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Any Medical Professionals Here... (Compression Fractures and Breathing)?
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I fractured T8 - L2 vertebrae in 2015 with L1 and L2 being the worst at 15-20% compressed. Ever since, I have frequent issues with my back tightening up and restricting my breathing. When this occurs, the same effort (say 200 watts) requires 10-15 higher bpm heart rate. So I go to my local chiropractor and he cracks a few things (seems the issue is more centered around the lower thoracic spine than L1 and L2. 10 minutes later I walk out of there and I can breathe again and my power vs heartrate issue is immediately fixed... for about a week or two before my spine seems to revert to it's old dysfunctional ways again.

Question 1: What quick fix can I do at home to resolve the issue? I'm thinking I may be traveling for a race and I won't have my chiro that understands my issue nearby. I have yet to find any stretches, foam rolling, or other exercises that crack my spine in the same way my chiro can.

Question 2: What can I do to see long term change???


Last edited by: cmeeks: Mar 13, 18 12:54
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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You need a doctor practicing evidence-based medicine and/or a PT he recommends, not a chiropractor.
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Re: Any Chiropractors Here (Compression Fracture Question)? [Hammer Down] [ In reply to ]
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Ah, I was waiting for that hahaha. PT? Really??? Every PT I've ever been to has strung me along, wasted lots of my time and money, and provided no real results. Chiro at least has provided an instant (albeit temporary) fix for my back issue. Say what you want about Chiropractors, but my evidence says it's the only thing that works for this issue so far. I swear the PT avoids explaining the issue out of fear I'll learn more about it on my own and fix it myself whereas the Chiro explained what was going on during the first visit.

By all means, if you practice evidence based medicine, I'm asking for your advice too!
Last edited by: cmeeks: Mar 13, 18 9:57
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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Cracking the spine (cavitation) does nothing but makes you feel good as you have no real disorder other than being temporarily uncomfortable. Your compressed spine is what it will be from now on unless you sustain trauma or become osteoporotic. There is no evidence in what you claim, perhaps a placebo effect however. Have you actually tried riding on or just doing something else other than going to get your back cracked? Bike fit? Lower your seat?
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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I had a similar compression fracture about a year ago, I still have it to some extent but it's much less painful.
As others have said, adjustments can provide some temporary relief but a heavy schedule (6 appts in 2 weeks) of PT at the chiropractors clinic helped me more. I still let them do the adjustments, they seem to enjoy it so much:)
What helped more than both was yoga.
Sometimes it's hard to establish where the problem is but the yoga stretching covered all my shoulders, back, hips and quads and after 2 or 3 classes I felt more comfortable than I have for years, some times it doesn't hurt at all getting out of bed.
The caveat with my n=1 survey is that I was real mess to start with. I was low hanging fruit.
The good news is that almost all yoga centers will give you a free or cheap introductory week (I went 8 times!) so it wouldn't cost much to try.

Good luck.
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Re: Any Chiropractors Here (Compression Fracture Question)? [AndrewL] [ In reply to ]
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AndrewL wrote:
Cracking the spine (cavitation) does nothing but makes you feel good as you have no real disorder other than being temporarily uncomfortable. Your compressed spine is what it will be from now on unless you sustain trauma or become osteoporotic. There is no evidence in what you claim, perhaps a placebo effect however. Have you actually tried riding on or just doing something else other than going to get your back cracked? Bike fit? Lower your seat?


I've tried foam rolling, stretching, trigger point, massage therapy, tens, belly breathing, pounding on it in frustration, etc etc. I have not tried anything bike fit related as it's an off the bike issue as well in the form of shortness of breath and tightness along my thoracic spine. Trust me - I've considered placebo effect as well and I've attempted to ride through it many times with no success. I spend LOTS of time on the trainer in erg mode in zone 2 for hours at a time. This is a great time to keep a loose upper body, practice breathing, and see how low I can keep my heart rate. When my back is acting up, however, my heart rate is invariably 10-15 bpm higher and it's pretty infuriating (not to mention uncomfortable) when my heart is racing to maintain 60-70% FTP. It makes it hard to finish some of these workouts as decoupling adds to the already high heart rate. So yeah, I've tried riding through it for days at a time. When I was riding less frequently, I might go a month or two without seeing the chiropractor. At 15-20 hours/week, it seems I need to go a couple times a month minimum. When I do - instant relief and instant drop in heart rate. No amount of trying to "feel good" or focusing on lowering my heartrate can seem to replicate it, so placebo??? I don't think so.
Last edited by: cmeeks: Mar 13, 18 12:33
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Re: Any Chiropractors Here (Compression Fracture Question)? [BLACKSHEEP] [ In reply to ]
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BLACKSHEEP wrote:
I had a similar compression fracture about a year ago, I still have it to some extent but it's much less painful.
As others have said, adjustments can provide some temporary relief but a heavy schedule (6 appts in 2 weeks) of PT at the chiropractors clinic helped me more. I still let them do the adjustments, they seem to enjoy it so much:)
What helped more than both was yoga.
Sometimes it's hard to establish where the problem is but the yoga stretching covered all my shoulders, back, hips and quads and after 2 or 3 classes I felt more comfortable than I have for years, some times it doesn't hurt at all getting out of bed.
The caveat with my n=1 survey is that I was real mess to start with. I was low hanging fruit.
The good news is that almost all yoga centers will give you a free or cheap introductory week (I went 8 times!) so it wouldn't cost much to try.

Good luck.

I have no doubt most athletes could use more yoga simply to be good humans. I'm curious to know if you also experienced the tightness along your spine I'm experiencing and if there weren't some specific yoga stretches that seemed to help with that problem.
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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You know what the Ivy League, Atlantic Coast Conference (ACC), Big Ten Conference (B1G), Big 12 Conference, Pac-12 Conference, and Southeastern Conference (SEC) all have in common? None of their member institutions offer a degree in chiro anything. Look at any list of the best colleges and universities in the U.S. and not a single one of them has a chiropractic department. You want to know why? The same reason they don’t offer courses in alchemy, astrology, palmistry, and telepathy. It’s not based in science. Sorry

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Re: Any Chiropractors Here (Compression Fracture Question)? [imsparticus] [ In reply to ]
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imsparticus wrote:

You know what the Ivy League, Atlantic Coast Conference (ACC), Big Ten Conference (B1G), Big 12 Conference, Pac-12 Conference, and Southeastern Conference (SEC) all have in common? None of their member institutions offer a degree in chiro anything. Look at any list of the best colleges and universities in the U.S. and not a single one of them has a chiropractic department. You want to know why? The same reason they don’t offer courses in alchemy, astrology, palmistry, and telepathy. It’s not based in science. Sorry

I've always laughed that people think Chiropractics is a real science. It's a scam. Who seriously thinks popping bones in your back fixes back issues? Who would go to school for this and waste thousands on a scam education?

Make Inside Out Sports your next online tri shop! http://www.insideoutsports.com/
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Re: Any Chiropractors Here (Compression Fracture Question)? [BryanD] [ In reply to ]
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BryanD wrote:
imsparticus wrote:

You know what the Ivy League, Atlantic Coast Conference (ACC), Big Ten Conference (B1G), Big 12 Conference, Pac-12 Conference, and Southeastern Conference (SEC) all have in common? None of their member institutions offer a degree in chiro anything. Look at any list of the best colleges and universities in the U.S. and not a single one of them has a chiropractic department. You want to know why? The same reason they don’t offer courses in alchemy, astrology, palmistry, and telepathy. It’s not based in science. Sorry


I've always laughed that people think Chiropractics is a real science. It's a scam. Who seriously thinks popping bones in your back fixes back issues? Who would go to school for this and waste thousands on a scam education?


Okay, I don't really want to get involved in any argument relating to the legitimacy of chiropracticing much less the legitimacy of chiropracticing as a word in the english language. I don't care! I've shared my experience - you can't argue that. So if you are a chiropractor, spine surgeon, physical therapist, or Joe Blow with a similar back injury, I would be extremely interested to hear YOUR explanation of what might be happening and a potential fix. Hit me with all your medical expertise please!
Last edited by: cmeeks: Mar 13, 18 13:03
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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We are all telling you that your n=1 experience means nothing in the context of academia and professional medical opinion :)

Make Inside Out Sports your next online tri shop! http://www.insideoutsports.com/
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Re: Any Chiropractors Here (Compression Fracture Question)? [BryanD] [ In reply to ]
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BryanD wrote:
We are all telling you that your n=1 experience means nothing in the context of academia and professional medical opinion :)

Not helpful. Try again ;-)
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Re: Any Chiropractors Here (Compression Fracture Question)? [BryanD] [ In reply to ]
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Mine has never cracked my back. He did fix an issue where my leg got literally turned off by a pinched nerve while running, and now I'm back to sub 7 minute miles.
There's quack chiro's and real fixers. Probably more quacks than good ones. But don't call them all a scam.

NO
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [cmeeks] [ In reply to ]
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This is not a compression fracture issue. You are describing a derangement of the spine (something out of place) that is mechanically reduced with manipulation. This form of treatment is indicated in acute onset of spine pain with a corresponding loss of range of motion. Once the derangement is reduced and your pain resolves there are specific exercise that should be performed that will help to maintain the reduction. With the reduction maintained, the offending area will scar down and your likeliness of deranging again will decrease. However, the key here is to figure out what actually causes your pain. Perhaps it is prolonged periods of flexion, sitting, bending forward or something like that. You cannot begin to prevent this problem from occurring until you figure out what causes it and stop the offending actions. I'm a PT, board certified in orthopedics and a spine specialist. I don't necessarily have an issue with chiropractic care when it's used in methods that are supported in the literature. Again, the issue is not compression fracture or chiropractic. The issue is what are you doing to cause this problem. Over time, and without care, it will likely worsen or become more difficult to reduce, or not reduce fully or not stay reduced as long. Pay attention to your body and what causes your pain. Avoid what hurts. My bias- find a Mckenzie credentialed physical therapist, show up with your problem and relay your history. If you do your exercises avoid provocative positions or movements you have a real shot to prevent this from recurring.
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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"I'm curious to know if you also experienced the tightness along your spine I'm experiencing and if there weren't some specific yoga stretches that seemed to help with that problem. "

I have had tightness along the spine, all the way from the sacrum to the neck. I've had backache since I started cycling 20 years ago so I can't really say what causes it.

There isn't enough ink in this laptop for me to list all my injuries. Suffice to say in just the last 5 years: fractured tailbone, compressed L1/L2, 2 fractured neck vertebrae, fractured femur, broken wrist and rib. All separate accidents. And that's only the breakages.

With all these injuries and more, I walked the dog at 6am, 3 days into my free week of yoga, and felt a weirdly limber in my legs, hips and back, I was almost pain free. I hadn't ridden that week so that helped, but it was a very pleasant surprise.

It seems that when you get a bad injury there's a tendency to just think of the bones, but there's usually a lot of soft tissue damage too. The bones heal a lot quicker than the soft tissue, which is why treatment should continue long after the bone is healed; at my age probably for the rest of my life.

Specific lower back yoga can be found online (youtube helps with technique) and Tom Danielson's book on back exercises for cyclists is a great resource when you are healed.
But you might as well do all the back rather than self diagnosing.

Lets face, it cycling is not good for the back.
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [cmeeks] [ In reply to ]
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I fractured T8 in 2014 - burst fracture with 60% compression, along with lesser damage to T7 and T9 as well as the discs in between, and a host of other injuries at the same time.
I've never specifically had any issue with breathing other than occasional intercostal cramps.
What's worked best for me is PT (twice per week) along with massage (once per week). I don't see the need for that ever ending. Between those appointments I can usually get relief using a foam roller. Strangely, lifting weights often helps, specifically squats. When nothing else works, I have a prescription for Tramadol, which will generally take the edge off.
I used to see a chiropractor as well, but I'm not convinced it was doing anything at all.
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [Ex-Rower] [ In reply to ]
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I doubt those fractures are the issue. They are almost within the realms of normality if you are 50+. It's uncommon to see a spine older than this without a bit of wedging. Most people have no idea how they got it.
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [AndrewL] [ In reply to ]
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AndrewL wrote:
This is not a compression fracture issue. You are describing a derangement of the spine (something out of place) that is mechanically reduced with manipulation. This form of treatment is indicated in acute onset of spine pain with a corresponding loss of range of motion. Once the derangement is reduced and your pain resolves there are specific exercise that should be performed that will help to maintain the reduction. With the reduction maintained, the offending area will scar down and your likeliness of deranging again will decrease. However, the key here is to figure out what actually causes your pain. Perhaps it is prolonged periods of flexion, sitting, bending forward or something like that. You cannot begin to prevent this problem from occurring until you figure out what causes it and stop the offending actions. I'm a PT, board certified in orthopedics and a spine specialist. I don't necessarily have an issue with chiropractic care when it's used in methods that are supported in the literature. Again, the issue is not compression fracture or chiropractic. The issue is what are you doing to cause this problem. Over time, and without care, it will likely worsen or become more difficult to reduce, or not reduce fully or not stay reduced as long. Pay attention to your body and what causes your pain. Avoid what hurts. My bias- find a Mckenzie credentialed physical therapist, show up with your problem and relay your history. If you do your exercises avoid provocative positions or movements you have a real shot to prevent this from recurring.


I fully agree that the compression fractures themselves are no longer the issue. They simply set off a chain reaction of issues with the surrounding musculature that I haven't been able to fully resolve since the accident. I'm sure my posture at my desk job is a large source of the ongoing problem and relapse of the stiffness in my back. So the question is, what are some exercises I can do on my own that would reduce the derangement and improve my range of motion? I've been making huge improvements with my cycling the last three months, but the issue came back in a big way this week and I'm just a few weeks away from my "A" race. I need a short term patch that pinpoints the lack of mobility and manages it well enough to get me through that race. Longer term, do you have any recommendations on someone I can see in Houston?
Last edited by: cmeeks: Mar 14, 18 5:13
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Re: Any Chiropractors Here (Compression Fracture Question)? [cmeeks] [ In reply to ]
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cmeeks wrote:
Ah, I was waiting for that hahaha. PT? Really??? Every PT I've ever been to has strung me along, wasted lots of my time and money, and provided no real results. Chiro at least has provided an instant (albeit temporary) fix for my back issue. Say what you want about Chiropractors, but my evidence says it's the only thing that works for this issue so far. I swear the PT avoids explaining the issue out of fear I'll learn more about it on my own and fix it myself whereas the Chiro explained what was going on during the first visit.

By all means, if you practice evidence based medicine, I'm asking for your advice too!

I'm but a lowly student so ask me after residency and I'll be happy to give you advice, unfortunately that doesn't help you now. The key part of my statement is to go to a doctor, and let that doctor refer you to a PT if needed. PT quality can vary drastically, especially when people go to them with their athletic performance in mind as opposed to just getting through the day.
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Re: Any Chiropractors Here (Compression Fracture Question)? [Hammer Down] [ In reply to ]
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Hammer Down wrote:
I'm but a lowly student so ask me after residency and I'll be happy to give you advice, unfortunately that doesn't help you now. The key part of my statement is to go to a doctor, and let that doctor refer you to a PT if needed. PT quality can vary drastically, especially when people go to them with their athletic performance in mind as opposed to just getting through the day.

If there's one thing education taught me, it's that the more you learn, the more you will realize you don't know
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [AndrewL] [ In reply to ]
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AndrewL wrote:
This is not a compression fracture issue. You are describing a derangement of the spine (something out of place) that is mechanically reduced with manipulation. This form of treatment is indicated in acute onset of spine pain with a corresponding loss of range of motion. Once the derangement is reduced and your pain resolves there are specific exercise that should be performed that will help to maintain the reduction. With the reduction maintained, the offending area will scar down and your likeliness of deranging again will decrease. However, the key here is to figure out what actually causes your pain. Perhaps it is prolonged periods of flexion, sitting, bending forward or something like that. You cannot begin to prevent this problem from occurring until you figure out what causes it and stop the offending actions. I'm a PT, board certified in orthopedics and a spine specialist. I don't necessarily have an issue with chiropractic care when it's used in methods that are supported in the literature. Again, the issue is not compression fracture or chiropractic. The issue is what are you doing to cause this problem. Over time, and without care, it will likely worsen or become more difficult to reduce, or not reduce fully or not stay reduced as long. Pay attention to your body and what causes your pain. Avoid what hurts. My bias- find a Mckenzie credentialed physical therapist, show up with your problem and relay your history. If you do your exercises avoid provocative positions or movements you have a real shot to prevent this from recurring.

THIS!!!!! Now, unfortuantly for the OP, it sounds like an issue that will not be resolved with a "quick fix". This happens with some injuries and some injuries can be chronic and debilitating. Obviously this isn't positive but you have to be honest with your condition and go see a spine specialist (NOT a chiro....sorry but stop going to them) as for PT, sometimes you have to complete home exercises prescribed daily to ensure a pain free life.
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [tridude93] [ In reply to ]
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tridude93 wrote:
Obviously this isn't positive but you have to be honest with your condition and go see a spine specialist (NOT a chiro....sorry but stop going to them) as for PT, sometimes you have to complete home exercises prescribed daily to ensure a pain free life.

Yep. I crushed a T6/7 pretty good a couple of years ago. As it was still healing up I went to a chiro who was highly recommended and he was able to help with some of the pain that was still lingering from the whiplash related to the acciden. However, the experience confirmed my suspicions about the industry; chiropractors operate on the subscription model. After each session I'd immediately feel better but it never lasted and he was always ready to sign me up for the next appointment.

Instead of falling into that cycle I went to a sports oriented PT who prescribed a series of exercises to strengthen muscles that support the affected area and that has been successful long term. If I fall out of the habit of doing the exercises then issues start to pop up and then will fade away again after getting back in the routine. In my opinion chiropractors have their place with regards to immediate pain management but a proper sports oriented physical therapist will offer a much better long term plan.
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [cmeeks] [ In reply to ]
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I will say I also question your symptom set (shortness of breath) and mechanism you describe. Rehab medicine is not rocket science; root cause, short term symptom management, intervention addressing root cause, maintenance/long term symptom management...

I think you are stuck on short-term symptom management, hence the vicious cycle...some people/providers may like this approach.

I think you need to shop for a better provider. However, if you want to try a home/road version to mimic your short-term relief try inversion therapy;)
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [ktm520] [ In reply to ]
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Inversion therapy... ugh, I hate being upside down...

Regarding a quick fix, I agree - I do need to find a long term solution and the chiro obviously isn't it. BUT, my copay on the chiro is cheap and it provides immediate relief usually for a couple weeks, so it's been working to get me through my training quite well. And I like my chiro. He doesn't pressure me to come back in nor does he try to sign me up for a "plan". I can call them up when the issue comes up and they always squeeze me in same day, so it has been convenient to say the least.
Last edited by: cmeeks: Mar 15, 18 8:59
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Re: Any Medical Professionals Here... (Compression Fractures and Breathing)? [cmeeks] [ In reply to ]
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+1 for yoga.

Youtube "yoga for back pain," you'll find plenty of options. Weed out instructors that don't work for you (annoying voice, wrong pace, etc.), but mix it up to try a lot. Practice yoga mindfully and you might be surprised how quickly you feel better. And you'll discover your weaknesses in the process.
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