I frequently like to remind myself, and my patients, that getting physical activity doesn’t always have to be in the form of a structured workout. Remember- workouts are a relatively recent construct. They compensate for the fact that we don’t get enough physical work in our regular lives. Nobody “worked out” 100 years ago. They didn’t need to. Exercise was inherent in their lifestyle, provided by walking, hauling, farming, etc. In our modern, convenience-driven world, however, we need to inject all the opportunities we can for movement and activity, as a means of keeping us young, healthy, and pain-free. So, here are some great ways to increase your daily activity without having to snap on the spandex and hit the gym:

1. Get a pedometer. It measures the number of steps you take everyday. Work toward 10,000 steps per day as a goal.
2. Take the stairs instead of the elevator.
3. Park further away, rather than driving that extra three minutes finding a spot closest to the front door.
4. For small grocery trips, carry a basket instead of pushing a cart.
5. Do calf raises (rising up on your toes) and isometric exercises (contract and hold major muscle groups for 20 seconds) while in the shower.
6. When at the desk or computer, have a timer that reminds you to get up and move every 30 minutes. Stand up, rotate & bend at the waist…reach overhead…lean through an open doorway to stretch your chest/pecs.
7. Have some exercise tubing in a desk drawer at work and do some arm curls, presses, and rows a few times a day.
8. Use an exercise ball as a seat several hours a day- roll and bounce on it for core strength.
9. When watching TV, exercise at the commercials. Squats, ab crunches, stretches.
10. Suck in your stomach 5 times a day for a hold of 10-15 seconds. This is a wonderful way to strengthen the core & support the spine.

Look for opportunities every chance you get for a little physical effort during your day, rather than opting for convenience. You’ll be surprised how strong, flexible, and mobile it can make you in a very short period of time.

For those of you looking for a simple, effective approach to core strengthening and back pain relief, I highly recommend Foundation Training.  Developed by chiropractor Dr. Eric Goodman, this unique, yoga-esque approach strengthens the deep spinal muscles and large postural muscle groups through a combination of isometric (sustained hold) and mobility exercises.Much of the success of the program lies in its emphasis on creating back muscle strength, rather than just abdominal strength. Too many core exercise programs focus merely on the abdominal muscles, forgetting that much of back pain relief, good posture, and functional mobility lies in strengthening the muscles of the spine itself. For a society facing an epidemic of excessive sitting and core de-conditioning, it is critical that we target these muscle groups effectively and safely. As such, I feel that a program like Foundation Training, done several times per week, is a must for maintaining spinal health.

As with any new program, start out slowly and gradually. Though the protocols may look simple and straight-forward, they target areas that few of us use often. So, take your time working up to even the basic workouts suggested in Foundation Training. Aim to spend 15-20 minutes on these exercises every other day, and watch your back pain ease and your mobility improve within even the first week.

While I don’t agree with every conclusion drawn or reference cited by Taubes, the thing he does best is draw a link between how our bodies work metabolically, and how we act behaviorally. He explains why we do what we do with respect to eating, and not just how it effects our physiology. Why do we overeat? Why do we crave unhealthy, sugary carbohydrates? Why is it so hard to break the cycle of obesity? Taubes speaks in frank terms about what we’re doing wrong in this country, while showing surprising empathy for the plight of those battling obesity. Most importantly, he outlines simple, approachable changes that will allow us to get back on the fat-loss wagon.

If you’re looking for an interesting, approachable read on the topic of nutrition, that will inspire you to break the cycle of weight-gain and disease, I highly recommend Taubes’ book.

Let’s look at what happens after an acute injury. Imagine you bend forward to pick something up off the floor, and you feel a sharp, painful pinch in your lower back. Chemicals are released from the spinal joints and tissues at the sight of the injury that cause local blood vessels to flood the area. This swells and pressures the injury in an attempt to brace it. These chemicals also irritate local nerve endings, causing pain to let you know the area is injured. Lastly, these inflammatory chemicals act as messengers that tell the immune system to begin laying down fibrous scar tissue around the joint to spackle it in and repair it. The end result- you feel stiff and sore, and, over time, may be left with long term aches and immobility in your lower back due to the scar tissue used to repair the area.

The reason, as chiropractors, we recommend ice after an acute injury like this is that it buffers this inflammatory response. We understand that long-term happiness for the muscles and joints of the body lies in them being able to move and function flexibly. Ice prevents swelling from getting out of hand, provides natural pain relief, and prevents scar tissue from being laid down in excess. Thus, the injury heals better, faster, and more comfortably, and ends up more flexible and functional down the line.

Heat tends to be most effective when used on more chronic injuries and aches to keep them flexible and comfortable. Use it on areas of chronic muscle tension, to reduce achiness from chronic arthritis, or as a means of improving body flexibility prior to exercise and activity. Avoid heat in the initial stages of an acute injury or pain flare-up.

Simple Guidelines for Use of Ice vs. Heat:

1. Use ice in the first 48 hours after an acute injury or significant flare-up of pain.
2. 20 minutes is the magic number when using ice. Apply for 20 minutes every 1 ½ to 2 hours.
3. After the first 48 hours following an injury, try “contrast therapy”- a mix of heat and ice. A good contrast therapy schedule is heat for 15 minutes, followed immediately by 10 minutes of ice.
4. Much like ice, when using heat on chronically tight muscles or achey joints, limit the application to 20 minutes.
5. Always ice or heat through a thin cloth to avoid irritation and damage to the skin.
6. Flexible gel ice packs, bags of frozen peas, or crushed ice in a zip-lock bag all work well for ice therapy.
7. To make a homemade heat pack, put 1 to 2 cups of dry rice in a sports sock and tie off the end. Microwave for 60-90 seconds, and you have an effective moist heat pack for relieving aches and tension.
8. Ice massage is a wonderful way to provide relief for repetitive stress injuries like tennis elbow. Fill a Dixie cup with water, and freeze it. Tear off the upper rim, exposing the ice, and gently massage it over the irritated area for 2-3 minutes to reduce pain, inflammation and scar tissue accumulation.
9. Never ice before exercise or stretching.
10. To combat chronic morning stiffness, try a 20 minute soak in a bath or hot tub.

1. You should start thinking about replacing your old mattress after about 8 years of use, or sooner if you notice it beginning to sag where you sleep. Also, consider a change of mattress if you are chronically waking with hip or lower back pain and stiffness.
2. Rotate your mattress head-to-foot every six months to reduce wear. If possible, also flip the mattress over. (Check with your mattress manufacturer to find out if your particular mattress is able to be flipped.)
3. If you notice a little premature sagging in your mattress, try putting a thin sheet of plywood between your mattress and box-spring for extra support.
4. When buying a mattress, take your time. Lie down on a lot of different mattresses, of different styles, to get a feel for each. Always lie down in the position you spend most of your sleeping time.
5. The “feel” you are looking for from your mattress is one of supported weightlessness. You shouldn’t feel pressure being put too prominently on any one area of your body as you lie on it.
6. Avoid mattresses that are too soft, or have too thick a pillow-top. Thick pillow tops do not allow you to gain the benefit of the supportive springs/coils of the mattress, and often lead to premature sagging of the mattress and eventual back pain. Remember- you can make a firm bed softer (via mattress toppers, etc), but it’s tough to make a soft bed firmer.
7. While memory-foam style beds can provide great support, they can also keep you very warm at night. If you are prone to overheating at night, you may want to avoid these. Also, lighter-weight individuals sometimes complain that these beds are too firm for them. Lastly, ask about the chemicals used in the manufacture of these beds, as they can cause considerable allergy and off-gassing issues for some individuals.
8. Try to opt for mattresses containing natural materials, whenever possible. Cotton and wool tend to breathe better than synthetics, and are better for the environment when it eventually comes time to dispose of your mattress.
9. Consider a Sleep Number-style, air chamber bed if you and your spouse have vastly different mattress needs. These beds allow for individual firmness customization for each person. You will definitely want to try these beds out before purchase, however, as they do have somewhat of an “airbed” feel to them. And, if you and your spouse like to cuddle mid-bed, these mattresses often have an uncomfortable central barrier that can make this uncomfortable.
10. Consider using two extra-long, twin-sized mattresses on a king-sized box-spring if you and your spouse prefer differing mattress firmness, but still like conventional mattresses.
11. Avoid buying a waterbed, as they lack effective spinal support.
12. Try to always buy beds from a retailer that provides a 60 or 90-day exchange or return trial period. It is the best way to ensure that your investment in a mattress was the right one.