We received approximately 30 inches of snow from the Blizzard of 2013 over the weekend!  It was nice and light and fluffy when it came down, but now we have had some rain making the snow wet and heavy.

There is a lot of shovelling to be done and it needs to be done with care.
- Bend your hips and knees
- Keep the load close
- Pivot with your feet 
- Do NOT twist with your back
- Take breaks
- Pace yourself
- Try this extension exercise for your back
- And only shovel if you are healthy

You can see additional information on the B2b Blog below dated January 2011.

Dr. Wilmarth
Back2back PT

See APTA's Move Forward:
http://www.moveforwardpt.com/Resources/Detail.aspx?cid=bc1413cc-3ed6-4cf9-888f-3955df4a1b13

Back2back PT: Back2back Basics

Back2back Physical Therapy:

Optimizing function via body balance

 

New Year’s Resolutions: A healthier, more balanced you…is it a fairy tale?

Happy New Year: these words generally bring to mind resolutions and goals for the new year.  People often agonize over some of the same resolutions every year, namely better balance and health in their daily lives.  We sign up for the gym, buy exercise equipment, and at least think about starting with some new diet plan.  But just how can you make it last as in the fairy tales so that you can live ‘happily ever after’?  Is it possible?  I am here to say yes, one step at a time.

How can we bring Goldilocks and her lessons to current day healthcare?

In The Annotated Classic Fairy Tales (2002) Harvard University professor Maria Tatar points out that the tale is typically framed today as a discovery of what is "just right" (Tartar M, 2002).

Author Christopher Booker characterizes this as the "dialectical three", where "the first is wrong in one way, the second in another or opposite way, and only the third, in the middle, is just right." Booker continues, "This idea that the way forward lies in finding an exact middle path between opposites is of extraordinary importance in storytelling".

The Goldilocks Principle describes a situation, which is just right in a manner akin to that portrayed in the tale. The concept prevails not only in literature, but also in astronomy and economics. A Goldilocks planet is neither too close to nor too far from a star to rule out life, while a Goldilocks economy describes one which is sustaining moderate growth and low inflation, which is seen as allowing for a market friendly monetary policy.

http://en.wikipedia.org/wiki/The_Story_of_the_Three_Bears

Back2back Physical Therapy puts a focus on Optimizing function via body balance.  The Goldilocks Principle applies for the body in this situation as well.  You do not want too much, or too little; you want to be ‘just right’.  This applies to the body as a whole as well as to individual parts, for example, the spine or the shoulder.  It seems simple, and it can be.  However, all systems need to be in balance in order for each individual to be able to find his or her ‘just right’.  And what is ‘just right’ for one person may be different for the next.

A physical therapist can assist you in determining your optimal balance for functioning.  Your goal is to be able to then determine your balance point yourself and to apply certain principles so that you can solve the balance dilemma in any given situation.  However, healthcare in today’s world is no fairy tale and knowing where to start can be difficult at best.

With the recent resurgence of the fairy tales, I thought it fun and practical to apply these tales and their characters to some of the principles of Back2back PT.  Just as the children in the fairy tales need to be smart and keep their wits about them, so do we need to do this when it comes to our body.

Let’s start with the Back2back Basics with Snow White and & 7 Dwarfs.

You should ask yourself the questions of the 7 Dwarfs.

Doc – It is best to seek the care of a healthcare provider?  See a Doctor of PT (DPT) or your Primary Care Physician (PCP) sooner rather than later.  Do not delay.  Seek healthcare. Find a DPT. www.moveforwardpt.com

Dopey – Do you feel dopey and lethargic?  Are you not at your best?  Do you feel ‘fuzzy’?

Sneezy – Do you have a cold, the flu or allergies? Have you ever hurt your back when you sneezed?  What’s pressure got to do with those discs?

Happy – Are you happy?  Is pain or discomfort of some sort preventing you from being happy? Are you seeking happiness, but not able to find it?  Being happy is generally easier with a balanced back, body and life.

Sleepy – Are you getting enough sleep? Do you feel sleepy all the time?  Are you lethargic?  Does it matter how you sleep?  How is one to sleep balanced? 

Bashful – Are you afraid to verbalize your pain?  Are you afraid to seek medical care? Don’t be bashful.  You will only hurt yourself if you delay.  There is no time to start like the present.

Grumpy – Are you Grumpy at home or work?  If you are not feeling well, then you may tend to be grumpy. If you are not balanced and do not seek medical care, grumpy tends to creep in more and more in your daily life.

If you answered yes to any of the 7 Dwarf questions, then you should seek medical advice with a DPT or MD, bringing us back to Doc.  It only takes a few minutes to find a healthcare professional in your area.  Make it your New Year’s resolution to Optimize function through body balance starting with your DPT or MD.

You can find a PT through the American Physical Therapy Association’s website at:

http://www.apta.org/apta/findapt/index.aspx?navID=10737422525

There are many places to find an MD, but you can start with the American Medical Association’s Find an MD website:

https://extapps.ama-assn.org/doctorfinder/recaptcha.jsp

So, if you want to start on the road to living happily ever after, make a resolution to take it one day at a time.  Try your best to maintain balance, but if you do not, then try to bring it back to get it ‘just right’.

EXERCISE:

This is the first of my Top 10 Rules for a Healthy Back

PS - You likely learned them all in pre-schoolJ

1.     Balance – Front-Back and Side-Side: All areas.

When you are standing, imagine a Plumb Line dropping from the ceiling.  Ideally, the Plumb Line should go through your: Ear – Shoulder – Hip – Knee – Ankle in standing.  This generally means that your spine is in a neutral or balanced position.

Abdominal Bracing: 

In standing, keep the knees ‘soft’ or slightly bent, then try tightening your abdominal muscles.  Think of bringing your belly button towards your back.  This will assist in stabilizing your spine.  Practice holding this for 5-10 seconds. 

Once you are able to perform this with ease, try doing it in various positions. 

Lying on your back with your knees bent may be easier to practice initially if you are having any difficulty in standing.

Finding your Neutral Spine (Approximate Neutral):

In standing, keep the knees ‘soft’ or slightly bent, then tighten your abdominals and flatten your low back (posterior pelvic tilt).  Next, relax the abdominal muscles and arch your back in the opposite direction (anterior pelvic tilt).  Gently, go back and forth from a flat back to an arched back.  Perform smaller movements until you find a position that feels approximately in the mid-range of the available motion.  This will generally be your Neutral Spine position.  We will talk more about this in future posts.

TIPS:

Think of your spine as building blocks, you know, the same ones that you used in pre-school.  When you are have a neutral spine and are in a balanced position, all the blocks are stacked well and remain in place.  However, if one block slips forward, then another one may need to slide back to balance the stack.  When this occurs, there is more stress and strain and the likelihood of the stack of blocks being unstable is much higher.

I will give tips to maintaining a balanced spine in various positions on my next post.

QUOTE:

“There is no secret to balance.  You just have to feel the waves.”

                                                                                             Frank Hebert

REFERENCES:

Maria Tartar, Marie. The Annotated Classic Fairy Tales (annotated edition). W. W. Norton & Company, October 14, 2002.

http://en.wikipedia.org/wiki/The_Story_of_the_Three_Bears

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All I'm saying is simply this, that all life is interrelated, that somehow we're caught in an inescapable network of mutuality tied in a single garment of destiny. Whatever affects one directly affects all indirectly. For some strange reason, I can never be what I ought to be until you are what you ought to be. You can never be what you ought to be until I am what I ought to be. This is the interrelated structure of reality.

— Dr. Martin Luther King Jr.

 

* King Came Preaching: The Pulpit Power of Dr. Martin Luther King JR., by Mervyn A. Warren & Gardner C. Taylor, InterVarsity Press, 2008, ISBN 083083253X, pg 174

 

 

Exercise: 

·      Remember that your body is an interrelated structure.  Take time to feel how the body is balanced when you sit, stand or perform activities of daily living.

 

Tips: 

·      If you have inflammation in the form of tendonitis, bursitis or some other --itis, then there is something in your interrelated structure/body that is out of balance.  The inflammation is a symptom and it is important that you find the underlying cause in order to get Back2Balance.

 

Quote: Our lives begin to end the day we become silent about things that matter.   - Martin Luther King Jr.

 

 

* Always consult your individual medical care provider before starting any exercise program.*

TIMING IS EVERYTHING

 

This week we experienced a true NorEaster…snowstorm.  We had over 2 feet of snow at my home, and this all came in less than 24 hours.  However, we were not alone with snow and cold weather up and down the east coast and apparently 49 of the 50 states had snow somewhere in the state at the same time.  Florida was the only state escaping the snow.  The good news was that everyone was prepared and took the right steps and we could handle the snowstorm with relative ease.

 

This is the case with the body as well.  If you are prepared and take the appropriate steps, then you will more seamlessly be able to maintain balance.  Those people who are flexible and strong and who paced themselves with shoveling did fine and were able to enjoy the day off that most had in the Boston area.  Even universities that had never closed before, or had not done so in many, many years, announced a snow day for all.

 

I vividly recall a snowstorm several years ago (2007) that came on during the day when people were at school and work.  Even though people left early the streets became like a parking lot with gridlock everywhere.  The snow kept coming and the plows could not get through, resulting in a standstill for the vehicles.  It took me 7 hours to travel 30 miles from Boston to Andover. There was congestion everywhere and many spots where you just could not get by due to abandoned vehicles.

 

The body gets congested as well, and I am talking about musculoskeletal congestion.  Without the proper amount of movement in all directions, things, namely connective tissue including muscles, tendons, skin, and fascia, get tight.  This lack of good mobility in the connective tissues results in more difficulty moving when there is a need.  Muscle knots, as they are known to most, become more frequent and this soft tissue congestion can limit mobility and cause discomfort.

 

Those who did too much all at once and who may have been less prepared for the snow and shoveling ended up in my office the day after the snowstorm.  Shoveling involves forward bending as well as frequent twisting.  Many times people do not bend their knees enough or keep their back straight enough.  This combined with the fact that the snow was heavy and there was a lot of it, made for a recipe for disaster for those whose bodies were not balanced to begin with prior to the storm.  In addition to the stress placed on the musculoskeletal system, muscles and joints, shoveling also places a strain on the cardiovascular system.

 

The repeated forward motion of shoveling places stress on the spine from low back up through the upper back and neck.  You can decrease the stress on your spine by the following:

            1 – Keep your spine straight with the correct amount of each curve.  This is known as a neutral spine and will be discussed in future blogs.

            2 – Bend the hips and knees and use the muscle strength of the legs to do the brunt of the lifting.

            3 – Pivot with the feet and limit the twisting in the spine.

 

You can balance the flexion of shoveling by performing the very simple exercise known as Extension-in-Standing (EIS). After sitting, bending forward or lifting, such as with shoveling, place your hands on your hips/buttocks as if you were putting them in the back pockets of jeans.  Then gently push forward as you arch your spine to the back as much as tolerated. You can look straight ahead or look toward the ceiling or sky.  The motion of the low back is the most important aspect of this exercise.  This combined with taking the time to lie on your stomach for 5 minutes a day (Blog 1 Exercise) will allow you to function well even during the toughest of snowstorms.

 

 

Exercise: 

·      Spend 5 minutes during each day, afternoon and/or evening, lying on your stomach.

·      After sitting or bending forward or lifting or just because, put your hands on your hips/buttocks as if you were putting them in the back pockets of jeans.  Then gently push forward as you arch your back to the back. You can look straight ahead or look toward the ceiling or sky.  It is more important what your low back is doing. Repeat up to 10 times as frequently as necessary.

 

Tips: 

·      If you have been doing a lot in a flexed position, for example sitting or shoveling, perform extension afterwards in order to balance your body.

·      If you cannot yet tolerate extension, then at least get more neutral by walking for example.

 

Quote: Hide not your talents. They for use were made. What's a sundial in the shade?- Benjamin Franklin

 

* Always consult your individual medical care provider before starting any exercise program.*

 

 

 

Welcome to the Back2back Blog! 

 

I have created this blog to assist in the mission of Back2back PT, which is to optimize function via body balance.  To my clients I am often referred to as the Balance Doc since my goal is to facilitate balance through neuromusculoskeletal rehabilitation.  In function as in life, we try to create the optimal balance.  The back is the core of our body and Back2back is your center for getting back into balance, regardless of what that means for you.

 

Optimizing function by enhancing body balance with the neutral spine as the core can mean a different thing for every individual.  This includes any and all of the following:

• Back2Balance  ©
• Back2Work  ©
• Back2Sports  ©
• Back2Yoga  ©
• Back2School  ©
• Back2Health  ©

The common denominator with all of the above-mentioned is getting Back2Core-Stability  ©   and this starts with biomechanics and balance.

 

We all sit far too much these days, driving, at the computer, eating, watching TV or at the movies or theater or sporting events, working, studying, even blogging and much more.  All of the high tech items often have us sitting, which puts stress on our spine from low back up through the upper back and neck.  We need to balance this by:

            1 – sitting in ergonomically appropriate chairs with lumbar support,

            2 – getting up every 30 minutes even if it is only for seconds or a minute,

            3 – stretching into extension after sitting, and

            4 – walking in between sitting in order to balance the spine.

 

How many of you lie on your stomach at any time during your average day, or night?  Something as simple as lying on your stomach can assist in creating balance for your back and you.  Think about the amount of time you and your back spend in a bent or flexed position.  By lying on your stomach you can assist in reversing the curves.  Like the Red Sox who reversed the curse after 86 years, it is never too late!  One of the simplest exercises that helps to keep your back in line and can even prevent back pain and dysfunction can be lying on your stomach. 

 

It does not have to be for long, 5 minutes spent in the afternoon or evening can be enough for some people.  More is not necessarily better.  If you are not able to do this yet, you can try lying over 1-2 pillows and gradually progress as you can tolerate.  The bottom line is that lying on your stomach is a position that we as a society do not get into often enough and thus 80% of us end up with low back pain at some point during our lives.

 

My plan, other than putting things in writing and sharing, is to talk about balance from a professional perspective.  I am not sure how often I will write yet, that will depend upon my balanceJ  I do hope to make connections and to jump start dialogues.  Email me at mwilmarth@back2backpt.com if you have any questions or comments.  As with everything, I know that this will be a learning experience as I utilize high tech tools in an attempt to enjoy every moment while keeping balance in all aspects of my life.

 

Exercise: 

•            Spend 5 minutes during each day, afternoon and/or evening, lying on your stomach.

 

Tips: 

•            Get up from sitting every 30 minutes.
•             Walk in between times when you are sitting.

Quote: 

• The wishbone will never replace the backbone. - Will Henry

 

* Always consult your individual medical care provider before starting any exercise program.*

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