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TasGirevik

Bad backs and joints

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What you need to know!

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Reaching for the cure

Kettlebells fix bad backs ("The kettlebell beats the drudgery of conventional low back rehabilitation,typically floor or mat exercises and machinery")

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Fully repaired back

Your Spine

 

Like a stack of bricks , each resting on a sponge , held together by ligaments and guyed by numerous short and long muscles/tendons , this structure is highly complex . The spine is supremely adjustable according to static load and moving forces. It allows upright walking and directs forces as limbs are moved . In the modern world we spend too much time poorly aligned , head forward , shoulders rounded and lower back arched. Coupled with a lack of abdominal tone this results in tight muscles , inflexibility  , malaligned gummed up joints and pain. Everything is “forward”, tending towards the "foetal" position. Coupled with excessive tension in the back muscles ( caused by cumulative life stresses , emotional and physical ) this eventually causes the hunched posture and stiff movement typical of old age. However , recognising these factors enables us to correct the deficiencies and overcome chronic bad posture . Even significant deformities and imbalances can be corrected. However , postural and movement patterns tend to be habitual hence constant , lifelong practise is required to keep the spine healthily aligned and fully mobile.

 

The sitting posture , "ergonomic" or not , causes a pattern of tight hamstrings and hip flexors , a tilted pelvis with either excessive or insufficient lumbar curve (lordosis), and usually a dgree of twist (scoliosis) .Even in an ergonomic workplace  , prolonged sitting or standing  causes a buildup of tension and often , activation of trigger points in tight / weak muscles.

 

Rehabilitation requires ongoing commitment to proper balanced posture and what has been termed scrambling the day to prevent badly patterned movement. Stretching and strengthening the hip flexors , hamstrings and back muscles will ameliorate existing and recurring  problems. A kettlebell can in many instances be incorporated into the office environment.As a “prop” it acts as a constant reminder to take a break and stretch/strengthen. It is a brilliant instant stress buster - sending your adrenaline and muscle stress into oblivion!

 

The spine is also tremendously resilient and versatile if used correctly. It is capable if trained of bearing huge loads and can move in a wide range of positions. With a correctly conditioned spine ,  forward bending and round back lifting  under load is NOT contraindicated and indeed a necessary movement to master to prevent pain and injury in a host of activities eg gardening , moving shopping bags and small children etc etc. In general though , bending  and especially twisting backwards under load is not recommended , though correctly executed yoga backbends are tremendously beneficial in creating space between the vertebrae and balancing the stabilising muscles. Due to activation of both stabilising (tonic) and moving (phasic) muscles, Kettlebells promote a strong , flexible and balanced spine capable of withstanding tremendous force in real world situations.

 

 

Bad backs

 

In most cases this results from imbalances acquired though prolonged sitting , work injuries and lack of exercise. The final state is tight and weak hip flexors and hamstrings, weak glutes and abdominals and often hypertonic back extensors – Kettlebells and appropriate dynamic stretches will in most cases fix these problems fast, regardless of perceived “incurability”..

 

 

Joints, muscles and the nervous system

 

Proprioception

 

This terms refers to “joint position sense” a sophisticated pathway whereby the brain can automatically and subconsciously compensate for changes in movement. It underscores all movement and when compromised through injury (anywhere from the central nervous system (brain & spinal cord) down to specialised receptors around the joints) such movement is rendered less efficient resulting in further injury or reduced efficiency. As an example , certain diseases which attack the nervous system (classically seen in late stage syphilis) result in “neuropathic’ joints with severe osteoarthritis and limb deformities.

 

By testing balance under load and in various positions , kettlebells reinforce proprioception and are especially beneficial for rehabilitation e.g. of sprained ankles, bad shoulders and in older people.

 

Joint stability & mobility

 

Joints range from the tiny to the big ; some are assigned minor adjustment duties (eg the facet joints in the spinal column allow rotational movements) whilst others are required to move limbs through a broad range (e.g. elbow/knee and shoulder/hip joints). With increased range of movement comes reduced stability – the shoulder is the classic example of a joint with tremendous potential e.g. it enables you to scratch anywhere! But it is inherently unstable. Joint stability requires strong gristle - connective tissue capsules, ligaments and tendons. Also required is a balanced and strong muscular system to prevent uneven loading of the joint surface . Where the system is out of kilter , the joint may sublux (slip a little) or at worst dislocate (complete separation of the joint surfaces). Where there has been a previous injury e.g. a dislocation , that joint is especially vulnerable to subsequent stresses.As the body becomes older , connective tissue becomes less elastic hence there is a need to compensate by building stronger connective tissue (collagen) – and the way to do this is by repeatedly applying load to the joints.

 

Joint mobility refers to the ability of the joint to move freely through its required ROM. This is not only dependent upon the health of the supporting/moving tissues but on the state of the lining surface (cartilage) and the presence of synovial fluid. Essentially the latter “oils” the joint and the synovium (a membrane enclosing the joint) provides the lubricant. Importantly ,this also brings nutrition into the area and removes wastes such as traumatised cartilage or sometimes blood if there has been significant trauma..

 

As one becomes older,  the synovium becomes less active , and as muscles stiffen up through accumulation of trigger points (see below) and maybe scar tissue, so too the joints become more “sticky “,  and in the case of small joints can become locked by surface tension. In order to slow or prevent this process , it is essential to “oil up the joints” daily to keep things moving. If you open a door fully every day , even with rusty hinges the door will continue to function until it “rusts out”. Therein the  fallacy of not moving a stiff joint “because it might damage it further”.  That is a joint destined for ongoing degeneration.

 

Joint mobility exercises  , which are essentially forms of calisthenics along the lines of  tai chi & flowing yoga poses ,  keep all the joints healthy. As a rule,  you need to do more of these as you age. If the joint is sore / tight , it needs more repetitions , done carefully and if necessary spread throughout the day. To do nothing because of soreness is inviting increased disability. True , an acutely injured joint may be sore but is it is vital to restore movement rapidly to allow synovial fluid to circulate , and prevent ankylosis , the process whereby joints become stiff, fibrosed (scar tissue) and eventually immobile.

 

 According to  Drs. Verkhoshansky and Siff, "…joints subjected to heavy impact are relatively free of osteoarthritis in old age and those subjected to much lower loading experience a greater incidence of osteoarthritis and cartilage fibrillation… It appears that the cartilages of joints subjected to regular impulsive loading with relatively high contact stresses is mechanically much stiffer and better adapted to withstand the exceptional loading of running and jumping than the softer cartilage associated with low loading.  Thus, joint cartilage subjected to regular repetitive loading remains healthy and copes very well with impulsive loads, whereas cartilage that is heavily loaded infrequently softens… the collagen network loses its cohesion and the cartilage deteriorates (Swanepoel, 1998)." 

 

An excellent joint mobility dvd can be purchased here :

 

http://www.dragondoor.com/b16.html

FURTHER READING : Warning ! Technical section...

Osteoarthritis in detail

A scientific Powerpoint presentation on cartilage & joints

Connective tissue : Structure & Function