think in the new south it's not easy to go to another country you know nothing about why i am do this because we can't stay in venezuela. that. closely global news that matters. made for martin's. coming up on in good shape. back pain is what helps and what does. get moving why even children can have back problems. and scoliosis therapies for curvature of the spine in childhood. hello and welcome to in good shape about today's show topic you probably are already an expert we will

talk about back pain and everybody knows somebody with back pain on knows somebody who knows somebody with back pain or has a pain in self and she will probably say come on count me out because i literally know everything about it. but the question is do you know the right stuff because there are a lot of myth. back pain often comes on suddenly and can be torturous most people suffer some kind of back pain at least once in their lives. jonathan has had back problems for quite a while he tried out many different therapies and found a lot of misleading information but he got help from an orthopedic doctor a physical therapist and a biomechanics expert or else. one widespread myth is that only older people suffer from back problems here are good for them in the past it

was always taught that people under the age of 21 couldn't have a slipped disc today my youngest patients are 13 or 14 if it's jonathan was very fit and did plenty of sports until the back pain started. his 1st thought was to simply rest his back but exercising less is not a good solution long term. if he exercises the great healer and the days just said you need to go to bed for 2 weeks with a cushion under your knees and not move are long gone and the results were disastrous covers for fall if you are sick broke. if you can walk without pain it's recommended you take several short walks a day. initially jonathan was prescribed painkillers that's ok for a while but they're not a long term solution what's important is exercise but what kind of exercise is best

you can make a lot of mistakes it's not about having big muscles per se physiotherapist philly on and laid off and has patients who worked out a lot but that's not the issues. you don't need the big fat muscles the studies if you want to train the stabilizing muscles along the spinal column we were. to tackle the foundation not the big surface muscles we have one is fundamentally and . marcus was has physiotherapy once a week his case is very typical he spends too much time sitting down. so i've had back pain for nearly 10 years since i started my office job sitting at a desk and not moving much. it's important to exercise every day but you need to know which muscles to work. there's a few of these core areas the diaphragm back stomach and seat muscle stabilize the lumbar region. muscular in durance is the key in other words how long

a muscle can keep working that's why it's important to train the muscles every day . while searching online for help jonathan stumbled on dr stuart macgill and internationally renowned expert on the spine he spent more than 30 years studying back problems and highlighted early on the risks of certain exercises like sit ups while as it turns out the more sit ups that you do you increase your risk of back pain of crying from lines or the so the problem comes from the constant bending of the spine macgill discovered that sit ups can even trigger a slipped disc jonathan's physical therapist showed him an alternative option the plank which strengthens the back and abdominal muscles stretching exercises are often recommended for back pain but dr mcgill says too much flexibility isn't good . well we've actually studied this the more flexibility you have in your back the

greater your risk of having future disabling back pain. that's because the spine itself can't carry much weight it needs the surrounding muscles that support it's like tension wires. another widespread myth is that only an operation can ultimately relieve the pain yoke posh used to think that too one spinal disc problem was operated on twice but he still wasn't pain free. images of all the stick to see in the scatter to operations on the exact same spot with the exact same symptoms i came to realize that i could get this to 3rd 4th or 5th time and in the end it was a more conservative therapy that cured me from not an operation. it was orthopedic specialist martine mariano that ultimately helped him he believes many surgeons are too quick to operate when it's often not necessary for the

greater awareness now and more people know you shouldn't rush into an operation but the number of back operations still hasn't decreased. jonathan has seen 5 different doctors in all nearly 50 sessions a physiotherapy cairo therapy and aussie up at the plus daily exercises but it was worth it he is now virtually pain free money. if you take a look into an ancient medical textbook out of the 19th or early 20th century you will find virtually nothing about back pain totally different story today because pain is the main cause for disability worldwide what is the real concern for doctors is that back pain affects more and more young people like children or lessons so what's the cause of it is it stress is it too much pressure i think it's small. of exercise and. former world champion skier felix

wants to help children enjoy physical exercise that's not as easy as it sounds in the coronavirus era but a lack of physical activity can affect children's health and even lead to cardiovascular illnesses so fine it's a song as far as that goes it's pretty sad more than 80 percent of children worldwide don't come close to getting the amount of daily physical activity as outlined in the latest recommendations and the world health organization recommends 60 minutes of movement today but lockdowns have restricted access to sports activities leaving some kids virtually immobile with digital media adding to the effect. that maybe digital media where you can find so many other diversions is just what's needed to motivate them to get active get up and follow this video clip how about doing these exercises that might be a possibility and. that's why felix noida is trying to get kids moving with

online videos it doesn't take much to be active even at home in front of the t.v. . every minute counts you don't have to be strict and say it has to be an hour's workout is enough to do some kind of physical activity at home. because the right type of training is both healthy and fun. because. it's not always from sitting in front of the computer all the screen when children develop back problems they can also be male formations of the spine that develop from growth you see normally the human spine is curved backwards and forwards at specific places but it can be in the words as well and this is called scoliosis. eustace could find his way to the treatment room blindfolded the 10 year old was diagnosed with scoliosis last year he'd never noticed anything wrong before like most of those affected now he wears a corset. when most funding does once you have to remember to make sure it

is properly fitted and said that the buckles don't come on. target and you have to wear it a lot i wear it 20 to 21 hours a day so. we went for a routine checkup and the doctor did a forward bend test and saw the curvature i hadn't noticed anything before. and pediatrician vincent flynn bagus says the condition that's often discovered by chance which is why parents should watch their kids backs closely because of treatment begins and time the chances are good that this abnormal spinal curvature can be corrected so it's. an x. ray images reveal the change since used just began his treatment. just as you can see with our patients here that with the aid of the corset a remarkable correction is occurred because the whole spine is now as straight as

an arrow and that's a wonderful adjustment. but it has to be said that if he stops wearing the corset and the spine will reach or enjoy its original shape that's why it's vital that the patient where in the course of this thing is to thaw photogs so it's hard and. scoliosis is usually only obvious in very extreme cases the spinal curvature can be seen for instance when both arms are hanging loosely but one shoulder is higher than the other. a forward bend can also be very informative even people with no medical knowledge can often recognize it that way it's not known of scalia says has a genetic cause but fortunately what helps is known we should because i'm 40 movement is important that children need to get enough exercise induced there's no reason children with scoliosis should be exempt from sports lessons at school every kind of exercise is a good life you could be going to school. used as has learned to live with his

condition and hardly notices the course it anymore. i do sometimes if i don't move right i feel it but when i'm just standing here like this i don't. and if his treatment continues to go well useless will be able to stop wearing his corset once he's through puberty. you want to learn more about scoliosis me too and this is why it's now time for our interview and here's medical peter. a physician for pediatric orthopedics in berlin dr young much a sec examiners and treat children and adolescents who display milds to severe curvature of the spine. hello doctor mother circle who want to talk about scored all those what is exactly school uses a growth disturbance and devolves the torsional deformity of the

spine especially in the growth spurt before puberty and in puberty and this torsional deformity. appears mostly in the thoracic spine and also in walls a lateral movement how does this differ measure come about the parents do something wrong no not whatsoever we in most of the cases we really don't know or what the or region or of this problem is parents sometimes are suspected of neglected their children and then causing trouble but not in the case of school horses 90 percent of those cases are without any known cause score uses that often develops during puberty. what science should look out for. they should look for asymmetry of the plumb

line that means when they watch their children from behind or from the front having lost the symmetry that they're used to all in the what we call bending test they could look for rotational problems when we look at a child we can immediately recognize this torsional problem of the forensic spine by the bending forward test where the child demonstrates or shows this is symmetry what consequences come scores of when one of the summit of the most problematic. disturbances of the function of the line we see elderly patients with scoliosis that cannot breathe properly during efforts or daily work while having

a large curvature so we have to be aware of that problem by treating the scoliosis as early as possible saw to avoid these large curves you can treat. appropriate are available when you discover the problem early enough you can stop a very simple methods of physiotherapy physiotherapy involving. exercises of balance and exercises of symmetry curvatures exceed a certain extend we have to use other means of helping. the child to come in to take into symmetry and mostly we use braces braces.

there is successful in the growing child and the growing teenager while the deformity is still soft it is still more bile i can see an example of the success for a trick monk behind you can your term or something about his interests this young lady develop a great curvature. to the right together with gordon so we started with brace treatment different braces during growth saw different designs as you can see and at the end of the roughly 2 years we have a fairly good result of symmetry and the torsional problem that she had in the beginning that is completely reduced and sole we're quite happy with that result think before the stork and the small stock don't want to circle on the w. . well you work oh thank you the social. in good shape your

weekly health show on d w covers many aspects of health care we look at what's new in medical treatment nutrition fitness country. we talk about these topics in depth with experts and give you the chance to pose your own questions so you do get in touch. the covert 19 pandemic has changed the way we work for many people we work in the office but in the home office and this may lead to back pain because what we need is a good desk is a good chair and a great poster. deanna fi t. davies works for an internet agency an average 8 hours a day. after months of working purely from home she's really feeling the effects of not being in the office sitting for long periods has become

a real problem for her. current demand for the pain is like a burning sensation it's very unpleasant and at times really painful so that i can't stay seated any longer i'm forced to get up and move around a bit since we're being many people are having similar issues right now. one of the problems of working from home office furniture that's not ergonomically suitable incorrect posture and lack of exercise can all lead to problems and pain orthopedist sebastien coy about is all too aware of the issues. the. yes some of us that working from home for many patients are generally moving around less they spend most of the time sitting at a desk staring at a screen with very little variation plus sports activities are very limited right

now. because her condition hasn't improved deanna fi t. davies is here to get help. the orthopedist is able to rule out any underlying problems and soon identifies the cause of her pain. muscle tension in the lower lumbar region is what's causing the problem this problem and she's not the only one with these problems. and let's. studios close down the whole lockdown scenario i've had more patients who are working from home and experiencing more problems than i and they can't make up for it by going to the gym to work out in fitness to. special exercises under the guidance of a physio therapist can be helpful. so which exercises help most.

now in this case stabilization training and exercises to loosen the muscles help relieve the tension some exercises require professional supervision to be really effective. and i never saw you should only try it on your own i've been shown want to do and can do it correctly otherwise you'll just train the service muscles and not the supporting and pastoral ones that really need it which won't solve the problem comedy mystery at least not hide behind. the 27 year old normally goes to the gym to keep fit but right now it's closed because of the lockdown. so what compensates best. there are many ways to keep fit including home workouts. in general exercise is always good i would really appeal to people out there to do something for their health and get some exercise as far as that's possible right now and

continue at home and the exercises you've learned during physiotherapy or at the gym it's all the fault. deanna c.t. davies has found combining the exercises from her physio therapist with her own personal training works best. we just learned that the back pain surgery is often unnecessary that pain medication can be dangerous in the long run and that sports and exercise cannot be enough to treat it so in my office i often recommend manual therapy. christina visa has been plagued by pain in the small of her back for the past 2 years despite all efforts to find a cure 70 got worse. for cracking the mastic i did various times of physical therapy afternoons to massage the government for massages and ended up spending

a lot of money overall. and of course when you're in pain you try everything. in the end she couldn't do anything without pain killers she knew that wasn't a long term option so she decided to try manual sarah pay. the towel efficacious is this method of treatment which doesn't use any aids and the hands the latest studies show it can work well for chronic back pain manual manipulation of the affected area has been shown to be as potent as any painkiller and even tops other alternative methods like acupuncture. but what is it that makes manual sarah p. so effective. can use your hands to manipulate the muscles so that you can relieve muscular tension and you can also influence joint mobility this so-called joint play. therapist. mobilizes

specific muscles on joints in christina's back. i slide my hand under the vertebra and the edge of my hand forms a hypo. like a pivot through which i can mobilize the area during the stretch then i turn the patient back over my hand off she breathes it and when she exhaled i increase the stretch right in the area where she's restricted. to a patient often has a picture in their mind a sense that something has popped out or a vertebra is out of place obviously that's not the case that would be dreadful and not a case for manual therapy but what we're actually looking at is a functional disorder of some things within the whole functional apparatus that is not moving properly it's a manual therapist to find it and supports the patient and being able to move

normally again. and it works well studies say handholds like these improve my ability with chronic back pain even more effectively than analgesic injections and ice they're a pain. in fact for patients with acute back pain manual therapists can often provide relief more quickly provided the therapist can locate the exact source of the pain. it's important to keep in mind that severe back pain could be caused by a slipped disc which might happen when you pick something up and feel a sudden pain in your back or leg you should have a doctor take a look at the nerve is affected whatever manual therapy wouldn't be appropriate same with a heart attack or some cardiac infarctions are not felt in the chest but in a bag. but if it's nothing serious manual therapist

and can immediately tackle the pain. if something hurts let me know instead of mobilization she uses a manipulation technique this one usually recognizable by its characteristic cracking sound and you breathe in. and out so. that's it's a brilliant technique when you have acute symptoms caused by blockages. it's the old tale of waking up in the morning with a stiff neck and neck and lights and how it's. just blocked it can be released by manipulating it and the pain disappears immediately. but it is still for. unlike with the mobilization technique manipulation intervenes in the complex system of bones and muscles. you mobilise that soon the mobilization technique to mobilize is to get something moving with libby i

manipulate so in other words i apply additional pressure from the outside pushing or pulling to open a joint in a certain direction and i have come to believe. in the case of chronic back pain the manipulation session is usually not enough those patients do strength training and coordination exercises as well that's because they've halted their posture to accommodate the pain which over time affects muscles and ligaments but that's over stay with me i didn't expect that arc i had looked into it beforehand sort of there go but it's hard to london because i'm aware of so many things again now my eyes are. like how i move and my posture on page 500. which i've been able to improve greatly using the equipment here and i'm still giving in to the home. manual therapy may not be a cure all for back pain but used in combination with all the treatments it can

certainly be highly effective. so after all this it's time for back so thing walk but not for so long because we all want to be back here next week for next week's show.

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