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. 

Recovering from a Calf Injury

When dealing with a calf injury, it's crucial to follow a specific routine before jumping back into your favorite sports or running activities. A tear or strain in the calf muscle is painful and can lead to chronic issues if not properly rehabilitated. Here’s a comprehensive guide to help you recover and regain your strength effectively.

Understanding the Calf Injury

A calf injury typically occurs at the weakest point of the calf, where the muscle meets the tendon. This can happen on the calf complex's inside (medial side) or the outside (lateral side). Either way, it's essential to improve mobility and realign the collagen matrix and muscle fibers for the healing process.

The Rehabilitation Process

Rehabilitating a strained or torn calf muscle involves several key steps:

1. Mobility Improvement: Add tension to the muscle while it heals, facilitating the alignment of collagen matrix and muscle fibers. This sets the foundation for the healing process.
2. Strengthening Exercises: Incorporate exercises in all three planes of motion to rehab the tendons effectively. Strengthening the calf muscles is vital for a full recovery and a triumphant return to doing whatever it is you love to do.
3. Endurance Building: Calf muscles are multi-joint muscles, moving in various directions simultaneously. They endure different forces during activities like running or sports. One way to test your readiness to resume activity is to skip on your toes with the injured leg. You might be ready if you can sustain it for 10 minutes without pain. If it hurts or you can’t skip, it’s not time to return to running just yet. What this video of how I rehabilitate people with a calf injury: [embed]https://youtu.be/Nuxd36P-Z8w[/embed]

Integrating Specialized Exercises

To enhance your recovery process, integrate the following exercises into your routine:

1. Foot Exercises: Work on your foot's flexibility and strength. Check out this video for guidance.
2. Foot Core Strengthening: Strengthen your foot core to support the calf muscles effectively. Here are some foot core strengthening exercises to try.
3. Hip Exercises: Incorporate hip exercises into your routine to improve overall lower body strength. Watch this video for practical hip exercises. Also, ensure your hips are working as well as they can. Find a whole stretch routine for tight hips here.

By following these steps and exercises diligently, you can effectively recover from your calf injury and prevent it from becoming a chronic issue. Rushing back into sports or running without proper healing can worsen the injury and lead to long-term problems. As anyone who has injured their calf knows, these muscles play a significant role in your mobility and athletic performance. Taking care of them after an injury is crucial. By focusing on mobility, strengthening, and endurance, you can ensure a full recovery and reduce the risk of future injuries. So, be patient, stay consistent with your exercises, and soon you'll be back on your feet, stronger and more resilient than before. Stay tuned for more tips and exercises to keep you active and injury-free!  

High Cholesterol Might Mean You Live Longer

I'm captivated by the study of longevity. I'm not suggesting I want to live forever, but as I recently turned 46 (yes, it was my birthday a few days ago), I'm contemplating the possibility that I might only be halfway through life. This realization underscores my responsibility to maintain my body in optimal condition for another four decades or so if I want to lead a healthy, active, and fulfilling life until the end. None of us can predict exactly how many years we have left. However, unless there are genetic or environmental factors that shorten our lifespans, most of us have the potential to reach the age of 100 and beyond. To put it differently, if we can glean insights from studies like this, they might help us age without succumbing to common ailments such as diabetes, dementia, kidney dysfunction, or heart disease. This is why the research conducted in Sweden is so intriguing. The study involved 44,000 individuals born between 1893 and 1920. Researchers began tracking them from their 65th birthday, examining blood markers related to inflammation, metabolism, liver and kidney function, as well as indicators for malnutrition and anemia. Specific markers they measured were:

• Uric acid measured inflammation.
• Total cholesterol (TC) and glucose indicated metabolic status/function.
• Alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), albumin, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and lactate dehydrogenase (LD) gauged liver function.
• Creatinine assessed kidney functioning.
• Iron and total iron-binding capacity (TIBC) indicated anemia.
• Albumin was used for nutrition.

Of these individuals, 1224 (84.6% female) reached their 100th birthday. Among them, only 2.6% had heart disease, compared to 8.7% of non-centenarians. Merely 0.02% suffered from dementia, compared to 1.1% of non-centenarians, and 0.5% had diabetes, as opposed to 3.2% of their counterparts. These individuals, at least on paper, weren't burdened with lifestyle-related diseases like others.  What did their blood markers show? Cholesterol, as you might know from my previous blogs, plays a crucial role in the body as a fundamental building block for hormones and various bodily processes. Interestingly, those who lived the longest didn't have low cholesterol; they actually had high total cholesterol levels after the age of 65. While this might be specific to the Swedish population, it's essential to note that this study represents the most extensive examination of longevity and associated biomarkers to date. Consequently, it demands our attention. Could this challenge our current understanding of cholesterol? In the researchers' words, "We found that a higher total cholesterol level was associated with a higher chance of becoming a centenarian, which contradicts clinical guidelines regarding cholesterol levels but aligns with previous studies showing that high cholesterol is generally favorable for mortality in very old age." Another significant finding was that individuals who lived the longest had remarkably low serum glucose levels. In essence, those with higher glucose levels in their blood did not live as long. The researchers summarized their findings in the discussion, stating, "Higher levels of total cholesterol and iron and lower levels of glucose, creatinine, uric acid, ASAT, GGT, ALP, TIBC, and LD were associated with a greater likelihood of becoming a centenarian." What the study doesn’t show is what type of lifestyle these people led.  The good news is that we already know that paying attention to and optimizing the 6 aspects of lifestyle medicine will help all these markers. Nutrition Physical Activity Sleep and Recovery Managing Stress Avoiding toxic substances Maintaining strong community If you have had a recent blood test and noticed something isn’t right, if you want to learn how to optimize your lifestyle to add a health span to your lifespan, hit me up. I help people via goal-orientated lifestyle optimization coaching that can help them live a long, purpose-filled life. Sources: https://link.springer.com/article/10.1007/s11357-023-00936-w