Wednesday

Tips for Daily Life to Improve Your Spinal Health (Part 2: Common Activities)


This post, the second in a series on how to improve your own spinal health, will focus on common daily activities. Likely, you don’t spend much time thinking about how you stand, sit, carry objects, talk on the phone, and other such things because it has become so second-nature to you over the years. I’d like to draw your attention to a few of these seemingly harmless activities, suggest some easy ways to tweak your habits and, ultimately, help prevent future damage to your spine.

Essentially, your muscles are constantly either getting stronger or weaker, and chairs that don’t require you to do any work or use any strength are bad news. If you sit for 9 hours straight every day in one of these chairs (probably in an office work environment), what do you think the end result will be? We put approximately 30% more pressure on our low backs when sitting as opposed to standing, so, if you can, try to create a standing workstation for yourself, as I have in my own office. If you do this, make sure your keyboard is at elbow level and the bottom 1/3 of your monitor is at eye level. This will require you to look slightly up at the screen, which encourages a proper neck curve.  

For many of you that may not be possible, but that doesn’t mean there aren’t alternatives. If your boss allows it, you may sit on a large exercise ball. If you’re sitting up straight, as you should be, an exercise ball will engage your core and strengthen it. And if an exercise ball isn’t professional enough for your work environment, I also sell an excellent cushion that turns any chair into a simulated exercise ball and will still engage your core muscles (see picture below). Ask me if you’re interested in purchasing one. 
If you find that you’re stuck on a normal office chair, you should definitely get up and stretch every so often. I recommend moving for approximately 10 minutes every hour, if possible. Remember what I said earlier about where your computer monitor should be! And pay attention to your posture as you sit at your computer; if you find that you’re hunching over, force yourself to straighten up until good posture becomes a habit.


Even when work is over, most people spend lots of their free time sitting, so pay attention to the couches and chairs you use. It is important to have adequate lumbar support in these pieces of furniture the same way it’s important in a mattress, as I mentioned in the first post of this series. We can end up sitting for hours on end, and keeping your body in the same position with little to no support for the lower back is asking for trouble. If buying new, spine-friendly furniture isn’t in your budget, though, the next best thing is to put a pillow or two behind your lower back. Also, if you’re sitting in a recliner or in a reclined position, bend your knees and hips at 90°. You can put a pillow or other object to support them if that’s more comfortable for you.

Another thing to keep in mind is the fact that you put more weight on your discs when leaning, twisting, or rotating when sitting. I have seen patients who actually threw out their backs by picking up a pencil after a long day of sitting at a desk. Remember to turn your entire body when you need to reach for something, and above all, do not combine leaning, twisting, and rotating your body all at once. When you need to pick something up for any reason, in the workplace or not, try to do what infants do: squat, pick the item up, use your legs to stand up straight again, and then squat to set the item back down. Use this simple rhyme to remember: toes and nose. When you lift an item, you should point both your toes and your nose towards it. Using the strength of your back to pick things up—especially heavy things—is never a good idea.


Now, a note specifically for men (and women who carry their wallets in their back pockets). If you want to demonstrate what sitting on your wallet does to your back, try sitting half of your buttocks on the palm of your hand and see how it causes an imbalance to your spine. This simple, seemingly unimportant habit can eventually lead to spinal problems, so the next time you’re about to sit down with no regard for the  wallet in your back pocket, simply remove it and put it back when you stand up again. Easy, right?

And a note specifically for women (and men who carry over-the-shoulder bags or backpacks). Human hands are designed to carry things. Our shoulders aren’t. And yet, women constantly use their shoulders to bear the weight of heavy purses. The average American woman’s purse weighs a whopping 25 pounds! Regardless of whether you carry a purse on one side for your entire life, or switch sides every so often, just imagine the strain you’ll be putting on your body after years of this. Try lightening your purse by taking out anything non-essential, carry a handbag rather than a purse with a shoulder strap, and if you carry a backpack, use both straps to distribute the weight more evenly between your shoulders. 

The last, but certainly not least, important tip is to pay attention to how long you’re on the phone every day. If it’s any longer than 1 hour, you should seriously consider purchasing a headset with an earpiece instead. An even simpler option is to use your speakerphone instead of holding the phone directly to your ear for an extended period of time. And, contrary to popular opinion, switching which ear you use doesn’t lessen the damage to your neck—it only damages all the parts of your neck equally, and that’s hardly a positive choice to make!

As you can see, there are many variations to all the tips I’ve provided, and you may even come up with some of your own! The key is to never see these everyday activities as insignificant. Everything you do, from the moment you wake up to the moment you go to sleep at night (and when you’re sleeping, too!), may eventually add up to make the difference between a healthy or an unhealthy spine. Keep this in mind, and stay tuned for my next blog post, which will cover two very important topics: exercise and nutrition.

Tips for Daily Life to Improve Your Spinal Health (Part 1: The Morning Routine)

I hope the previous blog posts describing my techniques have been informative for you, but I’m not the only person who can help improve your spinal health. There is so much more that you can do on your own to reach your peak physical condition if you are willing to make some small lifestyle changes. This post is the first in a series that will detail these suggestions.

Let’s begin with a simple question: what do humans spend one-third of our lives doing? The answer is sleeping. Considering this, it isn’t surprising that the position we sleep in can have a great impact on our spines. Another question: what do you think is the best position for sleep? If you answered “on your side” or “on your stomach,” you were wrong. Besides the fact that sleeping on your stomach provides no back support, it also increases Lordosis (the inward curvature of the lumbar and cervical columns) and pressure on your nerves. In addition, rotating your head to one side to breathe—as you must when sleeping on your stomach—cuts off some of the blood supply to the brain. In fact, sleeping on your back is the best option.

But even if you already do sleep on your back, there are ways to tweak this position to make it even more beneficial for your spine. First, use a pillow that supports your neck and lets your head hang back, perhaps even to the point of touching the bed (if you can handle it). Also, try bending your knees and using a sleeping bag or large pillow to support them. This allows your spine to maintain a proper curve during the nighttime hours. In addition, if you snore, it opens the airways and your chance of snoring greatly decreases. Try sleeping this way for at least three weeks (the amount of time it takes to create a habit), and if you find that you cannot get adequate sleep while on your back, then move to your side.

When sleeping on your side, make sure that you don’t find your arm beneath your pillow to prop your head up. If you do, this means that your pillow isn’t thick enough. Your elbow should not be higher than your shoulder when sleeping. If you don’t believe me, try this: when you’re sitting or standing, try raising your elbow above your shoulder and see what a strange position this puts your body in, and then imagine holding it there for hours on end. Clearly, this is not an ideal position for the muscles and bones of your spine/shoulders. While you sleep on your side, your head should be propped up to its natural resting position from the shoulder to the neck, not any higher or lower. To prevent rotation of the hips, sleep with a pillow between your knees to keep the hips even and level with one another.


Make sure that, above all, your mattress has adequate low back support. This means no air mattresses or waterbeds and no thick pillow-tops. Mattresses should be firm and flat.
Continuing on a traditional daily routine, you should pay more attention to the way you get out of bed in the morning. When you’ve been sleeping for 6-9 hours, your muscles must be warmed up and stretched before you can expect them to function at their full capacity, just as you would warm up before a workout. Try this stretch routine the next time you wake up, rather than hopping right out of bed. First, lie on your back. Then, repeat the following exercises three times each:
  • Point your toes.
  • Raise your arms so that they are straight in front of you, point your fingertips and reach forward as far as you can while still keeping your back on the bed, then bring your arms back.
  • Bring one knee to your chest, then the other, and then bring them both to your chest together (as pictured below).

  • Roll to your side, push yourself up sideways (rather than doing a sit-up), and carefully swing your legs so that your feet are on the floor.
Once we’re out of bed, usually the first thing we do is head to the bathroom and brush our teeth. How do you brush yours? Do you stand bent over the counter? If you do, try this instead: place one foot in front of the other, bend (engaging your abdominals), place your forearms on the counter, and use your wrist to brush your teeth rather than your arm. Doing this helps decrease the chance of pulling a muscle or injuring a disc before your body has had a chance to stretch fully.


As I said previously, this is only the first in a series of posts that will address the ways that you can improve your spinal health on your own. Keep an eye out for the next, which will focus on the lifestyle changes you can make during the day—at work, at home, and everywhere you go!




Scoliosis and Short Legs


I’ve seen numerous patients over the years that anatomically have one leg shorter than the other, and many of them didn’t even know it until they saw their x-rays. Although a slight difference in leg length may not seem to be a big health issue, it can certainly be a cause of concern. If left untreated, it can even cause scoliosis. Scoliosis is a condition in which the spine has an abnormal curve; from an x-ray, the spine of someone with scoliosis can resemble an “S” or a “?” rather than a straight line.[1]
             

The importance of discovering a short leg and beginning to treat it is especially crucial for teens who are still growing. Even if a short leg is noticed by a young person’s doctor, often times, they will use a “wait and see if it fixes itself” approach. This technique makes no sense when you apply the Hueter-Volkmann Law. Let me explain what the Hueter-Volkmann Law is. It is an orthopedic rule—a proven law, much like gravity, not a theory--regarding bone growth, which states that “compression forces inhibit growth and tensile forces stimulate growth.”[2]
            Essentially, this means that if you have a short leg and your body leans towards that leg, putting more weight on it (which it will do), the problem will only be aggravated.  Rather than wait and see if the leg grows, we must even out or even reverse the pressure by using a foot lift, a plastic device placed in the insole of the shoe. Doing this allows the leg to grow and catch up to the longer leg.

            I have seen significant improvement in my patients’ leg lengths even within three short months of wearing a foot lift. For individuals who are still growing, this means that they have no more need for a lift! Unfortunately, for adults who have reached their full growth potential, the foot lift needs to become a permanent fixture in their footwear. This is why it’s so crucial to find a shorter leg and act to fix it as soon as possible.



[1] “Scoliosis” Wikipedia page. 2014 <http://en.wikipedia.org/wiki/Scoliosis>
[2] Orthopedic Journal, Volume 11 Spring 1998 Pages 27-35