Category Archives: Back Pain

Pain, exercise and mindfulness – Part 3


In parts one and two we reviewed how pain can put us in a spiral of inactivity, gradually reducing strength and stamina which can limit function and lead to secondary pain from inactivity.  Exercise designed right can reduce pain by improving mobility and strength, yet too much exercise can increase pain.    Mindfulness has been shown to reduce pain.  When we combine exercise with a mindful mindset, we are more likely to make movement a tool for helping with pain.

When exercising to lose weight, we can get focused on burning more calories and getting enough steps each day.  This focus makes it tempting to ignore signals that the body cannot tolerate that amount or type of movement.  Add to that all too popular  “no pain no gain” approach and the use of competitions or challenges to boost motivation.  These are just a few of the ways popular approaches to fitness promote ignoring your body rather than listening to it.

Many people want to lose weight in order to reduce pain.  While weight loss may help to some degree in some cases, we need to look at what happens in the body with weight loss.  The fact is that weight loss without exercise promotes muscle loss. Muscle loss means less support on those painful joints that are trying to tell you they need more support.  This is one way weight loss alone could make the pain worse, not better.

Pain research is telling us that when we ignore pain, the body only speaks louder to get our attention, in the form of more pain.   If we practice ignoring pain while losing weight,  we are missing out on the benefits mindfulness offers to help us quiet the pain signals.    Mindfulness does not mean focusing on the pain, it is shifting mindset about the pain.  Three qualities of mindfulness are paying attention with:

  • Curiosity:  when we shift to curiosity, we move away from frustration about the pain and the temptation to either push past it or let it keep us from moving at all.  Instead we can try moving lightly at first and be curious about how to move in a way that could reduce the pain.  If you are an “all or nothing exerciser”, this can take some practice. However, the shift is key to getting out of this cycle of doing too much, ending up in pain and then moving less.
  • Openness:  This means being open to trying different approaches to and types of exercise. It means being open to learning about what your body needs right now,  letting go of comparing yourself to what you did in the past or what you think you should be able to do now.    Openness means focusing on what your body can do now as the way out of the exercise and pain cycle. For example, stretching may not burn a lot of calories, but it may be a way to start moving on a regular basis and build up your body’s movement tolerance so it is ready for more movement down the road.
  • Kindness:  Mentally beating yourself up while you exercise (or paying someone else to push you) can actually be keeping you in a pain cycle.  Think of how you would treat someone else you care about, a pet or a small child, who is in pain.  You would want to do what you can to help.  That is the attitude of kindness you can apply to yourself when you exercise.  The interesting thing about research on self-kindness is that is leads to more motivation, not less. Kindness does not mean letting yourself off the hook or being too easy on yourself. It just means you will work with your body rather than against. it.

The research is becoming more and more clear that movement and mindfulness both promote healing.  In order for these two resources to work together though, we need to shift how we approach exercise for weight loss away from pushing the body to burn calories and sculpt it into the shape we want to using exercise as a resource for taking care of this body we are trying to help through weight loss.  Just like anything else, it takes practice.  Practice exercising with a mindset that is curious, open and kind you will begin to find ways to use exercise t  help yourself feel better not worse.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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by | December 11, 2017 · 7:19 pm

Pain, exercise, and mindfulness – Part 2

Last week we looked at how pain can put us in a spiral of inactivity.  The decrease in movement can lead to more pain,  less movement, more pain… and so on and so on.  Exercising when you have pain is tricky.  There is a fine line between doing  enough to feel better and doing too much ending up in more pain.  Pain, in the end, lowers motivation, keeping the spiral stuck in the downward direction.

There is a key ingredient we can add when approaching exercise that can help us with this dilemma – mindfulness.  Research is showing mindfulness can be very effective in dealing with pain.    Mindfulness meditation has been shown in clinical trials to reduce chronic pain by 57 percent. Accomplished meditators can reduce pain by over 90 percent!  Mindfulness is not just a form of meditation.  When practiced regularly, it helps us to have a mindset that is open, curious and kind.  Mindfulness and pain research tells us that our thoughts about pain – its history, our fears, memories, beliefs, all affect the levels of pain we experience.  This three-part article explains the process in more detail.  It’s worth a read if you are dealing with pain issues right now.

meditation-1000061Exercising for weight loss can promote the opposite mindset. When we ignore our body’s symptoms in order to push the body to burn more calories, we are being anything but curious, open and kind.  The “no pain no gain“,  “if some is good more is better” and “just do it” mindsets promotes mindlessness.   These mindsets work for sports training but not for lasting success with weight loss and health.     There is no evidence that our muscles need to be sore in order to get stronger.  Studies show something really is much better than nothing when it comes to exercise.  And when we “just do it” we miss out on the helpful signals our body is sending us.

Next week we will blend our approach to exercise for weight loss with this skill of mindfulness to discover an approach to exercise that can reverse the spiral of inactivity and pain.  This week, check out the article on the connection between mindfulness and pain management so you are ready to apply it to approaches to exercise for true weight loss success.

Keep Moving, Be Well


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center


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by | December 5, 2017 · 2:39 pm

Pain, exercise, and mindfulness: Part 1

Pain is one of the biggest barriers to exercise.  Beyond the obvious limits it creates, pain leads to what we call a spiral of inactivity:

Cycle of inactivity

Pain makes us move less. Since our body is a “use it to keep it system”, when we use our body less, we lose strength, stamina and mobility, which means movement is more challenging, and so we move less.  Over time this inactivity causes stiffness, making movement less comfortable.  After a time of less activity we lose muscle mass which means less support for painful joints.  Both of these can lead to more pain, and the spiral continues.

The way out of this spiral is to move in order to regain strength, stamina, mobility, function and support around joints. However, what if you have pain when you move? Should you push through pain or listen to it?  It feels like a catch 22 and the spiral seems irreversible.

Add to that the all too common “no pain no gain” approach to exercise and the “suffer through in order to get to your goal” approach to weight loss.  These can often make pain worse, and leave us believing we need to work through the pain to get to our goal. This discomfort and the frustration it causes can create not only physical but  mental barriers to weight loss.  It may seem hopeless, but it is not.

The first step is awareness about how our approaches to exercise and to weight loss are making it more difficult to turn the spiral around.   Athletes need to push through pain to gain a competitive edge.  For health and well-being, pain is your body trying to tell you it cannot tolerate that level of movement right now.   Ignore it and it will only “speak” louder.   There is no gain in pain.

If you have tried the “get through the first few weeks of a diet until you see results” approach to weight loss, you know it is just not sustainable in the long run.  There is no badge of honor for those weeks of suffering through hunger, derivation, sore muscles and fatigue.  Not only does it leave us with less motivation to try again next time, it makes our brain look for comfort – and food is a quick and easy source of comfort.

If you goal is to lose weight to feel better, why suffer through exercise in order to feel better?   Why not take a direct line to feeling better even before the scale moves?  It is possible when you drop the “suffer through” approach and listen to your body with exercise.

This week simply notice your mindset when it comes to exercising for weight loss and the long term effects of it.  It helps to keep in mind, weight loss is not a goal.  Goals have an end.  Sustainable weight loss is a shift in what we do and how we think.  Mindfulness helps us make that shift. Next week we will take a closer look at the research on mindfulness and pain to uncover how it can help with exercising when you have pain.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center



by | November 29, 2017 · 7:05 pm

Reducing Weight Without Losing Weight – Part II

This is a comment a patient posted in the stretching blog last month.  I had to share her inspiring words:   I’m 8 months post gastric sleeve and have lost 172 lbs since July 2013! Been in PT since October 15, 2014 twice a week. I had to start in the pool i was so bad, but ive graduated to all office visits and I’m getting stronger by the day! I became disabled due to disk disease and got to the point we’re I sat in a recliner for 8 year because my pain became intolerable. I started PT so I could start to walk again and they found so many more problems, my knees are bent from sitting for so long so they need to be manipulated every visit, extremely painful. What I’m getting too is, stretching is crucial to my recovery program. All my muscles had become so bad from sitting that stretching them is an everyday thing for me. When my sciatic starts bothering me I have a stretch where I sit with my foot on the opposite knee stretching my lower back muscle and I’ll tell you it actually works. I have gained enough strength that I can now walk through Walmart when I was only able to use the cart for years!!! I can shower standing up, cook, clean, and none of it would have been possible without PT and the stretching and exercise I do there! I just wanted to share with you my experience and how important stretching is to my everyday recovery.

Thanks to those of you who send along some help with my car dilemma I appreciate your advice 🙂

The big point in the last blog was that how we hold our body changes our body on a cellular level – for better or worse.  And the amount of time we spend in a position has a direct impact on how much it will improve or deteriorate how our body feels. 

How we sit and stand affects everything from our joints, muscles, digestion, breathing, focus, and probably a lot more.

What did you notice last week about how you sit and stand? 

Here are some very basic and simple points to pay attention to.  As always these are general suggestions and guidelines and I trust you to do what feels best for your body: 

  • Standing as best you can, keep your feet parallel to each other (notice if your default position is with toes pointing in or out)Picture-21
  • feet under hips (not wide apart and not too close)
  • weight in heels – this is a BIG one.  (the goal is the picture on the right in red. The picture on the left in blue shows the effect of weight in the toes)when your weight is more on the front of the feet – notice what happens to the hips.  They push forward.  This puts extra pressure on the front of the feet, the knees, the front of the belly and the lower back. The shoulders and head tend to move out of alignment too.  Practice keeping your weight in your heels and hips when standing. 
  • lower back in neutral – not flat and not rounded.  There should  be a comfortable curve in the lower back and the hips should be in neutral
  • ribs facing hips – this is another big one.  Place your hand on your breastbone (sternum) – it should be close to vertical to the ground.  When we “stand up straight” the ribs tend to flare forward.  This causes strain in the back and takes the shoulders out of healthy alignment.  
  • roll the shoulders open – the inside of the elbow facing forward and shoulders and chest rolled open – Check the ribs again to be sure they did not flare forward again.   Remember….ribs down, shoulders back
  • head balanced on shoulders – ears over shoulders

Do the same when sitting just keeping feet on floor under knees. Then balance your weight on your hips so the lower back is in neutral andthCAWVYXYC move up from there with the description above.  Sitting with the back curved, like when slouching or sitting back  on a couch creates more work for the lower back. 

This is a simply way we can improve health in moments during our day.  When muscles and joints are hurting they are just letting you know they are over worked. Much of the time this is from positioning during the day. 

Posture-Before-AfterWhen pain is reduced from proper alignment, motivation to move increases.  With the body aligned properly, risk of injury with exercise is less.  So… all of this alignment awareness can lead to more movement and help with weight loss. 

Think beyond the gym for health and well-being and healthy weight. 


Keep Moving, Be Well




by | March 18, 2015 · 4:27 pm

Reducing Weight without Losing Weight

thCABPF7GPI took a car for a test drive this week. My current car is a 2004 and I have the seat perfectly adjusted so I can sit in alignment. Sitting in this 2010 car my head was pushed forward by the head rest. No matter how I adjusted the seat I could not sit with my hips shoulders and ears in alignment. That darn head rest kept pushing my head forward.

So, I asked the car salesman.   He said that not too long ago the government changed the guidelines for manufacturing car seats. They wanted to make sure that the head is on the head rest….. so they moved the head rest forward…

Does anyone see a HUGE red flag here?

Were the older cars wrong? Or, could it be that our bodies have “adapted” to our new computer working, cell phone gazing, sitting shape? Please say it isn’t so! The government, in trying to keep us safe (which I greatly appreciate), adapted the guidelines to fit this new position of our body?thCA2EI8K7

What is the big deal you may ask.

Take an object about 10 lbs.and hold it in your hands. Notice the weight. Now extend your arms so you are holding it in front of you with your arms straight. The weight did not change but it feels heavier, right?

Now think of your head (weighs about 10 lbs.) held up by your neck. With the head jutted forward those poor neck muscles are working over time. And then the back muscles need to help out.

Exercise is important. But it is only about 3% of our day if we do 45 minutes of exercise a day. The other 97% of our day is hugely thCAJSWG40important. How we hold our body during most of the day can be a breeding ground for chronic pain and injury. It can also be the breeding ground for health and well-being. It is our choice.

This week: pay attention to your body position in daily activities like driving, eating, reading, watching TV, working on a computer, brushing your teeth, talking on the phone, looking at your smart phone.

  • Notice where your head is in relation to your body.
  • Notice where you feel your weight most when sitting – on your tailbone and back, front of your hips or in the middle.
  • Notice the weight of your arms and legs.
  • Notice where your weight is on your feet when standing – on the toes, heels or in-between.
  • Which side of the body do you use more?
  • Which side do you put more weight on when sitting, standing or carrying?

Feel free to add your comments about what you notice and we will continue the chat next week…

Keep Moving, Be Well




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by | March 12, 2015 · 6:16 pm