The Stenosis Diagnosis

March 3, 2019

Efficient movement is truly an art. In sports, it's called "good form."  But to us non-jocks, trying to get something done in the kitchen, garage, or garden, it's simply called "good body mechanics." 

Many people have come to believe that a shoulder-width stance is the ideal stance for almost every activity. Maybe this is related to the number of personal trainers and therapists who advise people to exercise with their feet shoulder-width apart, or maybe it's just been repeated so often that very few people question it. The problem with this belief, though, is that without the feet wider than shoulder-width apart, bending your knees won't help much. Especially not during lifting.

Try this experiment in lifting a light object:

1) Place something light--maybe a pen--on the floor in front of you. Stand with your feet only shoulder-width apart, then bend your knees and pick up the pen.

2) Next try the same thing with your feet wider than shoulder-width apart. The first thing you'll n...

October 21, 2018

Sometimes the simplest things can make the biggest difference,  especially when it comes to how we move and use our bodies. One of my favorite movement strategies not only optimizes your efficiency when you reach for something, but strengthens the legs and back muscles safely. It's called "The Golfer's Tee Trick."

This nifty technique requires a bit of practice, and a fairly decent sense of balance, but is definitely worth learning for the safe retrieval of some light object off the floor, such as the just-dropped pen, odd bit of change, or piece of candy. The trick basically consists of turning yourself into a human teeter-totter by gently swinging one leg up behind you, while you reach toward the floor. Once you have what you want, the weight of your leg helps bring you back up. If you have pain in your right leg, put the right leg behind you. If you have pain in your left leg, put the left leg behind you. See how it feels.

The beauty of this maneuver...

July 29, 2018

If walking on land creates weakness in the legs, striding back and forth across a pool can be the perfect strategy to increase heart and respiration rate, without the risk of falling.

May 27, 2018

Some of us believe the best way to protect the spine is to move like a robot. We walk around like a robot (holding in our abs). We lift things like a robot (back straight, knees shoulder-width apart). We make love like a robot, and so on. But the fact is, human beings are not robots. It's normal for us to move in multiple planes, diagonals, and spirals. We need rotation in our spines when we walk to promote healthy circulation and normal tissue elasticity.

Those of us with spinal stenosis should avoid extreme rotational or repetitive large twisting movements--but we shouldn't tense up and stop moving as our bodies are designed to move. Keep moving like a person--let those arms and shoulders swing when you walk! Breathe deeply and try to stay relaxed. 

April 23, 2018


Tai Chi for Spinal Stenosis? Yes, absolutely! If you have trouble standing, I recommend Tai Chi in a tall-sitting position, such as sitting on the arm or back of a couch or on high stool or bed. Some of my patients report dramatic post-surgical recovery breakthroughs after practicing just a few Tai Chi warm-up moves several times throughout their day.

One reason for this may be that many conservative (and post op) back exercises are about stabilization and strengthening in these very linear planes. People can be taught inadvertently by conventional PT exercises, to move around like robots.

Tai Chi helps you learn to move your whole body, not just one part at a time, so you move more efficiently, effortlessly, and with less stress on the joints.

July 22, 2017

Pliability, circulation, and joint lubrication are as important as the ability to generate force with our muscles. Even the way we breathe can have a huge effect on the spine.

Physical therapists and athletic trainers are well-versed in ways to strengthen different muscles. You may be told by these professionals that certain muscles need to be stronger to support certain injured joints. If you have strong leg muscles or butt muscles, your knees will be well-supported. If you have strong abs or back muscles, your spine will be more "stable." This is the conventional way we think of exercise: Your spine is a ship mast, supported by ropes and pulleys (muscles). Strengthen the ropes and pulleys and your spine will be better supported. Well, to some degree, this is true. But this is by no means the only reason to do--or way to think of--strengthening.

Let me state the obvious: Your spine is not a ship mast.

When we think of the spine as a ship mast, it helps us to understand muscles from a mec...

July 2, 2017

Occasionally, clients with lumbar spinal stenosis ask me about rowing machines. Are they good? Are they bad? What muscles do they work?

Rowing provides a work out for several large muscle groups (gluteals, quads, abs, lats), some that directly attach to the spine. Working muscles that attach to the spine improves circulation to the spine, which can be very advantageous for someone with spinal stenosis. Rowing also allows you to get a low impact aerobic workout, without having to be on your feet for long periods. Still, as with any new exercise, you'll want to proceed with caution. It's best to try out a rowing machine for a few minutes first, see how you feel the next day, and progress from there. Also, you'll want to start with small arcs of movement and low low resistance.

Advantages: 1) rowing specifically targets back muscles 2) it can be tailored quite easily to fit your fitness and strength level 3) is excellent for more fit individuals 3) involves exercising in a sitting position,...

June 18, 2017

REHAB YOUR OWN SPINAL STENOSIS

Strategies to Improve the Health of Your Spine

Terri Night
Terrific Books (164 pp.) $24.95 paperback
ISBN: 978-0-9974566-0-8; March 18, 2017

BOOK REVIEW

A seasoned physical therapist draws on her 25-plus years of knowledge about the causes and treatment options for spinal stenosis, a narrowing of the spinal canal.

“Reading this book...will make you a more knowledgeable and prepared collaborator with your chosen healthcare practitioner,” says the author at the opening of her debut self-help book. Night keeps this promise throughout the work by breaking down intimidating scientific lingo with approachable graphics in three sections that focus on diagnosis, different types of treatment (including dealing with inflammation, exercise methods, and various other wellness techniques), and surgery. One graphic highlight, for example, depicts a stack of 24 Krispy Kreme donuts constituting the central nervous system within the spine; she uses the image of cutting the sta...

June 11, 2017

Strategic exercise is smart exercise--exercise designed to provide the best chance for success. All you need to do is keep to a few basic principles:

  • Choose just one or two exercises at a time and a realistic goal.

  • Use gradual progression (just...go...slow).

  • Should you have a flare-up--make adjustments rather than just ditching the whole program.

Let's take a look at the exercise strategies of Kyle and Bill:

Kyle is told by his doctor to exercise for his spinal stenosis and to "get out and walk." The next day, he hits the sidewalk! His goal is to walk 3 miles per day until he starts feeling better. He doesn't use any kind of cane or walker because, "That'll just make me weak!" At about 500 feet, his legs are wobbly, but he keeps on going, determined to meet his goal. Finally, his legs give out from under him. Undeterred, Kyle drags himself to his feet and continues his walk. Then, he falls and breaks his hip. (You see, he literally did hit the sidewalk!) For the next 8 we...

May 15, 2017

The following information was presented in a lecture at the Golden Future 50+ Expo in Pasadena, California on May 13th, 2017:

Intro:

My name is Terri Night. I’ve been a physical therapist since 1988—so, coming up I’ll be going on 30 years. Boy, did that fly by! In my career, I’ve worked all up and down the West Coast, including the Cedars Sinai Institute of Spinal Disorders, and with some of the best spine surgeons in the country.

Like the many of you, I have my own “back” story. When I was 25, I had what I like to call my "jackass injury." I was taking classes in a Brazilian martial art called Capoeira, and was in the best shape of my life. I was walking down the sidewalk one day and, for some reason, thought it would be a good idea to take a running, leaping kick. I planned to do this kick as I sailed past a speed-limit sign, and (a la Singing in the Rain meets Rush Hour II) grab the sign pole and twirl around. This turned out to not be such a good idea. As I flew past the sign, I grabb...

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TERRI NIGHT, MSPT

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