The Biggest Cause Of Back Pain

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Will Harlow, specialist over-50s physiotherapist, shares the most common cause (and its remedy) in this video:

The seat of the problem

The issue (for most people, anyway) is not in the back itself, nor the core in general, but rather, in the glutes. That is to say: the gluteus maximus, medius, and minimus. They assist in bending forwards (collaborating half-and-half with your back muscles), and help control pelvic alignment while walking.

Sitting for long periods weakens the glutes, causing the back to overcompensate, leading to pain. So, obviously don’t do that, if you can help it. Weak glutes shift the work to your back muscles during bending and walking, increasing strain and—as a result—back pain.

The solution (besides “sit less”) is to do specific exercises to strengthen the glutes. When you do, focus on good form and do not try to push through pain. If the exercises themselves all cause pain, then stop and consult a local physiotherapist to figure out your next step.

With that in mind, the five exercises recommended in this video to strengthen glutes and reduce back pain are:

  1. Hip abduction (isometric): use a heavy resistance band or belt around legs above the knees, push outwards.
  2. The clam: lie on your side, bend your knees 90°, and lift your top knee while keeping your body forward. Focus on glute engagement.
  3. Clam with resistance band: use a light resistance band above your knees and perform the same clam exercise.
  4. Hip abduction (straight leg): lie on your side, keep legs straight, lift your top leg diagonally backward. Lead with your heel to target your glutes and avoid back strain.
  5. Hip abduction with resistance band: place a resistance band around your ankles, and lift leg as in the previous exercise.

For more on all these, plus visual demonstrations, enjoy:

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  • Protein: How Much Do We Need, Really?

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    Mythbusting Protein!

    Yesterday, we asked you for your policy on protein consumption. The distribution of responses was as follows:

    • A marginal majority (about 55%) voted for “Protein is very important, but we can eat too much of it”
    • A large minority (about 35%) voted for “We need lots of protein; the more, the better!”
    • A handful (about 4%) voted for “We should go as light on protein as possible”
    • A handful (6%) voted for “If we don’t eat protein, our body will create it from other foods”

    So, what does the science say?

    If we don’t eat protein, our body will create it from other foods: True or False?

    Contingently True on an absurd technicality, but for all practical purposes False.

    Our body requires 20 amino acids (the building blocks of protein), 9 of which it can’t synthesize and absolutely must get from food. Normally, we get those amino acids from protein in our diet, and we can also supplement them by buying amino acid supplements.

    Specifically, we require (per kg of bodyweight) a daily average of:

    1. Histidine: 10 mg
    2. Isoleucine: 20 mg
    3. Leucine: 39 mg
    4. Lysine: 30 mg
    5. Methionine: 10.4 mg
    6. Phenylalanine*: 25 mg
    7. Threonine: 15 mg
    8. Tryptophan: 4 mg
    9. Valine: 26 mg

    *combined with the non-essential amino acid tyrosine

    Source: Protein and Amino Acid Requirements In Human Nutrition: WHO Technical Report

    However, to get the requisite amino acid amounts, without consuming actual protein, would require gargantuan amounts of supplementation (bearing in mind bioavailability will never be 100%, so you’ll always need to take more than it seems), using supplements that will have been made by breaking down proteins anyway.

    So unless you live in a laboratory and have access to endless amounts of all of the required amino acids (you can’t miss even one; you will die), and are willing to do that for the sake of proving a point, then you do really need to eat protein.

    Your body cannot, for example, simply break down sugar and use it to make the protein you need.

    On another technical note… Do bear in mind that many foods that we don’t necessarily think of as being sources of protein, are sources of protein.

    Grains and grain products, for example, all contain protein; we just don’t think of them as that because their macronutritional profile is heavily weighted towards carbohydrates.

    For that matter, even celery contains protein. How much, you may ask? Almost none! But if something has DNA, it has protein. Which means all plants and animals (at least in their unrefined forms).

    So again, to even try to live without protein would very much require living in a laboratory.

    We can eat too much protein: True or False?

    True. First on an easy technicality; anything in excess is toxic. Even water, or oxygen. But also, in practical terms, there is such a thing as too much protein. The bar is quite high, though:

    ❝Based on short-term nitrogen balance studies, the Recommended Dietary Allowance of protein for a healthy adult with minimal physical activity is currently 0.8 g protein per kg bodyweight per day❞

    ❝To meet the functional needs such as promoting skeletal-muscle protein accretion and physical strength, dietary intake of 1.0, 1.3, and 1.6 g protein per kg bodyweight per day is recommended for individuals with minimal, moderate, and intense physical activity, respectively❞

    ❝Long-term consumption of protein at 2 g per kg bodyweight per day is safe for healthy adults, and the tolerable upper limit is 3.5 g per kg bodyweight per day for well-adapted subjects❞

    ❝Chronic high protein intake (>2 g per kg bodyweight per day for adults) may result in digestive, renal, and vascular abnormalities and should be avoided❞

    Source: Dietary protein intake and human health

    To put this into perspective, if you weigh about 160lbs (about 72kg), this would mean eating more than 144g protein per day, which grabbing a calculator means about 560g of lean beef, or 20oz, or 1¼lb.

    If you’re eating quarter-pounder burgers though, that’s not usually so lean, so you’d need to eat more than nine quarter-pounder burgers per day to get too much protein.

    High protein intake damages the kidneys: True or False?

    True if you have kidney damage already; False if you are healthy. See for example:

    High protein intake increases cancer risk: True or False?

    True or False depending on the source of the protein, so functionally false:

    • Eating protein from red meat sources has been associated with higher risk for many cancers
    • Eating protein from other sources has been associated with lower risk for many cancers

    Source: Red Meat Consumption and Mortality Results From 2 Prospective Cohort Studies

    High protein intake increase risk of heart disease: True or False?

    True or False depending on the source of the protein, so, functionally false:

    • Eating protein from red meat sources has been associated with higher risk of heart disease
    • Eating protein from other sources has been associated with lower risk of heart disease

    Source: Major Dietary Protein Sources and Risk of Coronary Heart Disease in Women

    In summary…

    Getting a good amount of good quality protein is important to health.

    One can get too much, but one would have to go to extremes to do so.

    The source of protein matters:

    • Red meat is associated with many health risks, but that’s not necessarily the protein’s fault.
    • Getting plenty of protein from (ideally: unprocessed) sources such as poultry, fish, and/or plants, is critical to good health.
    • Consuming “whole proteins” (that contain all 9 amino acids that we can’t synthesize) are best.

    Learn more: Complete proteins vs. incomplete proteins (explanation and examples)

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  • Discipline is Destiny – by Ryan Holiday

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed another of Holiday’s books, The Daily Stoic, and here is another excellent work from the same author.

    We’re not a philosophy newsletter, but there are some things that make a big difference to physical and mental health, the habits we build, and the path we take in life for better or for worse.

    Self-discipline is one of those things. A lot of the time, we know what we need to do, but knowing isn’t the problem. We need to actually do it! This applies to diet, exercise, sleep, and more.

    Holiday gives us, in a casual easy-reading style, timeless principles to lock in strong discipline and good habits for life.

    The book’s many small chapters, by the way, are excellent for reading a chapter-per-day as a healthy dose of motivation each morning, if you’re so inclined.

    Bottom line: if you’ve noticed that one of the biggest barriers between you and your goals is actually doing the necessary things in a disciplined fashion, then this book will help you become more efficient, and actually get there.

    Click here to check out Discipline is Destiny, and upgrade yours!

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  • ADHD medication – can you take it long term? What are the risks and do benefits continue?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Attention deficit hyperactivity disorder (ADHD) is a condition that can affect all stages of life. Medication is not the only treatment, but it is often the treatment that can make the most obvious difference to a person who has difficulties focusing attention, sitting still or not acting on impulse.

    But what happens once you’ve found the medication that works for you or your child? Do you just keep taking it forever? Here’s what to consider.

    What are ADHD medications?

    The mainstay of medication for ADHD is stimulants. These include methylphenidate (with brand names Ritalin, Concerta) and dexamfetamine. There is also lisdexamfetamine (branded Vyvanse), a “prodrug” of dexamfetamine (it has a protein molecule attached, which is removed in the body to release dexamfetamine).

    There are also non-stimulants, in particular atomoxetine and guanfacine, which are used less often but can also be highly effective. Non-stimulants can be prescribed by GPs but this may not always be covered by the Pharmaceutical Benefits Scheme and could cost more.

    How stimulants work

    Some stimulants prescribed for ADHD are “short acting”. This means the effect comes on after around 20 minutes and lasts around four hours.

    Longer-acting stimulants give a longer-lasting effect, usually by releasing medication more slowly. The choice between the two will be guided by whether the person wants to take medication once a day or prefers to target the medication effect to specific times or tasks.

    For the stimulants (with the possible exception of lisdexamfetamine) there is very little carry-over effect to the next day. This means the symptoms of ADHD may be very obvious until the first dose of the morning takes effect.

    One of the main aims of treatment is the person with ADHD should live their best life and achieve their goals. In young children it is the parents who have to consider the risks and benefits on behalf of the child. As children mature, their role in decision making increases.

    What about side effects?

    The most consistent side effects of the stimulants are they suppress appetite, resulting in weight loss. In children this is associated with temporary slowing of the growth rate and perhaps a slight delay in pubertal development. They can also increase the heart rate and may cause a rise in blood pressure. Stimulants often cause insomnia.

    These changes are largely reversible on stopping medication. However, there is concern the small rises in blood pressure could accelerate the rate of heart disease, so people who take medication over a number of years might have heart attacks or strokes slightly sooner than would have happened otherwise.

    This does not mean older adults should not have their ADHD treated. Rather, they should be aware of the potential risks so they can make an informed decision. They should also make sure high blood pressure and attacks of chest pain are taken seriously.

    Stimulants can be associated with stomach ache or headache. These effects may lessen over time or with a reduction in dose. While there have been reports about stimulants being misused by students, research on the risks of long-term prescription stimulant dependence is lacking.

    Will medication be needed long term?

    Although ADHD can affect a person’s functioning at all stages of their life, most people stop medication within the first two years.

    People may stop taking it because they don’t like the way it makes them feel, or don’t like taking medication at all. Their short period on medication may have helped them develop a better understanding of themselves and how best to manage their ADHD.

    In teenagers the medication may lose its effectiveness as they outgrow their dose and so they stop taking it. But this should be differentiated from tolerance, when the dose becomes less effective and there are only temporary improvements with dose increases.

    Tolerance may be managed by taking short breaks from medication, switching from one stimulant to another or using a non-stimulant.

    boy looks frustrated, sitting at table with adult
    Medication is usually prescribed by a specialist but rules differ around Australia.
    Ground Picture/Shutterstock

    Too many prescriptions?

    ADHD is becoming increasingly recognised, with more people – 2–5% of adults and 5–10% of children – being diagnosed. In Australia stimulants are highly regulated and mainly prescribed by specialists (paediatricians or psychiatrists), though this differs from state to state. As case loads grow for this lifelong diagnosis, there just aren’t enough specialists to fit everyone in.

    In November, a Senate inquiry report into ADHD assessment and support services highlighted the desperation experienced by people seeking treatment.

    There have already been changes to the legislation in New South Wales that may lead to more GPs being able to treat ADHD. Further training could help GPs feel more confident to manage ADHD. This could be in a shared-care arrangement or independent management of ADHD by GPs like a model being piloted at Nepean Blue Mountains Local Health District, with GPs training within an ADHD clinic (where I am a specialist clinician).

    Not every person with ADHD will need or want to take medication. However, it should be more easily available for those who could find it helpful.The Conversation

    Alison Poulton, Senior Lecturer, Brain Mind Centre Nepean, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Peony Against Inflammation & More

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    Yes, this is about the flower, especially white peony (Paeonia lactiflora), and especially the root thereof (Paeoniae radix alba). Yes, the root gets a different botanical name but we promise it is the same plant. You will also read about its active glycoside paeoniflorin, and less commonly, albiflorin (a neuroprotective glycoside present in the root).

    It’s one of those herbs that has made its way out of Traditional Chinese Medicine and into labs around the world.

    It can be ingested directly as food, or as a powder/capsule, or made into tea.

    Anti-inflammatory

    Peony suppresses inflammatory pathways, which thus reduces overall inflammation. In particular, this research review found:

    ❝Pharmacologically, paeoniflorin exhibits powerful anti-inflammatory and immune regulatory effects in some animal models of autoimmune diseases including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE)❞

    The reviewers also (albeit working from animal models) suggest it may be beneficial in cases of kidney disease and liver disease, along with other conditions.

    Source: The Regulatory Effects of Paeoniflorin and Its Derivative Paeoniflorin-6′-O-Benzene Sulfonate CP-25 on Inflammation and Immune Diseases

    Here’s a larger review, which also has studies involving humans (and in vivo studies), that found it to effectively help treat autoimmune conditions including rheumatoid arthritis and psoriasis, amongst others:

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    Antidepressant / Anxiolytic

    It also acts as a natural serotonin reuptake inhibitor (as per many pharmaceutical antidepressants), by reducing the expression of the serotonin transporter protein:

    Gut Microbiota-Based Pharmacokinetics and the Antidepressant Mechanism of Paeoniflorin

    (remember, most serotonin is produced in the gut)

    Here’s how that played out when tested (on rats, though):

    Effects of Paeonia lactiflora Extract on Estrogen Receptor β, TPH2, and SERT in Rats with PMS Anxiety

    Against PMS and/or menopause symptoms

    Peony is widely used in Traditional Chinese Medicine to reduce these symptoms in general. However, we couldn’t find a lot of good science for that, although it is very plausible (as the extract contains phytoestrogens and may upregulate estrogen receptors while dialling down testosterone production). Here’s the best we could find for that, and it’s a side-by-side along with licorice root:

    ❝Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin❞

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    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

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  • Best morning routine?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    You’ve Got Questions? We’ve Got Answers!

    Q: Best morning routine?

    A: The best morning routine is whatever makes you feel most ready to take on your day!

    This one’s going to vary a lot—one person’s morning run could be another person’s morning coffee and newspaper, for example.

    In a nutshell, though, ask yourself these questions:

    • How long does it take me to fully wake up in the morning, and what helps or hinders that?
    • When I get out of bed, what do I really need before I can take on my day?
    • If I could have the perfect morning, what would it look like?
    • What can evening me do, to look after morning me’s best interests? (Semi-prepare breakfast ready? Lay out clothes ready? Running shoes? To-Do list?)

    Don’t Forget…

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    Learn to Age Gracefully

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  • Little Treatments, Big Effects – by Dr. Jessica Schleider

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The author, a clinical psychologist, discusses how mental healthcare has come a very long way, yet still has a long way to go. While advocating for top-down reforms, she does have a stopgap solution:

    Find ways to significantly improve people’s mental health in a single-session intervention.

    This seems like a tall order, but her method is based on good science, and also, most people will agree from experience that big changes can happen to someone in the space of moments, at pivotal turning points in life—they just have to be the right moments.

    Dr. Schleider recommends that therapists train in (and then offer) this method, but she does also give comprehensive advice for self-therapy of this kind too.

    These self-therapy directions, ways to induce those life-pivoting moments for the better, are perhaps the greatest value that the book gives us.

    Bottom line: if you’d like a lot of the benefits of therapy without getting therapy, this book can definitely point you in the right direction, in a manner that won’t be a drain on your time or your wallet.

    Click here to check out Little Treatments, Big Effects, and see what a difference you can make for yourself!

    Don’t Forget…

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    Learn to Age Gracefully

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