HealthBlog 

My HealthBlog is a collection of thought-pieces and observations that often challenge conventional notions about our health and well-being.  I welcome questions and comments via email to refallday@aol.com.
 

The Health of Ivan Ilych

by Jonathan D. Simon, D.C.

If you sit on a bench and watch people walk by, you may notice an array of poor postures, uneven gaits, clenched jaws, forward-curling shoulders--patterns of structural imperfection and associated tension at wide variance from what is anatomically possible for our species at its best. If you could look inside the minds of these people passing, you might see a corresponding array of nonstructural tensions, as they work ceaselessly to hold off the threats and challenges surrounding them. There is no assailant visible, perhaps, but so many of these ordinary people are nevertheless under assault: they might have been born into it or have grown used to it and so do not notice, but the very breadth of their knowledge assaults them, the disharmony and busyness of their city, the complex requirements of post-modern life.

Unlike people born into the simpler rhythms of a rapidly vanishing life, our people—though arguably better off in many ways—carry a world view which, even in leisure, rarely allows for repose. They are not attached to the land, they do not make things with their hands, they do not witness birth or death (except as sensationalized through media); they sense that we are fabricated, not really born, to fit into a dwarfing steel-concrete-glass-plastic-synthetic environment whose seeming indestructability (how, short of apocalypse, would you go about taking down Midtown Manhattan?) throws up the disturbing illusion of immortality: death, banned from the room, whispers outside the door; pathetic clumps of green and patrolled parks show Nature reduced to little islands in our self-important sea.

People notice diseases, they notice bad knees, they notice wrinkles, they notice pain. They tend not to notice their balance, their gait, their breathing. They tend as well not to notice their fundamental fears, the ever-present psychological assailants. These, unlike disease symptoms, are constants, and we tend to notice change. It is no wonder then that so much attention has been focused on diseases, on the things that go wrong with a person's body, and so little on the things that are wrong, have been wrong throughout all or much of the person's life.

Tolstoy told the story, in "The Death of Ivan Ilych," of a man whose life had been "most ordinary and therefore most terrible." His life, molded to fit the standards of normality and respectability, was wrong, but this did not occur to him until he was almost through the battle with the disease—affecting some organ or other, it was never clear which one—that ended his life. With their detachment, condescension, and futile ministerings, the doctors appear simultaneously offensive and ridiculous, but who else's counsel is there for Ivan Ilych to follow? If we could only have intercepted him as a younger man—urbane, practical, competitive, upwardly mobile. If we could have seen the tension in his scalenes, his TMJ, the lack of fullness in his breathing. If we could have noticed the rigidity of his posture, how his weight did not flow through his body to the Earth when he walked. And then if we could have dared to diagnose the detachment, the defense, the walls, the unacknowledged confusion really, in his eyes, in his smile, in the tenor of his voice.

What could we--as "alternative" healthcare providers—have done to help him? Could we have touched certain points to relieve the stress stored in the meninges; moved certain bones, released certain muscles to restore ease and fluidity to his structure; pumped cerebrospinal fluid to support his nervous system? Then, though he had not yet one sign of disease, nor reason for concern, could we have founded his recovery upon a restoration of trust, a recognition of how closed he had become and a willingness to reopen? Could we have freed him to see—or imagine, for it may not be a literal truth—the graciousness of the Earth upon which he stood and into which he would one day die; and would this vision have helped the weight flow through his body when he walked, so that he would not always be straining, tense in self-protection and competition? Could we have treated Ivan Ilych and taught him, in the days before anything had gone wrong? In Tolstoy's story, it took death to teach him, and terrible agonizing pain. If the doctors had kept Ivan Ilych alive, or even spared him his pain, he would never have come to see what was wrong with him. He would never have seen that his body was breaking down because he had withheld it from life.

Working with the body is so important because a tense body is like a padlock on the spirit, and will not allow a person the freedom to overcome the anxiety which, in all likelihood, brought that body to its state of tension in the first place. What even Tolstoy could not guess was that Ivan Ilych's body also was betraying him, just as he was betraying it, long before he fell ill. Its unacknowledged torques and tensions must have limited him, not just physically but in character and spirit—harassing him, undermining his energy, his openness, his courage, replacing these with the quiet desperation that led him inexorably to choose his "ordinary" life from among the pre-fab models of his culture.

Not every person passing your bench is an Ivan Ilych. But who among us may not soon enough die in a hospital, fighting death or anaesthetized into submission, intact, safe behind our walls, having died long before?

 

About Chiropractic

by Jonathan D. Simon, D.C.

Chriropractic is a profession that, I must admit, lends itself to skepticism. Misconceptions about chiropractic abound, and indeed no single conception would accurately encompass all that chiropractic has become today.

Yet abiding within this confusion are seeds of an approach to the human body and human being with great potential for a healing that goes far beyond the relief or masking of symptoms. While much space could be devoted to tracing the roots and history of chiropractic, the key thing to recognize is that chiropractic has been ambitious in a way that conventional medicine, until very recently, has not been. Chiropractic's founder in 1895 was ambitious enough to seek the root causes of what he called "dis-ease" (a term I initially thought rather silly) of the human body, and its developers have continued that search in the years since, exploring subtle and previously unacknowledged mechanisms of the body and discerning relationships between the functioning of these systems and overall health.

Some of this exploration was observational and would not meet the standards currently accepted for scientific research (but note than even such "impeccable" contemporary reserach often finds itself radically modified or even reversed in short order). But much of great importance has been revealed, if not yet fully understood. Because many roads have been opened up and followed, a patient today encounters in chiropractic a variety of approaches to healing. Most have roots in experience and sharp-eyed observation; some are wishful thinking; all are adhered to passionately, sometimes to the disparagement of other approaches.  A patient visiting five chiropractors might well get five different analyses of his or her situation and five different conceptions of chiropractic.  If one doctor forecefully adjusts your spine, another gently contacts meridian points, a third rocks your head in a rhythmic motion, a fourth gives nutritional supplements, and a fifth prescribes exercises and orthotics--where is the truth?  Does one of them see it?  Are the rest of them wrong? Are they all wrong?

These are very reasonable questions to ask.  The fact is that the interrelationship of all the body's systems is not fully understood by anyone.  But there are certain patterns that repeat themselves and working with them brings relatively consistent results. Each approach is, to use a metaphor well-traveled in holistic health circlees, but one of several doors to the room. The real contribution of chiropractic has been first to recognize the existence of this room of optimal health and understand that symptoms are generally merely its outer walls, then to find a number of the many doors that open into the room itself.  This is an evolving process, and one that conventional medicine itself--in its growing emphasis on stress factors, exercise, complex mind-body phenomena, nutritional variables, and other quirky and previously unacknowledged aspects of holistic health--has finally begun to emulate.

The founder of chiropractic in 1895 cited "toxins, trauma, and auto-suggestion (i.e., the mind's impact on the body)" as the root causes of human "dis-ease."  This at a time when germs alone were thought to be the enemy. We now recognize relationships between the nervous systems and immune function, between emotional states and resistance to disease, between nutrition/exercise and emotional states, between emotional states and posture, between posture and muscle balance, between muscle balance and immune function, between immune function and disease and cancer, between repetitive stresses and all of the above, and on around the circle of health.  Our success at beating back the effects of germs has been substantial, but we are still beset (perhaps more than ever) by "toxins, trauma, and auto-suggestion." Our fortifications against these phenomena, our abilities to equilibrate their effects, are natural to us, but break down under stress and improper use of the body, requiring support and restoration. When a doctor of chiropractic works with the body--whether through the spine, the muscles, the organs, or its lifestyle--he or she seeks to support and restore these natural fortifications.

This is, essentially, a lifetime process, requiring more or less work at different junctures.  When some disparage chiropractic as an on-going treatment, or say that chiropractors all encourage a dependency in their patients, it may be because they do not fully understand or share this chiropractic (and, increasingly, the modern medical) view of health.  Once you come to take a vigoroous and ambitious stance on the matter of your own health, much of what may initially have seemed dubious about chiropractic begins to make much better sense.

 

The Importance of Breathing in Earnest

by Jonathan D. Simon, D.C.

What is so important about breathing?  Why work on it?  Why worry about something that just goes on by itself whatever you do?

My answer to these questions is simple: Breathing is the best indicator we have of the body's physical (and emotional) state of balance and tension.  It is diagnostic of, and therapeutic for, musculoskeletal holding and myofascial torque patterns.  Many of these are chronic imbalances that have evolved in an individual from a combination the biomechanical challenges that are our legacy as a bipedal species and the repeated performance of certain tasks (such as typing and texting) that mold the body and pattern its tensions.

Most of these patterns escape the individual's awareness, yet are a steady drain on health, performance, and temperament.  And they frequently result in symptomatic conditions, often located in remote areas that many doctors would have a hard time associating with the underlying pattern (how many would, for instance, associate a sore wrist with a pelvic or cranial imbalance?).

We take balance for granted, just as we take breathing for granted.  We may admire really fine displays of balance by gymnasts and other athletes.  But, since most of us are able to keep our balance under the normal circumstances of life, we don't think of balance as any sort of personal challenge.  Nobody gets a gold or silver medal for being able to walk down the street! But our likely inability to balance, say, on a tree limb points up the fact that our balance apparatus is not very fine-tuned. If you climbed a tree, you would probably notice that at certain points you would have to hold on in order to avoid falling--either to a branch or internally, with a contortion of your body and a clenching of muscles.  If at that point you were to "relax" and "release" those clenched muscles, you would fall off the limb.  A similar thing happens on the ground or even in your chair--but it is milder and perpetual, so well practiced that you probably don't even notice that you're holding on to maintain balance.

It is hard to imagine releasing muscles that don't even feel clenched, and this is where breathing comes in.  When the body "holds on" to maintain balance or provide leverage, whether at rest or in the performance of some activity, the passage of breath is inevitably affected.  Free, full breathing absolutely requires the release of tensed muscles, not only of the turnk but also of the neck, jaw, and cranium.  Any attempt to breathe fully--with full expansion and evacuation of the lung spaces, full excursion of the disphragm, full and appropriate movement of the craniosacral respiratory system--will be impeded and frustrated by muscular and fascial holding patterns in areas a disparate as the pelvic girdle, the forearms, and the jaw.  You simply can't take a breath that is both full and effortless.

With the release of such tensions (through bodywork, mindful exercise, visualization techniques, even letting one's "inner child" find his or her truth), the free, full breath becomes possible.  And with the free, full breath comes a sense of how relaxed and open your body could be if it learns to balance and move and center more elegantly, rather than to reflexively hold on.  Once you've experienced that "clearance breath"--and the accompnaying feeling of well-being and security--there's no going back!

It might seem worthwhile, at that point, to spend a part of each day or devote a bit of continuous bandwidth to reteaching yourself breathing and balance--little by little letting go of the tensions your body erroneously believed it needed to hold onto, and thereby reclaiming some of the health that our species has lost as it has evolved higher and higher.

 

Breathing and Shopping

by Jonathan D. Simon, D.C.

Ever get one of those beautifully simple and commonsensical ideas, a vision of lots of people doing certain things and pretty much everybody being a lot better off for it?  I saw today across America everyone coming out into the morning sunshine for half an hour to breathe!

There were guides helping out, showing how to practice, how to relax the tensions that grip the lung space, how to use the breath to discover and release these tensions.  It was like a party, a real get-together, with fellowship and cooperation (how could we possibly make breathing competitive or pollitical?!), recognition of shared structure, shared stresses, shared tensions.  It seemed so concrete, so much less abstract than vague dreams of world peace, so doable. People seemed to like it so much that they said they'd come out again tomorrow.

Why is such a nice idea so ridiculous?  What stands between the vision and the reality?  Why does such an ostensibly health-conscious society take the basic daily working of their bodies so much for granted?  Why is it for so many "hit the snooze button then bolt out of bed, grab the toothbrush, put on the coffee, grab the iphone, and start multi-tasking"?  Why aren't we--the ultimate machines--considered worth the work, or even a tithe of the work, we put into the machines we have designed to "help" us?

Could it be that we like it the way it is?  That we like the billions upon billions of Advils and Zantacs and Prozacs consumed each year for the headaches and bodyaches and heartaches, that we like the caffeine and nicotine dependencies and the junk-food fixes, the oxycontin, and the ice packs and hot packs, and the fellow behind us who hits his horn and hits it hard the instant the light turns green?  Or is it ignorance: that people simply don't realize what a little better-directed effort could do?  Or perhaps laziness: "If I'm not being paid for it, can't put a FitBit number on it, can't show it off to anyone, why should I bother?"  Or is it something else?

Consider how vital anxiety is to the economy.  When we feel small, inadequate, harried, not up to the standard of all the models, all the beauties and all the hunks, all the superior creations of artists and scriptwriters and advertisers flashed into our souls frome the economic quasar at the center of our society, we go out and shop.  We exercise the power to buy--things, mostly things we do not need. No matter--it is the power that counts and the fleeting connection to the breast that oozes "stuff:" cars, jeans, iphones and androids, bright and shining objects.  To the mall, to Ebay, to Amazon we go to spend and suck, when the need is high not for things but for reassurance.

Of course nothing cuts through this buildup of anxiety quite like five minutes (can we spare it?) of even semi-conscious, semi-competent breathing.  The restoration of balance (physical and emotional), the sense of well-being, the evaporation of urgency, impatience, neediness are remarkable.  But in an economy where a monthly slip of 0.5% constitutes a national disaster, the elimination of anxiety-related buying, which could well account for half the sales in this country, would bring about a collapse and transformation more profound than any the modern age has seen.

In whose interest then is health?  Is it possible that my simple idea, if it worked, would bring on an instant of serenity (silence in heaven for the space of half an hour?) followed by utter chaos and World War III?  Is breathing really that dangerous?

If you are worried, you needn't be.  For we, in spite of our vast empire of fitness clubs and medical research facilities, are for the most part both ignorant and lazy when it comes to our health. And the complexities of our bodies demand more from us than a simple one-day effort if we are to overcome the evolutionary quirks that have made us such an anxious and aggressive species and culture.  And the powers that be--at least they like it the way it is: the drug companies and medical establishment obviously, but also the entire global corporate village.  They are unlikely to be sponsors of my silly idea.  And without their getting behind it, what vision of millions of people coming out in the morning to practice breathing could ever become reality?

 

Balance and Hypertonicity

by Jonathan D. Simon, D.C.

Balance (and its close cousin, leverage) is so important to us that, without thinking, we are constantly adjusting muscle tension levels to maintain it. Ideally, the muscular input, in a wide range of postures and movements, is gentle, flexible, and fluid.  Instead we often see patterns of sustained hypertonicity--muscles that are more tense than they need to be.  These patterns grow extensive and locked-in as the body compensates for its imbalances, and then compensates for its compensations.  The body will practically put itself, or at least parts of itself, in a muscular cast to achieve balance, navigate the gravitational field without losing it and falling down.

Look around you at the other animals and you will see the primary reason for this: you won't see (leaving out meerkats and a few other rare and transitory exceptions) any bipeds!  This is because bipedalism is difficult and, throughout most of land-based evolution, very disfavored by natural selection.  In primates and eventually humans, it conferred particular advantages that have led to at least a momentary terrestrial dominance, so it has survived and, in a sense, prospered. But it is, as I noted, both very difficult and very uncommon.  In the state of nature, losing your balance and falling down would often be fatal (hence the fallen toddler's primal instinct to cry out lustily--to attract attention and help--even when unhurt). So it is for a good reason that the body is willing to sacrifice other dynamics to preserve basic balance, unless it is challenged to balance more elegantly.

Why is pursuing this challenge worth it? Hypertonic muscles, tightened to maintain balance, stress joints and are more susceptible to injury. Beyond this, though, chronically contracted muscles are, metabolically, like lights left on or water left running in a house. The energy required to maintain the persistent contraction is the same energy required to go through a gym workout or run a road race. The catch is that instead of improving circulation and flushing out waste products, as in these and other forms of exercise, hypertonic (held) muscles impede circulation, block drainage, and store the lactic acid and other waste products they generate.  It is this buildup of toxins that makes your muscles sore and tender to deep touch.  A healthy muscle can take fairly intense pressure painlessly.

The energy drain and the storage of toxins in the tissues tend to cause overall fatigue, heightened irritability, impatience, anxiety, as well as such seemingly far-flung effects as temporarily reduced visual and mental acuity; dermatological symptoms like oily skin, dull hair, and even hair loss; cold hands and feet; diminished strength and coordination; and a craving for sweet and/or fatty foods (the junk food fix).

Probably the most interesting and overlooked effect of hypertonicity is that upon respiration. The chronic overtightening of the postural muscles of the pelvis and trunk restricts the movement and range of our most important skeletal muscle, the diaphragm.  Breathing shifts from abdominal to thoracic, with strain upon the scalenes and other accessory muscles of respiration. Brachial plexus syndromes, with arm and hand symptoms, are one consequence.  But, in addition, breathing takes place in the poorly vascularized lung apices (tops), while the lung bases are underused, leading to an inferior ventilation/perfusion ratio and a diminished oxygen supply to the tissues.  Again, fatigue results.  The postural muscular resistance to the diaphragm's critical role in moving the viscera (liver, stomach, intestines, etc.) also adversely affects visceral motility, drainage of toxins, and overall function. Finally, constrained respiration inhibits pumping of the cerebrospinal fluid, which has a profound effect upon the nervous system only recently understood.

That's a lot to trade for an expedient, inelegant balance! The challenge of hypertonic muscles is that, in spite of their wide-ranging effects, one is generally unaware of their presence.  These are primarily postural muscles (and fascia) over which we are not accustomed to exercising the voluntary control normally exercised over, say, the biceps muscle of the arm.  Remember that the hypertonicity in these muscles is serving what strikes the balance centers of the brain as the vital purpose of maintaining balance--and that part of the brain ordinarily has priority! These muscles would not, therefore, logically send out pain messages directly asking the body to reduce their tension level.  One may feel vaguely harassed but the source is hard to identify.

One way to relax a hypertonic muscle is to first become aware that it is tensed, an awareness which takes varying amounts of time, concentration, and practice to develop.  One very common example is noticing if you tend to cross and lock your legs when sitting for any length of time: that leg lock, innocent as it seems, is the body's way of using guy wires and scaffolding to compensate for less-than-fully-developed seated balance biomechanics.  By uncrossing your legs, you "put the challenge" to that primary mechanism.  Note how quickly and unconsciously your legs recross--that will tell you a lot about the primary mechanism and how much work it may need. The process is one of retraining or reprogramming of the nervous system--in a sense, against its "will"--as one learns, in effect, to balance more efficiently, more elegantly, more simply (hint: balance is always about working with, rather than against, the force of gravity!).  Given the deep-seated and wide-ranging effects of chronic hypertonicity, such retraining can be of great long-term value in terms of skills, health, and happiness.  It is a good example of working together on a causal level to achieve progress beyond the mere relief of symptoms.

 

 

Some Questions Marathoners (And Other Endurance Athletes) Have Asked

Q: Should I take on a marathon?

A:  Ask your body!  If you can listen carefully, your body will give you the answer.  Do you run pain-free, fluidly, without nagging foot, knee, or back symptoms?  Can you run long distances without hiking up your shoulders, clenching your jaw, thrusting your head forward, or “making a face?”  And without popping loads of Advil or Tylenol?  Only if all these things hold true is a marathon likely to have a positive impact on your overall health.  The reality is that, given the biomechanical challenges of bipedalism, very few of us have a flawless gait. Because a marathon requires upwards of 20,000 strides to complete, any flaws—whether pronation, supination, unequal leg length, muscle imbalances—as well as the compensations for those flaws—get magnified through extreme repetition.  Imagine doing 20,000 biceps curls!  The reality is that the vast majority of marathon runners are biomechanical bad news by the time they get to Heartbreak Hill, if not a lot sooner.  Marathons and Ironmans have, quite arbitrarily, become the staples of modern athletic “heroism.”  So if you find yourself drawn to a marathon because, like Everest, “it is there,” make sure the heroic impulse doesn’t override signals from your body that damage is being done. High-demand activities, like marathons or running in general, feel heroic.  But low-demand activities (e.g., the simple shifting of weight from foot to foot that you experience in Tai chi) are foundational and where the patterns can be developed that support better and safer performance of high-demand activities.  It’s tempting to just tell your body what to do, order it around.  Instead try a dialogue. Set flexible goals—and listen to your body.

Q: What is the secret to good marathon and overall endurance training?

A:  Set flexible goals—and listen to your body!  Beyond that, variability is key.  Use your body in as many different and complementary ways as possible.  This means lots of cross training, including swimming if at all possible.  Tai chi, martial art forms, dance, and yoga are other helpful components of an overall training regimen.  Don’t shy away from variability within your runs either.  While ultra-consistent biomechanics are important to sprint and short-distance performance, endurance athletes should avoid locking their bodies into unvarying biomechanical patterns, especially if their bodies are signaling them with discomfort or restricted breathing.  The damage done in endurance activities doesn’t generally come from the muscles that are moving but from those that have locked into stabilization patterns that increase tension and tug on joints and tissues. The best way to break or reset those stabilization patterns is to slightly vary the activity and take a quick break from face-forward linear mode: change your stride length, change your pace, add more torso rotation, let your jaw relax, even turn around and jog lightly backwards for 30 seconds or so, or stop and do some shoulder rolls or a little mock Tai chi.  You will be amazed at the way your body responds to the little break in pattern with more fluidity and a “second wind” of added energy. When training try not to be a slave to your stopwatch!  Explore your limits, but do it mindfully.

Q: How should I start my runs?

A:  Running is, biomechanically speaking, a cycle in which the kinetic energy of falling is converted into propulsion.  Of course there’s more to it than that—it is biomechanically highly complex. But falling is a key component, and the more relaxed the falling the less energy wasted and the less strain on joints and tissues. So the best way to start a run—when the muscles may be stiff and the “engine” cold—is by letting your body fall naturally, with complete relaxation, from foot to foot.  No thought of speed or forceful forward propulsion!  Just lean forward slightly and fall from foot to foot in tiny steps; let the rebound or slight bounce from each fall connect into the next fall, without any haste.  If you do this right, someone is likely to come up to you and ask “Are you OK?”  To which you answer “Never better!”  After anywhere from 10 or 15 seconds to about a minute, if you just let your body drop from foot to foot, an amazing thing will happen: just like with an automatic transmission, your body will “shift gears” and the falls will become longer and more rapid, as you accelerate into a full and easy run.  The value of starting this way?  The pattern you set will be without the strain that often accompanies setting out to run at some preconceived pace, before either your muscles or your nervous system have warmed up to the demands of running.  You stay relaxed and avoid beginning your run with compensations which then often lock in and persist throughout the run, diminishing its quality and leading in the direction of injury.

Q: My hamstrings are always tight.  How should I stretch them?

A:  Don’t! At least not the way you see most runners do it: foot up on bench or railing, teeth gritting, leg shaking.  Hamstrings and Quads are antagonist muscles (hamstrings flex the knee and extend the hip while quads extend the knee and flex the hip) and antagonist muscle groups are often out of balance.  In runners the imbalance almost always favors the quads, meaning that they are too short and strong while the hamstrings are already stretched.  That is why they get so tight: they are tightening to protect themselves from being stretched and torn; they are in effect under chronic internal strain from the pull of the stronger quads (and other hip flexor muscles).  If instead of stretching your hamstrings you learn to release your quads (that is lengthen them by neurological signal rather than physical stretch), the imbalance is relieved and the hamstrings respond by loosening up without having to be stretched.  To release your quads (and all the hip flexors), instead of pulling your ankle up to your butt and feeling the quad burn, you loop a towel around your ankle (you can also just grab the back of the bottom of your pants leg), lift it gently just about the height of your knee and let your leg dangle from the hip socket while “talking” to the muscles of the front of the hip, telling them they can relax and let go. Pretend that you have a 10-lb weight hanging from your knee and let it gradually lower your knee till your thigh is hanging straight down (don’t cheat by tipping your sacrum forward!).  If your knee makes it all the way down so that your thigh is hanging straight down from your hip socket, then use the towel to gently shake out your leg (that is, rotate it away from your butt toward the front in gentle cycles); this will “clear” all the hip and leg muscles that put internal strain on the hamstrings. If the knee seems to not want to drop fully down, that’s OK—it may take a week or two to get your hip flexors to let go enough to do the shakeout part. But they will let go and your hamstrings will say thank you and loosen right up.

Q: So forceful stretching is never a good idea?

A: I almost never say “never,” but it certainly shouldn’t be your routine!  When you forcibly stretch a hamstring (or any other muscle) you make it longer by creating micro-tears in the muscle.  These micro-tears then heal not with genuine Grade-A muscle tissue but with fibrous adhesive tissue patches—analogous to the cheap asphalt they use to fill in potholes on Mass Ave!  That is junk tissue and it behaves a lot like Saran Wrap—it needs to be stretched all the time because it is not inherently elastic the way muscle cells are.  So by forcibly stretching you wind up developing fibrotic muscles (that need to be stretched all the time) and actually worsening problems like the quad-hamstring imbalance; it is a vicious cycle.  As a general rule, if you have to grit your teeth, hold your breath, or make a face to stretch a muscle, you should not be doing it.  If it hurts you should not be doing it.  If you learn how to release muscle groups with neurological commands, your need for forceful stretching will pretty much disappear!

Q: What are some good warm-up and cool-down exercises I can do?

A:  For warm-up the overall idea is to let go of the kind of holding patterns that develop from prolonged sitting, driving, typing, and other unnatural activities that often precede your run.  I recommend the lowly toe-roll and kick-through.  For the toe-roll, simply shift about 90% of your weight to the other foot, flex your ankle so your toe is pointed to the ground like a pen, and roll your ankle around with your whole leg and hip as relaxed (a la Bojangles) as possible.  Go for 15 seconds or so in both directions (clockwise and counterclockwise), then shift feet.  For the kick-through (a favorite of soccer players, but great for any runners), face a wall (or railing, or anything you can hold onto lightly) at about 45 degrees. Use the wall to maintain your balance while swinging the inner leg back and forth like a pendulum or scythe, the longer and looser the better.  Feel the energy come from the ground (through your plant leg) to your center and then out your kicking leg.  Do each leg for as long as it takes to feel fluid and relaxed, including your shoulders and back, as your weight lets go to the ground and muscles that were being used as stabilizers are transformed to movers.  Very low-tech and very effective.  For calf stretching, a simple rocker device known as a Pro-Stretch (c. $20) provides a gentle release and helps insure that tight calves do not throw off your gait biomechanics.  I do these same simple exercises for cool-down as I did for warm-up. Don’t grit your teeth and force stretches just because your muscles are warm!  Remember they are cooling down and shortening naturally; just help it be a gradual process and you will retain more of your flexibility gains.

Q: What kind of orthotics are best for distance running?

A:  If you need orthotics to control over-pronation and/or other problematic foot motions, you have a choice among a wide variety of types over a wide price range.  Distance runners should generally not choose (or accept) rigid (e.g., hard plastic) orthotics. The deceleration phase of the stride should be graded, not abrupt, with at least some of the high G-force of footstrike, roll, and push-off absorbed by a softer, compressible orthotic material.  Rigid orthotics present a serious risk of injuring knees, hips, and back, especially when taken for very long runs.  Orthotics should not cost $600 or even $400—that is gouging.  In fact in many cases off-the-shelf orthotics (e.g., Dr. Scholl’s; they have measuring machines in many Walgreen’s and CVS stores), costing a small fraction of prescription models, will turn out to work very well.  There’s often some trial and error in finding the right orthotic—less troubling when the “errors” are $40 than when they are $400!

I hope these observations have been helpful.  There are many questions about running and many different types of runner.  There’s a lot to think about if you wish to stay healthy and have a long, enjoyable running career.  Please feel free to contact me to discuss any aspects of endurance athletics about which you may have questions.  Yours in health -- Jonathan

 

40 Health Questions Worth Asking (And Trying To Answer!) 

1.     What are some good “rules” for the gym?

2.     How are weight-bearing, balance, and breathing related?

3.     What part of your body came first in evolution?

4.     Why is your belly so important? Why do the “Eastern” disciplines focus on it so much?

5.     What was the first stress reflex of all living things?

6.     Why do children first learning to write hold their pencils in a “death grip?”

7.     Why is “letting go” so crucial to health and healing?

8.     What is “static stabilization” or “architecture” in the body?

9.     How does visual imagery work to change body dynamics?

10.   What is the difference between performance training and foundation training?

11.   What are the three primary stress patterns in the body?

12.   Why practice “low-demand” exercises and activities?

13.   How does modern culture contribute to stress patterns?

14.   Why is too much “binding energy” so bad for you?

15.   What is the best way to reduce binding energy?

16.   Does a “shoulder” really exist?  How about a “hip?”

17.   What are the best exercises?

18.   Why should you not be doing sit-ups?

19.   Why is swimming such a good exercise?

20.  What should you do in the water?

21.   Is stretching always good for you?  What kind of stretching?

22.  What’s the difference between stretching and releasing?

23.  What should you do when your back or neck goes into spasm?

24.  How can you benefit from Tai chi without going to a class or spending lots of time?

25.  Why does cranial work help things elsewhere in the body?

26.  Can you do your own cranial work?

27.  What are the two most important five-minutes of the day?

28.  What should you look for in a mattress?

29.  Why should you sit on a water bottle?

30.  Why is spiral movement so good for you and too much linear movement so bad?

31.   Who would benefit from weight work designed to isolate muscles?

32.  What happens to feelings—such as anger or grief or fear—that you don’t express?

33.  Have you met your “inner child?”

34.  Where should you look for your inner child?

35.  Do you listen to your inner child or tell him or her to shut up?

36.  What is the most important five-letter word in the language when it comes to health?

37.  Who wants to be an explorer?

38.  How are health and ease related?

39.  Can you age backwards?

40.  Why are we typically so hard on ourselves?

If any (or all) of these are of interest to you, please feel free to get in touch and ask away! (refallday@aol.com - 617-538-6012)