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Recipe by Kamille! http://www.bhamfitadventure.com/blog/2011/10/12/energy-bars

 These are great to tie you over and quite filling.  If you’re vegan, then try using maple syrup or agave nectar.  If you have a peanut/tree nut allergy, you could always use sun butter.

Ingredients:

 5 – 6 cups; 17.5 – 21 oz; 500-600 grams rolled oats

2 1/4 cups; 8 1/2 oz; 236 grams medjool dates (seeds out)

1/2 cup hot water

1 cup; 8 oz; 226 grams natural smooth peanut butter

1/2 cup; 6 oz; 170 grams honey

3/4 cup; 3.5 oz; 100 grams almonds

1/2 cup; 2.5 oz; 65 grams oat bran

1/4 cup; 1.25 oz; 34 grams whole wheat flour

2 tsp cinnamon

1 1/2 tsp pure vanilla extract

1 tsp kosher salt

 

Directions:

 Soak your pitted dates in a bowl with the hot water and cover with a plate for about 10 minutes.  Drain the water and dump dates into a food processor.  Puree it up.  You will need to scrap the sides occasionally.  Add the peanut butter to the dates and puree again.  While the machine is running, add about 1/3 of the honey (save the rest for later).  The mixture will clump into a ball and that’s okay. Remove as much of the date mixture into a small bowl–set aside.  Put in the almonds and pulse at 3 second intervals until they are coarsely chopped.

 

 In a large bowl, combine 5 cups (or 500 g or 17.5 ounces) of rolled oats, leaving the additional 1 cup of oats aside, oat bran, w.w. flour, almonds & salt.  Mix it all up.

 

 Put the date puree mixture into the rolled oats bowl.  Add the vanilla now & using your hands, begin to mix the ingredients altogether.  This will take a bit to incorporate the oats into the date puree.  You want the oats to be completely bound by the date mixture.  Go ahead and add the rest of the honey to help soak more of the oats & bind it all together–mix some more.

 

Line a half sheet pan with parchment paper and press mixture into the pan.  You will want them to be about 3/4 inch thick.

 

 Bake at 300 degrees for 20 minutes.  The underside of the bars will have more of the toasty look.  (You can cut them and turn them over & bake for an additional 5 minutes)  Cut them into squares (or bars).  Serves about 12-15.

 

Well I hope you enjoy this recipe as much as I did. Thank you for your time and energy…be well

Jaime Hernandez

Health and Exercise Prescriptions

http://www.healthandexerciseprescriptions.com

 

 

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Hello readers.  3 months till spring! It is time to get ready to stay active hiking, biking, walking, running and just plain enjoying the sun to come.

You can lose safely 1% of your body fat per week. That means if you weight 180 lbs you could lose 1.8lbs of body fat per week. THATS 9LBS in 5 weeks!!

Here are the three tips  to help your success in your quest to get the body and health you have always wanted.

1. You must get in at least 30 minutes of activity a day. The intensity in any thing physical determines how many calories you burn during that activity. So if you are walking at a slow pace compared to fast walking or jogging you are  burning less calories. 30 minutes of moderate activity burns about 250 clalories per 30min.(It takes burning 3,500 calories to lose 1lb of body fat)
2. Remember you should be doing some kind of weight bearing activity 2-3 times a week. Such as a  full body weight training program. This will help you gain muscle which is your fat burning machinery and will raise you metabolism.
3. Food is 70% of your success in losing the body fat.  How much food should you consume? Your calorie intake can be anywhere from 1,400 calories to 2,200 calories on average.Make sure to increase you fruits and veggies to help keep you full. 5 servings a day of fruits and veggies is very important. A serving  is equal to a half a cup. Always balance your meals and snacks.

Well this is a great start to make your plan. If you need more guidance in you health and fitness goals then contact me at healthybellingham@hotmail.com

Thank you for your time and energy…Be well.

Jaime J. Hernandez

Health and Exercise Prescriptions Inc.

360-223-3696

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Most adults have back pain at some point and time in their life. Back pain is one of the most debilitating injuries that is suffered by the majority of Americans. This blog post is for everyone; nurses, parents, lawyers, butchers, bakers and software makers who all need a healthy back to do their jobs and perform their everyday activities.  It is also a blog post for people who run (like me:), ride, swim or skate; people who throw things, swing things, paddle things or kick things!!…a blog post for people who want to avoid injury and improve their life and sport.

Did you know that 80-90% of people are doing the wrong exercises to help with their back issues.

Stabilizing your spinal segments is the key to help your back pain. We now know through much studied science that the spine has many muscles that perform different functions, some act as sensors, some act as stabilizers and other work to create powerful movements. Now that we know these differences and understand spinal function we can better develop an exercise prescription that will train trunk muscles for their specific functions.

Always go to your primary care physician and get the “OK” before you start an exercise program. At Health and Exercise Prescriptions we create exercise prescriptions that are made for the individuals and their special conditions/Medication and or previous injuries. CHECK US OUT >http://www.healthandexerciseprescriptions.com

How fragile is our spine? Did you know that the spine would buckle under 20 lbs of load with out our supporting muscles; becoming injured. Normal every day activities put at least 175 lbs of pressure on our spine. As you can see our supporting muscle are essential for everyday normal task, lifting, bending, etc.

Your back pain keeps coming back not because of a “muscle problem” but, more a” neurologic problem” most likely from the injured nerve.Our neurologic system plays a key role in spinal stabilization….our muscle are controlled by our nervous system to function. If you “pinch” a nerve it makes the nerve impulse less strong; example if a muscle usually contracts at 100%… after a nerve gets “pinched” it my only contract at 60%  of full strength.So the weakness is neurological and not so much muscular. Neuromuscular re-education is a specific way to train the segments of your spine and the muscles that where effected directly by the nerve being “pinched”  so as to regain the full contraction of the muscle being recruited during movement activities.

Spine 101

Our spine has 30 individual bones called vertebrae which are connected by ligaments and spinal disc in between the vertebrae. The disc and ligaments attach one vertebrae to the next and limit the small amount of motion that occurs between vertebrae when ever moving.

Upper region of the spine is called the cervical spine, the middle of the spine is called the thoracic spine and the lower back is lumbar and sacrum respectively. Each segment of your spine (which there are 30) has nerves that feed out to muscles and organs to communicate to them. These nerves feed out of the spine through holes called  inter-vertebral foramina ; when the joint is not aligned up it can impinge these nerve roots ,effectively shutting down communication to certain muscles and organs.

All movements of your body result in some degree of motion at the spinal joints. The key to healthy movement is spinal stability!

Did you know that your disc and ligaments are the weak link in your spine! The disc and ligaments can only take approximately  13-20 lbs of load before an injury occurs. Without the many layers of muscle to support your spine it would collapse.

Lets summarize what we have just read….all joints in the body must be properly aligned for the joint to function properly just like a door hinge. If your door hinge was not properly aligned the door would probably not shut or function properly.

We now know that there is a difference between spinal stability muscles(stabilize vertebrae segments) and spinal movement muscles(are big muscles). Stabilizing muscles are small and are generally  in the middle layer of the trunk muscles and usually only cross a couple of spinal(25) segments. Spinal Movement muscles are bigger muscles and are more the outer layer of muscle such as the Abdominal and obliques. 

As you can see back pain can be more complicated to rehabilitate than just doing some crunches and back extensions. The next part of this series we will discuss which muscles are working when you are exercising stabilizing muscles and  give you one example of an exercise that does just that.

Well I hope this helps you out little bit understand your spine and the differences between stabilizer muscle training and the bigger spinal movement muscles.

If you would like a personal Health and Exercise Prescription that would encompass your whole body please contact me.

Thank you for your time and energy….Be well

Jaime Hernandez

Health and Exercise Prescriptions

http://www.healthandexerciseprescriptions.com
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Food portions in a “super-size” society are hard for the majority of Americans to resist.Don’t be a victim of portion distortion. We eat more and move less on average. The epidemic of that combination of events has made our top 5 preventable diseases exploded. Knowing how much food(energy) to put in your body is 70% of your success with reaching your goals of body fat loss or general health.

Do you know basic food portion knowledge? If not use the following images to help determine portion size for general types of food.

1 cup of cereal = a fist
1/2 cup of cooked rice, pasta, or potato = 1/2 baseball
1 baked potato = a fist
1 medium fruit = a baseball
1/2 cup of fresh fruit = 1/2 baseball
1 1/2 ounces of low-fat or fat-free cheese = 4 stacked dice
1/2 cup of ice cream = 1/2 baseball
2 tablespoons of peanut butter = a ping-pong ball

You should journal your food and measure it for two weeks to get an idea of how many calories you are actually consuming. After you learn that, you will be better able at knowing how much energy is in the food you are eating, therefore enabling you to be more consistent with your calorie consumption.

You can look up the foods you eat and how many calories they are at http://nutritiondata.self.com/ check it out!

Most of us eat more than we need ant any one meal, which adds up to more calories that get stored as fat. I am going to give you a few tips that will help you reduce your cravings to help control your portion sizes.

1. Don’t skip meals and snacks!! Skipping meals or snacks makes you more hungry and more likely to eat too much when you do eat. It can also slow your metabolism. You should try to eat or snack every 3-4 hours.
2. Eat slowly.It takes about 15-20 minutes to get the message to your brain that your stomach has been satisfied. It’s amazing how much food we can eat in 5 minutes. Try to chew your food slowly and enjoy it. Put down your utensil between bites. Extending your meal to 15 -20 minutes will more likely insure that you will not eat more than your body needs.
3. Drink a 8-16oz  glass of water before you eat. Getting in the habit of drinking a glass of water before your meals can be a good habit to make sure you are not eating out of being thirsty.
4. Make sure that your meals and snack have a proper balance of Carbohydrates , protein , and fat to better satiate your hunger for a longer period of time.

Well I hope this information takes out some of the guess-work to understand food portions. If you would like a food plan with and exercise regimen contact me at

healthybellingham@hotmail.com

Thank your for your time and energy…Be well

Jaime Hernandez

Health and Exercise Prescriptions

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The importance of water

Water intake and fluid balance are among the least understood and most neglected areas of overall health and weight management. Life and health depend on water. In fact approximately 70% of your body weight is water. It is needed to carry vital substances to cells and waste away from cells. In addition water is necessary to moisten the lungs and respiratory tract, lubricate the joint surfaces and internal organs, and ensure proper digestion.

Because water is so important to health the body attempts to maintain proper fluid or water balance at all times. If you consume too little water, a hormone called aldosterone is secreted to stimulate the body to conserve every molecule of water and sodium that it can. This water retention is especially pronounced if protein intake is too low or if there is a hormone imbalance.

If you have abnormal kidney and heart function, you actually need to drink more water to get rid of excessive fluid. Drinking more water reduces the production of aldosterone and stimulates the excretion of water and sodium. Increasing water intake actually decreases water retesting as well as the bloating and added weight gain that accompanies it.

How to increase your water intake

Start keeping a fluid intake diary and make sure you are drinking at least two glasses of water for the next two days. After two days at this amount, increase to three glasses of water per day. From this point increase by one more glass every other day until you reach your breakthrough point. You will know when you have reached this point by the sudden reduction in signs of fluid retention, a sudden loss of weight of several pounds and a normal thirst.

Although much individual variation exists, some doctors recommend you drink at least one half you body weight in ounces of water per day. For example a 140lb person would drink 70 oz of water per day.

Some helpful hints to increase you water intake:

• In the morning, fill a 64 ounce bottle with water and finish it by the end of the day.
• Leave a post-it note to yourself at the desk, on the refrigerator or other conspicuous spots to remind you to drink a glass of water.
• Keep a water bottle that measures fluid ounces at your desk or wherever you spend a lot of time and take one when driving in your car. This can help you keep track of how much water you drink each day.
• Create a buddy system with your co worker, friend, or family member to make sure you are drinking your water
• Add a lemon, orange, or lime slice to your water for flavor

Well I hope this simple information changes the way you view your thirst and water. Your body needs a constant supply of clean H2O to keep nutrients and toxins flowing to there nescarry organs for elimination or processing nutrients.

Thank you for your time and energy….Be well

Jaime Hernandez

If you would like more informtion on a complete health and wellness plan than contact me  at healthybellingham@hotmail.com or 360-223-3696

Health and Exercise Prescriptions

http://www.healthandexerciseprescriptions.com

What are the most common injuries in snowboarding?

Ok are you ready to make your body fined tuned with a workout specific to improve your snow boarding skills? I hope you have been doing a basic preseason workout routine because now it is time to do more specific training.

Snowboarding is still one of the fastest growing sports amongs 18-30 year olds. I the year 2000 there where about 7 million snowborders in the US  and has grown with about 25% of them being women. To be an Exceptional snowboarder it requires certain skills, a high degree of strength and balance to transition from edge to edge while maintaining balance with never ending changes in speed, terrain, and weather.

There are many types of snowbaording some of which we will name , freestyle, free carving, free riding each has there own set of training elements. With the program that we are going to put together it will incompass the broad spectrum of skills required to the sport in general.

1. wrist fractures/sprains,
2. ankle fractures/sprains,
3. shoulder injuries
4. whip lash.

Some special care should be taken to do regular injury prevention exercises so that you lessen you chance for injuries.

Lets look at some of the basic movements in snowboarding.

Stance and balance

How to maintain body balance is the key point of this skill. It is critical for any snowboarder to keep their body on the center of the board. After the rider is well aware of their body balance, they can perform various tricks by moving the balance. Riders can improve this skill by doing exercises like hopping between each turn, or switch riding.

When first starting out, it is important to determine a rider’s stance. The two types are “regular” (left foot forward), or “goofy” (right foot forward). Once a rider is more advanced, they may learn to ride “switch”. This is done by riding with the opposite stance than they learned from. A regular rider switches to goofy, while a goofy rider switches to regular. This is done mostly in terrain park in preparing and/or landing spins.

Stance width is the distance between the center of the front and back binding. To ride comfortably, a rider must get the width correct. It is almost entirely reliant on the rider’s height, but can easily be altered for different terrains.

A forward stance is used mostly for beginners and all-mountain riders. The common degrees are +20˚/+6˚. Duck stance is used mostly for freestyle riders. The common degrees are at +15˚/-15˚ (mirrored).

Stopping

This is a skill any snowboarder must have in order to maintain control while going down the mountain. A lot of people go to fast for how well they can stop and often times that is how they get hurt. There are several ways to come to a complete stop. A boarder can put pressure down on their toe side edge, concentrating their weight on the back of the board. This will naturally guide the board to the right (If riding regular). If the boarder continues to put pressure on their toe side, they will eventually become perpendicular with the trail, and come to a stop. Another way to slow down and stop would be to put pressure on their heel side edge, which will guide the board to the left and will naturally slow down as the board becomes perpendicular to the trail.

Pivot and steering

This skill is closely related to the turning of the board. Pivoting and steering are mainly performed by rotation of the body. When people first ride snowboards, they are advised to use their upper body to move their boards. By rotating their upper body, they can change the direction of the boards. It is crucially important for an instructor to make riders feel the rotation of their body; from upper body to the board. To improve this skill, there are exercises such as fall line pivot, motorboat exercise, and static steering.

Edging

Riders can use their hips, knees, and ankles to create the edge. Key point of this skill is how to maintain body balance on the edge of the board. Riders can control their speed with greater ease by riding on the edge. Riders can also perform carving turns after they learn to keep their body balanced on the edge. Exercise for these skills are static edge change exercise, rail-to-rail, and J-turn. Also known as carving.

Pressure control

If riders are good at pressure control, they can perform much more stable riding. This skill is essential when riders are on the bumpy slope, or on the various terrains. By flexing or extending the body, a rider can absorb or add to the pressure of the board, controlling speed. Advanced riders can use lower parts of their bodies to control the pressure of the board. Exercises for this skill are fall line stop, ollies, nollies, and small straight air.

Timing and coordination

This skill is about changing in rhythm of the performance. If you are good at this skill, you are very confident with performing any kinds of turns by coordinate your body movement in a proper timing. Exercises for this skill are top gun turn, counting with focus on symmetry, and tornado turns.

So now we know the basics of what it takes to snowboard. Let talk about your weekly exercise schedule. The majority of your movements in snowboarding will come from your core outward.

Some of the best ways to cross train is to use a trampoline or do some sort of gymnastics to learn more dynamic balance.

Well that will be the topics that I will cover today. If you would like a full exercise program design contact me.

Stay tuned for the next blog post on nutrition for a snowboard athlete.

Thank you for your time and energy

Jaime Hernandez

Health and Exercise Prescriptions

http://www.healthandexerciseprescriptions.com

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The concept of insulin resistance
Insulin is a hormone produced by your pancreas that transports glucose (blood sugar) from the bloodstream into your cells where it is used to make energy. However, in many people the cells become resistant to the action of insulin- a condition called insulin resistance. To compensate, the pancreas goes into overdrive and releases even more insulin in an attempt to counteract the resistance, creating the condition of hyperinsulinemia.
Insulin resistance can lead to reduced energy production throughout the body, reduced ability to burn calories, increased blood sugar levels, and muscle loss or sarcopenia. All of these factors increase the risk of chronic disease and accelerated aging.

Risk factors for diseases of aging
• High blood pressure
• Abnormal cholesterol metabolism
• High triglyceride levels
• High insulin levels
• Increased body fat
• Increased waist-to-hip ratio
• Decreased muscle mass
• Decreased strength

What is Insulin Resistance Syndrome/Metabolic (X) Syndrome
Insulin resistance is associated with a condition called “metabolic syndrome “which is characterized by a variety of additional manifestations including high triglyceride or fasting blood sugar levels, increased waist circumference, low HDL (good) cholesterol, and high blood pressure.*People with metabolic syndrome have and increased risk to type 2 diabetes and heart disease and may go on to develop other chronic diseases such as stroke, polycystic ovary syndrome, or Alzheimer’s disease to name a few.

The Insulin Story

*Normal person
The rise in blood glucose after a meal stimulates the pancreas to secrete insulin. Insulin attaches to the insulin receptors on the cell surface and enables glucose to enter muscle and fat cells, where it is stored or burned for energy.

*Insulin Resistance
The pancreas secretes sufficient insulin, but, the cell is resistant to insulin’s action. To compensate, the pancreas may secrete more and more insulin. The excess insulin manages to keep blood sugar levels within the normal range-though often at the upper end of that range-and the patient is not considered diabetic. Those with insulin resistance often experience high levels of both blood sugar and insulin at the same time. They may also develop high triglyceride levels, low HDL (“Good”) cholesterol, high blood pressure, and/or other signs of metabolic syndrome, such as an increased waist circumference. These individuals have a high risk of diabetes, heart disease and other disorders.

*Type 2 Diabetes
Fasting blood sugar is elevated for extended periods of time. In type 2 diabetes there are two main reasons for this problem: 1.) The pancreas secretes insulin appropriately, but the insulin is not adequate to lower blood sugar because the body is resistant to it or 2.) The pancreas may no longer able to secrete the proper amounts of insulin leading to elevated blood sugar.

Well that is the short and skinny of Insulin and Metabolic syndrome and how it can impact your life. Putting together a wellness plan to  address your whole body will give you the best outcome.

If you would like a complete  Health and Exercise Prescription that will help with both of these disease process than contact me via email or phone. healthybellingham@hotmail.com  360-223-3696

Checkout the website for more information.

http://www.healthandexerciseprescriptions.com

Thank you for your time and energy….Be well

Jaime Hernandez

Health and Exercise Prescriptions

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This is a Video of a Client Testimonial Over Coming His Spondylolisthesis To Be Able To Run, Bike and Stand without pain.

I see a lot of people in pain with various injuries and it really does take a special exercise program to help them. I found that treating each person as an individual when I design their exercise program is very important. There are a lot of personal trainers and gyms with group classes that do not address the body as a whole.  When you get a Health and Exercise Prescription from our studio it encompasses the whole body and we can work with your primary care physicians to tailor a program that will help get you back to uninjured state.

Well I hope you enjoyed the video and are encouraged that you can over come your back pain or injury with the right program.

If you would like your own Health and Exercise Prescription then contact me by email or phone call.

healthybellingham@hotmail.com or 360-223-3696

To see what other special conditions that I can help you or someone you know with go to my website.

http://www.healthandexerciseprescriptions.com

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Wow its October and we are coming up on the holiday season. Now is a great time to get motivated with millions of Americans who are taking this months national walking month to get in their 10,000 steps a day to change their life. You do not have to walk all 10,000 steps all at once.

Did you know that one-third of adult Americans are obese? Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death.

One of the easiest ways to control your body fat is to stay active. Walking is a great way for you to kick off your new exercise program!

What are the benefits of walking 10,000 steps a day?

1. Health, Walking helps your heart and lungs become stronger. Also by doing a little bit of walking everyday you can significantly reduce the chances of becoming obese and there for stave of many of the preventable diseases.
2. Walking is also a good way to be social with your friends. Walking and talking can be great  for your mental health.
3. It’s inexpensive!The gear to walk is fairly inexpensive so anyone can do it. You need a good pair of shoes and regular workout clothes and you are ready to go. If you want to get fancy you can. There are many ways to keep track of your steps either with a phone app or a good old fashion pedometer. 2,000 steps is about one mile and you should always start slow and work your way up to 10,000 steps if you have been sedentary so that you do not get injured.
4. Fresh air!Getting outside to get some fresh air is great too! So pick your favorite hiking trail and enjoy your walk.
5. Its easy!Set up your new walking program by putting it in your daily schedule so that you make time to get it done…in other words make a plan.

Well it is that is it. It can really be as simple or complicated as you want …so find a walking buddy and get started tomorrow.

If you need any help with previous injuries, weight training , stretching or a food program please contact me and I can help you put a program together that can maximize your over all out come of better health.

Thank you for your time and energy…Be well

Jaime Hernandez

Health and Exercise Prescriptions

http://www.healthandexerciseprescriptions.com

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Low Back Pain, its Impact on You and Society “Our bodies have evolved over millions of years to do one thing: move,” says James Levine, M.D., Ph.D., of the Mayo Clinic in Rochester, Minn., and author of “Move a Little, Lose a Lot.” “As human beings, we evolved to stand upright. For thousands of generations, our environment demanded nearly constant physical activity.”

Since prehistory, humans have been physically active to survive and thrive.  In the last century, global industrialization has reduced an individual’s daily requirement for physical activity and has replaced it with sedentary activities in the modern office and home.   At the current time:

• The U.S. healthcare system spends $70 billion annually for the treatment of low back pain.
• Low back pain causes a productivity loss of $100 billion to the US economy annually.
• Low back pain is the second leading reason for absence from the workplace after the common cold.
• Low back pain is the #1 disability claim in the U.S.

Low back pain (LBP) is one of our country’s most prevalent and costly healthcare challenges with more than one-fourth (26.4%) of American adults reporting back pain in the past three months and accounting for 20 million physician visits per year [Deyo, 2006]^[1].

The lifetime incidence of low back pain is 80% [Deyo, 1998]^[2].

In the workplace, LBP is the leading (and most expensive) cause of disability for people under the age of 45 [Andersson, 1999]^[3].

Further, LBP remains one of the leading causes for U.S. workers’ compensation claims and absenteeism with an estimated 102 million lost workdays annually [Guo, 1999]^[4].

Approximately 7 million new low back pain cases seek medical treatment every year. The total cost to the U.S. economy associated with LBP is estimated to exceed $100 billion per year [Katz, 2006]^[5].

Low back pain can be caused by a number of etiologies or causes ranging from ruptured discs with a clear physiological causation to nonspecific with no clear physiological causation.

Non-specific low back pain is with ~80% the largest contributor to the diagnosis of low back pain.

70 % of the nonspecific low back pain cases can be traced to an atrophied Lumbar Multifidus muscle.

The modern chair contributes to the problem.  The modern chair has evolved into a device which promotes relaxation and equatingit with lack of movement. This causes complete atrophy of the human body, specifically the lower back.

Conventional, “ergonomic “office chairs are designed to cradle the stationary human body with adjustments for arm and foot rests, lumbar support and other body parts.

The only movement/ exercise the sitter gets in these chairs is by manipulating the adjustments because no single setting feels comfortable for an extended period of time.

All established seating manufacturers are now beginning to acknowledge the need to change this goal and are seeking active seating alternatives.

The combination of a sedentary life style and the modern chair design is causing a major health problem.

Do you need help with exercise to help with your back?

Contact me at healthybellingham@hotmail.coom

Jaime Hernandez

Health and Exercise Prescriptions

 

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[1] Deyo RA, Mirza SK, Martin BI, “Back Pain Prevalence and Visit Rates,” Spine 31(23): 2724-27, 2006

[2] Deyo RA, “Low-Back Pain,” Scientific American 279(2): 48-53, 1998

[3] Andersson GBJ, “Epidemiological features of chronic low-back pain,” Lancet 354:581–85, 1999.

[4] Guo HR, Tanaka S, Cameron LL, “Back pain prevalence in US industry and estimates of lost workdays,” Am J Pub Health 89:1029-35, 1999.

[5] Katz JN, “Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences,” J Bone Joint Surg (Am) 88: 21-24, 2006.