If you’ve ever hurt your lower back, you know how much it can affect your life. Whether you’re getting up from a chair, carrying groceries or hoisting a barbell overhead, your lower back is involved in nearly every movement.
While lower back injuries should be treated with the help of a doctor or physical therapist, many cases of lower back pain can be avoided with simple exercises that strengthen the core muscles and teach proper movement of the spine. Stuart McGill, PhD, professor emeritus at the University of Waterloo and the world’s premier authority on spinal health, designed exercises to build a healthy spine.
McGill’s research has been pivotal in helping people understand core training for a healthy spine should focus on stability exercises like planks. Movements that bend the spine like crunches and situps, could even contribute to lower back injuries if performed incorrectly or too often. McGill’s “big three” exercises can be combined into a daily routine that requires no equipment and can be done at home or in the gym.
If you’ve been injured and your doctor has cleared you to work out again, or if you’re perfectly healthy and want to give yourself the best chance to keep your spine pain-free, try these three simple exercises to start building a more resilient spine for all of life’s activities.
Back pain can often be traced to two simple culprits:
1. The lower back itself moves too much.
2. The joints around the lower back (e.g., hips and upper back) don’t move enough.
The McGill curlup teaches you to stabilize your lumbar spine (lower back) using your abs, while moving through the thoracic spine (upper back). The act of pushing the lower back into the floor is how you properly “brace” your abs, so remember how that feels because you should be using it for just about every other exercise you do.
The move: Lie on the floor, face up to the ceiling. Bend one knee until your heel is flat to the floor, a few inches away from your butt. Keep the other leg straight and dig the heel of that foot into the floor, pointing your toes to the ceiling. Place your hands under your lower back and actively push your lower back into your hands to engage your abdominal muscles. Bring your chin toward your chest but keep your head on the ground. Continue to push your lower back into the floor to gently lift your shoulders off the ground. Make sure not to curl your chin toward your chest or let your lower back leave the floor. Perform all your reps on one side, then repeat on the other side.
Sets and Reps: 2 sets of 5–10 reps per side, holding each rep for 3–10 seconds (hold each rep longer to make these more challenging)
The McGill curlup teaches you how to brace your abs, now it’s time to put that stability to the test with bird dogs. This teaches you how to move your arms and legs around a solid core position without moving from your lower back.
The move: Start on your hands and knees with your hands directly under your shoulders and knees directly under your hips. Flatten your back by bracing your abs much like you did with the curlup, but instead of pushing your lower back into the floor, tighten your abs as if someone is about to punch you in the stomach. Reach out with your opposite arm and leg until both limbs are parallel to the floor. Be careful not to arch your lower back — imagine keeping your leg long and low. Repeat with the other arm and leg, making sure to brace your abs on every rep.
If you feel like a fish out of water when doing bird dogs because you’re not quite coordinated enough yet, try them with just your legs first. Once you’re able to lift your leg parallel to the floor without arching your lower back, add in your arms, too.
Sets and Reps: 2 sets of 5–10 reps per side, holding each rep for 1–5 seconds (hold each rep longer to make these more challenging)
SHORT SIDE PLANK
Curlups and bird dogs mostly work your ab muscles on the front of your body: the rectus abdominis and transverse abdominis. But we can’t forget the important oblique muscles, your “side abs.” The short side plank builds strength in your obliques to prevent unwanted twisting and side bending of the spine.
The short side plank resembles a traditional side plank but leaves your bottom knee on the floor for added stability. Think of it as a more user-friendly side plank so you can learn how to properly use your obliques to support your spine.
The move: Lay on your side with your bottom elbow and leg on the floor. Bend your knees until your upper and lower leg form a 90-degree angle. Tuck your bottom elbow tight to your side, squeezing your bottom fist. Lift your bottom hip off the ground while leaving your bottom knee and elbow on the floor. Pull your shoulders back and squeeze your glutes to keep a straight line from your head to your knees. Inhale through your nose and exhale through your mouth for the duration of the exercise. Repeat on the opposite side.
Sets and Reps: 2 sets of 5–10 seconds per side. Even though 10 seconds may seem quick, exhaling forcefully (like you’re blowing up a balloon) can make even just 10 seconds seem challenging.
[June 17, 2013, Rensselaer, NY] – Fibromyalgia, a painful condition affecting approximately 10 million people in the U.S., is not imaginary after all, as some doctors have believed. A discovery, published this month in PAIN MEDICINE (the journal of the American Academy of Pain Medicine), clearly now demonstrates that fibromyalgia may have a rational biological basis located in the skin.
Fibromyalgia is a severely debilitating affliction characterized by widespread deep tissue pain, tenderness in the hands and feet, fatigue, sleep disorders, and cognitive decline. However, routine testing has been largely unable to detect a biological basis for fibromyalgia, and standard diagnosis is based upon subjective patient pain ratings, further raising questions about the true nature of the disease. For many years, the disorder was believed to be psychosomatic (“in the head”) and often attributed to patients’ imagination or even faking illness. Currently approved therapeutics that provide at least partial relief to some fibromyalgia patients are thought to act solely within the brain where imaging techniques have detected hyperactivity of unknown origin referred to as “central sensitization.” However, an underlying cause has not been determined, leaving many physicians still in doubt about the true origins or even the existence of the disorder.
Now, a breakthrough discovery by scientists at Integrated Tissue Dynamics LLC (Intidyn), as part of a fibromyalgia study based at Albany Medical College, has provided a biological rationale for this enigmatic disease. The small biotechnology research company, founded by neuroscientists Dr. Frank L. Rice and Dr. Phillip J. Albrecht, reports on a unique peripheral neurovascular pathology consistently present in the skin of female fibromyalgia patients which may be a driving source of the reported symptoms.
“Instead of being in the brain, the pathology consists of excessive sensory nerve fibers around specialized blood vessel structures located in the palms of the hands,” said Dr. Rice, President of Intidyn and the senior researcher on the study.
“This discovery provides concrete evidence of a fibromyalgia-specific pathology which can now be used for diagnosing the disease, and as a novel starting point for developing more effective therapeutics.”
Nerve Endings Come In Many Forms
Three years ago, Intidyn scientists published the discovery of an unknown nervous system function among the blood vessels in the skin in the journal PAIN.
As Dr. Rice explained, “we analyzed the skin of a particularly interesting patient who lacked all the numerous varieties of sensory nerve endings in the skin that supposedly accounted for our highly sensitive and richly nuanced sense of touch. Interestingly however, this patient had surprisingly normal function in day to day tasks. But, the only sensory endings we detected in his skin were those around the blood vessels”. Dr. Rice continued, “We previously thought that these nerve endings were only involved in regulating blood flow at a subconscious level, yet here we had evidencs that the blood vessel endings could also contribute to our conscious sense of touch… and also pain.”
Now, in collaboration with renowned Albany Medical Center neurologist and pain specialist Dr. Charles E. Argoff, the study primary investigator, and his collaborators Dr. James Wymer also at Albany Medical College and Dr. James Storey of Upstate Clinical Research Associates in Albany, NY, clinical research proposals were funded by Forest Laboratories and Eli Lilly. Both pharmaceutical companies have developed FDA-approved medications with similar functions (Serotonin/Norepinephrine Reuptake Inhibitors, SNRI) that provide at least some degree of relief for many fibromyalgia patients.
“Knowing how these drugs were supposed to work on molecules in the brain,” Dr. Albrecht added, “we had evidence that similar molecules were involved in the function of nerve endings on the blood vessels. Therefore, we hypothesized that fibromyalgia might involve a pathology in that location”. As the results demonstrate, they were correct.
To analyze the nerve endings, Drs. Rice, Albrecht, and postdoctoral researcher Dr. Quanzhi Hou, used their unique microscopic technology to study small skin biopsies (less than half the size of a pencil eraser) collected from the palms of fibromyalgia patients, who were being diagnosed and treated by Drs. Argoff, Wymer, and Storey. The study was limited to women, who have over twice the occurrence of fibromyalgia than men. What the team uncovered was an enormous increase in sensory nerve fibers at specific sites within the blood vessels of the skin. These critical sites are tiny muscular valves, called arteriole-venule (AV) shunts, which form a direct connection between arterioles and venules (see diagram).
As Dr. Rice describes their function, “We are all taught that oxygenated blood flows from arterioles to capillaries, which then convey the deoxygenated blood to the venules. The AV shunts in the hand are unique in that they create a bypass of the capillary bed for the major purpose of regulating body temperature.”
A Thermostat for the Skin
In humans, these types of shunts are unique to the palms of our hands and soles of our feet which work like the radiator in a car. Under warm conditions, the shunts close down to force blood into the capillaries at the surface of the skin in order to radiate heat from the body, and our hands get sweaty. Under cold conditions, the shunts open wide allowing blood to bypass the capillaries in order to conserve heat, and our hands get cold and put on gloves.
According to Dr. Albrecht, “the excess sensory innervation may itself explain why fibromyalgia patients typically have especially tender and painful hands. But, in addition, since the sensory fibers are responsible for opening the shunts, they would become particularly active under cold conditions, which are generally very bothersome to fibromyalgia patients.”
A role in regulating blood flow throughout the body.
Although they are mostly limited to the hands and feet, the shunts likely have another important function which could account for the widespread deep pain, achiness, and fatigue that occurs in fibromyalgia patients. “In addition to involvement in temperature regulation, an enormous proportion of our blood flow normally goes to our hands and feet. Far more than is needed for their metabolism” noted Dr. Rice. “As such, the hands and the feet act as a reservoir from which blood flow can be diverted to other tissues of the body, such as muscles when we begin to exercise. Therefore, the pathology discovered among these shunts in the hands could be interfering with blood flow to the muscles throughout the body. This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation fibromyalgia patients. This, in turn, could contribute to the hyperactvity in the brain.”
Dr. Albrecht also points out that alterations of normal blood flow may underlie other fibromyalgia symptoms, such as non-restful sleep or cognitive dysfunctions. “The data do appear to fit with other published evidence demonstrating blood flow alterations to higher brain centers and the cerebral cortex of fibromyalgia patients” he stated. Senior Research Chair of the Alan Edwards Center for Pain Research at McGill University, Dr. Gary Bennett, commented after seeing the results that “It is exciting that something has finally been found. We can hope that this new finding will lead to new treatments for fibromyalgia patients who now receive little or no relief from any medicine.”
This discovery of a distinct tissue pathology demonstrates that fibromyalgia is not “all in your head”, which should provide an enormous relief to fibromyalgia patients, while changing the clinical opinion of the disease and guiding future approaches for successful treatments.###
About Integrated Tissue Dynamics LLC (Intidyn)
Integrated Tissue Dynamics LLC, located in Rensselaer, NY amid the Capital region’s Technology Valley, provides flexible and scalable pre-clinical and clinical research and consulting capabilities on skin and nerve related chronic pain afflictions in collaboration with the pharmaceutical industry, government agencies, academia, and a network of pain specialists throughout the United States. The Intidyn ChemoMorphometric Analysis (CMA) platform can be used to detect chemical and structural changes in the skin and other tissues related to chronic pain, numbness, and itch associated with a wide variety of afflictions, including diabetes, shingles, complex regional pain syndrome, carpal tunnel syndrome, sciatica, fibromyalgia, psoriasis, chemotherapy, unintended side effects of pharmaceuticals, and others.
How to Support Further Research on Fibromyalgia and Other Types of Chronic Pain
Tax deductable donations to support the research of a nationwide network of pain specialists, which includes Drs. Argoff and Wymer at Albany Medical College, can be made to the Clinical Pain Research Program at the University of California San Diego, an American Pain Society Center of Excellence, by contacting the UC San Diego Office of Development (giving.ucsd.edu; 858-534-1610; specify area of research) or UC San Diego Center for Pain Medicine (anes-cppm.ucsd.edu; 858-657-7072). This network, referred to informally as the Neuropathic Pain Research Consortium, includes top neurologists, anesthesiologists, and research scientists at leading universities and pain treatment centers in California, Illinois, Maryland, Massachusetts, Minnesota, New York, Utah, Washington, and Wisconsin.
Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue.
Pain Medicine, May 20. doi: 10.1111/pme.12139 [Epub ahead of print].
You may already suspect your metabolism slows as you age. According to research published in the Public Health Nutrition journal, you’re right. In a review of data on energy expenditure, researchers found simply getting older is associated with progressive declines in basal metabolic rate. On top of that, there are many daily habits that can drain your metabolism even further.
But you don’t have to go down without a fight. Cut out the below habits and watch your metabolism and energy levels improve.
Eating a nutritious breakfast is always a good way to start your morning. Because your metabolism slows down during sleep, eating can fire it up and help you burn more calories throughout the day. According to Rush University Medical Center, “When you eat breakfast, you’re telling your body that there are plenty of calories to be had for the day. When you skip breakfast, the message your body gets is that it needs to conserve rather than burn any incoming calories.”
OK, so it’s about more than just eating something in the morning. If you grab a sugary donut or eat a muffin in the car, you’re setting yourself up to crash later. Instead, choose something with filling protein and fiber like eggs, yogurt and berries or whole-wheat toast topped with peanut butter.
Going from your office chair to your car to your couch can lead to a very sedentary routine. And sitting for extended periods puts your body into energy-conservation mode, which means your metabolism can suffer. According to the UK’s National Health Service, “Sitting for long periods is thought to slow metabolism, which affects the body’s ability to regulate blood sugar, blood pressure and break down body fat.”
Cardio is great, and it can quickly burn calories, but once you’re done running or cycling, your calorie burn quickly returns to normal. When you do HIIT and resistance-based workouts, however, your calorie burn stays elevated for longer as your muscles repair themselves. Per the American Council on Exercise (ACE): “Strength training is a key component of metabolism because it is directly linked to muscle mass. The more active muscle tissue you have, the higher your metabolic rate.” And, according to ACE, a pound of muscle burns an additional 4–6 calories each day compared to a pound of fat.
Protein feeds your muscles, promotes satiety and is an important component to sustaining a healthy weight. Eat too little, and you may have trouble building or maintaining muscle mass — and per the above, we know muscle’s importance to metabolism. Also, protein requires more energy to break down than carbs or fat, so you’ll actually burn more calories during digestion.
One bad night’s sleep is enough to leave you feeling sluggish and impair your cognitive processing. String together several nights in a row — or a lifetime of inadequate sleep — and science shows decreased metabolism and hormonal imbalances may follow.
In a study published in The Journal of Clinical Endocrinology & Metabolism, researchers found drinking 500 milliliters of water (about 2 cups) increases metabolic rate by 30%, and that spike lasts for more than an hour. So, drink water throughout the day to stay hydrated, and you’ll get the added benefit of a boosted metabolism.
When stress levels increase, your body produces a hormone called cortisol. Cortisol leads to increased appetite, makes us crave comfort foods, decreases our desire to exercise and reduces sleep quality — all things that negatively impact metabolism. So, while you can’t always control your stress levels, managing stress can go a long way toward protecting your body’s internal fire.
There are mixed reviews on dairy consumption in hormone based cancers. Fortunate for Canadians, their milk supply is protected from added hormones, where the US supply is not. If you go for organic, is it better? Organic dairy is GMO-free which should technically then be free of hormone mimickers like organophosphate and glyphosate. Is this all we have to worry about?
Insulin growth factor
There’s more to the story of dairy and hormones. Insulin growth factor (IGF-1) is in all dairy products, naturally. Even natural organic milk will have it. IGF-1 both protects aging bones and has the potential to aggravate hormone based cancers. It seems that IGF-1 prevents cells from dying when they should and thus has the potential to promote the spread of existing breast cancer cells. From this we might conclude that less IGF-1 (less dairy) in the diet may reduce the spread of an existing hormone based cancer. Research continues.
“A 3 serving increase in milk consumption per day is associated with an 18.6% (95% CI= 0.9% to 39.3%) increase in free IGF-I levels.
For breast cancer survivors research says to reduce dairy. At 1/2 c a day of yogurt, this may be enough to have reduced, but this is a decision you will have to make for yourself, given the facts we know and the ones we may not yet know.
What about the bones?
After estrogen deprivation therapies, the bones are often weakened. For protection, protein (about 1g per kg of body weight per day), weight bearing exercise as well as your mineral matrix is important.
Calcium supplementation should not exceed 500mg. Daily recommended intake of calcium is about 1200-1500mg per day. Many dairy alternatives like almond or cashew milk are supplemented with calcium. Food sources include canned salmon with the bones in it, sesame seeds, broccoli, dark leafy greens, chia seeds and molasses. Although spinach is high in calcium it not easily available as it is also high in oxalates that bind it.
Decisions about health are personal. We make the best decisions we can with the information we know at the time.
Here are some other related links you might like to check out:
About the author:Dr. Laura M. Brown ND is a Naturopathic Doctor with a Functional Medicine approach. She is a Certified Gluten Practitioner, A HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them. More at www.naturalaura.caand www.forwardhealth.ca
One of the hardest parts about starting a fat-loss program is knowing you won’t be able to eat a lot of the foods you enjoy. At least, not in the same quantities. For this reason, some people try to achieve their fat-loss goal through exercise alone, hoping they’ll burn enough calories during their workout to make up for poor diet choices.
WHY EXERCISE ISN’T ENOUGH
First of all, exercise tends to increase appetite, says Tiffany Chag, RD, a sports dietitian at the Hospital for Special Surgery in New York. If you’re not paying attention to what and how much you’re eating, you could take in more calories per day than you were getting before you even started your exercise program. “We don’t really realize we’re doing it,” Chag says. Over time, this could lead to stalled results or even weight gain.
In a recent study, a group of lean, overweight and obese women followed an eight-week exercise-only program. Not only did the women see zero fat reduction, but appetite hormone levels increased significantly in overweight and obese participants. These hormonal changes could explain the lack of fat-loss results, according to researchers.
THE CALORIES PARADOX
In addition, exercise only burns a small percentage of calories in the overall scheme of things. A vigorous 30-minute strength session, for example, only burns roughly 223 calories for a 155-pound person, according to Harvard Health. That’s the approximate equivalent of a couple of tablespoons of olive oil or a protein bar.
Granted, exercise — and strength training, in particular — will have you burning calories long after your workout is over, but it may not be as much as you think. “People often get a false sense of how many calories they’re actually burning [during exercise],” says Steve Moore, MS, lead physiologist and health coach with the Penny George Institute for Health and Healing LiveWell Fitness Center at Abbott Northwestern Hospital.
All too often, we assume we’re burning more calories than we actually are, which makes it easier to reach for higher calorie foods. In fact, we can overestimate the calories burned by as much as four times the actual amount, leading us to eat 2–3 times our caloric expenditure from that workout, according to the results of a study published in the Journal of Sports Medicine and Physical Fitness.
You might lose fat through exercise alone, but you’ll have far greater success if you pair your exercise with a healthy diet.
In a study published in Obesity, overweight and obese postmenopausal women who followed a combined diet and aerobic exercise program lost more weight over the course of one year than women who followed a diet- or exercise-only program. Still, the women who followed the diet-only program lost significantly more weight than the exercise-only group (8.5% versus 2.4%), and only slightly less than women who followed the combined program (8.5% versus 10.8% for the combined approach).
Don’t think you have to completely overhaul your diet or add crazy amounts of exercise to see results. Set achievable goals, like adding one extra serving of vegetables per day or taking the stairs instead of the elevator, and focus on meeting those goals for a few weeks before adding in other changes, Chag says. “[Your goal] has to be something that’s measurable, but set the bar so low that you can’t fail.”
When you eat a heavy meal, it can often make you feel sluggish afterward and even disrupt sleep. But getting up and taking a short walk after eating can help combat this. Not only is walking a great low-impact activity to help you stay healthy overall, it can specifically aid digestion and control blood sugar levels — preventing crashes in energy. Here, a look at the research and why evening walks are particularly beneficial for digestion and controlling blood sugar:
EFFECTS OF HIGH BLOOD SUGAR
Chronic high blood sugar can negatively affect your health. Over time, it can cause damaged blood vessels, nerve problems, kidney disease and vision issues. Chronic high blood sugar can also lead to insulin resistance and impaired glucose tolerance, risk factors for Type 2 diabetes.
HOW WALKING AFTER EATING HELPS
While walking any time of the day can have positive effects on health, taking a stroll after a meal may be especially effective for managing blood sugar levels. A study published in Diabetes Care found walking for 15 minutes after a meal three times a day was more effective in lowering glucose levels three hours after eating compared to 45 minutes of sustained walking during the day.
Walking at night might be the most beneficial since many people eat their largest meal in the evening and then tend to sit on the couch or lay down after. Another study focusing on individuals with Type 2 diabetes found that even 20 minutes of walking post-meals may have a stronger effect on lowering the glycemic impact of an evening meal in individuals with Type 2 diabetes, compared to walking before a meal or not at all.
HOW IT CAN HELP DIGESTION
Individuals suffering from digestion problems and discomfort may also see some benefits from walking. A small 2008 study found walking increased the rate at which food moved through the stomach. Other research has found that walking after a meal may improve gastric emptying in patients with longstanding diabetes, where food may typically take longer to digest and empty from the stomach.
THE BOTTOM LINE
Walking is one of the most studied forms of exercise, with research demonstrating it’s an ideal activity for improving health and longevity. Try going for a brief walk after a meal (especially in the evening) to help with digestion and blood sugar control.
A healthy regular stool is not always indicative of a healthy microbiome. History of autoimmune conditions, food sensitivity, sugar cravings, gas, pain, bloating, bad breath, candidiasis, brain fog, mood changes, weight issues, skin issues, joint pain, trauma, stress, headaches, use of birth control or other hormones, frequent use of antibiotics and certain drugs can all be factors or indicators of microbiome disruption.
What drugs affect the microbiome?
Your microbiome may be out of balance if you are currently, or have history of taking, any of the following drugs:
Food sensitivities often rise when the microbiome is off balance. It is important to recognize the foods that are bothersome. Then remove them for a while and do the work to remove unwanted microbes and replace with healthy ones while repairing the gastrointestinal tract lining. Protocols are patient specific based on the microbiome the lining of gastrointestinal tract and the overall health of the patient.
Dr. Laura M. Brown ND is a Naturopathic Doctor with a functional medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them. More at www.naturalaura.ca and www.forwardhealth.ca