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:
- Hip abduction (isometric): use a heavy resistance band or belt around legs above the knees, push outwards.
- The clam: lie on your side, bend your knees 90°, and lift your top knee while keeping your body forward. Focus on glute engagement.
- Clam with resistance band: use a light resistance band above your knees and perform the same clam exercise.
- 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.
- 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:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- 6 Ways To Look After Your Back
- Strong Curves: A Woman’s Guide To Building A Better Butt And Body – by Bret Contreras & Kellie Davis
- How To Stop Pain From Spreading
Take care!
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Just One Thing – by Dr. Michael Mosley
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This is a collection of easy-to-implement changes that have good science behind them to show how they can benefit us. Some things are obvious (e.g: drink water); others, less so (e.g: sing, to reduce inflammation).
The book is divided thematically into times of the day, though in many cases it’s not a hard rule that a thing needs to be done at a certain time. Others are, like a cold shower in the morning and hot bath before bed—you might not want to switch those around!
The style is very pop-science, and does not have in-line citations for claims, but it does have a bibliography in the bag organized by each “one thing”, e.g. it might say “get some houseplants” and then list a number of references supporting that, with links to the studies showing how that helps. For those with the paper version, don’t worry, you can copy the URL from the book into your browser and see it that way. In any case, there are 2–6 scientific references for each claim, which is very respectable for a pop-sci book.
Bottom line: if you’re looking for evidence-based “one little thing” changes that can make a big difference, this book has lots!
Click here to check out Just One Thing, and improve your life!
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Mental Health Courts Can Struggle to Fulfill Decades-Old Promise
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GAINESVILLE, Ga. — In early December, Donald Brown stood nervously in the Hall County Courthouse, concerned he’d be sent back to jail.
The 55-year-old struggles with depression, addiction, and suicidal thoughts. He worried a judge would terminate him from a special diversion program meant to keep people with mental illness from being incarcerated. He was failing to keep up with the program’s onerous work and community service requirements.
“I’m kind of scared. I feel kind of defeated,” Brown said.
Last year, Brown threatened to take his life with a gun and his family called 911 seeking help, he said. The police arrived, and Brown was arrested and charged with a felony of firearm possession.
After months in jail, Brown was offered access to the Health Empowerment Linkage and Possibilities, or HELP, Court. If he pleaded guilty, he’d be connected to services and avoid prison time. But if he didn’t complete the program, he’d possibly face incarceration.
“It’s almost like coercion,” Brown said. “‘Here, sign these papers and get out of jail.’ I feel like I could have been dealt with a lot better.”
Advocates, attorneys, clinicians, and researchers said courts such as the one Brown is navigating can struggle to live up to their promise. The diversion programs, they said, are often expensive and resource-intensive, and serve fewer than 1% of the more than 2 million people who have a serious mental illness and are booked into U.S. jails each year.
People can feel pressured to take plea deals and enter the courts, seeing the programs as the only route to get care or avoid prison time. The courts are selective, due in part to political pressures on elected judges and prosecutors. Participants must often meet strict requirements that critics say aren’t treatment-focused, such as regular hearings and drug screenings.
And there is a lack of conclusive evidence on whether the courts help participants long-term. Some legal experts, like Lea Johnston, a professor of law at the University of Florida, worry the programs distract from more meaningful investments in mental health resources.
Jails and prisons are not the place for individuals with mental disorders, she said. “But I’m also not sure that mental health court is the solution.”
The country’s first mental health court was established in Broward County, Florida, in 1997, “as a way to promote recovery and mental health wellness and avoid criminalizing mental health problems.” The model was replicated with millions in funding from such federal agencies as the Substance Abuse and Mental Health Services Administration and the Department of Justice.
More than 650 adult and juvenile mental health courts were operational as of 2022, according to the National Treatment Court Resource Center. There’s no set way to run them. Generally, participants receive treatment plans and get linked to services. Judges and mental health clinicians oversee their progress.
Researchers from the center found little evidence that the courts improve participants’ mental health or keep them out of the criminal justice system. “Few studies … assess longer-term impacts” of the programs “beyond one year after program exit,” said a 2022 policy brief on mental health courts.
The courts work best when paired with investments in services such as clinical treatment, recovery programs, and housing and employment opportunities, said Kristen DeVall, the center’s co-director.
“If all of these other supports aren’t invested in, then it’s kind of a wash,” she said.
The courts should be seen as “one intervention in that larger system,” DeVall said, not “the only resource to serve folks with mental health needs” who get caught up in the criminal justice system.
Resource limitations can also increase the pressures to apply for mental health court programs, said Lisa M. Wayne, executive director of the National Association of Criminal Defense Lawyers. People seeking help might not feel they have alternatives.
“It’s not going to be people who can afford mental health intervention. It’s poor people, marginalized folks,” she said.
Other court skeptics wonder about the larger costs of the programs.
In a study of a mental health court in Pennsylvania, Johnston and a University of Florida colleague found participants were sentenced to longer time under government supervision than if they’d gone through the regular criminal justice system.
“The bigger problem is they’re taking attention away from more important solutions that we should be investing in, like community mental health care,” Johnston said.
When Melissa Vergara’s oldest son, Mychael Difrancisco, was arrested on felony gun charges in Queens in May 2021, she thought he would be an ideal candidate for the New York City borough’s mental health court because of his diagnosis of autism spectrum disorder and other behavioral health conditions.
She estimated she spent tens of thousands of dollars to prepare Difrancisco’s case for consideration. Meanwhile, her son sat in jail on Rikers Island, where she said he was assaulted multiple times and had to get half a finger amputated after it was caught in a cell door.
In the end, his case was denied diversion into mental health court. Difrancisco, 22, is serving a prison sentence that could be as long as four years and six months.
“There’s no real urgency to help people with mental health struggles,” Vergara said.
Critics worry such high bars to entry can lead the programs to exclude people who could benefit the most. Some courts don’t allow those accused of violent or sexual crimes to participate. Prosecutors and judges can face pressure from constituents that may lead them to block individuals accused of high-profile offenses.
And judges often aren’t trained to make decisions about participants’ care, said Raji Edayathumangalam, senior policy social worker with New York County Defender Services.
“It’s inappropriate,” she said. “We’re all licensed to practice in our different professions for a reason. I can’t show up to do a hernia operation just because I read about it or sat next to a hernia surgeon.”
Mental health courts can be overly focused on requirements such as drug testing, medication compliance, and completing workbook assignments, rather than progress toward recovery and clinical improvement, Edayathumangalam said.
Completing the programs can leave some participants with clean criminal records. But failing to meet a program’s requirements can trigger penalties — including incarceration.
During a recent hearing in the Clayton County Behavioral Health Accountability Court in suburban Atlanta, one woman left the courtroom in tears when Judge Shana Rooks Malone ordered her to report to jail for a seven-day stay for “being dishonest” about whether she was taking court-required medication.
It was her sixth infraction in the program — previous consequences included written assignments and “bench duty,” in which participants must sit and think about their participation in the program.
“I don’t like to incarcerate,” Malone said. “That particular participant has had some challenges. I’m rooting for her. But all the smaller penalties haven’t worked.”
Still, other participants praised Malone and her program. And, in general, some say such diversion programs provide a much-needed lifeline.
Michael Hobby, 32, of Gainesville was addicted to heroin and fentanyl when he was arrested for drug possession in August 2021. After entry into the HELP Court program, he got sober, started taking medication for anxiety and depression, and built a stable life.
“I didn’t know where to reach out for help,” he said. “I got put in handcuffs, and it saved my life.”
Even as Donald Brown awaited his fate, he said he had started taking medication to manage his depression and has stayed sober because of HELP Court.
“I’ve learned a new way of life. Instead of getting high, I’m learning to feel things now,” he said.
Brown avoided jail that early December day. A hearing to decide his fate could happen in the next few weeks. But even if he’s allowed to remain in the program, Brown said, he’s worried it’s only a matter of time before he falls out of compliance.
“To try to improve myself and get locked up for it is just a kick in the gut,” he said. “I tried really hard.”
KFF Health News senior correspondent Fred Clasen-Kelly contributed to this report.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Women seem to feel pain more acutely and often feel ignored by doctors.
ShutterstockMedical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How extreme heat can affect you—and how you can protect yourself
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Because of climate change, last summer was the hottest in the Northern Hemisphere in 2,000 years—and this summer is expected to be even hotter. The record may continue to be broken: Extreme heat is expected to become even more frequent.
The scorching heat has led to an increase in heat-related deaths in the United States, according to the Department of Health and Human Services, with approximately 2,300 deaths in the summer of 2023. Extreme heat, defined as a period of two to three days with high heat and humidity with temperatures above 90 degrees Fahrenheit, can have serious health consequences, including symptoms like headache, dizziness, loss of consciousness, nausea, and confusion.
As we face more extreme heat, you may be wondering how you can protect yourself and your loved ones. Read on to learn about heat-related illness, who’s most at risk, and more.
What happens when our bodies are exposed to extreme heat?
As our body temperature rises, our bodies attempt to cool down by opening up more blood vessels near the skin to begin sweating. The evaporation of our sweat regulates our body temperature, but it also leads to losing fluids and minerals.
When it’s too humid, sweating alone doesn’t do the trick. The heart must work harder to bring blood around the body. It starts beating faster, which can cause light-headedness, nausea, and headache.
This process can affect our health in different ways, including increasing our risk of hospitalization for heart disease, worsening asthma, and injuring kidneys due to dehydration. It can also result in heat-related illness. Below are some effects of heat on our bodies:
- Heat cramps: Occur when a person loses salt through sweating, which causes painful cramps. Symptoms begin as painful spasms after heavy sweating, usually in the legs or the stomach. Heat cramps can lead to heat exhaustion or heat stroke.
- Heat exhaustion: This occurs when the body loses an excessive amount of water and salt, usually during intense physical activity. Symptoms include irritability, heavy sweating, and weakness, including muscle cramps. Heat exhaustion can lead to heat stroke.
- Heat stroke: This is the most severe heat-related illness. It happens when the body can’t cool down and reaches a temperature of 106 Fahrenheit or higher within 10 to 15 minutes. If the person doesn’t receive emergency treatment, it can cause permanent disability or death. Symptoms include confusion, loss of consciousness, and seizures.
What should I do if someone experiences a heat-related illness?
If you or someone you’re with begins to show signs of heat illness, the Centers for Disease Control and Prevention recommends the following:
- Heat cramps: Stop all physical activity, drink water or a sports drink, move to a cool place, and wait for cramps to go away before resuming activity. If the cramps last more than an hour, you’re on a low-sodium diet, or you have heart problems, get medical help.
- Heat exhaustion: Move the person to a cool place, loosen their clothes, use a cool bath or cloths to try to lower their body temperature, and give them a sip of water. If the person throws up, or if their symptoms last longer than an hour or worsen, get medical help.
- Heat stroke: Call 911 immediately. Then, move the person to a cooler place, use cool cloths or a cool bath to help lower their temperature, and don’t give them anything to drink.
Read more about heat-related illness and what to do in each case.
Who’s more vulnerable to extreme heat?
While everyone can be affected by extreme heat, some people are more at risk, including people of color.
A 2023 KFF report outlined that because of historical residential segregation in the U.S. (known as “redlining”), people of color are more likely to live in areas that experience higher temperatures from rooftops, asphalt, and sidewalks that retain the sun’s heat (known as the “urban heat island effect”). Additionally, communities of color are more likely to live in areas with fewer trees, which act as a canopy and provide shade, making the heat worse and more direct.
Children under 5, adults 65 or over, and pregnant people are also more vulnerable to extreme heat. If you have a chronic health condition like diabetes, heart problems, or a mental health condition, you’re also at higher risk. (Some psychiatric medications, like antidepressants, can also make people more susceptible to heat).
Lastly, anyone exposed to the sun and extreme heat for long periods is also at higher risk. This includes athletes, people who work outdoors, and unhoused people.
What can I do to prevent heat-related illness during a heat wave?
During a heat wave, follow these tips to stay cool and protect yourself from heat-related illness:
- Never leave your pets or children inside a car.
- Wear loose, light-colored clothing (dark colors absorb more heat).
- Find shade if you’re outside.
- If you don’t have air conditioning in your home, go to a place where you can cool down, such as a local library, community center, local pool or splash pad, or mall. Check to see if your city has designated cooling centers. (Cities like New York have a list of places.)
- Wear a hat.
- Drink (non-alcoholic) fluids often to stay hydrated—and if you have pets, give them water frequently as well.
- Check on your family members or older neighbors who may be more sensitive to extreme heat.
- Avoid using your stove or oven too often or during the hottest parts of the day.
- Cover your windows with shades to keep the heat out.
What are some resources to prevent heat-related illness?
If you need financial assistance to cool down your home, such as to purchase an air conditioner, apply to the federal government’s Low Income Home Energy Assistance Program.
Before you head outside during a heat wave, use the CDC’s HeatRisk tool: Enter your zip code to find the current heat risk in your area and get tips on what to do to stay safe with each risk level.
During a heat wave, also look for a cooling center in your state using the National Center for Healthy Housing’s list.
Check out the National Weather Service’s for more tips and resources.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Steps For Keeping Your Feet A Healthy Foundation
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Important Steps For Good Health
This is Dr. Kelly Starrett. He’s a physiotherapist, author, speaker, trainer. He has been described as a “celebrity” and “founding father” of CrossFit. He mostly speaks and writes about mobility in general; today we’re going to be looking at what he has to say specifically about our feet.
A strong foundation
“An army marches on its stomach”, Napoleon famously wrote.
More prosaically: an army marches on its feet, and good foot-care is a top priority for soldiers—indeed, in some militaries, even so much as negligently getting blisters is a military offense.
Most of us are not soldiers, but there’s a lesson to be learned here:
Your feet are the foundation for much of the rest of your health and effectiveness.
KISS for feet
No, not like that.
Rather: “Keep It Simple, Stupid”
Dr. Starrett is not only a big fan of not overcomplicating things, but also, he tells us how overcomplicating things can actively cause problems. When it comes to footwear, for example, he advises:
❝When you wear shoes, wear the flat kind. If you’re walking the red carpet on Oscar night, fine, go ahead and wear a shoe with a heel. Once in a while is okay.
But most of the time, you should wear shoes that are flat and won’t throw your biological movement hardware into disarray.
When you have to wear shoes, whether it’s running shoes, work shoes, or combat boots, buy the flat kind, also known as “zero drop”—meaning that the heel is not raised above the forefoot (at all).
What you want to avoid, or wean yourself away from, are shoes with the heels raised higher off the ground than the forefeet.❞
Of course, going barefoot is great for this, but may not be an option for all of us when out and about. And in the home, going barefoot (or shod in just socks) will only confer health benefits if we’re actually on our feet! So… How much time do you spend on your feet at home?
Allow your feet to move like feet
By evolution, the human body is built for movement—especially walking and running. That came with moving away from hanging around in trees for fruit, to hunting and gathering between different areas of the savannah. Today, our hunting and gathering may be done at the local grocery store, but we still need to keep our mobility, especially when it comes to our feet.
Now comes the flat footwear you don’t want: flip-flops and similar
If we wear flip-flops, or other slippers or shoes that hold onto our feet only at the front, we’re no longer walking like we’re supposed to. Instead of being the elegant product of so much evolution, we’re now walking like those AT-AT walkers in Star Wars, you know, the ones that fell over so easily?
Our feet need to be able to tilt naturally while walking/running, without our footwear coming off.
Golden rule for this: if you can’t run in them, you shouldn’t be walking in them
Exception: if for example you need something on your feet for a minute or two in the shower at the gym/pool, flip-flops are fine. But anything more than that, and you want something better.
Watch your step
There’s a lot here that’s beyond the scope of what we can include in this short newsletter, but:
If we stand or walk or run incorrectly, we’re doing gradual continual damage to our feet and ankles (potentially also our knees and hips, which problems in turn have a knock-on effect for our spine, and you get the idea—this is Bad™)
Some general pointers for keeping things in good order include:
- Your weight should be mostly on the balls of your feet, not your heels
- Your feet should be pretty much parallel, not turned out or in
- When standing, your center of gravity should be balanced between heel and forefoot
Quick tip for accomplishing this last one: Stand comfortably, your feet parallel, shoulder-width apart. Now, go up on your tip-toes. When you’ve done so, note where your spine is, and keep it there (apart from in its up-down axis) when you slowly go back to having your feet flat on the ground, so it’s as though your spine is sliding down a pole that’s fixed in place.
If you do this right, your center of gravity will now be perfectly aligned with where it’s supposed to be. It might feel a bit weird at first, but you’ll get used to it, and can always reset it whenever you want/need, by repeating the exercise.
If you’d like to know more from Dr. Starrett, you can check out his website here 🙂
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Cherries vs Elderberries – Which is Healthier?
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Our Verdict
When comparing cherries to elderberries, we picked the elderberries.
Why?
Both are great! But putting them head-to-head…
In terms of macros, cherries have slightly more protein (but we are talking miniscule numbers here, 0.34mg/100g), while elderberries have moderately more carbs and more than 4x the fiber. This carbs:fiber ratio difference means that elderberries have the lower glycemic index by far, as well as simply more grams/100g fiber, making this an easy win for elderberries.
In the category of vitamins, cherries have more of vitamins A, B9, E, K, and choline, while elderberries have more of vitamins B1, B2, B3, B6, and C. The margins of difference mean that elderberries have the very slightly better overall vitamin coverage, but it’s so slight that we’ll call this a 5:5 tie.
When it comes to minerals, cherries have more copper, magnesium, and manganese, while elderberries have more calcium, iron, phosphorus, potassium, selenium, and zinc. A nice easy win to top it off for elderberries.
On the polyphenols (and other phytochemicals) front, both are great in different ways, nothing that’d we’d consider truly sets one ahead of the other.
All in all, adding up the sections, an overall win for elderberries, but by all means enjoy either or both!
Want to learn more?
You might like to read:
- Cherries’ Very Healthy Wealth Of Benefits!
- Herbs for Evidence-Based Health & Healing ← one of them is elderberry, which hastens recovery from upper respiratory viral infections 😎
Take care!
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