Back Pain, Knee Pain, Squats and Logic - What Are We Missing?

I've spent 20 years in the gym environment, and the educational training I did for my work pre-dated much of what is now considered 'functional training'. Yet I somehow think we're missing some connection between what exercises are done, associated joint and back pain and the loop back to a better way of doing exercise.

Universally the instruction for squatting is to go no lower that 90 degrees at the knee, yet if I asked you to lift a heavy object, instinctively you wouldn't bend that much to lift.

Most people I know when bending to that angle causes the low back to start to flatten and this puts it at greater risk of injury.

And for many with knee problems, an underlying issue is muscle imbalance in the quads, where the medial part that works most in the last 30 degrees of leg straightening is weak relative to the outer part of the quad.  So doing deep, heavy movements by default creates an imbalance, which is often then exacerbated with leg extension type exercises.

My theory is this:

1. Any squat type movements should only be to 45 degrees at the knee when loaded with weight. So this includes squats obviously, leg press & Hack Squat.

2. Full depth movements such as lunges should be encouraged so long as the back is well stabilised with the core muscles. These can be weighted to help build bulk for those wanting it.

3. Full depth squats (bum to the ground and heels on the floor) is a practical means of maintaining full range of movement, function leg strength, and since it should be done without weight reduces the risk of back or knee injury.  

Restoring our capability to live to the boundaries of how our body functions makes more sense than doing an exercise purely because we can. This is what functional training is really about.

What Is Health Insurance To You?

You own a car, you have insurance, you have belongings and you insure them.

You're health is essential but you only take health insurance since you pay a medicare levy if you dont.

You take the hospital part since you really don't want the bills associated with expensive medical procedures, and of course hope you'll never need it.

And yet the extras part of your insurance cover is nothing like these other insurances. I've never struck anyone who thinks of it in the same way as hospital cover: "I have physiotherapy cover but I hope I never need it". No the general perception is - this extras cover should pay for my health. And bummer, it doesn't. But how can it? The companies that provide insurance need to make money, so if these 'extras' products did cover the full cost, it would cost more than if you simply paid for it yourself.

So how important is your health? Who's responsibility is your good health? If we all expect insurance to pay, guess what - in the end it's us anyway! And then we end up with the American mess where health insurance is so expensive no-one can afford it anyway.

So all this seems quite negative, yet the point is that we all have to take responsibility for our personal health. That means both in an effort to maintain it, and to bear the everyday cost of achieving it. We pay our taxes to help with the expensive stuff - but it's time public health policy started to reflect personal responsibility as a first line of defence. And supported it with sensible help and advice, coming from enlightened doctors, nurses, chiropractors and allied health practitioners. if we don't then the future of health care will be one where you don't have a choice, simply because we (collectively) can no longer afford it.

Natural Childbirth Means A Healthier Life

The following is pulled verbatim from the SMH Sun 30th May. Thank goodness medical science is beginning to realise that whenever possible, natural is the way to go. And to catch up with modern thinking on the cause of allergies and chronic diseases.

BABIES born by caesarean section are more vulnerable to asthma, allergies and infection as they miss out on receiving their mothers' good bacteria during birth, a scientist says.

Professor Patricia Conway, of the School of Biotechnology and Biomolecular Sciences at the University of NSW, said babies delivered vaginally received protective bacteria as they passed through the birth canal. Left on the baby's skin, this bacteria could then colonise the intestine and help inoculate newborns against hospital bugs. Gut flora was also crucial for developing a balanced immune system, Professor Conway said. "With a C-section, the newborn baby misses an opportunity to pick up a lot of mum's good bacteria," she said.

"This can have long-term health implications, as the development of a good intestinal ecosystem is necessary for health and immunity to allergies, from childhood right through to adulthood."

Professor Conway said emergency caesareans, performed after labour had begun, meant babies did receive some of the beneficial bacteria, particularly if the waters had broken. But elective caesareans were ''sterile'' and gave babies no chance to pick up any of the mother's good bacteria.

However babies had other chances to receive their mother's bacteria, during skin-to-skin contact directly after birth and if they were breastfed.

Australian College of Midwives vice-president Hannah Dahlen said babies born vaginally had the advantage of hormonal surges during labour, which made them more wide-eyed and able to connect with their mothers.

Both mother and baby experienced a surge in catecholamines - the fight-or-flight hormone - during labour, making babies more alert at birth.

Recent studies had shown white blood cells in babies born by caesarean were different to those born vaginally, potentially altering the way their bodies responded to attacks on their immune systems for the rest of their lives.

The studies could explain dramatic increases in rates of diabetes, testicular cancer, leukaemia and asthma among babies born surgically, Dr Dahlen said.

''In labour, the baby has a gradual escalation in its stress response and then a gradual decline. Research has shown that this could prime our bodies to respond to stress in a certain way,'' she said.

''With a C-section, there is a cold cut and the baby has a dramatic stress response. It could be setting that child up to always over-respond to stress.''

In 2008, European researchers examined 20 previous studies on the link between type 1 diabetes and caesareans and found babies born surgically had a 20 per cent increased risk of developing diabetes.

They hypothesised the increase could be attributed to surgically born babies having gut microbes picked up from hospital environments rather than their mothers' vaginas, having reduced or delayed exposure to infection in early life or being exposed to non-specific perinatal stress.

Codeine ban will induce headaches: pharmacists (SMH March 26)

What a load of trollop.

Laws limiting the volume of codeine based medication you can buy could be argued for or against. yet the message of this article was that it would lead to increased costs and more inconvenience.

But did you read the heading? They actually mean it. "Greg and Mary Walsh of Concord, who have four children, estimate they use a 12-pack of combination analgesics every week. They buy in packs of 48 because they are cheaper and ''then it's always there'' but will now have to visit a pharmacy almost every week.

''It will lead to us running out,'' Mr Walsh said. ''When it's needed, it won't be there. so you'll have to put up with the pain until it subsides or until you get around to going to the chemist."

This type of comment I think shows that the problems we have with the health system are not limited to the system itself, but the decades of mis-information provided as best care for problems. You would think that this family (and many more like them) should stop and ask - WHY do we need so many drugs? WHAT is causing the symptoms? And actually do something about the problem rather than pretending that drugs are the answer.

Usual Care for Low Back Pain Often Not in Sync With Clinical Guidelines

"The usual care provided by Australian general practitioners for low back pain does not match the care endorsed in international evidence-based guidelines and may not provide the best outcomes for patients, according to new research published in the February 8 issue of the Archives of Internal Medicine."

Low back pain is the 7th most common reason Australians head to the GP, yet this report shows that not only are they typically give the wrong advice, they're given poor advice, and prescribed inappropraite medication the majority of the time.

I do get clients who are actively recommended not to continue with chiropractic care by their GP, despite plenty of evidence that supports it as an appropriate approach for back care. Oddly enough most of these reports focus on pain relief, and then say 'live with the problem', failing to recognise that a well implimented care plan can make a huge difference to how healthy you can be.