Archive for the ‘Tips’ Category

Guest author: Donna Kirschner on Being Fully Present…

Thursday, July 8th, 2010

As Donna and I both actively pursue our fitness goals, Donna has considered many interesting approaches to our relationships with our bodies, our fitness routine, and our food. Donna’s approach has spilled into other aspects of our lives. Please enjoy her post (and the second book review in 3 days!)

Lately, I’ve been on a journey to be fully present, particularly when Iʼm eating. This means savoring my food, really tasting it, and funny as it may seem, sitting down to eat. As a busy mother, or perhaps thatʼs just the excuse, I found myself ingesting way too many calories while standing up. Thereʼs likely a myth at work there that suggests that the calories somehow donʼt count if youʼre not actually sitting down while you eat. Or that eating isnʼt important enough and needs to be rushed. But the problem with that approach is that itʼs rarely satisfying. So I was lucky enough this past weekend to come across Geneen Rothʼs well-titled book, When You Eat At the Refrigerator, Pull Up a Chair: 50 Ways to Feel Thin, Gorgeous, and Happy (When you Feel Anything But). Roth explores the relationship between food and emotion in a way that offers self- compassion. Her work really speaks to me. So lately Iʼm trying to really taste my food. To feel it in my mouth and savor it. Iʼm finding that Iʼm eating more slowly, enjoying myself and, for the first time in my life, feeling really full regardless of how much food is left on the plate.

This experience of savoring my food also has positive consequences for savoring the present and being in the proverbial “moment.” How many of us move through much of our lives distracted by other moments, either dwelling in the past, worried about the future, or distracted technologies that take us out of our here and now? So, in the interest of urging you to be kind to yourself, Iʼm going to echo Geneen Rothʼs wish for her readers: I urge you to take five minutes each day to be fully present and grounded. Take some deep breaths to draw you into your body and into this moment. Notice sensory things, like the feel of the ground beneath your feet or the chair beneath your bum. If youʼre outside, notice the sun on your skin. If youʼre drinking something, feel it in your mouth and as it moves down your throat. If youʼre washing your hands, feel the soap on your skin; if youʼre having a conversation with someone, do what you can to be with them as fully as possible. If youʼre living with pain, notice the pain and the parts that feel good. If youʼre with someone you care about, just savor their presence. If youʼre alone, enjoy the gift of being with yourself.

Please be kind to yourself and be here, in this moment with all your presence and all your heart.

-Donna H. Kirschner, PhD.

Thank you to Donna for your post, and thank you for visiting. Be well!

-Andy

Philadelphia Eagles Training Camp will be creeping up on us soon….

Spooning…with Kylie Minogue!

Wednesday, July 7th, 2010

Well, perhaps more accurately would be Spooning AND Kylie Minogue- but I got your attention, didn’t I?

OK, so you know this is primarily a blog about back and neck pain, and while I occasionally touch upon subjects which delve into other areas of health and wellness, back and neck pain is essentially where I’ve stayed. Well, today being my birthday, I have decided that I can write about pretty much anything I want- and while the first part of today’s post is an ergonomic suggestion of sorts, the second half is purely an indulgence on my part- a review of Kylie Minogue’s new album, Aphrodite.

Spooning…

Spooning, the holding of one’s intimate partner, back to front- particularly while sleeping, is one of the most comfortable and comforting gestures one can show to their significant other (I wanted to say ‘lover’ but thought better of it after some thought.)

Spooning- to the photographer who took this image, sorry to have nicked your work. If you send me your name I will gladly credit you!

While spooning is a wonderful way to sleep, the position does put the partner on the ‘outside’ for shoulder and neck pain, as their ‘bottom’ arm usually needs to be extended upwards to clear the ‘inside’ partner’s shoulder.

Some tips for comfortable spooning:

-The ‘inner’ partner should slide downwards so that the top of their head is below the chin of the ‘outer’ partner. This prevents hyperextension of the shoulder.

-Since you are both lying on your side, be sure to place a small pillow between your knees to provide support for your hips.

-You will be sharing body heat, so you can probably get away with a lighter blanket, preventing overheating and sweatiness.

-Whether you are on the inside or outside, you will be laying on your side. Be sure to have sufficient support for you head so that your neck isn’t in an overly flexed or extended position.

Just my two cents!

Aphrodite…


This week I posted my first book review, and today I will post my first (and perhaps last) music review of Kylie Minogue’s new album, Aphrodite, released this week.

I have enjoyed Kylie’s music for many years. I have always admired her unpretentious dance sound. Her music has always been about having a good time, and with all of the nonsense going on in the world, that’s something we all really need from time to time.

Kylie’s last album, X, was her first after a difficult battle with breast cancer. While I was pleased to see her back in the studio, all in all that album was slightly disappointing to me. There were some good tracks, but overall, X lacked focus and drive.

I am pleased to report that Aphrodite is a welcome return to form, and will likely be recalled as her ‘comeback’ album following her illness, rather than X.

The opening track, All the Lovers, is incredibly hooky- nearly as much so as her dance masterpiece Can’t Get You Out of my Head, and sets the tone for what proves to be one of the most polished pop albums I have ever heard, recalling ABBA as well as some of the dancier numbers from her own earlier work. Better Than Today will certainly be placed amongst the best of her work, with a great lyric and acoustic rhythm guitar backing that totally gets you out of your seat.

Kylie has been huge throughout most of the rest of the world, while only having sporadic hits here in the States. Her tour of North America last year was well received, and I can only hope she will return here to support her new album. The title track ‘Aphrodite’, backed by a solid step show / drum line beat contains the lyric “It’s the truth, It’s a fact, I was gone, and now I’m back.” I for one, am glad.

Overall rating: 5 vertebra (out of 5)

Conclusion: Best dance album of the summer.

A fantastic book for kids (and adults really) dealing with pain…

Monday, July 5th, 2010

I don’t do a whole lot of  book reviews here on BackWords. The truth is, if you were going to buy a book about back pain, I would prefer if you bought mine. However, occasionally I come across a book that covers things in an interesting or fun way differently from my own approach. In this case, the book focuses on a topic I don’t usually address in my couples-based approach.

Be the Boss of Your Pain by Timothy Culbert, M.D., and Rebecca Kajander, C.P.N.P. is an wonderful book that gives kids really wonderful tips and strategies for helping to reduce the effect of pain on their lives. With information on the physiology and psychology of pain, the book never panders, and is written in a comfortable, accessible style. The book lays out a mission statement in the first few pages, explaining that the goal is to help kids get rid of pain, make fewer visits to the doctor’s office, take less medicine, and basically how to get back into their lives.

With an approach that covers body, mind , and spirit- the authors include information on breathing and visualization exercises, as well as information about other modalities such as aromatherapy and acupressure- all in a way which is presented in a way children can understand and get excited about.

Children suffering with painful conditions often face difficult circumstances- frequent doctor’s visits, and dependency on adults for relief can leave kids feeling helpless and out of control of their lives. Be the Boss of Your Pain gives kids an opportunity to regain some of that control. For those of you familiar with my work, you know that is the goal of much of what I do. I have a copy of it in my treatment room, and virtually every patient has picked it up, and commented on what a fantastic concept it is- offering tips which are also applicable for adults. Check it out.

Thanks for visiting!

-Andy

Barefoot Running: A panacea for back pain? and NEW iPad friendly Back Together web portal!

Tuesday, June 22nd, 2010

Barefoot Running…


A patient sent me  an article about barefoot running. She had been suffering with back pain for many years, and apparently several of her friends had suggested this variation on running as a cure.

There are several articles floating around the internet and in running magazines about this phenomenon, and my patient asked me if I thought it was for her. After all, in theory your feet should have all of the benefits of thousands of years of evolution to get them perfected. Sneakers have only been around for a hundred years or so. Would running barefoot normalize her mechanics and finally rid her of her back pain?

My answer is: I’m not sure.

Everyone’s foot mechanics are slightly different, as well as their running mechanics, and only under certain circumstances will these mechanics have any meaningful effect on your back pain. Your feet are designed to be able to absorb all of the impacts of running- and that impact may effect your pain, but there are other factors to consider:

-Everyone (most of us anyway) has been trying to wear supportive footwear, in an effort to protect their feet from harm. By and large, I think this is a wise idea. The downside is that the small muscles which support your arches are used to the ‘help’ that comes from quality arch supports. Your feet may not tolerate this transition well.

-Heavier individuals may not tolerate the impact particularly well.

-Shoe manufacturers have gone to great lengths to  create impact absorbing compounds for the soles of their running shoes. Passing the stress of the foot striking the ground up into the musculoskeletal system may put runners at risk.

These are just a few of the things that popped into my mind while having the discussion with the patient. If you are thinking about trying out ‘Barefooting’ try these suggestions:

-Start off with distances which are a fraction of your regular running distances. You will be asking things of your body it is not used to- so ease into it.

-Find locations to run with softer surfaces which will transmit less impact into your spine- and try to find place where you are less likely to step on objects which may cut up your feet. Many cities have grassy parks which are regularly combed for trash- which may be a perfect place to start.

-Don’t start off on the beach, as this will tax the lateral structures of your legs and ankles, putting you at greater risk for injury.

-There are a couple of manufacturers who have produced shoes with minimal soles and cutouts for your individual toes. This may provide some of the experience of barefoot running while still providing some level of protection from debris.

- And lastly, if you do try barefoot running, make sure your tetanus shot is up do date.

As always, If you have any experience with barefoot running, please share it here.

iPad / iPhone friendly Back Together portal…

If you have tried to access the Back Together website on an iPad or iPhone, you probably noticed that what you saw was a blank screen. I am pleased to announce that as of this afternoon, the Back Together main site will detect if you are using an iPhone or iPad to view the site, and route you through our new portal designed specifically for these devices. From the main page you can access the blog, visit backtogethertv (my YouTube channel), become a friend on Facebook, as well as purchase Back Together products. Sorry it took so long to get this up & running!!!

Thanks for visiting! Look for a fitness challenge update later this week.

Andy

My newest post on Martha Stewart’s Whole Living Daily blog- on Journaling and Pain Management…

Tuesday, June 15th, 2010

Here is the link to my most recent Martha post. This one builds on the notion that ‘Success leaves clues’- meaning that by paying attention to the activities in your life which may be making you feel better or worse, you have a real opportunity to feel relief.

Enjoy!

-Andy

The Rosetta Stone at the British Museum

Your spine is a metaphor for everything going on in your life….

Wednesday, June 9th, 2010

Many years ago, a cognitive therapist I was working with said something that stuck with me for a long time. She said that the spine is a metaphor for everything going on with your life, the good things and that bad- which is so true, and which lead me to the question I often ask patients: If it is a reflection of the good and the bad, which one are you going to focus on today?

I like to use the analogy of relating the spine to the trunk of a tree. When you look at the rings on a tree, you can see all of the history of the tree. In a museum here in Philadelphia, they have a cross section of one of the oldest elms ever cut down in the city. In it’s rings, you can see where there were fires, years of drought, places where the tree had been struck by lightning- they identified the rings that coincided with all of the major wars. By looking at the rings, you can tell what went on when, and the tree carried all of those ‘experiences’ with it until the day they cut it down.

Your spine is so similar- not that there are rings you can reference, but many of the aches and pains you experience can be tied to events in your life, and stressors happening today can effect all of the things  going on in your spine already. For many people, the spine is the first place their stress goes (In my practice, there seems to be an even split between the spine and the stomach.) For example, if you have a history of low back pain, don’t be too surprised if it gets much worse when you are going through a tax audit. The flip side, is that when you get the big tax refund, you may find that your pain miraculously disappears.

I have one patient with sciatica from her piriformis- I can tell how her business is doing by how tender her piriformis muscle is. If she’s had a lot of sales, I can really move her sacrum. If sales are slow however, I can barely touch her. I am often asked if stress causes this or causes that. I believe that stress doesn’t cause anything- it just takes those things that you already have and makes them worse- sometimes much worse.

It can be a very helpful exercise when experiencing pain to try to think about all of the things going well in your life ( I sincerely hope there is something!) It can become so easy to focus on the pain, and all of the negative ways in which it has effected your life- those are the bad ‘rings.’

Throughout your day, take a few moments to focus on the good ‘rings.’ Your family? Kids? Good experiences? Whatever- try and find it. It has become kind of a cliche to talk about ‘finding your happy place,’ but taking a few minutes to actually find it can get your mind off of your pain, and onto better things.

Be well,

-Andy

The rings in a tree trunk tell you all about the tree's 'experiences.'

My newest post on Martha Stewart’s Whole Living Blog- Your clothing and back pain.

Friday, June 4th, 2010

As a follow up to yesterday’s tip of the day on your shoes and how they can affect back pain, my most recent post on the Martha Stewart website is about your clothing and how it affects back pain.

I hope you have a great weekend!

Best,

Andy

Your clothing may be causing you back pain.

B.T.T.o.D: Wearing heels? Keep ‘em low, or keep ‘em wide, keep ‘em supportive……

Thursday, June 3rd, 2010

I almost hate to talk about shoes in the midst of all of this Sex and the City hyperhype. If I hear the words ‘Manolo Blahnik’ one more time, I may need therapy. But the truth is, high heels get somewhat of  a bad rap in discussions about back pain. You always hear about how wearing these shoes or those shoes caused back pain, but there are some things you can do to prevent this from happening to you. When you are considering how shoes might affect you, there are a few things to consider:

-If you need to wear heels for work, or an occasion- try to keep them no higher than 1 to 1.5 inches in height. Higher than this, and you will alter your pelvic tilt, and compromise your body mechanics.

-If you must wear heels higher than that, try to stick with ones that have a wider, more supportive heel (mules for example.) These will provide lateral support and put you at less risk than stiletto types.

-There are no dress shoes (for women or men) that are particularly supportive, so really try to wear them only when you need to. Good shock absorption and arch support can to a lot to protect your back from harm. I love when I see folks walking to work in a suit wearing sneakers, and changing into their shoes when they get where they are going.

As a guy who wears cowboy boots most of the time, I take my footwear seriously!

Just a few thoughts. Be Well!

-Andy

Honestly- these shoes are HEINOUS!

Video: Hobbies & Back Pain- You need something ELSE to think about…

Tuesday, June 1st, 2010

hobbies

Hobbies can be pushed aside when you are suffering from back & neck pain, which is particularly sad as hobbies and passtimes can do so much to restore a sense of normalcy and help psychologically when you are hurting. Think about some of the things you really enjoy, and find ways to bring them back into your daily activities.

-Set aside some time, several times a week to do the things you love. Again, obvious, but we all get so wrapped up in the stuff we have to do, that we often forget to make room for the things we like to do.

-If your hobby exacerbates your pain, perhaps finding an adjunct to your hobby can provide some satisfaction. For example, if you are a bodybuilder dealing with a bout of low back pain, while now is probably not the time to resume bodybuilding- maybe you could train someone else, or better yet- write an article about your experience and send it to me here to post on the blog!

-You may have to modify how you participate in certain activities. In Susan’s case (from the video) she had to take regular breaks while painting in order to remain comfortable. When I had low back pain following an accident, I  found that frequently changing the height of my piano bench helped prevent discomfort. You may need to experiment to find what works.

Our bodies and minds are so tightly linked, that leaving the activities you love behind will most certainly contribute to your pain. It may take some trial and error to find ways to make it work- but do the things you love- you will almost certainly feel better.

Be well!

-Andy

A view of our little patio garden- one of my hobbies.

Viewer Question: How much rest should I give my back?

Monday, May 24th, 2010

Here is a viewer question I received over the weekend:

“I woke up a few days ago, and when I got out of bed, I felt something ‘pop’ in my lower back. As soon as I stepped onto the floor, I knew I was in trouble. I had excruciating pain just over my left hip, radiating into the middle of my back.

I saw my GP that evening, and he prescribed something called a Medrol pack, and told me to take it easy for a few days. The medicine has definitely taken the edge off, but it really hasn’t gone away. It feels a little better after I walk around for a while, but I am afraid of overdoing it. How long should I rest it?”

-Stephen

First Stephen- I am sorry you are in so much discomfort, and second, thank you for your question.

That your physician gave you a Medrol Dose Pack suggests to me that you are in a considerable amount of pain. The Dose Pack is a tapering dose of steroids which helps to rapidly reduce inflammation. Now, I haven’t examined you myself, but judging by your description, your pain may be coming from your lumbar spine or your sacroiliac joint. The fact that you feel relief after taking a short walk supports this.

Assuming you have no other issues going on, you should feel slow improvement over the next several days.

As for how long you rest it, that largely varies from person to person. General rule holds true here- if you rest, you rust. Sure you need to give it a couple of days to calm it down, but after that initial acute phase, it is almost always in your best interest to slowly increase your activity levels as tolerated. Reintroduce your daily activities and exercises in a slow, progressive manner, and back off the ones that cause you pain. Your body needs to move, and remaining too sedentary will only cause you to stiffen up, and lose muscle tone. If you continue to feel discomfort ALWAYS follow up with your physician. Remember, your doctor isn’t going to come to you, so even if they’ve seen you- get re-evauated if your pain persists.

I hope this helps Stephen, and again, thank you for your excellent question!

Best,

Andy