I cringe everytime a patient comes in with a shoulder issue as they are so complex and difficult to treat. The majority of shoulder problems I see are due to computer use. When you are sitting at the computer stop for a moment and see how your body is positioned. Most likely you are hunched forward a bit, shoulders and head forward. Staying in this position for minutes, let alone years, causes the pectorals (chest muscles) to contract, and the upper back muscles to overstretch. I have seen shoulders stuck so far forward that I do not know how structurally they are staying on a persons body. Once the shoulder is misaligned the tendons, muscles and ligaments stop functioning correctly.
My job is to get the shoulder in better alignment and teach my patient how to live in their body better. First they need to take quick breaks during the day to stretch. Clasp your hands behind your back, squeeze your shoulder blades together and stretch your shoulders back. Hold this position for 30 seconds and do it 5-6 times per day. Next you need to WIGGLE, yep wiggle. Roll your shoulders back, both at the same time then alternate them. I have my patients do this for 20 seconds every hour.
The following video shows some basic exercises to strengthen the upper back. A strong upper back counteracts the shoulder forward posture. We did the exercises with kettlebells but you can use any hand weight. If you are weak between the shoulder blades I would start with a light exercise band and work up to weights. The motion comes from between the shoulder blades and not the muscles at the base of the neck. See how Jakes shoulders stay down when he does the exercises.
Yours In Health!
Dr. Wendy
The Turkish Get Up
The Turkish Get Up is an amazing all over body workout. One move over and over and you will work every single muscle in your body. Do it for a while and you will get your cardio with it. I love teaching the Get Up and when people ask what muscles it works I have them do it several times. They immediately feel it everywhere. In order to go from the starting position (lying down) to the first stage (sitting) you must engage your core. To do the high hips you must engage your core and butt. This move is great because it opens your hips and most Americans have such tight restricted hips (a big cause of lower back pain). To get off the floor you need to use your entire leg. As you may have noticed, your arm is always engaged as you have to keep the bell over your head. One aspect of fitness you will get that most exercises don’t include is balance. You have to keep your entire body tight and balanced in order to not fall over. Having the bell over your head makes you stay in control.
I love doing this exercise for one minute then alternating with one minute of swings. It’s a basic exercise drill that gives you strength, stability, endurance, cardio and the feeling that you can take on the world.
Yours In Health!
Dr. Wendy
I remember the day Yasemin walked into my gym. I looked at my trainer, Jake, who was teaching the new client class, and gave him a “Good Luck” glance. Yasemin walked in on obvious distress and was wearing a heavy duty lower back brace. She wanted help for her severe lower back and leg pain and wondered if kettlebells could help.
Jake initially thought doing any exercise program would be out of the question. Despite wearing the supportive corset, Yasemin had pain with all movements. She couldn’t even hold a good posture for lifting. Jake didn’t expect her to be able to gain anything from the class but she was determined to try to get stronger.
Initially they started with basic joint mobility exercises and non-weighted kettlebell movements. She practiced deadlifts, swings, squats and presses with no weight. This program went on for a few weeks and Yasemin’s posture and movements began improving. Her pain level had started dropping so Jake decided she could try working with the 4 kg kettlebell.
Once she added weight to her routine her progress took off. She stayed with the 4 kg for several weeks then progressed to the 6kg. Doing high volume swings coupled with lots of planks seemed to be the key to her success.
I talked with Yasemin about her back pain and kettlebells.
W: How did you injure your back?
Y: There was not an incident that I could single out as a cause to my back injury.
However, in the last six years I’ve been traveling frequently – domestically and
internationally – all alone. I did a lot of luggage dragging, pulling and carrying. I
think that was one of the causes. I used to work out more regularly and do yoga prior
to that, but in the last six years I was hardly involved in any consistent exercise or
workout program.
W: When did your back pain start?
Y: The first time was in November 2005. I could not move in bed. I stayed in bed for
two days before I saw a doctor. I felt somewhat better after a month long course of
physical therapy, but the back pain came back a year ago.
W: What treatment did you do prior to doing kettlebells?
Y: Physical therapy, massage, wearing steel corset, ointments, hot pads, traction, leg and
back exercises on the floor and analgesics.
W: What other treatments did the medical doctors recommend that you refused to do?
Y: I refused to take high dose of analgesic injections to the pain areas (leg and back). I
also declined from surgery.
W: Why didn’t you do surgery?
Y: When I heard about the recuperation time, the risk factors involved and that healing
was not guaranteed for 100%, I could not accept the idea.
W: How have kettlebells helped you?
Y: I thought I would never get back to normal sitting and sleeping positions. I could not
stand up easily once I was seated on a chair or sofa. In bed, I could not turn from side
to side without serious pain. I had no strength to carry anything or to lift my body up.
Kettlebells gave me the core strength I needed to do the exercises that I was asked to
do. They gave me my self-confidence back and I am a healthy person again. My
body is toned down and I also feel more energetic. I can concentrate on something
without having the fear that my back would hurt.
W: Do you still have back and leg pain?
Y: Nothing like what I experienced 3-4 months ago. I sometimes feel slight soreness in
my right leg when I jump rope or bear crawl, but it is nothing next to the pain I
experienced several months ago. I can easily say, NO BACK PAIN! I can carry
stuff and, more importantly, I can carry myself around with no problem. I don’t
have to worry about how to stand up once I am seated.
W: Considering the severity of your condition you appeared to have fixed up pretty fast.
How do you feel about your healing process?
Y: I thought I was a hopeless case. I never thought I would be back to myself since I
am 56 already and I gave birth to two kids (24 and 17). I never thought I would have
my body back with a strong back. It is a great feeling that I am energetic and strong
again as I was when I was 25; it all happened in such a short time (less than six
months) even I can’t believe it. I keep going because I don’t want to lose my health
again and I enjoy it greatly.
I later found out that Yasemin had a copy of her MRI and I asked her to bring it in for me. I looked at it and was in shock. She had a huge disc herniation with severe atrophy of the lumbar multifidii at all levels in the lumbar spine. The multifidii are the primary stabilizers of the spine. There are numerous research studies out that show it is multifidus atrophy, not disc herniations or degenerative arthritis that causes lower back pain. Yasemin proved that point. Once she got stability in her muscles her pain reduced and her function improved. I believe her high rep swings were the key as they build back endurance like no other exercise I have seen.
Surgery most likely would have givenYasemin only temporary relief because what she needed was to gain stability, strength and endurance in her muscles. Kettlebell training gave her all three. Yasemin’s presentation is something I seen in my chiropractic practice on a daily basis. Unfortunately, many people want a quick fix and surgery is done. For some people surgery is the answer but for the others a good exercise program is essential but exercise is hard. I commend Yasemin for doing the work she did.
At this point Yasemin swings the 12 kg and the 16kg kettlebells. Swings, deadlifts, planks and squats have been the most effective exercises for her. She comes to class three times per week and doesn’t like to take much time off. She has shown tremendous determination and has been an inspiration to the entire class. Yasemin knows if she keeps up the program she can be strong and pain free for life!