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.