Lower back pain has been a problem for many, for a long time now. It is one of the most prevalent issues that affects almost all of us at some time or other. Lower back pain can be a major source of disability and disconnection, especially when it gets out of control. Over the decades, beliefs and current wisdom around a variety of topics has evolved. Health topics in particular, such as cholesterol, sugar, dietary intake in general, as well as exercise have changed in almost unrecognisable ways. What is considered good for us has changed, only take a look at a video on “exercises for ladies” from the 1930’s to 1980’s and you see the drastic change compared with today.
A great example of this was the vibrating belt machine that was designed to passively help ladies trim and tone their waist without having to actively exercise. This machine was popular in the 1930’s and had a resurgence in the 1960’s too.
Ultimately our mindsets and understandings have shifted dramatically. However there is still one major belief that we still encounter time and time again with parents, grandparents and family members in general. This belief is one that simply promotes vulnerability in the lower back, and leads to a false sense of security that everything is strong. If we can shake this mindset before we injure our lower back, we will be all the better for it, but should you be reading this after a back injury (or any other injury for that matter) then it is essential that you demote this belief to the archive of outdated thinking.
Today we’ll break down why this is such a problematic belief and more importantly provide mechanisms for why other options are better, and even “less effort” and much less time consuming than you’d perhaps think.
“I’m so busy, I’m active all day on my feet, in the garden, around the house, I’m exhausted by the end of the day… That will keep me strong and fit as I age”
This is perhaps the biggest stumbling block that some have to wrestle with, be this in clinical settings when the topic of rehabilitation exercises are discussed, or be it when struggling with back pain. The belief that you should be fit and strong because you’re busy doing things around the house all day or out and about doing chores, activities, even manual tasks, such as gardening and more. Although these tasks are tiring, they do not promote strength beyond a very low baseline, and they certainly are not progressive. Let’s explore this a little further.
Our body is fundamentally efficient and wants to be lazy
One of the design features of the human body is its desire to be lazy, this is not a statement of “being lazy” but it helps us frame the processes in the body. Maintenance of healthy productive tissues: muscles, tendons, ligaments, bones, joints, circulatory system, requires energy expenditure, a significant amount of it too! Your body will therefore take into consideration the activity you perform on a daily basis, the things you do day in and day out. It will evaluate how challenging these things are typically, and what in the way of strength and fitness is required “just to live”.
Your body is constantly evaluating this process which we’ll get onto in one moment. If you’re busy, perhaps spending whole afternoons in the garden, or out walking with friends, pottering around the house, etc, your body will evaluate these tasks and the level of competence required to perform these. You will then maintain a level of conditioning commensurate with the tasks at hand. And not one bit more!
The body has no desire to spend “resources”, or “energy” maintaining strong ligaments and muscles etc if you are infrequently lifting anything, for example, there might be that one 20kg pot in the garden that gets moved twice a year. If you’re only ever walking around the house or out and about, your circulatory system has no need to adapt and change to be able to move in a more brisk manner. The body is lazy and it will optimise for your current level of activity.
This is where vulnerabilities creep in.
How the seasons weaken your body without you knowing
Knowing that your body is adapting and adjusting to the sustained demands placed on it, or lack thereof, the seasonality of life, especially the further north you go from the equator can lend itself to exacerbating this process and exploiting you. For many activity levels drop dramatically during the winter months, this translates to a period of 4 to 8 months of significantly lower levels of activity on all fronts. This often leads to the “slowdown” you experience. But why is this?
Each year you go into the autumn at 100% of your fitness levels, and through the winter, levels drop down for obvious reasons, the body is lazy, now you come back out again in the spring, almost like a bear that’s been in hibernation, a measly 50-65% of what you were. Through the ensuing months you gradually build back up levels of activity, but because there is not the formalised approach to this, you only build back up to 80-95% of last year’s levels, this is your new 100%. Even if it is 99%, it’s not 100%. Then autumn rolls round and your “new 100% fitness takes another hit down to 50-65% by the spring time… The cycle repeats.
You can see how over the years, and the decades, the gradual inevitable deterioration of your body’s condition takes place. And this is assuming there were not any accidents or injuries in the winter or summer months.
Often those who have this belief that “they’re busy and active all the time” do not partake in more formalised “working out” because it is considered unnecessary. Why? Because you feel tired or even exhausted by the end of the day, you must be doing enough to keep fit and strong, right? … Wrong.
Just because you’re “tired” or “exhausted” at the end of the day, doesn’t mean you’re fit or strong.
This is another major flaw in the thinking process behind this belief. The linking of your health or strength and resilience to how you feel, instead of objective measures. There are a few issues with this which we’ll break down below.
The hardest thing you do is the hardest thing you do
Whatever it is, whether it’s a day on your feet or a hard session of working out, the hardest thing you do all day feels like the hardest thing you’ve done! It never gets easier, you just get stronger and it is only in retrospect that you find things easy. For example, many members in the Back In Shape Program, especially when they get to the latter Phases, will look back at their earlier exercises and realise just how much easier they are. Yet back when they were doing them in the first instance, to strengthen their back and core, they were difficult! Really difficult.
You must use objectivity to measure the “difficulty” of your tasks if you are to effectively evaluate your performance. Just basing things on you feeling tired at the end of the day is not an appropriate metric.
Thresholds need to be exceeded for change to happen.
This is perhaps one of the more detailed points that you must take on board. It is how the body works. We’ll take the example of a nerve and a light switch. Both of these require a threshold to work. In the human body we constantly have chemicals called neurotransmitters in the space between nerves. This creates a low level of stimulation, but it is only when a sudden surge of these chemicals are dumped into the space that the connecting nerve sends a signal. Just like the lightswitch, if you press it down half way, it will not signal to the light that it needs to turn on, you need to press it all the way so it “clicks” and then the connection turns the light on.
Just spending all day in low level activity within capacity, does not pass any thresholds required for your body to consider it necessary to adapt and change. You’ll still feel tired at the end of the day, but you’ve been “half pressing” the lightswitch all day.
Instead, you need a full press!
You might be thinking sometimes you do a full press, that one day for an hour, you were working really hard because you had to do that one thing that needs to be done every so often, once a month, once every couple of months, even once a fortnight. You hit the lightswitch fully and you really noticed it! That would be above threshold, yes, that’s the stuff that can get your body to change, but not if you just do it once!
Before we move on. Being busy and active all day is like half pressing the lightswitch, it does not change your body. You need to have a challenging stimulus in a short space of time, i,e. 20 minutes to 60 minutes in order to really turn the light switch on and trigger change. But there is a catch.
Repeat exposure to the appropriately difficult challenges.
These exposures need to have a degree of objectivity and frequency to them, like we said before, the body is lazy and it will not bother to change if you do not regularly expose it to these challenges. Regularly means for the desired duration mentioned previously, 3 to 5 days a week. Anything less than this is simply not enough regularity for your body to be pushed to devote resources to the strengthening and adaptive process.
Ultimately, these one off tasks that might hit a threshold, could be considered extraordinary activities, and this is where the risks are, this is where you injure your lower back, your neck, your knee or shoulder. You think, gosh that’s heavy but I’ll just do it quickly then I won’t need to do it again for another 3 months. This is why your lower back gets injured.
Preventing lower back pain with a proactive approach
As we mentioned earlier, the seasons and time are against us and unless we commit to taking a proactive approach we leave ourselves vulnerable to injury and lower back pain is one of those issues that can really affect our quality of life. To offset this natural degradation of our musculoskeletal system, we must take action. Failure to change our behaviour will result in gradual erosion of our pain free mobility, leaving us more and more fragile as we age. Do not put this down to an inevitability of ageing. We could perhaps make the statement that grey hair as we age is a foregone conclusion, almost all human beings over a certain age will begin to grey, physical ability, strength and resilience however are not the same. There are more than enough examples of those in their 70’s, 80’s and older doing feats of athleticism and showing displays of strength and resilience that those half their age would struggle to attempt competently. Many of these examples may have even begun their pursuits upon their retirement.
Don’t make excuses for yourself because it doesn’t need to be terribly time consuming or difficult, so let’s get into it.
How much time will be required to build strength in your body and lower back?
This is the biggest sticking point for so many, as we’re all busy, as soon as we leave school or education, we have commitments, then families and jobs, and then we retire and somehow manage to maintain a certain degree of business, or so we think. There is always time to fit something in. A quote from a business person springs to mind, “if I need something done, get someone who’s always busy to help”. Or something to that effect.
When it comes to the specifics, there is always an up front time commitment that can be off putting, a little practice to get technical skill right to work out safely is important. This will invariably mean devoting one twenty fourth of your time each day to practising technical skill. This might be necessary for a couple of weeks to a month, but is well worthwhile.
Beyond this, to build strength you need to devote perhaps 30 minutes to 45 minutes 3 to 5 times per week to strengthening your body. What does this amount to? I’ll write it out…
Three to four hours out of one hundred and sixty eight hours each week.
To ensure that as you age you remain mobile and able to thrive and enjoy life.
You can find the time.
Start out with technical practice for your lower back health and avoidance of injury
As we just mentioned, technique is important, often this will be overlooked, which is why people get injured and why they do not have success. However, there are three steps to help make sure you have success and do not fall into trouble.
Firstly, get an understanding of your posture and core engagement. Learning to engage the core region and postural muscles with a chest pop is an excellent starting point, this will be relevant for all the following steps and should be incorporated into your daily living.
Secondly, choose simple real world exercises that are immediately impactful to your daily living, favourite examples of these are the squat, the hip hinge, and the reverse lunge. Or as I like to call them, sitting on a chair, washing your face, and climbing the stairs. These are extremely applicable to real life as we have discussed on the relevant podcast episodes on how hip pain can occur with lower back pain, and how knee pain and lower back pain can also go hand in hand.
Thirdly, practice the exercises individually with instruction, in front of a mirror so you can see what you’re doing. Additionally, if you’re serious, then use your smartphone to record your technique to critique your form. This is something that is so hugely helpful for members of the Back In Shape Program. Sharing videos of technique reveals areas that weren’t even considered and ultimately this makes things much safer for the next step.
You must add resistance and load to strengthen your lower back.
Instead of the seasonal example we discussed earlier, imagine if you came out of the winter with 110% of the strength, fitness and health that you went into the autumn in. You can see how over the decades this could lead to a very different trend to the one so many resign themselves to. You might think this is not possible especially at your age, but we’re here to tell you, that is the same limited thinking based on incorrect beliefs we mentioned earlier. Really that belief is nothing more than an excuse you’ve developed over the years. We’ve members in their late 60’s and 70’s increasing bone density, verified by external scans, and others arresting declines in these important measures because they’re committed to building resistance over the long term and each year that passes they improve their strength.
Granted there are natural physiological limits of human beings, these are real. But none of you reading this are anywhere near such limits and you likely never will be, nor should you need to be.
This step is all about finding that threshold. By steadily adding resistance to the movements we mentioned above, you’ll be able to tell your body that this is the new normal, it is what your body is required to do on a weekly basis. The body, after the appropriate consistency is applied, will respond in kind. This means using resistance bands, and/or weights to apply load to the body, stimulating adaptive changes in the muscles, joints, tendons, bones and spinal discs. Not only that, your cardiovascular system and circulation in general will get benefits as well as your immune system. It sounds far-fetched but the reality is, you could consider this kind of practice to be the best anti-aging and anti-fragility medicine on the market and guess what?
How this all fits into your lower back pain prevention
In conclusion, this way of adding a relatively minimal amount of resistance training, to your weekly routine, 3 to 4 hours a week total, gives you a regular stimulus that is more intense than anything else you’re doing in the week. But at the same time it is safer too, because it is a dedicated time to challenge yourself, safely under control. Generally tiredness and fatigue from a busy day of “life’s activities” is fine, but it is that 3 to 4 hours that makes everything else easier and your body more resilient to those tasks over the time.
Expelling this wrong belief that being busy equates to keeping you fit and strong, will allow you to build real resilience in your body, and should you be unlucky enough to have an injury you will be much better placed to recover in no time. You’ll find that as the years go by, you can do more, not less, and with the focus on the exercises we mentioned earlier, you’re building a strong structure to protect your lower back for the long term.
As we age, long periods of forced or voluntary inactivity contribute hugely to a rapid diminishing in your ability to remain mobile, the onset of dis-ability, and immobility, is something to be avoided at all costs. Being busy is not enough. This is why we say you must work on regular resistance exercises and why we recommend those particular foundational movements, the squat, hip hinge and reverse lunge. We cover this and more in the full Back In Shape Program, where we have members of all ages doing great things and recovering from back pain and getting back to the things they love. But there’s one thing better than recovering from back pain, and that is being able to start the strengthening process without the inconvenience of back pain. Perhaps for many it was a crisis, the back pain, that forced them to adopt a new perspective of things. Hopefully if you’re reading this, you don’t have pain and you can act now to make the commitment to building strength and resilience and ensuring prosperity and freedom as the years and decades go by.