Life on the ranch

OK, so it's been a while. But hey, you've been working on your back, and making splendid progress, right? I wanted to add some photos for you to enjoy so that you don't get the feeling that's it's all hard work and no play.

This is the Dave Costello training stables. Dave is a World Champion horse trainer, and a world class judge for the rodeo event called Cutting. He's recently been inducted into the National Cutting Horse Association Hall of Fame!

His stables are in Paso Robles, Ca. (3 hours from San Francisco). His fiance is also a world class cutter, and she also happens to be my sister! The both of them took my daughter and taught her to ride a cutting horse in just a few short weekends and a spring break, entered her in some competitions, and she ended up winning one! Her winnings are considered scholarship money for college (or some form of higher education), and can only be used as such. What a great idea.

Also, please enjoy the photo of the Big Game aftermath (Cal 34, Stanford 28).

Cheers!

Newsletter: Back Pain, part 5

Now that your flexibility is getting better, you'll probably notice that some of the back pain has dissipated.

Time for rehabilitative exercises, and ones you should keep doing even after your pain has gone away. Note: a traction bench is usually a good purchase. They run about $250 -$275, and can be found at Perform Better or Power Systems websites.
OK, now it's time to work. Your number one priority is safety -more specifically, do not do anything that hurts your back. One thing you will definitely learn while getting back into exercising is proper mechanics, because your back will tell you if you are doing it right or wrong. Things you used to do easily, and didn't think much about, suddenly get a lot of your attention because you will realize that the way you were performing some movements were actually WRONG! If you want to turn back pain into an educational experience (and you should), you will use that back as a personal trainer.
1-Core: one muscle group that should be attacked is the glutes. Yes, you heard me - the glutes. Typically, when the back goes out, it's because you were using it too much to lift your body up, pick things up, etc. The muscle group that's SUPPOSED to perform those movements are the gluteals (maximus and minimus). Why is it under my core list? Because it IS a core muscle. Forgotten, and your back does the work or supporting your upper body against gravity at all angles, in all positions. Not a good thing. The back muscles were designed to be supporters, not movers.
To get to your glutes, you need to do any exercise where you can get your knees above your hips : lunges, step ups, sumo squats, and overhead squats are my exercises of choice. No machines, either. Free body motions, very light weight at most, and keep your weight on your heels, not your toes or the balls of your feet. You want your core muscles above your hips working to support your spine while you exercise your glutes. Perform motions slowly, and keep a natural spine position - no arching the back.
2- Core: Lower abs. These are the abs that round your lower back. I like "knee curls" where you lie on your back with your hands under your butt (letting your hips and lower back 'fall' behind the hands), and pull your knees to your chest, keeping knees bent as much as possible(i.e. heels to hamstrings). Pull your knees up until your hips roll off your hands, then roll back down and touch your toes to the ground, but do not rest your feet on the ground - just tap the ground with your toes and start the movement again.
3- Core: Lower abs. If at the gym, use the ab sleeves and perform the same knee raising motion as in the knee curls. The thighs have to come up to an above parallel position, or stop the exercise. This is a great exercise because you get both lower ab work and decompression of the spine in the same movement.
4- Core: Lower and upper abs. Lie on your back, putting hands behind the head. Bend knees, then lift legs straight up over your hips and hold them there. Then lift your head and shoulders up and hold them there(keeping your elbows out). You have your legs straight up, and your shoulders and head up. From this position, scissor kick your legs so that your feet separate only 1 foot in the beginning. When you get stronger, you will be lowering one leg all the way to the ground while the other leg is vertical.
Do these exercises to fatigue, but not failure. Each ab exercise should be done so that a total of 50-60 reps are performed. Pick two glute exercises for each workout, and perform a total of 60 reps (usually in 3 sets).
Do your stretches, and you're done. We will add more exercises once you perfect these.

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Newsletter: Back Pain, part 4

The decompression exercise seems to help a bit, even more than you thought it might. You want to accelerate the healing (i.e. eliminate pain) now. It's time to begin gentle stretching moves. You'll want to tie this into the decompression exercise as well, doing the stretches after the decompression.
Stretch #1 - lay prone (on your back), and pull one knee to your chest, holding the knee with both hands. This is a very basic hip/lower back stretch. Hold this stretch until you feel the tension in your back subside. Why do I say this? You will notice that the typical 15 -30 second hold you hear about so often does not apply to you because in that time period, you will notice that your back is still tense. Think yoga here. Slowly pull the knee as far to the chest as you can, and try to relax your lower back as much as possible. Wait until you feel it "give" before you end the stretch. Repeat with the other leg. You start this stretch in that sit-up position you had for the decompression exercise. When you're ready to advance the stretch, just extend one leg out while you're pulling the other knee to the chest.
Stretch #2 - lay prone, and pull both knees to the chest. The goal here is to get the hips off the ground. This will be difficult in the beginning because the lower back muscles won't want to release enough to allow that to happen. Keep working at it. The same rule applies here as to the length of time you hold the stretch.
These two stretches are the ones you will get if you go to physical therapy. You can do these on your own very easily. Get in and out of the stretch positions the same way I told you to get in and out of the decompression exercise.
Stretch #3 - More advanced. Sit on something soft, like a pillow (Bosu, if you're in the gym), and spread your legs as wide as you can. Reach forward as far as possible, making sure to support yourself with your hands by putting them on the ground. This stretch will focus on both your hamstrings and your lower back (a good combo since both tend to cause back pain when tight). Hold the stretch as long as you want, sticking to the rule on length of time for holding the stretch. By the time you're able to do this stretch, your lower back muscles will release, but they will be tender, so returning to your starting position must be done slowly. Your muscles will thank you for it. After going down the middle of your legs with this stretch, try reaching out over each leg, putting one hand on either side of that leg. Move to the other leg, and then finish back in the middle. Do not fight this stretch! If you can't reach the ground with your hands, then it is too soon to do it. You may try this stretch with assistance from another person, but make sure that person knows what he or she is doing!
Stretch #4 - More advanced. Lie prone, pulling both knees to your chest. Kick one leg out straight and rest it on the ground, while holding other knee to chest. If you have your left knee up, drop your left hand off that knee and lay it on the ground, straight out, palm on the floor. Use your right hand to pull your left knee across your body as far as possible. The goal is to get the knee to the ground. Start by trying to get your foot to the ground. Breathe out and relax as much as possible as you rotate over. You will take somewhat more shallow breaths as you rotate further, but keep focusing on relaxing your lower back with each exhale. Do not be afraid if you feel a "pop" in your lower spine. That's just your verterbral joints releasing from their compressed state. This stretch should not be attempted until you can roll your hips off the ground in stretch #2. Important: After you stretch to one side, pull both knees to the chest to realign your spine before stretching the other side.
Stretch #5 - More advanced. Sitting in a chair, or on a bench, cross one leg over the other so that only the ankle of one leg is resting just above the knee of the other leg. Sit straight (neutral spine), and push down the knee of the crossed leg so that it is parallel to the ground. If you can do this, then while holding that position, lean forward as far as possible keeping the neutral spine (do not round it yet). Hold this position for about 1 minute. Then, relax your spine as much as possible, rounding it, and reach over the crossed leg with both hands like your trying to tie your shoelace on the shoe of the supporting foot. Repeat on the other side. Do this stretch twice each side. This stretch can be done as often as you'd like, and I highly recommend it!

Newsletter: Back pain, part 3

Click on the link below to get some helpful information and client reviews about back pain and options for treatment. It also includes videos, and pictures of what spinal disc herniations look like through an MRI (magnetic resonant imaging).
Decompression again, as I stated earlier, is the first order of business. This doesn't mean hanging upside down right away, as even getting to a position where you can hang upside down may be too painful. No, it's best to start with focused decompression - localizing just one part of the body, making it easier to get in and out of the position. Use a foam roller for this, or even a couple pillows. Lay on your back, delicately bring your knees up, keeping your feet on the ground, so you look like you're in a sit-up position. Lift your butt up off the ground being careful not to arch your back. Slide the pillows, or foam roller, under your butt just below the pelvic crest. Gently relax on to the pillows or roller. Let your lower back relax and "fall" into the space provided between the pillows or roller, and your shoulders. Stay in this position until you feel most of the pain subside (it may even go away completely!). Repeat this drill as often as you'd like (I did it in the morning, at lunch during work, and at night before bed). When you're done, slide the roller or pillows out to one side, and roll to your side, bringing your knees up toward your chest. Relax for a second in this position (which should be a sleeping position for you during this time). Then, to get up, rotate your chest to the ground, and use your arms to press you up on to your hands and knees. Bring a foot forward, put your hands on that knee, and press up to a standing position. Easier said than done, I know, but you'll get the hang of it. Eventually, you'll want to get up that way all the time, healthy back or not!

http://www.wevegotyourback.org/p315.html

Newsletter: Back pain, part 2

Diagnosis. All right, what happened? Was it a sharp wincing type of pain that came from one side of the back, or was it a headache type of pain (more dull than sharp, but still debilitating) that seemed to emanate from inside your spine? It's very important to think about this, because if you do see a doctor, you'll need to describe in detail what happened, what you felt, and what you did about it. More often than not, the sharp pain from either side of the spine means muscle strain (slight tearing of the muscle), followed by a cramping of that muscle - it's a protective mechanism built into your body that you have little control over. Believe it or not, this is the lesser of the two evils of back pain. This problem is much easier to treat. Muscle -or soft tissue - injury will require less recovery time, in general.
Structural injury is a more serious problem. You're probably dealing with a bulging -or herniated- disc. What's the difference? A bulging disc is just that -bulging out from the space it occupies between the two vertebrae above and below it. It means it's compressed, and the soft nucleus pulposus center has pushed out either through a tear in the connective tissue surrounding the disc, or pushing the connective tissue itself out. The bulge can either directly impinge on a spinal nerve, or cause a narrowing of the space where the spinal nerve comes out (foramen)between the two vertebrae, and the bones of the vertebrae (facets) are pinching the nerve.
Secondly, a question to ask yourself is this: "did I experience any discomfort or pain down either of my legs prior to the pain hitting me?" If so, you may have sciatica, which is a pinching of the sciatic nerve that runs down the back of both legs, and is fed by the spinal nerves in the lower lumbar area as well as the sacral area. Pinching of this nerve, and the resulting pain down the legs, lets you know that you have a bulging disc, and that the problem is a structural one. Muscle cramping around the sciatic nerve will most often ensue, so attacking the soft tissue problem first will help alleviate some of the discomfort of sciatica until you can treat the structural one.
Decompression is the first order of business for the structural problem. Rest and Ice is the first order of business for the soft tissue problem. (Actually, Rest and Ice will help with the structural problem as well, but only initially. You will still have the structural problem after the rest and ice, and that needs to be addressed.)
Next: treatment options

Newsletter: Back pain, part 1

This will be a multi-part newsletter regarding back pain. It will include injury complexes, diagnosing, the experience of back pain (back pain existentialism), back pain and the physician response, multiple treatment options, physical therapy, and finally, living with back pain and the very practical means you can follow to decrease -or even eliminate- the pain completely! But first:
One morning, you get up out of bed, a little tight but nothing you haven't experienced before, and head to the bathroom. On the way you decide to put your slippers on, but seem to be struggling with one of them, so you bend over to straighten it out. Then it hits you. Wham - an incredible shock wave of searing pain emanating from your lower back and heading down your legs. You cannot move. Even the thought of moving causes more searing pain. You wait for it to subside, and in the meantime, while bent over, you ask yourself,"What did I do to deserve this? How did this happen? I went running, but that was over 4 days ago, and I haven't done anything since!" The pain starts to wane a bit, and you chance a move - one that will get stress off your back. You head to the floor, knees first, then hands. You think you have made it, crouched on all fours on the floor. You figure that if you can at least hold this position, maybe the pain will go away completely because it seems to be getting better (and you remember from some book, infomercial, trainer friend - can't remember the source specifically while concentrating on breathing through the pain - that getting to the floor, flat on your back, may be the best thing for you). And so you try. You begin to lay down on one side of your body and wham -there it is again! An immobilizing, tear producing, searing pain that feels like someone stuck a knife in your lower back and thenattached electical cables to both your legs and plugged you in. Fortunately, you fall over anyway and there you are, on the floor, on your back. It is here -in this position- that you realize that you are not infallible, that you cannot do everything, and that maybe, just maybe, your way of life -the path you have been following - may be the wrong path. You wonder if you will ever get up again. You wonder...what's next?
Elite athlete, weekend warrior, working professional just trying to get in shape, new mom, and more...all have gone through this experience. Some experiences are a little different than others, some more painful than others, but the tearing of lower back (multifidus, erector spinae, quadratus lumborum) muscles, their ensuing seizing, and the compression of lumbar spinal nerves generally can be traced through this experience.
Why did it happen?
Some sort of stressor had to exist, such as a workout, a bad fall, or long days at the office, coupled with the following:
1) overexertion of lumbar muscles
2) tight hamstrings during a stressful workout that includes long strides (sprinting, stairs, etc.)
3) weak lower abdominals
4) tight, or strained, psoas (hip flexor)
5) tight lower back muscles
6) improper technique when lifting, or bending over
7) weak glutes
8) bad posture when sitting at work
9) loose joints resulting from hormonal changes (new moms)
10) poor eating habits (weakens the body)
11) being overweight
12) high stress levels
13) weak, or injured knees
14) tight hips
15) recent ankle injury
16) Other

I've seen one - and in rare cases, even all - of these triggers lead to back pain. It is inevitable if nothing is done to correct the trigger.
What do you do about it? Diagnosing the problem is the first step to recovery, and that will be the topic of the next newsletter.