"Jolie Bookspan, the Fitness Fixer, brings us a detailed post about how to look upward without placing strain on our necks. I like the part about how our necks are not Pez dispensers – good visual image. The article is a good reminder that we need to use proper form in all of our daily activities, not just while we’re at the gym."
On the web, Grand Rounds is a collection of the best on-line medical posts from the past week. A different host works hard each week to find and list the articles. This is different from the Grand Rounds in a hospital, which is a lecture for doctors about a patient or topic.
Thank you to this week's host for doing the hard work of collecting and featuring our information.
--- Read success stories of Fitness Fixer methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Here is Friday Fast Fitness - Save your neck while biking, while drinking from a water bottle while biking, and get a needed upper back stretch at the same time:
Main concept - your neck is not a Pez dispenser. Don't tip and pinch back at the neck to look upward to drink or look forward while riding.
Notice if you jut your chin forward and upward to drink or ride.
Instead, extend upward through your entire upper back. Keep your chin fairly still and see how much upward range you can get from your upper back. Instead of rounding the upper back forward, you get a nice straightening stretch.
Craning the neck (pinching backward at one joint) and pushing the chin forward, pinches and compresses your discs, joints of the neck bones, the soft tissue, and nerves.
To help remember good biking form, I put a reminder on a healthy water bottle. Keep your exercise healthy. Click AcademyGifts or the image to order.
--- I make posts from fun mail and success stories. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
"I enjoy the all day exercises using squat and lunge for my daily activities. Thank you for sharing your philosophy.
"However, those exercises are mainly for lower body. I would like to ask if there are good all day exercises for upper body parts i.e., shoulder, neck.
"I found some stretches for shoulder and neck that you introduced.
"Thank you and best regards, Vietanh"
This is a great question and understanding that fitness is something that you do during real life. In gyms and health centers, even therapy settings where people are going there for the purpose of fixing and increasing function, they sit waiting in terrible unhealthful positioning - photo at right - waiting for a class or activity for health. I have read fitness books saying the posterior shoulder is "difficult to target." Hold your shoulders straight, rather than letting them slump forward. You will get built in upper body functional exercise. Apply this to exercise, to lifting, sitting, sewing, all you do.
Look at your many hours each day of real life - when you prevent round shoulders with retraction to neutral, you are getting upper back extension exercise. When you sit and bend and lift right instead of rounding forward, you get healthful, functional upper and mid range back extension. When you use neutral spine to walk, run, kick, and jump, by extending at the hip instead of allowing the lower spine to increase in arch passively into hyperlordosis, you get healthful lower back extension and abdominal exercise at the same time. It is the abdominal muscles that will flex you forward to straight, rather than overarched. They only do this when you deliberately use them. Strengthening alone does not create movement to healthful position. Healthful positioning strengthens and gives exercise. Look at the photo above again and see that how you really live, not a gym, is your exercise and health.
Apply upper body muscle use for function in daily life:
Using upper back muscles to prevent rounding forward in round shoulders gives continuous built in exercise. This is not forcing, just mobile, comfortable muscle use. How are you sitting while reading this?
There is more to this excellent question. Will come in future posts.
---
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Fast Fitness - Built in Upper Body and Core Exercise Carrying Children
Friday, May 29, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - get better exercise and stop aching back and shoulders when carrying children (or anything else) in backpack carriers or by piggyback:
Put on the carrier (and baby for a fun practice ride or use groceries, etc). Look sideways in a mirror.
See if you round your upper and or lower back forward. See if you lean your upper body backward under the weight. Notice if you increase your lower spine inward curve, are tilting the hip out in back to hold up the carrier.
Straighten upper and lower body segments. You will feel a strong pull on your abdominal muscles when you reduce overarching in the lower spine and prevent leaning the upper body backward. You will feel an upper back workout when you don't lean or round forward.
Use straighter positioning all you can:
It may be "natural" to try to offset loads by hunching and contorting your body, but it still hurts.
Overarching the lower spine makes carrying feel easier because it shifts weight to the spine joints (facets) and surrounding soft tissue, and off the ab muscles. Rounding forward feels easier as it shifts weight to the discs and off the back muscles.
Get more exercise and less joint trauma with neutral posture.
Looking downward with good neck dynamics: Holding healthful position does not mean never look up or down to see where you are going. It means to get natural, built-in upper body exercise, burn calories, and enjoy your time going places with the kids - Tax Preparation Health
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
RSS feeds are still going down - Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Certain headaches can be initiated or aggravated by tense facial muscles (squinting, scowling, furrowing brow), and by tight, tense, overstretched muscles in back of the head, neck, and shoulders, common with letting the upper body slouch forward. Headaches from tight muscles were formerly categorized as tension headaches. A growing theory includes upper body muscle use among triggers of a different kind of headache, the migraine, previously thought of as only a vascular event.
The wide range of kinds of headache is not my major field of study. I had previously had results with patients retraining upper body position to stop tension headache. I was not aware my own research would be useful to people with other kinds of headache, so I am learning from my patients who frequently report stories just like this one recently in from engineer Johannes Ernst:
Dr. Ernst writes:
"Some mindblowing ideas one might come across by accident instantly convert you into a new missionary because they are so clearly and obviously true, no further check required. Your particular religion ;-) of fitness is one of them.
"I would summarize it as follows: if our ancestors, over 10's of thousands of years, had had as many ailments as we have today, the human race would have died out a long time ago. No ergonomic chairs but only rocks and logs to sit on? No exercise equipment? Not even one pill a day? Just leaves and furs instead of expensive mattresses and beds? Humans clearly had no chance.
"Well, but here we are nevertheless. So given how many ailments we have, something that we are doing these days must be much worse than what our ancestors did in the forests. Jolie's mindbogglingly straightforward answer: instead of using ever-more complicated medical and fitness tools and regimens, whose benefits, never mind costs, often are marginal or doubtful, what about we use our bodies how they were meant to be used? Duh!!
"The shameful thing is that medicine, as a profession, does not necessarily nudge anybody in that direction. Often, its leading practitioners seem totally oblivious to what should be a "Duh".
"What is wrong with this picture?
"In my case, over the course of 25 years of headaches, healthcare professionals on two continents, etc. etc., nobody, never, not once, suggested, that I could improve my posture. I got all the drugs, regardless of how expensive, few of which would make much difference other than to put me out cold.
"Last week, for the first time, about 6 weeks since I got a few of Jolie's books, I managed to extinguish an immobilizing headache through some rather simple exercises, completely without drugs. I totally expect that I will be able to do it again. (I did! This morning!)
There is more to headache than muscles and posture. Many causes can be controlled without unhealthful pills. The book Health & Fitness in Plain English THIRD edition has an entire chapter devoted to known ways to prevent and end a headache.
--- 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. Limited Class spaces for personal feedback. Top students may apply to get certifiedDrBookspan.com/Academy.
Readers, patients, and students have asked me for years to write down for them about good lifting and bending over babies and children. I wrote articles and books. I did experiments in the lab. They still said they couldn't remember. So I made something for all of you. You can give these to everyone in need for Mothers and Fathers days, coming up, and all year.
Here it is, quicker and easier than reading the books:
If the photo does not appear (blogger is having troubles) click this link.
I designed singlets and one-piece suits for infants, T-shirts for toddlers and children, various sizes and colors.
One student had asked me to write down and hang the information around her neck so she would have an easy way to remember all the time. So I made a bib too - for the baby - so she could see it each time she bent to feed and lift.
I was surprised people wouldn't just remember on their own to live in a way so important to their health. But they kept coming back asking for me to tell them again. I am drawing the various concepts and putting them on daily items as funny reminders. I will show them in future posts if readers are interested.
Click the photo or go to this site for all the educational gifts designed so far - http://www.cafepress.com/AcademyGifts. Send your requests for other ways to have fun health built in to daily memory.
---
Read success stories of Fitness Fixer methods and send your own. Questions come in by hundreds. I make posts from fun ones. See if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. RSS feed currently not working, so click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Vertebral Artery Compression, Dizziness, Discs, and the Forward Head
Tuesday, December 02, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
I received an e-mail from Serbia. Miroslav had suffered eight years of dizziness from compression of the vasculature and nerves of his neck. Then he found how to prevent the bad position called "forward head" using my methods. Miroslav had previously read various sources promoting the often-repeated bad advice to bend the neck forward as a the way to make space for the nerves that exit the back of spine. A little knowledge is a dangerous thing. That kind of forward bending is not a healthy way over the long term.
Bending the spine forward pinches vertebrae closer in front and farther apart in back, creating unequal pressure that over time, wedges and squeezes discs rearward and outward, like squeezing a tube of toothpaste. A disc nearly always bulges (herniates/moves/slips/migrates/extrudes) toward the back of the spine out the enlarged space, from years of the bad posture of sitting and standing with a rounded/bent forward spine.
Sitting and standing straight would make more space for the nerves without the herniating force. Miroslav also had a forward head as a regular posture, also called "straightening the cervical lordosis." He had been flexing his neck (bending forward) trying to fix his various numbness and pain, and wound up compressing verves, blood vessels and other structures.
Miroslav wrote in one of his blog posts that he was practicing Alexander technique for the previous few weeks, "as specified in Richard Brennan's book /head up and forward." After getting worse and trying various doctors and cures, Miroslav found my web site. He wrote:
"Dear Dr Bookspan, "I have found Your articles online and they have been extremely helpful. I just wanted to say that I appreciate Your work immensely. Few last articles I wrote on http://cvelee.blogspot.com/2008/11/quick-solutions.html regarding my problem and how You have helped me. If You have time, you can catch a glimpse of them. "With respects, "Miroslav Cvetinov"
Here is the post from his blog:
"Q u i c k s o l u t i o n s
"I am strong opponent to quick solutions to many of our everyday problem, whether money or health related. In such manner, I didn't expect my dizziness to disappear over night without trace.
"I had it since 2000. So 8 years before, they did everything necessary to rule out other diseases : EEG, Dopler, Blink reflexes, Evoked potentials... everything clean.
"In 2007. dizziness worsened so neurologist sent me to do endocranium MRI/MRA. Totally clean: no lesions whether white MS or atherosclerotic, balanced blood flow...
"2008. I have found article from Dr Jolie Bookspan, describing forward head posture and neurological deficits. I did have extremely straightened cervical lordosis, so I qualify for FHP. I started practicing healthy head postures : head back and FLEXION.
"I always thought that neck flexion was the key to healthy disc, because it opens neuroforamen, and that that degree of neck flexion wasn't possible without FHP. But, guys, I am physics scientist, I do not know how did it miss me : head-neck system has 5 degrees of freedom. I could pull it back, yet keep healthy degree of flexion. Just think of extending back of the neck while shortening front portion of it. That compulsive strengthening of SCM muscles I did, didn't do me any good, but...
"Anyway, MY TREMENDOUS DIZZINESS DISAPPEARED IN A MOMENT!! MOMENT, not day, not week, immediately. How? I do not know! I do not care! Thanks Dr Jolie.
"I can look over my shoulder while walking now. Easily without dizziness, loss of balance and lightheadedness. This it totally new.
"I have to give credit to 2 doctors more: 1. Dear ENT Vukoja Novak - he was the first one out of many doctors to tell me that if I consider it real, organic disease and not anxiety/panic related, I should check out carotid arteries on Doppler and cervical spine on roentgen. Latter revealed disk degeneration and straightened lordosis. He was the first to point to the spine. 2. Dr Mijanović - While doing EMG, he told me that tongue is clear except huge amount of hyperexcitability and asked me to check out something serious and real. I suggested left arm, with disesthesia running in C6 dermatome. He asked me about dizziness, I told him " I do have it, a lot of it, but dear doctor, I have panic disorder and somatoform disorder. It is due to this.". After poked me with a needle in left deltoid he immediately said "I can assure you, your dizziness are due to your spine."
"So, now I know. Not that it was spine, it can be cured in a moment:)"
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.
Overhead Lifting, Reaching, and Throwing - More Part I
Wednesday, August 13, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Nice e-mails and requests came in after Part I last Monday about the overlooked training habit which slowly impinges and tears the rotator cuff. Here is one that covers the points from all received so far.
Reader Hanson writes:
"Thank you Dr. Bookspan for exactly the missing link. I had been attending months of expensive private yoga lessons at [well known studio name deleted] for my shoulder woes without much relief, and maybe have worsened my circumstances. I thought becoming worse with yoga was preferable to surgery that my orthopedic surgeon at [top California facility name deleted] said was required. The yoga directress said more months were necessary (for her wallet?) and I must learn to cool my mind (before I questioned why I wasn't getting better?). I sure didn't question when she wore that little outfit. She showed me yoga poses to "awaken" the area and other fuzzy yoga talk. Poses were raising arms overhead, leaning over with arms overhead, sitting with arms up, and so on. My shoulders burned, she said it was "awakenening." Now I discovered from you it was "impinging." No one said anything about a forward head when I raised arms. I did the same as the directress did. She had this bad posture too. She said do it slowly if it burns. So I burned up my shoulders slowly. Instead of paying the yoga directress for another private session of self-injury raising my arms with head forward I printed your blog and held it overhead to read it. I didn't lean myself back and didn't tilt my head forward. The shoulder is already better. I found all those yoga lessons never prepared me to stand up straight. They told me yoga gives you posture, but it didn't give me anything except a worse shoulder. The "awakening" came from your blog saying use this for life not just exercise. I can lift arms without pain now. I keep my head straight, not forward. Can you put more pictures up of what to look for and can you tell people about your blog?"
Left (pink), upper body leaning backward (explained in Part I). Tilting unevenly compresses the lower spine by increasing the inward curve under load, and fools some into thinking the arm is stretching fully. Center, hunched (raised) shoulders and forward head. Hunching compresses the area. Keep shoulders down when raising arms. Don't raise arms and shoulder together. Right (yellow), leaning upper body backward and forward head. Can you detect the forward head camouflaged by the upper body lean back?
Head forward when raising arm. Shoulders rounded, further compressing the area when lifting the arm.
Head forward when raising arm, shoulders rounded. Also pictured - lower back rounded, tilting the hip (pelvis) too far under. Shifts weight to the lumbar discs (click The Cause of Disc and Back Pain).
Fix Your Fitness to be Healthy and Stronger. Be able to do more, not give up lifting:
Click labels under this post for all Fitness Fixer on each topic.
--- 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 apply for certification throughDrBookspan.com/Academy. Get more in Dr. Bookspan's Books.
Taxes are due April 15th. Piles of papers, forms, schedules, receipts. Readers have asked how to be healthier while working at the desk, and how to keep their cool during tax preparation.
Several readers asked how to stop neck pain when looking down over deskwork. Reader John M, specifically asked "How do you suggest someone look down (to look at a chart etc at work) without pushing the (herniated neck) disc out more (or aggravating symptoms)?
Three photos above show tilting the neck forward and/or jutting the chin forward. Holding the head forward of the neck and body is a major source of upper back and neck pain. The "forward head" is hard on the soft tissues, the joints of the vertebrae called facets, and the discs of the neck, and is a major overlooked cause of "upper crossed syndrome." The forward head is just a bad posture, and easy to stop. It is not necessary to jut the neck or chin forward to look downward.
Check how you are sitting right now. Are you letting your neck hang forward, are you jutting your chin forward, or are you pushing or rounding your neck and upper body forward? Instead, keep chin in, loosely and gently. If needed, bring your chair closer in closer to the desk and lean the upper body back instead of rounding your lower back against the chair back and leaning the upper body forwad.
To look down comfortably - tip chin down in relaxed straight position instead of jutting the head and neck forward. That is healthy positioning for everyone - injured or not. No need to lean or hang the head or neck forward, or round your upper back to look downward.
More Fitness Fixer with quick techniques to feel better during desk work:
Read inspiring success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
---
Forward head photo 1 by Kevin K. Luu Forward head silhouette photo 2 by äÁǻǵ Forward head writing at desk photo 3 by My Hobo Soul Straight good cooking posture photo by Presta
Several readers asked what else they can do for painful head and sinus congestion, because after two+ weeks of medicines and doctor visits, they were no better, or were worse. Common treatments do not work as claimed, including decongestants and sprays, and can cause sinus pain to continue and recur.
What Are Sinuses? The sinuses in your head are eight spaces in your skull behind your eyes and nose. They produce mucus, and that is good. Mucus produces antiseptics, and traps and filters germs and particles that you don't want to pass into your respiratory system and the rest of your body. Sinusitis occurs when one or more of your sinus cavities become inflamed.
Inflamed by Inhaling Things Sinuses can become inflamed without any germs causing it, for example from inhaling particles, allergens, or liquids up the nose. If you have ever "gotten water up your nose" in a pool, you have felt the results. The practice of irrigating the nose and sinuses with salt-water sprays is often prescribed for sinus congestion, and even for preventive "maintenance," but it removes important protective mucus layers and natural disease-fighting compounds, and is irritating in itself. Some people regularly spray the sinuses using a variety of squeeze bottles, or a device called a neti pot. It is an unnecessary practice, and does not prevent the underlying cause of sinus pain. It sets up an addictive cycle of rebound congestion and irritation, and increased risk of infections and discomfort to follow.
Another contributor to rebound congestion is regular use of camphor inhalers. Sniffing camphor is a widespread practice throughout Asia, where decorative camphor containers shaped to fit the nose are sold in most grocery, pharmacy, and convenience stores. Camphor irritates mucus membranes causing a cycle of irritation, more camphor inhalation, and more congestion. Some people develop a habit of inhaling camphor, thinking it is for their congestion, not realizing they have a substance inhalation addiction called "huffing."
Decongestants Decongestants are a big money item in drug store sales. They are not the best treatment for sinus pain and congestion. You are already too clogged up. You do not want more "drying out." The clogged areas would do better becoming more dilute by drinking hot liquids, not by becoming more gummy and concentrated with the "drying out" of a decongestant. After the decongestant wears off, a rebound can occur of more congestion. Taking more decongestant perpetuates a negative cycle, and can raise blood pressure. Cough syrups and pills that contain dexomethorphan (DXM) to block coughing are not as effective for coughs as hoped, but are popularly abused by kids looking for a cheap, easily available "high" ("rhobotripping") with unhealthy physical and psychoactive effects. Infections and Antibiotics Sometimes sinuses fill with bacterial or viral fluid. Antibiotic do not help against sinusitis, even the kinds colonized by bacteria. Antibiotics can kill your body's good "bugs" or weaken them, leaving you susceptible to stronger bad bugs, who learn how to live and multiply in your body. Antibiotics taken orally reduce the needed numbers of beneficial flora that normally live in your GI tract. The nutritional and immunogenic products that they normally make in your body are not made, and the organisms responsible for several illnesses can rapidly reproduce and get out of control. An example is antibiotic-associated Clostridium difficile (C. difficile) colitis, an infection of the colon that occurs primarily among patients exposed to antibiotics. More than three million C. difficile infections occur in hospitals in the U.S. each year. He number is growing. An estimated 20,000 C. difficile infections occur each year in the U.S. outside the hospital - directly caused by taking antibiotics.
Healthier Ways to Decongest and Sooth:
Hot steamy showers and baths.
Hot facial compresses.
No need for fancy vaporizers with chemicals (more camphor or other irritants to inhale). Put on a kettle or any pot of water and heat until steaming. Stand at a distance where you feel the warm steam, without standing close enough for any chance of burns. No need to bend over as in the photo at right. Stand in healthy comfortable position for your back and neck.
Eat spicy foods that you like, such as wasabi or chili peppers.
Drink hot peppermint tea, or other warm, aromatic teas with lemon.
A walk outdoors in fresh air and sunshine helps clear breathing and pain.
Do any fun exercise to heat your body. Increasing body temperature loosens clogging secretions and generates heat shock proteins that have been found to be pretty good for you. The post Exercise and Cancer touches on the basics of heat shock proteins.
More information on preventing and resolving sinus problems, things to know about antibiotic use, and other infectious topics are in the book Healthy Martial Arts.
How many of you caught that the photo in the Fast Fitness post - Fix Positioning by Watching Others is of terrible body positioning that is a common source of upper body pain and injury?
I received letters asking about the photo. Several readers did not catch that the reason for the photo was that both people were standing in terrible rounded forward posture. Some readers thought the photo was not of bad posture, but showed people with interest in the game or that they way they were standing was a needed position to see the ball.
It is a harmful body position called forward head and round shoulders.
The rounded and tilted forward position of the upper back, neck and head is a bad positioning that is a major cause of:
Upper back pain sometimes called Upper crossed syndrome
Look in your fitness magazines and videos and look around during fitness classes and the gym to see if you can see the forward head and a rounded upper body. It's a handy reminder that it is not healthy, and to exercise in better, healthier ways.
Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II
Thursday, January 17, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
In Part I of this post on Monday, photographer Bernie tells of fixing years of pain that doctors told him only surgery would fix, even after three surgeries. Here is a look "behind the scenes."
10 March 2005, Bernie e-mailed me:
"I've had this persistent paresthesias for 4+ years. I just learned about you yesterday. Where are your back & spine classes held. Tomorrow, I'm having lumbar myelogram & CT at (top name deleted here) Hospital. Before I consider anything else, I want to learn about your methods."
I wrote back with class information. I had two classes coming up. One was the next month. The second would be in early May and only a few blocks from where he lived. I told how we work to see change in pain right in class. I asked him to let me know the test results and that I hoped to see him in class.
20 March 2005 he wrote back:
"Thanks for asking, I never expected you to keep in touch. The myelogram and CT showed moderate central spinal stenosis at L4-L5. Severe facet joint arthropy & hypertrophy of ligamentum flaxa causing compression of the lateral recesses stenosis of L5 on both sides, kinking of L5 nerve root sleeves on both sides. I have a copy of the xray, showing the "hourglass" at L4-L5
"(name deleted) is the attending, 3-B Orthopaedics. He said the next step is surgery, by ( ), at ( ) Hosp. I asked if strengthening of my upper body would help support my spine. He said "try it" so I'll be at physical therapy next week to start.
"I have a commitment for the weekend of April 2-3 so can't attend that class, much as I'd like to. Since I live at (close to) your class at Temple CC is my best chance of attending. Cordially, Bernie Cleff"
I checked back in to make sure he was signed up for the May class and to ask what he was doing in Physical therapy. He wrote:
29March 2005 "The phys therapy that I'm getting concentrates on my core muscles. Thanks for getting in touch...very kind of you."
I wrote back saying that conventional core exercises were not the best thing. Usually they are forward bending actions that will further compress the discs, the nerves, and also do not retrain the abdominal muscles in the way they work when you go about daily life. Strengthening does not automatically support the spine. I wanted to make sure that he had my Ab Revolution book, which was then out in a training manual version. He said he had it with him for PT. I found out two years later that they had the book, but they were not using it, and were doing traditional forward bending abdominal exercises.
10 May 2005, the day after the Fix Your Own Back Pain workshop was held, Bernie wrote me,
"Hello, I did sign-up for your class at TUCC on Monday 5/9, but I was too tired to attend. On top of that, I am scheduled for spine surgery at ( ) on Wed 5/11/05, with ( ). After having 2 epidurals and physical therapy I decided to go for the surgery. My nerve that is pinched is in the shape of an hourglass (at L4- L5) and (the doctors told him) that no body position or exercise changes are going to help at this time. Both legs are numb and I am walking like a drunk. It is kind of you to keep in touch. I hope to meet you at your fall class."
Days later, Bernie had the surgery. He tells about it, and his next two years, in Part I of this story. The doctors all considered his surgery a "complete success." They said the surgery went completely according to plan, with no complications. His recovery was in line with expected results. The fact that his pain returned, was worse, and complicated by limited movement from his plates and screws and other surgical hardware not a factor to them. They felt the limited movement was beneficial and a goal of the surgery. The commonly held idea is to stop motion in the area to stop the pain.
In late October of 2007. I arrived to teach the Fix Your Own Back and Neck Pain Workshop. I had 16 people waiting for me. One was Mr. Bernie Cleff, a funny white-haired muscular man of 80, who was in much pain.
We had a fun, energetic class. One of the students was a young man from India. He sat unsmiling as I mentioned various yoga poses that can injure discs in the neck. I explained that I am not against all yoga, and studied years to become a teacher myself. He sat unsmiling. We did three specific techniques to stop the neck pain process and a beautiful smile radiated from the young man from India. He had three herniated discs in his neck from his yoga practice of the specific moves I had mentioned, together with sitting badly at a computer for his work. He already knew those yoga moves hurt his neck. He had just been worried the pain would never stop. When the pain stopped right there in class, he smiled.
Another of the students was a golf pro, who I consulted with afterward to test out my work on lower back pain and golf. More on this in Lower Back Pain and Golf.
Mr. Cleff did great in the first class. This class was done over two weeks. I gave the students things to try during the week before the second (last) class.
Oct 25 2007, he wrote me:
"Today (Thursday) is my class day at The Clay Studio, working over the wheel for 5 hours. I felt good with very little noticeable pain. Usually after walking the 5 blocks from my home to the studio both my legs would tingle badly and I would stop to rest halfway. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to check-up. You are one hellova person and I'm thankful that I've met you.
"I've had my spine problems with the pinched nerves for a long time - roughly 4-5 years - and I'm slowly getting better since you came into my life. There is no other way to say it. Thanks Jolie."
He was improved in one class, and he felt that he was "slowly" getting better. I like an empowered student who does not want to dawdle to get better. The day after the second of the two sessions, Bernie wrote:
28 Oct 2007
"Last night, I walked about 7 blocks to restaurant AQUA (great value, low cost & delicious) and back home another 7 blocks.
"Upper back extension causes no pain, lower back does. I can do plank on elbows, holding for 60 seconds now, no pain.
"If you want to make photos of a geriatric doing your things, it's OK with me. as you've seen, I'm not bashful or delicate. I will work at getting better, my daughter is getting married January 5 and I want to be able to dance with her and my wife."
Bernie went back to his doctors to ask about a small amount of remaining pain. They told him he should have more surgery and gave him prescriptions. He wrote to ask me:
"On Nov. 2 I have a follow up with the spine surgeon (same guy) and on Nov 14 a consult with a Neurologist ( ). Do you have any suggestions about a pain med FENTANYL, which was suggested by a doc at the V.A."
I wrote back that Fentanyl is a surgical grade narcotic. It is used "off-label" for back pain and there have been deaths. I asked him to tell me more about what hurt, and when, so we could stop it without any harmful medicine, and also what the neurologist said.
14 Nov 2007, he wrote:
"I had an office visit with the neurologist at ( ), he said my twisted nerve at L5 will never get better and I will always have pain."
They told him to have another spine surgery, and take Fentanyl, and he will always have pain? Then why did they put him though all that surgery?
He wrote:
"Hello, I still have some tingling in both knees...but much better than 2 weeks ago! There has always been pain in my left flank between spine & hip, never told you because the knees were my greatest problem… The lower back pain persists, but only left side. When I do the trap stretch leaning to left--puts much pressure on that pain. Leaning to the right feels like a good stretch. Any additional suggestions?"
I found that that he was still doing "their" exercises. Conventional exercises of bending forward to stretch the hamstrings are often prescribed for back pain. The assumption is that tight hamstrings have something to do with back pain. However, bending forward is one major contributor of this kind of back pain. I changed how he stretched his hamstrings to one of the ways we did in class.
He was also continuing to overarch his lower back when walking, which was a large source of the tingling pain. When he used the Trapezius stretch, he was also overarching, which makes pain when bending to that side. This kind of pain is often confused for spinal stenosis. One classic sign of stenosis is pain when bending toward one side. However, the narrowing is not true stenosis, but just overarching which narrows and pinches the area. For someone who has stenosis, not pinching the area further with overarching is frequently enough to stop pain.
What was complicating everything was his surgeries. They were considered "completely successful." The two knee replacements were "completely rehabbed" meaning he could bend his knees enough to sit in a chair. He could no longer stretch the front of his hip enough to prevent the kind of tightness that encourages standing and moving in overarched position. The back surgery put a plate in his back to prevent much movement. That meant that even small overarching movements were enough to pressure the newly immovable area. The back hurt, and the tight back and hip were compressing nerves going down both legs.
After we fixed these issues he wrote two mails:
"Jolie You hit on the spot. I will keep at it gently."
and
"Jolie, a quick note to tell you today I walked 12 blocks, stopping to stretch hamstrings.. often on steps or fireplug....as you suggested...also lunge stretch. I will dance at my daughter's wedding. Much thanks.
"There will not ever be more surgery on my body."
For the flank pain, he had been for many tests, and was even scheduled for a kidney evaluation. The muscles in the area were so tight, that I biked over to his home to do a sports medicine technique to stretch it out for him, and checked his other stretches. I went over how to stretch the front of the hip without overarching his lower back. His sweet funny wife made me lunch. We got some fun photos of things as gifts for you, of fun stretches and activities.
He wrote:
"I've had x-rays, MRI, bloodwork, surgery, injections, no Dr. had any solution. YOU HAD THE ANSWER. No wonder so many people have thanked you."
He did the work and gave me the credit. That's a good man.
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.
Like a Bonsai Tree Your terrible posture at My dinner table
The photo above shows an injurious positioning called "a forward head." A forward head position presses cervical (neck) discs outward, causes upper back and neck pain often called "upper crossed" syndrome, and can press the nerve going down the arm, leading to arm pain and hand/finger numbness. Jutting the chin upward with the neck forward can, over time, create a spondylolisthesis (vertebral shifting). Raising the arm with the shoulder rounded and the neck forward adds to shoulder and rotator cuff injury.
Check yourself for a forward head position when eating and drinking (and on the phone):
Corner of the jaw is far forward of the shoulder
Neck tilts forward
Jaw juts forward
Neck pinches backward, with high compressive force
Shoulder rounded
Don't round your back or jut your chin forward. Instead, keep chin in when you eat and drink and talk on the phone. To look upward, get the upward motion more from straightening your upper back, and not from one joint in your neck. The neck is not a hinge joint.
Don't rely on, "Keep ear over shoulder" thinking that is straight posture. You can see in the photo that the ear is over the shoulder, but the neck is craned badly.
Use healthful positioning for built-in upper body muscle exercise and easy pain prevention. Check yourself sideways in a mirror. Watch other people eating and drinking for an easy reminder. Happy Holidays.
Rich Tarpinian, IT systems engineer, musician, hockey coach, and vegan, fixed grinding neck pain, back spasms, disc pain, and tension-type headaches. He had not been comfortable sleeping in any position. Rich said the neck grinding and discomfort, "felt like it was never going to go away."
Rich writes:
"Thanks again for your help! Here's my update. I stopped cranking my neck around and the grinding stopped within the 2 weeks or so that you had indicated.
"I am controlling my body positioning, more aware, and have eliminated lots of neck tension even though I work at a computer all day. The anxiety I was having about disc problems, etc., has mostly been replaced with good knowledge, a feeling of control, and an ability to heal.
"Every morning (instead of sitting on the bed) I get out of bed the way you have recommended - why? because it makes sense. I don't sit on the bed and then try to straighten my body as I start to walk. I get up from the face down position in the already standing position.
"I've always had an interest in the mechanical aspect of how the body moves and what the sources of problems can be which is why, when I was pouring over information on the internet, your information regarding cause/effect relationships instantly caught and held my attention.
"I eat a pretty good diet - vegan with a good amount of raw foods, but had not paid much attention to posture and movement. I will now.
"As a side note, I coached hockey for about 8 years and played up until about 4 years ago. I had an opportunity to get back into some coaching recently but was really worried about the neck issues that I had been having for weeks. I also used to get a lot of back spasms when I played/coached. After experiencing the progress from your recommendations, which came just in time, I stepped confidently back on the ice a couple of weeks ago and have felt good given some expected muscle soreness that is now gone. The hardest thing was lacing up the skates but, once I was on the ice, I felt great.
"What you have done effectively is to empower people with the knowledge of how to find and return to the correct answers in order to maintain their own bodies. You've done that by providing reasons where needed, presenting conflicting information to show contrast, and using repetition to help solidify the important concepts."
"The key is that I now understand the causes of the problem and can, for the most part, manage the process when things start going wrong. As I cruised the internet looking at information, my anxiety meter kept rising - until I found your article on fixing the neck grinding problem which prompted me to read your other articles on sitting, lifting, etc. The article was immediately positive with a no strings attached approach to fixing and preventing the problem. My overcoming the neck issues is directly attributable to you."
Rich first fixed his pain using my web site summary sheets. These Fitness Fixer posts also describe techniques used:
Two important stretches to do first thing in the morning and throughout the day to restore ability to sit, move, and stand without unhealthful neck position - Fixing Upper Back and Neck Pain and Nice Neck Stretch
Having muscles soreness is not bad, it means you're out having fun. Make sure there is no pain or soreness in the joint. That is the difference. See Teen Dies After Using Muscle Soreness Rub
In May, blog reader Bill (Lieutenant William Slabonik) sent an inspiring story - Freed From Pain, He Rides Again. Bill had been told by several sources that surgery and disability retirement were his only options. He used Fitness Fixer information to change a future as damaged as x-rays of his spine, to the active life he loves, without pain. He used information from the upper back and shoulder posts, among others, to learn how neck discs, upper back muscles, and other structures are damaged with mal-positioning, and how to employ healthy muscle use so the discs can heal and arm numbness stops, even riding long bike trips, lifting heavy gear, and in his demanding work as a pilot. He fixed low back chronic pain with the simple neutral spine repositioning away from a hyperlordotic (over-arched lower spine) when standing, shown in Prevent Back Surgery and all the posts on neutral spine.
In the May update, Bill told how he fixed the injuries and rode the Pennsylvania State Police Memorial century ride. Last week Bill reported in:
"My goal of riding the 200 km night ride down the Jersey shore was a success. I rode from 10pm 'til 9am with no problems covering the distance of 125 miles. I actually felt like I could go on a lot further. I have also completed a 2-day 200-mile ride to visit my brother-in-law in Maryland. I now can get on my bike on any day and reasonably crank out a hundred mile ride. No serious pain or discomfort noted. Only the usual slight soreness in the rear end and hands and elbows that seems to come with any long ride. The neck, shoulders and back did incredibly well, - I constantly checked my position while on the bike and did some "Healthy Stretching" whenever I was off the bike. Mission accomplished."
Note to readers - I will cover hand and arm soreness with biking in posts to come. I already worked with Bill to prevent local hand numbness from compressive leaning on the wrists, which Bill put to immediate use. I asked Bill to take photos for you of his simple changes in biking positioning to change damaging neck, shoulder, arm, and hand use to healthy ones.
Bill says,
"My son has promised to help me with the photos. I must ride herd on this project and get back to you soon.
"My confidence and health have skyrocketed. My daughters are leaving for college and I am looking forward to an empty house soon. They have thanked me for being there when they needed me and asked me why I just don't go and do something I would love to do. I am applying for retirement this morning and have completed an interview for a job flying in mainland China. I have two other airlines trying to get me to interview. Wish me luck on my next amazing adventure. And thanks for your help and encouragement."
Bill - Free Man
Bill, all hats off to you. Keep flying high. More good things are still to come. Keep us posted.
This weekend in the Northern Hemisphere, the moon will be new, and the night dark, and the skies filled with the shooting stars of the Perseid Meteor shower.
Every 130 years or so, the Swift-Tuttle comet circles the Sun, streaming icy, dusty debris the size of sand and peas. Every mid-August, the Earth passes the orbit of Swift-Tuttle, raining fiery remains through the atmosphere. Igniting against the air's intense friction, they "shoot" across the sky. Books by people who study these things say they fly about 37 miles per second (60 kps), most burning away far above the ground.
The Perseid showers are seen in the sky around the constellation of Perseus the Hero, giving the name. Early Greeks explained that the god Zeus, father of Perseus, visited Perseus' mortal mother Danae in a shower of brightness. Later the event was renamed (or reborn) as "The Tears of St. Lawrence" for their appearance during the August festival of Saint Laurentius. Chinese, Japanese, and Korean writings of Perseid showers date from the 8th century. I grew up on Russian childhood social-utopian folk bedtime stories of comets, mixed with my Grandmother's whispers of fiery conflagration, later determined from an unknown comet or part bursting over Tunguska Krasnoyarsk Siberia around 1908, devastating the forest (later politically reinvented as a nuclear event, and editorially as UFOs for Russian science fiction writing and American television).
What about your neck? When watching meteor showers standing or sitting, don't martyr your neck. If you crane your neck and push the chin forward when looking upward, you put destructive force on the neck, shown in three examples that follow:
Three images above show craning the neck and jutting the chin. Injurious compression builds in vertebrae, discs, and surrounding soft tissue.
The left and middle images show leaning the upper body backward. Thoracic lean overly arches the lower back (hyperlordosis), adding weighted compression to the joints called facets and soft tissue of the lower spine.
The right photo shows unhealthy craning with the chin forward, common in some yoga and exercise classes. It adds sizeable compressive loading on the back of neck vertebrae plus shearing force on the discs. When raising arms upward, it contributes to rotator cuff compression and injury. Click Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.
I understand that jutting the chin far forward is often taught as proper form. I have taken yoga classes in India with major names and those unknown to the outside world. One teacher told me pushing the neck and chin forward protects the discs. It unfortunately doesn't. Shearing force on the discs is severe when you jut the chin forward then raise it. Shear is a structural strain when one layer shifts sideways (or front to back) in relation to the other. Damage may take years to accrue until visible on x-ray. Don't jut your chin forward, especially not when looking upward.
Photo 3 above shows tilting the neck forward when looking through binoculars (left figure with yellow arrow). The chin is not forward, but the forward head still creates painful forces on the upper back contributing to upper crossed syndrome, disc trouble, and muscle strain in the classic diamond and hangar shape across the upper back. The pain is easily stopped. Keep neck vertical and chin in (right green arrow).
You can look directly upward for all you need in healthful position. Here are ways:
Keep your chin in, loosely and relaxed.
Shoulders back.
The back of your head lifts loosely upward without strain.
Straighten the rounded-forward curve of the upper spine - get more upward gaze range from your upper back.
Don't yank or force the head and chin back, or the corners of your neck will ache.
Don't lean back by arching your lower back.
Healthy upward gazing is a nice good-feeling stretch and exercise for the upper back and neck without injury. Use it for all overhead needs, photo 4 of Amsterdam policeman at right.
The time where we pass through the Perseid shower is long, from about July 15 through August 25. The highest activity is predicted over the Northern Hemisphere this coming weekend. Look up on Saturday, 11 August before dawn, Sunday morning the 12th, late Sunday night through Monday early dawn.
Because of the tilt to Swift-Tuttle's orbit, its fiery dust falls almost entirely on Earth's northern hemisphere. Southern hemisphere friends see few Perseids. The next good Southern hemisphere meteor shower is hoped to be the Geminid showers in December.
The constellation where meteors appear to come from is called the radiant. The Perseid meteor shower radiant is the constellation Perseus. The Leonid shower is hoped to peak this 18 November. Look toward the constellation Leo. The Geminid shower radiant is the Gemini constellation. Watch in mid-December with the evening crescent of the moon.
In photo 5 at left of looking up through the telescope, the general position is pretty good, but the neck is a bit more forward than needs to be. Get more healthy range from the upper back by "unrounding" and lifting up with the upper back, and less by jutting the neck forward.
Experiment on your own. Use a mirror and send in your photos of remaking healthful fun overhead gazing activities.
--- 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 free - updates via e-mail or RSS, upper right. For personal medical questions - Replies to Medical Questions. Limited Class space for direct feedback. Top students may earn certification throughDrBookspan.com/Academy. Get more in Dr. Bookspan's Books.
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=8de5f337-0ab4-4957-8875-39bdfe2301b7)
