“The core muscles provide stability for the entire body as it moves,” @ClevelandClinic

cleveland evrything starts wit your core

If you’re planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.

“The core muscles provide stability for the entire body as it moves,” says Smith. “These muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.”

Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.

Getting started with your core

To get your core muscles in shape, you need to exercise.

“Our bodies were made to move, so any physical activity is really important,” says Smith.

She recommends these specific core-strengthening exercises below.

The first one engages the deep muscles in the abdomen, called the transverse abdominis. “These muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,” says Smith.

“The more you work on these muscles, the more it will become second nature to hold these muscles tight when you’re lifting grocery bags, doing yard work or any other kind of physical activity,” says Smith. This will help support your body.

Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.

Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. “It’s better to take your time, maybe do fewer reps, but with better quality,” she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.

Move on from the core

Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.

Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.

With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. “You don’t have to be in pain to make gains,” she says.

Beginner exercises for core strength

For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.

Abdominal bracing

Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.

Bridge

Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.

Clamshell

Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Don’t let your pelvis roll back during the lifting movement. Hold for 5 seconds.

Planning to Start Exercising? Start with Your Core First

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 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 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/

 

Is Hot Yoga Right for Me? @ClevelandClinic

Most people understand the basic health benefits of yoga: flexibility, stress relief and muscle strength, just to name a few. But why is it different when you turn up the heat? Is the increase in degrees a gimmick or is it actually beneficial to your health?

What is hot yoga, anyway?

Hot yoga is exactly what it sounds like — yoga practiced in a hot environment. Most hot yoga classes have an increased room temperature set anywhere between 90 and 105 degrees Fahrenheit. That’s quite a difference compared to normal room temperature (68 to 72 degrees Fahrenheit). Why so hot? The heat helps lubricate tendons and ligaments, making it easier to fold into certain stretches and poses. “The heat allows participants to get a deeper stretch because their body is warmer and they can move into the poses a little deeper,” says yoga instructor Jennifer Sauer.

The potential pros of hot yoga are:

  • Increased flexibility.
  • Muscle-building.
  • Body-toning.
  • Reduced stress.
  • Detoxification.
  • Weight loss.
  • Reduced pain.

On the flip side, it can also be easy to overdo it in a hot yoga class. Because of the high temperature in the room, you might not realize how hard you’re working and you could end up taking stretches too far before your body is ready.

The potential cons of hot yoga are:

  • Dehydration.
  • Higher risk of injury.
  • Dizziness.
  • Lightheadedness.
  • Trouble breathing.

Hot yoga should be something that you ease into. So taking some regular yoga classes first and getting an idea of your current flexibility level is recommended. Beginner yoga classes also help build on your knowledge of the poses and sequences.

“While people have reported pain relief, detoxification and weight loss from hot yoga, scientific research is limited,” Sauer says. “It’s safe to say that hot yoga is more vigorous than traditional practices,” she notes, “but the jury is still out on overall calorie burn and weight loss.”

When you combine hotter temperatures with extra exertion, your body is working harder and therefore increasing your heart rate. So, ultimately, you are burning a good amount of calories during your hot yoga session — the data just doesn’t exist yet for hot yoga specifically.

Who should avoid hot yoga?

Like other types of exercise, hot yoga isn’t for everyone. Hot yoga is not suggested for those who are pregnant or have a heart condition. The heat can also aggravate asthma.

Sauer recommends looking out for side effects such as dizziness, lightheadedness and not being able to take a deep breath in. “If that happens, return to a stable position or leave the studio until you feel better,” she says. “It’s important to stay hydrated and listen to your body.”

Think you’re ready to give it a shot?

When it comes to hot yoga — try attending a few basic or beginner yoga classes first. Then when you feel comfortable, try incorporating a heated class.   

Here’s how to find the best yoga class for you.

“There are different styles of yoga, so if you try a class that doesn’t appeal to you, try another type of yoga or a different instructor,” Sauer says. “The heat isn’t for everyone — and that’s perfectly OK!”

Cleveland Clinic: How to get back to sleep and why it’s so important:

cleveland back to sleep

Your bed should be a place of relaxation and rejuvenation. But if you’re having trouble sleeping, that’s likely not the case.

Not only can not sleeping be frustrating, but getting a good night’s sleep is vital to maintaining your overall health and mental well-being. Seven or more hours of quality sleep each night recharges your body physically, but can also help flush toxins from your brain and allow your mind to fully rest — which assist in your mental alertness, decision-making, and overall clarity the next day.  And if you’re sick, your brain needs to be in tip-top shape to help you recover.

That’s why sleep expert Nancy Foldvary-Schaefer, DO, says you should do everything you can to address any sleep issues you’re experiencing.

Different ways your sleep can be interrupted

Besides external influences like recurring noises (from a crying infant to a snoring partner) or travel-related time changes that keep you up at night, sleep deprivation may come in many other forms.

“For example, some people experience chronic insomnia — a sleep disorder in which you have trouble falling and/or staying asleep,” Dr. Foldvary-Schaefer says. “Others may experience cycles of waking up but not being able to get back to sleep.“

And sometimes, even if you’re able to fall asleep but were focused on unresolved issues or worries right before you closed your eyes — this may affect the quality of sleep you actually achieve. “You may find yourself groggy in the morning or feeling tired, cranky or unproductive,” Dr. Foldvary-Schaefer says. “Also, a lack of sleep can affect your judgement and emotional response to otherwise normal daily activities.”

How stress can affect your sleep

Many of us tend to bring our daily stress to bed with us — which is exactly the place it doesn’t belong. It’s not easy to leave stress at the end of your day. But keeping these stressful thoughts in focus right before sleep can definitely prevent you from getting some good shuteye.

“This is something you should try to avoid whenever possible, as it can cause a variety of sleep problems,” Dr. Foldvary-Schaefer notes. “It may take practice, but committing to stress-reduction behaviors at the end of your day is very important. The more active you are in kicking stress out of bed each night, the more likely your overall sleep quality will improve.”

How to de-stress before bed

You may not be aware that bringing stress to bed could be causing a negative cycle to form. If you have trouble falling asleep, the longer you lie awake, the more aggravated you may become. Soon you may unknowingly associate your bed as a place of discomfort, rather than one of comfort. The key is to remove any negative association with your sleep space by forming healthy pre-sleep habits. Dr. Foldvary-Schaefer offers these tips for developing better pre-sleep practices:

  • Plan for tomorrow earlier in the evening — Carve out time each night before or after dinner to “wrap up” your thoughts about the last 24 hours. Plotting out your next day well before bedtime can help you check that “planning box” early enough to give yourself time to transition and quiet your mind before bed.
  • Get up if you’re not asleep after 20 minutes — It may be a good idea to take your frustrations to a different room and leave them there — literally. A short walk will get your brain actively focused on motor coordination, rather than worrying. Write down what’s on your mind on a piece of paper and revisit it in the morning. You’ll return to bed anticipating a fresh perspective in the morning (a best practice, anyway) — and leave your bedroom as your special place to rest and relax.
  • Develop your pre-sleep ritual — Take a walk after dinner to catch a sunset, take a long bath or enjoy a nightly cup of caffeine-free herbal tea.
  • Avoid overstimulation — Avoid not eating, working, or browsing a screen of any kind in bed. Reading a book off-screen may help, or enjoying a relaxing playlist to give your mind something to connect with, but not be overstimulated by.
  • Practice yoga or meditation — Closing your eyes, practice simple mindfulness, awareness or concentrated focus on your breathing for five minutes. This can help your body and mind relax — and transition  you to a more restful sleep.

If trying some of the strategies above to reduce or manage your stress aren’t helping your insomnia, cognitive behavioral therapy (or CBT-i) might be a good option.

“CBTi is a structured program that helps you identify and replace thoughts and behaviors that cause (or worsen) sleep problems with new habits and thought patterns that promote healthy sleep,” explains sleep expert Michelle Drerup, PsyD.

“CBTi is offered by trained specialists nationwide, including at many larger hospitals or academic medical centers,” Dr. Drerup adds. “There are also several online programs, such as Cleveland Clinic’s Go! to Sleep program.”

Illness may be the reason you can’t sleep

A lack of sleep may also indicate a variety of sleep disorders or other health concerns that need to be addressed with proper medical diagnosis and treatment. Once your medical conditions are treated, you may eventually see your sleep improve.

Underlying medical conditions that may prevent you from sleeping include:

  •  Chronic pain.
  •  Acid reflux.
  •  Restless legs syndrome (RLS).
  •  Sleep apnea (in both men and women).
  •  Hormonal changes caused by menopause.
  •  Narcolepsy.
  •  Diabetes.
  •  Night terrors.
  •  Sleepwalking.
  •  Depression.
  •  Common issues related to aging.

“If any of these are the case, you likely won’t sleep comfortably through the night until the problem is identified and properly treated by a knowledgeable primary care physician or specialist,” Dr. Foldvary-Schaefer says.

Make sure you keep track of symptoms you are experiencing, and tell your doctor about them as soon as possible. Your primary care physician may explore your sleep history and/or give you a physical examination. This could include examining your upper airway muscles, for example. If sleep apnea is suspected, you may be referred to a sleep disorders center for a comprehensive sleep study. Or you may be suffering from other conditions that could result in treatments like short-term hormone replacement therapy, antidepressants or other kinds of medicines — all which depend upon proper diagnosis.

Be aware and stay proactive 

Overall, the key to getting better sleep comes from first identifying your sleepless activity, reducing your stress before you hit your bed, and talking with your doctor if you notice other symptoms — so you can get back on track to a good night’s sleep.

If You’re Having Trouble Sleeping, Here’s What To Do