July 28, 2015
July 27, 2015
Since I discussed both the Bird Dog and the Abdominal Crunch, I thought a few words about the Side Bridge might be in order. Why? Because there are a couple of points that sometimes get missed and if not part of the technique will lead to problems.
First, the Side Bridge is another strengthening exercise. That means breathing and bracing opportunity; lots of bracing, of everything…
It is particularly important to contract hard the Latissimus Dorsi muscle (“lats” in gym jargon) so that the upper arm bone will be help in place against the shoulder blade bone. This contraction is one you will want to learn because it is a precursor to any and almost all pushing or pulling that you might do. Nowadays it is calling “packing” the shoulder – it’s a big deal. You may not have learned it somewhere else. You can learn it here. And you can practice it here.
Try to get your Side Bridge to look like the person in the picture: she is doing it well. It’s ok to cross your ankles. And there are several modifications to make the exercise even more difficult (or “novel”), but this is the standard and will work just fine.
Practice breathing while you brace. Use the seconds held as reps and the 3-5 Protocol to build strength gradually (search “progression” for more information on the single most important principle in exercising safely.) FYI, the Search Box is over to the right:-)
July 24, 2015
I mentioned the Big Three the other day.
Here I want to clarify the Abdominal Crunches part of it. I do this because most people still think crunches and sit-ups are pretty much the same thing. Rather than take up a bunch of space dealing with all of that confusion, here I will discuss the exercise that I use with patients who are coming out of an episode of back pain and want to prevent a relapse. (At the end, if this isn’t too long, I will review proper Crunch technique.)
The “Reverse Back Crunch” is an exercise taught by Peter Egoscue in his book, Pain Free. To do the exercise you lie on your back like you were going to do a crunch (knees up, feet flat). It doesn’t matter what you do with your head (leave it down) or your arms because they are not involved.
From here you simply push your lower back down into the floor/mat/bed (whatever you are on). That’s it! Push down – contracting in other words – for a couple of seven second breaths. Then release and relax. Then repeat, 6, 8, 10, 12 times whatever seems like a “challenging” number of repetitions. Rest a while and do it again. It is a (ab) strengthening exercise so, as mentioned earlier, you can use the 3-5 protocol. But it also sends reflex signals to the lower back muscles to relax, so that’s a bonus – and a needed one for many.
[I looked for a photo, but only found photos showing things I wouldn’t want you to see, so…]
Now the crunch. You can Google it and find YouTube videos, but what I recommend you won’t find there. Keep the chin on the chest the entire time! This protects your neck and keeps you from injuries you don’t need. Up ’til your palms are on your knees; down until your shoulder blades touch is a rep. This is a decent exercise and the one used to test you for normal abdominal strength. When you can do a “normal” number of these we can talk about an ab exercise that is really worth doing; one that has at least 6 different benefits – which justifies taking the time and trouble to do anything at all for your abs.
July 23, 2015
There are three exercises recognized (in the literature on such things) as helpful in developing core lower back strength in the management of low back pain – very little else is clearly recommended based on the research when it comes to low back pain. They are the Side Bridge, the Abdominal Crunch, and the Bird Dog. Known as the Big Three, these are strengthening exercises, but they are much more than that.
(Note: two things, first you don’t get to do strength training exercises while you are in pain; we now know that that isn’t a good idea. There are a few “exercises” that we give people very early in their recovery but they are more movement patterns than exercises and their purpose is specific to maintaining joint motion and helping patient hold their adjustments. Second, these (The Big Three) are strength training exercises primarily so don’t confuse them with flexibility exercises or exercises for some other purpose. I am a big on you knowing why you do what you do.)
Now what I want to say about the Bird Dog is that it’s quite a good exercise, much under-rated and under-utilized. With it, first off you discover (meaning it can be a test) whether your balance and control are what they should be. It’s progressive so there are at least 4 different levels of difficulty – you find out where you loose control/balance by starting easy and working up.
And because they are strength exercises, you can use the 3-5 Protocol to progress in strength. Progression in strength naturally means a progression in balance/motor control. And this balance/motor control is critical if you want to gain low back stability, hold adjustments, and fully recover (beyond just pain relief – so you can prevent relapse!!) and attain normal function.
Normal function, by the way, is usually the goal of care once pain relief is achieved… for those who are interested in not re-living their pain any time soon. And who wouldn’t want to be at least normal anyway, right?
A side benefit of the Bird Dog is the benefit it offers the shoulders in terms of range of motion and stabilizing strength – the same could be said for the hips (where many people do not extend as far as they should when they walk).
Another benefit (and the real reason that I wanted to write this Post) is that doing the Bird Dog is an opportunity to practice the Breathing and Bracing that we teach patients. All of it together is important. Doing it all together as a practice (meaning regularly) will create the results that you want.
One caution that often does not get taught is the need for maintaining Neutral Spine. After talking about that for 10 minutes in reference to the lower back, often the neck is not noticed and the person doing the exercise has the neck in full or near full extension. Keep it in neutral (you will be looking at the floor in other words).
I am getting interrupted but the idea of this Post is that the Bird Dog really is a very good exercise and you should do it more often and longer – you should also do it in ways that are “novel” and “challenging” to get the most benefit.
You, and your chiropractor, will notice the difference. Here is Dr. Oz doing the Bird Dog… toward the end. Ignore most of the rest of it.
I looked for a decent photo to put on this Post but had technical issues (most were not that good anyway). Maybe I will work out something later, I have to go…
July 22, 2015
July 21, 2015
July 20, 2015
She’s a new patient, 30 years old; she had a car accident in 2007, another in 2014 and in March she “face planted” while doing hot yoga. Since then she’s had neck “tension” and a “foggy” feeling neck with weird sensations over the back of her head on to the top of her head. She had severe vertigo twice since March and one panic attack.
Anyway, I saw her on Friday and, uncharacteristically, I insisted on neck X-rays so that I could see her spine. The X-rays showed the effects of earlier trauma in terms of mal-alignment of the entire neck part of her spine backward until it forms now a straight-line instead of being gently curved to the front. A typical finding, and there were no other findings that would preclude me adjusting her spine.
I explained that she was subluxated, that I was going to adjust her subluxatations with the Activator adjusting instrument following the Activator Methods Protocol. I recommended the, for me, standard six visits in about a months time. And she was adjusted.
When she got up off the adjusting table I said what I often say, “expect a miracle cure”. And she said, “I already feel like the fuzziness is gone.” I could not have promised that, but I’m not surprised. I am also not surprised that she had a variety of other types of treatments that did not work as well before she came to chiropractic – that’s the case with almost all new patients.
July 15, 2015
I write this Post at the risk of affending all the other massage therapists that I refer patients to for care, but… (we are all good at what we are good at, they are all great too, in different ways).
Laureen started seeing patients in our office yesterday. Here is how that went: at one point a guy patient of mine was sitting in the reception room when a patient of hers came out from treatment. This woman said to my patient “Do you know this woman (referring to Laureen)?”
I had talked to him about Laureen, but he had not yet met her, so he said, “No.”
And she said, “You have to see her! I will pay for your treatment!”
Well, it turns out that three visits earlier she was disabled, now she isn’t. So she is very happy, so happy that she wanted to share that happiness by helping someone else experience the benefits of Laureen’s care.
On her business card it says that Laureen is a massage therapist and that she specializes in Cranial Sacral Therapy. I tell patients that Michael Jordan was a basketball player too, but that doesn’t quite capture who he is. It’s the same with Laureen. Yesterday was tip-of-the-iceberg stuff. I know because I have known her for almost and year and many of my patients have seen her, as have I.
I first heard about her through patients of mine who were coming back with results none of us could otherwise get, and stories that no one could make up and most people would not believe.
And now she is here on Tuesdays. She does have some openings still for the next couple of Tuesdays. Call her at 360.631.6890 to make an appointment. I have often, half jokingly, said that the day will come with they have to put an airport next to her office and we won’t be able to either afford her or get on her schedule without an extended wait. Take advantage of her now while you can – and find out for yourself what she can do for you. You will thank me later.
P.S. – But don’t expect someone to offer to pay for your first visit, that I can’t guarantee:-)
July 14, 2015
“Don’t wait for illness, invest in the maintenance of health. … There needs to be an emphasis on maintaining good health, preventing disease and slowing progression of disease when it does happen. There’s no choice; it has to happen.” – Harvard Professor Rifat Atun
From this article on the Global Burden of Disease 2013 (the latest one).
July 13, 2015
At first I thought that these were unripe Thimble berries, but no, they were ripe and delicious. They must be some kind of Raspberry. I found them on the south east slopes of Mt Adams. A nice area but short on water and long on bugs.