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Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain Fully Updated and Revised

Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain Fully Updated and Revised

by Vijay Vad M.D., Peter Occhiogrosso
Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain Fully Updated and Revised

Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain Fully Updated and Revised

by Vijay Vad M.D., Peter Occhiogrosso


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The classic program for relieving back pain, revised and updated with the latest innovations in treating pain and maintaining mobility.
Dr. Vijay Vad’s Back Rx program has helped readers with back pain, joint pain, arthritis, and related conditions for decades, using a clinically proven mind-body regimen to reduce pain and painkiller usage. In this expanded edition, Dr. Vad explores the extraordinary innovations in managing pain to restore health and wellness not only to your back, but to your entire body.
In addition to the stretches that are the touchstone of the program, Back Rx includes new information on

   • The best overall eating regimen for back pain sufferers, including new guidance on the science of Intermittent Fasting (IF).
   • Exercise, including high-intensity interval training (HIIT).
   • The use of medical marijuana and CBD oil (cannabidiol) to relieve back pain.
   • The safest way to use over-the-counter anti-inflammatory and analgesic drugs, such as ibuprofen and acetaminophen.
   • Developments in ergonomics, from furniture to clothes.
   • An assessment of the future of back pain relief, including the latest advances in stem cell treatment and electronic stimulation.
   • Introduction of the Back Rx app, a powerful self-help tool to enhance compliance and end your pain once and for all.

Including dozens of exercises and poses, all clearly demonstrated in precise photos, Back Rx will put the power to relieve back pain in your hands.

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Product Details

ISBN-13: 9781592400454
Publisher: Penguin Publishing Group
Publication date: 02/09/2004
Pages: 256
Sales rank: 253,766
Product dimensions: 7.00(w) x 8.97(h) x 0.61(d)
Age Range: 18 - 14 Years

About the Author

Vijay Vad, MD, is a sports medicine physician at the prestigious Hospital for Special Surgery and is on the faculty of Weill Cornell Medical College, both in New York City. His research focus is developing simple and effective solutions for back pain and arthritis. He is the former physician for the professional men’s tennis tour and Westchester Classic of the PGA tour. He is also the author of two PBS national television specials, “Stop Back Pain” and “Active with Arthritis.”

Peter Occhiogrosso has been the author or coauthor of more than twenty books on subjects ranging from spirituality to world religions to pain relief, three of which have become New York Times bestsellers. He previously collaborated with Dr. Van on the books Arthritis Rx and Stop Pain.

Read an Excerpt

If youÆre hurting now, skip ahead to page xvii for some simple ways to ease the pain. Come back to read these pages when youÆre feeling better. In order to make a full and lasting recovery from low back pain, you must first understand what causes it.
Low back injuries usually heal within weeks, a testament to the backÆs inherent strength and resilience. But long-term healing is notoriously difficult to achieve. One episode of low back pain generally leads to another. Four out of five people will suffer a recurrence within one year, and then face a 70û80% risk of further recurrences. The right treatment can make all the difference between healing completely, building a more injury-resistant and resilient back in the process, and falling into a downward spiral of recurrent injury that defeats every measure of conventional and alternative care and leads to failed back syndrome, long-term dependency on pain medication, and even surgery. That downward spiral traps far too many low back pain sufferers.

IÆve had to heal my own low back pain. So I write this book both as a physician and as a fellow sufferer. The Back Rx program enabled me to beat my low back pain for good. And it has helped thousands of patients I see in my sports medicine practice and research at the Hospital for Special Surgery, an affiliate of Cornell University Medical Center in New York, where I also serve on the faculty as a professor. Back Rx achieves these results by blending carefully selected elements of rehabilitation, yoga, and Pilates with a central focus on breath control. It is one of the few exercise programs for the low back to be shown effective in controlled clinical trials.

In an ongoing study, my research colleagues and I are monitoring the progress of two groups of low back patients who receive the same medical care and take the same pain medication, except that one group does the Back Rx program for fifteen minutes three times a week. At the end of the first year, the group doing Back Rx had a 70% success/cure rate (as measured by a more than 50% reduction in low back pain), whereas the other group had only a 33% success/cure rate. The group doing Back Rx also needed much less pain medication and had significantly less recurrence of back pain than the other group.

Building on the work of many other low back pain researchers and clinicians at the Hospital for Special Surgery and elsewhere, my research and clinical practice have demonstrated that an exercise program like Back Rx can be the key to healing low back pain without surgery or long-term dependence on medication.
The study I conducted found that the players most susceptible to low back pain had the least range of motion in the hips. In 2001 the PGA asked me to do a parallel study of professional golfers. This study produced the same results, showing a significant link between a restricted range of motion in the hips and the incidence of low back pain. This finding is important for the rest of us, whether we are fitter than average or committed couch potatoes, because of the sedentary nature of modern life and work. Sitting in chairs, which most of us do for long hours every day at work, school, and home, leads inexorably to a restricted range of motion in the hips.

The Back Rx program accordingly features exercises specifically designed to counteract this tendency and increase the range of motion in the hips.
A number of books have emphasized the mindÆs role in low back pain in a conceptual way, without offering reliable, concrete methods for putting the concept to practical use. The way one recent book puts it is typical: to heal low back pain, it tells readers vaguely, ôlearn to work with your negative feelings.ö Negative feelings from stressful experiences can indeed hinder full recovery and heighten recurrences. But healing low back pain begins not with psychotherapy, but with mind-body physiotherapy. You have to engage the mind at the fundamental level of body awareness, posture, and balance first. These three fundamentals form the essential foundation for healing the whole person.

Back Rx meets this challenge and teaches you how to engage the mind in healing through its focus on breath control, a key feature of both yoga and Pilates.

In my sports medicine and back care practice, my research on low back pain, and my own efforts to lead a healthy lifestyle, IÆve gained an increasing appreciation for the benefits of yoga and Pilates. Yoga, which I first learned to do at my grandfatherÆs side as a young child in India, engages the entire body in healthy breathing, while freeing the mind to focus without distraction or anxiety on anything it needs to do. This age-old practice has a mind-body potential that the latest neuroscience is only beginning to understand. For its part Pilates, whose founder, Joseph Pilates, was greatly influenced by his study of yoga, is the best strengthening practice yet developed for the core body musclesùof the torso, back, abdomen, pelvis, and thighsùthat are crucial to good back health.

The paradox is that although yoga and Pilates are ultimately the best possible way to maximize back health, in the short run the vigorous twists, turns, and bends of advanced yoga and Pilates can actually cause back injuries. ItÆs quite a catch-22: the very thing that can help you the most can very easily hurt you.

Back Rx solves this problem with a carefully sequenced introduction of yoga- and Pilates-based movements and poses that will strengthen the back without traumatizing it. From the first step on, this sequence of medical yoga and medical Pilates addresses the body and mind together by showing you how to find and follow your natural breathing rhythm. The slow, sustained, deep, gentle breathing of Back Rx helps you in two ways. It automatically clears and refocuses the mind, and thus begins to melt away emotional and mental stress without any direct mental effort or concentration. And it tunes the body, so that each deepening breath progressively relaxes and conditions injured or atrophied muscles.

There are three series of Back Rx exercises to heal and strengthen your back. Each series takes fifteen minutes to complete and should be done three times a week for eight weeks on average. Series A alone will get you moving pain-free again after an acute low back injury. Many patients maintain good long-term back health by continuing to do Series A regularly, without moving on to Series B or C.

For those who want to raise their back fitness for sports and recreational enjoyment or as a stress-, injury-, and age-fighter, however, Series B offers a vigorous back toning routine and Series C provides a strenuous core body workout.
The more relaxed your breathing becomes, the less pain you will feel. As you become better able to focus on your breathing for a few minutes at a time, you will also prepare your mind and body to work together in the rest of your healing.
The free and easy movement of childhood is everyoneÆs birthright, but most of us have lost it by the time we are adults. That doesnÆt have to happen. And if we do lose the joy of movement, we can almost always regain it.

One of the most important things to know about the low back is that a high level of pain does not necessarily indicate severe damage. The pain of a low back injury can be worse than a root canal without an anesthetic, but even the most painful injuries seldom pose any serious threat to the spine or brain. The vital parts of the body are simply too well protected for that, except in the most extreme cases. So donÆt lose hope or fear the worst because the pain is bad. If you follow the pain-relief guidelines on pages xviiûxx and do the exercises in this book for fifteen minutes, three times a week, the odds of a full and lasting recovery are overwhelmingly in your favor.

The human back is so robust because of the way its intricately interwoven parts reinforce each other. The backÆs function is to support balanced movement and posture and to protect the nerve bundles within the spinal cord. These nerves, the bodyÆs information superhighway, carry electrical impulses to and from the brain, where the impulses are translated into sensations, images, emotions, and thoughts.

The back does its job with a hardy structure of bones, muscles, tendons, and ligaments. Layers of muscleùthirty-one muscles tie into the pelvis aloneùwrap protectively around the spine, which makes a gentle S-curve from the neck to the tailbone, or coccyx. The spine has twenty-four vertebrae separated and cushioned by the intervertebral discs, which are shock absorbing, doughnut-shaped pads made up of a soft inner portion, the nucleus pulposus, and a hard outer portion, the annulus.

There are seven cervical, or neck, vertebrae (commonly referred to as C1-C7, counting from top to bottom); twelve thoracic, or chest vertebrae (T1-T12); and five lumbar, or lower back, vertebrae (L1-L5). If a physician or other caregiver diagnoses a low back problem located at disc levels L4-L5, for example, this means that the focal point of the injury is in the area of the fourth and fifth lumbar vertebrae and the disc sandwiched between them.

All of the vertebrae have small projections called facet joints that stabilize the spine and allow it to move in different planes.

Below the fifth lumbar vertebra is the sacrum, a triangular-shaped bone with five segments (S1-S5) that attach to the pelvis (or ilium) to form the sacroiliac joints. Together with the bodyÆs core muscles, the backÆs S-curve can gently dissipate the energy of harsh impacts or sudden, wrenching movements like a giant spring, and the fluid that fills the soft inner portion of the discs can absorb shocks better than any other known substance. That is, as long as we maintain them in good shape.

At birth the discs are 80% water. As we age, they gradually lose water, stiffen, and turn brittle. Nothing can entirely stop this natural aging process. But as IÆll explain in Chapter 4, proper back exercises can be a great age-fighter, dramatically retarding the discsÆ loss of water and keeping us flexible and resilient.
As I mentioned in the introduction, one muscle imbalance that tends to be especially significant for low back pain is the poor flexion and reduced range of motion in the hips, which results from too much sitting in chairs. In Chapter 2, weÆll look more closely at how chair-sitting upsets the bodyÆs natural balances and how we can restore them.
Proprioception underlies all of our body awareness. With good proprioception, we sense intuitively when our bodies are in proper alignment and we instinctively walk and move with good posture and balance. This helps the back by enabling the discs to breathe. Like the rest of the body, the discs depend on the circulatory system to bring them essential, nourishing oxygen. Blood vessels at their periphery are the final stage of this delivery system, so far as the discs are concerned.

Walking in balanced alignment with good posture pumps a steady, ample flow of oxygen to the discs with the rhythmic muscular contraction and expansion of every step. By contrast, our modern chair-bound lifestyles cramp the discs into a stressed position and starve them of oxygen for hours at a stretch. This not only weakens abdominal and back muscles and reduces hip flexion and range of motion, it also inevitably degrades our proprioception and body awareness. With this degraded proprioceptionùa condition that being overweight, out of shape, or a smoker can worsenùwe walk and sit hunched over, straining our discs and back muscles with every movement without realizing it. As proprioception weakens, our brains lose the all-important ability to ôseeö ourselves accurately in space.

The mindÆs role in low back pain naturally extends to other levels of awareness. Stressful life experiences that agitate our minds and burden us with excessive anxiety, guilt, and other difficult feelings have long been known to be linked with low back pain. And a low back injury can easily trigger a pain-depression cycle that blocks recovery. Over time, an unbalanced state of mind can contribute to low back pain as much as, or more than, any other factor. The bottom line is that if we go too far off-kilter in any area where we need balanceùphysically, mentally, and/or emotionallyùwe face an increased risk of low back pain.

All things considered, there is no doubt that balance is the hallmark of a healthy back. When your back is truly in balance, all sorts of tasks become easier to do and life becomes physically, mentally, and emotionally less stressful. Our stress doesnÆt disappear by any means, but we become energetic and resilient enough to handle it and thrive. With that in mind, letÆs look at the mechanisms of low back pain and the specific ways in which the Back Rx program counteracts them, especially the healing power of doing the Back Rx exercises with proper breath control.
Being in good shape does not guarantee a pain-free back. Elite athletes are as vulnerable to low back injuries as the rest of the population. And just like the rest of us, the worldÆs best athletes can hurt themselves as easily taking out the trash as they can in competition. The sports pages regularly report on athletes who are sidelined by ruptured discs from a variety of causes.

A disc herniates when its soft inner portion, the nucleus pulposus, pushes out through a hole or tear in its tough outer portion, the anulus. Then leaking disc fluid can inflame surrounding tissues, a condition known as chemical radiculitis. If the herniated disc hits a nerve, it can send electric shocks of pain through the back, buttocks, and legs. Thereafter, because of the bodyÆs complex, interconnected structure, the pain can spread to seemingly unrelated areas, such as the neck, shoulders, middle and upper back, abdomen, hips, thighs, and even heels.

Because we felt fine right up until the moment when we turned in an awkward way, lifted a heavy box, sneezed, or bent down to pick up a pencil, we tend to think of that single event as being the one that caused our pain. But far more often than not, the lift or the sneeze is not the ultimate cause of the pain, but only the incident that triggers a painful reaction to accumulated physical, mental, and/or emotional stress and overuse. If you focus solely on the trigger incident, you risk putting your recovery on a shaky footing. If you look back further, youÆll usually recognize that prolonged stress has been making you feel increasingly vulnerable for some time. YouÆll see, too, that your body has been trying to signal you all alongùpossibly with subtle symptoms like tightening muscles, increasing tiredness, and minor achesùthat you need to slow down and relax a little. But youÆve been too wound up and distracted by daily obligations and worries to pay attention. Instead of listening to our bodies when injuries are small and can heal quickly, we tend to ignore them until they reach the breaking point.

No doctor can take away your stress. But if you learn how to listen to your body better, you can treat small injuries before they became big ones. You can even avoid injury entirely. In short, the most important treatment you receive for low back pain is not what others give you, but what you give yourself in the form of heightened self-awareness and better self-care.

Good habits of self-care build physical, mental, emotional, and spiritual resilience. In putting self-care front and center, however, I donÆt mean to suggest that you must heal your back pain all by yourself. Everyone can benefit from othersÆ help in healing. When I hurt my own back, I looked for care and help from others at home and in the doctorÆs office. In Chapter 3 and Chapter 11 IÆll explain how physicians and other caregivers can help you heal your back. But I canÆt overemphasize that proper self-careùlike the Back Rx programùis the foundation for all healing from low back pain.
Try it for a while, and youÆll see. The sooner you feel a telltale strain in your hips, the more vulnerable your back is to injury.

By contrast, sitting in chairs disengages some of these core body elements and puts enormous strain on others. As I mentioned in the introduction, my research indicates that chair-sitting contributes to measurable deficits in hip flexion and range of motion, even in highly conditioned professional athletes. Worst of all, chair-sitting maximizes pressure on the discs and decreases their oxygen supply.

Remember, the discs breathe by taking in oxygen from blood vessels at their periphery. But we suffocate our discs by sitting in chairs too often and for too long. We sit in chairs, in a disc-freezing posture, even when weÆre ôrelaxing,ö while watching television, surfing the Internet, reading, or playing a video game.

It would be a saving grace if we at least walked from one daily activity to another. Instead we sit down in chairs to travel in trains, planes, and automobiles. Most car manufacturers now describe their car seats as ergonomic. Luxury car makers, in particular, like to boast about their body-friendly seats. Unfortunately, even an ergonomic car seat will not significantly reduce disc pressure. The basic chair-sitting posture defeats every ergonomic tweak that the car companies devise.

Back health is much better in the Third World, where many people still grow up sitting cross-legged on the ground or floor and walking from one activity to another, and where relatively few people spend their workdays in a desk chair. In the Third World, backs breathe better.
These three Magnetic Resonance Imaging (MRI) scans (Figures 3û5) show the discs at three stages of the life cycle. The first shows a young personÆs healthy, well-hydrated discs. The second shows a middle-aged personÆs discs with dehydration under way and a herniation of the disc at L4ûL5. In the last, age-related stenosis is beginning to become problematic.

Fortunately, proper exercise that increases the backÆs flexibility, strength, and endurance, and thus makes good balance and posture possible, can dramatically retard these natural aging processes and moderate their effects.

The bottom line is that low back pain needs a recovery program that will give first aid to injured muscles and discs; tune up poorly developed muscles and tendons in our hips; and help us learn to listen to our bodies to enhance proprioception and body awareness throughout the life cycle. Back Rx treats both sides of this complicated mind-body puzzle. Its combination of physical therapy exercises with medical adaptations of yoga and Pilates can reset the balance between core muscle groups. At the same time, its calming breath control can reset the balance between the body and the mind.

Now letÆs look closely at how Back Rx can help you progress successfully through every stage of low back pain care and recovery.

Chapter three The Four Stages of Low Back Pain Care and Recovery
Stage I care is for just about everyone with low back pain. It involves a sequenced combination of rest, medications (anti-inflammatories, muscle relaxants, and pain relievers as needed), heat and ice, and gentle rehabilitative exercise. Back Rx is a comprehensive program of Stage I care.

This first stage of care can resolve 80% or more of all low back problems. It should not be bypassed or curtailed, unless surgery is indicated as described on page 17. When other treatments are tried, Back Rx or a similar program of Stage I care should almost always be continued, or resumed as soon as possible afterward, in order to realize their full benefits.

Stage I care may be complemented by traditional physical therapy, osteopathy, medical massage, chiropractic, acupuncture, or some combination of these. For more information on these treatments and how to decide if theyÆre right for you, see the rest of this chapter and Chapter 11.
The potential for such complications is frightening, and in the immediate aftermath of back injury or reinjury, when the pain is overwhelming, it can be hard not to fear the worst. But once again, please remember that almost all low back pain sufferers can achieve a full and lasting recovery with a sound program of Stage I care like Back Rx, especially if they have the right caregivers in their corner.
The specialist physicians most often involved in low back care are physiatrists, neurologists, anesthesiologists, orthopedic surgeons, and neurosurgeons. Except for physiatrists, specialist M.D.s do not participate much in Stage I care. In later stages of care, a neurologist can be helpful if a person is suffering from foot drop or other signs of neurological weakness. If it becomes necessary to explore surgical interventions such as a discectomy, orthopedic surgeons and neurosurgeons with fellowship training in spinal surgery have state-of-the-art spinal surgical skills. They also have the expertise to offer informed second opinions on prospective surgery. In cases of ongoing severe pain, especially pain that persists after surgery, anesthesiologists with pain management fellowship training should be consulted.

The first consultations with specialist physicians should occur within six months of injury, if possible. After six months, healing becomes a lot harder and the prognosis for full recovery from a low back problem becomes less favorable.
All things considered, in the event of a low back problem you should probably turn first to your present primary care physician and his or her referral network. Someone who knows you and your medical history, and whom you trust and feel comfortable with, has a better chance of getting your recovery in high gear quickly and managing it smoothly than a doctor who is meeting you for the first time.

If you do need to find a doctor from scratch, whether a general practitioner or a specialist, the best way to find any good caregiver is through word-of-mouth recommendations from people you trust. You can also learn about different medical specialties and find referrals on the websites of physiciansÆ groups. At the end of the book youÆll find an appendix with a list of organizations and websites that can help you with your search.
Granted that, and granted that equally good healers can have very different credentials, you want to make sure that the caregivers you go to have the appropriate credentials for their different fields. Keep in mind that whereas conventional medicine regularly tests its practices in controlled studies, most of integrated medicine has not yet been documented with the same rigor. Of the common alternatives to conventional medical care for the low back, only massage therapy and osteopathy have so far been proven effective in clinical trials. There is other, if less rigorous, medical evidence for the value of acupuncture and chiropractic, however, and I have seen many patients helped by each of them.

To find a good practitioner of one of these treatments, ask around. Personal recommendations from people you know and trust are the best way to find a good healer. After that you have to follow your instincts. Everyone is different, and every case of low back pain is different. As long as you are making an informed choice, you should feel free to pick and choose the therapies that seem best suited to your individual needs, perspective, and lifestyle. The proof is then in the pudding. A therapy may be very appealing for one reason or another, and it may help other people. But if it doesnÆt help you over the course of a few weeks or months, you should abandon it and move on to something else. As with conventional medical care, you should try to find the right integrated medical care for your case within six months of your injury. After that point, healing becomes much harder, no matter what the treatment is.

IÆll have more to say about these varied treatment options in Chapter 11. Here I would only caution that where chiropractic is concerned, you should not have any high-velocity manipulations of the head and neck. They can cause spinal cord injuries and strokes. ItÆs not a high risk, but why take the chance that youÆll be the one person in many thousands who is crippled or killed?
The array of potential treatments for low back pain is enormous. Conventional medicine, osteopathy, physical therapy, massage, acupuncture, and chiropractic can all benefit people with low back injuries, but in my experience, some are more effective at one stage of recovery than another. And at every stage of recovery, some of these things work better for some people than they do for others. Moreover, none of them can guarantee a cure. Good self-care can make all the difference, enabling you to leverage the power of the treatments you receive from others. Professional athletes can often heal astonishingly quickly, simply because of how well they have learned to listen to their bodies and how they are able to use their body knowledge to guide those who care for them.

At the core of what Back Rx teaches are habits of self-care and self-attunement that can ultimately transform your relationship with your body. Most of all, Back Rx trains you to tune clearly and surely into the stream of signals that the body is always processing. When you make a habit of listening to these signals on a regular basis, they tell you which muscles need stretching and strengthening and what the limit of the effort should be. They guide you to apply the gradually increasing, moderate stresses that aid healing, and to avoid the extreme stresses that retard it. The bodyÆs proprioceptive faculties also ôtellö you more and more accurately when you are in proper alignment and balance for any activity and when youÆre not, helping you to maintain the good posture and flowing movement that ultimately keep back injuries from occurring.

As you build a habit of listening to your body while you do the Back Rx exercises, you develop the ability to ôlistenö more and more at a subliminal level throughout the day, without the need for conscious attention. Eventually youÆll reach the point where you notice right away when stress and overuse are beginning to affect your back, and youÆll then be able to take proactive steps to moderate and even prevent episodes of low back pain before they occur. Ultimately youÆll become able to direct this sharpened mental focus and enhanced energy to boost your performance in every area of your life.

One of the best ways to help further this process, after the initial inflammation and severe pain of an acute injury have subsided, is through self-massage and partner massage. All healing needs the human touch, and none more so than low back pain. The first thing to realize about self-massage is that you canÆt hurt yourself. At most, if you really got carried away, you might give yourself a superficial bruise, but you canÆt exert enough pressure with your own unaided hands to damage anything below the skin level.

But if you canÆt apply enough pressure to hurt yourself more than a little bit, you can easily apply enough pressure to help yourself a lot. You can massage and manipulate your own body to a remarkable degree, if you do so with a sense of play and a willingness to experiment.

The way to start is to put your fingers or hands on the injured areas and rest them there for a moment. YouÆre about to get reacquainted with your bodyùyouÆve probably been injured so badly in the first place because youÆve literally lost proprioceptive touch with your bodyùand thereÆs no need to rush.

Now focus on your breathing. Slow it down. Exhale fully. Empty your lungs. Inhale slowly and deeply. Hold the breath for a count of three. Exhale slowly and continue the cycle for ten breaths.

As you rest your hands or fingers on the injured areas of your body and breathe in this slow, controlled, sustained way, your body will begin to tell you how it wants to be touched, rubbed, kneaded, pressed, and prodded into alignment. The knots in the muscle tissue that are keeping your body from relaxing into its natural alignment are bunched up around, and are themselves largely composed of, small sacs of water. As Rick Sharpel, a leading medical massage therapist in New York, puts it, ôMassage works by moving those tiny sacs of water so that they spread out smoothly along the entire length of the muscle, rather than being bunched up in the belly of the muscle.ö

Medical massage generally treats the belly of tight muscles by rubbing crosswaysù called cross-fiber massageùmore than lengthwise. You can use any part of the fingers, knuckles, hands, wrists, or forearms to do this. A massage therapist or a gentle, trusted partner might also use the elbows to apply sufficient steady pressure to reach and unkink severe muscle strains.

You can even use objects to do massage. There are many household objects you can use, from a solid doorjamb to a bag full of tennis or golf balls. Put a towel over the bag of golf balls or other objectùsome people even like to use a rock with a definite edge or pointù and then carefully lie down on the floor on your back. Rest your lower back on the object and begin to apply the pressure where and how your body says it helps. If you are doing some rehabilitation work at a gym or under the supervision of a therapist, you might also use an extra-large-diameter sports ball to lie back and roll around on.

The amount of pressure that you apply or a massage therapist applies is obviously a critical factor. As a general rule, the more relaxed you are, the more that steadily increasing pressure will be pleasurable rather than painful. But when massage therapy reaches the point of maximum tendernessùsome massage therapists call it the point of exquisite painùyou have to be willing to endure some increased short-term discomfort in the interest of better healing. This healthy stress is produced by slow, sustained, controlled movements and gradual increases in pressure to a point just below your pain threshold, not by sharp, stabbing actions or sharp, stabbing pain at or above that threshold."

Excerpted from "Back RX"
by .
Copyright © 2004 Hilary Hinzmann.
Excerpted by permission of Penguin Publishing Group.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents


Introduction: The Back Rx Way to a Healthy, Pain-Free Backxi
What to Do If You’re in Pain Right Nowxvii

Part one chapter one: How Your Back Works3
chapter two: Why Your Back Hurts9
chapter three: The Four Stages of Low Back Pain Care and Recovery15
chapter four: Flexibility, Strength, and Endurance: the Three Keys to Good Balance and Posture25
chapter five: Power Tips for Healthy Backs35
chapter six: Resuming Activity after a Low Back Injury51

Part two: Back Rx Series A, B, and C
chapter seven: Introduction: Doing the Back Rx Exercises57
chapter eight: Return to Movement: Back Rx Series A63
chapter nine: Resuming Full Activity: Back Rx Series B95
chapter ten: Into the Fast Lane: Back Rx Series C 119

Part three chapter eleven: Other Caregivers143
chapter twelve: State-of-the-Art Treatments and the Future of Low Back Care149
Appendix: Resources on the Web156

What People are Saying About This

From the Publisher

“After three months, the results have been striking: 80%… reported that their pain was reduced by at least half”—The Wall Street Journal

“[Dr. Vad’s] holistic approach can work for anyone willing to put in just a little time and positive thought.” —Ellen Barkin

“[His] innovative research on the professional tennis and golf tours and the practicality of Back Rx make it suitable for professional athletes and weekend warriors, as well as couch potatoes.” —Bill Norris, athletic trainer, Association of Tennis Professionals Circuit

Back Rx has been medically proven to have significant positive effect on low back pain caused by disc pathology.” —Don Aspergen, Sports Medicine Division, the PGA Tour and Senior PGA Tour

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