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Raking The Leaves without Breaking Our Backs

Gorgeous, vibrant colorful leaves: they are what make our Michigan autumns so beautiful. The leaves are everywhere, by the sides of roads and highways, in parks and forests…and in our lawns. We know we will eventually need to remove those leaves from our lawns. We are also aware that we have to attend to the chore before the first snowfall and before too many rainstorms make the leaves too difficult to move.

But for pain sufferers, we need to find ways to rake the leaves while still protecting our back. Raking leaves often includes bending, twisting and lifting. We need to be mindful of our body position and mechanics, so that we don’t cause pain or exacerbate pain we already experience. Obviously, a leaf blower that you can comfortably tote will make shorter work of raking, but you typically will still need to rake at some point in the operation.

Here are a few tips on preserving your upper and lower back and reducing the chances for straining for neck and shoulders:

Warm Up: Just like all exercise, you don’t want to go straight from the bed to the flowerbeds. Do some light stretching or calisthenics before you even attack the leaves, especially if you live a particularly sedentary lifestyle.
The Right Rake: Be sure that your rake “fits” you, that it it is not too heavy and neither too long nor too short.
Just Shoe It: Wear supportive shoes that aid in good balance and protect you from the elements.
Love the Glove: Gloves protect your hands from blisters and of course the Michigan chills.
No Twisted Sisters: You really have to be mindful of how you move your body. Plant yourselves in front of the leaves and move the leaves forward or backward without twisting your spine or shoulders.
Change Your Stance and Your Hands: According to the American Chiropractic Association: “When raking, use a “scissors” stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.”
Heads Up: Try to look forward and up as much as possible to prevent neck strain and soreness.
Bend at the Knees: Avoid bending at the waist as much as you can. Bending the knees saves your back.
Stop and Stretch: After 15-20 minutes, stop for a moment and stand fully with the rake on the ground, hands on the hips and gently bend backwards. Do this 3-5 times before returning to your raking.
Hydrate: Bring your water bottle outside with you and take frequent breaks. If you are sweating, you need to drink a bit.
Rejuvenate: After you are done, do some light stretching and take a nice warm bath or shower to help relax those muscles. And just think: you won’t have to do this again for a while!

Sleep Positions for Pain Sufferers

For anybody who deals with chronic, acute or intermittent pain, sleep can be problematic. Clearly, lack of restorative sleep can exacerbate pain, making us tired and unable to cope with regular life stresses the following day. Yet, good sleep can be difficult to obtain when the sleep positions don’t allow us to relax relatively pain-free.

Mattresses, couches and recliners: does it matter? It appears that you don’t necessarily need the newest mattress, but you do need to have a mattress that doesn’t create pressure points. Bursitis patients, however, need to be sure that they don’t sleep on too firm a mattress.

Couches contribute to a great deal of neck, back and shoulder pain, because they are not meant to be sleep surfaces. They do not provide adequate neck and back support. If you regularly fall asleep on the couch, you need to move yourself earlier to the bedroom.

A full recliner (and also an adjustable bed) is often a very effective solution for pain patients. Because it offers so many positions, there are more options to experiment with. Full recliners and hospital beds are also much easier to transfer in and out of to a standing position, which is helpful for hip, leg and back pain sufferers.

If you have had a recent surgery and spent time in a hospital bed, try to remember which positions in the hospital bed gave you the greatest relief. What angle did you keep your legs? Your head and shoulders? Did you lie on a particular side?

Pillows matter. Shoulder pain sufferers often have the hardest time finding a comfortable sleep position, but adding pillows to the mix can be helpful. Neck pain patients need to ensure that their pillows are not so large that they cause the neck to flex. Memory foam pillows are good, as are feather pillows that compress nicely, if you don’t have allergies to feathers. (Feather pillows do need to be replaced more often than foam pillows.) If you haven’t purchased pillows in a while, there are lots of varieties to experiment with: body pillows, small roll pillows, as well as pillows with various gradients in size and firmness. You can be creative, too. Often a rolled up hand towel is the perfect size.

Sleeping on your back is the typical sleep position for those recovering from spinal surgery. For those who are not used to this position, it can be a chore to fall asleep. Be sure to elevate your legs with pillows, so as to minimize the strain on your back.

Sleeping on your side is the most common recommendation for lots of pain patients, including those with osteoarthritis, bursitis, spinal stenosis as well as hip pain sufferers. Pregnant women should also sleep on their side for prevention of lower back and hip pain. For some patients, sleeping on the side can be made even more comfortable with a pillow placed between the bent knees, or by placing long body pillows along the back or stomach. Some people get more relief in a sleep position that includes a fairly straight body and legs; others prefer a more fetal, curled-up position.

Shoulder and hip pain sufferers should sleep on the unaffected side (if the pain is limited to one side).

Sleeping on your stomach is often recommended for patients with degenerative disease. A firmer mattress and a very thin pillow placed under the stomach and hips are also helpful. Sleeping on the stomach is not recommended for patients with neck pain.

Old sleep habits die hard. But it is important not to quit a new position just because it doesn’t feel natural. It can take a few weeks to for a new sleep position to stop feeling strange. Give the process time and really evaluate if you are getting a longer, more rejuvenating sleep before making any further changes.

Depression and Pain

photo by Sander van der Well

Those of us who suffer chronic pain (pain that does not ease after 3 months’ duration) are at increased risk for developing depression.

Depression is misunderstood by many. Depression is not a character flaw or weakness. Depression is real and it can be as debilitating as the chronic pain that preceded it. We have seen with the death of Robin Williams, that depression, when treated improperly, can be life-threatening.

According to the Diagnostic and Statistical Manual of Mental Illness (DSM-V), depression is considered major or often termed clinical when it lasts for at least two weeks and when its symptoms are present daily. The symptoms include the following, five of which should be present in the case of a diagnosis of depression.

An overall feeling of sadness and hopelessness, irritability and recurrent crying spells
Significant changes in appetite resulting in either weight loss or weight gain
Major changes in sleep patterns, typically a desire to sleep all the time or an inability to either fall asleep or stay asleep
Restlessness or agitation, or complete lack of energy
Little or no energy or attention for the activities that used to entertain us or bring us joy
Decreased sex drive
Feelings or worthlessness, overwhelming guilt feelings
Inability to concentrate or remember big or little things
Thoughts of death, suicide, or wishing to be dead, fantasizing about funeral and the aftermath of our death

Dealing with chronic pain requires a team approach. There must be attention paid to the physical nature of your complaints, appropriate therapy must be administered, any medication must be prescribed and adjusted when necessary and constantly monitored for effectiveness as well as side effects. In addition, the mental aspect of pain must be addressed. Patients must avoid saying to themselves, “If I could just get rid of this pain, I’m sure my mental status would improve.” Instead, patients need to be honest with their care providers about the nature of their depression: their moods, the duration of their depression, what their thought processes are, and particularly if they are considering hurting themselves.

Depression, in and of itself, is not always easy to treat. But patients who are already receiving medical care for pain relief are at least part of the medical community and are often open to the treatments that work for depression, combined with chronic pain. These include:

Medication to alleviate severe depression.
Avoidance of triggers of chronic pain, which can in turn, increase depression.
Cognizance of lifestyle choices that contribute to depression, including alcohol and substance abuse, high stress activities, close proximity to difficult or even abusive people
Increased physical activity when possible, including endorphin-producing cardiovascular activity, stretching, and light walking.
Meditation and breathing exercises.

Net Gains: Playing Tennis Safely

Tennis is a fabulous sport to watch or to play, and the temperate Michigan summer is an ideal environment for regular matches.

Tennis is terrific exercise, combining a great cardio workout along with usage of a wide variety of muscle groups.

Tennis is a relatively low-injury sport, much lower than soccer and golf. Injuries can be avoided with some smart preparation prior to playing and improved techniques.

The most common tennis injuries are:

sprained ankles
back pain or strain
tennis elbow
shoulder bursitis
calf strain

To prevent each of these, consider doing the following:

To prevent sprained ankle, first avoid playing on slippery pavement or when you are really tired. If you are prone to twisting your ankle, considering wearing an ankle brace.

Back pain prevention is that old standby: stretching prior to playing and building up your core and abdominal muscles. Yoga and Pilates, situps and crunches all improve back and core strength. The worst thing you can do for your back is to go out on the court cold with no warm-up whatsoever. Be cognizant that serving places a lot of strain on the back because of the hyperextension (bending backwards) that is involved.

The infamous tennis elbow is caused mostly from repetitive motion, and often a racquet grip that is too tight. This causes the muscles that connect from the forearm to the humerus to be inflamed. Be sure that your tennis racket handle is not too small for you. Take frequent breaks when you play to bend your wrist up (the stop sign) and to bend your wrist down. You may benefit from a tennis elbow compression strap, but only on the advice of your health professional.

Shoulder Bursitis prevention requires that the tennis player pay particular attention to the muscles of the shoulder and really maintain good strength in all of the arm muscles. Lifting weights that target biceps, triceps, trapezius and scapula muscles all will benefit the tennis player. A variety of rowing-style exercises are also helpful. Serving the ball places the greatest strain on the shoulders, so it is advisable to utilize a coach and/or a physical therapist to evaluate your serve and make corrections in your mechanics.

Calf strain occurs when you are starting your motion, pushing off to the left, right, forward or backward to return a volley. Adequate nutrition before a match helps (carbohydrates seem to make the difference, too) as does hydration and monitoring your own fatigue level.

Staying the Course: Preventing and Dealing with Golf Injuries

It seems like such a great idea: summer golf in Michigan. We have weathered through the cold winter and the wet spring and the beautiful, temperate summer is our reward. It’s fun and great exercise and just plain rejuvenating to get out and play 18 holes regularly.

But don’t be fooled. Despite the relaxation that golf at its best can provide, golf can also pose chances for injuries and pain.

In general, golf injuries are caused by repetitive use, the same thing that causes carpal tunnel syndrome and tendonitis. When golfers repeat the same motion over and over, they can unwittingly put serious stress on the same muscles, joints and tendons, causing injury.

The most prevalent golf injuries are golfer’s elbow and low back pain.

Golfer’s Elbow is also known as medial epicondylitis. Golfer’s elbow is essentially an inflammation of the tendons that connect the muscles in your forearm to the inside bone at your elbow. Golfer’s elbow results from overuse of these muscles and tendons, which can lead to pain and soreness at the point of the elbow closest to the body.

You can prevent golfer’s elbow by strengthening these muscles, particularly the muscles in your forearm. Some easy exercises include squeezing a tennis ball for at least five minutes per hand, and any wrist curling exercises that are weight-bearing.

Low Back Pain is caused by golf swing mechanics that put additional pressure on the muscles in your low back. If you suffer from poor flexibility or weakened muscles in that area, a round of golf can exacerbate that weakness. In addition, you have to be aware of how you’re toting around your golf bag, being sure to lift it appropriately.

You can prevent low back pain by increasing your flexibility and strengthening the muscles in the back and abdomen. Yoga and Pilates could be helpful, as well as basic stretching. Abdominal workouts like crunches also build strength and add to flexibility. Any weight-bearing activities that mimic rowing or pulling down can also add to back strength.

Golfers could also benefit from checking in with a trainer or golf professional to have another person examine their swing, correcting mechanical flaws that could contribute to back problems. Typically, the issues in a swing that should be corrected are poor posture and overswinging.

All golfers should spend time stretching before a round, paying special attention to arms, wrists, back and abdominal muscles.

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Raking The Leaves without Breaking Our Backs

Sleep Positions for Pain Sufferers

Depression and Pain

Net Gains: Playing Tennis Safely

Staying the Course: Preventing and Dealing with Golf Injuries

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