Exercise and back pain
While it’s official that exercise is good for you, for a lot of people with low back pain, there are mixed messages regarding what is helpful, and what is harmful. Many think the experience of low back pain is always a sign of damage and fear that exercise may cause them more problems. However, scientific studies now indicate that prolonged rest and avoidance of activity for people with low back pain actually leads to higher levels of pain, greater disability, poorer recovery and longer absence from work. If your back pain lasts a while, lack of movement can cause the muscles to become weak. This makes it more likely that you’ll strain them in future.
When people have low back pain, they are often told that activities involving lifting, bending, twisting and high impact (eg, jogging, running) should be avoided. However, just because lifting and running might be more sore than usual, this does not mean that the activity is inherently dangerous or should be avoided.
It is now believed that bending and lifting should actually be practised to help strengthen the back, similar to a runner getting back to running after spraining an ankle. Overall, using your back normally (to twist, bend, run, etc) will make it stronger, more flexible and healthier in the long run.
Exercise can significantly prevent the recurrence of an episode of low back pain. It also helps reduce low back pain and disability levels, when people start gradually and stick with it in the long-term.
Indeed, the average results for exercise in the treatment of back pain are on par (or better) than the results from treatments such as drugs or surgery; with fewer reported side effects and lower attached costs.
Contrary to popular belief, most types of exercise are of some benefit, with no single type being the best at reducing pain or improving function for people with a low back problem. People should feel comfortable and choose simple options such as walking, running, cycling, swimming, yoga and Pilates; knowing that all are believed to be safe and effective for low back pain.
The amount of exercise you do is probably more important than the type of exercise. The greatest gains result when an inactive person starts doing any exercise, but getting more than 150 minutes a week has the greatest health benefits. Doing the exercises in a relaxed manner e.g. moving normally, not guarding and not breath-holding, and progressing gradually may also be important.
When you are in pain, starting exercise can be hard. Underused muscles get sore more quickly than healthy muscles. Feeling stiff and sore after exercise does not indicate harm or damage to your body – it simply reflects your body not being used to the activity. It is best to start by doing some gentle activity and then increase your levels when you feel confident to do so.
No drug or tablet delivers the diverse range of benefits as exercise – a fact that is often overlooked as part of the management of low back pain. Be aware too that all low back pain is not the same – what worked for someone else may not be right for you, and if you are suffering from acute back it’s best to get professional advice prior to starting an exercise regime.
Sources: www.independent.ie; www.csp.org.uk
Image from yodiyim:freedigitalphotos.net
Understanding Your Hunger Hormones
You are out to dinner with a friend and the bread arrives at your table. You are not very hungry, but you think, “I’ll just have one little piece.” A few minutes later, you realize you have eaten three slices before your meal even arrives. What’s going on here?
Even though you are not physically hungry, your body gave you the signal to eat. That’s the work of three hormones in your body that control hunger — insulin, ghrelin and leptin. They are important because the way these balance can impact your weight and health.
Insulin is made in the pancreas and allows cells to take sugar or glucose from the blood stream to use as energy.
Approximately one-third of the population inherits what is known as a resistance to respond properly to insulin, which prompts the pancreas to secrete more insulin if you eat a meal high in refined or “simple” carbohydrates such as white pasta or white bread.
When the insulin does not respond normally which means allowing sugars to enter the cells of the body, you can experience what is known as insulin resistant hunger. Rather than being physically hungry, you might experience it as a “gnawing” desire to eat.
If you consume meals high in refined carbohydrates on a regular basis that are not balanced with respect to protein and good fat, you may continually crave carbohydrates.
Running on Empty
The more refined carbohydrates you consume, the more your energy levels fluctuate between high and low throughout the day. Consequently, you never truly feel like you are running on real energy.
It is important to know that the body prefers carbohydrates or glucose as its primary fuel. If you are eating a very high carbohydrate diet, your body will first try to utilize the carbohydrate before tapping into calories from fat or protein.
If you are trying to lose weight you may not tap into your fat stores if you continue to eat a diet high in simple carbohydrates, your body will simply prompt you to continue eating these foods, leading to increased hunger and chronic carbohydrate cravings.
Ghrelin vs Leptin
The hormone ghrelin makes you feel hungry and leptin causes you to feel full. An easy way to distinguish between the two is that ghrelin grows your appetite and leptin lowers it.
They work to your advantage when your diet is in balance and maybe surprisingly when you are receiving adequate sleep. They work to your detriment when your diet is out of balance and you are lacking sleep. Most importantly, the macronutrients you eat — carbohydrate, protein and fat — strongly influence them.
David Cummings, M.D., of the University of Washington, School of Medicine, has done multiple studies on how macronutrients affect the hunger hormones.
In 2007, he and his colleagues conducted a study that showed:
- Proteins were the best suppressors of appetite
• Fats have a neutral effect on appetite
• Carbohydrates initially lowered the appetite, but then rebounded soon afterward with a vengeance — causing the appetite to be even greater than before the food was introduced.Sleep and Appetite
In 2004, Eve Van Cauter of the University of Chicago conducted a study to see if sleep deprivation altered appetite. They tested men who slept 4 hours for two consecutive nights followed by 10 hours of sleep for two consecutive nights. They found that after sleeping for 4 hours versus the 10, the men had:
- Leptin levels that were 18% lower
- Ghrelin levels that were 28% higher
The men said they were much hungrier than usual and craved salty, sweet food. One compounding issue: a drop in leptin can signal the body to slow down the metabolism.
In summary, sleep deprivation not only increases hunger levels, but lowers metabolism, not a good combination for health and weight loss.
How to help your hunger hormones work to your advantage:
- Have protein at all meals, but especially at breakfast. Breakfast sets the appetite tone for the day so consuming some high-quality protein such as eggs, plain yogurt or cottage cheese with some nuts will lower your ghrelinlevels and minimize a spike in insulinlevels to keep hunger at an even keel throughout the day.
- Stay away from refined-carbohydrate-only meals and snacks such as cereal, a bowl of pasta, crackers, crisps and starchy snacks. Even having a healthy snack such as fruit alone can trigger a spike and a drop in insulin, so add some nuts or a piece of cheese with the fruit.
- Put ghrelin to rest: Getting adequate rest keeps your ghrelinand leptinlevels in check to allow for normal levels of hunger.
The History of the Modern Paralympics
Sport for athletes with an impairment has existed for more than 100 years, and the first sport clubs for the deaf were already in existence in 1888 in Berlin. It was not until after World War II, however, that it was widely introduced. The purpose of it at that time was to assist the rehabilitation of the large number of war veterans and civilians who had been injured during wartime.
In 1944, at the request of the British Government, Dr. Ludwig Guttmann opened a spinal injuries centre at the Stoke Mandeville Hospital in Great Britain, and in time, rehabilitation sport evolved to recreational sport and then to competitive sport.
On 29 July 1948, the day of the Opening Ceremony of the London 1948 Olympic Games, Dr. Guttmann organised the first competition for wheelchair athletes which he named the Stoke Mandeville Games, a milestone in Paralympics history. They involved 16 injured servicemen and women who took part in archery. In 1952, Dutch ex-servicemen joined the Movement and the International Stoke Mandeville Games were founded. These Games later became the Paralympic Games.
In 1960, 400 athletes with disabilities, from 23 countries, gathered at the Olympic Stadium in Rome, just days after the Olympics had concluded. They competed in archery, basketball, swimming, fencing, javelin, shot put, club throwing, snooker, swimming, table tennis and the pentathlon.
For more than a decade, Paralympic competition was only held for summer sports. Then, in 1976 in Sweden, the first Winter Games were held – the first games, also, to feature athletes who were not wheelchair users. 198 athletes from 16 countries competed in alpine and Nordic skiing for amputees and visually impaired athletes; ice sledge racing was a demonstration sport.
In 1982, the “International Co-coordinating Committee Sports for the Disabled in the World” (ICC) was created. Finally, on 22 September 1989, the International Paralympic Committee was founded as an international non-profit organisation in Dusseldorf, Germany to act as the global governing body of the Paralympic Movement.
The word “Paralympic” derives from the Greek preposition “para” (beside or alongside) and the word “Olympic”. Its meaning is that Paralympics are the parallel Games to the Olympics and illustrates how the two movements exist side-by-side.
The first Summer Games of the modern Paralympic era were held in Seoul, South Korea, in 1988. 100,000 attended the Opening Ceremonies, which featured skydivers, thousands of children, and 700 wheelchair dancers. Over 950 world records were set, with Trischa Zorn of the US winning 12 Gold medals in swimming and setting 9 world records.
The first Winter Games to take place in Olympic venues were held in 1992, in Tignes and Albertsville, France. Since then, both winter and summer Paralympic Games have taken place exactly two weeks after the Olympic Games, in the same arenas and on the same tracks and slopes.
Sources: www.paralympic.org; www.pbs.org; www.paralympiceducation.org.au