Low Back Pain

Brinjikji et al 2015  Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6.

Brinjikji et al 2015  Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6.

Low back pain is the leading cause of disability in Americans under the age of 45 and the most common physical condition leading to doctor visits. Many new studies are now questioning the causative role of disc herniations, osteoarthritic changes, and spinal stenosis in low back pain. Results show that although association is high, causality is low. One study divided people into two groups: one with a long history of low back pain, the other with no history of pain. When researchers compared X-rays, MRI’s, and CT scans there was no physical difference between the pain and non-pain groups. In fact, the spinal pictures of the non-pain group often looked worse. Because of this many orthopedists and neurosurgeons are now learning to treat the patient, not the picture.

Some doctors now recommend two years of physical therapy before getting any kind of surgery on the back. In 2006, The Journal of the American Medical Association found that over this period of time, patients with low back pain and leg pain improved nearly as much as those who went under the knife, with differences in outcome described as “small and not statistically significant.” 

As we come to accept that our bodies begin to breakdown with age, an increase in pain doesn’t have to be part of this breakdown equation. The table above, from a study published in the American Journal of Nueroradiology, shows that although one-third of adults over 20 show signs of herniated disks, statistically only 3% of these disks actually cause symptoms. 

So if low back pain is not a problem with the skeletal structure, it is most likely a problem with the soft tissues of this area. Getting massage from a well trained and therapeutically-minded massage therapist, coupled with low stress aerobic exercise such as walking or swimming could relieve your back pain without the high cost of surgery. 

Interested in further reading and listening? Check out this Time Magazine feature, this New York Times article, or this NPR show.

Rigor

Last week I returned to my massage alma mater in Bend, Oregon to take a continuing ed class on deep tissue sports massage with a focus on injury treatment and prevention. My instructor was Bill Musser, a former NCAA College Division All-American swimmer, an orthopedic nurse, and a university instructor, coach, and administrator, with 40 years of manual therapy under his belt. We've all heard the term rigor mortis, the postmortem state of muscular contraction; but it was Bill who first coined the terms rigor livis, and explained that the same thing happens in the muscles of the living. 

Muscles need a type of fuel called ATP to contract. In individual muscle fibers, myosin heads lock onto actin and then ratchet the fiber tight, like an oar pulling a boat forward through water. What most folks don't realize is that muscle fibers don't just use ATP to contract; they also need ATP to relax, for the myosin to let go of the actin. If we exhaust all available fuel during the contracting phase, muscles will remain in a locked, shortened state. This is rigor. 

Deep tissue massage is the physical act of breaking myosin heads away from the actin they are locked onto, returning the muscle fibers to their original, resting state. How can we prevent our muscles from forming rigor? The two easiest ways are with sufficient hydration and a proper warm up. 

Water is the catalyst for ATP fuel production in muscle cells. We loose 8oz of water for every 15 minutes of physical exertion, or two pounds an hour, so we need to make sure muscles can continue to make the ATP they need to avoid rigor from forming due to dehydration. Seventeen gulps of water two hours before exercise gives the body time to turn this water into blood and to keep tight bands of rigor from forming. 

At rest, 80% of our bodies blood supply is in our trunk, close to our internal organs. It takes 8-12 minutes of gentle aerobic activity to open up the capillaries in our extremities like the arms and legs. We all take time to warm up before working out or going for a run, yet we rarely do so before we do a deep clean of our homes, move a piece of furniture, or take the trash to the dump. Our muscles don't discriminate between exercise and non-exercise exertion. If they are asked to perform work without the necessary blood available, then tight bands of rigor will form, leading to decreased range of motion and muscle weakness. 

We need to understand that exercise happens throughout the day, not just in the gym. Especially with the summer months ahead, drinking enough water and adding a warm-up, like ten minutes of walking, to our morning routine will have us -- and our muscles -- ready for whatever adventures come our way! 

We Make We Move Wednesday

Breath / 10" x 22" / oil on panel by Jessica Lee Ives / 2017

Wednesday We Make We Move posts bring together the art of movement, and the movement of art.

 

The fine motor movements made by painters, writers, and musicians are not unlike the full-bodied exertions of runners, climbers, and swimmers; both express kinesthetic intelligence. Human movement is a privilege and a wonder to experience. It is how we make. It is how we move. It is how we live in this world. And it is how we make this world livable.

Interviews with Artists and Athletes: Mara Crans

 

At Making Movement, we have the opportunity to work with some amazing people who inspire us in our everyday lives. These interviews shed light on how they excel in their art or sport.

 
 

Mara Crans

 

What are your greateast athletic accomplishments?

I have completed two full distance ironman competitions, five half iron mans, a five mile open ocean swim race, and multiple sprint and Olympic distance triathlons and road races. But the competition I am most excited to participate in is the Swim Run race in Casco Bay this summer. In this race you swim to each island, then trail run the island while tethered to your partner --. a total of 8710 yards open ocean swim (not taking rides and currents into consideration) and fourteen miles of trail running. I'm excited because I will be competing with my eldest son! 

 

What are the foods that you eat everyday?  

There really isn't a set group of foods I eat everyday. Lots of variety and I really listen to what my body needs depending on the day's workout. I usually start the day with a banana and peanut butter, and a preworkout drink of spirulina, morninga, chorella, frozen pineapple, water, a scoop of my electrolyte mix (or miso), and some beta alanine. Post workout I immediately take in my recovery drink then I get a full recovery meal in within the hour. This can be a huge salad with mixed greens, beets, carrots, avocado, chickpeas, quinoa, almonds, and a cilantro dressing or a homemade breakfast burrito made with sautéed kale/chard/spinach, sweet potato, scrambled egg, quinoa, chili black beans all wrapped in a sprouted grain tortilla, or somedays a big turkey/avocado or tuna sandwich. Snacks in the afternoon include apples with almond butter, macadamia nuts, or cheese, and dinner is a well rounded mix of protein, lots of veggies, and carbs. 

 

What supplements do you take everyday?

I take Calcium, Vitamin D, a probiotic, EFA capsule, zinc, magnesium, and B12. During the heavy training season I take beta alanine, glutamine, and branched chain amino acids to aid in recovery.  

 

How often do you train a week and for how long?

During the season I train six days a week 2.5-4 hours a day usually but can be up to 8 hours when training for a full ironman. In the off season 5-6 days a week 1.5-2 hours a day.

 

What do you do for your rest days?

Rest!!! And I prepare a lot of my food and training snacks for the week. I try to cook and bake all my training food myself. 

 

When you train or compete, what is your choice for music?

I never listen to music. Part of my training is learning to be ok with the quiet, just being in my own head because that is how it is in a race. I try to practice giving myself pep talks when I get tired or hungry or cranky. I also love to just listen to the birds and nature sounds while I run and bike. 

 

What books or authors do you recommend to your friends most often?

Lately I've been recommending a lot of cookbooks by athletes. I'm a collector! I especially love the one by Shalene Flanagan entitled Run Fast Eat Slow, and The Endurance Training Diet and Cookbook by Jesse Kropelnicki. 

 
 

We Make We Move Wednesday

Swimming Elk Lake / 5" x 7" / oil on panel by Jessica Lee Ives / 2017

Wednesday We Make We Move posts bring together the art of movement, and the movement of art.

 

The fine motor movements made by painters, writers, and musicians are not unlike the full-bodied exertions of runners, climbers, and swimmers; both express kinesthetic intelligence. Human movement is a privilege and a wonder to experience. It is how we make. It is how we move. It is how we live in this world. And it is how we make this world livable.

We Make We Move

Art Of The Pickup / 8" x 10" / oil on panel by Jessica Lee Ives / 2017

Wednesday We Make We Move posts bring together the art of movement, and the movement of art.

 

The fine motor movements made by painters, writers, and musicians are not unlike the full-bodied exertions of runners, climbers, and swimmers; both express kinesthetic intelligence. Human movement is a privilege and a wonder to experience. It is how we make. It is how we move. It is how we live in this world. And it is how we make this world livable.

Inflammation Medication

Our fridge can vary in appearance depending on how recently we’ve gone grocery shopping -- from a bountiful garden of plenty to a frozen desert of empty shelves. There is one thing that remains a constant no matter the landscape, however: a large glass pitcher filled with an orange-yellow liquid. This is our go-to drink. It is homemade and has more health benefits than can fit in this one blog post.

The main ingredient is turmeric, which contains curcumin. This is a powerful anti-inflammatory that serves as a natural pain killer. The journal Oncogene published the results of a study evaluating several anti-inflammatory compounds and found that aspirin and ibuprofen are least effective, while curcumin is among the most effective anti-inflammatory compounds in the world. Many people think diseases such as cancer, ulcerative colitis, arthritis, high cholesterol, and chronic pain can be the result of excess inflammation in the body.

We also use fresh ginger root which has a powerful antioxidant and anti-inflammatory compound called gingerol. Gingerol has been proven to be effective against exercise induced muscle pain and even the proliferation of cancer cells. It not only has amazing health benefits, but it’s delicious too.

Just cut up 5 to 6 inches of ginger and turmeric into a metal bowl and add a full teapot of boiling hot water. Once this has cooled add a few shakes of cayenne pepper and a quarter cup of apple cider vinegar. This lowers blood pressure, detoxes the liver, and stimulates the circulation of blood vessels. It also helps your body maintain a healthy alkaline PH level. Finish by squeezing in a fresh lemon and strain the contents into a glass picture for the fridge. This inflammation medication is great mixed with hot water or cold, carbonated seltzer.

 

We Make We Move

Glide Outside / 5" x 7" / oil on panel by Jessica Lee Ives / 2017

Wednesday We Make We Move posts bring together the art of movement, and the movement of art.

 

The fine motor movements made by painters, writers, and musicians are not unlike the full-bodied exertions of runners, climbers, and swimmers; both express kinesthetic intelligence. Human movement is a privilege and a wonder to experience. It is how we make. It is how we move. It is how we live in this world. And it is how we make this world livable.

Frozen Sunset / 10" x 22" / oil on panel by Jessica Lee Ives / 2017

"Don't Be A Stupid" from Katy Bowman's Movement Matters

I've slowly been making my way through Katy Bowman's Movement Matters: Essays on Movement Science, Movement Ecology, and the Nature of Movement, digesting each paradigm shifting essay one by one. Katy uses human movement -- its mechanics, its history, and its theory -- as a tool to blow holes in the way we think. About everything. Because her essay "Don't Be A Stupid" is such a clear, concise, and convicting read I'm reproducing it here in an effort to tease you into buying, borrowing, or kindle-ing the whole book. You won't regret it.

***

Don't Be A Stupid

In a Huffington Post article "Sitting May Harm Health Says AARP," Ann Brenoff discusses the metaphor likening sitting habits to smoking habits. She isn't all that impressed by the information and isn't going to stop sitting because, frankly, it appears she believes that "mounting evidence" deserves sarcastic quotes:

Why don't I stand, you ask? For a few reasons. I once worked next to a woman who insisted on placing her office computer on a pedestal sot that she could stand all day in front of it instead of sitting. For her, it worked out well. For everyone else, not so much. For one thing, nobody appreciated being towered over. Her standing blocked our already limited view of office life (mostly people sitting in front of their computers in little cubicles) and projected her already-loud voice to an intrusive level. An office community is a delicate balance of personal needs and consideration of others. The others must trump the personal needs if there is to be harmony and productivity. It took mere minutes before my co-worker's standing raised people's blood pressure. She eventually sat down.

I get it. She doesn't want to stand because she feels that standing disrupts others' personal needs and so forth. To each their own -- or to each everyone else's own, I guess.

But look at this part (emphasis mine): "You may never convince me that sitting is the greatest threat to my health; whereas smoking certainly remains one of the chart toppers. Smoking is a choice that some stupid people make..."

I read this as saying that people who smoke do so because they are stupid, and people who sit do so because they are considerate.

This attitude, that those who are doing the "right" thing are somehow smarter or better than those who aren't, doesn't appear to contribute to our health and happiness. 

I guarantee that no matter how well informed or well-read or degreed or dressed up or dressed down or organiked (a word, right?) or McDonalded or well-behaved or radical-ed up your life is, there is someone out there, right now, who is doing it better than you. There is someone out there messing up their kids less, eating better, doing more for the planet, doing more for humankind, using less fuel, giving more money, and being kinder to others. Which, by the reasoning used in the quoted article, makes YOU the stupid one.

People who do not share your views or behaviors are not stupid; they just don't share your views. They may never share your views in the exact same way that you may never share theirs. Who's to say which views are correct?

Your faith in your beliefs is equal in magnitude to the faith of every other person on this planet in their own beliefs. Every second of time you spend lamenting that others don't think like you is time spent not honoring your beliefs. If you believe improvements in your personal health, the environment, and to human rights are that great, wouldn't your time be better spent actually working on them?

Before you so easily drop the "S" bomb on others, realize that someone has just dropped the Stupid all over your head. And it sucks to be stupided on. The end

P.S. This is the letter I am writing to myself; I'm just letting you look at it.