What is The Role of Pelvic & Leg Imbalances in Scoliosis?

I've been helping people take a whole-body approach to their scoliosis for years.  One of the reasons for this is that we can't ignore the rest of the body when dealing with scoliosis. Dentists and researchers have long postulated imbalances in the teeth (1) may play a role in idiopathic scoliosis, and many other disciplines have good theories about what causes scoliosis. There is, currently, no 'smoking gun' when it comes to the cause of adolescent idiopathic scoliosis. However, it is worth looking at the rest of the body for anything that could contribute to scoliosis or prevent it from improving.  One area I'm particularly interested in is the pelvis. I view the pelvis as the foundation of the spine. If we drop a midline or 'plumb line' down the front of someone's body it would follow their spine and then dissect the pelvis in half. However, my scoliosis patients often have their pelvis rotated or shifted to one side. Often, this is an adaptation to scoliosis, but what if it's an adaptation to something with the feet or hips that is actually making the scoliosis worse?

Let's look at some common causes of pelvic imbalance and see what we can do about them. 

• Apparent Leg Length Deficiency: This condition arises when postural muscle imbalances cause one side of the body to draw up the leg despite equal lengths. The solution is to find which muscles are tight and how they affect the joint. For example, tight hip external rotators will externally rotate the hip, making the hip a little longer. Tight hamstrings, popliteus, and calf muscles can flex the knee, causing the leg to appear shorter. Stretching and mobilizing the joints and muscles will help in these cases.
• A collapsed arch on one foot pulls the hip down on the same side. Foot strengthening exercises and, in some cases, orthotics can help with this. 
• True Leg Length Deficiency: There is an actual difference in bony length between the left and right sides. This is best corrected with a lift on the shorter side. 

However, sometimes, the anatomy of the scoliosis can also drive the pelvis into rotation and an oblique tilt. This has to do with the weight shift that happens when scoliosis isn't balanced. In an S-curve, this occurs when one curve is larger than the other, but it's also common in adult degenerative lumbar spine scoliosis. But this is then compounded by postural habits that tighten up muscles. Assessing the hips in all six cardinal directions is essential before starting any corrective-type exercise. In the Scoliosis Correction Protocol, we use 22 different body tests to build a picture of imbalances in our patients before we get them to do any specific scoliosis exercises. This allows the scoliosis exercises to be more effective as they are not 'fighting' against muscle imbalance elsewhere in the body that could be adding to their scoliosis.  Understanding the interconnectedness of pelvic and lower extremity imbalances with scoliosis progression underscores the holistic approach required for effective management. By addressing these contributing factors through tailored interventions, we can optimize postural alignment and mitigate the impact of scoliosis on overall spinal health. As healthcare practitioners, we must learn to recognize and address these intricate relationships to provide comprehensive care for individuals with scoliosis. I hope you found this information helpful. If you want my help to see if we can use specific exercises and lifestyle medicine to help you recover from pain, injury, or illness, please reach out to me via ed@edpaget.com

1. https://www.researchgate.net/publication/7842106_The_Influence_of_an_Experimentally-Induced_Malocclusion_On_Vertebral_Alignment_in_Rats_A_Controlled_Pilot_Study

4 Top Exercises for Bulging or Herniated Disc Relief

Understanding Disc Bulges and Herniations Up to 85% of us will experience back pain at some point in our lives. For most, this pain is temporary and resolves within a few days. It is often caused by a pulled muscle or ligament. However, for some, the pain may be the result of a disc bulge or herniation. In a disc herniation, the gel-like liquid at the center of the disc, known as the nucleus pulposus, is squeezed out of the surrounding ring, much like jam being squeezed out of a doughnut. This "jam" can then push on the nearby nerves, causing inflammation, which leads to pain that radiates down the leg, a condition known as sciatica. Disc bulges and herniations are common when the joints of the lower spine are overused, such as in individuals who frequently bend forward or have tight hips, causing the lower back to compensate by moving more. While disc bulges are very common, they don't always cause pain. For example, up to 84% of people in their 80s have disc bulges without any pain, but they sometimes do cause pain.

Avoiding Surgery for Disc Issues

Some people may consider surgery for disc issues, but studies have shown that there is not much difference in long-term outcomes between those who undergo surgery (1) and those who do not. Dr. John Sarno, a renowned physician, believed that simply providing information and education could help many people overcome their back pain. (2) While information is valuable, it doesn't always relieve the pain. That's why we're going to explore four exercises that can help pump out inflammation, relax the muscles, and keep the spine strong and mobile.

Exercise 1: Somatic Flower

This exercise involves lying on your back and using your breath and movement to mobilize the spine. Start by taking a deep breath, feeling your belly expand. As you exhale, allow your back to arch slightly off the ground. As you do this, let your knees drop outward, relaxing the muscles in the front of your body. As you exhale, rotate your hands externally, pulling your shoulder blades together. Then, on the next inhale, rotate your hands inward. Repeat this sequence 5-8 times, moving slowly and in control to help pump out inflammation and improve mobility in the lower back and hips.

Exercise 2: Prone Extension and Leg Lift

For this exercise, you'll start by lying on your stomach, with your head turned to the side and your hand resting on the ground. Lift your head and chest off the ground using your upper back muscles rather than your lower back. This is important as it helps to avoid further straining the already irritated area. Next, lift the opposite leg off the ground, focusing on pushing the pelvis down into the ground to stabilize the lower back. Avoid arching your lower back as you lift your leg. The key to this exercise is to engage your upper back and your glute but not extend or move your lower back too much.  Repeat this movement 3-5 times on each side, then try lifting your whole arm off the ground as you lift your leg and head.

Exercise 3: Spinal Flexion and Extension Cogs

For this exercise, you'll need a chair. Sit up tall, with your hands dangling down by your sides. Begin by rotating your hands backward, which will gently arch your lower back. Imagine there's something on top of your head that you're trying to push up towards the ceiling. Next, rock to the back of your pelvis, flexing your spine and allowing your chin to come forward slightly. Avoid letting your ribs flare out. Repeat this sequence of arching and flexing your spine, breathing in and out 5-10 times. This exercise helps to mobilize the spine in both flexion and extension, complementing the previous lying-down exercises.

Exercise 4: Nerve Flossing

The final exercise is designed to help move or "floss" the nerves that may be irritated by the disc issue. Start by sitting up tall and extending one leg out in front of you, but don't push into any pain. Just as far as you can go before you feel a stretch. Look up as you do this. Next,  breathe out and slowly slide your leg back to a normal sitting position, allowing your chin to tuck towards your chest. Then, repeat, as you breathe in, use your back muscles to extend your spine, look up towards the ceiling, and slide the leg out in front of you again. Repeat this sequence of flexion and extension 10-15 times, focusing on keeping the movement smooth and controlled. You may feel some tension down the back of your leg, but the goal is to stay within a pain-free range of motion. Repeat on the other side. Remember, these exercises are designed to help pump out inflammation, relax the muscles, and improve mobility in the spine and surrounding areas. If you have any specific concerns or questions, don't hesitate to reach out to a healthcare professional for personalized guidance. I hope you found this information helpful. If you want my help to see if we can use specific exercises and lifestyle medicine to help you recover from pain, injury, or illness please reach out to me via ed@edpaget.com

1. https://pubmed.ncbi.nlm.nih.gov/20949289/
2. https://www.nytimes.com/2021/11/09/well/mind/john-sarno-chronic-pain-relief.html

Muscles Matter – The Science Of Aging Gracefully

The link between muscular weakness and aging

The researchers state, “There is a large body of evidence linking muscular weakness, as determined by low grip strength, to a host of negative aging-related health outcomes. Given these links, grip strength has been labeled a ‘biomarker of aging.” When most people think of aging, they consider it in terms of the number of years they have lived, also known as their chronological age. However biological aging, which refers to the changes that occur in our bodies over time can be different from chronological age. Biological age is a more meaningful measure of aging as it is modifiable and varies from person to person. By measuring biological age, we can gain insights into disease risk and overall health.

How do we measure biological age?

Scientists have recently developed epigenetic clocks to give you an idea of your body’s biological age. For example, imagine we are studying identical twins who were both 40 years old, but one was overweight, never exercised, drank excessively, and had a history of high stress. By contrast, the other ate well, managed stress, and had a regular exercise regime; an epigenetic clock should be able to look at the DNA of the ‘hard living’ twin and notice that their body had aged faster than the other.

How do they do that?

These clocks analyze patterns of DNA methylation and by comparing an individual's DNA methylation pattern to a reference population, researchers can estimate their biological age. There are even clocks such as the PhenoAge clock, which have proven to be accurate predictors of remaining life expectancy and disease risk. To learn more about epigentic clocks check out my interview with the inventor of PhenoAge, Dr. Morgan Levine here.

What does this have to do with grip strength?

Muscular weakness has been linked to various adverse outcomes associated with aging, like diabetes, cognitive decline (e.g., Alzheimer’s disease), and early all-cause mortality. What this study aimed to do was see if there was some connection between what the epigenetic clocks showed and what the grip strength test showed. Not everyone has access to epigenetic testing so simply measuring grip strength would be a great proxy for this. What was remarkable is that they did discover that increasing muscular strength contributes to a slower pace of biological aging.

So what does this mean?

To me, it really underscores the importance of regular physical activity, including strength training, in our lives. This is important because nearly all my clients over 50 have no regular weight training routine. If they lift weights, they are usually 2-5 lbs, which is not enough.

Four key takeaways:

1. Exercise for longevity: Incorporating strength training exercises into your fitness routine can be a powerful tool in promoting a longer, healthier life. If you don’t know how to do that, there are many resources for personal trainers on the internet as well as in person.
2. Quality over quantity: The focus should not just be on adding years to your life but on adding life to your years. Strong muscles may contribute to a more active and independent lifestyle as you age. Do we stop playing because we get old, or do we get old because we stop playing?
3. Preventative medicine: By taking steps to maintain and improve your muscular strength now, you can stave off age-related health issues in the future. Add to the bank now to help protect yourself in the future.
4. Lifestyle medicine approach: Don’t forget that a balanced diet, mental stimulation, and social engagement are also important factors in healthy aging. A lifestyle approach to well-being is vital if you want help with lifestyle medicine.

Studies like this highlight the significant link between muscular strength and biological aging. Maintaining strong muscles appears to play a vital role in slowing down the aging process. If you want to age gracefully, keep active, and put healthspan into your lifespan then incorporating regular strength training into your daily life should be a key part of your future.

What Inspired Me to Go Alcohol-Free

What Inspired Me to Go Alcohol-Free?

In recent times, there's been a noticeable wave of celebrities and influencers embracing an alcohol-free lifestyle. People like Blake Lively of Gossip Girl Fame, Bradley Cooper, Drew Barrymore, Eminem, and Zac Efron have been vocal about their journeys. However, what truly pushed me to make this change was a podcast conversation with an old friend. He candidly described his weekly routine of heavy drinking – from Wednesday nights to Sunday afternoons, a cycle of anxiety and unhealthy habits. He realized that nobody really cared if he drank or not and during the COVID lockdowns questioned if it was something he needed in his life or not. This realization hit home when he compared spending Saturdays hungover and lethargic versus energized and healthy after a high-energy Cross fit workout. For me, even a single beer affects my sleep and triggers sugar cravings, which is not in line with my health and fitness goals. 

How Long Have I Been Alcohol-Free?

It's only been four months since I decided to go alcohol-free. The accumulation of insights from my friend's story, my own experiences, and a Rich Roll podcast featuring Ruari Fairbairns of "One Year No Beer" finally pushed me to take the leap.

Positive Changes Since Going Alcohol-Free

One of the most significant shifts I've noticed is in my role as a parent. Sharing custody of my kids meant having a "free" Friday night each week. Initially, I relished the idea of carefree evenings reminiscent of my younger days. However, waking up groggy on Saturdays wasn't the image I wanted to portray to my children. Even a small amount of alcohol left me feeling "hungover." Special occasion binges led to brutal hangovers, signaling that my tolerance had dropped. Listening to Ruari Fairbairns, I found a balanced perspective. He emphasized cutting down rather than complete abstinence, advocating for mindful drinking choices. He noted that if he asks people to stop drinking he gets a very small percentage of people to comply.  If he asks people to cut down he gets a high compliance rate. He went on to say that if someone offers him a high-quality drink, in the right environment with the right people he's going to say yes.  But a cheap daytime beer...no way. That resonated with me, and I'm still waiting to find the right drink in the right place with the right people!

Improvements in Physical Health

As a lifestyle coach, my health was already good. Nevertheless, eliminating alcohol has notably improved my sleep quality. Even one beer used to disrupt my rest, and without it, I've found deeper, more restorative sleep.

Challenges and Insights

One of the unexpected challenges has been friends questioning when I'll return to drinking, especially my British friends. The pub-centric culture in the UK can make this decision seem radical. However, I've noticed a natural end to social gatherings when alcohol isn't involved. The conversation stays engaging and purposeful, and I've become adept at leaving early. With my 5 a.m. wake-up call, late nights don't hold the same appeal.

Tips for Those Considering Going Alcohol-Free

If you're contemplating reducing or eliminating alcohol, ask yourself why you drink in the first place. Is the reason strong enough to continue? Recruiting support from friends and family can be invaluable. It can be a lonely journey without a supportive community. Having others champion your goals makes the transition smoother and more enjoyable.

Conclusion

Going alcohol-free has been a revelation, not just for my physical health but also for my mental clarity and overall well-being. It's a personal journey, one that has led to better sleep, improved relationships, and a deeper alignment with my values. Whether it's for a short break or a long-term commitment, the benefits are clear. If you're on the fence, take the leap. You might just find a whole new perspective on life waiting for you.