Live Well: Guide to Back & Spine
Healthy to the Core Exercise and good posture prevent back pain By Mike Boyer
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aybe you should have listened to your mother when she told you, “Sit up straight!” Poor posture is a big reason for back and spine problems as people age, says Dr. Jonathan Borden, a neurosurgeon with TriHealth in Montgomery. “The spine is all one component,” he says. “When you exaggerate the curve in the low back [by slouching in a chair while working at a computer, for example], it exaggerates the curve in your neck.”
An estimated 80 to 90 percent of people will experience some type of back pain in their life, say the experts. “Someone told me back problems are second only to the common cold in terms of frequency,” says Borden. The problems extend from the very young to the very old. Dr. Jennifer Chung, a physical medicine and rehabilitation specialist for The Christ Hospital, points to multiple reasons. “One is rising obesity which predisposes people to arthritis and also impacts the
spine,” she says. Another issue is the pervasive nature of technology as we sit at computers all day. “A lot of people with neck pain who come in the office spend the majority of their work day at a computer and don’t realize that sitting in a poor posture position for almost eight hours in a day contributes to lot of the degenerative disk changes and arthritis we see in the spine,” she says. Wear and tear from daily activity, particularly among the older population, is also w w w.
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Live Well: Guide to Back & Spine contributing to back and spine problems. “We’re living longer because of improved and better health care so of course we’re seeing more back problems in the geriatric population because there are more of them,” she says. Exercise, particularly maintaining strength in the core muscles of the abdomen and the lower back, throughout life is critical to maintaining a healthy back and spine, say physicians. When patients come in complaining about back pain “we start by teaching them how to exercise and how to do some physical therapy and get their weight under control. That usually takes care of 90 percent of the problems,” Borden says. “One of the things that I like to tell people is that the spine is like the mast of a ship,” Borden says. “If you’re in a storm the mast will start to bend and you have to tighten down the ropes to hold it up or otherwise it will break. The ropes are the muscles around your spine. Core strengthening and physical therapy stabilizes the spine and can prevent either the progression of
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“Core strengthening and physical therapy stabilizes the spine and can prevent either the progression of arthritis and disk problems” —Dr. Jonathan Borden, TriHealth
arthritis and disk problems.” The Mayfield Clinic has embraced the concept of the “spine athlete” for people who are undergoing treatment for back problems or have a healthy back. “We tell people that now that we have gotten you better, or physical therapy got you better, you have to keep yourself better [through exercise and healthy living],” says Dr. Marc Orlando, a physical medicine and rehabilitation physician at Mayfield. Besides not smoking and eating a health
diet, he suggests non-impact exercise. “We think Pilates is a great core strengthener,” he says. “Even something as simple as sitting on a big Swiss ball, like you see in a therapy gym, is good. Sitting on one of those for 30 minutes takes abdominal strength. “A lot of our patients have sit-down desk jobs and they ask, ‘Well, how can I work 10 hours a day, take my kids to activities and still get a work out?’ Get a Swiss ball and two or three times a day sit on it for 30 minutes. It’s a great way to strengthen your
Live Well: Guide to Back & Spine “Something as simple as sitting on a big Swiss ball, like you see in a therapy gym, is good. Sitting on one of those for 30 minutes takes abdominal strength” —Dr. Marc Orlando, Mayfield Clinic
core. What we find is people who work on strengthening their abs say they don’t have a problem with their back when they play golf or engage in other activities,” he says. At the other end of the spectrum, as people age the discs in the back degenerate and they develop arthritis. The Mayfield Clinic sees more than 20,000 patients annually but four out of five are treated without surgery.
“It’s not like replacing a hip or a knee. I can’t replace your back,” says Orlando. Chung says patients experiencing pain tend to avoid exercise but that’s a mistake. “It’s detrimental if they are sedentary,” she says. “Stretching is important and any sort of cardiovascular activity is good.” Orlando and Chung both recommend aquatic exercise as people age. “It’s not only great from a cardiovascular
standpoint,” Orlando says, “but your body weight is about a third of what it is on land so it puts much less stress on your back.” Sitting at a computer, Chung says, “I recommend keeping the computer at eye level. That keeps the back mainly erect and your arms parallel to the ground. “ When standing, she says, keep your shoulder blades together. “Leaning forward or back from the spine is not proper posture.” The bottom line, says Orlando, is that to have a healthy back and spine you have to work at it throughout your lifetime. “Be a spine athlete and protect your core,” he says. “Everything starts with core. If you have a good strong core you can do anything you want, whether it’s play golf, or tennis or volleyball or whatever. If you have a good core, everything else follows in sync. If you have a bad or non-workable core, don’t work at it, or are over weight, then you end up as a weekend warrior who comes in with that common back pain. That’s what we’re trying to prevent.” n
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