What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

Is this you when your back feels stiff?  Looking for relief from stiffness or pain by twisting it out?  Hoping for that crack that feels like what you get from your chiropractor?  It’s not the same.  It’s more dangerous to do this yourself and you should learn about why this is.

 

Read more from the original post and early book excerpt by following the link below: “When the jammed-up joints are properly released, then the hyper-mobile joints – the ones that are cracking all the time – should not feel the need to do so much of the work anymore”

It might be that you’re noticing cracks and pops with regular daily movement or you are making your joints do this repeatedly throughout the day in the hopes for relief from pressure.  In both cases you should learn more about what’s really going on, so you make informed choices…

Source: What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

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Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

yoga-dancer-1024x855Recently I’ve had a few questions from patients who are reading the book.  One that keeps coming up is about whether or not stretching is good or bad for us.  Stretching is a very confusing topic and has been one of scientific controversy for years which makes the answer not so straightforward.

In this first volume of my book series Every Body’s Guide to Everyday Pain™, Put Out the Fire I spend some time explaining that stretching is actually a mechanical stressor and therefore risky for people dealing with everyday pain.  This means that the elongation we cause by stretching can result in stress to the underlying structure.  Usually  when all things – mechanical, biochemical and emotional – are in balance, a reasonable stretch doesn’t cause any trouble.  However, when we are out of balance in any one of these areas and if we are already in pain, then stretching the compromised area is a terrible idea.

We often get away with stretching without consequences during times when we are not in crisis. Unfortunately with this sort of benign experience in mind and due to the fact that stretch-sensation neurologically eclipses the pain of inflammation, the concept that stretching is not good for your pain, is a very puzzling one to accept.

If you stretch a muscle in distress, you are basically signalling to your body that the tightening over-reaction – the one you are trying to find relief from – is indeed justified.  In this case, your stretch will perpetuate the underlying reason for muscle pain and tightness instead of resolving the problem.

The reason muscles grab and get tight is 100% protective in nature.  It is always the most reasonable response to unreasonable conditions.  You may not agree that the conditions are “unreasonable” but your brain and body’s assessment is all that matters during times like this.  If you don’t stop and find out what they’re protecting you from, there may be much worse discomfort lurking around the next corner.

Another interesting point is that the elongation stress associated with stretching can happen without, what looks to us like, a traditional intentional stretch.  Lengthening stress to muscle fibers is something that can be produced with sustained pressure on a muscle or a tendon.  When a muscle bundle is made to deform in this way it’s perceived by the brain as elongation. If that area is already inflamed, it will be a problem.  So, all of you foam rolling or ball rolling advocates beware!

A large part of my mission in educating patients is to highlight the subtleties in movement and posture that matter when we are in pain, but which often don’t seem very obvious to us.  By learning about these not so obvious contributions to pain, we can stop berating ourselves for “falling apart” and acknowledge the way forward. Recognizing the validity in our pain is a vital step towards feeling better and staying out of pain in the future.

An important part of Volume Two – Fix the Fire Damage will include information about exactly how and when to stretch safely and how to solve the problem of muscle tightness for the long term.

Click on this link for more at the original article Source: Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

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Do You Have a “Flexion Intolerant” Back?

GEDSC DIGITAL CAMERAYou may or may not have heard this new buzz term in the world of physical medicine and rehabilitation.  It is certainly gaining traction in my industry thanks to a couple of brilliant minds in the world of functional movement and kinesiology: Stuart McGill Ph.D.,and  Craig Liebenson D.C. for starters.

I see how  very helpful it can be, to the average person in pain, to be able to identify and label their condition.  The term “Flexion Intolerance” has come to serve that very purpose in my own practice.  In particular I’ve found it very helpful to point people to this internet resource developed by a fellow chiropractor: Fix Your Own Back dot com.  Dr. Snell provides an easy to use guide to help people in pain figure out if their back pain situation might be one that can respond very well to some basic changes to just a few everyday things.  We often take for granted these everyday activities until we’re in pain.

Pain is the primary and most effective motivation for most of us to want to investigate and learn more about our bodies. I believe it’s important that everyone realize before they are in pain, that “flexion” is not something our lower backs are very well designed to put up with in the first place, but especially not in the way that our modern lives demand.  We are all actually, by design, flexion-intolerant.  In particular, we are intolerant of the kind of flexion and the amount of flexion our modern day backs are exposed to.

What is Flexion?

It’s the technical term used to describe a forward bending motion (in the spine) which in the extreme looks like rounding.  Imagine the fetal position  – the ultimate example – full body flexion.  It’s no secret that bending to pick up something heavy can be “dicey” for the back and most of us know that this could result in pain if we’re not careful.

The unfortunate thing  is that flexion in the lumbar spine / lower back can be happening without the outward appearance of rounding – for example while sitting many of us are actually putting the lower back into flexion without meaning to – even if we’re not necessarily slouching.  The brain is pre-programmed with what can be considered our “safe” amount of flexion both in degree and frequency.  This pre-programmed set point is different for every single body, but it’s what determines when and under which conditions we suddenly experience our flexion intolerance as full blown pain.

You’ll find much more about this idea of our individual mechanical set point or blueprint for safe movement at Stop Everyday Pain dot com.  This is where my blog to book project is taking shape.  Check it out, become part of the process or just follow along to find out why things hurt that didn’t used to hurt and figure out what you can do about it.


 

[photo credit: wikimedia commons]

Is “Sway Back” Really Still A Thing?

Balancing RocksApparently it is …*head shaking in disbelief*

If you do an online search of “sway back” you’ll see a bunch of links referring to “hyperlordosis” or even just “lordosis” with a variety of images of the spine from a side view showing the curves of the spine.  Prevailing, mainstream information resources on this “condition” will have you believe that it’s a disorder….something that needs fixing.

Not so fast.

The natural shape of the spine should look like this:

Google Images

Notice, the term “lordosis” simply refers to the natural shape of the neck and the low back.  There is nothing pathological about this and in fact it’s necessary for spinal health that these two areas curve the way they do.  If you do not have enough of a lordosis in either area you will experience spinal dysfunction and eventually pain.

This pervasive age-old idea that “sway back” is something bad, is extremely misleading.  If there is something that looks like “hyperlordosis” or an accentuation / exaggeration of the natural curve or sway of the lower back, it may or may not be a bad thing.  The worst thing you can do is to tell a developing body to flatten that part of the spine.

I spend ninety percent of my patient education time explaining that tucking the pelvis and sucking in the belly while upright – sitting or standing – is actually damaging and stressing the spine.

What makes any shape of the spine dysfunctional is muscular and chemical imbalance in the body.  You cannot assess whether or not there is a problem with the spine by simply looking at the degree of lordosis.  If the curve in the low back is sharper than average, look at the neck – is that curve also sharper than average?  Look at the upper back – is that curve sharper than average in the opposite direction? Then it’s possible that this sharp lower back curve is actually completely appropriate for that person.

The shape of the spine is like a mathematical equation that should equal zero when effectively balancing the weight we carry front to back (and side to side). We need to have two S-shapes in order to provide appropriate shock absorption against gravity.  We also need to keep the spine strong in order to keep these curves from lazily collapsing on top of each other – which is when we run into trouble.

Weakness of our spinal stabilizers – the teenie-tiny muscles (multifidi mainly) that connect our spinal bones to each other deep inside – is what leads to back pain and dysfunction.  Lordosis is not a problem until weakness in the muscles allows the bones to collapse on top of each other with the forces of gravity.  This is true for kyphosis as well.  No matter what your shape, it’s not until weakness and de-conditioning sets in that there’s any problem with whatever shape that is.

So, please stop trying to flatten your spine.  It’s not helping you.

Do keep working on core stability with things like plank and hover and balance work.  Be careful of crunches since that motion curls your lordosis in the wrong direction.  Honor your curves in every sense of the word.  You’re shaped the way you are for a reason.  Don’t let that reason be that someone told you long ago to “suck it in” or “tuck it in” going against natural design.

Stay active and avoid sitting when possible and your lordosis will thank you!


For more on what’s really behind pain and dysfunction go to stopeverydaypain.com

 

 

photo credit: Fotolia

Do You Think Your Weight is Causing Your Back Pain? Not So Fast.

Big_Fat_Red_Cat

wikimedia commons

If you are carrying a little more weight than you would like or than is considered technically ideal for your frame, then you probably already have enough guilt and shame around this.  If you’re overweight and you have back pain the last thing you want to hear and yet the first thing you’re ready to assume is that your back pain is because of your weight.

This assumption is a very common one because according to popular media, obesity is the reason for all of our problems.  I don’t deny that morbid obesity is called “morbid” for a reason.  It will tend to shorten your life according to the science.  But when it comes to back pain the connection isn’t as clear as you think if you’re just moderately overweight – and I use the term “overweight” loosely because standardized charts that tell us who is and isn’t “too heavy” do not take into account body density, composition and activity level.

Focusing on and stressing about your weight is a sure fire way to put on more pounds and it won’t do a darn thing for your pain.

I’ve been seeing and treating back pain of all shapes and sizes for over twenty years and the only common thread is inflammation – not size, not shape, not weight.  Inflammation can reach critical mass anywhere in any body and when it does, our structurally and chemically vulnerable areas will be where we experience the discomfort of that inflammation…and sometimes that comes in the form of back pain.  The story of inflammation is extremely complex and deserves more than a blog post to do it justice, but the bottom line is that inflammation is triggered by three main things:

  1. mechanical stress or imbalance
  2. chemical stress or imbalance
  3. emotional stress or imbalance

These imbalances have to reach a critical mass before they cause any pain at all, so they often go on for years undetected and then when there finally is pain, we are reluctant to acknowledge these real causes and instead turn our attention to the easy target like body weight.  Each of these three things when out of balance, can be caused by excess body weight but are also caused by a multitude of other things that aren’t necessarily related to being overweight.  Plenty of skinny people have back pain.

Heavy and thin people alike put their spines under mechanical strain by sitting too much and developing poor body movement mechanics throughout life.  None of us will know it until we are in pain.  Then we can’t help but notice all the things we thought were okay to do suddenly hurt like crazy.

Heavy and thin people alike put their body under chemical stress by the foods they choose to eat or the toxins and allergens they are inadvertently exposed to.  Some have genetic predispositions to experience chemical stress more easily than others.

Heavy and thin people alike experience emotional stress with varying sensitivities and thresholds; all of which can add to the expression of inflammation.

It’s not your weight, but it might be your fat to muscle ratio…

…and this is something that the lean crowd should be sure not to overlook, because it’s easy to buy into the pervasive notion that someone is healthy just because they’re thin but no one is exempt from having a high fat to muscle ratio.

Fatty tissue is also called adipose.  Adipose produces a type of cell called an adipokine.  Adipokines are cell signaling proteins that help fatty cells communicate with the rest of the body.  Unfortunately these adipokines are pro-inflammatory and the more adipose you have the more inflammation your own body will produce.

On the up side, muscle cells – when active – secrete something called a myokine and for a reason that still eludes researchers, even though this myokine is in the same family as adipokines, it exerts an anti-inflammatory effect on the body!  What better motivation could there possibly be for getting your body moving?!  This is such a no-brainer.  Keep your muscle to fat ratio high and you’re much less likely to have back pain associated with chemically inflammatory adipose.

It’s not your weight alone, but it might be if it was a sudden gain…

What I’ve observed is that when there’s a sudden weight gain, like with pregnancy for example, there is a much greater probability that back pain is related to that weight gain because it’s a sudden change that the structures of the spine haven’t had time to adapt to.  When someone has had the same proportion of “extra” weight without much fluctuation throughout most of their life, then the back pain is less likely related to weight.

It’s not your weight, it’s the fact that you think  it’s your weight.

Now that you know it’s not necessarily your weight that is causing your pain, you can stop stressing about it. Just this simple decrease in stress is going to lower the inflammation in your body…and possibly make it easier for you to shake the pain.

The other problem with people who are stressed about their full figures, is that they will adopt the particularly stressful body habits of trying to suck in the gut and tucking the butt.  You can read more about why these are so bad for your back here, but for now do your best to eliminate that mechanically inflammatory habit!

For most moderately overweight bodies losing weight is not the answer to back pain.  Gaining strength and muscular balance is  the answer for all body types when dealing with back pain.  This is not to say that taking a few pounds off would not ease the load on any skeleton in pain but to focus on weight loss will backfire eventually and is not a good use of your energy.  To focus on strength building will cause an incidental weight loss that is much more sustainable and far reaching.

Even if you’re not in pain, please stop fixating solely on what and how much goes in your mouth, and start focusing on moving your body to make it stronger.

To read more about what is really behind your back pain go to Stop Everyday Pain.

 

References:

Advances in Medical Sciences 2009, 54(2): 150-157 Role of adipokines in complications related to obesity. A review. Gnacinska M et al.

Journal of Experimental Biology 2011; 214(337-346) Muscles and their myokines. Pedersen BK.

Science 1991 Oct 18;254(5030):421-3.Autocrine or paracrine inflammatory actions of corticotropin-releasing hormone in vivo. Karalis K, Sano H, Redwine J, Listwak S, Wilder RL, Chrousos GP.

Are You a (Spinal) Crack Addict? Just Say No!

Skin care

photo credit: Fotolia

I fondly refer to you as a “crack” addict if you’re someone who can’t sit in front of me for even just a few minutes without tilting your head in an attempt to make your neck crack.   Like with any addiction there’s a reason it started.  It probably feels good –  it gives you relief from some discomfort you might be feeling in your head neck or shoulder.  But before you know it, you’re stuck in a vicious cycle that is out of your control and you’re cracking parts of your spine several times a day without even thinking about it.

For some people it’s the mid back crack that happens when you squeeze your shoulder blades together and stick your chest out.  For others it’s the spinal twist that you do in your chair when you get stiff instead of just getting up for a minute to move around because you don’t want to lose your train of thought.  Both are very common problems for our computer bound modern lives. Here’s more from my book preview on the danger of doing these kinds of movements.

The desire to crack comes from a sensation of tension, stiffness, or pressure.  The cracking you do to yourself helps alleviate this discomfort. The reason this self-cracking becomes an addictive habit is because it feels good but more than that, it’s because joint “cavitations” (cracks) actually access a natural pain killing chemical feedback loop.  But how long is the relief lasting for you before you need another “fix”?

The problem is that when we try to crack our own spines we are naturally not able to be very specific.  The methods we use involve long levers (movement or stretching over a long distance from point to point) and so usually what ends up releasing and cracking is an area that is already hyper-mobile in the first place. The weakest link is what yields first.  The joints that need the release can’t be accessed in this way and so, what we are doing when we crack ourselves in this non specific way is reinforcing the original reason for this tightness and pressure sensation.

Your body is really smart and when there is a hyper-mobile area of your spine that is doing an uneven, unfair extra amount of work, it’s generally because there are neighboring areas of the spine that have stopped pulling their weight – either they have jammed up or there’s been a mix-up in the messaging to that area because of prolonged one sided tasking or bad body habits. When the neural messaging gets mixed up sometimes muscles just turn off and stop working – leading to joint dysfunction. The muscles around the hyper-mobile segments of the spine will start to tighten up and over-engage in an attempt to help you stabilize this area that they are told, by the brain, is moving too much.  So, when you squeeze and twist and stretch to get those already hyper-mobile areas to crack, what you’re doing is reinforcing the need of the muscles in that area to stiffen up.  So, while the crack itself feels good because of the short lived release of pain killing endorphins, it’s actually feeding the problem.

Not only are you adding to the problem and creating a greater ongoing need for relief, your chosen method of relief (constant cracking) creates friction.  Friction causes inflammation and as that inflammation builds it causes pain – in addition to the stiffness and pressure. (You can read more about inflammation and pain in this post excerpt from my book)  Over time this friction related inflammation will cause real structural damage to your joints.  This kind of damage over time can result in things like weakened and bulging discs, facet syndrome, formation of bone callouses or osteophytes. (click here for more on this in another post excerpt from my book about everyday pain)

Now you have a joint that is over-worked and irritated and if you keep up with the cracking you’ll also be disabling the more appropriate first line of defense in spinal stability and that is the ligament system.  The ligaments are like guide wires that connect bones to bones and provide architectural integrity.  Without good tone in the ligaments your muscles have to work overtime to protect your joints from excess movement.  Your muscles should not have to do the job of your ligaments.  But that’s often what we’re experiencing when we develop that desire to crack and pop ourselves.

The only way to break this cycle and get the joints that are really stuck to move again, is to have professional help.  Chiropractors are trained to be extremely specific with spinal adjustments and our goal is to introduce movement only to areas that are not moving correctly.  Restoring motion to segments that are stuck will alleviate the work load in those areas that chronically do too much.  This is the only long term answer to the “crack” addiction that so many suffer from.

A healthy spine does not feel the need to crack.  A spine that is moving correctly and to it’s full potential does not let you know that it needs a crack.  A spine that has strong supporting muscles does not ask for this sort of attention.

If you think you might be a spinal “crack” addict, think about getting some help.  Find a chiropractor who will work with you to make it a goal to help you feel that urge to crack with decreasing frequency.  You also need to get some advice on what you can do specific to your situation, to stabilize your spine in order to help make your treatments last longer and avoid undoing all of the good work.

More on the cracking or lack of cracking of spinal adjustments in a future post…

What are your thoughts?