Yoga for Beginners (Yoga for Stress Relief / AM/PM Yoga for Beginners / Essential Yoga for Inflexible People)

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The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition

The first edition of this workbook is regarded as a classic in its field, and was the first book to introduce trigger point therapy to the general public as a self-care tool for alleviating chronic pain caused by a variety of conditions, including arthritis, back pain, carpal tunnel syndrome, fibromyalgia, headache, muscle ache, and repetitive strain injuries. As the author makes clear, all such conditions are related to lack of oxygen in exhausted or injured muscle tissue. Trigger point therapy has been used for decades by doctors, pain specialists, and massage therapists to quickly stimulate the flow of oxygen and promote rapid pain reduction. This book makes the same techniques available to the general public with instructions that are easy to follow, and abetted by an extensive collection of charts and corresponding illustrations.

The author?s interest in trigger point therapy began when he used it to successfully treat his frozen shoulder. Since that time, he has dedicated himself to teaching others the same techniques. That dedication is obvious throughout his writing and the care he takes to make the therapy understandable to the lay public. Also included in this new edition is updated information that should be of great interest to pain specialists and bodyworkers, as well as useful instruction in a variety of relaxation techniques. Overall, this book is an excellent self-care resource for anyone interested in pain relief.--Larry Trivieri Jr.

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Physical Therapy for the Lower Back: How to Prevent and Treat Lower Back Pain

Lower back pain is one of the most common causes of job-related disability and why some people miss work. It is also the second most common neurological ailment in the United States, second only to headache. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain.

For some fortunate people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, during which case the condition is termed as "chronic" and "progressive," meaning it can only grow worse over time.

Moreover, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year.

According to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are reflexively inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if patients do not feel pain and are able to return to normal activity levels.

As a result of the inhibition of these muscles, called lumbar multifidi and the transversus abdominus, lower back pain occurs. However, there are steps you can take to prevent the same thing from happening to you.

Lower Back Pain and Physical Therapy

One way to prevent the inhibition of the lumbar multifidi and transversus abdominus is through a series of physical therapy exercises.

Designed to strengthen the muscles of the lower back and keep the spine healthy, these physical therapy exercises may range from back stabilization exercises to muscle strength development and several wide variety of techniques.

In addition, a physical therapist may also recommend such methods as heat therapy, ultrasound, massage, mobilization, and education about posture and body mechanics in order to prevent lower back pain from recurring.

Some of these methods will be discussed later on. You will also find some practical self-help tips provided by experts to help you avoid lower back pain or prevent the condition from worsening.

However, before we head on to learning how lower back pain is treated through physical therapy, it is important that we first understand what causes lower back pain.

Lower Back Pain: CAUSES

There are actually many types of back pain, but the most common is pain in the lower back. Why? You might ask. The reason is simple: you carry most of your weight in the lower back. Thus, it is highly likely that a person would suffer pain in that area.

There is no definitive cause of lower back pain. Sometimes, the causes of the condition are so complex that it is difficult to pinpoint just a single one.

However, physical therapists and other healthcare professionals have observed that lower back pain is often a result of strained back muscles and ligaments due to any of the following activities:

o Improper posture

o Heavy lifting

o Sudden awkward movement

o Muscle spasm

o Stress

We could all be guilty of the above activities. We may not suffer any back pains now, but it is likely that as we get older and the degree of inhibition of the back muscles as a result of these activities increases, back pain becomes a very distinct possibility.

In addition to these common activities, lower back pain may also result from specific conditions, such as:

o Herniated disk (when the disk material presses on a nerve)

o Sciatica (when a herniated disk presses on the sciatic nerve. The condition causes sharp, shooting pain through the buttocks and the back of the leg.)

o Spinal stenosis (when the space around the spinal cord and nerve roots becomes narrow. This is caused by arthritis and bone overgrowth, the pain resulting from when a nerve gets pinched in the narrow space.)

o Spondylosis (a type of arthritis affecting the spine due to degenerative changes brought on by aging)

o Spondylolisthesis (when one vertebra in the spinal column slips forward over another)

Lower Back Pain: TREATMENT

The treatment of lower back pain depends on several factors, including the specific type of lower back pain (whether it is chronic or acute) and the purported cause.

For instance, acute lower back pain is commonly treated with pain relieving drugs, such as analgesics, or some forms of exercises that can help relax the muscles.

On the other hand, chronic back pain - or one that lasts for more than two weeks and is progressive - may be caused by some underlying condition, during which case the treatment plan may consist of resolving the underlying condition to treat the back pain.

Lower Back Pain and Physical Therapy Exercise

Physical therapy exercise is one of the most common methods of treating lower back pain. In fact, many home remedies for lower back pain consist of exercise, because the general theory is that if you remain active, you remain healthy. This is true in most cases.

However, for purposes of this article, the exercises featured here will be those that are practiced by physical therapists to treat patients with lower back pain.

Generally, in physical therapy exercises, the exercise program for back pain should encompass a set of stretching exercises, strengthening exercises, and low impact aerobics. Read below for more on these exercises:

-Stretching

The back of a person is composed of the spinal column and contiguous muscles, ligaments and tendons. All these are designed to move in consonance with each other so that any limitation in the range of motion in any of these components of the back result in back pain.

Stretching for lower back pain specifically targets soft tissues, such as muscles, ligaments and tendons, found in the back and around the spine. By stretching, the spine and soft tissues are mobilized, increasing motion and thus, relieving pain.

There are many kinds of stretching exercises employed by physical therapists. One is the Hamstring Stretching Exercise which works to relax tight hamstrings, a common symptom of lower back pain. This exercise is said to help decrease the intensity of lower back pain among sufferers.

-Strengthening

Physical therapists generally use two forms of strengthening and back pain relief exercises, usually depending on the specific condition of the patient. These are the McKenzie exercises and dynamic lumbar stabilization exercises. However, the two forms of strengthening exercises may also be combined should the therapist find it appropriate to do so.

-McKenzie Exercises

Named after a physical therapist in New Zealand, McKenzie exercises are primarily extension exercises that could help reduce pain generated from the disc space and also may help reduce the symptoms of herniated disc by reducing pressure on a nerve root.

For acute pain, the McKenzie exercises should be done frequently, at least once every two hours. In addition, patients are advised to avoid flexing their spine when exercising.

-Dynamic Lumbar Stabilization Exercises

Using this back exercise technique, the first thing that a physical therapist does is to look for the patient's "neutral" spine. This refers to the position that allows the patient to feel the most comfortable.

Afterwards, when the patient is in that position, the back muscles are then exercised in order to "teach" the spine how to stay in this position.

Performing these exercises on a regular basis can help strengthen the back muscles and keep the spine well-positioned.

Low Impact Aerobic Exercises

The purpose of low impact aerobic exercise is to recondition the back. Patients who undergo reconditioning of the back through low impact aerobic exercise will have fewer episodes of lower back pain.

In addition, whenever an episode of lower back pain does occur, the pain is less intense and lasts only for a short period.

Another benefit of low impact aerobic exercise is that patients tend to stay functional - that is, they can continue with their regular work and carry on with recreational activities. In contrast, patients who do not undergo low impact aerobic exercises typically experience the gradual loss of their functional abilities.

For low impact aerobic exercises to achieve their desired results, they should be continuous. This will increase the heart rate and keep it elevated as well as increase the production of endorphins, which are pain fighting hormones released by the body.

Here are some examples of low impact aerobic exercises that you may want to try in order to lessen or reduce lower back pain:

-Walking

One of the simplest forms of aerobic exercises, walking is generally considered as very gentle on the back. To get the maximum benefit from walking as a form of low impact aerobic exercise, walk two to three miles three times per week.

-Stationary Bicycling

This form of aerobic exercise is less painful on the back since there is lower impact produced. This is beneficial for patients with lower back pain who may find walking too painful.

-Water Therapy

Sometimes referred to as aquatherapy, water therapy is simply doing exercise in the water. The buoyancy works to provide effective conditioning at the same time stress on the back is reduced.

Nishanth Reddy is an author and publisher of many health related websites. Visit his website for more information about lower back pain relief and treatment methods. Learn different treatment methods used for back pain relief.

Lower Back Pain Relief

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Understanding and Overcoming Back Pain

According to the reports of the mass communications media, back pain afflicts eight out of ten of us sometime in our lives. That's old news.

You may have tried the traditional medical solutions -- strengthening, stretching, pillows, braces, a special bed, pain relievers, muscle relaxants, massage, exotic surgeries, or other approaches -- acupuncture, biofeedback, relaxation techniques. For the good these approaches do, many people still have back pain after treatment and expect to have to live with it. It's either that, dependence on ongoing therapy, or muscle-relaxant drugs, which nobody likes because they dull mental clarity.

There's been nothing better, until now.

From your own experience, you probably know that traditional therapies often produce only short-term, partial relief or require regular -- even lifelong -- care. But it need not be that way.

There is something better available -- a new discipline in the field of health care: clinical somatic education. Most back pain sufferers who resort to clinical somatic education should expect full recovery in a space of days or weeks.

Clinical somatic education is not education of the thinking mind, but of the brain as master control center for the muscular system. Clients rapidly improve their muscular control and freedom of movement through a mind-brain-movement training process. Clinical somatic education affects the brain the way biofeedback does, but with importance differences, one being speed of results and the other being the durability of the improvement. Changes are usually definitive and need no further professional help.

Clinical somatic education recovers fitness for the activities of daily living.

New Information on Back Pain

Somatic educators are likely tell you something unusual: your back muscles are not weak, but musclebound -- tight by habit, not by disease. You can free yourself from back spasms by improving your muscular control of your back; you can relax back spasms and have them stay relaxed with a few minutes of structured movements, each day -- which beats paying your [fill in your favorite therapist]. This statement applies as much to people with degenerative disc disease and herniated discs to those who have only a twinge, now and then. The underlying cause is the same: muscle tension.

"If that's true," you may ask, "why doesn't my doctor (or therapist) know about it?"

The answer is that until recently, no method existed that could rapidly improve muscular control rapidly enough to be clinically practical. Word takes time to spread and gain credibility.

You may think, "Back spasms are too painful, too serious to be dismissed that quickly, or that easily."

That's understandable -- but a misunderstanding of your situation.

Conventional Therapeutics and Back Muscle Spasms

Conventional treatment methods, as you already know, are not effective enough for many people. Most therapies try to strengthen, stretch, or adjust people out of back trouble by working on muscles or the skeletal system. But bones go where muscles pull them, the control center for the muscular system is the brain (not the therapist), and these approaches don't address the brain's control of muscle action, so the problem remains or returns. The problem isn't in your muscles; it's in your brain, the organ of learning and the center of long-term reflex actions, such as postural reflexes.

That's why the relief obtained by conventional therapeutic approaches to back spasms is usually temporary and you remains subject to re-injury and to prescribed limitations to movement.

Habits, including muscular tension habits, exist as patterns of brain programming. They're learned or acquired. Tension habits can be unlearned, and actually, relearning muscular control is the only approach that works for long term relief of back pain. You must overcome the reflexes that underlie back pain and gain control of your back muscles, to the degree of being able to relax them.

Medical doctors, chiropractors, physical therapists, osteopaths, and bodyworkers use predominantly manipulative methods. They mean well, but temporary or incomplete improvements are common; cures are rare.

Problems arising from muscle tension cannot be "cured" by manipulation because muscle tension is not a disease, but a habit maintained in the brain. Habits can't be "cured"; they can be changed through retraining.

A Correct Understanding of 'Strengthening and Stretching'

The idea behind the common "strengthening and stretching" regimen for back spasms is usually based on a misunderstanding; it's a misunderstanding because the muscles involved are almost never weak, but tired; it's a misunderstanding because the muscles involved are not "short" and in need of stretching, but "in contraction" and in need of relaxation. Sore muscles don't need strengthening; they need rest and refreshment. They don't need stretching; they need to relax and lengthen.

You need to regain your ability to relax, something you can't regain by being manipulated by someone else; you regain it by relearning to relax -- a form of learning, albeit a specialized one for which you will probably need training.

Back Muscle Spasms May be Painful, but Not Themselves an Injury

One of the automatic reactions of the body to injury is to tighten up. That's part of the pain of most injuries, particularly of musculo-skeletal injuries. It's a reaction that protects the body from further injury. There are cases where the tightening up of back muscles is such a protective reaction, and a necessary one -- where actual damage has occurred, such as a ruptured disc or a violent accident. In such situations, surgery may be necessary and somatic education will either not help or produce only temporary relief, at least until after surgery, unhappy news for some, but realistic.

If you've seen a doctor for your back spasms, he or she has either discovered that you need surgery or that you don't. Surgery is a last, desperate resort and most doctors are reluctant to recommend it. If you have been sent for therapy or given drugs, yours is not a surgical situation, meaning that your spasms are not a protective reaction against injury, but a reflex-conditioning problem.

In the majority of back spasms, there is no injury. The back spasms are just a movement malfunction -- a tension habit formed under stress. It's the "tension" part of "nervous tension."

So, why do back spasms occur? You now have part of the answer. Let's look a little more closely.

Your muscles obey your brain. Except for momentary reflexes controlled in the spinal cord (tested by your doctor's hammer tap), that's the whole story. So, if you have tight, spastic muscles, they're caused by your brain.

This answer is a "good news/bad news" type of answer. The bad news is that your muscles are out of control, and it's your brain's fault! Your brain isn't broken, just trapped by the memory of stress or injury in your history. The good news is that your brain can be relearn to relax those muscles.

Where do Back Muscle Spasms Come from?

One thing you will almost always notice about people with back spasms, if you exercise your powers of observation, is their high shoulders and swayback. Touch the muscles of their lower back, and you will find the same thing: hard, contracted muscles, not soft, weak, flabby muscles.

The major source of back spasms is the lifestyle of being "on the go" -- driven, driving, productive, on time, and responsive to every situation. This is a new idea for most people, so here's the explanation.

Our post-modern lifestyle triggers an ancient neuromuscular (bodily) response (known to developmental physiologists as the Landau Reaction); this reaction involves a tightening of the muscles of the spine in preparation for arising from rest (sitting or lying down) into activity (sitting, standing, walking, running). The Landau Reaction consists of the muscular responses involved in coming to a heightened state of alertness in preparation for moving into action; triggered incessantly for years, it becomes a tension habit -- one that often outlasts the moment (or stage of life) when it was necessary.

(The general viewpoint taught in physical therapy, it should be noted, is that the Landau Reaction is a temporary developmental response seen in infants, that does not persist into maturity. However, the muscular action pattern seen in mature adults under stressful conditions is identical to that seen in infants experiencing Landau Reaction -- shoulders, back, and hamstrings go into action (get tight).

Many Back Pain Issues Come from the Same Cause

Somatic educators usually find, upon examination of a person's musculature, that their pain comes not from an injury, but from overworked muscles; is not a medical problem or an injury, but a conditioning problem that often causes diagnosable medical problems. Their clients have back muscles conditioned into a painfully high state of tension. Most of the time, people can be brought to relax back spasms through brain-muscle training, and when they do, the pain and the problem disappear.

Though injuries from traffic accidents, falls, etc., also trigger muscular reactions that can become habitual, the Landau Reaction is behind most of the back-spasm epidemic in our society. It's a consequence of accumulated stress.

While you can't avoid the Landau Reaction (it's a necessary and appropriate part of life), you can avoid getting stuck in it. If your lifestyle puts you habitually in a state of reaction, you have to "de-habituate" yourself from it, so that your rise in tension occurs only as a momentary response to situations and does not become your chronic state.

Attempts to De-habituate the Landau Reaction

Most therapeutic approaches to back spasms are -- without knowing it -- attempts to de-habituate the Landau Reaction.

Cures for the tension and stress associated with the Landau Reaction include relaxation techniques, hypnosis, massage, skeletal adjustments, electrical stimulation, muscle relaxant drugs, and at last (as at first) pain medications.

Until recently, there was nothing better. Now, a clinical somatic education can rapidly improve muscular control, freedom of movement, and physical comfort. Once you have gained control of your Landau Reaction, a brief daily regimen of certain movements is sufficient to keep you from accumulating the daily tensions of a driven and overloaded life. You can keep refreshing yourself.

If you have numbness or tingling in your extremities, your problem is more severe and requires a medical evaluation to rule out serious conditions. Even if you have surgery, you will still need to learn to relax the tight muscles that initially caused the problem. If yours is not a surgical situation, then somatic education is probably viable for you.

The new methods used to de-habituate Landau Reaction are highly reliable and have no adverse side effects, apart from occasional temporary soreness the day after a session, soreness that fades out in a day or two, leaving you flexible, comfortable and stronger than before.

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Lawrence Gold is a long-time practicing clinical somatic educator certified in The Rolf Method of Structural Integration and in Hanna Somatic Education, with two years' hospital rehab center experience (Watsonville Community Hospital Wellness and Rehabilitation Center: 1997-1999) and articles published in The American Journal of Pain Management (Pain Relief through Movement Education: January, 1996, Vol. 6, no. 1, pg. 30) and in The Townsend Letter for Doctors and Patients (A Functional Look at Back Pain and Treatment Methods: November, 1994, #136, pg. 1186 ).

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