Is anyone working harder than the big man in the red suit this time of year? With just a few days before Christmas, I began to think about St. Nick and the likelihood that the dude is most likely dealing with some physical pain, especially related to his back. Here are some reasons why.
First of all, the grey beard is a telling sign. Santa is probably at least well into his sixties. Unfortunately for him and his contemporaries, the discs located between each vertebral segment of the spine have lost some of their elasticity over the years. Think of your discs as little jelly donuts. A thick fibrous shell protects a soft gelatinous center. With age, the fibrous shell loses it's ability to contort and adapt to different loads and forces. The fibers begin to break and the nucleus, or jelly, may begin to poke through to the outside. This is known as a "bulging disc". When it completely pops through you have a prolapsed, or herniated, disc. These bulges or herniations can press against a nerve root where it exits the spinal column. What you are left with is pain and/or tingling that can radiate down into your buttocks, leg, and even foot. In addition to possible changes in his discs, a person of Santa's vintage might expect to have some bony changes in their spine that can also lead to pain. Stenosis is a narrowing of the spinal canal (where your all-important spinal cord is housed and protected) and/or the spaces where the nerve roots exit the spine. The symptoms associated with this condition are typically exacerbated with standing and can cause radiating pain with walking. People with stenosis are the folks you see stooped over as they walk down the street, barely able to look up. These are just a couple of examples of non-traumatic, age-related back issues that can cause pain.
Along with his age-revealing beard, Santa has another evident physical characteristic which makes him prone to low back pain. The big round belly he developed through years of cookies, eggnog, and booze (let's face it, what else could possibly keep the guy so jolly in those frigid temps?) is likely effecting his back. A healthy spine is well-supported in the front, back, and sides. With his pot belly protruding in front of him, there is a stronger force being placed on his spine from the front. The big belly means Santa probably has some pretty weak abdominal and deep core muscles. Very doubtful he's partaking in any North Pole Pilates sessions. This unbalanced spine has an increased likelihood for developing painful symptoms.
This time of year, Santa spends a ton of time sitting so that millions of kids can jump on his lap and make their requests, presuming they were given the green light by the "Elf on the Shelf". So what does that mean for the big guy's back? Well, a few things, perhaps. First of all, remember the jelly donut? Well, if you put one on the ground and stepped on the front half of it, the donut will compress underfoot and the jelly will look to shoot out the opposite side. Sitting essentially does the same thing to your discs. When we are seated without proper low back alignment, we are flexing our lumbar (lowest section) spine, meaning we bend it forward. That movement causes the vertebrae (spinal bones) to compress together in the front and gap in the rear. The same thing happens when you stepped on that jelly donut. The outside fibrous ring of the disc mushes down, and the nucleus (jelly) seeks to find space toward the back side of the spine. The nucleus shoots out the back where the nerve roots exit the spine, presses up against one of them, and pain! People who have bulging or herniated discs typically don't like to sit for long periods of time for this very reason. If indeed Santa is dealing with some lumbar disc pain, the cheery facade must be due in part to a healthy dose of Vicodin.
A second reason all that sitting might take it's toll on Santa's low back is the tightening of his psoas muscles, which are responsible for flexing his hips. When you sit, this muscle is put in a shortened position, and over time it can become chronically tight. "So what?" you might ask. Well, because of it's attachement to the spine, a tight psoas muscle might apply too much pulling force to those spinal segments, in turn throwing off it's healthy balance. This is an important muscle that should not be forgotten when addressing back pain. If you are someone who has to sit all day at work, make sure to learn how to stretch you hip flexors. Your low back will feel better as a result.
Another reason for Santa's potential back pain is what he's doing as he sits. The discs throughout our spines accommodate different pressures depending on our positioning. For example, there is a whole lot less interdiscal pressure when we're lying down as opposed to standing up. The greatest level of disc pressure in our low backs occurs when we're seated in a slumped position. To make matters worse, leaning forward to pick up a load, especially with a twisting motion, increases the pressure even more. What is poor St. Nick doing all day throughout every mall in America? Sitting, leaning forward, and hoisting one child after another onto his lap. A recipe for disc disaster. If he wanted to give his discs some relief at the end of his sitting marathon, Santa might want to lie on his back with his feet elevated and supported by a low stool (hips and knees bend at 90 degrees). This is the position with the least amount of pressure on the discs.
One final reason that sitting could be problematic. If Santa sits on a big fat wallet while he's navigating his sled around the world, two things could occur. For starters, a thick wallet might throw his pelvis off kilter. In the short term, probably not a big deal. But over the course of a long sleigh ride or drive, this could have a negative effect on the sacroiliac joint, where the pelvic bones meet the sacrum (tailbone). Again, all about balance. An additional hazard of a big wallet is pressure on the sciatic nerve, which originates from nerve roots in the lumbar spine, comes together as a big thick nerve, and runs down through your buttock to your leg. This nerve happens to run beneath a muscle in your buttocks called the piriformis. A tight piriformis may be enough to put pressure on the nerve, so it's important to learn how to stretch it. In addition, sustained direct pressure on that muscle and underlying sciatic nerve (as occurs with a big wallet and long drive) could be enough to cause sciatic pain.
Last but not least is the stress of Santa's job. Distributing millions of gifts to children worldwide over a 12 hour period has to get his blood pressure rising. Over the years in my clinic, I've seen first-hand the correlation between stress and back pain. In fact, there is a doctor at NYU named Dr. John Sarno who hypothesizes that back pain is nothing more than a manifestation of emotional tension and stress. He theorizes that physical pain is in many ways easier for us to cope with than mental stress, and that by expressing itself physically rather than emotionally, we are able to get up and function each day. Otherwise, the emotional stress would render us incapacitated. He therefore uses talk therapy as a central intervention in treating low back patients. I know he has devoted disciples who subscribe to his theory (Howard Stern is a famous example), and I can attest to the connection through professional as well as personal experience. In the weeks before I got married, I began to experience low back pain ( and my hair was falling out). It was by no stretch incapacitating, yet it was noticeable and annoying. I didn't feel stressed out but apparently I must have been. In the final days preceding the wedding, the pain ramped up. But then, as soon as we were lounging poolside in Hawaii.......no pain!
Is poor Santa and others like him destined for back misery? No, not necessarily. While there's not much to be done about his age, Santa can certainly help himself out with some general exercise, core strength training, stretching, use of a lumbar support roll while sitting, use of a money clip in the front pocket instead of a fat wallet in the back, and standing up at least once every half hour or so. Not every back patient experiences pain for the same reason, but these simple interventions are probably a wise idea for all of us if we hope to maintain good back health. Nobody is ever a lost cause, and it's never too late to start.
So, when Santa wedges his XXL body down your chimney this year, offer him some extra cookies and eggnog for his efforts. Better yet, give him some vegetables, a yoga/Pilate's mat, and a CD with some relaxing meditations. His back will thank you for it.
MERRY CHRISTMAS AND HAPPY HOLIDAYS TO ALL OF YOU!
First of all, the grey beard is a telling sign. Santa is probably at least well into his sixties. Unfortunately for him and his contemporaries, the discs located between each vertebral segment of the spine have lost some of their elasticity over the years. Think of your discs as little jelly donuts. A thick fibrous shell protects a soft gelatinous center. With age, the fibrous shell loses it's ability to contort and adapt to different loads and forces. The fibers begin to break and the nucleus, or jelly, may begin to poke through to the outside. This is known as a "bulging disc". When it completely pops through you have a prolapsed, or herniated, disc. These bulges or herniations can press against a nerve root where it exits the spinal column. What you are left with is pain and/or tingling that can radiate down into your buttocks, leg, and even foot. In addition to possible changes in his discs, a person of Santa's vintage might expect to have some bony changes in their spine that can also lead to pain. Stenosis is a narrowing of the spinal canal (where your all-important spinal cord is housed and protected) and/or the spaces where the nerve roots exit the spine. The symptoms associated with this condition are typically exacerbated with standing and can cause radiating pain with walking. People with stenosis are the folks you see stooped over as they walk down the street, barely able to look up. These are just a couple of examples of non-traumatic, age-related back issues that can cause pain.
Along with his age-revealing beard, Santa has another evident physical characteristic which makes him prone to low back pain. The big round belly he developed through years of cookies, eggnog, and booze (let's face it, what else could possibly keep the guy so jolly in those frigid temps?) is likely effecting his back. A healthy spine is well-supported in the front, back, and sides. With his pot belly protruding in front of him, there is a stronger force being placed on his spine from the front. The big belly means Santa probably has some pretty weak abdominal and deep core muscles. Very doubtful he's partaking in any North Pole Pilates sessions. This unbalanced spine has an increased likelihood for developing painful symptoms.
This time of year, Santa spends a ton of time sitting so that millions of kids can jump on his lap and make their requests, presuming they were given the green light by the "Elf on the Shelf". So what does that mean for the big guy's back? Well, a few things, perhaps. First of all, remember the jelly donut? Well, if you put one on the ground and stepped on the front half of it, the donut will compress underfoot and the jelly will look to shoot out the opposite side. Sitting essentially does the same thing to your discs. When we are seated without proper low back alignment, we are flexing our lumbar (lowest section) spine, meaning we bend it forward. That movement causes the vertebrae (spinal bones) to compress together in the front and gap in the rear. The same thing happens when you stepped on that jelly donut. The outside fibrous ring of the disc mushes down, and the nucleus (jelly) seeks to find space toward the back side of the spine. The nucleus shoots out the back where the nerve roots exit the spine, presses up against one of them, and pain! People who have bulging or herniated discs typically don't like to sit for long periods of time for this very reason. If indeed Santa is dealing with some lumbar disc pain, the cheery facade must be due in part to a healthy dose of Vicodin.
A second reason all that sitting might take it's toll on Santa's low back is the tightening of his psoas muscles, which are responsible for flexing his hips. When you sit, this muscle is put in a shortened position, and over time it can become chronically tight. "So what?" you might ask. Well, because of it's attachement to the spine, a tight psoas muscle might apply too much pulling force to those spinal segments, in turn throwing off it's healthy balance. This is an important muscle that should not be forgotten when addressing back pain. If you are someone who has to sit all day at work, make sure to learn how to stretch you hip flexors. Your low back will feel better as a result.
Another reason for Santa's potential back pain is what he's doing as he sits. The discs throughout our spines accommodate different pressures depending on our positioning. For example, there is a whole lot less interdiscal pressure when we're lying down as opposed to standing up. The greatest level of disc pressure in our low backs occurs when we're seated in a slumped position. To make matters worse, leaning forward to pick up a load, especially with a twisting motion, increases the pressure even more. What is poor St. Nick doing all day throughout every mall in America? Sitting, leaning forward, and hoisting one child after another onto his lap. A recipe for disc disaster. If he wanted to give his discs some relief at the end of his sitting marathon, Santa might want to lie on his back with his feet elevated and supported by a low stool (hips and knees bend at 90 degrees). This is the position with the least amount of pressure on the discs.
One final reason that sitting could be problematic. If Santa sits on a big fat wallet while he's navigating his sled around the world, two things could occur. For starters, a thick wallet might throw his pelvis off kilter. In the short term, probably not a big deal. But over the course of a long sleigh ride or drive, this could have a negative effect on the sacroiliac joint, where the pelvic bones meet the sacrum (tailbone). Again, all about balance. An additional hazard of a big wallet is pressure on the sciatic nerve, which originates from nerve roots in the lumbar spine, comes together as a big thick nerve, and runs down through your buttock to your leg. This nerve happens to run beneath a muscle in your buttocks called the piriformis. A tight piriformis may be enough to put pressure on the nerve, so it's important to learn how to stretch it. In addition, sustained direct pressure on that muscle and underlying sciatic nerve (as occurs with a big wallet and long drive) could be enough to cause sciatic pain.
Last but not least is the stress of Santa's job. Distributing millions of gifts to children worldwide over a 12 hour period has to get his blood pressure rising. Over the years in my clinic, I've seen first-hand the correlation between stress and back pain. In fact, there is a doctor at NYU named Dr. John Sarno who hypothesizes that back pain is nothing more than a manifestation of emotional tension and stress. He theorizes that physical pain is in many ways easier for us to cope with than mental stress, and that by expressing itself physically rather than emotionally, we are able to get up and function each day. Otherwise, the emotional stress would render us incapacitated. He therefore uses talk therapy as a central intervention in treating low back patients. I know he has devoted disciples who subscribe to his theory (Howard Stern is a famous example), and I can attest to the connection through professional as well as personal experience. In the weeks before I got married, I began to experience low back pain ( and my hair was falling out). It was by no stretch incapacitating, yet it was noticeable and annoying. I didn't feel stressed out but apparently I must have been. In the final days preceding the wedding, the pain ramped up. But then, as soon as we were lounging poolside in Hawaii.......no pain!
Is poor Santa and others like him destined for back misery? No, not necessarily. While there's not much to be done about his age, Santa can certainly help himself out with some general exercise, core strength training, stretching, use of a lumbar support roll while sitting, use of a money clip in the front pocket instead of a fat wallet in the back, and standing up at least once every half hour or so. Not every back patient experiences pain for the same reason, but these simple interventions are probably a wise idea for all of us if we hope to maintain good back health. Nobody is ever a lost cause, and it's never too late to start.
So, when Santa wedges his XXL body down your chimney this year, offer him some extra cookies and eggnog for his efforts. Better yet, give him some vegetables, a yoga/Pilate's mat, and a CD with some relaxing meditations. His back will thank you for it.
MERRY CHRISTMAS AND HAPPY HOLIDAYS TO ALL OF YOU!
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