Readers have sent in their success stories on understanding how some of the most common musculoskeletal pain occurs so that they can keep it from coming back.
Here are just four letters of success:
1. From Monica in Montana last November:
"Hi Dr. Bookpan, "I've been reading your articles again. It seems reminders were in need. My back seems well (thanks to you!) but when I started having pain on both sides of my hips, I realized I was returning to walking with duck feet to a certain extent - an old habit. It's just enough to cause me problems. I'm working at watching this very much and it is better.
"I thought I was using all of the good bending to pick things up rather than using my back. When (my) knees gave me some issues, I came back to re-read your knee article too. I'm found that I was so tight that I can't get my heels to stay on the floor when I bend, so I wasn't doing good bending. I am getting a plan together of your stretching and strengthening exercises. I'll probably end up with all of your books, with not only now in mind : ). Your information makes me up lifted when it comes to aging, not that I'm old, 43. I spent so much of my youth in pain, so now I try hard to take care of myself in healthy ways and stay out of pain. "Thank You! Monica "
I wrote back with things to do and Monica replied:
"Dear Dr. Bookspan, "Thank you for the reply. "I received your book. I've been taking it in and implementing the methods. I can say it's only been a couple of days and my hip is improving. With this experience of really helping myself I knew I would no longer rely on other people solely for help and thank you for making available tools to very common obviously misunderstood health issues. What you are doing is making a difference. Please do not concern yourself with a reply. I know you will read this and that is good enough for me. Warmest Regards, Monica (Montana)
In April, Monica sent this follow-up:
"I hope you are doing well! With your help I have lost 8 1/2 pounds! For years I've wanted to lose at least 10 minimum. I'm almost there and it's been so easy I have a feeling all that can go, will go. I use to be heavily into bodybuilding. It set up a mentality about getting enough protein. As I grew older and did not work out like I use to I still kept up the protein. Due to reading your book Health & Fitness in Plain English, it put my fears of dwindling muscle due to not enough protein to rest and put them in reality.
The consumption of grains and protein took a dramatic decrease. I have a lot of energy and my body is getting leaner and leaner. Life is so much easier. My back is still doing great. When I hurt my back I looked at all the things that may have contributed to the injury. I am humbly grateful for being able to see (all this)…I am better. I am sleeping again. "
2. Laraine first wrote that her same pain had returned. I replied and asked her to check if she had gone back to the same habits that caused the first pain, and gave her ways to check.
Laraine replied: "Good Morning Dr. Bookspan: "I e-mailed you several times regarding the extrusion in my lower spine (L1 S1) & you were kind enough to respond to each & every e-mail. I know you are busy & you still took the time to answer. I am practicing the body mechanics daily & doing the exercises & I am improving - thank you so much again for your support....
"You replied back asking if I was not just doing the exercises but using them to live and move correctly. Sometimes I didn't. I try to do them exactly the way the book has instructed --- and as you said not to do them as a regiment but incorporate them in daily life.
"I wanted to let you know that I did do the wall test at home yesterday & I noticed that my shoulders were slouching. I guess for the past couple of weeks after I was making progress I went back into the habit of bending forward a little with my shoulders & didn't realize it. Yesterday, you mentioned to check your posture with the wall after the three extension exercises, I concentrated on neutral spine & noticed the pain subsided & I was much better.
"Thank you again for the reinforcement - sometimes after using poor body mechanics for so long, it takes time to change that - we simply find it easy to go back to the old habits of poor posture without realizing & can get discouraged thinking we are not going to get better. I really believe in your book & if I keep doing things the correct way & maintain that, I will eventually heal.
"As I said in my previous e-mails last month, this is the most logical & sensible way to maintain a healthy back. I know it will take time - but as long as I make progress, I will be patient. I guess I lost my moral yesterday & thought I was going backwards. Keep up the good work - you are wonderful... You are an inspiration to all that have pain. Also, thank you for your persistence in making sure that I am doing the stretches & exercise correctly...."
"This back injury had sure been challenging for me. Now I'm better. I'm glad that I found your website." Laraine P"
3. Our own Inspirational Ivy from New Zealand made gains:
"It is now four years since I discovered your website. With your help and advice I was able to overcome debilitating sciatica in my right leg plus foot drop. Since then I have carried on using your methods to keep free of pain.
"In the early hours of Friday morning, I awoke to excruciating sciatic pain down my left leg. I asked myself as to why this has happened, telling myself that I had not been doing any bad bending or similar. OR so I thought. Yes, these past few days I have been rushing here and rushing there which has resulted in me being lax about my movements, in particular, standing at he bench while cooking etc. I always put my spine into the neutral position. Always!!!!!!! I am asking myself. It would appear - not so.
"Yesterday and today, I have stopped rushing about and telling myself every time I move "Think Ivy, think before you do anything." I seem to remember using those very same words four years ago."
I wrote back, to Ivy that I hoped it took more than "a little rushing" to cause such pain. It may sound odd, but I hope it took a lot of bad bending and standing. No one should have so little margin - you need the strength for leeway for unexpected events and still not cause pain. No one should need to live "on eggshells" or reduce activities to prevent pain.
Ivy replied:
"Thank you for you kind words. I have now fully recovered thanks to your help and advice. I could not understand as to why I was not recovering as I THOUGHT I was doing everything correctly. I referred to your book "Fix Your Own Pain Without Drugs or Surgery" and the penny dropped - because I was experiencing pain, I was leaning forward as I walked. Once I rectified my posture, the pain went immediately. Silly me, I was aware of the pain but not of my posture.
"Yesterday, I was watching one of the residents here watering her garden. She is experiencing a severe attack of sciatica. I noted that she not only bent to the side she was also leaning forward. Her back was arched so her butt stuck out. I made a few suggestions in the nicest possible way and this was her reply. Mind you, you have probably heard this one before "It sounds like too much work to me." Needless to say, I walked away.)
"I am now free of pain thanks to your wonderful advice. Thank you Dr Jolie, what would I do without you. "Love and hugs Ivy"
Ivy wrote with several follow-ups that all continued fine. She went on to use good bending after her cataract surgery where bending over is harmful to the recovering surgical site (as well as the back).
4. A special e-mail came in from JayaKrishna (Kris):
"Dear Dr. Jolee ( I am the Indian guy from Jersey who attended one of your seminars in person).
"It has been almost 5 years since I first read your article in the December of 2004.
"After 5 pain free years, it is was only last week when I suddenly felt my lower back tightening up again for the first time. Almost predictably I started feeling severe shoulder pain. But this time I was fully prepared. I went back to the basics. Whom else to seek for help other than St.Jude of the Joints. I pulled all the articles written by you and read them one by one. Thanks to your principles, I then did some deep soul searching and found out that cause was violating of the golden principles outlined by you due to the pressure of work or the strange feeling of invincibility that comes from enjoying good health.
"It is very strange that when we recover and start enjoying life again, we sometime forget and start thinking ourselves to be invincible. Bad habits creep in again.
"As an atonement for my violations I ordered two more books by you from Amazon: which is Healthy Martial Arts, and Stretching Smarter. I took my new year resolution to be always mindful of these golden principles from you. I promised myself a one day sabbatical every year when I would re read your articles and reiterate these golden points.
"I once got this little nugget of wisdom in a party (Most unlikely place). Nursing drinks in our hands, we were all discussing on the secrets success and happiness when one of the drunks said the most profound statement: The one who is punished the most in a particular endeavor or area and is still standing will have the secret to success and knowledge.
"Looking at your life, your education, experiences it is no wonder that you have been chosen to share your treasure trove of knowledge on healthy living. I cant tell you how much I am grateful for your acquaintance. "Regards, Kris Jayakrishnan"
Perceived exertion is your own description of how hard you are exercising
Perceived exertion is usually described on a scale of 1 to 10 (very, very easy to extremely hard).
Until recently, perceived exertion was found to correlate with actual oxygen consumption, meaning your body is actually working medium hard with medium oxygen consumption when the effort feels medium hard. Perceived exertion scales are becoming ineffective as young people become increasingly unused to exercise and rate almost any minor effort as extremely hard.
It is not an injury when you exercise hard enough to have sore muscles over the next three to four days. It is not an injury when you use your body enough to feel aching effort in your muscles. It is not a respiratory problem when you are out of breath from hard exercise. It is not a medical problem when you are tired at the end of the day. If you have worked hard, being tired enough to sleep is right and needed, and avoids the need for taking medicines to sleep.
Work to increase the effort it takes to become out of breath and feel hard muscular effort. Work to increase the amount of work it takes for you to feel something is moderately hard.
What does it take to sit up straight? Is it possible that the numbers of physicians, surgeons, instructors, and trainers who entered did not know? We now have five winners:
Paul J was first to write in to the contest with understanding,
"Brains are required to think and correct bad posture."
Steve Rice knew it when he wrote in the hints that first in importance, above doing any strengthening or stretching is,
"1. Engage the brain to develop better postural habits. No matter how strong the elongated muscles get, and how long the contracted muscles get, if the brain says "slouch" that's what the body will do. The other steps (stretch/strength) are necessary but not sufficient to fix the posture problem.
He also correctly stated that you use back muscles (not abs) to pull your spine back to straighten from rounded forward.
1. Only the brain is required. I simply have to do it! 2. Name the muscles -- lean back by stretching the pectorals, and maintain neutral spine in the lower back. All these years I was just too ignorant to use them until Dr. Jolie said so! 3. I think it's 'cause their chest is too tight from rounded shoulders. Good pectoral stretching, and remembering to maintain good posture will correct.
It's that remembering thing that's the problem. Fortunately my back keeps reminding my brain to use what I've learned! :-D
"Thanks, again, especially for what I've learned from you. My back is getting much better and I don't need a doctor!!!"
I learned things from readers:
Hopefully joking, were not one, but two surgeons who wrote that surgery is required to cut tight front (anterior) muscles.
Readers think abdominal muscles do every motion of all your limbs whether they do or not.
Readers think that somehow squeezing your abdominal muscles makes you move, and they think using one set of muscles magically makes you stop (inhibit) others. This is an often repeated bit of mythology, not true in all cases as previously thought. In fact, we couldn't move properly if it were true.
Readers think abdominal muscles somehow stop you from rounding forward and make you sit straight if you just do something called "engage." I have no idea how or what that would be. Abdominal muscles are flexors (bend the spine forward - not the body as a whole). Fourth winner Mr. Georges Nakhlé, my Academy instructor and manager of the Middle Eastern division was one of the two entrants who knew that abdominal muscles do not straighten you from a rounded forward position. Your back muscles are needed to pull back enough to straighten you (only if you use them). He names them in the Hints. Abdominal muscles do not attach to your legs. They cannot pull your body closer to your leg (or leg closer to body) if you are sitting with your hip slouched back away from your leg.
A helpful comment from Anonymous in Contest Hints enlightened me about a major source of the problem - readers honestly don't know what muscles do, and they feel like outsiders when hearing names of muscles and their actions. This is important. It opened a large door for me.
Thanks to these reader comments, I know to start writing articles explaining actual muscle use. No one should need any medical degree or training to know your body, names of parts, and how you move. Just like if you are not a mechanic, by knowing simple car parts, you can save much money and pain and being fooled by fancy sales talk.
Fifth winner was reader Sister Mary Smackham Witherstick of the Royal Order of Order,
"Quit yer sorry whining. Straighten up laddies!"
How hard was that?
Maybe our slogan for this contest could be the zombie cry from Return of the Living Dead,
--- 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.
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.
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.
When I worked as a military research scientist, strong brave men got hazardous duty pay to spend a day with me.
I measured what humans can do, physically and mentally, and how to make them better at it. I tested pilots undergoing acceleration to see what determined susceptibility or resilience to blackouts and other g-force effects. I tested combat swimmers to see what makes them swim faster, farther. I worked on modalities to prevent astronauts' bones from de-mineralizing, because without the pull of gravity, muscles do not make the bones retain calcium. After weeks in space, astronauts return with the equivalent of years of bone loss. I worked on countermeasures. I tested ground troops to see how much they could carry and why.
My work trains the person, making him self-contained and able to withstand harsh conditions without special clothing, tools, or pills. Another department works with garments that help resistance against temperature, weaponry, and other effects. Another group are the 'gadget guys' making yet more things I have to make the guys able to carry around. Another department is pharma-chemicals - what drugs they could develop and administer to block need for sleep and food, heighten focus, or increase strength or speed. Some heart drugs are long-known and used for steadying the marksman's hand by decreasing the contractile pulse of the heart.
Click the labels under this article for more Fitness Fixer on each topic. I have written several posts, with more to come, on my work to "extend the human envelope."
--- 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. 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 - How to know what heart rate will give you a cardiovascular training effect.
Several formulas calculate exact heart ranges and "target heart rates." There are a variety of commercial (expensive) heart rate monitors. Arguments in sports medicine continue on which is the right formula and if heart rates in water or at elevation can be calculated the same way. These issues will be covered in posts to come. For now:
Your body is smart. Heart rate generally follows "perceived exertion." If you feel your running or other exercise pace is moderate, your heart rate is likely to be at a moderate training range. If it feels light, then heart rate will likely be too low to give much training effect.
Find something you enjoy enough to continue more than ten minutes at a time.
Keep a pace that you feel is moderate to hard, depending how you like it.
If your running or other exercise pace feels moderate, it is also moderate for your cardiovascular system. If it feels hard, your heart and body and mostly likely working hard for your current level If it feels light, then it is too light to give much training effect.
--- Read and contribute 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 personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. For personal evaluation take a Class. Top students can apply to become certifiedDrBookspan.com/Academy.
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