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PART II of 'No More Back Pain'
Bad Exercises and Bad Diving Practices
Part III of 'No More Back Pain'
by Dr. Jolie Bookspan
The Diving Doc that Harvard University
St. Jude of the Joints" shows you how to save your back from common bad
This is part II of "No More Back Pain." Part I explained how the majority of back pain comes from bad standing, sitting, lifting, and carrying habits. The relentless pull of bad mechanical use of your body during normal activities will eventually strain, tear, degenerate, and injure you in the same way that parts in your car that are rubbing, tilting, or not seating properly will cause early wear and tear. This is true even for pain from arthritis, curvatures, and bad discs. These conditions are worsened, even created by tight weak muscles and bad body mechanics. This is true no matter how many "back exercises" you do. That is why it's so important to learn the concepts of good body mechanics, presented in Part I and not just "do exercises." Doing back exercises a few times a week but not understanding the concepts, and keeping old, bad postures and habits that hurt in your back in the first place is like eating blocks of butter and ice cream morning, noon, and night, then doing your "exercises." You are not balancing the harm.
Strengthening And Stretching Is Crucial
The Whole Answer
Strengthening muscles through the usual back exercises will not automatically "give" you good posture or make you bend and lift properly. Strong muscles will not automatically "support" your body and joints, and will not magically prevent back pain. Plenty of muscular people have terrible posture and lifting habits, and the back pain that comes with it. Instead, you need to consciously learn to apply good body mechanics. If you used your muscles properly all the time to support your own body weight and the weight of your tanks and gear, you wouldn't need to "do exercises" at the end of the day for your tired, sore, stiff back. Conventional back exercises follow, then some innovative exercises that are surprisingly effective to retrain you for real muscle use, posture, and back pain relief.
Obviously you don't want to do things that send pain or numbness down your leg. There are many exercises commonly done in gyms and fitness centers that are terrible for your back. Part III next month will cover bad exercises, bad stretches, and common daily things that divers do that harm their backs. That doesn't mean you shouldn't work your muscles hard. Without exercise, back muscles weaken and tighten. For health, you want to develop a stronger and more active body and lifestyle with exercise.
How do you specifically strengthen back muscles? You must contract them against a load. That does not mean "tighten" them, an outdated concept. Tight muscles are part of the problem. Most people will stretch their back but never exercise it by actually using (contracting) the muscles. Here are a few (of many) good back exercises:
Back Extension (also
good for your neck)
There are several ways to contract the muscles of your low back to work
- Another easy one is to lie on your back, both knees bent with feet on the floor. Lift your hips gently, hold ten seconds, then lower. Work up to at least ten repetitions. To progress, do this with one ankle crossed over the opposite knee, or hold one foot off the floor. This works your back, abs, and legs.
- Kneel on all fours on a soft mat. Tuck your hips under as if you were starting a crunch, to take the arch out of your back. You will feel your abs working. Do not tighten or "suck in." Just use your muscles to move your back into good posture, like using any other muscles. Raise one leg until it is straight behind you. Don't let your back arch, do the work with your hip and legs. As you progress, lift your opposite arm in front of you at the same time you lift one leg. Hold and repeat. This is a very mild exercise and you can soon progress to exercises that better simulate using your muscles in daily life against gravity to keep good posture. Following are a few.
Surprising But Important Back Exercises
- Holding a proper push-up position is surprisingly effective for your back and posture. How is this functional? It teaches you how to hold your body straight without arching or hunching, even against a high load. This simulates tanks and gear pulling on you while you carry them and uses a lot of back and abdominal posture muscle stabilization to counter it.
Assume a push-up position. Tuck your hips under you, as if starting a crunch to take the arch out of your back, but without curling forward. When you do this, you will immediately feel your weight come off your back, and a big exercise for your abs. Prevent your back from dipping into an arch or your behind from hiking upward. That is the same bad posture while standing up that presses your weight onto your low back and makes it hurt in the first place. Keep your elbows slightly bent. If your arms are so weak that you lock out the elbows, strengthen them, but don't use that an excuse to hurt your elbow joints next.
- Another functional exercise strengthens your entire torso and retrain you to keep your posture from slouching to the side during activities: When holding your straight, hip-tucked pushup position above, lift one arm and turn your body so you are standing on one arm and the side of your feet. Hold your posture straight and strong. Don't let your hips sag. As you improve, try dipping your hip toward the floor and raising again to straight posture. Increase the length and number of repetitions. Do both sides. As you strengthen further and improve your balance through this exercise (also important for preventing injuries) begin to lift your upper leg from the floor too.
- Do Back Exercises Standing Up. You need to exercise your back the way you use it in real life--isometrically and standing up so that you retrain how to stabilize against gravity and loads. Tie the middle of a long rubber tube around a doorknob, post, railing, friend, or other device at around shoulder height. Hold both ends in front of you and stand far enough back to create a good pull. Pull both your arms straight down to your sides without leaning back or arching. Hold. Repeat. If you consciously hold proper posture while doing this, you strengthen and retrain all your torso-stabilizing muscles. Now with both arms still straight, lift both arms up overhead without arching your back or leaning back, to retrain how to carry loads with good posture. Repeat. Keep breathing.
The whole idea is to retrain you to use good postural mechanics during motion. Turn to the side and use the same concepts to customize your own exercises to strengthen your back to hold strong and steady during movements you commonly do.
Abdominal Exercises. A common, but unproductive mind-set is to exercise your abdominal muscle separately from the rest of your body. The exercises above will use your abs effectively in conjunction with your back muscles in just the way you need for real life. The October issue of Alert Diver featured abdominal muscles and how to use them for your real life. Next month Part III will detail ab exercises to avoid.
Fix Your Own Pain
Take a look at Part III for the surprising ways you may be sabotaging your back with bad diving and exercise habits, and what to do instead to keep your life pain free.
Chinese politician Sun Yet-Sen said, "To understand is hard. Once one understand, action is easy." Good muscle support for your joints comes not only from strengthening and stretching but reeducating your body for proper use, not by stopping your activities and "resting it" or "doing exercises." You'll burn calories when you move properly and get great exercise without going to a gym. You'll be straighter and taller. You'll be a better diver. Have an active life to help your back.
Scuba-doc wants you to be happy and
more information see the fun, new edition of Health & Fitness in
English. Thirty-one chapters on all aspects of Exercise, Nutrition, and
Health with step-by step solutions to make your life fun and healthy,
two chapters on neck and back pain.
Part III of Back Pain
by Dr. Jolie Bookspan
The Diving Doc that Harvard University calls "The St. Jude of the Joints" shows you how to save your back from common bad practices
This is Part III of "No More Back Pain." Part II covered important exercises to strengthen while you retrain posture and habits for standing and moving in real life. This article covers exercises that are common but harmful.
Exercises That Harm
Most people spend their lives doing most activities in a posture that rounds their backs like a turtle. They sit, stand, walk, and exercise round-shouldered and round-backed. This shortens muscles in your chest and shoulders 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 the 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. They sit on hard boat benches wearing heavy tanks with backs rounded, banging over the waves - Bam!-Bam!-Bam!-Bam! Then after exercising and diving they bend over at the waist to pick up their gear bag.
Hamstring Stretches. It's commonly accepted that tight hamstrings can contribute to back pain. The irony is that many hamstring stretches are done in ways that round and strain the back and squash discs. Leaning over at the waist for toe touches does stretch your back and hamstrings, and may feel good, but it is terrible 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 is 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.
A safer 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.
Since tight hips can also contribute to
you can do a variety of hip stretches from this position.
Deadlifting. You already know you should not lean over from the waist or hips to lift anything. 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. You're straining your back and missing a built-in opportunity to exercise your legs and burn calories if you would only lift properly. Worse, you lift heavy tanks and gear bags wrong, then maybe go to a gym to do straight legged dead-lifting. People 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. This 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.
Bad Neck Stretches
Why Not Crunches?
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 to move your spine away from an arched posture, the same way you use your arm muscles to move your arm. Abs connect from your ribs to your hips on the front and sides. When they contract, they pull your ribs closer to your hips. But most people only exercise their abs by hunching forward for ab exercises. Then they stand and work with slack abs allowing their ribs to lift up, hips to drop down, and their back to arch. The book "The Ab Revolution" explaining all this is available on amazon.com.
When you don't use your abdominal muscles while standing up, allowing your low back to sway backward or to the sides, it exaggerates the normal inward curve. This relates to the next problem, "lordosis."
Lordosis is usually completely controllable. But 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.
What exercises do people do with this arched (lordotic) posture? You'll see it in an astonishing number fitness videos, books, and classes. The video star may say to "keep neutral spine" but if you look at them, they have arched backs with their behinds thrust out in dozens of exercises from leg lifts to lifting weights, to using stretchy bands. See Part I of this article in the January issue for more on how to lift things with good back mechanics.
A common back exercise where arching is a
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. Same with the standing
leg lift, very common in exercise classes. Try both these exercises in
front of a mirror.
Why Not A Pillow Under The Knees?
Getting In and Out Of Chairs, Boat Seats
Don't Walk Toe-In or Toe-Out
Fix Your Own Pain
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.
Book link here…..
Dr. Jolie Bookspan is a career military scientist with a private practice in Sports Medicine in Philadelphia.