Chronic back pain has become another epidemic condition in the Western world with around 80% of people suffering from back pain at least once in their life. It is also very common for a back injury to cause intermittent symptoms for over a year after the injury, 80% of cases to be exact. Around 20% of people never fully recover from a back injury.
There is currently a revolution in the understanding of what drives these types of chronic pain. One that not many people are aware of - that pain is perceptual. The new evidence-base is suggesting a bio-psycho-social approach to chronic pain, and that treating pain as only physical ("bio") is missing the role the mind has to play.
The emerging biopsychosocial model of chronic pain is this - The normal tissue healing time after an injury is around 3-4 months, and in this time it is perfectly normal to experience pain and associated symptoms of inflammation during this time. Any injury that lasts longer than this time is classified as "chronic pain".
With chronic pain the pain is almost an entity in itself, and the tissue damage and inflammation can become only one part of the factors driving the pain. The pain or "alarm" signal being sent from the physical site of the inflammation to your brain is interpreted and moderated by your brain. How your brain interprets this pain in a large extent controls how much pain you experience, and how severe that pain is.
To give you an example of why the thinking around chronic pain is changing, is that back pain is so difficult to diagnose when searching for only physical factors. Strangely enough, if you take ten people off the street with no back pain and scan their lower back, half of them may have herniated discs but no pain. How can this be?
The physical "alarm" sent by your injured tissue can be amplified by your perceptions of pain and injury. For example, if you catastrophise and fear that the back pain associated with a herniated disc could become more severe and need surgery, or land you in a wheelchair, your brain will amplify the pain. In other words, anything that creates a high level of fear about your injury and makes you think that you are fragile, is going to amplify the pain or "alarm" felt. This can then lead to avoiding any physical tasks to wait until the pain goes away, leading to weakening of your core musculature and increasing the mechanical stresses that may be driving your pain, further increasing your pain.
Chronic stress and constant hyper-arousal of your nervous system also amplify the pain and "alarm". Studies on the predictors of back pain actually found that emotional stress is a more significant predictor of back pain than whether or not you have a herniated disc. When interviewing patients about the history of their back pain it is not uncommon for them to remember some low-level discomfort that wasn't much of an issue early on, which blew up into severe chronic pain around the same time as a severely stressful life event, and persisted for a long time afterward once the chronic pain cycle had started.
Psychological studies on hope and optimism found that people who score more highly in hope and optimism tend to have higher pain tolerances, and that undergoing a treatment to improve peoples hope and optimism also increases their pain tolerance.
Chronic neck and shoulder pain is often closely related to stress, the primitive response to fear being to raise your shoulders towards your ears to guard yourself. This tense "guarding" in addition to poor movement patterns with your head and arms can overwork your neck and shoulder muscles leading to pain and discomfort after time. Amplify that with stress, avoid activity due to fear, get a scan which shows (normal) age related degeneration in your neck, catastrophise that you'll never be able to play tennis again and need neck surgery, and you have started a chronic pain cycle.
Another common pitfall is not differentiating between a good and perfectly normal pain associated with using your body or resuming physical activity, and a bad pain that is a sign of aggravation of inflammation. Not understanding the difference between these two types of pain often leads people to avoid any physical activity if even the slightest bit of pain is experienced, further worsening the mechanical contributors to their pain, and becoming dependent on passive modalities. This might include an over reliance on pain killers, massage, acupuncture, etc.
It is interesting that in patients with chronic pain, education about this self-feeding paradigm of chronic pain can be enough for their pain to improve on some level.
A large focus of the exercise therapy for chronic pain is to help people to have confidence in their bodies again, to understand what both normal pain and a "bad" pain feel like, to realise that they can exercise safely and keep themselves fit and strong despite experiencing some normal pain, and how to safely get back into previous activities that they used to enjoy. Purely providing an exercise program is just one very small part of what is important.
Practical Tip:
What to do if you or someone you know are suffering from chronic joint or muscular pain?
- If it is still under 3-4 months from the onset of the injury, go and see your GP for advice and request a referral to a good physiotherapist.
- If the pain has lasted longer than this time (4 months +, even a year or more), you can assume that a combination of tissue injury, mechanical stresses, poor coping responses and negative beliefs about your injury are driving your chronic pain cycle. Once again see your GP for advice to rule out other causes, and request a referral to a good exercise physiologist.
The bottom line is - Don't let the pain become you.
Monday, December 20, 2010
Wednesday, July 28, 2010
The Status Quo
One of the biggest problems that I face in my work is that many people react to the mere mention of change with loathsome thoughts and feelings. People tend to get stuck in certain eating and living habits which have benefits that they enjoy, such as favorite types of meals which happen to be fattening, and enjoying relaxing at the end of a working day instead of doing exercise. Its unfortunate that for many people it takes a buildup of a lot of negative influences in their life to start to be open to change, or enough of a good incentive to be lured into change.
This is a problem in an individual sense, in that if a person living this way does not intervene with their lifestyle their weight and risk of poor health are likely to keep growing indefinitely. The loathsome thoughts and feelings are a negative influence to improving this scenario, but is there a bigger picture influencing this?
What I notice is that a great part of the problem is our food and exercise culture. What is considered normal for the average Australian is a life without any exercise, high consumption of processed foods, high consumption of meat and animal products, and a much smaller relative consumption of whole plant-foods.
In most cases, except for the current youngest generation, it all starts in primary school. The canteen is full of meat pies, sausage rolls, sandwiches with white bread and jam, sugary drinks, sugary ice blocks and hot chips. Exercise is really only related to sport, and if you don't like sport then there is no mention of exercise for the sake of exercise. For many, this continues all the way through high school and later life.
Some scary statistics of our country include:
- Approximately 60% of Australians do not exercise at all.
- Approximately only 20% of Australians exercise enough to protect their health.
- Australia has some of the highest rates of obese and overweight people in the whole world.
- 86% of Australians do not eat an adequate amount of vegetables each day.
- 46% of Australians do not eat an adequate amount of fruit each day.
- The average Australian consumes 30% too much saturated fat, related to consuming too much meat and animal products.
- 1% of Australian women aged 15-49 consume the recommended intake of folate, a crucial nutrient during pregnancy.
When you look at health statistics, this starts to paint a scary picture:
- The most significant predictor of chronic disease second to smoking, is lack of physical activity.
- 1 in 3 people in Australia die of heart disease, a lifestyle related preventable disease.
- There is building research evidence that a high consumption of meat and animal products increases the risk of cancer.
- Some researchers believe that 60-70% of the influences to cancer are preventable and lifestyle related.
- Australian and other Western countries have the highest rates of type-2 diabetes and cancer.
Considering that regular aerobic exercise is a powerful protector from heart disease, and only 20% of the population are likely to be exercising enough to enjoy the full protection, its not surprising that 1 in 3 people will die of heart disease.
You may argue that the problem is not quite as bad as I make it seem, however as I alluded to in my previous post on nutrition ( http://thehealthmind.blogspot.com/2010/06/my-favorite-health-food-shop-fruit-and.html ), other parts of the world that live very differently to us have far better health and a fraction of the chronic diseases that we have in the West. Provided that they have their basic needs met for health such as hygiene and available medical services, they also often have very long life expectancies. As soon as they migrate to the West they pick up the same disease rates as us, so its not their genes that are protecting their health.
Enough of the grisly talk on death and disease. When considering the food, exercise, and health culture (or lack of) in Australia, do you really want to be part of the status quo? When someone suggests to you than an unusual amount of exercise and rabbit food (whole plant-foods) is going to help, is it such a shock and burden when everyone else around you are part of the lifestyle disease epidemic? Is it really worth getting angry and outraged to be asked to live differently to what seems normal, and to what you are used to?
Time to look around you.
Practical tip: Make your own mind up. Decide what is best for you regardless of what everyone around you chooses to do, and regardless if its threatening to their way of life. You need to decide whether you want to be part of the status quo or not.
When starting to increase your amount of exercise, make it manageable and enjoyable. Keep it regular and build yourself up. You don't need to go straight to running marathons.
When trying to improve your diet, investigate low-GI foods for weight loss. If you want to have better health, try to meet the 5 vegetable and 2 fruit a day guideline for a start.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
This is a problem in an individual sense, in that if a person living this way does not intervene with their lifestyle their weight and risk of poor health are likely to keep growing indefinitely. The loathsome thoughts and feelings are a negative influence to improving this scenario, but is there a bigger picture influencing this?
What I notice is that a great part of the problem is our food and exercise culture. What is considered normal for the average Australian is a life without any exercise, high consumption of processed foods, high consumption of meat and animal products, and a much smaller relative consumption of whole plant-foods.
In most cases, except for the current youngest generation, it all starts in primary school. The canteen is full of meat pies, sausage rolls, sandwiches with white bread and jam, sugary drinks, sugary ice blocks and hot chips. Exercise is really only related to sport, and if you don't like sport then there is no mention of exercise for the sake of exercise. For many, this continues all the way through high school and later life.
Some scary statistics of our country include:
- Approximately 60% of Australians do not exercise at all.
- Approximately only 20% of Australians exercise enough to protect their health.
- Australia has some of the highest rates of obese and overweight people in the whole world.
- 86% of Australians do not eat an adequate amount of vegetables each day.
- 46% of Australians do not eat an adequate amount of fruit each day.
- The average Australian consumes 30% too much saturated fat, related to consuming too much meat and animal products.
- 1% of Australian women aged 15-49 consume the recommended intake of folate, a crucial nutrient during pregnancy.
When you look at health statistics, this starts to paint a scary picture:
- The most significant predictor of chronic disease second to smoking, is lack of physical activity.
- 1 in 3 people in Australia die of heart disease, a lifestyle related preventable disease.
- There is building research evidence that a high consumption of meat and animal products increases the risk of cancer.
- Some researchers believe that 60-70% of the influences to cancer are preventable and lifestyle related.
- Australian and other Western countries have the highest rates of type-2 diabetes and cancer.
Considering that regular aerobic exercise is a powerful protector from heart disease, and only 20% of the population are likely to be exercising enough to enjoy the full protection, its not surprising that 1 in 3 people will die of heart disease.
You may argue that the problem is not quite as bad as I make it seem, however as I alluded to in my previous post on nutrition ( http://thehealthmind.blogspot.com/2010/06/my-favorite-health-food-shop-fruit-and.html ), other parts of the world that live very differently to us have far better health and a fraction of the chronic diseases that we have in the West. Provided that they have their basic needs met for health such as hygiene and available medical services, they also often have very long life expectancies. As soon as they migrate to the West they pick up the same disease rates as us, so its not their genes that are protecting their health.
Enough of the grisly talk on death and disease. When considering the food, exercise, and health culture (or lack of) in Australia, do you really want to be part of the status quo? When someone suggests to you than an unusual amount of exercise and rabbit food (whole plant-foods) is going to help, is it such a shock and burden when everyone else around you are part of the lifestyle disease epidemic? Is it really worth getting angry and outraged to be asked to live differently to what seems normal, and to what you are used to?
Time to look around you.
Practical tip: Make your own mind up. Decide what is best for you regardless of what everyone around you chooses to do, and regardless if its threatening to their way of life. You need to decide whether you want to be part of the status quo or not.
When starting to increase your amount of exercise, make it manageable and enjoyable. Keep it regular and build yourself up. You don't need to go straight to running marathons.
When trying to improve your diet, investigate low-GI foods for weight loss. If you want to have better health, try to meet the 5 vegetable and 2 fruit a day guideline for a start.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
Wednesday, July 7, 2010
#2 Most common reason not to exercise - "I didn't feel like it".
I want to start this post with a disclaimer once again. I believe that everyone is entitled to making their own choices about when to exercise or not and if they want to exercise at all. Similar to my last post the goal of this one is to consider a new perspective on exercise.
One of the most common pitfalls I observe in people trying to adopt regular exercise is choosing not to exercise based on emotional reasoning. What I mean by emotion reasoning is that when they are about to leave for their workout and are deciding whether to go or not, if the person does not feel like it they often wait for the right emotion or excitement to push them into action and help them make their decision. When this exercise friendly emotion does not appear they decide to skip the exercise session and do something else, and also usually rationalise their decision to ease their guilt (e.g. "I really need to catch up on xy and z", or "its okay I'll make sure I go tomorrow"). Rather than using an objective reason to make the decision such as an honest cost/benefit analysis of exercise, or whether you actually have the time or not, the emotional state at the time is used to make the decision. Essentially, for the person who uses emotional reasoning, when the time comes for the planned exercise session if they feel tired, stressed or generally down, they choose not to exercise.
This may seem perfectly reasonable at first glance. If you don't feel like doing something then why do it? Really? Once again, it is every persons choice as to what to do with their time and when. The problem with using emotional reasoning for your decision is - when I ask most regular exercisers "how often do you actually feel like having a workout?", they almost always answer "barely ever". After I ask some more questions they often report to only feeling like exercise around 5% of the time or less.
Here lies one of the first major road-blocks for someone attempting to adopt regular exercise - If you only exercise when you feel like it, you will barely ever get out the door. The other problem with using emotional reasoning is that once you have given in to this type of decision making once, it gets a lot easier to do it a second time and a third. After a few times it starts to get easier not to exercise at all instead, and the next thing you know it might be off the books again.
A lot of people talk about "building a habit" when it comes to adopting exercise and this is true when it ties in with emotional reasoning. You need to build a habit of exercising regardless of how you feel at the time. Otherwise the prevailing habit of choosing not to exercise will be strengthened, especially at times when you don't feel like it. Just like anything worth having it will probably require some hard work, effort and sacrifice to build a new habit of regular exercise.
Research on the emotional state of people who exercise report a good boost in energy levels and reduction in stress levels directly after an exercise session, and after four weeks of regular exercise people usually experience a powerful anti-depressant effect. Even if you might not feel like it before, I can bet that you will be happy that you did it afterward.
Practical tip: If you know that you are an emotional reasoner, have some strategies in place at the time that you are about to exercise to counter this scenario. You know best about what strategy is likely to work for you, but some that have worked for others are:
- Writing a table with the costs and benefits of regular exercise and having it ready to review whenever in a tough moment.
- Asking a friend or family member to give you some tough love when you are second guessing your workout, and to not give you any incentives to skip the workout.
- If you do push yourself out the door even if you don't feel like it, give yourself a (healthy) reward.
- Having your exercise clothes and water bottle (or whatever you need) ready and near the door so that you have less time to dwell on the fact that you don't feel like it.
- Remind yourself that most people only feel like exercise 5% of the time, so just push yourself out the door regardless of whether you feel like it or not.
- Before the workout score between 1-10 your energy level, stress level, and general mood on one half of a piece of paper. Fold it so that you can't see your answers and then re-score yourself after the workout. Was it as good or bad as you had imagined?
There are some scenarios where it is not a good idea to exercise at all however they are very few. These depend on any specific medical conditions that you may have. Some more universal situations where it is okay not to exercise are:
- When you are running a temperature/fever. If you have a cold but you do not have a temperature/fever then light to moderate intensity exercise is generally still okay.
- If you are experiencing "bad pain" during exercise - Pain that gets worse and worse the longer and the more frequently you exercise. If you do experience any pain during exercise it is best to consult your doctor or exercise physiologist to determine whether it is a "good" or "bad" pain, and whether any rehabilitation strategies need to be used.
- If you have been told by a valid health practitioner not to exercise, or you have been told by a health practitioner that you have an absolute contraindication to exercise (unlikely as these are usually only very severe medical conditions).
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
One of the most common pitfalls I observe in people trying to adopt regular exercise is choosing not to exercise based on emotional reasoning. What I mean by emotion reasoning is that when they are about to leave for their workout and are deciding whether to go or not, if the person does not feel like it they often wait for the right emotion or excitement to push them into action and help them make their decision. When this exercise friendly emotion does not appear they decide to skip the exercise session and do something else, and also usually rationalise their decision to ease their guilt (e.g. "I really need to catch up on xy and z", or "its okay I'll make sure I go tomorrow"). Rather than using an objective reason to make the decision such as an honest cost/benefit analysis of exercise, or whether you actually have the time or not, the emotional state at the time is used to make the decision. Essentially, for the person who uses emotional reasoning, when the time comes for the planned exercise session if they feel tired, stressed or generally down, they choose not to exercise.
This may seem perfectly reasonable at first glance. If you don't feel like doing something then why do it? Really? Once again, it is every persons choice as to what to do with their time and when. The problem with using emotional reasoning for your decision is - when I ask most regular exercisers "how often do you actually feel like having a workout?", they almost always answer "barely ever". After I ask some more questions they often report to only feeling like exercise around 5% of the time or less.
Here lies one of the first major road-blocks for someone attempting to adopt regular exercise - If you only exercise when you feel like it, you will barely ever get out the door. The other problem with using emotional reasoning is that once you have given in to this type of decision making once, it gets a lot easier to do it a second time and a third. After a few times it starts to get easier not to exercise at all instead, and the next thing you know it might be off the books again.
A lot of people talk about "building a habit" when it comes to adopting exercise and this is true when it ties in with emotional reasoning. You need to build a habit of exercising regardless of how you feel at the time. Otherwise the prevailing habit of choosing not to exercise will be strengthened, especially at times when you don't feel like it. Just like anything worth having it will probably require some hard work, effort and sacrifice to build a new habit of regular exercise.
Research on the emotional state of people who exercise report a good boost in energy levels and reduction in stress levels directly after an exercise session, and after four weeks of regular exercise people usually experience a powerful anti-depressant effect. Even if you might not feel like it before, I can bet that you will be happy that you did it afterward.
Practical tip: If you know that you are an emotional reasoner, have some strategies in place at the time that you are about to exercise to counter this scenario. You know best about what strategy is likely to work for you, but some that have worked for others are:
- Writing a table with the costs and benefits of regular exercise and having it ready to review whenever in a tough moment.
- Asking a friend or family member to give you some tough love when you are second guessing your workout, and to not give you any incentives to skip the workout.
- If you do push yourself out the door even if you don't feel like it, give yourself a (healthy) reward.
- Having your exercise clothes and water bottle (or whatever you need) ready and near the door so that you have less time to dwell on the fact that you don't feel like it.
- Remind yourself that most people only feel like exercise 5% of the time, so just push yourself out the door regardless of whether you feel like it or not.
- Before the workout score between 1-10 your energy level, stress level, and general mood on one half of a piece of paper. Fold it so that you can't see your answers and then re-score yourself after the workout. Was it as good or bad as you had imagined?
There are some scenarios where it is not a good idea to exercise at all however they are very few. These depend on any specific medical conditions that you may have. Some more universal situations where it is okay not to exercise are:
- When you are running a temperature/fever. If you have a cold but you do not have a temperature/fever then light to moderate intensity exercise is generally still okay.
- If you are experiencing "bad pain" during exercise - Pain that gets worse and worse the longer and the more frequently you exercise. If you do experience any pain during exercise it is best to consult your doctor or exercise physiologist to determine whether it is a "good" or "bad" pain, and whether any rehabilitation strategies need to be used.
- If you have been told by a valid health practitioner not to exercise, or you have been told by a health practitioner that you have an absolute contraindication to exercise (unlikely as these are usually only very severe medical conditions).
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
Tuesday, June 29, 2010
#1 Most common reason not to exercise - Not enough time.
I want to start this post with a disclaimer. It is a personal philosophy of mine that everyone has the right and free-will to choose to spend their time however they want. The purpose of this post is not to convince or coerce you to spend your time otherwise, the purpose is merely to reflect and perceive a situation from different view points. If you don't have the time to exercise or you do not exercise, that is your given right and I am not the almighty to challenge that.
The scenario that I want you to consider is the most common reason that people have for not exercising - "not enough time". I believe that this is a symptom of our society as much as it is a symptom of someones life circumstances. Unreasonable work demands, family and relationship commitments, poor public transport, high housing costs causing people to live far from work, traffic congestion increasing commuting time, etc.
Regardless of the circumstances as to why a person does not have enough time to exercise, my concern with this scenario is not that you may not have time to exercise. My concern is that in your mind and when explaining your reasons to other people, you are forfeiting control of your life and to things outside of yourself.
Consider another way to view the scenario. It is not that you don't have enough time to exercise, it is that you have chosen other priorities in life to be more important than exercise, and therefor you have not given yourself time to exercise. Rather than blaming external factors on why you don't have enough time to exercise (i.e. "I have no ability to change that"), accept that its a choice that you have made and as a result you have not put the effort in to make the time. The significant distinction is whether in your mind you have control over the situation or not.
The second scenario requires some honest self-reflection. No one is perfect, and no one has a perfectly balanced life doing all of the things they think they should. Everyone has the right to choose how they want to live their lives even if elements of it are self-sabotaging (i.e. not exercising and gaining excess weight).
If you identify with this reason not to exercise, what I would like you to do is consider the fundamental difference between these two perspectives and have the courage to self-reflect. If you choose to take the second view of acceptance of your current priorities, then that is a small step in a good direction. You can take back control over your choices about how you choose to spend your time, you can stop beating yourself up over not looking after yourself as much as you would like, and you can stop resenting other people and other things for stealing your time.
The same goes if your friend or family member is in this scenario (and I bet that many are). Help them to make this distinction and move one step forward in a good direction, and never try to put them down over their personal choices.
At the end of the day if you decide that it is important enough for you exercise regularly then you will put the effort in to make it work. It might be inconvenient, it might require change, it may mean an early start, and it might mean negotiating with other people, but you will make it work if you choose to. This is also your choice, one for you to make and not for anyone else.
I hope that sparked some thought...
Practical tip: Beneficial and lasting change does not happen from beating yourself over the head with a stick (blame, "should", "must", "have to"). Nor does it come from someone trying to coerce with similar tactics. Lasting change usually happens from honest self-reflection. Change will happen IF and WHEN the person chooses to change.
If you do choose to put exercise at a higher priority then it often helps to be creative with what type of exercise and how you can make it easiest to stick to. Indoor, outdoor, alone, with others, individual sport, team sport, recreation, relaxing, exhilarating, muscle focused, endurance focused, experiment and make your choice. The principles of the human body stay the same, the type of exercise can change.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
The scenario that I want you to consider is the most common reason that people have for not exercising - "not enough time". I believe that this is a symptom of our society as much as it is a symptom of someones life circumstances. Unreasonable work demands, family and relationship commitments, poor public transport, high housing costs causing people to live far from work, traffic congestion increasing commuting time, etc.
Regardless of the circumstances as to why a person does not have enough time to exercise, my concern with this scenario is not that you may not have time to exercise. My concern is that in your mind and when explaining your reasons to other people, you are forfeiting control of your life and to things outside of yourself.
Consider another way to view the scenario. It is not that you don't have enough time to exercise, it is that you have chosen other priorities in life to be more important than exercise, and therefor you have not given yourself time to exercise. Rather than blaming external factors on why you don't have enough time to exercise (i.e. "I have no ability to change that"), accept that its a choice that you have made and as a result you have not put the effort in to make the time. The significant distinction is whether in your mind you have control over the situation or not.
The second scenario requires some honest self-reflection. No one is perfect, and no one has a perfectly balanced life doing all of the things they think they should. Everyone has the right to choose how they want to live their lives even if elements of it are self-sabotaging (i.e. not exercising and gaining excess weight).
If you identify with this reason not to exercise, what I would like you to do is consider the fundamental difference between these two perspectives and have the courage to self-reflect. If you choose to take the second view of acceptance of your current priorities, then that is a small step in a good direction. You can take back control over your choices about how you choose to spend your time, you can stop beating yourself up over not looking after yourself as much as you would like, and you can stop resenting other people and other things for stealing your time.
The same goes if your friend or family member is in this scenario (and I bet that many are). Help them to make this distinction and move one step forward in a good direction, and never try to put them down over their personal choices.
At the end of the day if you decide that it is important enough for you exercise regularly then you will put the effort in to make it work. It might be inconvenient, it might require change, it may mean an early start, and it might mean negotiating with other people, but you will make it work if you choose to. This is also your choice, one for you to make and not for anyone else.
I hope that sparked some thought...
Practical tip: Beneficial and lasting change does not happen from beating yourself over the head with a stick (blame, "should", "must", "have to"). Nor does it come from someone trying to coerce with similar tactics. Lasting change usually happens from honest self-reflection. Change will happen IF and WHEN the person chooses to change.
If you do choose to put exercise at a higher priority then it often helps to be creative with what type of exercise and how you can make it easiest to stick to. Indoor, outdoor, alone, with others, individual sport, team sport, recreation, relaxing, exhilarating, muscle focused, endurance focused, experiment and make your choice. The principles of the human body stay the same, the type of exercise can change.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
Wednesday, June 16, 2010
Posture - More than carrying books on your head
When most people think of posture they may think of perfectionists and someone with a stick whacking you in the spots that are sticking out where they shouldn't, or to lift things up that shouldn't be sagging. They may think of health professionals doing their intrusive assessments, or their mother yelling at them on the way to school.
The one concept that people often don't realise when thinking about posture, is that posture is your whole body balancing against gravity. In addition to this, not many people also realise that your body is one big biomechanical machine. To be able to appreciate this understanding of posture and the body, I will first cover some fundamental principles of functional anatomy in plain English which will help you to appreciate the importance of posture.
In most major joints of the body such as the hip, spine, shoulder and neck there are a group of muscles which can be classified as the deep group. This deep group of muscles tend to be more concerned with holding a joint in a stable position, and the properties of the muscle tend to be geared more to holding isometrically for long periods of time, keeping the joint stable and strong. Some muscles included in the deep group of the trunk that may sound familiar are the transversus abdominus, multifidus, diaphragm, and pelvic floor.
The larger muscles which are more concerned with gross movement are the more obvious and usually closest to the skin (e.g. pectorals, biceps, triceps, deltoids, quads, gluteus maximum, rectus abdominus). These muscles are considered the global layer, and tend to be geared more for movement and powerful contractions such as pushing, pulling and lifting.
Essentially, in an ideal scenario the deep group of muscles hold the joint stable and in a strong position in order to serve as a platform for the global muscles to exert powerful contractions, and to move in an efficient manner. The saying that "most exercises come from your core" is true in this sense, in that the core builds a stable platform for your joints to move from. The deep muscles and global layer working together in a synergy.
Where posture becomes important in the scheme of deep and global muscle concepts, is that when your posture is balanced and close to what is considered ideal posture, the deep muscles have their best opportunity to work and stabilise the main joints in your body. They use their high capacity for holding and enduring to keep your joints strong and stable while using less energy. Being exercised regularly the deep muscles naturally tend to be stronger and more easily recruited during movements. This then provides a stable platform for efficient and powerful movement of the limbs, and keeps the strain on joint structures to a minimum. The analogy is that of a building crane - if the base of the crane is not stabilised and steady, then the arm of the crane is going to be even more unstable.
What tends to happen when your posture is unbalanced and out of alignment, is that the body starts to develop "holding patterns" where muscles from the global group take over the role of keeping the joint stable, tending to become overworked and tight. In conjunction with these muscles becoming tight, the deep muscle group of the joint rarely get a chance to work effectively, weakening and decreasing in size, allowing them to become "lazy".
This then places more strain on the joint structures and makes you more prone to injury. In the case of the trunk muscles, this combination of a holding pattern and unbalanced posture may even make breathing slightly labored due to the diaphragm serving a dual purpose for trunk stability and breathing, and not having a chance to work efficiently.
To use a practical example of how changes in posture effect balance and muscles in the body, have a look at the images on this website: http://burkecleland.com/?p=174
Using the "forward head" posture as an example of how your body is one big balance against gravity, first understand the effect of the head being forward. Seeing as the head is placed forward, the global muscles on the back of the neck will become overworked and tight (e.g. cervicle extensors, upper trapezius), and the deep group of muscles under the chin will become weak (e.g. deep cervicle flexors). This is a scenario which can predispose you to neck pain, headaches, and rotator cuff impingement.
To further elaborate on the balance against gravity in this example, seeing as the head and shoulders are forward, the hip needs to tilt forward and place the buttocks further back to regain the balance against gravity. The global muscles of the lower back (e.g. erector spinae) will become overworked and tight, and the deep muscles of the trunk (e.g. transversus abdominus, multifidus, diaphragm, pelvic floor) will be disused and become weak and "lazy" seeing as pelvis and trunk is held in a sagged position requiring less use of these muscles. This can predispose you to lower back pain, hip pain, and lower back injury.
To elaborate even further and speculate (without much scientific evidence), seeing as breathing may be slightly shallower and more labored in a holding pattern such as this, the frequent breathing rate may even bring about mild symptoms of anxiety and contribute to stress tension in the neck and shoulders, further exacerbating the cluster of chronic pain in the neck and back.
After using this single example of how the body is one large interconnected balance against gravity, and a large and complex biomechanical machine, is posture really only about carrying books on your head?
In essence: Posture is about keeping your joints in a strong position, and giving your muscles the best possible opportunity to work in the way that they were designed. It is about the right muscles doing the work to hold joints table (the deep group), and the large muscles to remain ready for powerful gross movements (the global layer) rather than taking over the holding of joints. It is about ensuring that you are breathing well, and that your joints are well supported and moving efficiently.
I hope this sheds a new light for some people as to why posture and technique is important in weight training and sports training, as the more you repeat and promote a bad postural habit, the stronger that bad habit gets.
Practical tip: Remind yourself as often as possible throughout the day to keep balanced posture. Head upright, shoulders back, spine neutral, hip neutral. Anything that you do in a day can be considered a postural exercise - sitting, packing the dishwasher, hanging out the washing, an gym session. With constant reminding and repetition holding the balanced posture will become more familiar and require less conscious effort. This constant reminding will also help you to train yourself into new movement patterns which utilise these deep muscles in the way that they were designed.
If you combine this with exercises designed to strengthen the deep muscles, and stretch the global muscles that are prone to becoming tight in these holding patterns, then you have a good holistic exercise program.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
The one concept that people often don't realise when thinking about posture, is that posture is your whole body balancing against gravity. In addition to this, not many people also realise that your body is one big biomechanical machine. To be able to appreciate this understanding of posture and the body, I will first cover some fundamental principles of functional anatomy in plain English which will help you to appreciate the importance of posture.
In most major joints of the body such as the hip, spine, shoulder and neck there are a group of muscles which can be classified as the deep group. This deep group of muscles tend to be more concerned with holding a joint in a stable position, and the properties of the muscle tend to be geared more to holding isometrically for long periods of time, keeping the joint stable and strong. Some muscles included in the deep group of the trunk that may sound familiar are the transversus abdominus, multifidus, diaphragm, and pelvic floor.
The larger muscles which are more concerned with gross movement are the more obvious and usually closest to the skin (e.g. pectorals, biceps, triceps, deltoids, quads, gluteus maximum, rectus abdominus). These muscles are considered the global layer, and tend to be geared more for movement and powerful contractions such as pushing, pulling and lifting.
Essentially, in an ideal scenario the deep group of muscles hold the joint stable and in a strong position in order to serve as a platform for the global muscles to exert powerful contractions, and to move in an efficient manner. The saying that "most exercises come from your core" is true in this sense, in that the core builds a stable platform for your joints to move from. The deep muscles and global layer working together in a synergy.
Where posture becomes important in the scheme of deep and global muscle concepts, is that when your posture is balanced and close to what is considered ideal posture, the deep muscles have their best opportunity to work and stabilise the main joints in your body. They use their high capacity for holding and enduring to keep your joints strong and stable while using less energy. Being exercised regularly the deep muscles naturally tend to be stronger and more easily recruited during movements. This then provides a stable platform for efficient and powerful movement of the limbs, and keeps the strain on joint structures to a minimum. The analogy is that of a building crane - if the base of the crane is not stabilised and steady, then the arm of the crane is going to be even more unstable.
What tends to happen when your posture is unbalanced and out of alignment, is that the body starts to develop "holding patterns" where muscles from the global group take over the role of keeping the joint stable, tending to become overworked and tight. In conjunction with these muscles becoming tight, the deep muscle group of the joint rarely get a chance to work effectively, weakening and decreasing in size, allowing them to become "lazy".
This then places more strain on the joint structures and makes you more prone to injury. In the case of the trunk muscles, this combination of a holding pattern and unbalanced posture may even make breathing slightly labored due to the diaphragm serving a dual purpose for trunk stability and breathing, and not having a chance to work efficiently.
To use a practical example of how changes in posture effect balance and muscles in the body, have a look at the images on this website: http://burkecleland.com/?p=174
Using the "forward head" posture as an example of how your body is one big balance against gravity, first understand the effect of the head being forward. Seeing as the head is placed forward, the global muscles on the back of the neck will become overworked and tight (e.g. cervicle extensors, upper trapezius), and the deep group of muscles under the chin will become weak (e.g. deep cervicle flexors). This is a scenario which can predispose you to neck pain, headaches, and rotator cuff impingement.
To further elaborate on the balance against gravity in this example, seeing as the head and shoulders are forward, the hip needs to tilt forward and place the buttocks further back to regain the balance against gravity. The global muscles of the lower back (e.g. erector spinae) will become overworked and tight, and the deep muscles of the trunk (e.g. transversus abdominus, multifidus, diaphragm, pelvic floor) will be disused and become weak and "lazy" seeing as pelvis and trunk is held in a sagged position requiring less use of these muscles. This can predispose you to lower back pain, hip pain, and lower back injury.
To elaborate even further and speculate (without much scientific evidence), seeing as breathing may be slightly shallower and more labored in a holding pattern such as this, the frequent breathing rate may even bring about mild symptoms of anxiety and contribute to stress tension in the neck and shoulders, further exacerbating the cluster of chronic pain in the neck and back.
After using this single example of how the body is one large interconnected balance against gravity, and a large and complex biomechanical machine, is posture really only about carrying books on your head?
In essence: Posture is about keeping your joints in a strong position, and giving your muscles the best possible opportunity to work in the way that they were designed. It is about the right muscles doing the work to hold joints table (the deep group), and the large muscles to remain ready for powerful gross movements (the global layer) rather than taking over the holding of joints. It is about ensuring that you are breathing well, and that your joints are well supported and moving efficiently.
I hope this sheds a new light for some people as to why posture and technique is important in weight training and sports training, as the more you repeat and promote a bad postural habit, the stronger that bad habit gets.
Practical tip: Remind yourself as often as possible throughout the day to keep balanced posture. Head upright, shoulders back, spine neutral, hip neutral. Anything that you do in a day can be considered a postural exercise - sitting, packing the dishwasher, hanging out the washing, an gym session. With constant reminding and repetition holding the balanced posture will become more familiar and require less conscious effort. This constant reminding will also help you to train yourself into new movement patterns which utilise these deep muscles in the way that they were designed.
If you combine this with exercises designed to strengthen the deep muscles, and stretch the global muscles that are prone to becoming tight in these holding patterns, then you have a good holistic exercise program.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
Monday, June 7, 2010
My favorite health food shop? - The fruit and veg section of the supermarket.
Why is it that plant foods are considered good for our health?
The short answer is - no one knows yet.
The longer answer is - plant foods contain thousands of chemical compounds, often with compounds that are unique to each plant food. As they are eaten and digested all of these compounds react with saliva, digestive enzymes, bacteria, and each other. Most common fruit, vegetables, nuts, legumes, and spices also tend to have cancer fighting compounds that are unique to each food, their function having been discovered only recently. What they all do to our body once they have all been digested and ingested is not very well understood, and it is very difficult to study in living humans. What is known is that they all act together in a synergy to promote good health.
Until the farming and industrial revolutions, humans largely lived nomadic hunter-gatherer lifestyles. Moving from food source to food source, eating a wide range of whole plant foods and wild animal foods, and doing some form of daily physical activity in order to continue to survive. It is also known that thousands of years ago, some animals were able to produce some of the vitamins that we now know we need, such as vitamin-C, however over many years of existing on plant foods they lost the ability to produce these vitamins and became dependent on dietary sources.
Could it be that our bodies have become dependent on the nutrients within these foods? The recent changes to our lifestyle that are a result of living in a modern world, are only a blink of an eye compared the long amount of time that humans lived as hunter-gatherers.
The areas of the world which still eat diets consisting mostly of whole plant foods and wild organic animal foods tend to have very low rates of all of the most common chronic diseases in the West. They also tend to have long life expectancies when basic needs for health are met, such as hygiene and available medical services.
What most people consider normal in the West, such as heart disease, cancer, type-2 diabetes, obesity, dementia, Alzheimer's, etc. all happen to share similar risk factors - low consumption of whole plant foods, and a high consumption of processed foods and industrially farmed and produced animal foods - i.e. the Western Diet. They are all known to be conditions where you genes react with your lifestyle, could it also be due to a void of these plant nutrients seeing as they usually are destroyed and stripped away during the production of processed foods?
(back to talk of nutrition)
The list of known vitamins, minerals, amino acids, anti-oxidants and fat classes are just the tip of the ice-berg in the understanding of nutrition and health. Vitamins and their importance to health were only discovered in the early nineteen hundreds. In terms of nutrition as a science, to quote Michael Pollan, "nutrition is where surgery was at in the sixteen hundreds". With the current body of knowledge on nutrition, it is emerging that foods are far more than the sum of their parts. So, how can modern nutrition science help us promote health in our own lives and find a better way of living?
Something to chew on:
Maybe we're just allergic to the Western lifestyle, and the only truly effective answer to the epidemic of lifestyle related health issues in the West is to try to reclaim a more traditional way of living and eating?
We can fill in the blanks and try to explain this question over the next few hundred years in terms of nutrients and their functions if we really want to, however the evidence is there already today, you just need to see the bigger picture.
Practical tip: How can you replace something that you eat regularly that is a processed food, with a less processed and more natural alternative? Not only will doing this increase your intake of these beneficial and mysterious plant nutrients, they also tend to keep you full for longer and help to promote weight loss.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
P.S. If you enjoyed this point of view, I thoroughly recommend that you read "In Defense of Food: An Eaters Manifesto" by Michael Pollan. If you're not afraid of reading something controversial, then I also recommend reading "The China Study" by Campbell & Campbell.
The short answer is - no one knows yet.
The longer answer is - plant foods contain thousands of chemical compounds, often with compounds that are unique to each plant food. As they are eaten and digested all of these compounds react with saliva, digestive enzymes, bacteria, and each other. Most common fruit, vegetables, nuts, legumes, and spices also tend to have cancer fighting compounds that are unique to each food, their function having been discovered only recently. What they all do to our body once they have all been digested and ingested is not very well understood, and it is very difficult to study in living humans. What is known is that they all act together in a synergy to promote good health.
Until the farming and industrial revolutions, humans largely lived nomadic hunter-gatherer lifestyles. Moving from food source to food source, eating a wide range of whole plant foods and wild animal foods, and doing some form of daily physical activity in order to continue to survive. It is also known that thousands of years ago, some animals were able to produce some of the vitamins that we now know we need, such as vitamin-C, however over many years of existing on plant foods they lost the ability to produce these vitamins and became dependent on dietary sources.
Could it be that our bodies have become dependent on the nutrients within these foods? The recent changes to our lifestyle that are a result of living in a modern world, are only a blink of an eye compared the long amount of time that humans lived as hunter-gatherers.
The areas of the world which still eat diets consisting mostly of whole plant foods and wild organic animal foods tend to have very low rates of all of the most common chronic diseases in the West. They also tend to have long life expectancies when basic needs for health are met, such as hygiene and available medical services.
What most people consider normal in the West, such as heart disease, cancer, type-2 diabetes, obesity, dementia, Alzheimer's, etc. all happen to share similar risk factors - low consumption of whole plant foods, and a high consumption of processed foods and industrially farmed and produced animal foods - i.e. the Western Diet. They are all known to be conditions where you genes react with your lifestyle, could it also be due to a void of these plant nutrients seeing as they usually are destroyed and stripped away during the production of processed foods?
(back to talk of nutrition)
The list of known vitamins, minerals, amino acids, anti-oxidants and fat classes are just the tip of the ice-berg in the understanding of nutrition and health. Vitamins and their importance to health were only discovered in the early nineteen hundreds. In terms of nutrition as a science, to quote Michael Pollan, "nutrition is where surgery was at in the sixteen hundreds". With the current body of knowledge on nutrition, it is emerging that foods are far more than the sum of their parts. So, how can modern nutrition science help us promote health in our own lives and find a better way of living?
Something to chew on:
Maybe we're just allergic to the Western lifestyle, and the only truly effective answer to the epidemic of lifestyle related health issues in the West is to try to reclaim a more traditional way of living and eating?
We can fill in the blanks and try to explain this question over the next few hundred years in terms of nutrients and their functions if we really want to, however the evidence is there already today, you just need to see the bigger picture.
Practical tip: How can you replace something that you eat regularly that is a processed food, with a less processed and more natural alternative? Not only will doing this increase your intake of these beneficial and mysterious plant nutrients, they also tend to keep you full for longer and help to promote weight loss.
Alex Budlevskis
Exercise Physiologist
Rozelle Total Health
P.S. If you enjoyed this point of view, I thoroughly recommend that you read "In Defense of Food: An Eaters Manifesto" by Michael Pollan. If you're not afraid of reading something controversial, then I also recommend reading "The China Study" by Campbell & Campbell.
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