Core Strength and Flexibility

This is Part I of what will be a series of posts regarding core strengthening and flexibility. spkDC

Your core is more than the “six-pack” that is envisioned when the subject is discussed. Your core musculature includes the following areas: back, flank, pelvis, and buttocks all of which are responsible for assisting in the stabilization of your spine when you bend, twist, rotate, sit, and stand. So whether you’re a “gym rat” or an “occupational athlete” your core, and your mindful attention to it, is imperative in preventing back and/or neck pain.

Obviously there are various workouts that can improve core strength but some require a certain level of fitness while others, if not executed properly, can result in further injury and/or pain. However, there are exercises which are appropriate no matter what your reluctance or time constraint is. Because let’s face it, any form of physical activity that can enhance your spinal stability is better than none at all.

No inanimate device or solitary treatment to date is the be all end all cure for low back pain, an issue which ranks second to respiratory infection for primary care visits. That being said, when it comes to musculoskeletal pain, no website or anecdotal opinion is a reasonable substitute for an objective examination by a musculoskeletal specialist to determine the cause and subsequent treatment for your low back pain. Ignoring pain that hasn't gotten better or become worse after 72+ hours will only amplify the issue and altering your body mechanics to decrease its provocation can cause additional problems.  

Studies have shown that regular stretching AND strengthening of core musculature can help you avoid back pain and/or ease chronic pain. The objective of regular core “mindfulness” is to hone conscious control over the position and movement of your body’s center, an area known in traditional Chinese medicine as the “dan-tien” [don-tee-en]. You should think of your core as the “conjunction junction” between your torso and lower extremities (thighs, legs, and feet).

All bodily propulsion either originates or is transferred through the core via the kinetic chain. Muscle weakness/tightness within the chain (i.e. back, flank, pelvis, buttocks) can/will decrease the strength/stability of your movements and set in motion joint misalignments and/or adverse limb placement thereby perpetuating injury over time (“the straw that broke the camel’s back”).

Core strength and flexibility is the key to ambulatory power, balance, and stability which is vital to injury prevention. Your core affects just about everything you do whether it be taking a walk, rising from your chair, putting on your shoes, turning to back your car down the driveway, or simply standing still and a weak inflexible core can make on the job tasks, hobbies, sports, or housework quite unpleasant.

Aside from maintaining a healthy back, core strength and flexibility will help you feel, think, and look better:

• Deconditioned core musculature leads to slouching which in turn places wear and tear on the bones, ligaments,and discs of your spine and decreases your ability to breathe properly. Good posture will not only make you look thinner but project self-confidence and leadership. Strengthening postural muscles also decreases the load placed on your hips and knees which in turn staves off the onset of osteoarthritis.

• Regular exercise has been shown to ease depression and improve mood which in turn will help you not gain weight or regain pounds you've lost

• In older adults, regular exercise improves functional abilities which in turn help to maintain/boost bone density, prevent falls, and sharpen mental function

• Regular Exercise = ↓ Risks ForEarly Death [i.e. heart disease, stroke, type 2 diabetes, high blood pressure, metabolic syndrome, etc.]

• Some people [under a medical doctor’s supervision] may be able to cut back on certain medications which can eliminate/ease unwanted side effects as well as save you money

Dangers of Forward Head Posture

Neutral posture is observed when a plumb line passes through the center of the ear, shoulder, hip, knee and just in front of the ankle (Illustration - LEFT). Forward Head Posture [FHP] is present when the head at rest is positioned in front of the center of the shoulder. The movement of this much weight (About ten pounds) in front of the plumb line causes a shift in the body's Center of Mass, or balance point.

The good news is that the human body has an exquisite self-balancing system to compensate for shifts of the Center of Mass. The bad news is that these compensatory changes can be quite extreme (Illustration - RIGHT ) and cause severe structural stresses and even changes in organ systems.

There is a predictable pattern of compensation as the body realigns the Center of Mass. This is called the Trinity of Forward Head Posture [FHP].

1. Head moves forward of the shoulders. This changes the body's center of mass and center of gravity, triggering a response in the body's balance system.
2. To counter-balance the mid and upper back drifts backward, the shoulders rotate inward.
3. In response to that movement, the pelvis tilts forward

Several major studies have concluded that FHP is a direct indicator of a person's overall health:

• Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture; however, many symptoms, including pain, may be moderated or eliminated by improved posture.¹
• Hyperkyphotic (hi-per-kie-fah-tick) posture [excessive curvature of the thoracic spine, commonly referred to as hunchback] predicts increased mortality. Interventions specifically targeted at improving hyperkyphotic posture could result in reduced mortality rates.²

What is Kyphosis?

• Researchers found that even mild forward head carriage is “detrimental” to a person’s “overall health”. They concluded that the farther the head/neck moved in front of the seventh (7^th) cervical vertebrae “all measures of health status showed significantly poorer scores” and that this forward translation increased a person’s pain and decreased their ability to function!³
• Researchers at the University of Leeds in the UK found a direct cellular connection between muscles in the neck and a part of the brainstem - called the nucleus tractus solitarius (NTS) - which plays a essential role in regulating heart rate and blood pressure. This finding quite possibly explains why an injury to the muscles of the neck (i.e. whiplash) can at times change a person’s blood pressure and heart rate. It stands to reason that repetitive use injury to these same muscles (i.e. slouched posture at your desk and/or computer, cell phone, tablet use) may very well adversely alter these vital signs too!

Poor Posture Alters Your Vital Signs

Major Effects of Forward Head Posture

- For every one inch the head sits forward of the shoulders, an additional 15-30 pounds of tension is placed on the muscles in the back of the neck.

The Physics of Forward Head Posture

- It has been estimated that a person with Forward Head Posture uses 30% more body energy to keep the body erect.

- As the body shifts, certain muscle groups get stretched and become weak, and other groups shorten, and become weak. This results in degenerative changes that twist and distort the spine and subsequently shorter stature.

 

<sup>There is nothing good about poor posture and regardless of the activity (work or play) posture affects your overall performance. At least 85% of the back/neck pain related issues that enter my office derive from improper posture. Poor bodily usage directly impacts the biological, psychological, and social aspects of our daily lives leaving us dysfunctional, exhausted, and in pain. Implementing proper body mechanics is simply a mindful adherence to good habits that must be practiced with moment to moment awareness.  

Even though poor posture is not self-correcting it can be reversed. A chiropractor near you utilizing manual therapy, therapeutic exercise, and lifestyle advice can help you overcome upper crossed syndrome [see image above] and return you to a neutral posture in no time</sup>

¹ Lennon J, Shealy N, Cady, RK, Matta W et al. Postural and Respiratory Modulation of Autonomic Function, Pain, and Health. American Journal of Pain Management. 1994;4 (1):36-3

² Journal of the American Geriatrics Society. Volume 52, Issue 10, pages 1662–1667, October 2004

³ Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F. The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976) 2005 Sep 15;30(18):2024-9.

⁴ The Journal of Neuroscience, 1 August 2007, 27(31):8324-8333

EXERCISE WALKING FOR BETTER BACK HEALTH

Taken from our 01 Aug 14 Spine-Health Powered Newsletter

People with ongoing or recurrent episodes of lower back pain should consider the benefits of walking as a low‐impact form of exercise.

Aerobic exercise has long been shown to reduce the incidence of low back pain. However, people with low back pain often find some forms of exercise too painful to continue, and therefore don't get the exercise they need to maintain good health. Exercise walking is one way to benefit from regular exercise while not aggravating the structures in the lower back.

BENEFITS OF EXERCISE WALKING

There are many inherent health benefits from a regular routine of exercise walking, such as:

 - Strengthens muscles in the feet, legs, hips, and torso - walking increases the stability of the spine and conditions the muscles that keep the body in the upright position.

 - Nourishes the spinal structures - walking for exercise facilitates strong circulation, pumping nutrients into soft tissues and draining toxins.

 - Improves flexibility and posture - exercise walking along with regular stretching allows greater range of motion; helps prevent awkward movements, and susceptibility of future injury.

 - Strengthens bones and reduces bone density loss - regular walking for exercise helps prevent osteoporosis and can aid in reducing osteoarthritis pain.

 - Helps with controlling weight- any regular exercise routine helps maintain a healthy weight, especially as one ages and metabolism slows.

EFFECTIVE EXERCISE WALKING TECHNIQUES

Using the following techniques will help improve the benefits of walking:

     1. Walk briskly, but as a general rule maintain enough breath to be able to carry on a conversation.

     2. Start out with a 5 minute walk and work up to walking for at least 30 minutes (about 2 miles) at least 3 to 4 times a week.

     3. Maintain good form while walking to get the optimum aerobic benefit with each step and help protect the back and avoid injury. These elements of form should be followed:

 - Head and shoulders: Keep the head up and centered between the shoulders, with eyes focused straight ahead at the horizon. Keep the shoulders relaxed but straight - avoid slouching forward.

 - Abdominal muscles: It is important to actively use the abdominal muscles to help support the trunk of the body and the spine. To do this, keep the stomach pulled in slightly and stand fully upright. Avoid leaning forward as you walk.

 - Hips: The majority of the forward motion should start with the hips. Each stride should feel natural - not too long or too short. Most people make the mistake of trying to take too long of stride.

 - Arms and hands: Arms should stay close to the body, with elbows bent at a 90 degree angle. While walking, the arms should keep in motion, swinging front to back in pace with the stride of the opposite leg. Remember to keep hands relaxed, lightly cupped with the palms inward and thumbs on top. Avoid clenching the hands or making tight fists.

 - Feet: With each step, land gently on the heel and midfoot, rolling smoothly to push off with the toes. Be mindful about using the balls of the feet and toes to push forward with each step.

DO I NEED WALKING SHOES?

Exercise walking, as with other forms of exercise, requires the right equipment for a safe and effective routine. Good walking shoes are an important investment; choosing the appropriate walking shoes is important to maximize the benefits of exercise walking.

Finding the proper walking shoe may take some time and a bit of money, but it is essential for achieving long and short term benefits. Shoes are the most important piece of equipment in walking.

Walking shoes provide a basic protection and mechanical support for the foundation structures of the body - the feet - which in turn help keep the entire body balanced and aligned. When there is a minute imbalance in the feet, the compensatory domino effect causes changes throughout the body.

Specifically, when the body's natural gait motion is off balance, the body counterbalances the problem by redistributing weight. This ultimately changes the natural posture and alignment of the spine, leading to muscle strain and back pain over time. Though the imbalance may seem minor, in the long run, the stresses added to the body can add up and cause unnecessary wear and tear.

The right walking shoes can help foster excellent balance and posture during exercise walking, while poorly fitted walking shoes can cause pain or increase susceptibility to injury. It is best to find a technical running shoe store that will watch the individual's walk and will provide a shoe that fits based on the individual's specific biomechanics (this service is not typically found in large chain stores).

Walking shoes should allow the feet to naturally roll slightly inward (pronation) and outward (supination) to help absorb the different forces acting on the body. For many people, either one or both feet under pronate (roll outward) or over pronate (roll inward), altering the balance and length of the leg during stance, as well as gait. Some shoes are designed to control over pronation, whereas others are designed to encourage pronation.

Therefore it is important to make sure that walking shoes match each individual's specific biomechanical pattern.

An additional side effect of pronation and supination is the change in the natural curvature of the arches of the feet.

The feet are the crucial elements of gait motion, and maintaining a smooth gait is critical to preserving good spinal health. To ensure the correct balance during exercise walking, one must limit over pronation and under pronation of the feet. Good walking shoes should provide this stability.

USING A TREADMILL

When using a treadmill for walking exercise, all of the above guidelines are still important, with the additional caution to avoid using the handrails as much as possible (unless they are needed to keep balanced).


Click here for more information about walking and guidelines for buying walking shoes: http://www.spine- health.com/wellness/exercise/walking-  shoes-exercise-walking

Chiropractic Care Boosts Surgery Avoidance

This PSA from the Foundation for Chiropractic Progress discusses how chiropractic care has enabled many people to avoid invasive surgical procedures. 

Back on the Job - Chiropractic Care