A Strong Core is Your Best Guard Against Back Pain @ClevelandClinic

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 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.

https://health.clevelandclinic.org/2016/07/strong-core-best-guard-back-pain/

 

A Healthy Protein Guide: What To Eat and Limit: Julia Zumpano RD,LD. @ClevelandClinic

Lean meats, fish, dairy and plant proteins can help you meet your protein needs without piling on saturated fat and sugar

You have options when it comes to putting protein on your plate. Lots and lots of options. But as you’re considering what proteins to include, remember this: Not all proteins are created equal.

For example, both hot dogs and cooked lentils offer protein — but one brings a little more to the table when it comes to nutrition and your health. (It’s lentils, just to be clear.)

“There’s more to it than just getting as many grams of protein as possible,” says registered dietitian Julia Zumpano, RD, LD. “Quality matters — and a lot of us don’t regularly consume good-quality protein that enhances our overall diet.”

What makes a protein source a good choice?

Foods aren’t made of protein alone. That’s why simply comparing the number of protein grams on two nutrition labels doesn’t really tell you which might be the healthier choice.

Other factors matter, too, including the food’s overall nutrient profile. Consider how much added sugar, sodium or saturated fat it contains. Look at whether it provides beneficial nutrients, like fiber, vitamins and minerals.

“Over the long term, all of these affect your health,” says Zumpano.

Ideally, she recommends getting most of your protein from a variety of whole or minimally processed foods. That can include animal-based products, as well as plant-based protein sources.

What might that look like for meals? Start with these healthy protein sources.

Fish

If you’re fishing for a healthy protein, the seas are an excellent place to start. Like other animal proteins, fish naturally provide a concentrated source of protein. Fish generally contain about 7 grams of protein per ounce, although the exact amount varies by type.

Many fish are also lower in saturated fat and higher in omega-3 fatty acids, a one-two combination that makes them a standout for heart health. They’re also packed with key nutrients like vitamin D.

“Fish is a phenomenal protein source,” says Zumpano. “Regularly swapping it in for other meat sources can help you build a healthier and more varied eating pattern.”

Lean red meat

Red meat has a place in a healthy diet. But the key is to choose lean cuts.

Picking a leaner cut gets you protein — about 7 grams per ounce — while minimizing saturated fat. Examples of lean cuts include tenderloin, sirloin, top round and flank steak. For ground beef, opt for 90% lean or higher.

Skinless poultry

Chicken, turkey and other poultry can give you protein without all the saturated fat found in some other meat choices — but how you prepare it makes a difference.

Zumpano recommends going with skinless white meat poultry. Like fish and red meat, it provides roughly 7 grams of protein per ounce. (There’s some variation depending on what you choose.)

Prefer dark poultry meat? That’s OK! It has a place on the table. Ideally, try to choose dark varieties (like legs, thighs and wings) a little less often because they’re higher in saturated fat.

Lean toward baking, grilling or roasting your poultry, too, and go easy on adding salt. Avoid deep-frying chicken or coating it in breading to stay on the healthier side.

Dairy foods

Dairy-based foods can be an easy way to work more protein into your day, especially at breakfast. Zumpano says she often recommends eating Greek yogurt or cottage cheese in the morning.

Greek yogurt typically packs 11 to 12 grams of protein in a half-cup serving. Cottage cheese has 12 to 14 grams of protein in a half-cup serving.

Starting the day with either can pay off later. A protein-rich breakfast can help support steadier energy, blood sugar and appetite levels, which can keep you from crashing as the hours pass by.

Eggs

Eggs are another simple, whole-food protein source that traditionally shines in the morning.

But eggs can also bring a protein boost to your lunch, Zumpano says. Hard-boiled eggs make a good snack, too!

That versatility with eggs makes it easier to spread protein intake throughout your day, which maximizes your body’s ability to get the most out of it. One large egg typically has 6 grams of protein.

Legumes

Plant proteins deserve a regular place on your plate — and not just if you’re vegetarian or vegan. Cooked beans, lentils and other legumes provide about 15 grams of protein per cup, along with benefits you won’t get from meat alone.

“Plant proteins offer a whole slew of powerful vitamins, minerals and antioxidants — and the fiber that’s in it aids in creating a healthy gut microbiome, digestion and regularity,” Zumpano explains.

Nuts and seeds

Nuts and seeds are another easy way to add plant-based protein to your diet when you get the munchies. They offer a healthy dose of protein — on average, 6 to 7 grams per ounce — along with fiber and other nutrients.

The healthy fats found in nuts and seeds can also help manage your blood sugar and appetite throughout the day.

“A handful of nuts or seeds can be a nutrient-dense snack choice that offers far more than chips or other carb-heavy options,” notes Zumpano.

Tofu and tempeh

If you want to make plants the star of the meal, tofu and tempeh are excellent choices. These soy-based foods are rich in protein and have enough texture and heft to serve as meat substitutes.

Tofu typically offers between 10 and 15 grams of protein per half cup. Tempeh is higher at 15 to 20 grams.

But don’t feel like you need to go “plant-only” to use tofu and tempeh. Add them into your meal rotation with red meat, chicken and fish. “Use them to build some variety into your diet,” suggests Zumpano.

High-protein foods to limit

A package that screams “20 grams of protein!” doesn’t automatically make a food healthy.

Some protein choices come with lots of saturated fat or heavy processing that may make them less than ideal.

Try to limit:

  • Processed meats: Bacon, sausage, hot dogs and deli meats may contain protein, but they’re also high in saturated fat. That doesn’t mean they’re off-limits forever — but they shouldn’t be your go-to protein sources.
  • Fast-food burgers and other fatty meats: Yes, a double cheeseburger or a deli sandwich has protein. They also tend to come with a lot of saturated fat, sodium and calories. Try to limit meals from a drive-thru window.
  • Highly processed protein-enhanced foods: Protein chips. Protein cereal. Protein waffles. Yes, protein seems to be everywhere. But everything you eat doesn’t need to be protein-packed. Don’t choose processed food solely for the promise of extra protein.

Tips to make healthier protein choices

You don’t need to obsess over every gram of protein when putting together meals. Instead, focus on quality, variety and nutritional balance. Zumpano recommends:

  • Choosing whole foods: Build meals around foods that aren’t heavily processed.
  • Mix up your sources: Don’t rely only on animal protein. Include plant proteins, too.
  • Spread it out: Many people pack in their protein at dinner and skimp at breakfast and lunch. Aim for a more even distribution.
  • Pair protein with fiber: This combination can slow digestion, helping support steadier blood sugar levels and keeping you feeling full longer. It can also make meals and snacks more balanced and satisfying.
  • Be skeptical of protein marketing: High-protein is only one part of the nutritional story. Look closely at products to understand better what you’re eating.

“Protein doesn’t have to feel complicated,” reinforces Zumpano. “Find some protein-rich whole foods you enjoy and build meals from there. Do that consistently and your body will get the healthy protein it needs.”

Physiotherapy improves physical function, general health and mental health for people with CVD ❤️ @worldphysio1951 #WorldPTDay

https://www.instagram.com/reel/Dc-xDybjMNW/?stkn=em96NjltNGtxazBk

worldphysio1951

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Original audio

  • 📅 World PT Day is tomorrow!

    Don’t forget to use #WorldPTDay and tag WorldPhysio1951 when sharing your activities.

    Need anything to help mark the day? Access our free World PT Day resources and materials, available in more than 50 languages: https://ow.ly/Tyca50ZJvPy7h

Improves physical function, general health and mental health @worldphysio1951 #WorldPTDay

https://www.instagram.com/reel/Dc-xDybjMNW/?stkn=em96NjltNGtxazBk

worldphysio1951

•

Original audio

  • 📅 World PT Day is tomorrow!

    Don’t forget to use #WorldPTDay and tag WorldPhysio1951 when sharing your activities.

    Need anything to help mark the day? Access our free World PT Day resources and materials, available in more than 50 languages: https://ow.ly/Tyca50ZJvPy7h

Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong! @ClevelandClinic – Susan Williams, MD. endocrinologist

cleveland muscles

Cleveland Clinic
@ClevelandClinic

Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!

You may not realize it, but we all start losing 1 percent of muscle mass each year after age 30. That’s why your diet in later years should not look the same as it did when you were younger, says endocrinologist Susan Williams, MD.

Skipping breakfast, eating fast food and being inactive in your 20s and early 30s might not hurt your health in the short term. However, poor nutrition and lifestyle habits take their toll over time.

People who embrace good habits early on really get ahead of the game, Dr. Williams says. But it’s never too late to start eating better and taking better care of your body.

Whether you’re 30 or 50, Dr. Williams offers three important tips to get started in eating right when you are thinking about your long-term health.

RELATED: Do You Know How Much Exercise You Really Need? 

1. Keep your weight in check

A roller coaster of weight gain and loss can change your body composition and leave you with more fat mass and less lean muscle mass.

2. Eat three balanced meals a day

You also want to limit your snacks in between. The word “balanced” is especially important because eating a wide variety of foods will help you prevent nutritional deficiencies.

Dr. Williams suggests this simple shopping list:

  • Lean proteins. Choose chicken, white fish, oily fish like salmon, eggs, tuna fish and red meat (less frequently than other protein).
  • Whole grains. This includes multigrain breads, and long-cooking rice or oats.
  • Veggies. Go for fresh or fresh frozen. Choose what’s in season and enjoy a variety to get the vitamins and minerals your body needs.
  • Fruit. Fresh fruit is best, followed by frozen. Canned fruit can be OK, but choose options in light syrup or water. Check the label and avoid added sugar.
  • Dairy. Choose milk, yogurts, cheeses and cottage cheese that are low-fat or fat-free.

Steer clear of cookies, cakes, pies, ice creams, juices and rich desserts. If that sounds like no fun, Dr. Williams advises treating these foods as treats. Save them for dining out or special occasions, but don’t make them part of your daily diet.

RELATED: Which Bread Is Best For You — Whole-Grain, Multigrain or Whole Wheat?

3. Use your muscles

Eating protein and being physically active are equal partners in the quest for maximum health, Dr. Williams says. Muscles are made of protein, but simply eating protein is not enough to save them.

“Muscles in your body are a use-or-lose proposition,” she says. “You need to use them to keep them strong.”

Can’t carve out time for the gym? Try this daily routine:

  1. In the morning, stretch for 10 minutes.
  2. At lunch, eat and then walk for 10 minutes.
  3. After dinner, spend 10 minutes with stretch bands or light weights.

Even a half hour of physical activity can make a world of difference, especially if you make it a habit in your 30s. “Don’t let your weight creep up while your muscle mass creeps down over your 30s and 40s,” Dr. Williams says. The longer you wait, the harder it will be to get started — and the more muscle you will have already lost.