Glen Oaks Health and Spine

Kemenosh

GREAT INFORMATION

evin Neeld answers your health questions in the first-ever GAP Fitness Q&A. If you have a fitness question for Neeld, send it to Tony Regina, GAP Assistant Director of Communications.

Kevin Neeld
I’ve had trouble gripping my clubs lately. I do use a glove, but I don’t feel like I’m holding my irons firm enough to hit a good shot. Is this a hand-strength issue, and if so, what should I do to address it?
From a physical standpoint, the issue you’re describing could have many origins. As you mentioned, it could very well be a grip strength issue. However, it could also be a rotational mobility issue, which could stem from restrictions in your hips, thoracic spine (upper back), and/or shoulders. In any case, the restriction will cause you to hit end-range earlier in the range of motion, which can lead to compromised stability anywhere down the arm, including the hands. This is a classic example of a “symptom” being somewhat remote from the true cause. The good news is that mobility restrictions can be remedied using a combination of soft-tissue work, either with a foam roller or at the hands of a manual therapist, and using a few basic exercises, such as those outlined here.
If grip strength is truly the limitation, then any exercise that involves you holding dumbbells will work. A few great ones to consider adding to your exercise routine are reverse lunges, stiff-legged deadlifts, one-leg stiff-legged deadlifts, farmer walks, and one-arm farmer walks.

What quick exercises can I do on the first tee before my round begins? I often forget to do any stretching before I play. I think I need to do something to avoid injury.
This is a great question. A quick routine that would help open up your hips and shoulders and active your core is:

Lying Knee to Knee Mobilization — 10 repetitions

Half Kneeling Hip Flexor Stretch with Thoracic Rotation — 10 repetitions per side

Squat to Stand w/ 1-Arm Overhead Reach — 10 repetitions per side

Wide Stand Windmills — 10 repetitions per side

Glute Bridge — 20 seconds

Front Plank — 20 seconds

Side Plank — 15 seconds per side
This circuit shouldn’t take more than three to five minutes and will do wonders in both keeping you healthy and improving your performance.

Walking 18 holes is getting tougher for me each year. My knees constantly bother me. I don’t want to depend on a golf cart for each round. What can I do?
The most important thing is to identify the root cause of why your knee is bothering you. It might be worth getting it looked at by a doctor or physical therapist to get an official diagnosis of what’s going on. Knee pain that has a gradual onset throughout the course could result from a mobility restriction in the ankles and/or hips. In either case, a restriction causes excessive stress across the adjacent joint (the knee), which becomes progressively irritated as more volume is put across it. For example, if you lack hip rotation range of motion, then it’s very likely that you’ll compensate by rotating slightly more through your knee (or lower back-a common cause for back pain). This may not hurt the first time you do it. It may not hurt the 23rd time you do it. But after more and more repetitions of the faulty pattern and walking on an irritated joint, it’s likely that the pain will worsen.
Carrying a few extra pounds of body weight can also be a cause of excessive stress placed on any joint, including the knee. Putting together a comprehensive weight loss plan may be a bit outside the scope of this Q&A, but a quick approach to consider is:
• Eat more real food (foods that can be hunted or grown)
• Swap out some of your on the course beers for Generation UCAN protein shakes, which help facilitate fat burning
• Brush your teeth when you have cravings to snack throughout the day and at night

I’m physically capable of playing golf. Mentally, not so much. Any exercises for the mind?
This is a tough topic to address without fully knowing what your mental restriction is. Do you have a difficult time concentrating? Does your performance quickly unravel after a bad swing? Different problems warrant different strategies, but here are a few general tips to help golfers mentally prepare and focus on the course:
• Visualize yourself, from an outside perspective, hitting the ball successfully. In other words, imagine you’re a “fan” watching you hit the ball perfectly. During the visualization process, pay attention to the fluidity of the swing and the seemingly effortless power you generate. Maintain this visualization process as you take your practice swings. The more clearly you can visualize yourself being successful, the better the process will translate.
• A great way to improve your focus and accuracy can be found in using a preparatory breathing technique. Simply, inhale slowly through your nose for a four-count. Pause for four seconds. Exhale slowly through your mouth for a four-count. Pause for four seconds, and then repeat the process two to three more times. This technique, or some variation of it, is recommended in a number of psychology books, but I most recently came across it in On Combat by Lt. Col. Dave Grossman and Loren Christensen. In their industry, the technique is used to help soldiers and law enforcement quickly calm their nerves in a combat situation to allow for a more accurate shot. Hopefully your golf outings don’t have life and death consequences, but the parallel is in the importance of precision.

Is there anything I should do after playing a round? Isn’t golf a workout itself?
It’s fair to consider golf a workout. The degree to which you get health benefits from playing are related to your physical condition. The better conditioned you are, the less physical benefit you’ll receive from playing. That said, golf still offers a number of physical and psychological benefits from being outside (preferably on a sunny day where Vitamin D is plentiful) and from doing something you enjoy.
Regarding what you should do after playing a round, the main focus is on reversing the structural adaptations that occur from the round. Performing the same pattern from a similar posture throughout the day will cause certain joints to lose range of motion. Going through a quick stretching circuit afterward can help restore the appropriate muscles back to their resting length to prevent a progressive loss of important range of motion. The circuit below will only take about five minutes:

Half Kneeling Hip Flexor Stretch with Forearm Stretch — 30 seconds per side

Half Kneeling Hip Flexor Stretch with Opposite Pec Stretch — 30 seconds per side

Half Kneeling Quad Stretch

Lying Knee to Knee Stretch — 60 seconds

Lying Glute Stretch — 30 seconds per side

Lying Active Posterior Neck Stretch — 60 seconds
Kevin Neeld is the President, COO and Director of Athletic Development of Endeavor Sports Performance in Pitman, N.J. Through the application of training and injury prevention techniques, Neeld specializes in guiding athletes to optimal health and performance. For more information on training with Neeld, click here.

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o write your mission:

Prioritize. From your notes, find what best represents your core value.
EXAMPLE OF NOTES: I teach adults in my community to read. I educate my community about the need for increasing adult literacy. I support community related events for adult literacy. I promote increased literacy in grade schools.
PRIORITY: To make literacy available to every person on the planet. (This statement is very clear and focused on the core value).
Dare to dream big. A clear and grand dream inspires – thus it increases effectiveness.

Keep it short and to-the-point. Length will decrease a statement’s punch and effectiveness. Your vision statement can be longer. Starbuck’s mission: “to inspire and nurture the human spirit – one person, one cup and one neighborhood at a time.”

Be specific. Your mission statement is a tool – as real as your adjusting table or your office building – that works for you, helping you to succeed in moving your life in the direction of your choice.
Your mission statement is your value, your compass guiding you as you make a hundred daily decisions. You can ask: “Should I buy this item or spend 20 minutes talking about planting trees?” The answer is: If it helps you accomplish your mission, it is good: if it distracts you from your mission, it is bad.
Your mission statement also gives your subconscious mind a goal, and your subconscious works constantly and tirelessly in whatever direction you set for it. A vague mission does not give your subconscious good directions.
Clarity serves all that is good.

UNDERSTANDING OSTEOARTHRITIS: THE MOST COMMON FORM OF ARTHRITIS
Osteoarthritis, also known as degenerative joint disease, affects up to 30 million Americans, mostly women and usually those over 45 or 50 years of age. The goal of any osteoarthritis treatment plan is to increase the strength of the joints, relieve pain, improve or maintain joint movement and reduce the debilitating effects of the disease. Take an in-depth look into osteoarthritis and its treatment options in
this month’s newsletter.
OSTEOARTHITIS OVERVIEW
For many, osteoarthritis pain may become markedly worse over time or with specific activities. Characteristic signs and symptoms of osteoarthritis include:
Stiffness. A common marker of osteoarthritis is stiffness in the joint that is most pronounced first thing in the morning, or after a prolonged period of inactivity (such as sitting in a car or airplane). The stiffness usually resolves within 30 minutes of light activity, as the joints “warm up” through gentle movement.
Pain. Another common symptom is pain in the joint that worsens during or after too much movement.
The pain may be experienced as dull and aching, or sharp and piercing. In the most severe cases of osteoarthritis, patients may also feel
pain when the joints are at rest or only moving slightly.
Soreness. The joint may feel tender to touch or with slight pressure.
October 2011
BROUGHT TO YOU BY: Mark Kemenosh
Dr. Mark Kemenosh
Address
Glen Oaks Health and Spine
3 Jefferson Drive
Laurel Springs, NJ 08021
Telephone Number
856-228-3100
Treatments
• Active Release Technique (ART)
• Biomechanical Video Analysis
• Chiropractic adjustment
• Chiropractic care
• Footlevelers personalized foot scan
• Kinesiotaping
• Pilates Studio
• Rehabilitation
• Scoliosis Screenings
• Spinal manipulation
• Titlilist Performance Institute (TPI) Level 2
“We care for world class athletes to weekend warriors”
Inflexibility. Patients may
experience loss of full range of
motion in the affected joint.
Read about other
symptoms, causes, diagnosis and
treatments:

http://www.earthritishealth.com/t

ypes/osteoarthritis/osteoarthritissymptoms-
and-signs
SPONDYLOSIS:
WHAT IT ACTUALLY
MEANS
Spondylosis refers to a situation
where there is degeneration of
the spine. It could describe
degeneration in the neck (cervical
spondylosis) or degeneration in
the lower back (lumbar
spondylosis). Patients are often
confused by the term because,
like many other spine terms,
doctors tend to use the term
spondylosis differently. For
example, doctors may use the
term in any of the following ways:
- To refer to general back pain in
which there is degeneration of
the spine but no known cause of
back pain
- As an “umbrella” term to
describe any patient who has
both degeneration of the spine
and lower back pain
Read about other ways
doctors use the term and the
importance of looking for the pain
generator:

http://www.spinehealth.

com/conditions/backpain/
spondylosis-what-it-actuallymeans
CERVICAL
OSTEOARTHRITIS
(NECK ARTHRITIS)
Just as in the lumbar spine,
the facet joints in the cervical
spine can degenerate and lead to
arthritis in the neck. Many
terms are used interchangeably to
refer to cervical osteoarthritis,
including cervical spondylosis,
degenerative joint disease, or
simply neck arthritis.
Treatments for cervical
osteoarthritis are usually
nonsurgical and may include one
or a combination of the following:
- Rest when the pain is severe
- Non-steroidal anti-inflammatory
drugs (NSAIDs), such as
ibuprofen (e.g. Advil), naproxen
(e.g. Aleve), or COX-2 inhibitors
(e.g. Celebrex) to relieve the pain
from the inflammation that
usually accompanies the arthritis
- Traction and/or chiropractic
manipulations to help control
chronic symptoms or provide
relief for more severe episodes of
pain from osteoarthritis
Learn more about cervical
osteoarthritis and treatment
options:

http://www.spinehealth.

com/conditions/arthritis/ce
rvical-osteoarthritis-neck-arthritis
SPECIAL OFFER: http://glenoakshealthandspine.com/
Contact Dr. Kemenosh
to learn more or schedule an appointment
856-228-3100

http://www.spine-health.com/doctor/chiropractor/mark-kemenosh-laurel-springs-nj

Low Back Pain and Golf

Low back Pain is the bane of most golfers and we will look at it from 3 perspectives: the swing and biomechanics, physiology and fitness.

Swing flaws and poor posture can ruin a back ( and a round) continuously! Golf IS physically demanding and applies a tremendous amount of one-sided rotational torque. The constant pressure of gravity along with overuse applies intense force to the muscles, facets, vertebra, discs and surrounding soft tissue in the lumbar spine and pelvis. Reverse spine angle, early extension and excessive arching are all recipes for severe back pain. Club biomechanics is also very important so ill fitting equipment can also be a part of pain scenarios. These issues should direct you to your PGA professional to help you swing more efficiently, effectively and pain free
The hot topic in physiology is “the core”. This is where most golfers are weak and need strengthening and some training. If there are muscle imbalances and weaknesses along with deconditioned anatomy, pain will result from the twisting and accelerated torque in the golf swing. The current research is really paying attention to areas that are dysfunctional/not painful as the starting point of physical breakdown. I’ll show you some exercises and ideas here to tune up these weakened areas. The core muscles are much more powerful than the smaller back muscles so if they are engaged we prevent and minimize low back pain in your game.
Fitness is necessary for good long-term pain free golf. It’s important to know your body and that’s where a health and fitness provider can really give you body awareness. Free up any restrictions and adhesions, improve range of motion and correctly add power, mobility and stability. This is where your programs that I have talked about in the past come in: Pilates, cardiovascular conditioning, strength training, yoga for golfers, rotational exercises, inversion therapy and more. So it is VERY important to use the Functional Movement Screen (FMS) and Selective Functional Movement Assessment (SFMA) as a baseline. Get your team and body together to fight and prohibit low back pain so you can play longer and stronger!
CORE EXERCISES
Lying flat on your back with your knees bent and your feet flat on the ground, extend your arms out to your side with your palms facing up. From there push your heels into the ground and lift your pelvis up. Perform reps of this focusing on using your glutes to lift and minimizing your legs (hamstrings). To make this harder, you can cross your arms over your chest.

Cats & Dogs
Start in the quadruped position (all fours) with your thighs and arms perpendicular to the floor. Without bending your elbows, lift your head and try to lower your spine as far as possible creating the dog position. Now, lower your head and lift your spine as far as possible creating the cat position. Repeat this back and forth for the prescribed amount of time

Curl Up

Lying flat on your back with your knees bent and your arms behind your head or placed under your lower back, get into a neutral pelvic posture and brace your abs. From here, slowly curl up each vertebrae, starting from your neck, one at a time until you feel your shoulder blades coming off the ground. Slowly lower yourself and repeat.

Kneeling Chops

Start by kneeling down with a medicine ball in both hands and get into a good forward flexed and stable posture. Without lifting up out of your posture, rotate your shoulders and lift the ball up diagonally across your chest. Make sure you rotate around your spine and don’t flatten out your shoulders. Now, quickly bounce the ball into the ground and rotate your shoulders in the opposite direction, catching the ball on the other side. Repeat in the opposite direction

Cross Over Hip Stretch

Begin this drill by laying flat on your back with both knees up and feet flat on the ground. Next, take your right ankle and cross it over your left knee, and allow the left knee/right ankle complex to fall slowly down to the ground on the LEFT side. While the complex is slowly lowering to the left, place left hand on the RIGHT knee and gently aid this slow lowering of the legs. Once the legs have fallen completely to the left and your left hand is pulling the right knee towards the ground, you may turn your head to the right to try and get the maximum out of the stretch. Always perform this stretch in a very slow and controlled manner, never to the point of pain. Repeat procedure on opposite side

Plank Alternating Arm / Leg

[Pick the date] [Edition 1, Volume 1]
WHAT IS CAUSING MY NECK PAIN?
Most episodes of neck pain are due to a muscle strain or other soft tissue sprain. This type of injury can also be caused by a sudden force (whiplash). Patients might complain of having a stiff neck. Neck pain often improves with time and with non-surgical care such as medications, chiropractic manipulation and specific neck exercises. If the neck pain continues or worsens or is accompanied by arm pain or numbness, there may be a specific condition that also requires treatment.
STIFF NECK CAUSES, SYMPTOMS AND TREATMENTS
By far the most common cause of a stiff neck is a muscle sprain or muscle strain, particularly to the levator scapula muscle. Located at the back and side of the neck, the levator scapula muscle connects the cervical spine (the neck) with the shoulder. This muscle is controlled by the third and fourth cervical nerves (C3, C4). The levator scapula muscle may be strained or sprained throughout the course of many common, everyday activities, such as:
 Sleeping in a position that strains the neck muscles
 Sports injuries that strain the neck
 Any activity that involves repeatedly turning the head from side to side, such as swimming the front crawl stroke
 Poor posture, such as slouching while viewing the computer monitor
BROUGHT TO YOU BY: MARK KEMENOSH, DC
SPINE HEALTH NEWSLETTER – SEPTEMBER 2011
ABOUT DR. KEMENOSH
Dr. Mark Kemenosh and his team at Glen Oaks Health and Spine in Laurel Springs, New Jersey are experts in treating shin splints, hip pain, back pain, neck pain and all soft tissue issues. To learn more about Dr. Kemenosh, click on the “request an appointment” button to schedule your initial consult.
Visit Dr. Kemenosh’s profile on Spine-Health.com to learn about his latest treatments and his special offers for new and returning patients.

http://www.spine-health.com/doctor/chiropractor/mark-kemenosh-laurel-springs-nj

856-228-3100
Brought to you by: Mark Kemenosh, DC
[Pick the date] [Edition 1, Volume 1]
Brought to you by: Mark Kemenosh, DC
Glen Oaks Health and Spine
3 Jefferson Drive
Laurel Springs, NJ 08021
856-228-3100
Special Offers: http://glenoakshealthandspine.com/
 Excessive stress, which can lead to tension in the neck
 Holding the neck in an abnormal position for a long period, such as cradling a phone between the neck and shoulder.
Read more about stiff neck causes, symptoms and treatments:

http://www.spine-health.com/conditions/neck-pain/stiff-neck-causes-symptoms-and-treatment

WHAT CONDITION IS CAUSING MY NECK PAIN?
While neck pain (in the cervical spine) is less common than lower back pain (in the lumbar spine), millions of people experience neck pain and/or related arm pain at some point in their lives. The vast majority of episodes of neck pain will get better with time and can be addressed with non-surgical treatments. Ongoing neck pain may be caused by a specific condition such as a cervical herniated disc, cervical stenosis, cervical degenerative disc disease, or cervical osteoarthritis. Learn more about these conditions and their telltale symptoms:

http://www.spine-health.com/conditions/neck-pain/types-neck-pain

NECK EXERCISES FOR NECK PAIN
Chronic or recurrent neck pain can be severely debilitating and can also be accompanied by upper back pain, shoulder blade pain and headaches. These symptoms, along with tight neck muscles and stiff joints, can make even the simplest daily activities painful. An appropriate neck exercise program can address most of these symptoms as follows: Neck Stretches Flexibility and stretching exercises can expand or preserve the range of motion… Neck Strengthening Specific strengthening exercises will help maintain improved posture… Aerobic Conditioning Aerobic exercises increase blood flow to the muscles and soft tissues of the neck and upper back… Learn more about ways to exercise the neck and its benefits:

http://www.spine-health.com/conditions/neck-pain/neck-exercises-neck-pain

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.Foot Levelers’s Notes
Weak Feet Weaken The Body
.by Foot Levelers on Monday, September 12, 2011 at 5:07am.Confusion behind OTC orthotics

An immense number of men and women suffer from foot ailments throughout the world. Many will seek relief from Over-The-Counter (OTC) orthotics because they are generally inexpensive and provide soft, temporary comfort for aching feet.

OTC orthotics offer basic support to the feet and cannot fully correct a body’s postural imbalances. The body relies on the complex shape of each foot to provide stability and balance, and OTC orthotics do not fit the mold.

Why?

OTC orthotics typically provide a “one size fits all” support to the medial arch. This has led to a common misconception among consumers that there is only one arch in each foot. Or there is only one arch in each foot that needs treatment.

In actuality, there are three arches in each foot, and they all must be supported. The medial, lateral, and the transverse arches make up the supportive structure in the feet called the plantar vault.

As stated in The Physiology of the Joints, “The plantar vault is an architectural structure which blends all of the elements of the foot – joints, ligaments and muscles – into a unified system.”[1]

How does the plantar vault work?

When standing, the three arches in the feet support the entire kinetic chain, creating an equal foundation for the body. They each work in unison to provide stability for the body. If the medial arch is pronated, it will cause the ankles to roll inward. As a result, the knees will follow suit, which can misalign the hips. That can then lead to imbalances in the neck and shoulders.

There is a high probability that men and women with foot ailments will also have musculoskeletal pain and misalignment in their posture. This is because the plantar vault in the feet has been compromised and is not able to fully support the rest of the body.

Generic

OTC orthotics are similar to the cement foundation that only supports half of the house. While one side is being supported, the other side gets neglected, resulting in an imbalanced structure.

Generic orthotics are designed for one pair to fit millions of people. However, each person has a different body type, activity level and posture. Just as two people will not have the same DNA, two people will not have identical feet. One pair of orthotics will not be able to treat the same ailments for two people.

Individually Designed

Stabilizing Orthotics engage the plantar vault by correctively supporting the arches in the feet, as well as the body’s kinetic chain. This can only be done by making each pair specifically to the needs of the patient.

When each component of the plantar vault is supported by a solid, equally distributed foundation, it is engineered to withstand the different pressures and stresses that the world throws at it.

[1] Kapandji, I.A., (1987). The Physiology of the Joints. Annotated diagrams of the mechanics of the human joints – 5th ed. Volume 2: Lower Limb. Churchill Livingstone

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[Pick the date] [Edition 1, Volume 1]
LOW IMPACT EXERCISES FOR BACK PAIN RELIEF
Often times patients with severe back pain or certain conditions, such as when bones are weakened or have swelling and inflammation of the joints or even muscle strain, it is nearly impossible to perform high impact exercises. Since maintaining good health, muscle structure and flexibility is crucial to preventing further issues, it is imperative that patients find activities they can perform safely. Read the articles below and follow the links to the full article for more information on low impact exercises for back pain relief.
LOW-IMPACT AEROBIC EXERCISE
Along with specific back exercises, aerobic exercises that increase the heart rate for a sustained period are very beneficial for helping back problems. Aerobic exercise increases the flow of blood and nutrients to back structures which supports healing, and can decrease the stiffness in the back and joints that lead to back pain. While many patients with back pain are able to participate in vigorous exercise like running or step aerobics, others find it easier to engage in low-impact exercise, which does not jar the spine.
Types of low impact exercises:
- Walking. In general, walking for exercise is very gentle on the back, and walking two to three miles three times per week is very helpful for patients. Walking also has the advantage of not requiring special equipment (except a good pair of shoes suitable for walking) and it can be done inside or outside, in almost any location, including at home on a treadmill.
- Stationary bicycling. For those patients who are more comfortable seated rather than standing, biking or stationary biking may be preferable. Bicycling or „spinning‟ classes have grown in popularity over the last decade as more people
BROUGHT TO YOU BY: MARK KEMENOSH, DC
SPINE HEALTH NEWSLETTER – AUGUST 2011
ABOUT DR. KEMENOSH
Dr. Mark Kemenosh and his team at Glen Oaks Health and Spine in Laurel Springs, New Jersey are experts in treating shin splints, hip pain, back pain, neck pain and all soft tissue issues. To learn more about Dr. Kemenosh, click on the “request an appointment” button to schedule your initial consult.
Visit Dr. Kemenosh’s profile on Spine-Health.com to learn about his latest treatments and his special offers for new and returning patients.

http://www.spine-health.com/doctor/chiropractor/mark-kemenosh-laurel-springs-nj

856-228-3100
Brought to you by: Mark Kemenosh, DC
[Pick the date] [Edition 1, Volume 1]
Brought to you by: Mark Kemenosh, DC
Glen Oaks Health and Spine
3 Jefferson Drive
Laurel Springs, NJ 08021
856-228-3100
Special Offers: http://glenoakshealthandspine.com/
realize the benefits of this lower impact form of exercise. There are several upright and recumbent (reclining) bikes that can be purchased for home use, and many come with programs preloaded so that patients have a good variety of sessions from which to choose.
Read about additional low impact exercises: http://www.spine-health.com/wellness/exercise/low-impact-aerobic-exercise
YOGA AS A TREATMENT FOR BACK PAIN AND NECK PAIN
A combination of physical exercises, breathing exercises and meditation, yoga may appeal to people as a means to stay fit and relax, but it also has practical applications for treating chronic back pain and neck pain from a herniated disc, arthritis and other conditions.
Several types of yoga exist, with their applications often beneficial to certain types of patients. The following are just some examples of the different types of yoga:
- Iyengar yoga. Iyengar yoga stresses proper alignment and precise movements yet incorporates modifications that often benefit back pain and neck pain patients whose mobility may be limited as a result of their symptoms.
- Ashtanga yoga. Emphasizing powerful flowing movements like push-ups and lunges, Ashtanga yoga is appropriately described as “power yoga” and often appeals to patients who have previously rehabilitated from a back injury.
Read about other types of yoga for ongoing back and neck pain: http://www.spine-health.com/blog/exercise-fitness/yoga-a-treatment-back-pain-and-neck-pain
WATER THERAPY EXERCISE PROGRAM
Water therapy exercise programs consist of a variety of treatments and exercises that are done in a pool and may be specifically designed to provide relief of low back pain or neck pain. These exercises also serve to condition and strengthen muscles to help avoid future recurrences of back pain.
Water therapy exercise is especially helpful in cases where a land-based exercise program is not possible due to the intensity of pain, decreased bone density, disability or other factors. As such, water therapy is a versatile exercise and is particularly good for people with conditions such as:
- Osteoarthritis
- Advanced osteoporosis (with susceptibility to and/or pain from fracture)
- Muscle strain or tears
Read more about the benefits of exercising in water: http://www.spine-health.com/wellness/exercise/water-therapy-exercise-program
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