March 31, 2009

Common Exercises That Harm Your Back and Neck and Good Ones To Do Instead To Fix Your Pain

Posted in physiotherapy at 2:58 am by Edwin

Myths
– To help back pain, pull knees to chest, especially first thing in the morning.
– Crunches to strengthen your abs are important for back pain prevention.
– If you strengthen your core, you will prevent back pain.
– You must rest for back pain.
– Back pain is usually from lifting something the wrong way one day.
– Once you have back pain, you will always have back pain.
– “I don’t need to know about back pain prevention because I do yoga (tennis, Pilates, swimming…)”
– You must tighten your abs and “draw them in” or press them to your navel

Facts
People do an astonishing number of things every day to strain, weaken, and pressure their backs. They bend forward all day in bad posture, then exercise bent forward and stretch by bringing knee to chest. They may do “back exercises,” but not be aware that strong muscles will not automatically give you good posture, make you bend and lift properly, or magically prevent back pain. They wonder why they still get back pain even though they “do their exercises.” Many wind up in back surgery, or long term or recurring pain, not understanding why their physical therapy or exercise program “didn’t work.”

Exercises That Harm
If you understand the concepts of how you can get injured by simple bad habits, then you can easily tell if you are moving in healthy ways, if an exercise will help or harm, or if you’re doing a good exercise in bad way. You’re not helping yourself if all you do is a “list” of exercises. Worse, many people are given a list of things to never do again. This list is often favorite activities that made their lives worthwhile and fun, that they need for exercise, or even have nothing to do with their back pain.

Most people spend their lives doing activities in posture that rounds their back like a turtle. They sit, stand, walk, and exercise round-shouldered and round-backed. This shortens chest and shoulder muscles in front, and overstretches and weakens your back. Like squeezing a water balloon in front, when you round forward, it squeezes the front of your discs between your back bones (vertebrae) above and below the disc. Chronically slouching forward and lifting things with your back rounded will push the disc out, little by little. Walking hard without using your muscles for shock absorption squashes the discs all the more. When a disc pushes out (herniates) it can press on nearby nerves, sending pain down the back of your leg (or arm if the disc is in your neck). Tight muscles from this bad posture can also press on the same nerves mimicking this kind of pain, often called sciatica. A degenerating disc is not a disease, but a simple, mechanical injury that can heal, if you just stop grinding it up and pushing it out of place with terrible habits.

Now think of all the exercises, from crunches, to toe touches, to dead lifting, to everything you do seated rounding forward. Instead of keeping good posture, people ride stationary and regular bicycles with head forward and back rounded. They sit on exercise, weight, and rowing machines with their back rounded. They stretch their legs by rounding their back. Then after exercising, they bend over at the waist to pick up their bag.

Hamstring Stretches
It’s commonly accepted that tight hamstrings can contribute to back pain. Unfortunately, many people stretch their hamstrings by rounding and straining their back and discs. Leaning over at the waist for toe touches does stretch your back and hamstrings, and may feel good, but it is injurious for your back. This is true even for yoga stretches where you bend over at the waist without supporting on your hands. You know never to bend over like that to pick something up. It doesn’t magically become good for you just by calling it a stretch or a time-honored exercise. The weight of your upper body smashing down on your discs is the same as lifting a package like that. Although it often feels good on tight muscles, it’s tough on your back in the long run. This does not mean that stretching or yoga are bad, but that some of the many poses, just like some of the many products in a health food store, are not as healthy as they could be, and there are other things to use instead. Many yoga instructors who understand this teach their classes with other poses instead of unsupported forward bending. It is injurious pressure on your discs to lean over from a stand no matter if you do it with a “flat back” or rounded “rolling up one vertebrae at a time.”

A healthier hamstring stretch is to lie on your back and hold one leg in the air, keeping shoulders, head, and hip flat on the floor and back straight. Keep your other leg straight and flat against the floor too. Many people can’t because the front of their hip is too tight. They need to stretch.

Deadlifting
Deadlifting is an exercise where you bend over forward at the waist or hip to lift a weight. You already know you should not lean over from the waist or hips to lift things around the house or at work. Yet you probably do this hundreds of times every day – making the bed, lifting laundry, looking in the refrigerator, petting the dog, lifting children and packages, picking things up … all day every day. Then you go to the gym to do straight legged dead-lifting. Trainers claim it works the back and leg muscles. That is true but at the price of slowly (or quickly) harming your discs and other structures. You’re straining your back and missing a built-in opportunity to exercise your legs and burn calories if you would only lift properly.

Deadlifting is another example of something that may “work” in one way but still have other undesirable effects. Like smoking to lose weight, it will “work” but is unhealthy for other reasons. Learn to think critically and understand that often several factors go into evaluating overall worth of an exercise. Instead, bend your knees for lunges that train you for daily lifting and exercises your legs at the same time.

Bad Neck Stretches
Forced neck stretches like pulling chin to chest, and shoulder stands including the yoga positions of The Plow and The Frog force discs outward, increasing risk of herniation over time. Forced head turning and rotation by practitioners of spinal manipulation is documented to sometimes result in stroke, even death from tearing neck blood vessels.

Why Not Crunches?
Many people are taught that you need to work your abs to help your back. However simply strengthening a muscle will not automatically change how you stand or reduce back pain.

A recent survey in San Diego looked at which ab exercises produced the most ab muscle activation. From the results they listed these exercises as the best ab exercises. What they missed is that an exercise can work a muscle well but still promote bad posture and not be good for the rest of you. Crunches don’t train you how to use your abs the rest of the day when you are standing up. Crunches promote poor posture, even when done properly. Crunches make a person, who likely spends much of their day already hunched over a work area, practice that hunched posture which may be mechanically promoting the back and neck pain they think they are working their abs to prevent.

Worse, many people are taught that in order to use their abs they must “tighten them.” You can’t breathe or move properly with tight muscles, and tight muscles are part of the problem in many pain syndromes. Using your abs does not mean “sucking them in,” “tightening them,” or “pressing your navel to your spine.” It just means using them like any other muscle, without tightening. To do what? Abs connect ribs to hips. Abs work to bend your spine forward by drawing ribs and hips closer together. When you stand up and allow your lower spine to curve too much inward, that causes pain and problems and is not using the abs. Using abs means simply bending your spine forward enough to reduce an overly-arched posture, the same way you use your arm muscles to move your arm. But most people only exercise their abs by hunching forward for crunches and other forward bending. Then they stand and walk away, allowing their ribs to lift up, hips to drop down, and their back to arch – with no use of the abs at all to prevent this huge cause of back pain. This arching allows the weight of the upper body to pressure your low back.

Amazingly, many trainers and exercise instructors teach you to exercise in an arched posture. This relates to the next problem, “lordosis” which is the source of a lot of back pain.

Lordosis
Many people with back pain are told they have a “condition” called lordosis. They get the impression this is something built-in, genetic, or unavoidable, or something that “just happens” to them. That is untrue. Lordosis is just bad posture where you allow your low back to arch when standing. Technically the word “lordosis” originally meant the normal inward curve of the low back. It has commonly come to mean too much inward curve, allowing the back to sway. Arching allows the weight of your upper body to rest on your low back bones and structures instead of your trunk muscles. Too much arching can cause wear-and-tear on soft tissues and discs, and irritate the joints, called facets, where each vertebra attaches to the one above and below it. Lordosis is a common cause of back pain, but is just a bad posture habit. Worse, people are often told to exercise in this posture. You’ll see it in an astonishing number fitness videos, books, and classes, and in dozens of exercises from leg lifts to lifting weights, to using stretchy bands. The instructor may state the phrase “use neutral spine” but when you look at them, they are often arching their back with their behind thrust out. This is a poor posture, not a sexy one, and a common source of back pain.

Try this for ab exercise that teaches how to stand in healthful position and reduce overarching:
1. Stand up and arch your lower back so that your behind sticks out and you let your upper body weight rest lean backward and down. You may feel familiar pressure.
2. Straighten your spine posture by tilting your hips under you and bringing your upper body more forward, as if starting a crunch. Don’t curl enough to round your upper body forward, but enough to pull you to straight, tall, proper posture with only a small inward curve to the lower back. Don’t push your hips forward, just tuck the hip, also called a pelvic tilt. The lower back pressure should be instantly gone.
3. If you can’t figure how to do #2 above, stand with your back against a wall and press your lower back toward the wall so that the space between your lower back and the wall decreases. Feel your hip tilt under you and the large arch in your lower back decrease. Hold the new straighter posture all the time. Do not tighten, clench muscles, or hold your breath to do it. See the Abs article.

Try this for functional abdominal exercise:
For a good exercise to work your abdominal and back muscles at the same time, while retraining good posture habits to hold your spine straight while standing, hold a pushup position. Keep your hips tucked, as if starting a crunch, to straighten your spine and get your body weight on your core muscles and off your lower back.

There are many good ab exercise like this that work your abdominal muscles while retraining how to hold your back without arching. Try variations on the pushup, with the tuck, above. Lift the back leg, without arching. Lift one arm in front. Lift the opposite leg and arm. Turn to the side to stand on one arm and leg. Keep torso posture straight without sagging in your middle, toward the ground. See the abs article for more.

What About Hands and Knees Leg Lifts? Another common back exercise where arching is a problem is leg lifts to the back. From a hands-and-knees position, the exercise is to lift one leg in back until level with your body, then lower. The way most people do this is to arch their back. The same problem happens with the standing back leg lift, very common in exercise classes. If they used their ab muscles to hold the spine flat and not arched, they would get a far better exercise and train how to use the body during movement. Here is how (Try these exercises in front of a mirror to better know your positioning):

1. On hands and knees, first, let your back arch and lift your leg slowly. You’ll find it is easy to lift your leg. You may even feel the old familiar pressure in your low back.
2. Now tuck your hips and upper body just a bit, as if starting a crunch, not curling forward but enough to make your back straight.
3. Lift your leg again without letting your back arch. You will feel you need to use far more low back and upper leg muscle to do this. It is a more effective exercise that does not mash your low back in the process.

Using your abdominal muscles for real life and daily healthy movement is the key, not lying on the floor for a few minutes doing crunches. Just strengthening is not what will make muscles support your back. Using this new thinking about how abdominal muscles really work, you can use your muscles to hold your spine in healthy position. that is how you will prevent back pain. This method is called Dr. Jolie Bookspan’s Ab Revolution™. The new book is available and gives exercises from the simplest to the most challenging. You will learn how to use your abs for real life, and never need crunches again.

Lordosis is Usually Completely Controllable.
Remember to use this posture control technique technique all the time, during all your activities, and with everything you carry. When you pick up a load, don’t arch back to “balance it” When wearing a backpack, don’t arch or hunch forward. Use your muscles to keep good posture. It’s more exercise and it’s good for you.

If you habitually stand with your back arched, your back may tighten to the point where you can’t straighten it. All the ab exercises in the world won’t help you control your posture because you’re stuck in the “booty-out” posture. You just need to stretch and retrain your posture.

Why Not A Pillow Under The Knees?
Many people are told that to alleviate back pain they must sleep with a pillow under their knees. The rationale is that lying on their back with legs straight will make their back arch too much and create a “lordosis” (see above) that pressures the back. A pillow under the knees takes the arch out so they believe that solves the problem. The irony is that is exactly what perpetuates the problem. When the front of your hip is so tight that you can’t stand and lie down flat without your back being pulled into too much arch, you need to stretch your hip to stop that problem, not keep your hip bent, allowing it to remain tight and perpetuate the problem. Remember that you need to stand up straight too – if you can’t lie flat with only a normal low back curve and your legs straight, you can’t stand up properly either. Are you too stiff to lie flat without a pillow under your head too? You need to stretch your shoulders and chest so they don’t hunch forward so much. No wonder so many people have so much pain.

Impact
People are often told to give up all impact activities once they have back pain. Instead of learning how to move with shock absorption, they dutifully give up activities, but still walk around with such poor shock absorption that just walking is higher impact than if they ran, or even boxed, with good mechanics. Use your leg and truck muscles to walk softly and decelerate with each step, not just stomp and clomp, particularly when descending stairs or sloped ground, and when carrying things.

Getting In and Out Of Chairs
Do you flop down in your chair – whump – sitting down hard, jolting your spine? Instead, use your leg muscles to decelerate. It’s a free squatting exercise for all the many times a day you get into and out of your chair. Can you get out of your chair without needing your arms? Can you sit and stand from your chair without leaning far forward? Don’t lean forward, just stand up. Work on leg strength and balance.

Feet Straight Ahead, Not Toe-In or Toe-Out
This bad foot and leg posture usually results from being too tight on one side and too weak on the other side to counter it. If it doesn’t feel normal to walk straight, if may be simple tightness.

Fix Your Own Pain
Moving and lifting properly does not mean never to bend forward, arch back, or run around. You need good range of motion and frequent movement and activity for a healthy back. Check your posture and movement habits to see if you chronically hold a round-shouldered posture, or habitually let your back slump into an arch under your body weight and the weight of your back packs and the things you carry.

Don’t let bad postural mechanics grind your back structures down to where it will be harder to fix later. I am not saying not to exercise. Just the opposite. With the concepts of healthy body mechanics learned here, you will be able to do far more than before. The idea is to get you back to your life (and more) doing fun, exciting, and healthy activity. Click here for our fun classes where you get a workout while retraining posture and ergonomics for health.

Yes, some of this is information is different from what you may have heard. The old stuff wasn’t working as well as it could and new strategies were needed. This innovative information is now well used and established. Count how many times you bend wrong every day – it will be many dozens of times. Then count the calories you’d burn by bending with your legs instead and how much you’d save your back. Done properly it is good for your knees too. You can strengthen during normal daily activities, become more active than before, and fix your own back pain.

6 Comments »

  1. matt said,

    This blog’s great!! Thanks🙂.

  2. Hi, nice post. I have been thinking about this topic,so thanks for blogging. I’ll likely be subscribing to your posts. Keep up great writing

  3. Claire said,

    Some of this is good but some of it is also not accurate so don’t take it as gospel. Some of the exercises the blogger suggests are not good are in fact well evidence based e.g. the blogger refers to tightening/drawing in of abdominals, this is in fact a basic ‘core stability’ exercise aiming to strengthen the transversus abdominus muscle which is a postural muscle and helps to keep your back in a good posture. Most people have weak trans abs due to poor posture, allowing ‘global’ muscles to do all the work – they are not made for this and therefore start to ache. Tightening trans abs during low back exercises is well documented and has plenty of evidence. As does stretching the back of the neck bringing the chin backwards whilst lying flat or against a wall. Lumbar lordosis is normal, however, what the blogger is referring to is in fact usually diagnosed as hyperlordosis, which is a condition created by chronic poor posture but once it has got to this stage exercise is necessary to correct it and it is a result of weak abs and glutes and tight hip flexors and low back – exercises should be done to correct this in conjunction with improving posture.

    Comments on hamstrings stretches good though as are some of the ideas about functionally improving movement to help back pain. Ab crunches are alright so long as done in conjunction with back strenghtening exercises and abdominal stretches to avoid curvature of the spine. It is also vital they are done correctly (by tightening trans abs which means that the abdominals are working rather than the back).

  4. My brother suggested I might like this website. He was once totally right. This publish truly made my day. You can not consider simply how a lot time I had spent for this information! Thanks!

  5. Hello there! I know this is kinda off topic but I’d figured I’d ask.
    Would you be interested in trading links or maybe guest writing
    a blog article or vice-versa? My site covers a lot of
    the same topics as yours and I think we could greatly benefit from
    each other. If you are interested feel free to shoot me an e-mail.
    I look forward to hearing from you! Wonderful blog by the way!

    • Edwin said,

      ok,what’s your blog and email?


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