Jill Miller, who is the inventor of a program called Yoga Tune Up, recently revealed on her blog about a month ago that she needs a total hip replacement. At the age of 45. Now, she has been absolutely instrumental in helping many, many people discover a modality that can really help irritated tissue and brought it to the main stream. The story, however is what I want to bring your attention to today.
What was telling about her first blog post, which you can find HERE (and I’ll link to the second part HERE) is that she felt nagging pain not only for most of her life but for the past seven years. Until recently she didn’t bother to have it looked at because she was worried about surgery for personal reasons. That’s fine.
This is one of the most respected and knowledgeable (from an anatomy standpoint) body teachers IN THE WORLD and even she ignored her symptoms. We all do it, from your fellow office worker to high level athletes who want to keep competing.
“I’m okay, I just need to stretch.” “I’ll start using my therapy ball.” “I’ll take a couple of weeks off from running and everything will be fine.” And then we go back to doing the same thing that caused the problem in the first place and are suddenly surprised when the issue comes back – and worse.
Just this week another client of mine’s husband after almost a year of pain finally decided to go to the doctor and get checked because his knee wouldn’t stop failing and buckling. My prediction is either a torn ACL or a severely torn meniscus (or both). The problem is that he’s been walking around on it for the better part of a year without any treatment or attention, and likely it’s gotten a lot worse. This might mean that something that could have been helped with therapy before might need surgery now.
I’ve said it before and I’ll say it again:
Your body isn’t stupid.
Pain, collapse, restricted range is a signal that something is wrong.
The sooner you figure it out and fix it the better off long term you will be.
If you have water coming into your basement, you figure out where it is coming from and plug the leak. You don’t sit there and wait for it to subside, clean it up and then wait for it to happen again. Mold sets in. The leak might get bigger. Other things can come into play that make a simple leak a catastrophe. Your body is no different.
When your body is subjected to stress, it responds to it. This can result in either stronger muscles, or deterioration and loss of integrity. A large part of my job is finding out the perfect balance between just enough and too much load, stress or torque on joints. You need to consider your body as a whole and what loads it is being subjected to daily, weekly and annually to really figure this out.
And in case you’re wondering, sitting is a load. Driving is a load. Weight training is a load. Yoga is a load. I remember when I sat through the Yoga Tune Up course (I did not certify because I have no desire to be a yoga instructor) and a room full of body practitioners looked at me like I had two heads when I suggested that yoga poses – especially extreme ones – are still heavy forces through joints. They are, in case you’re wondering. Jill Miller says that herself in her articles. Years ago I wrote a post about why a downward dog is downright dangerous for most people. It’s HERE.
One big fundamental rule I teach my clients is that they should walk out of a workout feeling better – not worse. This means they are far more likely to have had an appropriate level of stimulus and will have a better long-term response. They won’t get worse, they will get better. Isn’t that the whole idea?
The point of this is that nobody is invulnerable to the rules of the body, even people who have spent their whole life practicing something that is supposedly therapeutic. Don’t assume that if you have a problem that things like stretching and pounding yourself with a yoga ball is the answer. It might just make things worse over time. Seek out someone who knows the rules of the body and can identify a proper strategy to bring your body back into balance and stop overloading tissue.
So the next time you work out, try taking a step back. Are you pushing through pain? Have you had a problem for a while and have been ignoring it? Take a really close stock and tell yourself that you should probably get that taken care of before subjecting your body to even more stress.
Because nobody wants a hip replacement at the age of 45. At least I don’t.
Feel free to message me or find me on social media if you have something you would like to identify or a question. Injuries and providing solutions are what I deal with every day.
Finally the finishing touches to my back pain series. This was prompted by the epidemic of back issues that have been posted all over my social media lately. It seems that this winter many people have decided to “throw out” their backs. And this is something that is completely avoidable. The problem lies in that you’ve already likely done it to yourself. Now we have to make sure that it doesn’t happen again.
In July I wrote two articles on back pain. The first one which you can find here was about identifying what and why back pain typically occurs. The second one, which you can find here was about movements you can use when you’re feeling stiff or sore to help provide relief for general stiffness and soreness.
This part is about the exercises. Now, most therapists and trainers would identify that you need “more core strength”. What does that actually mean? Many people will think that yoga, pilates or even just simple crunches will do the trick. As I said in Part Two, the “core” is a very complex thing and can’t be isolated into one or two muscles. You have to strengthen the entire complex, and this stretches from the pelvis all the way up to the shoulders and even down into the legs.
So how do you begin? Well, a good place to start is by working on movements that you have to perform daily anyway.
My number one exercise to develop and improve back strength and resolve symptoms of back pain: The Deadlift.
In fact, if you were only allowed to do one exercise for the rest of your life, this would probably be my first recommendation.
Pretty simple, right? Picking something up and putting it down. This is not actually true. There is a lot of proper technique and intention behind this movement and I strongly suggest you have a competent coach (not your “brother-in-law who lifts”) teach you the movement and all of its’ parts. It includes the ability to squat, hip hinge and also keep your spine engaged throughout the movement, all individual components that you need to be aware of.
The good thing about this exercise is that it can be regressed so that my 103 year gold Grammie can do it, or progressed to an Olympic lifting level. It is very versatile and hits most of the muscles in your body in a very good way. One of my goals with any of my clients (even those with compromised backs) is a good solid deadlift.
My second choice for back strength actually involves the hips more than anything. Strong hips (and you can feel free to think “glutes” here) are essential for spinal integrity. Therefore my number two is: Hip Thrusters.
Now, this can be an uncomfortable position for many so I typically suggest starting this movement on the floor, then progressing to a Swiss Ball for mild loads, then a bench or modified floor position for heavier ones. You also need to make sure that your legs are in the proper position and you can actually hinge at the hips before you can do this properly. Again, please consult a professional coach to help give you the right technique.
Easy regression is an isometric hold in the up position (on the floor or a mat) for 15-20 seconds to start. Focus on pushing through the heels and pretending you’re holding a pencil between your butt cheeks and not letting it go.
Now, we also need a movement that takes place in the frontal plane – which means up and down if you’re standing up. This makes sure that the spine is being trained with forces that it will experience frequently. One way that people frequently hurt their backs is by extending a load over their heads they have no business lifting.
Most people also have very little upper body strength in relation to their lower body or vice versa. Men are horrible at this because they want to have a big upper body and never make their legs strong so their poor spine is like a pipe cleaner balanced with a big rock on top of it – and easily collapsed.
Therefore my next exercise for proper back health is very simple: The Pull-Up.
I realize that most people can’t do one full pull-up properly. Therefore I’ve given you two pictures that show easy ways to do these assisted in a gym or at home. If you need more ideas feel free to email me or google it and you’ll find a few more. I have at home clients do this with a bed sheet and a door frame sitting on the ground.
This movement not only is great for loading your spine in a frontal plane, it also hits those often neglected upper body pulling muscles that don’t get a lot of use. I encourage all of my clients to get to the stage where they can do pull-ups without much assistance. There are also a variety of choices in terms of grips and adjustments to enhance the strength in your shoulders without wrecking them. Please be careful and progress things appropriately.
Oh, and yes there is some debate over whether this is a frontal or sagittal plane movement. I believe it is a frontal plane movement. If you want to debate it, feel free to call me out.
There is a long list of complimentary exercises that I would add to this list. Some of them include:
- Overhead Pressing
- Romanian Deadlifts
- Back Extensions and Reverse Back Extensions
- Loaded Planking with movement
- Lateral Side Flexion
- Loaded Trunk Rotation
- Split Squats
And the list can go on. However, if you want to get started on the path to good spinal strength, these three are your first and best bet towards good spinal strength.
You might also notice that none of these first three exercises are traditional “core” exercises. However, all of them load your spine quite nicely and give you the benefit of adding strength in a bunch of other places as well. This is essential for total body health.
All of these exercises can be progressed and regressed by a competent coach. Always remember that exercise is tailored to the individual, and a good coach will adjust your program based on need and result (and goal).
I’m planning on putting together a proper E-Book on Back Strength coming soon. If you would like a free copy, feel free to subscribe to my site by adding yourself to the list at the side, or follow me on Twitter at @strengthottawa, Instagram at @strengthrehabottawa and on Facebook at Strength Rehabilitation Institute of Ottawa. I’m also always interested in your thoughts and feedback, so feel free to Share this as well on any social media.
Take care of your backs!
The full title of this should be How To Shovel Snow (And Not Hurt Yourself). We just had our first fairly serious snowfall in Ottawa and inevitably this brings on clients starting to shovel large amounts of the white stuff.
This also inevitably brings on back problems, shoulder problems and even knee problems from doing this seemingly simple activity. If I told you to pick up a 20 pound weight, for most of you it isn’t a problem (especially if you work with me). However, if I told you to pick it up, then throw it about five feet beside you while twisting, then repeat that about 200 times you might be a bit sore. This is actually what you do when you’re shoveling snow, it’s just you don’t realize it.
Some simple physics: The further something is away from you the heavier it is on your joints. This is actually an exponential relationship, meaning if something is twice as far away, it is four times the load. So my first basic thing is to have a compact shovel – the shorter handle you can manage the better. However, this is sometimes a trade off for having to bend more, which we will get to in a second. Having the right shovel in terms of size and length can help in the long run.
Tip #1: The place people run into problems most while moving snow is that they tend to pick up a load, then twist and throw it. Twisting under load makes your lower back extremely vulnerable, especially with a flexed spine (ie bent forward). Position seem familiar?
If you can pick up the load and throw it straight in front of you it lowers the impact on your back significantly. Pushing it in front of you also works, using one of those large sled like shovels. It may take some creative positioning but your back will thank you.
Tip #2: People have a dominant side, and feel more comfortable moving with that side. My next tip is to switch sides frequently in order to give one side a rest. You can do this with every 10 shovel loads, every 5 or whatever you like. Make a system and use it. Not only will this help your back, but it will also lower the impact on your shoulders and arms. This usually means you can go for longer if you need to. However, this isn’t always the best way to do things.
Tip #3: If you’re not in fantastic shape and don’t have good cardiovascular health, take frequent breaks – even long ones. The snow isn’t going anywhere (until April) so you have lots of time. Lifting and repetitive movement is hugely anaerobic activity and can get your heart rate to dangerous levels for long periods of time (hence frequent heart attacks). Keep your exertion levels in check. If you need to, stop and take 2 minutes – is your heart rate back to below 60% of your maximum? Then continue. As you work harder, your body will take longer to recover from the exertion and if you find that your heart rate isn’t coming back down even after 5 minutes then stop the activity altogether and come back after a long break. Don’t be a hero just because you want to get the driveway finished. It’s hard work just like any other workout.
Tip #4: To save your shoulders, try to keep your arms bent, especially when you have a loaded shovel and you’re lifting. Having your arms extended puts most of the load directly on your shoulders and they usually aren’t strong enough to support it. Again, imagine if I handed you a 20 pound bar and asked you to hold it straight out in front of you. Your shoulders would think it was about 80 pounds. If you simply bend your arms, and put some force into your biceps and wrists then the load is lessened to the shoulder significantly.
Tip #5: Shovel more frequently if there is a large snowfall. Doing it 2-3 times with a small amount is much better than trying to move 30 centimeters all at once. So many people wait until the snowfall is over and then move a huge amount all at once, rather than moving 1/3 at a time 3 times. Again, in terms of overall volume this will greatly reduce the potential for overload and therefore injury. Better to lift half the amount more often than a larger load and increase risk of hurting yourself.
We here in Ottawa embrace winter (or at least we’re supposed to). Don’t let something as simple as clearing your driveway be the reason you have to rehab a serious back injury or shoulder problem this holiday season.
If you enjoyed this article, please feel free to SHARE it on social media. And, if you have a problem with your back or shoulders you need help with, feel free to contact me at firstname.lastname@example.org or on Twitter @strengthottawa or find me on Facebook here.
As a bonus, here’s my dog Woofie enjoying the snow! Hope you have a great day!
This past weekend I had the privilege of attending a cadaver dissection lab, the first one ever offered to trainers in Ottawa. This was a unique opportunity to see the things that I affect every day stripped right down and actually see inside the joints and muscles and other structures. Incredible for learning even more about how we work from the inside out.
You have over 640 muscles in your body, some estimates go as high as 667 depending on what is classified as a muscle. Every time you move you affect dozens of these. When you can actually move a joint that has been stripped away and see how these muscles pull and stretch and work together, one of the most amazing things to me was how resilient your body is on an ongoing basis.
One example was that there were two different feet from the tibia down. One had one heel basically underneath the tibia and another had the heel slightly offset to the outside. Imagine every foot strike (taking thousands a day) hitting just slightly off center. What would that do to things further up the line? Multiply that by say ten years and you’re talking about 7.3 million steps. Knee cartilage takes the same wear and tear over time, as does the hip and back. And that’s without ever lifting anything or moving quickly.
We take this for granted. Our body is obviously really, really tough but more often than not especially in athletics we think that it will heal and all will be fine. This type of movement and trauma changes it permanently. I saw several examples inside joints where wear and tear that you wouldn’t even know was there existed.
I got to see nerves actually coming out of the spinal cord and how thick they are. There are areas of the body where these nerves are constantly compressed over and over again, even without any type of inflammation. They still hold up for long periods of time without fraying, breaking or even compressing enough to cause an issue. This told me that when you have a problem with a nerve – it’s a serious problem. On the flip side, I got to see the nerves that actually run through the center of the spine and how protected they are, but also how delicate and could be easily destroyed.
There were certain muscles that until I saw how the fibers actually sat and saw the lines I thought functioned in slightly different ways. When you moved them you could also see how the muscles might stretch and align themselves to allow a completely different type of mechanical ability. It also illustrated how many muscles work together to achieve movement, whether it be something as simple as typing on this computer or as complex as lifting something quickly from the floor over your head.
I actually got to see fascia – connective tissue that provides tension for a lot of the body and also creates patterns of contraction that move throughout the body and connect different areas. Many of you probably know Gil Hedley and “The Fuzz Speech”? It’s there. Seriously. I saw it, touched it and even broke it up. Incredible to think that such a thing is really there, but there it was. All over the place. And it was very easily altered.
Now you may not really care about this stuff – but you should. These muscles don’t just help you when you’re exercising. They help you walk, get out of bed, brush your teeth, sit down, stand up and play with your kids. They provide strength for lifting your grocery bags or performing household tasks like gardening and cleaning. It is an incredible thing and very humbling that all of these things just work – on demand – for dozens of years without stopping or really breaking down until the buildup becomes so extreme.
The other big takeaway from a spiritual point of view was actually something I hadn’t considered when I first signed up. All of these cadavers were once people. They had lives and families and experiences that reflected in the way that their bodies presented. A couple of them had joint replacements. A couple of them obviously had trauma or arthritis or something happen to their bodies over a period of time. You really never know when this body that you are walking around in could suddenly either break down or simply pass on. We all are a sum of the experiences that we have, whether it be emotional, mental, or in this case, physical. If there’s one takeaway I can give you, it’s this:
DON’T TAKE YOUR BODY FOR GRANTED
You have a finite amount of everything. Steps, breaths, movements and experiences. Treat your body well because it is truly the vessel that carries you every day from one of these experiences to the next. It will fight off what you do to it, and obviously incredibly well, but eventually it will break down. Stave that off as long as you possibly can and enjoy being able to move, breathe and experience amazing things for decades to come.
If you enjoyed this please feel free to share and like it on social media. My Facebook page is here and you can follow me on Twitter @strengthottawa. You can also check out my web site at http://www.srottawa.com and feel free to contact me if you have any issues you need help with. Treat your body well today!