FOHAC News Bracing to Life #222

Published: Sun, 11/03/13

Fair Oaks Health News

Welcome

November 3, 2013

Bracing to Life

Hi ,

I spent last weekend in a seminar reviewing all the new research on spinal stability and rehabilitation. I like to take this particular seminar every couple years to keep up to date on all the new research in my field. Some of that research has direct application in what I recommend to my patients for care. So much of what we learned in school was based on tradition, and not actual studies about what actually works. The biggest piece I want to share today has to do with bracing.

For the last 40 years a lot of research has gone into trying to find just what exercises do the best job of rebuilding the spine after an episode of pain. The first question was whether exercise is even of any value. Over the years that question was studied intensely and the consensus is that exercise is absolutely vital to achieve long term recovery. Exercise is not recommended during the acute phase of recovery. Adjustments and more passive physical therapy modalities are used during this phase and they are shown to be quite effective. But after the first four weeks of care, furth

er recovery is greatly improved by the addition of specific types of therapeutic exercise. And when you recheck patients after 6 months and after a year, those that did not do exercise usually had much of their pain return. Only those who maintained their exercise program showed decreased pain and improved functionality.

A second finding that I have not addressed in my practice is the concept of maintenance care. I have always run an "emergency care" type practice where I tell people to come in when they have symptoms. Maintenance care is a big concept in Chiropractic, but one I never saw any hard data from studies to justify the extra care. Well now there is such data, and from sources that were not funded by Chiropractors. Measuring pain and functional capacity, those who got regular maintenance care did much better than those who only treated when they had symptoms. With such hard data to reckon with I will have to change my stance on the subject of maintenance care.

Now let me get on to the subject of bracing. When exercise was studied for recovery and rehabilitation of spinal injuries, it was found that most of the exercises that were traditionally recommended were either of no value or actually made the injury worse. We have all seen these exercises, usually as a tear-off sheet given to us by some doctor. The idea was a good one and the exercises made logical sense, but the body is complex far beyond our logical understandings. It was not until long-term studies were done on the outcomes of these exercises on very large numbers of people that the truth was revealed. The technology had to be developed and used to study exactly what muscles were involved in supporting the spine and during what types of activities. Most of the old exercises focused on the large movement muscles of the spine. Strengthening these muscles is not what an injured spine needs. The spine needs strong stabilizer muscles to recover. These are muscles that hold the spine steady, not muscles that move the spine. The spine needs to be rock steady strong. Our lifting muscles should be the big leg muscles, not the back muscles.

A startling bit of research mentioned last weekend had to do with the cause of low back disc problems. Scientists actually measured the pressure inside the discs of healthy adult men. They found that just bending forward increased the pressure in the disc 450%. The back only bends 11 degrees. All the rest of the bend happens at the hips. Just bending forward causes enough pressure to "blow out" a disc. The research says that a disc only has so many bends in it before cracks start to appear in the inner layers

and the central disc gel starts to push out between the layers. Eventually the gel will push all the way out and give you a herniated disc. Here is the kicker - after sitting for 10 minutes we start to slouch causing the low back to bend about 7 degrees on average. That will push up the pressure in the disc 250% to 300%. Eventually just sitting will do the same thing bending forward does to the disc. This is why we have so many back problems today. The average American spends 80% of their day sitting. This is not good.

So what is the best thing we can do to fight this problem? Obviously not sitting so much is a good start. Never bend at the waist. Always flex at the hips when reaching for anything at floor level. Don't even bend forward over the sink when you brush your teeth. I can't tell you how many times I have heard a patient tell me how their back went out while they were simply brushing their teeth. But the most proactive thing we can do to help prevent the problem in the first place is bracing.

What is bracing? Bracing is tightening and strengthening the muscles all the way around your waist. The most important muscles are the transverse abs that wrap sideways around your waist forming a girdle. The next most important are the multifidi muscles in close to your spine that go up and down your spine. And the third most important are the ab muscles in the front of the stomach. Actually there are over 20 muscles that form the core stabilizers around your middle designed to stabilize your spine.

Stabilize is a key concept here. These muscles are not for movement. If your middle is moving, these muscles are turned off, leaving you vulnerable to injury. That means the traditional sit-ups and spinal twists are out. Those are exactly the wrong exercises I mentioned earlier from the tear-out sheets that doctors have been handing out forever. There was a misguided idea that since the back muscles would spasm when in pain that what they must need is to be stretched out...wrong! The back needs to be stronger, not more flexible. Spasming is a protective measure to stabilize the spine with the big movement muscles when the smaller stabilizer muscles were not able to do their job. Fixing the pain and spasm is about getting the stabilizer muscles to do their job, not about stretching out the tight muscles trying to protect you.

How can you tune in to what bracing feels like? First put your right hand over the muscles of the right low back. Now go to raise your left arm. Before your left arm even moves the low back muscles on the right side tighten up to brace the right low back from the uneven pull on the back that happens when you raise the opposite side arm. Feel how that muscle tightens up. If your back muscle does not tighten up then you have dysfunctional motor control of your low back and really need to do this bracing exercise a lot. Now imagine someone was going to punch you in the gut and you had to tighten your gut to prevent injury. Feel the gut muscle tension. This is bracing. You want the muscles on your sides to tighten as much as the muscles in the front. You also want the muscles along the spine to tighten at the same time. Do not tighten up super hard, just moderately and hold for 6 to 9 seconds. You want to be able to still do a good deep belly breath while bracing the trunk muscles.

Bracing the core trunk muscles is paramount to building a strong back. Practice this hundreds of times a day. Every time you go to sit down, brace first. When you want to stand up, brace first then stand. If you reach out your arm for any reason, brace first. The idea is to train your body to automatically brace any time you do anything. When I prescribe any rehabilitative exercise, you want to brace while doing the exercise. I have been telling this to patients that I have put on the Foundation exercises - brace the whole trunk while you are in the foundation posture exercise.

My plan is to incorporate more exercise rehab training into my practice. The evidence is clear - long-term functionality requires regular spinal stabilizer strength training. We have to get up out of our chairs and move more. Sitting is killing us. In fact a fun little bit of info a patient passed on to me this week is that studies show that sitting for a job is as dangerous to your health as smoking. One study is quoted as saying that every hour of sitting is as dangerous as smoking one cigarette. I am encouraged by many of my patients that have switched to standing desks for their work. Now just get them to stand on balance pads barefoot to build foot and knee stabilization and we will really have a health boost.

What is the message today - brace those core muscles every chance you get. This is a lifetime prescription. You will need this every day of the rest of your life, so get into it!

Take care,

David

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On the Wire

Walking cuts breast

cancer risk

A study that followed 73000 women for 17 years has shown that walking seven hours a week significantly reduced their risk for developing breast cancer. Since exercise is critical for health in general, it is good to be able to measure specific benefits to simple exercise that are meaningful to average folks.

Walking

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"If money is your hope for independence, you will never have it."
~ Henry Ford

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Obesity kills more Americans than previously thought

For people born between 1915 and 1919 obesity was responsible for only 3.5% of deaths. Since that time the rate has climbed to over 18% of deaths for blacks and whites between the ages of 40 and 80. This is just the tip of the iceberg as the rates of obesity have been going up steadily. Amongst the young obesity has become the norm, so these stats will only get worse each year. Every fat cell is a little factory for inflammation that attacks all the other tissues of your body. Loosing the gut is a lot more than a beauty issue.

Obesity

"Can anything be so elegant as to have few wants, and to serve them one's self? "
~ Ralph Waldo Emerson

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Low dietary fiber increases cardiovascular risk

It has been known for a long time that dietary fiber helps to reduce inflammation, metabolic syndrome, obesity, and cardiovascular risk from lab studies. Now large scale population studies show that the lab data is right. Those people who eat the lowest amounts of dietary fiber do indeed have the highest rates of heart disease and all the rest. So eat your fiber. Vegetable fibers and fibers from things like flax, chia, and coconut are the best as most folks have some degree of trouble with grains and therefore grain fibers.

Fiber

"No one can build his security upon the nobleness of another person. "

~ Willa Cather

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Our address is 9725 Fair Oaks Blvd.

Finding the new location is very easy. Coming from highway 50 up Sunrise Blvd, you turn left and go up a block. We are on the right hand side - the building just past the Subway Sandwich shop. If you are coming down Sunrise from the Mall area then just turn right on Fair Oaks Blvd and up a block on the right.

If you are coming from the Roseville area you could come down Sunrise Blvd, but that is a long trek. It is probably shorter time wise to come down Auburn Blvd - San Juan Ave like you have been for the Sunset office, but instead of turning left at Sunset, keep going straight 3 more lights to Fair Oaks Blvd and turn left. Go down 2 lights to New York Ave, go through the intersection, and immediately turn into the turn lane once the center divider ends. We are on the left.

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About Dr. DeLapp

Dr. DeLapp has been a philosopher, non-force Chiropractor, medical intuitive, and health innovator for over 30 years. He began experimenting with medical intuition in 1972 while studying physics at UC Davis. In addition to physics he designed and completed an individual major in the philosophy and psychology of education. Shortly after he choose to pursue a career in the only truly health oriented profession available at that time, Chiropractic. He graduated with honors in 1981 with his doctorate and opened a private practice.
Since that time he has continued his research into the effects of consciousness and learning on health.
He developed the Biomagnetic Retraining system for correcting movement abnormalities.
Since 1991 he has focused on developing a powerful system for uncovering and assisting the mind-body connection in health and personal growth. The in-depth coaching, guided by the subconscious direction from the body, is called Heartflow and the simpler mind-body retraining for health and unfoldment he has named Gracework. Both are available at Fair Oaks Health.

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