M ORE PRAISE FOR D R. D I N UBILE AND F RAME W ORK
No doubt about it, FrameWork is an important book that I know you will enjoy and find helpful on your road to optimal health, conditioning, and achievement. Its a must-read for anyone who cares about his or her body and wants it to last.
Governor Arnold Schwarzenegger
During my 21-year major-league career it was amazing to see the advances in training and medicine from the time I first made it to the big leagues in 1981 to the time I retired in 2001. Dr. DiNubiles book is a striking example of that and how a firm understanding of your body and how best to keep it in shape can enhance every part of your life. Having gone through my share of injuries, from bumps and bruises to a herniated disk, I wish that resources like FrameWork were available to me throughout my career.
Cal Ripken, Jr.,
baseballs all-time Iron Man, two-time AL MVP, perennial All-Star
Dr. Nick has the uncanny ability to understand the language of the human body. He knows how it speaks. In the movie industry and in sports, the body is invaluable as an instrument. Dr. Nick is invaluable at keeping that instrument tuned to perfection. He is a healer of the highest order.
M. Night Shyamalan,
The Sixth Sense, Unbreakable,Signs, The Village
FrameWork is an indispensable text that gives individuals essential advice and information on how to protect and enhance arguably our most valuable assetthe health and function of our musculoskeletal systems. Renowned orthopedic surgeon Dr. Nicholas DiNubile offers a wide variety of useful tips and practical guidance such as how to conduct a simple self-assessment of the condition of our muscles, bones, and joints, and, more importantly, how to properly exercise to safely improve our functional movement capabilities. At the American Council on Exercise, we were so impressed with the content in FrameWork that it is used as the core foundation of a continuing education course for our more than 50,000 fitness professionals. This book is a must-read for anyone interested in experiencing the joys of leading a physically active lifestyle and developing a body thats built to last a lifetime.
Cedric X. Bryant, PhD, FACSM,
chief science officer, American Council on Exercise
I have known Dr. DiNubile for many years, and his reputation as a specialist in sports medicine is legendary. Now he has compiled into book form knowledge accumulated from many years of working with athletes, which should enable even the nonathlete to achieve total fitness.
Kenneth H. Cooper, MD, MPH,
founder, president, and CEO, The Cooper Aerobics Center
This is the owners manual that should have come with your body.
Dr. Neil Liebman,
team chiropractor, Philadelphia 76ers
Dr. Nick is a great doctor. Hes not only an excellent surgeon but also an understanding, feeling practitioner in all musculoskeletal-related concerns. As he says, since we are living longer, this aspect of health care has surpassed the common cold for frequency of treatment. I am fortunate enough to have had Dr. Nick repair one of my knees. Being a good example of just the kind of extended-wear person Dr. Nick is talking about, now I am even more grateful to get advice from one of the brightest (and nicest) guys in the field on how to keep my frame working for me. I, like a lot of us who have borrowed time from science, can only very strongly recommend his words to anyone and everyone interested in keeping their bones working to their best potential as we gracefully glide, run, skip, bat, pole-vault, hike, or bike into our happiest days.
William Hurt,
Academy Awardwinning actor
Dr. DiNubile is the master of preventative medicine for the musculoskeletal system.
Wayne L. Westcott, PhD, CSCS,
fitness research director, South Shore YMCA, Quincy, MA
FrameWork teaches you how to take optimal care of your body so you can enjoy both life and leisure more. For athletes, its essential for a long healthy career.
Jay Sigel,
U.S. PGA and U.S. amateur golf champion
Dr. DiNubiles FrameWork provides cutting-edge information not only from a health and wellness standpoint but from an athletic performance aspect as well.
Gary Vitti,
head trainer, LA Lakers
To my dream team:
Marybeth, Emily, and Dylan
It would be almost impossible to acknowledge the many individuals who have helped influence and shape my thoughts and philosophy as expressed in FrameWork for theLower Back. Teachers, medical colleagues, patients, and friends, in the gym or on the field, have all had an impact for which I am grateful.
I would also like to extend my sincere gratitude to the following individuals: Arnold Schwarzenegger for his friendship and inspiration over the years and also the gang at Oak Productions, especially Lynn Marks; David Caruso, my friend and partner in creating innovative health solutions through technology; Lois de la Haba, my agent, who believed in me and this project from the very beginning; Bruce Scali for his talent, professionalism, and collaboration; the top-notch, enthusiastic team at Rodale, including Karen Rinaldi, Chris Krogermeier, Colin Dicker-man, Courtney Conroy, and also John Hamel, Troy Schnyder, Christina Gaugler, Lois Hazel, Joanna Williams, and Adrienne Bearden-Gardner; Joe Kelly, whose images grace the pages of this book; Roger Schwab for his friendship and thought-provoking discussions and state-of-the-art workouts and facility at Main Line Health and Fitness; the Philadelphia 76ers and Pennsylvania Ballet, two first-class organizations Ive had the pleasure to work with over the years and where I have learned firsthand the extraordinary capabilities of the human body and that given the right circumstances, healing can indeed be accelerated; Frank Nein for his help and support in cyberspace, especially at www.drnick.com; the many physicians and health care professionals who contributed their thoughts, philosophy, and expertise found within the pages of this book; my dedicated staff, Mary Moran and Barb De Jesse; and most importantly, my loving, supportive familyMarybeth, my wife and creative advisor, and my children, Emily and Dylan, who inspire me every single day.
CONTENTS
Theres good news and theres bad news on the health care front: Were living a lot longer (life expectancy has doubled over the last hundred or so years, and the curve is still decidedly upward), but, as Ive said before and never tire of saying, weve outlived the warranties on our bodiesour frames, if you will. The simple truth is evolution doesnt work very fast; it takes its sweet time to catch up, and the structure that was perfectly fine for an average 40-year life span a century ago isnt exactly up to snuff now.
Any machine, including the human one, will lose efficiency and break down at some point. Of all the people who have ever lived past the age of 65, two-thirds are alive today, so its no surprise that musculoskeletal ailments leapfrogged the common cold in 2004 as the number-one reason for doctor visits. Problems with muscles, bones, and joints fill many physicians schedules, driven in no small measure by arthritis in all of its forms. Lower back injury is the most frequent claim for those out on workers compensation, and lower back pain is at or near the top of the musculoskeletal list for everyone else, too.
Including me.
You see, when I was a little younger, I sustained an injury that reminds me to this day of the one spent horsing around on a beach, when I got tackled and my back was wrenched in a way it wasnt designed to handle. I sucked it up then, I sucked it up later on, and there are plenty of days now when I suck it up and carry onjust as millions of others who have had a similar experience do.