Where To Continue with Fitness Fixer During Health... Stuart's Community Health As A Lifestyle Thank You Grand Rounds 6.31 Academy Developmental Ability and Special Olympics... Fast Fitness - Eighth Group Functional Training: S... Dr. Jolie Bookspan Earns Humanitarian Prize Shihan Chong Breaks 10 Blocks of Ice At Age 70 Arthritis, Hip Pain, and Success With Running Fast Fitness - Seventh Group Functional Training: ... Prevent Pain From Returning - Readers Successes August 2006 September 2006 October 2006 November 2006 December 2006 January 2007 February 2007 March 2007 April 2007 May 2007 June 2007 July 2007 August 2007 September 2007 October 2007 November 2007 December 2007 January 2008 February 2008 March 2008 April 2008 May 2008 June 2008 July 2008 August 2008 September 2008 October 2008 November 2008 December 2008 January 2009 February 2009 March 2009 April 2009 May 2009 June 2009 July 2009 August 2009 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010

Functional Fitness as a Lifestyle By Mail Room Workers

Jolie Bookspan, M.Ed, PhD, FAWM
Peggy Santamaria wrote me that she was using my work, and my illustration Backman!™ to teach healthy movement to workers for a good day's work without injury and repetitive strain:
"Hi Dr. Bookspan,
"Very excited to report that I met with the Appalachian Crossroads staff and the trainees of the Mail Room Service Unit. The goal is to connect developmentally disabled adults with a paycheck for good work done well.


"I had created some Backman!™ flash cards illustrating some of the daily work in the mail room. These were distributed to the trainees with explanations for the staff about our new program. Then I met with the trainees and talked more about functional fitness.

"We then practiced some of the healthy movements needed for their work day. We took pictures to document their great understanding of what we are working toward. I will make these photos into small posters that can hang in their workspace.

"They are all excited about what we are doing and are proud to be part of the Academy.
"Peggy"

Here is Ms. Santamaria's update with the successful outcome plus great photos. I personally congratulate and thank each participant:

"Hi Dr. Bookspan:
"Here is an update on Academy activity. As you know, I am working with staff and trainees at Appalachian Crossroads, a private nonprofit human service agency that primarily serves developmentally disabled adults in Garrett County, Maryland.


"One of the Appalachian Crossroads work units provides a "mail room" service to local businesses. The trainees in the mailroom provide support, expertise, and manpower to process everything from daily statements to sales catalogs to monthly newsletters. More than 1.2 million pieces of mail go through the hands of 18 employees each year.


"As the Academy’s director of Developmental Abilities I set about creating a program using your work and Fitness Fixer to help the trainees work in a healthy way and be functionally fit. I met with staff and trainees of the unit to hand out instructional flash cards featuring Backman!™ going through the daily functions required in the mail room.


"The Appalachian Crossroads folks were super. They got right to it. With the help of staff they were ready to work and demonstrate their functional fitness skills. I took pictures that I am making into small posters for their work area.


"I will continue to work with these men and women as well as others in the custodial service unit, the grounds crew, supported employment, and the day program. It is a privilege to be working for the Academy and sharing your fitness message.
"Peggy Santamaria"


This is a shining example of getting things done well, simply, and intelligently. Thank you Peggy! Thank you Appalachian Crossroads staff and mail room!

Readers, The Mail Room is teaching us how to keep things healthy and smart. They are role models and generous guides for all of us. Use what they have done, and send your stories of using this work for Good.

Academy Web Site of This and Related Work:
Related Fitness Fixer:
Random Unrelated:


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Forward Air Head Syndrome - Doing Sets and Reps and Missing The Point of the Exercise

Jolie Bookspan, M.Ed, PhD, FAWM

NEW YORK - SEPTEMBER 10:  'Crazy Legs' Conti p...

After the article Help Yourself last Monday, I received many notes from readers. Almost a dozen the first few hours. Notes saying that that once they understood how my method changes "doing" exercises into stopping causes of injury, they tried to help their friends who had pain. The friends turned their generous help back into the party line of doing sets and reps of stretches and exercises, then returned to habits that recaused their injury. They missed the greater point of using the retraining after the reps stop - during actual real life.

One reader wrote how he explained to his friend about the cause of degenerating discs and vertebrae of the neck. His friend was constantly jutting the neck forward - a painful posture called a "forward head." The friend protested that he had a disease of the facets, the joints of the vertebrae. The reader explained that damage to the facets was caused by the bad posture called a forward head. The friend insisted he had disc deterioration and bulging. The reader explained the cause was simple bad posture called a forward head. The friend agreed to try my method, did a few stretches mentioned in part of one of my articles, then went back to their forward head posture, and complained that the method didn't work because pain returned. He wanted to know exactly how many and which other exercises to do and how long it would take for the exercises to work.

Check some of the comments to certain Fitness Fixer articles. Some commenters miss the point that the stretches or exercises may help you feel better for the moment (and if they don't then you are doing them wrong) but you must change injurious movement habits. Prevent tilting your hip and use neutral spine instead when you stand and walk, to prevent lower back and SI pain. Stop craning your neck. These are voluntary actions that need your brain to work.

Reader Paul J wrote this accurate assessment:
"The Department for Silly Syndromes has determined that Forward Air Head Syndrome is closely related to Cerebral Detachment Syndrome that occurs in patients that read the writings of Dr. Bookspan.

"The patient knows how to read and understands words; however after reading Dr. Bookspan’s writings, a detachment in the cerebral cortex seems to occur often affecting the patient’s ability to think and type. The patient exhibits some of the following symptoms:
"The recommended treatment for those suffering from CDS is to watch the movie* ‘What About Bob?’ This may not cure CDS however it should temporally delay the effects of CDS."


(*In the movie, a psychiatrist gives his nice but overanxious patient a book, to understand and solve his own problems. Instead, the patient drives the psychiatrist insane with repeated unneeded questions (and did his previous doc in with the same).



Related:

Unrelated Random Fitness Fixer:

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How To Remember Good Kid Lifting and Carrying

Jolie Bookspan, M.Ed, PhD, FAWM
Back pain from lifting and carrying babies and young children is common. Rehab and PT programs commonly have people spend time (away from their children and other important things they need to do) to lift weight to strengthen back muscles.

Here is an idea - if weight lifting helps, lift the kids. Just lift them right, so that you do not get the back pain in the first place. It is not the lifting that causes the pain.

Good Kid Lifting:
  1. Prevents pain,
  2. Strengthens your muscles,
  3. Gives built in exercise (functional exercise the way your muscles work),
  4. Increases contact with your young kids, important to their development,
  5. Improves ability to keep time with your children fun, healthy, and happy.

Readers asked me to make reminders for them about how to lift and carry their young children.

I created several different reminders on good lifting, bending, carrying. Fun T-shirts for kids are available in several colors and fabrics. There are bibs, singlets, and shirts for babies, and fun Back and Neck Saver reminders for grownups too.

Related Post:
Mothers Day and New Parents Back and Neck Savers

Get the T-Shirt:
Click www.cafepress.com/AcademyGifts

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Headache From Head Position

Jolie Bookspan, M.Ed, PhD, FAWM

Muscles connecting the upper extremity to the ...

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!)

"In case you ask, I do:
Pec stretch and trapezius stretch
Scapular mobilization exercise (in book Fix Your Own Pain Without Drugs or Surgery)
Upper and lower back extension (Fix Pain book)
Push-ups until I am sweating profusely or can't go any further; usually that happens at the same time ;-) (neutral spine for pushups covered in Fast Fitness - Strengthen by Changing Your Plank)
A concentrated effort to keep my shoulders back and down 24 hours a day, including at night, and my chin in.
"Not exactly hard, is it.

"Well, just had to get this off my chest.

"Cheer,
Johannes"


Dr. Ernst has more to report. To be continued in future posts.
I asked if he had a photo for us. He wrote:
"I didn't think I was quite bargaining for a photo. If you must, use this one, preferably unedited. It reflects my aspirations I think ;-)

"P.S. two out of three RSS/Atom feeds on your blog are broken."
http://netmesh.info/jernst-files/pushing-the-big-tree.jpg
if photo does not load, try - http://netmesh.info/jernst-files/pushing-the-big-tree.jpg


Healthline tells me they are trying to fix the feeds, which continue to go down after each fix. Use the "subscribe by e-mail" option for convenience.

Related:
Other Contributors:
  • 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.

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Surgery for Knee Arthritis, Meniscus, Not Needed To Stop Pain, Restore Function

Jolie Bookspan, M.Ed, PhD, FAWM
Good news. If you don't like or want knee surgery for most arthritis or meniscus injury, you don't have to have it. Lack of need for surgery has been demonstrated over many years in rehabilitation populations, and in a mostly ignored older clinical study. Recent studies confirm you can stop most pain and restore function just as well without surgery through good physical rehab.

Millions of Americans undergo arthroscopic surgery for knee pain every year. Over the last 30 years, arthroscopic surgery has been routinely accepted and prescribed for knee pain without undergoing rigorous evaluation.

Even when a 2002 study published in the New England Journal of Medicine (NEJM) found that results of arthroscopic surgery for knee osteoarthritis were no higher than medicine and physical therapy alone, the surgical community "remained unswayed."

Dr. Brian Feagan, co-author of a study in the Sept. 11 2008 issue of the NEJM stated, "It really didn't change practice that much. That's why this second [study] was really important."

Feagan's randomized, controlled trial involved 178 patients, average age 60. All had moderate-to-severe osteoarthritis of the knee. Half underwent arthroscopic surgery plus medical and physical therapy. The other half used medical and physical therapy alone. After two years, both groups' scores on a measure of arthritis severity were about the same.

A second study also published in the same journal issue, found that meniscal tears are common in the general population and, "may not, in fact, be responsible for painful symptoms." That means that if you have knee pain, and have scans and imaging which show a meniscus tear, it may not even be the tear that is causing the pain.

"There's going to be a swing in practice," said Dr. Feagan.

Study authors stated that meniscal tears detected on MRI may confuse matters and lead to unnecessary therapy. This is a similar finding to back pain where patients with pain are shown to have a herniated disc, stenosis, or other finding, but the pain is not from the anatomical finding, but the same bad movement habits, slouching, and lack of good movement that make anyone hurt. Discs also often appear herniated, and spines compressed by stenosis on scans of people with no back pain. Don't base your treatment and future on a picture. Scans are not tea leaves.

Supportive and inflexible shoes are often prescribed in the belief that they restore healthy tracking, but studies show that these shoes increase knee load and tendency to arthritis. You may do rehab for the meniscus that shows up on x-ray, but still have pain that may only be from the from hard "supportive" shoes. You can "support" and align and stabilize your own feet and ankles and knees using good mechanics and your own muscles.

Poor knee stability increases risk of developing arthritis, and increases wear on the meniscus. Studies tracking results for years following surgery are finding that surgery "adds no benefit over rehabilitative training alone." That means you don't need the surgery to fix or prevent possible future arthritis.


You don't have to have surgery to stop knee pain:


How to fix and prevent knee pain from arthritis and most meniscus injury:

Next:


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Does Running Ruin Your Joints?

Jolie Bookspan, M.Ed, PhD, FAWM
A study in the American Journal of Preventive Medicine found no evidence of accelerated rates of osteoarthritis among long-distance runners.

Further, weight-bearing exercise like running helps stave off osteoporosis by maintaining bone mineral density.

Study source:
American Journal of Preventive Medicine
August 2008; 35(2):133-8
.




With good movement mechanics, running will not cause early wear on your bones and joints. With injurious poor movement habits, of course, you can wear and injure the joints.



Posts showing good movement mechanics during exercise and daily life:

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Vertebral Artery Compression, Dizziness, Discs, and the Forward Head

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:)"


Here is my web site post that Miroslav used: http://www.drbookspan.com/NeckPainArticle.html

These Fitness Fixer Posts explain more:


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Most Helpful Olympic Advice So Far

Jolie Bookspan, M.Ed, PhD, FAWM

The commentators for US gymnast Justin Spring's great Olympic floor exercise routine last week told how Spring underwent months of rehabilitation for knee, ankle and other injuries. The commentators continued about his rehab, exercises, physical therapy teams, and surgeon. Spring landed the end of his difficult routine with straight-legged jolt. One of the commentators mentioned again about the surgeon who fixed the injury. The other commentator replied, "The surgeon should have told him to bend his knees."

The commentator is right. The best health care is not to collect money to cut and treat someone, but prevent the need for cutting them. Landing with a straight knee transmits impact to your spine, neck, ankles, hip, and knee joints. Landing with properly bent knees absorbs impact more through the muscles. Landing hard with a straight knee can push the upper and lower leg bones hard against the two tough pads in each knee called menisci (singular is meniscus) that help cushion each step.

Over repeated hard landings, holes and tears can bore through the meniscus. With repeated landings at an unhealthy joint angle, cartilage can overstretch or tear. The tough strap that crosses the middle of the knee joint, called the anterior cruciate ligament (ACL), can overstretch or tear with repeatedly landing on a twisted knee. More on this to come. It is mostly an avoidable training error, not a gender issue as previously thought. Ankle wear and injuries can result from the same. Injury forces increase when the landing is on knee or ankles allowed to sway inward instead of maintaining motion at the midline. These injuries can heal without surgery. More on this in posts to come.

Sometimes injury results from a single high-force landing, such as a bad parachute landing, jumping from extreme heights, or a car crash where a passenger sitting with straight legs is propelled forward (or the engine backward) hard against their feet forcing compression past strength. An example is an ankle injury called a pylon injury, where the far end of the lower leg bone crushes.

Know the mechanism of injury so that you can get out and have fun, and do extreme sports while you move in ways that reduce unhealthful forces. Preventing repeated bad movement habits can also give your joints a larger margin for occasional unexpected dings.

  1. Check what you do with your knees when you step or jump down. From small landings, bend knees a small amount.
  2. Larger heights and circumstances (carrying a heavy backpack) can benefit from more shock absorption using the thigh and hip muscles with deeper bending. It should not be the knees that take up the shock of the bending. It should be the muscles of the hip and leg.
  3. Keep effort on the muscles through how you position your knees. Letting them slide forward shifts weight to the joint. Keeping knees back by only sticking out the backside in back can shift weight to the lower spine. Keep knees back with neutral spine and you will feel the effort in the muscles.

Here is how - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending.
Here is why - Why So Many Aerobics Injuries?
Here is an example to get started - Down the Stairs.
Knee position when jumping - Healthy Knees.
Posts on avoiding surgery.
Check comments and replies already present in posts for more.
Click the labels below each post for more Fitness Fixer posts about each topic.
Try fun books.

Justin Spring and other gymnasts know to bend their knees. Athletes giving their all at Olympic levels need no criticism from anyone. We just want them to stay healthy.

Photo of UMichigan/Oklahoma meet by Matthew Bietz

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Overhead Lifting, Reaching, and Throwing - More Part I

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:



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Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury

Jolie Bookspan, M.Ed, PhD, FAWM

The photo at right shows one main contributor to shoulder and rotator cuff pain, and one for lower back pain. Can you see them? Can you see why the person in red is not getting as much stretch in the shoulder as they think?

I see patients for shoulder pain all the time. Their chart says, "normal range of motion at the shoulder," or the chart reads with a number of angle degrees corresponding to directly overhead reach. I ask the person, "Reach up for me please." They lean their upper body backward, increase the inward curve of the lower back, and their hand points directly overhead. Often they do this while tilting their neck and head forward, which puts the shoulder at a position of compression when the arm is raised. I show them how to straighten the upper body upright, reduce the lower back over-arch, and return to neutral spine. I ask them to reach up again. They can't. They shoulder is too tight to reach directly overhead. They were never stretching their shoulder when they thought they were. They were getting the motion from their lower back, not shoulder. They were only leaning backward, adding compressive load to their lower spine joints, called facets. This will be covered next in Part II.

In the photo, note that the head is forward, a major contributor to rotator cuff injury during overhead arm motion. Lifting your arm with the neck and head tilted forward mashes the upper arm bone against the shoulder bones. This compresses the soft tissue between them, including the rotator cuff and nerves that go down the arm. Each small pinch can eventually saw at the area until a rotator cuff tear begins.

Rotator cuff injury is common, even in people who do no overhead athletics, like pitching, martial arts, or kayaking. Reaching upward is common around the house and for exercise. Starting in the morning, you wash or comb hair (or polish a bald head). You pull clothing on and off overhead. You reach in cabinets, wave goodbye, shield your eyes from the sun, open car trunks and hatches, put things up on racks, shop for groceries and put them away in cabinets, lift children, clean curtains and tub walls, put work in overhead shelves - many reaches, all day, every day. At the gym there are overhead lifts, stretches, and arm motions.

Compressing the nerves that pass through the area and go down the arm sets is called impingement. Impingement is not a disease. Someone with a diagnosis of impingement does not have a real diagnosis. Impingement is not a cause of pain, it is a result. If you stop the mechanical cause, then you can stop the resulting impingement. No drugs or surgery or repeated therapies are needed:

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Photo by Rose Davies

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Fast Fitness - NoCost Hand Strength and Rehab Equipment

Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness -hand exercise without rehabilitation equipment.

One of the exercises against repetitive strain syndrome is to exercise the muscles that open the hands. There are expensive commercial devices you can buy for this. One consists of a special glove with weights and pulleys to resist your ability to open your hand. Or you can:
  1. Hold the fingers of one hand closed with your other hand
  2. Open the hand against the resistance of the hand holding it closed
  3. Do as many as comfortable. Repeat with the other hand. Vary intensity and number.
If you want to go high-tech, put a rubber band around the fingers instead of using your other hand. Push each finger in a variety of ways.

photo by Jolie

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