Don't Fear Lifting

My seven year-old daughter, Katie, asked me recently if she could be in one of my blogs.  This recent snow day, she got her chance.

I was working through a quick 9 minute kettle bell routine (exercise doesn't have to take long!) with Katie in the room.  Anytime she sees me doing some sort of exercise she usually joins in, which I love.  Afterwards, I gave her a quick lesson on how to lift safely via a dead lift.  Check her out:

I can't tell you how many times people express fear of lifting something from the floor.  I've had people ask me to write them a letter vouching for the fact that they "can't" lift things at work.  Perhaps some are simply looking for an excuse to avoid the full job responsibilities.  Others may genuinely be afraid because lifting is how they injured themselves in the first place.  Or they have been told by another health care provider to "avoid lifting heavy things".

What is heavy, anyway?  I've had folks freeze when asked to pick up 10 pounds!  This really ought to be an insignificant weight for almost everybody.  We are designed way too sturdily to go around life fearful of lifting a measly 10 pounds from the floor.

Katie's dead lift above was 20 kg (44.1 lbs).

Granted, my daughter has never had a pain seed planted in her brain due to a lifting mishap, so she has no fear.  But if a 7 year-old girl can safely pick up something nearly matching her body weight, it ought to make one question a fear of lifting significantly less.

If you ever find yourself unwilling or unable to perform a routine task like picking something up, get to work figuring out why.  Then, develop a safe strategy for relearning the task so that you no longer live with fear avoidance.  Life's too short for that.

Pain Free? Don't Take it For Granted!

This is the mug that I use at work:

I try to be an optimistic person.  I kind of have to be, because nearly every one of the clients I work with every day is in some level of pain (with the exception of the older adult with a gait or balance impairment).  It's really the only reason that they land in my clinic.  Pain or injury brought them in, and I want to do my best to show them the way out of it.

It's often said that we take our health for granted, and it's probably true.  We're too busy to stop to reflect on what it means to be fully functional, disease and pain-free.  So, tomorrow morning when you get out of bed to start your day, take a moment to reflect on some of the following things:

Can you to sleep soundly without pain?

Can you get dressed without pain?

Can you climb stairs without pain?

Can you sit without pain?

Can you walk without pain, and without fatiguing easily?

Can you get down to and up from the floor with relative ease, and without discomfort?

Can you take a deep breath without pain?

Can you bend down to touch your toes or put on your socks and shoes without pain?

Can you get out of bed without pain?

Can you reach up overhead to get things from cabinets without pain?

Can you lift, pull, push, and carry things without pain?

Can you enjoy your recreational activities without pain?

Can you perform your job without pain?

These are just a few of the things that folks report having difficulty doing due to pain and/or weakness.  If you can do all of these things without any issues, take a moment to appreciate how fortunate you are.

Pain is a good thing.  It helps keep us alive and acts as a warning when something may be wrong.  While we all want to avoid pain, don't fear it.  Just find out what to do about it when it comes along and impacts your daily life.

Most importantly, be grateful for the days when all your systems are in working order.  It's truly a blessing that should not be taken for granted.

Three Simple Back Exercises

Here is a statistic from Steven Brill's recently released book on the current state of health care in the United States, "America's Bitter Pill":

"We spend $85.9 billion trying to treat back pain, which is as much as we spend on all of our country's state, city, county and town police forces.  And experts say that as much as half of that is unnecessary."

Wow.  That is just a staggering fact to digest!

Here's the thing.  Most back pain will go away within a reasonable period of time.  What I'm consistently teaching my patients is how to manage their backs, rather than let their backs manage them.  Towards that end, I want to share with you three very basic exercises that will go a long way towards helping you keep a healthy back.  They don't require any special equipment or a gym membership.  Just a little effort, consistency, and attention to form.

Stuart McGill, PhD is a professor at the University of Waterloo outside of Toronto.  He is considered the foremost expert on spine biomechanics and is a go-to resource for anyone in the field of rehabilitation.  If anyone has studied the spine and its properties more thoroughly than Dr. McGill, he or she has yet to identify themselves.  Dr. McGill has shared what he considers his "Big Three" core exercises for good spine health.  They are the McGill curl up, the plank, and the birdog.  Here is a quick clip of each:

McGill Curl Up

The Plank

The Birdog:

In this clip, I use a foam roller as a "coach" to help keep me in a neutral position.  It is not necessary but simply augments the exercise.

Each of these exercises can be progressed or regressed, making them more difficult or easier based on one's capabilities.  As you can see, they're pretty basic movements that don't require more than a little floor space.  Give them a try.  They're free.  Maybe, just maybe, they will help you do your individual part in chipping away at that $85 billion price tag.

Logging Your Pain

Several weeks ago, I noticed that my right thumb was bothering me.  Nothing major, but a bit of a nuisance.  My first thought was that I may be developing some arthritis due to the fact that I use my hands all day long in my practice.

On Wednesday, I got home from work and took the Christmas tree down, finally.  As I sprawled out on the floor and worked to unscrew the base from the trunk of the tree, it hit me as to why my thumb has been bothering me.  It was just an overuse issue, not arthritis (thankfully).  It happened that our tree this year required a bit more attention than usual as it wouldn't seem to stay upright.  Therefore, it necessitated more adjustments than typical.  Had I just taken a moment to think back to when my pain began, I would have figured it out.  I should have known better.

When taking a history in the clinic, I ask patients to describe many things about their painful condition.  When does it hurt?  What is the intensity?  Are there certain positions that bring out your pain?  What makes it feel better?  Was there a specific event that precipitated your pain?  These are just a few examples of the information I'm seeking in order to help piece together the puzzle.  They will help me find the root cause of the issue, and ultimately design a proper treatment plan.

This history taking may seem obvious and easy, but I can assure you that it isn't always.  Most folks are too consumed with everyday life to note exactly when their pain began (I'm not talking about traumatic events here, such as a car accident, which are obvious).  But because the nature of insidious onset pain can provide your health care provider with very valuable information, it's important to identify causation as thoroughly as possible.

One simple suggestion that I would offer is to keep a pain log.  For several days, jot down when you notice your pain.  What activities are you doing to exacerbate it?  What positions?  What's the intensity?  When you put in in writing, you'll be better able to notice patterns.  And as I mentioned, it's these patterns that will help you and your health care provider figure out the best plan to ultimately resolve your condition.

The next time you're in pain, think about the possible causes.  When you can't think of a thing, keep thinking.  Pain doesn't crop up for no reason.  You may find yourself surprised that the cause, while not initially evident, is more obvious than you thought.