I have noticed an interesting evolution in my practice. When I was in my 20′s the vast majority of my patients were similar in age, and therefore had questions commonly found in the 25-38 year old crowd. Questions like, “How do I get a six-pack?” used to dominate the discussion.

Now in my 40′s, the tones of vanity have given way to cries for survival!

“Why is this happening to my body?”
“Will I ever be able to do that again?”
“Why is it taking me so long to heal?”

And my personal favorite, “Do you have any secrets for living longer?”

Well luckily, I do advice in the area of longevity, but I have to warn you, be careful for what you wish for, because when pressed on the subject, most honest people are able to admit, its not living longer that we most desire, its living more quality years.

So before I dive into the first lesson for longevity a few Rules We Must All Agree On:

1. Anti Aging is QUACKERY! I will tell you that real scientists agree that they cannot do such a thing, so anyone making those claims is a con artist and a charlatan.
2. Our Goal is more quality years NOT more total years.
3. Longevity is more than just your physical being, it is the health of your mind and spirit.
4. I am not sharing any Rules or hidden secrets, I am sharing lessons learned from the most successful cultures on this planet. Cultures that seem to have fooled the clock, or the science books, about the concept of living a long and happy life. Many of these lessons were taken from studies done in the book “The Blue Zones.”

Without further delay:

RULE NUMBER ONE: Move Naturally

Considering I just completed a marathon, this first rule may surprise you. The research suggests that longevity isn’t about running marathons and triathlons, and it isn’t about being the weekend warrior. Worse still, it isn’t about the 90 day P90x or Insanity workouts, its about making regular, low-itensity physical activity, part of a daily routine. Cultures that spent their lives gardening, or working as shepherds; doing daily yoga or taking regular nature walks, did the best.

Remembering that “LIFE” is the marathon, so don’t approach it as a sprint. All of the longevity cultures studied incorporated some form of regular, low-intensity activity that satisfies each of the following:

-A large emphasis on core strength at least twice a week,
-Daily balance exercises
-Aerobic exercise 5 times a week.

STRATEGIES TO INCORPORATING LESSON ONE

1. Inconvenience Yourself-Use the stairs not the elevator, get up to change the channel, get rid of the electric can opener/snow blower/garage opener.
2. Have Fun. Keep Moving.-Rather than exercising for exercise sake, make your lifestyle active. Take walk breaks instead of coffee breaks, don’t join a gym if you hate it, do things that keep you active that you enjoy.
3. Walk.- Its easier on the joints, always accessible and invites company.
4. Make a Date.-Getting out and about can be more fun with other people. Knowing someone else is counting on you will motivate you to keep at it.
5. Plant a Garden.-Working a garden requires frequent, low-intensity, full Range of Motion activity, and you have the benefit of fresh vegetables!
6. Enroll in a yoga class.-Just be sure to practice it 2 times a week.

Here are five common fitness barriers, along with some tips for making them disappear.

Barrier #1: Too Busy
It’s unlikely that you’re too busy to exercise. You probably just need to use a little creativity to get the most out of your time.

Get up 30 minutes earlier. If your days are packed and the evening hours are just as hectic, get up 30 minutes earlier twice a week to exercise. Once you’ve adjusted to early-morning workouts, you can add another day or two to the routine.

Rethink your weekend rituals. Your Saturday matinee could be reborn as a Saturday bike ride, a trip to the pool or a hike.

Squeeze in a few 10-minute walks throughout the day. If you don’t have time for a full workout, don’t sweat it. Shorter spurts of exercise spaced throughout the day offer benefits as well.

Park in the back row of the parking lot. Or park a few blocks away — and then walk quickly to your destination.

Barrier #2: Boredom
It’s natural to grow weary with a repetitive workout, especially when you’re going it alone. But exercise doesn’t have to be boring.

Exercise with a partner. Enjoy the camaraderie, and offer encouragement to one another when the going gets tough.

Vary the routine. Rotate among several activities — such as swimming, walking and cycling — to make things more interesting.

Check out sports leagues or exercise classes. You’ll learn new skills while getting a great workout.

Barrier #3: Fear
If you’re nervous about injuring yourself, try the following techniques.

Try an exercise class for beginners. Focus on the basics, and don’t worry about the hard stuff.

Consider working with a personal trainer. Get a customized fitness tutorial from a certified expert who can monitor your movements and point you in the right direction.

Keep the exercise simple. Start with a simple walking program. As you become more confident in your abilities, add new activities to your routine.

Barrier #4: Lack of Money
You don’t need a gym membership to get a great workout. Consider these alternatives.

Try the community center. Exercise classes offered through a local recreation department or a community fitness group might fit your budget better than an annual gym membership.

Take the stairs. Skip the elevator when you can. And try to make climbing stairs a workout in itself.

Do strengthening exercises at home. If you can’t afford weights, try inexpensive resistance bands. Or do squats or push-ups using your body weight to gain strength.

Watch exercise videos. Try videos on cardio kickboxing, aerobics, tai chi, yoga or other techniques.

Start a walking group. Round up friends, co-workers or neighbors for regular group walks. Plan routes through your neighborhood, near your workplace, or at local parks.

Barrier #5: Lack of Support
Remind those close to you how beneficial exercise can be — and ask them to join you.

Suggest a new adventure. For example, invite a friend to go to an indoor climbing wall or rent a tandem bicycle.

Exercise and play with your kids. Sign up for a parent-child exercise class. Take your family to the park for a game of tag or kickball. Swim with the kids in the pool instead of watching from your chair.

In the end, there’s no obstacle to fitness that can’t be overcome. Just put your mind to it, take it a step at a time, and you’ll be surprised how easy exercise becomes over time.

Here are 5 simple ways to cut 250 calories:

1. Drink plain coffee instead of a sweetened coffee drink. Flavored coffee drinks are delicious but filled with way too much sugar. Drop 250 calories (or more) when you stick with plain coffee or tea instead of sugar-filled coffee drinks.
2. Jog for 30 minutes. Want in on a little secret? The hardest part about a simple 30 minute jog is the act of getting your shoes on and walking out the door. It’s true.
3. Exchange 20 oz of regular soda for water. You know that soda is filled with tons of sugar, so why are you still drinking it? Every time you crave an ice cold cola picture swallowing spoonfuls of white sugar. That’s probably the easiest way to weight gain. Stick with water and kiss those extra calories goodbye.
4. Swim laps for 30 minutes. If your response to my jogging suggestion was ‘I have bad joints’, then you are in luck. Swimming is one of the best aerobic activities you can do, and it is impact-free. When you swim you recruit your entire body, a process which requires lots of energy—AKA calories.
5. Eat an apple instead of a cookie. Do you always go for something sweet after dinner? While your first instinct may be to reach for a cookie or a bowl of ice cream, why not consider what nature has to offer? Fruit is sweet, natural and lower in calories than traditional desserts.

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.

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

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

If you are living anywhere close or around the Northern Virginia area, then you are ** snowed ** in today … just like yours truly. As I sit in the home office recovering from what surely NOT be my last round of snow shoveling, I am realizing that my back is feeling a little tight. I’m certain I won’t be the only person who experiences some discomfort, or maybe even flat out pain, from this season’s snow-inspired outdoor workouts.

In light of this weekend’s #snowmageddon I have provided some helpful tips below and pulled together some videos of exercises that are very useful in preventing back pain.

Remember, these exercises are also therapeutic should pain, tightness or soreness develop.

1. The side plank
2. Therapeutic home exercise for upper and middle back
3. The fundamental core exercise

I also recruited my two kids to help demo my advice to most of you out there who I’m sure are stuck shoveling piles of endless snow…like me!

Let’s begin!

Tip #1

Tip #2

Tip #3

The right tools can make a large job manageable, the wrong tools will make for a very long day.

Tip #4

Injuries are far more likely to occur when you are fatigued and form breaks down.

Tip #5

Stay safe … and stay warm!

Dr. B

I’m kicking off a weekly video effort, aiming for Wednesdays, to demonstrate and share exercises, stretches or body movements to mitigate pain and/or improve mobility.

This week’s video showcases three (3) therapeutic home exercise you can easily do at home to help alleviate upper and middle back pain.

The exercises featured in the above video are called Cat/Camel, Modified Sphinx and Advanced Sphinx and will reduce pain and stiffness in the middle and upper back.

Follow Dr. Booker on Twitter at http://www.twitter.com/capitolrehab or fan him on Facebook at http://www.facebook.com/CapitolRehabArlington

I came across this info just yesterday about BeltLife, an “Innovative Product Designed to Relieve Low Back Pain Naturally, Safely and Comfortably” … here’s the blurb:

BeltLife is a premium low-back heat wrap designed for athletes, outdoor enthusiasts, and everyday back pain sufferers. It’s shaping the natural back pain relief revolution.

http://www.prweb.com/releases/2009/11/prweb3179234.htm

So I guess we are using heat again to treat low back pain.  In short, for people who suffer chronic low back soreness due to muscle tightness or fatigue, heat will provide temporary relief.  It certainly won’t make the low back pain any better for any sustained period of time, and if used for prolonged periods will lead to de-conditioning, increases spasms and swelling and long term chronicity…but at least it felt good for a little while.

Question: When was the last time you saw the Trainer for your favorite sports team run onto the field and throw a hot pack on an injured athlete?  Your answer is NEVER and the reason is simple…heat increases blood circulation which does provide some short term benefit, but inevitably it results in increased inflammation.  Always use ice in the case of an acute injury, because your first goal is treating any musculoskeletal pain is to control inflammation.

For low back sufferers the rules are simple:

1.  If the pain is sudden and acute, use ice as directed above.

2.  If the pain is chronic, you have to CHANGE the conditions that have caused your back to be chronically dysfunctional.  IE:  You have got to:

    a.  Strengthen the weakened muscles,
    b.  Relax the overactive muscles
    c.  And mobilize any joints that lack movement or have become fixated.

I will talk at great lengths about the role of proper rehab for chronic conditions in the future.  But for now, the moral of the story is improving chronic pain requires work, and those who put in the work, benefit tremendously.  Just like you can’t simply walk into a gym and suddenly be in great shape, you can’t simply wrap a hot pack around your back and think you cured chronic pain and dysfunction.