Tag: lowbackpain

Just Because it Can Move, Doesn’t Mean it Should be Moved Often

Most of our skeletal muscles span across two or three joints. When the muscles contract, they will move the joints and create movement. To train individual muscles, you simply move the joint against resistance. At least this is the principle behind strength training. Want a bigger biceps? Do more bicep curls! We learn this in highschool biology!

The old classic biceps curl

Based on this understanding, the classic recipe of getting a solid washboard abs is to do lots of crunches and sit-ups. If you want to have strong backs, do Jefferson Curls.

One of the clips you will see on youtube when you search for “Jefferson Curl”

What Is The Problem

As they say, the devil is ALWAYS in the details. Moving individual joints may be great for individual muscle hypertrophy, but it may not always be great for joint health. Any first year biology undergraduate student can tell you that there is a spectrum of joints in our body based on its mobility and stability. The more mobile the joint, the less stable it is.

Some of the joints with varying level of mobility

Some of these joints are built for power production (i.e. speed and strength combined) while others are built for stability. Some joints are simply stronger in certain position than at other position. The spine has many joints that allows movement. Execute too many movement under load, say sit-ups or Jefferson curls, and you will end up with spine disk herniation. There’s a reason why career powerlifters and olympic weightlifters would not move their spine while lifting weights off the floor.

The Solution

Your typical undergrad should also be able to explain that there are three types of work that can be done by muscles:

  1. Concentric. Such as when you curl up in a bicep curl.
  2. Isometric. Such as when you hold the barbell at 90 0 angle without moving.
  3. Eccentric. Such as when you lower the barbell in a bicep curl.

And here is where wisdom comes into play. Training all the muscles the same way will simply result in chronic pain. For those of you with low back pain, it is easy for the doctor or physiotherapist to say “you need more core strength”. Its another thing to train your core with proper exercise in proper posture. For those that need to train their core to alleviate their low back discomfort, Back Mechanics is an excellent source. The push up is a good exercise to train your upper body and core as long as you train properly.

Painkillers and the Gift of Pain

Nobody likes pain.  This is why we invented painkillers.  Are painkillers useful?  Of course they are.  People entering surgeries, just experiencing major trauma and and mothers about to deliver babies are just a few of many justified uses of painkillers.  But how about in the field of rehabilitation and chronic pain?

Trauma and Painkillers

Recently I experienced grade 2 ankle sprain caused by my own carelessness.  It was painful for me to simply put my feet down, let alone walk.  What follows was a merry go round of 2 X-Rays and one MRI.  Three ligaments were torn severely but not completely.  Some foot tarsal bones were also severely bruised but none were broken.  The orthopedic surgeon happily prescribed me a list of prescription medicine that includes strong painkillers up to the third week after the incident.

My case may not be typical.  However, it cannot be denied that when a patient just experienced trauma, painkillers would be on the top list of drugs the doctor will prescribe.

Why This is Good and Bad

Traumas cause pain.  Of course painkillers would be useful to help the patient get a decent rest that helps in recovery.  However, every sane doctor will admit that painkillers have side effects.  And painkiller dependency is not something any patient would want.  In my case, the injured ankle was no longer causing any pain when it is in neutral position and not bearing any weight within 3 days after the incident.  Continued dosage of painkillers in my bloodstream at that stage can cause more harm than good

Why Painkillers Could Interfere With Rehab

Believe it or not, pain actually has a function in our body.  We even have specific tissues called pain receptors simply to perform this function.  In the case of ankle and knee rehabilitation, it actually helps tells you which particular position, movement or loading that will worsen your injury.  I was able to tell which particular ligaments were injured before the MRI result came in.  Skilled physiotherapists can use pain as information to devise a training regimen that will best suit the situation.  The training regiment can help improve your recovery and prevent repeated injury in the future.  If you are on a heavy painkiller, your sense would simply get dulled, and it will interfere with your proprioception and rehab work. Proprioception is the muscle and ligament’s capability to sens its surrounding without the aid of vision.

In many cases such as mine, the general consensus by the American Orthopedic Association is that the patient should start basic physiotherapy once it becomes pain free to a certain range of motions.  Keep in mind that rehab and gradual pain free motion and weight bearing is essential to your recovery.  The keyword here is being gradual and pain free.

Chronic Pain and Painkillers

By definition, chronic pain is a type of pain that you experience either continuously, or on and off over an extended period of time.  As Dr. McGill lamented in his book, Back Mechanics, the problem is that too many doctors are using painkillers to simply stop you complaining.  If you are only getting painkillers without any treatment to address the underlying pain, then over time you will only become increasingly dependent on an ever increasing dosage of painkillers.

Conclusion

As Dr. McGill mentioned, whenever a doctor started prescribing you painkillers, you should ask the following questions:

  1. Why?  What is the underlying problem that is causing the pain that needs to be addressed
  2. How long?  What is the action plan to taper the usage of these painkillers.

Ultimately, pain in itself can be a gift even among elite athletes.  You should not simply bury your pain in painkillers without understanding the cause and how to deal with the pain.

The next time you feel pain, don’t think of it as something bad.  Your body is actually telling you what is wrong.  Treat it as a gift.

Why is Sitting Painful?

If sitting creates back discomfort you have a highly sensitized back, or tissue damage, or both. Avoiding this pain trigger will reduce the pain sensitivity. Avoidance of the pain triggers is part of the documented strategy to de-sensitize back pain throughout the day as evidenced in Back Mechanic.

Sitting causes the low back to flex which is normally not an issue. But modern life has increased sitting time at work, on the road, and at home. Soon sitting at the computer becomes uncomfortable. We call this the flexion intolerant back. Specific low back tissues become stressed and sensitized, in particular the spine discs and ligaments. Sitting upright to restore the natural curves to the spine relieves this stress. But it “costs” in terms of muscle work resulting in those muscles to tire and allow the spine to slouch. This increases disc and ligament stress. The link between prolonged sitting and disc pathology is well established. Reducing stresses in the back associated with sitting not only makes sitting more comfortable, but it helps build more capacity for pain-free movement throughout the day.

The objective is make sitting a dynamic activity with frequent posture change and support the natural curve of the low back.

Reduce the pain. Make sitting a dynamic task.

The ideal sitting posture is one that continually changes. The EmbraceAir  dynamic sitting supports (shown below) use the latest science to ensure minimal stress on the low back tissues, and to provide for posture change. Using an inflatable bladder the user increases or decreases the lumbar support. This measurably reduces stress. The inflation/deflation pump facilitates easy pressure change to create regular posture change. (Evidence and explanations are in Dr. McGill’s textbooks). Static back rests simply cannot provide these advantages.

Even with the dynamic sitting supports, those who have back pain exacerbated from sitting generally are able to reduce disc annulus stresses with the following exercise (shown below, source: Back Mechanic ). Stand up out of the chair, reach for the ceiling, then push for the ceiling with the hands, then fully and deeply inhale. This process should take about half a minute. Gentle and progressive extension of the lumbar spine is achieved dispelling the accumulated stresses.

For use at work, in the car, watching TV…

The EmbraceAir was designed to provide more support for watching TV, and in helping those with shorter thighs to achieve more comfort and support. The pneumatic bladder support is strategically adjusted within the frame to fit all body types.

EmbraceAir Plus Back Support

The ideal sitting position is a dynamic one. EmbraceAir back support gives this dynamic sitting position based on the latest research. It ensures minimal strain on your back tissues while enabling change of posture from time to time. The air bladder inside can be easily adjusted to increase or decrease lumbar area support. This will reduce lumbar tissue strain. The easily accessible hand pump can conveniently help you adjust your posture. Static Back support cannot provide this feature.

Ideal back supports must also have sufficient firmness. Failure to provide this will allow the spine to change over time where the lumbar spine will flex, suppored by the ligaments and cause pain due to uneven pressure on the spine disk.

Embrace Air Plus comes with inner air bladder. The Canadian patented design will give you the ideal support with 3D adjustable position can be used to match your unique spine shape.

Lordotic curve adjustment can be done by easily adjustable air bladder volume. This will also enable the users to adjust their seating position from time to time.

Each person’s lordotic curve position is also different based on genetic and height factor. EmbraceAir Plus’ unique design allows the user to adjust the lumbar support position according to their own spine. 

EmbraceAir Plus also comes with additional cushion for your spine. This additional support will ensure your back will not experience excessive strain when you sit for extended period.

For buyers in Indonesia, please contact us at magnus.performance@gmail.com or via our online store at tokopedia. For buyers in Hong Kong, please purchase at Wing On department store or at the following retail stores:

http://www.healthcarehk.com/php/product.php?goods_id=80

http://shop.freemax.com.hk/product-detail_Embrace-air.html

Embrace Airplus Back Support 充氣背墊

Harvard Bribery and Other Bad Sciences

When I first started out my serial on the non-relation between fat and heart disease, quite a few people, some whose opinion I highly respected, doubted me although they cannot deny the fact that the researchers I quoted were valid. Over the past few weeks, there’s been a flurry of articles on neutral media that justified my position. Everybody from DailyMail, New York Times, STATNews, Quartz (itself a Harvard publication), NPR,  and Reuters were all busy publishing their take on JAMA’s bombastic review of internal Harvard documents that disclose the Sugar Lobby’s influence in medical research. So let me guide you through this and other bad sciences I’ve been seeing in the news:

Harvard Bribe, Heart Attack, and Sugar Consumption

bribe

As I have mentioned in my past post, there was never any statistical proof to support the claim that high animal fat consumption blocks arteries.  However, the Sugar Lobby wanted to increase US consumption of sugar without making us too fat, hence need to keep the total calorie consumption equal, so something gotta give. Hence Henry Haas, president of Sugar Research Foundation simply pops the idea about having the public reduce fat consumption instead. Regardless of fat’s contribution to satiety and as important vitamin solvent for our body to absorb.

In fact, most neutral researches has proven since 1962 that low-fat high-carbohydrate (sugar is simple carbohydrate) is the main culprit in cholesterol increase. So what did SRF did? simple, SRF vice president, John Hickson started his crusade to “change the negative attitude towards sugar” since 1964, regardless that blood sugar rather than blood cholesterol or high blood pressure is the better predictor of atherosclerosis. Long story short, SRF put Dr. Mark Hegsted, Harvard Professor of Nutrition and Fredrick Stare, another Harvard nutritionist in their pocket. This bribe amount was so big, that Marion Nestle of New York University simply said “I thought I had seen everything but this one floored me”.

Again, all these were not something I made up on the spot, they are all within the disclosed Harvard documents JAMA publishes, you can read them yourself. And we haven’t even looked at SRF’s relationship with other universities.

As a comparison, modern day scientific recommendation of added sugar consumption is 25 gram for normal adult woman and 36 gram for normal adult man. A regular sized can of coke (355 ml) contains 39 gram of refined sugar and a regular sized bar of snickers (57 gr) contains 28 gram of refined sugar (yes, more than 1/2 of your bar of snickers is made of pure sugar). So if you ate a bar of snickers and drank a can of coke, all in a single day, you already consumed double your daily recommended consumption of refined sugar.

To clarify my position on this. I do think that the healthy sugar recommendation mentioned are for average people. Manual laborers and athletes that does a lot of aerobic and anaerobic training definitely need more sugar consumption during particular windows of opportunity. Sugar itself is also better than high-fructose corn syrup and artificial sweeteners. The “good fats” mentioned here are also natural animal fats, animals raised chock-full of antibiotics are simply not as good and food deep fried in vegetable oils high in Omega-6 (soybean oil, canola oil, etc) need to be avoided.

Now moving on to other bad sciences

Low Back Pain is Caused by Your Mind

mind

Yes, basically Dr. John. E. Sarno and his big fan at Forbes, Edward Siedle thinks that because of the mind-body connection, low back pain is basically caused by your mind. I.e., they are implying that people that experience deliberating low back pain are simply going mad. Euhm.. one advice Edward, stick with covering pension funds.

As Dr. McGill, the leading expert in spine research with over 30 decades experience salvaging careers gold medal winning athletes has said, there is a cause for every back pain, and low back pain has many causes, hence you can’t treat it like diabetes where there is one common cure. The mind does have an affect on the body in a way that the mind can cause the pain to feel worse than the actual issue. However, the must be a fundamental physical cause of the pain to begin with.

Hence “pain clinic” that advises you to note your daily pain level should be avoided as this will cause you to dwell in your pain even more. And when your doctor said that “its all in your head”, he’s basically implying that he has no clue on what causes your pain. If you want to read more on how to self diagnose your own back pain and how to deal with it, I highly recommend you read Dr. McGill’s book, Back Mechanics.

Weight Training Damaged Your Back or Knees

Well, unfortunately the web is full of misguided advice from individuals that should know better. Trust me, doing side lunges like that this fitness model does is a quick recipe for knee problems.  If you follow the advice of this blogger regarding kettlebell workout where she told you to suck your tummy in for abdominal bracing, then trust me, you will end up with low back pain. Dr. McGill in his research already proved that this method is simply bunk in his research and this is why powerlifter does simply the opposite to protect their backs. For the athlete in you that wanted to be more athletic while sparing your back, I highly recommend you read Ultimate Back Fitness and Performance for actual science based training.

So yes, weight training is a wonderful way to increase your athleticism, maintain joint health, boost up metabolism and testosterone level, and reverse osteoporosis. But the key is doing it the right way. Doing it the wrong way, either wrong posture or wrong programming will cause all these nasty diseases like rhabdomyolysis, knee pain, low back pain, etc.

Low Back Pain and Why You Deserved It!

Common sense #1: that if you hit your thumb with a hammer while trying to drive a nail into the wall, then your best bet is probably make sure that nothing touches your thumb until its no longer sensitive to pain. This process might take a while, depending on how hard you hit your thumb, how heavy the hammer was, and how fast your natural healing process work. Repeatedly hitting your thumb with the hammer will not make it tougher. It will make it more sensitive and further damage the thumb. Keep on hitting your thumb non-stop and it will become so painful that a slight graze will make you feel incredibly painful.

Common sense #2: is that the spine heals at much slower rate than any other tissue in the human body. Like several order of magnitude slower.

Last but not least, Common sense #3: that if you experience pain, then the best method of curing it is finding the cause of the pain and eliminate it.”What doesn’t kill you will only make you stronger”….. or make you crippled.

Some of my personal close friend and relatives are struggling with low back pain on a daily basis. And yet a lot of them (as was I) have daily habits that is basically bad for their back. Now even a whole world of physio exercise would not give long lasting solution if they continue to “scab the mound” and re-injuring their damaged back. Same goes to electromagnetic frequency therapy. Remember common sense #1. Unless you get rid of the cause, the injury will not heal itself and continues to re-occur. So you must practice spine hygiene to allow your back to heal itself as you continue your daily activities pain-free.

Surgeries only works if the cause of your pain is a traumatic accident. So if you are having episodic back pain or you can experience good and bad days, then surgery is definitely NOT for you. This is based on Dr. Stuart McGill from University of Waterloo’s clinical and lab experience of over 30 years. Even if you insisted on getting the surgery to “fix” your back, if you don’t practice healthy spine hygiene, you will only get repeated injury at different locations from where you were cut up.

So below are some practical spine hygiene guidelines you should be doing if you are one of those struggling with low back pain:

  1. If a particular exercise hurts you in the joints, stop it. I have trained people with great result in terms of muscle mass gain and body fat loss. Some muscle ache is normal if you are de-conditioned. But joint pain, and more importantly, spine pain? That’s a big no-no. For back pained individuals, you should avoid certain exercises that includes, sit ups, crunches, pilates roll ups, and some yoga poses. If you often hits the gym and you find deadlifts and squats hurt your back, you might be doing some “butt wink” and you need to get it fixed. You might actually have a disc bulge. Not everybody is born with the hip physiology to do a deep ass-to-grass squat and not everybody can pick the bar off the floor. Come and see me to asses your hip and fix your deadlift and squat mechanics. Remember common sense #3.
  2. Move from the hips not the back. And I’m talking about incorporating this in your daily life like when you sit, tie shoes, lie down and pick things up. Remember common sense #1. If you feel pain from doing these list of activities, then you most likely uses your lower back as the prime mover, not the hips. If you want to read more on proper training drills that will help you do these activities pain-free, please read more of Dr. McGill’s book,.
  3. Sit straight in neutral spine position. Now I must admit that this is something I need to remind myself often. But if your back is no longer in pristine condition and you sit in slouched position over extended period, you would most likely stand up feeling pain afterwards. One of the solutions is to have proper lumbar support in your car and chair. No bean bag chairs!
  4. Healing takes time! Remember common sense #2. You will need to commit yourself to your healing process over extended period. Best to incorporate them as part of your daily habit. So if you only do them during the physio appointment, don’t expect any improvement.

OK. So actually, you don’t really deserve your back pain. Most of our lives we have simply been lied to about what we should do to make it healthy. Be it by some yoga master (anybody knows any gold medal winning yogi?) or massage therapist that insisted we should mobilize our spine. I for one had the fog lifted up from my eyes (and had my squat and DL numbers up by 50% pain free!!!) after I had the McGill training and I hope to share this knowledge with you. Of course now that you are starting to know better, you owe it to yourself to practice it and begin the journey towards a healthier back!

If you want to learn more on how to not only be living pain free, but also become more athletic, then I highly recommend you learn more from Back Mechanics: Step by Step McGill Method to fix Back Pain. If you are an amateur or professional athlete that needs that iron core but already got your back compromised (no weighted sit ups, crunches, wiper and other stupid stuff I used to do), then I highly recommend you read Ultimate Back Fitness and Performance for advance core training of gold medal winning athletes.