All posts in Conditions

Benign Prostate Hyperplasia (BPH)

By the time you are 60 years old — if you’re a man — there’s a fifty-fifty chance that you’ll be suffering from an enlarged prostate. If you live long enough, your chances climb to 90%.

An enlarged prostate — a condition called benign prostate hyperplasia (BPH), is a non-cancerous swelling of the prostate. As your prostate begins to swell, you’ll typically feel the urge to make more frequent trips to the bathroom, your urine stream could be weak, and you’ll have a hard time finishing, you’ll probable dribble more than usual.

An enlarged prostate can also interfere with your sex life and your overall quality of life. Often an enlarged prostate is a symptom of a hormone imbalance in part due to testosterone and estrogen imbalances. A process called aromatization causes testosterone to be converted to estrogen, triggering both male breast development and/or prostate problems. Most doctors take a ‘watch-and-wait’ approach to an enlarged prostate. They figure if it doesn’t grow too fast and the symptoms don’t become too severe, then it’s something you can live with. If the symptoms get worse and become unmanageable, then the next option they recommend is surgery.

This is not the approach I recommend for my clients. There are many intelligent options and steps to try prior to recommending surgery. In fact, you can begin treating your enlarged prostate right away. Many of the same steps you take now for an enlarged prostate can also protect you from prostate cancer in the future — an unrelated condition. Natural approaches can be successful in relieving a lot of the symptoms that come with an enlarged prostate.
Caring for an Enlarged Prostate…

How to Slow Its Growth and Keep it From Becoming a BIG Problem

Most doctors chalk up an enlarged prostate to a natural part of the aging process. And that’s why they feel comfortable taking a hands-off approach until things get real bad!
This pro-active strategy is part of a therapeutic lifestyle change that improves the quality of your life and has the added bonus of cutting your risks of cancer. So, just how do you keep your prostate from growing out-of-control?

I emphasize a proper diet as a major to help prostate health. This involves a low carbohydrate diet. It’s also important that you be physically active. Daily physical activity helps. Research shows that men who get the most exercise reduce their risks of an enlarged prostate by 40%. Increasing your metabolism and preventing muscle wasting (especially of type II muscle fiber) by strength training is very helpful. Doing only cardio aerobics won’t help muscle from wasting, in fact it may add to it. Resistance exercise is the key.

The way to stop/reverse, or outright prevent poor quality testosterone build up, is by doing resistance training with bodyweight exercise, free weights, kettlebells, bands, or cables – I do not recommend weight machines because these do not resemble real life movements. Weight machines limit motion and enhance loss of flexibility. Where in real life are you sitting down and pushing weights other than in a gym? You might call the combination of diet and resistance training Prostate Fitness.

Most people don’t want to do or stay committed to the fitness portion. We’ve been brainwashed into using food as medicine, as a substitute for pills and potions, and that alone will do it for us. Don’t be lazy! Put a demand on your endocrine system so that testosterone is being used. Thirty minutes of high intensity weight training four-six times a week will restore your manliness.

Once you start eating right and taking care of your embodiment, many ailments/problems start to disappear – and instead of a swollen prostate, a new healthy guy comes to life.

The diet must include cruciferous vegetables like broccoli, cauliflower, or cabbage five to six times a week. Snacks that are high in zinc and magnesium are also beneficial to your prostate.

Higher levels of estradiol promote prostate enlargement and getting that under control reduces the problem. For some men, the problem is that testosterone gets converted to estradiol, especially if testosterone replacement uses patches or creams – less so with injections. The life extension foundation, while not mentioning prostate issues specifically, notes after a review of almost all the literature on estradiol that estradiol is best in men when it is within the 20-30 ng/ml range. Lower levels and higher levels than 20-30 ng/ml leads to a greater incidence of stroke, heart problems, bone thinning and other issues. The lab reference range goes from 0 to 50 or so.

Additionally, having high or low estradiol leads to Erectile Dysfunction (ED), depression, anxiety, lethargy, low motivation and a whole host of other problems that one’s doctor is prone to prescribe a wide range of drugs instead of testosterone replacement. Most often men require supplements to prevent Testosterone from converting to estradiol.

Some Physicians hold that DHT (5-alpha diHydroxyTestosterone) is the culprit of prostate health. Areas of the body rich in hair follicles are also rich in 5-alpha reductase, the enzyme producing DHT. That conversion can be thwarted by means of half doses of OTC progesterone (found in the menopause section of natural food stores).
Supplements
Supplements I recommend can be ordered on my website by clicking onto the Metagenics website.

Testralin is designed and intended for daily, ongoing support of the prostate gland and to balance hormones in aging males (40 years and older). In terms of mechanism of action:

– The vitamins and minerals in the formula (for example Vitamin B6, B12, and folic acid) support liver enzymes involved in hormone detoxification.
– The isoflavones and lignans support sex hormone binding globulin (SHBG) production and sensitivity.
– Isoflavones also have an inhibitory effect on 5-alpha reductase, the enzyme in the prostate that converts testosterone to 5-alpha dihydrotestosterone, the main prostatic androgen. Furthermore, isoflavones are also known to inhibit aromatase activity, the enzyme in adipose tissue that converts androgens to estrogens. Lastly, according to the article attached, since prostate cancers and BPH specimens can express estrogen receptors, their growth may also be inhibited by the antiestrogenic effects of isoflavones.
– Turmeric serves as an anti-inflammatory and the green tea catechins are powerful antioxidants that protect tissues from oxidative stress.

Tribulus Synergy (aka puncture vine) has traditionally been used (literally for more than 1000 years) as an aphrodisiac for males. It has recently been used as a performance enhancer by some former Eastern block countries. While the mechanism is not really known, it is felt that Tribulus Synergy decreases testosterone clearance as opposed to directly stimulating its production.

Ashwagandha, also referred to as “Indian Ginseng,” has also been traditionally used as a “tonic” for men. Finally, cowage/mucuna contains natural L-dopa, a side-effect of which is spontaneous erection.

Thus, the rationale for using Tribulus Synergy is more philosophical and in line with the traditional use of these herbs contained in the formula. While Tribulus has very controversial documentation in western literature, it is one of the oldest herbs in Traditional Chinese Medicine and is well respected in that circle.

1. Tribulus.
“… In castrated rats, increases in [testosterone] levels by 51% and 25% were observed with [testosterone] and [tribulus] extract respectively that were statistically significant. [Tribulus] increases some of the sex hormones, possibly due to the presence of protodioscin in the extract. [Tribulus] may be useful in mild to moderate cases of ED…” Phytomedicine. 2008 Jan;15(1-2):44-54. The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction–an evaluation using primates, rabbit and rat. Gauthaman et al.
2. Ashwagandha.
“…Withania somnifera, popularly known as Ashwagandha is widely considered as the Indian ginseng. In Ayurveda, it is classified as a rasayana (rejuvenation) and expected to promote physical and mental health, rejuvenate the body in debilitated conditions and increase longevity…” Prog Neuropsychopharmacol Biol Psychiatry. 2007 Sep 21 Withania somnifera: An Indian ginseng. Kulkarni et al.
3. Mucuna.
“…Mucuna pruriens possesses significantly higher antiparkinson activity compared with levodopa in the 6-hydroxydopamine (6-OHDA) lesioned rat model of Parkinson’s disease…” Phytother Res. 2004 Sep;18(9):706-12. Neuroprotective effects of the antiparkinson drug Mucuna pruriens. Manyam et al.

“…From animal research, there is ample evidence for a facilitating effect of dopamine on sexual behavior…These results support the view that dopamine is involved in the energetic aspects of appetitive sexual behavior in men…” Neuropsychopharmacology. 2005 Jan;30(1):173-83. Effect of a single dose of levodopa on sexual response in men and women. Both et al.

Other supplements often recommended are Nettle root (not leaf). This is a very good supplement to take if you’re suffering from benign prostate enlargement. Nettle inhibits the Aromatase and 5-Alpha Reductase enzymes that cause enlargement of the prostate, and it inhibits the binding of DHT to the prostate cells. Just don’t overdo it…take too much, or take it too often, and you’ll experience a reduction in your testosterone levels.

Vitamin D3 is particularly important for prostate health and the higher ones blood serum levels, the lower the chance of prostate problems including cancer.

I hope this helps!

Dr. Jeffrey Tucker

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Damaged skin question

Hi Dr. Tucker. I spent a lot of time in the sun and have abused my skin over the years. What vitamins or supplements should I take to help my skin look better?

The skin is the largest organ of your body. Most of the time, the body does a pretty good job of healing your skin from scorched sun, cuts, scuffs, and scratches.

Poor, abused skin can get healthier, but it needs to start on the inside. Make sure you drink plenty of water everyday.

A German research team recruited 45 healthy women between the ages of 18 and 65 and divided them into three groups. For 12 weeks, one group received a daily flaxseed oil supplement, one group received a daily borage oil supplement, and one group received a placebo. Before the intervention began, nicotinate was applied to each subject’s skin to prompt reddening and inflammation.

Results: Compared to baseline, flaxseed oil was most successful in reducing skin reddening and blood flow, while significantly increasing hydration. Borage oil prompted similar results, but not as significant as flaxseed oil. Except for a slight improvement in hydration, there was no change in skin condition in the placebo group.

I recommend a product from Metagenics called Omega-EFA. It contains alpha-linolenic acid – an omega-3 fatty acid which should help your skin.

OMEGA-EFA™
Natural Lemon Flavor
• Supplies a balance of omega-3s (EPA & DHA) from cold-water fish and omega-6 (GLA) from borage seed oil
• Supports cardiovascular health and healthy neurological function
• Features a natural lemon flavor to promote patient compliance
Each Softgel Supplies:
Natural Marine Concentrate …………………………….500 mg
EPA (Eicosapentaenoic Acid) …………………………….155 mg
DHA (Docosahexaenoic Acid) …………………………..120 mg
Other Omega-3 Fatty Acids ……………………………… 40 mg
Borage Oil …………………………500 mg
GLA (Gamma-Linoleic Acid) ………………………………90 mg
Other Omega-6 Fatty Acids …………………………….150 mg
Other Ingredients: Natural lemon flavor, rosemary extract, ascorbyl palmitate, and natural mixed tocopherols.

References
1. Curtis CL, Rees SG, Cramp J, et al. Effects of n-3 fatty acids on cartilage metabolism. Proc Nutr Soc 2002;61(3):381-89.
2. Harris WS, Park Y, Isley WL. Cardio-vascular disease and long-chain omega-3 fatty acids. Curr Opin Lipidol 2003;14(1):9-14.
3. Belluzzi A, Brignola C, Campieri M, et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn’s disease. N Engl J Med 1996;3334(24):1557-60.
4. Helland IB, Smith L, Saarem K, et al. Maternal supplementation with very long-chain n-3 fatty acids during pregnancy and lactation augments children’s IQ at 4 years of age. Pediatrics 2003;111(1):e39-e44.
5. Lombard CB.What is the role of food in preventing depression and improving mood, performance and cognitive function? Med J Aust 2000;173(Suppl):S104-S05.

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Do I Have Temporomandibular Joint (TMJ) Disorder?

TMJ is a collective term for a broad range of disorders displaying a variety of signs – radiating pain in the face, neck, or shoulders; limited movement or locking of the jaw; painful clicking or grating when opening or closing the mouth; and a significant change in the way the upper and lower teeth fit together. Other common symptoms include headaches, earaches, dizziness, hearing problems, and difficulty swallowing.

The Jaw Symptom Questionnaire consists of the following questions:

? Does it hurt when you open wide to yawn?
? Does it hurt when you chew or use the
jaws?
? Does it hurt when you’re not chewing or
using the jaws?
? Is your pain worse upon waking?
? Do you have pain in front of the ear, or
earaches?
? Do you have jaw muscle or cheek pain?
? Do you have pain in the temples?
? Do you have pain or soreness in the teeth?
? Do your jaws make noise so that it
bothers you or others?
? Do you find it difficult to open your mouth
wide?
? Does your jaw ever get stuck/lock as you
open it?
? Does your jaw ever lock open so that you
cannot close it?
? Is your bite uncomfortable?

In my experience if a patient answers more than three of the above questions they will benefit by education, an anti-inflammatory home care program including dietary changes, nutritional supplements, heat or ice applications, avoidance of mechanically stressful activities, and resting the jaw (practice the “lips apart and jaws relaxed” procedure).

In office treatment that I provide include: warm laser, soft-tissue therapy and specific muscle massage. I also train clients in corrective exercise therapy.

General Nutrition for TM Disorders

• EC Matrixx™ is a mechanism-specific formula designed to support healthy connective tissues by supporting the extracellular matrix, a key structural component of connective tissues such as tendons, ligaments, and cartilage. Features berberine and tetrahydro iso-alpha acids (THIAA), which have been shown in laboratory research to influence MMP-13, an enzyme involved in the maintenance of connective tissue structure.
THIAA has also been shown to beneficially influence multiple cellular signaling processes related to connective tissue health.
Supports biochemical processes that influence the health of the extracellular
matrix.
• Chondro-Relief Intensive Care — 3-6 capsules daily with food. Joint & soft tissue support with MSM, Green Lipped Mussel, Hyaluronic Acid and ASU.
• Inflavonoid Intensive Care — 3-9 tablets daily with meals. For relief of minor pain.
• E-Complex 1:1 — 2-4 softgels daily. 1:1 ratio of alpha and gamma tocopheryls.

Order at www.DrJeffreyTucker.meta-ehealth.com

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LASER TREATMENT

Dr. Tucker says “One of the major goals of my treatment is to increase the blood flow and oxygen content to the tissues and that helps to reduce pain”. Cells and tissues that have a poor blood supply and low oxygen content as a result of inflammation, swelling/edema, and injury have been shown to have a significantly higher response to warm laser therapy than normal healthy structures.
Applicable conditions of laser therapy
1. Low back pain
2. Wound healing
3. Dermatological conditions
4. Temporo-mandibular Joint Dysfunction
5. Frontal and maxillary sinus inflammation
6. Rotator Cuff injuries
7. Epicondylitis (elbow pain)
8. Small joints of the hands
9. Trigeminal Neuralgia
10. Bell’s Palsy
11. Neck pain

Laser is used for sports injury, back problems, neurological conditions, wound/post surgical healing, fracture healing, Carpal Tunnel Syndrome, soft tissue therapy, wounds, burns, arthritis, strains, tendonitis, temporary increase in local blood circulation, relief of minor muscle & joint aches, pain & stiffness, relaxation of muscles, & muscle spasms.

Laser therapy has been shown to: stimulate cell growth; increase cell metabolism; improve cell regeneration; produce an anti-inflammatory response; produce an edema (swelling) reduction; reduce fibrous (scar) tissue formation; stimulate nerve function; reduce the production of substance P (a pain producing chemical); stimulate long-term production of nitric oxide; decrease the formation of bradikynin, histamine and acetylcholine (painful chemicals); and stimulate the production of endorphins. Dr. Tucker finds “These responses are responsible for the pain-relieving effects often observed in patients treated with laser therapy”.
Tucker says, “Laser therapy influence the cells at the molecular level to improve healing”. The result is rapid regeneration, normalization and healing of damaged cellular tissue. This painless warm light therapy is a trigger for improving metabolism.
Dr. Tucker uses class IV laser therapy approved by the FDA with the highest wavelength for deeper penetration. Penetration is paramount in order to stimulate deep musculoskeletal, vascular, lymphatic and neurological structures.
He uses the top healing and pain reduction modalities available today. Dr. Tucker’s unique treatments not only include laser therapy, he also uses the Deep Muscle Stimulator (DMS), exercise therapy and First Line Therapy nutritional recommendations.
“The most common musculoskeletal conditions I treat are neck pain and low-back pain”. The most common generators of pain in the cervical regions are the zygapophyseal joints of the neck in acute (traumatic) and chronic neck pain conditions. Several authors have reported the most common tissue of pain origin in the low back to be the outer layer of the disc. Given that the depth of these painful structures lies below multiple layers of muscle and fascia, Tucker uses a therapeutic laser device that has the ability to penetrate multiple layers of tissue.
Treatment plans include:
• Sports Medicine Laser Therapy.
• Painless laser therapy sessions (You must feel it to see why).
• Specialized plans for chronic pain relief.
• Deep Muscle Stimulator (DMS) massage.
• Exclusive 30-minutes sessions directly with Dr. Tucker.
• No long term commitment treatment plans. You can be done with care.
• Specialized Corrective Exercise Training.
• Myofascial Trigger Point Therapy for misdiagnosed pain.
• Nutritional & weight loss advice.
• Performance Enhancement.
What is High Power Deep Tissue Laser Therapy?
Laser Therapy is a non-invasive, safe, and effective treatment modality where light is used to relieve pain, reduce inflammation, and promote wound healing and soft tissue repair. Most therapy lasers on the market today have a power range from 5mw to 500mw, making them a cold laser. Our laser will emit a power range from 1000mw to 10,000mw, making this a high-power heat deep tissue laser that can put an end to your pain fast!

You get better FAST!

How is the treatment done?
The laser is placed in contact with the skin allowing the healing energy to penetrate tissue, where it interacts with various intracellular bio-molecules resulting in the restoration of normal cell function. This also enhances the body’s natural healing processes. In essence, light energy is converted into biochemical energy.

The result; normal cell functions are restored. The process results in a disappearance of symptoms and increases the speed at which your body heals.

Other Effects; the immune system response is stimulated, lymphatic drainage is improved, production of growth hormone is increased, & the body’s natural healing process are enhanced.

FAQ’s

What does laser therapy have over other forms of therapy?
It does not require the use of drugs or surgery, there are less side effects or risks, and it is quick and convenient. Studies have shown that it is equal to or more effective than other forms of physical therapy. Pain relief is often immediate.

Does it hurt? What does the treatment feel like?
There is a warm heat sensation during treatment. Clients work with me to make sure the temperature is not too hot. There is no pain associated with the treatment. Laser treatment is relaxing and you welcome to ‘dose off’ during the session or we can talk during the session. Occasionally it occurs that pain can increase or begin 6-24 hours after a treatment session. This is because the laser light starts the healing process. This type of pain is particularly likely to arise when the health problems are chronic in their nature. It usually subsides after a few days but can, in rare cases, last longer.

How long does the treatment take?
The typical course of treatment is 10-20 minutes, depending on the size of the area being treated. Acute conditions may be treated daily, particularly if they are accompanied by significant pain. More chronic problems respond better when treatments are received 2 to 3 times a week. Treatment plans are determined on an individual basis.

How many treatments does it take?
This depends on the nature of the condition being treated. For some acute conditions, 3 to 6 treatments may be sufficient. More chronic conditions may require 6-12 sessions. Conditions such as severe arthritis may require ongoing periodic care to control pain.

How long before results are felt?
You may feel improvement in your condition (usually pain reduction) after the very first treatment. Each treatment is cumulative and results are often felt after 2 to 4 sessions. If you don’t notice relief with the laser, I will add the Deep Muscle Stimulator (DMS) to your therapy. Depending on your condition I may start with the DMS first.

Are the results long lasting?
Therapeutic Laser Therapy is about healing. It’s not about masking or covering up a condition. When you feel better from this therapy… it’s because you are better. Therefore results have been found to be quite long lasting.

Can it be used in conjunction with other forms of treatment?
Yes, laser therapy is even more effective when combined with other forms of therapy, including physical therapy, chiropractic, massage, soft tissue mobilization, electrotherapy, and following surgery. I combine our warm laser therapy with specialized corrective exercise techniques to relieve your pain fast!

Is it a cold laser treatment?
NO! Our laser is a Class-4 Deep Tissue Laser with much deeper penetrating power. No cold laser on the market today can come close to the fast-acting therapeutic effects of our Class-4 device. Chronic pain relief and hard-to-fix cases are my specialty. I have many patient’s who have tried cold laser therapy with no success and with just ONE Class IV heat laser treatment they start feeling better. All lasers are not the same.

How do I know if laser therapy is right for me?
I will evaluate your condition and perform a complete functional examination to determine if you are a candidate for this procedure. Call us to schedule your evaluation and Q&A session. The only way to know is to try a course of therapy.

Can laser therapy be used over medical implants or over metal?
Yes, laser therapy is a light treatment. No heating is involved with the surgical or metal implants. It can be used safely with no side effects. It is extremely effective for post-operative wound healing. Many hip and knee replacement patients see us for care.

Is it covered by medical insurance?
Some insurance covers the procedure, but not many. Most patients who decide to receive the benefits of laser therapy are sick and tired of being sick and tired, so they choose to seek this effective method of treatment on their own. Price is usually not a consideration when you have been suffering for so long.

The average course of therapy in our facility is just 10 visits. Other facilities with cold lasers can reach 20 or more visits. So you get better faster, which saves you money on additional insurance co-pays and deductibles.

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Functional Exercises: Hamstring Stretching for Low Back Pain

by Jeffrey H. Tucker, DC, DACRB

The sun salutation in yoga is where you begin by standing on your mat with your feet together (toes and ankles touching) and your arms by your sides. Lengthen your spine upwards from the tip of the tailbone to the crown of your head. Inhale deeply. Exhale and bring the hands together in the prayer position. Inhale as you stretch your arms up beside your head, lengthening and arching your spine. Exhale and bend forward, hinging from the hips, with your arms stretched out in front. Place your hands flat on the mat beside each foot, bending your knees if you have to. Try to bring your forehead to your knees. STOP right here. The sun salutation continues on with other maneuvers, but I want to talk about the toe-touching portion. It’s this maneuver, whether during a yoga class, bending over in the shower or picking up an object on the floor that can cause so much trouble for our lower backs.

A forward bend does not require straight legs. The key is to aim for a perfect hinge from your hips no matter how straight you can press your legs. If you can touch the floor but the spine is bowing to achieve this, you leave the hip hinge open and the stress is carried in the back and knees. Short hamstrings are common and the body compensates for this restriction by increasing motion in the lumbar spine. In normal functional movement, the brain and central nervous system (CNS) have a variety of strategies available to perform any functional task or movement. During functional bending-forward movements, a relatively stiffer hamstring muscle tends to resist ideal movement, but function is maintained by excessively increasing lumbar spine flexion range. This is what is called “compensation.”

It’s not unusual for a person with tight hamstrings to compensate with resultant lengthening or overstrain of the lower lumbar spinal extensor muscles (lumbar spinalis and superficial multifidus). Once the lumbar spine has developed abnormal compensatory motion, the stabilizing muscles and supporting structures (e.g., ligaments) around the lumbar joints become too flexible, more lax or provide insufficient stiffness or resistance to motion. These joints are now poorly controlled by the muscles. This can cause pain in the low back region with daily activities and unguarded movements, as well as sitting, standing and lying postures.

The lumbar spine may be more flexible relative to the hips in flexion due to lengthened erector spinae and shortened hamstrings. The muscles that control excessive lumbar flexion (lumbar erector spinae) have more give than the muscles that limit hip flexion (hamstrings). In summary, if you repeatedly bend forward with tight hamstrings, the lumbar spine may give more easily than the hips. Excessive flexion will occur in the lumbar spine relative to the amount and timing of flexion at the hip joints. This results in compensatory lumbar flexion and potential lumbar spine instability.

A lumbar flexion instability does not require that muscle or connective-tissue structures are tight or short (e.g., hamstrings in the lumbar flexion dysfunction), although you may have a sense of the hamstrings being tight. It does matter that the hamstrings are less flexible and have less give than the muscles at the site of greater relative flexibility or those designed to control dysfunction (erector spinae). Likewise, it does not require that muscle or connective- tissue structures be weak at the site of greatest relative flexibility or overstrain (e.g., abdominals in the lumbar extension dysfunction). It only requires that they have more give or are functionally longer than the muscles at the adjacent segment (hip flexors), which may be very strong or short.

The hamstrings seem to have a clear function. They produce range-of-joint movement (flex the knee joint and extend the hip). The hamstrings are an eccentric resistor of knee extension in sprinting. Correcting the length of the hamstring may be important while simultaneously strengthening the lumbar region. The following procedures are not to be done if your low back is in the inflammatory stage.

Self Test: Bend over and try to place fingers or palms to the floor. Measure the distance of the middle fingers from the floor. Benchmark is the ability to have palms flat on the floor.

Dysfunction: Not able to touch fingers to the floor; you feel discomfort or pain in the low back; or your thoracic spine or lumbar spine are bowing, with the hip hinge wide open.

Solution: Think of a belt lifting the hips up and elongating the spine. Push your heels down and push your bottom up. Stretch the hamstrings with the back locked. Practice separating the tailbone from the chin while hinging at the hips.

Self Test: Bend over and try to place fingers or palms on the floor.

Dysfunction: The thoracic spine and the hamstrings feel tight.

Solution: Practice bending over at the hip hinge with outstretched arms over your head while simultaneously maximally tightening and squeezing the buttocks (gluteals) and fists (keep the arms outstretched). Continue bending over at the hip hinge, fists and buttocks as tight as possible, for eight seconds. Release the tension but don’t come back up yet. Repeat the squeezing of the glutes and fists for eight seconds. Practice this maneuver with your buttocks against a wall and then continue to get lower and farther away from the wall. Try to isolate the hamstring muscle and belly, not the attachments behind the knees. Repeat this maneuver five to seven times.

Self Test: You look at your posture and see that the thoracic spine is rounded. Your normal posture has rounded shoulders.

Dysfunction: You have restricted thoracic spine motion or you have kyphosis (loss of the normal spinal curvature).

Solution #1: Release the knotted tight tissue, joints or adhesions along the spine by lying on a foam roller and putting pressure on the knots for 20-30 seconds while breathing. Do this daily for five to 10 minutes.

After this, lie down on your stomach with your hands and arms along the sides of your body (palms up). Lift up the head, shoulders and torso as high as you can toward the ceiling. Build up to the same number of repetitions as your age.

Solution #2: Practice squats while facing a wall. Stand close to the wall so your nose almost touches it; try to move your feet closer and closer to the wall. Keep the feet straight forward, allowing the movement to occur in the hips and lengthening the spine.

To stretch the back and the hamstring: Use the bow maneuver. While the back is at 90 degrees, pry one hand to the opposite heel; keep prying side to side. An important principle of stretch is to spread the load. You can go further with less stress. Repeat the original toe-touch test.

Still can’t put your palms on the floor?

Solution #1: Thoracolumbar spine post-isometric relaxation (PIR): This definitely will allow the client to bend further in the toe touch. This maneuver requires two people.

  • The client bends over with proper mechanics at the hips (push the heels down and the bottom up). Remind the person to “spread the load.”
  • Tell them to keep their weight even from the toes to the heels.
  • Place both flat palms on the client’s lower thoracic spine.
  • Ask the client to lift the thoracolumbar region, initiating from the hips and elongating the spine (think tailbone-to-chin). Resist the client’s upward movement for approximately eight seconds. You are not pushing down; you are resisting their upward movement. You do not have to be heavy-handed to give the client’s back a nice release and stretch.
  • Have the client release the upward push and simply follow them downward (lower).
  • The client stays in the new lower position and repeats the process three to five times.

Solution #2: Long-sitting partner stretch with post-isometric relaxation (PIR) technique: This maneuver requires three people. One is the person being stretched and two assistants. Two people face each other on the floor. The third person is sitting back-to-back with the person being stretched. The client’s legs are straight in the long-sitting pose. The client must hinge in the middle. The first assistant’s legs are straddled to the outside of the client’s legs. The second assistant is gently leaning against the client’s back to prevent them from leaning backward.

The first assistant takes hold of the client’s wrists in a monkey grip. The client leans forward as if they were folding, hinging from the hips, lengthening the lower spine out of the hips, making the stomach as long as possible and bringing the back as close to parallel to the floor as possible. The first assistant leans backward taking out the slack in the arms. The client is using muscles to actively extend the spine and lengthen the back of the legs, moving them forward. Remind the client to keep the arms straight and “stretch the back, breathing into the tailbone.” Keep the head in alignment with the spine. The weight of both assistants supports the stretch. Repeat this maneuver three to five times, using the principles of PIR. To come out of the stretch, the client can bend their knees slightly as they come upright.

Resources

  1. Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthopaedica Scandinavia, 1989;230(60):20-4.
  2. Cholewicki J, McGill S. Mechanical stability in the vivo lumbar spine: implications for injury and chronic low back pain. Clinical Biomechanics, 1996;11(1):1-15.
  3. Comerford M. Lumbo-pelvic Stability. Course notes. 2003 and 2006 Copyright Comerford.
  4. Hodges P. Transversus abdominus and lumbar multifidus muscle. Course notes. 2002 Copyright Hodges.
  5. Tsatsouline, Pavel. Stretch Course. 2007 Copyright Tsatsouline.
  6. Vermeil A. Sports & Fitness. Course notes. 2005 Copyright Vermeil.
  7. All the coaches and sports-medicine scientists who have shared their knowledge with me.
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