By Paul Chek, HHP, NMT
Did you know that low back pain is the most common orthopedic disorder
in the world? Amazingly, one of the major causes of back pain is
sitting. For many of you, this is quite a problem because today,
more people work seated than any other position. Typically, people
get up and sit to eat, sit to drive to work, sit at work, sit on
the drive home, sit to eat dinner and sit in front of a TV until
they go to bed. That's a lot of sitting!
Do we have some strange affinity for chairs? It would appear so,
yet as I will show you, this affinity is misguided.
While it's quite likely back pain was a problem even before chairs
were invented, the arrival of the chair in our lives certainly did
nothing but increase the incidence of back pain. This was demonstrated
by Dr. Harry Fahrni who studied the Bihl tribe of India. The Bihl
didn't use chairs and, at the time of Fahrni's visit, were very
primitive. Dr. Fahrni had X-rays taken of the lumbar spines of 450
Bihl tribesmen ranging in age from 15-44. He then took a comparable
series of X-rays of heavy laborers in Sweden and an additional series
of X-rays of light workers in San Francisco.
Fahrni's studies only confirmed what he knew from experience: The
more active Bihl who didn't use chairs had healthier spines than
other groups (see Figure
1 for images of healthy and degenerative spines). He found heavy
laborers in Sweden had a high incidence of lumbar disc narrowing
of 80 percent by age 55. Light workers showed an incidence of 35
percent narrowing by the same age. In stark contrast, the images
of the primitive Bihl tribesmen showed an incidence of only 9 percent
disc narrowing. 1
Dr. Fahrni's findings (Figure
2) show avoiding chairs and having an active lifestyle may be
significant contributions to maintenance of a healthy spine. However,
being active alone is not enough to avoid back problems.
From a movement perspective, there is no doubt both the light workers
in San Francisco and the heavy workers in Sweden were active, so
what may account for the difference there? My clinical experience
suggests, in the heavy workers, the patterns of movement would be
quite repetitious while the light workers may simply not have gotten
Among the Bihl tribesmen and women, the activities of hunting and
gathering would ensure adequate movement as well as a myriad of
movement patterns. Such consistent, dynamic activity would serve
to pump fluids through the spinal discs, keeping them well nourished.
The Swedish and American participants also came from industrialized
nations where sitting is commonplace.
However, when we squat the way native tribesmen do (Figure
3), the torso is supported by the thighs, allowing relaxation
and decompression of the spinal column, which can only keep it well
hydrated and healthy (Figure
I Can't Escape My Chair: What Can I Do?
When you sit in chairs for hours each day, the spine doesn't get
enough movement and fluid is leached out of the discs. This minimizes
incoming nourishment because the discs have no direct blood supply
and are fed by a process of absorption facilitated by pressure changes
in the case of the spine.
Since the primary constituent of a spinal disc is water, it only
makes sense to keep properly hydrated to prevent your discs from
dehydrating. This means drinking at least half your body weight
in ounces of water daily. A person weighing 200 pounds would need
100 ounces of water daily. I know for a fact drinking water can
decrease pain in degenerative spines because I've seen it happen
over and over again in my own practice.
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When we sit much of the day, we typically don't get enough movement
or exercise to keep the muscles and ligaments of the spine healthy.
As our spinal discs dehydrate they narrow. This causes the ligaments
of the spine to become progressively more lax.
This condition is a very common cause of spinal instability that
typically leads to more serious lumbar pathology such as pinched
nerve roots, disc herniations or arthritic changes that crowd the
spinal cord and nerve roots. Symptoms suggestive of spinal instability
Sensing the need to manipulate or adjust your own joints (i.e.
popping your own back or neck).
Pain or discomfort that is relieved by adjusting your own spine,
particularly when the same or similar symptoms return and can
again be alleviated by self-manipulation or manipulation by
a trained manipulator. In addition to pain, such symptoms as
tingling, numbness, spasm, muscle weakness and a sense of tension
around a joint that are repeatedly alleviated by manipulation
indicate spinal instability.
Popping or clunking sounds coming from a spinal joint(s) when
performing a characteristic movement, such as rotating the spine
in one direction, yet this symptom does not result with rotation
in the opposite direction.
A trained professional will notice washboarding, which is hyper-activation
of the deep spinal stabilizers in the region of the lax joint.
But, there is a solution to minimize the detriments of sitting
too much -- the Swiss ball (Figure
5). As a sphere, the Swiss ball has a reduced base of support,
moves easily underneath you and requires both the activation of
your postural muscles and your balance mechanisms.
A study conducted by Swedish Naprapath Joakim Dettner and his colleagues
found, when compared to massage therapy, simply balancing on a Swiss
ball in a seated position for one-minute intervals with 30 seconds
rest seven times in a row, in place of any other form of treatment,
significantly decreased pain and disability. 2
Using The Swiss Ball Effectively As a
To get the most benefit from your Swiss ball as a chair, follow
these four suggestions:
Always choose a ball at least one size too large. For exercising,
when sitting on the ball, your thighs should be parallel or
slightly inclined with the hip no more than 10 degrees above
the knee relative to the horizontal plane. To use the Swiss
ball as a chair, you will use the same guidelines, but start
with one size too large (the person that would exercise on a
55 cm ball should sit on a 65 cm ball) and deflate it until
your hip is slightly elevated relative to your knee. This will
give you a soft ball to sit on, whereas if you sit on a ball
properly inflated for exercising, you may suffer compression
of your sciatic nerve and related discomfort.
an anti-burst Dura Ball Pro ball
. If a traditional Swiss ball is punctured by a staple or any
sharp object, it can explode and you can easily get injured
hitting the ground, the wall or furniture! Anti-burst Duraballs
will deflate slowly and safely.
Always check the floor daily and remove any potentially offending
Don't get rid of your chair just yet! Sitting on a Swiss ball
requires full activation of your postural muscles and if they
fatigue, you will just be someone sitting on a Swiss ball with
poor posture, which defeats the purpose. Therefore, I recommend
only sitting on the Swiss ball as long as you can hold good
posture, like you see James doing in Figure 5. When you're tired,
switch to the chair for an equal time period and rotate back
and forth between the Swiss Ball and chair. For example, you
may sit for 15 minutes on the ball and 15 minutes on a chair.
As your postural muscles get stronger, reduce the amount of
time you sit on the ball.
Exercise As You Sit
While sitting on the ball, you can pump nutrition into and remove
waste from your spinal muscles, ligaments and discs as you work
by using the following fun and effective movements on the ball:
The Seated Posture Trainer (Figure
6): Sitting with good posture, simply lift one foot off the
ground for a second or two and alternate from left-to-right repeatedly
for 30 -- 60 seconds intermittently throughout the day.
Seated Balancing (Figure
7): When you are comfortable lifting one foot and then the other
and can do it with good posture, try lifting both feet off the floor
and balancing on the ball. Again, work at keeping good upright posture
just the way you see C.H.E.K Practitioner J.P. Sears doing here.
The first few times you try this, I suggest moving the ball away
from furniture so you have room to move if you lose your balance.
Remember, the harder it is to balance on a Swiss ball, the more
you need the exercise!
Forward and Backward Tilting of the Pelvis (Figure
8a and 8b): Here you see me demonstrating how to tip the pelvis
forward. Imagine the pelvis is a bowl and you are pouring the fluid
in the bowl out over your belt buckle and then backwards. As you
do this exercise, keep your head and shoulders as still as possible
to encourage the pumping motion in your low back region. This is
a good abdominal and back muscle exercise too! Performing 20 repetitions
two to four times an hour can be very beneficial.
Side-To-Side Tilting (Figure
9a and 9b): Keeping your head and shoulders still, rock your
pelvis side to side 10-20 times two to four times an hour.
Pelvic Circles (Figure
10): Moving your pelvis in circles is very effective too! Again,
keep the head and shoulders very still to encourage lumbar pumping
and muscle coordination. This will also improve your performance
on the dance floor! Do pelvic circles at random throughout the day
for good results.
Pelvic Figure 8s (Figure
11a and 11b -- Front to Back & Side to Side): As you can
see in the images below, you can make figure 8 movements in a front
to back motion or a side-to-side motion. This is a better, more
comprehensive coordination exercise. You may perform this at random
or complete 10-20 figure 8s in each direction each hour for great
By using a Swiss ball (Duraball) as a chair, I'm positive you will
enjoy the same benefits that my staff and I at the C.H.E.K Institute,
as well as thousands of patients seen by C.H.E.K practitioners around
the world, do every year.
To get your anti-burst Duraball, or for more information, books
and videos on how to use your Swiss Ball for improved health and
vitality, please click on the links below or visit
the C.H.E.K Institute Web site.
Backache: Assessment and Treatment W. Harry Fahrni, M.D.,
Mosqueam Publishers, Vancouver, BC, 1976
of Chronic Low Back Pain by Co-ordination Training -- A Randomized,
Controlled Pilot Study" Joakim Dettner, DN, Dag Elmfeldt,
M.D., PhD, Kurt Svärdsudd M.D., PhD; Department of Publich
health and Caring Sciences, Family Medicine; Kroppsinvest Kliniken,
Ronneby, Sweden; AstraZeneca, R&D, Mölndal, Sweden
(For more information about this study, contact Dr. Joakim Dettner
Paul Chek, Holistic Health Practitioner and certified
Neuromuscular Therapist, is the founder of the C.H.E.K Institute
in Vista, Calif. He is also sought-after consultant to sports
organizations, his services have benefited numerous professional
sports teams, athletes and individuals seeking optimal health
Paul has produced more than 60 videos, 17 correspondence courses
and is the author of several books, audio programs and articles.
For more information on Paul's popular "You Are What You
Eat" audio/workbook program, or for any of his other health/exercise
courses, videos and books, call 800/552-8789, 800/552-8789 (New
Zealand or Australia), 44 (0)1273-856-860 (Great Britain) or
visit online at the
CHEK Institute Web site. Please feel free to request a catalog
of CHEK Institute products.
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