The Root Cause of Rhomboid Pain

Dealing with persistent pain between the shoulder blades is something that can disrupt your day, making concentration at work a challenge, turning driving into a struggle, and even triggering headaches that leave you wanting to lie down. Many people mistakenly attribute this discomfort to a tight muscle in their upper back, often pointing to the rhomboid muscles. People try rubbing, massaging, cupping, and putting hot towels on it, but rarely does that work. More often than not, the culprit isn't a muscle issue but rather a stiff joint where the ribs meet the spine, known as the costo-vertebral joint. This joint irritation then affects the overlaying rhomboid muscle, contributing to the pain. While a quick massage of the rhomboid might provide temporary relief, it doesn't address the underlying issue. To truly beat the pain, focusing on getting the ribs and spine moving is crucial. With this in mind, I've created a series of simple exercises designed to target and remedy the root cause, facilitating joint mobility and relieving tension in the upper back muscles, including the rhomboids. These exercises do many differing things but aim to:

• Mobilize the Upper Back: By engaging in specific movements, you can promote mobility in the upper back, targeting the costo-vertebral joint and allowing for greater freedom of movement.
• Lengthen the Scapulothoracic Joint and Traction for the Neck: Addressing the scapulothoracic joint and loosening muscles that connect the scapular to the neck is crucial for relieving tension in the neck. These exercises focus on lengthening and providing traction to this mobile area, promoting a healthier and more comfortable range of motion.
• Improve Flexion and Extension in the Spine: Enhancing flexibility in the spine is a vital component of these exercises. By incorporating controlled movements as you breathe, you'll work towards improved flexion and extension, fostering a more resilient and adaptable upper back.
• Pulling Up and Rotating the Ribs: Targeting the ribs, these exercises use the muscles to both pull up on and rotate the ribs. These movements stretch the shoulders front and back and mobilize the costo-vertebra joints, contributing to overall relief.

[embed]https://youtu.be/mMQ92YXW3LM[/embed] If you've been grappling with persistent pain between the shoulder blades, it's time to shift your focus from mere muscle massage to addressing the root cause. The video shows you simple yet effective exercises that are designed to break the cycle of discomfort by promoting joint mobility and releasing tension in the upper back: no more nagging upper back pain, just a more mobile back and better posture. As you may know I help people recover from illness and injury using a combination of specific movements and lifestyle medicine. If you want to see if I can help you, we can jump on a call to find out.  Simply go to the contact page, message me, and I’ll get back to you as soon as possible. 

Neuropathic Foot Pain and Effective Exercises for Relief

If you're experiencing neuropathic foot pain, you're not alone. This type of pain stems from dysfunction or damage to the nervous system and can result from various causes, ranging from diseases to injuries.  Before beginning any kind of rehabilitation, it’s crucial to understand why you have pain in your foot.  The causes of foot pain can vary from things like plantar fasciitis, an overuse injury to the foot, or damage to the skin. However, neuropathic foot pain is caused by damage to the nerves.  One prevalent contributor to this is diabetes, where prolonged high blood sugar levels can damage nerves, causing pain, tingling, and numbness, particularly in the extremities. Physical trauma where the nerves are injured, infections like herpes zoster (shingles), autoimmune disorders such as rheumatoid arthritis, and certain medications can also lead to neuropathic pain as they all affect the body's nerves. If you're unsure about the cause of your foot pain, seeking a professional diagnosis is crucial. Whether you're managing it with medications or lifestyle changes, incorporating specific exercises can really help. I’ve made a quick video below that shows you 4 exercises that can help alleviate neuropathic foot pain: [embed]https://youtu.be/_vCyfjssVUE?si=Q7SZHwmBgrJFWPM8[/embed] Exercise 1: Tennis Ball Foot Rolling A common cause of compression on the nerves is tightness in the foot's fascia. You can relieve this tightness by massaging each area of the foot with a tennis ball. The motion helps loosen the fascia, skin, and connective tissue, promoting better blood circulation to the peripheral nerves. Be mindful of the pressure applied, avoiding excessive body weight. This is important because, ironically,  neuropathic foot pain can be accompanied by numbness, and it is sometimes hard to tell how much pressure you are applying, which can lead to bruising of the skin.  Exercise 2: Toe Lifts The nerves need a fresh supply of nutrients to heal.  This comes in the blood, but the problem is the feet are the furthest part of the body from the heart, and blood flow is often compromised.  This is why some people seem to have really cold feet all the time! To help with this, we want to move the feet and ankles so they pump blood back up the legs. Enhance coordination by lifting each toe individually, starting from the outside and working down to make your foot as wide as possible. This exercise engages intrinsic foot muscles and can be performed for 3 to 4 minutes. Exercise 3: Ankle Mobility for the Calf Pump Adding onto the mobility of the feet in the exercise above, this exercise really gets the blood flowing.  The idea is to work on the calf and front shin bone muscles by moving your foot up and down while lying on your back. Perform three sets of 20-30 reps on each leg, ensuring ankle and toe movement. You can progress this exercise by repeating the toe and heel lifts while sitting on a chair. Exercise 4: Calf Raises On A Step Taking the exercise above to the next level, we will use our body weight to increase mobility and strengthen the calf by performing calf raises on a step. Stand on the edge of a step and let your heels drop down.  Then, contract the calf muscles to lift your body back up.  Do two sets of ten reps with feet pointing inwards and two sets with feet pointing outwards. When incorporated into an overall fitness routine that considers things like nutrition, sleep, and avoiding toxins, these exercises can contribute to effectively managing neuropathic foot pain. If you want my help in managing your pain, illness, or injury using specific exercises and lifestyle medicine, email me at ed@edpaget.com, and I’d be happy to see how I can help. Always consult a healthcare professional before starting a new exercise regimen, especially if you have underlying health conditions. Take proactive steps to address the root causes of your pain and enhance your overall foot health.

Core Exercises for Individuals with a Fused Spine: A Safe and Effective Guide

One of the common concerns post-spinal fusion surgery is how to maintain core strength despite limited mobility in the fused area. Understanding the limitations and focusing on specific exercises can help individuals maintain a strong core. This article and video demonstrate a series of safe and easy core exercises designed for people with a fused spine. It is essential to note that these exercises are suitable for individuals beyond the initial six weeks of their surgery and only if they do not cause or exacerbate pain. You can go through the four exercises below like a circuit and repeat each three times. [embed]https://youtu.be/f3-EsN72WY8?si=ZHAU1OlVD59DZdyW[/embed] **Glute Bridge** The glute bridge exercise targets your buttocks and lower back muscles, enhancing core stability without straining the fused spine. To perform this exercise:

• Lie on your back with your knees bent and feet flat on the ground.
• Slowly lift your hips toward the ceiling while engaging your glutes.
•  Ensure you do not overextend your lower back during the movement.
•  Hold the bridge position briefly before lowering your hips back down.
•  Focus on controlled movements rather than height, keeping the core engaged.
• Aim for 10 bridges repeated 3 times. 

**Supine Leg Lowers** Supine leg lowers are excellent for strengthening your lower abdominal muscles without compromising your fused spine. Here's how to do it correctly:

• Lie on your back with your thighs extended straight up toward the ceiling and your knees bent at 90 degrees so your shins are parallel to the floor.
• Lower one leg toward the ground without arching your lower back.
• If comfortable, progress by lowering the opposite arm simultaneously, engaging your core.
• Return to the starting position, ensuring a smooth, controlled movement.
• Aim to lower each leg 10 times and repeat 3 times through. 

**All Fours Kneeling with Knees Off the Ground** This exercise focuses on balance and stability, engaging your core muscles effectively. Follow these steps to perform it safely:

• Start on all fours with your hands directly under your shoulders and knees under your hips.
• Lift your knees off the ground so only your toes and hands touch the floor. 
•  Lift one leg off the ground, maintaining a stable spine and avoiding overarching or rounding your back
•  If this is manageable, progress by lifting the opposite hand and leg at the same time while keeping your balance.
•  Engage your core muscles throughout the exercise to stabilize your spine.
• Hold each arm and leg off the ground for 30 seconds and repeat 2-3 times. 

**Crawling** Crawling is a functional and dynamic exercise that challenges your core muscles while promoting coordination and balance. To perform crawling safely:

• Begin on your hands and knees with your back parallel to the ground. Lift your knees off the floor about an inch (2-3cm). 
• Move your opposite hand and knee forward simultaneously, keeping your core engaged.
• Ensure your movements are smooth and controlled, maintaining a neutral spine position.
• Focus on coordinating your limbs and stabilizing your core muscles.
• Move forward and back about 3 meters, taking your time to do this, about 30 seconds.

Maintaining a strong core after spinal fusion surgery is crucial for overall stability and well-being. Incorporating these specific exercises into your routine can strengthen your core muscles without putting undue stress on your fused spine. Remember, listening to your body and avoiding any movements that cause pain or discomfort is essential. Always consult your healthcare provider or a qualified fitness professional before starting any new exercise regimen, especially after surgery. With proper care and attention, you can maintain a strong and stable core, promoting better posture, movement, and decreased wear on your spine.

The Power of Lifestyle Choices in Preserving Cognitive Function

The growing field of lifestyle medicine holds the key to maintaining brain health and reducing the risk of dementia. In a recent podcast episode, Dr. Tommy Wood, assistant professor of pediatrics at the University of Washington, provided an enlightening discussion about the power of lifestyle choices in preserving cognitive function. In the podcast, we did deep dives into: Nutrition Physical Activity Sleep Community [embed]https://youtu.be/1MHT14Gx898[/embed] Nutrition Nutrition plays a crucial role in cognitive health. Dr. Wood emphasizes the importance of a nutrient-dense diet, one that avoids ultra-processed foods and focuses on the overall quality of food. High-nutrient foods and a quality diet have been linked with long-term brain health. For example, essential nutrients like B vitamins, choline, and creatine may affect long-term dementia risk. Dr. Wood also discussed some fascinating research that indicates our belief in what we're eating could impact our blood sugar levels, adding a psychological aspect to nutrition's role in cognitive health. To illustrate this, he references a paper where 2 groups of diabetes were given a protein drink and were allowed to read the label.  One group noticed a higher spike in their blood glucose levels even though both groups had the same drink!  The difference is that one group had a label that referenced a high sugar content! Physical Activity We also discussed the importance of physical activity for brain health. Regular physical activity helps regulate blood sugar levels, which is essential as we age, especially after the age of 40. Tommy noticed that the more physically fit and strong you are, the better your cognitive function will be. A combination of aerobic and resistance training has been associated with improvements in brain structure and function, and he goes into detail about what that could look like; it might be less than you think. Sleep Sleep and its effect on cognitive health cannot be understated. Dr. Wood shed light on the consequences of sleep deprivation and sleep apnea on brain function. He also discussed the potential benefits of sleeping with a sleep mask to reduce the impact of light exposure during sleep. Additionally, he touched upon the fascinating aspect of how the perception of time can influence our sleep and stress levels. He quotes a study where people were allowed to sleep for 8 hours but were told they only had 5. Cognitively, they performed as though they had 5 hours of sleep. Conversely, people who did have 5 hours of sleep but were told they had 8 performed better! Community The episode also underscored the role of social interaction in reducing dementia risk. Research shows that social support and stress can directly impact our physiology, which in turn can increase our risk of developing chronic diseases in the long term. Social interaction helps to build and repair the brain, especially in early development and in the elderly. Moreover, cognitive function peaks around the time formal education ends, underscoring the significance of mental stimulation in preserving brain health. Concussion Creatine, choline, and omega-3s were highlighted as potentially beneficial for concussion prevention and recovery. These nutrients can help improve outcomes after a concussion and improve overall cognitive health. It is recommended that those with early symptoms of cognitive impairment get tested and supplement these essential nutrients that may be difficult to obtain on a plant-based diet. Lifestyle medicine offers a wealth of strategies for enhancing cognitive function and preventing dementia. A combination of nutrition, physical activity, adequate sleep, and social interaction can significantly impact brain health and reduce the risk of cognitive decline. With lifestyle medicine, we can all hold the keys to preserving our cognitive health and adding healthspan to our lifespans.