Overall, 22 people have been hospitalized with the E. coli O157:H7 strain, across 11 states. No deaths have occurred, but in three cases patients developed a type of kidney failure called hemolytic uremic syndrome, the CDC said.
Whenever my lower back gets tight (which happens more often than not after being glued to my work chair for hours on end), I sit on the floor and slowly move into my favorite yoga pose: half lord of the fishes, also known as a seated spinal twist. Just a twist to the left and right never fails to restore my sore back.
Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.
But unfortunately, yoga is also the source of many back-related injuries, especially among older adults. A study published in the November 2016 Orthopedic Journal of Sports Medicine found that between 2001 and 2014, injury rates increased eightfold among people ages 65 and older, with the most common injuries affecting the back, such as strains and sprains. So, the question is this: how can you protect an aching back from a therapy that has the power to soothe it?
The main issue with yoga-related back injuries is that people don’t follow proper form and speed, says Dr. Lauren Elson, instructor in medicine at Harvard Medical School. “They quickly ‘drop’ into a yoga pose without gradually ‘lengthening’ into it.”
This is similar to jerking your body while lifting a dumbbell and doing fast reps instead of making a slow, controlled movement, or running on a treadmill at top speed without steadily increasing the tempo. The result is a greater chance of injury.
In yoga, you should use your muscles to first create a solid foundation for movement, and then follow proper form that slowly lengthens and stretches your body. For example, when I perform my seated twist, I have to remember that the point of the pose is not to rotate as fast and far as possible. Instead, I need to activate my core muscles and feel as though my spine is lengthening. Then I can twist slowly until I feel resistance, and hold for as long as it’s comfortable and the tension melts away.
Talk to your doctor first about whether it’s okay to begin a yoga program if you suffer from low back pain. Dr. Elson suggests staying away from yoga if you have certain back problems, such as a spinal fracture or a herniated (slipped) disc.
Once you have the green light, you can protect your back by telling your yoga instructor beforehand about specific pain and limitations. He or she can give you protective modifications for certain poses, or help guide you through a pose to ensure you do it correctly without stressing your back. Another option is to look for yoga studios or community centers that offer classes specifically designed for back pain relief.
Remember that the stretching and lengthening yoga movements are often what your low back needs to feel better, so don’t be afraid to give it a try. “By mindfully practicing yoga, people can safely improve their mobility and strength while stretching tight and aching back muscles,” says Dr. Elson.
The post Yoga for people with back pain appeared first on Harvard Health Blog.
Recently, our Safe at School Director, Crystal Jackson, got the chance to chat with Fran Cogen, MD, CDE, Director of Diabetes Services and Interim Co-Chief of Pediatric Endocrinology at Children’s Hospital. Dr. Cogen’s practice serves approximately 1,800 patients in the D.C./Maryland/Virginia metro area, with 85 percent of those patients living with type 1 diabetes. Dr. Cogen has been working with diabetes patients since 2002 and is also a member of the ADA’s Safe at School Working Group. Ms. Jackson and Dr. Cogen spoke about the Safe at School program, diabetes management in schools and how parents can work with schools as a team—check out part two of this interview series.
Fran Cogen, MD, CDE
Crystal Jackson: Would you say that, in addition to having experience in helping students manage their diabetes, training is a critical component for school staff AND school nurses?
Fran Cogen: Yes, I think it’s very important for anyone taking care of a child during school and afterschool activities to be adequately trained to manage, or for nurses to be able to delegate insulin and glucagon administration, how to recognize and treat a low, and how to deal with ketones, which are the main emergency situations in school.
CJ: What about managing diabetes on field trips?
FC: We get a lot of complaints that there’s no trained staff to accompany students on field trips, and that the parents must go. That is simply unacceptable, because field trips and other school-sponsored activities are under the school’s jurisdiction. A parent should not be required to accompany a child on a field trip. A school nurse or other school staff members trained to give glucagon, provide other necessary care and handle emergencies should be assigned to be present on the field trip.
CJ: When parents of patients voice these concerns, what advice do you usually give, and where do you send them?
FC: The first thing is to complete the Diabetes Medical Management Plan. We try to get parents to work with the schools on 504 plans before there is conflict. If things are not going well, then they call my diabetes team. Our nurse educators talk to the school to see if we can resolve the conflict. If we can’t, then our physicians will attempt to resolve the conflict. Fortunately, on most occasions, our diabetes nurse educators can resolve the problem. If that doesn’t work, the next step is for the parent to go speak to the person who supervises the [school] nurse, such as the principal. If the issue continues to remain unresolved, then we phone Crystal Jackson [laughs]. Seriously, I urge them to call the American Diabetes Association at 1-800-DIABETES.
CJ: Is one of your strategies when advising parents on sending kids back to school to be proactive and to get their Diabetes Medical Management Plans and 504 plans in order?
FC: Yes, because conflict is decreased and you begin a collegial relationship with the school nurse and principal. We strongly suggest that the parent NOT use the 504 plan as a threatening document to their child’s school. Many schools say, “we don’t need a 504 plan,” but we think it’s a very good idea, because then you can get your concerns and requests in place and in writing.
CJ: When did you first get involved with Safe at School, and why?
FC: I think I first got involved when a D.C. patient’s mother had to go into their child’s school and give insulin injections. My team became involved to provide the training of the D.C. Public Schools’ staff.
CJ: Schools are required to train certain staff. Can you talk about the training that your staff developed and how you deliver it?
FC: We developed an online training for the DCPS as well as a return demonstration, which is one of the key components of diabetes management in our curriculum. We offered a two-day session in D.C., in which school staff first did online training. Then we had different hands-on stations wherein our staff demonstrated how to do insulin injections, glucagon, insulin pumps, etc. If I had to make an ideal training recommendation, I think it is necessary to have a didactic component which you do online, and then have the appropriate diabetes team to come and do hands on demonstrations.
CJ: What do you think the biggest barrier to the school’s ability to provide needed care is?
FC: Not having a nurse or back-up staff at each school who have been trained to provide care to the student in accordance with the student’s DMMP.
CJ: Do you think just having a school nurse is enough? Is there another side of the equation?
FC: I think there have to be redundancies. In my vision, there’s a school nurse, however, if she’s sick or unavailable it is necessary to have a few trained people as backup, particularly for field trips. One great way to [choose surrogates] is to train willing teachers and administrative staff, as well as athletic coaches and those who will be with the kids after-hours.
Interested in learning more about our Safe at School program? Check out our resources here.
