A Healthy BACK for LIFE ESSENTIAL EVERYDAY TIPS Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au CONTENTS INTRODUCTION – HOW’S YOUR BACK 1 BACK TO BASICS 1 THOSE DISCS 2 DO’S AND DON’TS 2-3 WHEN SHOULD YOU SEEK HELP 3 HOW TO THINK WITH YOUR BACK 4 CAN I REALLY HELP MY BACK AS I SLEEP 4 HOW TO BEGIN YOUR DAY THE BACK FRIENDLY WAY 4 EXERCISE - YOUR BACK’S BEST FRIEND 5 WALKING - THE HEART’S AND BACK’S BEST FRIEND 6 WARM UP AND COOL DOWN 7 STRETCH IT OUT 7 LIFTING - MAKE IT EASY ON YOUR BACK 7 DRIVING AND BACK HEALTH 8 HOW’S YOUR POSTURE 8 WORKING ON YOUR BACK 8 YOUR SEATED WORKSPACE 8 YOUR STANDING WORKSPACE 9 YOUR BACK FEET 9 DIET FOR BACK HEALTH 9 YOUR BACK AND WATER 10 STRESS AND YOUR BACK - RECOGNISING STRESS 10 REDUCING STRESS 10 RELIEVING STRESS 10 PREGNANCY - WHY YOUR BACK HURTS 11 PREGNANCY ALTERS YOUR CENTRE OF GRAVITY 11 PREVENTION 11 GOLDEN RULES TO A HAPPY BACK - MAKING LIFE EASY FOR YOURSELF 11 WHERE TO FROM HERE 13 Disclaimer The information contained in this online site and e-books as offered is intended to provide accurate and helpful health information for the general public. It is made available with the understanding that the author and publisher are not engaged in rendering medical, health, psychological, or any other kind of personal or specific professional services on this site and e-books offered at any time. The information should not be considered complete and does not cover all diseases, ailments, physical conditions or their medical treatment and chiropractic care. It should not be used in place of a call or visit to a medical, health or other competent professional, who should be consulted before adopting any of the suggestions in this site or e-books or drawing inferences from them. The publication of this information does not constitute the practice of medicine and any information relating to drugs contained herein is general in nature. It does not cover all possible uses, actions, precautions, side effects, or an interaction of any of the medicines or procedures mentioned. Nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular drug in any form. The authors, writers, publishers, associated marketing organisations and the operator(s) of this site and e-books offered specifically disclaim any and all responsibility for any liability, loss or risk, personal or otherwise incurred as a consequence, directly or indirectly, of the use and application of any of the material on this site. 3 1.0 Introduction HOW’S YOUR BACK? The number of times a day you don’t get asked this question isn’t surprising. Few people are really interested in the state of your back – why, most don’t even think about their own... until something goes wrong with it! And that’s just the problem; few of us think enough of how we look after one of the most sensitive areas of our body – strong, yes, but still sensitive. If we did we would have fewer spinal problems, neck pain, muscular disturbances and, indeed, less need for the services of chiropractors. People are gifted with a freedom of movement that allows them to enjoy a wealth of pursuits; walking, jogging, gardening, horse riding, fishing, socialising with friends, and retail therapy...whatever makes you happy. At the heart of that mobility is a healthy back. Unfortunately when life’s toils take their toll, the spine is often one of the first places affected. It doesn’t take much – often it is as simple as jumping up too suddenly from the dinner table or being in too much of a hurry to play that regular game of squash you enjoy and not bothering to warm up first. The first agony of the back twisted at an acute angle to reach your opponent’s shot has to be experienced to be believed! It could simply be that you’ve been sitting hunched over a desk or computer for hours on end and now your neck is telling you the story by way of surges of pain through your shoulder and down your arm. Whatever the reason, it is only once the nagging ache or that sharp, stabbing pain start to set in that the realisation of what you might have done hits home. Your back is, as ‘they’ say, ‘out’...so what do you do about it? What will put an end to the agony? Well, many people will immediately reach for the pain killers, and this is a perfectly natural thing to want to do. After all, you want the pain to go away so that you can get on with the day-to-day living. Having taken something to deaden the pain (for that is precisely and ALL that pain killers do – deaden the pain temporarily) now you NEED to know how you can eliminate the awful feeling that pain helps to spread around the rest of your body. The objective of this publication is to demonstrate one of the ways, if not the best way, to handle the situation of the back that has been ‘put out’. Included will also be tips on how to avoid putting it out in the first place. Initially, then, we need to know the basics of how the back (spine) functions and its relative importance in the order of the human skeleton and how we use and sometimes abuse it. 2.0 BACK TO BASICS The spinal cord is vital to the functioning of your entire body. All sensations and all the organs from the nape of your neck to the cuticles of your toe nails rely solely on that one main highway of electricallycharged cables. With the correct care and protection provided by the muscles, ligaments and bones the highly sensitive nerves emanating from and running down the spinal column are safe from damage. If, on the other hand, we disregard some obvious precautions, it is generally our back/neck that lets us know in no uncertain and often very sharp terms; the pain is at first noticeable and then unbearable. The good thing is that you have the opportunity to make choices and implement real change to ensure you enjoy a healthy back for life. So, whether or not you are in good shape or are experiencing back pain of varying degrees or are recovering from that all pervading pain in the neck, take heart and discover some of the ideas that will make a healthy back a natural part of your everyday existence rather than an episodic cycle of pain and discomfort. Whatever the condition or state of your back the information here will help you to get back on the road to recovery or simply aid in the maintenance of your existing healthy spine. Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au Either way we will be offering some recommendations for minimising your discomfort, avoiding damage and engaging in a mindset for ongoing back health or when to seek specialist advice. 2.1 THOSE DISCS Whereas some back problems are related to those almost legendary discs between vertebrae in the spine we find, when we speak to a practiced chiropractor, that not all pain in the spine or lumbar region is as the direct result of a so-called ‘slipped disc’. This is, of course, where we would do well to turn to the very person who is most likely not only to erase the pain but also to put you ‘back’ in the condition you were before you did the damage – your friendly chiropractor. We all know that the spine, spinal column, backbone, whatever name we give it, is a strong but, nevertheless, highly sensitive region of the human body. The difference between your backbone and that of the experienced chiropractor is that she/ he knows much better how to take care of it – their own and yours. Most chiropractors practice what they preach so, if your chiropractor is walking around upright and without pain it’s a fair bet that they’re doing what they’re telling you to do. A chiropractor will generally tell you that, when healthy, the bones of the spine are strong and dense. They need to be – one of your spine’s main jobs is to protect your spinal cord. The spine has four regions - starting from: • the neck and then* • progressing to the pelvis *the regions which are • the cervical region,* • the thoracic region,* • the lumbar region* • the sacral region.* A chiropractor knows and is very familiar with the function of each of these areas. She/he will also be aware of what the region looks and feels like when its joints are working normally, or not – chiropractors call these joint problems subluxations. But, whatever we call them, the fact remains that the spine is a precious area of the body and should therefore be treated as such. It may be fairly flexible but it does prefer certain positions over others. Consequently posture is important during our everyday activities – moving, standing or sitting. At one time or another we have all jerked our body sharply in one direction or another and felt that ‘ouch’ twinge of pain. Momentarily we paused in what we were doing, assured ourself that the pain wasn’t continuing, and gone on with the activity thinking all was fine. The secret in moving is to warm up first – even when getting up into a standing position after sitting for some time. Many of these points are obvious – as obvious as the somewhat hackneyed saying that ‘prevention is better than cure’. We all know this; what we don’t all know is how we can apply the rules of ‘prevention’ to help us to avoid doing silly things with our backs that put us out of physical (and sometimes even mental) action! Here are a few practical tips to preventing damage to our back; some of them will be obvious but, like many things, they become obvious only once someone has pointed them out to us. 3.0 DO’s & DONT’s > DOs • Bending, twisting or even just moving in a limited range is something the spine appreciates – try not to make sudden, jerky or sharp movements • Do move often and carefully if your work or hobby places you in one position for prolonged periods • Lift objects with a straight back, using the (bent leg) muscles to take equal parts of the strain. Always think about looking to the ceiling when 5 you are about to lift. This will automatically shift your lower back into a more stable position. • Lift heavy objects from between your two feet and with arms and legs slightly flexed, not straight (actually, try not to lift heavy objects at all – use a fork-lift) • When you are about to lift something, consciously brace your abdominal muscles. These muscles offer welcome support to your back • When is a good time to hold your tummy muscles? Answer : All the time • Regular and gentle exercise to keep an all round suppleness in the muscles and ligaments – in turn this will strengthen, manipulate and lubricate the spinal region helping it to resist injury • If driving long distances, plan to take a 10 minute break every 2 hours to get out and walk around. This helps you not fall asleep at the wheel, but it also helps to prevent the back from fatiguing as well • Ensure that you use good luggage that has wheels. They are there for a reason. > DON’TS • Don’t overdo exercise • Don’t repeat the same movement too many times – overuse syndrome is the result and can often lead to quite serious injury to the back. • Don’t smoke. The discs in the spine have poor blood supply at the best of times. Smoking will compromise these blood vessels as it does your whole vascular system. With reduced blood comes reduced nutrients and oxygen. This means the daily repair work our body does is less effective. As the discs are less able to do their regeneration each day (or night more accurately) degeneration results over time. • Don’t leave any strain or injury before seeking some attention, no matter how mild you consider them. A chiropractor will be able to tell you what the problem is and how it may be cared for – especially if you get this attention as soon as possible after the injury. Because most back pain is the result of stress on the body (in one form or another) and this stress emanates from at least one or, commonly, a combination of physical, chemical or emotional imbalances it is vital to good health to obtain attention with minimum delay. If left untreated the body starts to compensate which can lead to wear and tear on joints, vertebrae, discs, muscles, nerves or ligaments and a weakness in various parts of the body. This can lead to more serious problems developing. 4.0 WHEN SHOULD YOU SEEK HELP? Quite simply, if it hurts, get it checked. Many people forget the obvious – that pain is a warning that the body needs attention; to ignore this is courting trouble over the long term. Many minor injuries, if caught at the outset of pain, can be rectified with little or no bother (and minimal cost). Muscle pulls and strains, although quite common, can be severe. Other spinal tissues can also experience injuries. Ligaments can be sprained or torn, joints can become irritated, and of course, spinal discs can be moved out of position. Some people attempt to treat their own back injuries, maybe even getting someone in the family to massage the injured area. After a strain or injury to the back, the body can have a variety of natural reactions causing numerous symptoms, including back pain. If, after rest, your severe back pain has not subsided, you should seek professional help. In such cases the only way to relax intense spasms is with the assistance of a health care professional; it is at such times that your friendly chiropractor looks really good! Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au It isn’t only muscle or ligament strains that present the back with pain – other mis-alignments can cause pressure on nerves and present the arms or legs with tingling sensations or numbness. If these symptoms are present, whether or not you are aware of having ‘tweaked’ your back, then this is a good time to seek help. It is critical to realise that serious injuries that are ignored or are dealt with incorrectly can be dangerous, leading to further impairment and possibly irreparable damage. 5.0 HOW TO THINK WITH YOUR BACK The great thing is that you have the perfect opportunity to change many of your daily habits into ‘back friendly’ activities, thus minimising risk to your back health. The best advice I have ever received regarding a preventative back mindset is to “Think with your back”. Modern life is in a big hurry but, when it comes to the health of your back, it pays to move at your own pace. As anyone who has suffered from severe back pain will tell you, there are ways of performing different activities in everyday life that minimise the risk of damaging your back and simplify tasks in a commonsense manner; the result is that it makes your life easier. Ease into any physical activity rather than charging in head-long. Don’t have false pride, ask for help to lift heavy items where you need it; set up your work and play spaces for convenience and comfort. Why make life difficult for yourself by storing frequently used items in uncomfortable, difficult to reach locations? That other favourite and well-used axiom ‘work smarter not harder’ works here too. The overriding maxim is to ‘think with/for your back’. The best way to do this is to train yourself to be aware of the different activities you perform on a daily basis and to take notice when you feel forces and stresses applied to your back. It is likely that there are ways you can adjust your approach to these activities to make life easier on your spine. However, it requires a conscious choice to be ‘back aware’. This alone could be one of the greatest paradigm shifts you can make to ensure a healthy back for life. The great thing is, you’ll find there are myriad ways you can make life easier on yourself which, when combined, give your back the best chance of staying healthy. You will quickly embrace ‘back healthy’ habits; the dividends of your new mindset will last a lifetime. 6.0 C AN I REALLY HELP MY BACK AS I SLEEP? A third of our lives is spent in bed - it is the time when our body takes the opportunity to rejuvenate and replenish itself, consequently it is in bed that we should spend ‘quality time’! By this I mean ensure that we get the best night’s sleep possible – every night. Among other factors the shape, type and condition of your mattress will determine the quality of your sleep. If your spine is in an unnatural position for much of your sleeping hours you should expect back problems. Connect the dots on a common sense basis and it all adds up to the answer to your backache or otherwise. Here are some tips to follow for taking care of your back while at the same time getting a good night’s sleep: • Establish whether you have a mattress that is too soft – in more cases than we would believe backache is due to a mattress that ‘bends too much in the middle’. If you are considering investing in a new orthopaedically-designed mattress, take the time to find the perfect fit for you. • Lie on a range of different mattresses and have your companion or the sales assistant assess whether your back is positioned neutrally in your usual sleeping posture (not on your front). Make sure your partner lies on the bed with you as this can also affect your positioning. When you are considering price take into account the 7 fact that you spend a quarter to a third of your life in bed - the investment should match the importance. • You can effectively ‘injure’ your back while asleep – if you lack the correct support in relation to posture it is the likely reason for that backache you feel upon waking. Your body needs to change positions as you sleep; if you’re lying in a trough you could be damaging your spine without being aware of it. HOW TO BEGIN YOUR DAY THE ‘BACK FRIENDLY’ WAY As you lie in bed your muscles, ligaments, tendons and bones (including spinal vertebrae) all tend to relax completely. Upon waking and beginning to get out of bed all these body parts are being asked suddenly to work together. While you’re getting ready in the morning to start your day there are a number of actions that could put stress on your back. As you move and turn to swing your legs out of bed remember that for much of the night, during sleep, your spine has almost certainly been reclining in one position – at least for the last hour or so of slumber. If you then move to jump your legs to the floor rather than swing them gently into position, the stillresting body parts are likely to receive an unwelcome awakening; the spine most of all. The correct way is to move gently into a sitting position whilst still thinking of how your back is reacting to what is, to most of us in winter especially, an unpleasant sensation, even at the best of times. For some it pays to stretch before you get out of bed, stretching helps to warm the body and make it more supple. Gentle supported movements get the circulation going and prepare you mentally for getting up. Getting out of bed may sound simple, but if you have ever experienced back pain, you will be only too aware that this fundamental task can be totally challenging. If your bed is low to the ground you are making life difficult for yourself. Once it is elevated you don’t have as far to get up - it’s that simple. When it comes to getting out of bed, the secret is to use your supported weight to your advantage, minimise any twisting movements keeping your spine in the vertical plane (upright). Roll onto your side then raise your knees with your legs supported on the bed. Use your hands to lift your torso as you slide your feet and legs from the bed and towards the ground until you are in a seated position. Stand up using the assistance of your hands on your thighs. When you are getting back into bed, you simply reverse the process. Now you are up, stay aware. Your back is still warming up so beware of bending over casually at the wash basin with your weight unsupported. Your upper body is a heavy weight to leverage across an unprepared back. Use the bench, wall or wash basin for support wherever possible. You really don’t want to have to admit to your friends that you put your back out while brushing your teeth! When you go to the toilet, make sure you support your weight on the way up and down. If you thought it would be embarrassing telling people you injured yourself brushing your teeth, imagine telling them the toilet was the culprit. Now it’s time to put on your shoes. For someone with back pain, it’s a long way down to your feet. Lifting your foot up onto a chair will alleviate a lot of the bending. Some of the best friends you will find are short socks and long shoe horns - if your partner can help you, all the better. EXERCISE – YOUR BACK’S BEST FRIEND Some people cringe at the sound of the word ‘exercise’ but, if they were to realise how important it is to incorporate exercise into their everyday lives and practice it regularly, many would weigh less and be physically fitter! We are all aware of the benefits of exercise to Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au help with so many aspects of our personal well-being, and probably none more so than that of the back. In the absence of a little regular exercise the body protests in many ways, from becoming overweight, to circulation problems, diabetes, heart conditions and a host of other emotional as well as physical ailments being presented. The spine and back benefit from a little regular exercise bearing in mind that this region of the body is asked to handle much of the daily load we place on it through work and play. But what if you have a backache? In such cases you will not feel like doing any exercise. By the same argument if you don’t get at least some regular exercise your back is almost certainly going to ache at some point; it becomes a vicious cycle if your back hurts, you will probably stop exercising. But if you stop exercising, you are more likely to injure your back. Without exercise, you can easily put on extra weight. More weight puts additional stress and strain on your back, making it hurt even more, and so it goes around However, even if your back is bothering you, it is important to get at least a little exercise. Movement helps to keep the joints in your back lubricated and loose. Life might bombard you with pressures that limit your time to exercise, but we are talking about your quality of life so, start to make it ‘back friendly’ and find the time. You don’t have to go out and run a marathon, we’re talking about a simple walk, a change in the way you are performing everyday activities, a ride on your bike, an easy swim; these are all activities we have enjoyed as kids but may not have maintained as the years have gone by. If you are serious about your back’s health, you should definitely make exercise an integral part of your life - but where do you start? Well, before rushing out and buying a new home gym it would be wise to check things with your friendly chiropractor. If you have had any form of back or, for that matter, any other health condition, it is critical for you to talk to your local health practitioner to make sure they approve your anticipated regime. You wouldn’t take a car out to race unless you knew its mechanical parts had been thoroughly checked. You certainly don’t want to aggravate a back condition by doing the wrong activities. The important thing is to start small - allow time for recovery by pacing yourself with easy exercise at regular intervals. Build it up, together with your cardio-vascular fitness, to a level with which you are comfortable. Set yourself some basic goals, not too high to begin with, and become consistent. If you are carrying more weight than you would like, an exercise program is likely to shed some of the excess weight , thus also reducing the burden on your spine. WALKING – THE HEART’S AND BACK’S FRIEND One of the easiest activities you can embrace is walking. You can squeeze a walk in at lunch time to the local shops, to wind down after a hard day’s work or to deliver a parcel. Better still, a regular brisk half-hour walk on the beach or in the park on a daily basis will soon have you thinking, breathing and enduring the day’s little obstacles much better. Sometimes it is just good to get outdoors away from the routine and to stretch your legs. Beware of your posture, stride out tall (even if you are short!). A good idea to keep in mind is that a lot of our beaches aren’t level – especially at anything except high and low tide. If you ever wonder how much that difference that small slope makes, try walking around for a while with only one shoe on. If tides require you to walk on the slope, make sure you walk the same distance back the other way. This will balance you back out again and not put unnecessary pressure on your back. Be relaxed, enjoying the freedom of the fresh air, sunlight and nature, at the same time engaging the muscles and joints to strengthen your back. As your fitness improves (and it doesn’t take long) you can 9 adventure out on your bike. Riding a bike is a low impact exercise but definitely requires an awareness of your posture. Make sure your bike is correctly set up to deliver a comfortable, healthy riding position. If you have any doubts about correct posture here, take your bike to your local cycle shop. These people know bikes better than most as they love their sport and often study the world’s best. They will be able to give you tips on how to best set yourself up. A swim in the pool or your local beach is also great for your back, engaging the muscles and ligaments, lubricating the joints in a supported watery environment. The resistance helps your muscles to work and your back to stretch. If you are at all concerned, avoid the surf. An unexpected wave caught at a wrong angle may be enough to set you back to square one. Calm water is the key. This doesn’t mean you just go for a float. There is work involved here. A lot of people aren’t strong swimmers, and that’s okay. Walking in water is excellent – try about elbow deep. There is virtually no impact or jarring. The water supports your weight. Your arms legs and back are being worked against resistance with every step you take. The harder you try to move, the stronger the water pushes back – it’s a great whole body workout. WARM UP AND COOL DOWN Before any form of physical activity be sure to warm up for a minimum of five to ten minutes beforehand, this will prepare you for action and helps to prevent injuries. The purpose of the warm up is to adjust the muscles to the more intense activity level to come gradually enough to prevent injury. Running gently on the spot and flexing leg and arm joints and muscles is really all you need for most pre-exercise warm-ups. Another good philosophy is to do what you are going to do, but do it at half pace. So if you plan to walk fast, have some time walking gently. If you want to run, make sure you walk first. Riding – ease into it with a slow roll for a couple of blocks. Swimming – do a couple of gentle laps and stretches before beginning your ‘real’ laps. The important thing is to ease into heavier exercise slowly and gently. Remember, if the weather is cold, your warm-up NEEDS to be longer. Cooling down is just as important as warming up. Stretching relieves muscle tightness, which is one cause of back pain. Stretching also helps to balance the action of muscles, enhancing ideal alignment and relieving joint strain. STRETCH IT OUT When it comes to stretches, talk to your health care professional or exercise consultant. Every back and every condition is slightly different and you want to make sure you are doing the right stretches to suit your back health. As an individual you must make sure that any exercise you engage in is specific to you and you alone. This is the major reason (apart from keeping up with the Beverly Hill Billies) that the stars engage personal trainers – they are personal to them. Here are a few basic rules you can apply: • Bouncing is for balls, not your muscles • The 15 second rule – hold the muscle stretched for up to 15 seconds to feel the stretch • Take a break between stretches returning to the neutral balanced state before starting again • Know your limits – stretch until you feel mild tension – no further • Relax and take your time – it isn’t a race; go easy and ‘feel’ your stretches. LIFTING – MAKE IT EASY ON YOUR BACK Before you lift any object, you must first make sure that you are capable of lifting it. After you have determined that you can lift the object, position yourself over the object, with your feet about shoulder-width apart. Try to get the object between your legs, when possible, so that you don’t have to reach out for it. Squat down, keeping your head up, shoulders back, and spine erect – feet shoulder width apart. The bending should come only from your hips, knees, and ankles – BACK STRAIGHT. Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au Get a good hold on the object and lift it with your head up, (NOT bent forward), using your legs to lift. Remember to think about looking to your ceiling. Your leg muscles are the strongest muscles in your body, and even though it takes more energy to use them, they can handle a lift better than your back. Keep the object close to your body; lifting or holding an object close to your stomach rather than at arm’s length greatly reduces the stress on your back and spine. Set the object down using the same technique you used to lift it. When picking up light objects that require you to bend right over, make sure you use a support. Hold your weight against a nearby solid object as you bend over to pick up anything; your back shouldn’t have to have all the strain placed on it. DRIVING AND BACK HEALTH Many of us actually spend far too much of our time behind the wheel of a car. However, few people give very much thought to what should be not only a comfortable but also a safe driving position, or what damage our car seats, if incorrectly positioned, might be doing to our backs. Here are some driving position tips to keep your back comfortable and ache and pain-free, and also to help keep you safe when you’re at the wheel: Let’s start with how you get in and out of the car. It may pay to slide the seat right back when getting in and out to give you some room. Use the same principle as getting in and out of bed, where you keep your weight supported throughout the action. Slide and rotate (swivel) your body on your butt with knees together rather than twisting. Use the steering wheel, seat, door frame and handles to support your weight rather than leveraging your weight in a twisting motion across your back. Now you are seated, adjust your seat to a comfortable position where you can comfortably reach all the controls in your car with mirrors adjusted appropriately. Having done all this take a moment to consciously become aware of your back’s position in the order of all that has just gone before. If you are happy with your position at the wheel you are now ready to drive even long distances with minimal strain on neck, back or shoulders. HOW’S YOUR POSTURE? Poor posture stresses your back. When you slouch or stand with a swayback position (where your low back curves too far inward), you exaggerate your back’s natural curves. Such posture can lead to muscle fatigue and injury. In contrast, good posture relaxes your muscles and requires minimal effort to balance your body. When standing, aim for feet shoulder width apart, knees slightly bent, back straight and head in alignment. When sitting try not to slump or slouch; poor posture, such as slouching when sitting or standing, can place a great deal of stress on your muscles, ligaments, and discs. This stress can make it more difficult for proper healing to occur and may increase back pain. Choose postures and positions that allow you to keep your back relatively straight – imagine the base of your neck in line with and immediately above the base of your spine. WORKING YOUR BACK Most people work several days a week, some sitting, some standing and some on the move. The bottom line is that no matter what you do, your back will benefit from positive back-friendly choices. YOUR SEATED WORKSPACE Many people work in offices and spend long periods of their day seated, often using computers or answering the phone. If you are in this type of occupation a good ergonomic chair will always be beneficial. Look for a chair with a positive lumbar (lower back) support. It should allow you to nestle comfortably into it with your back well supported. Adjust your seat height so 11 that your feet rest flat on the floor. Another school of thought is to avoid the backrest completely. Sit on the front edge of the chair with your feet tucked in underneath you. This will mean that your knees sit lower than your hips. This position encourages the natural lumbar curve to be maintained and reduces the pressure on the discs in your lower back. This also allows for more options of posture. By moving one foot forwards, into almost a running stance, you can shift how you are carrying your weight. By then alternating to the other foot forwards, you get to change again. The important thing is that the longer you go without moving, the more likely “plastic ligament deformation” will occur. This means that your ligaments act more like chewing gum, rather than an elastic band. This tends to kick in around the 20 to 30 minute mark. By regularly changing your posture, you give the weight bearing parts of your back a chance to recover. For some a pneumatic ball is preferable as it requires the engagement of the core muscle groups to hold a comfortable seated position. Whilst not for everybody, particularly those with weaker muscle groups, the ball can become a constant subconscious exercise tool due to the need to adjust and move to sustain a comfortable balance. Armrests on chairs or the support of a desk are preferable to avoid tired upper back, neck and shoulders from the load of carrying the weight of your arms. The set up of your workstation is crucial to long term comfort and back health. Set up your monitor directly in front of your seated position to avoid twisting your upper body; your eye level should be roughly in line with the upper part of the screen. If you regularly refer to documents use holders and clips to align these materials in your direct line of sight to avoid constant twisting and adjusting as you read. Don’t forget to move position from time to time. If you are using a laptop it might pay to purchase an elevation stand to lift the screen up to a more suitable height. Take intermittent breaks to get up and move around to keep your back muscles active – go to the printer, discuss issues with a colleague, take a breath of fresh air, whatever works for you. If you are using the telephone frequently or for long periods at a time, especially whilst typing, avoid holding the phone between your head and shoulder. It may be time to use a headset instead so you can stay hands free. YOUR STANDING WORKSPACE If your job requires you to stand for long periods of time your back has to endure the compressive forces of gravity weighing down on your spine. There are a few little tricks you can employ to reduce the burden on your back. Keeping some mobility in your back through rocking your weight from side to side will keep the muscle groups engaged and the blood flowing. Make sure you take intermittent walks or mix it up with a combination of sitting and standing. It is helpful if you can locate a small step up so you can alternate your legs in an elevated position, relaxing the muscles in the pelvis and thigh and alleviating some of the stresses on the lower back. If you have a bench at a comfortable height, use it to support your weight when you can; every little bit helps. Try not standing directly on concrete – have a mat under your feet. Concrete tends to have a ‘drawing’ effect on feet, calf muscles and lower back that causes a cramp-like sensation in the nether regions of the body! Avoid bending forward whilst working at a desk. YOUR BACK FEET Your selection of footwear can have a marked affect on the health and condition of your back. Shoes with good arch support and absorptive cushioning are best. If you are frequently feeling discomfort it may pay to visit your local podiatrist to evaluate your foot condition and prescribe the right solution for you personally. High heeled shoes might be considered a fashion accessory for work, but they are not necessarily a woman’s best friend. They can cause increased curvature of the spine, compressing the facet joints and causing discomfort. Where possible, look for lower heals and make sure you wear comfortable Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au walking shoes to and from work. DIET FOR BACK HEALTH Selecting the appropriate diet is crucial to overall good health. When we speak of ‘diet’ we’re not referring to one of the many temporary but strict food deprivation sagas that some poor souls wishing to lose weight ‘go on’ on a fairly regular but unfruitful basis! True diet is a balanced pattern of nutrition intake that someone who values their health lives on from day to day – LONG TERM. Many diets offered to ‘help you lose heaps of kilos’ turn out to be fad diets that most people abandon after a couple of months. Diet, then, is a regimen that doesn’t necessarily have to be regimented. To help all parts of the body from head to toe we all need a healthy intake of daily food. However, what one person calls ‘healthy’ another would turn their nose up at, so ‘good food’ is very much a matter of individual taste so, that’s precisely how you should look at your own daily diet (food intake). (Maybe “a matter of individual taste” is a poor choice of phrase – taste is often our worst enemy, especially if our body is conditioned to craving some of the poor choices of food. I’m certain that people that have weight problems don’t have an issue with how good the bad things taste – even when they know they are a poor choice. An old-time acupuncturist once told me, “Be very careful of your taste buds – they can kill you.”) Based on common sense and the accepted healthy types of food (fruits, fresh vegetables, roughage, flax seed oils, omega 3s and 6s plus the alphabet vitamins). The correct and regular quality and quantity of food intake leads to a healthy lifestyle. As a direct result not only is the body able to withstand illness but, when it does succumb to a debilitating condition it is more likely to be able to recover; the same can be said for injury. Healthy people respond far more quickly to back injury care by a chiropractor. YOUR BACK AND WATER Water maintains the body’s fluidity; it lubricates joints and literally keeps us moving. Drinking plenty of water enhances the height of intervertebral disks keeping them the healthy shock absorbers they are. Water is necessary for nearly every bodily process so is good to have in generous supply. STRESS AND YOUR BACK Recognizing Stress Stress takes on many forms – it can be emotional, chemical or physical stress. It shows itself in our muscles, especially the muscles of the neck and shoulders, often called tension headache. This begins at the back of your neck and moves up or down (or both) from there. A thought or series of unwanted thoughts can bring on a ‘tension headache’. The cause of the pain associated with headache is most commonly connected to constriction and dilation of the blood vessels in your neck. When your neck and back are not getting their proper blood supply, they let you know it with pain. Prolonged restriction of the blood supply to the muscles can result in their being weakened. Weakened muscles subsequently become susceptible to damage or strain injury. It isn’t too difficult to see how, if the muscles in the back are out of condition, just how easily a problem with the back can develop. By learning to recognise stress when it appears is the first positive step toward resolving the issue – often before it has become a real problem. So, how do we learn to minimize stress? Reducing Stress We’ve already mentioned that mental or emotional stress can be just as damaging to the back as physical rupture or subluxation of vertebrae. A regular ‘money worries’ thought crossing the mind several times each day can be highly stressful. Such ongoing emotional tension build-up results in stress on the muscles, 13 ligaments, tendons, nerves, joints and small bones in the neck and spine. Over a long term period it can, and very often does, lead to serious back problems. We live in a stressful society these days, and short of moving out of the city for a sea or tree change retirement, which most of us aren’t ready for, we can’t avoid stress. Managing our stress – or more importantly – managing our body’s responses to stress is the key. Relieving Stress Recognising the emotional stress in your life is the first secret to handling it. Notice I said ‘handling’ it - not ‘overcoming’ it or even ‘dealing with’ it. Too many people make attempts at resolving problems by first telling their brains that here is an obstacle to be overcome; it isn’t. If you tell yourself that at the outset you’ll be battling the situation up hill with a sharp stick that’s precisely what you will face – get the picture? The way to look at the situation you have before you is that it is just that - a situation, nothing more; a challenge to be ‘handled’ in a similar way to the manner in which you would handle a simple decision through your normal day. Situations that concern you can be handled by mentally standing next to them and working them out as you would a puzzle in a childrens’ book. Another method of handling problems, especially problem people, is to avoid meeting up with them, that way they can’t stress you out. Other, more mundane stressors such as traffic hold ups and poor drivers can be viewed as yet another small daily challenge to have fun with. In fact many so-called stressful situations can be ‘had fun with’. Try it, it works for me so why shouldn’t it for you? Another effective approach to that stressful situation that makes you screw up your fists is ‘anticipation’. Try pre-empting so you can prepare yourself for outcomes. I’ve even been to the lengths of writing down in advance what I anticipated a particularly goofy government department employee was going to tell me. ‘Good fun and it eases the tension – especially when you show what you’ve written about to the sad person sitting next to you in the waiting room. • Smoking and caffeine have the effect of creating a sense of anxiety even when you aren’t anxious about anything. Cutting down (or out) your intake of stimulants will help reduce your stress level. • A walk or a run on the beach, across the park or common on a fine or chilly day can do the trick. Anything that takes your mind off the stress that’s the cause of your tension can help your overall composure - better still, eliminate the reason. There are almost as many ways to prevent back pain as there are bad behaviours that cause it. A strong, healthy back comes from removing the reasons for its aches. PREGNANCY - WHY YOUR BACK HURTS When you are pregnant your body produces a variety of hormones; one of these hormones is called Relaxin. This conveys a sense of calm and relaxation for the birth procedure, which is precisely what it is designed for - Relaxin causes the ligaments and the pelvis to soften to allow the baby to pass through with ‘relative’ ease. PREGNANCY ALTERS YOUR CENTRE OF GRAVITY Relaxing uterine ligaments cause additional strain to be placed on the spine and the surrounding muscles. The overstretched abdominal muscles are also not equipped to handle the entire weight of the uterus so the spine and back muscles will bear this extra load as well. This transfers itself to the spine and, voila! Bad Posture is the result, and we all know the result of bad posture – backache. PREVENTION Leichardt - (02) 9560 1300 www.thebackdrleichhardt.com.au Prevention is the best management for this discomfort. Preventive measures include: • Exercises (Particularly Pelvic Tilts) • Practicing good posture • Lifting and bending appropriately GOLDEN RULES TO A HAPPY BACK you bend and twist unsupported, you increase the load and induce shear forces (strain produced by pressure) on your back causing stress. Make a habit of facing the object you are lifting straight on. • Lift correctly - use your legs to take the load where ever possible. Keep your back straight and your head up; control your breathing (out) as you lift. • Be especially careful when picking up lighter things. It is when your back is relaxed and not prepared that it is most susceptible to injury. • Use leverage to your advantage when using tools. The classic example is using a spade. The further the distance and the more weight from your body, the greater the load applied through the spade and onto your back. Add twisting and you really start to stress your back. So take it easy, you are better off with more and smaller loads than fewer, large loads. Make sure if you are moving material, you are facing where you want to put the load rather than having to twist. • Think before you act. If you are moving something, plan where you are moving it from and too so that you don’t have to encounter clutter or a poor posture that adds risk to your back. • Where ever possible use mechanical devices to take the load. Trolleys, wheel barrows, fork lift vehicles. The correct implements are designed to carry loads far more efficiently than your back. • If all else fails you can call on a friend or hire someone to help you out. Know your limits and not to cross them. It‘s certainly not worth enduring back pain for a moments lack of thought or pride. • Avoid rapid movements, especially when you are cold - especially those that twist your back - this is asking for trouble. • Reconfigure your activities to reduce difficult, repetitive tasks that put undue stress on your Making Life Easy For Yourself Everyday you are faced with simple activities which, when handled with care, present little or no risk to your back health. Done incorrectly, quickly or without thinking, they can be the activities that take your system beyond its comfort zone and into back pain. Here are a few practical reminders from what we’ve been looking at earlier to help you make life easy on yourself and your back: • Hold onto solid supports wherever possible so you don’t expose your back to the lion’s share of the load. • Push - don’t pull...Think of pushing a wheel barrow and using your leg muscles to lift and push the barrow. It’s much safer than pulling and jerking with your back. If you are pushing, your centre of gravity through your spine is shifted to the posterior elements of the spine ie the facet joints – or away from the discs. When pulling you have to shift your weight anteriorly which then loads up the discs. Given that many lower back injuries are disc related, it pays to push rather than pull. • Keep any weight you are lifting close to your body - the farther away the weight is from your own centre of gravity the greater the forces are exerted on your back. • Your back hates bending and twisting - when 15 back. • Plan any task you are embarking on to minimise the amount of lifting, the distance you have to travel and the load you have to bear. It could be as simple as moving your car to a closer location and loading everything in it once rather than spending unnecessary carrying time and effort that put risk on your back. • Keep regularly used items in easily accessible places so that you don’t have to reach high or low for them. • Keep heavy objects in ‘back friendly’ locations. If you know you have a weighty object that you have to move from time to time, make sure it is stored in a readily accessible location, preferably at waist height for ease of access. • If you feel pain, stop what you are doing. Pain is a warning sign. There is nothing heroic about getting a sore back for days simply due to stubbornness or pride. • Maintain mobility - your back feeds and grows and lubricates itself with movement. When you stop, your back stops and your muscles atrophy. If you stay still for too long, the blood flow isn’t aerating your system and you are more susceptible to damage. • Know when you are stressed or tired, or perhaps you had a little too much to drink the night before; whenever you are feeling off colour it is likely that your back is too. It is susceptible to the burdens you place on your body and there are times when it won’t respond as you would like. If you don’t feel right, don’t test your back. It is not always forgiving. • Beware of drugs - whether recreational or medicinal, drugs are usually employed to mask issues. They don’t resolve the problem and can give you a false sense of security regarding your back’s real state. • Your body is a total system - if you want to strengthen your back your entire body contributes. Strengthening your core area will certainly add a useful reinforcement to help stabilise your back. Consider Pilates or other similar exercises to strengthen your body as a system. WHERE TO FROM HERE? There are times when your body lets you know that it needs some help. Whether it is back pain, tiredness, discomfort, disease or other ailments, you don’t have to endure life’s tough grind; in fact, you deserve to get the most out of life. A visit to your local chiropractor could be the answer to finding comfort, freedom, mobility and balance – all of which lead to a more relaxed daily life. Often, without your being aware of it, spinal misalignments (or subluxations) are playing a role in your discomfort or symptoms and affecting your quality of life. These subluxations have the potential to hamper your movement, cause chronic pain, restrict your comfort and limit your health potential. Fortunately, chiropractors understand the vital relationship between your spine, your nervous system and your total health and wellness. Chiropractic care is about delivering the balance and freedom to your body through your nervous system, to allow you to get the most out of life.