Don’t Forget Your Back

Most of us spend a large portion of the day hunched forward.  Think about when you are working on the computer, cooking, driving or even relaxing.  Your typical posture during these activities is head and neck forward, shoulders rounded forward, back curved and hips flexed.    When you remain in this position for an extended period of time, the muscles in the front of the body tend to shorten or contract, while the muscles in the back of the body tend to weaken.    This can be a set up for back, neck and shoulder problems and in addition, tends to make you look shorter, heavier and less confident.

Stretching before and after exercise as well as during the day is often overlooked in the rush to “get your workout in”.   Stretching however, has numerous benefits.   According to a study published in the Annals of Physical Medicine and Rehabilitation Medicine in September 2016, by I Fekhfekh, et al, dynamic muscle stretching of the knee musculature actually resulted in an increase strength gain in those muscles.  Interestingly, this study also found a decrease in the postural stability of the knee after stretching.    In English, it appears that stretching helps your to build strength, but may decrease the stability of the muscles you stretch at least temporarily.

In general, stretching helps to improve flexibility, joint range of motion, and usually is helpful for injury prevention.    Stretching helps by increasing blood flow to the muscles stretched.  This increased blood flow carries important nutrients to your muscles to allow for muscle growth and repair.  In addition, the increased blood flow helps to wash away muscle “waste” which leads to decreased soreness and inflammation of the muscle.

If allowed to remain in a contracted position for a prolonged period of time, our muscles will shorten.  For example if you spend a large portion of your day sitting in a chair or driving, the muscles in the front of the hips, your hip flexors will shorten.  These muscles have a direct effect on both your posture and your back health.

 

So what should you do?

It is important to stretch the muscles in the front of the body at least daily.

Exercises that focus on the hip flexors:

-Kneeling hip flexor stretch  – in the position of a lunge, allow your back knee to touch the floor and drive the hip of your front leg forward.  This will stretch the hip flexor of the knee on the floor

Pigeon stretch – extend your right leg straight back and bring the heel of your left leg underneath your right hip.  Then drive your hips forward towards the ground.  Stretch and repeat on the other side.

Yoga poses such as: low lunge, crescent lunge, upward facing dog, and revolving side angle pose

 

Stretches that focus on the chest muscles and prevent rounded shoulders:

Door Frame stretch- stand in a doorway or at the corner of a room with your arms up like you were going to stop traffic.  Line your arms up from the elbow to the hand with the doorframe or in the corners of the wall.   Step towards the door and you should feel a stretch in your chest (pectoralis “pec” muscles) and hold for 20-30 seconds.

Wall slides – stand with your back to the wall and keep your shoulders against the wall.  Walk forward 1-2 steps and slide your arms up and down the wall and squeeze your shoulder blades together.  You should feel a stretch in your upper chest muscles.

Shoulder squeeze stretch –  clasp your hands together behind your back and slowly try to lift your hands.  Squeeze your shoulder blades together to stretch out the chest wall.

Yoga poses include : bridge pose, camel pose, cobra pose and cow face pose

 

Stretches for your neck:

– Chin Tucks (Neck Retraction) – keep your shoulders back and your head in a neutral position (eyes facing forwards, chin level) slowly move your head backwards until you feel a slight stretch in the back of your neck.  Hold for 10-20 seconds and repeat.  If needed you can apply a gentle pressure on your chin with your fingertips to press your chin backwards and deepen the stretch.

Incorporating these exercises into your daily routine will help to prevent shortening of the muscles in the front of the body which leads to poor posture and often pain of the neck and back.  As always, if you are having pain which persists you should be evaluated by a certified health care professional to ensure that these exercises are safe for you.

This week we primarily discussed stretching exercises to prevent muscle contraction, and next week we will discuss the importance of strengthening the back muscles to further combat the issues of a hunched posture.

Exercising With Arthritis

 

We have all different levels of fitness. Some individuals have been exercising for years, while other individuals have never exercised a day in their lives.  We are all at different levels in terms of our cardiovascular fitness, our muscle strength and flexibility and our overall health.   It is quite important to remain active in spite of arthritis.  In fact, movement in people with arthritis is crucial to health and well-being.

Despite what we once thought, it is my experience that it is possible to modify the severity of certain types of arthritis.   In my mind, arthritis, chronic pain and other autoimmune diseases are the result of multiple factors.  All these factors such as genetics, environmental exposures, nutritional deficiencies, dietary influences, and gut health to name a few factors, all line up as if you were to “win” in the slots.  When this potent combination occurs in your body, havoc ensues.   The result is inflammation and chronic disease.   While you can’t change your genes per se, it is now thought that you can change or modify your gene expression.  In addition, you can certainly modify some of the other risk factors just mentioned to offset the severity of your debility.

In most cases, moderate exercise is essential to health and well being.  Proper, varied forms of exercise raises heart rate, raises endorphins, improves muscle strength, improves balance, improves flexibility and increases blood flow throughout the body including the muscles and joints.  In the case of arthritis, there is inflammation in the joint capsule and the bones themselves which leads to severe pain and often deterioration.     The nerve endings in the joint become super sensitive and pain can be unbearable.

Believe it or not, your choice of diet can directly impact your ability to exercise. When you consume an Anti-Inflammatory Diet, often you will notice you will able able to exercise with less pain is because this diet eliminates many known triggers for arthritis.

 

Some examples of arthritis triggers include:

  • Fried and processed foods
  • Thought to be due to compounds called AGE – (advanced glycation end products) These products are the result of heating, grilling, and frying foods.  The body utilizes pro-inflammatory molecules called cytokines in an effort to break them down and the result is excess inflammation in general as well as in the vascular system (blood vessels).
  • Sugary foods
  • Dairy
  • Alcohol
  • Foods/Oils with Omega-6 fatty acids – such as vegetable oil (safflower), corn oil, fried foods, certain nuts and seeds, mayonnaise

 

Some examples of beneficial foods include:

  • Foods containing high levels of Omega-3 Fatty acids – (ex. salmon, herring)
  • Avocados
  • Flax seed
  • Cherries and other berries (contain anthocyanins that are thought to be anti-inflammatory)
  • Leafy vegetables, broccoli – contain vitamin D
  • Green tea – has EGCG (epigallocatechin-3-gallate) a powerful antioxidant
  • Vitamin C containing foods (ex. papaya, brussel spouts, broccoli, citrus fruits)
  • Garlic, onions and leeks

 

It is very important to listen to your body.  Pay attention to the foods you are eating and the way you feel.  Often times, foods that are considered healthy may cause issues for you.  If you suffer from arthritis, try rotating your foods (i.e. do not eat the same food everyday).   If there are certain foods you think might bother you, wait 3 days in between eating them.  Then pay attention to the way you feel when you re-introduce those foods.  If you notice you have more difficulty with pain or decreased ability to exercise try eliminating the offending foods for a week or two.

Typically, it will take several weeks of following the diet closely before you see results with regard to decreased pain from inflammation.

When exercising with arthritis, it is important to modify your exercises as per trainer recommendations.  If exercises hurt, if possible, discuss with your trainers to find another way to exercise that muscle group.  In the beginning, there may be some exercises you simply cannot do.  What is important is that you are attempting to exercise.  With each passing week you will find that you can do a little more than the previous week.  Progress may be slow, with ups and downs.  As always, if despite closely following the diet, you are still having issues, it might be time to seek the advice of a health care professional.

Exercise as a Pick-Me-Up: Can You Combat Depression

Depression is a very complex emotion that is influenced by many factors.
Sometimes depression can be brought on by a serious illness in yourself or a family member. Other times, depression may be due to significant life altering events. In many cases, genetics and gene expression can play a crucial role.   While it is not thought to be possible to change your genes, it is possible to change your gene expression (they way your genes work). In addition, there are many lifestyle modifications you can make to improve your emotional state.  Today we will focus on the beneficial role of exercise in treating depression.

The number of research articles written on the causes and treatments for depression is staggering. It has been repeatedly demonstrated that people suffering from depression have altered brain chemistry and function. The ENIGMA consortium, a large multi-center collaboration of 70 institutions, has analyzed both genetic data and neuroimaging studies with regard to depression. They have established that the size of the hippocampus, the area of the brain responsible for memory and emotion, actually decreases in response to chronic depression.

So what can you do to prevent this?

Exercise!!!

An excellent article written by Lynette Craft and Frank Perna, in The Primary Care Companion – Journal of Clinical Psychiatry, published in 2004, address various theories as to why exercise helps depression.   It is highly possible that the combination of all of the theories presented below lead to the beneficial effects of exercise with regard to depression.

The first hypothesis as to why exercise benefits those with depression is termed the Thermogenic Hypothesis. The idea behind this hypothesis is that exercise raises your core body temperature and the temperature in your brain. When the temperature rises this increases the activity of certain areas of the brain thereby altering brain chemistry and improving depression.

Another theory is termed the Endorphin Hypothesis. This hypothesis asserts that exercise increases endorphin levels. Endorphins are substances what are released by the brain during exercise, and help to relieve pain and increase feelings of pleasure.   Endorphins essentially are morphine or opioid compounds produced by our bodies.   There is some criticism to this hypothesis because it is not known if these elevated levels of endorphins detected in the blood after exercise actually induce a change in brain chemistry.

Currently the Monoamine Hypothesis seems to have the most support. The basis for this hypothesis is that exercise causes an increase in the availability of neurotransmitters such as dopamine, norepinephrine and serotonin in the brain. The concentrations of these neurotransmitters are often lower in depressed people. In fact, most anti-depressant medications work by preventing breakdown of these important neurotransmitters.   Studies done in the 1970’s by RM Post and others have demonstrated an increase in these neurotransmitters both in the blood and in the urine after exercise.   Theoretically, this rise in neurotransmitters may lead to a decrease in depressive symptoms.

The Distraction Hypothesis states that intense exercise leads to distraction from worry and depressing thoughts.   In this hypothesis, exercise is likened to a meditative state and serves to provide solace and relief from feelings of despair.   These distraction activities serve as a type of coping mechanism.

Finally, there is the Self-Efficacy Hypothesis. This hypothesis asserts that by consistently participating in an exercise program, you develop a sense of confidence. This cycle becomes a self-fulfilling prophecy. Initially when you begin an exercise program, you are filled with feelings of doubt and insecurity, however as you begin to stick to the program and see benefits, you become more confident and determined to persist.   This confidence is thought to offset depressive thoughts.

Most likely all of these hypotheses are at least partially correct. So what’s the take home message?

Stick to it and continue exercising!!!  

The most common benefits of exercise include:

  • Improved endurance
  • Improved cardiovascular fitness
  • Improved balance
  • Improved strength and flexibility
  • Improved body composition (increased muscle mass, decreased fat stores)
  • Improved sleep
  • Improved self-esteem
  • Stress reduction
  • Decreased depression and anxiety

The most important times to exercise are the times you don’t want to exercise. It is rare that you will leave an exercise session feeling worse then when you entered. Not every day will be the best day, but you just need to show up and give it your all. If you are on the fence about coming in, just focus all the benefits you obtain from routine exercise!