In August our amazing Olympic team brought home life time best performances and medals galore. The joy and delight on their faces was moving and something you can share to an extent by joining the para-olympic athletes as they inspire even more through their heroism in the face of adversity.
The common theme from the Rio games is one of inspiring the next generation to compete, but what about the current and former generation? Yes that’s us lot, who have probably been mainly sat on the sofa while watching, possibly with a glass of wine and a few crisps and nibbles. Well, we all need a break from the usual bad news don’t we?
But why not participate yourself next time you settle down to watch some sport. You could do a stretching routine or even some floor exercises and feel the burn with those on the screen. I’ve been doing it for F1 for years as it stops me falling asleep, even on the highlights program!
If that seems a little too much there are exercises you could do while barely leaving the sofa. Here are a few to help you.
We all get up and down from chairs regularly through the day. How many of do so with a groan due to back pain? Following this simple back pain exercise will help strengthen your thighs, Buttocks and spine. The end result stable and stronger low back, hips and knees.
After a break from exercise it is easy to get carried away and bite off more than you can chew. If you don’t take a sensible controlled view you will be more likely to get injured. So here are a few steps to consider when you restart……
The Technical Bit:
Anti-Cholesterol drugs such as statins reduce your cholesterol by slowing down the production of cholesterol by the liver. They do this by interfering with the action of a key enzyme, HMG-CoA-Reductase. Cholesterol production is not fully blocked nor is the production of other substances that are derived from the same pathway, such as steroid hormones and vitamin D.
Because cholesterol synthesis is reduced, the liver takes up more cholesterol carrying LDL particles from the blood. The net result is a reduction in circulating LDL-cholesterol (bad cholesterol).
Statins also help to stabilise the fatty plaques (fatty deposits or atheroma) within the lining of the arteries. This is why people who are at high risk of heart disease or stroke or who have diabetes, may be prescribed a statin even if they have a normal cholesterol level.
There’s no doubt that a healthy lifestyle helps lower cholesterol. The question is whether it can lower your levels enough – and that depends on how high your levels are and what your doctor has set as your goal.
Eating a heart-healthy diet can lower LDL cholesterol at least 10%. If you lose 5% to 10% of your body weight, you can cut LDL cholesterol 15%, and reduce triglycerides 20%. If you exercise at a moderate intensity — meaning you have enough breath to talk but not sing — for at least 2 ½ hours a week, you can further cut triglycerides 20% to 30%. (Exercise can also increase your HDL, the “good” cholesterol.)
That’s a great start, says Michael Miller, MD, director of the Centre for Preventive Cardiology at the University of Maryland Medical Centre. “Lifestyle changes certainly are the cornerstone of cholesterol reduction.”
Of course not. Doctors say the best way to protect your heart is to make healthy lifestyle changes while taking a statin. I say the best way is to make healthy lifestyle changes and avoid the statin unless you are diabetic or have recently had an acute cardiac event.
If you look at the medicine supported websites you’ll see the following:
Like many pharmaceutical drugs, statins can have body wide side effects and may also interact with other medicines you take. potential side effects can include:
Did I just hear that right? 60% of people on statins get no benefit from reduction in heart attacks! I wonder what the figures are for reduction in heart attacks by adopting a healthier lifestyle. When you consider that 9% of people on statins will get adverse effects on every cell in their bodies. This is due to a reduced ability to release energy from the mitochondria (the powerhouses of the cell) due to the reduction of Co-Enzyme Q10. This is well documented to adversely affect muscle, but it can also lead to fatigue of nerves too. However some studies have found that Statins may help improve dementia. These studies however are not high quality and further research is needed. (3)
When I see data like that and patients who are stiff and ache all over I begin to question if this reliance on statins is worth the loss of quality of life for at best a 40% reduction in CV events. I also wonder why time and time again patients who are on statins don’t get advised to take Co-enzyme Q10 when statins adversely affect your ability to produce energy through the inhibition of Co Q10.
Here’s another little known fact. After a year of taking Atorvastatin any increase in HDL (the good fat) is gone and in fact a reduction in the good fat from the starting baseline is often found. It is also noted that the first dose is the most effective, subsequent increases in dose have a much reduced benefit at 6% reduction in LDL as opposed to around 50% for first intial dose.
If your GP recommends that you go on a statin and you have struggled with commonly associated significant stiffness aches and pains; there are alternatives available. Colesevalam is a statin that works more specifically at a “gut level”, so does not produce side affects of muscle and joint pain and stiffness. It can for some however cause constipation and flatulence. So neither is perfect but may be a more favourable solution. It is however much more expensive that a generic statin.
Here’s a viewpoint from a GP;
The important bits: Nice (the National Institute for Health and Care Excellence) has issued guidance that proposes reducing the cardiovascular primary prevention risk threshold – the level of risk at which statins can be prescribed – from 20% to 10%. In other words an increase in prescribing of statins.
In May 2014 a national conference of general practitioners passed a unanimous motion calling for Nice to recommend such changes only on the basis of a full disclosure of trial data. This was followed in June by an unprecedented open letter to Nice (click link to read) from a number of senior doctors and academics expressing four main areas of concern: medicating healthy people; non-disclosed side-effect data; relying on industry-funded statins trials; and conflicts of interest within Nice.
There needs to be more transparency with respect to statins. Eat a diet high in good fats and lower in bad fats. There is plenty of info out there and we will add some suggestions in the near future.
A viewpoint on statin effects – benefits and problems Thomas F Whayne, Jr, MD PhD FICA Int J Angiol. 2008 Winter; 17(4): 178–180.
Coenzyme Q10 and statin-related myopathy. Drug Ther Bull. 2015 May;53(5):54-6. doi: 10.1136/dtb.2015.5.0325.
Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.Swiger KJ1, Manalac RJ, Blumenthal RS, Blaha MJ, Martin SS. Mayo Clin Proc. 2013 Nov;88(11):1213-21. doi: 10.1016/j.mayocp.2013.07.013. Epub 2013 Oct 1.
Skiing and boarding involves prolonged periods of hip and knee flexion. This involves working the Gluteal muscles, hip adductors, quads and foot muscles hard to help stabilise and control knee and hip flexion. If you want to be able to ski a whole run and keep doing that all day for a week then you’ll need to start these exercises if you haven’t already.
1. Everyone knows the sitting on a wall exercise but to improve function you need to go a step further and squat with 60 degree knee bend and hold this position without a wall. To protect the knee push the knees out a little.
2. A progression of this is the one leg squat. Make sure you bend fully at the hip and not the back. Your bottom should move backwards rather than the knee moving forwards, your spine should stay locked out. It is fine to touch a wall for balance but move on to free standing if possible. By now you will be getting good hip strength and the muscles at the inside of the thigh will be stabilising the knee well.
3.A variation of this is the running man. Simply squat on one leg and move your arms as if running while staying on one foot. So you are doing repeat squats but stabilising with arm movements as if running.
4. If you want to get into the deep powder or power down the pistes then the next exercise is great for training explosive power. Lateral Bounds will give you the bounce you need to transfer your weight all day long. Simply jump forwards and sideways while springing in big steps. Use your swinging arms to stabilise. You’ll need a lot of room for this one so it’s really best done outside or at a gym with a running track.
Start on week one with the static squats, on week 2 add the dynamic squats, then week 3 one leg and finally if fit and strong the bounding in week 4. Do every other day to allow time for recovery. Stretch after the exercises.
18 million people suffer from hayfever in the UK to some extent. For some it can be life changing and for most just annoying. Hayfever is triggered when pollen proteins are recognised by an over-sensitized immune system.
The result is an aggressive response by your immune system to neutralise what it thinks is a mass invasion. Recently scientists in the US reviewed 23 studies involving 1900 people and found that those that ate a probiotic yoghurt a day had a significant reduction in symptoms.
It is now thought that a variety of allergies are triggered by a lack of good bacteria in the gut. Overzealous cleaning and lack of exposure to naturally occurring pathogens in the soil and on our food have lead to a reduction in our gut flora. This news is further evidence that a healthy gut flora of probiotic bacteria can help desensitise your immune system.
A gut that is populated with good bacteria is less inflamed and the endothelium or lining of the gut is healthier. An inflammed gut can lose it’s ability to protect and can become “leaky”. This simply means that larger molecules can cross it’s wall and enter the body than normal. As around 70% of your immune system is sensibly placed where it is needed most i.e. around the gut, it can easily be stimulated to attack larger molecules such as proteins. The result is the body’s policemen get a bit carried away and indiscriminately go on patrol attacking things that are in effect harmless. In severe cases the immune system can start to attack the body itself. Indeed there has been a large body of evidence recently where this association has been noted.
The friendly bacteria also help to breakdown food stuffs that we are unable to deal with. So that can aid digestion and reduce the feeling of bloatedness. A word of caution though, the Yakult, Actimel type handy shots contain a lot of sugar and should be avoided. It is much better to supplement with a broad spectrum or high concentration probiotic. Alternatively live cultures of natural yoghurts should be used. Again beware some have a lot of sugar added. At Back In Form we stock or can order a variety of high quality probiotics as this is such an important contribution to overall health.
As a Chiropractor who looks at a functional neurological approach to pain and poor function I was delighted to find this article and video on the phenomenon called Neuroplasticity.
Neuroplasticity is the ability of the nervous system to adapt to changes in the environment. These changes in stimulus result in a re-wiring of the connections, so that you can effectively learn a new skill, recover from injury or adapt to a stimulus. If the stimulus is significant you can learn instantly. For example you generally won’t keep touching a hot surface.
However sometimes the complex associated tasks that we learn as part of our development are so ingrained that it takes an age for an adult to un-learn them and learn a different set of rules to achieve the same thing. Here it is brilliantly and entertainingly demonstrated by a backwards steering bicycle.
The interesting thing is how it demonstrates how easily a child can adapt. This is due to the plasticity of the developing brain. From a treatment perspective this demonstrates why it takes time to make lasting changes with respect to chronic pain. The same un-learning of pain and promotion of pain suppression takes time to learn and is only done through repetition of positive stimulation such as adjustments , exercises and focusing on movement. The bigger the stimulus the more wiring that occurs. This is why adjustments have a greater effect.
To put it simply “THE MORE YOU FIRE IT, THE MORE YOU WIRE IT”
Anyway here’s the video, hope you enjoy it.
Thankfully the action of the nerves that detect movement and pressure suppresses this pain at the spinal cord and you don’t feel it. However loss of movement of an area means the suppression is reduced and pain can start to be felt. Anyone who’s sat through a long film will know that. Your body is literally telling you to move so that you don’t damage it. The brain itself can also suppress pain from above if it is busy doing other tasks that are deemed more important, ie running away from danger or doing something more pleasurable.
Pain is felt when the impulses from those pain fibres actually manage to reach the sensory cortex of the brain. So you register pain in the head. To achieve this you must have increased excitation of the pain nerves. This can be down to an increase in stimulus or a lower threshold to fire the nerves. The chemistry of your body and level of electrolytes can influence pain generation. If your body is lacking in nutrients that are used for the building blocks of natural anti-inflammatories then you will generally be more likely to experience pain. Or if tissue is injured, chemicals released by the damaged cells lead to easier excitation of pain nerves and you feel pain.
It is possible to have a lot of wear and tear and have no pain at all. Similarly you can be in agony when there is very little damage showing. So if you have an x-ray or scan of a recently injured joint that was previously pain free and it shows degeneration or a tear of a structure don’t go straight for the surgical option. There is little correlation between tissue damage and pain. Think twice or even three times, seek an opinion of someone who isn’t a surgeon. You may be in pain simply because the pain nerves are more excited and the suppressive mechanisms aren’t working. If this is the case surgery won’t make any difference as the torn tendon might not have been the source of the pain. It could be coming from somewhere else entirely.
Surgery should always be a last resort, once it’s done it can’t be reversed. There are risks of infection and risks of further pain due to the inflammation and excitation of pain nerves from the surgery itself. In some cases this can trigger a complex pain syndrome that is self fulfilling and perpetuates.
The natural approach begins by activating the neurological mechanisms that suppress pain. Stimulation of these nerves anywhere in the body can help, the strength of the effect is variable depending on what area is stimulated and is related to the representation on the brain itself. Movement, mobilisation, manipulation, taping all help reduce pain. However they have to be applied correctly to ensure the balance of neurological activity is helping rather than hindering.
If the physical therapy approach you choose isn’t successful, try a practitioner in a different discipline such as Chiropractor or Osteopath, or vice versa. Or even two different practitioners within the same profession as they do work quite differently a lot of the time. After you’ve exhausted all options consider the surgery but remember the pain won’t just disappear after surgery, you will still have a period of 6-12 weeks of recovery and rehabilitation to go through.
Also you should look closely at your diet. Lack of fresh fruit, whole foods such as nuts, seeds, dark leafy green vegetables and oily fish can mean the body does not have the raw materials to create anti-inflammatory chemicals. Furthermore smoking and alcohol can aggravate inflammation.
The use of the painkiller Gabapentin alongside manipulation and stimulation can also be helpful to suppress the nerves so that treatment can be gently started in chronic pain syndromes. We do not recommend the use of Non Steroidal anti-inflammatories or paracetomol as the former is detrimental to gut, heart, liver and kidney health and the latter has no benefit long-term and will reduce your emotional as well as your pain sensation.
Recent National Pain Audit figures show a worrying trend. A staggering 20% of health expenditure in the UK is now spent on back pain services. Chronic pain affects 8-60% of the population depending on the definition of pain (1). Severe pain affects 11% of the population and 8% of children. Yes 8% of children, a group that are generally ignored as problems are put down to” growing pains”.
If more attention was put to diagnosing and recognising that young people start their journey to chronic pain young then maybe something could be done to redress the trend.
Severe chronic pain affects relationships, work status, sleep, mood, general ability to do daily tasks and all aspects of general health. Even more worryingly, daily back pain is linked with increased risk of a coronary event. This makes sense as less activity means reduced cardio-vascular fitness. Movement of the spine and joints also feeds activity into the brain and the resulting reflexes help to support and drive not only movement but also the autonomic responses that control body functions such as blood pressure and heart rhythm.
The simple reason is that as a population we are less active. People drive to work or school nowadays then many have sedentary roles that mean the body is held still for long periods. This will cause mild pain as your body will want you to move. That in itself is not a problem until it is repeated day after day for long periods. Gravity is a very strong force and even when you are not moving it exerts constant pressure. For example looking down at your smart phone will increase the weight of your head threefold. That’s a heavy load on your neck muscles and discs.
If you are also getting heavier then the forces become greater and the stress on structures and changes in posture results in a greater chance of back pain. If you are active you will generate reflexes and fire nerves that help to suppress pain, for more on this go here.
Nerves love to fire if they are healthy. If you fire them enough they will grow new and stronger connections and the result is healthier tissue and better faster, more accurate responses. If you don’t fire the body will remove the connections and the opposite occurs. You get less energy, less accuracy and tissues that are supplied become weaker.
However if you are already weakened, then firing too much can fatigue the nerve to the point that it can become so tired it will actually become very weak and eventually die. This is a process known as apoptosis. So if you are weak already or have nutritional compromise then you may overdo it and cause harm.
Firstly make sure you have the raw ingredients to support good nerve cell activity. A good healthy diet should give you this. So avoid fast food or ready meals with flavour enhancers. Monosodium glutamate will fatigue your cells very rapidly as it acts like a turbo, so will high sugar diets as nerve cells do not need insulin to absorb and use sugar. The result is like an engine over-revving, it will go pop at some point! Avoid too much caffeine, never drink energy drinks that is nerve cell suicide! Excessive alcohol and smoking are also highly detrimental to nerve health.
Leafy green veg is full of great nutrients to support cell health. Fish is a good source of protein and essential fatty acids, as are seeds, nuts and pulses. Magnesium is very supportive of energy release in cells and is found in dark leafy greens, nuts, seeds, fish, beans, whole grains,avocados, yoghurt, bananas, dried fruit, dark chocolate, and more.
Assuming your nutrition is good the next step is to start exercising your body and mind. If you are very weak start gently and build up incrementally at a round 5-10% increase in activity a week. If you feel very tired make a note of when that happened and only do 70% of that. Stay at that level for a few weeks and then start to increase activity. It may be a slow road but if it’s steady you will progress smoothly. If you try and jump activity too fast you may get more tired and / or injured.
Gradually you will start to feel a lot better. This isn’t easy though as the reason you got bad in the first place may be down to bad habits and these can be hard to break. So make gradual changes to your lifestyle and you will be more likely to keep on the straighter and narrower path.
Take a look in a full length mirror at yourself and see if the following applies to you.
A commonly seen aberrant posture in clinic is one where your foot is turned out, the arm on the same side is held slightly flexed at the elbow and is rotated inwards so that you can see more of the back of the hand than the other side when looking face on. The same shoulder will also be held forwards. Typically this is due to weakness of the anti-gravity muscles down one side of the body and is a milder presentation than Pyramidal Weakness found in some typical stroke patients.
The anti-gravity postural muscles hold the shoulder back and rotate the arm outwards. They also lift the leg and foot from the floor. Commonly this pattern of weakness leads to rotator cuff problems, tennis elbow, hip pain, shin splints etc. If you have had any of these problems or get them repeatedly despite having had treatment then you possibly have a functional weakness of a relay area in the brain called the Ponto-Medullary-Reticular-Formation or PMRF for short.
You can have as much Physiotherapy, Chiropractic, Osteopathy or whatever other therapy you like, but if the weakness is established the problem will keep recurring. Why? Because the brain will keep pulling you into the poor posture. If you are exercising and getting stronger you will have less symptoms, but push it hard and you’ll be likely to get your injury again. This is because the area in the brain will fatigue one side faster than the other and your control will diminish. The result, yet another injury. Just think how many sports people have struggled through their careers with hard to treat injuries. The list is endless.
By specifically treating to enhance function in this area we can help to restore normal function. If we combine this with visual exercises we can help to hard wire the pathways to strengthen them. This requires repeated stimulation over a short period to get the nerves to express genes that lead to growth of new connections. It won’t happen without repetition.
So if you’ve ever had a car accident or a whiplash type injury from sports such as horse riding, skiing, boarding and obviously boxing then you may be prone to these problems. If you’ve ever had a concussion or been knocked out the chances of this are significantly increased.
Make sure you find someone who can look at these patterns to help you for the longer term and not just a quick fix.