DAY 229 - Core Strengthening: Close but Not the Whole Story

photo courtesy istolethetv

Core strengthening has been such a hot topic in the fitness world for many years. And no question, there is value to it. But, like most things in the universe, just a little closer look affords us more of what we dearly want.

One definition of core strengthening is “the balanced development of the deep and superficial muscles that stabilize, align, and move the trunk of the body, especially the abdominals and muscles of the back.”

Low back pain may be the most common reason that individuals seek to strengthen their core.

Now, let’s break it down.

There is nothing more “core” to the torso than the digestive tract. Though most advocates of core strengthening are focused on skeletal muscle function, it is critical to understand that the muscles of the back and abdomen are markedly influenced by the function of the digestive tract through neural pathways referred to as viscerosomatic reflexes. When the digestive tract is distressed by food allergies, constipation, antibiotics, imbalanced gut flora, or spinal joint aberrations, muscles of the back and abdomen are negatively affected, and pain can result.

Strength is not all it is cracked up to be. Many remember in their youth, their first exposure to martial arts, and their amazement at seeing larger, stronger opponents thrown to the mat by smaller, weaker individuals who had mastered greater skill. Ultimately, the greatest function in the torso is attained through integration and coordination of all components, visceral and skeletal.

It is often overlooked that during “core strengthening”, at least two other beneficial influences are being affected on the back and torso. While performing strengthening exercises, spinal dynamics are improved as a result of vertebral joints being moved through ranges of motion, and the digestive tract is benefited by contraction and relaxation in the abdomen which improves movement of the contents through the tract.

While some folks exercise the heck out of their abs and back muscles, and have their back pain go away, others will get no relief, and neither group will necessarily be exploring their gut core. I have had the opportunity to evaluate a number of patients who swore that core strengthening had taken care of their back problems. Clearly, for some of them it did reduce or resolve their pain. But it was obvious during physical examination that many had excessively tight back muscles, stiff spinal joints, and a gut that was tender to touch.

My advice to all would be to remember that coordinated, fluid motion trumps strength; and if you want to get to the core of back pain, or any other health problem, don’t forget your gut, it affects everything.

DAY 177 – America is Due for its Annual Chiropractic Check-Up

Dr. Eve Venturi treating Dr. Young

It’s a simple idea; maybe so simple as to be overlooked or misunderstood; but the annual chiropractic check-up is not only a concept whose time should have already come in America, but should have arrived at least 39 years ago.

Chiropractic was founded in America in 1895. In 1972 the US Congress voted to make chiropractic care available under Medicare. Chiropractic was clearly determined to be of value, for at least our elderly, 39 years ago. Recognizing that those under 65 years of age also have spines, and that degenerative diseases don't begin at 65, one might conclude that all American's would be benefited by chiropractic care.

We all know that it is wise to see our dentist each year, and we do so because of 4 factors: 1) we have teeth, 2) teeth  are known to become unhealthy and painful, 3) dentists specialize in treatment of the oral cavity, and 4) preventive care is less expensive and results in better oral health than that achieved by repairing damaged teeth.

The situation with chiropractors (doctors of chiropractic – DC) is a bit more complicated, because while we do specialize in treatment of the spine, we are also licensed as general practitioners, treating virtually all conditions, and being limited only in regard to the use of drugs and surgery. But, for the moment, let us focus on chiropractic expertise in spinal function and spinal health.

It would be reasonable for all Americans to have annual spinal check-ups provided by a spinal health expert; a chiropractor. The same 4 factors that drive the annual dental check-up, drive the need for the annual chiropractic check-up: 1) we have spines, 2) spines are known to become unhealthy and painful, 3) chiropractors specialize in the treatment of the spine, and 4) preventive care is less expensive and results in better spinal health than that achieved by repairing a damaged spine.

It is important to additionally consider that while dental problems can be very serious, their effect on our society, compared to the effect of spinal (back and neck) problems, is minor. Back pain is the second leading cause of lost work time, and was estimated to have cost America $100 billion in 1998.

Do you get at least one spinal check-up per year?

I am suggesting that our culture needs a chiropractic check-up, and a wake up to spinal health.

PS – I know that there are some doctors, other than chiropractors, that can provide excellent spinal evaluation. If you have one, then see her/him at least annually.

DAY 157 - It Came Out of Nowhere

Patient: (with distress) Doctor, I have no idea what caused this back pain. It came out of nowhere.

Doctor: That’s got to be upsetting, to be experiencing pain that seems to have been unprovoked.

Conversations like this are common in my practice. They start out interesting, and become even more so.

Early on, with each patient, I suggest that nothing comes out of nowhere; that there are many happenings that we don’t understand, and influences that we can’t see, but all events are brought about by related phenomena. For a thoughtful doctor, it is usually not difficult to begin to solve the mystery of the surprising back pain.

Given that stress is pervasive, and a known cause of back pain, I always bring it up as a probable contributor. Most of us, through adaptation or mental blocking, keep stress and its effects from our consciousness. Many people don’t imagine that the recent death of their sibling, and the associated feelings, could directly contribute to the initiation of back pain. In our culture, understanding that the chronic stress of a rotten job, an unhappy relationship, or an ill child, could cause back pain, is not common. The tendency is to be surprised when an ongoing input finally causes a sudden and overt change; in this case, pain.

An interesting part of our cultural understanding of the effects of stress, is that we actually do know and appreciate that chronic stress can, and reasonably should cause back pain, in others, but find it difficult to accept that it would be true for us.

We have a tendency to think that one must DO something, like lifting a heavy object, to cause back pain. We are less apt to think about the effects of what we DON'T DO. Patients, confused about the cause of their pain, rarely offer that they have not been going for walks regularly, have not stretched in six months, or have not had a salad in the past week. They never mention the bowel movement that they haven’t had for 3 days.

Further off the American radar as a cause of back pain, is food allergy, even though it may be the most common. Most of us have never heard that eating a food such as dairy products for years, or decades, could chronically provoke ones immune system, causing focal inflammation and tissue damage in muscles and joints, and ultimately pain in the back. Pain caused in this manner may not come out of nowhere, but those who have never even heard that foods can cause back pain, are always blindsided.

Most back pain is caused by long-term, combinations of stress, poor diet, lack of sleep, lack of aerobic exercise, lack of stretching, and food allergies; not from falling down a flight of stairs while moving a grand piano. But without the necessary perspective ... back pain can appear to come out of nowhere.

DAY 72 - Warning: Your Insides Are Connected to Your Outsides

What I am about to tell you is one of the most important things I have ever learned about health and the human body.

Nerves interconnect our internal organs, also called viscera, and our musculoskeletal parts, or soma. Trauma, inflammation, or infection in the viscera or soma, can cause symptoms or functional changes in the other. These 2-way influences are called viscerosomatic and somatovisceral reflexes, depending on the direction of the signals.

Though not usually understood as such, one of the most common examples of a viscerosomatic reflex is the low back pain that very often accompanies a woman’s menstrual period. What is virtually unknown to most American women, and apparently most doctors, is that low back pain, or low back dysfunction without pain, can initiate the somatovisceral side of the cycle, often resulting in the causation or worsening of pelvic menstrual symptoms. (The most common types of dysfunction in the back and neck are tight muscles and stiff joints.)

To emphasize the critical importance and breadth of effect, here is a brief list of other viscerosomatic and somatovisceral reflexes:

Most Americans know that kidney infections can cause back pain. Most Americans don’t know that back dysfunction can affect kidney function.

An impending or acute heart attack can cause chest pain, upper back pain, left arm pain, and/or pain on the left side of the neck, jaw or head. Dysfunction in the neck or upper back can influence heart function.

Digestive problems in the esophagus, stomach, small intestine, and colon can cause back pain. Spinal dysfunction in the neck, upper back or lower back can have negative impacts such as constipation, diarrhea, intestinal gas, nausea, or digestive pain.

Inflammation or disease in the liver and gall bladder can cause back pain.

Respiratory problems such as asthma can cause back pain, while back problems can cause respiratory symptoms.

Pancreatitis can cause back pain.

Moral: When you have back pain, or a problem with an internal organ, remember that your insides are connected to your outsides. When you didn’t injure your back, but it hurts, think of your insides.

(Note: Autonomic Nervous System Chart, above, available at DCFirst.com)

DAY 51 - My Left Knee

Not nearly as popular as the Academy Award winning 1989 film, My Left Foot, Starring Daniel Day-Lewis, the saga of my left knee is the story of a doctor’s struggle to get off his rear-end and take care of himself. It is also a story of redemption and a great detox fast.

I was 54 in November of 2005 when my left knee began to hurt. At times it ached. At times it felt fine. Most of the time it was mildly to moderately painful to walk. I often walked with a limp.

As any chiropractor would know, it was reasonable to assume that my low back was a significant, or THE cause, of my knee pain. Nerves that come from the low back, supply all the muscles of the hips, buttocks, and legs. If these nerves are compromised by associated causes and effects of a stiffening of the joints of the low back, the function of the muscles that support and control the knees can also be compromised, resulting in knee pain.

Given my history since childhood of low back pain that developed into serious degenerative disc disease, and given my poor track record for doing daily stretching exercises, my low back was most probably the cause of my knee pain.

That same November of 2005 I knew that I needed to clean up my act and start stretching 30-60 minutes per day to restore mobility to my low back, regain the function of my knee, and end the pain. And I meant to.

On April 28, 2006 I entered this honest self-appraisal in my health journal:

“And now ..... my own frailty. I have been doing a poor job of caring for myself over the last 3 years. Doing an hour's worth of yoga helped. But I have not done my yoga regularly. Today marks 2 days straight that I have done an hour of yoga each day. I have let my stretching go so long, that now it is both painful and exhausting. But, at least, what is happening makes sense. My current goal is to see if I can do an hour of yoga each day until the knee pain is completely gone for a week. Then I can stop until the pain comes back. :)  I would like to get back to being able to put my palms on the floor when standing, and head to the floor between my legs when seated.”

The years rolled by, and on December 12, 2008 I posted the following:

“The left knee pain continues in a non-debilitating way – but clearly limiting. And I still haven’t changed my life to fix it.”

Without making excuses, it is worth noting that I wasn’t watching soap operas or professional sports when I could have been stretching. I was leading a very full life that included many personal, family, community and global health enhancing activities. Daily I talked with myself about the choices that I was making, and the risks that I was taking. Sometimes I just had to put an election or an issue like nuclear weapons or global warming before my bodily ills. At other times I was just too exhausted to make the time and get myself on the floor for an hour of stretching.

Nonetheless, March 17, 2010 rolled around, and this is what I had to say:

“My left knee continues to be a problem – I limp nearly daily – I am very limited in my ability to walk any distance. My low back has been stiff for the last 5-6 years and I have done little to change it.”

Here comes the redemption part. I started writing this book, Turning 60 Consciously ... With Something to Say, on my 59^th birthday on October 5, 2010. I’m spending 2-4 hours per day writing, and let me tell you, I am more conscious. Though I am not doing a great job, the consciousness seems to be having an affect and I am doing better with my stretching; 3-4 days a week of 30-60 minutes. And guess what, my knee is doing much better!!! The last 2 evenings I have gone on a 45 minute walk, and had very little pain, and just the slightest limp!!!

The question now, as it is for each of us, is can I stay on the wagon.

I promised you a gem of a detox fast:

On January 25, 2006,  3 months into my knee problem I began a 3-day UltraClear-only (a hypoallergenic meal replacement for improved metabolic detoxification) detox diet/fast (not a true fast, but a fast from regular food). I don’t recall if I had knee pain on day one of my UltraClear diet, but on days 2 and 3, I had no knee pain. On the morning of January 28 I began to eat regular food. For breakfast I had a bowl of homemade applesauce with cinnamon (no sweetening); a banana; a bowl of brown rice with avocado, salt, and flax oil. During the first half of the day I experienced a tiny amount of knee pain. For lunch I had a bowl of plain brown rice. When I stood up from eating my rice, I had mild-moderate pain in my left knee.

Food allergies and intolerances can cause pain anywhere in the body; commonly in the knees. Removal of suspected foods from the diet can often result in symptom lessening and functional improvement. Using UltraClear as a food/meal replacement can be an excellent way of continuing nutrient intake while avoiding possible allergic reactions.

DAY 49 - Got Knee Pain? Part III

Functional treatment of knee pain by healthcare practitioners, as contrasted with cover-up treatment, can be valuable, and in many cases, invaluable. A doctor of chiropractic (DC) can provide treatment through adjustment (manipulation) of the lower part of the spine, the knees, and/or the feet. Some DCs are trained to advise patients regarding non-musculoskeletal treatments such as dietary change, improvement of digestive function, and vitamin supplementation.  Other practitioners that treat knee pain include; doctors of oriental medicine, homeopathists, herbalists, naturopaths, bodyworkers, physical therapists, podiatrists, and osteopaths.

Knee pain is not uncommon in children. In my experience, adverse food reactions are the most common cause of childhood knee pain. These pains, and associated leg pains, are often misdiagnosed as "growing pains”. Beware that there is no evidence that growing causes pain. These pains are often in one leg, or favor one leg. This being the case, one would have to ask is the leg that is pain-free not growing? Again, growth does not cause pain.

Finally, I offer three pieces of advice:

1)         take the time to find out what’s causing your knee pain, and make the necessary changes to correct the imbalance,

2)         beware that chronic joint pain is an unquestionable sign of ongoing inflammation in the joint, that inflammation is destructive to tissues, and that unresolved, it is probable that your knee will deteriorate at an accelerated rate,

3)         recognize your knee pain as an opportunity to learn about your body, and appreciate that the functional changes that you make to heal your knee will enhance the health and vitality of your entire being and your entire life.

DAY 21 – Every Child Needs a Chiropractor

Every child deserves, and needs evaluation and treatment from a knowledgeable doctor of chiropractic (DC).

For those of you who may react negatively, or with incredulity to the above statement, please read along and hear me out.

Proper function of the spine, and the muscles, nerves and connective tissues of which it is comprised, are critical to a child’s health and vitality. The most common spinal dysfunction that affects children is a gradual loss of motion and flexibility in the spinal joints. This loss can be a major factor in, or cause of back or neck pain. A knowledgeable DC is trained to diagnose this loss of mobility, often before pain occurs and before damage is detectable on an x-ray.

Back pain in children is very common. A 1994 Scandinavian study, by Trousler, showed that 51% of 1,174 school children had experienced back pain.

For most families in America, the two choices of practitioners to treat childhood spinal pain or spinal conditions are a DC and an MD (family practice or pediatrician). In my opinion, the best choice is a knowledgeable DC. DCs specialize in treatment of the spine, while neither family practice nor general pediatricians do. Additionally, MDs rarely address prevention of spinal problems, while prevention would always be a primary focus of a knowledgeable DC.