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.
Dr. Bookspan's Ab Revolution™ Core Retraining Relieves Spondylolisthesis Pain
Monday, April 12, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
When a vertebra in the lower spine slides forward on the one below it, it is called spondylolisthesis. In June, I will be presenting my research at an international medical meeting, on a technique I developed to relieve the lower back pain that results from spondylolisthesis.
Like many medical words, spondylolisthesis comes from two Greek words - spondylo, means "spine," and listhesis, means "to slide." Why do the bones slide?
The standard medical literature contains several customary explanations for the condition, each repeated from the next. Often, people who are found on x-ray to have spondylolisthesis are told they have a disease. Often, one of the remedies repeated is surgery. Having spondylolisthesis does not mean you have a disease, or a condition that need medical treatments or surgery. I have found in laboratory studies of many patients with spondylolisthesis, that the lower spine can slide like that when they stand with too much inward curve of the lower back, called swayback and hyperlordosis. It is a slouch, that over time, can push the lower spine bones forward on each other. It is reversible without surgery or medicines.
Normally, your spine bones are held in place, like other joints, by the shape and action of the joints between them. The joints of the vertebrae are called facets, which means "little faces." Facet joints are oval and flat, and look like they are looking at you when you look at them. When you stand and move with your lower spine overarched, that overarched bad posture is a common cause of lower back pain. Nothing much may show up on x-ray for many years. After years overarching the lower spine, the facet joints begin to abrade and grind, and show degenerative change. The vertebrae may also begin to slide.
Fixing the slide involves deliberately moving your lower spine out of slouching and into neutral spine. The forward slouching (slipping) vertebrae can normalize right then. By no longer slouching in a way that slides the vertebrae, the cause of the pain is stopped. I will be presenting this work at the annual meeting of the American College of Sports Medicine (ACSM).
Fitness Fixer reader Teresa recently finished her PhD. Teresa wrote:
"Two abstracts I submitted for the ACSM Annual Meeting from my dissertation have been accepted for poster sessions (one for Exercise is Medicine, the other for scientific abstract)! So I get to go to Baltimore for the ACSM Annual Meeting/Exercise is Medicine Congress. The first one is "Are Physicians Discussing Strength Exercise with their Patients Over Age 40." The second one -"Influence of Physicians’ Knowledge, Beliefs, and Attitudes on Strength Exercise Adoption by Adults over 40."
"Your example in submitting your abstracts on the Ab Revolution training for low back pain was an inspiration that has helped me. I am excited to be doing these two!
"I love keeping up on the FitnessFixer. Thank you all for your help and support!
"This is my first time doing this and any suggestions from a veteran like yourself of (presenting at these) meetings would be HIGHLY APPRECIATED. Also, I really look forward to meeting you in person!
"I look forward to hearing from you soon (now with my tax paperwork off to the preparer, I'm ready to buckle down to make my posters). "Teresa Merrick, PhD"
Congratulations Teresa.
How to relieve pain from spondylolisthesis and other injuries, without surgery or medical treatments: 1. Here is the book, The Ab Revolution™, available through my books page - www.DrBookspan.com/books or click the image below:
2. Read related Fitness Fixers below and more on my web site www.DrBookspan.com.
Video of How to do neutral spine - The movement is a simple "pelvic tilt" done while standing to reduce an overarch to neutral spine. It is not an exercise to repeat 10 times, or other number of times. It is stopping the painful injurious slouch one time and remaining in healthful relaxed neutral position for general life and movement - Friday Fast Fitness - Neutral Spine in 5 Seconds.
Ivy from New Zealand continues making her community healthier, one neighbor at a time. What does she do that helps so many? Here are just a few stories from her many updates:
"Yesterday, I was talking to a 64 year old woman who is a new resident to this country and she told me that she was experiencing back pain. I told her that I could help her - she was most insistent that she hated exercise so I promised that I would not have her exercising that what I would show her would be what she could do as she went about her daily life. I showed her how to lie on the floor and lift herself up on her elbows. She marveled at the instant relief. I then showed her how to squat and do lunges which she was most receptive to. I showed her how to sit up straight, shoulders back and suggested that she lift her ribs (to learn to unround the upper back instead of forcing the straightening from the shoulders or neck). I was most amused she put her hands over her rather ample breasts and lifted them up. It looked so funny. It is the first time I have had someone do that to lift her ribs."
In January 2010, this update came:
"Just the other day when I spoke to Jean she remarked how young I look. (Jean is the lady who I helped re back pain) She said that she felt envious when she compared herself at 62 with me at 73. I remarked that I could not help but be surprised as all I see are the wrinkles when I look in the mirror. No, she replied, we all get wrinkles, it is your slim, fit body plus the fact that you walk so fast. So........., there is hope for me yet!!!!! Smile, "Hugs to you both "Ivy"
In January, Ivy sent me a happy e-mail. The large-chested neighbor who thought pain was due to her size was able to stop upper back pain with healthy techniques, and holding her weight in healthy positioning on her muscle, rather than letting shoulders round and slouch in painful position:
"Jean tells me that she is now free of back pain. She is lying down on her stomach lifting herself up on her elbows on a daily basis. Needless to say she is very happy with the results.
"Re the trapezius and pectoral stretch - she will be visiting me over the next few days (to check good positioning learned from it).
"Re: Merlene (Strengthen a Neighbor, Strengthen a Community) - I did not have to telephone Merlene, she called me to ask if I could vist her. She showed me how well she was doing re her balance. Also, she was delighted re her weight loss. I checked her posture and it was perfect. No longer any back pain.
"She asked if I could help re strengthening her legs. I showed her how to do lunges.
"Merlene is always a pleasure to work with. She is a delightful lady. Love and hugs to you both Ivy"
At the end of January Ivy wrote again:
"Jean: I visited her at home this morning to show her both the Pectoral and Trapezius stretch. She tells me that she no longer has any pain in her back and hip. She also tells me that she has shown her daughter the back stretch and she, too, no longer has any back pain. So.........two very happy women.
"Merlene: I also contacted Merlene this morning to see how her lunges are going. She, too, is happy with her progress.
"Jean did make a comment as to how much I could help people here in the village. I replied that I do try, however, the request has to come from them personally. It is all a matter of choices. Some choose to take medicines, others do not (and use healthy ways to fix the pain without needing medicines).
"Love and hugs to you both Ivy"
February brought this:
"Over the weekend, I received an e-mail from a friend who lives in Australia, telling me that she had back ache. She had had it for a week and had decided that once the weekend was over, she would go to the doctor to get some pain relief.
"I wrote back and told her to lie on the floor or bed and lift herself up on elbows. I have just received a reply saying that the pain has gone.
"Today while shopping in my local organic shop I got talking to a lady who had decided that she would shop for healthy foods instead of the usual junk food. She explained that her family had minor health problems and thought that perhaps if she changed their diet, the health of the family would improve. She noticed what I had in my shopping trolley so asked if I would mind helping her. Actually, I must admit that I did enjoy doing so. She could not believe the knowledge that I was able to pass on and was most grateful. One of the things she asked was how to make sprouts. Not a problem I replied and explained how I, personally, do sprouts. I hope I see her again soon so I can catch up on their progress.
"My shopping which usually takes 20-30 minutes took more like an hour and a half. I assure you, it was time not wasted.
"Hugs Ivy"
Does Ivy meet people who work against themselves? Last October she wrote me about one:
"Thank you for the post re helping oneself. I must have missed your post "Somebody Please Do My Personal Responsibility For Me." (my computer would have been out of action) To be honest, I could not help but burst out laughing at some of the excuses, as I, too, hear these same words time and time again.
"As an example, about 3 years ago, a lady approached me for help re her weight. I might add that she was morbidly obese.
"I wrote her out what I believed to be a balanced diet with plenty of food so that she would not feel hungry. She was thrilled to see that she had lost 16 lbs when I weighed her the following week. For the next few weeks there were no weight losses at all. I asked her if she was following the diet. No, was her reply, you allow me too much food, so I cut down on the quantities. I then get hungry and eat what I shouldn't. This went on for 6 weeks.
"Needless to say, I gave up on her.
"This same lady now lies in bed all day. She does no exercise what so ever. Her husband does everything for her. Once in awhile I see her go out with her husband in the car.
"It is so sad. I did but try. No doubt you can tell many similar stories.
"Have a great day "Hugs, Ivy"
Wisely, Ivy has focused her energy on others since.
Reader Peg S. put healthy bending to work in real life, wrote in with this success story, sent a title for it, took photos and sent them with captions. Thank you Peggy for great work:
"Dr. Bookspan, your emphasis on squats and lunges in place of unhealthy bending has saved my back during long hours of snow shoveling.
"Lots of snow has fallen in far western Maryland - over 265 inches so far this season - with three back-to-back blizzards (22 feet of snow, or 673.1 centimeters).
"All that snow needed to be moved. I avoided unhealthy bending and had no back discomfort after hours of lifting snow-laden shovels.
"When I took a break, I emailed my yoga class students reminding them of the healthy movements such as squat and lunge in their snow removal efforts. They later thanked me for the reminder.
"Thank you for the information on back health!!!" Peggy S
Peggy is teaching these and other healthy movement techniques to developmentally disabled adults to train useful work skills and prevent injuries. See the first results in Functional Fitness as a Lifestyle By Mail Room Workers Peggy, her colleague Patty, Reader Paul J, and I have been working on Peg and Patty's project of using human powered devices like bicycles, to make electricity. More on this to come. Contact me if you can offer real input to design or build.
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.
--- Read success stories and send your own. See if your answers are already here - click Fitness Fixer labels, links, archives, andIndex. Subscribe free - "updates via e-mail" upper right. For personal medical questions - Replies to Medical Questions. Limited Class space for personal feedback. Top students may earn certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Doctors Don't Prescribe Effective Back and Neck Pain Therapy - Exercise
Wednesday, February 03, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Studies have confirmed that directed exercise is beneficial for chronic low back and neck pain. Is it being used? In a survey reported in Arthritis Care & Research, of 684 patients with chronic low back or neck pain, only 14.4% were prescribed exercise by their physicians. By contrast, 63.8% of those seeing a physical therapist and 33.1% of those who saw a chiropractor were prescribed exercise.
Other significant predictors of an exercise prescription were being female, having greater than a high school education, and being on workers' compensation.
Primary source: Freburger JK, et al "Exercise prescription for chronic back or neck pain: Who prescribes it? Who gets it? What is prescribed?" Arthritis Care Res 2009; 61(2): 192-200.
My colleague, family medicine physician Dr. Fabrice Czarnecki sent me this:
A study did a review "prospective controlled trials of interventions." These are studies that evaluated effectiveness of various interventions to prevent back pain (BP) in working age adults. In short, after all the math and big words were sifted through, they found that, "only exercise was found effective for preventing self-reported BPs in seven of eight trials. Other interventions were not found to reduce either incidence or severity of BP episodes compared with controls. Negative trials included five trials of education, four of lumbar supports, two of shoe inserts, and four of reduced lifting programs."
Their conclusions: "Twenty high-quality controlled trials found strong, consistent evidence to guide prevention of BP episodes in working-age adults. Trials found exercise interventions effective and other interventions not effective, including stress management, shoe inserts, back supports, ergonomic/back education, and reduced lifting programs. The varied successful exercise approaches suggest possible benefits beyond their intended physiologic goals."
Bigos SJ, Holland J, Holland C, et al. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J. 2009 Feb;9(2):147-68. (Review) PMID: 19185272
Not all exercise fixes pain. Many exercises cause lower back pain, even those commonly used in rehab and PT programs. Prescribing random exercise is not effective.
--- 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 spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
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.
Reader Success - Using Good Bending For Shoveling Snow
Tuesday, December 22, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
About two feet of snow fell over the weekend in the Northeast US. I got a lovely Christmas card shortly after. I wrote back to thank the sender for remembering me.
KathyB replied,
"I not only remembered you, I've had you on my mind, as I so often do. I was thinking on Sunday, after I'd shoveled snow for 3 hours straight without hurting my back, and again yesterday when I did another half hour, that you gave me a gift that just keeps on giving, that I'll NEVER forget what you've done for me, and I thought how wonderful it must be to be able to do something like that for people.
"I wish you and Paul the very best always,
"Kathy"
Kathy - you make it all worthwhile. Kathy writes well. In fact, she is a professional mystery writer. I will ask her to tell us about some of her exciting books in the future.
In 2006 KathyB stopped 13 years of back pain using my work. She describes what she did in the comments of:
--- Read success stories and send your own. See if your answers are already here - click Fitness Fixer labels, links, archives, andIndex. Subscribe free - "updates via e-mail" upper right. For personal medical questions - Replies to Medical Questions. Limited Class space for personal feedback. Top students may earn certification -DrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
A number of conventional standardized fitness tests, surprisingly, are not accurate. They do not test what they claim to test. To get real answers that you can use, it is important to know if you are doing what you think you are doing.
An example of a test that does not test what it claims is the "Sit and Reach" test. Sit and Reach is assumed to test hamstring flexibility, but is more a measure of how much you can round your spine. Many people can pass the Sit and Reach with little hamstring flexibility and an unhealthful angle at the hip - tilted back (shown by shorts side seam) rather than vertical. The Sit and Reach is required testing for numerous military, corporate, and school fitness programs
Another standard fitness assessment uses crunches or sit ups, supposedly to test abdominal muscle function. Bending or curling forward does not give a predictive measure of how well you can use your abdominal muscles to adjust your spine position for spine health, for sports ability, to prevent back pain, in short, to move in healthy ways in real daily life and work where you need it most.
A test may be reliable, which means it gives the same answer each time you test the same thing. For example, a scale should measure the same item at the same weight each time. A reliable scale may not be accurate. That means, it may be wrong by the same amount each time. But it does give the same answer reliably. Having a reliable test does not mean it will be accurate. Accuracy and reliability are both necessary components of devising tests that are actually helpful.
I worked years researching more prognostic and beneficial tests for several common fitness measures. If your military or police division, school, or industry wants to hire me to train you in simple new reliable and accurate tests, let me know.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right.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 success stories of Fitness Fixer methods and send your own. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Reps of Exercises Don't Fix Pain; Fixing Causes Does
Monday, October 19, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Monica from Montana bent over dogs daily in her dog boarding kennel. She spent the summer doing stretches, exercises and going to chiropractors for severe back pain. She did all her "sets and reps" (repetitions) of the exercises her various practitioners gave her. The pain kept coming back. What did she do differently that stopped this cycle?
I first heard from Monica through her short happy note:
"Thank You!! So much. I've had quite the drain of lower back pain the whole summer. Finally I got online and read your article and have now begun the fast road to recovery. The first day I did have relief. Now it's been three days and I can't stop talking about how good I feel. Today I drove six hours and was still comfortable! "Thank you again, "Monica "Montana"
I wrote to thank her for using my work as intended and taking time to tell me. She replied:
"Hi Dr. Bookspan, "The whole summer of 2009 was plagued with lower back pain, I thought due to raking pine cones. I did my usual routine. Going to the chiropractor. Doing stretches (the wrong stretches) all day long thinking they were giving me relief and come to find out by reading your website I was re-injuring my back over and over by doing these improper stretches of bending forward. When I found your website it all made sense so I immediately implemented your instruction and what do you know I immediately started feeling better.
"The pain did not all go away over night, it has taken time to heal, tolerable time thank you. At the end of August I wrote to you saying thank you. It is now the first part of October and the lower back pain is pretty much gone.
"When the pain makes an appearance I immediately pay attention to body position and it (the pain) goes away. I also suspect the chairs I use at work were a part of setting me up for this injury. The chairs are like saddles to "help with upright posture." The molded hard part of the back of the chair is protruding to where it was subtly pushing on my tail bone I've now realized. I think that's a part in why the injury was so low in my back. Plus I think the saddle part of the chair had been affecting my hips. This has taken some time to realize I was so used to these chairs. This whole combination has caused quite a bit of pain and discomfort but due to your website I started looking at all of these things and am reaping the benefits.
"Thank You Dr. Bookspan! You are a bright expression of this essence we all are. The essence of compassion, clarity and skillful means. "Much Love, "Monica
Thank you Monica, for lovely writing.
I wrote back to Monica to see what, specifically, she found helpful, and make sure that after time, she remained pain free, had her life back, and could do more than before she started using my work. To help readers, I make sure these reader inspiring stories are tutorials, not just testimonials. For new readers who have not previously heard of fixing causes rather than doing a few sets and reps of exercise and stretches, I ask success story writers to include specifics.
Monica continues with two commonly prescribed forward bending stretches that add to a common source of pain, rather than fix any problem:
"The main (wrong) exercise I kept repeating over and over was to sit in a chair, bend forward with arms between my legs to stretch as much as I could. This would make my spine move as if straightening - I thought. I also found that bending forward over the front knee created a stretch that would make my spine move. I realize now this was not a good thing."
She also described habitual body positioning that are classic contributors to pain. Even if you do all your sets and reps of exercise and stretches, if you don't prevent these causes of pain, you won't stop the resulting pain:
"My habits have been to let the bottom of my pelvis bend back at while sitting or standing. You know the "butt out" posture. While walking, my feet tend to face outward too. I've now been more conscious to keep my feet square and tilting the bottom of my pelvis forward to give my spine more support. Works like a charm.
"For real life bending... The first thing I do in the morning is go feed dogs in my dog boarding kennel, so in order to pick up bowls and put them back down I now bend my legs instead of bending over using my back. I try to keep my heels to the ground and come up easy while I'm still gaining strength to take care of my knees. My legs have adapted quickly. I bend using my legs all day long and really try to take care of my knees and back.
"I hope this helps someone. "Warm Regards, "Monica"
If You Have Questions How To Do This For Yourself:
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Robert Davis, frequent Fitness Fixer success story contributor, wrote to me with observations that will encourage, educate, and help many -
"I am beginning to see an almost "plague" in our society. That plague is auto-assumption that age automatically will start to equal degradation of your body."
Mr. Davis, a young lifter, had first left a comment to a Fitness Fixer article last year asking about fixing his back injury from weight lifting. His success stories came in frequently from there, telling how he gained better health and ability than before his injury. In a recent update letter to me, he sent these insights:
" I have not mailed in a few months. However I did not want to forget what got me back to what I love. I have had no issues with my back for months now. It went from dreadful to move, to better then ever.
" It is all so simple once it becomes ingrained. At first it does seem to be a chore learning to (bend right with a lunge and) squat and all the other things to correct bad habits. However these things, with conscious repetition, become habits. No longer do I have to think about healthy movement!
" This has been beneficial not only for my back, but for all areas that were troublesome. The more I loosed up, bent correctly, and used movement correctly, the more minor problems just seem to fade away!
" I have a new mantra when I workout with weight. It is called "on the muscle" chant. Every exercise I perform I say this in my mind and concentrate all weight on the muscles (instead of making it easier by shifting weight to joints). If I feel it is too heavy and I am doing some joint crushing, I back off the weight. I do not lose anything backing off. I gain something. More strength to do the same "on the muscle". In sum, I have really really chosen healthy movement over getting in an extra few pounds with "joint/arch or whatever" assistance. It is not worth it. You will get it eventually "on the muscle!"
" One sad thing I am noticing though lately after going thru stuff myself is this. I am beginning to see an almost "plague" in our society. That plague is auto assumption that age automatically will start to equal degradation of your body. I grew up as a pre-teen/teen in the late 80s and into the 90s. I never remembered regarding people who were much older as limited. I think this phenomenon is a cultural condition based on no facts, and the massive influx of pharmaceuticals. I could be wrong but that is what I see.
" I am amazed at all the people I run across in the gym who are told to "not do this or that". I often think of my grandfather and the time period he grew up in. He was very active and working under cars and whatnot till a few months before he passed away. No one told him his age would hamper that.
" I could go on and on about this but I think particularly in America, we are in a self created plague where age is a bad thing and something to postpone. What little do people know is that healthy movement, awareness, and lifestyle help one get thru all this without having to stop what they love.
" Look at me. From a debilitating back injury to returning to what I love to do - "lift weights in the gym." I was skeptical I would have ever made it back when I got hurt. However I am kinda glad now I did get hurt as sometimes there is a gem inside what otherwise would seem problematic. That Gem was learning (from you) how to do what I love to do without worry of age or injury ever detouring me from that. I am in my mid 30s now and plan to stay on top of myself with your methods for as long as I have a passion for this(and I feel that is a very long time). After all I see the body builders in the 70s and am truly inspired to keep going.
" Thank you! I also wanted to just check in and give a little insight of what I was doing and my thoughts on things =P "Robert Davis"
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Fast Fitness - Count How Many Times You Help Or Hurt Your Body Daily
Friday, July 17, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - a simple tool to help you notice how many times during your ordinary day you can either get functional built-in exercise for leg, back, and hip muscles plus a Achilles tendon stretch, or produce a common factor in back and knee pain.
Every time you bend down to reach or retrieve something, count it
See how many bends you do for ordinary chores and by the end of the day
Choose if you want to hurt or help your fitness each time.
David from Belgium has written numerous Fitness Fixer success stories and created many photos and videos for better learning. He writes:
"I just spent half an hour vacuuming our house downstairs.
"When I do chores like these, I try to practice some focus instead of letting my mind wander all over the place.Usually this means I try to remain aware of my breathing (breathing normally, not grunting, straining, or holding breath to reach or lift things).
"But today I thought of one of your articles that said how many times on average a person bends over during the day. So I decided to count this for myself, just for fun and something to focus on.
"In the roughly 30 minutes of vacuuming, I counted 67 squats. Now that's a good workout! =)
Photos by David of squat and lunge for household bending
Bending over "wrong" is a common factor in back pain, and not only for out of shape people. It is common in many weight lifters. Bending "wrong is often done as an exercise. It doesn't strength back muscles as much as other ways, and puts large load on the discs, So it's not a helpful trade-off.
Previous Fitness Fixer posts explained that doing a few good rehab exercises and stretches for back pain won't undo a day of bad bending, and that you bend hundreds of times each day. "Fitness as a lifestyle" does not mean doing crunches during TV commercials or doing squats while on the phone. It means how you live. Get real exercise, built in, during real daily movement.
You get to choose whether you add an obvious check mark in the pile of things that don't benefit your fitness or whether you get functional exercise.
Fitness Fixer post on good bending for knees and back at the same time:
--- Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
How Effective Are Medical Treatments For Back Pain?
Monday, July 13, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Many well-known conventional treatments for injured athletes and military personnel came from ways to keep wounded combatants able to continue fire, not to maximize their long-term survival or later health.
Years of my career laboratory research was improving physical training for athletes and military, and developing injury protocols that were healthy, not just a remedy for the moment. I also found that much good sports medicine for athletic motion was never applied to the more common body motions needed all day. Not only can the athletes benefit, but everyone else. Many patients and readers have success using my improved non-surgical methods, and write us their stories (click for reader stories). Many more have success without writing about it. Other readers asked about various medical (surgical/drug) treatments, and why don't I use them.
Thank you to my colleague Fabrice Czarnecki. M.D. emergency room physician, for sending me a report, recently published in a prestigious medical journal. The work was a systematic review of the "benefits and harms of nonsurgical interventional therapies for low back and radicular pain."
The medical methods they looked at were local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation.
Their results: "For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies.
What does all that mean? They summed it up in their conclusions: "Few nonsurgical interventional therapies for low back pain have been shown to be effective in randomized, placebo-controlled trials."
Report name: Nonsurgical interventional therapies for low back pain: a review of the evidence for an American pain society clinical practice guideline. Published in Spine. 2009 May 1;34(10):1078-93.
Medical reports on these methods (as well as general strengthening exercises) frequently show what is called a scattershot success - meaning if you try it on hundreds of people, it's bound to hit a few of them. Often these hits (moderate improvements) are about the same as chance or as time passing and the person heals on their own over the weeks of the treatment and recovery. Use those medical treatments if you believe in them and prefer them.
I prefer a direct approach:
Instead of shots to anesthetize the area, or surgery to remove or fuse an area, retrain movement to be healthy so that you no longer injure the area and it can heal.
Instead of medicines to mask the damage you cause, stop the damage.
Stopping damage does not mean stopping movement, activity or fun. Use healthy body mechanics to become able to do more than before.
Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Comments, A Medical Conference, New Findings on Discs
Monday, May 25, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
By the time this post comes out, we should be halfway out West to a medical conference. I'm presenting a study, which took years to do, and which found something unexpected.
I am a medical researcher. I find out the things that doctors (with any luck) then learn and put into practice. A research career has all (and more) of the medical schooling, but without the burden of the medical salary. In previous studies, I found that chronically overdoing the inward lower spine curve pinches the lower spine. It forces the spine joints, called facets, backward against each other, eventually wearing them out, and compresses surrounding soft tissue. After long periods of standing, exercise, and lifting with too much inward curve, lower back pain is not a big surprise or mysterious to fix. In the work I am presenting, I found that although it is known that the main factor to injure vertebral discs is too much bending forward, that overarching backward can hurt discs too. This is a new proposed mechanism of disc injury.
There is supposed to be a small inward curve to the lower spine. With the (very) small normal inward curve, spine bones line up on top of each other like stacks of cups so that there is equal pressure on discs from front to back. That is called normal lordosis (inward curve). Chronic bending forward manages to unequally load the discs so that they push out in back. Overarching also unequally loads the area. It seems to pinch already protruded discs, and may even factor in the herniation process. I will be presenting on years of my work that lead to this finding.
I made a diagram showing the disc injury coming from overarching/ hyperlordosis/ hyperextending the spine that is so common in pop fitness. The Healthline blog software is still not loading any new photos of my own. Stock photos or those from other people's sharing sites appear, but I the blogger is not letting us get my own diagrams and student photos to you, for now. I mailed the image to Healthline.com staffer Jerry, who said he could upload it for you. It should appear here, below this paragraph, so you can understand better why hyper-lordosis, although common, and often taught, it not neutral spine and can make unnecessary pain. The damage and pain can be quick to fix when you know how. Click the labels "facets" and "lordosis" for posts explaining this issue.
I have to pay the travel to get to the conference, pay the conference fee, essentially, pay to work. I have to bring a computer and projector to give my own presentation (or pay an AV fee to the conference) but won't have Internet access to see or answer questions. Leave fun comments but hold questions for the next two weeks.
Photo is me, taken on the way on the way to a previous medical conference, out for some barefoot climbing.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For answers to personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify throughDrBookspan.com/Academy.See Dr. Bookspan's Books. ---
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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