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A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.
A physical therapist answers your questions
If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? We spoke with Cleveland Clinic physical therapist Patti Mariano, DPT, to find out.
Q: What is your core?
When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.
Your core includes:
Front abdominal muscles — the rectus abdominis
Muscles along the side of your body — the internal and external obliques
A deep muscle that wraps around the front — the transverse abdominis
Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi
Your core also includes the diaphragm and muscles of the pelvic floor. I also consider the gluteal muscles as core muscles.
Q: What is the relationship between core strength and back pain?
Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs, which lie between the spinal bones, for stability, which can cause pain.
But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.
Q: What are some exercises for the core that can help with back pain?
Here are my top five:
Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
Bird dog — Kneel on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
Scissors — Lie on your back with your arms at your sides and legs pointed straight into the air above your hips. Press your lower back into the mat and tighten your abdomen. Lower your right leg until it’s a few inches from the floor. Raise your right leg up and begin lowering your left leg the same way. Continue switching right and left.
Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.
For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.
Q: Can you injure your back by trying to strengthen your core?
Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.
Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.
The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.
Q: When should you talk to a doctor about your back pain?
If any of the following is going on you should consult with your doctor:
Your pain has been going on for longer than a month, despite resting from activities that make it worse.
Your pain is getting worse.
Your pain wakes you from sleep.
Your pain is in your low back but also is going down one or both of your legs.
You notice that one leg is becoming weaker than the other.
Q: Where should you turn if you want help in creating a plan to address back pain?
Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.
Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely.
The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.
JUST RELEASED: Canada’s long-anticipated revised food guide! Specifically, the new food guide suggests eating plenty of vegetables and fruits, choosing whole grains, and eating “protein foods.” The image is an example recommended daily diet. Learn more: https://food-guide.canada.ca/en/
Moderate-to-vigorous exercise appears to boost cardiorespiratory fitness, which quantifies how well the heart & lungs supply oxygen to the muscles. Higher CRF during midlife is linked to a lower risk of heart disease later: https://bit.ly/3rEwvXe#HarvardHealth
Stay hearty and healthy no matter how cold it gets
Skies are gray, clouds are lowering and the temperature is dropping. And with the changing weather usually comes a transition in food, from the lighter fare of summer to more hearty winter meals.
But what’s the best way to make the switch and stay healthy? Should you really switch up your diet that much? And what’s the best way to adapt your meal planning during the coronavirus pandemic so you don’t have to leave your house as much for grocery runs?
To figure out the best way to approach your winter meal planning, we talked to registered dietitian Lisa Burnett, RD, about some important tips and tricks to getting through the long, cold season with your nutrition intact.
The most important nutrients
You’ve probably heard a lot about the need to up your vitamin D intake, especially during the winter. That’s because vitamin D not only is essential to muscle and bone health, deficiency in vitamin D has also been linked to decreased immunity and fatigue. And it’s harder to keep your vitamin D up in winter.
“We’re supposed to get most of our vitamin D from sunlight but there’s less sunlight in winter, especially in certain regions,” says Burnett. Certain foods like fortified dairy products and cold-water fish (like salmon and tuna) are good sources of vitamin D.
The bottom line, she says, is getting plenty of fruits, vegetables, whole grains and lean proteins. And it’s important to remember that even if the seasons change, your body still needs the same maintenance.
“While your tastes may change, your needs don’t change a lot in terms of the vitamins and nutrients you need,” she notes. “It’s always important to eat well and keep eating fruits and vegetables to get those vitamins and minerals.”
Packing in those nutrients
Other nutrients Burnett suggests getting in your regular cold season diet as it’s better for your body to absorb these through digestion than through supplements.
“Vitamin C can boost your immunity so it’s a great thing to include however if you’re getting two-to-three servings of fruit and three-plus servings of vegetables each day, you should be able to get adequate amount of vitamin C,” she says.
And getting those vegetables doesn’t mean you have to eat a huge serving, either. Generally, a half-cup is good.
Bell peppers are a good veggie source for vitamin C, Burnett says. And for fruits, the reliable citrus fruits are good sources as are cranberries, which are more in-season, especially during the holidays.
When the season gets colder and drier, many people complain of dry, itchy and flakey skin. vitamin E can reduce inflammation and can help skin health and if you’re keeping that fruit-and-veggie intake up, you should get plenty of that, too.
B vitamins are also important, she says, as they’re antioxidants and influence your energy and brain functions. “Your dark, leafy greens are good sources for those vitamins as are legumes, like beans and lentils,” she adds.
Speaking of tastes changing with the seasons, colder weather often brings on a wave of heartier, heavier foods. But, while these meals may be beloved cold-weather traditions, Burnett says to beware of starches.
Hearty versus healthy
“Winter squashes are considered vegetables, but, nutritionally, they look a lot more like starches,” she points out. “They do have vitamins and minerals but they also have a lot of carbohydrates.”
One way to moderate that intake, she says, is to make sure you include another vegetable into your meal plan instead of another starch. “For instance, if you’re eating chicken with butternut squash, have a salad on the side instead of bread or potatoes. That helps keeps down the starch portion of your plate.
Soups
Soups are very popular in winter for a variety of reasons: they’re easy to make, they warm you up in the cold, they can keep in your freezer or fridge and they offer a wide range of flavors and combinations.
But one thing you should be wary of, Burnett says, is sodium. “That high sodium content is always a fear with soups. If you check the labels of a lot of popular store-bought soups or soups you can buy at restaurants, they have those high sodium levels.”
Instead, she says, consider making your own soups. Not only can you make your own flavor combinations but you can ensure they’re healthier options. And when it comes to bases, she also suggests choosing broth over cream.
“In cream-based soups, you’ll have those saturated fats from whatever dairy was used to make that cream base,” she says. “A great idea is to use low-sodium broth and use real, fresh ingredients.”
One more advantage of soup? A welcomed versatility in a time of social isolation.
Long-term meals
Because of the ongoing pandemic, it’s best to minimize trips to the grocery store (to protect yourself) and minimize those grocery delivery orders (to protect workers). That makes long-term meal planning and meal freezing an overlooked yet key step to staying safe and nutritious this winter.
And that’s where soups can be a big help. Says Burnett, “Soups are great to freeze so they last a long period of time. You can always pair it with a salad or, if it’s a lean protein-based soup, it could be a whole meal by itself. That’s also true of stews, too, as long as you stick healthy, fresh ingredients.”
Burnett says that batch-cooking – cooking many meals in one batch – is a big plus for the winter. “You can make several plates of three or four meals, free them and then work through them over the course of a few weeks,” she says.
She adds that crockpots are a good way to prepare those batch-cooked meals. “With a crockpot, you not only can cook large portions to break up over time but you can also get in everything you need, from proteins to your vegetables with necessary nutrients and minerals.”
The one thing to keep an eye on, besides ingredients, is portion size, she adds. “Certain comfort foods, like lasagna, do well with freezing and keeping for a while. You just need to be aware of portion size and what other vegetables and food options you’re cycling in to go with it.”
Fruits and veggies: fresh, canned or frozen?
Fresh fruits and veggies are always the best options if you can swing it. But certain items may be out of season depending on the time of year. Or maybe you’re looking to minimize trips to the grocery store or get certain produce in bulk.
In that case, you’re faced with a decision: canned or frozen?
According to Burnett, go with frozen. “Frozen vegetables and fruit have come a long way. Steamer bags make it much easier and have helped improve the quality. And nutrient-wise, those frozen options are fairly comparable to the fresh options.”
With the canned options, you run into issues like higher sodium in canned vegetables and higher sugars in the syrup with canned fruits. “There are some options that are healthier, like low sodium canned vegetables,” she says, “but you’ll just need to keep an eye on the nutrition labels and looked for those added sugars and salt.”FACEBOOKTWITTERLINKEDINPINTERESTEmailmeal plannutrientsvitamin cvitamin D
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