Friday, January 22, 2010

Back problems - regular update

Just a mini-report: diet still continues fine, keeping on task, low-carb, no snacks except some nuts in the evening (no jokes, now--I know I'm the nut in the evening). I've eaten at restaurants for lunch most of this week with a colleague and have kept to salads with added meat--at Mexican restaurants have eaten no chips--which is something, and hasn't been difficult. Energy is much better and more consistent.  My past experience says that after two to three weeks of low carb I will have much more energy.

I've been walking most mornings (although not this one) and continued back exercises. Cluster headaches continue, a bit worse, but manageable (although it means taking naproxen + tylenol--not especially liver-healthy). If my past history is a guide, the series lasts for two to three weeks, then fades. My sleep is marginally better, but headaches often awaken me early in the morning. Hopefully, that will change. With the return to teaching I've been getting up much earlier, but haven't yet gotten to a consistent, every day wake time (I will).

I mentioned back problems: minor injury in gymnastics in HS (landed a dismount and back went into spasm), continuing occasional problems, gradually getting worse, leading to an L4/5 (the lower discs) laminectomy (disc surgery--they go into the spinal canal to remove disc material that has extruded into the canal and is pressing on nerve roots) in 1986 (and was repeated in 1989). In my case, I was having numbness of the toes of my left foot, extreme sciatic pain, etc. Lots of conservative treatments were tried with no success. In 1988-89 I knew things were still not right and had several episodes of spasm, went on a trip to Sweden and Germany in April (it was to be for 3 months), but cut short the trip after 2 months and flew home, had an MRI, and the second surgery.

I've been OK since, although I still have to be careful and can have persistent low-back pain or short periods in spasm.

As I've recently discovered, the exercises most closely connected with better backs are about stability. By that I mean not: flexibility (helpful, but may make the problem worse), strength (isn't the full issue), or other elements. If the correct muscles can gain considerably in endurance (not so much strength), the spine is kept much more stable and the back muscles will not go into spasm.

Much of the research is by Stuart McGill in Toronto. He has several books on the subject and I've just ordered a new book by Rick Jemmett: Back Stabilization: The New Science of Back Pain. The most common exercises are:
1 - the bird dog, which strengthens the multifidus muscles, which weave through the spinal facets and stabilize the spine
2 - the plank, which strengthens and stabilizes the abdominal core
3 - the side plank, which strengthens the transverse abdominals (this video shows both regular and side plank variations). This link also has a very good interview with Stuart McGill, plus one of McGill's other exercises, the curl-up.

Again, the first goal is endurance, so exercises are gradually extended in length of time/number of repetitions. With the side plank, I'm only strong enough to do this from the knees, so I need to wait until I get sufficient strength and endurance before I start to do from the feet (see the video to see what I mean). As you can see in the last video, one can combine side plank to regular plank to side plank (on the other side) without pause--much more advanced, of course.

My past experience is that if I DO these exercises regularly, my back feels MUCH better. The point is to do them--and that's the point of this transformation . . .

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