Jason Brewton, Director of Physical Therapy at Texas Back Institute, shares 5 tips for protecting your back!

1)  The 20:20 rule:  For every 20 minutes you sit get up for and move around for 20 seconds.  

 2)  Flex the hips and knees not the low back when doing functional activities like:  brushing teeth, sweeping, vacuuming,  or washing dishes.

3)  Lift with your legs not your back, squat or kneel to pick up low items. Don’t use your back like a crane.

4)  Avoid slouching when sitting, use a low back support or rolled towel to support lumbar spine (even on couch).

If you look like this when you are sitting, you could be doing more harm to your back than good!


5)  If sedentary, walking daily may make a difference in your back health. Park a little further away at the mall or walk over to your co-workers office rather than calling them on the phone.

Making little changes in your daily activities can help you maintain a healthy back. 

Tell us what you do to protect your back!


***If your back pain last longer than 1-2 weeks you should see a Texas Back Institute physician to determine if you are candidate for physical therapy to address deficits in:  flexibility, soft tissue dysfunction, range of motion, posture and trunk and core strength.****

Walk Away from Back Pain

January 13, 2012


Can you help protect your back by a regular walking routine?

Back pain is one of the leading causes of missed work, and chronic back pain is something many people must cope with every day. Back pain can be excruciating, debilitating, and in some cases, even disabling. For many back pain sufferers, the types of exercise and participation in physical activities often become limited. According to Dr. Rey Bosita of Texas Back Institute, walking can be one of the most effective remedies for your back pain.

At Texas Back Institute we love participating in charity walks. They are a great way to give back, spend time with friends and get some exercise!

Our group at Race for the Cure!

The Texas Back Institute group at the American Diabetes Association Walk!

Benefits of Walking

There are many inherent health benefits from a regular routine walking for exercise, such as:

  • Strengthens muscles in the feet, legs, hips, and torso. Walking increases the stability of the spine and conditions the muscles that keep the body in the upright position.
  • Reduces stress. Walking helps release the feel-good chemicals endorphins and serotonin in the brain and reduces stress that often makes back pain worse.
  • Nourishes the spinal structures. Walking for exercise facilitates strong circulation, pumping nutrients into muscles and removing toxins and inflammation that are causing pain.
  • Improves flexibility and posture. Exercise walking, along with regular stretching, allows greater range of motion and helps prevent awkward movements and susceptibility of future injury.
  • Helps with controlling weight. Any regular exercise routine helps maintain a healthy weight, especially as one ages and metabolism slows.

For people with ongoing back pain, a balanced and stable walking regimen maintains and enhances one’s ability to continue doing everyday activities while reducing the likelihood and/or severity of additional episodes of back pain.

To realize the full benefits of walking, certain guidelines need to be followed as outlined below.

Tips to Effective Walking for Exercise

There are several stretches and techniques that will improve the benefits of walking, as well as help prevent injury.

Stretch before walking. Prior to exercise walking, stretching should be done to prepare the joints and muscles for the increased range of motion needed. It is important to take an easy five-minute walk to warm up the muscles before stretching so they’re not completely cold when stretching.

Using the following techniques will help improve the benefits of walking:

  • Walk briskly, but as a general rule maintain enough breath to be able to carry on a conversation.
  • Start out with a 5 minute walk and work up to walking for at least 30 minutes (roughly 2 miles) at least 3 to 4 times a week.
  • Avoid hills or uneven surfaces. Hills require leaning forward and increasing your effort, so try to walk on level ground to avoid injury.
  • Maintain good posture while walking to get the optimum aerobic benefit with each step and help protect the back and avoid injury. These elements of form should be followed:
    • Head and shoulders: Keep the head up and centered between the shoulders with eyes focused straight ahead at the horizon. Keep the shoulders relaxed but straight—avoid slouching forward.
    • Abdominal muscles: It is important to actively use the abdominal muscles to help support the upper part of the body and the spine. To do this, keep the stomach pulled in slightly and stand fully upright. Avoid leaning forward as you walk.
    • Hips: The majority of the forward motion should start with the hips. Each stride should feel natural—not too long or too short. Most people make the mistake of trying to take too long of stride.
    • Arms and hands: Arms should stay close to the body, with elbows bent at a 90-degree angle. While walking, the arms should keep in motion, swinging front to back in pace with the stride of the opposite leg. Remember to keep hands relaxed, lightly cupped with the palms inward and thumbs on top. Avoid clenching the hands or making tight fists.
    • Feet: With each step, land gently on the heel and mid-foot, rolling smoothly to push off with the toes. Be mindful about using the balls of the feet and toes to push forward with each step.

Walking can also help prevent back pain. The better toned your muscles are, the less likely you will have frequent spasms. So, strap on a good pair of tennis shoes and start walking to possibly help reduce your back pain, and keep on walking for long-term better health.

What type of exercise do you like to do to stay healthy?

****Disclaimer: Please check with your physician prior to startnig any kind of exercise program to make sure you are healthy enough to begin. ****

A Leader in Spine Surgeon Practices…Texas Back Institute founder, Dr. Stephen Hochschuler, leads the way to help patients find relief from neck and back pain!

Today Becker’s Orthopedic and Spine Review released a list of 10 Spine Practice Leaders to Know. Dr. Stephen H. Hochschuler, one of Texas Back Institute’s founding partners made the list! Congratulations Dr. Hochschuler!

Stephen H. Hochschuler, MD (Texas Back Institute, Plano). Dr. Hochschuler is co-founder of Texas Back Institute and former president of the Spine Arthroplasty Society. During his career, he has served as chairman and sat on the board of directors for SpineMark. He also founded the spine division at Veterans Administration in Dallas and served as a clinical instructor at the University of Texas Southwestern Medical School. He is a founding member of the American Board of Spinal Surgery and chairman of the Texas Back Institute Holdings Corporation. Dr. Hochschuler earned his medical degree at Harvard Medical School in Boston and completed his orthopedic residency at the University of Texas Southwestern School in Dallas. He also spent time in the United States Air Force.

Congratulations to Dr. Stephen Hochschuler!  We are so proud to have you as one of Texas Back Institute’s Founders and Spine Surgeons! 

Dr. Stephen Hochschuler with Chief Development Officer, Cheryl Zapata, and Texas Back Institute CEO, Trish Bowling on Doctor’s Day the other year! 

Orthopedic Spine Surgeons and Founders of Texas Back Institute, Dr. Ralph Rashbaum, Dr. Richard Guyer and Dr. Stephen Hochschuler.

Orthopedics This Week

January 6, 2012

We are very proud to be Texas Back Institute especially this week!  On a day to day basis each member of our team makes a difference in our patients lives.  It can be something as small as reasurring a patient that their injury should heal on it’s own in time or sometimes can be as big as performing a surgery that allows our patient to play with their children again.  However large or small the accomplishments, we relish in knowing that we are making a difference with our patients. 

Well, today we are excited to share that Orthopedics The Week (OTW), the most widely read publication in the Orthopedics industry, has featured some of the things that Texas Back Institute is involved in outside of our day to day treatment of patients. 

The article below is about our CEO Emeritus and Chief Strategy Officer, Mike Franz, and his involvement in the International Spine and Orthopedic Institute (ISOI). 

“Marrying” Chinese and Western Surgeons”

Mike Franz is CEO of the International Spine and Orthopedic Institute (ISOI), a high-level, unprecedented cultural exchange of sorts. Franz, who is also CEO Emeritus and Chief Strategy Officer of the Texas Back Institute (TBI), tells OTW, “The Kerlan Jobe Clinic and TBI have jointly founded the International Spine and Orthopedic Institute (ISOI) with a goal of establishing orthopedic surgery hospitals in China. We are focusing on affluent Chinese patients, expatriates, and medical tourists. We have a unique partnering of Western and Chinese surgeons; to access the surgeons in China, we are relying on our existing relationships with senior orthopedic professors in that country. Through their introductions we are meeting skilled Chinese surgeons and are conducting training programs here and in China. Having established these relationships, we can thereby seek out affluent Chinese patients. The perception in China is that Western medicine is in a more advanced state than Chinese medicine, so there is quite a demand for what we are offering. Our U.S. training hubs are TBI (for spine), and Kerlan Jobe (for sports medicine and total joints). We are proud to have already created a partnership with the First Affiliated Hospital of Suzhou University last March, whereby we renovated a VIP orthopedic center and now send U.S. surgeons there. The next project is a private hospital where we have ownership in the orthopedic department and we will put our model into it. Our ultimate objective will be for ISOI to have majority ownership in standalone orthopedic surgery hospitals in China, something we expect will start to occur in 2013.”


The second article OTW published highlighting the Texas Back Institute this week features Dr. Lieberman and some of his thoughts on the future of spine surgery. 
This is Dr. Lieberman with one of his patients from the Uganda Spine Surgery Mission.

 “Closer Than Ever to Arresting Degeneration”

Dr. Isador Lieberman of the Texas Back Institute has “no doubt” that biologics is the future of spine surgery. He tells OTW, “We are seeing more information these days on regeneration and alteration of the degenerative cascade—and the reversal of the degenerative cascade. This is stuff that will put us heavy metal spine surgeons out of business…and that is a good thing. The FDA has already starting shaking the trees with companies, and having them come out with stem cell possibilities. But the slowness of the regulatory process will ultimately delay the availability of this technology for patients. The good news is that we are closer than ever to arresting the degenerative process so that we’ll be able to manipulate that process with targeted therapeutics like growth proteins or something that is part of the BMP group. Many researchers are looking at various applications and trying to reassign them to another application. As for the regulators, somebody has to step up and point the FDA in the right direction. We need a point person who will say, ‘This is what you need to do; this is how to handle this opportunity. Why are they so hesitant?’ Because they look at this stuff and say, ‘We don’t know how to categorize it… is it a pill, an implant, or a procedure’… and no one wants take responsibility for this process.”


As part of the publication OTW also did a Top Ten of 2011 list.  Although one one story barely missed making it on the list, they highlighted this story of hope and love. We were honored and humbled as this one is very close to our hearts!  Please read the article below.


 The birth of an orthopedic superpower, the death of a young engineer, dangerous accusations of clinical investigative bias, turmoil in markets and companies and reflections of an inventive genius were picked by our readers as the most popular stories on the pages of Orthopedics This Week in 2011

Readers clicked their way to over 6 million page views of stories during the year. Those clicks, tracked by Google Analytics, told us what readers found most interesting.


Before we list the top ten stories, one important story just barely missed the cutoff but was important to our readers because it reminded us of the humanity and purpose of our great orthopedics industry.


Hope and Love


On June 6, Jeff Guyer, a young orthopedic engineer asked us to “continue to breath in hope and breathe out love” in his last blog before peacefully passing away. The son of Rick and Shelly Guyer reminded us that engineers, surgeons, nurses and all the other providers love to go to work every day in the hope to improve patients’ lives.


Jeff led a team that designed the GLIF (guided lumbar interbody fusion) procedure which won an OTW Best Spine Technology Award in 2009.  

So to end this post we ask that everyone take a second to “Breathe in Hope, Breathe out Love”!




For Henry Contreras, of Panhandle, Texas, country living required a lot of physical activity.  To relax after a long day of work Henry loved to ride his Harley-Davidson motorcycle. So when his back pain got so bad that Henry could no longer keep up with the physical demands of living in the country or ride his Harley, he knew he needed a solution.

Unfortunately, two other attempts at surgery to relieve his pain were unsuccessful.  In fact, he felt little or no relief after going through major surgery twice!  Desperate for help, Henry sought out Dr. Rey Bosita an orthopedic spine surgeon at the Texas Back Institute, for treatment.

“I was very limited because I was in such tremendous pain.  So the things I needed or wanted to do, I couldn’t,” Henry recalls.

After a physical evaluation and a review of Henry’s imaging studies Dr. Bosita knew that he could help Henry.  Together Dr. Bosita and Henry carefully considered the possible treatment options and made the decision to have a mini 360 fusion

“Henry had several conditions that needed to be addressed, including bone spurs and curvature of the spine.  The mini 360 fusion was the most appropriate surgery for Henry because it would provide stability to correct the deformity in his spine and provide the stability he so badly needed.  He was definitely in bad shape.   Just looking at his x-rays before surgery made my back hurt too!” states Dr. Bosita.

“I was concerned about having surgery but I knew I couldn’t live my life the way I wanted if my back pain continued.” Henry adds, “Dr. Bosita and his staff gave me hope for a better quality of life.  I knew I could trust them.”

Today, after successful spinal fusion surgery, Henry stands nearly an inch and a half taller, and his initial back pain is completely gone. He is able to do all the activities he needs and wants to do, which includes riding his beloved Harley, with much less pain. 

“I tell everyone that if they have back or neck pain, they need to go to the Texas Back Institute and see Dr. Bosita.  He is the best!”

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