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 β€” the rectus abdominis
  • Muscles along the side of your body β€” the internal and external obliques
  • A deep muscle that wraps around the front β€” the transverse abdominis
  • Muscles in your back that are located between your spine bones and run along your spine β€” 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 β€” the tissue that connects bone to bone β€” 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 β€” 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 β€” 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 β€” 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 β€” 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 β€” 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 β€” 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/

 

Looking to stabilize your blood sugar, lower your cholesterol, reduce inflammation and feel full longer? Look no further than the delicious apple! @ClevelandClinic

Cleveland Clinic

@ClevelandClinic
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You go to the store to pick up some apples. Seems simple enough β€” until you’re faced with a dozen different varieties in the produce aisle. You want the healthiest apple, so which one will keep the doctor away?
Dietitian Mira Ilic, RD, LD, reveals the juicy details about this popular fruit.
Big difference in taste, not nutrition
Apples have slightly different nutrients depending on their type and color. For instance, Red Delicious apples have polyphenols that are exclusively found in dark red fruits. Polyphenols are plant compounds that may help prevent cancer, heart disease and other conditions.
But if the thought of biting into a Red Delicious isn’t appealing, don’t worry. Any apple you buy will deliver a punch of health-boosting nutrients.
β€œThe nutritional differences among apple varieties are small,” says Ilic. β€œBut the taste differences are big. Don’t choose an apple based on a small nutrient difference if you don’t like the taste.”
Choose fresh and local apples
Whatever apple variety you pick, make sure it’s fresh. Old apples aren’t as nutritious, don’t taste as good and could be rotten. β€œChoose a firm apple with no bruises,” says Ilic. β€œLook for bright color, keeping in mind that some apple varieties are naturally more colorful. Fresh apples usually have a nice aroma, too.”
Whenever possible, go with local apples. The less your apple had to travel, the more nutritious it is when it gets to you. July through October is prime apple season in the U.S. During these months, local apples are easy to find.
When you choose apples in the off-season, check the sticker for its country of origin. If your apple traveled a long distance, it probably lost some of its nutrition in transport. Try to choose apples that come from a nearby country. β€œWe don’t have the option to eat local apples year-round,” Ilic says. β€œIn the off-season, we have to get apples from other parts of the world. No matter where they come from, wash them thoroughly.”
You don’t need any chemicals or tools to wash your apples. Wash your hands first. Then wash your apple with running water. Gently scrub the skin with a cloth or brush.
Are organic apples healthier?
Some organic fruits may be slightly more nutritious than conventionally grown ones. But you don’t need to buy organic apples. They tend to cost more, which can be a downside if you’re sticking to a grocery budget.
β€œGrowers use different growing practices for organic apples and while pesticides are used on conventionally grown apples, some organic growers may actually use pesticides approved for organic farming,” explains Ilic. β€œThe government has guidelines about what pesticides growers can use. Both types are safe and nutritious. Just wash them well if you’re still concerned about pesticide residue or you can peel your apples, but you’ll lose some nutrients and fiber found in the skin.”
Have fun with apple sampling
With so many apple varieties, you’re bound to find one you like. Hold an apple sampling by picking a few different types. Cut them into bite-sized pieces, put them on a plate and label them. Have your family members try the different apples and choose their favorite.
An apple sampling can be a fun way to get kids to eat more apples, too. Kids often like having some control over the types of foods they eat.
All apples are amazing
Whether your favorite is a sour Granny Smith or a sweet Honeycrisp, you can’t go wrong with apples. β€œAll apples are a good source of fiber, including pectin, which may help lower cholesterol,” Ilic says. β€œThey also contain phytochemicals like polyphenols, which are antioxidants linked to multiple health benefits. Some studies have suggested that apples may also help reduce the risk of some cancers.”
Bottom line: An apple a day is a healthy habit, so don’t stress about picking the right one. β€œEat the apples you like because they’re all healthy,” Ilic says.

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Fitness: Only 5,000 steps a day needed to stay healthy, study shows @bbchealth #physicalactivity

Walking is key to reducing the risk of death, according to a new study

By Annabel Rackham

BBC News

It has long been touted that 10,000 steps a day is the magic number you need to stay fit and healthy – but a new study shows fewer than 5,000 may be enough to see a benefit.

The analysis of more than 226,000 people around the world showed 4,000 was enough to start reducing the risk of dying prematurely of any cause.

Just over 2,300 is enough to benefit the heart and blood vessels.

The more you do, the more health benefits are seen, researchers said.

Every extra 1,000 steps beyond the 4,000 reduced the risk of dying early by 15% up to 20,000 steps.

The team from the Medical University of Lodz in Poland and Johns Hopkins University School of Medicine in the US found the walking benefits applied to all genders and ages, regardless of where they lived.

However, the biggest benefits were seen among the under-60s.

Prof Maciej Banach, from the Lodz university, said that while the number of advanced drugs for treatment was growing, they were not the only answer.

“I believe we should always emphasise that lifestyle changes, including diet and exercise, which was a main hero of our analysis, might be at least as, or even more, effective in reducing cardiovascular risk and prolonging lives,” he said.

Woman walking
Image caption, Walking to the shops instead of driving, or getting off the bus a couple of stops early could be enough to make a difference

According to World Health Organization data, insufficient physical activity is responsible for 3.2 million deaths each year – the fourth most frequent cause worldwide.

Honey Fine, a personal trainer and instructor for global fitness company Barry’s, emphasises the problems that come from sitting down too much.

“It can slow your metabolism and affect muscle growth and strength, which can cause aches and pains,” she tells the BBC.

“Sitting down for too long can also cause all sorts of back problems, we find this a lot with people with office jobs, that their backs are constantly put in a stressed compressed position which causes a lot more problems later on in life.”

She explains the importance of non-exercise activity thermogenesis – also known as Neat, “which in simple terms is everything we do that uses energy and burns calories”.

“Tasks like standing, carrying shopping, washing the floors, hoovering, pacing whilst walking on the phone – it’s all the little things that make us more active that help us to burn calories more efficiently,” she said.

English peas in pod pasta recipe with mint and grated Parmigiano Reggiano.@ClevelandClinic #healthaware

There is something special about using fresh peas straight out of the pod. This recipe was inspired by our root-to-stem philosophy of cooking: It always seems like such a waste to throw away the pea pods, but they are relatively inedible. To make use of the pods, we’ve pureed them into a spring-fresh pasta sauce. Remember: Pasta for breakfast is a great choice, especially when it’s loaded with healthful pea protein.

Ingredients

Kosher salt
1 pound fresh English peas in pods (yields about 1 cup shelled peas and about 3 Β½ cups pods)
Β½ cup water
ΒΌ cup extra-virgin olive oil
2 small spring onions or 2 large shallots, chopped
2 small spring garlic (whites) or 3 garlic cloves, minced
2 tablespoons Greek yogurt (optional)
12 ounces whole grain pasta, such as linguine, rigatoni or small shells
Freshly ground black pepper
ΒΌ cup fresh mint (peppermint preferred), thinly sliced
Espelette pepper to taste (optional)
Grated Parmigiano Reggiano cheese (optional)

Directions

  1. Bring a large pot of water to boil and add enough salt to make it salty like the sea.
  2. Meanwhile, wash the peas. Pull off the stem ends: remove the peas and place in a small bowl. Reserve the pods.
  3. Fill a bowl with cold water. Set aside. Add the empty pea pods to the pot of boiling water and cook for 5 minutes. Using a slotted spoon or spider, remove the pods from the boiling water and transfer to the bowl of cold water to cool quickly. Drain the pea pods and add to a Vitamix or high-speed blender. Add Β½ cup water. Puree for 2 to 3 minutes.
  4. Place a fine strainer over a bowl and add the pea pod puree to the strainer, pressing on the solids to release as much puree as possible into the bowl. Discard the solids in the strainer. Reserve the puree in the bowl; season to taste with salt and pepper.
  5. Cook the pasta in the pot of boiling water until al dente, stirring occasionally.
  6. Meanwhile, in a large skillet, heat the olive oil over medium heat. Add the onions and garlic and sautΓ© until softened, 3 to 4 minutes. Add the peas and cook 2 minutes. Stir in the reserved pea pod puree and Greek yogurt, if using, and cook just until heated through. (Don’t overcook the peas or puree as the sauce will turn brown).
  7. Using tongs or a spider, transfer the pasta to the sauce in the skillet. Toss until combined. Season to taste with salt and pepper. Transfer the pasta to the serving bowl. Add the basil and mint. Serve with Espelette pepper and grated Parmigiano Reggiano cheese, if using.

Nutritional info (per serving)

Makes 4 servings.

Calories: 554 kcal
Total fiber: 12 g
Soluble fiber: 0.1 g
Protein: 15.5 g
Total fat: 16.7 g
Saturated fat: 2.0 g
Healthy fats: 12.1 g
Carbohydrates: 84 g
Sugars: 7.7 g
Added sugars: 0 g
Sodium: 178 mg
Potassium: 433 mg
Magnesium: 14 mg
Calcium: 134 mg

Source: The What to Eat When Cookbook by Michael F. Roizen, MD, Michael Crupain, MD, MPH and Jim Perko, Sr, CEC, AAC.