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Yoga: Good for many, but not without caveats

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Many people have been attracted to Yoga for its many benefits. 

 Doctors have often recommended Yoga for their patients, to help with back pains, injuries to the limbs, or for routine post-operative care.

However, that does not mean Yoga is automatically safe for all.  It has come to light that many amateur enthusiasts force themselves into text-book (or video) positions even if the pose hurts.  The dangers are not just with the unsupervised beginners.  In class situations, there are instructors who will try to force all the people to get into all the poses, even if it means exhorting them past the point of pain or comfort.  Other instructors are too swift with their pacing, forcing participants to change positions too quickly for comfort. 

An interesting new look at Yoga has been written by William J. Broad, pointing out that many people should not be doing certain Yoga poses, and some should not be doing Yoga at all.  A compelling look at the good and bad sides of Yoga is to be seen in the following link, which is highly recommended: NYTimes-Yoga

However, this is an example of the universal rule of sports; not every body is suited for every activity.  That’s why such diverse body types excel in the Olympics, where the marathoners and sprinters have completely different strengths and aptitudes, not to mention body builds.  And, within running, there are many of us who are simply not built for it, such as people with issues of bony alignment, arthritis, or pains when running on concrete.  Others are not suited to the mental discipline required in long distance running, and simply cannot appreciate the zen of it.  Swimming is another sport thought to be universal, but many just sink like a stone, or otherwise seize up with fear when they get near the water.

 So the point is to consider the whole menu of options for sports, activities, and therapies.  Following the latest fads is fine if you turn out to be well suited to it.  But be prepared to bail on even the gentlest of exercises if they don’t work for you.   

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Avoid That "Postural Challenge" In Your Later Years!

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The human body was built for “hunting and gathering”, not “hunt-and-peck” typing. Our DNA and our evolution is built on movement. However, we now have invented a work form that is virtually movement-free: the modern office. Instead of walking, foraging and farming, we now sit all day, with tense fingers poised over keyboards, and our eyes straining to read back-lit images. an image of poor posture in the workplace By the end of the day, our shoulders are up around our ears, our necks are craned forward, and our noses are almost touching our screens. Our legs are folded like a card table, and our arms and wrists are stiff from their tense day of hovering over the mouse or keyboard.

To make matters worse, we have none of the usual animal signals of the passage of time. We don’t get winded, so we don’t take time out to catch our breath. We don’t need the sun (and many of us do not have outside windows at work) so don’t get the signals of increasing amounts of daylight to help wake us up. And we are not hiking over great distances, nor carrying loads on our frame, so we don’t have to think about good posture. In fact after years of hunching over our computers at work, our spines become curved like a “question mark” when viewed from the side.

A shipwreck’s anchor chain crusted in coral quickly fuses into its last position. The same thing can happen to the human spine. If movement is denied, and if the spine is left to compress itself into the distortions of modern desk work, then old age will surely be a postural challenge. We often note that our elderly tend to have a curved spine, or “postural kyphosis”. However, it should be noted that this is very rare among dancers, or devotees of Pilates, Yoga, or the Martial arts.

The reason is simple. If we only exercise the muscles on the front of our chest and neck, then we draw our body closer to the screen in the classic “hunchback” mode.

To recap, consider the following points to help you fight the office hunch, and keep your posture forever young:

1.Set a timer. Every fifteen minutes or so, set a timer, or have your computer screen alert you to take a quick few moments to stretch, roll the neck and shoulders, and to squeeze the shoulder blades together. Try a few phantom rowing movements as well, then plunge back to your work.

2.Set your ergonomics. Make sure you have a screen height that approximates your eye-level when you are sitting up straight. Don’t use a laptop down on your knees (at least not for long), and make sure you have a separate keyboard down at a comfortable level so the forearms are parallel to the ground. Lastly, have a decent chair, which can be adjusted in several dimensions to fit your comfort level.

3.Use the reverse muscles in the gym. Back exercises like the lat pull-downs, upright rowing, as well as certain yoga poses will help reverse the forward drift of the pectoral and neck muscles as they draw your face into the screen all day. A professional trainer can assist with proper programs here, as well as with the use of such aids as the foam roller. The latter is basically a Styrofoam version of a three-foot long cigarette, with about a 4-6 inch diameter. Lie on the floor with this tube along the length of your spine, from the back of your head to your tailbone. Balance with your legs. Then use your arms to hoist light weights in a “bench press” or “butterfly” move, for three sets of ten or more repetitions. Take deep breaths with each movement, and you may notice some “cracking” noises coming from your upper spine. This is a great technique to “open” up the disc spaces, and fight against the forward compression that we associate with age.

4.When you walk, look ahead, not at your feet. Remember to stand tall, and frequently pull your shoulder blades together to tone up these muscles. Also swing your arms normally as you walk, don't have your shoulders seized and arms stiff. The military has always taught posture from the beginning of any soldier’s training; not for simple appearances, but for function (if soldiers had to carry heavy packs and march miles into battle, they would all arrive with stiff backaches if they slouched the whole way). When your body posture becomes part of your muscle memory, you are on the way to a youthful aging process.

For further reading: http://en.wikipedia.org/wiki/Kyphosis

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Foot pain from Plantar Fasciitis

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One of the more common complaints I see in our Sports Clinic is foot pain, and probably the most common cause is inflammation of the thick band of fascia along the sole of the foot. an image of people walking downtown As with all of medical terminology, the suffix “-itis” simply means “inflammation”. 

So this is not a disease that spreads to other parts of the body, just a mechanical “wear and tear” issue from daily use. Walking on hard surfaces is one of the big causes, as any pedestrian in a big city knows. Also excessive pounding from impact sports such as running can also be to blame.

For a more complete understanding of the problem, check out this link:

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

For treatment options, consider the following:

1.       Eschew the (dressy) shoe.  We are built for walking, but not on concrete, and certainly not in dress shoes.  If you do much pedestrian activity, consider a comfortable-if-ugly pair of good walking shoes, then carry or leave your dress shoes at work.  If you are a runner, make sure you replace your shoes long before they start to look old, and, if you are a beginner, make sure you increase your weekly mileage gradually.

2.       Try a simple heel lift, such as a thicker walking shoe, or a simple cheap pad for your regular shoes.  Even a half-inch lift can pitch your body weight onto the balls of the feet, instead of the heel.  Usually the worst option is no lift at all, such as a pair of flats or sandals. 

3.       See a foot specialist.  If you have poor alignment of your feet and ankles, you may be heel-striking off-center whenever you walk or run.  This is where orthotics can be very useful, but not the cheap squishy ones in the store.  If you actually need an orthotic to correct your foot architecture, get a professional to take a proper imprint of your foot, then make up a hard orthotic that will only fit you.

4.       Consider some simple options, like home stretches, massages, and exercises followed by ice packs. Remember to also stretch the calf muscles and Achilles tendons, as they directly pull around the corner of the heel bone, and apply tension to the plantar fascia.  

5.       If the above is not working, an excellent option is medical acupuncture, but this works best if one treats the whole calf/Achilles mechanism as well as trigger points into the heel or sole.  Usually just three or four needles will suffice, and a few treatments will bring quick resolution.  For more on how acupuncture works, see our blog on acupuncture

If nothing else works, ask your doctor about a cortisone injection.  Not our first choice, but a reasonable option if pains are resisting all other attempts.

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How to take the knee stress out of running

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Here are some good tips for reducing the stress on your knees. 
an image of a woman jogging

 

One of the more common stress relievers is exercise, and simple running leads the pack. In large part, running has become so popular because of several features:

  1. It takes no time to coordinate. Just go when you are ready, with or without friends. No teammates are needed, you don’t need to book time on the court or field, and, with minor modifications in equipment, you can run day or night, summer or winter.
  2. It doesn’t require lessons. Although there are certainly very good lessons to be had, most people can just take off. Not true of skiing, tennis, and, least of all, golf.
  3. It is cheap. An old t-shirt and shorts, and a good pair of running shoes gets you started. No need for pads, helmets, uniforms, or equipment.
  4. It is a great way to burn off calories, and counteract the lack of movement incumbent in the modern work station.

The down-side of running is really just two-fold:

  1. Running can be boring, if you are not into the zen of it. Remedy: try running on a treadmill, and tune in to a video screen, or read a magazine while you trot. If you are an outdoor person, consider the ipod or other portable sources of sound. However, it is best to only plug into one ear, so the other one is left free to alert you to impending traffic warnings, or the sounds of an upcoming biker or dog.
  2. Running can hurt. Not every body is built for running. Some people have knock-knees or arthritis in feet, ankles, knees, or hips. Others have scoliosis or just poor posture, and find they get back pains if they run on hard surfaces. Others have unrealistic goals, and try to run too far before they get fit. (One tip from running coaches for beginners is to walk for a minute, then run for a minute. Repeat. Then gradually build up the minutes of running, still with a minute of walking between each set)

 

However, in medicine it is never that hard to figure out what kind of an injury a person has. The real question is what kind of a person does the injury have. I see runners every week in my office, often with the same pains, for example in the knees. Some are looking for an excuse to get off the compulsory running team at school, and want a note to join the swim team. Others are devoted to running, and nothing else will do as an option. It is in the latter group that we focus on in this article.

While running can cause pains in many body parts, let’s focus on the knee for now. One of the most common complaints is “runner’s knee”, otherwise called the “patella-femoral” syndrome. If you suffer from this, please read this article:  “patella-femoral” syndrome

In severe cases, we may need to have the patient lay off all running for a while, and switch to other “cross-training” exercises that don’t cause pain. The list of these could include such things as blading or skating, biking, or using the elliptical machine, or yoga. As a home treatment, it is good to follow the RICE principle after activity (Rest, ice, compression, elevation above the heart). Also remember that you may be making your knees hurt while you are NOT moving during desk duties all day. Set your computer to alert you every fifteen minutes, so you can flex/extend your knee regularly. See your doctor for specific guidance, and for customized strategies that might include orthotics, physiotherapy, massage, acupuncture, a trainer in the gym, or even a running coach.

 

For more info on coaching for beginners, read this link: http://hyannisroadrunners.com/

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Stress Advice: How to be a good boss...to yourself!

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The most important job that any of us can have is that of manager…of our own department of one.  And nobody ever wants to work for a bad boss.  So let’s take a look at some of the working conditions that we place upon ourselves, and see if we would tolerate any of them being imposed by anyone else.

1.       Exercise deprivation:  Out of a standard 168 hour week, this boss only allows 3 hours for any exercise. image of a bad work environment

 

2.       Food rationing: The foods that will prevent disease and promote good health will be locked away.  The only ones served will be those with empty calories, hormones, chemical additives, and known dangers to our health.  The results will be illness and premature death from obesity, diabetes, and heart disease.

 

3.       Time rationing: The maximum time allowed to speak to our spouse/significant-other in private is no more than 15 minutes a day.  For those with young children, no more  than 9 minutes a day of solo conversation.  The rest of our time away from work will be consumed with talking or thinking “shop”, otherwise known as "unpaid overtime".  New stresses will result: one in two marriages will fail, and friction between kids and their parents will rise.

 

4.       Air contamination:  The work environment will be polluted by carbon monoxide and other chemicals, in doses enough to cause illness, and early death. 

Certainly none of us would put up with these horrible work conditions.  And yet, if we are stressed out, and join most of the general public in the above parameters, we are being the worst possible boss to ourselves.  Let’s take a look at the above parameters:

1.  Most people do not allow themselves 3 hours of exercise a week. If they did, they would instantly improve their cardiac health, muscle tone, their mood, and even their resistance to diseases. 

2.  Most choose the wrong foods, making an epidemic of type 2 Diabetes.  Poor nutrients, high calories, and quick eating make for fattening “fast” foods.  Doctors' offices are filled with people complaining of the resulting ill health.

 3.  National averages for meaningful conversation within families are very disappointing.  With the intrusion of 5 hours a day of “tube time”, most children are too engrossed in the internet, video games or television to have a real interaction.  Parents too are watching their own diversions on different screens, either their own laptops or live television.  With the decline of the dinner hour, family opportunities for conversation dwindle.  Not much interaction occurs when one family member at a time reheats their dinner on the microwave, then eats in their room or in front of their laptop.  

4. Smokers are poisoning themselves with carbon monoxide, among other heinous dangers.  While none would allow anyone else to pollute their air,  smokers are completely blocking out their own laws of cause and effect.     

To turn the tables, try to imagine what a great boss would offer.  Healthy nutrition, time away from work for friends and family, and clean air to breathe.  Then commit yourself to being that great boss.  Your stress levels may be the same at work, but your health and performance will improve! 

 

 

 

 

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Stress and Constipation: How to Move Things Along

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Constipation, or passing stool with difficulty less than three times a week,  is a common reaction to modern stress.  This is at first glance curious, because our bodies were hard-wired for centuries for the exact opposite response.  In primitive times, stress consisted of an acute attack, such as from a wild animal in the forest. 

 

The body was (and still is) programmed to immediately eject the contents of our bowels, to lighten our load for "fight or flight".  An excellent modification if one is being chased by an enraged predator, or is cornered and forced to summon Herculean strength in self defense.  When the blood supply is urgently needed in the limbs for strength and speed, there is no blood to spare languishing around the digestive tract, so it shuts down for business.

However, in the modern workplace, stresses are chronic and innocuous, and our hard-wired reflexes have become useless.  While we are still set for "Fight or Flight", there is nobody to hit, and nowhere to run.  Even worse, our busy schedules make good bowel habits even more challenging.  We are programmed to have a gastro-colic "dumping" reflex about a half-hour after stretching the stomache with a huge meal.  Problem is, we are now rushing of to work, so that breakfast stimulation creates the wrong reflex for the bus trip, or traffic jam.  As a result, we hold back that urge, then try to pass stool a few hours later, when the body is offering no help at all.  So lets take a look at some ways to help the modern battle for regularity:

1. Drink plenty of water.  Most people, like car engines, are down a quart.  More water at the top end will help soften the stool at the bottom end.  A good time to drink that extra water is after a big meal, to further generate that "dumping" reflex soon thereafter.

2. Eat more fiber.  There is no fiber in refined sugars, or refined flours, or, for that matter, refined anything.  Fiber should best come from multiple sources, such as bran, fruits, nuts, and vegetables.  There is no fiber in anything that comes from an animal.  Not in meats, fish, chicken, and not in milk, cheese or eggs.  That means an Atkins Diet of high protein provides no fiber until you get to the part with the green vegetables.  Fiber cannot be found in processed foods either.  Read the fine print, and you will note that Aerosol Spray-Cheese is devoid of any fiber.

3.  Tone those abdominal muscles.  The six feet of colon contents need to be propelled along the way, and this propulsion is inhibited by a sloppy abdominal wall.  While sit-ups can lead to low back pain if not done correctly, crunches can help, or many of the abdominal work done in Pilates and Yoga. 

Belly dancing is an excellent example of another way to ripple the abldominal muscles, and encourage the bowel tone as well.

4.  Watch the time.  Remember your gastro-colic dumping reflex will strike a half hour after your big meal.  So make plans to be sitting on the toilet, not on the bus when this happens.

5. Be wary of drugs as a frequent response.  If one uses non-prescriptive suppositories, pills, or enemas too often, the results are often worse.  Lazy bowels can be the unintended consequence of too much "help".

6. If you truly cannot get your bowels back on track, please see your doctor for proper investigation. 

This may include Xrays, ultrasounds, or MRI's of the abdomen, and can even include colonoscopies to rule out other underlying conditions. 

 For more reading, consider:.

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

http://familydoctor.org/online/famdocen/home/common/digestive/basics/037.html

 

 

 

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