Monthly Archives: June 2012

Non-Specific Low Back Pain Exercise Therapy

As often discussed in my research reviews, pain in lower back remains an enigma in modern day health care. It is a common, disabling, and costly condition that we know relatively little about in terms or pathoanatomical causes and effective treatments.

This study was reported in the print and television media, so I felt it important to review here. As always, if you have any questions about this or any of my other reviews, please feel free to contact me.

The goal of this large meta-analysis was to evaluate the effectiveness of exercise therapy in the treatment of low back pain in adults. Exercise therapy was intentionally defined in this study as a heterogeneous group of interventions from general physical fitness interventions to various types of stretching and aerobic exercise protocols. 61 published reports of completed, randomized controlled trials comparing an exercise intervention to placebo, no treatment or other conservative treatments were included in the analysis. Patients suffering acute ( 12 weeks) low back pain were included in the studies (most of the studies involved chronic patients).

The trials evaluated provided the following insights:

• there is clear evidence that exercise therapy is at least as effective as other conservative therapies for chronic low back pain, despite conflicting evidence that it is any better
• for acute pain in lower back, exercise are not more effective than other conservative therapies (note that exercise therapy is not the same as advice to stay active, which is currently a recommended, evidence-based intervention for low back pain)
• there is some evidence to support a graded-activity exercise program for sub acute low back pain in occupational settings

Conclusions & Practical:

This study concludes that evidence from randomized, controlled trials demonstrates that exercise therapy is effective for reducing pain and improving functional outcomes in patients with chronic low back pain. It appears that clinically important improvements are more likely to be seen in healthcare environments, meaning that exercise therapy may work better when supervised by a healthcare provider (see companion article regarding strategies for implementing exercise therapy for low back pain).

It seems intuitive that exercise would be an appropriate intervention for low back pain, provided that it is administered by qualified professionals in a safe, supervised environment. This seems to be a situation where the literature still needs to catch up to clinical practice. To this end, I feel more research needs to be directed toward the effectiveness of combining physical and clinical interventions commonly used in practice. I feel the absence of clear data on the treatment of low back pain is due to the lack of “clinical reality” of most randomized trials.

Most manual medicine practitioners combine a number of interventions in addition to exercise to treat these patients. In order to studies to reflect the benefit of such treatment regimens, more large-scale trials need to be performed with this type of design.

Health Coaching – Top 10 Reasons to Hire Or Be One

Health Coaching is a relatively new profession which focuses on helping people making positive changes in their health, physical, mental and emotional lives, that they have not been able to do for themselves. Its about people deciding that the personal cost for not making some changes has become too high. They are willing to trade pain for gain — so to speak. Here are ten “pain for gain” reasons to hire (or become) a health coach.

1. Health Coaching and Weight Loss

One of the most challenging (and discouraging ) behavioral changes that people try to make is losing weight and keeping it off. We are all aware of the health risks associated with being overweight. Many people have been on the weight loss and gain it back yo yo ride for years. What can make the difference and break this vicious cycle is a trained professional to guide you how to take it off and keep it off. This can be done with a few key lifestyle changes which are easier than you might think especially with the support of a health coach. What would it mean to you to lose 20-40 pounds and never gain it back. Visualize yourself at your ideal weight. What does that feel like? What does it look like? See yourself there now. Feels great doesn’t it?

2. Health Coaching and Eating Habits

A second behavior change that is tied to and often more challenging than weight loss is our eating habits. We love to eat ( and eat and eat and eat) And most of us are addicted to some form of junk food. Mine is chocolate. How our lives could change if we could make a few basic improvements in our daily diet. More energy, better sleep, less illness because of a boosted immune system, healthier skin, look better, feel better. So how do we do it. A health coach can introduce and effective program that makes sense and is easy to do if you are motivated to make a few changes and reap the rewards.

3. Health Coaching and Stress

Stress can literally destroy people’s lives. The pace today is hectic and people are paying the price. Marital break ups, illness, child abuse, addictions, mental ill health, low self esteem, the list is endless. The price is high and robs us of a quality of life.. We live a fast paced life with multiple responsibilities. Learning to manage stress can literally save your life. What a different life you could lead if you could tame the tiger and learn to channel stressful events so they worked for you rather than against you. A health coach can show you how to do that.

4. Health Coaching and Positive Relationships

Positive nurturing relationships are vital to a healthy life. How well we get along with others including our own family often will determine our level of emotional and mental health. Lots of people are challenged in this area because they have not learned the social skills it takes. Ongoing conflict with people at work or at home can and not knowing “how to fix it” can really compromise your quality of life. The solutions to these kind of difficulties are easier than you might think. There a few “learnable” skills that can make a huge difference in your relationships. Ask yourself what it would mean to you to have much more positive and enjoyable communication and relationships with someone at work, your family, your spouse or your kids. Health coaching can make the difference.

5. Health Coaching and Communication Skills

I hear this all the time. ‘We can’t communicate, we argue all the time, he/she doesn’t listen to me, we’re not on the same page, i wish i could tell him what i think, I just don’t know what to say. Perhaps one of the greatest failures of our educational system is not teaching basic communications skills, how to connect with people, how to listen, how to say what you think or feel so people will listen. Probably the #1 reason for failed relationships is people not knowing how to communicate effectively with each other. There are basic effective easy to learn talking and listening skills that would resolve most misunderstandings and health coaching can teach you them easily and quickly.

6. Health Coaching and Exercise

Exercise. A four letter word for some. The fact is just a little more routine exercise in our daily lives could have a significant impact on our health. I like to walk and jog and lift light weights. It could be bike riding, swimming or flopping on the floor during commercials and doing some light stretching. A lack of exercise can ruin your health. A health coach can get you started towards a more active existence and help you stick with it long enough for it to make a significant difference. Go for it.

7. Health Coaching – Preventative vs. Curative

A distinct advantage of health coaching is that it is preventative as opposed to curative. Would you rather have someone help you prevent diabetes or some other debilitating disease or visit a doctor to get treated after the fact. That is the choice a lot of people are facing but the point is you have a choice and if you don’t choose for yourself, life will choose for you. Make a wise choice and choose the path of prevention. You will reap the rewards of better health and health coaching can get you there.

8. Health Coach – Being a Role Model

Be a trend setter, be a role model for others. Just think of the impact you could have on other peoples lives especially those you care about most. What if because of changes YOU made your mother, father, sister, brother, child or friend made a significant change in their health. What would that feel like? You often see people make dramatic changes after the heart attack. Well those same changes can be made right now and have the effect of preventing a disastrous heart attack or stroke. What if because of the changes you made it prevented a family member or friend from having a serious illness. This scenario is quite possible. Because I have started to run on a regular basis both my kids and my wife have started walk/jogging. What a thrill for me. Who knows how that will benefit them in the years to come. So be a trend setter in your family. Your family will love you for it and you will feel great about yourself for doing it.

9. Health Coaching and Self Esteem

A lasting benefit of health coaching is how you feel about yourself when you succeed at making important changes in your health. This is because of the positive feelings and feedback you get from family and friends ( and when you look in the mirror ). You’ve lost weight and people notice and comment. You’re not as stressed out and it feels good. You have more energy and you are more active. You’re sleeping better and you look more rested. Your relationship with your spouse and kids has improved. People around you will often mirror your mood and energy. You’re more fun to be around, not as irritable, short tempered or demanding. Your doctor notices and commends you for your efforts. You just feel good about yourself and you’re not going back to the way it was. Never!!

10. Health Coaching – It Could Be For You

One of the things that happens for some who go through health coaching and derive significant benefits from it, is they get exposed to the process and see how much it benefits others and how it could be a powerful change agent for people ‘stuck in the muck’ and suffering the consequences. It can often influence them enough to consider being a health coach themselves. Health coaching is a rapidly growing profession and is open to most people as an income choice, part time or full time, who have a genuine interest and desire to help others. Not to mention that the average hourly for a session ranges from 100 to 200 dollars for a session. A rather ‘healthy’ income.

So in summary, these are just a few of the benefits for hiring ( or becoming ) a health coach. Decide that you deserve excellent vibrant health and if you can’t achieve it on your own or would like to speed up the process consider hiring a health coach. A healthier, happier life awaits you.

Good Thing About Running

If you think you’ll need the bulky and extremely pricey gym equipment just to acquire the body the thing is in magazines, you’re entirely wrong. The just factor you’ll need my friend is actually a pair of jogging pants and shoes and you’re good to go.

Here are some of the advantages you can get through running.

Running is actually one of the greatest cardiovascular workouts that you could perform without having to generate in order to the gym. It helps you save a great deal of cash, and it also could be worthwhile. If you’re planning on cutting down your own weight, running can provide you with precisely what you need. It enables you to sculpt down your stomach and quads. Running frequently enables you to leave behind your own flab since it burns down the calories that you simply earn from eating greasy foods and foods high in sugar.

Running additionally improves the circulation in the body. It can be a good exercise for people who are in danger of high blood pressure. Along with enhanced blood circulation, the cells in the body tend to be well oxygenated and therefore can function from it’s greatest. If you must know, good circulation in the body may add years for your life. This hastens your organs to function therefore problems regarding bowel problems, hormone imbalances might be specific. And since it is a very good cardiovascular exercise, Continue reading

Celebrity Personal Trainers

Personal Trainer to the Stars!!

Celebrity Personal Trainers!!

Who are these amazing personal trainers that train the stars, professional athletes, celebrities, rock musicians, and the rest of the rich and famous?

Well, being a personal trainer and a perfectionist, I did some research to find out who they are and how one becomes a personal trainer to the stars. The research I uncovered about these so-called celebrity personal trainers that charge fees of $300+ per hour for their expertise indicates that, like the rest of the personal training industry, there are no requirements of any sort to become a celebrity trainer. Most of these celebrity trainers simply happened to be in the right place at the right time.

I had a close friend who was in a car accident. Since the insurance covered it, he went to see a chiropractor after the accident. During the first few visits, he and the chiropractor got to talking, and they hit it off. The chiropractor happened to know some celebrities, and just by knowing him, my friend got a gig training a star. Fortunately, my friend had a good knowledge base and was great at working with people, although the chiropractor had no real way of knowing this at the time. There was something in it for the chiropractor, though, in that he got a cut for recommending the my friend to the celebrity.

Mangers of celebrities would be doing their star clients a favor if they used a little more caution when hiring personal trainers and the like. As with any referral, a thorough screening and background check are in order before simply hiring a trainer on some other celebrity’s say-so. Unfortunately for the client, the endorsement by another famous person is often all it takes for an unqualified musclehead, who knows virtually nothing about how to work with people or train the human body, to get in the door.

Just Because They’re Famous Doesn’t Mean They’re Knowledgeable

I want to state that I am by no means bashing personal trainers who work with stars, or any individual’s personal trainer — although it’s always important to find and hire a trainer with the highest level of education, experience, and certifications. Unfortunately, it’s not necessarily the people with the best qualifications, but rather those with the best marketing and biggest mouths who usually get all the attention. Take note: This DOES NOT MEAN they know a hill of beans about training. The thing about the lack of regulation in this field is that you don’t really have to be very well-qualified to get a job doing it. If you’re good at causing a big commotion and conveying confidence about your ability to make people feel good, you will succeed in the business, whether or not you can actually deliver on your promise.

Take a look at the industry and you’ll see that celebrity personal trainers are a dime a dozen now. All the biggest stars — Britney Spears, P‑Diddy, J‑Lo, Oprah, Madonna, Tom Cruise — have personal trainers. Even the trainers themselves are getting famous now, just because of their celebrity clients. Two of the most celebrated personal trainers are Bob Green, Oprah’s trainer, and Gunter, trainer to many celebrities.

I have watched many of these personal trainers on the news and listened to their advice about which diets work and which are the best nutrition products on the market. Trust me, their biggest gift is their ability to get in front of a camera to sell their products, because their advice is questionable, at best. Still, no one can argue their ability to generate millions of dollars because of their proximity to the rich and famous. The sad part is that they’re making a large portion of their money by exploiting millions of uneducated, unmotivated people, playing on their unrealistic desires to look like the next celebrity on the big screen.

We’re Not All Going to Look Like Supermodels or Professional Athletes

Let’s say you work really hard and you’re in the best shape of your life, but you still don’t look like your idealized image of the perfect man or woman. People, let’s be honest with each other. Not everyone is going to look like Pamela Anderson or Brad Pitt. Genetics play a big role in our looks, not to mention the cosmetic enhancements created through plastic surgery, air brushing, and camera tricks. Being healthy and fit doesn’t mean you will never have a little fat on your body. Looking great and feeling great without the aid of drugs, cosmetics, and surgery will take you to better places than any amount of fame will ever give you.

Before you decide you want to look like a cover girl or a superjock, it’s really important to get comfortable with yourself exactly as you are. Sure, you’re going to feel better as you lose weight and build muscle, but the you inside is going to be the same. Yes, your shapely new build may inspire confidence, but the raw materials of your personality are going to be exactly the same. Are you fundamentally happy with your life and who you are now — or are you waiting around for external improvements to make you feel better on the inside? Just like the roots of a plant determine the quality of its fruit, it’s the invisible, internal stuff that determines the happiness of your external life.

Celebrities Whine & Complain Just Like Everybody Else

As a society, we’ve been trained to look up to people whose job it is to pretend everyday to be someone other than who they are. And because of the glitz and glamour associated with their Hollywood lives, we put them up on pedestals and give extra weight to what they say — for no reason other than the fact that they’re famous.

I hate to break it to you, but I have trained some celebrities and stars — and the truth is they are no different than you or I. Granted, it’s their job to look great all the time, so they spend a ton of time and money making sure they keep on looking good. But they whine and complain just as much as the rest of us. Wouldn’t you love to get paid to look good, rather than paying someone to help you look better?

Once upon a time, only celebrities hired personal trainers, in part because only celebrities could afford them, but also because looking good was viewed primarily as the arena of the famous. It’s good to know we regular folks are getting smarter, in that we’re beginning to realize just how important personal training is in the lives of everyone, not just famous people. If you think about how important a healthy body is to every aspect of your life, you might come to realize that a good trainer is more important than your hair dresser, your CPA, or even your mechanic. In fact, a personal trainer is a mechanic — only the machine he or she works on is not a car, but the most important machine you will ever own: your body.

Personal trainers help keep you healthy by motivating you — and the celebrities — to get in shape and keep off the fat.

The Results of Quick-Fix Shape-Up Programs Never Last

I am constantly amazed when I hear celebrities and their personal trainers promoting their diets and/or nutritional products. If the alleged “professionals” holding the media limelight still don’t know how the body functions (and far too many of them don’t), it’s no wonder our nation just keeps on getting fatter. There are two significant problems with quick-fix formats for training and nutrition. First, these extreme exercise and diet regimens that quickly get stars in phenomenal shape for a movie role or a tour are terrible for the body. Yet many celebrities are willing to do whatever it takes to get in shape as quickly as possible because they know their jobs could be on the line. Secondly, regular people, fans of these fabulous-looking stars, try to follow the celebrities’ diet and exercise programs, only to wind up failing, both because they cannot keep up the extreme regimens and because the programs are unnatural and impossible to sustain for any length of time.

Remaining super-lean year-round can be challenging, especially if you’re on an exercise program that leans you down in as little as 8 to 12 weeks, such as a bodybuilder’s diet and exercise regimen. This process can get you looking phenomenal for a day or two, but I guarantee it won’t last much beyond that, because our bodies simply cannot function at that level for any sustained period of time. However, you can achieve these results and stay super-lean year-round with a lifestyle change that incorporates healthy meals and regular exercise. A program like this is geared to burn fat as opposed to primarily building muscle, unlike the regimens celebrity personal trainers often put their star clients on.

The thing is, short-term training programs to get in shape for a one- or two-day event (like a bodybuilding contest) do work, but because they occur at an unnaturally rapid pace, they cannot be carried out for any real length of time, at least not without doing serious harm to the body. But sure enough, most celebrity personal training programs are designed around this quick-fix process because so few personal trainers really understand anatomy and human kinetics, the science of how the human body functions. There are well-educated trainers — they just happen to be unfortunately rare. I have worked in the industry for many years, and seldom encounter other trainers who have degrees or even quality certifications, or who continue to develop their education and expand their knowledge about human function and performance. In this unregulated industry, no one is checking to see if personal trainers are performing any kind of continuing ed — and I promise you, most are not.

All this is not to say that you should not hire a personal trainer. Hell, even personal trainers who know hardly anything about creating a quality exercise or nutrition program still can create an environment where you can get in great shape. They can motivate you to achieve better health and make much further progress than you would likely ever accomplish on your own. Almost any personal trainer is better than no personal trainer. Almost.

Differing Levels of Training Experience — and Results

Certainly there are people reading this who feel they can do it — the fitness program and healthy diet — all on their own. More power to anyone who can create a healthy eating plan, incorporate a weight training routine, and practice a regular cardio regimen on their own. Please know, however, you are the extreme exception. For many people, the problem isn’t in creating the program or even finding the discipline to commit to it. The problem is that in trying to do it all themselves, they are creating the wrong program for the results they wish to achieve. These are the folks who train regularly, yet see little or no results. They then get frustrated and quit, thinking they have tried everything when it comes to losing fat, that they simply must not be disciplined enough — when, in reality, discipline has very little to do with it.

There also are those who think they know a lot because they’ve achieved great results on their own, when in actuality, they’ve just been blessed with good genes and would benefit by doing almost any kind of exercise. Most of your models, movie stars, and celebrities fall into this category, so any exercise and nutritional program a personal trainer gives them is likely to work like a charm. Under the guidance of a knowledgeable personal trainer and certified nutritionist, these people would see more and better results than they had ever dreamed possible. And the best part would be that the results would last, rather than simply providing the short-term fix they’ve become used to.

Lastly, of course, are the people who don’t care about their health, don’t have time to exercise, or never exercise, because exercise hurts, they hate to sweat, or their self-esteem is in the toilet and they figure it’s a waste of time to even try. While this sort of personal apathy toward preserving one’s health through exercise and proper eating may seem like no one’s business but the individual’s, it really is a very selfish act. Treating your body well, including getting regular exercise and eating healthy food, is the most unselfish thing you can do. Think about it — if you don’t take care of yourself now, sooner than later, others will have to take care of you. Since you were too lazy, busy, or depressed to invest the time or energy in staying healthy, you will, inevitably, make others suffer.

A Qualified Trainer Will Tailor a Program to Meet Your Needs

If companies and governments were wise, personal trainers would be mandatory and health insurance would cover them. Well, a guy can dream, can’t he? Seriously, even if you only see a trainer once a week — or even once a month — to check in and make sure you’re performing your exercises properly, it’s better than not seeing one at all.

Take the time to do the research, and then invest in a qualified trainer who is knowledgeable about how to help you achieve your personal goals. If you have a special need — a back injury, joint problems, limited range of motion — find someone who can address your issues specifically. Don’t jump on the latest celebrity trainer bandwagon, just because the person is a trainer to the stars. Find a personal trainer who knows how to train your human body and get you results.

Fame Doesn’t Equal Expertise — Particularly in the Health & Fitness Industry

Celebrity personal trainers, spokesmodels, movie stars, athletes, and other rich and famous people probably got where they are because they’re great at what they do. That does not mean you should follow their advice about health and nutrition. You probably wouldn’t ask a plumber advice about how to change your car’s oil, would you? Likewise, celebrities may look good, but that doesn’t mean they — even celebrity trainers — know anything about proper exercise and nutrition. Hire a health, fitness, and nutrition professional. They are the only people whose advice you should take regarding these subjects. Even medical doctors generally are not the best advocates for proper fitness and nutrition, because they are trained in specific fields and seldom are aware of how all the parts of the body work and move in cooperation.

Have you ever noticed how some of the famous people dishing health advice are not even in that great of shape? Why would you take advice from someone who isn’t in peak physical condition? That’s like getting your hair cut by a stylist with a bowl cut or having a gap-toothed orthodontist install your braces. Not to mention that anyone can look great, but still feel terrible because they achieved their looks through an unhealthy method.

Research Pays Off When Searching for a Qualified Trainer

The thing is, you don’t know what you don’t know. As a result, many people fall into the trap of buying the baloney stars like Britney Spears, Oprah, and Dr. Phil are selling. And even though a star might actually have a fabulous, incredibly knowledgeable trainer, a lot can be misinterpreted between the time the trainer offers exercise or diet specifics to his celebrity client and the time that celebrity repeats the info to his or her adoring public. It’s like that game of Telephone you played when you were a kid — by the time the information reaches you, it has turned into misinformation.

How do you know who to believe anyway? One star says they got great results by simply lifting weights and eating fewer calories. The next celebrity says they lost tons of weight by eating a low-fat diet high in protein. Another famous somebody swears by a daily swim, lots of veggies, and whole lot of good carbs. Arghhhhhh!!!! It all sounds confusing as hell. And, in a way, it is.

A program that’s right for a size-2 supermodel probably is not right for a heavy stay-at-home mom who is just now learning to incorporate any exercise into her day. The proper program for an individual depends on his or her biochemistry and the specific way their body functions. Understanding human kinetics is not as easy as A-B-C. When it comes to the human body, there may be many underlying reasons why one person begins a simple walking program and, voila, they look phenomenal, while another person runs, lifts weights, and kills themselves in the gym, only to step on the scale and find they’ve gained another pound.

The human body is awash in mysteries, and a good personal trainer will help you solve yours so you can lose all the fat you want and add all the muscle you desire. Again, personal training is all about you and your results. And even if all your exercise and effort don’t drop a pound off you — if you see no noticeable changes — know that the exercise is benefiting your body and your health, and it would be stupid to discontinue your program. Rather than quit, find someone to help you fine-tune your regimen so you can begin to see the results from all your hard work.

The main thing is this: Don’t follow someone’s advice just because they claim to be a personal trainer to the stars or charge $300 an hour. None of that means their program will get you the results you want. There are no healthy quick fixes. Get on a quality exercise program and eat properly, period. Don’t waste time, money, or energy, only to become frustrated. Do the research and hire a professional who can give you sensible advice that will get you on your way to looking good and feeling great.