A fit and healthy back despite the Pesach cleaning

With Pesach approaching many will be spending long hours cleaning floors, shifting crockery, and wiping down surfaces. All these activities put a strain on the back and if done incorrectly may lead to damage.

A bit of anatomy:
The spine consists of many little bones called vertebrae, shaped according to the job they have to perform. Between each vertebra is a disc. Discs are similar in structure to jelly donuts - an outer shell made of tough cartilage, surrounding a fluid called the nucleus pulposis. Discs consist surprisingly of 90 % water yet they are able to resist enormous amounts of stress and strain. Finally the spine is packed together with ligaments and muscles, giving it strength and flexibility.

Damage to the spine:
Damage can occur to any of the structures listed above. To avoid injuring the back one should follow some basic steps.

Avoid bending and twisting simultaneously as one might do whilst cleaning a bath, making a bed or loading a suitcase into the back of a car. It multiplies the stress through the spine and typically causes a slipped disc at the worst, and a muscular tear at best.

When lifting or lowering a weight, bend your knees while squatting and let the strong muscles of your legs do the work not the small muscles of your back.

Keep the weight of what you are carrying close to the body. If you are moving pots and plates from shelf to shelf try to hold the weight close to you. The further away the weight is from the body's center of gravity the more effort is required of the muscles and more risk of injury.

Try to avoid stooping for long periods such as leaning over the sink to wash dishes or over the kitchen table. Try and get into the habit of transmitting your body weight onto the table or basin as this relieves stress from the back muscles which will otherwise fatigue and give pain.

Stop:
Stop and think about what you are about to do. Injuries often occur because of rushed activity; behaving in a way unsuitable for the body and eventually causing strain.

Rest:
As muscles fatigue they become less efficient and less protective. Pushing oneself beyond fatigue will eventually take its toll. Breaks should be taken after 45 minutes of work. I advise lying on one's back on a carpeted floor or on a towel, knees bent at 90 degrees with calf muscles resting on a chair or sofa. Place a telephone book under the head. Rest arms on the belly, no distractions other than music. This allows the spine to return to neutral and the surrounding muscles to relax. Stay in this position for approximately 12 minutes – it is a great way to revive one's energy.

Haman was hung over Purim. Don't let it happen to you.....

It's that time of year when most people will be drinking until they don't know the difference between Mordechai and Haman. We all know how easy it is to consume copious amounts of alcohol and know how regretful it can sometimes be the morning after.

A hangover is a term used to describe the uncomfortable combination of symptoms that follow after the body has undergone a bout of heavy drinking. Symptoms usually include headache, nausea, fatigue, sensitivity to light and noise and dryness of mouth. These symptoms normally begin some hours after the drinking has stopped. The intensity of the symptoms varies according to the amount one drinks, the kind of beverage consumed and the regularity with which one normally drinks.

Let's try and understand the physiological basis for a hangover. Alcohol has the effect of increasing the amount of urine produced. The medical term for this is that alcohol is a diuretic. Since it is not uncommon for a person to also vomit and sweat when drunk one can understand why a person may suffer from mild dehydration after an alcohol binge resulting in headache and physical discomfort.

Alcohol has the direct effect of causing inflammation of the intestine and stomach (gastritis) and this is especially true with beverages with high alcohol content. This may explain the feeling of nausea associated with drinking.

The type of beverage that you drink will also affect the intensity of the hangover. As well as alcohol, beverages contain a substance called congeners produced in the fermenting process and which give a drink its taste and smell and contributes to the drink's intoxicating effect. Drinks that are pure ethanol such as vodka or gin result in less of a hangover than drinks that contain large quantities of congeners like whisky or red wine.

Treatment for hangover

Hangovers normally last between 8-24 hours but there is a way to limit the intensity of a hangover.
* Don't get drunk quickly. Drink small quantities at one time.
* Consume drinks with pure alcohol – vodka or gin.
* Consume fruits or fruit-juices to stabilize your glucose levels.
* Eat bland foods like toast or crackers (complex carbohydrates) to stabilize glucose levels.
* Rehydrate with water


In summary, a hangover is difficult to prevent in the event that one is going to get totally sloshed but the best one can hope for is damage control. Stick to one type of drink, drink in small amounts, and make sure that one is not drinking on an empty stomach., that way not only Purim will be enjoyable but so will the morning after.

Summer running happens too fast..... a sensible return to exercise.

Summer is approaching and there is a fresh feeling in the air. The worst of winter is behind us and people are considering returning to sport.

The experience of starting a new sport or hobby and discovering that it causes more discomfort than relief is disappointing.

For this reason one has to select one's sport and routine thoughtfully.

The body is organic and responds negatively when bullied into physical activity. Encouragement, not force, is the recipe of the day and so an over-zealous return to exercise after months of absence is inadvisable. The body requires time to adjust. A regular routine of fast walking between 20-30 minutes 3 or 4 times per week is a good way to start before taking it to the next gear. Whichever sport you decide to adopt begin slowly. Run for 10-15 minutes at a slow pace, again 3-4 times before increasing the speed or the distance. Similarly, with swimming; excessive activity will strain the neck, shoulders or back. A moderate return to physical activity gives the body a chance to adapt and get stronger.

It is inadvisable to do the week's exercise in one fell swoop. To go from sedentary work all week to playing 2 hours of energetic football is not giving the body's soft-tissues time to adapt organically. Not only can it lead to injury, it is a strain on the heart.

Anyone above the age of 30 years will have noticed how the body feels less flexible than it did ten years ago. Body tissue is made up of elastin and fibrinogen protein. With age, fibrinogen becomes the dominant protein resulting in lost elasticity and injury. These proteins are however dynamic and we can restore the quantity of elastin through exercise.

Recovery is vital - after an episode of exercise where physical demand has been placed on the body, our "architecture" and physiology need time to adapt and meet the demand. This does not occur immediately, rather over 2-3 days following exercise. Therefore recovery time is important. Interrupting the recovery period with further exercise reduces the body's opportunity to reorganize itself and potentially weakens it.

Once in a routine exercise must put a demand on the body in order for there to be a significant improvement in health. All too often people in the gym read newspapers on the tread-mill or bicycle distracting the person from serious exercise. It lulls a person into a false sense of security thinking they are caring for their body but the benefits are minimal. Instead, exercise must leave one feeling puffed-out with fatigued muscles. Once that feeling has dissipated recovery has occurred.


There is more to say on this subject but I will conclude here and return at a later date, but the important matter to remember is; return to exercise slowly, carefully and push the limits when ready. I should stress that doing exercise does not mean that the body can handle better the likes of cigarettes and poor diet. On the contrary, doing exercise in an otherwise unhealthy environment is potentially more damaging.

Heartburn during pregnancy

Heartburn is a common phenomenon in pregnant women. It is the result of the regurgitation of the acidic contents of the stomach back up into the esophagus. If chronic, this may cause the esophagus to become inflamed and extremely painful.

The esophagus has a muscle (sphincter) that acts as a stopper preventing regurgitation. The sphincter is surrounded by our main breathing muscle, the diaphragm. During pregnancy the mother's body undergoes major postural changes. The diaphragm, ribcage and spine must accommodate for the increase in size of the uterus - the diaphragm stretches expands, the ribs flare and the spine flattens. If tension exists in any of these structures they find it hard to accommodate the increase in size often resulting in pain. Commonly the diaphragm is affected. It remains tight and contracted and unable to relax and contract as it is supposed to do when we breathe. Furthermore, its function as a sphincter is compromised, it doesn't contract around the esophagus well and this may be one of the reasons for regurgitation.

Osteopaths are trained to diagnose soft-tissue tension in the body. They explore the areas of the body where tension exists such as the diaphragm, the ribs, the spine and the pelvis. Osteopaths use safe, gentle and accurate manual techniques to correct these areas of tension and allow the necessary changes in the body to occur smoothly as the uterus expands thus reducing the chances of heartburn.