Discover How Exercises Help Fix Your Back Pain

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When you embark upon a program or plan to fix your back pain, an understanding of the process can be very helpful in setting your expectations so you’re not surprised along the way. It also helps avoid becoming disheartened when expectations based upon a lack of understanding are not met. Time and time again we find those that understand their own body, and the process of rehabilitation do best, for the longest, with the least setbacks along the way! 

Understanding your own back pain genesis

This is a vital step as without understanding where we’ve come from we cannot really hope to have success in knowing where we are going. To the degree you have a longer history of back pain or sciatica, this is more vital to your success in resolution of the injury than many think. 

If you’ve never had back pain before and this is your first episode which started yesterday, then this is almost not relevant to you, but we know that the chances of this mythical person reading this article is approximately the same as the likelihood of winning the lottery! 

The majority that will read this, perhaps yourself, will have a history of back pain or sciatica, perhaps many episodes, perhaps one chronic drawn out occurrence. You’ve often tried many different things without success. You’ve tired pain killers and had many visits to the Doctor or other medical professional without success. Less commonly, you’ve just been ignoring it. 

The common feature amongst those who recognise their own exploits in the above examples, is that you’ve been gradually doing things slightly differently as a result of the pain. The longer these “things” have been done differently, the more they are ingrained into your daily life. The more hidden they become.

It could be the way you now put more weight through the “good side”, or the way you wiggle your back when getting out of a chair. It could be the way you squat down on a dog walk to round your back and give some “relief”. The list is endless. Then we get into the changes that have been made within, some with longer term pain medication use affecting the perception of pain signals and normal signals, muddying the water when it comes to feedback and sensation. It could be the neurological process of sensitisation that’s taken place, a particularly frustrating process of neurological change whereby you feel things that are not “painful” as pain.

A particularly difficult adaptation that we see in those with longer term issues in the back is the inability to differentiate between muscle spasm and tightness that is due to fatigue of weak muscles being pulled apart, and muscles which have become chronically tightened and shortened. This often results in a misguided need to constantly be stretching and how so many get hooked on things like knee hugs and rounding the lower back for relief. Almost like a drug, these are difficult for some to eliminate!

The one major factor maintaining your back pain and injury

Ultimately with education of how the back works, and better understanding of your back, you can start to reflect on the genesis of your own back pain. Slowly you can begin to identify things you’ve been habitually doing that maintain your poor back health, and remove or modify them.

One of the major factors that develops as a result of the steady decline in back health is a loss of muscular competence, in two ways. Firstly we lose the ability to move correctly employing our muscles to move our body around in the real world. This has the effect of making movements of daily living inefficient, perhaps even provoking because they focus strain onto injured tissues. For example, every time you get out of a chair, instead of having a strong upright posture and driving yourself up from the legs, you lean slightly to the left, round your lower back forwards and push up off your arms tipping yourself forward until momentum carries you far enough forward and you straighten up with an awkward wiggle. 

This example of poor movement and contribution of the muscles is evident, and deeply subconscious after 3-6 months or more of practice multiple times a day, what began as a conscious pain avoidance pattern is now, just the way you get out a chair, you don’t even notice you do it anymore.

The second issue is the loss of muscle strength and competence, the tissues are so very weak you hardly move normally, everything  is a challenge, and you’ve learned to just avoid putting yourself into these positions. But that makes activities like carrying the shopping, moving around, going up and down the stairs and many other daily activities frequently a source of relapse. 

We often find in the membership for those with longer histories, when we get them doing some of the simplest of exercises, like those in Phase Two of the program, there is such weakness that full repetitions without the muscular strength and control are just not possible!

If you cannot lie on your back and move one leg without your lower back being pulled out of kilt and irritating the injury down there, why would you expect that the daily activities of living would be any less strenuous? 

You’ve just got better and better at working around your weakness, but this is a race to the bottom! We’re running away from the problem. 

The way forward is to address this major issue, that takes time, commitment and no one can do it for you!

3 ways your exercises help you fix your back pain & what is actually happening.

In an era of instant gratification, we have a challenge. The expectation is that I take this pill, and something happens right now. The reality is that the process of healing is not a process of sensation, where we can perhaps block stimuli and “feel different”. With healing, and strengthening, there is a process where your body has to do something, which takes time. 

If for example I ask you to refurbish the leaking roof on a house, the process of the instruction happens in a moment, perhaps a 30-60 minute meeting. If it rains the next day, before we’ve made significant progress, I might be upset that the roof has leaked into the house, but we knew it was going to take 2 weeks to make it waterproof so as inconvenient as it is, this “relapse” is unfortunate, annoying, but understandable.

Your strengthening exercises are the instructions, and your body the builders & roofers in the example above. The roof of your body might have some gaping holes, and you must give your body regular 30-60 minute instruction – your daily strengthening exercises – so it knows how to rebuild. Until your body’s builders make sufficient progress, you’re still vulnerable to having a leak!

This is why the reflection outlined in the initial part of today’s post is so vital. Keep this in mind as we move forwards.

Relief exercises for back pain – how do they work?:

This first tranche of practices would be what we refer to as Phase One in the program. These are there to relieve the strain on the tissues, but they are not rebuilding the back, your body is trying to do that every day. In cases of a broken or sprained ankle, you can relieve the strain for a 6 week period by putting the ankle in a cast, this is not possible or advisable with the lower back. So we must accept this is the case, and that we’re still doing things every day that strain the injured site. Therefore having a routine that can work to counteract this reality is vital. 

You see this regularly in medicine, you might be given a drug that is helpful, in this case let us say you take Drug A that gives you something positive, but it has a side effect that strains a system of the body. You take Drug B to combat the strain that A places on your system so you can continue on without trouble and benefit from A. In pharmaceuticals, we know all too well that sequence doesn’t stop and Drug B but goes on and on, more on that another day. 

Your daily activities in the example are Drug A, you have to do them, we have to live and work and take care of a variety of commitments in spite of our back pain – because of this we need Drug B, in this case, your relief exercises, to combat this strain. If we choose the wrong exercise, we end up requiring Drug C, D and so on, but if we really understand the back, the right exercise choice for Drug B will oppose the stress of our daily activities without “side effects”.

The purpose here is that your relief routine is a routine that can be done to take the strain off the injured site at regular intervals until such a time as the body has built up sufficient resilience to more effortlessly handle the strain of daily activities and allow for healing to take place. 

Strengthening exercises for lower back pain – how do they work?

The misconception around these exercises is that they are fixing the injury and so the incorrect assumption is made:

“I’ve been doing my Phase 2 exercises or Phase 3 exercises for a few weeks now, shouldn’t my back be fixed by now?” 

Strengthening exercises, when done, create the stimulation on the body to build tissue, in the case earlier, the act of doing the exercises is comparable with the instruction to fix the roof. The building in both cases is done as a result of regular instruction.

In the early days of resistance exercises we need to learn how to do these correctly and so are getting little in the way of real strengthening taking pace, however as time progresses we build good technique so our body can benefit from the gradually progressive strengthening exercises. Our body changes over time. 

Strengthening takes place, alongside the additional benefits that come from learning to move correctly in order to execute the exercises with good form. This acts as a further buttress against the daily strains you place your body under. This allows you to more effectively move through your day with minimal strain being focussed on the weak and healing tissues. 

For those of you with long standing back issues and significant weaknesses, it will take some time to break the cycle and be at a point where your muscular strength and competence is sufficient to effortlessly oppose the strains of daily living, but once you do, you’ll really start to notice momentum build!

Before we move to the last point, it is worth acknowledging that nowhere in the previous points have we stated that the exercises are healing your back! They are simply working to provide protection, support and good practice so that your back can heal itself without interruption.

How strengthening your lower back and healing work together

Once you’ve reached a point where your strength movement competence has passed a “threshold” you have a body that is much less vulnerable to daily aggravation from menial tasks. Your healing will be taking place without interruption on the whole. The strengthening that you continue to progress with now takes on a secondary action.

For reference, this sort of workout would be akin to that being done in later Phase Three, and Phase Four of the Back In Shape Program.

This secondary action is the guided strengthening of the soft tissues that are healing. The cells and tissues in this area of your low back are dynamic, regardless of whether you have a back injury or not! These tissues need guidance on what sort of loads they need to be capable of handling on a daily basis. Given a consistent and progressing stimulation from your loaded resistance work, these tissues get those valuable signals. For example, the load you’ve been using in your hip hinges and squats tell your spinal discs that you expect them to be strong enough to handle a 25kg load for successive repetitions. The muscles of course are involved in this, but the load on the spine is helping guide those tissues on where resources need to be deployed to build resilience. 

Remember you didn’t get to 25kg overnight! We use that just as an example.

Where you get caught out stopping too early with your back pain exercises

This process of continuing on with the resistances is so important and where so many fail. When you have a back problem and you’re consciously aware of it, you are more careful. The grave mistake many make as their pain subsides, is failing to hit that third checkpoint mentioned above. Healing and adaptation only goes as far as is necessary. So if you started feeling better doing your bodyweight squats in Phase Two or a 10lb hip hinge in Phase Three and stopped, your back did not see the need to build resilience anymore.

The strain from daily activities is now no longer limited as you don’t “feel in pain” and so you start doing more, activities you’re not conditioned for and the structures in your back begin to be overwhelmed again!

This is one of the vital lessons that we teach in Phase Three of the program. Have an honest evaluation of the sorts of things you’re expected to do on a daily basis, you might even be doing these even though you have bad back pain. 

For example, carrying shopping bags, 6 kg, carrying a load of wet laundry 10 kg, carrying the little one into the car, 15 kg, the holiday suitcases 25 kg or more! If you are doing these activities and do not feel comfortable enough to do a squat with a nominal dumbbell or a core exercise on the floor, perhaps you need to re-evaluate.

Take a moment to consider the sorts of forces you expose your body to on a daily basis, and the sorts of forces you would like to, should your back not be an issue, then set about making progress through your strengthening exercise that far exceeds these sorts of activities!

Some final thoughts and action points for your low back exercises

  1. Evaluate your back pain genesis, how did it start and how long has it been an issue
  2. Reflect on the sorts of habits and practices you might have picked up that could be holding you back 
  3. Honestly evaluate your current levels of strength, the ability to perform simple exercises like those in the early parts of the Back In Shape Program (Phase One and Phase Two)
  4. Set about making a measured improvement in your strength, whilst knowing that the more progress you make, the safer you’ll be on a daily basis.
  5. Be realistic given 3) on how much progress you need to make!
  6. Commit to making progress regardless and being reflecive when you do have the inevitable bumps in the road.
  7. There is a reason that we provide so much education in the program to go alongside the exercises, make sure you apply those lessons to your daily life as you make progress with your strengthening!

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