Making Exercise Healthy Medicine
How to Fix Discs and Sciatica
Without Drugs or Surgery
Herniated, Bulging, Slipping, Degenerating Discs, Pinched Nerve, Sciatica -
How To Understand Causes and Fix Them Yourself
(plus a little about sciatica not from discs)
© Jolie Bookspan, MEd, PhD, FAWM
Director Neck and Back Pain Sports Medicine
Headmaster, Academy of Functional Exercise Medicine - the Fixa U School of Healthy Medicine
Dr. Bookspan pioneered functional exercise and fitness,
and developed methods to solve pain and improve function,
now used by military and top spine centers around the world.
Copyright & Reprint Instructions Protected by Copyscape Plagiarism Checker
Hello, welcome to my no-ad web site (DrBookspan.com). My work is evidence-based primary-source sports medicine methods that you can use yourself, right away, to make your life better. There are hundreds of articles here on my web site. Main navigation links to more are at the bottom of this page.
On THIS Page: Fixing discs, sciatica, and other radiating pain - in healthy ways that leave you able to do more, not less. It also has links to more free articles on my web site that relate to getting your discs, your back, and your life, better and healthier. Don't Worry - Disc pain and sciatica can stop quickly. Discs are living parts of your body and can repair themselves like other living body parts. This article shows how to stop sources of the pain and damage so that repair is not stopped by you continuing the damage. Instead of stopping activities you love, this article summarizes how to use healthier movement habits so you no longer damage the area, no longer get the pain, and your discs can repair. You can have your life, better and more active than before.
People are often wrongly told that disc injury and sciatica are mysterious or long-term conditions. They are often wrongly told to accept or "live with" pain and reduced activity, given pain pills and other potentially unhealthful drugs for long periods, and told there is no choice but surgery. News reports quote spine specialists saying that back pain is difficult, or that no one knows why disc and sciatic pain occur and re-occur, or that they are caused by weak muscles. These statements are not true (even if they sell a lot of treatments, surgeries, and news articles). Disc injury and sciatica and other radiating nerve pain are usually simple to understand, and simple to fix without surgery or drugs, and without ongoing adjustments, strange exercises, restrictions on impact activity, special beds, braces, or equipment. Much cost, time, and worry currently spent in medical treatments are unnecessary, and often unhealthful.
It's not health care if it's not healthy. Not all exercise is medicine. Not all medicine is healthy. I change that. I developed methods to fix your discs in healthy ways through years of research in the lab, and put it here on my web site for benefit of the world. Now go read this article - get better and the world will be better.
Note: If your lower back hurts during and/ or after standing, walking, and running, and you feel better to sit, to lean or bend forward or bend over to touch your toes, start with my separate article to fix that different kind of lower back pain, then come back here.
Answers In A Nutshell
- Discs can heal. Sciatica can stop without medicines or surgery. It usually takes about a week (in serious cases) to stop pain if you use these methods right. You should feel the difference right away, the same day as you stop causes and start healthful movement instead. If you do not feel some positive difference right away, you're doing it wrong.
- Disc bulging, degeneration, tearing, herniation, and sciatica are not a "condition" or something that once you have, you have for life. It is an injury that, like a sprained ankle, usually comes from bad movement habits. The term "disc disease" is a wrong and inaccurate term. It is not a disease, not caused by a germ or mysterious chemical agent, or from aging. It is an injury that can heal and you can prevent from returning. This article shows the injurious movements that cause it, and healthy ones to use instead. Then your discs and sciatica can heal and you can be stronger and more active than before. Not all sciatica is from disc injury, and those causes can also be identified and fixed for positive changed right away.
- Disc injury and sciatica are the RESULT of what you are doing to injure the area - things you can fix yourself. Even when inflammation and immune response are identified, they are results, not causes of the pain and injury. This article will show you how to understand and fix causes instead of using drugs and surgery for the results. Fixing results is like catching blood in a bucket instead of stopping the bleeding.
- You may have several causes of pain. If you fix some of them, you will fix some of your pain. The answer is not to continue on, missing the rest, saying "it just takes time." Don't allow the other damaging causes to continue. Check for other causes you may have missed and fix them all. Then you will stop all pain, and instead of alternating feeling better from fixing one thing and hurting from other causes, wondering why you have intermittent results, you fix all and heal all and go on stronger and better than before.
- You do not need to have surgery or extended medical treatments to relieve disc pain or sciatica.
- You do not need to give up impact activities like running or martial arts, give up weights, heavy occupational work, or other active things you love to do (also, many people walk with higher impact than a good runner runs - running does not HAVE to be high impact - more on gait in the Fix Knee Pain page). You do not need to hold rigid position or one posture. Discs can heal, and the right healthy movement is part of that. This is different from doing sets and reps of exercises, then going back to injurious daily habits. You can go on to be able to do more, not less, using this work correctly.
- You do not need special chairs, beds, devices, braces, potions, or gimmicks to "put you" into any specific position.
- Not all back pain and pain down the leg (sciatica, femoral, and other nerve pain) is from bad discs, even if your scans show bulging discs or other disc changes. Use my several other summary articles to understand and fix the other causes too.
- Common medicines and prescription drugs can cause back and body pain. Un-needed treatments and surgeries are done - causing more pain and reduction in physical ability. Easy changes can stop the need for harmful medicines.
- This information is not "alternative medicine." This is common sense FUNCTIONAL sports medicine techniques, applied to real life - where you actually need it. I consider it simple standard-of-care.
- This article explains all the above. Make sure you understand the overall concepts (many highlighted in green). The end of this article (where it says "More fun...") gives many helpful links to pages on this site for more articles and resources. The Bottom of every page on my web site gives main navigation links.
I have found certain people like this information so much that they have copied sections verbatim with illustrations to their own web sites without credit or written link to this site, or me as sole author (Dr. Bookspan). You may ask to share this info with full credit, but don't steal. See copyright reprint information at page end. I have begun embedding copyright information into graphics.
A Short Story of My Work Developing These Methods (skip this if you want to go straight to fix pain with the article below)
This information is not copied from someone else who said it, or something I heard in a gym or in exercise science or medical school. I am the scientist who researches what really happens. This information is what I found through years of work. I started lab research studies in the 1970s to find why standard back pain exercises and treatments didn't work. I saw that injury rehab info was not being applied to how people move and live. I applied it. People got better. I had been taught the same as everyone else that discs can't heal, but my work showed that was not so. When I worked on studies of the human body during immersion for combat swimmers, the experimental subjects, other docs, and others in the lab kept complaining about their back and I saw the treatments and exercises their PTs and docs gave them did not work or made them worse. I fixed them so that I could continue my work, and because I care and knew from the evidence of my work you don't have to live with pain. Their doctors started calling me (calling the lab actually, as I don't have a phone) asking how I fixed them so well. They (and their physicians) started taking classes with me. In the 1980s, class participants asked me to write everything down for them. I was surprised. I thought they should have taken notes. I typed information sheets for them. More doctors came to me after taking my classes, saying they knew their standard Patient Handouts were ineffective exercises. They asked me to make handouts for their patients. I was surprised. Again. I thought they could do that themselves. I typed Patient Handout sheets for them. I kept collecting data like a good scientist, doing studies to test and retest methods, and develop better ones. When the Internet came out, I sent handouts electronically, instead of photocopies. In the 1990s I typed everything in several training manuals that became books. One is Health & Fitness In Plain English - How To Be Happy, Healthy and Fit for the Rest of your Life. After two different publishers, the new THIRD edition of How To Be Happy, Healthy and Fit... eliminates wrong things previous publishers added over my objections. Another book is Fix Your Own Pain, with patient stories in every chapter showing why patients get better, or don't, and why. Several more books of my life's work tell how to make life pain free, stronger, and more fun. Each book is different. I have seen fitness and rehab myths and fads come and go, but these methods remain effective over time, checked and rechecked with new data. More about me in Research. Limited Classes and appointments to train directly with me, and workshop certification by me through AFEM for top students. See my books and eBooks on the BOOKS page, and at the bottom of this article.To keep this quick and easy, much is shortened.
Use this summary to get better now, and get the books and eBooks for the rest:
Now, go fix your discs
How Discs Herniate - Injury You Can Prevent and Fix
Discs are tough, like the cushion firmly sewn on top of a high chair or stool. They do not slip around. Discs are firmly attached to the back bones above and below them. Years of bending your spine forward, squashes and degenerates discs in front, and pushes them outward toward the back.
You accumulate disc damage when you bend wrong to pick up things wrong, sit rounded forward for hours, do forward bending exercises, stand slouched. Chronic forward bending (flexion) also overstretches the muscles and long ligament down the back, and makes room for vertebral discs to protrude. It is easy to see why discs eventually get injured. Bad bending - bending wrong by leaning over at the hip or waist (including hip hinges and hamstring stretches of bending over to touch toes) - continually put shear force on discs, that eventually can micro-tear and peel away from their regular position on the vertebrae. Think of braces on your teeth. After years of pushing, things eventually move.
Discs can heal when you stop injuring them with daily bad habits. Accumulated disc injury is avoidable. You don't have to give up activities. Instead, this article shows you how to move in healthy ways while you go about your regular activities, then be able to do even more and get your life back.
Left - normal disc between two vertebrae. Right - disc pushed backward (herniated) from years of bad forward bending.
"Bad bending" shears and tears at discs. Chronic forward bending squeezes discs in front, gradually pushes discs outward in back and sides.
Sitting with your lower back rounded and continually doing bent-over stretches can eventually tear and push your discs enough to degenerate and herniate, and press nerves sending pain down your arm or leg.How are you sitting right now to read this?
Disc and Sciatic Pain Are Not So Mysterious
People do an astonishing number of things every day to degenerate their discs, and push and tear them out of place, bit by bit, and irritate and press on the sciatica area. You know you shouldnt lift wrong, but you do all day, every day picking up socks, petting the dog, for laundry, trash, making the bed, looking in the refrigerator, and all the dozens of times you bend over things. You work bent over your desk or bench. You drive bent forward. If you work out, you may lift weights bent over, do crunches and Pilates which are more bent forward flexion - many bad moves sitting standing and shoulder stands, yoga and PIlates twists that shear discs, stretch by bending forward touching your toes, do yoga bending over at the waist, do aerobic kicks and martial arts kicks with your back rounded and pelvis tilted under rather than neutral, bike rounding forward, then bend over to pick up your gym bag to go home. No wonder your discs are getting banged up. It takes many years of abuse to start degenerating and pushing discs out of place and make the sciatic nerve (and others) raw and painful. It's not aging, but simple mechanics.
Some people think it is a good stretch to bend over forward. Bending over may stretch muscles but also puts the leverage on the spine and off the muscles where it belongs, plus slowly shifts discs outward, eventually herniating them ("slowly" means after years of this kind of bad stretching). Most people know that bending forward and sitting rounded or bent forward injure the discs. Yet they stand, bend, sit, and lift wrong many dozens of times a day, day after day, then compound the problem with conventional exercises and stretches that bend forward in the gym, yoga and PIlates class.
People may do special "back exercises," hoping to fix the pain that results but not be aware that strong muscles will not automatically make you bend and lift properly to stop the source of the damage, or make up for all the things you do the rest of the day to hurt your discs. They wonder why they still get pain even though they take their medicine and "do their exercises." Discs can heal quickly, but you never give them a chance because you spend so much time bending forward, which pushes the discs outward (usually toward the back). Discs, like other living parts of your body, spend time in repair, and you feel better. Then when you go right back to bad bending, bad sitting, standing slouched so that the discs are crushed and pushed out of place and sciatic nerve pressed, it is not a mystery when pain comes and goes. Many people wind up in unnecessary surgery, or long term or recurring pain, not understanding why their physical therapy, pills, or yoga "didn't work."
Not A Disease
A hurt disc is a simple, mechanical injury that can heal. Someone with a slipping or degenerating disc, or sciatica, is often told they have "degenerative disc disease" or "disc disease." I t is not a disease. The condition is misnamed. It is an injury that can heal, and stop hurting and pressing on nerves and other things that also hurt. It is simple. Check for unhealthful movements when you bend, sit, walk, and do all you do, so that you are not continually injuring your discs even as your body is trying to heal them. This is as simple a concept as not scratching off a scab every day in a wound. This does not mean rest. Discs, like the rest of your living body need exercise for growth and repair and health. Use these articles (and books for more) to learn how to identify and use healthy movement, not injurious movement.
Discs Can Heal. Sciatica Can Stop.
Disc injury and sciatica do not have to be a long term problem. It is not a condition you must live with. It can, and should, be stopped in days. It is an injury that you do not have to allow to continue. Disc degeneration or slippage (herniation) and sciatica from all the many causes can heal and stop hurting - if you let it - no differently than a sprained ankle. Stop damaging your discs and nerves with bad bending, standing, and sitting habits and your discs can heal. It takes years to herniate a disc or irritate the nerves, and only days to weeks to let them heal and never come back - by stopping bad habits.
Chronic forward bending can eventually push discs outward (herniate) and break down little by little (degenerate). Continually standing and walking with feet turned out shortens muscles, which can tighten until becoming uncomfortable and also pressing on nerves. These problems are easy to avoid and easy to fix.
What Are Discs?
Discs are tough fibrous cushions between each of your vertebrae (back bones), from your neck, down the middle of your back, to your lower back. You also have two discs in each knee, commonly called a meniscus. You have a little disc between your lower and upper jaw bone at your temporo-mandibular joint (TMJ).
Discs are living parts of your body. That is good, and why they can heal. Vertebral discs do things like help you bend (right or wrong), and keep your bones from grinding against each other. They are not soft jelly donuts, as commonly said. The covering of your discs is strong and firmly attached between each vertebrae. It doesn't easily slide around. When I studied anatomy dissecting cadavers (bodies of people passed away) you could poke discs with knives with little effect. It takes a lot to tear and peel them from the bone. Like bar stools with stitched on cushions, they adhere tightly to the bone.That's a good thing, since discs take a lot of pounding. They are tough. After years of bad bending and lifting habits, they can finally fray and break down. Bad bending puts much shear force on discs, that eventually tears the discs away from the bone. It is no mystery. Damage, herniation and bulging are reversible without pills or long treatments surgery.
Which Discs Herniate?
It used to be that the most common disc herniation occurred in the neck and lower spine. At the neck, people often jut their chin forward (or up) and angulate (pinch) the back of the neck, or keep the head hanging forward instead of relaxed upright neutral spine. More in the Neck Pain article.The low back discs are the leverage point of bad bending, bad forward stretches in yoga, yoga twists that put high shear forces on discs, and bad sitting.
It is becoming common for middle back discs (thoracic) to be pushed outward with all the sedentary people sitting rounded hours a day, day after fay, year after year, compounding the poor posture during workouts with conventional (yet unhealthful) forward-bending abdominal exercises, Pilates, crunches, and rounded back for Spinning and biking. More in the Healthy Sitting Article and The Fixing Bad Exercise articles.
Why Does Pain Go Down One Leg or Arm or Around Your Torso? What Is Impingement and Sciatica?
It takes years of bad bending habits to make a disc start to break down (degenerate) or push on it unevenly so that it finally bulges out of place. When the disc is damaged, that alone can hurt. If you are lucky, you will get this small warning sign some small pain or pressure in the side or middle of your back and top of your hip. Sometimes the sciatic nerve is irritated from bad movement even before discs are damaged enough to press on it. By fixing your spine positioning to healthy daily habits and doing some extension described later in this article, you can stop disc damage and sciatic pain and keep them from coming back.
If you let more time go by with damaging sitting and body positioning habits, the disc can begin to push outward, and press on nearby structures, like nerves. That is called impingement because the disc impinges on (presses against, or take up the space of) the nerve. That spreads more pain to other places. After years of damaging the disc, you may suddenly feel the pain shoot like electricity when bending wrong one more time, or reaching for something small, or sometimes, the disc is so ready to give out, you are standing or sitting, thinking you have done nothing at all to bring on the sudden bolt of pain. It was years in coming and no mystery.
When a disc herniates enough, it can press on nerves that goes down your leg, sending pain down your leg. Pain may be down the back if the nerve that is pressed it that nerve that goes there, usually the sciatic nerve. Pain may go down the front if the disc presses the front nerves. Several of these nerves work both for feeling and movement of your leg. That means if you squeeze it, it will hurt and may also reduce the function of your leg. Pain may stay high in the torso if you have damaged your discs higher up.
Discs dont usually protrude straight back. Their path is blocked by a long, tough, band running down the back of your discs called the posterior longitudinal ligament. That is good because that helps keep them in place and protects your spinal cord, which lies behind the discs. Since the disc can't bulge straight back, if you keep pushing it out, it has to go somewhere and it squeezes out sideways. The long nerves going out of your spine to your body and legs are also on the side. When a disc bulges against these nerves, pain extends down one leg or around one side of your body.
Pain Down Your Arm
If you squash and push the discs in your neck with a forward head posture - letting your head tilt "chin-forward" instead of holding it up straight, the disc in your neck may herniate the same way as discs in your low back, and press on nerves that go to your arm, sending pain down your arm. For what to do to fix that, go to the article on how to fix neck pain, bad cervical discs, and upper back and shoulder pain.
When Back Pain Isn't From What Is On Your X-Ray
Often, a person may be in great pain from simple damaging bending and movement habits. They may go for an x-ray or MRI, and the scans show a degenerating or herniated disc. The pain may not be from the disc, but from the strained, tired muscles from bad habits. Like car tires that are mid-life, but perfectly good, some wear easy show on exam but may be unrelated to the pain. Pain is falsely ascribed to the disc. Pain continues, but from the poor mechanics. This is no mystery. Change the bad habits to change the pain.
Sometimes, people go for surgery for the "bad disc." But their pain persists or returns because they never corrected the bad mechanics that caused the pain. Or they may herniate another disc for the same reasons they herniated the first one bad sitting and lifting and all the other bad habits that they did not easily change.
When Pain and Impingement Comes From A Different Cause, Not Disc
Sometimes scans show a disc is protruding or degenerated to varying amounts, but the pain is not from the discs. Often pain is from other things, but confused for discs. Disc treatments continue with poor or random success.
Tightness - Lower back tightness, posterior hip, piriformis and other muscle tightness
Tight muscles in the lower back and hip can make the lower back uncomfortable, and also press on the same nerves as an injured disc, mimicking radiating nerve pain and sciatica. Tight muscles in the front of the chest and shoulder, from years of rounding your upper back and keeping your neck hanging forward can send pain down the arm, even when a disc is not involved.
One contributor (of several) to hip tightness causing sciatic pain down the leg is standing, walking, and moving with legs turned out - duck foot. The muscles that turn your leg and feet out are in back of your hip (in your behind). They fasten from the back of your hip bone to your upper leg bone going sideways. The sciatic nerve passes behind, and in some people, through one or more of these muscles (mainly the piriformis muscle). When these muscles get tight from years of walking, sitting, and standing with your hip bent and your feet turned out, the tight muscles can press and add to sciatic pain.
If you get lower back relief by bending forward, it is not likely the disc is what is the cause (or main cause) of your pain. Discs do not like that kind of movement. Injured discs will let you know by hurting. If bending forward relieves the pain, then you are likely to have two other causes - tight muscles back there that feel better to be stretched so that they are not tight, and/ or you stand swaybacked. Swayback is too much inward curve to the lower back. The severe angle pinches and presses. Leaning forward reduces the too large inner curve.
A problem comes when patients who have pain from tightness or swayback, but are wrongly told they have a disc problem, are given forward bending stretches.Most conventional forward bending stretches are bad for discs, but since the person doesn't have an injured disc as the source of pain, they feel better. In this way, unhealthful forward-bending stretches get prescribed for disc pain, in error, and people say they don't know why it "works sometimes and not other times."The reason is that they did not know what they were treating, and randomly help sometimes and make it worse other times. Not good medicine, and certainly not good science. Especially for the pain-wracked people who thought "they tried everything" and go to unnecessary surgery, or become dependent on pain pills. The difference should be very clear to spot and know what healthy fixes are needed. For people with both disc and tightness, the right stretches are needed in addition to stopping unhealthy bending. This is no different than what anyone else benefits from.
What to do for tightness that causes pain:
Some posterior hip stretches and good bending to avoid disc pain are on the Fitness as A Lifestyle page
Several specific stretches for tight posterior back and hip that are NOT bad for discs, are found in the book Stretching Smarter Stretching Healthier.
Bad Hamstring Stretching
Another thing commonly mistaken for sciatic pain is hamstring strain. The pain may be in the backside and can go down the leg. See if the pain is really around the the bump you sit on where the hamstring attaches and goes down the thigh along the hamstring muscle. An even more common source of back and disc pain is the hamstring stretches themselves. Check if you are doing conventional hamstring stretches by sitting or standing bent forward. They are a classic mechanism for pushing discs outward. There are far better and more functional ways to stretch the hamstrings, described below, in other free articles on this web site (like the Stretching Smarter Article), and in my books. I did lab studies that found no relation between hamstring flexibility and lower back pain - click to see why it is so often mistakenly prescribed for back pain.
Over-Arching the Lower Back - Swayback (Hyperlordosis)
A major hidden cause of ache in the lower back comes from allowing too much inward curve in the lower back - called hyperlordosis and swayback. This kind of pain is usually felt during/after long standing, walking, running, lifting overhead. Sitting or bending forward relieves this kind of pain, leading to all kinds of indirect and strange exercise rituals. Preventing the slouching posture will stop the pain and injury from it in the first place - see this article on fixing hyperlordosis. This article also explains relation of this kind of slouching to disc injury.
Other Nerves Than Sciatic Nerve
Not all pain that goes down the arm or the back of the leg is from pinched nerves. Also, not all pain that goes down the back of the leg is from the sciatic nerves. It can be from other nerves too, and can be also fixed with stopping unhealthful movement habits.
Back muscle spasm can be breathtakingly sudden and painful, but can be eased out the same way as a leg cramp - with specific directed action to make the muscle release from contracted state. Spasm may accompany hurting a disc or occur by itself. Spasm is another big area where people are wrongly diagnosed as having a disc injury, with wrong treatments and stretches (or tragically surgery) prescribed for disc. See the Fix Back Pain article for specifics about spasm.
"I work as an emergency room nurse in Australia, and we don't always have time during the course of our work to think about our backs when resuscitating people, but we put your web site up on our large screen to remind us to bend and move in ways that won't have us feeling terrible by the end of our 12 hr shift. Thanks again for your help, it is a pleasure to read your articles." ~ Cheryl.
What To Do Every Day To Stop Causing Sciatica and Hurting Discs and Let Everything Heal
Use Good Bending All The Time
You know not to bend wrong to pick things up, but you still do it? Every day. Hundreds of times a day. Instead, bend your knees in a squat or lunge. You already know that. But most people don't do it because their legs are too weak or they do it in ways that hurt their knees.
Count how many times you bend down each day to get things for everyday life. For most people, it will be several hundreds of times a day. Imagine the injury to your back by bending wrong that many times each day. Instead bend right. Don't do bad bent over stretches. Check your training and exercise routines for all the many common and unhealthy exercises and stretches.To squat down (crouch or bend for things) keep both heels down touching the ground, and your body upright.
Bending right is the most important thing you can do to heal your discs. Bending wrong hundreds of times a day pushes your discs out, no matter how many "back exercises" you do. Let your discs heal and get free leg exercise at the same time. Don't keep a large inward curve to the lower back. that was a fad for a while but caused much back pain. Good bending does allow some lengthening of the lower spine which gives a built-in (functional) needed lower spine stretch far superior to bending over forward to touch toes.
Bend well, heels on the ground, knees back for all the hundreds of times a day you bend and lift.
Don't do squats and lunges as an exercise, but as the way you really move all day for real life. You will save your back, stretch your Achilles tendon, and fix your knees at the same time.
The lunge (below) is not an exercise but a retraining. Use the lunge along with the squat to actually bend and reach all the things you need in a day. It is many times a day. This is instead of bad bending over. Retrain bending habits and get free leg and back exercise at the same time.
- Tuck hip under to remove back arch and stretch the front of the hip IN THE REAR LEG. If you do not feel the front of the hip in the rear leg getting nice stretch then you are doing it wrong.
- Bend knees to dip towards the floor without touching the floor. At least dip down a few inches.
- Don't let your front knee come forward. Keep your front knee over ankle.:
Good bending for all the many dozens of times you need to bend and reach things every day.
Keep your front knee over your foot (left) not forward (right).
Bend properly for everything, even the sink and water fountain, to pick things up from the floor, to look in the refrigerator, and take things out of the dishwasher. Keep your torso more upright and bend your knees. Keep your knees over your feet, not tilting and slouching forward, which is hard on the knees. This is not posture (a static rigid concept to most), but functional body mechanics, good ergonomics, healthy movement mechanics, functional movement.Don't use injured knees as an excuse to wreck your back. Bending properly will strengthen your knees as well. Use a lunge position with one foot in front and one in back. Keep your weight on your leg muscles, intending over resting your weight on the discs of your back.
See how to bend in healthy ways for back and knees on the Knee Pain Page
First thing each morning, don't sit on the edge of the bed.Instead, turn over to lie face down. Prop on elbows, not so high that anything hurts. If your lower back pinches, lower until it feel good. If you have tightness, or are doing this wrong, it may hurt. Stop until you know why, and fix that. Notice and allow your entire spine to "un-round" along the entire length, not folding back at the lowest point and/ or neck. It should feel good and help you start your day with straighter positioning. Get out of bed without sitting. If this makes your back hurt the same way you notice during the day standing, then discs may not be your entire problem, but overarching the lumbar spine. See that article here
Lie face down, comfortably propped on elbows as above, several times a day. If it hurts, you are doing it wrong. Position yourself so that it feels better, not worse. Don't force upward. Try a lower position or see if you are bending back from one area in your lower back instead of straightening out the upper back more. It should reduce the pain. If it makes you feel worse, don't do this, and check causes. If front hip tightness causes you to overarch the lower back when lying face down, stretch your front hip muscles with the lunge, described earlier (and other stretches in my Stretching Smarter book). More about why it hurts some people to lie face up or down in the article on Abs, Overarching, and Back Pain.
Done right, lying face down slightly propped on elbows for a few moments helps you learn to get more range from the upper instead of lower spine, unloads discs, and helps you feel better.
This alone is not a fix for discs - all your daily life movement is the fix.
If lying this way makes your lower back pinch or hurt, your front hip and thigh muscles may be tight, which shifts movement to the lower spine instead of the front hip where it should be. First, lower until you are comfortable to be able to use this helpful position. More important - stop the cause - Stretch your front hip muscles with the lunge, described earlier and more fully in the Stretching article (plus other front hip stretches in my stretch book).
Sit In Healthy WaySit without rounding at your desk, car, and elsewhere. Be comfortable; no need to be ramrod straight or hold muscles tightly. That makes more pain, of course. Raise your computer monitor so you don't need to bend over or forward to read. Move your TV higher. Stop curling downward and forward to watch. Use a lumbar roll (soft jacket or towel will do) to fill the concave space in many chair backs that allow rounded sitting. Lean slightly back for comfort - leaning upper back against the chair back instead of pushing lower spine into the lumbar roll or chair back.For more, see the article Healthy Sitting.
Carry Loads In Healthy Way
Stand and carry loads upright, without jutting your head and neck forward or rounding your low back. Don't lean backward to "balance" the weight. That causes problems of its own. Use your muscles to stand straight.
To see common lifting and carrying bad habits that contribute to back pain, and what do instead, see the article on this web site on Lifting and Carrying Without Back Pain.
Notice All Your Daily Exercise Routines Check For Bad Exercise
Don't do injurious exercises (described below).This doesn't mean do less, or not do fun things. It is to be able to do more without working against yourself.Use good exercises to retrain bending habits and how to position your body in healthy ways when moving around (described below).Dont Exercise in Ways that Damage Your Discs
People say they exercise for their health, but often exercise in ways that are not healthy.
- If you sit to lift weights, remember that sitting is harder on your discs than standing. Sitting rounded multiplies damaging force. A common exercise injury occurs when sitting rounded on weight machines. After years of unhealthy sitting position, adding pushing against a leg press or other resistance can become too much for the discs and other low back structures, sending pain into the behind and down the leg. Stand to lift weights. For even more healthy training, stand on one foot when lifting (safely) to add balance and stability to your training.
Don't round your hip and low back against resistance (weighted flexion).
The problem is not as much the amount of weight you lift, or that you are exercising, it is more if you are using injurious positioning. Instead of pushing your lower back against the seat or pad, lift up to sit straight and lean your upper back against the seat.
- Many people hurt from excessive forward bending all day in their real life. Then they go to the gym and add to that problem with the many conventional exercises involving more forward bending: toe touches, knee to chest, leg lifts, and crunches. Ironically, many people do these thinking these will help their back. Motion often temporarily makes you feel better, however, many of the forward bending exercises are not what is needed (like cigarettes - temporary relief but long term grater problems). It is important to strengthen the muscles that pull back the other way and to learn how to use muscles to straighten the back, not only round it. These are the extension exercises (to follow).
- Don't stretch by bending forward at the waist or hip. Many people are surprised to find that they injure their back doing forward yoga stretches. most people know it is injurious to pick up a package that way. It is not really a surprise. Other people think that bending over to pick things up is right and because it stretches the back of the legs. It does stretch, but it is not a healthy stretch. It puts the leverage and pivot point on your discs. LIke smoking, it feels good (to some) but the drawbacks are not worth it. For more interesting information on what exercises harm and which help, read the article on How to Avoid Bad Exercises and Section 3 in the Fix Back Pain article explaining Why Yoga Forward Bends Are Like Lifting Packages Wrong.
Difference Between Strengthening, and Doing What Is Needed To Stop Pain
As described above, disc pain has a large component of bad movement mechanics, not weak muscles. Strength does not stop you from bad bending that puts herniating forces on your discs year after year. Many people do strengthening exercises and become stronger people who still bend wrong, move wrong, and slouch. "Core" exercises are especially misunderstood and repeated and prescribed without any understanding that stronger abdominal muscles have little to do with the most common causes of back pain. Moreover, most conventional core training exercises are done in bent forward ways that reinforce the same bad mechanics you started with. For the research and interesting story on what abdominal muscles really have to do with back pain, see my article on Abdominal Muscles - what they do may surprise you. Bending, standing, moving, and living your life with healthy movement mechanics is up to you. The rest of this article tells more on how.
Where strengthening helps - Someone may use good body mechanics all day, yet ache with fatigue at the end of the day. That is not a disc injury or true back pain that needs treatments, and should not be addressed with medications. Another instance is someone who really is so weak that they can't hold up their own body weight and instead, shifts it onto their joints, which wear with time and grind under the weight (slouching).
A little strengthening allows you to do more before fatigue pain sets in, and to be more able to use good mechanics instead of slouching. Strengthening will not keep you from slouching or bad bending, and don't fall prey to unhealthful exercise programs claiming to cure disc pain using core strengthening. Almost any movement can make you feel better for the moment. Over the long run, it's better not to use injurious core flexion for core strengthening or random back exercises. Use good mechanics
Strengthening and stretching are good, but alone will not change posture or lifting habits, and so cannot cure back pain or posture problems. Many contribute to the original problem of over rounding and bad posture. Look around the gym to see people hunching forward and bending over to lift things. This pressures discs further. Back exercises are supposed to be used to retrain you how you hold your body all the time. Doing exercises for back pain is not like getting a shot of penicillin or going to confession. It does not fix bad habits the rest of the time.
One common example is doing "pelvic tilts," then stopping your "back exercise" and walking away letting your back flop into bad posture, instead of keeping the proper tilt you just practiced. Back exercises are supposed to be used to retrain your thinking and habits when you get back up off the floor. This does not happen automatically. This is where many people have missed the point of back exercises. Strengthening has no effect on posture if you dont apply the strength the rest of the day to control joint angles for all activities.
A big problem comes when people with disc pain are given exercises and stretches that bend forward. Those may temporarily stop pain from a different problem - swayback spine position - but are the wrong thing for discs, and do not stop swayback after the exercise.
Instead of abdominal exercises that bend forward like crunches, much of PIlates, and toe touches, first understand, then use the following Good Exercises:
Good Exercises to Retrain Muscles and Positioning Habits - Functional Exercise
Back pain exercises are misunderstood. People often injure their back all day then hope to fix it with a few exercises. They don't understand when this does not work. They lie on the floor to do exercises, then go about their real life bending and sitting wrong and all day. It is like eating butter and sugar all day, then doing 10 minutes of exercises and wondering why it doesn't "work" to lose weight. The key is what you do all day, every day.1. Instead of Crunches, PIlates and Other Flexion Exercise, Use These:Isometric Abs. Most people exercise their abdominal muscles by bending forward. Bending forward is a main way you pressure discs outward, eventually degenerating and bulging (herniating) them. The following re-training drill teaches how to use your abdominal muscles without forward bending. It is a better workout than abdominal crunches. It is a myth that strengthening abs will fix back pain. That may sound strange. But stronger abs do not make you stop bending wrong and standing in the ways that injure discs. In fact, most of the abdominal exercises taught are the very forward bending exercises that injure discs and pressure the back more. It is another myth that tightening abs and pressing navel to spine helps in fact, it can make more pain. You can't breathe in or move easily if you tense your abdomen in the way commonly taught.What do abs do to help prevent back pain? A major purpose of your abdominal muscles is to prevent your lower spine from swaying inward when you are standing. This is called hyper-lordosis or swayback. Swayback is not the primary force that injures discs. It mostly make another kind of lower back pain in the soft tissue and joints called facets. People with swayback get pain after long standing and running. Most disc pain originates from too much forward bending and is usually felt with bending and sitting. An interesting result of stopping swayback is that for someone with a bulging disc, standing swayback presses more on the already hurt disc. Often people with both swayback and an injured disc feel immediate relief when they stop swayback. Check in a mirror if you stand swaybacked, and use this in addition to the rest of everything on this page. Then your discs can feel better now while they heal from no longer injuring them by stopping bad bending and bad sitting.The following shows you how to do general healthy strengthening and exercise without forward bending. This is not represented as a disc fix, but you do need to understand the concepts to prevent pain from swayback, to get good healthy exercise in general, and importantly to exercise in ways that does not bend forward, but uses your core and abs the way your body actually needs - to hold healthy spine position.
The "isometric Ab" retraining drill shows you how to keep your lower back from overarching
under loads that you lift overhead, as if you are standing. It is a more effective and functional way to train your core muscles, and better for your discs, than exercise that bend and curl you forward.
- Lie face up, arms overhead on floor, biceps (elbow area) by your ears.
- Press your low back toward the floor to remove the arch. You will feel your abdominal muscles working to prevent your back from arching.
- Hold a hand weight in each hand, an inch above the floor, without letting your lower spine increase in arch or lift up from the floor. Keep your low back against the floor by using abdominal muscles to straighten your spine. It is better exercise to hold two hand weights, one in each hand, rather than one hand weight held by both hands together.
- Straighten your legs so that you can practice the way you need to hold your spine when standing - spine in healthy position without bending knees.
This is how your abs should work all the time, when standing up, to prevent too much arching. Use this exercise to practice using your abs to control the posture of your back, even against moving resistance, simulating real life activity when standing up. Notice that you don't need to tighten your abs to do this. Use your abdominal muscles, like any other muscles, to move your body to healthy position.
Retrain the Push-up Position: This is another exercise to retrain neutral spine, and get good exercise for body and core without forward bending. It is a far better abdominal workout when done with neutral spine than abdominal crunches, and has the advantage of retraining you how to use your abdominal muscles to put your spine in healthy position when you stand up. The exercise itself is not a back pain or disc fix, it is a way to learn how to stop injuring your back when you exercise and how to retrain healthy movement so you do not do injurious things that hurt in the first place.
In a push-up position (hands and ball of the feet, not on knees) tuck your hips under so that your back doesn't arch. The motion is like doing a crunch until your spine straightens. Done right, you will immediately feel your abs working. You will also immediately feel any pressure in your lower spine disappear, that was caused by swayback (arching). The purpose of this exercise is to train your abs at the same time you relearn how to hold your back when you are standing up. Keep your back straight, not letting it sag like a hammock. Tuck hips as if you were starting a crunch, but don't lift your behind up in the air or drop your head. Make your posture as straight as if you were standing up. Use a mirror, if available, to see yourself and learn what healthy position feels like. Use this new healthy position all the time, particularly when you stand and reach overhead. Don't let your back arch to reach overhead. Use the principle of this tuck exercise. For more about ab exercise and preventing the pain from arching, see the abs article The Ab Revolution No More Crunches No More Back Pain.
When you tilt your hip under to reduce a too-large inward lower back curve, you will immediately feel your abs working and pressure gone from your back.
2. How to Stretch Your Hamstrings Without Ruining Your Discs
Tight hamstrings are commonly thought to contribute to back pain. This is turning out not to be completely true. Worse, hamstring stretches are often done in ways that round and strain the back and degenerate discs.Leaning over at the waist, both standing and sitting, for toe-touches does stretch your back and hamstrings, and may feel good, but it is terrible for your back. This is true even for yoga stretches where you bend over forward sitting or standing touch toes. You know never to bend over like that to pick things up or sit like that at your desk. It doesn't magically become good for you by calling it a stretch.
- Stand no more than arms length from a wall. Stand straight. Both feet pointing forward, not out.
- Lift one leg to press the foot and heel toward the wall, directly in front of you.
- Stand upright. Don't round your back, or let your hip curl under you. This is a functional hamstring stretch - you need to stand, lift legs, and balance without being so tight you are pulled into unhealthful rounding.
- If your hip curls under, it may be because the front muscles of your hip are too tight. Use this retraining drill to stretch and straighten, not further round the back. See the stretching article.
This hamstring stretch is different and more functional than putting one foot up on a bench.
3. When Walking and Exercising
- Walk with feet parallel, not turned in or out. Weight on entire sole, not pressing inward flattening the arches.
- Walk, move, exercise and sit down with shock absorption, not stomping.
- Notice your upper back position - prevent rounding the spine and shoulders.
- Notice lower spine position. Check if you are allowing a slouch that tilts the pelvis forward which overarches the lower spine, pinching the vertebral joints called facets, and the discs. Use your muscles to move to neutral spine - important for disc health - see Neutral spine article.
How Long Does It Take To Fix Disc Pain, Pinched Nerve, and Sciatica?
If your pain is from damaging movement mechanics, you should begin to feel the difference the same day as you use everything presented above as intended, and stop injurious movement.
If you're not feeling better right away, check what you are doing compared to what you have learned above and in the other free articles:
- Check what you are actually doing compared to what you think you are doing (you are doing it wrong).
- Are you doing bad exercises from other sources? It is common to do a few movement from my work, but continue or add injurious moves from other sources that slow recovery and re-injure.
- Are you tightening or clenching any muscles? Tight muscles can hurt and impede healthy movement.
- Are you overcompensating? Are you making new bad movement habits that seem opposite of original unhealthy movement thinking that will "undo" or fix?
- Is something else causing the pain, such as infection, shingles, growths, or other non-movement based situations?
It takes years to hurt a disc, but only days for it to start repairing once you no longer are bending badly and damaging it. Make sure there is not something else contributing to your pain. It is is almost always quick and straightforward to start getting your life back and start feeling better right now. Don't wait.
Good Bending RAP Song to Help Remember
Here ia a fun rap to remember good bending as one of many components of back health. It is the same rap lyrics as on the Fix Back Pain page, but with emphasis on the Backman! (tm) drawings for better learning. Rap lyrics by Dr. Bookspan. Rapped for us by Raymond Lott, former United States Marine Corps sergeant (RSonic, The Marine Rapper), who served combat tours with infantry battalions in Iraq 2006 and Afghanistan 2008. (NOTE: I wrote lyrics that when you bend wrong, back pain "IS NO" mystery. Sgt. Lott changed it to, "ain't no...") Other than that, learn and enjoy:
If this Rap for Good Bending does not load, try the direct link on my Flickr page:
To see the same rap featuring Marine combat veteran Sgt. Raymond Lott, who made me these videos to help the world fix pain, click the Fix Back Pain page.
To send your own Rhymes and Rhythms for Remembering Health, see the Projects Page.
To keep this article a quick and easy summary, much is left out. The books tell more.
A herniated or degenerating disc, and sciatica and pain down the arm or leg, are not a mysterious "condition" or disease. The cause is often simple mechanics. People spend their day sitting, working, walking, and driving in the very hunched posture that pushes discs out the back. They hunch over the computer, lifting and bending wrong all day, walking heavily, and slouching all day, and then exercise in ways that strain and pressure discs and muscles. They do yoga and Pilate's exercises that forcibly pressure discs. They try remedies that do not address the cause of the problem, do physical therapy in ways that exacerbates the original problem, give up favorite activities, have surgery then return to previous injurious habits, then everyone is astonished that they "tried everything and nothing seemed to work." It's like eating butter and sugar all day, then waving your hands in the air for 5 minutes and saying "I don't understands why I don't lose weight, I do my exercises." How is your body positioning right now? Use your muscles to stand and bend properly for all daily tasks to stop pushing the disc out to the back, degenerating and herniating it. Do back extension exercise to take the pressure off your discs and help retrain how you extend the spine - evenly, not yanking or bending more from one segment while leaving the rest without movement. Bonus: beside fixing injured discs, standing and moving in healthy ways for real life burns calories, strengthens, and is a free workout.
- Watch other peoples posture, gait, and movement habits. It will remind you how often you may be injuring yourself.
- Notice injurious postures in fitness magazines doing "fitness and health" moves. It will remind you not to do them, and why pain is no mystery.
- Notice your own habits. Make sure your pain is not from medical conditions (vascular, infection, other) or from many medicines known to have body pain as side effects.
- Please don't combine other people's injurious stretches and exercises then come back to me and say my work isn't fixing that.
- Use principles learned here with me to identify and eliminate the cause of your own pain.
- Does my work mean you never do any flexion? Of course not - that is misunderstand the concepts. The idea is notice if you spend most of your day that way and then use predominantly flexion exercises on top of that. Then it is no mystery why you hurt. Understand, don't memorize blanket and arbitrary rules.
- Dont memorize rules and postures or think that an exercise or kind of exercise will fix back pain, - which is more likely from a number of all your bad mom vent habits.
- Exercise is more than good for you - it is crucial for your health and recovery. Not all exercise is healthy, just like not all food and medicine - there is junk food and unhealthy medicine. Use my work to understand the concepts so that you can tell what is healthy movement for yourself. Then apply it to your life - happy, healthy, active.
- Send me photos showing the principles in action, Prizes for best candid.
- Send me your success stories about using these principles. Send typo corrections, nice notes, and success stories.
- Please do not e-mail saying you are "doing the exercises 10 times and want me to tell you how to fix your discs." I get hundreds of those mails. Here is the answer now: If you stop hurting your discs with bad bending, bad sitting, and bad exercises, then a major source of disc injury will stop. It is not the exercises that fix things, it's you. Sure, send nice e-mails of what you are trying, and photos of your happy successes. First make sure you understand everything in the free article above. The books tell more. Smile, breathe. Pass this knowledge on to others.
Don't Change These Concepts and Methods Back To "What You Know" (Ingrained Wrong) - These Methods Work Only As Written and Intended:Henry Louis Mencken said, "Any man who afflicts the human race with ideas must be prepared to see them misunderstood" Even so, please don't change my work back into what you know, or what others say, or what you learned somewhere else. his is different and works differently than the pop fads that have become ingrained in fitness and health. To paraphrase Bertrand Russell, "An untrained man's report of what a knowledgeable man says is never accurate because he unconsciously translates what he hears into something he can understand." My work is primary source, and often - not what we learned in school and the gym. Remember, that is good.
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