific stretches relieve the tight muscles that make neutral spine difficult?
Usually the tight muscles are in the front of the hip (anterior hip muscles) called hip flexors. Several specific easy stretches restore resting length to the front hip. Several of my patients and readers find that posterior hip stretches also help quickly. Liz first wrote in with her success story, How a Reader Stopped Recurring Pain, Got Stronger, and Said Aha!
Liz continues her story:
"Dear Dr Bookspan, "Just a few days ago I checked back to read your blog…since I posted my "Short history" which turned out to not be so short. I was particularly trying to share one thing that had happened to me, for which I couldn't find any specific help until I read your blog, which was back pain after bike riding.
"Even short walks hurt my back before I discovered your work, let alone the way my back felt after a bike ride, a future of pain, getting fat and depressed from lack of activity.
(trouble persists with getting photos to load - Liz' photo should be here and hopefully will soon)
"I thought I'd send at least one photo of me on my bike (I think I have mastered the dorky cyclist look) after a 12 km ride home from work and 12 kms to work that morning. If it hadn't been for you I would not have been able to do this, I would have not experienced the joy it gives me to use my muscles, feel my body doing what it was meant to do.
"I like being able to look after myself and not rely on an external source, like a chiropractor, to keep me well. Whenever I take out your book (Fix Your Own Pain) to refer to, my husband says, 'oh oh, what's wrong?' Mostly now it's just to refresh my memory of an exercise or principle you have written or to check I'm not doing something terrible to my knees. What a marvelous reference book it is.
"After I hurt my back during my first trial cycling to work, I read so many books and articles and web pages on back pain, and many on cycling and back pain. Mostly they were about pain caused by the racing position or impact injuries from bumps in the road. Then I read one of your blog entries where a readers/patient explained he had to give up cycling because of the pain he experienced in his lower back a while after he had been on a ride.
"This is what happened to me, in that blog you explained that a few specific stretches were useful for specific muscles. I checked many pictures of anatomy, which named the muscles that I seemed to be having trouble with, I went back to your book and read more about hips and how tight muscles in the hip area can cause lower back pain. It seems, sitting at a computer all day, then using my leg and hip muscles to propel myself up really steep hills was causing the muscles in my hips to tighten a great deal. That's why I tried your figure 4 stretch.
"It did precisely what I needed it to do, now if I don't do it regularly, I can feel my pelvis is tilting the wrong way, all by itself and my lower back starts to hurt. And when I lie on my back my front hip/pelvic bones (iliac crest) stick way out because of the extreme tilt. Then I do the lying figure 4 stretch and they go back into the right place. Now I know exactly what to do to end the pain and I wanted to make sure, should anyone be searching for help, that they will know there is an answer and your work is the source.
"Thank you for helping me find my joy." Liz.
Neutral spine is pictured at left. Too much inward curve (hyperlordosis) is pictured in the middle and right drawings. Abs are too long, lower spine is pinched in back.
Habitually keeping too much inward curve (hyperlordosis) shortens and tightens lower back muscles. Tight lower back muscles pull the back of the pelvis upward, tilting it outward in back and forward in front. The tight area feels normal when held shortened (hyperlordotic) and resists lengthening enough to stand in neutral spine. Stretching the lower back allows neutral spine to become possible and feel normal.
I wrote back to Liz asking if she was using anterior hip (hip flexor) stretches too and if she felt the posterior hip stretches working to let her restore straight hip instead of tilting forward.
Liz replied:
"Yes, being a mostly sitting worker I do the hip flexor (anterior front hip) stretch too, I'm sure it helps my ability to voluntarily keep my hips tilted correctly all the time, I can feel with my hands when they 'flatten'. I do this stretch everyday, sometimes twice a day and it's very helpful. I have on occasion skipped this stretch and only done the posterior hip stretch and I've found I have had no trouble achieving neutral spine. But I do it anyway, it's got to be good for me!
"This is my description of the reason I do the posterior hip stretch, mostly on my bike ride days (though it's so good for me, now I do it twice a day) - Even though I am tilting my hips voluntarily to the best of my ability, if I have not done the posterior hip stretch I feel a sharp pinching in my lower back, where the 'dimples' are, sometimes only one side sometimes both. I feel my front hip bones with my hands and can tell my pelvis is not correctly angled, I can't tilt it correctly any further without starting to use muscle force. Not the gentle neutral spine you describe.
"When I lie down and try to gently straighten my spine to neutral, I find I can't and my front hip bones stick out quite a bit. It feels like a muscle somewhere is holding on to my pelvic bone so firmly I can't move it without force. So then I do the posterior hip stretch on both sides for 30 seconds or more if it's feeling wonderful. Often I feel one side is far tighter than the other. Then I test again by lying straight, feeling my front hip bones with my hands and gently moving into neutral spine and I find they are nice and flat, and stay that way. Also the pinching pain goes quite rapidly. Occasionally the pain doesn't go away for a few hours, a hot bath helps. If this happens I do the posterior hip stretch a few times over an hour or two and that also helps. I expect this means I may have done a wee bit of damage to the soft tissue, amazing how the body heals.
"I have discovered that even on non-biking days, if I do this stretch regularly, I rarely feel any pain in my back at all. I'm not 100% certain if it's the combination of stretches that I do, including the hip flexor stretch, but I feel this one is critical for the correction of some kind of internal postural muscle, that is not behaving in a natural way, through some unconscious action of mine."
Usually, no special exercises are needed to have neutral spine. Worse, a common scenario is someone doing exercises then walking away with the spine still arched, never applying the exercise to real life. They become stronger people with the same bad posture - the exercise was not used for function. Instead, just stop the bad position and deliberately move your spine to neutral. However, when the area is too tight to move to neutral, here are stretches. The stretches don't change your voluntary posture, you do that. They just can make it possible:
First, Don't Tighten:
First make sure you don't tighten or clench abdominal or posterior hip and leg muscles. Tightening does not change posture, inhibits movement, and makes it hard to move to neutral spine.
Then, check if you just need a guide to help feel how to reduce the lower spine arch without pushing the hip forward, leaning back, or moving everything else:
If you find you are still too tight, stretch the front of the hip (anterior) and back (posterior):
Anterior Hip Stretches:
Until I make a post for this one, a relaxing start to stretch the front of the hip is to lie face up with knees bent and ankles crossed. Let knees separate to each side as far as comfortable. Keep lower legs next to each other, not one on top of the other. Do this without shoes, to fit your feet side by side without resting the lower leg on the foot. Experiment with pressing your lower back toward the floor. This stretches front and back at the same time, as needed for straighter standing. If this stretch is too much at first, start lying on your back with only one knee bent to the side, the other leg straight. Rest bottom of the foot of the bent leg at the knee of the straight leg.
A nice stretch over a bed or bench - Quick Relaxing Hip Stretch. If this one is too much, try it lying flat with a pillow under your hips. Gradually use a bigger pillow. Finally, lie with legs stretching down from the edge of the bed and no pillow.
A big stretch - Relaxing Hip, Leg, and Groin Stretch. If the Relaxing Hip, Leg, and Groin Stretch is too much to start with, do it face up instead of face down (see the first stretch above).
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.
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Autumn Yard Work - Limiting the Person Instead of the Injury Again?
Wednesday, October 01, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
A Medline article on autumn yard and housework gives a list from the American Academy of Orthopaedic Surgeons, which they say will reduce injuries. Their list includes doing less, lifting lighter loads, not lifting overhead, or using turning action to the side.
The Orthopaedic Surgeons' list is another case of limiting the patient to limit the pain.
It is unfortunate to instruct patients to do less physical activity. It is no mystery that restricting activity reduces strength, flexibility, and balance. When patients become tight and weak, they are next sent to physical therapy to lift weights and stretch. Instead, go outside. Get free exercise, get stronger, increase balance, have some fun instead of being held back.
It is not a mystery that if you spend an afternoon bent wrong over a rake, lifting wrong, and hunching your shoulders, you will be achy. Have fun doing yard work in the fresh air in healthy, commonsense ways:
Carry Heavy Leaf Bags - check if you lean backward to hold and carry loads. Instead of leaning, which pinches the lower spine, stand upright, use neutral spine - Prevent Back Surgery
You Don't Need Expensive Ergonomic Rakes And Tools Or Fancy Padding. The majority of the world does far heavier work with far less. Bend right (links above) instead of bending over. To prevent hand irritation and blisters, don't clench your grip and be willing to toughen your hands and skin. Being too delicate means fragile skin. The soil has many substances beneficial to health and disease reduction, some documented to reduce depression. Post on this to come. Don't be too afraid to get dirty.
Doing less is a flawed approach to preventing injury in the short term, and over the long run, will undermine your health and abilities. Use your brain for healthy, fun ways to keep doing more of your favorite activities.
"You're never too old to become younger" -Mae West
--- Questions come in by the hundreds. I make posts from fun ones. See if your answers are already here by clicking links and archives and the Fitness Fixer Index. Read success stories of these methods and send your own. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy. ---
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.
Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine
Friday, June 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - quickly change your posture to change your luck on Friday the 13th. Hyperlordosis (swayback posture) seems to be unlucky - it causes lower back pain. You can do this in seconds to make a certain change to healthier spine for yoga or practicing the lunge. If you don't believe in luck, you're lucky. It's just good posture and simple anatomy.
Reader David from Belgium demonstrates in this 20 second movie that he made for us:
First ten seconds - he steps into a yoga pose called Warrior pose, but allows overly arched lower spine. He also demonstrates leaning more weight forward of center line, which is a different issue.
Note how the belt line tips downward in front and the lower spine overly curves inward - more than a normal curve.
At second 11 he levels the hip to bring the posture to neutral spine. Then he kindly demonstrates overarching when raising the arms further. Instead, hold neutral spine and raise the arms from the shoulder, not the lower back.
To prevent shoulder impingement when raising arms, keep shoulders down and back, don't just chin and neck forward, keep them gently in. A forward head posture compresses the rotator cuff when lifting arms. See Safer Overhead Military Press.
I never expected repeated requests to see how to do neutral spine in different activities. It is the same. Just apply the same neutral spine and that’s all. I thought one post would do it, but will post each activity readers ask about. I am aware that there are yoga and fitness places which teach to overarch the spine as part of the move. Teaching swayback does not seem to be as helpful as teaching neutral spine. Changing lunge and Warrior pose to neutral also improves the stretch to the front hip muscles of the back leg. Lucky.
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.
--- 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.
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Reader Joe Blatt recently celebrated his 63rd wedding anniversary. He was a Broadway choreographer and dancer.
He demonstrates how to keep good flexibility and balance through the ordinary daily activity of standing to put on shoes and socks, and tying your shoes.
Read inspiring success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Fast Fitness - Functional Agility, Flexibility, Strength
Friday, November 30, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - build balance, leg and hip strength, and flexibility as a lifestyle.
Lightly sit down on the floor and get up again without your hands.
Being able to rise from the floor is natural lifestyle movement, done in many places in the world by people up to the oldest years. My martial arts student Ms. Han demonstrates in the short mpeg movie. Click the arrow to run the video:
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