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The Core Program

Fifteen Minutes a Day That Can Change Your Life

The Core Program
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Introducing the fitness program designed by a physical therapist exclusively for women — proven to increase strength, tone muscles and reduce aches and pains in just 15 minutes a day!

Few women realize that most popular fitness regimens are designed for men. Yet women have their own unique fitness needs — and using a program developed with men’s bodies in mind is not only ineffective, but can actually result in injury.

Renowned physical therapist Peggy Brill has devoted her life to developing an exercise program specifically for women. Based on her understanding of movement dynamics and body structure, these exercises focus on developing and balancing the muscles in the anatomical center of the body — the core — which includes the back, hip and abdominal muscles.

Peggy’s remarkable head-to-toe workout targets the “hot spot” areas — neck, back, pelvis, hips, knees — that cause problems for even the healthiest women. In just 15 minutes a day, The Core Program’s easy-to-learn exercises will help women:

• Strengthen their bodies to achieve balance and alignment
• Eliminate everyday aches and pains
• Prevent bone loss
• Protect against osteoarthritis
• Improve sleep, digestion and circulation
• Enjoy better sex
• Feel energized all day long
• Overcome the effects of aging

With inspirational case histories, detailed photographs illustrating each exercise and self-tests for rating balance, flexibility and strength, The Core Program is an owner’s manual for the naturally strong, healthy body every woman should have.


From the Hardcover edition.
Random House Publishing Group; December 2008
256 pages; ISBN 9780307483300
Download in EPUB
Excerpt
Section I: What My Core Program Will Do for You

Chapter One: What Every Woman Needs to Know

Can you imagine having all the energy you need, all the time?

Nancy, 32, has it. "Sitting at the computer all day used to leave me feeling drained. But now that I’m doing the core exercises, I don’t feel like I’ve been run over by a truck by the end of the day. After work I’m taking a course in art school instead of dragging myself home and collapsing on the sofa."

Would you love to feel great every day?

Maria, 42, does. "For the first time in much too long I feel terrific, from head to toe. I never thought I’d feel this way again. I was dragging myself around, always feeling as if I were just one step away from moving at the pace of my 85-year-old grandmother. Best of all, I can accomplish everything I need to do, from lifting and carrying to walking long distances. I can’t thank you enough!"

Is the notion of moving with ease and beautiful posture something you dream about?

For Jenna, 47, it is a reality. "Finally, I feel graceful; my strides are fluid. When I catch a glimpse of myself in a store window I see a confident woman, not someone who looks like she carries the weight of the world on her shoulders."

Do you wonder what it would be like to be able to summon strength anytime you needed it?

Carol, 36, can. "My arms and shoulders and even my hands were losing so much strength that I could barely carry my groceries. I figured it was just a sign of getting older. Not only do I really appreciate being proved wrong — now I don’t have to think about whether I have the strength I need. It’s always there."

Would you like to rid yourself of aches and pains once and for all?

Leslie, 40, did it. "Whenever I played on my company’s softball team I felt it the next day. Back strain. Shoulder pain. Now I’m a star hitter and the day after a game I can savor the victory — not try to soothe aches and pains."

Is the idea of having dependable stamina immensely appealing?

Ellen, 37, knows how great it is. "I’ve been jogging for a few years but I was getting more and more worn out from it, partly because I was having a lot of discomfort in my hips. Now I enter mini-marathons, and keeping up with my husband is no trouble at all."

Core Benefits

You can enjoy all the benefits described above, and more, if you will give fifteen minutes a day to performing the Core exercise program I’ve used with such success for the women I treat in my practice. Moving through your busy life with a strong and supple and pain-free body is your right — because that is how nature intended you to be. I’m going to show you how to restore to your body what your life as a woman saps from it.

Why I Wrote This Book

One morning a few years ago, I was on my way to work. As I stood, surrounded by other riders on a slow-moving bus, I started to observe how some of the women aboard carried themselves. I’ve had this habit for a long time. Even before I became a physical therapist I was always fascinated by the way people — and especially women — held, and moved, their bodies.

A well-dressed, fit woman in her forties who was standing next to me kept tugging at the strap of her obviously overloaded carryall. Her whole body leaned so far to the right it seemed as though the carryall had a gravitational pull all its own. Near her, a woman in her twenties, who was sitting, tilted her head to an extreme angle as she talked on a cell phone. She continually rubbed her neck, which was obviously hurting. Then there was the tall thirtyish woman who carried fatigue around her shoulders like a heavy shawl. Her whole body slumped forward as she held on to the back of a seat with both hands.

What a shame, I thought to myself. These women look so uncomfortable — and they don’t have to be.

Then, as the bus stalled in traffic, I noticed a woman on the street, who was at least eighty years old. In sharp contrast to the women on the bus, all of them much younger than she, this woman carried herself with freedom and ease. As she strode confidently on her way, her body was in perfect alignment. Looking at her, I realized how much I could do for the women on the bus — and every woman.

My work could give them the gift of strength and easy movement and physical balance today, and for the rest of their lives. They too would look, and move, like that confident, graceful, strong woman on the street, no matter what their age.

I decided right then that I would write a book that would enable women to use everything I had learned through my work, and that this book would be my way of fulfilling the commitment I had made, after my mother’s early death from a heart attack, to the cause of women’s health. I want to help women to change their lives, starting at the core. And I know how to do it quickly, easily, and inexpensively.


Fifteen Minutes a Day That Will Change Your Life

The Core Program is the fifteen-minutes-a-day, five-times-a-week exercise regimen that will give you benefits no single other fitness program can offer. In a very short time it will:

Build strength

Abolish muscle aches and pains

Improve your posture

Put an end to joint stiffness

Give you a graceful, easy stride

Eliminate fatigue after each session

Relax your body so that you get a good night’s sleep

Improve your balance

Enhance your stamina for the day ahead

Heighten your sexual pleasure

Rid you of occasional nausea and headaches and other symptoms for which doctors can find no cause

In fact, from your very first workout, you will experience an increased sense of well-being — a new sense of ease, energy and relief from everyday aches and pains.

The Core Program will give your body a head-to-toe workout that will also tone your muscles and carve inches off your waist and hips. You’ll look great and feel terrific. Best of all, the easy-to-do Core movements can be done no matter how old you are. It doesn’t matter whether you are overweight or skinny, fit or sedentary. Maybe you’ll be able to do only one or two to start, but eventually almost everyone is able to perform all the exercises in the Core Foundation. Many others will go on to the more advanced versions of the program.

All you need is an exercise mat, which stores easily under a bed, or simply use a large folded towel for cushioning. Wear an outfit that allows you easy movement. Sweats are fine; so is an old leotard or leggings and a T-shirt. After you master the Core Foundation program, you have the option of continuing to the Intermediate program, and eventually to the Ultimate Core. These more advanced programs include some new exercises, and some variations on the Foundation exercises. They also introduce the use of simple hand and ankle weights, for added benefits.

I know that being a woman equals being busy. Family. Career. Children. Friends. Shopping. Traveling. Cooking. Grooming. Gardening. Cleaning. Exercise. And this is only a partial list. With two children (one a baby), two physical therapy offices and one husband, my life is extremely hectic. So hectic, in fact, that I barely managed to do the photo shoot for the exercise sections of this book before I got really big with the pregnancy for my second child. I was three months pregnant when we did these photo sessions, as may be obvious in some of the pictures. So I think I understand as well as anyone how precious, and how short, time is. That’s why I made sure that the Core Program is lifestyle-friendly.

Do the program when it is convenient for you, in the privacy of your home or as part of your gym workout. Do it in the morning, the evening, or anytime in between. (I have patients who close their office doors and take a restorative fifteen-minute Core "break" in the afternoon.)

As a Woman, You Need the Core Program

The Core Program derives from my experience of treating thousands of women for the most frequent aches and pains they experienced in their heads, necks, shoulders, arms, backs and legs. I noticed that, no matter where they were feeling discomfort, all of their problems seemed to relate to underdeveloped and unbalanced muscle groups in one area of the body — the core. What I’m calling the "core" is the torso, which extends from the base of the neck to the bottom of the spine, and includes the abdomen and all the back and hip muscles. These are the parts that stabilize as well as encase the vertebrae surrounding the spinal cord, through which the thirty-one pairs of spinal nerves branching off from the spinal cord emerge.

The brachial plexus is the group of nerves that branches off the spinal cord through the area of the neck, extending into the upper extremities of the body. The sciatic nerve, the largest nerve in your body, which is actually made up of a group of five nerve roots, emerges from the lumbar spine and passes through the buttocks and down each leg, supplying the lower extremities of the body. Because their ultimate source is the spinal cord, the nerves in both your arms and your legs function best when you have a strong and stable core.

Both the neck and the lower back are dependent on the core muscles to stabilize the spine so that all the vertebral segments align with one another in a way that does not compress the nerves that pass through them. When nerves are compressed they can’t deliver full electrical impulses to muscles. When that happens, the muscles can’t work the way they should. Weakness and pain are the result.

In almost all of the patients I was seeing, I found that the core muscles supporting the torso weren’t as strong as they needed to be — and that was the root of the discomfort.

The exercises I give to my patients — the exercises of the Core Program, which are the same exercises I’ll be giving to you in this book — strengthen the core muscles. When those muscles are strong, discomfort disappears, and as long as you keep doing the program, it won’t come back. Working the core muscles also helps to keep your body in good alignment, so that sitting and walking and running are easier.

There is a clear cause and effect. The stronger the core, the better the body works. Just as a firm infrastructure supports a building and prevents it from breaking down inside, a reinforced core becomes the basis of a strong, supported body.

That’s why it made great sense to me to write a book offering a series of exercises specially designed to strengthen the core — and to gear it to women. As women facing women’s challenges, we need to do what is necessary to make sure our bodies function smoothly throughout our lives. As I’ll discuss in more detail in chapter two, there are numerous lifestyle stresses and strains that are unique to women, as well as physical demands on us, none of which we can do much to change. What we can change is how we respond to them. It’s imperative that we take charge of how we use our bodies, which is what the Core Program can help us to do — and the earlier we make these changes, the better.

I always ask my patients if they would risk waiting until they were age 65 to fund a retirement account. After they look at me dumbfounded for a moment, they all reply with an indignant "No!" The same conclusion applies to meeting the needs of your body. Doing the Core Program is like investing in a retirement plan for your health. Start it now, and watch those dividends roll in. You’ll be able to live your life to the fullest. You’ll also find that the more you do the Core Program, the more effortless it becomes. I’ve been doing it for so long, it’s as automatic as brushing my teeth.

Ultimately, the Core Program does something no other fitness plan can do: It makes you resilient against the "normal deterioration" of age.


The Missing Fitness Link: A Core Program to Complement Other Fitness Regimens

If you are doing either aerobics or weight training or both, you might think that the exercise you are already doing, along with nutritious food and supplements, is all you need to keep your body in good condition. But that’s not true. Please don’t misunderstand me: I strongly support both aerobic exercise and weight training, as well as eating a balanced diet and drinking plenty of water, of course.

However, these healthy choices can’t give your body the strength, balance and alignment it requires to perform hundreds of daily actions effortlessly, and without any kind of physical discomfort. Nor can other fitness programs prevent injuries — much less relieve pain.

Only the core exercises can enable your skeleton, muscles and joints to work together optimally, because only the core exercises offer the unique combination of strengthening, stretching, balancing and realigning that allows your body to withstand daily wear and tear.

However, you may choose, as many of my patients do, to add the Core Program to other workouts. Whether you quietly practice yoga, take part in boisterous aerobics classes and/or do strenuous weight training, the core exercises will give you a complementary program that will make your other fitness efforts more effective. These terrific movements will align and strengthen your body to prevent the injuries that often occur in other exercise programs. Even if you are just planning to begin a walking routine, doing the Core Program first will help you build your muscles properly, thereby preventing the muscle strains and pains you might otherwise suffer, especially if you haven’t done any exercise in a long time.


Bodywork Techniques: Help, Not a Cure

Many patients who come to me have tried many of the bodywork techniques that are so popular today. All offer some benefits — and a few present some significant drawbacks. Here are some you may recognize:

The Alexander Technique and Feldenkrais, which both feature gentle and rhythmical balance-related movements. Unfortunately, they both lack strength-building components.

Pilates, which is excellent at strength-building, muscle-balancing and alignment. But to use Pilates equipment you have to go to a Pilates studio, usually paying for individual instruction. You can also go to mat classes, but it’s hard to master the Pilates techniques without one-on-one attention.

Massage therapy, which helps to relax people while easing muscle soreness, but does nothing for strength. Also, it’s not something you can do yourself. In order to get the temporary restorative benefits of massage therapy, you have to pay for the services of a massage therapist.

Tai chi, which focuses on weight shifting and is good for stability, balance and strength. However, the movements of tai chi neither strengthen the arms nor open the spaces between vertebrae so that nerves can avoid becoming impinged.

Yoga, which increases muscle flexibility but doesn’t build core muscle strength. It can also overstretch and thereby weaken certain muscles, resulting in imbalances in opposing muscle groups.

Only the movements of the Core Program deliver relaxation and muscle building and flexibility and body realignment. No formal instruction or instructor is necessary, and there is no risk of injury.


A Physical Therapist’s Approach to Physical Fitness

I understand how a woman’s body can safely achieve fitness because, unlike most other fitness experts, I received in-depth hands-on medical training. I took four years of premed courses in college, where I majored in biology. Then for two years I attended a physical therapy school that was part of the University of Medicine and Dentistry of New Jersey, before attaining my degree. I have also done extensive study of the musculoskeletal system in advanced postgraduate courses.

When a patient comes to see me, I use my training as a physical therapist to evaluate her in a particular way. Besides listening to her description of pain and dysfunction, I determine the range of motion of various joints and perform a thorough manual muscle test to assess the strength of all the major muscle groups.

As a physical therapist, I assess a woman’s body from head to toe. I know every muscle and joint and can pinpoint areas that need help. I know how to exercise muscles in order to balance them. And I know how to put the joints in alignment, which allows the bones to bear weight as they should, while eliminating any strain on your joints. But I don’t just heal injuries. I work with my patients to show them how to prevent future injuries — that’s part of my job. I can help women regain strength — without joint injury — in seconds. (See the box on page 12.)

After treating thousands of patients, I can confidently say that there is a recognizable pattern of muscle weakness and tightness that leads to almost all of the common injuries I see. Knowing what has worked well for my patients has enabled me to design a series of exercises to strengthen what tends to get weak and stretch what tends to get tight. This is why the Core Program’s effects go beyond mere fitness — they will affect your ability to feel well and function at maximum capacity throughout your life.

While fitness experts can make your muscles strong, they don’t look at a woman’s body the way I do. Their advice to lift weights to build bone mass makes excellent sense, but they often lack the expertise they need to teach you how to do it in a way that won’t harm your joints. And they are unable to address the underlying causes of achiness and fatigue.

I’ve been a physical therapist for nearly fifteen years. I love what I do for a very simple reason: Every day I work with patients who get better. The smile I often see on a woman’s face after just a couple of minutes of treatment tells me she is on her way to feeling great. And that gives me tremendous gratification. I see tension melt away along with aches and pains. I see changes in bodies as women learn to move themselves in more efficient ways. Best of all, I get to listen every day to women who tell me that they feel better than ever before, and that they have found a new trust in their bodies and new hope for the future.

Making such life-improving changes is a huge accomplishment for anyone, but more than a few of the women I treat are recovering from severe injuries and complicated surgical procedures. A number of them are referred to me by physicians at several major New York City medical centers, including the Hospital for Special Surgery, St. Luke’s—Roosevelt Hospital Center, NYU Medical Center, New York—Presbyterian, and the University Hospitals of Columbia and Cornell.

My work introduces me to all kinds of interesting people of all ages. In my private practice, I treat children under 10 as well as grandparents over 90. In my waiting room people who haven’t exercised in years share sofa space with Olympic athletes. Business people, including top executives from Fortune 500 companies, regularly arrive at my Manhattan office. I also operate a second Brill Physical Therapy office on-site at Morgan Stanley for employees of the company and their families.

On occasion, I travel to my patients. I’ve been to Beijing to help a high-level government official who had suffered from chronic back pain, and several times a year I fly to North Carolina to take care of the coach and players of the nationally ranked men’s basketball team at Duke University.

Still, much of my work is focused on the musculoskeletal systems of women who are probably just like you. They have vague aches and pains that doctors can’t explain, or they have minor injuries that have occurred while doing exercise or playing a sport. Included among the common injuries I see are herniated discs; rotator cuff tears; tennis elbow; all kinds of neck and back pain; bursitis/tendinitis (which is inflammation from overuse) in the hip, shoulder and knee; cartilage and ACL (anterior cruciate ligament) knee tears; chondromalacia (dull aching pain behind the kneecap); sprains and strains; Morton’s neuroma; hammertoes; bunions; heels spurs; and plantar fascitis (inflammation of the plantar fascia, the connective tissue on the bottom of the feet). By the way, age does not necessarily contribute to these injuries. Thirteen-year-olds get them just as adults do.

But no matter what injuries I am treating, my work centers on building up and protecting the core of the body, because all these injuries are caused or made worse by core muscles that aren’t as strong as they need to be.


Instant Strength Booster

This simple yet incredibly effective neck retraction will boost your strength in seconds as it relieves tension in neck muscles. The movement expands the spaces between vertebrae so nerves in the upper extremities are free to send electrical impulses to muscles in the hands and arms. The muscles, in turn, can generate more force. (This is the same thing you do in the first movement of the first exercise in the Core Foundation, the Head-to-Toe Prep.) You can do this anytime, anywhere.

The Movement

Sit, or stand, straight.

Slide your head back, tuck your chin so that the back of your neck is elongated and your ears are over your shoulders, and pull your shoulder blades together. Hold the position for three seconds.

Release slowly to a relaxed position.

Repeat six times.


The First Core Goals: Strength and Toning, Balance and Alignment

My female-centered regimen goes to the heart of what women need to function well and feel as good as they possibly can. I’ll show you how to work with your body, not against it. Instead of feeling weighed down by fatigued muscles, you’ll get a burst of energy that will give you a lift. Knowing you can depend on your body, and watching it become better toned and defined within a few months, will give you a whole new level of confidence.

To make all these wonderful things happen, the Core Program will:

Rebalance your muscles

Unlike other fitness routines, the Core Program restores balance between muscles that work as a couple. The job of muscles is to pull, either concentrically (by creating force through shortening), or eccentrically (by absorbing force through elongating). But, as is the case with many couples, often one muscle becomes more dominant than the other. When this happens, their relationship is not equal. The result is that the muscles don’t work in harmony, and the joint they attach to suffers.

Think of it this way: The muscle couples work like a seesaw, with the joint they attach to being the axis of motion. When that seesaw goes up and down in a constant, equal motion, the joint is where it should be. It’s the same way in your body. There must be balance between muscles in order for them, and the joints attached to them, to work efficiently and painlessly. If there’s an imbalance, problems can occur.

For instance, if you slouch, over a period of time the pectoral muscles in your chest will shorten, and become dominant. Over time, the upper back muscles with which they are paired will become elongated, or stretched. Then it becomes more difficult for the back muscles to pull with equal force. And here’s an example of what can then go wrong: You want to push a heavy door open, but when you move your shoulder, your dominant pectoral muscles kick in before the upper back muscles with which they are paired. This imbalance alters the force on the shoulder joint, and can lead to injury. If you strain to push open a door and you feel pain in your shoulder, it means that your pectoral and back muscles are not balanced and your shoulder joint is out of alignment.

Release muscle tension

Muscles that have shortened feel tense. By stretching short muscles, you can release tension and experience an immediate feeling of relaxation.

Strengthen muscles without bulking up the body

Moving the body against gravity reinforces muscles. The more you do the exercises, the more they will define your muscles, thereby toning your body and giving it a sleek look.

Enhance stamina

Deep breathing, an integral part of the Core Program, delivers oxygen to muscles, which gives them endurance while also helping to relieve muscle tension.

Reshape your body

You’ll tone your abdomen, hips and buttocks and give your arms better definition, too. Inches will disappear even without dieting because the more muscle you have, the more fat your body will burn. You’ll be enhancing your lean muscle mass. If you are on a weight loss plan, doing the exercises will give you an extra boost.

Restore alignment

By stretching muscles that are shortened, and strengthening muscles that are weak, your joints will be restored to their optimal position. This means that your skeletal alignment will be reestablished. With your joints in their optimal positions, you will sit, stand and walk tall and strong and move with ease. Your posture will improve, allowing you to move more gracefully.

Increase flexibility

The flexibility of both muscles and joints is augmented. Achieving optimal muscle flexibility allows joints to move through their normal range of motion.

Increase capacity for sexual pleasure

Because the core exercises strengthen the pelvic floor muscles, which include the muscles that contract during orgasm, you may discover a surprising side benefit — easier-to-reach, more intense orgasms.


The Second Core Goal: Prevention

You may believe that aging will take an inevitable toll on your body. Perhaps you’ve already begun to notice that when you go to the gym you are having a problem with urinary stress incontinence — "leaking," in more colloquial terms. This condition afflicts many women, especially as they get older.

Or if either arthritis or osteoporosis runs in your family, you might be concerned that you will eventually have to cope with one of these conditions. Perhaps you look at your grandmother and wonder whether you too will morph into a weaker version of your former self.

I’m happy to tell you that these scenarios do not have to happen. While a woman’s body goes through inevitable physical changes over the years, age by itself doesn’t determine how well a woman moves or holds herself nor does it dictate how strong or how healthy she is. There’s a lot you can do to help prevent arthritis and osteoporosis as well as many other problems.

The Core Program will:

Reduce the risk of developing osteoarthritis, or relieve the symptoms

This painful joint inflammation, which stems from either overuse or underuse, can be avoided. When joints are in their normal alignment they absorb the forces exerted against them without injury. When joints are balanced they are lubricated, because the synovial fluid that is secreted by the membrane surrounding the joints isn’t cut off by any kind of compression. A balanced joint is friction-free and healthy, allowing for ease of movement.

Sarah, who had chronic knee pain from arthritis, made great progress once she started doing the core exercises. "Walking down steps was so painful and I was getting worse. I just couldn’t accept that, at 32, I was going to lose mobility. With the Core Program the pain disappeared, my strength returned and now I’m in really good physical shape."

Reduce the risk of developing osteoporosis, or relieve the symptoms

The core exercises cause muscles to pull on bone, which prompts the production of new bone cells. You can actually help create more bone mass by doing these movements. This is very important, as a decrease of just 10 percent in bone mass can result in 50 to 100 percent greater incidence of fracture. Bone density tests, which measure standard deviations from peak bone mass, have shown genuine changes in patients whom I have put on this exercise regimen.

Ana, who at 80 had osteoporosis, was amazed at the differences in her body. "I gained one whole point in bone density since I was tested last year. In addition, I can move so much better than I did before. After three months on the Core Program I could turn my head from side to side without a problem — and that’s something I hadn’t been able to do in much too long."

Decrease or eliminate the incidence of urinary stress incontinence

The same muscles that contract during orgasm can stop the flow of urine. So in building up the muscles of the pelvic floor, which hold the pubic bone and tailbone in place, you will also be helping to prevent urinary stress incontinence. The muscles of the bladder are strengthened as well.

Avert injuries

Muscle weakness leads to injury. When a demand is put on your body that you can’t meet — whether it is lifting weights or lifting a child, taking an aerobics class or running to catch a bus, even sitting at a computer all day — injuries happen. But when your musculoskeletal system is strong and well balanced, you are much less likely to hurt yourself.


The Third Core Goal: Making Sense of Discomfort

I’ve heard so many variations on this theme. Perhaps you are bothered by an ache in your side that just won’t go away. After a couple of weeks the bloating and distress prompt you to make an appointment with your doctor. After looking you over, she recommends a few diagnostic tests. When they come back normal and you tell her you’re still not feeling right, she recommends one or more invasive tests. (It is critical not to overlook a potentially serious condition. All my patients have proper screening to rule out any pathology causing uncommon pain.)

One week and a couple thousand dollars later, you get the great news: There’s nothing wrong with you. But, while you heave a sigh of relief, you still don’t feel very good. The physician’s suggestion to try to minimize stress seems like a good idea, but you wonder if that will really help what is bothering you.

From your doctor’s point of view, "something wrong" means a clearly defined illness or injury. These are the organic dysfunctions mainstream medicine looks for and knows how to treat. Unfortunately, when no such problem can be detected by tests, the patient falls into a "gray" area. What is bothering you is caused by a problem outside the doctor’s range of expertise.

If this is the situation you find yourself in, my program may be able to give you the help you need. Many "gray" problems are caused by a problem at the core — which is my area of expertise.

First, take the self-tests on pages 27—31 to determine whether your core muscles are weak. Then start doing the Core Foundation exercises and stick with them for at least three weeks. In as little time as a week you’ll start to feel better and experience major reductions in discomfort — and a major boost in energy and well-being. And soon you will discover that you want to kee