Core Stability

The core is where the most of the body’s power is derived. It provides the foundation for
all movements of the arms and legs. The core must be strong, have dynamic flexibility
and function synergistically in its movements in order to achieve maximum performance.

  • Motion of the human body is not isolated to one muscle or tissue moving in one specific
    direction. Rather, it is a complex event involving agonists and antagonist structures that
    work together to create changes in position and/or location, and to stabilize the body in
    all three directional planes. Regardless of what sport one plays, it is essential to have core strength and trunk stability to maximize performance and prevent injury.

What Makes Up the Core
The foundation of the core is much more than the abdominal muscles. It includes
muscles deep within the torso, from the pelvis up to the neck and shoulders. The core
includes the following structures:

  • Multifidus – deep spinal muscles that run segmentally from the neck (C2) to the
    sacrum. They produce extension and, to a lesser degree, rotation and lateral
    flexion forces that provide stability to joints at individual levels of the spine.
  • Interspinales, Intertransversarii, Rotatores – deep structures that attach
    directly to the spinal column. These are very important for rotatory motion and
    lateral stability.
  • External Obliques – abdominal muscles that attaches at the lower ribs, pelvis,
    and abdominal fascia.
  • Internal Obliques – abdominal muscles that attaches at the lower ribs, rectus
    sheath, pelvis and thoracolumbar fascia.
  • Transversus Abdominis – abdominal muscles that attaches at the lower ribs,
    pelvis and thoracolumbar fascia, and rectus sheath.

These abdominal muscles work together to transmit a compressive force, and act to increase intra-abdominal pressure that stabilizes the lumbar spine. They also work individually to perform trunk rotation, while the internal and external obliques on the same side can work together, or synergistically, to laterally flex the spine.
Rectus abdominis- abdominal muscle that attaches at the fifth through seventh ribs, the lower sternum and the front of the pubic bone. This muscle flexes the spine, compresses the internal organs of the abdomen and transmits forces laterally from the obliques. It is a common fallacy that the upper and lower rectus are isolated differently. Training the rectus can be done with one exercise.
Erector Spinae – help to counterbalance all the forces involved in spinal flexion. They begin as the sacrospinalis tendon that attaches at the sacrum and ilium. This tendon then gives rise to different muscles that run up the spine and obliquely to attach at lateral parts of the vertebrae and the ribs. In the cervical region, these muscles attach at the base of the skull.
Quadratus Lumborum – attaches at the 12th rib and the upper 4 lumbar vertebrae and the pelvis. It stabilizes the lumbar spine in all planes of motion, stabilizes the 12th rib and the attachment of the diaphragm during respiration and laterally flexes the trunk.
Latissimus Dorsi – this is the largest spinal stabilizer. It attaches via the thoracolumbar fascia to the lumbar vertebrae, sacrum and pelvis, and runs upward to the humerus. It assists in lumbar extension and stabilization, and also performs pulling motions through the arms.
Thoracolumbar Fascia – connects the latissimus dorsi, gluteal muscles, internal obliques and transverse abdominis, supplies tensile support to the lumbar spine, and is used for load transfer throughout the lumbar and thoracic regions.
Abdominal Fascia – connects to the obliques and rectus abdominis, and to the pectoralis major. Fascial connections that cross the midline transmit forces to the muscles of the opposite side of the body.

Training the Core
The common myth is that training the core simply involves sit ups and back extensions.
An efficient core routine consists of multiplanar movements – training in all planes of
motion. As the body moves, the center of gravity changes, and forces exerted by, and on,
the body’s tissues are constantly changing. Dynamic stabilization must be included to
increase proprioception and stability in the trunk, as well as in the rest of the body. This
allows the parts of the body to react efficiently to external forces and stresses, such as
gravity, changes in terrain, and carrying loads, as well as the internal forces exerted by
other muscles.

Dynamic stability is best achieved through training in functionally practical positions that mimic activities or movements in one’s particular sport, or in life as a whole. With this in mind, one can conclude that most core training that is done while sitting or lying down and limiting pelvic movement has little functional value. Medicine balls, balance boards and stability balls are great tools for core training and should be integrated into every program. Core exercises should include strengthening, as well as challenges such as standing one-legged and/or two-legged on stable and unstable surfaces, reacting to external forces such as a partner’s light push or the catching and throwing of a medicine ball, and moving the joints of the body through all planes of motion.

The goal of functional core training is to develop in the core a system of efficient
automatic responses to work as a stable base from which to generate optimal force and
motion.

Postural Distortion and Biomechanical Dysfunction
Consider how the chronic shortening of just one muscle, which happens to be a core
muscle, can impede performance and cause imbalances that lead to injuries. The rectus abdominis is a good example of an over worked muscle. As this muscle is overworked, the other core muscles are often ignored. Crunches, leg raises and exercises using abdominal machines all work only in the sagital plane, therefore limiting “benefit”
to muscles that produce hip and trunk flexion. (Note that repetitive trunk flexion places
increased injury-causing stress on the intervertebral discs of the lumbar spine). It is
imperative to train the core in a multi-planar fashion, especially the transverse plane, in
order to create stabilization in the trunk, and in effect more optimal posture, strength and motion in the entire body. The following is a common example of the result of
overworking the rectus abdominis. A tight rectus abdominis, when creating tension, or pull, on its upper and lower attachments, including the anterior pelvis, anterior ribs and inferior sternum, produces a flexion force in the trunk. This has consequences beyond the immediate structures affected.

These consequences include a chain of effects that begin with shortening and tightening
of the pectoral muscles. These muscles will exert an inferior tension on the clavicle,
superior ribs, and the anterior scapula and will assist in internally rotating the humerus.
The force of gravity also contributes to the internal rotation of the glenohumeral, or
shoulder joint, as the trunk flexes forward. Internal rotation of the humerus tensions and lengthens the external rotators of the shoulder which in combination with the tension exerted on the anterior scapula by the pecs, will bring the scapula into protraction, lengthening and weakening the middle and lower trapezius, and rhomboid muscles. (Note that a tight latissimus dorsi can also be a primary contributor to internal rotation of the humerus.) The internally rotated humerus and protracted scapula will place the rotator cuff muscles at a biomechanical disadvantage in dynamically stabilizing the glenohumeral joint. The cuff will not function effectively, increasing the risk of injury. The reaction of the cervical spine is two-fold. The lower segments of the cervical spine follow the forward and downward movement of the trunk, and they themselves flex, causing lengthening and weakening of the deep cervical flexor muscles. (This can also stress the outer layer of the intervertebral discs, which over time, may lead to injury.) Naturally, if the lower cervical spine flexes forward, the head will follow, and if this force is not countered, gravity will cause the head to fall forward. In order to prevent this from happening, tension will develop in the cervical extensors, including the upper trapezius, splenius, semispinalis, spinalis and sub-occipital groups, which attach to the base of the skull. The upper cervical segments including the base of the skull are extended, shortening the sub-occiptal muscles. This extension will allow the skull to remain somewhat level as it rests on the atlas, or the uppermost cervical vertebrae. The over-working of the upper trapezius muscle and lengthening and weakening of the middle and lower trapezius and the rhomboids will also contribute to early elevation of the scapula with shoulder motion. This will worsen the position of the glenohumeral joint and will further stress the rotator cuff. This example has been limited to the rectus abdominis. It is important to understand that single muscles are rarely the isolated culprits in postural distortions and biomechanical dysfunction. (An exception would be an acute specific muscle injury that has not healed correctly and has caused compensatory overloading in other areas.) Because muscles act synergistically and as agonists and antagonists, there is usually more than one contributor. There are also connections between muscles through tough fascial connective tissue, which help to transmit forces between tissues. These cases of dysfunction can be rooted in other parts of the body, as the musculoskeletal system functions as a whole. Not only will these faulty positions and compensatory biomechanics cause an athlete to move inefficiently. Over time they may lead to degenerative processes in the soft tissues and joints that will lead to further injury and impairment.
The neurological system also adapts to these changes, applying muscle memory, as it
controls the musculature. Training this system is essential in developing healthy
neurological pathways and muscle firing patterns. This is achieved through the methods
mentioned above – using medicine balls, balance boards and stability balls and
challenging the neuromuscular system. Any of the muscles mentioned above may be the source of dysfunctional patterns, but it will most likely be a combination of them that will be the cause. It is important to follow the entire kinetic chain when assessing and treating these conditions.
Cycling
Most cyclists focus on their hamstrings, quadriceps and gluteal muscles, and forget about
the importance of core stability. Consider how many hours the cyclist spends bent over in a flexed position on the aerobars, with no rotational or side bending motions. A strong core is needed to counterbalance these forces. With a focus on the core, a cyclist can generate more power and can sustain a higher level of intensity for longer periods. A stronger core also means less stress on the primary muscle movers and a delay in the build up of lactic acid. Even minor changes such as brake position can affect core stability. If the brake handle position is too low, the cyclist is forced to reach too far forward with their forearms. This reaching position forces the cyclist to raise their head forcing the pelvic girdle posterior. This position can cause a restriction in several key
muscles in the core, thus reducing performance. The ideal position for the forearms is to have the elbows bent and the forearms flattened out. In this position, the cyclist head drops into a more comfortable aerodynamic position, and the pelvis tilts forward. In this
position, the cyclist is able to use all the core muscles with improved efficiency.

Running
Now consider how a shortened rectus abdominis affects a tri-athletes performance during running. Although opinions about the ‘ideal running form’ vary greatly, most authorities will agree that the less energy that is expended, the more effective and efficient the running style will be.

When performing a biomechanical analysis, it is very common to see numerous
imbalances of which the athlete is completely unaware. By video taping an athlete during activity the practitioner can show and explain what is happening then correct it.
When analyzing a runner, some of the most common biomechanical faults looked
for are:
• Over-pronation (rolling in as arches collapse) in the feet – this can cause a series
of biomechanical imbalances from the foot up to the cervical spine.
• Excessive hip adduction – due to tight hip adductors and can cause increased load
in the lateral tissues such as the iliotibial band, tensor fascia lata and gluteus
medius.
• Lack of trunk rotation – due to restrictions in trunk rotators or shoulder extensors.

This can cause overload in the hip musculature, spinal joints, and other trunk
rotators.
• Lack of hip extension – caused by tight hip flexors restricting extension, and weak
gluteal muscles. This causes the extensors and rotators of the lumbar spine to
become overloaded in order to compensate for the lack of hip extension.
• Lack of shoulder extension – caused by restrictions in anterior shoulder muscles
or poor trunk rotation.

Educating yourself on how the core works will help to avoid injury, improve your athletic performance and increase training efficiency. Far too often people read the most popular book or take advice from someone who they think knows more than they do.
This cookie cutter approach does not take into account the persons specific needs and
goals. In my opinion anyone who participates in any sport or activity should have a
professional evaluate them for any weaknesses or poor movement patterns. I can’t tell
you how many patients have told me “It just started hurting I never did anything to it”. A
simple evaluation can save you from repetitive stress injuries.
Written by
Dr. Robert Inesta
Charles DeFrancesco
http://www.fitandfunctional.com

References:
1. McGill, S, Ultimate Back Fitness and Performance: Ontario. Wabuno Publishers. 2004.
2. Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function. 4th ed. Philadelphia: Lippincott Williams
and Wilkins. 1993.
3. Runnersworld.com

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How To Evaluate A Personal Trainer

When seeking a personal trainer, it is necessary for the public to educate themselves on how to interview the right person for the job. While there are many certified personal trainers out there, only a select few of them are truly competent. You should always ask and verify where their certification is from and what their credentials are. There are different types and levels of training certifications, only a handful of them are good. Most tests are multiple choice questions that are moderately difficult and some others require some essay or program design but are usually easy. A few of the certifications allow the trainer to take the test at home unsupervised. You should also not be fooled by a college degree. There are colleges out there teaching old cookie cutter information. More times than not these college programs do not create an environment that requires the trainer to demonstrate text book principles in an actual real life situation. What you need to look at is the continuing education courses the trainers have taken and how often they attend seminars. It is the seminars and practical workshops that make a trainer more knowledgeable.

It is difficult for the public to decipher a good trainer from a bad one. In many cases, even the worst trainer knows more about physical fitness than the average person. Below are some fundamental questions that should be asked before making your choice. They are designed to save you from choosing a bad apple.

Questions:

  • What certifications or degrees do they hold?
  • Do they attend workshops and seminars? Which ones?
  • How long have they been a trainer and where have they worked?
  • How thorough was your evaluation? Did they do a medical history and test flexibility, balance, core strength, proprioception, muscle strength and endurance?
  • Are they familiar with functional training (training according to daily activities or a specific goal)?
  • Have they explained the importance of flexibility?
  • Do they stress how important it is to properly brace the core and preserve the lumbar spine?
  • Do they know what P.N.F(Proprioceptive Neuromuscular Facilitation) stretching is?
  • Have they explained that function is more important than vanity?
  • Can they explain what they are going to do in the routine and how it benefits you?
  • Did they explain that cardio alone is an inefficient workout?
  • Do they have a basic understanding of nutrition?

If you already have a trainer you can evaluate them:

  • Does your trainer understand that a core routine is not a series of floor exercises?
  • Do they understand current research that proves traditional sit ups, leg raises and many of the common exercises that flex the spine can actually be harmful even for healthy people?
  • Are you doing more free weights and medicine balls than machines?
  • Do they ever take notes?
  • Are you being properly warmed up at the beginning and being stretched at the end?
  • Does your trainer change the routine periodically?
  • Does you trainer incorporate balance boards, swiss balls, single leg exercises and other challenged environments?
  • When training the core (midsection) does your trainer explain how important it is to do dynamic multiplantar movements as well as isometric exercises and the importance of low back exercises?
  • Does your trainer target weak areas?
  • If you feel pain in places that you should not like your knees, low back and neck does your trainer change or modify the exercise to a pain free range?
  • Do you truly understand what you are doing while you train?
  • Are you really getting results?
  • Do you do more back exercises than chest and abs?
  • Are you setting goals?
  • Are you talking about you and your needs?
  • Are you getting undivided attention?

If you answered no to any of these questions, then your trainer may be lacking key knowledge that is necessary for you to reach your fitness goals. More importantly, your trainer may be doing you more harm than good. It is simple for a trainer to deceive an unsuspecting client into believing they are knowledgeable. This is due to the general public not being educated about the fitness industry and trusting a gym will provide them with a competent trainer. In most cases, gyms are not always concerned with the quality of the people they are hiring. If a gym thinks a trainer possesses strong sales skills, they will hire them as long as they have some type of certification. A qualified fitness professional will understand at the very least everything listed above. Remember when hiring a trainer, to make sure they are a full time professional. Part-time does not cut it when it comes to your health. Would you go to a part-time Medical Doctor?

Be aware of trainers that are charging low rates. The going rate for a high level trainer in a gym like Equinox or New York Sports Club is around $85-$90/hr. Even their entry level trainers are $65-$70/hr and they are newly certified if that and have little or no experience. There are other gyms that charge way more than the rates just mentioned. In homes for a high level professional trainer are around $125 and can be more. You may be able to get a really good trainer for $90-$100 depending on travel time, trainers charging much less are either just starting out, not that good or a close friend. You get what you pay for. It is important you research the trainers’ certification and check to make sure they are currently certified by multiple accredited agencies.

It is important to understand that certifications and degrees are important but do not mean everything. You want to know about their clinical experience and the workshops they attend. Ask who they work with and get at least three references to call from current clients. See if they work with any local doctors, all the good trainers work with at least one doctor. Also see if they have written any articles. A bad trainer can hurt you, do your research and make sure they are experienced.

Charles DeFrancesco

www.fitandfunctional.com

 

Rest for Better Results

Most people know that exercise and physical activity are beneficial to their health. But how much is too much? Many fail to take any time off from exercising and therefore they are not allowing their bodies any time for recovery. Too much exercise can be just as dangerous as not exercising at all! It is important to remember that exercise can prevent injuries, but it can also cause them! Rest and recovery is an essential part of any exercise program. In order to train more effectively, you need a recovery plan. This will have a significant impact on your fitness gains and sports performance.

During a workout, muscle fibers are damaged. When resistance is placed on a muscle through running, weight training, etc, the muscle develops tiny microscopic tears, which activate muscle building. The tears cause the formation of new muscle protein strands which increase the strength and size of the muscle. Additionally, the tears start the process of healing by creating new cells to heal the damaged tissue and relieve any soreness. This alters the homeostasis in the body, which creates stress. The greater the tear in the muscle, the more likely it is to have muscle soreness and an altered homeostatic state.

After exercise, recovery is essential to muscle and tissue repair and strength building. Muscles are repaired and rebuilt only during the recovery period. Without proper recovery, especially after a workout that is too strenuous or prolonged, the body stays in the altered homeostatic state for longer than it should, which may lead to injuries. A muscle needs anywhere from 24 to 48 hours to repair and rebuild, and working it again too soon leads to tissue breakdown instead of building.

Recovery should take place both during and after workouts. It is important to rest between weight sets or cardiovascular intervals as well as between workouts in the same week. For weight training programs, never work the same muscles groups two days in a row. Rest helps replenish your energy stores, which get depleted during workouts. People often don’t find the time to rest and relax, but it is one of the easiest things to do to promote recovery and repair. One easy way to recover faster is to design a smart workout routine in the first place. You will limit your progress and undermine your recovery with excessive exercise, heavy training at every session or a lack of rest days.

Stretching is another way to aid in the recovery process. It prevents the muscles from becoming knotted and helps improve flexibility. Additionally, it is important to remain hydrated to aid in muscle recovery and to keep heart rate and blood pressure stable. Water supports every metabolic function in your body and must replaced when lost through sweat. A lot of fluid can be lost during strenuous workouts and it needs to be replaced both during and after exercise. Endurance athletes who sweat for hours and lose large amounts of water especially need to replace their fluids for optimal performance and recovery.

Sleep is also extremely important. It is imperative to get between 7-9 hours of sleep per night to ensure growth hormones and cortisol are produced and balanced. GH is largely responsible for tissue growth and repair. Sleep also enhances protein synthesis, boosts immune function, and helps relax the nervous system. Optimal sleep is essential for anyone who exercises regularly.

The most important thing that you can do to improve fitness, prevent injury and speed up recovery is to listen to your body. If you feel tired or sore, take a break or rest. Your body will tell you what it needs if you pay attention to it, rather than ignore the warning signs. The best way to ensure you are training and resting optimally is to consult with a personal trainer to design an effective exercise program and help prevent you from overtraining.

Why Does Everything Hurt?

As we get older,  it seems as if we discover a new ache or a pain in our body every day that never bothered us before.  Many of us are plagued by chronic pain and we often do not know how to alleviate it. Part of the issue is that we are constantly doing things during the day which exacerbate our symptoms and we don’t even realize it. Additionally, as we get older, we often forget that our bodies are not quite as resilient; after a week of sedentary behavior, we will hit the gym or play sports full-force on the weekend which lead to us injuring ourselves.

One of the most common complaints is lower back pain. This often results from sitting for too long and from sitting incorrectly. Sometimes lower back pain can be a result of a disc injury or arthritis, but for most of us, it is just the result of not moving enough. First, position your desk so you are sitting with proper posture. It is also important to get up for frequent breaks and to stretch and to move around. Outside the office, lower back pain can be exacerbated while exercising. It is imperative to make sure you are not using your lower back during weight lifting or other exercises. Instead, focus on activating the hips and glutes to protect your lower back during your workouts. Additionally, strengthen your core muscles to stabilize your trunk, which will also decrease the load on your back.

Another common malady is neck pain and stiffness. This can result from sitting improperly, walking incorrectly, driving with your head jutting forward, or from sleeping with you neck turned.  Also, stress and tension play a significant role in neck pain and stiffness as well.  Neck pain can increase outside during exercise as well. Often, while performing exercises, we lead with our chin and put extra pressure and strain on our necks without realizing it. Proper form and activation is key to keep the neck pain free. Meditation, stretching and other stress relief techniques are also helpful for decreasing neck pain.

Other common ailments are knee pain, joint pains, muscle strains, and carpal tunnel syndrome. If symptoms are severe and you do not see improvement, you should visit a doctor to rule out a major injury. Assuming there is no disc issue or major tear, sprain or break, many of these problems are caused by our activities of daily living and improper form during therapeutic and strength exercises. The way we sit, walk, talk on the phone, sleep, and exercise all impact how our body moves and feels. Form during exercise is extremely important. Many clients don’t realize their positioning is off and might be affecting their mobility, flexibility, cardio endurance, and strength.

Most people will feel better by engaging in a routine that includes stretching to improve join mobility. It is helpful to use tools like a foam roller or baseball to alleviate knots and to help stretching. Secondly, weight loss often helps with daily aches and pains. Extra weight can put pressure on the joints and cause pain and discomfort. A healthy diet and cardiovascular exercise can help decrease weight and issues with pain. Lastly, strength training, especially core training, helps decrease muscle pain because the muscles stabilize the joints.

It seems like the answer to feeling better and decreasing pain is to engage in physical activity with proper form. Always make your body a priority! If necessary, meet with a personal trainer to ensure you are performing exercises correctly and to make sure you are utilizing exercises to help with your individual issues.

Circuit Training for a New You

Circuit training is a type of interval training that incorporates a series of strength and/or cardio exercises with little or no rest between sets. It increases your heart rate while simultaneously strengthening your muscles using a combination of resistance training and high-intensity aerobics. This combination of weight training and cardiovascular work makes circuit training a valuable way to exercise.

One “circuit” consists of a set of prescribed exercises performed in order with little rest between each exercise. The circuit is then repeated one to several times. Many different exercise stations can be incorporated into circuit training. Usually, stations alternate between muscle groups so little rest is needed. To increase cardiovascular endurance in circuit training, brief bouts of high intensity aerobic exercise, like jumping rope, can be incorporated. The exerciser gains muscle through the resistance training, while she/he simultaneously increases cardiovascular endurance as a slightly elevated heart rate is maintained throughout the entire program.

There are many advantages to circuit training. First, it is fun and brings change and excitement to routine workouts. There are endless numbers of exercises you can add to each circuit to change it up and make it more interesting. This type of workout also burns more calories than doing cardio alone as you maintain an elevated heart rate throughout the whole exercise routine. Additionally, circuit training is a practical solution for those with time constraints as it allows you to combine cardio and muscular fitness together in one session. Further, you can set up as many stations and exercises as you want, to either shorten or lengthen your workout.  Another benefit to circuit training is that it is portable and convenient. It can be done at home, outside, or in the gym with minimal equipment. You can do use bodyweight to perform pushups, planks and lunges for strengthening and use stairs and jump ropes for cardio stations anywhere and at any time.

If you are looking for a new routine to help you lose weight and increase muscle mass, circuit training may help you achieve your goals. Circuit training is fun and is a great way to challenge your body, whether you are just beginning an exercise program or are a seasoned athlete.

 

HIIT It Up!

High Intensity Interval Training, or HIIT, workouts are a phenomenon that is sweeping the nation. What is it, and is it safe? Read on!

HIIT is a cardio session that consists of short, high intensity bursts. HIIT can be an incredibly effective way to work out to see the body composition and fitness results that you want, but you need to do it right. Numerous studies have shown that working your hardest is key when it comes to boosting endurance, increasing metabolism, regulating insulin levels, and losing body fat. HIIT routines that involve bodyweight work (e.g. push-ups) or added weight, such as kettlebells, medicine balls, or dumbbells, will tone your muscles while spiking your heart rate. All types of exercise will ultimately help you burn fat by burning calories, but the more intense the exercise, the more fat you will burn. As a result, it is a very effective way of helping people get the “shredded” look.

A true HIIT workout will involve pushing yourself to the max during each set, which should never exceed 90 seconds. These workouts are typically quick and convenient since they are such high intensity; they usually are 30 minutes or less. They can also be done virtually anywhere, with little to no equipment. The only stipulation is that you should rest in between sets. This may not be the first thing that comes to mind with such an intense workout, however, it is imperative. Recovery is essential so that the body works to adapt from the anaerobic (high-intensity) period to the low-intensity recovery period in HIIT. This workload results in high caloric expenditure, which can lead to fat loss.

That fat loss also comes from an increase in metabolism, which is a benefit to any high intensity workout. Research shows that this is due to an increase in post-exercise exercise oxygen consumption, or EPOC. EPOC speeds up your metabolic rate and can result in a metabolic boost for up to 48 hours after a complete HIIT routine! The high intensity cardio raises your metabolic rate to the point where you continue to burn calories even after the session ends—in some cases 15% more.

If weight loss is your ultimate goal, the old saying that you can’t out-train a bad diet is true…even if your workouts are super demanding. HIIT isn’t an excuse to neglect your diet, so keep it clean! By incorporating HIIT training into your exercise regimen and keep your diet in check, you’ll start to see some amazing results!

If you’re looking for a safe, but effective HIIT workout check this one out: https://www.youtube.com/watch?v=G43UTJoa6gw&t=2s

Living With Back Pain

Back pain can be a debilitating and life altering problem for many Americans. In fact, according to the Mayo Clinic, 80% of Americans will experience some type of back pain in their lifetime. Most of the time back pain is an uncomfortable annoyance, although in some cases, it may be serious and require medical attention. Pain is usually associated with how our bones, muscles, ligaments and tendons work together.

While back pain can occur at any age, it more commonly effects those between 35-55 years old. Other risk factors for back pain include a sedentary lifestyle, stress, anxiety, depression, smoking, pregnancy, sleep disorders, obesity, strenuous physical activity, and strenuous exercise, especially if exercises are not performed correctly. There are many possible causes of back pain, but the most common is due to strained muscles, strained ligaments, and muscle spasms due to heavy lifting, improper lifting form, or abrupt or awkward movements. For most of the population, everyday activities, poor posture or a bad mattress are frequently responsible for back pain.  This may be the result of sitting or standing too long, driving for long periods, sitting in a hunched position, over-stretching, bending awkwardly, or pushing/pulling/carrying items. Back problems may also be due to structural problems, such as ruptured disks, bulging disks, sciatica, arthritis, scoliosis, or osteoporosis. More seriously, pain may sometimes be due to cancer of the spine, spinal infections, bladder or kidney infections, and shingles, so contact a doctor if your pain is accompanied by fever, inflammation, numbness, pain radiating down the legs, or incontinence.

In most cases, back pain can be treated at home and will not need imaging scans or treatment by a physician, though surgery may be indicated for those with structural issues.  For pain, doctors usually suggest over the counter NSAIDS, codeine, and cortisone injections. To alleviate pain, complementary therapies such as acupuncture, shiatsu, chiropractic manipulation, and osteopathy are also sometimes recommended. TENS therapy (transcutaneous electrical nerve stimulation) may also be utilized; it emits small electric pulses through electrodes on the skin.

Wouldn’t it be great if we could avoid back pain altogether?  Well, there are steps you can take to prevent the onset of back pain. First, adopt healthy behaviors such as smoking cessation and maintaining a normal body weight. Additionally, it is important to engage in regular exercise to build strength and flexibility. Physical activity also helps to prevent obesity, which, on its own, is a risk factor for back pain. It is also important to be aware of your posture both when sitting and standing and to correct poor posture as often as possible. When standing, keep a neutral pelvis with straight legs, stand upright, and keep your head forward. While sitting, keep your feet flat on the floor and make sure your knees and hips are level. Your arms should be at right angles if you are using a keyboard, and your lower back should be supported. Next, be careful when lifting. Always bend your knees, never twist and lift, and push rather than pull objects!  Finally, make sure you have a supportive mattress so that your spine can remain straight.

If you follow these suggestions, you can help reduce the onset of back pain and also alleviate some of your discomfort if back pain does occur. Be as active as possible in a safe and effective way, and you can keep your body moving pain free as long as possible!