Training for Stability of the Neck and Back…Not What You Think! Dr. J. Shawn Leatherman

A brief look around any boardroom, construction site, grocery store etc… will provide any observer an insight into poor posture and de-conditioning syndrome. A deconditioned individual has only one option for lasting pain relief which is increasing their functional capacity. The average teenager and adult have pronounced spinal displacements due to chronic poor ergonomics of basic living, poor posture, and constrained working environments. Back or neck pain is the number one reason for a visit to the chiropractic physician and medical doctor! Shouldn’t you work to prevent injury and strain? The obvious answer is yes!

The most common reasons for back and neck pains are poor lifting techniques, abnormal posture, and repetitive micro-strain coupled with the lack of stability within the muscular system, and trauma. It is sometimes difficult to avoid trauma, but if you eliminate poor technique, improve the ergonomics of your work station, and train your spine for stability, you significantly reduce your risk of injury. Remember that we live in a gravity controlled environment and all muscular actions are in direct opposition to gravity. We stabilize bridges and buildings so they won’t buckle or break, you need to do the same for your spine.

That being said, conventional strength training with free weights and isolation machines will give general overall gains in muscular strength if utilized properly, but won’t necessarily target stability of the core or the spine. Muscles to target are the multifidus, rotatores, intertransversales, transverse abdominis, and the pelvic floor. Moreover, it is important to train for balance and symmetry thereby reducing abnormal weight bearing on all joints of the body.

Lifting technique is important for optimal health and the reduction of injury. To execute a lift properly, the back should be fairly straight while maintaining the normal lordosis (forward arch of the low back). This position will activate the musculature properly for stability while not recruiting the ligaments for support. Squatting is optimal, due to its neutral spinal position and the ability to use the muscles of the legs to accomplish the lift. Stooping should be avoided, especially with repetitive movements. Stooping creates an unstable configuration for the disk with increased tensile pressure on the posterior portion of the disk due to increased compression on the anterior portion of the disk. This can easily result in a rupture of the disk. In addition, objects should not be lifted if they are placed awkwardly which may require twisting and or bending, weights should be held close to the body, and jerky movements are only appropriate for highly trained individuals such as advanced athletes under the supervision of a trainer. The last key is to create contraction of the abdominal musculature before the lift. This provides greater stabilization the spine, and your entire core. You can easily accomplish this by sucking the belly button in toward the spine. This activates the transverse abdominus muscle which is key for all movements.

One of the most deleterious activities people engage in is sitting. Sitting increases disk pressure more than standing and encourages abnormal flexion (forward bending) of the neck and upper back in addition to slumping in the chair. These postures chronically load the disks, ligaments and musculature of the spine creating micro-injury and dysfunctional movement patterns.

Many of us spend the majority of our days at a desk, computer or workstation. We need to consider and modify our workspace carefully. Adding a support for the lumbar spine reduces disk pressures. A seatback angle of 5-15 degrees from vertical will reduce low back muscle activity and disk pressure. Proper desk height is approximately 30 centimeters from the seat of the chair. Arm rests are important in limiting strain on the upper muscular complex of the back and neck to include the trapezius, rhomboids, and levator scapulae. The shoulders should be able to relax with the elbows bent at 90 degrees while the hands rest on the desk surface.

Forward movement of the head on the neck is extremely problematic. For every inch forward the head moves in relation to the neck and shoulders, the compressive forces on the lower neck increase by the entire weight of the head, 10-16 lbs. Think about the difference in holding a bowling ball close to the body, or away from the body. This illustrates the differences in muscular work needed to support the weight and the ligamentous strain. Computer monitors should be elevated so that the center of the screen is at eye level while looking straight ahead. This will reduce eye strain; further reduce muscular tension of the neck while limiting the forward flexion of the head, therefore reducing the abnormal loading of the ligamentous complex. This will also help reduce those “work headaches”. Placing the monitor higher to induce a slight extension of the head is permissible.

Now that you have proper technique, and your workstation is optimal, structural and functional training of the musculature on the back of your body and your core is the key. You must have a balanced and relaxed spinal cord for optimal function. That being said, specific training is the way to achieve spinal balance and stability, and you don’t have to go to the gym to achieve it. If you can appreciate that we spend most of our days in a flexed position, the way to relieve that cumulative stress is to train the small stability muscles in an extended position.

Most people are flexed forward at the hips/pelvis, have rounded shoulders, and a forward head and neck, this is called Global Flexion. Extending the head backwards, opening up the chest by turning the palms of your hands outward and stretching your arms backwards relieves this global flexion. The last step is to stand up and bend backwards at the waist approximately 20 degrees. You have just accomplished the task of Global Extension. If you flex or tighten up all you muscles while in this position it further accentuates the value of the exercise and also promotes increased blood flow and oxygen delivery to the body. This is a relief position that everyone should use frequently throughout the day to abate cumulative postural stresses.

Moving on, posture is the next consideration. Your posture should not be a conscious task, but with the level of deconditioning in the population, conscious postural improvements are necessary. This is mostly common sense, and your mother has telling you to do this since you were a child. Exercise your postural muscles while walking. Stand up straight, hold your head up high and walk with confidence looking ahead of yourself, not at the ground. Pull your shoulders back, breathe deeply, and take confident long strides. This alone will bring more oxygen to your body by fully opening up the lungs, increasing blood flow, and reducing abnormal stress on spinal structures. You can also practice this position on a physio-ball or thera-ball to improve your seated posture and balance. Complex postural issues and stability issues need to be addressed by a professional.

Remember that weight training, aerobic activity, and general fitness types of activities are only good for you if done with proper form, balance, control and stability. If you don’t have good posture and spinal symmetry, a traditional workout program will only make those problems worse. It is essential to incorporate stability into your spine and your life before starting any exercise program. You should see a medical or chiropractic physician before starting a fitness regime to make sure you are in good health and able to handle the rigors of increased physical activity. If you have any cardiovascular issues, a stress test should be performed. Many subsequent doctor visits are caused by improper fitness activities; it is better to see you doctor before rather than after.

All chiropractic physicians will be able to teach you about postural imbalances and how to improve your own posture, but many chiropractors have additional post-doctoral training in advanced postural biomechanics and structural correction to help you attain improved spinal dynamics. Ask your chiropractic physician to tell you about their training, and provide written documentation about their qualifications. To learn more about postural correction check out http://www.idealspine.com/. In addition, a Certified Pilates instructor, http://www.nypilates.info/, http://www.pilates-trainning.com/ or Certified Personal Trainer http://www.nsca-lift.org/, http://www.ncsf.org/ can have great benefit. Remember to check their qualifications as well.

Children and Whole Food Diets Dr. J. Shawn Leatherman

During at least some of their childhood, you've probably watched your son, daughter, nephew or niece notice, "the grass is definitely greener on the other side of the fence." One of the biggest challenges to your family's healthy lifestyle is your child's perception that other people are privileged simply because they eat differently. As a parent, your strategic awareness and preparation for your child's fascination with the Standard American Diet (SAD) is paramount.
Adults are just as bad, conforming to the SAD just because so many other people are doing it. Or, they ascribe to some new fad diet which promises to work especially for them. You must not conform to all majority cultural practices, especially practices that are kind of dumb, and definitely not good for your health?

At no time is the parents' advantage greater than in earliest childhood for understanding the crucial role of food in setting the course for either chronic disease or a lifetime of good health. You must establish a healthy routine. By the time a child is ready to start their schooling; he or she has already developed a strong interest in being like their friends and doing what their friends are doing. Don’t let them conform.

Capture the natural head start of early learning and use it to your advantage. The example you set begins with the prenatal diet, as well as the quality of your child's food sources and choices. Before your child is pulled by the influence of those outside your family, manifest healthful choices at home.

Use family time to create an atmosphere of a near-perfect healthy lifestyle. Your child will get used to this and will associate home and family with health for the rest of his or her life. Changing to a whole-food diet can of course be accomplished later, but it will be harder. Tantrums, grumbling and other exaggerations of angst may make your quest difficult. The earlier you do it, the easier it will be.

Create a Routine
An easy, healthy routine is your greatest strength. Become accustomed to buying, preparing and eating whole organic foods. Make them the first impulse for meal preparation. Your goal is to build a solid dietary foundation for your child, improving their overall habits for a lifetime. Eventually it will become second nature for them to reach for whole rather than processed foods and to value those produced without synthetic fertilizers, pesticides, MSG, artificial colors, sweeteners and preservatives.

Kids learn from experience to appreciate the great energized feeling they get from a handful of carrot sticks, a meal with dark leafy greens, or a glass of organic whole milk. Make raw vegetables and fresh fruits available instead of boxed or bagged chips, cookies etc… Not only are they better for child’s health, they don’t have extra packaging or get stale in 30 minutes.

If you are just now transitioning to a whole-food diet, let your children binge on as much whole healthy food as they want. The inherent advantage of eating whole fresh foods is their sheer bulk replaces the chemicals and denatured food derivatives that we might otherwise eat. Now they won’t be full of crap, just full. Some suggestions for starting your kids off:

1. Start early and maximize the effectiveness of your efforts.
   
   • Breast-fed babies have a huge lifetime of health advantages over formula-fed babies. You will never again have the opportunity to make such a strong health impact, and at less expense than formula feeding. If circumstances only allow you to breastfeed your baby for a short time, the multitude of advantages is enormous, and will manifest throughout your child's life.
2. The first solid foods a child eats should be whole foods. Cooked squash, carrots, broccoli and other vegetables, avocado, banana and watermelon are good choices.
   
   • Snacks and meals for toddlers and preschoolers should be entirely whole foods. Their beverage is water, and that's it, until you find an organic/raw milk source. And even then, the main beverage is water. As a matter of fact your infant should not have any milk other than breast milk until the age of 1 year. Toddlers don’t need to know that empty foods like pasta, cookies, and ice cream exist. They might fill you up, but they do not nourish! You should additionally stay away from citrus, strawberry, and peanut butter for the first year as they may trigger allergic responses. Also never give a child under the age of 2 honey!
   • Parents shout, "How can I feed them healthy food? Hot dogs, and macaroni & cheese are the only things that they'll eat?" Obviously these parents started off with the wrong items in the kitchen. They are going to have to endure some tantrums to establish a better way of eating. This will be made easier if you keep the TV away from them.
3. Television indoctrinates the ingestion of processed foods and pharmaceutical lifestyle.

The messages you're striving to keep your child away from are delivered continually, and are deliberately placed in children’s programming.

• “You deserve a break today”, or “I’m lovin’ it!”
• Eat out, or open a package to get your ready-made food.
• Pour yourself a glass of colored liquid … “OH YEAH!”
• Your life is just not happy until you take a pill, or two.
• If Superman likes it, so will you!
• And my favorites … “enriched” or “wholesome”

If you have to de-program what the TV is telling your kids, you won't be able to compete. Start your own program! Advertise healthy foods and exercise not only with your words, but with your actions as well.

Either get rid of the TV or keep it in a room that always remains locked. Plan to view occasionally with your child and explain why sweet foods on TV are not good choices. Yes, this will force you to actually interact with your children more, but aren’t they worth it? Don’t you want to keep them away from pressure marketing? Don’t you want them to be free thinkers? Obviously you are not going to get rid of the TV. But the concept is to be aware of what they watch and monitor what exposure you allow them to have with television as well as their diets! Remember that their lifetime nutritional choices start with your choices, you are MOM and DAD, you are everything. Make your input count.