Be sure to hydrate before hitting the links, and take a few minutes to stretch.

Follow a round of golf with good hydration (not the cocktails you may be tempted to have) a good, high protein meal, and adequate rest to give your body the opportunity to recover (the length of time needed to recover varies from person to person- the simple rule is to wait until most of your muscle soreness has resolved.) This will ensure that you will be able to play throughout the season.

As the weather warms up here in the Northern Hemisphere, look for more tips and articles on getting the most pain-free experience out of Spring-Summer sports.

Enjoy,

Andy

A recent update to guidelines by the American Academy of Neurology based upon a study by the University of Kansas Medical Center suggested that a commonly used treatment modality, TENS, was not effective in the treatment of chronic low back pain.

TENS therapy has been in wide use for over 40 years, and many patients have reported benefit from it. The study implied that there was no clear benefit, but that the clinician should use their judgement to determine if it should be used on a particular patient.

Now, I do not use TENS in my office- however, pretty much all of the physical therapists I refer to do, and the patients I have spoken with frequently see benefit from the treatment. So what are we supposed to make of this study? Well, first of all- pain is a subjective issue. Unfortunately, there is really no way to objectively quantify pain. If a patient is telling me they are getting relief from a treatment that has no down side, I am ok with continuing it. The issue for you is going to be coverage. Up until now, it has been reasonably easy to obtain a TENS unit if you had a complaint of back pain. WIth these new guidelines, it will be harder to get a home unit, and I suspect physical therapist will cease to get paid when they perform it in the office. It will be interesting to see how this pans out.

A Quick Thought on Sneakers

A patient came in last week with complaints of low back pain which occurred when they were jogging. Now, there are lots of potential causes for back pain with exercise activities, but this patient’s pain developed over the course of several weeks without a change in their exercise regimen, and no injury or trauma.

As I went through his history, complaints, and physical exam- I eventually got to the topic of footwear. Was he wearing shoes appropriate to his sport? Yes. How old were his shoes? About 18 months….

Since he was running indoors on a treadmill, his shoes looked pretty much new- so he never thought to replace them.

Current shoe technology can do much to absorb the shock of sports activity- however, like all things, they can eventually wear out. Quality footwear, with good supportive arches, and shock absorption will prevent the impact of exercise from being transmitted up through your body and into your spine. If you work out regularly, it is probably a good idea to replace your sneaker every 6 months or so.

Feedback on Donna’s Piece Last Week

Thank you so much for your very kind thoughts on my wife Donna’s contribution last week- I forwarded all of your comments to her. She is already working on her next contribution. I cannot wait so see what she posts!

We are getting ready for more snow here in Philadelphia. Stay warm, and as always, be well.

-Andy

Philadelphia Flower Show- Every February, reminding us that the winter will end, eventually...

Dehydration can definitely exacerbate back pain and stiffness. Your body is requires hydration for a couple of things: If you think of your body is a machine, adequate hydration can help ensure that your soft tissue and joints are sufficiently lubricated. More importantly, all of your activity requires the electrolytes and other nutrients which are replenished through hydration. Dehydration can cause muscle spasm and cramping in extreme cases, and a feeling of soreness and fatigue in less extreme situations.

Now, something to keep in mind is that hydration should not come exclusively in the form of water- particularly if you are participating in strenuous activity likely to result in dehydration. Something not many people realize is that you can actually become dehydrated by consuming too much water. The easiest way to understand this is with a grasp of what is known as the OSMOTIC GRADIENT- that is the idea that minerals and electrolytes dissolved in water tend to go towards places where there are less of them. So, if you consume excessive water without replacing some of the nutrients lost through sweat and activity, the water can actually draw these substances out of your tissue, worsening dehydration.

As always, consume water throughout your day, but be certain that your diet contains sufficient nutrients to replace the ones you use- in short a nicely balanced diet.

If you are running a marathon, or participating in other strenuous activity/exercise- fluid supplements fortified with electrolytes and other minerals can be a useful aid.

One last thing, hydration falls under the larger topic of nutrition. Look back at the blog in late March or early April for a segment with a nutritionist who will discuss other nutritional considerations for back pain.

Thank you for your question!