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In my ‘One Thing’ series, experts in back pain from various fields share their one best piece of advice for preventing or eliminating back and neck pain. Today, physical therapist Meghan B. Tierney, PT, MPT, OCS shares her one thing. Meghan is the founder and proprietor of One Physical Therapy and Wellness in Bryn Mawr PA.
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Thanks for visiting,
-Andy
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Beth Rifkin was kind enough to submit a response to the yoga post last week. I am amazed by the variety of thoughts and opinions about yoga and how it can effect a variety of health conditions.
The other portion of the video is a response to a question from Trisha in Arkansas about a procedure called radio frequency ablation, or RFA. RFA can be used to treat several painful conditions- but it is not for everyone. Typically, it seems to be most useful for radicular conditions (radiating pain along the length of a nerve)- although many of the physicians doing it will tell you it is useful beyond that relatively small group of pain sufferers. In any case, it seems to be a far less invasive alternative to all out back surgery. I will be posting an interview with a physician who does dozens of these procedures each week in the not too distant future.
Thanks for stopping by!
-Andy
View of the Roman Encampment from the top of Mt. Masada, Negev Desert, Israel.
A few times each week, I post a brief tip or suggestion about avoiding or relieving back pain on my Facebook fan page. These posts are usually independent of anything I post here on the blog, and are just meant to provide folks with bite-size tips, and are rarely controversial. Last week I posted the suggestion that one never bend and twist at the same time (meaning, that if you need to pick something up off the floor, or reach down for some other reason, turn your body to face what you are grasping rather than twisting to one side or another while bending.) Well, this resulted in a whole bunch of mail and posts- particularly about how this suggestion would effect folks’ participation in yoga. Yoga does involve some bending and twisting- and in theory should ultimately help one to avoid back and neck pain rather than cause it. Here is a video post offering a few quick suggestions on ways to avoid back and neck injury while doing yoga. The tips are reposted in text version at the bottom of the post if you want to forward them to any of your friends or fellow yoga participants. I would enjoy hearing your thoughts and experiences regarding regarding back pain and yoga- whether it provided you relief or made you feel worse.
Enjoy!
(In the first take of this video, the woman behind me was waving into the camera. I asked her to please stop- but by golly she made sure her arm was featured in the video anyway. Congratulations lady- you now have a famous arm!)
Here are your tips to avoid yoga related back and neck injuries:
-As always, hydrate before, during, and after yoga. Even slight dehydration will increase the likelihood of straining or even tearing a muscle, and the enhanced fatigue that comes with dehydration will increase your chances of using poor body mechanics.
-Before a class, take a brisk 10-15 minute walk. This will warm up your muscle groups and prepare them for the challenge ahead. This helps even when getting read for a ‘hot yoga’ class.
-If you are new to yoga, work up to doing multiple classes per week. Your enthusiasm may push you to try and do 5 classes per week, but slow down. An NFL team I worked with brought in a well known yoga instructor to help with flexibility, and I cannot tell you how many low back sprains, neck strains, and groin pulls I wound up treating as a result of pushing too much, too fast.
-Listen to your body. If a new posture is painful- back off that posture. If you feel your discomfort is simply due to it being ‘new’, build up to it slowly. If pain continues, be sure you are approaching the posture with correct body mechanics (your instructor should be able to guide you.) If the pain persists, it may signal that something is wrong- see your doctor.
Thanks for stopping by!
-Andy
So, here is the link to an article in the New York Times this AM. Actually, this article was about the new show ‘Huge’ – a socially interesting concept for a show about the efforts of overweight teenagers to find dignity in their efforts towards transformation. However, the article also references the ‘gainer blog’ phenomenon (blogs devoted to finding ways to more efficiently gain weight. These blogs are not typically geared towards people who are ‘too thin’ trying to gain weight, but more towards overweight individuals celebrating and augmenting their obesity.) This was enough to get me doing some research. I have seen some of the people who proclaim that they are healthy in spite of being morbidly obese on some of the talk shows, and while they may be able to demonstrate good blood work- you simply cannot change the laws of physics. Your musculoskeletal system was just not designed to support tremendous amounts of weight, and even if one were to not exhibit any of the cardiovascular and endocrine issues associated with obesity, their feet, knees, hips, and yes- their spine- all are subject to greater wear and tear, potentially leading to pain, and surgical intervention. There are numerous studies out there which support this assertion.
The line in the article that caught me off guard was this notion that there is a conspiracy, and that this gainer phenomenon is ‘an outcry against the manipulations of a diet-industrial complex.’ If anything, the food industry is doing exactly the opposite thing- producing food products which promote obesity, and the media which provides advertising for these products puts all of them in our faces ALL THE TIME. This topic is poignant to me as I continue on my own fitness challenge, and try to get myself into the shape I know I should be. There are definitely social forces compelling many of us to get thin- particularly teenage girls- who are bombarded with images from all sides, so I don’t want to discount this notion completely- but I feel the greater force emerges from the food industry which continues to churn out numerous processed, fat laden, inexpensive, and apparently enticing foods. My suspicion here is born out by the disproportionate rates of obesity here in the U.S. relative to much of the world.
I don’t want to come across as against overweight people, but more in favor of a balanced healthy lifestyle. As someone who has battled with weight issues for much of my life, I can definitely feel empathy for those embroiled in the struggle to get fit.
Check back tomorrow for the Fitness Challenge update, and a book review of a really fantastic book for kids with pain syndromes.
Thanks for checking in!
-Andy
Be sure to check out the blog regularly for tips on how to prevent and relieve back pain. Back Together book and DVD programs available from Amazon.com. ORDER TODAY!
Many physicians do not believe that the sacroiliac joint moves in any consequential way. As an Osteopathic physician, I believe that it does.
Here is a brief response to a viewer question who was referred to me for his sacroiliac or SI pain. His general practitioner told him that they do not move, and that his pain had to be from his hip, in spite of several negative radiological studies of his hip, and continuing pain even after ‘treatment’ for his hip pain.
The SI joint is at the intersection of the sacrum and the pelvic bone (see picture below), and while it does not move much- it does indeed move. With each step it rotates anteriorly with the push off of your leg, and posteriorly with extension of the opposite leg. Occasionally with stress or poor body mechanics, this joint can become ’stuck,’ sometimes causing significant pain from what are known as anterior or posterior inominate dysfunctions.
Drawing of sacroiliac joint.
In a later post, I will provide you with some simple exercises you can do to help mobilize your SI joints, and I have asked Jorden Gold of the Stretch Zone to provide some stretches as well.
Later this week, look for my ergonomic review of the iPhone 4, and specifically how it compares functionally to the iPad.
Thanks for joining me!
-Andy
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.
Today, Matt Dubrow, D.O. presents his ‘One Thing.’ His recommendation, to stretch first thing in the morning, is a great one. You are far more likely to injure your back in the morning before you have adequately warmed up, than at any other time during the day. You would be surprised how many people throw their backs out while sitting on the edge of their bed putting on a pair of socks! Thank you again Matt!
I have asked stretching expert Jorden Gold to provide a follow up to this post, and give us his 3 best first-thing-in-the-morning stretches. Look for that post early next week.
Thanks for visiting,
Andy
Well, we are fast approaching the end of the school year, and with that comes finals season. Normally, during the rest of the year I don’t see a whole lot of teenagers with back pain, but this time of year I almost always see more high school and college age students who are hurting. As you will hear me say again and again- we simply weren’t designed to sit on our butts all day long. Watch my video tip of the day, then proceed to some other simple tips you can do to help protect yourself (or your kids!) from back pain while studying for finals.
To prevent yourself from experiencing back pain when studying for hours & hours & hours….
1) As I said in the video, get up periodically (optimally every 45 minutes or so.)
2) Keep yourself hydrated. Avoid the temptation to use energy drinks, as they will actually leave you dehydrated. Water will help you prevent stiffness, and ultimately if you are drinking enough, it will force you to adhere to (1) above.
3) If you are seated at a computer for studying, make sure your monitor is propped up to eye level (old phone books make a great monitor stand,) and your keyboard is at a height which allows you to have a neutral wrist position (with your wrists flat.) If you are using a laptop, and external keyboard can help you to optimize your position, and they are no longer an expensive proposition.
4) Use a book stand rather than holding onto a heavy textbook which will force you into an anatomically compromised position.
5) If your chair does not have one built in, roll up a small towel or t-shirt to use as a lumbar support. Place it into the small of your back.
These few suggestions may go far in preventing you from having to take finals in pain. I hope they help. If you have any other thoughts or suggestions, please share them with us on the blog.
Best,
-Andy
Photo from in the studio during appearance on Martha Stewart Radio Tuesday.
Yesterday, I had a great time being interviewed by Terri Trespicio on Martha Stewart Radio. We covered all sorts of different topics on back & neck pain from callers all around the country. I was also the butt of some pretty hardcore ribbing about the tatami mat I sleep on- but I digress. It really was a lot of fun. Terri is a great host, and the callers all had interesting questions and comments. If you missed it, it will be rebroadcast this weekend- check out the Whole Living website for more info.
Following the show, I had the chance to speak with Terri about some of the lifestyle issues which can contribute to back pain. Ironically, Terri had been dealing with some back pain this past week, and was headed to her physician’s office right after the show.
Here’s the clip:
Thanks for stopping by, and be well!
-Andy
Dr. Erin Finn is an Emergency Department physician, who sees every manner of back pain in her day to day work in the ER. Today she presents her ONE THING, a continuing series where experts in various fields share their number one suggestion for preventing or relieving back & neck pain.
You hear me harp over and over about the dangers of a sedentary lifestyle with regards to back pain. Here are some additional tips you can use to prevent becoming a victim of sitting on your butt:
-If you are sitting for more than 30 minutes, get up and stretch out your legs and back.
-Take a few minutes at lunch time to take a walk, even if it is just around your office building or school.
-If you have an exercise bike, or treadmill- set it up where you watch TV so you can take a sedentary activity, and make it an active one.
-Park your car a few spots out when you are grocery shopping, or going to the mall- the extra few steps won’t hurt.
-Don’t lose track of how much time you are wasting on the internet. GET UP!
-If you are a student, put some of your notes on 3×5 cards so you can ’stroll & study.’
-Take the stairs when you can.
So try to keep moving. Like Dr. Finn said- if you rest, you rust!
Be well!
-Andy
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