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Your back by Othon Molina, Ph.d.c, LMT First of all I want to make it clear that this information is not to diagnose nor prescribe, and it should not take the place of the advice of your doctor. This is intended to educate the back patient in conventional medicine. Consult with your doctor before starting any kind of nutritional or physical program. The back is the strongest part of our bodies and yet, it is one of the most common ailments of our civilization. Between 80 to 90% of the people will have some sort of back or neck problem in their lives. Everyone knows someone that has had hurt disk, had sciatica (Medically misleading, usually a disc injury), or back pain of some type. This is what we deal with, having a body and fighting gravity. It seems we are loosing the battle, considering our aches and pain as well as the fact that gravity will win every time. The fact that we are a moving structure that lifts, bends, runs, and sometimes, pushes the body beyond the capabilities we have prepared it for, is why we might suffer. When we where hunters and gardeners, we worked in harmony with nature and gravity, we didn t sit so much. We at least use time tested methods to strengthen the body by hard work. As we got more and more Civilized , we lost touch with nature and the natural laws that govern our bodies. We grew out of shape and we see the results. The back is built of strong bones, ligaments discs and very large muscle groups. Yet through poor attitudes, bad posture, lack of muscle tone, improper lifting and just plain ignorance, we constantly do our backs harm. The fact that so much of the population has neck or back problems and will continue to do so, until we change lot s of things, starting with our life. Our body is a reflection of what is going on in our life, and the back is a part that often speaks the loudest. By the time the pain is severe enough to see a doctor, there's not much most doctors can do. It takes five to 10 years to get in that condition, with the overuse syndrome. So unless it s some accident to say "Doc, fix my back" is like saying "correct my life for the last ten years." Even if you go to an orthopedic doctor, a chiropractor, or a therapist specializing in backs, it's going to take time and effort on your part as well as theirs to re-educate your body and change your life. It takes a big commitment to heal yourself naturally. Drugs and surgery should be the last resort, and most doctors are very conscientious now, about their use. There is a time and place for drugs, I have seen them help many people. We have even seen patients that got surgery and they still have pain and problems, so what is the x factor, why? I try not to answer why, but we need to look beyond cause and effect, to the basic inner struggle with life to get to the real solution. Doctor Bemard Portner, my friend and mentor is owner of his own very successful clinic is a specialist in Physical Medicine and one of the best back doctors in the state had this to say about the back. "Most back pain gets better responding to time and proper treatment. If treatments are going to be effective, a noticeable improvement should be seen within a few weeks. If no improvement is seen, question whether the treatment is worth while and seek alternative treatment. The trick is education. Learn to prevent further back problems with correct posture; proper lifting techniques and correct exercises." Attitude and lifestyle first, but that includes exercise as it is one of the keys in preventing back problems and in correcting and re-educating your body. "How long do I have to do these exercises?" is the question many of my patients ask "Forever," is my answer. Health is an on-going process and constant exercise is essential to maintain it. Just to reduce the daily stress on the body. In order to get and keep your back in prime working condition, you must make the commitment, nobody can do it for you. The right exercises will help correct your posture, keep joints flexible and strengthen the muscles to keep your back in good condition. Let's look at posture. You've heard from childhood to sit and stand straight. But do you know why? Well, when you slouch, your muscles are pulled out of heir normal working position. If it becomes a habit then your body grows that way. The muscles no longer provide the proper working system the body needs to be in harmony with gravity. In actuality the bones must hold the body up, with very little muscle action. That improper posture causes stress in the muscles. The resulting symptoms are aches, pains, and tense muscles working against each other, and this can transfer to stress on the joints, or discs. Flexibility is only one of the answers to this muscle tug-of-war, muscles become tense and loose their functionablity. With loss of flexibility, the joints, including those in the neck spine, hips, or lower back become more prone to ongoing stresses and with certain movements you can throw your back out  as we have heard it called. This is why we need stretching or yoga we need to keep the body stretched out. We have to work the body opposite to how gravity is pulling, as well as all muscle action is about contraction, yoga helps us to reduce the physical stress. But, you don't just bend over and throw your back out. This is a condition that has been developing for years. A certain movement creates a muscle spasm or a disc protrudes and pinches a nerve severely enough to temporarily hurt or paralyze you, the main culprits to all this pain is the disc. When they swell from too much pressure, or tear from a severe strain; they protrude and press on the nerves. This is the major problem, it can be corrected, but it takes time. Your body wasn't built in a day, and you have been alive how long? The longer the problem or chronic it is the more need for manual therapy to correct the structure. We need to learn a new pattern, of movement and living for long term correction of this condition. Strength is the final element necessary for a healthy back. If you have never exercised and your muscles have no tone, or if you only do certain exercises, you're probably out of muscular balance. The most common problem is weak abdominal muscles, which put stress on the lower back. Most people only use them in the morning getting out of bed. Exercises to increase abdominal strength is one of the most important components for a healthy back. The problem is many are commonly still done wrong. Take a Pilates class it has the best of yoga combined with very clear understanding of using the core abdominal muscles correctly. The best way to build up your abdominal muscles is by strengthening first; the deep stabilizer muscles in the pelvis or body core. You need to build a foundation for any training. We have to build the ligaments, the deep muscles and then the larger surface groups. Then for the abdominal muscles proper crunchies need to be done, without pulling on the neck. Straight ahead (Rectus), to the side (Obliques), then modify from there. As you can see even simple exercises can get complicated. The big problem is some stretches or exercises can help some, yet hurt others. It s also important what not to do as well as what to do when. For instance, during a back episode it s important not to do any knee to chest stretches, even if it feels better. As flexion pushes the disc out further and makes it much worse. Later this same exercise can help relieve your sore back muscles. During an acute condition, see a doctor, as often some anti-inflammatory medicine or even muscle relaxers, ice and bed rest can often correct most episodes. Also you want to do extension exercises (Arching the back as the cobra in yoga, or on your hands and knees letting your belly hand, and arch your back that way) these are much more effective. Of course properly administered manual therapy or massage may help as well. Building anything takes time and knowledge. To build any body first it must be aligned. My philosophy is this more than anything, if your body is out of balance you can only build the imbalances if you don t correct the structure first. This takes some knowledge and experience, as well as consistency on your part and a good program to follow. (see spine article for more detail on the back and neck). For information or questions call or e-mail; Othon Molina, Ph.d.c, LMT P.O. Box 1231 Kamuela, HI 96743 Cell: (808) 895-2688 www.molinamassage.com
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