Spine damaged by Sitting

Recently yet another good friend of mine was diagnosed with slipped (herniated) disc.

Most people thought slipped disc only happen to old people, or those who work in labourous jobs. But most of my friends who suffer from slipped disc are only in early 30s, and they are all white-collared PMEBs. They didn't do anything drastic or contact sports or been through any serious accidents or falls.. so how did they injure their spine?!

Sedentary lifestyle was the culprit! Even simply by sitting for long hours can damage your spine.

Our backs are perfectly evolved for a hunter gatherer lifestyle, which was much more strenuous than ours (and did not include chairs!) A bushman or aborigine crippled by back pain would be unlikely to survive long enough to have descendants, so evolution ruthlessly eliminated all but the fittest. So we have inherited a perfectly spine design for an active (but definitely) not sedentary lifestyle!

When we sit, the chair usually tipped the pelvis backwards off balance. As the torso weight bears down on the spine and the seat pushes the base of the pelvis up, the pelvis becomes a lever bending the spine forwards and distorting it. (There are ligaments to limit this bending. They are strong for brief exertions like lifting, but under prolonged stress they stretch till they can’t protect the discs.) The results are strained ligaments and compressed intervertebral discs. The more the pelvis slumps the more pressure it puts on the discs. The damage this causes gets worse the longer you sit in this posture.

Ideally we should adjust the height of the chair so that thighs are higher than the knees, thus allowing the thighs to slope downwards and prevent the slumping of the pelvis.

Applying Pilates principles will help to prevent pelvis from slumping too:

1. Think of length in the spine. Always sit as if there is a helium balloon tied to the top of your crown, lifting the entire spine up long to the ceiling.
2. Keep your navel to spine to allow the "powerhouse closet" to support your spine.
3. Gently draw your thighs together to get the adductors (inner thighs) and pelvic floor activated.

Spine Health for Drivers

An extract from a recent article on "Mind Your Body"(25 Sep 2009), which resonants with my previous entry "Good Posture for Drivers":

Rev up on Healthy Driving

"Back to comfort

Sitting in a car is quite different from resting on a couch because when the vehicle is moving, the body is subject to different forces - accelerations and decelerations, lateral swaying and up-down vibrations, said Dr Fong Shee Yan, consultant orthopaedic surgeon at Tan Tock Seng Hospital.

To minimise back and neck discomfort, he said, have car seats with good lumbar cushion support for the lower back and headrests for neck support.

Car seats should recline at about 100degrees horizontally, with the knees slightly above hip level. The driver's seat should be moved close to the steering wheel to best support the curve of one's back and to allow the knees to bend.

During a long drive, it is important to take frequent rest breaks and do some stretching exercises to ease the discomfort and pressure on the spine."

A Good Pillow for Quality Sleep

For the lucky ones we spend around one third of our lives sleeping. So it makes sense to put in effort in choosing the right "sleep-equipments".

"A bad pillow can be damaging your back, insomnia, neck pain shoulder pain, back pain and also headaches" says Marnie Douglas, a physiotherapist and a pillow expert. "Most people have the wrong pillow and they don't know what to look for when choosing a pillow."

Pillow design has become high-tech science. You can buy all sorts - for pregnancy, snoring, allergies, back and neck problems. In polyester, latex, foam, duck down, luxurious goose feathers, special NASA developed materials, even filled with water or buckwheat. They cost from just S$10 up to S$1000.

In fact, a study show that in HK, 90% people already suffer from moderate spinal misalignment due to improper sitting and standing posture, injury or simply lack of physical activity. Misalignment in the spine may cause compression to spinal nerves, thus giving pain. And if your spinal muscle cannot relax completely during sleep (probably due to a bad mattress and pillow), the misalignment problem may be worsen. (NB: click here for more info on "sleep science") So how should you choose a pillow? It was a myth that the firmer the better. In fact, one should checkout how a pillow re-bounce after compression. The stronger the pillow re-bounces, the more likely it may cause cervical misalignment.

Chiropractors use a little trick used to choose pillow, u can give it a try:
1. Lie face-up on the pillow.
2. Raise one of your arms at 90 degree (like pointing to the ceiling)
3. Ask a friend to press your arm down towards your hip, but at the same time u try to resist it.

--> if your body tremble or your head lift off the pillow while you try to resist the pressing force from your friend, it means the pillow does not provide sufficient support for your head.

Of course, if u already have a good pillow and u want to further improve your sleep, practice Pilates so that u can sleep better after de-stressing and re-connecting your mind with the body.

Anyway figure below is a good comparison (extracted from Next Magazine) of 4 common pillow fills for your reference. Click on image to enlarge. English translation follows.

	Pros	Cons	Life-Span	Price	Grading (5* being the best)
Buckwheat	Highly breathable; low re-bounce; conform to body shape regardless of sleep posture, well support the neck	Not machine washable; to be sanitized regularly with sunlight.	Up to 20 years	S$60-200	* * * * *
Foam	Soft; supportive; conforms well to head	Strong re-bounce; may turn moldy as sweat is not easily evaporated	~ 3 years	S$5-200	* * * *
Cotton	Less man-made material; Soft to touch.	The fills condensed & stiffen up with time. Not breathable and go moldy easily	1 year	S$6-10	* *
Goose Feathers	Soft	Not breathable, does not absorb sweat, may cause allergies	3-7 years. Dry-cleaned yearly	$10-100+	*

SMS-Thumb

Repetitive Stress Injury. I can never emphasize this enough, doing the same thing over and over again can be hazardous to your life. Mouse users beware of Carpal Tunnel Syndrome. Too much tennis, Tennis Elbow. Constant staring at computer screens-- Dry Eye Syndrome. Overdose on cardio exercises without conditioning, you get Runner's knee and all other kind of lower extremity problems.And if you use handphone too much, you get SMS-thumb.

Beside clinching the world's fastest SMS record, Singapore is again in the world's limelight when a school girl here became one of the first three patients in the world to be diagnosed with SMS-thumb, aka texting tenosynovitis. Repetitively punching on tiny buttons cause friction to the tendon and its covering, leading to inflammation of muscles of the thumb, giving rise to this agonising painful condition.

Like other overuse injury, sms-thumb can be treated and the first step is to stop the offending activity so as to prevent further aggravation, in this case stop sms-ing (or at least use the other thumb!). Medication may be prescribed as a follow-up measure and the patient may be given an injection into the tendon to ease the inflammation pain, along with home stretching and technique analysis and re-training. In severe cases, the tendon may need to be surgically released to relieve symptoms.

This condition is getting so widespread, especially among the young generation, that prompted Singapore Polytechnic to conduct a study to understand more about the physiology of sms-ing. It will measure the force and motion of the thumb and fingers used in SMS. But before any useful data can be used to advise you on which phone model is more "thumb-friendly", choose phones with big round buttons, as it has been observed that small or square buttons tend to strain your thumb more. Plugging in a keyboard to replace the tiny buttons, or switching to PDA phone might help too. Of course cutting down sms-ing not only will cut your cost, but will definitely be good to prevent yourself from getting a sms-thumb too.

Make Your Body Burn More Fat on Its Own!

There are many things in life that doesn't work in the "more-the-merrier" manner, unlike what most people think, dieting and exercise are just two of such examples.

Many overweight people achieved incredible amount of weight loss when they change their lifestyle, that is by eating less and exercise more. But they soon reach a weight-loss planteau, the speed and amount of weight loss start to slow down and even stop. They become so eager to continue losing weight that they stop eating proper meals, and they do cardio exercises like running and biking for few hours, DAILY.

Problem is, what if these people hit another weight-loss plateau? Are they going to increase their exercise duration to 24/7 just to lose extra pounds?! That just doesn't make any logical sense.

What really happen to these people is, as explained by Yahoo Health:

Our bodies are built to survive, so when you exercise for long periods of time (often and consistently) your body thinks it needs to hold on to fat for energy. Doing short (12-15 minute), intense exercise sessions builds strength and burns calories, but not fat, so it “feels safe” using fat stores for energy after exercise.

So if you run everyday for 30 minutes, you are turning your body into a fat-sparing machine. So what is the ideal strategy to keep your body efficient in burning fat and to spare your precious time for social life than to be stuck in endless cardio exercise?

1. Instead of running/biking everyday for 30min, exercise in short, intense bursts (interval training) for effective fat burning after exercise. E.g. Run for 10-15min at 80-85% (depends on your fitness of course ) max heart rate (MHR) instead your normal routine of 30min at 65% MHR

2. Build more lean muscle by increase the amount of resistance/strength/weight training you do. Muscle is ‘metabolically active’ and burns more calories than other body tissue even when you’re not moving. Don't worry, weight training is NOT going to make you look like body builder that easily.

3. Chill on the amount of food you are eating.

Here is a sample five-day/week training schedule for you:

Day 1 Weight training for big muscle groups (Back/Chest/ Legs) and short & very intense cardio training , e.g. 15-minute fast run/walk or fast cycling sprint intervals. Day 2 Moderately long, moderately intense session (30-45 minutes) of strong walking, cycling, or Pilates Day 3 60-90 minutes of a moderately paced walk/hike. Day 4 Short & very intense cardio session, e.g. 15-minute fast run/walk or fast cycling sprint intervals. Day 5 Weight training for big muscle groups (Back/Chest/ Legs) and moderately long, moderately intense cardio (30-45 minutes)

It would be great if you can add on daily Pilates practice to your training scheule too! But remember, more does not equal to better. Make sure you practice Pilates exercises with control and precision. Repetition is never the emphasis in Pilates.

Pilates and Sex - For Men

A reader asked how exactly can Pilates help in sexual sensation (as mentioned in my previous post). She understands that strong pelvic floor muscles can affect the tone of vagina, thus better sexual sensation for the lady. But what about the men? It never even occurs to her that men also have pelvic floor muscles! So, while keeping P-latte NC-16, I will write a little more about Pilates and Sex - for MEN.

Joseph Pilates stated that the five basic principles behind his method of exercise are concentration, control, centering, flow, and breathing. All very good compliments on how to have better sex.

Generally speaking, studies have shown that a key to an improved sex life is a healthy fit body. More specifically, Pilates fitness can show you how to have better sex. Because of the obvious, and not so obvious, body-strengthening benefits of a regular Pilates routine.

First and foremost, strong pelvic floor muscles equal stronger orgasms - for both men and female. Besides, in a study published in the British Journal of General Practice, 40 per cent of the male subjects who were put on Kegel exercise, attained normal erectile function, and another third showed improved performance at the end of study. Grace Dorey, visiting professor at the University of the West of England, Bristol, and lead author of the research, said that the results showed that pelvic floor exercises should be the first treatment for all men with erectile disorders and weak erections. Such exercises could also prevent impotence in men, and even improve the performance of those who do not have problems. “When men are going through a normal sex life, they should be looking to these exercises to extend their sex life. If you are performing reasonably well, this research would suggest that you may be able to improve your performance further,” the professor said. Pilates strengthen pelvic floor, thus enhance sexual performance.

Next, stronger abdominal muscles help to sustain the actions of sex. Stronger core equals stronger movements for a longer period of time. Isn't stronger and longer means better?

Want to try some of those fabulous Kama Sutra poses, but can’t quite get your leg over your head? Pilates improves your flexibility and overall range of movement at the joints.

Looser hips give you greater ease of movement and a freer feeling body. Nice.

In addition, some of the less obvious benefits of Pilates and how to have better sex have to do with oxygen. Pilates requires very deep, sometimes sustained breathing. This oxygenates your blood and sends oxygen to your muscles faster. The increased blood flow that comes from Pilates exercise can also benefit men who are experiencing some erectile difficulties; and increased blood flow in certain areas of man’s body can increase their feeling of strength., according to experts.

Plus, stronger body also allows for better stamina and an overall feeling of well being.

Last but not least, sex is many times more mental than physical. We all know how a little mental concentration can boost your experience. (wink…nod) Pilates exercise utilizes mental imagery to achieve the correct form and feeling to each exercise and the mental strength recruited during a pilates class can also be used in your sexual workout.

So you see, be the master of your mind and body and you will have control in all areas of your life. Pilates will be the way to an improved sex life.

Toes Saver for High-Heel Wearers

High-heels are must-have in a lady's wardrobe. They come in different shapes and styles and they are always in the fashion trend.

Why? Because high-heels can do wonders to enhance a lady's look. They make her look taller, legs appear longer and more slender. And they can also miraculously make buttocks seem firmer and rounder to the eyes.

But wearing high-heels regularly have detrimental effects to the feet, and to other parts of the body too. It may cause foot deformities like bunion and degenerative changes in the knee joints. Since high-heels affect the way a lady stands, it affects her posture and thus might cause problem in the spine too.

But how can any lady give up the sexy heels? Moderation is the key. Choose heels fit properly (though oftern not easy!), wear high-heels on alternate days allows your foot to rest and recover with wearing more comfortable footwear. Of course doing Pilates can help too, it can maintain foot health as many Pilates exercises stress on proper foot/ toes alignment, balancing and strengthening the foot structures.

You can also save your foot (and save yourself from giving up wearing that favourite pair of heels!) by spending just 5 minutes every night doing simple stretches. I had made a video sometimes ago to demostrate these stretches, but I have yet to figure out how to add on subtitles (can some kind soul pls enlighten me!). So instead I have borrowed a good illustration from a Hong Kong lifestyle magazine, Sudden Weekly, which demostrate the stretches. Please bear with these static images and instructions till some kind soul enlighten me with simple and non-time-consuming video editing:
For those who can't read chinese, here is the translation:

1st Pic on the left: Gently pull the 1st tarsal (aka the big toes) downwards. Hold 30 seconds to lengthen and relax the joint.

2nd Pic on the left: Gently pull the big toes and 2nd toes apart. Hold for 30 seconds to "straighten" the big toe

3rd Pic on the left: Grab a small towel firmly with all the toes, repeat 3 sets of 20 repetitions to strengthen the foot muscles.

1st Pic on the Right: Stretch the big toe up towards your shin. Hold for 30 seconds to lengthen and relax the plantar fascia (fibrous supportive tissue) under the foot

Calf Stretch: Stand with back foot flat on floor and transfer weight to front foot. Keep your back straight and hold for about 20 seconds for each leg. This will help relax and lengthen the calves muscles.

Remember just 5 minustes a day can help prevent bunion and give you a prettier and healthier feet. It can also reduce your chance of having to go thru expensive and painful bunion surgery.

~~ 5 minutes a day will give you a prettier and healthier pair of foot!

My Sports Bra Gives me Neck Ache!

It's a shame that, though I practive Pilates regularly, I suffered from bad neck aches.

Sometimes my neck ached so bad that I felt like the whole world was crumbling down my head.

Pilates had already given me a lot of pain relief. So you can imagine how bad it had been.

I changed my mattress, got myself a new memory foam pillow. I am careful with my posture, I have strong back muscles and I stretch regularly. I didn't know what's causing the ache and I even suspected something was wrong with the Feng Shui of my room, so I painted the walls a new colour and shuffled furniture into new layout. But why didn't the neck ache go away?

One weekend I was all alone at home working at my laptop and my neck started to ache badly. I wanted to rub the ache off my neck, so I reached for the massage oil. But the moment I took off my sports bra to make way for the massage, the pain immediately reduced 80%! Only then I realised, gosh, my favourite sports bra was the culprit!

I have been wearing this sports bra for years. I liked it a lot because it gave me very good support (maybe too good support) for my run. Apparently my body had changed over the years and my upper body had grown bigger, meaning the sports bra became tighter. The shoulder straps of the bra acted like super shortened upper trapezius muscles and bound my shoulders and neck uptight. That was what made my neck ached! No wonder all my stretches didn't work.

Besides neck ache, wrong bra size can also cause backache, shoulder pain, tender bust and bad posture. It is not a matter that ladies should take casually.

If you do have neckache (and bra size is not the main culprit), try the following:
1. Isometric exercises

• clasp hands together behind head and press head firmly against hands for five seconds, then relax pressure
• bend head forward and apply gentle pressure with hands for ten seconds, relax pressure once again
• repeat five more times or as needed.
  
• Do not force head too far forward and stop if any pain is felt.

2. Stretching

• bend head to right and hold for ten seconds, then roll gently, head forward, then to left.
• shrug shoulders, hold for a few seconds and then release.
  
• Repeat if needed.
  
• Go slowly and don't force head to shoulders, only go as comfortably as you feel.
  

Anyway, I found this video pretty cool, it gives a short and sweet overview on neckache and pain relief good exercises:

Pilates: How To Prevent And Relieve Neck Ache

Simple Pilates Exercises while you are driving

Keeping a healthy spine through regular exercise and stretching and maintaining good driving posture is a large part of warding off pain while driving. However, no posture is good posture if maintained for too long (greater than 10-30 minutes, depending on the individual). Therefore, it is important to move often while you are driving, but in a way that is not distracting. Here are some suggestions for how to move while sitting and driving:

Pelvic Tilt
Roll your pelvis forward to increase the arch in your lower back (you will feel like you are sticking your upper chest outward) and then roll back to neutral. This exercise helps move and loosen the lower back, and allow the discs in your lower back to be nourished with fluid. For Pilates practitioners, this is like printing & imprinting exerise on the mat.

Side Pelvic Tilt
Shift all of your weight over to the R hip and pick up the L buttock slightly off the seat. You will feel your L shoulder and L hip come closer to together. Switch and repeat with shifting the weight over to the L hip. This exercise also helps feed the discs in your lower back.

Gluteal Squeezes
Pinch and squeeze the buttock muscles together. Hold for 10 seconds and then relax. This exercise will help use the stronger gluteals as a postural muscle, allowing your lower back muscles to rest.

Shoulder Pinches
Squeeze your shoulder blades together and hold for 2-3 seconds. This will help keep your neck muscles from tensing up and work for the neck in the way gluteal squeezes work for the lower back.

Head Nod and Neck Rotations
Head nod as if you are saying "yes madam." Neck rotations would be like saying "no madam." Do this for 20 seconds. This will help warm-up the muscles at the base of the skull where headaches often begin.

Whichever movement or exercise you choose to perform or make up, what is most important is that you shift in some way, often enough to keep your spine from getting stiff.

"The biggest thing I do while driving is moving my head from side to side on the headrest - as if I were scratching my head. Obviously, I keep my eyes on the road the whole time. It's been a Godsend for my neck pain," suggested by a driver friend of mine who suffered from neckache.

This is a great example of how a little movement can go a long way to keeping blood flow to the muscles of the spine and allow for a prolonged drive. Do share with me if you have your very own little movements that give your spine some grooves in the car.

Good posture for DRIVERS

Since I got my driving license on 28th August 2007, I drove under supervision only twice, and then I was all on my own. Well, like many other new drivers, I feel liberated and empowered by this new skill, because I can go anywhere, anytime, with all my "luggage/ equipments" with me. I was constantly lost on the roads and generally a half-hour journey would extend into a full hour. (For example it took me 100min or 40km to travel from Serangoon to Gleneagles Hospital, an otherwise 20-min journey on a Saturday morning!) I realised how tiring it was to drive around. My whole body stiffen up in the seated position, my mental focus was on the road instead of keeping myself in proper posture. So after 20km on the road, I usually slumped in the seat like a couch potato in front of TV, without knowing it.


Bad news for people like me, who need to drive a lot for work, is that, prolonged sitting with bad posture in a poor seat can have painful consequences on the spine. Recent research has found that people who drive cars for more than four hours a day are six times more likely to take time off work for back trouble than those who drive for less than two hours (1).

Protecting our back while driving involves an interplay between our body's posture and the adjustment of our car seat. Rule of thumb is: adjust your posture and seat in a manner that places you in optimal posture - maintaining the normal curves of your spine, or in Pilates term, maintaining a neural spine.

Below are 8 simple steps that can guide you into optimal posture at the steering wheel:

1. First, be sure you are not sitting on anything that could throw your alignment off (such as a wallet).


2. Adjust the seat forward/backward to a point where you are comfortable. Your feet should easily touch the pedals. You should be at a distance from the steering wheel that is comfortable for your arms. You should have easy access to all controls. This is important, since excessive reaching can place more stress on the spine.


3. Next, if possible, adjust the seat up and down so that it meets your thigh a few inches from the knee. Your knees can be either slightly higher than or level with your hips, depending on your preference for your spine. If you are unable to adjust your seat in this manner, you may have to purchase a wedge, or use towels to raise the seat.


4. Now sit upright, with your back aligned straight, looking ahead through the windshield. Sit in a manner that maintains your normal spinal curves (slightly arched back, shoulders back, head/neck straight). Now, re-adjust the back of the seat to meet your spine at this position. The seat will likely be around 95 to 100 degrees. More than that will force the lower back to slump and the shoulders and head to come too far forward. The angle of the seat is helping to maintain the normal lower back curve.


5. To determine if you have optimal headroom, you should be able to get a fist (thumb pointed down onto the crown of your head) between the ceiling and your head.


6. Your head should hit the headrest at the level of your eyes. If the rest is too low, this can result in more trauma to the neck during an accident. You should be able to easily rest your head on the headrest without tilting your head back.


7. Finally, adjust the lumbar support if possible to help place your spine in a slightly arched or lordotic position. If this is not available on your seat, use a towel-roll to build the lumbar support. Most automobile seats are already constructed with a lumbar support built in. Often the support is either too high or too low. If the lumbar support is not adjustable, a towel roll will come in handy.

8. Of course not to forget to engage your powerhouse, the abdomeninals, by gentlydrawing your belly button towards your spine. Your powerhouse will give you excellent lumbar support.

References:1. Porter JM, Gyi DE. The prevalence of musculoskeletal troubles among car drivers. Occup Med (Lond) 2002 Feb;52(1):4-12.