Fast Fitness - Eighth Group Functional Training: Spine and Shoulder Stability With Overhead Motions
Friday, April 23, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - eighth in the series of Functional Fitness Training (Bookspan Basics) to teach your group, teams, classes, students, kids, battalions, or self. In this Bookspan Basic Training, you train positioning and muscle skills to reach overhead with healthy mechanics for the shoulder and lower back.
Assemble your group in neat rows. Stand in front in view of all. Tell them this is a basic, functional physical skill to learn to prevent injurious positioning during overhead motions.
Everyone reaches up. Have everyone notice if they lean their upper body backward to raise their arms. See if their tilt their beltline downward in front or push the hip/pelvis forward. See examples in both photos above and below. Explain that leaning back and increasing the lower spine arch are not a healthy ways to raise arms and that upright neutral spine is a stronger base for their arm movement and uses abdominal muscles.
Have everyone bring their ribs back down to level, pull upper body to upright, and tuck the hip under to straighten the pelvis to vertical and neutral. The motion is like doing an abdominal crunch standing up, without curling forward. You crunch enough to bring yourself to straight and upright. See our short movie of fixing this on Overhead Lifting, Reaching, and Throwing Part II - Lower Back.
Have everyone hold their upper body upright and vertical and notice where their shoulder is and try it again with healthy position.
Leaning back when raising arms increases the inward curve of the lower back, causing a swayback, hyper-lordotic posture. Hyperlordosis is a common source of "mystery" back pain. It comes when you over-arch - usually during long standing, walking, running, reaching, then goes away. People are mystified. Look at both photos again. It is easily prevented by stopping the injurious position then and there. Send your success photos to me at DrBookspan.com.
Make sure everyone breathes. A bad habit promoted by much popular fitness is tightening the abdominal and backside muscles to do minor movements. People hold their breath. Make sure all can do full relaxed belly breathing while holding neutral spine and reaching both arms overhead. Remind all to keep their shoulders down and not raise the shoulders when they raise the arms.
Ski fast and shoot rifles! A biathlon is usually a race of two sports in the same event. In the winter Olympic biathlon, athletes ski cross-country then shoot at targets (not competitors in front of them).
The Winter Olympics currently offers four different biathlon races. In each, skiers carry .22 caliber rifles, weighting just under 8 pounds (3.5 kg). Skiers race to each shooting stop along the course. Half the shooting stops are prone (lying face down). Half the shooting stops are standing. The commemorative medal at right shows a hyperlordotic stance (overly arched at the lower back) during standing aim that will be covered in future articles on back pain and target shooting. Check the article, Prevent Back Surgery, and see if you can guess the cause, and how to change stance for shooting without back pain.
Winter biathlon is said to originate with Norwegian soldiers training for military maneuvers. Other northern countries offer their own history of training these disciplines for military and defense.
A summer biathlon usually combines cross-country running and shooting.
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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.
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.
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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 - How Abdominal Muscles Prevent Hyperlordosis When Carrying
Friday, January 09, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - How to use your abdominal muscles to maintain neutral spine when carrying babies, and other things held and carried.
When you hold loads in front, notice if you lean your upper body backward - right-hand photo marked with red X. Leaning backward from the waist increases lumbar lordosis (hyperlordosis) which pinches the lower spine, causing aching after long standing.
Instead, stand upright - middle and left photo. The muscles that pull your spine forward to straight position against the load are your abdominal muscles. Upper spine angle will be a little more upright than pictured (center).
It is a myth that you must lean back to offset a carried load. You get a free abdominal muscle workout and increase abdominal muscles endurance by using them (not tightening) to change from painful to healthful standing position. Breathe normally.
David from Belgium is pictured at left. David has made many contributions to Fitness Fixer through photos, movies, success stories fixing his own pain and of his yoga students, translated many of my articles into Dutch, and has developed a healthier yoga style which he premiered at a world yoga congress last year
He did all this during the time he and wife (pictured center and right above) were expecting their first baby, arriving early last February. Thank you David and family from all of us.
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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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.
How Much Inward Curve Space Should There Be In The Lower Back?
Wednesday, November 19, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Reader Carina asked a good question on the post Prevent Back Surgery about how much space there should be in the lower back inward curve. Comments were not accepted by the Blogger software for several weeks, and I could not reply in the comments. Her question is so good, it was chosen for this Fitness Fixer post.
Carina writes:
"Hello Jolie, "Your information is so wonderful. Thanks for this stuff it's priceless.
I have been using the wall trick during the day when my back hurts (How to Feel Change to Neutral Spine). Wow it feels great. Only thing I can't STAY and walk like this. My knees are STUCK bent (or I go back to the big arch). I'd seriously look very odd walking around with bent knees. So here are my questions
"1) How much of my hand should go through when I am standing against the wall??? When I stand at the wall and do it naturally I can stick my whole arm to my elbow behind the arch.
"2) Besides these links you provided from a previous question Fast Fitness - Quick Relaxing Hip and http://windowsxp-privacy.net/?id=198760105 " (Note - the above link didn't come through in Carina's comment; I don't know which it is.)
"is there anything that helps me walk in neutral spine and not looking silly? "Thanks for caring about our backs, Carina"
Carina, great work. You have found that simply changing spinal angle (wall "trick") to reduce overarching works right away to reduce cause of pain. Next, here is how to retrain neutral spine into a normal natural stance:
1) Don't worry about "How much hand fits." It doesn't indicate amount of overarching. Lower spinal angle is what matters. Body proportions change the distance from wall - independent of spinal angle.
If you have too much tilt to the pelvis or you lean the upper body backward, lower spinal angle increases. To reduce an arch that is large, press the lower back closer to the wall.
The post Neutral Spine or Not? shows how to tell if your hip (pelvis) is tilted or straight, and/or if overarching (hyperlordosis/swayback) is coming from the upper body (leaning back). The wall maneuver shows you how to reduce the overarch. Don't press flat against the wall or you'll round like a beetle :-)
While standing at the wall, see if you can do a small "crunch" movement without rounding your upper body forward, to reduce the overly large arch. Movement is just from the hip and mid-torso. Hopefully, you will feel that you easily move the body without bending your knees. That should produce reduced lower back arch. Send some photos if you like and I will take a look.
2) Next, you need to make it possible and comfortable:
Check how you are standing. Don't try to touch the back of the legs to the wall. Just heels, backside, upper back, back of head.
Thank you for already checking the other links and finding the relaxing-hip-stretch. I couldn't tell which other stretch you wrote, but most stretches that lengthen a tight front hip can help. One that is functional for daily bending that you need to do anyway is Hip Stretch While You Strengthen Legs.
Hope to hear more about your successes. Send photos and I can post your continuing success in Readers Inspiring Stories.
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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.
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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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"Short history, I have hurt my lower back and neck several times previously through poor lifting technique and bad posture. My chiropractor did help, but it kept happening. I used to sit at a computer most of the day at work, then drive home, then go for a 30min walk with minimum stretching.
"Last year, when my back was ok, I decided to try riding my bike to work, three days a week, for the environment, the money, and for my fitness and weight. Each way is 12 kms, very hilly too in Auckland (New Zealand). After one week, my lower back was very badly hurt. I thought I'd never be able to ride to work again, that I'd have to get dressed sitting down for the rest of my life and I could barely walk. I felt like an old arthritic lady and I was only 38.
"I searched every book and website I could find, I had the idea it was my posture but I didn't know what to do about it. I found some information, but often what they recommended I couldn't do, they were too extreme or hurt me more or made no difference.
"Then I found your website www.drbookspan.com. Aha! I thought-this sounds good. And it was.
"I bought your book "Fix your own pain" and learn't more and got stronger and healthier, following your advice.
"But still my back hurt a bit, I would forget to tuck my pelvis, then it hurt and I'd remember. I would get up and move around more, I adjusted my chair and computer to help my posture at my desk, but would forget and slump and my back or neck would hurt and I'd then I'd remember.
"I can't believe how long it took me to "Click." When you say it's for every time you bend, you mean Every Single Time! Keep your pelvis gently tucked All The Time. Keep your back straight, heels down and knees over your ankles Every Single Time you bend.
"Then I started to remember alot more, and my back only hurt a little bit. Then just recently I decided to try cycling again.
"And my lower back hurt again. I went back to your book and read some more and thought. I read about the hip stretches and read your blog and thought.
"And I tried two stretches I hadn't tried before, the sitting figure-4 stretch and the stretch on your blog where you lay on your back to do the figure-4 stretch and gently lean to the side your foot is facing.
"What a difference they have made. I have to tell you just those two stretches have changed my life. Now I walk (pelvis gently tucked) with no pain, I sit (small lower back arch, chin in, relaxed) with no pain. Any little twinge and I do the seated figure-4 stretch and it's gone. After my bike ride I get down on the ground (in the changing rooms!) and do the stretch on my back.
"I found that I needed to lift my foot well up from the floor, keeping my hips level, and move both legs, still in the figure-4, over to the side my foot was facing, helped by holding my crossed ankle with my hands and keeping this stretch for about 30 seconds. This increased the stretch and felt sooooo gooood. And continued to feel good after the stretch.
"This is the first time I've added a comment to a blog, but I just had to let you know how grateful I am to you and your generosity in sharing your knowledge and I wanted to share with your readers about the increased stretch, I've learnt so much from reading their stories and your replies, I wanted to contribute a little bit too."
Many many thanks, Liz Auckland, New Zealand"
Liz, thank you for great work applying the concepts, rather than just doing treatments and exercises, and taking time to write to inspire and teach other readers. Send updates and photos when you can.
Going to a chiropractor does not solve the cause of the pain. Something may be tight or "out" but that is the result, not the cause. Save a lot of money and time by spotting the cause and making simple changes to stop it from happening again, yourself:
When Liz says "tuck the hip" it means straighten the lower spine to neutral position, not to round the back. Rounding is tucking too much. There is a difference. Here is a post with descriptions and drawings - Prevent Main Factor in Back Pain After Running and Walking
I have received urgent inquires from physicians and reporters after an ABC news report came out on surfer's myelopathy - lower body paralysis occurring shortly after surfing.
The main suspected mechanism is standing or lying for long periods with the lower back so overarched that it interferes with blood flow to the spine below it, causing a "stroke in the spine."
Overarching is a topic of my laboratory research as it relates to compression of soft tissue and the joints of the lower vertebrae leading to chronic mystery back pain.
Overarching the lower spine is an avoidable bad posture. It is simply and quickly changed by holding the pelvis level in what is commonly called neutral spine. Compression which impedes blood flow is a different, serious effect. Until I can post separately on it, to understand and avoid one main mechanism, check:
Holding neutral spine is not just an exercise to do then stop and return to overarching during life activity. Neutral spine is a healthy normal position to maintain comfortably, not rigidly, during ordinary activities and exercise. To see some of the issues of neutral spine, click:
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.
A widespread myth is that to fix posture you must strengthen sets of muscles.
After spending time and money on strengthening exercises, people often wind up as stronger people with the same poor body position. The fallacy is that strengthening does not create movement. You do that yourself.
A physician wrote me that he has hyperlordosis from surfing, and is "working" to fix it. He had spent much time waiting for the exercises to "work." What he missed is that surfing does not cause it, and how you stand can be fixed there and then by deliberately, volitionally changing how you stand. How? Try Friday Fast Fitness - Neutral Spine in 5 Seconds.
"Thank you. I am a D1 athlete and have been struggling with back pain/extreme tightness when lifting and playing in the same day. I have known I had bad posture while running/walking for about 4 years, went to physical therapy for it, and still haven't changed it. I kept waiting for a certain exercise to suddenly "fix" me. Duh, what fixes me is ME CHANGING IT. Shocking."
When certain muscles are tight, it can feel normal to stand badly. Even though it is popular to talk about tight hamstrings changing posture, that is mostly an issue when sitting. When standing, two tight areas are most common, chest and front hip:
Tight front chest muscles make round-shouldered position feel normal. Round-shouldered positioning keeps the front muscles shortened, in a cycle of shortening and tightening. The upper back muscles over-lengthen. This is why the most common stretch of pulling an arm over the front of the body is usually counterproductive. To fix anterior (front) tightness start with understanding and doing the pectoral stretch, described in Fixing Upper Back and Neck Pain and stop promoting an already overstretched posterior shoulder with The Stretch You Need The Least.
Tight front hip muscles make standing badly feel normal. The front of the hip is pulled downward, tipping the backside outward in back. The lower back increases in inward curve in a painful posture called swayback or hyperlordosis. Many people stand this way without knowing it because they think standing with the hip tilted forward in front is normal or "cute." Much of modern conventional "fitness" encourages this unhealthy, unattractive bad posture.
Hyperlordosis is a major hidden factor in lower back pain. People may undergo months, even years of treatments, adjustments, shots, medicines, therapies for discs, sciatica, facet pain, and other pain without knowing or changing the cause - allowing a too large an inward curve to the lower back.
The photo at right demonstrates an over-arch in the lower spine, the hip tilted forward in front, and a forward head while doing an activity supposed to be for health.
It seems impractical to do "fitness" in unfit ways - practicing unhealthy positioning, shown in the photo ->
Moreover, tilting the hip forward reduces the Achilles stretch and reinforces bad movement habits. For a more functional Achilles stretch try Better Achilles Tendon Stretch.
Hyperlordosis is not a medical condition or unchangeable anatomy. It is simple bad posture that you can allow or change right as you stand. Neutral spine is not pushing the hip forward, just moving it enough to make it level. See a short movie in the post Friday Fast Fitness - Neutral Spine in 5 Seconds. To stretch the front hip, try these:
Remember that stretching the hip and shoulder, and anywhere else, will not automatically make you stand right. You do that yourself using your own muscles and brain. Free exercise. Free fix.
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Stop Lower Back Pain From Swimming and SCUBA Part II
Tuesday, June 24, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Yesterday's post explained the most common hidden cause of lower backache after swimming and scuba diving. Swimmers and divers who get this chronic pain are often misdiagnosed with SI (sacroiliac) joint dysfunction, arthritis, disc injury or various "catch-all" terms for back pain with unknown origin. Scans may show damage to the facet joints, which can occur from spinal overarching. Injections and surgeries and various anti-inflammatories are often prescribed. No shots, medicines, or surgeries are needed. You do not need physical therapy or strengthening programs. All you need to do is stop overarching and maintain neutral spine when walking, running, swimming, and diving. It is easy, and is a healthy and normal spine position. You do not tighten any muscles to do it. It is just learning a normal posture.
Check yourself to see if you stand in hyperlordosis:
Stand up and look sideways in a mirror. Your belt should be level, as in the left drawing of neutral spine. The side seam in dress or trousers should be vertical from leg to waist, as in left drawing, not tilted forward at the hip (middle drawing).
Back up slowly and gently into a wall. If your backside touches first, it may be an indicator that you lean forward at the hip. If your upper back touches first, it often is a good indicator that you lean the upper body backward (right drawing).
Stand with your back against a wall, with heels, hips, upper back and back of your head touching. There should be a small space between your lower back and the wall, but not a large space. Then raise both arms overhead to touch fingers to the wall behind you to simulate swimming with arms outstretched. See if the lumbar curve increases. You should be able to stand with the back of your head touching the wall without increasing your normal curve, and be able to raise your arms without increasing it.
If you have a large space between lower back and the wall, try this:
If you can't figure how to do that, put your hands on your hips, thumbs facing the back, and roll your hip under so that your thumbs come downward in back.
Feel the large space between lower back and the wall become a smaller space.
Lower back pain that is caused by hyperlordosis should ease right away. Learn how to easily, gently do this while walking, running, swimming, or whatever you do. This is done without tightening or clenching any muscles.
Keep the good new neutral spine when you walk away from the wall, and all the time. Apply it to when you are swimming and scuba diving.
Muscle Use is Not Automatic The muscles that hold neutral spine are your abdominal muscles. They do not do this automatically, which is why strengthening programs do little to stop back pain. Someone may have strong abs but stand and swim in arched posture, with continuing lower back pain.
Heavy scuba tanks don't make you arch your back or have bad posture. Not using your ab muscles to counter the pull, and allowing your back to arch is the problem.
When you are standing up wearing tanks, straighten your body against the pull of the load and maintain neutral spine. Do not tighten your abs, just move your pelvis. If you notice yourself arching while wearing tanks, straighten your body as if starting to do a crunch but don't curl forward. Only straighten to neutral spine. Don't tuck so much that you lean back or push your hips forward.
No More Lower Back Pain From Overarching Transfer this neutral spine skill to your daily life for carrying gear, putting cargo up on racks, heavy packages on counters, and whenever you lift and reach. Use neutral spine when standing, walking, running, reaching overhead, swimming, and scuba diving.
Lifting and carrying heavy dive gear with good lifting mechanics is good and functional exercise. With bad lifting habits, it is a common and obvious cause of lower back pain in scuba divers. A second major cause of lower back pain after SCUBA and swimming is often overlooked and can occur after scuba diving and after swimming laps with no gear lifting.
Hyperlordosis When swimming or finning face down and horizontally through the water, many divers allow their lower back to increase in arch. They look like they are face down in a hammock - shown by the figurine below:
A small inward curve belongs in the lower back. When you allow the normal inward curve, (normal lordosis) to increase, it becomes hyperlordosis or overarching (swayback).
For most people, hyperlordosis is most common when upright, such as standing, walking, and running. Swimmers and divers who allow their back to overarch when swimming face down often notice the pain after swims and dives:
How Hyperlordosis Causes Lower Back Pain Hyperlordosis pinches the joints of the vertebrae called facets and the surrounding soft tissue. When swimming and diving in hyperlordosis, the fulcrum of the kick becomes the facets instead of the muscles of the abs and hip. When standing upright with a hyperlordotic lower spine instead of neutral spine, the weight of the upper body presses down on the overly pinched-backward lower back. Running in hyperlordosis causes more of the banging and pressing.
People with lower back pain from hyperlordosis usually feel they need to bend over forward, or sit, or raise one leg to relieve it. Often nothing shows up on x-rays and scans. Eventually, hyperlordosis can damage structures enough to show. Until then it just aches a great deal.
The cause of this kind of pain is often unrecognized and people may be told they have a condition called sacroiliac, or SI joint dysfunction, or nonspecific back pain, or other names.
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.
"Hello, I'm writing as someone who has incurred a training-related lower back injury and who has great interest in your words on hyperlordosis. I am hoping that you might shed some insight on how to achieve a neutral spine while doing "kettlebell swings." This is the exercise that has caused me back pain, and I would love to return to working out with kettlebells, but am not sure how to do so without creating too much lordosis. Any ideas? I appreciate any assistance you can provide and thank you for your contributions! Take care, Dan L"
Throughout history, people have lifted and swung weights of all kinds of shapes. Kettle bells (also called kettle balls and many other names) are usually ball-shaped weights with a handle. A variety of sizes is shown in the photo, above, along with a medicine ball for comparison.
Kettle bells were long used in various martial arts and cultural festivals and contests before being rediscovered for modern weight lifting. In general, you lift, swing, and move them to do various weight lifting exercises. Kettle bells are weights. Benefits of kettlebells are the same as lifting and swinging other kinds of weights.
The photo above shows injurious lower spine posture of the person lifting or swinging overhead, called overarching, swayback or hyperlordosis. His upper body tilts backward relative to the lower spine. There is too much inward curve, pinching and compressing the lower spine. You can even see this pinched fold in his lower back. This poor posture is a common cause of lower back pain. People who chronically over-arch this way often feel they need to bend over forward to make the pain stop. However, using neutral spine and not allowing the slouch while lifting overhead would stop the cause in the first place - right photo below.
Recent kettlebell devotees have made a small set of lifts, and limit swings to mostly vertical swings up and down between the legs. However, a wider range of movement and more function can be trained. Great benefits are possible using weights with handles for functional core stability training, as below.
The photos above, of injurious overarched spine position (left) and healthy neutral (right) while swinging a heavy medicine ball overhead, are from the book Healthy Martial Arts. My black belt student Christopher demonstrates. This is a similar motion as swinging kettle bells overhead by the handle.
In the left photo, Christopher demonstrates the hyperlordosis posture that compresses the lower spine and is a major cause of lower back pain. He allows the hip (pelvis) to tilt forward in front and out in back, and his upper body tilts backward relative to the lower spine. In the right photo, he reduces the overarching to neutral spine. The belt line changes from tipped downward in front to level.
Keep neutral spine when lifting and swinging kettlebells and any weight overhead (right photo). Prevent the slouch of leaning your upper body backward and tilting the pelvis (left photo). Leaning backward and allowing the hip to tilt are often mistakenly done to "balance the weight" and make the lift easier. Leaning the upper body back and tilting the pelvis are not necessary to balance a load - your own muscles can hold the load, and in fact, that is the point of lifting the weights.
Overarching increases the small normal small inward curve (normal small lordosis) to a large curve (hyperlordosis). Hyperlordosis increases compression on the joints (facets) and soft tissue of the lower spine. The same overarching is the hidden cause of back pain in women who lean back and/or tilt the hip trying to offset the load of a pregnancy - Back Pain in Pregnancy - and Why Men Can Get It. Leaning backward and overarching are not helpful adaptations as sometime thought, are not unavoidable, and are not limited to pregnant women. Overarching (hyperlordosis) is a common bad posture, and an often missed source of back pain. It can be easily prevented by using your muscles to hold neutral spine. The post Prevent Back Surgery shows photos of hyperlordosis compared to neutral spine during many activities.
Bending over forward to swing kettlebells between the legs is another exercise where injury and back pain frequently occur. Good squatting technique reduces the problem. Often weight lifters spend much time learning and debating good squat posture, then bend over (injurious bad bending) to pick up and put down their kettlebells.
Neutral spine while exercising with kettle bells is the same as neutral spine during anything else - just hold your spine position. Neutral spine is not done by tightening or clenching any muscles. It is done by moving your hip and lower spine the same way you move your arm to scratch your nose - without tightening, just moving it to where you want it. Holding neutral spine is the same as not slouching your shoulders or not letting your mouth hang open - a voluntary use of your own muscles - built-in exercise.
Keep breathing, Have fun. You can swing weights of any kind in any variety of ways, to be stronger and healthier, without injury.
Learn neutral spine swinging kettlebells, babies, and all other fun weightlifting:
Leaning back when raising arms increases the inward curve of the lower back, causing a swayback, hyper-lordotic posture. Hyperlordosis is a common source of "mystery" back pain. It comes when you over-arch - usually during long standing, walking, running, reaching, then goes away. People are mystified. Look at both photos again. It is easily prevented by stopping the injurious position then and there. Send your success photos to me at DrBookspan.com.
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