Many common causes of pain stem from neither diseases nor injuries, making them nearly impossible to diagnose. Doctors have a hard time finding a label for this kind of pain because there is nothing clinically wrong with the patient—other than the subjective experience of pain—nor are they able to offer any relief aside from surgery or medication.
While Essentrics cannot solve every case of chronic pain, I have seen it help many of these mystery cases. In this chapter, I take a closer look at the sources of chronic pain that are the result of unbalanced and immobile muscles along with atrophy and hardening of connective tissues. The fastest way to fix these problems is to simply reverse what caused them in the first place—either the wrong type of movement or no movement at all.
When it comes to exercise, we need to start thinking like Goldilocks: not too little, not too much, but just right. Doing just-right exercises can rebalance muscle groups, improve alignment, break up adhesions, help blood and oxygen flow freely, and—finally, permanently—heal your pain.
Our Sedentary Lifestyle: The #1 Cause of Pain
Dr. James Levine, director of the initiative Obesity Solutions at the Mayo Clinic at Arizona State University, coined the saying “Sitting is the new smoking.” The statement may seem provocative, but it is absolutely accurate. Immobility is a silent killer, one of the most damaging lifestyle choices we can make. Being sedentary slows or even stops certain vital bodily processes: Our circulation slows. Our arteries start collecting deposits. Our lymphatic system doesn’t get flushed out. Our cells become less sensitive to insulin and our pancreas weakens. Our muscles atrophy, their cells starting to die off.
By not moving, we’ve given our body the signal that it’s no longer necessary—so our body literally begins to prepare for death.
Immobility is as dangerous as a car crash or a major accident, yet it is far less obvious. It causes its devastation when we are doing absolutely nothing. A sedentary lifestyle has been linked to the following medical conditions and diseases:
• Arthritis
• Autoimmune conditions
• Cancer
• Depression
• Early-onset dementia
• Erectile dysfunction
• Heart disease
• Muscle atrophy
• Obesity
• Premature aging
• Sleep disorders
• Type 2 diabetes
Being sedentary clearly causes damage to our organs. So how do we define “sedentary”? The answer may surprise you. Being sedentary is defined as sitting for longer than six hours a day—a passive activity that anyone with an office job is typically required to do at least five days a week. Many of us who sit long hours at a computer may mistakenly believe that if we work out in the morning or evening, we’ll be inoculated against the effects of so much sitting. Not true!
In 2003, the Journal of the American Medical Association published a landmark study quantifying the effects of sedentary behavior. In analysis of the lifestyle habits of over fifty thousand women, the researchers found that every two-hour increment of time spent sitting (in this case, watching TV) per day was associated with a 23 percent increase in obesity and a 14 percent increase in the risk of diabetes.1 Given that our time spent staring at screens has only increased over the past decade, these risks would naturally seem to be compounding.
Indeed, in January 2015, the Annals of Internal Medicine published a meta-analysis showing that more than half of an average person’s life is spent sitting: in a car, on a bus, at work, in front of the TV, or at the dinner table. The Canadian researchers reviewed forty-seven studies that assessed the health effects of a sedentary lifestyle on thousands of people. They found that people who sat for prolonged periods had a higher risk dying from a multitude of illnesses as compared with their more active peers. What was particularly upsetting about this study was the finding that, even when people exercised for an hour a day, if they sat for 50 percent of their life, they were still at risk from the effects of the “sitting disease.”2
I consider myself a very active person because I do 30 to 60 minutes of exercise a day, park as far away as possible and walk to my destination, use the stairs when it is realistic, and go for walks when I have time. However, I spend many more hours writing, correcting exams, working on projects, traveling, and meeting with colleagues. As I do all these things, I sit. In fact, as I sit to write this book, I am surrounded by an office full of people sitting at their computers, whether designing workouts or editing TV shows.
When I was working on my first book, Aging Backwards, the research on atrophy scared the living daylights out of me. As soon as I understood the dangers of permitting one’s muscle cells to atrophy from lack of use, I rapidly became my own best student. I’ve rarely missed a day since to exercise each of my 650 muscles. I’ve always enjoyed exercise, but now I’m even more aware that if you don’t use it, you will lose it! When I do have to sit at my desk for hours at a time, I try to get up and move for a few minutes every half hour or so, which research shows does help to counteract the negative effects of sitting.
In today’s working world, there seems to be no avoiding being sedentary, which is why we need to navigate ourselves through this dangerous new reality and find healthy and sustainable solutions. Doing nothing may seem harmless, but we have to remind ourselves that the human body was designed to move. Movement is at the root of all life; it’s what keeps the engines of every one of our trillions of cells alive. When we stop moving, we start dying one cell at a time!
What Happens When We Don’t Move
The question of why immobility creates so much havoc in our bodies is answered in our cells. Our life force is contained in our trillions of cells. They require constant motion partly so that they don’t become glued to each other, so that nutrient-rich blood can circulate to every cell. When we are immobile, the cells stick to one another. A gluing chain reaction takes place with the neighboring cells, until large sheets of glued-together connective tissue harden around our organs and muscles, further immobilizing us. And embedded in this hardened tissue are even more dying, atrophying cells.
At first we experience a sensation of stiffness—but as the immobility accelerates, the stiffness increases. Immobilized muscle cells slowly atrophy and shrink, in time squeezing the joints together. This squeezing damages the joints, leading to chronic pain and, if not reversed, the need for surgery or even joint replacement.
Our cells require both nourishment and cleansing for survival; these tasks are carried out by the circulatory system. The circulatory system is designed to deliver nutrients and remove toxins by delivering fresh supplies of blood and oxygen around the body. With sedentary behavior, our circulation slows to a crawl, and very little nourishment is delivered to our cells. When a cell is starved of nutrients and has no way of releasing stored toxins, it suffocates from within. Basically, when we are sedentary, the body cannot use its natural, self-healing powers.
Immobility leaves us feeling tired and unwell, and makes recovery slow and incomplete—and, if we wait too long, more and more difficult. As I talked about in my first book, Aging Backwards, the negative feedback cycle of sedentary behavior can quickly get out of hand. Cell loss or atrophy triggered by immobility makes controlling weight extremely difficult because we sacrifice our mitochondria, the calorie-burning furnaces tucked into every cell. Obesity quickly becomes another self-perpetuating loop, with fat cells proliferating, muscle cells atrophying, and our body becoming weaker, flabbier, and stiffer over time.
Pain Is Unresolved Stiffness
When we wake up in the morning, we usually feel a little stiff from a long night of immobility. The less we move upon waking, the stiffer we feel—but after some stretching, the stiffness can go away.
Magnify that just-out-of-bed stiffness many times over, and you may better understand the sort of stiffness that many people chalk up to the aging process. Most people respond to this discomfort by moving less. But the less we move, the more our connective tissue solidifies, creating a chain reaction and exacerbating the problem. Remember: Pain is a message from the brain telling us that there is something dangerous happening to our body. The message of stiffness is a precursor to the pain message.
When any part of the body is immobilized, whether through surgery, injury, or lifestyle, the liquid connective tissue starts to congeal and harden. Over time, this liquid connective tissue gets gooey and harder, causing muscles to shrink from inactivity. A chain reaction takes over, aging us rapidly and painfully. And if we don’t rid ourselves of the stiffness—which can be quite easily done through a short, gentle full-body workout—we will likely soon experience pain. To stop stiffness from spiraling into pain, we must stretch out the stiffness, which nourishes our cells and lubricates our living matrix.
The congealing of connective tissue doesn’t happen uniformly around the body. As we walk, we may favor one hip over the other without realizing it. If we routinely lean on one elbow, the ribs on the opposite side might become glued together, leading to an imbalance in the musculoskeletal system.
Whether you are thin or overweight, weak muscles will deform the alignment of any joint, from the feet and ankles up through the hips into the spine. In addition to all the perils mentioned earlier, a sedentary lifestyle usually involves not only slouching but also not engaging all of our muscles and walking with a heavy footstep, slamming our feet down as we step. Heavy walking slowly breaks down the surface of the joints, damaging the knees, ankles, and hips, causing painful joint damage.
The Widespread Consequences of Weak Muscles
Our muscular structure is the machinery that moves our body and supports the bones, organs, and all other tissue. Muscles are designed to be strong enough to allow our body to feel weightless as we move around all day long. When our muscles are well cared for, we forget they exist—our body just does what we want it to do without pain or difficulty. Maybe that’s why the muscles are often referred to as the “guardians of our youth.”
But when our muscles are weak, we not only feel heavy and chronically tired but also unhealthy overall. Some of the most obvious consequences of weak muscles can be seen in our bones and joints. Weak muscles cannot prevent the weight of the body from compressing and pinching the joints and the connective tissue—leading to extremely painful premature arthritis and joint disease. Weak muscles also cannot protect us from losing precious bone mass, which leads to osteoporosis.
Weak muscles also endanger the health of our cardiovascular system. The vascular system—a network of sixty-nine thousand miles of veins, arteries, and capillaries that deliver blood throughout the body—requires strong skeletal muscles to keep things moving. Muscle movement creates a pumping action that naturally assists the circulation of blood throughout the entire body. Inactive, weak muscles, by default, leave the job of circulating the blood to the cardiac muscle. While the role of the vascular system is to circulate, the role of the cardiac muscle is to pump—so without the assistance of strong skeletal muscles, the cardiac muscle ends up doing double duty.
Digestion is also affected by weak muscles. When abdominal muscles are weak, the intestines have nothing to push against. This makes elimination slow and uncomfortable. When the torso muscles are weak, the lower body sinks backward while the upper body slouches; this poor posture crushes the esophagus, making swallowing painful and leading to acid reflux.
These are just a few of the reasons why weak muscles can lead to chronic pain. Muscles are designed to be strong, not weak. They strengthen rapidly with even the easiest exercises. The smallest increase in strength will rapidly improve our ability to move easily. The most important aspect of muscles is that they are designed to move the full body; it is by doing full-body movement that the magic of pain relief and improved health takes place.
Imbalanced Muscles
Having imbalanced muscles may sound like a relatively harmless problem—yet that is very far from the truth. Muscular imbalances are one of the key triggers that set off the chain reaction throughout the body that causes serious damage to joints and muscles. Consider that two of the worst pain conditions caused by imbalances in the skeletal muscles are back pain and arthritis. The amazing truth is that rebalancing the muscles is relatively easy with the correct exercises.
Treating back pain is a billion-dollar industry, draining both public and private purses. Lost wages for the employee and lost productivity for the employer make chronic back pain a costly condition. Beyond the issue of cost, chronic back pain can be so overpowering that any relief is welcome, even when that relief is fleeting and accompanied by serious risks and side effects. That’s why thousands of people turn to pain relievers or undergo back surgery every year—despite the fact that pain relievers have only temporary effects.
Recently, however, some doctors have recognized an alternative to surgery and drugs. According to Dr. Hamilton Hall, the founder of the Canadian Back Institute (now CBI Health Group) and the author of The Back Doctor, 80 percent of back pain can be relieved with correct rebalancing exercises. Thousands of people undergo back surgery every year—and it doesn’t always work. In many cases, correct exercises are not only cheaper and less painful than surgery—they are what’s actually needed. Preventing and adjusting muscular imbalance is the foundation of lasting back pain relief.
To better understand the role of muscular imbalance in back pain, it helps to understand the role muscles play in keeping joints balanced. The thirty-three vertebrae of the spine are designed to move in many directions: forward, back, side to side, and diagonally. Directly or indirectly attached to the spine are dozens of muscles whose job it is to move the spine in all its many directions. Some muscles help us twist, others help us bend forward, and still others bend us backward.
When the spine is poorly aligned, a group of back muscles will become overworked when it tries to pull the vertebrae back into alignment. When the overworked group can no longer sustain the constant state of stress, it goes into spasm. Anyone who has ever experienced a back spasm knows that the pain is excruciating and intolerable! Rebalancing the full musculature of the spine helps realign the full spinal vertebrae, taking the constant stress off the overworked muscles.
This is why having good posture and a fully mobile torso is essential in preventing back pain. Anytime our spine is not in correct alignment, we will inevitably suffer from back, shoulder, or neck pain. Having poor posture, slouching, or sitting at a desk all day tends to weaken the spinal muscles and thus leads to chronic back pain. We hear about bulging, herniated, or slipped discs, or disc decay or arthritis—the root cause of many of these excruciating back problems can be traced to imbalanced muscles.
MY EXPERIENCE WITH BACK PAIN
My ballet training led me to have poor alignment in both of my femurs (thighbones). This alignment is taught to ballerinas as “good” alignment, but it forces the thigh muscles to exist in a constant state of tension. I thought that tension meant my muscles were strong, which they were, but when a muscle is contracted it shortens, along with the surrounding muscles. So for me, the constant tension didn’t stay in the thigh muscles but spiraled into a related group called the psoas muscles, which attach to the lower spine.
By the time I reached forty, the contracted psoas muscles had pulled my L4 and L5 vertebrae (the lowest two vertebrae in the lumbar part of the spine) out of alignment, creating a bulging disc and premature arthritis of the spine. I was in a lot of pain for a long time. That’s when I met Dr. Bradley Bosick, a chiropractor and neurologist in Denver, Colorado, who explained to me that muscles should never be in a permanent state of contraction. Healthy muscles are meant to alternate between relaxation and contraction continuously throughout the day. Anytime anything is in a constant state of contraction, it is vulnerable to damage.
A slight shift in the alignment of my femurs instantly relieved the tension in my thigh and psoas muscles—and the muscles relaxed. That was when I finally understood the root cause of my chronic back pain: poor alignment unbalancing my thigh and back muscles.
Bad posture habits like mine are slow to change, because the correct posture feels unnatural and wrong at first. It took me a while to realign my thighbones and rebalance my muscles, but the difference in comfort, ease, and energy I’ve experienced since then is truly amazing.
Creating Essentrics helped me rebalance my spine and get rid of back pain. I have remained pain-free ever since—unless I miss too many days of exercise. Learning how to stand correctly has also de-stressed my thigh muscles, releasing what was once a constant tension on my spine.
Joint Imbalance
The human body has 384 joints. Joints are movable body parts in which adjacent bones are held together by a complex system of muscles, tendons, and ligaments. At the head of each bone is a lubricated, glassy surface that permits joints to glide effortlessly as we move. Joint damage is often caused when muscles shrink or shorten around the joint, squeezing the joints so tightly together that the lubrication required to make them slide can’t get into the joint. With no lubrication, the glassy surface is no longer slippery, and becomes drier and drier. Every movement, from standing to sitting, acts like sandpaper to grind away the protective glassy surface until the bones begin to grind. This is excruciatingly painful! We have to keep our joints well aligned, and the muscles surrounding them well balanced, to prevent them from being damaged or injured. Most joint imbalance begins in the muscles.
As noted earlier, our spine has thirty-three vertebrae. Vertebrae are designed to comfortably permit the torso to bend forward as we pick something up, bend sideways as we get out of a car, and twist as we turn to look behind us. Our fingers and knees, in contrast, have joints like hinges of a door—we don’t want our fingers or knees to be capable of moving in the same circular motion as our spine. Walking would be very unstable if our knees were capable of circular mobility, and holding objects would be awkward if our fingers moved all over the place! This is why muscles are designed to protect and maintain the alignment and range of motion of each specific joint. When the muscles surrounding any joint become imbalanced, the joint will lose its safe alignment and inevitably suffer damage. Pain is the message that tells us when that damage is happening.
Arthritis is a common result of muscle imbalance that leads to joint damage, and it can affect every joint of the body. The definition of a well-balanced muscle is that it must be equally strong and flexible and capable of easily doing the job it is designed for. When we don’t use our muscles over the years, they weaken, shrink, and can no longer support our body easily. Instead of being supported by our muscles, the weight of our body settles heavily into our spine, hips, knees, and ankles. The impact of gravity and our weight slowly wears away at all the protective cushions in our joints until the joint heads are exposed, their surfaces begin to grind, and inflammation results. This is known as arthritis. Arthritis pain feels like a knife shooting through the body—not a pleasant experience and something we should all try to avoid.
Arthritis takes decades to damage the joints. It doesn’t happen overnight! During those years, correct exercise can prevent or reverse much of the damage. Without such exercise, there will come a point of no return, when joint replacement or spinal surgery is necessary. The only way to slow down arthritis is to simultaneously stretch and strengthen the atrophying muscles through regular, gentle exercise.
On the other hand, it is very common for serious athletes and gym rats alike to overtrain their muscles to the point of limited mobility within the muscle fibers. Muscle fibers are designed to have a great deal of flexibility, like an old-fashioned telescope—they should be able to go from contracted (shortened) to lengthened by up to one hundred times in a nanosecond. An overtrained muscle stays contracted and firm to the touch, day and night, and can barely release to ten times its potential length. When the muscle never has an opportunity to stretch out to its full potential, an excessive tension builds within its fibers. The brain identifies the unreleased tension as pain, which is what people in gyms usually feel after a hard workout. Unchecked, the constant tension will lead to serious damage. If the training has been excessive some of the pain will also be due to inflammation. The brain, which wants us to be healthy, is warning us in the only way it can—through a pain message. Unaddressed pain from unbalanced muscle fibers goes on to cause serious damage to our joints.
Chronic Knee Pain
Knee pain is very common and often caused by muscular imbalance, poor bone alignment, or both. The knee joint moves like a door hinge, permitting the bones to swing forward and back. If a door hinge is loose, the door will swing unstably, causing damage to the full frame. The knee hinge works exactly the same—when the knee hinge is off balance, it causes damage not only to the actual knee joint but also to the entire body’s structural frame.
Most of us walk with our weight rolling toward either the inside of our leg or the outside (eversion and inversion, respectively). To figure out which imbalance you have, take a look at the soles your shoes to see which side of the heels wear out. If your feet are everting or inverting, which most people’s do, you are prone to knee or hip pain.
The full leg muscles on the side you roll toward will have to do more work than those on the other side. One side of your leg will get tighter, and the opposite side will get weaker. In time, this muscular imbalance will pull the leg bones out of alignment. Every time you walk, the weight of your body will no longer be cleanly distributed through the center of the leg and knee but will instead sink to one side. This poor alignment of the bones will lead to joint damage—and a whole slew of potential knee conditions can arise, from arthritis to sciatica. And, boy, will you feel this as knee pain! Heed the pain’s warning, and do something about it.
When you correct the imbalance through full-body stretching and strengthening, the pressure or squeezing together of the joints disappears. Unfortunately, the resulting cartilage damage cannot be self-healed—whatever has been destroyed will stay destroyed—but when we stretch and strengthen the muscles around the knee, we can prevent further damage from occurring.
Arthritis is a condition of progressive degrees. When caught early enough, it can be controlled so that you will never experience pain. Depending on the degree of damage, each person experiences a different degree of pain relief, and many people feel total pain relief when they do their exercises daily.
Hip Pain
The causes of hip pain are multiple: falls and other injuries, arthritis, torn labra (the rims of soft tissue around the hip sockets), and muscle imbalances. Exercises similar to those suggested for knee pain generally address the wide range of hip problems.
Paradoxically, the most common sufferers of hip pain come from two opposite demographic groups: sedentary middle-aged folks or really active people. However, the pain and immobility from which they both end up suffering is similar.
Muscles are designed to support the skeleton, and that includes our joints and bones. With regard to the first group, as noted earlier in this chapter, a sedentary lifestyle leads to weak muscles. Weak muscles cannot prevent the body’s weight from slamming into the hip joint with every step we make. This causes joint damage in the hip just as it does in the knee. With regard to the second group, athletes, professional and amateur, usually slam their hip joints together with every movement, whether it’s running, diving, hitting, landing, or punching. Athletes generally have little awareness of the damage that repetitive impact causes their joints, and they tend to have very high rates of hip replacement surgery.
The degeneration of the hip joints takes place over years, enabling us to become accustomed to feeling stiff and being weak. We chalk it up to aging. Eventually, the stiffness turns to mild pain. As the pain gets stronger, we visit our doctor, who may tell us that in the distant future we will need a hip replacement. The suggestion of a future hip replacement is accompanied by the explanation that, before the doctor can operate, we have to wait until the pain is unbearable and the joint totally destroyed. Much of this is referred to as hip arthritis.
As with the knees, imbalanced muscles in the hip are often caused by an incorrect stance of the feet, leading to poor alignment of the leg bones. If we roll in or roll out on our ankles, we pull the knees in or outward. This leads to a chain reaction of imbalance throughout the skeletal structure, from the soles of our feet through our ankles, knees, and hips. This imbalance will force one group of hip muscles to work harder than the other. As one group works harder, it naturally becomes stronger, while the other group becomes weaker and shrinks. This imbalance eventually leads to joint damage. The hip exercises in part 2 are designed to rebalance these muscles and reverse any pressure on the hip.
JUST FOR SENIORS: HIP PAIN
When seniors remain sedentary, they accelerate their aging process by permitting their muscles to rapidly atrophy and weaken. Many sedentary seniors have insufficient strength to support their skeleton. This causes their joints to slam heavily together, making all movement painful. Many types of seniors’ hip pain, including sciatica and arthritis, is caused by weakness. Walking upstairs can become problematic when hip and leg muscles are too weak to lift the weight of the body. The good news is that even a small amount of exercise will rapidly strengthen seniors’ muscles and thereby relieve the pain. After all, muscles are created to be strong, and that includes seniors’ muscles!
Poor Alignment
I like to explain the difference between good alignment (which is also called clean alignment) and poor alignment with a housebuilding analogy. If we hire a team of five workers to build one house and a team of ten workers to build an equivalent house, and ask both teams to finish the work in the same amount of time, common sense tells us that after finishing the house the five workers would be more exhausted than the ten workers.
Well, good alignment is like using all ten muscles of a joint to move us around instead of five muscles—it’s more efficient, less tiring, and causes less damage over the long term.
The weight of the body must flow all the way through the skeleton’s bones, finishing in the soles of the feet. However, good alignment starts with the feet and flows upward to the head, not the reverse. If our normal stance has our feet rolling outward, it will distort the alignment of our leg bones. The distortion will be forced to continue up the legs, twisting the knees, hips, and spine. In other words, when our feet are in poor alignment, all the bones in our body above our feet will then become poorly aligned.
While good alignment begins at the feet, moving upward, our weight distribution starts at our head and flows downward through the skeleton. If we have good alignment, there will be no stress on the joints. In addition, our muscles will be functioning in perfect balance.
Not so if we have poor alignment. With poor alignment the weight of the body will flow unevenly from the head to the toes, overstressing some muscles and leading to joint damage.
We have twenty-six bones in our feet; the joints between them need to be correctly aligned. Any joint that is incorrectly aligned will place the adjoining joints and muscles in a state of permanent imbalance and stress. Over a lifetime of poor foot alignment, the damage will spiral itself up our legs and manifest itself as ankle, knee, hip, and back pain.
Even though the feet play the initial and decidedly most important role in establishing clean alignment, they are by no means the only parts of our bodies that need attention. To understand alignment, you have to look at the full skeleton. Any joint that is out of alignment will lead to instability, stressed muscles, and pain. A clean alignment, one that includes fingers to toes and every joint in between, ensures that all the surrounding muscles are firing at their maximum effectiveness. Clean alignment means that the neurological loops from the brain to the muscles and from the brain to the organs will be clear and efficient. These loops are essential to keep the immune system strong and our body healthy and energetic. Clean alignment permits the joints to glide smoothly and safely, free from potential damage like arthritis. If we maintain clean alignment, there’s no reason our joints can’t remain vital and strong well into our golden years.
Posture
You have good posture when all of your muscles are as strong as they are flexible. Good posture should reflect a relaxed mobility. To me, poor posture looks like the Tin Man, upright but stiff and uncomfortable. Good posture should be easier to support than poor posture, no matter if you’re sitting or standing! In my view, the definition of good posture is a state of perfect alignment in which our 384 joints are perfectly aligned and our 650 muscles shift continuously from tension to relaxation.
Few people have that type of good posture holding their torso upright and their chest open with full relaxed mobility. Many people appear to have good posture, but they are in fact very stiff and rigid. Often their upper back is slightly rounded while their lower back is tight. Rounded backs are usually a sign of overbuilt pectorals and trapezius muscles (chest muscles). Tight hips are a sign of tight gluteus muscles (tight bum). Overbuilt or tight muscles are in constant stress—and we know that when muscles are in a constant state of stress, injuries and pain result.
Poor posture unbalances the erector spinae (muscles that keep the back straight), placing stress on the spinal vertebrae. If your teeth are crooked, an orthodontist uses braces to deliberately put stress on them to pull them into correct alignment with your jaw. But when your erector spinae are imbalanced, they pull one or more vertebrae out of alignment with the rest of the spine, causing slipped or bulging discs.
You can see now why unbalanced muscles are directly related to conditions such as bulging, herniated, or slipped discs; arthritis of the spine; and the need for spinal surgery. It’s a chicken-and-egg situation: correct alignment helps keep the muscles balanced correctly, while well-balanced muscles help keep the spine well aligned.
THE FALLACY OF BALLET DANCERS’ “PERFECT” POSTURE
When you think of someone with perfect posture, you might think of a prima ballerina, right? Unfortunately, this is a common misperception. As a ballet dancer, I used to look like I had excellent posture—my spine was upright and my shoulders open. However, at the time I was forcing my spine out of its natural S curve into a straight line.
A healthy spine has a natural double-S curve. Ballet dancers must be able to stand en pointe and pirouette without falling over. To do this, they are trained from childhood to line up their bones in as straight a line as possible, from head to toe. This forces the dancers to tuck in their tailbone so their bums don’t stick out, to avoid a weight imbalance as they spin. As a result, the natural alignment of most ballet dancers’ spines becomes deformed. In my case, the deliberate deformation of my lower spine led to years of debilitating chronic back pain. While I was in pain, my X-rays showed two slipped discs. Through regular, gentle, full-body exercise, I returned my spine to its correct alignment and, with it, became permanently relieved of pain.
People often blame computer use and texting as the major cause of poor posture, but I am not convinced that poor posture is a modern phenomenon. In fact, I believe it’s actually encouraged by our anatomical design! Our eyes are in the front of our head, not the back, and when we walk, we do so forward, not backward. When we sit, our knees bend in front of our body, not behind it. From the way I see it, it’s normal that we would gradually slump forward if we permit ourselves to. Computers may be compounding the problem, but since the beginning of time, humans have been inclined to have poor posture. After years of permitting the head to hang forward, the muscles and connective tissue of the upper back thicken from semi-immobility.
The image that generally comes to mind when we think of poor posture is an elderly woman stooped over with her neck bowed forward. The forward rounding of the spine, called kyphosis, may be the result of a congenital defect or may be developed later in life as a result of osteoporosis or poor posture. It becomes visible when osteoporosis has reached an advanced stage, forcing the neck and head to fall forward. Non-osteoporosis or congenital forms of kyphosis occur in men and women alike when they assume a rounded-back posture for many years—in other words, when they have consistently poor posture. The ensuing rounding of the spine stress the individual vertebrae at the point where the neck and the spine meet. As the neck droops forward the vertebrae shrink and become thinner. With kyphosis you will find little to no mobility in the person’s vertebrae and soft tissue in the upper back. When the spine is in a rounded posture like kyphosis, the muscles are in a constant state of stress, as the poor alignment leads to constant muscle imbalance. This chronic condition can be very painful.
In addition to the damage to the vertebrae, with every inch our neck bows forward, we load ten pounds of stress onto the supporting spine muscles. These muscles are then in a state of tension, and this tension is further increased by the continuous muscle contraction; they never get a moment to relax and release, as healthy muscles must do. Poor posture, with even an inch of forward bowing of the head, is exhausting and painful.
Poor posture actually shrinks our bodies. We don’t just give the appearance that we have become smaller—we actually do become smaller. This is because poor posture leads to atrophy.
Shrinking or atrophying is painful, just as growing pains were painful when we were adolescents. It does not happen evenly; as we shrink, it occurs unevenly throughout our bodies, creating the vicious cycle of muscular imbalance and joint damage.
The process doesn’t happen overnight. It takes years for the bones to weaken and the ligaments, tendons, fasciae, and other forms of connective tissue to atrophy. The good news is you can reverse both the poor posture and the atrophy. Improving your posture isn’t rocket science—it just takes persistence. Good posture means pulling your body upward, countering the force of gravity. As we stand erect, our muscles naturally pull us upward. As we slouch, our muscles naturally pull us downward. Good posture gently and naturally keeps us young and pain-free by fighting against the force of gravity.3
Reforming your posture means teaching yourself to stand, walk, and sit in positions that place the least amount of strain on supporting vertebrae, muscles, and ligaments. Remember that if you’ve trained your muscles to support poor posture for decades, this process of retraining can take some time and patience. In fact, when you first start to correct your posture, proper alignment will most likely feel uncomfortable and unnatural. But stick with it. Eventually, it will feel wonderful and effortless.
CORRECTING POOR POSTURE
It’s helpful to exercise in front of a full-length mirror, especially when you’re starting a program, so you can self-correct your alignment and posture if you notice yourself slouching. Once you become more familiar with the movements, you can take the mirror away.
Overbuilding Muscles
Overbuilding muscles is a common type of imbalance that occurs in athletes and fitness enthusiasts. Today many extreme workout programs have become the rage—a dangerous-for-the-joints rage! There are at least two main reasons why such programs lead to injuries and pain.
First, when one group of muscles becomes overbuilt, they cause an imbalance. The overbuilt group will overpower the weaker muscles, pulling joints out of alignment. This issue is very common in extreme and repetitive sports, and is one of the major reasons for chronic back, neck, and knee pain in these types of training fads.
Second, a healthy, balanced muscle fiber should move like an old-fashioned telescope: it should slide in and out as it contracts and stretches, and it should be capable of stretching and returning to its original shape. Overbuilt muscles are stuck in the contracted phase and have little ability to stretch. Remember that muscles are designed to be equally strong and flexible. There is not a single muscle that is designed to be only contracted to its maximum with limited mobility—not one! Yet this type of muscle training—called concentric training—is the basis of almost every sport and fitness method. This is why there are so many injuries and so much pain in sports and fitness.
Ballet is the only technique in the body-training world that builds muscles to be equally flexible and strong. It uses a technique called eccentric training, which simultaneously strengthens and stretches muscle fibers. I adopted eccentric training as the basis of Essentrics, because I saw that it protected the joints while maintaining the essence of full mobility within a muscle fiber.
When we analyze the physiology of a muscle cell, it is clear that the protein filaments—thick myosin filaments and thin actin filaments—are designed to slide in and out like a piston. The purpose of a muscle cell is to move—not to be glued in one contracted position. Overbuilding the muscles forces the cells to become locked into a contracted tight position, from which the cells cannot rebound to their original position. In an overbuilt body, the muscles are so tight that they will stay permanently in the same cut, ripped form day and night. That is not healthy or natural. We’ve been programmed to see excessively contracted muscles as sexy and strong, but what we are actually looking at is muscular imbalance and something that is unhealthy. The prioritization of strength over mobility reduces the range of motion, making movement limited, painful, and prone to injury.
Ironically, the pain from which most athletes suffer is unnecessary; it could be rapidly reduced simply by adding dynamic flexibility to the strength-training regimen. I know this because I have worked with hundreds of professional athletes with the objective of reducing their pain while making them winners! Overbuilding muscles is the major reason why the careers of so many high-performance athletes are cut short prematurely.
But it’s not just professional athletes who are suffering—it is everyday people just trying to stay in shape. Even though all evidence suggests that extreme strength training ages the muscles, joints, bones, and immune system, humans are competitive by nature. As they eagerly throw their full heart into a rapid but brutal CrossFit session, even smart, educated people are consciously playing a version of Russian roulette.
I have my theories on why there’s such reluctance to acknowledge this issue in sports and athletic training. First, until Essentrics came along, there was no alternative method of effective muscle strengthening. Basically, if you wanted to strengthen your muscles, you had no choice but to overbuild and unbalance them. The second reason is economic. Extreme training is a multibillion-dollar business—there’s not much financial incentive for trainers and coaches to discourage their clients from participating in these types of programs.
Scar Tissue Imbalance
Human tissue is like living cloth that has been tightly woven in patterns that permit it to stretch and rebound instantly to its original shape. When we have a scar, from injury or surgery, movement on either side of the scar is blocked. A scar does to the human body what a dam does to the landscape surrounding it. When we construct a dam on a river, it diverts the flow from its natural path, and the land that was previously watered by the river will suffer from drought. Any degree of blockage leads to immobility, which we know is bad for the mechanics of the body and leads to pain. Unfortunately, when we have an operation, scars are inevitable.
To understand the natural flow of human tissue, we can watch the skin of our tummy expand and contract as we breathe deeply in and out. Along with our skin, our muscles, ligaments, tendons, blood, lymph fluids, and nerves also move with every inhalation and exhalation. When we reach above our head to put on a sweater or bend forward to tie a shoe, all the tissues of our body stretch to let us move and then rebound to return to their original shape. When we have a scar, this natural flow is blocked.
That blockage of movement and energy initiates a negative chain reaction that can result in atrophy and imbalance; one side of the scar can look as shriveled as the land on the side of the dam that no longer has access to water. The mobility of both sides of the scarred area is affected.
If the muscles on either side of the scar are not equally stretched and strengthened and returned to normal health, soon they will be starved of nourishment and atrophy. I’ve seen this happen to many people who have had surgery—from breast or pancreatic cancer surgery to shoulder or back surgery. When people don’t spend enough time in physical therapy rehabilitating their scarred areas, the damage will escalate over the years and lead to serious pain.
A scar, even a relatively new one, needs to be stretched and/or massaged in order to prevent damage from atrophy. However, new scars must be treated carefully and differently from old scars. Be careful to stretch a new scar along its length rather than crosswise so that you do not pull the wound open as you stretch. An older scar that is well healed is no longer in danger of ripping open and should be stretched in all directions.
If a scar is not rehabilitated, it will leave a permanent feeling of stiffness, becoming a blockage or interference to the natural flow of the surrounding tissue. This sounds harmless—but it can become very serious. Each scar is different and so has different degrees of seriousness—its location, its size, and the reason behind the surgery all factor into its long-term impact. But all scars must be treated to avoid a lifetime of pain.
When the range of motion of any body part is limited by a scar, the surrounding muscles and other soft tissue will atrophy, the connective tissue that coats each cell hardens, creating new scar tissue. The area of the initial scar becomes even more immobilized and can even be hard to the touch.
The initial discomfort and stiffness from a scar is generally not the cause of the pain. The pain comes because of a muscular imbalance that is caused by the scar. If the scar is not sufficiently rehabilitated, this can be the start of a slippery slope. One scar can set off a chain reaction of scarring and immobility that leads to a lifetime of chronic pain.
Surgery
All kinds of surgeries can potentially lead to seemingly unrelated issues of immobility and chronic pain. In addition to the inevitable scar tissue that results from the surgical incision, surgery often changes the length of tendons and muscles, creating an imbalance in the movement of a joint. These repercussions of scars and imbalances often lead to chronic pain, which needs to be prevented with daily exercise.
Breast cancer surgery, for example, is known to cause adhesive capsulitis (frozen shoulder) and chronic shoulder pain. Pancreatic cancer surgery can lead to chronic chest, shoulder, and upper-body pain.
Spinal fusion surgery—a procedure that typically involves a bone graft or a metal implant in the spine to immobilize damaged vertebrae—may successfully eliminate the initial back pain but often brings with it unforeseen side effects, such as when the fused-together vertebrae rub painfully together. The worst side effect of spinal fusion surgery is the physical immobility of the surrounding and attaching muscles and tendons. This happens because spinal fusion sends a psychological message to the person that says he or she cannot or should not bend his or her spine. After surgery, many patients are afraid of damaging their spine, so they take extreme precautions not to bend or twist it. The fear of bending and twisting leads to weakening, atrophying, and shrinking of the spinal muscles. What such patients forget is that they have thirty-three vertebrae—if three vertebrae have been fused, they still have thirty vertebra to safely bend and twist with! Fusing of two or three vertebra is just a tiny part of the whole. To prevent additional spinal muscle imbalances, it’s important to keep moving and not become paralyzed by fear.
Injuries Old and New
Unfortunately, injuries are part of the human experience, the ultimate price of living a full, active life. Accidents happen! Very few people have not suffered at least one injury—especially in childhood or young adulthood, when we are afraid of nothing and prepared to try anything. Some of us who suffered injuries in our youth are still dealing with the pain thirty, forty, and fifty years later. Often this is because when we are younger, we don’t think twice about the long-term consequences of a sprain or a torn muscle or a broken bone, and we’re too impatient to spend the necessary time to recover and rehabilitate properly.
Honestly, you would not believe the stories I have heard. People have told me all kinds of crazy tales—of taking a bad fall while skiing and then getting up to finish the run; of tearing a ligament and going on to complete the marathon; of twisting an ankle and finishing the competition; of sustaining a concussion and staying in the game. I’ve even heard of a motorcycle rider who dislocated his shoulder in an accident and then got back on his bike to ride for several thousand more miles!
Life is too much fun, and we shouldn’t miss any of it because of pain from injuries. Injuries are common, and the human body is designed to repair most of them—but we don’t always give the body a chance to do its natural healing magic. In addition, many doctors don’t know how to take the step from healing an injury to rehabilitating the body back to its original state.
The good news is that even old injuries that have been ignored for decades can be rehabilitated. It’s always the same story of imbalances leading to damaged joints. And it’s always the same solution: to rebalance by carefully stretching and strengthening the full body.
Obesity
Obesity has become a major health epidemic, so I would be remiss not to touch on it in a conversation about the causes of chronic pain. Excessive weight is lethal for joint health. Our joints have the ability to last at least 125 years, well beyond our life expectancy. However, no matter how perfect any piece of engineering may be, joints cannot survive when excessive weight is placed on them. As a result, the obesity epidemic has caused an explosion in the number of hip and knee replacements.
Obviously, obesity is a very difficult condition to reverse. Of those who manage to lose 5 percent of their weight, only one in 20 can maintain that weight loss for longer than 5 years.4 We can see from the recidivism rate that losing weight is not just a matter of reducing the calorie intake. But the severity of the health impact on an obese person’s ability to comfortably and safely move around cannot be overstated. We need to move to keep our vital organs healthy, yet movement can feel awkward, uncomfortable, and, when the joints begin to wear out, painful.
If you are overweight, your joints will eventually become damaged from the unrelenting pressure put on them. Our muscles are designed to be strong, but they are not designed with enough strength to support an obese body. The truth is that carrying around extra pounds is exactly that: carrying. Whether you are carrying luggage, groceries, or your own excessive weight, repetitive carrying will place excessive stress on your muscles and joints and wear them out. There is no way to avoid or deny that obesity is very damaging to the joints.
Obesity also sets in motion a series of chain reactions that serve as a precursor to chronic pain—movement becomes tiring and painful, so the person becomes sedentary; the muscles weaken from a lack of movement; the connective tissue hardens; the immobile muscles atrophy; and atrophied muscles result in fewer mitochondria to burn calories. All of this leads to chronic pain felt throughout the body—everything hurts, all the time.
When my clients lose weight, they are always overjoyed at how much better they feel in their bodies, and how much less pain they experience on a daily basis. Many people don’t realize how much joint pain they’ve been living with until it disappears.
Poor Circulation
Blood is a life force that courses through our veins and arteries, nourishing and cleansing our cells, and feeding our brain. Simply stated, without blood we would die—and without good circulation our cells do slowly die.
Plaque that builds up in the arteries of the limbs can result in peripheral artery disease (PAD), which causes numbness, cell death, spasm, and blood clots. Narrowed or blocked arteries may also cause problems in the intestines or kidneys, and can decrease blood flow to the limbs and outer extremities.
The laws of atrophy and cell death apply to all cells of the human body, including the cells of the veins and arteries. As plaque builds inside the walls of the arteries, the arterial muscles become inhibited from movement. Immobility always leads to cell death, atrophy, and a hardening of the tissue—the arterial wall is no different. This is where gentle, deep, full-body stretching brings an important benefit.
We need good circulation in order to prevent many serious diseases and much pain. Poor circulation limits the body’s ability to heal itself. Blood circulates into every cell of the body, which means that we must maintain strong circulation in every part of the body. Large, full-body stretching movements are the most effective way to flush the blood through every artery and vein in the body for the maintenance of a healthy circulatory system.