Just as important as the mechanical therapy I provide to patients to eliminate their symptoms is the education I provide regarding how to keep their spines healthy in the future. A terrific analogy I've learned from mentors enlists teeth brushing. Just as we recognize the significance of keeping our teeth healthy via flossing, brushing, and dietary habits, we should acknowledge that devoting a few minutes a day to our spines is a worthy endeavor. My goal with patients in this educational arena has two facets.
The first is simply teaching people to be aware of the movements and positions our spines adopt on a daily basis. Unlike our peripheral joints which tend to get a fair amount of both bending and straightening throughout the day, when we look at spines, the majority of people in the US spend their days in an imbalance in favor of forward bending (flexion). (The upper neck, however, is often hanging out more in a backward bent (extension) posture. Why? Because our lower necks are stuck forward, and we need to see ahead!) To be sure, certain manual jobs, or desk jobs in which the computer monitor absolutely has to be to your side, create movement imbalances in other directions. Likewise for someone who takes hundreds of right-handed baseball or golf swings per day or throws overhead regularly. Once this observational ability sets in - which undoubtedly takes time - the plan of attack is straightforward: reduce the imbalance. This is akin to reducing your teeth's exposure to deleterious foods and drinks.
The second piece to keeping our spines healthy, and preventing re-injury, is intentional movement. As I tell my patients, just as you brush your teeth twice a day, give your spine some good, healthy movement twice a day. In the most common scenario, this translates to bending backwards - all the way backwards - about ten times twice a day. Sometimes it is rotation or even bending forward. My patients leave my care knowing what their specific movement is.
Like most people, over my lifetime, my spine scale was heavily tipped in favor of forward bending. Sitting slouched at desks over books, slumping "comfortably" into couches and chairs, and later bending over patients added up to a lot of spine flexion. Did I ever bend all the way backward? Maybe a handful of times. It's no wonder I injured myself. Once I learned to look at how we position ourselves, however, I adopted several changes to narrow the gap between the amount of my spine's flexion and extension. Firstly, I almost always sit with a lumbar roll which places my lower spine (except L5-S1, which remains in 60% flexion in sitting) in extension, or at least neutral. If I don't have something to support me, I sit up straight, slouching only occasionally. Secondly, I spend more time lying on my stomach propped up on elbows while reading, watching television, or using electronic devices. Thirdly, given the choice, I often choose to stand instead of sit; for example, I will stand when using my computer on my high counter or when out at places like bars or concerts.
As far as the second component - deliberate movements - I have two go-tos. A few times a month, I'll notice I need to rotate my spine to one side so I'll do that. Most days, though, I move my neck, mid back, and low back into extension a few times. This tallies up to roughly 5 minutes per day, which is a more than reasonable price to pay to keep what I call the "body's fuse box" working correctly. -Laura
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