FACT: Back pain is the second most common reason, after a sore throat, for a visit to the doctor.

FACT: Back pain is the leading cause of disability for people under the age of 45.

FACT: Most back pain is preventable.

I always love it when people smarter than me say things that I have been saying for years. Dr. Oz, of Oprah fame, was recently on Good Morning America talking about the most common causes of back pain.  To view the interview, click here.

Obviously, in a 5 minute interview, Dr. Oz doesn’t have the time to go into detail on a couple of the real life strategies for preventing or dealing with low back pain. But luckily, in this blog I do:

1.  If you sit for long periods of time, be certain to use a good, supportive low back, or lumbar pillow or support in your chair.  It is too expensive on your spine to attempt to sit in good posture for prolonged periods of time.

2.  It is important to have a stable core, but you must train your core in order for it to be stable.

3.  There are shoes for fashion and shoes for function, go for the shoes for function. One of the smartest things I see women do here in the Metropolitan DC area, is wear their sneakers on the metro, to and from work, and then switch out to the stylish shoes once they get to work.  Try to minimize your time in the stylish, yet, spine damaging shoes.

For more tips and suggestions on core stability and/or injury prevention, please do not hesitate to email me at DrBooker@CapitolRehab.com don’t forget to enter “Injury Prevention” in the subject line of the email.

Capitol Rehab is extremely proud of the amazing success of several of our Friends of Capitol Rehab at this weekend’s George Washington Parkway Classic 10 Miler. Your relentless training, and unending dedication has once again paid off. We want to congratulate all of the runners who entered and competed this weekend, including our very own massage therapist extraordinaire, Jorge Obando.

We want to pay a special tribute to our “Capitol Rehab Top Place Finishers.”  It is our continued honor and privilege to be a small part of your team.

In the Men’s Overall Category:

Steve Hallinan
First Place Overall
49:29

Christopher Raabe
Third Place Overall
49:58

In the Women’s Overall Category:

Samia Akbar
First Place Overall
56:02

Julie Culley
Third Place Overall
1:01:07

First Place in the Women’s 20-29 year old Division

Erin Swain
1:01:39

Sue Lowden is running for the Senate seat in Nevada.  Leading in most polls, Ms. Lowden revealed, what she believes is an innovative idea to bring down the cost of Health Care.  Ms. Lowden feels that we should consider returning to a system of bartering for health care.

Ms. Lowden says, ” “You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say, ‘I’ll paint your house.’ I mean, that’s the old days of what people would do to get health care with your doctors. Doctors are very sympathetic people.”

As a health care provider, I agree, doctors ARE very sympathetic people. In fact, many offices, including my own, often make accommodations for patients who may not be able to fully afford good care.  But providing solutions for those with financial hardship is not what Ms. Lowden is proposing.

Ms. Lowden is proposing an alternative form of payment for health care.  Instead of working to improve an inefficient health care system, a system that serious people on all sides of the debate agree requires improvement, Ms. Lowden is proposing the American people pay their doctors with poultry! 

In the words of the great orator Popeye, ”I’ve had all I can stand, and I can’t stands no more!”

Ms. Lowden’s proposal is so ridiculous, I feel compelled to introduce a bill myself.  I propose that doctors be allowed to open-hand slap any person who offers them a bucket of chicken as payment for their health care.

To be clear, this is not an endorsement for violence, this is an endorsement for common sense.  I am probably as much in the dark about the politics of this heated Health care debate as the next person.  I have my personal feelings, but like most Americans, I think the extremes on both sides are way out of bounds.  I don’t know what to make of the Obama Bill, but I’m certain it is neither the “Magic Pill” that will save America, nor is it our Armageddon.

Butthis much I do know;  If somebody doesn’t stand up against this chicken idea or “Catfish For Care” or “Mutton For Medicine”, hundreds of well intentioned people will be getting open- hand slaps in doctor’s offices all across this country!

There are several obvious reasons why this country no longer uses a barter system as a viable means of commerce:

1.  This barter system was common in the 1800′s and early 1900′s, right around the time doctors were using leeches and a shot of whiskey as regular courses of care. We have evolved as a people, and in 2010 are better than that.

2.  Bartering requires the person receiving the commodity, me, to want what  you have to barter.  No offense to the bucket of chicken, but I don’t want your chicken.  And lets not overlook the obvious, I don’t want the next 40 patients to enter my waiting room with their finest bucket of chicken (or catfish or whatever).

3.  Bartering almost used to work when the exchange was of equal value.  And that’s the real issue in this discussion.

How much is your health care worth?

-How much is Heart Surgery Worth?  A full picnic dinner with all of the trimmings?

-When your spouse wheels you into the doctors office, because your back pain won’t allow you to walk or stand up, are you saying that the value of the doctor who gets you back on your feet is worth a rack of ribs?  A plate of collard greens? A Nintendo wii?

I stand firm that the most valuable thing you have is your health.  I don’t even think it is debatable.  How important is that new car, or that job interview or even your Lotto ticket, if you were diagnosed with a terminal disease, or were having an apparent heart attack.

I don’t have all the answers to the health care debate, but I do know this.  We have completely lost our way as a society, when smart people, even leaders in our community think that ones health can be worth roughly as much as a meal at Applebees.

And worse than that, we still have this thing called Health Insurance which was designed so people could get good care, doctors could get paid to do good work and everyone could walk away happy in the end.

So here is all that really matters.  We have to agree:

-Our Health Care system needs to be improved, so fix it.

-We desperately need everyone involved in this discussion to get engaged and present good ideas.

-We don’t have time for insulting, crazy talk like “Bring your doctor a chicken” to pay for your important health care needs.

-We are better than this, and I have already given this politician and her craziness way too much ink…

I came across a good article on AOL addressing the ongoing movement to incorporate exercise with seniors as the preferred treatment for chronic pain.  People in the rehab industries have been preaching this for years. I like to remind my senior population that “exercise is not optional” and this goes for everyone over the age of 5!

Our bodies are living, breathing organisms that require movement and activity. In simple terms, Use It Or Lose It!

It is also important to remember that pain or chronic pain is not simply a function of age.  I have patients who complain of chronic pain at 30 years old, and I have marathon runners who are 80.  To a large extent, the level of chronic pain is determined b the person’s willingness to simply get up and move!

Here are the recommended exercises by Liz Neporent of AOL:

1.  Wall Ball Slides: An excellent, no-impact way to strengthen the thighs, hips and buttocks.  These crucial areas are susceptible to early atrophy and weakness due to prolonged sitting.

2.  Bridges: Another excellent movement to strengthen and lengthen the buttocks, hips and core. Especially good for people with knee problems who may have trouble getting into the squat position.

3.  Trunk Curl-Ups: ** This is the only exercise on this list that I highly recommend people avoid.  The research is overwhelmingly opposed to this exercise as it puts tremendous stress on the lower spine.  I have included a video of a more suitable exercise, one that can be easily modified based on ones ability. Click on side bridges to view the video.  **

4.  Water Aerobics: When it comes to cardiovascular exercise the common question I get is, “What is the best cardio exercise?” And my answer is always the same, “The best cardio exercise is the one that you are willing to do!” Water aerobics are fun and they reduce a tremendous amount of stress to the spine and knees.  So if you are a fan of water aerobics, then they are the perfect cardio exercise for you.

5.  Arm Curl: Can be done in the gym, or in a water aerobics class, but the use of resistance training for the upper arms is very important, especially in cases of arthritis and chronic pain of the upper body.

For more information regarding exercises for the senior population, feel free to email me at DrBooker@CapitolRehab.com and enter “Seniors” in the subject line.

To read the complete AOL article, click (Read Full Article Here)

CNN recently compiled a list of “5 Ways To Help Your Children Stay In The Game Injury-Free.”

The list goes as follows:

1.  Diversify your child’s sports portfolio. Essentially don’t just focus on one sport, but play a variety of sports so as to change the stresses on a young person’s body.

2.  Don’t let your child play if he or she is in pain.

3.  Know the pitch limits (for baseball).  Overthrowing for young athletes can create devastating arm and shoulder problems.

4.  Learn the coach’s “injury philosophy.”  What is the coach’s philosophy on playing young athletes who may be hurt?

5.  Be familiar with the common injuries for your child’s sport.

These are valuable tips, but they miss the most important tip of all!

A group called Canadian Sport For Life has identified the all too obvious answer.

Kids play too much and train too little.

Essentially, most adolescent sports injuries happen for a predictable reason. When our children play a particular sport, there are specific physical requirements of that sport.  Does the child, jump, throw, bend at the knees, rotate at the shoulder or waist, and if so, what are they doing to handle those stressful requirements?  The common answer is little to nothing.

When you take a close look at the training patterns of professional and elite athletes, the pattern is usually reversed. Professional and elite athletes spend most of their time preparing for their sport and less time actually playing it.

The sport specific requirements obviously differ from sport to sport, but if you have specific questions about injury prevention for your child, please feel free to email me at DrBooker@CapitolRehab.com and enter “Kids Injuries” in the subject line.

Dr. William Booker
Capitol Rehab of Arlington
703-527-5492

An April 6, 2010 Reuters article reveals that between 2002 and 2007, the federal Medicare program showed a 15-fold increase in the rate of complex surgeries to treat spinal stenosis.  Spinal stenosis is a common condition found in the elderly in which the spinal canal narrows, causing pain in the back and legs.

Here are the 4 Reasons you want to avoid complex spinal surgeries at all cost.

1.  Little benefit: Complex spinal surgeries offer little benefit over simpler procedures for most patients.  A higher percentage of the patients receiving the complicated surgery felt worse compared to patients receiving the less complicated procedure.

2.  Increased risk: Complex surgeries had an increased risk of complications. Study found patients who had the complex surgeries had nearly 3 times higher odds of life threatening complications compared to those who received the less invasive procedures.

3.  Less proven: The complicated procedures are far LESS proven than the more basic surgical procedures.

4.  Costly: The complicated procedures were FAR more expensive.

As an avid supporter of conservative care, I find this article remarkably enlightening.  Ignoring the obvious financial incentive to perform the more complicated procedures, it is hard to find much support for the use of unproven, more complicated procedures, especially when the more conservative approaches were as effective, if not more so.

To read the article in its entirety,  click Reuters Article.

For additional information please feel free to email me at DrBooker@capitolrehab.com

Bones have gotten a bad rap.

Admit it. Your only associations with bone health are negative. Fractures. Osteoporosis. Maybe cancer. And that’s probably about it.

The mainstream media is full of stories about good heart health, good brain health, even good skin health. But nobody ever talks about “good bone health.”

Even metaphorically, we never talk about bones for anything good. Think about it:

“I’ve got a bone to pick with you.”

“I’m working my fingers to the bone.”

“It hit me a bit too close to the bone.”

Bones always mean bad news. Skeletons are scary, whether on X-rays, at the front door on Halloween, or in our closets. We associate them with graveyards, physical (and moral) decay, and death.

And yet, no body part is more alive, or more essential to life. Without bones, you would die within minutes — make no bones about it.

In this article, the first in a series, I will tell you why I have a soft spot for bones. First, I’ll tell you about all the things that bones actually do in the body. Then I’ll tell you about the single greatest threat to bone health. Finally, in the next issue, I’ll give you the latest breaking news about what you should (and should not) be doing to keep your bones healthy and strong.

Here’s hoping it’s the only breaking bone news you ever get.

Boning Up on Bones

Pop quiz: there are six major functions of bone. How many can you name? (Without cheating.)

Bet you can’t get all six.

Ready?

Go.

Okay, pencils down.

Here are the answers:

1. Protection. Your skull protects your brain. Your vertebral column protects your spinal cord. Your rib cage protects your lungs and your heart. Your pelvis protects several organs. And all of your bones protect the soft marrow within.
2. Support. Your bones physically support the weight of your body. They also support your muscles, your organs, and even your teeth.
3. Movement. Muscle alone cannot create movement. Your bones give your muscles leverage. Without bones, you couldn’t even breathe — your ribs allow your chest to expand and contract. No ribs, no breathing. (That’s why I said without bones, you’d die within minutes.)
4. Blood Formation. Most blood cells are made in your bone marrow. That includes not only the red blood cells that carry oxygen, but also most circulating cells in the immune system.
5. Acid-Base Balance. Your bones release acidic and alkaline mineral salts as necessary to maintain the pH balance in your blood. The optimal range for human blood pH is very narrow — just 0.1 on a 14-point scale — and so your bones have to work constantly to make sure that your blood stays in this range.
6. Electrolyte Balance. Your bones serve as your body’s main mineral storage in the same way that fat is your body’s main energy storage. When your body is hard up for minerals, it turns to your bones to get its fix.

How many did you get?

The first three were easy. The last three were tougher. I would guess that very few of you got all six.

And yet, all six functions are vital for life. Now do you see what I mean about bones being underappreciated?

Is Your Back Pain Or Sciatica Caused By A Bulging Or Herniated Disk?

Last week I completed the upper extremity protocols of the Active Release Technique Series. For the record, I was introduced to ART some 10-11 years ago and thought it was great then. But as I have grown to learn, most great things have a tendency to evolve. When I was learning some of the active release protocols, it seemed as if there were maybe 20-30 protocols for the entire body. Last weekend, I was going to be tested on 110…JUST FOR THE SHOULDER, ARM AND HAND!!

I knew I was in a little bit of trouble when I received the 440 page manual and two 2-1/2 hour DVD’s two weeks before my session with instructions that read: “We strongly recommend that you watch your videos, practice all protocols and be very well versed in the anatomy prior to the workshop.”

Confident as always, I loosely followed those instructions and showed in Orlando for Day 1. I realized I was in big trouble when the instructor informed us that a 90% was required to pass! To make matters worse, the exams were held in a practical format, where I was going to be required to perform the procedures ON THE INSTRUCTOR.

The unfortunate news for me was that I was going to have to really know my stuff or the instructor would quickly know I was fudging it (during my school days, fudging it had been a speciality of mine; back then, setting really low expectations and trying to barely exceed them was my preferred way of doing things.)

I knew this was going to be the start of a couple really long days, followed by even longer nights.

The short story is that I passed and with a 94, if you have to ask.

The long story is that this information will be another great addition to Capitol Rehab of Arlington’s efforts to provide the best care possible. These new approaches for shoulder, elbow, wrist and hand problems, as well as radicular nerve pain into the arm, are going to allow us to even more effectively and rapidly treat the most difficult upper extremity problems. Perhaps even more exciting is the improved successes we can expect with post-surgical patients.

Dr. Beck has already completed the certification for the lower extremity and will be taking the upper extremity later this month. I will be completing the lower extremity sometime this summer.

If you have questions about upper or lower extremity injuries or about Active Release Technique, please do not hesitate to contact me at DrBooker [@] CapitolRehab.com.

Dr. Booker
703-527-5492