Archive for the ‘Ergonomics’ Category

B.T.T.o.D: For practitioners: Change the height of your treatment table regularly.

Thursday, February 18th, 2010

This one is geared largely towards Osteopaths, Chiropractors, Physical Therapists, Massage Therapists, etc…

Throughout your day, vary the height of your treatment table- not only to accommodate the size of your patients/clients, but also to keep your spine from getting acclimated to one position. There are many older practitioners out there with severe kyphosis due to the limited movement of their treatment tables- take advantage of the tools you have available, and change the height of your table throughout the day.

Best,

Andy

I-Technique 14-Sacral Circle 2

Shoveling More Snow, iPhone/iPad App, Amazon & Thank You!!!

Sunday, February 7th, 2010

The second massive snowstorm this winter…

Well, Philadelphia is still digging itself out from yesterday’s snowstorm, which means one thing- I am going to be swamped in my office this week. As I said after the last snowstorm, there’s really no ‘back friendly’ way to shovel your driveway and walk. When there is this much snow (24 inches plus where I live) it is pretty overwhelming no matter what you do. There are a few things you can do to help reduce your risk:

1) People forget that shoveling snow is a workout, and as with any workout a pre-exercise warmup and stretch is mandatory. Take a short walk before you start, and then a brief stretch, concentrating on your hamstrings and lower back.

2) And, as with any strenuous activity you need to stay hydrated- refuel throughout the shoveling.

3) Push the snow to the edges of the area you need to shovel before you start to lift it off the ground.

4) Take frequent rests to break the snow up into more manageable ‘chunks.’

5) If you can, get an ergonomic shovel which will help you to maintain good mechanics.

These tips won’t keep you from being sore, but they may help you to prevent a more serious injury.

iPhone / iPad App is coming…

Watch this site for some upcoming information on the upcoming iPhone / iPad Back Together application. The announcement of  the new iPad opened up a whole bunch of other possibilities for video, so we are re-tweaking our initial concept a little to offer you the most powerful back pain resource available for the iPhone / iPad platform.

Back Together on Amazon…

Amazon has been a really great site for selling my book- Back Together- Hands-on Healing for Couples, and soon you will be able to purchase the DVD program there as well. Our page is up, so you can check it out here. You should be able to purchase sometime in the next week or two.

Thank You!…

The Back Together community continues to grow, due to your support. Every month, I am seeing more visitors, emails, and messages here on the blog. For that I am grateful- so thank you. However, Back Together can continue to grow to become one of the most useful resources for back pain on the internet. So tell your friends, your family members, your coworkers- anyone who has back pain and who is looking for ways to get their pain out of their life.

Have a great weekend, and be well!

-Andy

L1000160

Atrium at the Please Touch Museum, Philadelphia.

B.T.T.o.D: Move your shoes!!!

Friday, February 5th, 2010

Right after you wake up for your day is the time your spine is most vulnerable. What worse time to be bending in your closet to duck under the clothes and grab your shoes? Many people are forced to bend and twist to get to their shoes- putting your back at even worse risk. Get a shoe storage bag that hangs on the back of your closet door, which gives you access to your shoes without bending & twisting. I found cloth bags that hold 10 pairs of shoes for under $10 at a major retail store.

Be well!

-Andy

IMG_2302

B.T.T.o.D: Keeping your wallet in your back pocket will shift your sacrum and pelvis, and cause you back pain.

Monday, February 1st, 2010

If you see today’s blog post, you will read about how small things have big effects. Here is one thing so many people- men in particular- do, that can cause all sorts of low back discomfort. Keep your wallet in your front pocket or in a bag or briefcase.

frontpage

Little changes and their big effect on your back pain.

Monday, February 1st, 2010

If you’ve read my book, there is a section about how little things can have a big effect on your back pain. I tell the story of a time when I went to a car auction with my father and witnessed someone repair a million dollar car with the twist of a dime used as a makeshift screwdriver.

Little things can have a huge effect- If you don’t believe me, try wearing your wristwatch (if you wear one) on the opposite hand you usually do. Notice how many times you lift the wrong arm to tell the time, and how soon you get exasperated by this. Pay attention to how many times you bang your watch on a door jam. You wil be surprised how much this small change can affect your day.

This came up last week when working with a new patient who had low back pain for the past few years. He had already had a million dollar workup from another physician, including an MRI and a course of Physical Therapy. He noticed his pain started when he began working at a new law firm in the city. He had a longer commute- so we discussed his car ergonomics. Then we reviewed the ergonomics of his desk chair.  Then his workout- we pretty much reviewed everything- and there was no clear cause for his pain. I looked over his MRI- and there was nothing special there. Upon physical examination, he had nothing really remarkable- a little low grade spasm in his low back on the left side, and a small dysfunction in his sacrum. I fixed this, and it provided him relief- but this relief only lasted about an hour.

This was a frustrating situation, and I decided to order a standing plain film x-ray. What this showed was that he had one sacroiliac joint nearly a quarter of an inch higher than the other. He didn’t examine this way in the office. How could this be? I brought him back in and checked again- his sacrum was level. I looked at the bottoms of his shoes to see if perhaps one was significantly more worn than the other (I usually do my initial examination barefoot), and when I turned his shoe over, his drivers license and a small stack of bills (about a quarter of an inch high) slipped out from under the insole…

It turns out that when he took the job in the city, he found that one of his office mates had been mugged in a parking lot going back to his car after hours, and in an effort to hide a few bucks and spare himself the aggravation of losing his driver’s license, and to have some emergency cash- he started stashing them in his shoe. Stuff out of the shoe, and that day his pain resolved.

This one little thing caused him 3 years of pain and annoyance. The moral of the story is that if you are experiencing back pain, it can really be beneficial to  pay attention to even the small things. When you see the Tip o’ the Day here, it may be something small, but its’ effect can be huge.

Be well!

-Andy

I bet orangutans do not get back pain...

I bet orangutans do not get back pain…

B.T.T.o.D: Lose the portable car seat, and carry your child in a sling or on-body carrier.

Thursday, January 28th, 2010

Sure, those baby carriers that snap into your car to be used as car seats are an engineering feat, and they do serve two separate needs, but they are an ergonomic catastrophe. They weigh too much, place the weight of the seat and your child too far away from your center of gravity, and strain your upper and lower spine unnecessarily.  Added to that, many parents are schlepping around all manner of additional baby paraphernalia which weigh them down even more.

Try leaving the carrier in the car and investing a few bucks in a sling or Bjorn like carrier. They weigh next to nothing, place your child near your center of gravity, and have the added benefit of bringing your child up to eye level- fostering eye contact with you and those around you. This has been shown to be a really positive thing for a baby’s development.

frontpage

Comfortable Sex: Some products for satisfying sex while recovering from back pain.

Tuesday, January 26th, 2010

When back pain occurs, it truly does affect virtually every aspect of your life. It can potentially change everything. For those of you who are familiar with my work, and my emphasis on your partner or spouse as a resource for healing, you know that I feel it is particularly important for back pain sufferers to be able to get back in touch with as much of their life before back pain as possible. One of the worst things that can happen when back or neck pain becomes a (temporary) part of your life is to abandon sexual intimacy, and all of the positive benefits that come with it.

Sex can have numerous benefits for pain sufferers;

-An endorphin release, which acts as a natural pain reliever.

-The slow mobilization of the segments of the lower back, sacrum and pelvis.

-The pleasure of intimate touch, and relief from the feelings of alienation which can sometimes accompany pain.

-The restoration of normalcy in a life which may have been drastically compromised by back & neck pain.

I did a post on this a little while back, and received many emails and messages about how couples found more comfortable ways to have sex- and it was really interesting (and sometimes entertaining really) to hear how people were able to reintroduce sexual activity into their lives. You can tell by the lengths some folks went to,  to see how much of a priority this was for them. More than a few of my viewers have swings installed their bedrooms- an elegant- if complicated solution.

I was contacted by a website, sensuouswife.com about some of the products they sell to help couples achieve comfortable sex. Their site is very interesting, and it is couples-friendly (ie: there are no threatening images of impossibly thin or chiseled models to make either of you feel inadequate.) Their product line is clearly aimed at heterosexual couples, but the products I described below could offer benefits to pretty much anyone. I have attached a few images from their site (with their permission of course) and some descriptions. The company provided some descriptions as well which are included under the images:

Wedge-ramp combination.

Wedge-ramp combination.

The Ramp/Wedge combo (or the individual Wedge and Ramp, for those who don’t want to buy both at once) is probably the best starting place for couples working to make sex less painful.  They give excellent support in a number of configurations, and they are designed to change the height or angle to make penetration easier and more comfortable.  Sex is much less strenuous for both partners – the person lying on the shapes has much better support, and the person on top usually finds that they can get things lined up without supporting himself or herself in odd positions or angles.  The angling also bring the couple closer together, so that they can look into each others’ eyes and talk to each other without straining.

The Esse

The Esse

The Esse.

The Esse.

The Esse is also designed to give support in a variety of positions, allowing both spouses to relax and enjoy each other.  Most users find that the support allows the spine to curve naturally and comfortably.  The Esse also has the advantage of being narrow enough to straddle, which many couples find is easier on the hips and knees, since the legs can be used efficiently and naturally.

The Whirl.

The Whirl.

The Whirl is less well-known, but many people find it very helpful, especially if they are dealing with hip or knee pain, since it can support the movement of thrusting by rolling back and forth.

Each of these products are covered in a velvet-like microfiber fabric, which is very soft and comfortable, but also “grips” other fabrics.  So unlike most pillows, the Liberator Shapes won’t slide around on the bed during use.  This also means that if a couple wants to customize the support by adding another pillow or two (for example, some people find the Ramp more comfortable if they have a pillow behind their head) the pillow will stay put on the shape and not slip around.

In looking over the products, they seem to offer some simple solutions to some ergonomic issues sexually active partners can encounter when trying to find comfortable ways to have sex. The two most useful from a low back pain standpoint would be the Whirl, and the Esse- which has the added benefit of offering neck support for neck pain sufferers. I really like these products- give them a look.

For those looking for more information on sex and back pain, I have posted on this before, but there is also an excellent book available entitled The Joy of Comfortable Sex by Pierre Angier, D.O. (available on Amazon)

I am so happy that there are people and companies out there which are addressing this problem. Sex is way to important to give up. Bringing sexual intimacy back to a relationship which may have even be ravaged by back and neck pain can really help to get things back on track, and help further your quest to get back pain out of your life.

Thanks for visiting, and be well,

-Andy

Fitness Challenge Update, Coming This Week: Sex toys for folks with back pain

Monday, January 25th, 2010

The Fitness Challenge

As I related last week, the fitness challenge got off to a nice start- both for my viewers, and for myself. I am into week two. Several folks have asked what I am doing, so here is a brief synapsis of what I project the first 4-5 weeks to look like:

-Cardio 4-5 times weekly. It’s wintertime, so I am basically confined to my Nordic Track until the weather gets a little better. I am trying to do between 45 and 75 minutes.

-I am calorie counting, and trying to keep my caloric intake at around 2200 calories/day. I have tried to shift the bulk of those calories away from simple carbs, but I am trying not to be unrealistic about what I can & cannot do.

-I am lifting weights 3 times/week at the moment, alternating between push (triceps,chest,quads, etc…) and pull (biceps, back, lats, glutes, etc…) muscle groups, leaving about 24 hours to recover. I will ramp this up, but I have not been lifting regularly for several years, and I don’t want to push myself backwards by not leaving adequate recovery time.

-I have been trying to walk whenever I can avoid driving. We all get used to driving everywhere- I actually think this is one of the best lifestyle modifications one can make.

-I am trying to pay more attention to my sleep, so I have better energy levels available to do the workouts and activities I have planned.

So that’s where I am with things. I have been getting a lot of folks back stories over the past week. Here is a sample:

My name is Michael, I am 39 years old and have been suffering with back pain since 2000. I injured my back at work when I fell off a shelf eight feet in the air and landed on my back hitting a metal floor. My injury consists of 2 discs (L3L4 and L5S1) and a partially crushed vertebrae at L4.

Since my injury, I have been unable to really do any strenuous physical activity. Daily activities cause varying levels of pain. Sometimes I can’t even put on my own shoes. As a result of my injury and inability to sustain physical activity, I have put on about 70 pounds, and now weigh a massive 305 pounds. This weight gain has increased my pain symptoms and further reduced my ability to function in day to day life activities.

I am going to be 40 in August, and I can no longer ignore my weight issues. Since the beginning of the year, I have started talking to a nutritionist and have begun to painfully do small things- like just walk my dog around the block. I have increased my water intake and I am trying to cut down on junk food. In just a couple of weeks I have begun (a little bit) to feel like I have more energy. I hope this energy will allow me o gain some momentum in changing my life.

I would like to be part of your fitness challenge and gain from your professional knowledge in combining fitness with back pain management.

Sincerely,

Michael M.

This is an example of exactly the kind of people I am hoping will benefit from this challenge. Work with me over the next few months, and send us your ‘after’ stories. My editorial staff will pick one from the lot who will win a Back Together package, including books and DVDs as well as other prizes from some outside sources. Mike- thank you for sharing your story with us. I hope you continue to improve, and look forward to hearing about your progress.

Sex toys and back pain:

A couple of months ago, I posted about finding a comfortable position for intercourse when dealing with back pain, and there was a lot of feedback from viewers about their experiences- successes and failures.

Shortly thereafter, I was contacted by ‘couples-friendly’ website designed to sell sex toys, products, and aids in a comfortable non-threatening environment. Tomorrow, I will be posting a review of some of these products (simply from an anatomic/ergonomic point of view) as well as some information about this interesting and fun website.

Best, and I look forward to hearing from you soon.

Be well,

Andy

Holiday in the Tropics...

Holiday in the Tropics…

B.T.T.o.D: Empty unnecessary contents from your purse or briefcase.

Thursday, January 21st, 2010

In keeping with yesterday’s tip about switching sides when you are carrying a briefcase or purse- here’s another simple and practical bit of advice: Dump the contents of your bag onto your kitchen table, and eliminate those things you don’t actually need to have with you. I am sure you probably have all kinds of stuff you don’t even remember you had in there. Reduce the weight of your bag, and you reduce the stress on your spine and shoulders!

You can bet Maggie Thatcher had only the bare essentials in her purse...

You can bet Maggie Thatcher had only the bare essentials in her purse…

Sitting will KILL YOU!

Thursday, January 21st, 2010

So, perhaps that is a slight exaggeration- but I am always so happy when a study comes out that confirms what my clinical experience has been telling me all along.

If you’ve ever seen or read an interview with me, I am pretty much always asked what I think are the major causes of back pain- and I always cite our propensity to sit too much as a major cause.

From an evolutionary standpoint, we simply were not designed to sit as much as we do. We are hunter-gatherers! We should be out doing rather than sitting. In fact, the lumbar flexion caused by sitting places high degrees of stress on the area of your vertebral discs most likely to herniate.

I’ve been saying this for years- and now a study in The British Journal of Sports Medicine which basically confirms it.

The study essentially states that sitting too long will cause a whole host of health problems, but did not elaborate on how much sitting constituted too much. According to the study, figures from a 2004 survey suggested that Americans spend more than half of their time sitting- between home, their commute, work, and back again- and that this sitting had detrimental effects on ones well being.

The take home point is this: GET OFF OF YOUR BUTT!!!!

Speaking of sitting too much…

That’s how I got into the situation which precipitated the Back Together Fitness Challenge.

Since the initial posting where I invited viewers to follow along with me as I get myself back into shape- I have received several stories from people who want to participate in the challenge. I will share some of the stories with you as they come in.

An interesting development is that there have been several companies that have stepped in to sweeten the pot for the person selected as a winner. Originally, I was going to give the winner a Back Together package including Books, DVDs, etc… Some of these companies have offered to contribute some additional prizes. I will work out which ones make sense, and will keep you updated.

Best,

Andy

L1000156

Midnight in the City That Never Sleeps…