I am guilty – guilty of not practicing what I’ve preached. I have always prided myself on strictly following the advice I give my patients. A patient taught me how important this was in my very first year of practice; I was scolding him for not having had a check-up in several years, and he asked me when was the last time I had been to MY family doctor… and it had been years. I found a doctor and went. It turned out that I had some health issues to work on. Ever since then, I’ve made a point of following the advice that I give patients: I exercise, I eat right, I have an ergonomic workstation… How can I possibly expect my patients to do it if I’m not willing to do it?
Except it turns out that even I don’t follow my own advice all the time. Over the last year, the active lifestyle I pride myself on led to some bumps and bruises and eventually, low back pain (the irony!). And I ignored it. I thought I was strong enough to work through it while I healed. I didn’t want to disrupt my workout schedule, my jujitsu training, my active lifestyle. Every now and then I’d make time to get some treatment, but the only thing I did consistently was complain about it. And it came and went, and came and went.
So it should be no big surprise to you to learn that my back has gradually gotten worse. That’s what happens when my patients don’t follow my advice, and that’s what happens when I don’t follow my own advice. I finally made an appointment to get it looked at, and the prescription is REST. And finally the gears turned and clicked and I understood: I should have taken some time off when my back first began to hurt. I should have stopped that cycle of chronic inflammation before it started. I’ve often warned, “if you don’t slow down when you need to, your body has a way of slowing you down.” True story. I could have been pain free this year if I’d listened to my own advice.
I admit that lately, I don’t always have the energy to do an intense workout. But I like to set goals and try my best to achieve those goals! If you’re not used to doing this in your exercises routine, start with something easily attainable then work your way up to some more challenging goals. You may be surprised at what you can achieve! Hope you’re having a wonderful week!
Trying new things…
Most of us don’t like change. Oh, sure, we want to improve, to do it better, faster, and have more fun doing it. Tomorrow. Today, we creatures of habit are most likely going to do what we did yesterday. We liked it then and we’ll like it tomorrow, and it’s easy to keep doing it. It’s pretty easy, too, to limit our ideas about self-improvement to the things we already enjoy doing. Maybe I’m a runner, and I want to run farther or faster. Maybe I like getting stronger, and in pursuit of that improvement I’ll do more reps, more of the same thing. You get the idea.
Last night I tried something I’ve never done before: Hot Yoga. I’ve always been a fan of balance, in theory. Strength should be balanced by flexibility, and flexibility should be tempered with strength.
In theory. But I hadn’t done much about flexibility in my own training. I didn’t know what yoga would be like. I didn’t know if I’d like it. But I spent an hour putting myself in new positions, and breathing, and paying attention to exactly how my body felt… and I liked it.
So let me encourage you to move in a new direction by trying something new. If you’re like me and you’ve focused on strength or speed, try a yoga or stretch class. If you do yoga, some strength training will help you hold your poses longer. If you play a sport focused on a skill, like golf, try exercising a different skill set. And if you are an all-round athlete, try sitting still and meditating. Get out of your comfort zone. Stretch yourself. Grow.
“I never lose. I either win or I learn.” This quote was a Facebook post from the folks at Spartan (an obstacle race course and fitness group), and it has been widely reposted, likely because others seem to be as struck by it as I am. Those words are probably as close as anything I have seen to a real credo by which to live: embrace setbacks as opportunities to learn, instead of rejecting them as personal failures. Setbacks happen to everyone on the roads to our successes. It is okay to make mistakes and it is okay to miss the mark and to fall down and to be hurt. Japanese proverb expresses a similar sentiment: “Fall down seven times. Get up eight.” We heard this a lot in Aikido and Judo practice. Accept that you will make mistakes, you will fall, you will fail before you can succeed. You will only learn if you are willing to also fail. “I either win or I learn” takes that important acceptance one step further: you can turn that fall or that fail into something valuable if you are open to learning from it. It is a great thing to persevere and never give up, but that single-mindedness can leave you banging your head against the same wall over and over again. Don’t do that, it hurts It is an even better thing to learn from both successes and failures. That has been true for me in all manner of endeavors. It was true when I was trying to lose weight, it was true when I was training for a black belt exam, it was true when training for a Spartan race, it was true in graduate school, and it has been true in my professional life as well.
So, don’t keep repeating what’s not working for you: learn why it’s not working, and change it. Don’t kick yourself because your diet isn’t showing results; think about where and how it’s not working for you. Don’t scold a child who did not meet your expectations; ask yourself how you failed to communicate and in doing so, teach the child it is ok to fail while you also learn to express yourself more effectively. Don’t hurt your back the same way twice!
Don’t give up because you have tried and failed. Think. Do things differently. Fail differently. Win or Learn…words to live by.
Shoveling snow can really do a number on your back!
Here are some things to keep in mind when shoveling.
Pick the Right Snow Shovel
Pick a light shovel so it doesn’t add to the weight of the snow. Make sure the handle is adjustable or long enough so you don’t have to bend over more than absolutely necessary.
Shoveling snow is strenuous exercise. You should warm up beforehand just like you would before working out in the gym or playing basketball. Do some light calisthenics (arm circles and raises, spinal twists, body weight squats) to warm up your muscles. You’ll know you are warmed up when you feel warm, start to sweat and are a little out of breath. Avoid stretching before you exercise…stretch after.
Use Good Form
Whenever possible, push the snow to one side rather than lifting it. Many shovels are designed to let you push snow. When lifting the snow shovel is necessary, make sure to use ergonomic lifting techniques:
Always face towards the object you intend to lift – have your shoulders and hips both squarely facing it.
Bend or HINGE at the hips, not the low back, and push the chest out, pointing forward. Tighten or flex your abs (think bracing) and your buttocks. Then, bend your knees and lift with your leg muscles, keeping your back straight and keep your face looking straight ahead or up. Just like you would doing an exercise in the gym.
Keep your loads light…work smarter, not harder.
If you must lift a full shovel, grip the shovel with one hand as close to the blade as comfortably possible and the other hand on the handle (handle and arm length will vary the technique). Keep your body as close to the blade as possible… the longer the lever arm, the more pressure on your back.
Turn to the side to dump your snow, avoid twisting your back (I know, it seems easier but it is much riskier for your back). Resist the urge to throw the snow.
Wear proper footwear to avoid slipping and falling.
It is easier to remove small amounts of snow than large amounts. Consider breaking the chore up into several sessions. Also, if possible, it is easier to shovel as the snow falls, rather than waiting for it to accumulate. Usually, you can push a few inches around.
This is also important for your heart. Snow shoveling is strenuous work and as you are bending and lifting, your muscles tighten around your organs, this internal pressure will raise your blood pressure. So it can be an intense workout for your body and your heart. If you start feeling dizzy or light headed, take a break. Heart attacks are common during snowfalls for this very reason. If you have high blood pressure or a heart condition, you’ll want to be extra careful when going out to shovel snow. If you have any questions, be sure to consult with your doctor or cardiologist before shoveling snow.
If possible, use a snow blower or borrow one from a friend or neighbor. If you already have back trouble, consider using a service for snow removal. If you have elderly or infirm neighbors, please help them!
Everyone knows we should exercise, and reminders are everywhere.
But when a lot of people think of exercise they think of unpleasant things: endless time in the gym on the treadmill, stationary bike or walking around a track. However, exercise comes in many forms: snowboarding, rock climbing, martial arts, dancing, gymnastics… I like to do a variety of things to keep fit and one of my mantras is that whatever I’m doing, it has to be fun. Charlottesville is a great area with lots of options to keep fit and most of them are well outside the gym. I got a great workout on the slopes this past weekend with my cousins snowboarding. I used my core and worked my legs to stay up right…and to protect myself when I fell 🙂
Another note about exercise, is that it can feed the soul as well as the body. I reconnected with cousins I hadn’t seen in the last year and I got out of the house; out into nature. What could be better than reconnecting with friends and family and getting some exercise while you’re at it?
Nothing like a little foam rolling to relieve a little tension from your muscles! It has helped me and my workouts tremendously!
Foam rolling is essentially self-myofascial release, which is basically a fancy term for self massage. It helps to ✔decrease adhesions and break up scar tissue, ✔ increase blood circulation, ✔ reduce soreness, ✔ improves tissue recovery which ✔ speeds up workout recovery and can help ✔ boost performance!!
If you’ve never tried it, I recommend doing so immediately! ~Dr. Eng
Variety. Why is variety important to fitness routines? I believe that it is important to do a variety of activities for physiological and mental reasons.
I have had many patients who are a superstar at one particular activity but they are getting injured too easily. In physiology, there is a term called the SAID principle. This stands for Specific Adaptations to Imposed Demands. This means that the body will adapt to the specific demands that are placed on it. If you train to run long distances at a slow pace, your body will adapt to that. If you train to lift heavy weights at the gym, your body will adapt to that training. I believe that your body needs different exercises so that it doesn’t adapt to the same stresses placed on your body all the time. Multiplanar movements will stimulate all muscles evenly and will reduce risk of injury.
Variety is important for mental reasons. I can’t stand doing the same thing every day or even every week! I get too BORED!!! Running outside, exercises DVDs at home, running on the treadmill, lifting at the gym, walking with my dogs, all kinds of sports, dancing, Pilates, yoga, Kettlebell workouts – you name it!!! (except for baseball- I can’t stand baseball. Sorry baseball lovers) All these different activities keeps me excited and challenged!
So, variety. That’s my secret!
So you need a new mattress — but what should you get?
That’s a great question! I just found myself in the same position. A few years ago I bought an expensive name brand mattress that felt great in the store…and slowly started killing me. When l I reinjured my back this past summer and it just wouldn’t heal, I began to suspect my mattress. A few weeks ago my suspicions were confirmed when I stayed in a hotel for a few nights, and my back pain got a lot better… until I got home. So it’s time for a new mattress!
So many mattress options confront us that it’s no wonder patients ask me which mattress they should buy. Soft, firm or something in between? Inner spring, memory foam, latex, air or some combination? Pillowtop or customer topper or feather bed? And just how much does a good mattress cost? Just like televisions (or wedding dresses), mattress models start around $500 but the scale goes up to premium models costing more than $5000! And no one mattress works for everybody: it’s a very personal choice.
So here is the skinny: the first and best way to narrow down your options is to consider your sleeping position. There are basically three sleeping positions, the stomach, side and back, and which position you use helps determines what level of mattress firmness you should aim for. Everything else is down to budget and preference.
Stomach sleeping: just stop. Stop it right now. Sleeping on your stomach puts additional strain on your spine, especially at the lower back and neck. If you insist on sleeping on your stomach, choose a soft pillow but a firm mattress to support your body.
Back sleeping: fine for most of us. If you have low back problems it may be helpful to elevate your legs from time to time by placing a pillow or a folded towel beneath your knees, but check with your healthcare provider. If you snore or have a cold it may be helpful to elevate your head and shoulders with firmer or additional pillows. Habitual back sleepers are likely going to be better off with a mattress in the range of medium to firm – again, to relieve strain on the spine. If you have respiratory or cardiac issues that require other sleeping positions, consult your medical specialist (this post is geared towards the musculoskeletal system).
Side sleeping: the most popular sleeping position, and the most optimal for spinal health. I sleep on my side myself. People with low back or hip pain my find it comfortable to sleep with a pillow between the knees. People with shoulder pain who like this position will prefer a softer mattress. I’d recommend a firm pillow but a soft to medium mattress for these sleepers, one that will conform to the body’s natural curves and pressure points. A firm mattress will press into the hips and shoulders and create pressure.
After you’ve thought about your sleeping position and desired firmness, other elements to consider include the type of mattress and the material it’s made from, as well as the warranty on such a pricey purchase.
Inner Spring: the plain old-fashioned mattress. These can range from soft to firm. Most innersprings these days are pillow top mattresses (I think so you won’t be able to flip it when it starts to sag and you’ll have to buy a new one). The classic innerspring is perennially popular, but you can also find hybrids with memory foam or gels.
Memory Foam: a polyurethane foam made from oil. Polyurethane foams have been around for a while, but memory foam was developed by NASA in 1966, eventually released to the public domain, and popularized for mattresses by Tempur-Pedic. Memory foam is exceptionally comfortable because it molds to the body in response to both heat and pressure. Of course, it also traps heat, which some people find uncomfortable, although newer mattresses include gels to dissipate that heat. Memory foams also come in different levels of density, viscosity, and resilience, which can be combined for different effects, so there are a lot of options available — some Tempur-Pedic mattresses have 9 different types of layered memory foam! Other issues to be aware of before purchasing a memory foam include off-gassing (when unwrapped they release chemicals for a few weeks), and their energy absorbency, which means they absorb motion, which can make it difficult for infants and small children to adjust position if sleeping on them. For this reason, it is not recommended that you put infants down to sleep on memory foam mattresses. Companies like Tempur-Pedic and Serta are known for their memory foam mattresses, but smaller companies you’ve never heard of make them too. These mattresses can also vary quite a bit in price. A name brand will cost you quite a bit, while a less well-known brand might cost you less than $1000. Consumer Reports provides mattress ratings that may help guide your choice, but always test the mattress before you buy. Many new mattress companies sell directly to the customer online and they have robust money back guarantees. These newer companies provide great mattresses at a fraction of the cost of more expensive brands.
Latex: the bounciest mattress around! Latex is made from rubber trees, a sustainable natural material. They have a really bouncy feel, but they don’t trap heat or smell. They can be layered or blended with other materials like memory foam or gels. All of those factors help make latex mattresses very popular, and it’s nice to know that according to Sleep Like the Dead, latex mattresses mostly have higher-than-average customer satisfaction ratings. However, these mattresses can be pretty expensive, and because the price point keeps some consumers away, they can be hard to find in showrooms for testing.
Air: adjustable air chambers surrounded by padding. The famous Sleep Number Bed is the most well known of these. The mattress can be inflated to your “perfect “ level of comfort. These mattresses can be good for couples who have different preferences in firmness.
Waterbeds: water chambers on top of a platform base, without additional padding. Water displaces at the heaviest pressure points of your body, relieving pressure but causing you to sag into the mattress. While some people find waterbeds comfortable, I do not recommend them.
Many people would prefer to find an environmentally friendly mattress. There are many options available, from latex to wool blends, and they can vary quite a bit. Most green options will be found at local vendors, so if that interests you make sure you do a local web search to find vendors in your area.
Many mattresses come with confusing warranties: 7 years, 10 years, 20 years, 10 years with 10 years prorated. Most warranties will list at what point they will consider a mattress “failed.” The standard for this is 1.5 inches of sag. However, many people start to experience aches and pains with as little as .75 inches of sag…so read this information carefully. While many companies claim that their mattresses will last 10 years or more, online reviews often suggest less. And it can be hard to claim on a warranty: you will probably need your purchase paperwork and a measurement of the sag.
When buying, start by doing some research on your own, like you would for any major purchase. You can easily begin online. I think you’ll find what I did… a ton of information, some of it confusing, some of it contradictory. I found two articles on how to choose a mattress with completely opposite advice on sleeping positions — both written in an authoritative style (but not with actual professional expertise!). So be aware of the need to evaluate what you read and hear about mattresses.
When you’re ready to look in person, take the time to test mattresses. Lie on a mattress in your favorite sleeping position for several minutes. Think about how it feels. Do you feel pressure anywhere? How would lying on it for an hour feel? Think about your neck, shoulder, back and hips. Think about any injuries you currently have and how it makes you feel. Test several mattresses before you choose one. And before buying, check on the return policy. Many companies offer upwards of 120 days to try it out, although beware return shipping and restocking fees.
Also, consider a less well-known brand. While brands like Tempur-Pedic, Serta and Simmons are familiar and reliable, they have also been marked up many times over by the time they reach the showroom where you are seeing them. There are several companies that will sell great mattresses to you directly at a fraction of the cost of a name brand mattress from a furniture or mattress store: Casper, Purple, Nolah, Level Sleep to name a few. However, you might be then taking a risk on a mattress without laying on it first. Below I’ll list some local Charlottesville stores that I’ve had good experiences in, and some well-reviewed online mattress companies that you may not have heard of.
Atlantic Organic Sleep Shop: I spoke with Sydney, who was very helpful. She showed me several latex and latex hybrid mattresses.
Essentials by Classic Furniture: Ask for Zeke, and he’ll take good care of you.
Mattress Discounters: I worked with the manager. They have a wide array of Tempur-Pedic mattresses. The manager was very kind and very helpful in urging me to pay attention to how a mattress felt.
Lesser-known but well-reviewed online mattress companies:
I have an update on these online mattresses. I’ve now slept on both a Casper and a Tuft and Needle. I have to say I was really impressed. I thought they were a great “Goldilocks” mattress. Not too firm, and not to soft. To be honest, I wish I had tried one. My last mattress that I got to help with my back cost 3x more than a Casper and I prefer the Casper! I know encourage all my patients to consider one of these online companies because of my own experience, the cost, the excellent online reviews, and the return policy. After a lot of my own research I wound up purchasing a Nolah which (as a side sleeper) I’ve been very happy with.
Most importantly, think about what is comfortable for your body and for your budget. Bear in mind that you’ll be spending 1/3 of your life on this mattress and it is probably worth a level of serious consideration and financial commitment. If you aren’t spending that much of your life on the mattress… you don’t sleep enough. Start!
Questions about choosing a mattress? Shoot me an email: [email protected]