March 4, 2010

Is Yoga the Best Exercise for Low Back Pain?

By:  Dr. Osar

In the last edition of  we discussed the most common cause of low back pain (LBP) and most of our chronic ‘everyday’ aches and pains – habitual movement patterns. If you missed the last newsletter, check it out here (provide link for last newsletter). In other words, how we move our body during work, play, and activities of daily living (ADL’s) contributes to most of our daily aches and pains.

Patients often ask us about the best exercises they can do to help with their LBP. While the answer to this question is complicated, I will give you the 3 guidelines your exercises must accomplish so that you can decide for yourself whether or not your exercise is appropriate for you. And equally important, in the next edition  we will discuss several of the key exercises that you can do at home to help keep your back – and your entire body – functioning optimally.


Guideline 1: You must breathe correctly!

ü     As we discussed in the last newsletter you must be able to breathe correctly to oxygenate your body. Equally as important, you must breathe correctly to stabilize your spine, including your low back. If you breathe incorrectly – as many of us tend to – you will be unable to stabilize your spine against your body weight, lifting your children or groceries, as well as while exercising.


How do you know if your breathing correctly? If you experience any of the following postural changes such as your head and shoulders are forward of your spine when looking from a side profile, you have an elevated chest position (also seen from a side profile) and wide lower rib cage (place your hands on either side of your lower rib cage), or if you experience chronic neck, shoulder or upper back tension/tightness you likely have a breathing problem.


Guideline 2: You must stabilize your low back.

ü     The muscles of your trunk and spine work to stabilize your low back as well as move you. They must stabilize first and then move you. If you reverse this process, meaning you move first then try and stabilize, you will create problems for your low back. This is generally what happens when we have pain and why we develop tighness in areas – our body is trying to stabilize us. Recall the body is trying to protect us and if we simply try to stretch these areas, we are removing the body’s protective mechanisms leaving us vulnerable to further injury.


Guidline 3: Combine breathing and stabilization into your exercise.

ü     Once you know how to breathe and stabilize, you must be able to take this into your exercise whether you enjoy running, Pilates, yoga, weight training, or golf. Too many of us try to do our chosen exercise expecting that it will make us breathe more efficiently and stabilize better. We must first learn how to breathe and stabilize correctly and then take it into our exercise.


What about things like Yoga for LBP? Yoga is great for overall breathing, stabilization,  and movement. However yoga can also cause injuries if your focus is too much on stretching and lengthening and not enough on stabilizing and control. The same goes for Pilates, core fusion, bootcamps and other types of workouts. We see many patients in our office that try to exercise and end up getting injured because their classes stressed working out harder rather than focusing on breathing and stabilization.



The goal of any exercise is to help protect your body from injury as much as it is for getting you into shape, reducing stress, and overall heart conditioning. Follow the guidelines listed above to make your exercise the most effective it can be and your back will thank you by moving and feeling better for many years to come.


If you need guidance or have any specific questions about exercise as it relates to you, feel free to set up an appointment with myself or Dr. Deppen or with our fitness professional and movement specialist Sara Fisher.  






February 11, 2010

Stretching For Low Back Pain

By:  Dr. Osar

Back pain. It’s like that relative that comes to visit for a week and then ends up never leaving. Back pain is so prevalent that nearly 8 out of 10 of us will experience low back pain (LBP) at some point in our lives. And we spend over $54 billion each year in this country trying to treat it.

And just mention the word LBP to a friend or relative and they will play armchair doctor suggesting everything from ‘the’ exercise that worked for them, to sending you to ‘their’ go-to-health or fitness guy/gal, to even sharing their prescription medications with you (don’t take them up on this one). And while some of these things may work, they often fail to provide any significant changes.

So why do so many of us experience LBP? There a myriad of reasons including but not limited to:

Ø  Degenerative joint disease  (more commonly referred to as arthritis);

Ø  Disc problems (more commonly referred to as a ‘slipped’ disc - note: there is no such thing as a slipped disc);

Ø  Muscle imbalances (some muscles are working too hard and some are not working hard enough);

Ø  Acute trauma (this includes falls, surgeries, accidents, etc.):

Ø  Repetitive trauma (the habitual way we move our body everyday).

The largest majority of us experience chronic LBP (and most of our daily aches and pains) because of repetitive trauma. In other words, the way we move our body everyday is less than ideal. This results in muscle imbalances, joint stress, as well as wear and tear on joint structures and soft tissues (muscles, ligaments, etc.)

Generally speaking, these imbalances cause some areas of the body to take too much stress (generally these are the areas where we experience pain). As a result we will feel tightness or stiffness as the body tends to limit motion in these painful regions.

For example, as a society we are generally stiff in the mid back and hips. This requires us to move more from the low back instead of sharing the load between the mid back, lower back, and hips. This results in irritation to the joints, discs, and connective tissue (muscles, ligaments, and fascia) of the low back. This in turn results in low back pain and resultant stiffness. And what do we all learn we should do when we are tight? You got it -


*This is a key point to remember whenever you or someone you know is experiencing chronic pain:

We experience stiffness and pain because we are unstable. Tightness, trigger points (knots in the muscles), and tension are your body’s protective mechanisms to make itself more stable. Stretching removes this protection.

So what can you do today to make yourself more stable?

  1. Breathe correctly! Breathing is much more than in through your nose and out through your mouth. The diaphragm is one of the body’s primary means of stabilizing and thus protecting the low back. You must do it correctly to get the optimal benefits.
  2. Get better sleep and drink more fluids. Most of us don’t get the requisite 7-9 hours of sleep our body requires to rest and recuperate. Don’t eat sweets or drink caffeine, try meditation, make your room dark and quiet to ensure more restful sleep and try going to bed even 30 minutes earlier if you don’t get enough rest. Drink more fluids. The discs of your spine are fluid filled. If you are dehydrated (don’t use thirst as a guide) your discs will also become dehydrated. Aim for a minimum of 1/2 oz. of water per pound of bodyweight per day. If you weigh 150 pounds, you should drink no less than 75 ounces of water per day.
  3. Visit your chiropractic physician so he may evaluate you and give you specific recommendations and exercises for your unique situation.

What else can you do to help you relieve your LBP? Check out these videos we created for you on proper breathing and stabilization of your low back.


November 19, 2009

When you Have Back Pain you are not in for Much Fun.

By:  Dr. Osar

I stole the title from Dr. Suess at the part about not being in for much fun.

Have you ever had that feeling like maybe your back was going 'go out'?

Perhaps you caught it just in time or maybe you didn't and your back 'went out'.

Maybe you ended up in bed or worse on the floor and were extremely uncomfortable.

One of the common pain complaints we see people in our office for is low back pain.  Either patients have that nagging low back or they come when they are in the midst of horrible back pain.

Back pain can be caused by any number things, muscle strain, disc problems, etc.

Often times we have found that if we teach our patients how to breath right and move right they can eliminate or significantly decrease their back pain and/or the feeling of their back 'going out'.

If you have low back pain or know someone that does have them contact us and let's see if we can help them.

Because, if you have back pain you are not in for much fun.

Thank you for reading and we wish all of you and your families a wonderful Thanksgiving!



October 28, 2009

Breathing to be Pain Free

By:  Dr. Osar

Evan OsarLast time, I told you just how passionate I am about helping patients breath correctly and why it is SO important to decreasing pain, tightness etc.

I know often times after we show patients how to breath correctly and how to practice it on their own, they will get home and back to life and forget what they learned.  I also understand as a teacher it is so important to make sure people hear, see and experience something to truly learn and understand new information. 

So to make sure you as our patient are getting the most of your treatments both when you are with us and when practicing on your own we have begun putting videos on our website so you may practice with real instruction at home.  I will include a link below where you may go and view the first two videos.  If we have gone over the importance of breathing CORRECTLY with you during your treatment and you are not sure if you are performing the exercise correctly or have forgotten how to do it or how to do it correctly we are sure you will find these videos to be helpful.  Here is the link:
click here for videos and if you have questions or comments please be sure to fill out the contact form on the website under 'contact us' or respond to this email.

Thank you for reading and for all your ghosts and gobblins out there we wish you a very safe and festive Halloween.