Dr. Phil Shares: How Long Should Workouts Last?

How long should a workout last? It seems like a question that should have a straightforward answer, but the truth is, there isn’t one. You could spend as little as four minutes on a workout: “There is no minimum,” says Marie Urban, regional group training coordinator for Life Time. “You can get a great workout no matter how much time you have.” Or, you could grind away for hours.

How long you spend working up a sweat is entirely dependent on your goals, personal preferences and the time you have available.

How long you spend working up a sweat is entirely dependent on your goals, personal preferences and the time you have available. Even if you take your goals into consideration, it can be tricky to determine a set workout length, as there are benefits to exercising for any length of time.

SHORT DURATION, HIGH INTENSITY

For example, if you’re trying to build aerobic and anaerobic fitness, you can accomplish that in only four short-but-intense minutes of work. How? Through a popular form of high-intensity interval training (HIIT) known as Tabata training.

Tabata training involves performing a cardio-focused exercise (e.g., sprints or burpees) as many times as you can for 20 seconds before stopping for a 10-second rest, and repeating for a total of eight rounds.

In 1996, researchers found performing a Tabata workout five days per week was more effective for building aerobic and anaerobic fitness than steady-state cardio.

Even traditional strength training offers benefits in the briefest of sessions. A recent study published in Medicine and Science in Sports and Exercise reveals young men who lifted weights for only 13 minutes per session three days per week made similar strength gains in eight weeks as men who spent 68 minutes in the gym three days per week. The only catch: Subjects performed all sets to failure, or the point at which they couldn’t do another rep with good form. So, there was no slacking here.

It’s worth noting this study included only 34 subjects, and the men had previous experience with strength training; whether the results would apply to new lifters, women or older adults remains to be seen.

GO LONGER FOR MORE RESULTS

In addition, the shorter training sessions weren’t as effective for increasing muscle size (also known as hypertrophy) as the longer sessions. As researchers note, higher training volumes are key for achieving muscle hypertrophy, and higher training volumes require a greater time commitment.

Still, the group that did 13-minute sessions gained some muscle, suggesting you may be able to get away with a quick workout from time to time. However, you would have to continue adding sets, reps and/or exercises if you wanted to continue seeing progress. According to the findings of a 2017 meta-analysis, adding one set each week was associated with an increase in the percentage of muscle gain by 0.37%. As you continue adding sets, reps and/or exercises, your training sessions inevitably take longer to complete.

If you’re training for a specific event (e.g., marathon, bodybuilding competition), your training sessions will likely vary in length as you near your event date, and may include sessions that err on the longer side (60 minutes or more). In these instances, it’s a good idea to work with a fitness professional and/or follow a quality training program, as opposed to trying to come up with your own workouts.

DAILY ACTIVITY MATTERS

By the way, your daily activity level is perhaps more important to your overall health than working out for a set period of time. Research even shows being sedentary can limit the positive effects of exercise. According to the U.S. Department of Health and Human Services, there’s a strong relationship between sedentary behavior and risk of death from any cause, as well as death from heart disease.

Urban recommends squeezing activity into your day wherever you can: Park far away from the store, take the stairs instead of the elevator, do pushups while you microwave food and crank out some situps during commercial breaks. “Having an active lifestyle is more important than working out for an hour every day,” she says.

by Lauren Bedosky

Shared by Dr. Phil; McAllister @ Forward Health Guelph

Dr. Kyle: High Intensity Interval Training!

I’m sure you’ve heard the hype about high intensity interval training (HIIT) – bursts of exertion separated by short periods of recovery – sound tough, right? That’s because it is. The attention around HIIT has provoked researchers to further investigate it’s physiological benefits, which have been promising.

The problem with most workout programs is lack of intensity. People putt around the gym for about an hour, jump from one machine to the next without breaking a sweat. What’s the problem? Nothing, if your goal is to build strength. But from a physical fitness and weight loss perspective, you are overlooking HIIT’s cardiovascular and fat-incinerating benefits.

HIIT is a time-efficient strategy to increase muscle and accelerate fat loss. Intervals of activity and rest can vary between 30 seconds to a few minutes. The duration and intervals can be modified depending on the individual and goal in mind. The objective is to create a fast-paced and physically demanding workout that challenges our threshold of exercise intensity.

So why HIIT vs. cardio?

HIIT is most commonly compared to moderate intensity continuous training (MICT). MICT, also known as steady state cardio, consists of long periods of activity at constant intensity. For example, 45 minutes of jogging at 5km/h is considered MICT. Although it provides significant cardiovascular improvements and may be a favourite for endurance training, HIIT can offer more!! Remember, you can’t go wrong with increasing the intensity of exercise. Let’s compare!

With regards to that pesky body fat, HIIT significantly reduces abdominal and visceral fat in both men and women (1). High intensity training, above 90% peak heart rate, was more effective at reducing whole-body adipose tissue. Many studies show HIIT is superior to MICT in improving aerobic fitness (2). Cardiovascular measures (VO2 max, contractile function, ejection fraction, respiratory fitness and endothelial function) significantly improved with 7-12-week HIIT programs. This holds true for people who have previously suffered from a cardiac incident. Implementing HIIT under supervision during cardiac rehabilitation can improve quality of life by enhancing their cardiorespiratory fitness. No deaths or cardiac events occurred during HIIT programs across all recent studies. What doesn’t kill you makes you stronger, right?

Additionally, studies have demonstrated greater improvements in insulin sensitivity, glucose regulation, HDL cholesterol, and blood pressure with HIIT compared to MICT (2,3). Improved insulin sensitivity allows the body to utilize glucose more efficiently as energy, instead of being stored as fat! By implementing HIIT with intermittent fasting, the body utilizes fat stores for energy, increasing fat oxidation and mobilization (4). HIIT is also more effective than MICT at reducing oxidative stress and inflammation (5). These benefits are observed in subjects across all age categories. HIIT doesn’t discriminate; all can experience the health advantages of HIIT.

HIIT is extremely efficient because we experience what’s known as “excess post-exercise oxygen consumption,” or EPOC – meaning we reap the calorie-burning effects hours after our workout.

During intensive exercise, energy stores are quickly depleted. Our carbohydrate stores, oxygen and other essential compounds are exhausted, resulting in an energy deficit. After HIIT, we eventually reach our normal resting level of metabolic function. Carb stores are replaced (with an appropriate diet), oxygen levels will increase, and body temperature will return to normal (6). These processes require energy, explaining why we continue to burn calories after exercise. Even though HIIT and MICT both induce EPOC, HITT increases lipid metabolism to a greater extent AND is extremely time efficient (6).

So whether you want to call it HIIT, interval training, circuit training, etc., say hello to the most time efficient and beneficial exercise available. Combining HIIT with intermittent fasting and a wholesome diet, expect accelerated fat loss and physical fitness improvements. So what are you waiting for? Let’s turn up the intensity to 11!

References:

1. Maillard F, Pereira B, Boisseau N. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Medicine. 2018 Feb 1;48(2):269-88.

2. Hannan AL, Hing W, Simas V, Climstein M, Coombes JS, Jayasinghe R, Byrnes J, Furness J. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open access journal of sports medicine. 2018;9:1.

3. Costa EC, Hay JL, Kehler DS, Boreskie KF, Arora RC, Umpierre D, Szwajcer A, Duhamel TA. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre-to established hypertension: A systematic review and meta-analysis of randomized trials. Sports Medicine. 2018 Sep 1;48(9):2127-42.

4. Wilson RA, Deasy W, Stathis C, Hayes A, Cooke M. Combining intermittent fasting with high intensity interval training reduces fat mass by increasing fat oxidation and mobilization. InAustralia and New Zealand Obesity Society and Breakthrough Discoveries 2018 Joint Conference, Melbourne, Australia, 16-18 October 2018. 2018

5. Ramos, Joyce S., et al. “The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis.” Sports medicine 45.5 (2015): 679-692.

6. Ahlert M, Matzenbacher F, Albarello JC, Halmenschlager GH. Comparison of epoc and recovery energy expenditure between hiit and continuous aerobic exercise training. Revista Brasileira de Medicina do Esporte. 2019 Feb;25(1):20-3.

Dr. Kyle: Posture Perfect

You can prevent slips and falls. You can reduce your risk of a motor vehicle accident. You can limit contact sports. One thing that you cannot avoid however, is gravity. If your body and spine are not aligned, the force of gravity will start to wreak havoc on your musculoskeletal system. Making sure we maintain proper posture throughout our work day is critical for longevity in our career. So how do we protect ourselves?

The secret to good posture is maintaining the spines natural curves. When standing, your head, shoulders, hips and ankles should all line up. When sitting, your ears, shoulders and hips should be in line and your buttocks should be at the back of the chair. Sit tall with your chest and head up.

Some tips for creating an ideal posture include:

• Stand tall with shoulders back
• Tuck your chin
• Brace the abdomen
• Squeeze your glutes
• Keep your knees slightly bent

Due to modern day technology, one of the most common signs of poor posture is anterior head carriage. This mean that the head is resting too far forward away from the body. We are not always cognisant of our head posture as we check our smart phones and work on our laptops. The farther our head protrudes forward, the greater the force on our neck. This can lead to chronic neck and upper back pain and lasting postural alterations.

One exercise I recommend to patients to reduce anterior head carriage are chin tucks. These can be done up against a wall or lying flat on your back. You simply bring your chin directly in towards the spine and hold. You can press gently into the wall or pillow to enhance the muscle contraction of your deep neck extensors. Now your spine will naturally carry the weight of your head and allow your neck and upper back muscles to relax. So keep your chin up and your pain levels down!

For more tips and tricks to enhance your posture, visit my Instagram page @drkylearam of email me at drkyle@forwardhealth.ca.

Dr. Kyle: Tips For Sleeping Better

1. Make your bedroom your oasis. If you are going to invest in something, why not invest in a good mattress and pillow that you will spend almost a 1/3 of your life on. Complete your bed with comfy blankets and sheets.

2. Keep it dark. Shut off all alarm clocks, TV’s, phones etc. Make sure no LED light is being emitted. This may require you to unplug some electronics around your room. Black-out curtains are a must.

3. Control room temperature. Make sure you are not too hot or too cold. There is nothing worse than sweating all night under the covers while your body struggles to maintain optimal body temperature.

4. Stop consuming caffeine after 2pm. This ensures that the effects of caffeine will be long gone before your head hits the pillow. Try a decaf coffee in the afternoon to fight off cravings.

5. Don’t work out within 2 hours before bed. This will disrupt hormone rhythms and deprive your body of energy stores needed to repair your body as you sleep.

6. Meditate. A simple 5-10 minutes mediation or deep breathing routine will calm the nervous system and transition you from our fight-or-flight response to your rest-and-digest state.

7. Reduce exposure to blue light after the sun goes down. Change display settings on your phone or use computer programs to block out blue light at night.

8. Have a chamomile tea or small snack with raw-honey to maintain your blood sugar levels throughout the night.

Sweet Dreams!

Dr. Kyle: Torn ligament? Maybe not.

Knee pain can come in a variety of presentations. Whether from a sports injury, slip and fall, or out of the blue, no two knee injuries are completely alike. The extent to which tissues are damaged is specific to the patient’s genetics, lifestyle, trauma, and fitness level. A well-trained athlete may be quite high functioning even with a serious tear, while a mild injury may keep a very sedentary person out of commission for several months.

Often times I will hear “hey doc, I think I might have heard a pop and the inside of my knee really hurts!”. My first reaction is to suspect a ligament tear. Once examining the patient further however, orthopedic testing shows stable knee ligament testing, no swelling or redness, and no severe joint line tenderness. So what’s the deal?

Like most soft tissue injuries, ligaments can be damaged to varying degrees. In the clinical world, there are 3 grades of ligament tears. Grade 1 is mild ligament damage, grade 2 is moderate, and grade 3 is severe/ruptured ligament tear. Common symptoms of a complete tear include sudden onset of pain and severe swelling, joint instability, and impaired function. The truth is, disruption of tendon fibers can happen to varying degrees. Think of muscle strains and ligament sprains on a spectrum of structural damage from 0 to 100%. The higher percentage of damage, the longer time it will take to establish preinjury performance levels.

Fortunately, if ligament stability is determined to be adequate by a healthcare professional, a conservative trial of care will often resolve symptoms. Ligaments in the body have the natural ability to heal on their own. Healing consists of 3 distinct phases including the inflammatory phase, the reparative phase, and the remodelling phase. Simply put, fibrotic scaffolding will be laid down so newly formed collagen can connect the severed ends of the tear. It is important to seek proper medical attention so that rehabilitation can begin as soon as possible.

For injuries of this nature, treatment will often begin with controlled range of motion exercises. Other modalities such a laser and acupuncture are helpful for enhancing healing at this stage. As tensile strength of the ligament improves, the joint will be able to tolerate more load. Eventually strengthening exercises will be included into the plan of management and progressed with increasing difficulty.

So if you or someone you know is worried that their knee pain may need surgical intervention, make sure you get it assessed by a medical professional who specializes in musculoskeletal injuries. It may be quite reassuring to know that with the right tools and knowledge the body will be able to heal and adapt on its own.

For more information, please contact drkyle@forwardhealth.ca or visit my professional Instagram page @drkylearam.

References:
Woo SL, Abramowitch SD, Kilger R, Liang R. Biomechanics of knee ligaments: injury, healing, and repair. Journal of biomechanics. 2006 Jan 1;39(1):1-20.

Dr. Phil Shares: 3 Common Walking Myths, Busted

3 Common Walking Myths, Busted

When it comes to exercise, walking doesn’t always get the respect it deserves — and it’s time that changed. Before buying into the idea that walking isn’t a worthwhile workout, learn the truth behind these three common walking myths.

There is a great feeling of accomplishment when your fitness tracker buzzes to signal you hit 10,000 steps. But Carol Ewing Garber, PhD, professor of movement sciences at Columbia University, believes it might be an arbitrary target.

Yes, there are studies that show walking 10,000 steps per day is associated with lower blood pressure and improved glucose tolerance but the idea of walking the equivalent of five miles per day could feel overwhelming to new exercisers.

“[Walking 10,000 steps] will result in health benefits,” Garber says. “But it should be noted that … there is benefit even with small amounts of walking and the benefits increase with the more steps you walk each day.”

Garber suggests aiming for 150 minutes of moderate-intensity exercise each week instead of setting a step count goal.

If you want to count steps, consider this: Walking an additional 2,000 steps per day — even if your current step count is minimal — helps lower body mass index and boost insulin sensitivity, according to research published in the journal BMJ.

Leslie Sansone, fitness expert and creator of Walk at Home Workouts is adamant: “Walking works for weight loss!”

A slow stroll around the block isn’t going to move the needle on the scale (although it does burn more calories than binge watching legal dramas). To lose weight with a walking workout, Sansone suggests high-intensity interval training or HIIT.

Picking up the pace — without breaking into a run — at regular intervals during your walk has a major impact on weight loss.

In one small study, researchers at the University of Virginia found that overweight women who logged three 30-minute, high-intensity walks and two moderately-paced walks per week for 12 weeks lost six times more belly fat than women who went for a slow stroll five days per week. A second study found that varying speed burned up to 20 percent more calories than maintaining the same pace.



Incorporating HIIT into your walking workout is simple, according to Sansone. After a 5-minute warmup walk at a slow pace, walk at a brisk pace for 30 seconds and then a regular pace for 4 minutes. Repeat the interval four times. End with a 5-minute cooldown walk.  

“Walkers have so many choices to get fit and stay fit for life,” Sansone says.

Walking can be a “gateway exercise” that helps new exercisers improve their cardiovascular fitness and stamina to transition to running but not all walkers want to run — and that’s OK.

“Walking is a good exercise for everyone,” Garber says.

study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology found rates of hypertension, high cholesterol, heart disease and diabetes were lower for regular walkers than runners.

While a walk around the block is a good start, maximizing the benefits of a walking workout requires logging sufficient time in your sneakers. Garber suggests focusing on distance, duration or calorie expenditure (all viewable on your fitness tracker) noting that it’s the amount of exercise that counts — for both walkers and runners.

“If you start fitness walking today, you will instantly feel better and know you’re doing something good for your body, mind and soul,” Sansone says.

by Jodi Helmer

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Kyle: Building Stronger Bones

When discussing bone health, we often talk about proper nutrition. Adequate vitamin D and calcium intake are usually recommended to enhance bone mineral density (BMD). What is not discussed as often is the role of exercise and weight training for increasing bone strength. A holistic approach looking at what we put IN our body as well as what we DO with our body is the key for building stronger bones.

As we age our body experiences several physiological changes. Our hormone levels change, muscle mass declines, and bones become less dense. Low bone density, otherwise known as osteopenia, increases our risk of fracture. Although we can bounce back from a slip or fall in our early years, a hip fracture in older individuals can have detrimental effects on quality of life. The good news is, there are important steps you can take to prevent or slow down the decline of BMD.

Research has demonstrated that healthy individuals and patients with osteoporosis can improve BMD with high-moderate impact activities and resistance training. A few examples of high impact exercises include step classes, jogging, and jumping jacks. Resistance or weight training on the other hand can include elastic band, pully, and free-weight based exercises. To put it simply, the more force you transmit through the bone, the more the bone will remodel and grow! Clinical judgment is needed to determine the intensity of force that each patient can tolerate.

Recent studies have found that high-intensity resistance training and impact training improves BMD and physical function in postmenopausal women. Low-intensity and light-resistance exercise programs are not enough to stimulate bone remodelling and improve BMD. Heavy multi-joint compound exercises such as squats and deadlifts induce extensive muscle recruitment and transmit greater force through the bones. In particular, these exercises will apply force through the lumbar spine and femoral neck, making them stronger and more resilient to fracture. Proper form and supervision are crucial when performing any high intensity or heavy loading activities.

Talk to a primary health care provider about your BMD and if an exercise program for developing BMD is right for you. Not only will exercise strengthen your bones, but it will have profound impacts on many other systems of the body as well. As always, if you have any question do not hesitate to contact me at drkyle@forwardhealth.ca or visit my Instagram page @drkylearam!

Reference:

Sinaki M. Exercise for patients with established osteoporosis. InNon-Pharmacological Management of Osteoporosis 2017 (pp. 75-96). Springer, Cham.

Mounsey A, Jones A, Tybout C. Does a formal exercise program in postmenopausal women decrease osteoporosis and fracture risk?. Evidence-Based Practice. 2019 Apr 1;22(4):29-31.

Dr. Phil Shares: What You Need to Know About Going to a Chiropractor

What You Need to Know About Going to a Chiropractor

The chiropractor. A lot of people swear by chiropractic treatments as the only way they get relief from back pain, neck pain, headaches, and a host of joint problems. Others aren’t so sure about this holistic wellness discipline. Regardless of what camp you’re in, allow us to demystify this type of care for you.

Chiropractors Train as Long as MDs Do

That’s right, a Doctor of Chiropractic (DC) studies for four years of undergraduate and four years of chiropractic school, using similar books that MDs use for study, says Scott Bautch, DC, president of the council on occupational health for the American Chiropractic Association. Chiropractors must also pass a licensure test and take continuing education courses to stay abreast of the latest trends in their field and maintain their credentials.

Chiropractors Can Help with Overall Wellness

People mostly see chiropractors for pain relief, but it’s becoming more popular to see a chiropractor for general wellness. “Chiropractors are increasingly becoming overall wellness advisors — advising patients about their eating , exercise, and sleeping habits,” Bautch says. Since chiropractors focus on the health of the nervous system, particularly the spinal cord, they are treating the entire body. Therefore, they are addressing both acute injuries (such as low back pain), as well as general, chronic issues (such as fatigue).

The First Appointment Will be Really Thorough

Chiropractors use comprehensive intake screenings to learn not just about what ails you, but also to get a complete picture of your overall health (hence the “holistic” descriptor). This will include health history questionnaires as well as functional and neurological assessments to see how your body moves, how well you can balance, etc. The doctor may also take x-rays. Finally, there will be a discussion about cost and course of treatment.

This thorough first appointment was experienced by New York City resident Karl Burns. In a tennis game, Burns swung his racket too forcefully and injured his low back. He was referred to chiropractor Cory Gold, DC. “At first, I thought, ‘I’ve never been injured before, I don’t need a voodoo doctor,’” says Burns. “But Dr. Gold and I immediately gelled. After many tests and questions, he told me, ‘Your treatment plan will be three times a week for a couple weeks, then two times a week for a couple weeks, then once a week — this is not a lifetime injury.’”

You’ll Likely Be a Regular, Initially

In most cases, people see chiropractors for acute injuries (like throwing your back out) or chronic conditions (like headaches), so it may take a few of weeks of multiple visits to stabilize the problem. After a few weeks of multiple treatments per week, treatment tapers gradually to once per week, then once per month for maintenance, until the spine is able to stay in alignment without the chiropractor’s adjustments. The course of treatment and length of time until stabilization vary from person to person.

That said, visits are often quite short — an average of 15 to 20 minutes — of hands-on manipulation. “Chiropractors aren’t trying to fight an internal battle against infection the way medical doctors are,” says Burns. “The treatment consists of much smaller movements and adjustments to your body and alignment of the spine.” Burns points out that he experienced pretty significant pain relief from the get-go. “Every time I walked out of there, I felt amazing,” he says. “The benefits are instant and can be perceived better [than with conventional doctors].”

You Won’t Be a Patient Forever

There’s a general belief that chiropractors want to make you reliant on them, but Bautch and Burns believe otherwise. “There are three phase of care,” Bautch says. “Acute — let’s get you functional; corrective — let’s adjust you so that it doesn’t happen again or as frequently; and then maintenance — maybe down to once a month.” Indeed, this is what Burns experienced — but he also learned the hard way the importance of self-maintenance. “Chiropractors take the approach of ‘let me teach you how to fish,’ not ‘let me just give you the fish,’” says Burns. He, like most patients, was given exercises to compliment and maintain his recovery — and he only ran into trouble again once he stopped doing them. “If I skip my exercises, sure enough, my lower back gets tight,” Burns says.

BY: Amy Roberts

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Kyle: Manipulation and Mobilization for Neck Pain

An estimated 66% of the population will suffer from neck pain in their lifetime (1). Neck pain is one of the most common musculoskeletal conditions treated by healthcare professionals. Often patients will report pain due to sleeping awkwardly, turning their head too fast, or reaching for something overhead. Whatever the mechanism, neck pain accounts for a significant proportion of sick leave, healthcare costs and lost productivity. Chiropractors have been at the forefront of treating neck pain for decades, and the results speak for themselves.

What does the evidence suggest?

Previous systematic reviews on chronic mechanical neck pain have provided substantial evidence for the effectiveness of chiropractic care. Both spinal manipulation and mobilization have been shown to be a viable option of care as compared to other standard treatment methods (2).

A recent systematic review by Coulter et. al. compared spinal manipulation and mobilization to other active modalities such as acupuncture, massage, and exercise to name a few (3). The study looked at patient outcomes such as pain, disability and health related quality of life (HRQol). They found that many previous reviews regarding non-specific neck pain reported evidence in favor of manipulation and mobilization. Other reviews concluded that manual therapies in conjunction with exercise provided superior results as compared to manual therapy alone (4).

As with many musculoskeletal conditions, it appears that a multi-modal approach is best. At this point in time, there is moderate evidence to support manipulation and mobilization for the treatment of chronic nonspecific neck pain in terms of pain and function. It appears that some movement and active rehabilitation is better for patient recovery then complete rest. More studies are still required to look at the benefits of chiropractic manual therapies long term.

To some, these conclusions may not be overwhelming, but research like this is what continues to carry the chiropractic profession in a positive direction. It is exciting to know that chiropractors and researchers alike are looking into the efficacy and safety of chiropractic care so we can better treat our patients and our community.

If you or someone you love is suffering with lingering neck pain, it may be time to schedule a comprehensive chiropractic exam to get to the root of the problem. As always, if you have any questions please do not hesitate to contact me at drkyle@forwardhealth.ca or visit my professional Instagram page @drkylearam.

References:

1. Cote P, Cassidy JD, Carroll L; The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976) 1998; 23:1689-1698

2. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: A systematic review and best evidence synthesis. Spine J 2004; 4:335-356.

3. Herman, P. M. (2019). Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician, 22, E55-E70.

4. Brison RJ, Hartling L, Dostaler S, LegerA, Rowe BH, Stiell I, Pickett W. A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine 2005; 30:1799-1807.

Dr. Phil Shares: Do This Daily For a Healthy Spine

Do This Daily For a Healthy Spine

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.

MCGILL CURLUPS

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)

BIRD DOGS

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.

by Tony Bonvechio

Shared by Dr. Phil McAllister @ Forward Health Guelph