“I just want to be fit and free from back pain”. This desire, sometimes desperate, is something that we’ve heard from more or less everyone we’ve seen over the years. Be it in a clinical setting or through the membership. The desire for those struggling with excruciating lower back pain or sciatica to be free from daily pain is strong to say the least. This is further compounded when hope seems to be lost after numerous iterations of failed therapeutic approaches and interventions. As we found from a survey earlier this year, nearly 40% of members had tried either surgery or injections to resolve their back pain without success. Over the years we’ve worked to help many in decidedly difficult circumstances break the cycle and make a lasting recovery, some of these instances offer profound transformations to those observing, but all mean the world to the individual whose life does change for the better. As anyone who’s really struggled with back pain for any length of time will tell you, being rid of it makes a world of difference.
Today we want to devote an episode to helping you find your way out of this kind of troublesome back pain with a plan drawing on some recent member experiences which tie in so nicely to illustrate this guidance with real world examples. Hopefully you find it gives you a moment to pause and re-assess if you’re going in the right direction and what that direction and or destination even is.
I want to be anywhere but here
This phrase is often where those at whits end will find themselves sooner or later. However it can be such a difficult place to find yourself for a number of reasons. On the surface, starting a journey where you don’t want to be can be helpful. Just start moving in any direction and you’ll be “not here” soon enough. The problem for those who’ve had lower back pain for any length of time is, there are traps along the way.
The world of “fixing your back pain for good” is fraught with conflicting information, stuff that supposedly will help but it turns out doesn’t. Often you’ve had such difficulty and first hand experience of this that it almost leads to a sort of action paralysis.
You know you want to be anywhere but here, the problem is that anywhere you’ve been from, leads you into trouble and right back to the one place you do not want to be, back in pain!
The difficulty of conflicting information is real, especially because lower back injuries are not quite the same as ankle, knee or hip issues. There is nuance which needs to be observed and often is missing in much of the advice out there. Short term results sacrifice long term resilience and quick fixes are all too common.
At this particular point the issue falls at the feet of the statement at the start of this section. A goal of, “anywhere but here”, when you’re petrified to move in any direction, is not a goal at all. And deep down most know this. On first questioning the knee jerk answer of “out of pain” is given, but on further probing, real tangible goals are actually verbalised. It could be:
- I want to play with my kids or grandkids without pain
- I don’t want to fear a long drive to see friends
- I want to be able to go on holiday without back pain cancelling the trip
- I want to be able to go climbing with my friends
- I want to be able to go to the gym again and workout
The list goes on. These are tangible things, the “why”. It is often the inability to do these things that motivates us to deal with the back injury in the first instance. Chances are that your back injury was present while you were still doing these things, but it was only when it got bad enough to prevent a critical event that “something needed to be done”.
For some of you reading this it will really resonate with your own back pain or sciatica journey. You’ll be able to draw on similarities between this story that we’re painting and your own experience! Stay with us as we move forwards from this point as we’re about to uncover the next steps to help you more successfully deal with the recovery producing something that lasts, rather than fleeting relief.
I just want to be fit and free from pain
There is nothing wrong with these desires, they are entirely reasonable however too many stop here. So close to the answer but so far from actionable steps. The second part of this phrase, the crucial part, is…
This answer inspires reflection, which leads to exploration of the “what” and this gives rise to “something”. Let us take the example of going on a “pain free” holiday. We might think of a relaxing trip by the beach or something equally tranquil to take us away from the hustle and bustle of daily life. You can then move to evaluate the “holiday”.
In this example, you’re going to need to take a suitcase, you’re going to need to pack, and carry, this suitcase and more, the travel, all these things need to be considered. But just the “load” element itself gives you an immediate target.
To continue the theme… “anywhere but here” turns into a vague destination “able to carry a 20kg suitcase” well that’s something specific that we can start to work towards. Immediately you have answers you have things you should be doing, can do, right now, to start to work towards that objective and away from pain.
We need to find a way to develop our lower back’s ability to bear load, precisely 20kg of load, for short periods, and perhaps awkward periods.
Take a moment now to ask yourself a couple of questions to help you get a destination in your mind’s eye. We’ll explore why this is so relevant very shortly, and how it prevents you from falling into the trap of purposeless exercises that are so commonly prescribed.
- What is your back pain stopping you from doing that you want to do?
- What do those things involve you doing?
- What would you need to be able to do, to do those things effectively without risk of re-injury?
If you have something in mind, such as the holiday example, or something as simple as being able to spend afternoons in the garden without a crisis occurring, then you will immediately be better placed to avoid falling into the trap of those purposeless exercises. You will immediately realise that you need to focus on building resilience in your lower back, resilience to load. This would make exercises such as pelvic tilts, stretching for the sake of stretching, knee hugs, child’s pose, sciatica flossing, the list goes on… It would rule out these sorts of activities through the simple fact that you cannot “child’s pose” your way to a stronger back, because a child’s pose does not build strength, it is a simple back stretch.
Too many people get stuck doing “activities” and “movements” like this. We’ve covered many of these in detail previously, and why they are not conducive with rebuilding a strong back. Because they are not designed to build strength. Yet too many get caught doing these exercises expecting something to happen.
Reflecting on your daily life: a real example
Even something as simple as reflecting on what you are requiring of your own body on a daily basis can be a helpful exercise, so infrequently practised that the hidden clues to your recovery remain permanently out of view. This past week we had an extremely diligent member go back and look at her daily activities, she was struggling with the lunging movement aggravating the knee’s. On subsequent evaluation, it turns out on any given day, due to the nature of her home, she might go up and down stairs amounting to over 400 stairs a day! This is a tremendous amount of repetition at something that we struggle to do competently. Is it any wonder we have vulnerability in this area.
Now you might think, well, surely with that many stairs you’d have stronger legs, wrong. What inevitably happens in the subconscious is that we gradually lean more on one leg, we gradually use the handrail more and so on. If we have a requirement to traverse a significant number of stairs each day, there is only one way to make this not an issue. That is the following:
- Learn to lunge correctly with good form
- Build an ability to do more lunging, with more weight.
This will allow for the long term health of the knees – and lower back, to be preserved, but not just preserved, bolstered. Resilience to all sorts of injury will be greater as a result. This reality was only possible however by the diligent reflection on how you use your body in reality every day. Seriously taking the time to reflect on this gives answers. For some it can be as simple as just wanting to be able to get through a day without some part of the body feeling like it’s going to fall apart. For those of you in this category, the above reflections are priceless!
“Strength is never a weakness & weakness is never a strength”
- Mark Bell
This quote epitomises the reality for more or less all of those with back pain that we’ve seen over the years. Our clinical experience and that with our members has been with ordinary people. There are some nuanced differences for an elite athlete who injured their back. But by and large they actually recover very quickly. The ordinary person however, often struggles, what little strength there is dissipates quickly upon suffering with lower back pain. Inactivity and voluntary reclusion from the sorts of activities that build or maintain such a protective strength compound the problem, leaving the individual weak and vulnerable.
Unless you live in the sea or in space, the things you want to be able to do involve you bearing load, forces and moving. There is yet to be a convincing exception to this rule. Some of you will require more load bearing and forces to be tolerated than others, but the requirement is there regardless. Be stronger than you are today, develop a capacity to bear load through careful progression of resistance based exercises that are real to life and that we can all do. You’re all doing them already, you just hadn’t realised it in most cases. Just like the 400+ stairs a day being 400+ lunges every day, you too have this same demand on your body. You can either start working to make sure your technical application of the movement to everyday activity is improved, or you can choose not to.
Hopefully today’s discussion has made you consider the merit in evaluating your own goals and direction of heading. What you need to develop and how to go about doing so. If you do need further help with this or are unsure what to do next then let us know in the comments, thank you for reading this far!