Copyright©2018byLeeAlbert,NMT.

Thematerialinthisbookisintendedonlyasaninformativeguideforthosewishingtoknowmoreabouthealthissues.Thisbookisnotintendedtoreplaceorconflictwithadvicegiventothereaderbyhisorherphysician.Informationinthisbookisgeneralandisofferedwith

noguaranteesonthepartoftheauthororDudleyCourtPress,LLC.Theauthorandpublisherdisclaimallliabilityinconnectionwiththeuseofthisbook.Thereaderisadvised

toseekadvicefromaqualifiedmedicalprofessional.

Nopartofthisbookmaybereproducedortransmittedinanyformbyanymeans,exceptforbriefexcerptsusedinareview,withoutpriorwrittenpermissionfromthecopyright

holder,whichmayberequestedthroughthepublisher.

DudleyCourtPressPOBox102

Sonoita,AZ85637www.DudleyCourtPress.com

ConnectwithLeeAlbertathttp://www.leealbert.com/LookforLee’spopularbook,YogaforPainRelief,featuredonPBS

CoverandinteriordesignbyDunn+Associates,www.Dunn-Design.com

ISBNpaperback:9781940013497ISBNebook9781940013503

LCCN:2017958187

Name:Albert,Lee(LeeMichael),1951-Title:LivePain-free:eliminatechronicpainwithoutdrugsorsurgery/LeeAlbert,NMT.

Descriptions:Secondedition.|Sonoita,AZ:DudleyCourtPress,[2018]|Includesindex.Identifiers:ISBN:9781940013497(print)|

Subjects:LCSH:Chronicpain—Alternativetreatment.|Chronicpain—Exercisetherapy.|Headache—Treatment.|Neckpain—Treatment.|Shoulderpain—Exercisetherapy.

Backache—Treatment.|Knee—Careandhygiene.|Carpaltunnelsyndrome—Treatment.|FibromyalgiaAlternativetreatment.|Temporomandibularjoint—Diseases—Alternativetreatment.Sciatica—Treatment.|Thoracicoutletsyndrome—Treatment.|Physical

therapy.|Massagetherapy.|Self-care,Health.

BISAC:HEALTH&FITNESS/Painmanagement.Classification:LCC:RB127.A3972018|DDC:616/.0472—dc23

PublishedintheUnitedStatesofAmerica

TomywifeMarciaforherlove,support,encouragement,andeditorialadvice

TomypublisherGailforherexpertise,dedication,andendlesshoursofchanges

Toallmyclientsandstudentswhohavetaughtmesomuch

5-starreviewsonAmazonforLivePain-free

I’ma56yr.oldformereliteathleteandcurrentlyanavidcyclist.NeckandlegpainwasunbearableuntilIappliedIntegratedPositionalTherapyfromthisbook.Itseemscounter-intuitiveandcountertoallPTI’vehad,butit’spracticalandworks.

—MaryBeallAdlerIworkwithclientsallthetimewhohavepainandthisisdefinitelyanothergoodresource.Thewristexercisealonehas

helpedmorethantwentyofmyfriendsandclientsendthewristpainthattheyhadpreviouslybeenconvincedwas“agerelated”andthatthey’d

havetolivewithit.NotTrue!Ihighlyrecommenditforpractitionerslikemyselfaswellastheaveragepersonwhowantstohealthemselves

naturally.—KathleenCaseyThisisanexcellentresource.Ofparticularhelpis

thesectiononrealigningthepelvis.IpersonallyhavehadsomelowbackissuesL-4andL-5misalignment/arthritisandsomespinalstenosis.ByreligiouslydoingtheseexercisesIhaveavoidedsurgerysofar!Iama

yogateacherandpersonaltrainerandhavefoundthestretches,techniquesandsuggestionsveryhelpfulformyclassesandclients.

—Pranagal

Very empowering to be able to take care of some things withoutconsulting a healthcare professional! Buy this book! We admire theefficacyandsimplewisdomofhissuggestions.Clearly, themanknowswhatheistalkingabout.

—SamyelFon

Theeasyexercisesinthisbookhavegreatlyreducedmychroniclowerback pain. I would recommend this book for anyone who experiencespainandwantstotakeasfewdrugsaspossible.

—MovieMaven

Thebook iseasy to followandputsallLeeAlbert’s teachings inoneplace.ItisafantasticreferencetoolandIhighlyrecommendit.

—Kctco

Excellentbodyworkroutine!—DavidLeung

Thisisawonderfulbook.Iusedthesequenceforlowbackpainanditworkedrightaway.Morepeopleneedtoknowaboutthis.

—Cryogini

Iamusingtheposturesfortheneckandfindthemtobepracticalandeffective. I would recommend this product to anyone who is ready tobecome responsible formaintaining the physical bodywithout drugs orsurgeryasthetitlesuggests.—ClaraFrazierThisisanotherverygoodresourceforthosewhowanttotakeamoreactiveroleinobtainingandmaintainingtheirhealth.Thetechniquesinthisbookarehelpfulanduseful.Ongoingpainhasgiven

mearunforthemoney.Ihatetakingmeds.Thisisatooltoeducateandhelpyourself.

—LynnRuedigerInveryeasytounderstandtermstheauthorexplainshowtocounterthemanyachesandpainsourordinaryandsedentarylife

stylescause.—Kathy

Thisbookhassavedmybackmorethanonce.I’velentitouttofriendswith back issues and pregnant friends who also found it helpedimmensely.And I’vegiven itasagift to familymemberswithbackandpainissues.It’snothingshortofmiraculous—LisaTener

contents

forewordtothesecondeditionforewordtothefirsteditionintroduction

chapter1:muscleimbalances:thekeytounlockingpain

chapter2:what’syourpainproblem?symptomsandconditionscheck-in

chapter3:overviewofintegratedpositionaltherapy(IPT)wellnessplans

chapter4:IPTwellnessplanfortension-typeheadachesandmigraines

chapter5:IPTwellnessplanfortemporomandibularjointdisorder(TMJ)

chapter6:IPTwellnessplanforcervicalmusclestrain(neckpain)

chapter7:IPTwellnessplanforthoracicoutletsyndrome(TOS)

chapter8:IPTwellnessplanforthoracicmusclestrain(upperbackpain)

chapter9:IPTwellnessplanforepicondylitis,lateralormedial(tennisorgolfer’selbow

chapter10:IPTwellnessplanforcarpaltunnelsyndrome(CTS)

chapter11:IPTwellnessplanforhippain(bursitis)

chapter12:IPTwellnessplanforlumbarmusclestrain(lowbackpain)

chapter13:IPTwellnessplanforpiriformissyndrome(sciatica)

chapter14:IPTwellnessplanformedialmeniscusinjury(kneepain)

chapter15:IPTwellnessplanforplantarfasciitis(heelspur)

chapter16:IPTwellnessplanforfibromyalgia

chapter17:thebasiccareofyourbody

thankyou

acknowledgments

caution

appendixa:propersitting,driving,andcomputerpositions

appendixb:fourstretchestobalancethepelvis

appendixc:threeneckstretches

appendixd:jaw

appendixe:shoulders

appendixf:chestexercises

appendixg:armandhandexercises

appendixh:hipandbuttocksexercises

appendixi:innerthighexercises

appendixj:lowerlegexercises

abouttheauthor

Westand,sit,andwalkeveryday.Ifyoucanimproveyouralignmentandefficiencyintheseactivities,youwillgoalongwayinreducingyourpain.

—IngridBacci,PhD

i

forewordtothesecondedition

’m delighted, honored, and humbled to write this foreword to LeeAlbert’s beloved book,LivePain-free: EliminateChronic Painwithout

DrugsorSurgery.Thousandsofuswaited impatiently for this importantworktoarriveonthebookshelves.Whenitdid,Icanjoyfullyattestitwasworththewait.Thisbookisoverflowingwithwonderful,profound,simple(and simply profound) tools and techniques for self-healing. Lee Alberthasbeenmygo-tohealerfortwentyyears.

I do not use theword “healer” lightly.When Lee first arrived in theHealingArtsDepartmentatKripaluCenter,whereIhavebeenalongtimefacultymember,hesoonbecamerenownedasamiracleworker.Havingbeenaroundthespiritualandholistichealthworldforsolong,Iwasnotonlyskeptical,Iactuallyrolledmyeyes.Ihadseenhundredsofteachers,gurus, and self-professed “healers” come and go. Some of them hadaccompanying bad behavior to add fuel to my irritated fire. I want myteachers to walk their talk. In my world, permission to be human isgranted, but permission to be arrogant and awful is not. Through theyears, I had spent a lot of money on bodyworkers who bragged theyknewexactlywhatwaswrongwithmeandwouldcureall.Dancingandteaching yoga on thinly disguised concrete floors for decades hadcreated all kinds of foot, knee, and hip and back issues in my valiantbody.

Eventually, with a rueful sigh, I signed up for this new IntegratedPositionalTherapymodality toseewhatall theexcitementwasabout. Idoubted thismanwouldaccomplishmuch,butwithashrug, Imarcheduptothefourthfloorwherethisstranger,LeeAlbert,waswaiting.

Wow.WasIeverwrong.Imetamild-mannered,laidback,kind,easy-going, “normal” guy who explained that with Integrated Positional

Therapy nothing should hurt, and that I would feel better quickly. Stillskeptical,Itoldhimaboutmymeniscusissues,myunhappyknees,andhowchallenging itwastodirectmyownLetYourYogaDanceTeacherTraining,aswellasYogaTeacherTraining,while limping!Hepromisedthatallwouldbewell.

Leeproceeded tooffersomesimple techniques:balancingmyhips,finding trigger spotswhere thepaindwelled,workinghismagic. Inonehour,Igotoffthattablefeelingeversomuchbetter.Istillhadawaystogowithmymeniscus issue,andLeegavemesomeexcellentself-helphomeworktokeepmeontrack.Beforesayinggood-bye,heshared,withatwinkleinhiseye,hismostimportantassignment.“Nowgorightdownto theKripalu Shop and get yourself some dark chocolate.” Although Idon’t eat chocolate, his assignmentmademe laugh. Andmy body feltgreat.Ithought:Nowthisguyistherealdeal!

Twentyyearslater,mykneesarestilldoingwell;theystilldanceandteach on disguised concrete!No surgery.No crutches. Just occasionaltune-upsessionsandongoingself-care.

Leehashelpedme throughallmysetbacks, realigningmybody toequanimityandbalanceagainandagain.Hehelpedmehealmyongoingneckissuesbysharingafoolproofneckstretch(foundinAppendixCofthis book). Not only do I use this technique formyself, I offer it tomystudentsinyogaclass.

In2012,whileonretreatvisitingaserene,bucolicabbey,IdiscoveredthattheMotherAbbesshadbeensufferingformonthswithsevereneckpain.IexplainedthatalthoughIntegratedPositionalTherapywasnotmydayjob,Imightbeabletohelpher.Shelaydownonamat,andIusedLee’sneck stretches.Thirtyminutes later shewaspain-free, bowing tome,callingmeaworkerofmiracles!IlaughedandtoldherallaboutLee.“MightIbuyhisbook?”shebegged.

As the years rolled by, Lee and I became pals and colleagues atKripaluCenter.Westartedaracetoseewhocouldwritetheirbookmostquickly.Hewonby twoyears,and thenbecamemycheerleader togetmine on the bookshelves.Wheneverwe seeeach other in the halls ofKripalu,weexchangehugsandhighfives.

At last, Lee’s second book arrived in June of 2017, much to thedelight of the yoga community: Yoga for Pain Relief. Long ago Lee

transformedthewayIpracticeandteachyoga.Hisknowledge,respect,andloveforthehumanbodyisvast;heimpartsthisknowledgesosimplythat it becomes funandeasy tograsp for thishumanitiesand fineartsbrain.

Teaching and training thousands of people a year at Kripalu andelsewhere, I am in a position to offer advice. Whenever my studentscomplained of ongoing physical issues, I used to say: “Make anappointment with Lee.” And then I would watch that student return toclasslateronwithatwinkleintheeyeandanewbody.Everysingletime.Nowadays,duetopopulardemand,itisnotaseasytogetasessionwithLee.ButthegoodnewsisthatnowyoucangetanIntegratedPositionalTherapysessionbecauseLeehastrainedmanyothersinthehealingartsdepartment. I did manage to get my skeptical older brother, Peter, asession due to his newly replaced hip. Lee helped him tremendously.Peterwasthrilledandcontinueshisexercisesonadailybasis.Leehastrainedhundredsofbodyworkers,yogis,andloversofthebodywhoflocktohisprogramsand trainings.Hedoesnotgiveus fish;he teachesushowtofish.

Leeoftensays:“Yourbodyisalwaystryingtohealitself.Allyouhavetodoislearnhowtolistentoit.Thebodyhasgreatwisdom.Wheneveryourbodyistellingyouonethingandyourbrainistellingyousomethingelse,alwayslistentothebody.Thebraincanmakeupsomeprettygoodstoriesthatarenotnecessarilytrue”(LivePain-free).

I truly love this book,Live Pain-free; the pictures are clear and thecontentexcellent.Whereverpainmightdwellinthebody,Leehasagoodsolution,with accompanying homework to keep that body part healthy.Lee’sgentle,kind,lovingspiritcomesthrougheachpage.

Asateacherandtrainer,IhaveplacedbothLivePain-freeandYogafor Pain Relief on my required reading lists for all my students andtrainees.Asapractitioner,Irefertothemoften.

IamforevergratefultoLeeforgivingme(andtheworld)agreatgift:asurefirewaytohealthebody.Youareluckytobeholdingthisbookinyour hands. And it is written by someone who is just as wise andwonderfulasthewordsyouareabouttoread.Enjoythebookandyournewbody!

ALee-lovingchocolatehugtoyou,

ALee-lovingchocolatehugtoyou,MeghaNancyButtenheim,MA/E-RYT1000

CEO,CJO(ChiefJOYOfficer)andFoundingDirector:LetYourYogaDance®

AuthorofExpandingJoy:LetYourYogaDance,EmbodyingPositivePsychology

y

forewordtothefirstedition

ou and your body are healing geniuses. Let me show you all theways.Pain definitely gets my attention, and I love finding easy, natural

solutionsforpainreliefand,wheneverpossibleofcourse,eliminationofpain.

I’mwritingtheforewordforthisbookbecauseIknow,throughmyownphysicalexperienceofpainandtheabsenceofpain, that thissystem—Integrated Positional Therapy—really works. Here’s how it worked andcontinuestoworkforme!

SomeyearsagoIstartedadancepractice.Afterawhile,Idevelopedsomeheelpainwhichthenworsened,andIstartedlimpingbecauseofit.I visited a chiropractor for months, which helped a little, but the paincontinued.Acupuncturedidn’tsignificantlyhelpeither.

Istartedanewstretchingregime,butwhenthepaincontinuedwithnorelief I visited an orthopedic doctor who treats the dancers in the SanFranciscoballet.Shewatchedmewalkanddiagnosedplantar fasciitis.She recommended orthotics, which I started using. Those didn’t helpeither.

I thenboughtaportable laserdeviceandalsobeganicingmyheelsaftereverywalkItook.I’madailywalkerandbeganwalkingshorterandshorterdistancesduetotheunresolvedpain.

ItwasallverydishearteningandIfelthopeless.Myhealthwasbeingcompromisedfrommylackofmobility.

That’s when I met Lee Albert, NMT, at Kripalu, and experiencedIntegratedPositionalTherapyforthefirsttime.

In thesession, IwarnedLee that ifhesqueezedmyheels, thepain

wassoacutethatImightbetemptedtopunchhim.He smiled gently and said, “I can show you how to resolve that in

aboutninetyseconds.”I felt very skeptical but also drawn to his mild mannered, ego-less

approach.Ashemovedmybodyintovariousgentlepositions,Icouldn’timagine

howthiscouldbeeffectiveall.Thenheshowedmehowtogentlybendmyfootbackwardandhold

the position. I felt tempted to push the position further for “greaterbenefit,”andhesaidsimply,“Thisisnotlikestretching.”

Hethensaid,“I’mlikeacarpenter.Myjobistoshowyouhowtobeplumb, level, and straight. If you like how you feel, you’ll do yourhomework.”

Thenhesqueezedmyheelandrotatedmyfoot.Iwaitedforthecascadeofpainandfeltvague,farawayremnantsof

thememoryofapain.Ilookedathimandabsolutelymarveled.Hesaid,“Itwilltakeabouttendaystotwoweekstoresetthemuscle

memorycompletelysoyouhavenopain.”NowIwasveryeagertoseehowthissameprinciplemightworkfor

therestofmybody!As Lee worked and showed me various positions, he said, “I’ll be

givingyouhandoutssothatyou’llhavethevisualstopracticewithanddoyourhomework.I’mheretoshowyouhowtodothisforyourself.”

IimmediatelydoubtedthatIcoulddoitwithouthimandsaidso.Hereplied,“Thisisnotasystemwhereyouneedme.Allyouneedis

yourself,yourbody,andthewillingnesstopractice.”Thenheadded,“Oldpeople are not bent over or crooked because they’re old. They’re thatwaybecausethey’vebeencrookedlonger.”

This statement and the system made practical sense to me, but Iwasn’t experiencing the dramatic release of pain in other parts of mybodylikeIhadwithmyheels.

UntilIgotupoffthetable.Ihadasensationofwhat I rememberaboutbeingsevenyearsold,

andrealizedthatitwascompletefreedomfrompain.EventhoughIhadveryminor,nondebilitatingpainintherestofmybody,Ididn’trealizehow

itmightfeeltobewithoutit.Itfeltutterlytransformativeandreleasing,andIfeltlikeskipping.Leepatientlyexplained that Ihadhomework todo,andshowedme

thehandoutsandexplainedthemainpositions. I lefthisofficeclutchingthepapersandgrinningatmygoodfortune.

Then I skipped across the wildflower meadow and felt like acommercial for this system. I wanted to call Oprah and everyone elsewithagiantaudienceandsay,“Let’sshowthistoeverybody!”

Of course I alsowanted to share the systemwithall ofmy readerstoo,buttherewasn’tabookorDVDyet.

I of course toldmy friends and family and showed themhow to dospecific positions. I experienced incredible changes in my neck,shoulders, and hips, and reveled in feeling pain-free in new ways; Icontinuedpracticing.

IalsoshowedpeopleIdidn’tknow,liketheguywhosoldmemynewcarwho limpedover tohandme thecontract. Iknew immediatelywhathe had. When I asked him why he was limping, he said: “Yeah, thedoctorsaysplantarfasciitis,andI’malsoolderandheavier,soit’sboundtohappen.”

I showed him the ninety-second hold for each foot and gave anabbreviateddescriptionofIntegratedPositionalTherapy.

The next day, I returned to pick upmy new car, and thisman rantowardme, shouting, “No pain! No pain! No limping!MyGod! It reallyworks!” He huggedme and asked if there was a book about it so hecouldlearnmore.Iassuredhimthatonedaytherewouldbe.

I loved the simple, practical, do-it-myself aspect of this new systemandbegantodomyhomeworkdaily.

It was immediately clear, and just as Lee had said, when I did thehomework, my body felt better. When I didn’t, the aches and painsreturned.

Imostlydid thehomework—which isabout fiveminutesaday—andfeltbetter.

EachyearwhenIreturnedtoteachatKripalu,Imadeanappointmentto seeLeeand learnevenmoreabout the system. I alsowished for ateacher in San Francisco where I lived to periodically show me more

nuances and sometimes work with me too. I knew that Lee trainedpeopleinthissystem,butsofarIhadn’tfoundanybodyelsewhoknewit.

IalsowishedforabookoraDVDthatIcoulduseathometoexpandmypractice.

I could see that Lee was so occupied showing people how to doIntegratedPositionalTherapythathedidn’tnecessarilyhavethetimeorenergytocreateabookorDVD.

IdecidedtosharethatIwasanauthorandwoulddoanythingIcouldtohelphimpublishhisbook,includingwriteanendorsementorforeword,whichheenthusiasticallyrespondedtoandconfirmedmythoughtsabouthistimeandenergyforcreatingabookorDVD.

Then the day came when Lee toldme that he was working with apublisheronthebook!

Iprayedthathe’dmetsomebodygoodthatwouldhelphim.Andhehad.That’s how this foreword came to be, and now you can experience

thissystemforyourselfandshareitwithothers,too.Ourbodiesare trulymiraculoushealingdevices ifwe just know the

rightbuttonsandknobsandifweknowtheIntegratedPositionalReleasesystem.

Andnowyouwilltoo.Happypracticingandlivingwithoutpain!

Withlove,Susan(akaSARK)Author,Artist,SucculentWildWoman

http://www.PlanetSARK.com

aintroduction

sthissecondeditionofLivePain-freegoestopress, I lookbackatthe impact that the firsteditionhashadandamsograteful. Ihave

receivednumerousemailsfrommyreadersexpressingtheirgratitudeformybookand thepain relief it hasgiven them. I’mabout to filmaPBSshow with Peggy Cappy that will demonstrate to a large audience theroot causes of pain and how to remedy it. This book has changed thewaypeoplethinkabouttheirpainandhasgiventhemhopethatthey,too,canlivepain-freebypracticingtheseeasyexercises.Forthosewhodon’tknowhowthisstarted,letmesharethestory.

Onabeautifulsummerday,theshiningsunfeltwonderfulonmyskin.Ihadrecentlycompletedmystudies tobeamassagetherapist.DrivingalongthehighwaysoftheplacidQuebeccountryside,Islowlypushedonthebraketostopatastopsign.SuddenlyinmyrearviewmirrorIsawacar racing towardme. I knew rightaway that itwouldn’t stop.Smack! Iwasrear-endedat60mph.

FortunatelyIwaswearingmyseatbeltanddidn’thitmyheadonthewindshield.Igotoutofthecar,whichwasatotalwreck.Icouldn’tbelieveit.Iwasfine—nothingbrokenorbleeding,whichwasamiracle.

Pretty soon the police came along. When they asked how I wasdoing, Isaid Iwasa littleshakenupbut thought Iwas fine.Due to theseverityofthecrash,theofficerinsistedIgotheemergencyroomtohaveadoctor lookmeover.At thehospital,adoctorcheckedmyvitalsigns,didafewrange-of-motiontestsformyneck,andsaidhethoughtIwouldbefine.

And I was fine … for three weeks. Then I started to get migraineheadaches.I’dhadheadachesbefore,butneveramigraine.Thesewereexcruciating!Externalsmells,sounds,orbrightlightswouldsetthemoff.Icouldbarelystand it.MydoctordecidedIshouldstartphysical therapy.LittledidIknowthatIwasgoingtohavetheseheadachesonceaweek

forthenextthreeyears.IspentthosethreeyearsvisitingnearlyeverytherapistIcouldfind.I

wasdesperateforrelief.IspenttensofthousandsofdollarsandsoughtoutthebesttherapiesIcouldfind—allwithnoresults.Thenonedaymywholelifechanged.

I went to a highly recommended therapist who did gentle forms oftherapy that didn’t seem like they were going to help much. After thesession, I thanked her and headed home, disappointed, knowing thiswasn’tgoingtoworkanymorethanalltheothertherapiesIhadtried.

Much to my surprise, however, the migraine headaches neverreturned. How could this be? One session, no deep work, and myheadaches were gone? Impossible! I had tried almost every kind oftherapyIcould thinkofandnothinghadworked.Howcould thisgentle,simple therapydo the trick inoneshort therapysessionandrelieve thehorrendouspainI’dbeensufferingwithforoverthreeyears?

I set out on a quest to find out what this therapy was and how itworked.Iwantedtoknowandtoshareitwitheveryoneontheplanet.

Thisbook isa resultofmyquest. I’vebeenpracticingand teachingIntegrated Positional Therapy now for thirty-plus years, helpingthousands of people to enjoy permanent pain relief without surgery ordrugs.Ihopethisbookwillhelpyouandyourlovedonesfindrelieffrompainfulconditionswithgentletherapeutictechniquesandsimple,ongoingself-care.

A quick note here to those readerswho tend to go directly to theirparticular condition: I appreciate your enthusiasm, but you will benefitmost by reading the first three chapters and the last chapter beforejumping to your condition. There is important information in thosechapters thatwillbemostbeneficial inyourquest to feelbetter.Oneofthemostimportantthingsyouwilllearnwillbehowtostretch.Stretchingincorrectlycanleadtopoorresultsorcanaggravateyourpain.

Asthisworkcontinuestobecomebetterknown,IamexcitedtoreportthatIhaveanongoingcertificationprogram.Currentlywehavenineteencertified practitioners and more on the way. These practitioners havecompletedacomprehensivetrainingprogram,andIamgratefulfortheirdedication, commitment, and caring. I am delighted to have theirassistance in teaching people to be pain-free. If you are in need of a

practitioner,pleasevisitmywebsite(www.LeeAlbert.com).Mygoal istohave a grassroots movement and create a village where an educatedpopulacecan treat themselves formanyof their achesandpains, thusreducing the costs of health care. With your help, this is possible!Togetherwedomakeadifference!

LeeAlbertwww.LeeAlbert.com

Lenox,Massachusetts

p

CHAPTER1

muscleimbalances:thekeytounlockingpain

ain! Everyone experiences pain at some point. The problem ofchronic pain in our bodies is complex and far-reaching.

Musculoskeletal pain encompasses many different areas, such as thehead, neck, back, limbs, joints, bones, and even chronic, nonspecific,widespreadtissuepain.

At least one hundred million Americans suffer from chronic pain.Chronic pain is defined as pain lasting longer than six months. Thatnumber goes much higher when we add the statistics for acute pain.Chronicandacutepaincanrangefrommildtomoderatetoexcruciating.According to a recent Institute of Medicine Report: Relieving Pain inAmerica:ABlueprint forTransformingPrevention,Care,Education,andResearch,painisasignificantpublichealthproblemthatcostssocietyatleast$560–$635billionannually.

Painisahugeeconomicburdenbothonourhealthcaresystemandonindividuals.Notonlydoesitcausehigher insurancerates,but italsocreatesvariousadditionalfinancialcostsfortheindividual.Studieshaveshownthatindividualswithacuteorchronicpainhavemuchhigherout-of-pocket expenses, therefore leaving lessmoney for other necessitiesthatwedeem important (like…havinga lotmore fun!).Employersarealso impacted because of lost workdays, as adults with pain reportmissing more days from work than people without pain. Chronic painaffectsmore people than the combined dollars spent for cancer, heartdisease,anddiabetes.

Despite the wide-ranging conditions and symptoms, all types ofmusculoskeletal pain share similar underlying mechanisms,manifestations,andpotential treatments. Inthefinalanalysis,mostpainis foundational, resulting from imbalances in amusculoskeletal systemthatisoutofalignment.Agreatdealofresearchpresentsevidencethatthe root cause of many neuromuscular pain patterns is due tobiomechanicalmisalignmentscausedbymuscle imbalances.Weare in

painbecausewearemisaligned,or “crooked.”Therapistsoften refer tothisasthemusclesbeing“lockedlong”or“lockedshort.”

Rememberwhenyourmothertoldyoutosituporstandupstraight?Well,shewasright!Yourmotherprobablydidn’tknowitatthetime,butgoodposture ismore thansimplyabout lookinggood.Goodposture isessential to a healthy, functioning, pain-free body.Most of your pain iscausedbypoorposture.Youareinpainbecauseyouaremisalignedor…crooked!Evenifyouthinkyouhavegoodposture,youprobablydon’t.Manymisalignmentsarenotobvioustotheuntrainedeye.

Thismayseemtoosimple,butlet’slookatsomeexamples.Pictureahouse in yourmind. Imagine that the basement of the house is a littlelowerononeside.Inotherwords,thehouseiscrooked.Overtime,thecrooked house develops all sorts of structural problems, i.e. the roofmight leak, windows are hard to open, the chimney leans, etc. Thestructureofthebuildingisnotcarryingtheloadthewayitwasdesignedbecause it is not straight. All these problems are caused by onecondition:thehouseiscrooked.

Youcouldalsoimagineacarwithitsfrontendoutofalignment.Thecarwillrun,butthetireswillhaveabnormalstrainonthembecausethecar is crooked, and those tires will wear out more quickly than if theywerealigned.

Thesolutionineachcaseistobringthebuildingorthecarbackintoproperalignment—givethecarorthebuilding“goodposture”soitcarriesitsloadthewayitwasdesignedto.

Let’sapplythistheorytothehumanbodyandyourpain.Doyouknowwhatthefollowingconditionshaveincommon:sciatica,plantar fasciitis,carpal tunnel, tennis elbow, low back pain, neck pain, and mostheadaches?

At first, they don’t seem to have much in common. They occur indifferent parts of the body and involve different musculoskeletalstructures.However, ifyoustepbackand lookat thebodyasawhole,youwillnoticethecommonelement.

This common element is called muscle imbalance. This simplymeansthatsomemusclesaretooshortandsomemusclesaretoolong.Bothmuscleswillfeeltight.Theshortmuscleiscontractedandtight,andthelongmuscleislikeanoverstretchedrubberband—toolongandvery

tight.Sinceeverymuscle isattachedtoabone, thesemuscle imbalances

pullthebonesoutofalignment.That’swhatmakesyoucrooked.Optimal functioning of the musculoskeletal system requires that

muscles be in balance in regard to strength and length. If they do notpossess this balance, then the muscles become painful and the jointwhere these imbalances are occurring will become compromised. Thisoftenmanifestsaspaininthatjointand/orlimitedrangeofmotion.

IllustrationA demonstrateswhatmuscles in balance look like. Theyareequalinbothlengthandstrength.IllustrationBdemonstrateswhatamuscle imbalance looks like. Notice that the muscle on the left inIllustration B is short and contracted. (This muscle is then consideredstrong.) The muscle on the right in Illustration B is too long andoverstretched. (This muscle is then considered weak.) These smallimbalanceswillcausethebiggerimbalancesweseeinthenextdiagram.

Thefigureontheleftiswhatabalancedbodylookslike.Thefigureontherighthasnumerousmuscleimbalances.Mostpeopleexhibitat leastsomeoftheseimbalancesandarenotevenawarethattheyhavemuscleimbalances. Another way to think about imbalances is to look at yourposture. Ifyouhavepoorposture,youhavemuscle imbalanceslikethefigureontheright.Ifyourmusclesareinbalance,youhavegoodposturelike the figure on the left. To be concise, amuscle imbalance iswhensomemusclesare too short and tight, and somemusclesare too longandtight.

Misalignment of the skeletal structure caused bymuscle imbalancecancausecompressionsofthenerves,discs,andotherstructuresinthebody. It can also cause the fascia to be twisted. Fascia is a band offibrous connective tissue enveloping, separating, or binding togethermuscles, organs, and other soft structures of the body. These twists,compressions, and tight muscles ultimately lead to less oxygen in thetissuesat thoseareas.Themedical term for this condition is ischemia,whichmeansaninadequatesupplyofbloodisreachingthetissues.Asa

result, thetissue isnotgettingenoughoxygen.That lackofoxygeniswhatcausesagooddealofthepain.

Weallhavedemandsthatkeepusworkingthroughourpain.Sowecontinuallyre-strainthesamemusclesthroughourdailyactivitiesuntilwelearn how to do those activities without causing muscle strain. Theprotocolslistedinthisbookwillhelpyouperformyourdailyactivitieswithnopainorshowyouhowtorelievethepainthatoccursbecauseoftheseactivities.Ourplan is to reduceoreliminateasmanycausesofmusclestrainaswecanandapplystretchesorslackenings(Idiscussslackeningindetailinchapter3)tocorrectthemuscleimbalances.

One of the most common causes of these muscle imbalances issimplypoorpostureand/orimproperergonomics.Slumpingatyourdeskor in your car pushes your head forward of your body, putting a lot ofstrainonyourneckandshoulders,whichnowhavetoholdupyourheadwithout the support of the spinal column. The average head weighsbetweeneightandtwelvepounds.Thatisveryheavy.Ifyoutriedtoholdthatmuchweightwithyourarms,youprobablywouldnotlastmorethanfive minutes. Yet we ask our neck and shoulder muscles to hold thatweight all day long. These muscles are not designed to hold up yourhead.Theyaremeanttomoveyourheadindifferentdirections,notholdthem in the same position for long periods of time. By correcting yourcomputer and driving positions, you will bring your head over yourshouldersandimproveyourposture.Yourbones(thespinalcolumn)willbeholdingupyourhead,whichwillhelptakethestrainoffthemuscles.

To summarize, muscle imbalances pull the frame of the body (thebones) into misalignment, causing pain in the body. The condition ofbeing out of alignment or crooked results inmany neuromuscular painpatterns.Anestimated80%ofallthepainyouwillexperienceinyourlifeisduetothesemisalignedmechanicalproblems.Musclesthatareeithertoolongortooshortpullyourbonescrooked,causingcompressionandreducingoxygentothetissues.

The key to understanding and eliminating pain is to be able torecognizethecause.Whenyougotoadoctor,youcouldbediagnosedwith any one of hundreds of conditions. In our Western model ofmedicine,standardtreatmentforconditionslikesciatica,plantarfasciitis,carpal tunnel, tennis elbow, low back pain, neck pain, and most

headachesinvolvestreatingthesymptoms,typicallywithapainkiller,ananti-inflammatory drug, or sometimes even surgery. Seldom doestreatment address the cause. The cause is muscle imbalance ormisalignment,andthecorrecttreatmentistogetyou“uncrooked.”

musclesdevelopimbalancesduetooverorunderuseInourdailylives,wehavealldevelopedhabitsthatimpactourmuscularsystem. These habits are things we usually do every day in our jobs,suchasthewaywesitandwhatwechooseforexerciseordon’tchooseforexercise.Allofourdailyactionsrequirethatweuseordon’tuseourmusclesinaparticularway.Someofourmusclesweusealotandsomeweusefarless.

Sinceallmusclesareattachedtobonesandotherconnectivetissue,providingskeletalstabilityandsupport,muscleimbalancesduetomuscletension,trauma,repetitive,orimproperusecanleadtoexcessivemuscleshortening or lengthening—allowing for the movement of skeletalcomponents that create postural misalignments, musculoskeletalstresses, andpain. In short, the root cause ismuscular imbalances. Insimple terms, some muscles become too long and some musclesbecome too short, leading to postural distortions and pain. As theimbalance becomes greater, the individual experiences pain thatbecomesmoresevere.

Themusclesweuseoftenwill tendtogetshorterandstronger.Themusclesweuselessoftentendtogetlongerandweaker.Thewaywesitalso puts somemuscles in a contracted position and some in a moreextendedpositionoftenforlongperiodsoftime.Forexample,whenyouare slumping in a chair, you will notice that the chest muscles havebecome shorter and the muscles between your shoulder blades(rhomboids)havebecomelonger.

Finally, we are going to talk about the solution to your muscleimbalancesandyourachesandpains.

integratedpositionaltherapytotherescueIntegrated Positional Therapy teaches you how to quickly identify themost common misalignments and to develop a quick and simple

approach to gettingback into balance. IPT is a gentle and simple self-care approach that has been shown to be effective at successfullyaddressing a wide range of common acute/chronic neuromuscularconditionsandassociativepain.Unlikeconventional treatmentmethodsthat focusonthesymptomsofpainandpainmanagement, IPTtakesanovelapproachtoeliminateneuromuscularpainatitsrootcause.

With a focus on the close relationship that musculoskeletalimbalances play in the development of general and localized pain, IPTdelivers simple, therapeutic self-care techniques that anyone can do.These techniques help identify and correct muscular imbalances andeffectively hone in onmanyof the root causesof pain. This pain reliefmaybeachievedwithstrengtheningandstretchingexercisesortargetedyogaposes.

Integrated Positional Therapy (IPT) is based upon the osteopathictechniques of strain/counterstrain and muscle energy technique.Strain/counterstrain slackens a muscle and makes it shorter, whilemuscleenergytechniquestretchesamuscleandmakesitlonger.

Please don’t be concerned about the technical terms. Thesetechniquesaresimplyused tobringyourbodyback intoalignmentandout of pain gently and quickly. Muscle energy technique (MET) andstrain/counterstrainareusedtocorrecttheimbalancesinthemuscles.

METisapowerfultooltoquicklyandeasilylengthentight,constrictedmuscles and restore range of motion. It is a form of stretching usingactiveisometriccontractions.

Strain/counterstrain can also be applied to these tight, constrictedmuscles.With this technique, the affected area is passively shortenedandheldfortwominutes,therebyallowingthemusclefiberstoeffectivelyreset and return to neutral. The results are often dramatic and longlasting.

Oneofthefirstprinciplestherapistsanddoctorslearnisthatthebody,including the musculoskeletal system, is always trying to achievehomeostasis. This means that it is trying to get back into balance oralignment. The great thing is that we are doing this every day, but it’ssomethingwearenotusuallyawareof.Here’sanexample.Doyoueverliedownonyourbackandinstinctivelyputyourhandsunderyourhead?You probably don’t think about the movement consciously. You do it

because it feels good; your body automatically does it.Why?Becauseyour body is trying to get back into balance. Thismovement of puttingyourhandsunderyourheadreleasesandrebalancestheshouldersandpartoftheneck.

Trythisexperimentforyourself:Placeyourlefthandonyourrightshoulder.Ifyouarewearingashirt

youmightfindaseamintheshirtinthisarea.Withyourlefthandpresssomewherealongtheseam.Thiswillbetenderorsoreinmanypeople.Onceyouhavefoundatenderspot, takeyourrightarmandgentlyrestthe forearm on top of your head. Now press the spot that was sorebefore.Doesitfeelbetter?Itusuallydoes.Nowholdyourrightarminthisposition on top of your head for two minutes. This period allows themusclememorytoreset.Aftertwominutes,putyourrightarmbackdownatyourside.Pressthetenderspotagain.Itshouldfeelbetter.Theeffectsof this techniquearecumulative,soeach time thepaingets lesserandlesser.

Afteryouhavefoundthesorespot,thisisthepositionofthearmthatwillrelievethepain.

Here isanotherexample.Doyouever sit ina chair andcross yourlegs?Almosteveryonedoesthisandyetwedon’tgenerallythinkaboutit.

Our body naturally crosses our legs for us because the position feelsgood. The body is trying to achieve homeostasis or balance by gentlystretchingtheoutsideofthehipandleg.Whenyourbodyisinbalance,itjustplain feelsgood. (Commonwisdom is thatcrossingyour legswhilesitting in a chair is bad for you, but it is simply the body’s way ofstretching themuscles on the outside of the leg and hip to bring thembackintobalance.)Whenyourmusclesareinbalance,youwillnolongercrossyourlegsbecauseitisnotneeded.

Yourbody isalways trying toheal itself.All youhave todo is learnhowtolistentowhat it istryingtotellyou.Thebodyhasgreatwisdom.Wheneveryourbodyistellingyouonethingandyourbrainistellingyousomethingelse,alwayslistentothebody.Thebraincanmakeupsomeprettygoodstoriesthatarenotnecessarilytrue.

Positional Therapy is the therapy that alleviated my migraines. Ideveloped Integrated Positional Therapy (IPT) by adding criticalcomponentstomakethetherapyevenmoreeffectiveinrelievingchronicpain.IPTiswhatInowpracticeandwanttosharewithyouinthisbook.InadditiontothebasicmusclereleasetechniquesofPositionalTherapy,IntegratedPositionalTherapy includes importantexercises tostraightenthepelvisandaddsWellnessPlanstoenhancetheimmediateandlong-termresults.

IntegratedPositionalTherapy(IPT)isdesignedtoeliminatepainatitsroot cause and not to simply hide the symptoms. As a self-caretechnique,thistherapycanhelpyoutocorrectthemuscleimbalancesinyourownbody.

With some easy-to-learn practices, you will learn to correct theimbalancesbymakingyourshortmuscleslongerandyourlongmusclesshorter.Thisprocesswilloftenbringyourbodyintoalignmentandoutofpain.

IPTcaneliminateor reducethepainassociatedwithmanycommonconditions, such as headaches and migraines, back and neck pain,carpal tunnel syndrome, limited range of motion and sports injuries,thoracicoutletsyndrome,sciatica,repetitivemotioninjuries,fibromyalgia,tendonitis,plantarfasciitis,andmanymore.Thisbookcoversthirteenofthemost common conditions. In some cases, a sessionwith a trainedIntegrated Positional Therapist may be advisable, butmost people will

find great relief from chronic muscle pain by following the appropriateWellnessPlandescribedinthisbook.

Simple, easy-to-do-at-home exercises and other lifestyle habits willmaintain the results. Ongoing maintenance is crucial to keeping yourbody pain-free. Remember the car analogy? Just as your car needsregularmaintenance to stay in greatworkingorder, your body requiresmaintenance to stay pain-free. Just fifteen to twenty minutes a day isoftenallthatisrequired.

The treatment protocols described in this manual are based uponthirty-plus years of clinical experience treating tens of thousands ofpeoplewithsuperiorresults. Inthepagesthatfollow,youwill learnhowto correct your ownmuscle imbalances. You will learn exactly what iscausingyourpain.You’ll learnhowtoimprovethequalityofyourlifebyreducing or eliminating the pain in your body that you are currentlyenduring.Youwillalso learnsomegeneral tipsonhow tobehealthier.EverythingIamgoingtoshowyouiseasyandtakeslittletimetodo.Noprevious experience is needed. No special equipment is necessary.Thesepracticesaredesignedtofityourbusylifestyle.Asamatteroffact,manyofthepracticescanbedoneinbed,onthecouch,orattheoffice.

Solet’sgetstarted!

c

CHAPTER2

what’syourpainproblem?

symptomsandconditionscheck-in

heck the following chart to find the condition that most closelydescribesyoursymptoms.Itdoesnotneedtobeaperfectmatch.Test for the condition until you confirm which condition is creating

yoursymptoms.Ifnoneofthetestsconfirmaparticularcondition,choosetheWellnessPlan for thecondition that ismostcloselyassociatedwithyour symptoms. If you have several conditions, choose the WellnessPlanforthedominantorprimaryconditiontostart.

Iftheseareyoursymptoms Youmaysufferfrom Dothistesttoconfirm

Sensationofpain,tightness,orpressurearoundtheforeheadorbackoftheheadandneck.Thepainissometimesdescribedasthrobbingorachingandcanaffectthefront,top,orsideofthehead.

Tension-TypeHeadachesandMigraines

Notestisnecessary.Ifyouhavepersistentheadaches,seeyourhealthcareprovider,asthiscouldbeasignofamoreseriousproblem.

Sensationofpainortightnessinthejaworinfrontoftheearwithsounds,suchasclicking,grating,and/orpopping.Canalsocauseheadachesandearachesandmakeitdifficulttoopenyourmouthwide.

TemporomandibularJointDisorder(TMJ)

Withthemouthopen,presslightlyonthejointneartheear.Ifthisispainful,thiscouldbeTMJortight,soremusclesthatcouldbeaprecursortothecondition.Ifyoucannotopenyourmouthverywideoritispainfultodoso,thiscouldbealsobeTMJ.

Sensationofpainintheneckthatcouldbedescribedasanache,stiffness,burning,or

CervicalMuscleStrain(NeckPain)

Bendyourheadindifferentdirections.Ifyoufeelpain,stiffness,oraching,thiscouldbe

stabbing.Thisconditioncanbeacuteorchronic.Itisoftenbetterincertainpositionssuchaslyingdownorstanding.

aching,thiscouldbeneckpainortight,soremusclesthatcouldbeaprecursortothecondition.

Sensationofpain,numbness,tingling,weakness,orcoldnessinthearmand/orhand.

ThoracicOutletSyndrome(TOS)

Raisebothhandsoveryourheadwithfingerspointingtowardtheceilingandpalmsfacingstraightahead.Rapidlyopenandclosehands.Dothisforoneminute.Ifyoufeelnumbness,tingling,orcoldnesswithintheminute,thiscouldbeTOSortight,soremusclesthatcouldbeaprecursortothecondition.

Painintheupperbackthatisoftendescribedasanache,tightness,burning,orstabbing.Thisconditioncanbeacuteorchronic.Itisoftenbetterincertainpositions,suchaslyingdownorstandingorsitting.Itisusuallyworsewithlongperiodsofsittinginachairorreadinginbed.Thepainmayalsoradiatedownthearms.

ThoracicMuscleStrain(UpperBackPain)

Bendyourbodyindifferentdirections.Ifyoufeelpain,stiffness,oraching,thiscouldbeupperbackpainortight,soremusclesthatcouldbeaprecursortothecondition.

Sensationofpainordiscomfortatthesiteoftheelbow,sometimesradiatingtootherpartsofthearm.Thiscouldbetheinsideoroutsideoftheelbow.

Epicondylitis,LateralorMedial(TennisorGolfer’sElbow)

Holdyourrightarmoutinfrontofyouwithelbowstraightandpalmfacingdown.Withthelefthand,bendtherightwristsothatthefingersontherighthandarepointinguptowardtheceiling.Thenbendtherighthandatthewristdowntowardthefloorsothefingersarepointingdown.Ifthiscausespainontheoutsideoftheelbow,itcouldbetenniselbow.Ifthiscausespainontheinsideoftheelbow,thiscouldbegolfer’selbowor

couldbegolfer’selbowortight,soremusclesthatcouldbeaprecursortothecondition.Testtheotherside.

Sensationofpain,numbness,tingling,burning,orweaknessinthehandandfingers.

CarpalTunnelSyndrome(CTS)

TestforCTSontherighthand.Fromanormalstandingpositionwithyourarmsatyourside,bendyourrightelbowto90degreeswithyourpalmfacingdown.Useyourlefthandtogentlypushyourrighthandtowardthefloor,creatingabendinthewrist.Ifyoudeveloppain,numbness,tingling,burning,orweaknessinthehandandfingerswithinaminute,thiscouldbeCTSortight,soremusclesthatcouldbeaprecursortothecondition.Testontheotherside.

Symptomscanbepainontheoutsideofthehiporinthegroinarea.Sometimesthispainoriginatesfromthelowback.Thepaincanrangefrommildtosevere.Itmaybesharporjustalittleachy.Thepainmaymakewalkingdifficult.Thepainisoftenworsewithactivity.

HipPain(Bursitis) Paininthehiporgroinareathatisworsewhenwalkingorweightbearing.

Sensationofpaininthelowerbackthatcouldbedescribedasanache,stiffness,burning,orstabbing.Thisconditioncanbeacuteorchronic.Itisoftenbetterincertainpositions,suchaslyingdownorstanding.

LumbarMuscleStrain(LowBackPain)

Gentlybendyourbodyindifferentdirections.Ifyoufeelpain,stiffness,oraching,thiscouldbelowbackpainortight,soremusclesthatcouldbeaprecursortothecondition.

Sensationofpain,numbness,tingling,orweaknessthatyou

PiriformisSyndrome(Sciatica) Situprightontheedgeofachair.Placeoneankle

tingling,orweaknessthatyoufeelinyourbackorbuttocksanddownyourleg,whichsometimesmaymoveintoyourfoot.

achair.Placeoneankleontheoppositethigh.Keepingthebackstraight,bendforwardatthewaistwhilebringingyourchesttowardyourknee.Ifthismovementincreasesthenumbnessortingling,thiscouldbepiriformissyndrome.Ifyourpainisonlyinthebutt,thiscouldbeatightpiriformis.Ifyoucannotgetintothisposition,thisisduetotightmusclesthatmayleadtothiscondition.

Repeatontheotherside.Ifatanytimethepainistooseveretoattemptthistest,callyourdoctorforevaluation.

Sensationontheinsideofthekneethatispainfultothetouch,oftenaccompaniedbyswelling.

MedialMeniscusInjury(KneePain)

Sitcross-leggedyoga-style.Ifthiscausespainontheinsideoftheknee,thiscouldbeamedialmeniscusstrainortear,ortight,soremusclesthatcouldbeaprecursortothecondition.Ifyoucannotgetintothisposition,thisisduetotightmusclesthatmayleadtothiscondition.Forsevere,acutepainoftheknee,firstseekevaluationbyyourphysician.

Sensationofpainintheheelorthebottomofthefoot.

PlantarFasciitis(HeelSpur) Ifthepainintheheelorbottomofthefootisworseinthemorningandimprovesthroughouttheday,orifthepainisworsewhenyouarewalkingwithoutshoes,thiscouldbeplantarfasciitisortight,sore

fasciitisortight,soremusclesthatcouldbeaprecursortothecondition.

Sensationofchronic,widespreadpainwithtendernesstolighttouch,oftenaccompaniedbyfatigue.Youmayalsofeeltinglingoftheskinthatfeelslikeneedles,aswellasnervepainandbrainfog.

Fibromyalgia Painmustbeonboththeleftandrightsideofthebodyandbothaboveandbelowthewaist.Thismayalsobetight,soremusclesordehydration.

i

CHAPTER3

overview of integrated positional therapy (IPT) wellnessplans

nthefollowingchaptersyouwillfinddefinitionsofeachofthethirteenconditionsmentioned in this book. This will help you understand the

mechanicsoftheconditionthatiscausingyourpain.Rememberthatallof these conditions are caused by certainmuscles being too long andtight and some being too short and tight. These tightmuscles pull thebones out of alignment, which can causemuscle pain, disc problems,nervecompressions,and tendonitis.Forexample, theheadaches that Iexperiencedasaresultofmycaraccidentwereprimarilyduetomuscleimbalances in the neck and shoulders. Once they were corrected, myheadacheslessenedandeventuallywentaway.

You will also find a list of common causes for each of theseconditions.Inorderforthebodytofeelbetter, it is importantnotonlytoreduceoreliminatethepainbutalsotoeliminatethecause.Thisprocessoften involves doing your daily activities in a slightly different way thatstopsthepainfromreturning.Theoldsaying:“Ifyoudowhatyoualwaysdid,yougetwhatyoualwaysgot”applieshere.

In my thirty-plus years of helping people, I have identified threeactivitiesthatalmosteverybodydoesandwhichcause50–60%ofallthepain I treat. These activities are sitting in a chair, sitting in a car, andsittingatacomputer.Itisnotthecomputerorthechairorthecarcausingthe pain, but the way you are using those instruments. If you just dothesethreethingsalittlebitmoreergonomically,halfofyourpaincanbeeliminated.InthefollowingpagesIwillshowyouhoweasyitistoobtaingoodresultsandhowbeneficialtheycanbe.

Most people have the sameor similarmuscular imbalances in theirbodies with some variations. This coincidence is explained by the factthatwedosimilaractivitiesalldaylong.Forexample,mostofusdriveacar,sitatacomputer,orslumpinourchairsforagoodpartoftheday.These positions will bring about similar muscular imbalances that will

produce similar aches and pains. Almost everyone has tight neck andshouldermuscleswhethertheyhurtornot.Neckandshouldertightnessisprimarilycausedbyslumpingover thecomputerorsteeringwheelorbywalkingwithyourheadforwardofthebody.Thesepositionsallcausetheneckandshoulderstobetight.

Almosteveryonealsohasapelvisthatisoutofbalance,i.e.crooked.Ihaveobserved,inmythirty-plusyearsoftreatingpain,thatifIbringthepelvis back into balance, the discs, the joints, the muscles, and otherstructureswillalsocomebackintobalanceandfunctionnormally,whichwillreduceoreliminatethepaininmanyotherareasofthebodyaswell.

Three primary pelvic imbalances lie at the root of many painfulconditions in the body. These are an elevated pelvis, a rotated pelvis,and a tilted pelvis. Most people present with at least one of these,althoughmostpeoplepresentwithallthreeinvaryingdegrees.Let’stakeacloserlook.

elevatedpelvisAnelevatedpelvismeans that onehip is higher than theother. I havemeasuredtheelevatedhiponmyclientstobeoffanywherefrom1/8ofan inch to almost 2.5 inches. Typically, the higher the hip, the morepainful the condition. People with an elevated pelvis will often bediagnosedashavingonelegshorterthantheother.Thisdiagnosisisnotusually correct. They have a functionally short leg but not a truly shortleg.Although the leg is not truly shorter, it is functionally shorterwhenwalking, which puts undue strain on the body structure. A functionallyshortlegmeansthisisatemporaryandcorrectablecondition.Ihaveonlyseen a few truly short legs inmy practice.Most of thesewere from abroken leg that did not heal correctly, leaving the bones at differentlengths.

Manypeoplewithanelevatedpelvisandthusafunctionallyshortlegwill be told to get a heel lift to help even out the hip. Sometimes thisstrategyworks,butoftentimesitdoesnot.Thisstrategymerelytreatsthesymptom and not the cause. So what can cause an elevated pelvis?Muscleimbalancesaretheculprit.Thetwomainmusclesinvolvedinthiscondition are the quadratus lumborum and the psoas. Either of thesemuscles,when they become short due to overuse or prolonged sitting,

canelevatethepelvis,causingafunctionallyshortleg.Anelevatedpelvisnotonlycontributes to lowbackpainbut tohip,knee,and footpainaswell.

rotatedpelvisArotation in thepelviscanbeeither inwardoroutward.Typicallywhenonesidegoesinward,theothersidegoesoutward.Theserotationscanbeanywheretoslightorquitepronounced.Ifyouliedownonyourbackand either one or both of your legs and feet turn out, that can be anindicationofarotatedpelvis.

Themuscle imbalances that can cause a rotated pelvis are the hipabductor group of muscles on the outside of the upper leg and theexternalrotatorgroupofmusclesthatarelocateddeepinthebutttissue.When thesemuscles become short, theymay rotate the pelvis. Thesegroupsofmusclesnotonlycontributeto lowbackpainbutsciatica,hip,groin,andkneepain.

tiltedpelvisAtiltedpelviscanbeeither forwardorbackward.Aforwardtilt iscalledananteriorpelvic tilt,andabackward tilt iscalledaposteriorpelvic tilt.Themostcommonistheforwardtilt.Thetiltcanbeanywherefromslighttopronounced.

The muscle imbalances that cause a forward tilt are the psoas—adeepmuscleinthemiddleofthebody—andtherectusfemoris,whichisoneofthequadricepmusclesintheupperleg.Thesearealsocalledthehipflexormuscles.

Themuscleimbalancesthatcancauseaposteriortiltaretheglutealmusclegroupinthebuttandthehamstringsonthebackoftheupperleg.

In either case, these imbalanceswill cause an exaggerated lumbarcurveandcompressthestructuresinthelowback,puttingunduestrainontheentirebodystructure. Inmyopinion,atiltedpelvis is theprimarycauseoflowbackpaininmanypeople.

Most people will have at least one of these imbalances, andmanyhave all three. I will teach you four stretches that, when practicedconsistently,usuallybringthepelvisbackintobalance.

The treatment protocols listed for each condition evolvedover thirtyyearstoensuresafe,effective,easyapplicationandweredesignedtofityourbusyschedule.Theyonlytakeminutesadayandwillgiveyouthetools to effectively deal with your muscular pains. Some of theseprotocols are about prevention, and some are proactive in reducing oreliminatingthepaininyourbody.Doingeachoneconsistentlyandgentlyisimportant.Noneofthesestretchesshouldhurt.

Youwillnoticethatmanyoftheprotocolsaresimilar.Mostincludethefourhipstretchestobalancethepelvis.Whetheryouhaveapaininthefootorthehead,therootcauseisoftenanunbalancedpelvis.

Iwanttotakesometimeheretofurtherdiscussslackeningamuscle.Mostofusarefamiliarwithstretchingamuscle,butnobodythinksaboutslackeningamuscle.Agoodanalogywouldbe to thinkof a string. If Itake the twoends of a string andpull them farther apart, this is calledstretching.Slackeningamuscle is takingthetwoendsof thestringandbringing themcloser together.Thisbrings themuscle intoslack.Whereslackispresent,tensionisnot.Whenourmusclesarenottense,wewillnotfeelpain.Thispositionofslackmustbeheldfortwominutesormoreinorderforthemusclememorytotakeeffectandkeepthemuscleloose.Thisoftenfeelslikeamiracle,asthepainsimplyseemstodisappear.

Remember the exercise in chapter 1wherewe looked for a tenderspot in the shoulder?Thatwas a demonstration of putting amuscle inslack.

Youcantrythisforyourselftofeelwhatitisliketohaveamuscleinslack.

Takeyourlefthandandgentlyplaceitonyourrightshoulder.Findaseamon your shirt that runs toward your neck. Somewhere along thatseam, press into the tissue with a finger on your left hand. You willprobably feel that it is sore, bumpy, or tight. This indicates a muscleimbalance in the region. Now keep your left hand where it is but stoppressing the tissue.Takeyour rightarmandgently rest the forearmontopofyourhead.Completelyrelaxitinthatposition.Holdittherefortwominutes,whichletsthemuscle“reset”itself.

Withyour lefthand,press the tissueagain. It should feelsofterandlesspainful. If it stillhurts,move thearm intoslightlydifferentpositionsuntilthetissuefeelsbetter.Youjustputthatmuscleintoslack.

Theseprotocolsaredesignedtotreatthewholebodyandnotonlythesiteofthepain.Bytreatingthewholebodyandremovingtherootcause,IntegratedPositionalTherapyobtainslonger-lastingresults.

howsooncanIexpectresults?Inmanycasesofpaincausedbymuscleimbalances,short-termreliefisimmediate. Rebalancing themuscles usually gives amuscle 80–100%reliefalmostimmediately,andtheeffectsarecumulative.Themoreyoudoit,thebettertheresults.

You can achieve long-term relief in three to five months if you arediligentwithyourexercises.That ishow long it typically takes toretrainmuscles—not a lot of time considering how long it took you to acquirethese imbalances.Performing the exercises consistentlybrings thebestresults.

If themuscle imbalanceshavebeenpresenta longtime,sometimesinflammation isaswell.TheWellnessPlanswill rebalance themusclesand,intime,reduceorclearuptheinflammation.

Lackofwatercanalsobeafactorinmuscularpain.Manypeopledonotdrinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonot get enoughwater achemore thanmuscles that are well hydrated.Also, thediscsneed tobewell hydrated tomaintain their softnessandavoid pinching or irritating a nerve. Good disc health is dependent onadequatewaterintake.

Rememberthatcaffeineandalcoholarediuretics,whichmeanstheytakewateroutofthebody.It isfinetohavethesethingsinmoderation,butremembertodrinkevenmorewater.Peoplewilloverlookthebasicslikedrinkingwater,anditisoftenthecauseofmanyachesandpains.Ingeneral,drinkhalfyourbodyweightinounceseveryday.Adequatefluidintake will help reduce the frequency of your pain and lead to betteroverall health. It can take up to six weeks to rehydrate, so please bepatient.Seechapter17forinformationonadequatewaterintake.

You will achieve superior benefits by performing the stretchescorrectly.

howtostretchformaximumbenefit

Humansaretheonlyspeciesthatstretchintopain!Stretchingshouldfeelgood. If you watch a cat or a dog stretch, you will see that theyexperience no strain and that they look happy and relaxed.When youwatchpeoplestretch,youwilloftennoticethattheylookstrainedandareworkinghard.Whatisthedifferencebetweenanimalsandpeoplewhenitcomestostretching?Animalslistentotheirbodies.Peoplelistentotheirbrains.Thehumanbrainkeeps tellingus ifa littlestretch feelsgood,abiggerstretchisevenbetter.Thismistakewilloftenleadtopain.

My observations as a therapist have shown that bringing musclesback intobalance requiresonlyconsistent,moderatestretches that feelgood. If you have soreness the next day, or if the stretch you areperforming is painful, you have probably overstretched yourmuscles.This isespeciallyso ifyouhavestretchedamuscle thatwasalreadytoolong.

Stretchingamuscletoodeeplycanleadto:

MuscletearsStrainedtendonsandsprainedligamentsMuscleweaknessJointdysfunctionInflammation

To achieve the most benefit from your stretching program, followtheseguidelines:

Warmupthemusclesbeforestretching.Thismeansyouhavetomakethemuscleswarmerbyraising thebodytemperatureat leastone degree. This warm-up should include some type of aerobicactivity.Musclesstretchbetterwhentheyarewarm.Stretchmusclesto75%orlessofyourmaximumeffort.Musclesrespondbettertoastretchinthemidrangethanattheirendrange.Donotoverstretchorstretchintopain.Holdeachstretchfor30–60seconds,butmakesureyouarenotstraining.Holdingthestretchlongerwillstretchboththemuscleandtheothersoft tissuesurroundingthemuscle. Ifyoucannotholdthestretchforaminute,youmightbestretchingtoodeeply.Donotbounceinastretch.Thiscanleadtomuscletears.

Modifyastretchifnecessary. Iwillshowyousomemodificationsin thisbook.Thestretchesandmodificationsareall in thebackofthe book in the appendices. Do not hesitate to make furthermodifications.Rememberthatyourstretchingshouldfeelgood.

Caution: Never stretch into a painful position. You will achieve betterresultsbybeinggentle.Thegoalisnottostretchasfaraspossiblebuttoslightly increase range of motion. Done every day, the results can bedramaticandpermanent.

Finally,althoughtheprotocolsinthismanualareeffective,sometimesmedicalattention is required. If theprotocolsarenotworkingoryouare getting worse, stop doing the exercises and please see yourhealthcareprovider.

h

CHAPTER4

IPTwellnessplanfortension-typeheadachesandmigraines

eadache isoneof themostcommon reasonspeopleseekmedicalhelp. In the United States alone, we spend an estimated $50–70

billion on headaches every year. That figure includes medical visits,alternativetherapies,andover-the-counterpainmedication.

Recent research shows that most headaches are probably acombination of tension andmigraine.Whether the headache is causedbythemuscletensionorthemuscletensionresultsfromtheheadache,treatingthatmuscletensioncanprovidesignificantrelieffromthepain.

Tension-typeheadachesare often due tomuscle imbalances in theneckandshouldermuscles.Thismeansthetightmusclesareeithertoolong or too short and pull or compress other structures in this area,leadingtopain.Eventhoughapersonexperiencesthepaininthehead,thecauseisoftenintheneckorshoulderarea.

Many migraine headaches are also aggravated by muscleimbalances,butsomearenot.Other factors formigrainearediet,brainchemicalimbalances,andhormonalimbalances.Thischapteraddressesmigrainesandheadachescausedbymuscleimbalances.Iftheprotocolslistedinthisbookarenotworking,checkwithyourhealthcareprovider,as you might have a migraine not caused by muscle imbalances ordehydration.

Youcanimproveoreliminateyourheadacheswithalittleawarenessand some self-care. It is vital to first identify and correct the commoneverydayactivities thatare thesourceofmusclestrain in theneckandshoulders that can lead to a headache.Many things you do every daymay lead to pain and spasm in the muscles of the head, neck, orshoulders.

Maintaininggoodpostureisessentialincorrectingmuscleimbalancesthatcanleadtoheadaches.

Anothermajorfactorinthecauseofheadachesisdehydration.Manypeople do not drink enough water to adequately hydrate their cells.

Musclesthatdonotgetenoughwaterachemorethanmusclesthatarewellhydrated. Ifyou feelaheadachecomingon, immediatelydrink twolarge glasses of water. Prompt fluid intake will sometimes stop theheadache. Ingeneral,drinkhalfyourbodyweight inounceseveryday.Thismayhelpreducethefrequencyofyourheadachesandleadtobetteroverall health. Fully hydrating the body can take up to six weeks, sopleasebepatient.

Stretchingtheneckmuscleseverydayisalsoimportant.Manypeoplehave a head-forward posture,whichwill put quite a strain on the neckmuscles.Atightneckcanleadtoaheadache.Manypeoplewalkintomyofficerubbingtheirneckandsayingthattheyholdalltheirstressintheirneck. While this is true, it is not the kind of stress most people thinkabout.Itisnotsomuch“Igotaticket,”“thebossyelledatme,”or“thecarbroke down.” This kind of emotional stress can of course add to thetension and pain in the neck and head. The real source, however, ismostlyamechanicalstressofhavingtheheadand/orarmsforwardofthebody when either sitting or standing. Bad posture is responsible for agreatamountof thestressand tightness in theneck thatcan lead toaheadache.

Stretchingthechestmuscleseverydayandstrengtheningtheupperbackwill start to trainyourhead tocomebackover theshoulders.Weareaheadforwardsocietybecausewespendalotoftimebentforward.Trainingyourheadtoalignwithyourshouldersmaysignificantlyreducetheamountofheadachesyouexperience.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduce thenumberandseverityofyourheadaches. Ifafterpracticing the Wellness Plan you still have no improvement, see yourhealthcareproviderforfurtherassessment.

symptoms:A tension headache is felt as pain, tightness, or pressure around thehead.Thepain issometimesdescribedas throbbingorachingandcanaffectthefront,top,back,orsideofthehead.Apersonfeelsthepainintheneck,upperback,eyes, jaw,orothermusclegroups in thebody. Itmayalsoradiatefromotherareasliketheshouldersorupperback.

commoncauses:Many lifestyle habits can contribute to a headache. The following aresomeofthemostcommonIhavecomeacrossinmypractice.

Poor posture, especially head forward of the body or arms heldextended for long periods of time. These postures are typical ofdrivingandcomputerpositions.Theyputa lotofstrainontheneckandshouldermusclesthatcanleadtoaheadache.Emotionalormentalstress,anxiety,TMJ,and/orteethgrindingatnight.Thiskindofstressmakesyourtightmuscleseventighter.Trythebreathingexercisedescribedinchapter17.Fatigueand/orlackofsleep.Fatigueupsetsthechemicalbalancein thebodyandcan lead toaheadache.Try togetseven toeighthoursofuninterruptedsleep.Dehydration. Lack of water can make your joints and/or musclesachealotmore.Seechapter17forinstructionsforproperhydration.Eyestrain. Eyestrain can cause a headache due to muscleimbalances around the eyes. If youwear glasses,make sure yourprescription isuptodate; ifyoudonotwearglasses,seeyoureyedoctor,asyoumightneedthem.Periodicallygiveyoureyesarest.Whileatthecomputer,takeabreakandstareoutthewindowforafewminutes. This shift in attention gives the eyes a different focalpointandhelpstorelieveeyestrain.Caffeinewithdrawal.Whengivingupcaffeine,alwaysdososlowly.Slowly coming off caffeine and keepingwell hydrated canmitigatetheeffectsofwithdrawal.Hunger. Low blood sugar can also lead to a headache. Eat abalanceddietatregular intervals tokeepthebloodsugareven.Donotskipmeals.Proteinhelpstokeepbloodsugarlevelsmoreeven.Readinginbedwithheadproppedup.Thisisacommonpracticethat leads tomany headaches. This position strains the neck andshoulder muscles and adversely affects the discs in the cervicalspine.

Witha littleawarenessandbyfollowingtheWellnessPlan in thisbook,you can easilymake the changes in your life thatmay help stop your

headachesfromreturning.

conventionalmedicalapproachStandard medical treatments for headaches often include painkillers,muscle relaxants, andantidepressants.Remember that thesedrugsdonotcureheadaches;rather,theyalleviatethesymptomsforawhile.Theydonotaddresstwoofthebiggestfactorsofheadaches—dehydrationandmuscleimbalances.

IPTwellnessplanfortension-typeheadachesandmigrainesMUSCLEREBALANCING:Thissectionexplainstheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoing theseexercisesnowandcontinuing todo themas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.They’redesignedtostretchthemusclesormusclegroupsthataretypicallytooshortinmostpeopleandpull thepelvisoutofalignment.Acrookedpelvisaffectsalltheareasofthebodyandisoftenamajorcauseofneckstrainandthusheadaches,asmanyheadachesarecausedby tightneckmuscles.Dothesestretchesthreetimesadayandholdthemforaminuteeach.

threeneckstretches(appendixc)Thesestretcheswill loosen themuscles in theneckandshouldersandallowmorebloodandoxygen to flow to theheadandneck.Stretchingthesemusclestakesonlyafewminutesandisagreathabittocultivate,asyouwillfeellesspainandstiffnessintheneckandwillbemorealert.Consistent practice will reduce or eliminate the cause of manyheadaches.Gentlystretchtheneckmusclesthreetimesaday.

slackenthejaw(appendixd)Slackening the jawwill help to loosen themassetermuscle in the jaw,which is usually quite tight and short inmost people.This tightmusclecanreferpaintotheheadand/orpullthejawoutofalignment,whichcanthen lead to a headache. Do this five times a day until the symptomssubside.

slackentheshoulders(levatorscapula&uppertrapezius;appendixe)

Slackeningtheshoulderswillrelievetensionintheshoulders,especiallythe upper trap and levator scapulamuscle. These areas are tight andsore inmost people.Do this exercise anytime you feel tension in yourshouldersorneckandatleastfivetimesaday.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.

shouldershrugs(appendixe)Shoulder shrugs will help relax your shoulder and neck muscles andbringmorebloodandoxygentothearea,reducingtensionandpain.Thiswill also help you feelmore alert.Repeat several times throughout theday.

strengthenrhomboidsandlatissimusdorsi(appendixe)Strengthening the rhomboids and the lats will help to shorten andstrengthen themuscles between the shoulder blades and themusclesbelow the shoulder blades, thus training themuscles to bring theheadovertheshoulders,improvingthepostureandreducingthestrainontheneck.Dothisthreetofivetimesaday.Holdforoneminute.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoolong,whichgivesapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenup

thechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsstraight,thebonesinthecervicalspineholdupthehead,andtheneckmusclescanthenrelax.Holdforatleastonetotwominutes.Dothisexercisethreetimesaday.

slackenthechest(appendixf)Slackening the chest muscles will relax the muscles in the chest,especially the pectoralis minor muscle. Relaxing these muscles helpspeople with shoulders rounded forward to bring them back into betteralignmentandwillhelpbringtheheadovertheshoulders,thusreducingstrainontheneck.Totallyrelaxandholdthatpositionfortwominutes.Dothistwiceaday.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwill ensure the pelvis stays in balance, your head is aligned over yourshoulders, and that you are not causing more stress on the neck,shoulders, and lower and upper back. These common activities areresponsibleforagreatamountofthepaininyourlife.Theseactivitieswilloftenmakeyourbodycrookedandleadtomuscleimbalancesthatcouldlead to a headache and possible lumbar or cervical disc problems. Byslightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignment.Thiswillhelpensurethatoncethepainisrelieved,itdoesnotcomeback.

walkorstandholdingyourwristbehindyourbackThis stance will ensure that you have good posture when you arestandingorwalking. Itwill bring theheadover theshoulders,open thechest, and correct a forward pelvic tilt. Use this positionwhen you arewalkingslowlyorstandinginoneplace.Whenwalkingbriskly,swingyour

armsnaturallytohelpmoveandcleanoutyourlymphaticsystem,whichisthebody’ssewersystem.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,sore muscles in many areas of your body and cause a headache. Inadditiontoyourdrivingandcomputerpositions,othercommonactivitiesthat causemuscle strain areusing thephone, andhousehold activitieslike chopping vegetables or vacuuming.Performing your daily activitieswithyourelbowsclosebyyoursidewilleliminateorpreventalotofyourpain.

staywellhydratedOneofthemostcommoncausesofheadacheisdehydration.Evenslightdehydration can cause a headache. If the headache is just starting,immediatelydrinktwolargeglassesofwater.Thiswilloftenhelp. Ifyoualready have a headache, start hydrating as soon as possible. Seechapter 17 for instructions on how to drink water and how much.Rehydratingthebodycantakeuptosixweeks.

keeptheneckaswarmaspossibleWearingacollar,turtleneckshirt,orscarfaroundyourneck,eveninsidethe house, can be helpful. Keeping the neck as warm as possible willhelpkeeptheneckmuscleslooseandreducepain.Acoldbreezeontheneckisafactorinmanyheadachesandstiffnecks.

regularexerciseLight, regular exercise such as walking every day for at least twentyminutes can help with your headache by increasing your circulation.Exercisealsoreleasescertainneurotransmitters(chemicals)inthebrainthatcanhelpreduceoreliminatepain.

heattheshouldersandneckfortwentyminutesUseaheatingpadontheneckandshoulderseverydayforabouttwentyminutes.Applyingwarmthwillhelptorelaxthemuscles intheareaandbringmorebloodandoxygentothetissues.Continueuntilthesymptomssubside.

successstoryA thirty-seven-year-old woman came to me for help with herheadaches.Shehad suffered from theseheadaches onceaweekforaperiodof fiveyears.Onapainscaleof1–10,herheadacheswere a 7 or 8. Shewas following her doctor’s advice and treatingthem with over-the-counter pain medications. She did not have aheadachethedayIsawher.Theyoccurredmostlyontherightsideofherheadinthetemple,forehead,andbehindtheeye.Headachesinthisareaalmostalwaysoriginateintheuppertrapmuscles,whichareon the topof the shoulder. I needed to findoutwhat shewasdoingtomakethismusclesotightthatitproducedaheadache.

Theuppertrapmusclegetstightwithanyhead-forwardposture,typically driving or sitting at a computer incorrectly. Sure enough,shehadadesk job. Iaskedher todescribeherworkstationsetup.She showedme how she sat at her computer. Her head was farforwardwhilelookingatherscreen,whichwastoolow,andherarmwasextendedtoofarawayfromherbodywhenholdingthemouse.Theentirepostureputtremendousstrainontheuppertrapmuscle.Themusclewassoretothetouch,whichisanindicationthatitwastightandlikelycausingtheheadaches.Iputherinthe“slackentheshoulder”position(seeAppendixE),andimmediatelythesorespotinheruppertrapmusclefeltabout90%better.Iheldittherefortwominutes.WhenI tookheroutof thatpositionand touchedthespotonhershoulder,thepainwas100%gone.Sheexclaimedthatitfeltlike amiracle had just happened. “Nomiracle,” I said. “Just goodscience.”

Anotherbigfactorwithheadachesisalackofwater.Evena1%declineinnormalhydrationlevelscouldtriggeraheadache.

I askedher if shewaswell hydrated, and she said, “Yes, asamatteroffactIamdrinkingalldaylong.”

“Good,”Isaid.“Whatareyoudrinking?”“Idrinkbetweensixandeightcupsofcoffeeaday.”She didn’t realize that coffee is a diuretic that actually takes

wateroutof thebodyanddehydrates it.Caffeinealsomakesyourmuscles tighter and can give you a headache if you consume toomuch. Iexplainedtoher that thetightmuscles inhershoulderandthe lack of water in the tissues were more than likely the maincausesofherheadaches. Iexplainedthatbecauserehydrating thetissuescantakefourtosixweeks,cuttingbackonthecoffeetonomore than two cups a daywas imperative. I also told her to startdrinking a lot of water. Avoiding coffee altogether would be evenbetterinthiscase.

IputherontheWellnessPlandescribedabove.Iexplainedthatthis protocol usually works well but that she would have to beconsistent. Since pain is the great motivator, I was confident shewouldfollowmyinstructions.

I saw her again three months after that appointment. Shereportedthatherheadachesweremostlygone,occurringonlynowand then and usually when she had too much coffee. She alsoreported the side effects of feeling happier and having bettermemoryrecall.

ThisWellnessPlanhasworkedformanyhundredsofmyclientswhosufferfromheadaches.

t

CHAPTER5

IPTwellnessplanfortemporomandibularjointdisorder(TMJ)

MJ is thecommonabbreviation for temporomandibular jointdisorder.Thisjointallowsyoutoopenandcloseyourmouth,chew,andspeak.

Animproperlyfunctioningjointcanbeverypainful.Muscleimbalancesintheneck,face,andjawmusclesoftenstartwithacrookedpelvisbecausethespinesitsonthepelvis.Ifthepelvisiscrooked,thespineiscrooked.Thismeansthetightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthisarea,leadingtopain.

The temporomandibular joint, sometimes called the “jaw joint,” is infrontoftheear.Thejointattachesthelowerjawtotheskull.Ifyouplacetwofingersonyourjawinfrontoftheearandchew,youcanfeelthejointmoving.TMJisaconditionwheretightmusclesputpressureonthejoint,andinmoreseverecasesevenpullitoutofjoint.

AnestimatedtenmillionAmericanssufferfromthiscondition.Youcanhavetight,sorejawmusclesandnothaveTMJ.TheprotocolfortreatingatightjawisthesameasforTMJ.AtightjawisoftenaprecursortoTMJ.You can improve or eliminate your TMJ or tight jaw with a littleawarenessandsomeself-care.Butfirstyoumustidentifyandcorrectthecommon everyday activities that are causingmuscle strain in the neckand shoulders that can lead to TMJ.Many activities you do every daymayleadtopainandspasmeitherinthemusclesofthejaworthoseofthehead,neck,orshoulders.

Thestrainofslumping,whichpushesyourheadforwardofyourbody,canleadtoTMJ.

Stretchingtheneckmuscleseverydayisalsoimportant.Manypeoplehaveahead-forwardposture,whichwillputquiteastrainontheneck.AtightneckcanleadtoTMJ.Badpostureisresponsibleforagreatamountofthestressintheneck.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduceyourTMJpain. Ifafterpracticing theWellnessPlanyoustillhaveno improvement,seeyourhealthcareprovider for further

assessment.

symptoms:TMJ is felt as pain in the jaw joint and/or the surroundingarea. Itmayalsobefeltasearpainand/orringingintheears.Whenthejointmoves,youmayhearsounds,suchasclickingand/orpopping.Othersymptomsincludeswellingofthefaceormouth,headache,anddizziness.Yourbitemay feeluncomfortable.The jawmayalsobecome locked ineither theopenorclosedposition.

commoncauses:Many lifestyle habits can contribute to TMJ. The following are someofthemostcommonIhavecomeacrossinmypractice:

Tight muscles around the jaw (especially the masseter), grindingteeth, and stress. Even emotional stress can cause tightmuscles.This kind of stress, in fact,makes your tightmuscles even tighter.Trythebreathingexercisedescribedinchapter17.Chewing gum, poor posture, reading in bed, cradling a phonebetween your ear and shoulder, or playing a wind or stringinstrument.Theseactivitiesputalotofstrainontheneck,shoulder,andjawmusclesthatcanleadtoTMJ.(SeeWellnessPlan.)

With a little awareness and by following the Wellness Plan in thisbook,youcaneasilymakethechangesinyourlifethatwillhelpalleviateyourTMJsymptoms.

conventionalmedicalapproachStandard medical treatments for TMJ often include painkillers, musclerelaxants,cortisoneshots,orBotoxinjections.Ifthesearenotsuccessful,surgery or corrective dental treatments are prescribed. Remember thatthedrugsandsurgerydonotalwayscureTMJ;rather,theyalleviatethesymptomsforawhile.TheydonotaddresstheprimarycauseofTMJ—muscleimbalances.

IPTwellnessplanfortemporomandibularjointdisorder(tmj)MUSCLE REBALANCING: This section provides the exercises topracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoingtheseexercisesnowandcontinuingtodothemasinstructed,youwill make your short muscles longer and your long muscles shorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshortinmostpeopleandpullthepelvisoutofalignment.Whenthepelvisis crooked, it affects all the areas of the body. A pelvis that is out ofalignment is often a causeof TMJandheadaches.Do these stretchesthreetimesaday.Holdforoneminuteeach.

threeneckstretches(appendixc)Thesestretcheswill loosen themuscles in theneckandshouldersandallowmorebloodandoxygentoflowtotheheadandneck.Doingthesestretches takesonly a fewminutesand is agreat habit to cultivate, asyouwill feel less pain and stiffness in the neck andwill bemore alert.ConsistentpracticewillreduceoreliminateamajorcauseofTMJ.Gentlystretchtheneckmusclesthreetimesaday.

slackenthejaw(appendixd)Slackening the jawwill help to loosen themassetermuscle in the jaw,whichisusuallyverytightandshortinmostpeople.Thistightmusclecanreferpaintotheheadand/orpullthejawoutofalignment,whichcanthenleadtoTMJ.Dothisfivetimesadayuntilthesymptomssubside.Holdfortwominutes.Donotperformthisexerciseifitworsensthepain.

slackentheshoulders(levatorscapula&uppertrapezius;

appendixe)

Slackeningtheshoulderswillrelievetensionintheshoulders,especiallythe upper traps and levator scapulamuscles. These tightmuscles cancontributetoTMJ.Theseareasaretightandsoreinmostpeople.Dothisexerciseanytimeyoufeeltensioninyourshouldersorneckandatleastfivetimesaday.Holdfortwominutes.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.

shouldershrugs(appendixe)Shoulder shrugs will help relax your shoulder and neck muscles andbringmorebloodandoxygentothearea,whichwillreducetensionandpain. This will also help you feel more alert. Repeat several timesthroughouttheday.

strengthenrhomboidsandlatissimusdorsi(appendixe)Strengthening the rhomboids and the lats will help to shorten andstrengthen themuscles between the shoulder blades and themusclesbelow the shoulder blades, thus training themuscles to bring theheadovertheshoulders,improvingthepostureandreducingthestrainontheneckandjaw.Holdforat leastoneminute.Dothisthreetofivetimesaday.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoo long,whichgiveapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenupthechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsstraight,thebonesinthecervicalspineholdupthehead,andtheneckandjawmusclescanrelax.Holdforatleastonetotwominutes.Dothisexercisetwiceaday.

slackenthechest(appendixf)

Slackening the chest muscles will relax the muscles in the chest,especially the pectoralis minor muscle. Relaxing these muscles helpspeople with shoulders rounded forward to bring them back into betteralignment and will help to bring the head over the shoulders, thusreducingstrainontheneckandjaw.Totallyrelaxandholdthatpositionfortwominutes.Dothistwiceaday.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestress on the neck, jaw, shoulders, and lower and upper back. Thesecommonactivitiesareresponsibleforagreatamountofthepaininyourlife.Doingtheseactivitiestheincorrectwaywillmakeyourbodycrookedand lead to muscle imbalances and possible lumbar or cervical discproblems.Byslightlychangingthewayyouperformtheseactivities,youwill keep the body in alignment and help ensure that once the pain isrelieveditdoesnotcomeback.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,sore muscles in many areas of your body like the jaw, neck, andshoulders. In addition to your driving and computer positions, othercommon activities that cause muscle strain are using the phone, andhouseholdactivities likechoppingvegetablesorvacuuming.Performingyourdailyactivitieswithyourelbowsclosebyyoursidewilleliminateorpreventalotofyourpain.

DONOTCHEWGUMChewing gum can tighten the muscles in the jaw and worsen the

condition.

slow,deepbreathingfor10–15minutes(seechapter17)Slow, deepbreathing relaxes thenervous systemand thus relaxes themuscles in the jaw.Done justbeforebedtime, thisexercisewill help toreducegrindingoftheteethatnight,whichisamajorcauseofTMJ.Dothisatleasttwiceaday.

successstoryA forty-five-year-oldmalecame toseemewhohadastressful jobandwassufferingwithjawpainthatwasdiagnosedasTMJ.Hewasusingabiteplatethathisdentistrecommended,andhisdoctorhadrecommended surgery.His pain levelwas 5 on a scale of 10.Hehadbeenexperiencing thesesymptoms forabouta year.Hispainwasmostly in the jaw,whichmadea clickingnoisewhenopeningandclosing.

WhenItouchedthemassetermuscle,whichisthebigmuscleinthejawarea,hefeltpainwithonlylightpressure.Islackenedthejawandpressedthetissueagain,andhesaidthathenowfeltnopainatall. Itwasgone.Afterholdingthatpositionfortwominutes,hesaidthathefeltmuchbetter.

I still wanted to know what was giving him these muscleimbalances in the jaw and causing the pain. The cause is usuallypoorcomputerordrivingpositions.WhenIaskedhimtodescribehisofficesetup,itappearedtobeaprettygoodergonomicsetup.Uponfurther inquiry, I found out that he liked to read in bed at nightpropped up against the headboardwith his head far forward. Thispositioncancausealotofpainintheneck,face,orjaw.

I explained the Wellness Plan above to him and told him heneeded tobeconsistent toget the resultshewanted.His jawpainwentawayalmost immediatelyandheadopted theWellnessPlan,whichkepttheconditionfromcomingback.

Ihavenotonlyusedthisprotocoltohelpmanyofmyclients,butI also eliminated my own TMJ from many years of playing the

trumpet.

t

CHAPTER6

IPTwellnessplanforcervicalmusclestrain(neckpain)

he neck or cervical spine is that part of the body that connects theheadtothetrunk.It iscomprisedofmuscles,nerves,arteries,bones,

and discs. These discs act like shock absorbers between the cervicalvertebrae.

Neckpaincanoccurduetomusculartightnessinboththeneckandupper back or as a result of compressed nerves in this region. Almosteveryonewill experiencea tight, soreneck inhisorher lifetime. Inmythirty-plus years of experience, I have only worked with a handful ofpeoplewhodidnothaveatightneck.

Pain felt in theneck isusually causedbymuscle imbalances in theneck,shoulder,orupperback.Thismeans the tightmusclesareeithertoo longor tooshortandpullorcompressotherstructures in thisarea,leading to the pain. A crooked pelvis is a contributor to neck painbecausethespinesitsonthepelvis.

Youcan improveoreliminateyourneckpainwitha littleawarenessand some self-care. Identifying and correcting the common everydayactivitiescausingmusclestrainintheneck,shoulders,orupperbackarevital.Manyactivitiesyoudoeverydaymayleadtopainandspasminthemusclesoftheneck,shoulders,orupperback.

Agoodplacetostartavoidingneckpainisbypracticinggoodposture.Note how you sit at work, in front of a computer, and when driving.Maintainingproperposturewillallowyourspinalcolumntodotheworkofholdingupyourheadratherthanyourneckmuscles.

Lackofwatercanalsobeafactorinneckpain.Thediscsneedtobewellhydratedtomaintaintheirsoftnessandavoidpinchingorirritatinganerve.Gooddischealthisdependentonadequatewaterintake.

Itisalsoveryimportanttostretchtheneckmuscleseveryday.Manypeoplehaveahead-forwardposture,whichwillputquiteastrainontheneck.Badpostureisresponsibleforagreatamountof thestress intheneck.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantlyreduceyourneckpain. Ifafterpracticing theWellnessPlanyoustillhaveno improvement,seeyourhealthcareprovider for furtherassessment.

symptoms:Pain in theneck could bedescribedasanache, tightness, burning, orstabbing. This condition can be acute or chronic. It is often better orworseincertainpositionssuchaslyingdown,sitting,orstanding.Itcanalso radiate to other parts of the body such as down the arms or theupperbackorhead.

commoncauses:Manylifestylehabitscancontributetoneckpain.ThefollowingaresomeofthemostcommonIhavecomeacrossinmypractice:

Impropersittingpositions,drivingpositions, standingpositions,andcomputer positions lead to head-forward posture that can causecervicalmusclestrainandperhapsleadtoadiscissue.Emotionalstresscanalsoaggravatecervicalmusclestrain.Try thebreathingexercisedescribedinchapter17.Readinginbed.

With a little awareness and by following the Wellness Plan in thisbook, you can easily make the changes in your life that will help toalleviateyoursymptomsofneckpain.

conventionalmedicalapproachStandardmedical treatments forneckpainoften includepainkillersandmuscle relaxants. Surgery is sometimes prescribed for nervecompressionor herniateddiscs.Remember that thedrugsand surgerydonotalwayscureneckpain;rather,theyalleviatesymptomsforawhile.They do not address the primary cause of neck pain—muscleimbalances.

IPTwellnessplanforcervicalmusclestrain(neckpain)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoingtheseexercisesnow,andcontinuingtodothemas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshort in most people and pull the pelvis out of alignment. A crookedpelvisaffectsalltheareasofthebody.Apelvisthatisoutofalignmentisoften a major cause of neck strain and thus headaches, as manyheadachesarecausedby tightneckmuscles.Do thesestretches threetimesaday.Holdforoneminuteeach.

threeneckstretches(appendixc)Thesestretcheswill loosen themuscles in theneckandshouldersandallowmorebloodandoxygentoflowtotheheadandneck.Itonlytakesafewminutes to do these stretches, and doing them is a great habit tocultivate,asyouwill feel lesspainandstiffness in theneckandwillbemore alert. Consistent practice will reduce or eliminate the cause of agreatamountof yourneckpain.Gently stretch theneckmuscles threetimesaday.

slackentheshoulders(levatorscapula&uppertrapezius;appendixe)

Slackeningtheshoulderswill relieve tension in theshouldersandneck,especiallytheuppertrapsandlevatorscapula.Theseareasaretightandsore inmost people. Do this exercise anytime you feel any tension inyour shoulders or neck and at least five times a day. Hold for twominutes.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.

shouldershrugs(appendixe)Shoulder shrugs will help relax your shoulder and neck muscles andbringmorebloodandoxygentothearea,reducingtensionandpain.Thiswill also help you feelmore alert.Repeat several times throughout theday.

strengthenrhomboidsandlatissimusdorsi(appendixe)Strengtheningtherhomboidsandlatswillhelptoshortenandstrengthenthemusclesbetweentheshoulderblades,aswellasthemusclesbelowthe blades, thus training the muscles to bring the head over theshoulders, improvingpostureand reducing strain on theneck.Hold foroneminute.Dothisthreetimesaday.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoo long,whichgiveapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenupthechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsstraight,thebonesinthecervicalspineholduptheheadandtheneckmuscles can relax. Hold for at least one to twominutes. Do thisexercisetwiceaday.

slackenthechest(appendixf)Slackening the chest muscles will relax the muscles in the chest,especially the pectoralis minor muscle. Relaxing these muscles helpspeople with shoulders rounded forward to bring them back into betteralignment and will help to bring the head over the shoulders, thusreducingstrainon theneck.Totally relaxandhold thatposition for twominutes.Dothistwiceaday.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdaily

life.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestressontheneck,shoulders,andlowerandupperback.Thesecommonactivitiesareresponsibleforagreatamountofthepaininyourlife.Doingtheseactivitiestheincorrectwaywillmakeyourbodycrookedandleadtomuscle imbalances and possible lumbar or cervical disc problems. Byslightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignmentandhelpensurethatoncethepainisrelieved,itdoesnotcomeback.

walkorstandholdingyourwristbehindyourbackThis stance will ensure that you have good posture when you arestandingorwalking. Itwillbring theheadover theshoulders,whichwillreduceor prevent neckpain.Thiswill alsoopen the chest and start tounround your shoulders. This position should be used when you arewalkingslowlyorstandinginoneplace.Whenwalkingbriskly,swingyourarms naturally, which helps to move and clean out your lymphaticsystem,thebody’ssewersystem.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,soremuscles inmany areas of your body like the neck. In addition toyourdrivingandcomputerpositions,othercommonactivitiesthatcausemusclestrainareusingthephone,andhouseholdactivitieslikechoppingvegetables or vacuuming. Performing your daily activities with yourelbowsclosebyyoursidewillhelp toeliminateorpreventa lotofyourpain.

keeptheneckaswarmaspossibleWearacollar,turtleneckshirt,orscarfaroundyourneck,eveninsidethe

house. Keeping the neck aswarm as possiblewill help keep the neckmuscleslooseandreducepain.Acoldbreezeontheneckisafactorinmanyheadachesandstiffnecks.

heattheshouldersandneckfortwentyminutesUseaheatingpadontheneckandshoulderseverydayforabouttwentyminutes.Applyingwarmthwillhelptorelaxthemuscles intheareaandbringmorebloodandoxygentothetissues.Continueuntilthesymptomssubside.

keepwellhydratedDehydration is a factor in cervical neck strain. Even slight dehydrationcancausetheneckmusclestoache.Manypeoplearedehydrated.Seechapter 17 for instructions on how to drink water and how much.Rehydratingthebodycantakeuptosixweeks.

regularexerciseLight, regular exercise, such as walking every day for at least twentyminutes, can help with your neck pain by increasing your circulation.Exercise also releases certain neurotransmitters in the brain that canhelpeliminatepain.

successstoryAwomaninherfiftiescametomecomplainingofpaininherneck,which she had suffered with for twenty years following a caraccident.Shehad initiallybeendiagnosedwithwhiplash.Thepainwasinthebackoftheneckontheleftsideandwasa6onascaleof 10, bad enough to often wake her at night. She had seenspecialists all over the country and in Europe. Despite their bestefforts,herpainremained.

Ihadherpointtoexactlywhereshefeltthepain.Iperformedthe“slacken the shoulder” move and then gently did the three neck

stretches.WhenIaskedherhowherneckfeltafterthat,shelookedsurprised.She admitted that she didn’t think Iwould to be able tohelp her, but the pain in her neckwas gone. Shewas even a bitangry.Shesaid,“YoumeanIsufferedfortwentyyearsandthisisallsomebodyneededtodo?”Shewassurethatherpainwasgoingtocome back, so I explained the Wellness Plan to her and theimportanceofbeingdiligent.Ialsoexplainedhowwhiplashandtheresultingpainisallaboutmuscleimbalances.Onceyouknowwhichmuscles are too long and tight and which muscles are short andtight,reducingoreliminatingpainbecomesquiteeasy.

AlmosteveryclientIseehasatleastatightneck,ifnotapainfulone.TheaboveWellnessPlantakesonlyafewminutesadayandisagreatpracticeforeveryonetoadopt.

t

CHAPTER7

IPTwellnessplanforthoracicoutletsyndrome(TOS)

hethoracicoutletisthespacebetweenthecollarboneandthefirstrib.Thoracicoutletsyndrome(TOS)isacompressionofthenervesand/or

bloodvessels thataffects thebrachialplexus(nerves thatpass into thearmsfromtheneck)andvariousnervesandbloodvesselsinthatspace.Thiscompressionisduetomuscleimbalancesintheneck,chest,back,andpelviswhennotduetothepresenceofanextraribcalledacervicalrib.Asaresult,thetightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthisarea,whichleadstothepain inthearmsorhand.

YoucanimproveoreliminateTOSwitha littleawarenessandsomeself-care. It is vital to first identify and correct the common everydayactivities that are causingmuscle strain in theneckand shoulders thatcanleadtoTOS.Manyactivitiesyoudoeverydaymayleadtopainandspasminthemusclesofthehead,neck,shoulders,andback.

Maintainingexcellentpostureisakeyfirststepinrelievingthestrainon muscles causing TOS. By correcting your computer and drivingpositions, youwill bring your head over your shoulders, giving yourselfgood posture. Your bones (the spinal column) will be holding up yourhead,whichwillhelptakethestrainoff themuscles.Holdingyourarmsonthesteeringwheelattheteno’clockandtwoo’clockpositionsstrainsthemusclesthatcauseTOS. Instead,bringyourarmsdownto thefouro’clock and eight o’clock positions to take the strain off the musclesresponsibleforcausingTOS.

Stretchingtheneckmuscleseverydayisvital.Thisisespeciallytrueofthemusclesonthesideoftheneck(scalenes).Thesemusclesattachonthefirstrib.Whentight,theypullupthatrib,decreasingthespaceinthethoracicoutletandpossiblycausingacompressionofthenervesandbloodvessels,whichcanresultinpainandtinglingdownthearm.

Manypeoplehaveahead-forwardposturethatcausesquiteastrainon the neck. A tight neck can lead to pain, fatigue, discomfort, and

possibly TOS. Bad posture is responsible for a great amount of themusculartensionintheneck.

It isalsoimportanttostretchandslackenthechestmuscles.Atight,short pectoralisminormuscle in the chest canbringonnumbnessandtinglingdownthearm.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduceyourTOS. If after practicing theWellnessPlan youstill have no improvement, see your health care provider for furtherassessment.

symptoms:Thoracic outlet syndrome is a sensation of pain, numbness, tingling,weakness, burning, or coldness in the arm and/or hand caused bypressureonthenervesand/orbloodvesselsinthethoracicoutlet.Itcanoccurononesideofthebodyorboth.Thepaincanbeinthewholehandorjustpartofthehand,asinonlythefourthandfifthfingers.

Tingling, pain, or numbness indicates a compression of the nerves.Coldnessindicatesacompressionofthebloodvessels.

ThesymptomsofTOSareoftenconfusedwithcarpaltunnel,astheycanbesimilar.Byperformingthetestsinchapter2,youwilllikelybeableto tellwhich condition youhave.Somepeoplewill havebothTOSandcarpaltunnelatthesametime.

commoncauses:Many lifestyle habits can contribute to thoracic outlet syndrome. Thefollowing are some of the most common I have come across in mypractice:

RepetitiveactivitiesthatrequirethearmstobeheldovertheheadoroutstretchedPoorposture,especiallyheadforwardImpropercomputeranddrivingpositionsCradlingphonebetweenshoulderandearorholdingphonetoearRidingabike

WhiplashGardening

These activities can all cause muscle imbalances in the neck,shoulders, and pelvis, which can cause compression of the brachialplexusinthethoracicoutlet.

With a little awareness and by following the Wellness Plan in thisbook,youcaneasilymakethechangesinyourlifethatwillhelpalleviatethesymptomsofTOS.

conventionalmedicalapproachStandardmedical treatments for thoracic outlet syndromeoften includepainkillers and muscle relaxants. Physical therapy is also widelyprescribed for thiscondition.Surgery issometimesprescribed fornervecompression or blood vessel constriction. Remember that drugs andsurgerydonotcure thoracicoutletsyndromeunless it iscausedby theextra rib, calleda “cervical rib.”Rather,drugsandsurgeryalleviate thesymptomsforawhile.TheydonotaddresstheprimarycauseofTOS—muscleimbalances.

IPTwellnessplanforthoracicoutletsyndrome(TOS)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancescausingyourpain.Bydoingthese exercises now, and continuing to do themas instructed, youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshort in most people and pull the pelvis out of alignment. A crookedpelvisaffectsalltheareasofthebody.Apelvisthatisoutofalignmentisoften a major cause of neck strain that can lead to thoracic outlet

syndrome. Do these stretches three times a day. Hold for oneminuteeach.

threeneckstretches(appendixc)Thesestretcheswill loosen themuscles in theneckandshouldersandallowmorebloodandoxygentoflowtotheheadandbrain,reducingpainintheneckandhead.Stretchingthescalenes,themusclesonthesideoftheneck,isespeciallyimportanttorelievethepainfromTOS.Stretchingthescalenescreatesmorespace in the thoracicoutlet, takingpressureoffthenerves.Gentlystretchtheneckmusclesthreetimesaday.

slackentheshoulders(levatorscapula&uppertrapezius;appendixe)

Slackeningtheshoulderswillrelievetensionintheshoulders,especiallytheupper trapsand levator scapula.Theseareasare tight andsore inmostpeople.Dothisexerciseanytimeyoufeeltensioninyourshouldersorneckandatleastfivetimesaday.Holdfortwominutes.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.Thismovemightbringonsometingling,whichisokayforshortperiodsoftime.

shouldershrugs(appendixe)Shoulder shrugs will help relax your shoulder and neck muscles andbringmorebloodandoxygentothearea,whichwillhelpreducetensionandpain.Thiswillalsohelpyoufeelmorealert.Thisexercisewillcreatemore space in your thoracic outlet and take pressure off the nervescausingthesymptoms.Repeatseveraltimesthroughouttheday.

strengthenrhomboidsandlatissimusdorsi(appendixe)Strengtheningtherhomboidsandlatswillhelptoshortenandstrengthenthe muscles between the shoulder blades and the muscles below theshoulder blades, thus training the muscles to bring the head over theshoulders, improving your posture, reducing strain on your neck, andcreatingmorespaceinthethoracicoutlet.Dothisthreetimesaday.Holdforoneminute.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoo long,whichgiveapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenupthechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsupstraight,thebonesinthecervicalspineholduptheheadandtheneckmusclescan relax,allowingmorespace in the thoracicoutlet.Holdforatleastonetotwominutes.Dothisexercisetwiceaday.

slackenthechest(appendixf)Slackening the chest muscles will relax the muscles in the chest,especially the pectoralis minor muscle. Relaxing these muscles helpspeople with shoulders rounded forward to bring them back into betteralignment and will help to bring the head over the shoulders, thusreducingstrainontheneckandtakingstrainoffthenervesinthethoracicoutlet. Totally relax and hold that position for two minutes. Do thisexercisetwiceaday.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestressontheneck,shoulders,andlowerandupperbackthatcanleadtoTOS.Thesecommonactivitiesareresponsibleforagreatamountofthepain in your life. Doing these activities incorrectly will make your bodycrookedandleadtomuscle imbalancesandpossible lumbarorcervicaldiscproblems.Byslightlychangingthewayyouperformtheseactivities,you will keep the body in alignment and help alleviate the symptomsassociatedwithTOS.

walkorstandholdingyourwristbehindyourbackThis stance will ensure that you have good posture when you arestandingorwalking. Itwill bring theheadover theshoulders,open thechest,andcorrectanypelvictilt.Thispositionshouldbeusedwhenyouarewalkingslowlyorstandinginoneplace.Donotperformthisexerciseif your symptoms of TOSworsenwhile doing it.Whenwalking briskly,swing your arms naturally, whichwill help tomove and clean out yourlymphaticsystem,thebody’ssewersystem.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,soremusclesinmanyareasofyourbody.Inadditiontoyourdrivingandcomputerpositions,othercommonactivitiesthatcausemusclestrainareusing the phone, and household activities like chopping vegetables orvacuuming. Performing your daily activities with your elbows close byyoursidewilleliminateorpreventalotofthesymptomsofTOS.

heatyourshouldersandthoracicoutletareaPutaheatingpadonyourshouldersandupperchestfortwentyminutes.Dothiseverydayuntilyoursymptomssubside.

successstoryAwomaninhertwentiescametomesufferingfromnumbnessandtingling in her right hand and arm. She had been diagnosed withthoracicoutletsyndromeandhadexperienced thesesymptoms forsixmonths.Althoughshewasnotinmuchpain,thenumbnessandtingling made it difficult for her to do her work as a massagetherapist.

First, I wanted tomake sure that she really did have TOS, ascarpaltunnelsymptomsaresimilar.Ihadherraisebothhandsoverher head and wiggle her fingers. This is the test for TOS. Sure

enough, in about twenty seconds, she started to have numbnessandtingling.

The thoracic outlet is the space between the first rib and thecollarbone.Symptomsdevelopwhenthereisnotenoughspace.Thefirst thing Ididwas tosee ifherpelviswascrooked. I found that itwas elevated about 1.5 inches.Since the spine sits on the pelvis,herspinewasalsocrooked.Since theribsattach to thespine,herribsbecamecrooked,reducingthespaceinthethoracicoutlet.

I did the four stretches to balance the pelvis, the three neckstretches,andtheslackenthechestmove.IhadherrepeatthetestforTOSbyraisingherhandsoverherhead.Shehadnotinglingthistime.

Themovements I did on her corrected hermuscle imbalancesand opened up the space in the thoracic outlet, preventing furthernerve compression. I further made sure that she was sittingcorrectly,asdescribedinAppendixA.

I explained theWellness Plan listed above and told her it wasvery important topractice thiseverydayso thathersymptomsdidnotreturn.

u

CHAPTER8

IPT wellness plan for thoracic muscle strain (upper backpain)

pperbackpainisacommonconditionthataffectsmillionsofpeople.Thepainradiatesanywherefromjustbelowthenecktoall theway

down to the bottom rib. The most common area is right between theshoulder blades. The spine is often divided into three sections. Thecervical spine, which consists of seven vertebrae, is in the neck; thelumbarspine,consistingoffivevertebrae,isinthelowbackregion;andthe thoracic spine, which consists of twelve vertebrae, makes up theupperandmiddleback.

Painintheupperbackisusuallycausedbymuscleimbalancesintheneck,shoulder,upperback,andchest.Thismeansthetightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthisarea,causingpain.Acrookedpelvis isacontributor toupperbackpainbecausethespinesitsonthepelvisandthusbecomescrookedaswell.

If a nerve in this area is compressed due tomuscle imbalances orinjury,thatpainmayradiateandbefeltinthearmsorchest.

Many activities a person does every day can lead to pain in themuscles of the head, neck, shoulders, or back. Learning to have andmaintainexcellentpostureisanidealplacetostart.

Lackofwatercanalsobeafactorinupperbackpain.Thediscsneedto be well hydrated to maintain their softness and avoid pinching orirritatinganerve.Discsshouldbeabout80%water.Gooddischealthisdependent on adequate water. Interestingly, a recent study found that70%ofherniateddiscscausenopaininthebody.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantlyreduceyourupperbackpain.IfafterpracticingtheWellnessPlan you still have no improvement, see your health care provider forfurtherassessment.

symptoms:Painintheupperbackisoftendescribedasanache,tightness,burning,or stabbing.This conditioncanbeacuteor chronic. It isoftenbetter incertain positions such as lying down or standing or sitting. It is usuallyworsewith longperiodsofsitting inachairor reading inbed.Thepainmayalsoradiatedownthearms.

commoncauses:Many lifestylehabitscancontribute toupperbackpain. Impropersittingpositions,drivingpositions,andcomputerpositionsleadtoheadforwardposturethatcancausethoracicmusclestrainandperhapsleadtoadiscissue.Muscleimbalancesintheupperback(thoracicregion)canleadtopainandtightness,especiallybetweentheshoulderblades.

Thefollowingconditionsarecausedbymuscleimbalancesandareamajorsourceofupperbackpain:

UnbalancedpelvisTight,shortpectoralmusclesOverstretched,strainedrhomboidsForward-rotatedshouldersHead-forwardpostureSomediscproblems

With a little awareness and by following the Wellness Plan in thisbook,youcaneasilymakethechangesinyourlifethatwillhelpalleviateyourupperbackpain.

conventionalmedicalapproachStandardmedicaltreatmentsforupperbackpainoftenincludepainkillersandmuscle relaxants. Physical therapy is often prescribed. Surgery issometimes prescribed for nerve compression or herniated discs.Remember that the drugs and surgery do not always cure upper backpain;rather,theyalleviatethesymptomsforawhile.Theydonotaddressoneofthebiggestfactorsofupperbackpain—muscleimbalances.

IPTwellnessplanforthoracicmusclestrain(upperbackpain)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoing theseexercisesnowandcontinuing todo themas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshortinmostpeopleandwhichpullthepelvisoutofalignment.Whenthepelvisiscrooked,allareasofthebodyareaffected.Apelvisthatisoutofalignment is often a major cause of neck strain and upper back painbecause those muscles are out of balance. Do these stretches threetimesaday.Holdforaminuteeach.

threeneckstretches(appendixc)These stretches will loosen the muscles in the neck, shoulders, andupperbacktoallowmorebloodandoxygentoflowtotheheadandneck.Takeafewminutestodothesestretches,makingthemahabit,asyouwill feel less pain and stiffness in the neck and will be more alert.Consistentpracticewillreduceoreliminatethecauseofagreatamountofyourupperbackpain.Gentlystretch theneckmuscles three timesaday.

slackentheshoulders(levatorscapula&uppertrapezius;appendixe)

Slackeningtheshoulderswill relieve tension in theshouldersandneck,especially theupper trapand levator scapulamuscle.Theseareasaretight and sore in most people. Do this exercise anytime you feel anytensioninyourshouldersorneckandatleastfivetimesaday.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.Holdfortwo

minutes.

shouldershrugs(appendixe)Shoulder shrugs will help relax your shoulder and neck muscles andbringmorebloodandoxygentothearea,whichwillreducetensionandpain. This will also help you feel more alert. Repeat several timesthroughouttheday.

strengthenrhomboidsandlatissimusdorsi(appendixe)Strengthening the rhomboids and the lats will help to shorten andstrengthen themuscles between the shoulder blades and themusclesbelow the blades, thus training themuscles to bring the headover theshoulders,improvingpostureand“reducingstrainontheupperback.Dothisthreetimesadayforoneminute.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoo long,whichgiveapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenupthechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsstraight,thebonesinthecervicalspineholduptheheadandtheupper back muscles can relax. Hold for at least two minutes. Do thisexercisethreetofivetimesaday.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestressontheneck,shoulders,andlowerandupperback.Thesecommon

activitiesareresponsibleforagreatamountofthepaininyourlife.Doingtheseactivitiestheincorrectwaywillmakeyourbodycrookedandleadtomuscle imbalances and possible lumbar or cervical disc problems. Byslightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignmentandhelpensurethatoncethepainisrelieved,itdoesnotcomeback.

walkorstandholdingyourwristbehindyourbackThis stance will ensure that you have good posture when you arestandingorwalking. Itwillbring theheadover theshoulders,whichwillreduce or prevent upper back pain. Thiswill also open the chest. Thispositionshouldbeusedwhenyouarewalkingslowlyorstandinginoneplace.Whenwalkingbriskly,swingyourarmsnaturally,whichwillhelptomoveandcleanoutyourlymphaticsystem,thebody’ssewersystem.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,soremusclesinmanyareasofyourbodyliketheupperback.Inadditionto your driving and computer positions, other common activities thatcausemuscle strain are using the phone, and household activities likechoppingvegetablesorvacuuming.Performingyourdailyactivitieswithyourelbowsclosebyyoursidewillhelpeliminateorpreventalotofyourpain.

heatupperbackfortwentyminutesUseaheatingpadontheupperbackeverydayforabouttwentyminutes.Applyingwarmthwillhelptorelaxthemusclesintheareaandbringmorebloodandoxygentothetissues.Continueuntilthesymptomssubside.

keepwellhydratedDehydrationisafactorinthoracicmusclestrain.Evenslightdehydrationcancausetheupperbackmusclestoache.Manypeoplearedehydrated.Seechapter17forinstructionsonhowmuchwatertodrink.Rehydrating

cantakeuptosixweeks.

regularexerciseLight, regular exercise such as walking every day for at least twentyminutes can help with your upper back pain by increasing yourcirculation.Exercisealso releasescertainneurotransmitters in thebrainthatcanhelpeliminatepain.

successstoryAman in his thirties came to seemecomplainingof a sharppainbetweenhisshoulderblades.Thepainwasmostlyontherightside.Iaskedhimwhathedidforaliving,asaperson’sjobwilloftengivemeaclueastohowthepersonacquiredthepain.Hetoldmethathesatinfrontofacomputerallday.

Hehadbeenexperiencing thispain forabout twoyearsonandoff,butlatelyithadbeenconstantandsometimeswouldevenwakehimupatnight.Itseemedtobegettingworse.

Iaskedhimwhathewasdoingtotryandalleviatethepain.Hesaid he had tried massage, which did give him some temporaryrelief. He said when the pain was extra bad, he would take apainkillerthatwouldgivehimsixhoursofrelief.

Pain between the shoulder blades is common and is almostalways due to sitting in a slumped position with the shouldersrounded forward and reaching too far for the mouse and/orkeyboard.

Whenapersonsits slumped, their chestmusclesbecomeveryshort and the muscles between the shoulder blades long,overstretched,andtight.Trythisforyourself.Roundyourshouldersforward and then touch the tissue between the shoulder blades.Theywillfeeltightandpainful.

Whenamuscleistoolong,overstretched,andtight,massagingitwillmake it feelbetterbutwillnotmake itshorterand thuscorrecttherootoftheproblem.

Inorder tomake the tissuebetween theshoulderblades relax,thispatientneededtostretchtheshorttissueofthechestmuscles.When I did that, his pain was noticeably better. Sometimes wheninflammation is involved, eliminating all the pain will take a littlelonger.

Ialsodidfourstretchestobringhispelvisbackintobalanceandshowed him how to do these stretches himself. Remember, acrookedpelvisgivesyouacrookedspine,whichthenleadstoupperorlowbackpain.

Ishowedhimthepropersitting,computer,anddrivingpositionsthat would help keep his pelvis straight. I taught him to place hisarmsatthefouro’clockandeighto’clockpositionswhendrivingandatthecomputer.

IstressedtheimportanceoftheWellnessPlan.Heleftmyofficewith his pain about 80% reduced. In a follow-up appointment hestated that he had followed my advice, rearranging his computersetupandmovingthesteeringwheelinhiscartoadifferentposition.His pain had thus gone away. He did confess that sometimes hedidn’tpracticetheWellnessPlanandthepainstartedtocreepback.But he felt confident, knowing he had the tools to keep the painpermanentlyatbay.

l

CHAPTER9

IPTwellnessplanforepicondylitis,lateralormedial(tennisorgolfer’selbow)

ateral epicondylitis is inflammation and pain at the site of the lateralepicondyle, where the wrist extensor muscles attach by way of a

tendon to the little bony bump on the outside of the elbow. A tendonattachestheextensormusclestotheelbow.Thisconditionisoftencalledtenniselbow.

Medialepicondylitisisinflammationandpainatthesiteofthemedialepicondyle,wherethewristflexormusclesattachbywayofatendontothe little bony bump on the inside of the elbow. This condition is oftencalled golfer’s elbow.Muscle imbalances in the forearmmusclesmeanthe tightmusclesareeither too longor too short andpull or compressotherstructuresinthisarea,whichleadstotheelbowpain.

Youcanimproveoreliminateepicondylitiswithalittleawarenessandsome self-care. It is vital to first identify and correct the commoneverydayactivitiesthatarecausingmusclestrainintheforearmsthatcanleadtoepicondylitis.Manyactivitiesyoudoeverydaymay leadtopainandspasminthemusclesoftheforearms.

With tennis or golfer’s elbow, the muscles and tendons that areinvolvedareusedinalmosteverydailyactivity—everythingfrombrushingyourteethtotypingatyourcomputer,anyactivitythatinvolvesusingyourhands. Proper posture and ergonomics will certainly help, but thesetendonsare inconstantuse throughout theday.Learning tokeepyourwriststraightandunbentduringalldailyactivitiesiscruciallyimportant.Abent wrist in either direction puts strain on the elbow tendons andaggravatesepicondylitis. Ifyouhavetroublekeepingyourwriststraight,useawristbrace,whichcanbeboughtatanypharmacy, tohelpkeepthewriststraightuntilthesymptomssubside.

Another importantpractice is toslackenthesetendonseverydaybyperformingthestretchandslackentheforearmsexercisesasdescribedintheWellnessPlan.Thispracticewilltakethestrainoffthetendonsoit

canbegintoheal.Lackofwater canalsobea factor inepicondylitis.Manypeopledo

notdrinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonot get enoughwater achemore thanmuscles that are well hydrated.Also, the elbow joint needs to be well hydrated to maintain goodlubrication.Goodjointhealthisdependentonadequatewater.

Donotrestyourarmsonthearmrestofachair.Restingyourarmsonarmrests can interfere with themotion of the forearmmuscles as theycontractandrelax,aggravatingepicondylitis.

Rest is still one of nature’s best healing methods. Since tennis orgolfer’selbowisusuallyanoveruseinjury,restingyourarmsandhands,or at least reducing the amount of activity, will speed up the healingprocess.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduce thesymptomsofepicondylitis. Ifafterpracticing theWellness Plan you still have no improvement, see your health careproviderforfurtherassessment.

symptoms:Epicondylitis presents as pain or stiffness at the site of the elbow,sometimes radiating to other parts of the arm.Thepain is oftenworsewhen typing or squeezing objects. The pain usually occurs in thedominantarm,althoughitcanbeintheotherarmorbotharms.

commoncauses:Many lifestyle habits can contribute to tennis or golfer’s elbow. Thefollowing are some of the most common I have come across in mypractice:

WorkingatacomputerPlayingamusicalinstrumentKnittingCuttingvegetablesCarpentry

TennisGolfPaintingLiftingheavyobjectsGrippingobjectstoofirmly

These activities can all cause muscle imbalances in the forearmmusclesthatattachtotheelbow.Limitingtheseactivitieswhenyouhaveasoreelbowwillspeeduptherecoveryprocess.

With a little awareness and by following the Wellness Plan in thisbook,youcanmakethechangesinyourlifethatwillhelptoalleviatethepainassociatedwithepicondylitis.

conventionalmedicalapproachStandard medical treatments for tennis or golfer’s elbow often includepainkillers, muscle relaxants, and anti-inflammatory drugs. Physicaltherapyisalsowidelyprescribedforthiscondition.Surgeryissometimesprescribed to clean up damaged tissue. Remember that drugs andsurgery do not always cure epicondylitis; rather, they alleviate thesymptomsforawhile.Theydonotaddressoneofthebiggestfactorsofepicondylitis—muscleimbalances.

IPTwellnessplanforepicondylitis,lateralormedial(tennisorgolfer’selbow)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoingtheseexercisesnow,andcontinuingtodothemas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

slackenthethumb(handsqueeze;appendixg)Slackening the thumb will release the muscle in the thumb called thepollicisandtheothermusclesonthepalmsideofthehand.Althoughitis

not the primarymuscle involved in epicondylitis, thismuscle is usuallytight and sore as well. Hold for two minutes. Do this as many timesthroughoutthedayasyoucan.

elbowtendonrelease(appendixg)Releasing the elbow tendons will take strain off the muscles in theforearmthatcancontributetoepicondylitis.Holdfortwominutes.Repeatthreetimesaday.

slackenandstretchtheforearm(wristflexorsandextensors;appendixg)

Slackening and stretching the forearm muscles will release the tightmusclesthatcancontributetoepicondylitis.Thesetightmuscleswillpullon the elbow andmay bring on symptoms. Hold each position for twominutes.Repeat ten timesaday, reducing thenumberof repetitionsasthepainsubsides. Ifoneof thedirectionscausespain,onlydo theonethatfeelsgood.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestressontheneck,shoulders,andlowerandupperbackbyholdingyourarmsandhandsinpositionsthatcanindirectlybringonthesymptomsofepicondylitis. These common activities are responsible for a greatamountof thepain in your life.Doing theseactivities the incorrectwaywillmakeyourbodycrookedandleadtomuscleimbalancesandpossiblelumbar or cervical disc problems. By slightly changing the way youperform these activities, you will keep the body in alignment and helpensurethatoncethepainisrelieved,itdoesnotcomeback.

keepelbowsclosetothebodywhenperformingdailyactivitiesHoldingthearmsawayfromthebodyfor longperiodscanleadtotight,soremusclesinmanyareasofyourbody.Inadditiontoyourdrivingandcomputerpositions,othercommonactivitiesthatcausemusclestrainareusing the phone, and household activities like chopping vegetables orvacuuming. Performing your daily activities with your elbows close byyour side will eliminate or prevent a lot of your pain. Do not rest yourarmsonthearmrestsofachair,asthiscanaggravateepicondylitis.

keepyourwristsstraightduringalldailyactivitiesForactivitiesthatyoumustdoduringtheday,keepyourwristsstraight.Abent wrist puts pressure on the elbow tendons and will bring onsymptoms.Ifyouhavedifficultykeepingastraightwrist,useawristbraceforthispurpose.Trytobeawareofyourwristpositionsothatyoudon’tbecome dependent on the brace. Use it as a short-term tool duringrecoveryandtohelpyoulearnproperwristposition.

restyourarmsActivities involving your hands are the main cause of this condition.Limitingoravoidingusingyourhandsforawhile inconjunctionwiththeotherexerciseslistedherewillhelpalleviatethepain.

heatforearmsfortwentyminutesUse a heating pad on your forearms every day for twenty minutes.Continueuntilyoursymptomssubside.

iceyourelbowIfyouhavesignificantpainintheelbow,icingitfortenminuteswilloftenbringquickrelief.Youcaniceyourelbowatthesametimeasyouheattheforearm.

successstoryAmaninhisfortiescametoseemewithadiagnosisfromhisdoctoroftenniselbow(lateralepicondylitis).Hehadbeensufferingwiththisconditionforaboutayear.Hisjobinvolvedsittingatacomputeralldayandhewasalsoatennisplayer.Morepeopletodaygettenniselbow from their computer than they actually do from tennis. Boththeseactivitiescancausetenniselbow.

Thisconditionissometimeshardtoclearupbecausewehavetouse the muscles in the forearm a lot in our daily activities, thusreinjuringtheelboweveryday.

Thetissueatthesiteoftheelbowwasverysoretothetouch.Iperformed themove to slackenand stretch the forearm. I touchedthetissueagain,andtheman’spainwasgoneforthefirsttimeinayear.

I explained to him that although the pain was gone, theinflammation was still there and he could easily reinjure thosemuscles.Iadvisedhimtogiveuptennisforfourweeksandshowedhim how to slacken the forearm muscles. I had him do thisslackeningtentimesadayfortwominuteseachtimeforaperiodoftwoweeks.Thenhewastoreducethefrequencytofivetimesadayformaintenance.

WhenIsawhimtwomonthslater,hereportedthataslongashedidtheWellnessPlan,hispaindidnotreturn.Ifhestoppedfollowingtheplan,thepainwouldstarttocreepback.

As amassage therapist, I usemy hands a lot and itwould beeasytogettenniselbow.Islackenmyforearmsfivetimesadaytokeepmyselfpain-free.

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CHAPTER10

IPTwellnessplanforcarpaltunnelsyndrome(CTS)

hecarpaltunnelisasmallspacelocatedonthepalmsideofthewrist.It is formedon the bottomby thewrist bonesandon the topby the

retinaculum,whichisabandofconnectivetissue.Themediannerveandseveral tendonsthathelpbendyour fingersrun throughthisspace, likegoing througha tunnel.Carpal tunnelsyndrome (CTS) isacondition inwhichthemediannerveiscompressedatthewristinthetunnel.Bendingthewristdecreasesthesizeofthetunnel.Themediannerveistheonlynervethatrunsthroughthetunnel.ThepainassociatedwithCTSisoftenduetomuscle imbalancesintheforearmmusclesunlessbroughtonbypregnancy. The tightmuscles in the forearm are either too long or tooshort and pull or compress other structures in this area, especially themediannerve,whichleadstothepainornumbness.

Youcan improveoreliminateCTSwitha littleawarenessandsomeself-care. It is vital to first identify and correct the common everydayactivitiesthatcausemusclestraininthearmsandhandsthatcanleadtoCTS.

The muscles and tendons involved in carpal tunnel syndrome areonesused inalmosteverydailyactivity—everything frombrushingyourteethtotypingatyourcomputer.CTSisaggravatedbyanyactivity thatinvolvesusingyourhands.Properpostureandergonomicswillcertainlyhelp,butthesetendonsandmusclesareinconstantusethroughouttheday.Keeping yourwrist straight andunbent duringall daily activities isvitallyimportant.Abentwristineitherdirectionputsstrainonthemediannerve,aggravatingCTS. Ifyouhavetroublekeepingyourwriststraight,useawristbrace,whichcanbeboughtatanypharmacy, tohelpkeepthe wrist from bending until the symptoms subside. It is especiallyimportant towear thewristbraceatnight,asmanypeoplesleepwithabentwrist,whichcanbringonthesymptoms.

Slackeningtheareaofthecarpaltunnelisimportanttodoeveryday.Thiswilloftentakethestrainoffthemediannervesoitcanbegintoheal.

Inthebeginning,youshoulddothistentimesaday.Youcandecreasethatnumberasyoursymptomssubside.

AlsohaveyourhealthcareprovidercheckyourvitaminB-12 levels.Low levels of B-12 are sometimes associated with carpal tunnelsyndrome.

LackofwatercanalsobeafactorinCTS.Manypeopledonotdrinkenoughwater toadequatelyhydrate theircells.Muscles thatdonotgetenoughwaterachemorethanmusclesthatarewellhydrated.Also, thejoints need to bewell hydrated tomaintain their lubrication.Good jointhealthisdependentonadequatewaterintake.

Donotrestyourarmsonthearmrestofachair.Restingyourarmsonarmrests can interfere with the motion of the forearm muscles andtendons as they contract and relax. This position can aggravate carpaltunnelsyndrome.

Rest is still one of nature’s best healing methods. Since CTS isusually an overuse injury, resting your arms and hands, or at leastreducingtheamountofactivity,willspeedupthehealingprocess.

Soaking the area in Epsom salts and warm water will often bringrelief.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduce CTS. If after practicing theWellness Plan you stillhave no improvement, see your health care provider for furtherassessment.

symptoms:Carpal tunnel syndrome is a sensation of pain, numbness, tingling,burning,orweaknessinthehandandfingerscausedbypressureonthemedian nerve in the carpal tunnel. This condition especially affects thethumband the first two fingers. It is often accompaniedby loss of gripstrength, making it hard to hold a cup or a phone, and can includeswellingofthehand.

commoncauses:Many lifestyle habits can contribute to carpal tunnel syndrome. The

following are some of the most common I have come across in mypractice:

SittingatacomputerPlayingamusicalinstrumentKnittingCuttingvegetablesCarpentrySleepingwithbentwristsPaintingLiftingheavyobjectsGrippingobjectstoofirmlyBiking

Theseactivitiescanallcausemuscleimbalancesintheforearmmuscles,affectingthecarpaltunnel.Limitingtheseactivitieswhenyouhavecarpaltunnelsyndromewillspeeduptherecoveryprocess

conventionalmedicalapproachStandard medical treatments for carpal tunnel syndrome often includepainkillers, muscle relaxants, and anti-inflammatory drugs. Physicaltherapyisalsowidelyprescribedforthiscondition.Surgeryissometimesprescribedto take thepressureoff themediannerve,whichcauses thepain and numbness. Remember that drugs and surgery do not alwayscureCTS; rather, theyalleviate thesymptoms forawhile.TheydonotaddressthebiggestcauseofCTS—muscleimbalances.

IPTwellnessplanforcarpaltunnelsyndrome(CTS)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoingtheseexercisesnow,andcontinuingtodothemas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

slackenthethumb(handsqueeze;appendixg)Slackening the thumb will release the muscle in the thumb called thepollicisandtheothermusclesonthepalmsideofthehand.Thiswillalsocreatemore space in the carpal tunnel, takingpressureoff themediannerve.Holdfortwominutes.Dothisexerciseasmanytimesthroughoutthedayasyoucan.

slackenandstretchtheforearm(wristflexorsandextensors;appendixg)

Slackening and stretching the forearm muscles will release the tightforearmmusclesthatcancontributetoCTS.Tightforearmmusclesmaydecrease the space in the carpal tunnel and bring on symptoms. Holdeach position for two minutes. Do this ten times a day, reducing thenumber of repetitions as the pain subsides. If one of the directionscausespain,onlydotheonethatfeelsgood.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestress on the neck, shoulders, and lower and upper back that canindirectlyleadtocarpaltunnelsyndromebyholdingyourarmsandhandsinpositionsthatcanbringonthesymptoms.Byslightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignmentandhelpensurethatoncethepainisrelieved,itdoesnotcomeback.

restarmsandhandsCut back on the daily activities that require the use of your hands asmuch as possible until your symptoms are improved. Typing, knitting,playinganinstrument,andchoppingvegetablesaretypicalactivitiesthat

make your forearmmuscles tight and bring on symptoms. Rest is stillnature’sgreathealer.

keepyourwristsstraightduringalldailyactivitiesForactivitiesthatyoumustdoduringtheday,keepyourwristsstraight.Abent wrist puts pressure on the median nerve and will bring onsymptoms.Ifyouhavedifficultykeepingastraightwrist,useawristbraceforthispurpose.Trytobeawareofyourwristpositionsothatyoudon’tbecome dependent on the brace. Use it as a short-term tool duringrecoveryandtohelpyoulearnproperwristposition.

wearawristbraceatnighttokeepyourwriststraightCarpal tunnel is often worse at night because most people sleep withbentwrists.Thispositionwillputpressureonthemediannerveallnight.Wearingawristbraceatnightwillhelp.

heatforearmandhandsUseaheatingpadonyourhands,wrists,andforearms.Dothisonceortwice a day for at least twentyminutes. Continue until your symptomssubside.

checkvitaminb-12levelsHaveyourhealthcareprovidercheckyourB-12levels.LowlevelsofB-12maybeassociatedwithcarpaltunnelsyndrome.

soakhandsandwristsinepsomsaltsSoak your hands and wrists in a little tub of warm water for twentyminutes a night for five nights. Make the water deep enough to coveryourwrists.UseaboutonepoundofEpsomsaltstothreetofivegallonsofwater.Epsomsaltismagnesiumsulfate.Itisanaturalmusclerelaxantandanaturalanti-inflammatory.

successstoryAwomaninhertwentiescametoseemewithadiagnosisofcarpaltunnelsyndrome.Shehadthesesymptomsforsixmonths,andherdoctorhadrecommendedsurgery.Sheworkedatadeskjobatthecomputerall day.Upon further inquiry, I foundout shewasalsoaknitter.Bothoftheseactivitiescanleadtocarpaltunnelsyndrome.

CTSisoftenhardtoclearup,asthemusclesinvolvedareusedofteninoureverydaylife.Irecommendedshegiveupknittingforatleast a month and that she wear a wrist brace to keep her wriststraight.Abentwristwillkeepaggravatingthemediannerve. I toldhertowearitwhilesleepingandduringtheday.

Ishowedherhowtoslackenthethumb,whichwilloftenrelievethesymptomsofCTS.WhenItriedtoslackentheforearmmuscles,bothdirectionswerepainful,sowedidnotpursuethatexercise.

I told her to heat her forearm muscles every night for twentyminutes.

Ialsoexplainedtheimportanceofdrinkingenoughwatertokeepthehandandwristwelllubricated.

Shelaterreportedtomethatthesymptomsofhercarpaltunnelstarted togeta littlebetterwithin fourdaysandhavecontinued toimprove. At the time I spoke with her, she was hopeful that shewouldnotneedthesurgery.

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CHAPTER11

IPTwellnessplanforhippain(bursitis)

hepainfromthisconditionmaybeontheoutersideof theupper legandhiportheinsideoftheupperlegandhip,whichiscalledthegroin.Thehip jointattaches the leg to the torso.This isaballandsocket

joint and allows for smoothmovementwhenwalking, if all iswell. Thepainmaybecausedbythejointitselforoneofthestructuresaroundthejoint such as the bursa, the tendons, the labrum, or the musclessurroundingthejoint.

The front of the hip is commonly called the groin. This is the areawhere the inner thigh on the upper leg and the abdomen meet. Thistypically involvesthehipadductors,hipflexors,andhipabductors.Painoften occurswhen themuscles in the groin are stretched beyond theirlimits.Groinpainoftenindicatesaproblemwiththehipjoint.

Hip and groin pain are common in both athletes and yogapractitioners and are often due to muscular imbalances in the pelvis,legs, and low back. This means that the muscles in these areas areeithertoolongortooshortandpullorcompressotherstructuresinthisarea,leadingtothepain.

Youcanimproveoreliminatehiporgroinpainwithalittleawarenessand some self-care. It is vital to first identify and correct the commoneverydayactivitiesthatarecausingmusclestraininthehipandgrointhatcanleadtothepain.Manythingsyoudoeverydaymayleadtopainandspasminthemusclesofthehipandgroin.

One of the most common causes of these muscle imbalances isoverusingcertainmuscles,which thenmakes them too short and tight.Peoplewhoareactiveusuallyhavetight,shorthipflexorsandabductors,andtightbuttoolongadductors.Thiscommonmuscleimbalancepatternpullsthepelvisoutofalignmentandcanleadtohipandgroinpain.

Manypeoplewalkandsitwiththeirfeetturnedout.Thisputsalotofstrain on the hip and groin. It is important to correct the muscleimbalancesthat leadtopeoplewalkingthisway.Trainingthefeet togo

back to theneutralposition,pointingstraightahead, isvital.Sittingwithyourtoesturnedinwillhelptocorrectmusclesimbalancesinthehipandgrointhatarecausingyourlegsandfeettoberotatedout.Donotstandorwalkwithyourtoesturnedin.Justsitthatway.Rememberthisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

Feet that turnout indicate themuscleson theoutsideof the legaretooshort.Practicingthehipabductorstretchwilllengthenthosemusclesandstart tobringthefeetstraighter, takingthestrainoutof thehipandgroin.

Lackofwatercanalsobeafactorinhipandgroinpain.Manypeopledonotdrinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonotgetenoughwaterachemorethanmusclesthatarewellhydrated.Thehipjointneedstobewellhydratedinordertokeepitlubricated.Thatwill reduceor eliminate any inflammation in the hip and/or groin.Goodjointhealthisdependentonadequatewater.

By adapting theWellnessPlan in this chapter you can eliminate orsignificantlyreduceyourhiporgroinpain.IfafterpracticingtheWellnessPlan you still have no improvement, see your health care provider forfurtherassessment.

symptoms:Symptoms can be pain on the outside of the hip or in the groin area.Sometimesthispainisreferredtothisareafromthelowback.Thepaincanrangefrommildtosevere,fromsharptoalittleachy.Thepainmaymakewalkingdifficultandisoftenworsewithactivity.

commoncauses:Manylifestylehabitscancontributetohiporgroinpain.ThefollowingaresomeofthemostcommonIhavecomeacrossinmypractice:

SportsInjuriesDancingDrivingYogaWeightlifting

Theseactivitiescanallcausemuscleimbalancesinthehiporgroin,which can lead to pain in this area. Limiting these activities when youhavehiporgroinpainwillspeeduptherecoveryprocess.

Theseconditionscausedbymuscleimbalancesareamajorsourceofhiporgroinpain:

ImbalancedpelvisExternalrotatorstooshortShortabductorsLongadductors

Thesephysiologicalchangescanalsocausehiporgroinpain:

HerniaBursitisArthritis

conventionalmedicalapproachStandard medical treatments for hip or groin pain often includepainkillers, muscle relaxers, antidepressants, cortisone, and anti-inflammatories. Physical therapy is also widely prescribed for thiscondition. Surgery is sometimes prescribed if these measures are notworking.Remember that the drugs or surgery don’t always cure hip orgroinpain; rather, theyalleviate thesymptoms forawhile.Theydonotaddresstheprimarycauseoftheproblem—muscleimbalances.

IPTwellnessplanforhippain(bursitis)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedto practice in order to correct themuscle imbalances that are causingyourpain.Bydoing theseexercisesnowandcontinuing todo themasinstructed, you will make your short muscles longer and your longmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)

Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theyaredesignedtostretchthemusclesormusclesgroupsthataretypicallytooshortinmostpeopleandpull thepelvisoutofalignment.Acrookedpelvisaffectsalltheareasof thebody.Apelvis that isoutofalignment isoftenamajorcauseofhiporgroinpain.Dothesestretchesthreetimesaday.Holdforaminuteeach.

slackenthehipflexors(psoas&quadriceps;appendixh)Lyingonyourbackon the floor,bendat thehip90degreesandat theknees90degrees,restingthelowerlegsonachairorsofa.

strengthenthehipextensors(hamstringsandgluteusmaximus;appendixh)

Themainhipextensormusclesarethehamstringsandgluteusmaximus.Thesemusclesaretypicallytooweakinmanypeople.Weakhipextensormusclesareamajorcauseoflowbackorhippain.Dothisstrengtheningexercise three or more times a day for at least one minute or longer.Don’tpracticethisexerciseifitcausespain.

strengthentheinsidethighs(adductors;appendixi)Sittinginachair,foldabedpillowinhalfandplaceitbetweentheknees.Gently squeeze the knees together for five seconds.Repeat ten times,restforaminute,anddotenmore.Continueinthismanneruntilyoucandofivesetsoftenreps.Thiswillstrengthenthemusclesontheinsideoftheupperleg.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Adjustingyoursittingpositionswill ensure thehipstays inbalanceand

thatyouarenotcausingmorestress in thegroin.Sitting is responsibleforagreatamountofthepaininyourlife.Sitting,driving,andtypingonacomputer the incorrect way will make your body crooked. By slightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignmentandhelpmakesureoncethepainisrelieved,itdoesnotcomeback.Whendriving,makesureyourfootisstraightonthegaspedalandnotturnedoutward.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwith your legsand feet slightly turned inwill takestrainoff thehipandgroin. Do not walk or stand like this. Do this only when sitting.Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

useheatonthethighHeat the hip and groin twenty minutes every night. These are themusclesontheoutsideoftheupperleg(hip)andtheinsideoftheupperleg(groin).

successstoryAman in his thirties, a soccer player, came tome complaining ofseverepaindeep in thegroinareaon the right side.Hesaidhe’dhadtwingesofthepainforfourmonths,butnowitwasdebilitating.Thepainwasmuchworsewhenhewasplayingsoccerandnotsobadwhenhewassitting.Hehadseenhisdoctor,who ruledoutaherniaandalabraltear.

Iobservedthattheman’spelviswasquiteoutofbalance.Itwaselevated and quite rotated. These conditions can cause a lot ofstrain in thehipandgroinarea.When Ipalpated the tissueon theinside of the leg, it felt ropy and tight,much like an overstretchedrubberband.

IbalancedthepelvisasmuchasIcouldandtoldhimhewould

need to do some stretching at home so he could help resolve therestofproblem.Igavehimthefourstretchestobalancethepelvis.Iemphasized that he should do only these stretches until the painsubsided.

In addition to the tight muscles in the groin area, which wereoverstretched,hehadsomeinflammationinthearea.Itoldhimthatwould probably clear up in a few weeks if he would follow theWellnessPlananddrinkplentyofwater.

His pain gradually subsided and he was able to play socceragain. It tookabout threemonths forhim to recover. IemphasizedthatheshouldkeepdoingtheWellnessPlanIgavehimsohecouldcontinuetoplaysoccerpain-free.

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CHAPTER12

IPTwellnessplanforlumbarmusclestrain(lowbackpain)

helowerbackisalargeareathatconnectstheupperbodytothelowerbody. Pain felt in the lower back is usually caused by muscle

imbalancesinthislumbarregion.Thetightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthisarea,leadingtothepain. Tight muscles will often pull the pelvis out of alignment and/orcausethespinetobecrookedand/orcauseadiscissue.Painmayalsoradiatefromotherareaslikethemidorupperback.

Lowbackpainisverycommon.Almosteveryonewillexperiencelowback pain at some time in their life. According to the Journal of theAmericanOsteopathicAssociation,wespend$100billioneachyearonthiscondition.Headacheandlowbackpainaretwoofthemostcommonreasonspeopleseekmedicalattention.

You can improve or eliminate low back painwith a little awarenessand some self-care. It is vital to first identify and correct the commoneverydayactivitiesthatcausethemusclestrainthatcanleadtolowbackpain.Manyactivitiesyoudoeverydaymayleadtopaininthemusclesofthehead,neck,shoulders,orback.

One of the most common causes of these muscle imbalances issimplypoorpostureand/orimproperergonomics.Slumpingatyourdeskorinyourcarpushesyourheadforwardofyourbodyandroundsoutthelowerback,puttingalotofstrainonyourneck,shoulders,andlowback,which will likely pull the pelvis out of alignment. Keeping your backroundedforlongperiodsoftimeinyourchairisamajorfactorinlowbackpain.Ibelievethathalfthebackpaininthecountrywouldbeeliminatedifeveryonesatwith thepropersupport.Bycorrectingyour computeranddriving positions, you will bring your head over your shoulders andstraightenoutyourback,givingyourselfgoodposture.Yourbones (thespinalcolumn)willbedoing their job,whichwillhelp take thestrainoffthemuscles.

Pelvicmisalignmentiscommonandoftencauseslowbackpain.The

pelvis tends tobemisaligned in threecommonways:1) it is higherononeside;2) it is rotated;3) it is tiltedeither forwardorbackward.Mostpeoplehaveatleastoneoftheseimbalances,andmanyhaveallthree.Thestretchesdescribed in theWellnessPlan forLumbarMuscleStrainwillhelprealignthepelvis.

Lackofwatercanalsobeafactorinlowbackpain.Manypeopledonotdrinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonot get enoughwater achemore thanmuscles that are well hydrated.Also, thediscsneed tobewell hydrated tomaintain their softnessandavoid pinching or irritating a nerve. Discs should be about 80%water.Gooddischealthisdependentonadequatewaterintake.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduce your low back pain. If after practicing theWellnessPlan you still have no improvement, see your health care provider forfurtherassessment.

symptoms:Lumbarpainispaininthelowbackthatcouldbedescribedasanache,tightness,burning,orstabbing.Thisconditioncanbeacuteorchronic.Itis often better in certain positions, such as lying down or standing orsitting. Itmaybepainful togetupoutofa chairorbed.Thepainmayalsoradiatedownthelegsandisoftenaccompaniedbypaininthegroin.

commoncauses:Many lifestylehabitscancontribute to lowbackpain.The followingaresomeofthemostcommonIhavecomeacrossinmypractice:

LongperiodsofimproperstandingLongperiodsofimpropersittingSports—especiallyone-sidedsportsliketennisandgolfLiftingheavyobjects

These activities can all cause muscle imbalances in the low back(lumbarregion),whichcanleadtolowbackpain.Limitingtheseactivitieswhenyouhavelumbarmusclestrainwillspeeduptherecoveryprocess.

Thefollowingconditionsarecausedbymuscleimbalancesandareamajorsourceoflowbackpain:

UnbalancedpelvisTight,shortquadricepsExternallyrotatedlegsSomediscissuesStenosis

conventionalmedicalapproachStandardmedical treatments for lowbackpainoften includepainkillers,muscle relaxants, antidepressants, cortisone, and anti-inflammatorydrugs. Physical therapy is also widely prescribed for this condition.Surgery is sometimes prescribed if other measures are not working.Rememberthatdrugsandsurgerydonotcurelowbackpain;rather,theyalleviate the symptoms for a while. They do not address the biggestcauseoflumbarmusclestrain—muscleimbalances.

IPTwellnessplanforlumbarmusclestrain(lowbackpain)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancescausingyourpain.Bydoingthese exercises now and continuing to do them as instructed, you willmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshortinmostpeopleandpullthepelvisoutofalignment.Whenthepelvisis crooked, all areas of the body are affected. A pelvis that is out ofalignment is often a major cause of neck strain and low back painbecause those muscles are out of balance. Do these stretches threetimesaday.Holdforoneminuteeach.

slackenthehipflexors(psoasandquadriceps;appendixh)Thehip flexormusclesare typically tooshort inmostpeople.Theveryactofsitting inachair,whichwehavedoneourentire lives,makesthehip flexors short. These short hip flexors will pull the pelvis forward,resultinginananteriorpelvictilt,whichcancauseanexaggeratedcurvein the low back, low back pain, or disc problems. Slackening the hipflexorsrelaxesthesemusclesandletsthepelvisreleasebacktoneutral,whichcanalleviatepain.Dothisslackeningthreeormoretimesadayforatleasttwominutesorlonger.

strengthenthehipextensors(hamstringsandgluteusmaximus;appendixh)

Themainhipextensormusclesarethehamstringsandgluteusmaximus.Thesemusclesaretypicallytooweakinmanypeople.Weakhipextensormusclesareamajorcauseoflowbackorhippain.Dothisstrengtheningexercise three or more times a day for at least one minute or longer.Don’tpracticethisexerciseifitcausespain.

half-frog(slackenthepiriformis;appendixh)Thehalf-frogpositionwillslackenthepiriformismuscleandtakestrainoffthelowbackandthesacroiliacjointoneithersideofyourlowback.Holdfortwominutesormore.Repeatontheotherside.Dothisfiveormoretimesaday,reducingtherepetitionsasyoursymptomsstarttosubside.Ifthispositionhurtsononeside,onlydothesidethatfeelsgood.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwith your legs and feet slightly turned in will slacken the inside thighmuscles(adductors)andtakestrainoffthelowerbackandtheknees.Donotwalkorstand in thisposition.Do thisonlywhenyouaresitting.Dothiseverytimeyousit.Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

strengthentheinsidethighs(adductors;appendixi)

Strengthening the adductor muscles will shorten the muscles on theinsideoftheupperlegandpullthelegsbackintoalignmentinaneutralposition, taking the strain off the low back and knees.Do ten of thesecompressionsand then rest foraminuteanddo tenmore.Continue inthismanneruntilyoucandofivesetsoften.Thisexercisewillstrengthenthe muscles on the inside of your legs and begin to reduce yoursymptoms.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestressontheneck,shoulders,andlowerandupperback.Thesecommonactivitiesareresponsibleforagreatamountofthepaininyourlife.Doingtheseactivitiestheincorrectwaywillmakeyourbodycrookedandleadtomuscle imbalances and possible lumbar or cervical disc problems. Byslightlychangingthewayyousit,drive,andtypeonacomputer,youwillkeep the body in alignment and help ensure that once the pain isrelieved,itdoesnotcomeback.

heatsoreareasfortwentyminutesUse a heating pad on the sore areas every day for twenty minutes.Continueuntilthesymptomssubside.

successstoryAmaninhisfortiescametoseemewhohadsufferedseverebackpainforalmosttwoyears.Hehadadifficulttimestandingorsittingforlongperiodsbuthadlittleornopainwhenlyingdown.HisdoctordidanMRIoftheregionandfoundnothingunusual.Thismansatat

adeskalldayforhiswork.Most low back pain is simply due tomuscle imbalances in the

pelvicregion,resultinginacrookedpelvis.Mostpeoplearecrookedinthreeways.ThismancertainlywaswhenImeasuredhim.

Iperformedthreestretchestobringhispelvisbackintobalanceandshowedhimhow todo thesestretcheshimself. Ialsoshowedhim the proper sitting, computer, and driving positions that wouldhelpkeephispelvisstraight.

Hewasa littlenervousaboutgettingoffmytable,becausethatmovementforhimwasusuallyquitepainful.Muchtohissurprise,heexperienced only a little pain when getting off the table. He wasalreadymuchimproved.

I impressed upon him the importance of theWellness Plan sothat his pain would not return. The stretches in this chapter tobalance thepelvisperformed three timesadaywillhelpwithmostlowbackpain.Hecouldnotbelievehowsimpleitwastoalleviatehispainaftertwoyearsofsuffering.

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CHAPTER13

IPTwellnessplanforpiriformissyndrome(sciatica)

he sciatic nerve has several branches coming out of the spinal cordinto the lower back.Parts of thenerve run through thebuttocksand

downthebackofeachlegtotheankleandfoot.Whenthesciaticnerveis irritated or compressed by a disc or a tightmuscle, the condition isgenerally called sciatica. When this compression is caused by thepiriformismuscle,itiscalledpiriformissyndrome.

Piriformissyndromeandmuscle-relatedsciaticaarebothcausedbymuscle imbalances in the hip and buttock muscles. Tight muscles areeithertoolongortooshortandpullorcompressotherstructuresinthisarea, leading to the pain. This condition is prevalent in peoplewho sitimproperlyforlongperiodsoftimeordoalotofdriving.

You can improve or eliminatemuscle-related sciatica and piriformissyndrome with a little awareness and some self-care. It is vital to firstidentify and correct the common everyday activities that causemusclestrainthatcanleadtosciatica.Manyactivitiesyoudoeverydaymayleadtopainandspasminthemusclesofthehead,neck,shoulders,orback.

A logical first place to start is to make excellent posture a habit.Keeping your back rounded for long periods of time in your chair is amajor cause of sciatic compressions. I believe thatmuch of the sciaticpain in the country could be eliminated if everyone satwith the propersupport.Bycorrectingyourcomputeranddrivingpositions,youwillbringyour head over your shoulders and straighten out your back, givingyourselfgoodpostureandlesspain.

Itisveryimportantthatyouperformthefourstretchestobalancethepelvis.Thesefourstretchesusuallybringthepelvisbackintoalignment.Thepelvis iscommonlymisaligned in threeways:1) it ishigherononeside;2)itisrotated;3)itistiltedeitherforwardorbackward.Mostpeoplehave at least one of these imbalances, and many have all three. Abalancedpelvisusuallyloosensthepiriformisandtakesthepressureoffthesciaticnerve.

Althoughitisacommonpracticetostretchthepiriformis,Ihavefoundthatstretchingthismusclewilloftenaggravatesciatica.Whenyoustretchamuscle,you temporarilymake it tighter, likestretchingarubberband.Thistightnessthenaggravatesthenerve.Slackeningusuallyfeelsgoodbytakingpressureoff thenerve.SeetheWellnessPlan for instructionsforslackeningthepiriformis,whichoftenbringsdramaticreliefalongwithinstructionsforslackeningthehipflexors,anotherexercisethatcanbringquickrelieffromsciaticpain.

Lackofwatercanalsobeafactorinsciaticpain.Manypeopledonotdrinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonotgetenoughwaterachemorethanmusclesthatarewellhydrated.Also,discsneedtobewellhydratedtomaintaintheirsoftnessandtopreventpinchingorirritatinganerve.Gooddischealthisdependentonadequatewater.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantlyreduceyoursciatica.IfafterpracticingtheWellnessPlanyoustill have no improvement, see your health care provider for furtherassessment.

symptoms:Symptomsofpiriformissyndromeorsciatica includepain thatbegins inyourbackorbuttocksandmovesdownyourlegandmaymoveintoyourfoot.Weakness,tingling,ornumbnessinthelegmayalsooccur.Thesesymptoms could indicate a disc problem or a tight piriformis. Thiscondition isoftenworsewhensittingor standing.Symptomscan rangefrommildtosevere.

commoncauses:Manylifestylehabitscancontributetosciatica.ThefollowingaresomeofthemostcommonIhavecomeacrossinmypractice:

BikingSittingimproperlyDriving,especiallyaclutch

These activities can all cause muscle imbalances in the low back(lumbarregion),whichcanleadtosciatica.Limitingtheseactivitieswhenyouhavesciaticawillspeeduptherecoveryprocess.

The following conditions caused bymuscle imbalances are amajorsourceofsciatica:

TightpiriformisHerniateddisc

Thesetwophysiologicalchangescanalsocausesciatica:

SpinalstenosisPregnancy

conventionalmedicalapproachStandard medical treatments for sciatic pain often include painkillers,muscle relaxants, antidepressants, cortisone, and anti-inflammatories.Physical therapy is alsowidely prescribed for this condition.Surgery issometimes prescribed if these other measures are not working.Rememberthatdrugsandsurgerydonotcuresciaticaunlessitisduetospinal stenosisorotherbonyordisc impingementon thesciaticnerve,which can be relieved surgically. Otherwise, drugs and surgery don’taddressoneofthebiggestfactorsofsciatica—muscleimbalances.

IPTwellnessplanforpiriformissyndrome(sciatica)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancescausingyourpain.Bydoingthese exercises now and continuing to do them as instructed, you willmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically too

shortinmostpeopleandpullthepelvisoutofalignment.Whenthepelvisiscrooked,all theareasof thebodyareaffected.Apelvisthat isoutofalignment isoftenamajor causeofpiriformissyndromeor sciatica.Dothesestretchesthreetimesaday.Holdforoneminuteeach.

half-frog(slackenthepiriformis;appendixh)Thehalf-frogpositionwillslackenthepiriformismuscleandtakestrainoffthesciaticnerve.Holdfortwominutesormore.Repeatontheotherside.Do this fiveormore timesadayand less frequentlyasyoursymptomsstarttosubside.Ifthishurtsononeside,onlydothesidethatfeelsgood.

slackenthehipflexors(psoasandquadriceps;appendixh)Thehip flexormusclesare typically tooshort inmostpeople.Theveryactofsittinginachair,whichwehavedoneourwholelives,makesthehip flexors short. These short hip flexors will pull the pelvis forward,resultinginananteriorpelvictilt,whichcancauseanexaggeratedcurvein the low back and/or sciatica or disc problems. Slackening the hipflexorsrelaxesthesemuscles,allowsthepelvistoreturntoneutral,andrelievespain.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwithyour legsand feetslightly turned inwill slacken theadductorsandgentlyreleasethepiriformis, takingstrainoff the lowerbackandknees.Do not walk or stand like this. Do this only when you are sitting.Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

strengthentheinsidethighs(adductors;appendixi)Strengthening the adductor muscles will shorten the muscles on theinsideof theupper legandpull the legsback intoneutralalignmentsothestrainistakenoffthelowbackandtheknees,releasingthepiriformis.Do ten of these compressions, rest for a minute, and do ten more.Continue in thismanneruntil youcando fivesetsof ten.Thisexercise

willstrengthenthemusclesontheinsideofyourlegsandbegintoreduceyoursymptoms.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correctingyourposturewhilesitting,driving,andworkingatacomputerwillensurethepelvisstaysinbalanceandthatyouarenotcausingmorestress on the neck, shoulders, and lower and upper back, which cancompress the sciatic nerveand lead to sciaticaor piriformis syndrome.Thesecommonactivitiesareresponsibleforagreatamountof thepaininyourlife.Sitting,driving,ortypingonacomputertheincorrectwaywillmake your body crooked and lead tomuscle imbalances and possiblelumbar or cervical disc problems. By slightly changing the way youperform these activities, you will keep the body in alignment and helpensurethatoncethepainisrelieved,itdoesnotcomeback.

useheatonlowbackandbuttocksUseaheatingpadonyour lowbackandbuttockseveryday for twentyminutes.Continueuntilyoursymptomssubside.

successstoryAmaninhisfiftiescametoseemewhowassufferingfromsciatica.Thepainwas inhis leftbuttockand traveleddown thebackofhisleft leg.Hehadsufferedwith thispainonandoff for tenyears.Hehadbeentophysicaltherapymanytimeswithonlymoderaterelief,buthisdoctorhadgivenuponhim.

Whatyoudoeveryday isalmostalwaysamajor contributor toyourachesandpains.Iwantedtoknowwhathedidforaliving.Hesaidhewasatruckdriver.Iaskedhimifhistruckhadaclutch.He

saiditdidandstatedthathispainwasalwaysworsewhendriving.Ihaveseenthismanytimesbefore.Peopleusuallyhavetheirfootonthe clutch with the foot turned out, which in turn contracts thepiriformis evenmore. In thisman’s case, this positionwas puttingpressureonthesciaticnerve,sendingpaindownhisleg.

I did the four stretches to balance the pelvis, which was quitecrooked.Ithenhadhimliefacedown.WhenIpressedgentlyonhispiriformis,themusclewassotightandinflamedthathejumpedandgave out a yelp. I immediately put him into the position known ashalf-frog, which will slacken the piriformis. I gently pressed thepiriformis again. He said that the pain was gone. I pressed thepiriformisa littleharderandstillhesaidhehadnopain inthehalf-frogposition.

I explained to him how crucial it was that he adapt the correctsittinganddrivingpositionsandthatheneededtokeephisfootontheclutchstraightandnot turnedout.Beforehegotoffmy table, Itoldhimhewouldstillexperiencesomepainbecausethenervewasirritatedandinflamed.

IadvisedhimthatifhefollowedtheWellnessPlanasdescribedinthischapter,hispainwouldmost likelybeallgoneintwotofourweeks.

I saw him a month later and indeed his pain was gone. Heremained pain-free as long as he used the proper lumbar supportandkepthisfootstraightwhenusingtheclutch.

I encouraged him to keep performing theWellness Plan, eventhoughhefeltbetter,sohissciaticawouldnotreturn.

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CHAPTER14

IPTwellnessplanformedialmeniscusinjury(kneepain)

hemedialmeniscusisabandofcartilageontheinsideofthekneeattheheadofthetibia.Thereisalsooneontheoutsideoftheknee.Itis

acommonsiteof injury,especially insports.Themedialmeniscusactsasashockabsorberbetweenthetibiaandthefemur.Largetearstothemeniscus may require surgery. Small tears will respond well to theprotocols in this book. Themeniscus is often damaged due tomuscleimbalancesinthehipandlegmuscles.Thetightmusclesareeithertoolongortooshortandpullorcompressthemeniscusandotherstructuresinthisarea,leadingtopain.

Knee replacements have almost doubled in the last ten years. Thetruthisthatyourkneesshouldlastlongerthanyoudo.Theywillnotwearoutaslongasyourpelvisisstraightandyouhavenounderlyingproblemlikerheumatoidarthritis.Thinkofourcarexample.Ifthefrontendofyourcar isoutofalignment,your tireswillwearoutquickly. In thiscase, thetires are your knees. Keep the pelvis straight to save your knees. Astraightpelviswillallowyourknees to take thestresson them thewaynatureintendedandlastalongtime.

Youcan improveoreliminateyourkneepainwitha littleawarenessand some self-care. It is vital to first identify and correct the commoneveryday activities that causemuscle strain in the pelvis and legs thatcanleadtopainintheknee.

One of the most common causes of these muscle imbalances issimply poor posture and/or improper ergonomics. Keeping your backrounded for long periods of time in your chair is a major cause of acrookedpelvis,whichthenleadstostrainontheknees.Ibelieveagreatdealof thekneepain in thecountrycouldbeeliminated ifeveryonesatwith the proper support. By correcting your computer and drivingpositions, you will bring your head over your shoulders and straightenyour back, giving yourself good posture.Your boneswill be supportingyou,whichwilltakethestrainofftheknees.

Manypeoplewalkandsitwiththeirfeetturnedout,whichputsalotofstrain on the knee, especially on the inside (medial). It is important tocorrectthemuscleimbalancesthatleadtowalkingthisway.Weneedtotrainthefeettogobacktotheneutralposition,whichispointingstraightahead.Trysittingwithyourtoesslightlyturnedin.Thispositionwilloftenquicklytakethestrainoffthekneeandrelievethepain.Donotstandorwalkwithyourtoesturnedin.Justsitthatway.

When the feetare turnedout, themuscleson theoutsideof the legaretooshort.Doingthehipabductorstretchwilllengthenthosemusclesandstarttobringthefeetstraighter,whichwilloftentakethestrainofftheknee.Remember,thisstretchshouldnothurt.If itdoes,youareturninginyourfeettoofar.

Kneepain is alsooften causedby your quadricepsbeing too short.These are themuscles on the front of the upper leg that attach at theknee. Quadriceps that are too short can cause knee pain. Gentlystretchingthesemuscleswillhelptoalleviatethepain.

Lackofwatercanalsobeafactorinkneepain.Musclesthatdonotget enoughwater achemore thanmuscles that arewell hydrated.Thekneejointneedstobewellhydratedinordertobewelllubricated,whichwillreduceoreliminateanyinflammationintheknee.Goodjointhealthisdependentonadequatewater.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantlyreduceyourkneepain. IfafterpracticingtheWellnessPlanyoustillhaveno improvement,seeyourhealthcareprovider for furtherassessment.

symptoms:Symptomsincludepainontheinsideoftheknee,oftenaccompaniedbyswelling.Thiscan indicateanythingfromaspraintoatear.Thearea isoften painful to the touch. A person with medial meniscus injury mayexperience limited rangeofmotionorpoppingandclickingsoundswithmovement,oftenaccompaniedbypaininthegroin.

commoncauses:Manylifestylehabitscancontributetokneepain.Thefollowingaresome

ofthemostcommonIhavecomeacrossinmypractice:

SportsDancingDrivingYogaWeightliftingSittingwithfeetturnedout

Theseactivitiescanallcausemuscle imbalances in theknee,whichcanleadtokneeormedialmeniscuspain.Limitingtheseactivitieswhenyouhavekneepainwillspeeduptherecoveryprocess.

The following conditions caused bymuscle imbalances are amajorsourceofkneepain:

ImbalancedpelvisExternalrotatorsofthelegthataretooshort

conventionalmedicalapproachStandard medical treatments for knee pain often include painkillers,muscle relaxants, hyaluronic acid injections, cortisone, and anti-inflammatories. Physical therapy is also widely prescribed for thiscondition. Surgery is sometimes prescribed if other measures are notworking. Remember that drugs and surgery do not cure knee pain;rather,theyalleviatethesymptomsforawhile.Theydonotaddresstheprimarycauseofkneepain—muscleimbalances.

IPTwellnessplanformedialmeniscusinjury(kneepain)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancesthatarecausingyourpain.Bydoing theseexercisesnowandcontinuing todo themas instructed,youwillmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)

Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshortinmostpeopleandpullthepelvisoutofalignment.Whenthepelvisiscrooked,all theareasof thebodyareaffected.Apelvisthat isoutofalignmentisoftenamajorcauseofkneepain.Dothesestretchesthreetimesaday.Holdforoneminuteeach.

half-frog(slackenthepiriformis;appendixh)Thehalf-frogpositionwillslackenthepiriformismuscle,allowingthelegandkneetoreturn toaneutralposition, takingstrainoff theknee.Holdtheposition for twominutesormore.Repeaton theotherside.Do thisfiveormoretimesadayandthenlessfrequentlyasyoursymptomsstarttosubside.Ifthishurtsononeside,onlydothesidethatfeelsgood.

slackenthehipflexors(psoas&quadriceps;appendixh)Thehip flexormusclesare typically tooshort inmostpeople.Theveryactofsittinginachair,whichwehavedoneourwholelives,makesthehip flexors short. These short hip flexors will pull the pelvis forward,resultinginananteriorpelvictilt,whichcancauseanexaggeratedcurvein the lowback.Oneof thehip flexorsattachesnear thekneeandcanputa lotofstrainon theknee,acommoncondition.Slackening thehipflexorsrelaxesthesemuscles,allowingthepelvistoreturntoneutralandtakingthestrainofftheknee.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwithyourlegsandfeetslightlyturnedinwilltakestrainoffthelowerbackandtheknees.Donotwalkorstandinthisposition.Doitonlywhenyouaresitting.Remember,thisshouldnothurt.If itdoes,youareturninginyourfeettoofar.

strengthentheinsidethighs(adductors;appendixi)After some healing occurs and your knee pain lessens, you can

strengthen the adductors. Strengthening the adductors will shorten themusclesontheinsideoftheupperlegandpullthelegsbackintoneutralalignmentsothatthestrainistakenoffthelowbackandtheknees.Dotenofthesecompressions,restforaminute,anddotenmore.Continuein this manner until you can do five sets of ten. This exercise willstrengthen themuscleson the insideof your legsandbegin to reduceyoursymptoms.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correcting your posture while sitting, driving, and working at thecomputer will ensure the pelvis stays in balance and that you are notplacing more stress on the knees. These common activities areresponsible for a great amount of the pain in your life. Doing theseactivities the wrong way will make your body crooked. By slightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignmentandhelpmakesurethatoncethepainisrelieved,itdoesnotcomeback.

useheatonthequadricepsThequadricepsarethemusclesonthefrontpartoftheupperleg.Useaheatingpadtowarmthequadricepstwentyminuteseverynight.Thiswillhelptoloosenthosemusclesandtakestrainofftheknees.

successstoryAwoman inhersixtieswhowasanavidyogapractitionercametomecomplainingofmoderatetoseverekneepaininbothknees.Shehadalreadyhadanoperationtorepairatearinthemedialmeniscuson her left side. Now her doctor was telling her that she would

probably need an operation on the other knee aswell.Her doctorgave her some pain medication and she was going to physicaltherapy,whichshesaidwasmakingitworse.

Shecomplained that the insideofher thighs,especiallyaroundthe knee and groin, felt very tight. She was doing a lot of yogastretches for thatareabutcouldnotseemtoget that tissue to feelloosenomatterhowmuchstretchingshedid.

Ihadherlieonherbackandobservedthatherfeetturnedwayout almost like a ballet dancer. In this condition, the tissue on theoutsideofthethighistooshortandtight,whereasthetissueontheinsideofthethighistoolongandtightlikeanoverstretchedrubberband.I touchedtheinsideofherkneesandtheywerequitesore.Iturned her legs and feet in for two minutes to rebalance thosemusclesaffecting theknees.When I touched the tissueagain,shehadnopain.Shecouldnotbelieve it,asherkneeshadbeensoreforyears.

OnceIexplainedtoherhowthetissuewastoolongontheinsideofherthighsandthatstretchingthattissuewasmakingitworse,sheunderstood.

I advised her to stop all stretching for the inside of the thigh(known inyogaas “hipopeners”). I showedherhow tostrengthentheadductorsandsitwiththefeetslightlyturnedin.

Ishowedherthefourstretchestobalancethepelvisandtoldhertodoonly those four stretches for aboutamonth.Shewasnot tostretchanyothermuscles.

Herkneesrecoveredandshedidnotneedanoperationonherother knee. I stressed the importance of continuing the WellnessPlantomakesurehersymptomsdidnotreturn.

p

CHAPTER15

IPTwellnessplanforplantarfasciitis(heelspur)

lantarfasciitisisinflammationoftheplantarfascia.Thisisthetissuethat forms the arch of the foot. Plantar means bottom of the foot.

Fasciaisconnectivetissue,and-itismeansinflammation.A heel spur is a hook of bone that can form on the heel. Plantar

fasciitis isoftenaccompaniedbyaheelspurthatcanbeseenonanX-ray.Heelspursaresoft,bendabledepositsofcalciumthatarearesultofmechanical tension and inflammation.Heel spurs usually do not causepain.Theyareanindicationthatplantarfasciitismaybepresent,whichistherealcauseofthepain.

Plantar fasciitis condition isdue tomuscle imbalances in thepelvis,lowerleg,andfootmuscles.Thetightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthisarea,oftenleadingtopain.

You can improve or eliminate your plantar fasciitis with a littleawarenessandsomeself-care. It isvital to first identifyandcorrect thecommoneverydayactivitiesthatarecausingmusclestraininthepelvis,lowerleg,andfoottissuethatcanleadtoplantarfasciitis.Manyactivitiesyoudoeverydaymayleadtopainandinflammationinthesemuscles.

Aswithmostmuscleimbalances,thefirstplacetostartiswithproperposture.Keepingyourbackroundedforlongperiodsoftimeinyourchairisamajorcauseofacrookedpelvis,which then leads tostrainon thefeetandpossiblyplantarfasciitis.

Manypeoplewalkandsitwiththeirfeetturnedout,whichputsalotofstrain on the feet. It is important to correct themuscle imbalances thatlead to walking this way.We need to train the feet to go back to theneutralposition,whichispointingstraightahead.Trytositwithyourtoesturnedin.Donotstandorwalkwithyourtoesturnedin.Justsitthatway.Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

The standardmedical treatment for plantar fasciitis is to stretch the

calfand icethefoot. Ihavefoundthat thismethodmaytakemonthsoryearstoheal thecondition.Amoreeffectivetreatment is toslackenthecalf and foot aswell as heat the foot by soaking it inwarmwater andEpsomsaltseverynight.Thiswilloftenbringreliefinweeksnotmonths.

Ifyouhaveplantarfasciitis,wearingshoeswithgoodarchsupportsisimportant. The arch support puts the bottom of the foot into slack andhelpstorelievethepain.Walkingbarefootor in flip-flopscanaggravateplantarfasciitis.

Lackofwatercanalsobeafactorinplantarfasciitis.Musclesthatdonot get enoughwater achemore thanmuscles that are well hydrated.Waterisagoodanti-inflammatory.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantly reduceyourplantar fasciitis. Ifafterpracticing theWellnessPlan you still have no improvement, see your health care provider forfurtherassessment.

symptoms:Withplantarfasciitisthemostcommoncomplaintispaininthebottomofthe heel or other part of the plantar area. It is usually worse in themorningandimprovesthroughouttheday.Itoftenoccursinconjunctionwithatight,sorecalfand/orAchillestendon.

commoncauses:Manylifestylehabitscancontributetoplantarfasciitis.ThefollowingaresomeofthemostcommonIhavecomeacrossinmypractice:

LongperiodsofstandingorwalkingRunningDancingWearingimpropershoes

Theseactivitiescanallcausemuscleimbalancesinthecalfandfoot,whichcanleadtoplantarfasciitis.Limitingtheseactivitieswhenyouhaveplantarfasciitiswillspeeduptherecoveryprocess.Wearshoesthathavegoodarchsupports.

The following conditions caused bymuscle imbalances are amajorsourceofplantarfasciitis:

ImbalancedhipTightcalfTightAchillestendonFlatfeet

conventionalmedicalapproachStandardmedicaltreatmentsforplantarfasciitisoftenincludepainkillers,musclerelaxants,cortisone,andanti-inflammatories.Physicaltherapyisalsowidelyprescribedforthiscondition.Orthoticsandanightsplintthatkeeps the calf stretchedall night are commonprescriptions.Surgery issometimesprescribedifothermeasuresarenotworking.Rememberthatdrugs and surgery do not always cure plantar fasciitis; rather, theyalleviate the symptoms for a while. They do not address the primarycauseofplantarfasciitis—muscleimbalances.

IPTwellnessplanforplantarfasciitis(heelspur)MUSCLEREBALANCING:Thissectionprovidestheexercisesyouneedtopracticetocorrectthemuscleimbalancescausingyourpain.Bydoingthese exercises now and continuing to do them as instructed, you willmakeyourshortmuscleslongerandyourlongmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshort in most people and pull the pelvis out of alignment. A crookedpelvisaffectsalltheareasofthebody.Apelvisthatisoutofalignmentisoftenamajorcauseofplantarfasciitis.Dothesestretchesthreetimesadayandholdforoneminuteeach.

achillestendonrelease(appendixj)TheAchillestendonisthethickcordonthebackoftheheelthatattachesthecalftotheheel.Releasingthistendontakesthestrainoffthecalfandtheplantararea (bottomof the foot.).Hold theposition for twominutesandrepeattheexercisethreetimesaday.

slackenthecalf(appendixj)SlackeningthecalfreleasesthecalfmuscleandtheAchillestendonandgivesalmostimmediaterelief.Holdthepositionfortwominutes.Dothisexercise at least five times a day. In this case, the more often youslackenthecalf,thebetter.

gentlestretchingofcalfmuscles(appendixj)Gentlystretchingthecalfwilllengthenthemuscleandtakesthestrainoffthebottomof the foot.Donotstretch toodeeply.Stretchingdeeplycanaggravate plantar fasciitis. If stretching hurts, the stretch is too deep.Repeat five to ten timesadayand less frequentlyas thepainstarts tosubside.

strengthentheinsidethighs(adductors;appendixi)Strengthening the adductor muscles will shorten the muscles on theinsideof theupper legandpull the legsback intoalignment to removestrainfromthe lowbackandknees.Whenyour legsare intheirneutralposition,yourfeetwillstrikethegroundasnatureintendedwhenyouarewalking,helpingtoalleviateplantarfasciitis.Dotenofthecompressions,restforaminute,anddotenmore.Continueinthismanneruntilyoucandofivesetsoften.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwithyourlegsandfeetslightlyturnedinwilltrainyourbodytowalkwithyour feetstraightand thus take thestrainoff theplantar fascia.Donotwalk or stand in this position. Do this only when you are sitting.

Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correcting your posture while sitting, driving, and working at thecomputer will ensure the pelvis stays in balance and that you are notcausing more stress on the plantar fascia and Achilles tendon. Thesecommonactivitiesareresponsibleforagreatamountofthepaininyourlife.Doingtheseactivitiestheincorrectwaywillmakeyourbodycrooked.Byslightlychanging thewayyouperform theseactivities,youwillkeepthebodyinalignmentandhelpmakesurethatoncethepainisrelieved,itdoesnotcomeback.

properarchsupportWalking barefoot aggravates plantar fasciitis. Always wear shoes withgoodarchsupports.Goodarchsupportskeepthecalfmusclesandthebottomof the foot inslack.Fortunately,mostof thebrandnameshavegoodarchsupport.Athleticshoesarebest.Avoidsandalsand flip-flopsuntilyourpaingoesaway.

restIfyouarearunnerorareonyourfeetalot,goodold-fashionedrestwillbequitehelpful.Restisstillnature’sgreathealer.Themoreyoucanrest,thequickeryouwillseeresults.

soakyourfeetinepsomsaltsandwarmwaterSoakyourfeetinalittletubofwarmwaterfortwentyminutesanightforfivenights.MakethewaterdeepenoughtocoveryourAchilles tendon.Use about one pound of Epsom salts to three to five gallons ofwater.

Epsom salt is magnesium sulfate, a natural muscle relaxant and anti-inflammatory.

successstoryAman inhis thirtiescametomewhohehadbeendiagnosedwithplantar fasciitis. X-rays showed he also had a heel spur. He hadsharppainonthebottomofhisheelwhenstandingorwalking.Hehad been a runner but had not been able to run for the previouseight months because of the pain. His doctor had given him acortisoneshot,whichhelpedforacoupleofweeks.Hewasgoingtophysical therapy, which was only helping a little. He was alsowearing a boot at night that kept his calf and Achilles tendonstretchedallnight.Hestatedthatthepainwas8onascaleof10.

Ihavetreatedmanycasesofplantarfasciitis,andIknowthatthestandardmedicalapproachseldombrings thedesiredresults.Withhim lying facedown on my table, I pressed the spot on his heelwherethepainwas located.Hereportedthat itwasquitepainful. Iputhiminthe“slackenthecalf”positionandpressedthespotagain.Hesaiditwasstillsorebutmuchlessso.Iheldthatpositionfortwominutes and then pressed the spot again. He said he now felt nopain.Hecouldn’tbelieveitcouldbethateasy!

Hewantedtoknowifhecouldstartrunningagain.Iexplainedtohimthatalthoughhefeltbetter,hestillhadsome

inflammationand that thepainwould return ifhedidnot follow theWellness Plan to rebalance his muscles. I told him that after herebalancedhismusclesandtheinflammationdecreasedby70%,hecouldslowlystartrunningagain.

Onafollow-upvisit,hereportedthathehadstartedrunningtwoweeks after he last saw me and had been running ever since. Iencouraged him to continue to follow the Wellness Plan so hissymptomswouldnotreturn.

f

CHAPTER16

IPTwellnessplanforfibromyalgia

ibromyalgiameanspain in themuscles, ligaments,and tendons—thesoft tissues in thebody.Fibromyalgia isachroniccondition thatalso

presents as fatigue and multiple tender points. Tender points can befoundinthebackoftheneck,shoulders,chest,lowerback,hips,elbows,andknees.Thepainmayspreadfromtheseareas.Thesetenderpointswill be on both the left and right side of the body and both above andbelowthewaist.

This condition is often due to muscle imbalances in many differentmusclesalloverthebody.Tightmusclesareeithertoolongortooshortandpullorcompressotherstructuresinthebody,leadingtopain.

People with fibromyalgia tend to wake up with body aches andstiffness, often because they have not consumed any water all night.Fibromyalgia ismorecommon inwomen than inmen.Othernames forthis conditionare fibrositis, chronicmusclepain syndrome,and tensionmyalgias.

Youcanimproveoreliminateyourfibromyalgiawithalittleawarenessand some self-care. It is vital to first identify and correct the commoneverydayactivitiesthatcausemusclestrainintheneck,shoulders,upperand lowerback,andarmsand legs thatcan lead to fibromyalgia.Manyactivitiesyoudoeverydaymay lead towidespreadpainandspasm inthemusclesinvariouspartsofthebody.

One of the most common causes of these muscle imbalances issimply poor posture and/or improper ergonomics, which then leads tostrain in widespread areas of the body that could be diagnosed asfibromyalgia.Bycorrectingyourcomputeranddrivingpositions,youwillbring your head over your shoulders and straighten your back, givingyourselfgoodposture.Yourbones(thespinalcolumn)willbesupportingyou,whichwilltakethestrainoffthemusclesandreduceoreliminatethepain.

Lackofwatercanalsobeafactorinfibromyalgia.Manypeopledonot

drinkenoughwatertoadequatelyhydratetheircells.Musclesthatdonotgetenoughwaterachemorethanmusclesthatarewellhydrated.Ihaveobserved thatmanyof thepeoplewhocome tomewithadiagnosisoffibromyalgiaaredehydratedtoagreaterorlesserdegree.

Byadopting theWellnessPlan in this chapter, youcaneliminateorsignificantlyreduceyourwidespreadpain.IfafterpracticingtheWellnessPlan you still have no improvement, see your health care provider forfurtherassessment.

symptoms:Fibromyalgia is characterized by chronic, widespread pain withtenderness to light touch. The pain can bemild to severe and is oftenaccompanied by fatigue. The skin often tingles in away that feels likeneedles.Nervepain,brainfog,andtroublesleepingarecommonaswell.

commoncauses:Thereisnoknowncauseoffibromyalgia,butthefollowingaresignificantcontributors:

PosturaldeviationsImpropersittingpostureImproperdrivingpositionsImpropercomputerpositions

Theseactivitiescanallcausemuscle imbalances in thebody,whichcanleadtofibromyalgia.Limitingorcorrectingtheseactivitieswillspeeduptherecoveryprocess.

Thefollowinghabitsleadtochemicalimbalancesinthebody,musclepain,andfatigue:

LackofwaterToomuchcaffeinePoordiet

conventionalmedicalapproach

Standard medical treatments for fibromyalgia often include painkillers,muscle relaxants, antidepressants, anti-seizure drugs, and anti-inflammatories. Remember that the drugs do not cure fibromyalgia;rather,theyalleviatethesymptomsforawhile.Theydonotaddressoneofthebiggestcausesoffibromyalgia—muscleimbalances.

IPTwellnessplanforfibromyalgiaMUSCLE REBALANCING: This section provides the exercises youshouldpractice tocorrect themuscle imbalances thatarecausingyourpain. By doing these exercises now and continuing to do them asinstructed, you will make your short muscles longer and your longmusclesshorter,bringingthembackintobalance.

fourstretchestobalancethepelvis(appendixb)Thesestretcheswillhelp tobring thebodystructureback intobalance,thuseliminatingamajorcauseofachesandpains.Theseexercisesaredesigned tostretch themusclesormusclegroups thatare typically tooshortinmostpeopleandpullthepelvisoutofalignment.Whenthepelvisis crooked, all areas of the body are affected. A pelvis that is out ofalignmentisoftenafactorinfibromyalgia.Dothesestretchesthreetimesaday.Holdeachstretchforoneminute.

threeneckstretches(appendixc)Gently stretch the neck muscles three times a day. Loosening themuscles intheneckandshoulderswillallowmorebloodandoxygentoflow to the head and neck. It takes a few minutes to stretch thesemuscles. It is a great habit to cultivate, as you will feel less pain andstiffness in the neck and will be more alert. Consistent practice willreduceoreliminatethecauseofyourneckpainandmayhelpwith“brainfog.”

slackentheshoulders(levatorscapula&uppertrapezius;appendixe)

Slackeningtheshoulderswillrelievetensionintheshoulders,especiallytheupper trapsand levator scapula.Theseareasare tight andsore inmostpeople.Holdthepositionforatleasttwominutes.Dothisexerciseanytimeyoufeeltensioninyourshouldersorneckandatleastfivetimeseachday.Donotdothisexerciseifithurtstoputyourarmontopofyourhead.

stretchthechest(pectoralismajor&minor;appendixf)In most people the chest muscles are too short and the rhomboidsbetweentheshoulderbladesaretoolong,whichgivesapersonahead-forward, bent-over look with rounded shoulders. Stretching the chestmuscleswill release tensionbetween theshoulderbladesandopenupthechest,whichwillmakeapersonstandupstraighter.Whenapersonstandsstraight,thebonesinthecervicalspinesupportthehead,andtheneckmusclescanrelax.Holdthepositionsforatleasttwominutes,anddotheexercisetwotofourtimesaday.

slackenthechest(appendixf)Slackening the chestwill relax themuscles in the chest, especially thepectoralis minor muscle. Relaxing these muscles helps people withshouldersroundedforwardtobringthembackintobetteralignmentandwillhelpbring theheadover theshoulder, reducingstrainon theneck.Totallyrelaxandholdthepositionfortwominutes.

slackenthecalf(appendixj)SlackeningthecalfreleasesthecalfmuscleandtheAchillestendon.Dothisexerciseatleastfivetimesaday.Holdfortwominutes.Inthiscase,moreoftenisbetter.

gentlestretchingofcalfmuscles(appendixj)Stretching the calfwill lengthen themuscleand relieve thepain in thatarea.Donotstretchtoodeeply.If thishurts,thestretchistoodeep.Dothisfivetotentimesadayandthenlessfrequentlyasthepainstartstosubside.Holdforoneminute.

strengthentheinsidethighs(adductors;appendixi)Strengthening the adductor muscles will shorten the muscles on theinsideof theupper legandpull the legsback intoneutralalignmentsothat the strain is taken off the low back and knees. Do ten of thecompressions, rest for a minute, and do ten more. Continue in thismanneruntilyoucandofivesetsoften.Thisexercisewillstrengthenthemusclesontheinsideofyourlegsandbegintoreduceyoursymptoms.

slackentheinsidethighs(adductors;appendixi)Most people sit with their legs and feet turned out to the sides. Sittingwithyourlegsandfeetslightlyturnedinwilltakestrainoffthelowerbackand theknees.Donotwalkorstand in thisposition.Do thisonlywhenyouaresitting.Remember,thisshouldnothurt.Ifitdoes,youareturninginyourfeettoofar.

SUPPORTIVELIFESTYLE:ThispartofyourWellnessPlanisdesignedto address the root of the problem and to relieve habitual muscleimbalancestoavoidaggravatingtheconditionasyougoaboutyourdailylife.

checksitting,driving,andcomputerpositions(appendixa)Correcting your posture while sitting, driving, and working at thecomputer will ensure the pelvis stays in balance and that you are notcausingmorestresson theneck,shoulders,and lowerandupperbackthat can lead to fibromyalgia symptoms. These common activities areresponsible for a great amount of the pain in your life. Doing theseactivities the incorrect way will make your body crooked. By slightlychangingthewayyouperformtheseactivities,youwillkeepthebodyinalignment and ensure that once the pain is relieved, it does not comeback.

keepwellhydratedOne of the most common causes of widespread pain is dehydration.Even slight dehydration can cause muscle aches and cramps. Many

peoplearedehydrated.Ifyouhavefibromyalgia,starthydratingassoonaspossible.See chapter 17 for instructionsonhow to drinkwater andhowmuch.Itcantakeuptosixweekstorehydrate.

epsomsaltbathSoak your body in a tub of warm water for twenty minutes. Use fourpounds of Epsom salts every night for five nights. Epsom salt ismagnesiumsulfate,anaturalmusclerelaxantandanti-inflammatory.

heatsoreareasfortwentyminutesUseaheatingpadonsoreareaseverydayfortwentyminutes.Theheatwillhelp themuscles relaxand feelbetter.Continue this treatmentuntilsymptomssubside.

successstoryA thirty-year-old woman came to me with a diagnosis from herdoctor of fibromyalgia. Shewas in constant pain overmost of herbody; her muscles and especially her joints were very sore.Depending on the day, her pain levels were anywhere between 6and8onascaleof10.Shewashavingtroublerememberingthingsandwas also experiencing depression. Her doctor had prescribedpainkillersandantidepressants.Shereportedexperiencingthispainforthelastfiveyears.

WhenItouchedhermuscles,itwasobvioustomethatshewasdehydrated.Hermusclesdidnot feel likewell-hydrated tissue.Herposture was quite poor, which indicated numerous muscleimbalances. It took me about thirty minutes to rebalance hermuscles and bring her body back into alignment. Her pain levelsdecreased immediately. I explained to her that her painwould notcompletelygoawayuntilhertissueswererehydrated.Improvedfluidintakewouldmostlikelyalsohelpwithherdepressionandbrainfog.Iexplainedthatitcouldtakeuptosixweekstorehydrate.

I showed her the Wellness Plan and instructed her to be

consistent, doing the plan every day so her muscle imbalanceswould not return. I also gave her advice on how to rehydrate herbody.

I saw her two months later and she reported she felt greatlyimproved, although she still had some pain. Sometimes therehydrationandtheWellnessPlantakealittlelongertowork.

Anothermonthafterthat,shereportedbeing90%pain-free.Shesaid thatmanydaysshehadnopainat all.Shealso toldmeshehad stopped taking painkillers and antidepressants and that hermoodhadgreatlyimproved.

y

CHAPTER17

thebasiccareofyourbody

ourbodyismuchlikeyourcar.Aslongasyouareusingit,itrequiressomemaintenance.Ihaveculledfrommypracticethemosteffective

habitstocultivatesoyoucanthrive.Whenpracticedconsistently,youwillhavemoreenergyandlesspain.

Inthischapter,youwillfind:

simplepracticestohelpincreaseyourwaterandoxygenlevelsthedaily5forbetterpostureandlesspainaneasypractice todramatically loweryourstress levels,whichwillhelpyoulivepain-free

Inorder for thebody to functionat peakhealth, youmust consumetwovital “nutrients” inadequateamounts.Theseareoxygenandwater.Usuallywedon’tgivethesemuchthought,buttheyareinvolvedinalmosteveryfunctionofthebody.Withoutthesetwonutrients,lifecannotexist.Painlevelsareusuallymuchhigherwhenthesetwonutrientsarenot inadequatesupply.Whenyourbodyhasenoughoxygenandwater, thenthe next step is for the nutrient to get to the cells. This task is donethroughcirculation.Exerciseis,ofcourse,thebestwaytoincreaseyourcirculation so your cells can receive all that life-giving, pain-reducingoxygenandwater.

oxygenIfyouaskpeoplewhat is themost important ingredient forgoodhealth,youwillseldomreceivetherightanswer.Themostcommonanswersareplenty of water or nutritious food. Both of those are important, but notnearlyasimportantasoxygen.Thinkaboutit.Peoplecanlivethirtydayswithnofoodandstillwillnotdie.Peoplecanlivefivedayswithnowaterand still be alive.However, fiveminuteswithout oxygen causes death.Clearlyoxygenisthemostimportantfactorinachievinggoodhealthand

apain-freebody.Everythinginthebodyworksbetterwhenitreceivesanadequatesupplyofoxygen.

Manypeopledonotgetenoughoxygen.Thisismainlyduetothefactthatwebreatheshallowly.Bythat,Imeanweareusingonlyasmallpartof our lungs. This is what is referred to as chest breathing. Properbreathingbyusingallofthelungsstartswiththeabdominalareafillingupwithairand then thechest.Mostpeople filluponly thechest,which isabout a third of our lung capacity. This amountwill keep you alive butdoesnotprovideenoughoxygenforoptimalhealth.

Anotherreasonwedonotgetenoughoxygenisthatourairdoesnotcontain as much oxygen as it once did. When scientists measure thepercentage of oxygen in the air in a pristine environment, such as acountry setting with lots of trees and few cars, the measurement ofoxygentodaytendstobeinthemid20%range.Whentheymeasuretheoxygencontentinanairsamplefromabigcitywithfewtreesandmanycars, theoxygenpercentage is in themid-teens.Oxygensamples frominsidebuildingsareevenlower.Theycanbeaslowas10%.

Whatisevenmoreeye-openingisthattheoxygencontentmeasuredfrom ice samples from three thousand years ago show the oxygencontentoftheairbubblesofthattimetobe40%.Aswecontinuetocutdowntreesandpollute theair,weareslowlydeprivingourselvesof themostvitalnutrientontheplanet.

Asidefromkeepingusalive,whyisoxygensoimportant?Lowlevelsofoxygenareassociatedwithallsortsofchronicdiseases.Oxygenhelpsto clean the blood of bacteria and viruses. Oxygen gives you moreenergy and boosts the immune system. Higher levels of oxygen areusuallyaccompaniedbybetteroverallheath.

Eighty percent of all the pain people experience in their lives ismuscularpaincausedbymuscleimbalances.Thereasonthatnoteverytightmusclecausespainhastodowiththeamountofoxygenthetissuesarereceiving.Whentissuesdonotgetadequateoxygen,theyhurtalotmorethantissuethatisgettingenoughoxygen.Evenifyouhaveatightmuscle, as long as you are getting sufficient oxygen, the oxygen willreduceoreliminatethepain.

Theeasiestwaytogetmoreoxygenistodevelopadailypracticeofdeep,slowbreathing.Thisiseasytodoandhasmanybenefits,suchas

reduced pain levels, clearer thinking, more energy, reduced bloodpressure,andlowerstresslevels.Dothefollowingexerciseatleasttwiceadayfortentofifteenminutesandalsoforshorterdurationsduringtheday.Itmaytakesomepracticetobreakthehabitofchestbreathing,butitiswellworththeeffort.

dailypractice:

Situpstraightorlieonyourback.Placeahandonyourabdomenandslowlyinhalethroughyournose.As you inhale, make sure that you feel your abdomen expandingagainstyourhand.Afteryourabdomen is full,continue to inhale.Nowyoushould feelyour chest expanding. This should be done with no effort orstraining.Slowlyexhalethroughyournoseormouth.Repeattheprocess.

waterWateriscriticalforallbodyfunctions.Expertsagreethatthebodyis60–70%water.Manypeoplearedehydrated—notclinicallydehydrated,butenoughtocausesomeseriousproblems.Properhydrationisthekeytoallofthebody’scriticalsystems.Goodhealthisalmostimpossibleifyourcells are not hydrated properly. Signs of dehydration include fatigue,dizziness, constipation, arthritis, headaches, high blood pressure,anxiety,anddark-coloredurine.

Waterissoimportantthatoneofthefirstproceduresadoctorwilldowhenyouareadmitted to thehospital is togiveyou intravenoussalinesolutiontohelpyouquicklyhydrate.Doctorsknowthatgoodhydrationiscrucialtogoodhealthandreducedmusclepain.

We losea lotofwatersimply throughbreathing. Ifyouareoutonacoldday,youcanseethewatervaporwitheverybreath.Ifyouliveinacoldclimateandliveinaheatedhouse,thetypicalhumidityis15–20%.That is considered desert conditions. Breathing dry air can lead todehydration.

Rememberthatcaffeineandalcoholarediureticsandthustakewaterout of the body. These types of drinks will not hydrate but ratherdehydrate and should be consumed in moderation. Drink a little extrawaterafterconsumingdrinkswithcaffeineoralcohol.

As thebodystarts toget lowonwater, ithas tomanage thiscrisis.The body has a priority system as to how it uses its water. Themainpriorityisthebrain.Thebodydoesnotwantthebraintogetlowonwater.Ifthebodyisnotgettingenoughwater,ithastotakeitfromotherplacestosendtothebraintokeepitfunctioningwell.

Oneof theplaces thebody takes thewater from is the joints.Asaresult, the jointswillnotbe lubricatedenough,whichwillcause themtoacheandbepainful.Thebodyalsotakeswaterfromthediscsbetweenthe vertebrae. This can cause the body to get shorter and possiblycompressanerve,whichisverypainful.Thebodyalsotakeswaterfromthemusclestosendtothebrain.Thisreallocationcancausethemusclesto ache more and be less flexible. When the body can no longer getenoughwatertosendtothebrain,symptomssuchasmemoryloss,brainfog,andheadachescanoccur.

Howmuchwaterandfluidsshouldapersonconsumeeveryday?Thekey is not howmuch you drink but howmuch your cells absorb. Thisamountcandependonmanyfactors.Ingeneral:

Waterisbetterabsorbedwhenitissippedslowlyandnotguzzled.Itisalsobetterabsorbedwhenitisroomtemperature,warm,orhot.If you are not on a salt-restricted diet, you will also absorb morewater ifyouaddapinchofseasaltorHimalayansalt to thewater.Themineralsinthesaltletthecellstakeinmorewater.Coconutwaterisalsoexcellentforrehydratingthebody.Seasaltandcoconutwaterbothcontainelectrolytes,whicharevitalmineralsthatare lostthroughsweatandurine.Electrolytesneedtobereplenisheddaily,astheyarevitaltohydration.

dailypractice:

Haveaglassofroomtemperaturewateruponawakeningtoreplacethefluidslostduringsleep.Sipwaterorherbalteaalldaylong.

Replenishyourelectrolytesdaily.Carryawaterbottlewithyouwhenyouarenothomesoyouhaveasupplyofwater.Beconsistent.Ittakesuptosixweekstorehydrate.Try to consume half of your body weight in ounces of water. Forexample, if youweigh150pounds, try consuming75oz.of fluidaday.Builduptotheselevelsslowlysoasnottoovertaxyourbodilysystems.If you are taking a diuretic, check with you doctor first beforerehydrating.

exerciseItiswellknownthatpeoplewhoexerciseareusuallyhealthierandhavemoreenergy.Oneofthereasonsfortheirsuperiorhealthisthattheyaregetting more water and oxygen to their cells through increased bloodflow. Blood delivers oxygen and water to the cells, which increasesenergyanddecreasespain.

Exerciseraisesyourheartrate.Theheartisthepumpthatcirculatesyourblood.Thebetterthecirculation,themoreenergyyouhaveandtheless pain you experience. Even if you have soremuscles, often just atwenty-minutewalkwillraisetheheartrateenoughtoreducepain.Ifyouarenotabletowalkforthatlong,findotherwaystoincreaseyourheartrate.Startwithfiveminutesandworkupfromthere.

Exercise also contributes to better mental focus and a reducedchanceofsufferingfromdepression.Exercisestimulatesbrainchemicalsthat can make you happier and more relaxed. Exercise also helps toprevent or reverse osteoporosis. It will also improve your digestion,increaseyourmetabolism,andhelpyoutosleepbetter.ExercisehelpstomanagecholesterolandhelpstopreventType2diabetes.Withallthesebenefits, it iscertainlyworthwhile to includesomeexercise inyourdailylife.

Many people lead a sedentary life. They wake up in the morning,drivetowork,sitatworkallday,drivehome,watchTV,andthengotobed.Thatisarecipeforpainful,weak,unbalancedmuscles,depressionand/orbrain fog,unhealthyweight levels,andsleeplessnights.Theold

adage“use itor lose it” is true.Beforeexercising,ofcoursecheckwithyour doctor and see if youare fit to do so.There is noneed for fancyequipment or expensive gyms, although thoseare fine.Simplewalkingwilldo.Thehumanbodywasdesigned towalkmanymilesadaybackwhenwewerehunter-gatherers.Startwithjusttenminutesofwalkingadayifthatiswhereyourfitnesslevelfeelscomfortable.Themainthoughttokeep inmind isnot todo toomuch toosoon.Moderation is thekey.Daily exercise that raises your heart rate even a little will bringtremendousbenefitstoyourphysicalandmentalstateofbeing.

dailypractice:

Walkordosomegentleexercisethatraisestheheartratefortwentytothirtyminutesaday.Thiscouldbespreadouttotenminutesthreetimesaday.Rebounding on a mini trampoline is also an excellent form ofexercisethatiseasyonthejoints.Increasethetimeslowlyasyourfitnesslevelimproves.

thedaily5forbetterpostureandlesspainInmyprivatepractice,Iconsistentlyrecommendfourstretchesandonestrengthening exercise to my clients. Most people will benefit frompracticingtheseexercisesinadditiontotheexercisesforyourparticularcondition.Makethemapartofyourdailyroutine,andyouwillbetrainingyourmusclestogiveyoubetterpostureandlesspain.Youwillalsohavemoreenergyandbeabletothinkmoreclearly.

Thisroutineisalsoappropriateevenifyouhavenopainatall.Makesureyouarenotstretchingtoodeeply. If ithurts,youarestretchingtoodeeply.

dailypractice:

Stretchthequads(seeAppendixB).Stretchthepsoas(seeAppendixB).Stretchthehipabductors(seeAppendixB).Stretchthechest(seeAppendixF).

Strengthenthehipextensors(seeAppendixH).

Theseshouldbedonetwotofivetimesadayforbestresults.Itdoesn’ttakeverylong.

meditationandpainreliefThebenefitsofmeditationforpainreliefaremany.ChronicpainaffectsastaggeringonehundredmillionAmericanseachyear.Manypeoplehavebeensufferingwiththeirpainforseveralyears.

I have noticed that my clients have often tried many differentapproachestohelpthemselveswiththeirpain.Theytakeupanexerciseprogram, change their diets, and start taking nutritional supplements.These can often bring some relief, but it has beenmy experience thatsometimes diets, supplements, and exercise can only take you to acertainstage.Fewofmyclientshaveever toldme that theyhave triedmeditationforpainrelief.

Numerous medical schools like Harvard, Yale, and UCLA haveconducted studies that prove a consistentmeditation practice providessignificant benefits to those who suffer from chronic pain, stress, andanxiety. Many of these studies can be found in well-respectedpublicationssuchasTheJournalofPain,TheJournalofNeuroscience,and The Journal of the American Medical Association. Lowering brainwavefrequenciesthroughmeditationcanbringdramaticandlong-lastingrelief from pain, stress, and anxiety, but this will require consistentpractice.

Neuroscientistsbelievethatstressreductionisamajorcomponentofmeditation’sbeneficialeffectonourhealth.Fromamuscularviewpoint,emotionalstress,whichcausesa“fightorflight”conditioninthebodybyreleasingadrenaline into thesystem,willmakethemuscles in thebodytighterandmorepainful.ManyofthecommondiseasesinAmerica,suchashypertensionandcardiacissues,havestressasamajorcomponent.Studies have also shown that people diagnosed with fibromyalgia(widespreadpaininthebody)haveimprovedbypracticingmeditation.Apersoncanachievelowerstresslevelsinaslittleasfourtosixweeksofaregularmeditationpractice.

dailypractice:

MeditationontheBreathSitcomfortablyinachairwithapillowinthesmallofyourback(seeAppendixA).Thisisaneasyandcomfortablewaytosit.Gentlycloseyoureyes.Bring your attention to the breath. Do not try to control it. Simplyobservethebreathmovinginandoutofthelungs.Undoubtedlythemindwillwanderandbeginthinkingotherthoughts.Whenthishappens,gentlybringyourattentionbacktowatchingthebreath.Startbypracticingfivetotenminutesaday.Youwillsoonfindthatyoucanfocusmoreeasilyandfeelmorerelaxed.

i

thankyou

want to personally thank you for your dedication and commitment toyourownindividualself-careandfortakingyourcareandcompassion

outintotheworld.Bysharingtheideasinthisbook,manypeoplewillbeabletohelpeachotherhavelesspainandmorevitality.

Weareata time in theworldwhen traditionalmedicalmodelsoftenhave no long-term solutions for what we feel in our bodies. We areseekingsolutionsthatoffermorethanshort-termrelief.Intuitively,wefeela need for the knowledge that can help us heal ourselves.We feel aneed to learn how to be less stressedwithout drugs and how to havehappinessaswejourneythroughlife.Ihavebeenhelpingpeopleforoverthirtyyearstoachieveapain-freelife.IthasbeenmyexperiencethattheIPTprotocolsdiscussedinthisbookhavegivenmanytheknowledgetohavemoreeaseintheirbodiesandmorecalmintheirhearts.

Weallhaveahandinweavinganewfuturefortheworld.Together,wearemakingadifference!Ibelieveweareonthisplanettohelpeachother. There can be no greater aspiration than to help your family,friends, andneighbors achieveamore fulfilling life by having less painandstress,andmorepeaceandhappiness.TheDalaiLamasaiditbest:“Whenwefeelloveandkindnesstowardothers,itnotonlymakesothersfeellovedandcaredfor,butithelpsusalsotodevelopinnerhappinessandpeace.”

It ismyutmostdesirethat the informationcontainedinthisbookwillbeofsomevalueonyourjourneywhileyouareonthisplanet.TrywhatIhave suggested and see for yourself that you are capable of helpingyourselfleadamorefulfillinglife.Iwishyoumuchpeace,happiness,andofcourseapain-freelife.

i

acknowledgments

wouldliketotakethisopportunitytogratefullyacknowledgetheworkofsomeamazingpeoplewhosecontributionswereinvaluable.ToMarciaAlbert,mywife,whosowillinglygaveofher time to read

themanuscriptandwasabletofigureoutwhatIwasreallytryingtosayandthenhelpmechoosetherightwords.

ToLisaOliver,MD,whoreadthroughthemanuscriptandmadesurethatIwasmedicallyaccurateandhelpedmenavigatemedicaltermsandprotocols.

TomymodelsAndySteigmeier LMT,CSCS, and Laura Jensen fornevercomplainingwhenwehadtoshootthesamephotooverandovertomakemehappy.

TomyphotographerKarlaArchambeault,whomadesureeverydetailofthephotoswascorrectandkepteveryonehappyandontrack.

Tomy illustratorPhilipNato,whoredreweverythingwithoutasinglecomplaintuntilIfiguredoutwhatIreallywanted.

I give each of you a heartfelt thank you for your love, support, andexpertise.Yourcontributionshavemeanteverythingtome.

—LeeAlbert,NMTFormoreinformation,pleasevisitLee’swebsiteatwww.LeeAlbert.com

w

caution

iththefollowingexercises,neverstretchintoapainfulposition.Youwillachievebetterresultsbybeinggentle.

Thegoal is not to stretch as far as possible but to slightly increaserange of motion. Done consistently, the results can be dramatic andpermanent.Nothingshouldeverhurtwhiledoingtheseexercises.

If pain occurs during an exercise, try the stretch or position moregently. If it still hurts, skip that exercise for now and continuewith theonesthatdon’thurt.

If you are not getting better in three to five months of doing theseprotocols, please checkwith your health care provider formore insightintoyourcondition.

appendices

appendixa

appendixb

appendixc

appendixd

appendixe

appendixf

appendixg

appendixh

appendixi

appendixj

appendixaProperSitting,Driving,andComputerPositions

ProperSittingPosition

Sitwithapillowplacedinthelumbarcurve.Thisisjustabovethebeltline.Itisimportantthatthepillowistherightthickness.Everychairandeverybodyneedsadifferentthickness.Thepillowshouldbethickenoughtobringyourheadbackoveryourshouldersandopenthechest.Apillowthatistoothickwillbeuncomfortable,andifitisnotthickenough,yourheadwillbeforwardofyourbody.Thecorrectpositionallowstheskeletontosupportyourbodyandshouldfeel

tosupportyourbodyandshouldfeelcomfortable.Thiswillcontributetooverallgoodpostureandreducedbackandneckpain.Ifthisispainful,disregardfornow.

ImproperSittingPosition

Thistypicalunsupportedpositioncancausemuscletensioninthelowback,upperback,neck,andshoulders.Thispositioncanalsomakethehipsunevenandleadtodiscproblems.Inthisposition,yourmusclesareworkingtoholdyouup,creatingtensionandpain.

ProperComputerPosition

Whensittingatyourdesk,keepyourelbowsbyyourside.Armsshouldbebentabout90

byyourside.Armsshouldbebentabout90degrees.Tofindthisposition,standnormallywithyourarmsatyourside.Bendtheelbowsto90degrees.Thatshouldbehowitlooksandfeelswhenyouaresitting.Thecomputermonitorshouldbeeyelevelandstraightinfrontofyousoyouarenotbendingyourneck.Feetshouldbeonthefloororonafootrestandslightlyturnedin.Danglingfeetcancauselowbackpainandpoorcirculation.

ImproperComputerPosition

Thiscommonpositioncancausemuscletensioninthejaw,shoulder,andneck.Donotreachforthemouseorkeyboard.

ProperDrivingPosition

Whendriving,useyourpillowandkeepyourelbowsatyourside.Handsshouldbeatthe

eighto’clockandfouro’clockpositions.Thispositionallowsyourbonestosupportyourbody,avoidsexcessivemuscletensionintheneckandshoulders,andhelpstoavoidpotentialtraumatothefaceifyourairbagsdeploy.Manystatesnowteachtheirnewdriverstoholdthewheelateightandfourasasafetyprecautiontopreventinjuryfromairbagdeployment.

WARNING:Ifyoudonotfeelsafedrivingatthefouro’clockandeighto’clockhandpositions,thendrivethewayyounormallydo.Itisbettertohavesoremusclesandbesafe.Ifyoudofeelcomfortabledrivingatfourandeight,youwillfindthatthisisamuchbetterergonomicposition.

ImproperDrivingPosition

Drivingwithhandsattheteno’clockandtwoo’clockpositionscancausemuscletensionintheupperback,shoulders,andneck.

appendixbfourstretchestobalancethepelvis

These stretches will usually bring your pelvis into alignment. They willensurethereisnoabnormalstrainonyourhipjoints,knees,orfeet,and

they correct themost common imbalances in thepelvis.Perform thesefourstretches three timesperday tokeepyourhips inalignment.Holdthesestretches for oneminute.Thesestretches shouldbedonegentlyand should not cause any pain. Breathe normally throughout theseexercises;don’tholdyourbreath!

QuadratusLumborumStretch

Standupstraightwithyourlegsslightlyapart.Raiseyourarmsandslowlybendtowardtheoneside,reachinguntilyoufeelastretchalongthesideofyourupperbody.Holdoneminute.Repeatontheotherside.

QuadratusLumborumStretch(modified)

Standupstraightwithyourlegsslightlyapart.Raiseyourarmononesidesothatyourfingersarepointingtowardtheceiling.Restyourforearmontopofyourhead.Onthesidewherethearmisonyourhead,slowlybendtowardtheoppositeside,untilyoufeelastretchalongthesideofyourupperbody.Restthenon-reachinghandonyourleg.Holdoneminutewhilebreathingnormally.Repeatontheotherside.

HipAbductorStretch

Lieonyourback.Bendonelegandplacethesoleofthefootontheoppositeleg.Gentlyuseyourhandtopullyourbentkneetowardthefloor.Feelthestretchontheoutsideoftheupperlegandinthebuttocks.Withoutlettingthebentkneemove,gentlypushthekneetowardtheceiling,resistingwithyourhand,forfiveseconds.Nowpullthelegintoadeeperstretchtowardthefloor.Holdforoneminute.Repeatontheotherside.

HipAbductorStretch(modified)

Sitinachairandcrossonelegovertheother.Thiswillgentlystretchyourhipabductormusclesontheoutsideoftheupperleg.Donotperformthisexerciseifyourlegs“fallasleep.”

QuadricepsStretch

Holdontothebackofachairorputyourhandonawalltohelpkeepyourbalance.Reachbackwithonehandtograspthefootandbringtheheeltowardthebuttocks.Feel

andbringtheheeltowardthebuttocks.Feelthestretchinthefrontoftheupperleg.Pushyourfootgentlyintoyourhandforfiveseconds.Bringtheheelclosertothebuttockstodeepenthestretchandholdforoneminute.Repeatontheotherside.

QuadricepsStretch(modified)

Placethetopofthefootandthelowerlegonachairorsofatoachievethisstretch.Repeatontheotherside.

PsoasStretch

Placeonefootonachairorstool.Thefootonthefloorisbehindthebody.Standtallandlengthenyourspine.Gentlyleanbackwarduntilyoufeelastretchintheupperthigh.Holdforoneminute.Repeatontheotherside.

PsoasStretch(modified)

Placeyourhandsonyourhipsandgentlybendbackward.Ifthishurtsthelowback,youarebendingbacktoodeeply.

appendixcthreeneckstretches

Thesethreestretchesreleasethemusclesintheneckandbringrelieftothearea.Theyalsoallowincreasedbloodflowandoxygentothebrain.Trydoingthesethreestretchesinawarmshowereverymorning,asthestretches work even better when the neck tissue is warm. Do theseexercisesonetothreetimesaday.Alwaysworkgentlyandslowly.

BackoftheNeckStretch

Withhandsatthebackofthehead,pulltheheadforwarduntilyoufeelaslightstretch.Gentlypushbackwardintoyourhandsforfiveseconds,butdonotlettheheadmove.Nowpullforwardintoadeeperstretch.Repeatafewtimesaslongasitfeelsgood.Thiswillstretchthemusclesalongthebackofyourneck.

SideoftheNeckStretch

Withyourhand,pullyourheadtoonesideuntilyoufeelaslightstretch.Reachwiththeoppositehandtowardthefloorthroughouttheexercise.Gentlypushyourheadintoyourhandforfiveseconds,butdonotlettheheadmove.Nowpulltheheadtothesideintoadeeperstretch.Repeatafewtimesaslongasitfeelsgood.Repeatontheotherside.Thisexercisestretchesthemusclesonthesideofyourneck.

FrontoftheNeckStretch

Turnyourheadtoonesidetolookoveryourshoulderuntilyoufeelaslightstretchinyourneck.Placeyourhandonyourcheekandgentlytrytoturnbacktothecenter,resistingwithyourhandagainstyourcheekforfiveseconds.Donotlettheheadmove.Thenturnyourheadintoadeeperstretchtowardthefirstdirection.Repeatafewtimesaslongasitfeelsgood.Repeatontheotherside.Thisexercisestretchesthemusclesonthefrontofyourneck.

appendixdjaw

SlackentheJaw

Gentlypushthelowerjawtoonesideandholdfortwominutes.Repeatontheotherside.

appendixeshoulders

ShoulderShrugs

Gentlysqueezeyourshouldersuptowardyourearsandholdfortenseconds.Repeatmanytimesthroughouttheday.

SlackentheShoulders(LevatorScapulaandUpperTrapezius)

Eitherlyingdownorsittingup,placeyourforearmontopoftheheadandletitrestinthatpositionwiththeheadtiltedtowardthepainfulside.Holdforatleasttwominutes.Thispositionwillrelievetensionintheshoulders,especiallytheuppertrapeziusandlevatorscapula.Dothisanytimeyoufeeltensioninyourshouldersorneck.Donotdothisifithurtstoputyourarmontopofyourhead.

StrengthenRhomboids&LatissimusDorsi

Holdyourhandsbehindyourback.Squeezetheshoulderbladestogetherforoneminute.Whilesqueezingtheshoulderbladestogether,alsopullthemdowntowardthefloor.Thiswillhelptostrengthenthemusclesbetweentheshoulderbladesandthemusclesbelowtheblades,thustrainingthemusclestobringtheheadovertheshoulders,improvingtheposture,andreducingthestrainontheneck,shoulders,andupperback.

appendixfchestexercises

StretchtheChest

Squeezeshoulderbladestogethergently.Holdforatleasttwominutes.Thiswillstretchthechestmusclesandbringtheshouldersbackintoalignment.Thiswillreleasetensionbetweentheshoulderbladesandthemusclesknownastherhomboids.

SlackentheChest

Placeeachhandontheoppositeshoulderasifhuggingyourself.Totallyrelaxandholdthepositionfortwominutes.

appendixgarmandhandexercises

ElbowTendonRelease

Gentlypushthetissueoftheforearmtowardtheelbow.Holdatleasttwominutes.

SlackenandStretchtheForearm—twodirections

Gentlytwistyourpalmsoyourthumbfacesdown.Thiswillreleasetensioninyourelbowandwrist.Holdatleasttwominutes.Thentwistthearmtheotherwayandholdfortwominutes.Ifanyofthesetwistsbringonthesymptoms,donotdotheseexercisesuntilyoursymptomsdissipate.

Ifyouaretreatingcarpaltunnelsyndrome,keepyourwriststraight.Abentwristcouldbringonnumbnessandtingling.

Fortenniselbow,thewristshouldbeslightly

Fortenniselbow,thewristshouldbeslightlybentbackward.

Forgolfer’selbow,thewristshouldbeslightlybentforward.

SlackentheThumb

Gentlysqueezeyourthumbandpalmtogethersothatyourlittlefingerandthumbaretouching.Holdatleasttwominutes.Ifyouaretreatingcarpaltunnelsyndrome,keepyourwriststraight.Abentwristcouldbringonnumbnessandtingling.

appendixhhipandbuttocksexercises

SlackentheHipFlexors(PsoasandQuadriceps)

Lieonyourbackonthefloor.Bendatthehip90degreesandattheknees90degrees.Restthelowerlegsonachairorsofa.Relaxinthispositionforatleasttwominutes.

StrengthentheHipExtensors(HamstringsandGluteusMaximus)

Lieonyourbackonthefloor.Armsareatyourside.Bendyourkneesandkeepyourfeetflatonthefloor.Liftyourhipsoffthefloorandkeepyourbackrelativelystraight.Youmaynowclaspyourhandstogetherbeneathyourhips.Youhavetheoptiontosqueezeablockorpillowbetweenyourkneestohelpstrengthentheadductorsaswell.

SlackenthePiriformis(Half-Frog)

Lieonyourstomach.Bendonekneeandbringthatlegabouthalfwayupalongthefloorsothatthethighisatarightangle(orslightlyless)toyourtorso(half-frog).Holdatleasttwominutes.Thiswillreleasetensioninyourlowbackandthepiriformis.Repeatontheotherside.

appendixiinnerthighexercises

SlackentheInsideThighs(Adductors)

Sitwiththethighsspiraledin(pigeon-toed).Relaxinthispositionforatleasttwominutes.

Relaxinthispositionforatleasttwominutes.Sittingwithyourlegsandfeetturnedinwilltakethestrainoffthelowerback,knees,andgroin.Donotwalkorstandlikethis;dothisexerciseonlywhensitting.

StrengthentheInsideThighs(Adductors)

Sitinachair.Placeapillowbetweentheknees.Youcanalsouseasmallball.Squeezethekneestogetherforfiveseconds.Dotenofthesesqueezesandthenrestforaminute.Doanothertensqueezesandrestagainforoneminute.Continueinthismanneruntilyoucandofivesetsoftenreps.Thiswillstrengthenthemusclesontheinsideofyourlegsandbegintoreduceyoursymptoms.

appendixj

lowerlegexercises

SlackentheCalf

Sitinachairandplacethesorefootorcalfontheoppositethigh.Gentlybendyourfoot,givingyourselfabigarch.Holdthatpositionfortwominutes.Thisputsthecalfmuscle,thebottomofthefoot,andtheAchillestendonintoaslackenedpositionandgivesalmostimmediaterelief.Inthiscase,moreoftenisbetter.

StretchtheCalf

Standontheedgeofastepandlettheheelsdropgentlytowardthefloor.Holdontotherailing.Holdforoneminute.Donotstretchtoodeeply.Ifthishurts,thestretchistoodeep.

AchillesTendonRelease

Placeyourfootontheoppositethighandgentlypushthetwoendsofthetendontogether.Holdfortwominutes.Dothisfivetimesaday.

abouttheauthor

Lee Albert, NMT, creator of Integrated Positional Therapy (IPT), is anationally recognized yoga instructor and expert in neuromuscular painrelief.Forover threedecades,Leehashelpedpeople learnhowto livepain-freeusingIPT’sinnovativetoolsandtechniques.Hetreatspatientsone-on-one at the Kripalu Center for Yoga & Health in LenoxMassachusetts.Leeconducts trainingseminars in IPT,Pain-FreeYogaand consults with businesses on ergonomic training for employees toreduceworkplaceinjuries.HeisalsotheauthorofYogaforPainRelief:aNewApproach toanAncientPractice (2017).Hiswork is featured inaPBSspecialwithPeggyCappy, “LivingPain-free.”ConnectwithLeeatwww.LeeAlbert.com.