Have You Been Suffering From Chronic Knee Pain?

Chronic knee pain is notoriously difficult to treat successfully. Persons with these problems often become discouraged as they shuttle from specialist to specialist, from rheumatologist to orthopedic surgeon to physical therapist to acupuncturist and back again. Lack of progress and improvement becomes understandable when one considers that typical evaluation and treatment are directed at the symptoms. But with chronic knee pain, and many other pain syndromes, actual benefits may be obtained by addressing underlying biomechanical problems.

Faulty biomechanics are at the root of many ongoing knee problems. Of course, various other diseases and orthopedic conditions may cause the same type of chronic pain. The most likely of these possibilities need to be considered and ruled out before a diagnosis of biomechanical knee pain is established. Osteochondritis dissecans, a torn meniscus, and synovial effusion are all frequently encountered in persons over age 40 with chronic knee pain. Rheumatoid arthritis, lupus, and ankylosing spondylitis are a few rheumatologic conditions which may result in sporadic or chronic knee pain.¹

When these medical entities have been eliminated as possibilities, a biomechanical causation becomes probable. How does a person develop "faulty biomechanics"? In fact, most of us have never received effective instruction in how to use our bodies. We stand and sit in all kinds of unsound postures, slouching and slumping and generally giving in to every available force of gravity. We stand with all our body weight on one leg, neck and shoulder muscles gripped tightly and abdominal muscles sagging and protruding. When we sit we slump down, stressing the lower back with poorly tolerated mechanical forces, or sit for hours with legs crossed, stressing the lower back, hips, and knees.

Over the course of a lifetime, our bodies have continually tried to adapt to a range of inefficient and stressful postures and habits. But eventually no more adaptation is possible.² As a result joints, muscles, ligaments, and tendons break down and fail. We experience this failure as pain. And once this type of pain has started, it is not going to go away unless the underlying causes are corrected. Specifically, the person's biomechanics need to be restored closer to normal.

Correction of posture takes time and can only be accomplished gradually. The key is to learn what to do, learn how to do it, and to be working on posture every day.³ The most important thing is to begin. Three basic biomechanical corrections are as follows: (1) When standing, be sure to have your weight over the balls of your feet and to have your weight evenly distributed on both legs. (2) Activate your deep abdominal muscles by visualizing an "inner lift". (3) Have straight lines of force running down your legs (rather than lines of force crossing at your knee, creating torsion and tension). Visualize "straight energy" flowing from your hip sockets, straight down through the center of your knees, straight down to your feet, between your first and second toes.

Visualizing and implementing these three biomechanical corrections on a daily basis represents the first series of steps toward improving knee mechanics and reducing chronic knee pain.

Chiropractic care is an essential component of a broad-based approach to the treatment of chronic musculoskeletal pain. Medication alone is never an effective solution to chronic pain as it does not address the root causes of the problem. On the other hand, if biomechanical issues are part of the overall cause, chiropractic care is able to provide a great deal of benefit.

Chronic musculoskeletal pain often has its origins in spinal misalignments and faulty joint mechanics along with muscle imbalances. These restrictions in spinal joint mobility may be due to long-term postural inefficiencies or to an old injury - a fall, a motor vehicle accident, or a bending-and-lifting back spasm that took a long time to heal. If imbalances persist, other structures begin to compensate. Sacroiliac joints and ligaments get tight. Hip joints lose some mobility. Knee and ankle motion are compromised, and eventually chronic back pain, hip pain, and/or knee pain develops.

Jennings Chiropractic Neurology Clinic addresses the cause of these many problems by analyzing, and identifying brain function, joint and muscle function and correcting the imbalance. We use NMR, a type of deep tissue technique that removes scar tissue and improves movement , function and removes pain. As the biomechanical function of your spine improves, so does the mobility of all other weight-bearing joint such as your hips, knees, and ankles. As a direct result, chronic pain begins to reduce and resolve.

¹Yusuf E, et al: Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis 70(1):60-67, 2011

²Suri P, et al: Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 62(12):1715-1723, 2010

³Bennell KL, Hinman RS: A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport 14(1):4-9, 2011

Anxiety - Wide-Ranging Health Effects

Humans appear to be hard-wired for modest levels of anxiety as a fear-arousal warning mechanism. Anxiety may be characterized as uneasiness, fear, worry, and apprehension. Anxiety is a common psychological state in which the basic message is "get away from this situation". The state is usually accompanied by numerous physiologic components including surges of the hormone adrenaline, increased heart rate and elevated blood pressure, and increased blood flow to the major muscle groups as the body prepares for "fight or flight".

These are all normal responses to environmental threats. The overall process is orchestrated by the amygdala and hippocampus, two regions of the brain's limbic system which process memory, emotional response, and spatial navigation. But for many people, if anxiety states become frequent and prolonged by various developmental circumstances in childhood and their teenage years, they may begin to respond to perceived rather than real threats. The anxiety state may persist and even become the default condition for the individual.

Those with chronic anxiety may experience chronic back pain,^1,2 chronic muscular tension, fibromyalgia,³ headaches, chest pain, shortness of breath, and heart palpitations. Chronic anxiety may cause a person to anticipate the worst, to have ongoing feelings of dread, to be constantly irritable and tense, and to experience panic attacks. Eventually the person may become worn out from the constant drain on their inner resources and a likely outcome is depression. The person simply cannot take any more stress.

Chronic anxiety has a specific impact on the musculoskeletal system. Persistently elevated levels of adrenaline create ongoing tension in the postural muscles of the lower back and the weight-bearing, antigravity gluteal muscles, pelvic musculature, and hamstrings. The long-term results may include chronic lower back pain, inflammation of the sciatic nerve, and lumbar disc disease. Of course, any of these health problems create more anxiety for the person, establishing a vicious circle of anxiety, pain, more anxiety, and more pain.

Solutions for chronic anxiety usually require multidisciplinary holsitic approaches. Nutrition, for example, is a key factor in restoring a person's homeostatic mechanisms. Significantly reducing one's intake of simple carbohydrates - soda, muffins, cookies, cake, fast food, and even juice - will often have a substantial impact. Making sure to have five servings of fresh fruits and vegetables every day will also provide great benefit. Healthy fatty acids are beneficial for brain function.

Chiropractic Neurology care can frequently provide considerable assistance to those with chronic anxiety. Dr. Jennings and Jennings Chiropractic Neurology Clinic has extensive training in the brain based approach to health, learning disabilities and emotional conditions. Frequently we find an "imbalance" of communication between different part of the brain. They can be considered timing delay or a decrease in sensory integration, not a chemical imbalance. By normalizing activity within the brain and nervous system and reducing muscular stress and tension, chiropractic care helps eliminate an unnecessary source of biochemical and physiologic stress.

Chiropractic care is about much more than bones, joints, muscles, ligaments, and tendons. The focus of Chiropractic Neurology is focused on the brain's control on the entire body including the musculoskeletal system, and yet the benefits of chiropractic care extend far beyond these connective tissue structures.

Chronic musculoskeletal tension results in numerous biochemical changes such as excessive and prolonged build-up of lactic acid, a metabolic end-product of muscular contraction. These metabolites, which are accumulating wastefully and unnecessarily, irritate local nerve endings. Nerve irritation leads to increases in local muscle tension, setting-up a vicious circle of muscle tension, nerve irritation, more muscle tension, and more nerve irritation. Importantly, the irritated nerves send signals to all the other parts of the body, causing increased levels of activity and unnecessary use of precious resources. In these circumstances, the person may become irritable, gets tired more easily, has sleep disturbances, and even may develop various diseases.

Chiropractic care is a powerful healing method that affects many body systems as a result of addressing stresses in the musculoskeletal system.

¹Newcomer KL, et al: Anxiety levels, fear-avoidance beliefs, and disability levels at baseline and at 1 year among subjects with acute and chronic low back pain. Phys Med Rehabil 2(6):514-520, 2010

²Hurley DA, et al: Physiotherapy for sleep disturbance in chronic low back pain: a feasibility randomised controlled trial. BMC Musculoskeletal Disord 11:70, 2010 [11 pages]

³Silverman S, et al: Toward characterization and definition of fibromyalgia severity. BMC Musculoskeletal Disord 11:66, 2010 [9 pages]

The Natural World

The natural world functions very well on its own. Left to their own devices, members of the tens of millions of species on our planet thrive and prosper without relying on outside agencies.

In order to grow abundantly, plants consume carbon dioxide, water, and nutrients from the soil. Likewise, herbivorous animals consume plants whereas carnivorous animals consume other animals. Insects eat a wide variety of foods, including plants, fruit, other insects, detritus (dead leaves, stems, and twigs), and even blood. Many types of bacteria and fungi recycle decomposing matter. Whales, the top predator in the oceans, may consume more than a ton of plankton per day in addition to fish, squid, and other crustaceans.

Every member of every species excepting humans (Homo sapiens sapiens) obtains everything it needs from the environment. Modern humanity is the only species for which the abundance provided by the global ecosystem is insufficient.

For instance, mountain lions, raccoons, and coyotes don't need sleeping pills. But humans spend more than $1.5 billion per year on the sleep aid Ambien. Dolphins, antelope, and bluebirds don't have problems with blood glucose levels. In stark contrast, the annual cost of diabetes medications in the United States was $12.5 billion in 2007. In the wild, oak trees, tuna, and elephants don't need nutritional supplementation. Humans, however, spend more than $23 billion annually in the United States alone. What is wrong with this picture?

As a species, humans have the unprecedented ability to manipulate and drastically alter the world in which we live. Also aside from epidemic infectious disease, there exists no natural check on human population growth. As populations expand, resources become scarce. Populations flocking to urban enclaves not only leave behind the countryside but also local sources of fresh fruits, vegetables, meat and poultry. Canning, packaging, and transportation of food over long distances become necessary to supply the energy needs of cities. But only calories and not much else are obtained by these methods. Energy is provided but food quality is substantially reduced.

Chronic disease becomes widespread. Diabetes, cardiovascular disorders including high blood pressure, heart attacks, and stroke, and obesity are all the direct result of a severely compromised food supply.^1,2,3

Our disconnect from the natural world poses many additional challenges. Our bodies were designed to meet the demanding physical requirements of a hostile environment. But for the most part we don't do physical work anymore. If we don't find satisfactory substitutes for strenuous physical activity our musculoskeletal, metabolic, and endocrine systems easily deteriorate. The consequences include osteoporosis, chronic aches and pains, gastrointestinal problems, and anxiety and depression.

It takes a lot of effort to maintain good health when we're so far removed from the natural world. We need to make sure our diets are healthy and we need to get sufficient and regular strenuous exercise. The short- and long-term benefits include happiness, self-esteem, and ongoing well-being.

Dr. Jennings is a Chiropractic Neurologist specializing in the non drug, non surgical approach to health.

Getting Healthy and Staying Healthy with Chiropractic Care

Nutritious food and regular exercise will only go so far if your nervous system is not working properly. Spinal nerve irritation can block the free flow of information between your brain and the rest of your body, interfering with healthy functioning and leading to a wide range of diseases. Irritated nerves cause too many nerve signals or too few nerve signals to flow between the brain and the body. Information transfer is either speeded up or slowed down - either situation leads to a breakdown in communication and results in various disorders and diseases. Dr. Ed Jennings is a Neurologist specializing in detecting and correcting spinal nerve irritation, brain asymmetry or nerve interference. Chiropractic adjustments help restore normal nerve transmission, helping restore optimal health and well-being.

Treatments can include manipulations, brain based exercises, occupational therapy, light or sound therapy, physical therapy, and nutritional protocols. The first step is to eevaluate how the nervous system is functioning.

¹Kesse-Guyot E, et al: Adherence to nutritional recommendations and subsequent cognitive performance: findings from the prospective Supplementation with Antioxidant Vitamins and Minerals 2. Am J Clin Nutr Nov 24 2010 (Epub ahead of print)

²Wolfe AR, et al: Dietary protein and protein-rich food in relation to severely depressed mood: A 10 year follow-up of a national cohort. Prog Neuropsychopharmacol Biol Psychiatry Nov 22 2010 (Epub ahead of print)

³Pekmezi DW, Demark-Wahnefried W: Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol Nov 24 2010 (Epub ahead of print)

Lifestyle Matters

The fitness boom was launched in America in the early 1980s by a small group of celebrities, including Jane Fonda, who recognized the importance of exercise for long-term health and well-being.

Although their methods were flawed, their vision was important. Over the past 30 years the notion of fitness as a valuable end in itself has persisted in the public consciousness. But for the most part, people do not take action on their own behalf in this critical area.

In a typical scenario, a person will finally decide to begin a plan to shed the 30 or more pounds of excess weight he or she has been carrying around for too many years to count. In a whirlwind of activity, the person joins a gym, buys a pair of snazzy cross-trainers, stylish new workout shorts, and tank tops, and even purchases 10 grueling sessions with a personal trainer. After this initial burst of enthusiasm, the typical fitness-seeking person will lose interest in 30 days. Health clubs across the globe rake in their profits from new member initiation fees, knowing full well that most new gym members discontinue their efforts within four to six weeks.

But fitness matters. And from an even broader perspective, lifestyle matters. In 2007, heart disease, cancer, cerebrovascular disease (including stroke and hypertension), and pulmonary disease accounted for more than 60% of the 2.4 million deaths in the United States.¹ It is now well-recognized that each of these diseases and conditions is specifically a lifestyle disease. With respect to cancer, less than 10% of cases are due to an inherited condition. The rest are a result of lifestyle choices such as smoking, excessive alcohol consumption. overweight and obesity, and lack of exercise.²

With respect to your long-term health, one key action step is to engage in regular vigorous exercise. If you haven't exercised in many years, daily walks are a good way to begin your life-long exercise program. Start with a modest 10-minute walk and build up over six to eight weeks to a daily 30-minute walk. Once you're walking 30 minutes a day, gradually increase your daily pace. When you've achieved a quick 30-minute daily pace and can maintain your schedule comfortably, you may begin to alternate strength-training workouts with your walks.

Fitness is not only a critical lifestyle enhancer, it is also a state of mind. People who are fit want to stay fit. A person who becomes fit usually discovers that he has begun to choose healthy food rather than junk. Frosted doughnuts, candy bars, and twisted ropes of raspberry-flavored sugar lose their allure and appeal. Organic trail mix, organic apples, and protein smoothies become preferred snacks. Persons who take on a fitness lifestyle find themselves losing weight, naturally and easily. No stress-inducing diets. No drastic weight loss. The pounds just fall away because the person is exercising regularly and eating a healthy diet.³

Now-fit people never want to put that weight back on again. The healthy lifestyle becomes the preferred lifestyle.

Dr. Ed Jennings of Jennings Chiropractic Neurology Clinic in Sacramento is a wellness expert. He teaches their patients how to begin safe, effective exercise programs. Chiropractors teach their patients how to create healthy food plans that will enhance their well-being and the well-being of their families. Healthy lifestyles are a key element in the overall chiropractic approach to long-term wellness.

Dr. Jennings is highly trained in nutritional science and rehabilitative exercise. In addition to your chiropractic hands-on treatment, regular exercise and healthy nutrition will help you return to high levels of wellness and well-being.

http://www.dredjennings.com

¹Xu J, et al: Deaths. Final data for 2007. Natl Vital Stat Rep 58(19), May 20, 2010

²Kirkegaard H, et al: Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. Brit Med J October 26, 2010 (Epub ahead of print)

³Brietzke SA: A personalized approach to metabolic aspects of obesity. Mt Sinai J Med 77(5):499-510, 2010

Principles of Posture

Long ago and far away, a fourth-grade teacher told a student to "stand up straight - you look like a pretzel". The unthinking adult only offered criticism. The child was left to try to unkink himself in the ways that probably caused more structural damage.

Most of us think good posture involves thrusting out the chest and pulling back the shoulders. Informing a person that he needs to improve his posture usually results in a sudden, robot-like increase in stature, the person stiffly incorporating most or all of these muscular stresses.

As a direct result of our weak relationship to sound concepts of what good posture actually is, most people have protruding stomachs, slumped shoulders, and necks that protrude far in front of their body's center. Aside from perpetually unattractive aesthetics, such chronically inefficient posture places ongoing strain on back and neck muscles. Poor posture interferes with normal functioning of your heart and lungs. Metabolic processes deteriorate owing to lack of normal oxygen supply. Poor posture not only leads to musculoskeletal problems like chronic back and neck pain, but also is implicated in gastrointestinal and endocrine diseases and many other disorders.

The welcome news is that achieving good posture is not that difficult. Work is required, of course, as well as consistent attention. But the work is not hard - it is merely new and different, for most of us. As we can guess, the key element in good posture is a straight spine. Importantly, straight doesn’t mean rigid.

The main consideration here is how to get your spine straight without tightening all your muscles and holding your breath.¹ The solution requires a little imagination. Picture in your mind a string dangling from the sky and attaching it to your sternum - your breastbone. You can name this image “hitching your sternum to a star”. You dangle from the string like a puppet.

Also, you imagine that the string is supporting all your weight. As a result, your chest lifts up easily and your spine straightens naturally and smoothly.

Another piece to the posture puzzle is to allow your shoulder girdles to rest on your rib cage. You don’t have to press your shoulders down to do this - just don’t hold them up. Most of us unconsciously tighten our neck and shoulder girdle muscles all day long. By starting to be conscious of what’s going on, we can start letting go of tight shoulder girdle muscles. The shoulders will then gently descend and come to rest on top of the rib cage, where they belong.

By paying attention to these basic postural corrections, over time we can develop a posture that is fluid and efficient. We will appear taller, comfortably reaching our full height with grace and ease. Tension and anxiety begin to reduce and we sleep more restfully at night. Good posture is good health.^2,3

^{Dr. Ed Jennings is a Board Certified Chiropractic Neurologist in the Sacramento area, specializing in posture, balance disorders, vertigo and other common neurological problems.}

Chiropractic Care Helps Create Good Posture

Most of our daily activities work against good posture. We spend large portions of our days sitting in an uncomfortable chair, peering at a computer terminal. Muscles tighten and joints get stiff as we make our way through our daily tasks and responsibilities. Neck muscles, lower back muscles, thigh muscles (quadriceps and hamstrings), and calf muscles shorten, lose their mobility, and become stiff and sore. Aches and pains add their burdens to chronically poor posture. Over time we become even less of the person we were meant to be. Chiropractic care helps you reverse these downward spirals. Chiropractic care helps you restore good posture by relieving mechanical stresses and strains and by causing your musculoskeletal system to become more flexible and resilient. The result is improved range of motion, reduced pain, and an enhanced sense of well-being.

¹Movahed M, et al: Fatigue sensation, electromyographical and hemodynamic changes of low back muscles during repeated static contraction. Eur J Appl Physiol Sep 30, 2010 (Epub ahead of print)

²Edmondston SJ, et al: Postural neck pain: an investigation of habitual sitting posture, perception of 'good' posture and cervicothoracic kinaesthesia. Man Ther 12(4):363-371, 2007

³Prins Y, et al: A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents. Physiother Theory Pract 24(4):221-242, 2008

Peeling the Onion

In the language of statistics, health is a continuous variable. A person's health can be expressed as an infinity of values ranging from abundant well-being to terminal states approaching death. If health were a discrete quantity you could assign a number to it. You could say that someone had 95% health or 32% health. You'd be able to measure health on an exact scale. But of course health is much more complex. Health status requires intermediate descriptive states for a more complete understanding of a person's level of wellness.

The practical outcome is that health is an expression of many factors, not merely one kind of activity. A person who has an extraordinarily healthy diet but has very high levels of stress may still suffer from cardiovascular disease, regardless of the amounts of omega-3 fatty acids and fresh fruits and vegetables he consumes.¹ A person may be a champion athlete, such as a ballet dancer or a figure skater, and yet have type 2 diabetes owing to a lifetime of unhealthy nutrition.²

There are many such cautionary tales, including that of a famous runner, author, and fitness expert who died suddenly of a heart attack at the age of 52.

Like an archeological dig, good health has many layers. It's always a mistake to stop digging (even though you think you completely understand a process), because a little more effort and a little more thought will reveal new patterns and new connections. This is the major problem with medications. You take a drug to stimulate one thing or inhibit another thing, but there always more layers to consider. Side effects result from trying to manipulate one layer of effects while ignoring the consequences to other important layers.

Statins are a good example of this process of failing to consider the layers of health. These drugs lower blood cholesterol levels by inhibiting the production of a liver enzyme that is part of the pathway of cholesterol synthesis. But statins have many side effects, including Lou Gehrig's disease, memory loss, liver damage, nausea, diarrhea, and muscle pain.³

In contrast, chiropractic care is designed to pay attention to all the layers. Chiropractic care, in fact, is a layer-optimization process. By restoring full functioning of a person's nerve system and improving the mechanical functioning of the musculoskeletal system, chiropractic care enables the body's layers of health to interact in the way they were designed to interact. Chiropractic care is a natural, efficient method of restoring and maintaining good health.

Chiropractic treatment, known as a chiropractic adjustment, involves methods of restoring optimal mechanical function to spinal joints. When joint mobility is optimized, nerve impulses flow freely from the brain to the body and back from the body to the brain. 80% of information to the brain arises from joints and muscles. At Jennings Chiropractic Neurology Clinic Dr. Ed Jennings focuses on the information coming in, sensory, outgoing information, motor system and the intercommunication within the brain.

Normal nerve transmission allows all body systems to function normally. Cells receive their instructions on time and in the right amount. Information (feedback) from the cells likewise reaches the brain on time and without distortion. Cells and tissues do their jobs efficiently and effectively and the body expresses optimum health. The channels of communication are open and information is freely transmitted back and forth. Thus, the layers of good health are in alignment. The body has a built-in healing mechanism. The job of the Chiropractic Neurologist is to enable that mechanism to work properly.

¹Knoepfli-Lenzin C, et al: Effects of a 12-week intervention period with football and running for habitually active men with mild hypertension. Scand J Med Sci Sports Feb 2, 2010 (Epub)
²Fuemmeler BF, et al: Weight, dietary behavior, and physical activity in childhood and adolescence. Implications for adult cancer risk. Obes Facts 2(3):179-186, 2009
³Sharma M, et al: Systematic review: comparative effectiveness and harms of combination therapy and monotherapy for dyslipidemia. Ann Intern Med 151(9):622-630, 2009

Four Resolutions for a Healthier Back

Tips for Keeping Your Resolutions

Don't Over Do It Set goals that are challenging yet attainable. Take some time to consider what is most important to you and choose a resolution that moves you in the right direction, yet is not a drastic, overwhelming change. Tell Everyone Spread the word! Support from friends, family and co-workers can make a huge difference as you strive to reach your goals. Making them aware of your goals is a great way to ask for that extra bit of support that can get you through even the toughest challenges. Treat Yourself Along the Way Be sure to be good to yourself and celebrate small achievements on the way to the big one. Reward yourself as a way to encourage more of the same successful behavior.

Eat more vegetables. Stress less. Take the kids out to the park more often. You may already have a long list of resolutions for the new year. This year, honor your spine, too. With the help of your doctor of chiropractic, these simple steps can promote a healthier back for the new year.

Consider replacing your pillow or mattress.

Do you wake up with aches and pains? It could be time to purchase a new mattress or pillow. The American Chiropractic Association (ACA) recommends finding a mattress that evenly supports your whole body. There should be no gaps between you and the mattress when you lie down. When choosing a pillow, select one that supports your head and neck in alignment with the rest of the spine, whether you sleep on your side or back. Keep in mind that what works for your partner may not work for you— there isn’t one mattress or pillow that fits everyone. Simple adjustments, such as adding foam padding, can help tremendously.

Re-evaluate your posture at work.

Americans spend an average of 44 hours at work every week— often behind a desk. To avoid poor posture that can lead to tension, back pain, and joint problems such as carpal tunnel syndrome, check that your chair is the right size and adjusted correctly, says the ACA. Do your feet rest comfortably on the ground? Does the chair offer lumbar support? Are you able to tilt or swivel easily while performing tasks at your desk? Also, be sure you have adequate light (so that you aren’t straining to see documents or a computer screen), adjust your computer monitor so that it is at eye level, and wear a headset for longer telephone conversations. And don’t forget to take frequent breaks and stretch throughout the day.

Learn how to lift correctly.

Many back injuries are caused by improper lifting of items such as luggage, backpacks or briefcases, storage boxes, or even groceries. But knowing how to lift properly can prevent serious injury. First and foremost, don’t bend from the waist. Keep your back straight, and squat to reach the item. Then, keep it close to your body as you lift, and avoid twisting motions. When traveling, check all bags that weigh more than 10 percent of your body weight.

Eat right and exercise well.

Eating a balanced diet and getting regular exercise helps your body stay toned and tension-free— and promotes a healthy weight and a happier spine. Smart exercise and a good diet can also prevent osteoporosis, which affects over 20 million American women. To start, the ACA recommends eating out at restaurants less (to reduce the amount of unhealthful fats and sugars you consume) and adding more fresh fruits, vegetables, and whole grains to your diet. Aim for a minimum of 20 to 30 minutes of exercise, three or four days a week.