The following is an e-mail I received from a patient's co-worker, and my advice to her:
Dear Dr. Batchelor:
I am sending you this e-mail in the hopes that you can help me with my back pain, diet, and fitness program.
I run so I can feel good, look good, and eat without gaining weight. Simply stated, if I don't run, I get fat! I had my body fat checked two years ago and it was 30%. One year later, after beginning my running program, my body fat was again checked and it was 22%. I must do something now to get back in shape before its too late!
Every year around this time, I start to have problems with my back. Since it gets dark earlier in the day now, I have less time to exercise outside, work in my yard, and walk my dog, and I spend more time driving home from work. Exercising in the gym just doesn't suit me; I've tried it, but the closest gym is so far away that I find myself driving more than working out, and since its cold and dark outside when I get home these days, the motivation just isn't there. I miss walking and running in the sun. I know that during these fall and winter months, I will gain on average 10-15 pounds, lose much of my muscle tone, lose my motivation for exercise, and experience increased back pain. I try to make up for it on the weekends, but two days of exercise isn't enough. My goal is to simply survive and make it through the fall and winter.
I experience my back pain the most when I'm sitting down. The pain starts in my lower back on the left side, then travels into my butt muscle and sometimes down the back of my leg. I find myself having to shift my weight when I am driving to try and alleviate or change the nature of the pain. Since I have to drive for a long period of time after work each day, the pain only gets worse as I drive. Can you help?
Cindy
Dear Cindy:
I understand your frustrations. Outdoor exercise always beats indoor exercise, and running in the sun always beats running in the moonlight, hands down.
Exercise
When you can't exercise, you lose the muscle tone in your back, which can lead to pain. When you can't exercise, you also may lose your desire to eat nutritiously. The result: You get fat, which places more stress on your back. It's a vicious cycle.
We all tend to be less motivated in the winter months. It is a normal physiological response, particularly because our bodies receive less sunshine during that time. That is why we must be more creative and make exercise more fun, until we can once again "dance in the sun." You need a treadmill and a stationary bike in your home or apartment, to allow you to maintain fitness until the sun shines once again. If possible, position these devices in front of the TV and turn on your favorite program. You will be entertained while you improve your fitness level. Bike for 20 minutes, walk or jog on the treadmill for 20 minutes and then stretch on the floor for 20 minutes. It's an hour of exercise, but it will seem like much less time because you have broken it up into three sections. Do this three to five times per week. If you get out of this exercise habit, it will be much more difficult getting back in the habit, so never take an extended number of days off from your exercise program unless it's unavoidable.
Diet
I've never dieted or eaten foods just to lose or maintain weight. I always choose foods based on their nutritional values and how they will meet my needs relating to human performance. I know it sounds too good to be true, but research proves that you should not eat three meals a day to lose weight. The ideal plan is to eat four to six small meals. Why? Going for long periods without eating can lower your metabolic rate 10-20 percent, which prevents your body from burning 250 to 300 calories a day. Ideally, you should be grazing like a cow. In addition, drinking six to eight glasses of water a day is important for good health and feeling full. Eating in a manner that delivers maximum nutrition to you is paramount.
The following is a good example of maximum nutrition. (This is my own nutritional program, and I love it. I can't wait to get out of bed each morning to have my smoothie!)
Breakfast: Either a huge smoothie with banana; natural peanut butter; soy milk; strawberries; honey and coconut; or natural granola with soy milk. I also supplement my morning meal with the following:
- glucosamine sulfate (2,000 mg)
- MSM (2,000 mg)
- green-lipped mussel (1,000mg)
- omega-3 marine lipid fatty acids (2,000mg)
- d-alpha tocopheryl natural vitamin e (400 mg)
- thiamin (55 mg)
- riboflavin (55 mg)
- niacin (55 mg)
- folic acid (200 mcg)
- biotin (100 mcg)
- pantothetic acid (55 mg)
- PABA (55 mg)
- choline (55 mg)
- inositol (55 mg)
- vitamin C (1000 mg)
- Knox gelatin (one packet per day)
Brunch: fruit bowl; natural peanut butter on whole wheat bread
Lunch: tuna sandwich; small salad; energy bar for dessert
Dinner: chicken salad; apple; herbal tea
Evening snack: nuts and fruit
Back Pain
Since your pain gets worse when you sit while driving, the lumbar disc, sacroilliac joint, piriformis muscle, and/or sciatic nerve must be involved. Most runners have tight lower-back muscles and hamstrings, and weak abdominal muscles. Let's schedule an appointment soon, but begin your program of stretching your lower back, your hams and strengthening your abdominal muscles now.
When you come in for your first visit, you'll fill out a case-history form. I'll do a comprehensive consultation and perform a complete examination of your back, including taking an X-ray. This will help determine the cause and correction of your back pain. In addition, I will check your body-fat percentage; have you fill out a food intake form; ask you about your fitness program; then design a nutritional and exercise program for you. Be sure to bring your old, worn-out running shoes and your new running shoes, so I can evaluate their wear pattern; similar to looking at the wear pattern of the tires on your car after they are worn out, much can be learned.
Daniel Batchelor, DC
Roswell, Georgia
(770) 992-2002
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