Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain

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9781592400454: Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain
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As a physician specializing in treating athletes, Dr. Vijay Vad has spent years researching how to cure back pain using medical yoga and Pilates. Profiled in The Wall Street Journal, his program requires just fifteen minutes a day for eight weeks to restore flexibility and prevent future injuries.

Offering a proven alternative to invasive surgery, Dr. Vad’s Back Rx provides the best of mind/body medicine by giving readers three step-by-step exercise series, demonstrated in 130 precise photographs, for implementing his popular program at home. Even readers with severely limited mobility will rejoice in Dr. Vad’s gentle introductory workout. Progressing through his self-paced program, they will discover a new range of exercises, breathing techniques, and tips for self-massage. For those who want to go even further and use this program for more than the treatment of a single injury, an advanced workout is included that puts readers on the road to peak performance.

The perfect combination of modern medicine, Pilates innovations, and ancient yoga postures, Back Rx builds important new fundamentals for lifelong freedom from pain.

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About the Author:

Vijay Vad, M.D. is a sports medicine physician and researcher specializing in minimally invasive arthritis therapies at the prestigious Hospital for Special Surgery in Manhattan and a professor at Weill Medical College of Cornell University. He is also the physician for the PGA golf tour and the ATP tennis tour.

Excerpt. Reprinted by permission. All rights reserved.:

Introduction:
The Back Rx Way to a Healthy, Pain-Free Back

If youÆre reading this book, youÆre probably all too familiar with the pain of a low back injury. A strained muscle in the low back can make you gasp with pain at the slightest movement. The herniation of a spinal disk, the most troublesome cause of severe low back pain, can virtually cripple you. Worst of all, in the aftermath of a low back injury, pain may take up permanent residence almost anywhere in the back or legs, including sites far removed from the point of injury.

If youÆre hurting now, skip ahead to page xvii for some simple ways to ease the pain. Come back to read these pages when youÆre feeling better. In order to make a full and lasting recovery from low back pain, you must first understand what causes it.

In North America, four out of five people will suffer a serious episode of low back pain at some point in their lives. Only the common cold causes more lost work days than low back pain for adults under forty-five years of age.

Low back injuries usually heal within weeks, a testament to the backÆs inherent strength and resilience. But long-term healing is notoriously difficult to achieve. One episode of low back pain generally leads to another. Four out of five people will suffer a recurrence within one year, and then face a 70û80% risk of further recurrences. The right treatment can make all the difference between healing completely, building a more injury-resistant and resilient back in the process, and falling into a downward spiral of recurrent injury that defeats every measure of conventional and alternative care and leads to failed back syndrome, long-term dependency on pain medication, and even surgery. That downward spiral traps far too many low back pain sufferers.

IÆve had to heal my own low back pain. So I write this book both as a physician and as a fellow sufferer. The Back Rx program enabled me to beat my low back pain for good. And it has helped thousands of patients I see in my sports medicine practice and research at the Hospital for Special Surgery, an affiliate of Cornell University Medical Center in New York, where I also serve on the faculty as a professor. Back Rx achieves these results by blending carefully selected elements of rehabilitation, yoga, and Pilates with a central focus on breath control. It is one of the few exercise programs for the low back to be shown effective in controlled clinical trials.

In an ongoing study, my research colleagues and I are monitoring the progress of two groups of low back patients who receive the same medical care and take the same pain medication, except that one group does the Back Rx program for fifteen minutes three times a week. At the end of the first year, the group doing Back Rx had a 70% success/cure rate (as measured by a more than 50% reduction in low back pain), whereas the other group had only a 33% success/cure rate. The group doing Back Rx also needed much less pain medication and had significantly less recurrence of back pain than the other group.

Building on the work of many other low back pain researchers and clinicians at the Hospital for Special Surgery and elsewhere, my research and clinical practice have demonstrated that an exercise program like Back Rx can be the key to healing low back pain without surgery or long-term dependence on medication.

My patients come from every walk of life, including professional sports, which allows me to see the full range of low back problems. Professional athletes are especially interesting patients in this regard. Understanding why even highly conditioned individuals are susceptible to low back pain provides great insight into the common denominators of this baffling medical condition and how best to address them. I see professional athletes as private patients and in my role as a consulting physician for the ATP tennis tour and the PGA golf tour. My involvement with both tours began with research studies whose results provide powerful evidence for the effectiveness of the Back Rx program. I initiated this research in 1999û2000, when I spent a year on the road with the ATP tennis tour.

During my year on tour with the ATP, I had two main jobs to do. One was to find qualified low back care physicians in the tourÆs many stops around the world, from Tashkent, Uzbekistan, to Moscow, Russia, to Rome, Italy, to Tokyo, Japan, to Shanghai, China. The other was to conduct a research study into why low back pain is so prevalent among professional tennis players.

The study I conducted found that the players most susceptible to low back pain had the least range of motion in the hips. In 2001 the PGA asked me to do a parallel study of professional golfers. This study produced the same results, showing a significant link between a restricted range of motion in the hips and the incidence of low back pain. This finding is important for the rest of us, whether we are fitter than average or committed couch potatoes, because of the sedentary nature of modern life and work. Sitting in chairs, which most of us do for long hours every day at work, school, and home, leads inexorably to a restricted range of motion in the hips.

The Back Rx program accordingly features exercises specifically designed to counteract this tendency and increase the range of motion in the hips.

The treatment room at a professional golf or tennis match is a microcosm of the low back pain world. On one table a top-10 player may be receiving treatment from an acupuncturist, while different competitors work with chiropractors, massage therapists, and osteopaths, as well as specialists in conventional physical therapy and rehabilitative medicine. I have observed that although no single one of these therapies works for everyone, each of them works for large numbers of people. Back Rx incorporates insights and healing knowledge from all of them, and in the course of the book I will offer guidelines for choosing which treatments are best suited to your own individual needs.

One thing that everyone who studies and treats low back pain agrees on is that it is fundamentally a mind-body problem. As weÆll see in more detail in Chapter 2, emotional factors and psychological stress play a major role in the onset and persistence of low back pain.

A number of books have emphasized the mindÆs role in low back pain in a conceptual way, without offering reliable, concrete methods for putting the concept to practical use. The way one recent book puts it is typical: to heal low back pain, it tells readers vaguely, ôlearn to work with your negative feelings.ö Negative feelings from stressful experiences can indeed hinder full recovery and heighten recurrences. But healing low back pain begins not with psychotherapy, but with mind-body physiotherapy. You have to engage the mind at the fundamental level of body awareness, posture, and balance first. These three fundamentals form the essential foundation for healing the whole person.

Back Rx meets this challenge and teaches you how to engage the mind in healing through its focus on breath control, a key feature of both yoga and Pilates.

In my sports medicine and back care practice, my research on low back pain, and my own efforts to lead a healthy lifestyle, IÆve gained an increasing appreciation for the benefits of yoga and Pilates. Yoga, which I first learned to do at my grandfatherÆs side as a young child in India, engages the entire body in healthy breathing, while freeing the mind to focus without distraction or anxiety on anything it needs to do. This age-old practice has a mind-body potential that the latest neuroscience is only beginning to understand. For its part Pilates, whose founder, Joseph Pilates, was greatly influenced by his study of yoga, is the best strengthening practice yet developed for the core body musclesùof the torso, back, abdomen, pelvis, and thighsùthat are crucial to good back health.

The paradox is that although yoga and Pilates are ultimately the best possible way to maximize back health, in the short run the vigorous twists, turns, and bends of advanced yoga and Pilates can actually cause back injuries. ItÆs quite a catch-22: the very thing that can help you the most can very easily hurt you.

Back Rx solves this problem with a carefully sequenced introduction of yoga- and Pilates-based movements and poses that will strengthen the back without traumatizing it. From the first step on, this sequence of medical yoga and medical Pilates addresses the body and mind together by showing you how to find and follow your natural breathing rhythm. The slow, sustained, deep, gentle breathing of Back Rx helps you in two ways. It automatically clears and refocuses the mind, and thus begins to melt away emotional and mental stress without any direct mental effort or concentration. And it tunes the body, so that each deepening breath progressively relaxes and conditions injured or atrophied muscles.

There are three series of Back Rx exercises to heal and strengthen your back. Each series takes fifteen minutes to complete and should be done three times a week for eight weeks on average. Series A alone will get you moving pain-free again after an acute low back injury. Many patients maintain good long-term back health by continuing to do Series A regularly, without moving on to Series B or C.

For those who want to raise their back fitness for sports and recreational enjoyment or as a stress-, injury-, and age-fighter, however, Series B offers a vigorous back toning routine and Series C provides a strenuous core body workout.

The vast majority of low back pain sufferers, more than 80%, can heal with Back Rx alone. For the small percentage who need to take other measures as well, Back Rx can be the spine that holds an effective treatment program together. There are exciting developments that can minimize the invasiveness and maximize the benefits of back treatments and surgeries. I look forward to telling you about them later in the book, including some minimally invasive, nonsurgical procedures that I have been fortunate enough to help innovate.

The Back Rx prescription offers a comprehensive mind-body solution for the mind-body problem of low back pain. Its combination of the most advanced modern medicine with the ancient wisdom of yoga and the core strengthening of Pilates will empower you to take your healing into your own hands and become your own best physician. The ancient yogists calculated that a human being takes 21,600 breaths a day, and the goal of yoga is to make every single breath a completely healthy one. If you can incorporate Back Rx into your life, youÆll make a great start at reaching that goal and living pain-free.

Low Back Pain First Aid Chest
What to Do if YouÆre in Pain Right Now

After a low back injury, follow these simple steps to ease your pain and begin your healing.
*Focus on and regulate your breathing. Proper breathing in a slow, controlled rhythm is the fastest pain reliever you can use. It shifts the mindÆs attention away from the pain and triggers the bodyÆs natural relaxation response. You can do this in any position, but if possible:
*Lie flat on the floor on your back with your knees up and your lower legs resting on a chair, an ottoman, or some pillows, or lie on your side in bed in a fetal position with a pillow between your knees. These positions should take the strain off your lower back, but if another position feels better, thatÆs fine. Every injury is different. Let your body guide you into the least painful position possible.
*Slow your breathing down as much as possible. Exhale fully, then inhale deeply and hold the breath in your lungs for a count of three. Exhale fully, and continue breathing in this way for at least two to three minutes.
*Repeat this process throughout the day to calm yourself and to deliver extra oxygen to overstressed muscles and disks, allowing them to begin to relax, breathe, and take in nourishment.
*Use visual imagery to guide your breathing and enhance the relaxation response. For example, try imagining your breath as a wave of golden light flowing through your entire body. Another good technique is to picture yourself in a favorite spot, real or imagined, where you feel safe and at ease.

The more relaxed your breathing becomes, the less pain you will feel. As you become better able to focus on your breathing for a few minutes at a time, you will also prepare your mind and body to work together in the rest of your healing.
*Pain or Gain. Being overly stoic may actually slow your recovery. Take anti- inflammatory and pain-relief medication to speed healing.
*The most readily available over-the-counter pain relief medicines are aspirin, ibuprofen (Advil), and acetaminophen (Tylenol). Ibuprofen is generally the best choice for low back pain, because unlike acetaminophen, it combines pain relief and anti- inflammatory benefits.
*Liquid gel pills work best, because they are absorbed more readily in the bloodstream. As a general rule, unless a doctor prescribes otherwise, you should take two liquid gel ibuprofen two to three times a day.
*Everybody reacts to medicine slightly differently, and you may find that it helps to to combine ibuprofen with acetaminophen, taking the first for pain and inflammation and the second for additional pain relief. In any case, do not take more than eight pills a day, total, unless your doctor prescribes otherwise.
*People with diabetes should be especially careful not to take high doses of these medicines for extended periods, because of the potential for kidney damage. Anti- inflammatory medication is also contraindicated for those with a history of gastric ulcers or compromised kidney function.
*If severe pain persists after seven to ten days of taking ibuprofen and/or acetaminophen, you should consult a physician.
*If over-the-counter medicines donÆt lessen your pain and inflammation significantly, donÆt wait a whole week to go to the doctor. More powerful pain relievers, anti-inflammatories, and muscle relaxants are available by prescription, and they are safe if used as directed.
*Like over-the-counter remedies, these medicines should only be taken short term. If they have not brought you any significant lasting relief after a few days, you should re- consult your physician.
*A number of herbal and other remedies are available for treating low back pain. These include herbal medicines prescribed by practitioners of traditional Chinese medicine and packaged natural and synthetic compounds sold by health food stores. Herbal medicine has great potential health benefits. The problem with herbal remedies, however, is that their benefits and drawbacks, if any, have not yet been tested in controlled studies. Some of them contain substances that could cause serious harm. For example, many Chinese herbs contain atropine, a substance that affects heart function. Equally important, the quality of herbal remedies varies widely. You cannot always be confident that you are getting the advertised ingredients in the right form. It is far safer to stick with well-tested over-the-counter and prescription medicines.
*Take modified bed rest for two to three days. This means that y...

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