Summer’s Back!

June 21, 2013

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Since the official beginning of summer is June 21st, the spine specialists at Texas Back Institute are preparing for the annual spike in the number of back injuries. “The primary culprits in this rash of acute back injuries are the accidents which occur when people get outdoors to enjoy some summer recreation,” notes Dr. Daniel Bradley, a spine surgeon at Texas Back Institute.

Activities such as mountain biking, water skiing and wake-boarding have an unusually high incidence of back injuries associated with them. Overdoing it on the golf course, tennis or basketball court can also lead to a visit to Dr. Bradley’s examination room. Even lifting those heavy suitcases into the car for summer vacation has the potential of causing painful back injuries.

So, how can you avoid the backache blues this summer? We asked Dr. Bradley for his advice.

Tips on Avoiding Summer Back Injuries

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“The best strategy for avoiding back injuries from summer recreation is to build core strength through proper conditioning before undertaking the activities, Dr. Bradley said. “Of course, this is easier said than done because in the summer, the weather is warm and we want to get out and play 36 holes of golf, rather than the 18 holes we are used to playing. Plus, we all believe we are in better shape than we really are.”

What is it about biking, equestrian sports, water skiing and wake-boarding that is makes them so dangerous to back health?

“The sudden pull on the ski line from the boat can cause trauma to unconditioned back muscles. However, this pales in comparison to the impact from falls that occur from a bike, horse, skiing and wake-boarding. A fall from this high speed can lead to strains and sometimes fractures to the vertebra of the back.”

What about swimming? Are there any potential back problems associated with taking a refreshing dip in the pool?

“So long as you’re careful on the depth of the water in which you’re diving, swimming is actually the best type of exercise anyone can do – in the summer or any other time of the year. In fact, we recommend regular swimming for those who are rehabbing from other back injuries. It’s extremely low impact and offers an excellent aerobic workout, while exercising all of the muscle groups.

Some summer sports such as fishing, tennis, golf and jogging seem to be pretty mild recreation. What are the possible problems with these activities?

“These activities are highly repetitive and sometimes involve twisting motions. While they are not high impact, they can exacerbate existing back pain if some form of stretching and muscle warm-up is not completed before the activity. By loosening up the muscles, they are more flexible and less likely to be strained by the motions of these sports.”  

How can someone determine when their back pain is related to soreness resulting from inactivity or a severe injury requiring medical attention?

“Any pain that does not subside after icing and over-the-counter pain medication over 2 or 3 days might require medical attention. Also, a physician should be consulted for any back pain which runs down the legs or arms and weakens these muscles.”

Summer is hot. Does heat have any effect on back pain or injuries?  

“Heat-related illnesses such as a heat stroke affect the central nervous system not the spinal muscles. I am not aware of any back injuries that are caused by the body overheating. However, the heat and fatigue can cause a person to be more careless in their physical activity and this can cause accidents. Plus, insufficient hydration can result in muscle cramps which can lead to injuries in the back and other areas of the body.”

Celebrating the Summer Solstice

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June 21st is the longest day of the year in the northern hemisphere and is known as the Summer Solstice. This is when the tilt of the earth’s semi-axis, in either the northern or the southern hemisphere, is most inclined toward sun around which it orbits.

While there are many myths and legends associated with the Summer Solstice, the most interesting place to celebrate the longest day of the year is at Stonehenge, located near Wiltshire, England. Many scholars believe this pre-historic monument was built to serve as a celestial observatory which helped predict events such as solstices, equinoxes and eclipses of the sun.

Online references note that during Summer Solstice, Stonehenge provides visitors with a visually stunning view of the rising sun. It can be seen rising above the ‘Heel’ Stone when one stands within Stonehenge facing north-east through the entrance towards the stone. The ‘Heel’ Stone stands just outside the main entrance of Stonehenge.

Whether you celebrate the beginning of summer at Stonehenge, in your backyard pool or favorite golf course, Texas Back Institute reminds you to exercise good judgment about the activities that can affect your back. Chronic back pain can take the fun out of this wonderful time of year. It can limit your ability to participate in the activities that are fun and can help you stay fit and healthy.

Don’t overdo it. Stay hydrated. And make this the best summer ever! 

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The fact that June 5th was National Running Day was lost on many people. Why? The joints and muscles of most individuals are not flexible or strong enough to take the pounding that running requires. However, almost anyone can walk and this exercise seems to be as effective as running. There’s even recent research that proves this.

In April 2013, Paul Williams of Lawrence Berkeley National Laboratory in California and Paul Thompson of Hartford Hospital in Connecticut compared 33,060 runners to 15,045 walkers and found that it’s how much a person exercises, in terms of energy spent, not how long he or she spends exercising. While it takes longer to walk a mile than to run one, when these two exercises compared in terms of energy expended, they are comparable yielding the same benefit.

The researchers measured blood pressure, blood sugar and cholesterol at the beginning, and then watched for six years to see who got diagnosed with high blood pressure, unhealthy cholesterol or diabetes. Those who exercised equally (in terms of energy output) got the same benefit whether they ran or walked. This study was published in the American Heart Association journal, “Arteriosclerosis, Thrombosis and Vascular Biology.”

In addition to these physical benefits, walking lowers stress levels in most people. A study at the Department of Behavioral Science at the University of Texas M.D. Anderson Cancer Center showed university students who walked had lower stress levels than sedentary people or even those who exercised strenuously. Plus, walking can be done almost anywhere – on the street, in a park or in a shopping center.

Is Back Pain Keeping You From Walking Tall?

With all of these benefits, why isn’t everyone walking every day? Sometimes, back pain precludes this activity. This is where the spine specialists at Texas Back Institute can be of assistance. We spoke with Dr. Stephen Tolhurst, an orthopedic spine surgeon at Texas Back Institute about the benefits and challenges of a regular walking program.

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To watch a video interview of Dr. Tolhurst explaining the benefits of walking for the back, please click here. 

Are there benefits to back health that are derived from a regular regimen of walking? If so, what are these?

Walking improves one’s overall health and this affects the whole body including the back and neck. The back tends to be healthier and less susceptible to injury and/or disease such as arthritis when an individual is active. Additionally, walking can help to keep the core muscles – abdominals, back and legs – stronger and this supports the back and neck.

What are some lower back problems that can keep someone from walking and how does one know when these pains are serious enough to visit the physicians at Texas Back Institute?

There is a condition called spinal stenosis, which is an abnormal narrowing of the spinal canal that can occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. The symptoms of spinal stenosis include pain, numbness and loss of motor control. The location of the stenosis determines which area of the body is affected. This can cause a “rubbery” feeling around the leg when walking. This condition is serious and should be treated by a spine specialist.

There are also situations where pain shoots down one’s leg when standing or walking. This could be caused by a herniated disc or pinched nerve and should also be treated by someone on our staff.

However, mild to moderate back pain or stiffness during or after walking is usually not serious. If the pain is not getting worse, it’s probably safe to work through. In fact, the exercise from walking will likely help this pain and stiffness.

What are the most common factors that can cause lower back pain and keep someone from walking?

The number one factor is a sedentary lifestyle and the lack of regular activity. In this situation, core muscles are weak and walking can cause back pain. Obesity also plays a role in back pain and it’s no surprise regular physical activity can help to reduce obesity. Sleeping on awkward surfaces, such as a cot, floor or even a too-soft mattress, can cause back pain.

Some people experience “side stitches” when they walk. Is this a back problem or not?

Side stiches are not a back issue. While there are lots of theories on what causes them, no one is sure. They are not dangerous but they are annoying. When I’ve gotten them, I’ve used deep breathing techniques – after inhaling, breathing out through pursed lips to force the exhale – and this helps me. Stopping and stretching is also a tactic to use to work out this pain. Under any circumstances, this is not a sign of spinal problem.

How You Can Get Started

Just knowing the physical and psychological benefits of walking is not sufficient to motivate most people to “put on their walking shoes.” Texas Back Institute is involved in the specialized care of neck and back pain, spine trauma, scoliosis, artificial disc replacement and related spine surgery – not fitness counseling. However, we recognize physical fitness can have very positive effects on one’s back health.

With this in mind, here are a few fun suggestions to get you and your entire family involved in a daily walking program.

  • Bring along a walking buddy. This can be friends or family and if they’re excited about feeling better…all the better!
  • Walking has to be fun, otherwise it’s boring. Finding visually interesting places to walk such as trails in parks and greenbelts and then combining natural studies such as bird watching or tree/flower identification activities with your walking buddy.
  • Purchase an inexpensive pedometer, clip it to your waist and keep track of the miles you walk each day. Some of these steps will come from your daily activities. The average person’s stride length is approximately 2.5 feet long and this means it takes just over 2,000 steps to walk one mile, and 10,000 steps is close to 5 miles. Set a reasonable and attainable goal and then log your daily steps in a journal and try to add more steps each day.
  • Take the stairs whenever possible. Climbing stairs is a great aerobic exercise and when you take them, you’re not stuck in an elevator with 5 or 10 other people.
  • Get some tunes for your walk with your mobile device and ear buds. Music is a wonderful addition to any walking program because it not only distracts the walker from fatigue, but sports psychologists have noted that a steady beat can elevate a person’s performance by as much as 20%! In order to get you in the mood, why not download some tunes that have “Walking” in the title. Here are some:

Spring and summer is a great time for you to step up to a walking program. With this advice from Dr. Tolhurst you have some of the medical facts you need to get started. Now all you need is your walking buddy, pedometer and walking tunes and you’re good to go. Are you ready? Start walking.

Patient of the Month

Robbin Hallford went from unable to stand to increasing the number of yoga classes she teaches thanks to the miracle of 360 fusion.

Baby Boomer Robbin Hallford is a teacher and yoga instructor who can proudly state she is more active now than in her 20’s thanks to the miracle of modern surgery. Hallford, a 48-year old mother of three, underwent a 360 fusion around her L4 and L5 vertebrae in March of 2011. Since that time, she has proven daily that she can stay active and continue teaching yoga. In fact, she is planning to increase the number of classes she is teaching this summer, only a year after surgery.

Surgery was not Hallford’s first choice. After several days of pain and the inability to move her left leg, she attempted to manage the pain with chiropractic treatments. It was during these treatments that x-rays showed the lumbar area to be foggy. The chiropractor suggested an MRI, which Hallford took to a physician who recommended Dr. Michael Duffy of the Texas Back Institute.

Dr. Duffy made every effort to help me control the pain, including steroid shots, pain control and anti-inflammatory drugs. Unfortunately, I had reactions to the medications, particularly the anti-inflammatory,” said Hallford.

Hallford collapsed in her class, which was the final straw. She decided to move forward with back surgery at Texas Back Institute. Dr. Duffy assembled a team of experts to ensure that Hallford’s surgery went smoothly. In March of 2011, they performed a 360 fusion on L4 and L5, giving Hallford much needed relief.

“We knew that Robbin’s condition would be considerably improved by a 360 degree fusion,” said Dr. Duffy. “Having a patient who was so dedicated to post-operative physical therapy certainly expedited her recovery.”

Hallford’sbackground is in physical therapy and kinesiology, so she was well aware of the effort it would take to recover from surgery.

“I was in devastating pain, thinking of giving up my yoga practice and going on disability,” said Hallford. “Thanks to Dr. Duffy and his great team, I am 100% better. I got the life back that I wanted. For me, surgery was the answer.”

Like many baby boomers, Hallford wants to continue an active life on her own terms and not let injuries or aging slow her down.

“My 48 does not look like my mother’s 48 or my grandmother’s. I do more now than I did when I was 20 years old. I’m stronger now. The surgery helped me to be able to keep that,” said Hallford.

Hallford is not a proponent of choosing surgery first. In fact, she chose to use her own knowledge and skills in yoga to postpone surgery as long as possible. In the end, it was the miracle of back surgery that gave her the life she wanted.

“If there is any way, do it without surgery. But it you cannot avoid it – go to TBI. I highly recommend Michael Duffy. To take me from where I was to where I am now, he’s a very skilled physician. The team they put together was top-notch. If you are facing [spine] surgery, I can tell you with all confidence you will get the best treatment and honestly I believe the best outcome.”

 

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The Olympics are going to be here before we know it. If you’re anything like some of the Texas Back Institute doctors and staff, you may find yourself motivated to push a little harder towards your personal fitness goals. If this is you, congratulations! Setting personal fitness goals is essential in making sure you don’t get bored with your workouts and it helps keep you on your toes.
Dr. Michael Duffy, Orthopedic Spine Surgeon at Texas Back Isntitute
Dr. Michael Duffy is an orthopedic spine surgeon here at Texas Back Institute and running is something he loves to do. In honor of the Olympics we have asked Dr. Duffy to share some of his running tips with our readers.

First things first…STRETCH! This can not be stressed enough. Stretching before you start your run is crucial. The last thing you want to do is pull a muscle just as you are getting close to reaching your fitness goals. Just take 5 minutes to stretch your legs, shoulders and arms. You can even do this while you are getting your iPod playlist ready to go.

Second, if you are running and you start to experience pain (unrelated to normal muscle fatigue) try icing the painful area and taking NSAIDs (Non steroidal anti-inflammatory drugs). If your pain does not subside, take a look at your footwear. If you don’t have the right running shoes they may be causing imbalance thereby placing stress on your knees, hips and back. Most running stores can help fit you for shoes – you just have to ask. If all of this fails, consult your physician for further testing.

Third, and this time we saved the best for last, HYDRATE – HYDRATE – HYDRATE. It’s so hot out this time of year, especially in Texas, hydration can happen before you know it. Make sure to drink lots of water before, during and after you run! Even the Olympians have to hydrate.

Just getting into a running routine? Share with us what motivates you!

Go Team USA!

Remember, when starting any new exercise program it’s important to consult with your physician to make sure you are healthy enough to do so.

Pace yourself – most runner injuries are results of doing too much too soon.

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. ****

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