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.

Water

As infants our bodies are composed about 75% of water.  The percentage of water present decreases as we age.  By middle age we are about 60% water and by old age we are composed of about 55% water.  This water is found both within our cells (intracellular water), and outside of our cells (extracellular water).  Extracellular water can further be divided into the water found in our blood stream (plasma) and the water found in the spaces between our cells (interstitial).   More muscular individuals contain more total body water because muscle cells contain glycogen (sugar stored for energy use) and glycogen binds water.  In contrast, fat cells contain very little water, so individual with more fat tissue will have less total body water.

Water is integral to our health and well-being.  Humans can survive for up to 3 weeks without food, but without any water, death with ensue within days.  The location of the water within our bodies can be an indication of health status. For example, swelling in the legs and feet can be an indication of blood clots, cardiac disease, lymphatic disease, kidney disease or even infection.  In general, our water homeostasis (balance) is tightly controlled.   Some of the many  factors that affect the distribution of total body water include:

  • Kidney Function
  • Nutritional Status – (protein content in the blood)
  • Cardiac Function
  • Water loss (such as through sweating and breathing)
  • Specialized Receptor Function (can detect over-hydration or dehydration)
  • Hormone level

 

Recently, a significant amount of attention has been devoted to different types of water and the various health benefits.

There are several different types of commercially available water.

These include:

Tap Water:  water from the faucets that has been treated, purified and disinfected.  Can contain fluoride and chlorine

Bottled Water:  can be either bottled tap water, or water that is from a spring that has been purified

Purified water:  physically treated to remove impurities

Distilled water: water that is boiled and evaporated to remove dissolved minerals and then re-condensed without any minerals

Reverse Osmosis: usually acidic, water forced through membranes to remove large particles, pollutants and minerals

Alkaline water:  water that has been separated and contains electric charges such as those found in magnesium and calcium ions

Deionized or demineralized water:  minerals ions and impurities have been removed, but may still contain germs and bacteria

Soft water:  water that only contains sodium

Hard water:  any water with dissolved minerals

Alkaline water has been popping up on grocery shelves everywhere.  Pure water has a pH of 7.0.  Alkaline water has a pH of greater then 7.0, and acidic water has a pH less then 7.0.

 

What is pH and why is pH important?

pH is a measurement of the relative amount of free hydrogen ad hydroxyl ions in water.  When water has more free hydroxyl ions it is basic and when it has more fee hydrogen ions it is acidic. The pH of water is important because it determines the amount of a substance that can be dissolved in water, the amount of dissolved substances that are biologically available, and the the toxicity of heavy metals found in the water.  In general, heavy metals are more toxic at lower pH’s because of they are increasingly solubility (higher concentration of heavy metals can be dissolved in the water).

Our blood pH is tightly regulated between 7.35 and 7.45.  When our blood pH gets too high (alkaline) or too low (acidic) it can be very dangerous and even fatal.

Just like our bodies tightly control our water homeostasis, our bodies have numerous intricate mechanisms to maintain our blood pH in the very narrow optimal range.  When our blood pH is abnormal it is usually due to an underlying cause which needs to be further evaluated and treated appropriately.  We cannot change our blood pH dramatically just by controlling our intake of acidic and basic foods/waters (unless your body’s control mechanisms are severely malfunctioning).

The theory behind the use of alkaline water is that it is ionized and can serve as an antioxidant to counteract the acidity of your blood.   The theory is that this “acidity” can lead to conditions such as cancer, arthritis and other inflammatory issues.   This has not been definitively borne out in the literature to date.   At this time, it does not appear that alkaline water has enough support to promote it efficacy in cancer prevention.   Drinking it occasionally should not have any significant effect on your health and well-being.

What is most important is to make sure that you are drinking adequate amounts of water.  This recommendation varies some depending on your physical activity, kidney function, amount of water loss, medications, etc.  The current general recommendation is about 2.7 liters per day for women and 3.7 liters per day per men.  That being said, look at your urine, if you have no known kidney issues, and your urine is very dark that is an indication that you may need to increase your water intake.    If your water intake is not adequate you are at risk for dehydration.

Some side effects of dehydration include:

  • Decreased physical performance (can occur with just 2% dehydration)
  • Reduced endurance
  • Increased fatigue
  • Decreased motivation
  • Mood disruption
  • Impaired cognitive function
  • Decreased alertness, increased delirium
  • Decreased short term memory
  • Constipation
  • Impaired kidney function
  • Decreased blood pressure (can cause fainting, light-headness)
  • Headache
  • Poor skin complexion

The take home message at this time seems to be to drink filtered, purified water if possible with naturally occurring minerals but without contaminants (such as heavy metals, hormones, plastics, and antibiotics) and artificial sweeteners.  In addition, it is important not to store water in plastic bottles which when heated (left out in the sun) can release BPA and other potentially toxic compounds into our water.     Currently, it appears that spring water, mineral water or purchasing a filter for your tap water are the best choices.