Unnecessary Spinal Injections Lead to Meningitis Outbreak

A lot of people have died and are still dying as a result of fungal contaminated steroid injections they received for their back pain.  Their deaths could have been avoided – if only they had the right information.

There have been no scientific studies that substantiate the reliability, safety or effectiveness of steroid injections for the relief of lumbosacral pain.  For that reason, The American Academy of Family Physicians does not recommend these injections as part of its treatment program.

It's estimated that at least 80% of cases of chronic, lumbar pain is due to mechanical (i.e., musculoskeletal) causes.  It should be remembered that chronic, low back pain is self-limiting and will resolve within 6 months without any treatment whatsoever. 

I can empathize with back pain sufferers who desperately seek relief from chronic, agonizing low back pain.  However, I'm sure there were those whose pain was somewhat endurable and could have been helped by a good physical therapist. 

Telling a person with excruciating back pain to be patient is like telling a drowning person that help is on the way. The treating physician might have told his patients that the pain would resolve by itself and that a physical rehabilitation program would shorten the recovery time.  If he had given his patients this advice, instead of an injection, ( in many cases, a series of injections ) they could have avoided the lethal injection.

Read about diagnostic and therapeutic injections in Back Surgery – Avoid the Nightmare by Benjamin Goode. 

Not as Harmless as it Looks

In 2000, approximately 25 million Americans of all ages took up the game of golf.  It’s estimated (USGA) that by 2020, 55 million players will enjoy this glorious game of triumph and frustration, except of course for the unfortunate 8 million ­–– the 8 million who will be looking desperately for medical attention for their newly developed low back pain. 

The new golfer soon finds out that what looks like a harmless, fun-filled pastime turns out to be a considerable athletic challenge –– especially to the muscles and ligaments of the lumbar spine.  They learn that playing the game effectively requires the golfer to engage in a vigorous, coordinated athletic maneuver –– one that most players are not physically prepared for.

There are certainly many ways to play the game, but if you want more power and distance off the tee, higher ball flight and consistent ball striking, you’ll have to adopt the modern golf swing.  But keep in mind, these benefits come at a significant risk ­­––

low back pain.

The modern golf swing is a perfect prelude to articular facet syndrome ­­­­–– flexion of the trunk combined with excessive lumbar rotation.  This maneuver is a recipe for chronic, low back pain.

Each vertebra has four facets –– smooth-faced surfaces that articulate with the vertebra above and the one below.  Each of these joints allow for a minimal degree of bending and twisting.  They are enclosed within a capsule of small ligaments that hold the joint together.  These small joints are most vulnerable to injury when they are subjected to excessive twisting during flexion of the trunk.  The modern golf swing can strain or tear fibers of these small, capsular ligaments.  When that happens, pain, muscle spasm and immobility are the usual results.

 

In the address position (as the player prepares to swing) the torso is flexed and held at a slight angle away from the target.  In the back-swing, a complete shoulder turn on restricted hips places rotational stress on the lumbar spine.  As the club is brought down into striking position, the “unwinding” of the shoulders produces even more rotational stress.  Finally, increased flexion of the torso is added at impact.  All in all, this maneuver requires a strong, well conditioned core musculature.

If you’re planning to take up the game of golf, or adopt the modern swing, be prepared.  Strengthen your core and protect your back.  (Read about the diagnosis and treatment of articular facet syndrome in Back Surgery-Avoid the Nightmare.)

The Mystery Continues

It has long been a mystery why some individuals are especially prone to develop chronic back pain while others are not.  The answer now appears to be genetic.

A common cause of low back pain is degenerative disc disease (DDD) – an age-related condition in which the discs dry out, become brittle and are easily torn or fractured.  As the disc deteriorates, sensory nerves within the disc become painfully exposed. 

A British study, published in the Annals of Rheumatic Diseases, looked at 4,600 people and found that the PARK2 gene was linked to age-related disc problems.

Investigators found that variants of the PARK2 gene appeared to have an effect in people with DDD.   The gene seemed to increase the speed at which their condition deteriorated.  The important question then becomes, can the gene be turned off?   Investigators say more research is needed to find the answer.

Dr. Frances Williams, of the Department of Genetic Epidemiology at King's College London, who worked on the study, said: "Further work to define the role of the PARK2 gene will, we hope, shed light on one of most important causes of lower back pain.  It is feasible that if we can build on this finding and improve our knowledge of the condition, we may one day be able to develop new, more effective treatments for back pain caused by this common condition."

Too Much of a Good Thing

The constant, exasperating pain in the low back may drive you to use a lot of acetaminophen (e.g.,Tylenol, Anacin, Liquiprin, Percocet).  The drug is commonly used to treat musculoskeletal pain, osteoarthritis, headache, back pain and other inflammatory conditions.  Make sure you’re not taking too much of it.

 The following is an excerpt from 

Back Surgery – Avoid the Nightmare

New Warnings About Acetaminophen

Be mindful of the amount of acetaminophen you’re taking. This is especially true if you’re taking other prescribed analgesics containing mixtures of acetaminophen and opiates. An overdose (more than 2,000 mg per day) of acetaminophen can damage your liver. Also, if you have diabetes or are prediabetic, remember that acetaminophen may produce false results in urine glucose tests.

“The risk of liver injury primarily occurs when patients take multiple products containing acetaminophen at one time and exceed the current, maximum dose of 4,000 mg within a 24-hour period.”

Prescribed analgesics often contain acetaminophen combined with opioids such as codeine, oxycodone, or hydrocodone. The amounts of acetaminophen in these combination products can be quite high. A tablet of Anexsia, for example, contains 750 mg of acetaminophen. Lortab, Tylox, and Vicodin have 500 mg, while Percocet has 650 mg.

The FDA has recently asked manufacturers to reduce the acetaminophen content in these products to safer levels. The important thing to remember is not to consume more than 4,000 mg of acetaminophen within a twenty-four-hour period. Taking more than that is flirting with disaster.

A Better Golf Swing With a Strong Core

When you do your core exercises, these are the muscles that are strengthened:

(Muscles of the pelvic floor, lower back and diaphragm are also part of the core musculature – they’re not shown in the illustration.)

A.  Serratus anterior

B.  Transverse abdominal

C.  Internal oblique

D.  External oblique

E.  Aponeurosis of external oblique

F.  Linea alba

G.  Tendinous insertion

H.  Rectus abdominis

The transverse abdominal (i.e., the deep muscle of the core) wraps around the trunk like a corset.  It attaches the lower ribs, diaphragm and lumbar spine to the hips.  In effect, it ties the rib cage and upper body to the pelvis and lower body.  It keeps you “connected.”

The core stabilizes the body, protects the spinal column and provides a firm support for the various physical activities we perform.

 

The upper body turn is the key to a full, natural release of the club.  Using the large muscle groups (internal and external obliques) to move the torso together with the arms and shoulders will ensure a proper release at the proper time.

Not only does a strong core facilitate a full and proper swing, it also protects the low back from excess strain.  Read about the supportive role of the core in avoidance of back pain in Back Surgery – Avoid the Nightmare

Back & Leg Pain Relief Without the Buzz

One of the most debilitating and intolerable effects of Failed Back Surgery Syndrome (FBSS) is the chronic pain in the low back and leg, lasting long after surgery.  Additionally, any conventional spinal cord stimulation treatment (SCS) used to relieve this pain very often leaves the patient with the undesirable side effects of paresthesia (i.e., numbness, tingling, buzzing and shock-like sensations).

Conventional SCS devices are commonly used to alleviate chronic pain.  However, they have been only moderately effective in alleviating leg pain (i.e., sciatica, nerve root compression symptoms) and even less effective in relieving associated low back pain.  Moreover, conventional SCS treatment produces a variety of uncomfortable tingling, buzzing and shock-like side effects (paresthesia).

The bioengineers at the Nevro Corp have high expectations.  They’ve developed a medical device designed to alleviate the chronic, debilitating pain in patients suffering from Failed Back Surgery Syndrome, with the added benefit of eliminating the paresthesia effects.

The Nevro device (Senza – RCT) is a high-frequency spinal cord stimulation (SCS) system implanted near the pain-generating site.  Small electrodes with batteries, implanted alongside the spinal cord, emit high-frequency electromagnetic pulses to the spinal cord to mask the transmission of pain signals to the brain.

 The Nevro System operates like conventional devices but delivers electromagnetic pulses at a much higher, more effective frequency. The Senza-RCT claims a two-fold advantage over conventional systems:  1. It provides prolonged pain relief in the low back and legs, and 2. It has none of the undesirable paresthesia side effects (I.E., numbness, tingling, buzzing sensations).

The FDA has approved the Nevro System for investigational use only.  Controlled studies are now being done to evaluate its safety and efficacy. 

Read about Failed Back Surgery Syndrome and its causes in Back Surgery – Avoid the Nightmare

 

The Osteoporosis Factor

A fall on the outstretched hand and resulting wrist fracture is often the first indication of osteoporosis in a postmenopausal woman.   If you’ve had such an injury recently and your X- ray image looks like the one shown below, it can be a helpful warning sign.

It’s an important notification that preventive measures need to be taken immediately to avoid much more debilitating injuries later on – fracture of the hip or spine, which can have devastating effects. Remember, by the time osteoporosis shows up on a plain x-ray image, you’ve already lost as much as 30% of bone mass.  Weak, osteoporotic bone becomes a risk factor in the treatment of other conditions that may require surgical treatment.  Diet, medication (including calcium and vitamin D supplements) and weight-bearing exercise can  halt or  retard further deterioration of bone mass and bone density.

 If you’ve had no fracture but are concerned about developing osteoporosis, a DXA scan (dual

x-ray absorptiometry) is the way to go.  It’s a more sensitive test that can detect osteoporosis much earlier. The scan (of spine or hip) may show that you have osteopenia – an early stage of bone loss that can lead to osteoporosis if not treated.   Read the details about the diagnosis of osteoporosis in my new book,  Back Surgery – Avoid the Nightmare.  

 The X-ray image shows the most frequent injury sustained after a fall on the outstretched hand.

Straighten Up and Sit Right

If you must subject yourself to  prolonged sitting, the least you can do is sit correctly.  It's one good way to avoid future episodes of low back pain.  Good sitting posture requires that you sit upright, preserving as best you can, the natural curve (lordosis) of the lumbar spine.  This means sitting with your back in slight extension.  Use a lumbar back support if necessary and be sure to include back extension and abdominal strengthening exercises in your workout routine.

There is strong evidence to show that a normal degree of lordotic curvature of the lumbar spine is associated with fewer instances of low back pain.  This is because moderate curvature in this area produces a more even distribution of compressive forces on the intervertebral discs.  Slouching in a chair tends to flatten out the lumbar spine and pinch the front portions of the lumbar discs.

Another thing you can do to avoid chronic back pain is to interrupt long periods of sitting with brief periods of standing.  Do this during the day as frequently as possible.  This way, you may be able to dodge the arrow that may be on its way toward your low back.  (Read about the effects of posture on the lumbar spine in Back Surgery-Avoid the Nightmare.)

The American Twist

A Great Exercise When Done in an “Age-Appropriate Manner” 

Benjamin Goode

bengoode@charter.net

www.bengoode-seniorfitness.blogspot.com

There have been many variations of this exercise performed here in the U.S. and since the origin of the so-called Russian Twist is a subject of continued debate, I prefer to call it the American Twist. 

At the gym, I see a lot of eager beavers grab a medicine ball, sink to the floor and vigorously begin their idiosyncratic version of the Russian, i.e., American Twist.  Many of them sit in a slumped, hyperflexed position as they swing the ball from side to side in a rather hurried manner.  Most of them are young (under 21), flexible, and in good shape. They can get away with this potentially injurious practice.

For us senior exercisers, it’s a different story.  We have to do the Twist correctly, in a controlled, deliberate way, with two important modifications.

1. Make sure to keep your back as straight as possible while doing this exercise.
2. Lean back only so far as your abdominal strength will allow.

Unlike our junior gym-mates, our muscles are somewhat tighter and shorter.  They’ve lost elasticity.  Our intervertebral discs have dried out and have lost much of their shock absorbing function.  Our spinal joints have undergone osteoarthritic changes.  We ought to keep these factors in mind when we do strenuous exercises like the Twist.

Sit on the floor with your knees flexed and your feet firmly planted.  Hold a light medicine ball directly in front of you in both outstretched hands. Keeping your back straight, lean back until you reach a comfortable, sustainable position. (An ideal setup would be a GHD Bench or an inclined bench that would allow you to lean back unassisted.)  If you begin to tire and find yourself hunching over into a “round-back,” hyperflexed position, stop doing the exercise.  To continue in this position puts you at risk of serious spinal injury. A twisting motion of the flexed spine places severe shearing forces on the articular facets of the vertebrae.  Small capsular ligaments that hold the vertebral joint in alignment can stretch and tear – a cause of chronic pain and disability.     (Read about this condition in Back Surgery-Avoid the Nightmare.)

Do this exercise with the above-mentioned, age-appropriate modifications and reap the rewards of:

• Increased range of motion in the rotation of the shoulders and upper torso; 
• Strengthening of the muscles that support and protect the lower back; 
• Cosmetic benefits of flat belly and slim waist.

Dr. Dalfino's blog on spinal decompression raises an interesting question:  How exactly can you target a specific spinal segment?  You know, there are really two distinct sources of disc pain.  There's discogenic pain resulting directly from the exposed sensory nerves in the disc itself.  And then there's the sciatic pain resulting from compression of a spinal nerve root by a bulging or herniated disc.

The Silent Disease

It sneaks up on you slowly, and then, suddenly, without warning, a bone breaks.  It’s often the first sign of osteoporosis – the silent disease.  Silent because there are no symptoms of the gradual thinning and loss of bone density in the progression of the disease.

Screening for osteoporosis using plain X-ray images is a waste of time.  By the time bone density changes are noted in these images, you’ve already lost 30% or more of bone mass.  A DEXA scan (dual-energy X-ray absorbtiometry) is the way to go.  It’s a more sensitive and reliable way to detect early stages of osteoporosis.  If you’re a 45-year-old woman – postmenopausal – it’s time to get a diagnostic, DEXA scan.  Read about osteoporotic fractures and special treatment procedures in Back Surgery – Avoid the Nightmare, available at Amazon.

A Book You Must Have

  

"It's amazing how much evidence there is that [spinal] fusions don't work, yet surgeons do them anyway."  

Sohail Mirza, MD, Chairman, Department of Orthopaedics, Dartmouth Medical School, Hanover, New Hampshire.

Back surgery has failed so often, it has become a new "disease" category – Failed Back Surgery Syndrome.

• Find out why most spinal fusion procedures end in failure.
• Do you know the risks and potential complications of back surgery?
• Is your surgeon a board certified specialist?
• Find out why conservative treatment is a better and SAFER choice.

Buy the book now at Amazon.


Give a copy to a friend or loved one to help him or her avoid the risks and complications described in the book.

                                                       

Avoid Back Surgery

Book Description

For those individuals contemplating surgery for relief of their back pain, this new book (available on Amazon) has got to be number one on your required reading list.  In Back Surgery – Avoid the Nightmare, you’ll discover some of the outrageous practices and procedures currently in use:

Complicated spinal fusion surgery – in most cases unnecessary; 

Painful, therapeutic injections – unproven and unreliable; 

Invasive, diagnostic tests – of questionable value, often dangerous; 

Excessive imaging studies – defensive medico-legal tactics.

Special attention is given to the controversial use of spinal fusion – a complex, expensive procedure with a low rate of success.  The reasons for this operation are explained and its risks and complications are described in detail.

Back surgery patients are not often told about the injurious complications following spinal surgery – complications such as:

Failed Back Surgery Syndrome

Back surgery has failed so frequently; it’s now a legitimate “disease” category.

Continued Pain After Surgery

The reason for this common complaint is that the wrong spinal segment was operated on.  Pressure on the offending nerve was never relieved.  Or worse, it was further irritated by the surgical procedure.

Faulty Placement of Artificial Discs

Improper insertion of an artificial disc can split the underlying vertebral body into dangerous, migrating fragments.

Wrong-Site Surgery

Disastrous consequences result when the surgeon operates on the wrong part of the body, the wrong patient or uses the wrong procedure.

Broken Hardware

Implanted screws, rods and metal plates can bend, break and become dislocated, damaging adjacent nerves and blood vessels.  Broken hardware is a sure sign of joint motion and subsequent failed fusion.

These and other surgical risks are described in Back Surgery – Avoid the Nightmare.

Benjamin Goode, ASFA, is a Senior Fitness Consultant, medical writer, and educator. He’s a strong advocate of patients’ rights and skeptical when it comes to the alleged benefits of the many diagnostic and therapeutic procedures now in vogue.  He believes that since acute low back pain is a self-limiting condition and because scientific evidence shows that both conservative and invasive treatments produce the same results after two years, spinal surgery – with all its risks and complications – is not a rational first choice.

The author is optimistic in his view of the advantages of conservative (non-invasive) treatment of acute, low back pain.  In the Chapter: A Winning Strategy,

he describes the benefits, safety and success of a recommended program of medication, physical therapy and rehabilitation.

Back Surgery – Avoid the Nightmare can help you navigate through a maze of ill-defined diagnostic categories, conflicting, pain-causing conditions, and controversial surgical procedures.  It lists important questions you should ask your surgeon before he operates.  It will provide you with the information you’ll need so that if and when you sign that “Informed Consent” release, you will be truly informed.

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Benjamin Goode, ASFA is a Senior Fitness Consultant, medical writer and educator. He has had more than twenty years’ experience writing and editing patient information materials in orthopedic surgery, sports injuries and rehabilitation.

In 1972, Mr. Goode and Dr. William A. Sinton founded and published the American Journal of Sports Medicine – the first professional American journal dedicated to the diagnosis and treatment of sports-related injuries.  This journal is now the official journal of The American Orthopedic Society for Sports Medicine.

“I’ve now turned my attention to the important role of exercise in the maintenance and enhancement of musculoskeletal health in an aging population.”

Back Surgery – Avoid the Nightmare

Dear Reader:  My book, Back Surgery – Avoid the Nightmare will be out very soon.  It's a must read for anyone contemplating back surgery of any kind – especially spinal fusion.  The fact is, they don't work.  In far too many cases, back pain persists or even gets worse long after surgery.  A second operation is almost always needed.

The following statement appears in the book:  "Goode is a strong advocate of patients’ rights and skeptical when it comes to the alleged benefits of many new diagnostic and therapeutic procedures now in vogue.  He believes tht since acute low back pain is a self-limiting condition and because scientific evidence shows that both conservative and invasive treatments produce the same results after two years, spinal surgery – with its risks and complications – is not a rational first choice."


Another quote from the Head of Orthopaedics, Dartmouth Medical School:  “ It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway.”  Sohail Mirza, MD, Chairman, Department of Orthopaedics, Dartmouth Medical School, Hanover, New Hampshire.


The book will be available on this site, Amazon, Booklocker and other online booksellers' sites.

The Most Important Exercises

No fitness program is complete without core-strengthening exercises.  It’s the most important set of exercises in your entire routine.  A strong and well-balanced core allows you to do all your other exercises and get the most benefit out of them.

The Heart of the Core – the deep muscles of the transverse abdominals – wraps around the trunk like a corset.  It attaches the lower ribs, diaphragm, and lumbar spine to the hips In effect, it ties the rib cage and upper body to the pelvis and lower body.  It keeps you firmly “connected.”  It also stabilizes the body, protects the spinal column and provides support for the various physical activities we perform.
Read about the importance of strengthening the core muscles in Back Surgery – Avoid the Nightmare.

Major muscles of the core are shown above.  They include muscles of the pelvic floor, lower back and diaphragm (not shown).  When you do your core exercises, these are the muscles strengthened. 

A. Serratus anterior;  B. Transverse abdominal;  C. Internal oblique;  D.  External oblique;  

E.  Aponeurosis of the ext. oblique;  F.  Linea alba;  G. Tendinous insertion;  H.  Rectus abdominus.

Think Twice About Spinal Fusion Surgery

If you’re thinking about having back surgery, you should know that  spinal fusion surgery is a risky procedure that’s most likely to fail. It has failed so often, it has become associated with a special, diagnostic category – Failed Back Surgery Syndrome  (FBSS).  This means that the vertebral bones operated upon have failed to heal, solid fusion has failed to occur, back pain will continue unrelieved and, more often than not, you’ll need another operation.

 

Many knowledgeable physicians and surgeons have studied the issue.  What do they have to say about the risks vs. benefits of spinal fusion surgery?

“It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway.”  Sohail Mirza, MD, Chairman, Department of Orthpaedics, Dartmouth Medical School, Hanover, New Hampshire.

“... among patients having surgery for degenerative disc disease, those who had spinal fusion surgery had nearly twice the rate of reoperations compared to those who did not have surgery ...”  Richard A. Deyo, MD, MPH, University of Washington, School of Public Health and Community Medicine.

"This procedure is offered to improve pain and function, yet objective outcomes showed increased permanent disability, poor return to work status, and higher doses of opioids."

Dr. Trang H. Nguyen of University of Cincinnati College of Medicine.

Don’t let your back pain drive you to the spine surgeon.  Lumbar pain is a self-limiting condition and you’ll eventually recover without any treatment whatsoever.  If the pain persists after 6 weeks, find a good physical therapist.

The American Academy of Family Physicians recommends conservative treatment for those who suffer chronic low back pain.  This includes restricted bed rest (not to exceed two days), continued activities, medication and rehabilitation (which can include chiropractic care).  Read all the details about the risks and complications of back surgery and the superior benefits of conservative treatment in my new book (soon to be published) Back Surgery – Avoid the Nightmare by Benjamin Goode.

Stiff Neck and Poor Posture

Poor postural habits – rounded upper back with head thrust forward – produces a state of constant muscular tension, usually associated with pain, headache and limited range of motion. This uncomfortable position is a constant source of pain and, if not corrected, can lead to permanent shortening of the sternocleidomastoid muscles and the muscles in the back of the neck (i.e., splenius, semispinalis and cervical erector spinae).  In other words, poor posture can lead to anatomical changes which, in turn, contribute to continued poor posture.

The sternocleidomastoid and deep scalene muscles of the neck are of major importance in rotating the head to the left and right.  Tightness and shortening of these muscles can severely restrict our ability to turn our heads.  The muscles in the back of the neck (i.e., splenius, semispinalis and cervical erector spinae) play the important role of extending the neck and stabilizing the head as it turns.  These muscles are under constant tension as they try to maintain the upright position of the head in spite of the spinal imbalance caused by faulty posture.

When chronic neck pain and restricted range of motion is the result of tight, shortened neck muscles, the best, conservative treatment should include repeated, brief periods of mild stretching combined with the application of moderate heat and massage.

In my next blog post, I’ll suggest a few simple exercises you can do each day that will relax and lengthen your neck muscles .  If you do the exercises regularly, you can increase the range of motion of your head and neck.  Stay tuned.

3 Simple Steps to a Younger Appearance

You can do a lot to correct that round-back, hunched-over posture that reduces your height and makes you look older than you really are.  All it takes are three simple stretching exercises added to your daily routine.  The following exercises are designed to improve muscle balance and restore good posture.  Do them each day for three weeks and you’ll notice marked improvement in your appearance and – attitude.

1. Posterior Neck Stretch

Lie on your back, bend your knees and keep your feet flat on the floor; with your elbows bent, move your hands up beside your head; tilt the pelvis to flatten your low back.  Press your head back with chin in to flatten the curve of the neck.  This exercise will help to loosen and lengthen the muscles behind the neck.

2. Shoulder Stretch

With your knees bent and feet flat on the floor, tilt your pelvis upward to flatten the arch of the low back.  Place both arms overhead and reach (horizontally) keeping elbows straight.  Move your outstretched arms as close in to the sides of your head as possible.  This maneuver will help to elevate the chest and strengthen the muscles of the shoulders and thoracic spine.

3. Wall-Standing Stretch

Stand with your back against the wall and with your heels three inches from the wall.  Place the back of your hands against the wall beside your head while keeping your elbows touching the wall.  Press your back against the wall to flatten the arch of the low back.  Move your arms slowly overhead (in a slight diagonal direction) maintaining contact with the wall.  For the best results, reach a little bit higher each time you do this exercise.  (This exercise can also be done from a sitting position using a chair or low stool pushed up against the wall.)

Exercises to Avoid

The following exercises are counter-productive and may be injurious:

• Lying on the back and raising both legs at the same time;
• Lying on the back and coming up to a sitting position with legs held down;
• Lying on the back with weight on upper back and doing “bicycle’ exercise;
• Standing or sitting with knees straight and bending forward to touch toes;
• Raising the trunk from a face-lying position.

These exercises places excessive stress on the lumbar spine, create muscle imbalance and tend to shorten the hip flexor muscles.

Set the Core – Prevent Low Back Pain

We all go to the gym essentially for the same reason – to make changes in our physical lives.  We want exercises that will help us lose weight, build muscle or improve our general health and appearance.  However, as we reach our 40s and 50s, there are physical and functional changes that occur within our bodies that interfere with the improvements we want to make.   These changes are part of the aging process we all have to contend with.

As we grow older, we become more vulnerable to certain types of injury. Our intervertebral discs dry out.  They become brittle and fractured.  The soft nucleus of the disc is forced out of its normal position and sometimes impinges upon spinal nerves.  Spinal ligaments become calcified and lose their elasticity.  Osteoarthritis of spinal joints can constrict spinal nerves and cause sciatic pain.  And even with relatively minor injuries, our recovery time is longer.

These changes occur in all of us – in some, they are mild, in others, severe.  The pain caused by these conditions varies considerably from one individual to the next.  A severe osteoarthritic spinal joint might cause niether pain nor discomfort in one individual while a much less severe condition can cause excruciating, debilitating pain in someone else.  A minor muscle strain, for example, can produce a painful spasm that can immobilize the entire body.

One of the most common injuries experienced by the older exerciser is a strain of the muscles that support the lumbosacral joint. Spasm, pain and disability are the usual consequences. Here’s a technique you can use that will protect your lumbar spine against sprains and dislocations (destabilization) during your normal exercise routine.  It’s called The Valsalva Maneuver.

The Valsalva maneuver is the attempt to force air out through a closed airway (glottis).  Power lifters and body builders use this technique to support the lumbar spine.  They call it “setting the core.” The maneuver increases intra-thoracic and intra-abdominal pressure adding rigidity to the lumbar spine and keeping it in alignment throughout the exercise.  You can master this technique with a little practice. 

First, take a deep breath and hold it for 3 or four seconds.  Now try to exhale  – but keep your airway closed.  You’ll feel your abdominals and paraspinal muscles tighten.  Now, open your airway and exhale normally.  Next, repeat this maneuver but this time release about 50% of the air you inhaled.  After 3 or 4 seconds, exhale normally.  Finally, do the same thing, but release another 20% of the air you took in.  You’re now left with about 30% of intra-abdominal pressure – sufficient to protect your lumbar spine during almost any exercise.  Remember – the stronger your core muscles are, the greater the protection you’ll get.  Don’t worry about the adverse effects of holding your breath.  You’ll find that as you gain more control over your “abdominal corset” you’ll be able to breath

normally – inhaling on exertion and exhaling as you complete the exercise.

Almost all of the exercises used in a strength-training program require a balanced, stable lumbar spine for support.  When you do any of these exercises, do them correctly. But before you do them, think kindly about your back ..... set the core.