Cause of the Ache in Your Tailbone when Sitting
Here’s what can cause the ache in your tailbone when you’ve been sitting. And what to do.
Does your tailbone hurt after you’ve been sitting for a while, even though you haven’t recently fallen on it?
“Although there is not one single answer to this question, the most common cause is coccydynia,” says Dr. Mark Galland, orthopedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina.
“This is a condition in which the smallest segment of the spine, the coccyx or tailbone, is irritated or inflamed,” continues Dr. Galland.
“This type of inflammation can be caused by arthritis, or post-traumatic or repetitive stress. This is a condition that is seen more commonly in slender people who do not have very much tissue in that area of their body.”
Does this mean gain weight if your tailbone is hurting or aching from sitting?
If you’ve always felt you were underweight, then perhaps it’s time to increase your caloric intake by eating more “clean” whole foods such as chicken, turkey, lamb, grass-fed beef, nuts and whole grains. Take up strength training to add muscle.
A physically fit person, or to put it another way, a person with a well-trained body, should not experience tailbone from sitting as long as the seat is comfortable rather than a hard slab of wood.
But if you’ve made sure the seat is comfortable and padded, and if people often call you “thin,” then maybe some healthy weight gain is in order.
Eating more junk food to add more fat is not a good solution to eliminating the hurt of a tailbone from sitting.
Make it a point to avoid sitting for long than 30-45 minutes at a time; get up every so often and walk around. Make sure your posture is correct when sitting.
Dr. Galland has authored many book chapters and papers in sports medicine. His advice and consultation have been sought by world-class athletes in track and field and Major League Baseball.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/fizkes
Why Your Grip Can Be Causing Elbow Pain when Bench Pressing
There’s a specific reason why your elbow hurts or feels “funny” when you bench press.
The tweaky kind of pain may occur the most as you remove the bar from the rack, then lessen a bit as you lower, then return more as you press up.
Elbow pain is caused by the grip.
If you have golfer’s elbow, chances are it hurts to grip things regardless of hand position (e.g., underhand, overhand).
Golfer’s elbow is an inflammation of the tendon that’s located at the inner portion of the elbow (medial to the body).
As a result, perhaps you’ve backed off on grip-and-pull exercises like lat pull-downs, rows and deadlifts. However, does your golfer’s pain kick up when you bench press?
Depositphotos.com
Perhaps the distinct discomfort is most pronounced when you lift off the bar, but subsides during the actual bench pressing. Or maybe it persists throughout the entire set.
Bench pressing itself won’t cause golfer’s elbow (however, it can cause tennis elbow: inflammation of the lateral epicondyle tendon, whereas golfer’s affects the medial or inner epicondyle tendon).
However, the bench press can stimulate the medial epicondyle tendon.
“Pain that is transmitted to the elbow during a bench press usually means that one is putting too much pressure on this joint as the force is transmitted down from the wrist to the arms and then shoulder,” says Dr. Moshe Lewis, MD, board certified in physical medicine and rehabilitation.
“Since the common flexor tendon attaches this muscle (the flexor muscle) to the interior of the elbow joint or medially, if it is already inflamed then a forceful grip during a bench press is likely to increase pain.
“One can decrease the grip — keeping the palm open and the bar balanced — and/or lower the amount of weight being pressed to help minimize further damage.”
Dr. Lewis is the founder and CEO of Golden Gate Institute for Physical Medicine in CA, which provides education and clinical management of pain.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Syda Productions
Cause of Sudden Severe Shoulder Pain that Comes and Goes
Find out why you get sudden “pain attacks” in your shoulder that can stop you in your tracks.
You’re just sitting there, maybe watching TV or eating, when suddenly, it strikes out of the blue: yet another pain attack of your shoulder, biting down hard on you.
You must stop what you’re doing and try to bear the pain without loudly moaning.
Let’s assume you’ve had your heart, aorta and lungs examined to rule out any conditions with these structures, as problems with these can indeed radiate discomfort to the shoulder.
So where can this intense, sudden shoulder pain come from, if you haven’t recently fallen on this joint, been hit there by a baseball or broken a bone there?
“Here too, making sure there is not a muscle or ligament tear is important, i.e., clinical exam and MRI,” says Dr. Moshe Lewis, MD, board certified in physical medicine and rehabilitation.
But let’s assume you’ve already had an exam and MRI, indicating no tear.
“If this is negative, presumably, the pain still has to be minimized or else therapy will only flare things more.
“Options include an anti-inflammatory or icing for acute pain, heat for chronic pain.”
So what’s causing your sudden, severe shoulder pain?
It’s likely arthritis or shoulder impingement.
Impingement is when the top of the humerus bone of the upper arm impinges upon one or more of the tendons of the rotator cuff, literally fraying it. See the image below.
Even if you think you’re sitting still, tiny, subtle movements in your position could shift the humerus against the inflamed edges of a rotator cuff tendon. This really hurts.
Another possible cause of sharp pain in the shoulder that comes and goes:
“Sometimes a cervical pinched nerve can masquerade as shoulder pain,” says Dr. Lewis.
“A good exam is in order.” This would likely be an MRI of the neck.
Dr. Lewis is the founder and CEO of Golden Gate Institute for Physical Medicine in CA, which provides education and clinical management of pain.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/SpeedKingz
Will Surgical Tibia Lengthening Improve Back Squat Leverage?
More and more people are having their tibias or shins surgically lengthened strictly for cosmetic purposes: that of being taller.
Surgical techniques for tibia lengthening have improved over the years, and people who desperately want to be taller are undergoing this painful procedure.
As a former personal trainer, and lifelong fitness buff, I am acutely aware of anthropometrics, particularly limb leverages as they apply to the back squat exercise.
I’ve already written quite a few articles on “long femurs,” meaning a femur longer than torso length will put a person at a biomechanical disadvantage in the back squat.
Short shin, long thigh
However, those whose femurs are equal in length to their torso, rather than longer, will still have a biomechanical disadvantage in the back squat — if their shins are disproportionately short for their whole leg.
The reason is that in order to keep from toppling backwards in a back squat, one must align their shoulders over their midfoot.
To put it another way, the foot has to get under the buttocks while squatting. The more under the buttocks the feet are, the less the athlete needs to lean forward.
Short Tibias Are a Disadvantage in the Back Squat
People with relatively short tibias can’t get their feet well under their butt. (Note “relatively” here; having “short shins” has NOTHING to do with overall body height; a tall person can have relatively short shins, and a short person can have relatively long, pedestal-like tibias),
To compensate in a back squat, they must lean far forward: not an efficient position for a back squat. Imagine someone with shins much shorter than their femurs.
Picture a profile of them squatting. Now “grow” their tibias to be longer than their femurs.
What happens? Long tibias act as support pedestals for a back squat.
So would surgical tibial lengthening enhance one’s ability to do a back squat?
Well, from a biomechanical standpoint, the answer is yes if recovery is complete; longer tibia relative to femur means better leverage.
But does this mean it’s a smart idea to undergo surgical limb lengthening if both your limbs are the same length, your legs are straight (no bone deformity) and all you want is better anthropometrics for the back squat?
Doctor’s Perspective on Tibia Lengthening
“As you know, many MDs frown on back squats because people tend to get carried away and put too much strain on this often weak or conditioned set of muscles,” says Dr. Moshe Lewis, MD, board certified in physical medicine and rehabilitation.
“I don’t know too many orthopedic surgeons who recommend tibial lengthening sheerly for cosmetic reasons or being able to do squats.
“The patients I have who had these procedures typically have more than 2 inches leg length discrepancy, typically having had a fracture or hip surgery.”
Bottom line: Don’t even think of having your tibias surgically lengthened to improve your back squat.
You’d need to avoid weightlifting for two years following this procedure for complete recovery! And complete recovery isn’t even guaranteed.
Plus, the cost is astronomical and not covered by insurance.
Dr. Lewis is the founder and CEO of Golden Gate Institute for Physical Medicine in CA, which provides education and clinical management of pain.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Dean Drobot
Cause of Stabbing Ankle Pain that Comes and Goes
Find out the likely causes of that awful, stabbing pain in your ankle that comes out of the blue.
You haven’t broken your ankle; you haven’t even twisted it.
Yet every so often you get a sharp or stabbing pain in this joint.
Likely Causes of Sharp Pain in the Ankle that Comes and Goes
“Typically it is due to altered kinetics, i.e., may be abnormal forces transmitted through one extremity versus the other,” says Dr. Moshe Lewis, MD, board certified in physical medicine and rehabilitation.
“Issues including weight and posture should also be addressed. We should investigate the anatomy of the feet and consider custom orthotics.”
Orthotics in this case are shoe insert devices that are custom molded to an individual’s foot shape, designed to redistribute forces and alignment for better comfort and elimination of pain.
Dr. Lewis continues, “The source of the pain has to be established and minimized before intense exercise.
“This could include a tendonitis, bone deformity, strained arch or even neuropathy.
“Typically, stabbing pain is thought due to the latter or a spur.”
Neuropathy means damage or dysfunction of the nerves.
It commonly affects the peripheral nerves, which are outside the brain and spinal cord.
This damage can lead to a range of symptoms, depending on which nerves are involved.
A bone spur, also known as an osteophyte, is a bony growth that forms along the edges of bones, often where bones meet at a joint.
Bone spurs may form in response to repetitive stress or injury.
In the case of the ankle, the repetitive stress might come in the form of frequent running, jumping or pivoting.
These activities can irritate the ankle joint, causing the body to deposit extra bone.
Activities like basketball, volleyball, jump rope or long-distance running put constant pressure on tendons and ligaments, leading to inflammation and eventually a bone spur forming as the body tries to stabilize the area — but ironically, leading to pain.
Bone spurs are are typically smooth but can become rough and thus cause pain or discomfort if they impinge on surrounding tissues, such as tendons or nerves.
To get to the bottom of what’s causing sharp or shooting pains in your ankle, make an appointment with a podiatrist, a physician who specializes in foot care.
However, if you’re an athlete you might want to consider a sports medicine doctor, since sport may be behind the discomfort.
Dr. Lewis is the founder and CEO of Golden Gate Institute for Physical Medicine in CA, which provides education and clinical management of pain.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Yuttana Jaowattana
Low Back Pain after Sitting: Cause & Solutions
Sitting should not have to cause low back pain, and there are things you can do to remedy this annoying problem.
Why do some people have low back pain after sitting for a while?
Let’s assume that if your low back hurts after prolonged sitting, it’s not because you recently fell, were in a car or ski accident, or wrenched muscles while lifting something heavy.
“Sitting creates the most pressure on the intervertebral discs,” says Dr. Moshe Lewis, MD, board certified in physical medicine and rehabilitation.
Sitting shifts the pelvis backward, flattening the natural lumbar curve.
This posture compresses the discs unevenly, especially in the lower back, increasing the pressure within the discs.
Unlike standing, sitting reduces support from core muscles and places more load directly on the spine.
Prolonged sitting, particularly with poor posture, can strain the discs and contribute to back pain or disc degeneration.
“Solutions include inversion/tilt tables, traction and core strengthening,” says Dr. Lewis.
Inversion/tilt tables and traction are not practical for many people, but anyone can get started on core strengthening.
I recommend core strengthening exercises several times a week.
The core is the low back and abdominal regions. There are many core strengthening exercises out there.
An example is the back extension with leg support (just about every gym has the equipment for this). Do eight to 12 times.
George Stepanek, CreativeCommons
Another exercise that will engage the core is the “camel back,” illustrated below. Do eight to 12 times.
A third exercise is the kettlebell swing. Start out with a small kettlebell and swing for eight to 12 times, working your way up to 15 times.
Shutterstock/gpointstudio
Freepik pressfoto
Below is another core exercise. Hold soup cans if you don’t have weights, or extend your arms without any weights.
Freepik.com
Do two to three sets of each exercise. If you don’t have access to a kettlebell, you can use a dumbbell if you have one around the house, or an old milk or juice jug filled with water.
A person with a strong, conditioned core will not experience low back pain after long periods of sitting.
Dr. Lewis is the founder and CEO of Golden Gate Institute for Physical Medicine in CA, which provides education and clinical management of pain.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Freepik/shayne_ch13
Complete Back & Biceps Routines You Can Do with Golfer’s Elbow
Can’t do pulling exercises (rows, chin-ups, deadlifts) because of elbow pain?
I have the solution. Elbow pain often comes in the form of “golfer’s elbow.”
This is an inflammation of the tendon on the inner (medial) aspect of the elbow. The medical name is medial epicondylitis.
Not all people with golfer’s elbow got it from golfing. It can also occur from sports involving throwing as well as from lifting weights.
Lifting weights is how I got golfer’s elbow. Many muscle building enthusiasts find that golfer’s elbow prevents them from performing exercises that involve pulling, because in order to pull something, you must grip it with your hand.
The medial epicondyle tendon is activated with gripping. Hence, gripping (as you do for the deadlift, seated row and lat pull-down) aggravates golfer’s elbow.
Work the Back and Biceps Despite Golfer’s Elbow
After a lot of experimentation at the gym, I figured out ways that someone with this condition can STILL DO PULLING EXERCISES.
How to do the deadlift with tendonitis of the elbow. Tendonitis doesn’t mean you must entirely sacrifice the deadlift motion and end up with pathetically weak back muscles.
How to do lat pull-downs. There is no need to give these up. You just have to know how to modify them to accommodate your elbow pain so that the tendon has a chance to heal.
How to do biceps curls. You can actually activate the biceps without having to grip the handles of a free weight or a machine.
Try my technique to prevent your biceps from going flat on you.
How to do shoulder shrugs. You won’t get traps like the Incredible Hulk, but at least there will be some degree of activation with this modified approach.
Golfer’s elbow stinks, but it doesn’t have to keep you from working the back and biceps muscles.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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How to Do Inverted Rows with Golfer’s Elbow
Believe it or not, there are two ways to do inverted rows while protecting your golfer’s elbow from further injury or pain.
If you have golfer’s elbow, you can actually do sets of inverted rows.
I’m a former personal trainer who had golfer’s elbow. It hurt when I did the slightest gripping against resistance.
The medial epicondyle tendon of the elbow is what’s involved in gripping, and it is this structure that’s at the center of golfer’s elbow.
To spare this tendon any stimulation and allow it to heal, you must avoid gripping — at least with the index finger. More on that later.
Gripless Inverted Rows for Golfer’s Elbow
The first way is with a dual cable cross machine that provides a width adjustment.
Set the pins on a total weight that exceeds your body weight. Next, lower the cable arms to a height so that the strap-handles’ distance from the floor is about the same distance you would normally use a bar when doing standard inverted rows.
Set the width accordingly. If you normally do inverted rows with your heels on the floor, your equipment setup is completed.
If you normally elevate your feet, bring over a 12- or 18-inch workout stool if your gym has these.
Do not position it between the strap-handles and the machine; there won’t be enough room to extend your body and perform the inverted rows.
Instead place the stool (or chair, whatever you have), out away from the arms (hopefully there’s room).
Place heels on it and pretend you’re getting into position for the exercise to make sure the stool is the right distance from handles.
You will NOT be gripping the plastic handles. Instead you will be inserting both hands through them so that the strap portion tugs against the underside of both wrists.
If you have golfer’s elbow only on one side, you still must put BOTH hands in this position to ensure equality on both sides of your body.
Though this technique — straps digging into the wrists — sounds painful, it’s not. You will likely be able to do full-out inverted rows this way with minimal discomfort, if any at all.
The plastic part of the handle must NOT make contact with wrists; slide it off to the side, and only the strap portion makes contact with your skin.
You can slip your hands through while sitting up, then recline back into the start position; or, you can insert hands while maintaining a reclined position.
You’re now ready to begin reps. The handles should be high enough off the floor so that, when you’re at the bottom of the movement, your arms are nearly straight.
If you feel aggravation in the tendon, cease the activity. I can only speak for what has worked for me.
I advise against using a forward-palm grip, as this pronation may aggravate the tendon. First try a supinated (palms facing you) grip, then a neutral grip of palms facing each other.
Suspension Straps
This same technique can be done with suspension straps. It’s a matter of personal preference.
But I actually think it’s a whole lot easier with suspension straps. The reason I myself did not use suspension straps was because, at the time I had the golfer’s elbow, the gyms I was working out at did not have suspension straps set up.
They now do, however. This device will work superbly and does not require the set-up hassle as the dual cable equipment.
The problem is that many gyms don’t have these suspension straps. But if yours does, I recommend that you try the inverted rows on these first.
Gripping that Excludes the Index Finger
It’s possible that you can avoid the pain of golfer’s elbow by excluding the index finger from your gripping activities.
The medial epichondyle tendon controls flexion of the index finger against resistance, such as when gripping or using it to press down on a knife when cutting meat.
Try the inverted row without the index finger. If it still bothers the elbow, then exclude the thumb, so that you’re gripping the handle with only the middle, ring and pinky fingers.
This is very doable but will require a reduction in weight load from what you’d normally use with all five fingers and a healthy elbow.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Golfer’s Elbow: How to Do Shoulder Shrugs if You Can’t Grip
There’s actually a way to do the shoulder shrug exercise against heavy resistance if you can’t grip due to golfer’s elbow.
Golfer’s elbow has the potential to make gripping hurt, since the medial epicondyle tendon in the elbow is engaged when you grip something, particularly when the index finger is involved. I’m a personal trainer and I have left golfer’s elbow.
To do shoulder shrugs with golfer’s elbow, you first need a dual cable cross machine.
The cable arms must be adjustable width-wise in addition to height-wise. Set the arms as low as they can go, and set the width so that it’s about the same as when you do regular shoulder shrugs.
How to Grip
Instead you’ll be slipping your entire hand through them so that the strap portion of the loop tugs against the underside of your wrist.
The plastic portion of the loop does not make contact with your wrist; it’s off to the side of the loop.
If the strap is against bare skin, this will be quite painful, so you’ll need to wear a barricade between your skin and the strap: a full-length Ace bandage wrapped firmly around your wrist.
Place it so that half of it is on either side of the crease in your wrist. Make sure the bandage is securely fastened so that it doesn’t unravel.
Even if you have golfer’s elbow in one arm, you will need to fashion your other hand with a bandage, to make the shoulder shrug equal on both sides of your body:
Both hands will be through the loops with the straps tugging against the undersides of the wrists.
Stand smack between the machine’s arms, lower yourself and position hands as already described, then stand straight, and you’re ready to do shoulder shrugs even though you have golfer’s elbow.
If you normally shoulder shrug with an overhand grip, you’ll probably need to use a neutral or underhand palm position, because golfer’s elbow may incite pain if you tug against resistance using a pronated (overhand) position.
Make sure that the hand on the side of the golfer’s elbow is open wide, as though you’re trying to make a hand print.
This deliberate hand print position will ensure that no inclination towards gripping (curling in the fingers) occurs.
You must avoid any inclination towards a gripping position!
To help with this, splint your index finger with a tongue depressor cut to size and taped.
This will make it impossible to curl in that finger.
The minute that finger curls in against any kind of resistance, the medial epicondyle is activated.
The thumb is also barred from gripping.
Simply perform the shoulder shrugs with these restrictions, and you’ll need to experiment with amount of resistance.
The strap will also be uncomfortable on the underside of the palms, but you’ll get used to it.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
How to Do Lat Pull Downs with Golfer’s Elbow
If you have golfer’s elbow, here is how to perform the lat pull-down without gripping a bar or handle.
If your golfer’s elbow makes it painful to pull against resistance, this means you can’t do lat pull-downs in the usual way.
I’m a former personal trainer who had golfer’s elbow — and I have some great information for you.
I didn’t want to give up my pulling exercises while the golfer’s elbow had a chance to heal, so I figured out a way to get around this.
Lat pull-downs can be done using a dual cable cross machine – but instead of gripping the handles with my hands, I grip them with the underside of my wrists.
This eliminates the activation of the medial epicondyle tendon because this wrist grip does not require any finger gripping. It’s the finger gripping that aggravates golfer’s elbow.
The arm bars of the dual cable cross machine need to be close enough together so that it’s not too cumbersome to get your wrists properly positioned.
This means a wide width will be cumbersome, but it’s doable, especially if you have a partner to help get your second wrist set up (it’s easy to do the first one; it’s the second one that’s cumbersome).
Rules for a lat pull-down with golfer’s elbow using the dual cable cross apparatus.
Wrap both wrists (for equality even though you have golfer’s elbow on one side) with an Ace bandage to protect them from the discomfort of the machine’s handle-strap from digging in. The bandage is centered over the crease in the wrist.
The plastic part of the machine’s gripping handle does NOT make contact with wrists; only the strap portion does.
Insert hands through the handles and slide the plastic part away from wrist. The lat pull-down should be done with palms facing you unless palms facing away produces no golfer’s elbow pain.
Using the Right Grip
A neutral grip is fine as well. It’s just that for some with golfer’s elbow, only the supinated (palms facing you) grip will be pain free.
Keep fingers extended on the golfer’s elbow side. This includes the thumb. Do not grip with any fingers or the thumb. The wrists will be flexed to carry out the pulling.
It won’t be easy keeping the fingers flexed, but if you don’t focus on this, you’re apt to find yourself gripping – and therefore aggravating your golfer’s elbow.
To help guard against accidentally gripping, splint the index finger (I use a tongue depressor and tape).
You can do this standing or seated, with torso at the angle you would normally use in a standard lat pull-down.
Start out with light weights to get the feel of this. A lat pull-down done this way will feel awkward but you’ll get used to it.
Do not jump a lot in weight increase; make sure your golfer’s elbow can tolerate this movement by gradually increasing the weight.
Alternative Modification
Do lat pull-downs as you normally would, except grip with only your middle, fourth and pinky fingers.
The caveat here is that you won’t be able to pull as much weight as with the Ace bandage method.
There’s also the risk of straining the flexor tissue in your fingers.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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