When it comes to back pain stretches there are a variety of stretches that are touted as helpful for lower back pain. These stretches or exercises are claimed to provide relief for lower back pain but are they really helpful or are they at best, a waste of time, at worst making your back problem worse, or do they actually relieve back pain and help you address the cause of the lower back pain or sciatica?
What is causing your back pain?
It is helpful to begin here as without appreciating the cause of lower back pain we are going to have a hard time establishing whether or not the cat cow exercise is going to help or harm the recovery process. Let us first help you categorise yourself. Are you an elite level athlete or individual with significant athletic development at the time of injury, not 10 years ago, but at the time of injury of your lower back? Did you also injure your lower back during an extreme pursuit with high levels of force and exertion at play culminating in failure of your lower back? This is really somewhat of a pointless categorisation as from experience the answer for 99.9999% of you reading this will be no.
For the sake of simplicity today, we will be writing for those of you who answered no to the above question. The cause of your lower back pain in this case will have two components, the first component being a lack of strength, and stability for the lower back and likely body in general, the second being a load based injury to the lumbar spine involving a segment or two, for example, L4, L5 and L5, S1. This injury will also be accompanied by reflexive muscle spasm and dysfunction as well as sensory disruptions i.e. pain in the back and/or pain going down the leg, or sciatica. We have a huge library of the specific diagnoses and conditions specifically across the website and Youtube channel so won’t go any further into the details here.
Suffice to say simply: you have an injury to the structural support for your lower back, with potential muscular involvement as well as a predisposition for injury in the way of weak muscles which create an unstable, poorly supported lower back (before it became injured).
Implications of an injury in the lower back
As a consequence of the injury in the lower back, avoidance of movement and exercise further exacerbate the shortfall in appropriate muscular strength and stability, as well as the injury itself, for example, a frayed rope is always going to fare less well than an in-tact rope when put under strain.
Injured tissue is always less adept at carrying out its role, if we suppose we take the example of an injured disc. Nearly all lower back injuries will have some degree of discal involvement, even if not a raging herniation. The discs’ ability to bear load without further damage is drastically reduced because of “fraying fibers” that have been injured. If we then strain those fibers moving excessively we will disrupt a natural healing process that is trying to take place. We ideally want to keep that disc as close to its neutral position as possible so it can properly start to patch up and put in place scar tissue as a temporary supportive structure while healing takes place.
How does the cat cow stretch work on your lower back.
The general proviso is that your back is stiff and not moving properly and that this is perhaps the root cause of your lower back. Sometimes there will be additional assertions in the chronic case that the fear of certain movements is often “psychological” while there are some merits in a distorted perception of things in the chronic case, we won’t get into them here as critique of that line of reasoning in this scenario would be a whole topic in of itself.
Seeing as your back is not moving properly, you should do the cat cow movement as it moves your back from extension into flexion and back again. So you can start to get “things moving again”. It all sounds quite reasonable if we thought of the lower back as in a position of un-injured stiffness or rigidity. Mobilisation techniques are fantastic methods by which a manual therapist – osteopath, chiropractor or Physiotherapist – would move the joints to help pry out extra mobility and eliminate rigidity. However, If said region is stiff due to an attempt to provide rigidity while the underlying tissues are healing and remodelling are we not interrupting the healing process. It is at this point that a critique of the critique will go something along the lines of, well you shouldn’t stop moving entirely because the area will seize up! And that is true! Like a sprained ankle, nowadays there is a short period of bracing, however you are encouraged to start to make some smaller movements to help the healing process.
The fact of the matter is, with your lower back, the simple act of moving from various load bearing scenarios, such as lying to standing, walking, and moving in general – even in the most rigid individual – will involve small degrees of “movement” going through the intervertebral segments, this includes the disc. This is why activities such as walking are so encouraged. If we take the example of walking, there will be changes in the way in which the torso is descending and therefore compressing the spine on heel strike, and between heel strikes, relative decompression of the segment, all of these movements, will involve small degrees of relative changes in pressure and relaxation in the structures that are injured in your lower back. But they are small movements. Not Whopping great end of range activities that are often pushed more because you “feel the stretch”.
They are movements with a small amplitude.
Now although it is not exactly the same, looking at surface wounds and their scabs, you see this sort of thing play out more visually. The junction between the scarred tissue and the healthy normal skin has some play in it, so small movements and stretches of this junction do not disrupt the scar tissue to healthy tissue junction. However, when we have cuts that are over a joint, where the movements are greater, a higher amplitude, we see that very often, you bend the joint even half its normal range and this is enough strain to detach the scab on your knee from the healthy skin adjacent.
What should we do with the cat cow stretch for back pain?
Hopefully by this point in the article your understanding of what the lower back needs and what the cat cow is doing is more complete. Ideally you’ve reached the conclusion that this particular exercise is one left well alone. At best it is a complete waste of time. One of the biggest obstacles that members and patients alike will throw up is:
“I don’t have enough time in the day to do these exercises”
Well, it’s helpful then if we do not use the time we do have in wasteful ways. More likely this cat cow stretch is both wasting your time, as well as interfering with the stabilisation process that is trying to take place at the level of the segment that’s injured in your lower back. Focus on your strengthening exercises that provide protection and support. Chances are that your lower back became injured there because your musculature failed to do its job protecting that part of your lower back. If it stops moving as much it has a lesser chance of becoming injured again! Adding extra mobility to an area that clearly is lacking in appropriate muscular support is a most unwise pursuit.
Leave the cat cow stretch for those without a back injury, focus on your strengthening, and building back support, and you’ll find, like many thousands of patients and members, that this pathway to restoring strength and control in our out of shape, poorly conditioned bodies is a truly rewarding journey that will have a bounty of additional unforeseen benefits to our overall health & wellbeing!
Comment of the week – Lindy
“I have had a life long dream to do a Triathlon, and yesterday, I managed it! I wanted to celebrate with you, because BIS has made this dream a reality. Thank you both.”
4 Steps for an effective “Relief Routine”!
The important distinction in this relief routine is that we are relieving the factors that are problematic first. Rather than simply focusing on relieving pain for pains sake. Sure, doing a cat cow might feel nice, taking incredibly powerful dosages of pain killers will “relieve pain” but you are not relieving the problematic factors which cause the pain. These 4 steps are what makeup our Phase 1 routine and are fundamental “spine health” practices that you can do in under 15 minutes!
- Relieve the strain of gravity
The load of gravity is happening every day whether you like it or not. having an exercise like the towel that safely and effectively unloads the intervertebral junctions is a vital part of your routine.
- Relieve strain from the hip musculature and muscle stiffness
Stretching the hip musculature on a regular basis so that it’s natural tightening that takes place during a back injury is mitigated against helps keep the hips from being maximally stiff and therefore straining the low back unnecessarily.
- Relieve the strain of erroneous movement
Provide your own support to the lumbar spine through learning to engage your core-set of muscles. These engaging on a moment to moment basis help mitigate against any unwanted movement that could exacerbate the lower back.
- Relieve the burden of excess inflammation building in the spinal column
There is limited space in the spinal column and rampant uncontrolled levels of inflammatory build up here create real trouble for those with back pain. The presence of an active injury will lead to the natural and normal reaction of inflammation. Unlike other areas of the body, in the spine there is limited space and therefore managing this build up with short periods of intermittent icing is vital to providing relief from this undesirable excess.