Ooooooo…

Why am I in agony with my back, and what can I do about it?

Have you (or anyone you know) ever had a back so bad you were stuck flat on it, unable to move or get up? How does that happen, and what can you do about it?

In the vast majority of cases acute back pain is purely muscular. In some cases degeneration of the spine or some other medical reason is the culprit, but often this is the exception rather than the rule. The biggest reason people get a sore back is due to muscular spasm/inflammation and it is often possible to relieve these kinds of symptoms almost immediately by focusing on improving range of motion.

One of the worst things about people having a sore back (apart from the obvious pain endured by the poor victim) is the huge cost this kind of thing inflicts on society (which is massive by the way). We are not just talking about the bill to fix the problem but also the cost due to the individual’s lost ability to remain productive. The bad news for employers is that, not only are things complicated by the time off work required, but often lifestyle is the issue rather than insufficient care by the employer to provide a safe workplace. So when a worker puts their back out at work tying a shoelace it actually (very often) has very little to do with the workplace. The shoelace problem is merely the straw that broke the camel’s back.

Some causes of acute back pain are:

Low energy

Often the result of…: Typically low energy is due to lack of nutritional and activity balance, with or without an un-balanced system (which can be full of toxins). Another way to put this is undue (or unmanageable) stress. The busier and more hectic our lives get the more our energy is sapped. Technology has a lot to answer for. It facilitates the rapid build-up on our daily “to-do” list. It helps us to perform work faster too, but not (in my humble opinion) enough to make up for the additional workload it creates. And all of this is compounded when technology breaks (as it often does. The computer is crashing, the scanner is not scanning, the printer is not printing, the router is not routing, the wireless is not wirelessing, or the programme is not de-bugged enough). So we are all uber busy and, in our haste, most likely not paying attention to correctly balancing our energy through adequate nutrition, rest, and exercise. Social employment of the same kind of technology exasperates the problem even more.

Good food takes time to produce and prepare. In this instant world we are often trading time and quality for convenience and instant gratification of our hunger pangs. Taste takes priority over nutritional value and so we typically end up eating more fast foods saturated in fat, sugar, and salt. Perhaps that is merely because, in the days of hunting and gathering, we humans may have been more balanced with our intake of these food types because our energy requirement was bigger and access inhibited. In these modern times of easily obtained excess the balance is all shot. Perhaps the refining of foods (such as sugar) tends to retain more if the nutritionally bad (which tastes good and therefore originally drew us to that food in the first place) and rejects a measure of the nutritionally good (a commercial decision because it does not enhance the experience of our taste buds). It could be due to the cummulative effect of all these things but in the end modern life tends to ‘feed’ (pun intended) nutritional imbalance. After a while we end up craving the nutrition we are missing. This gets us reaching for the all too common “pick-me-ups” like chocolate, ice cream, sweets, coffee, “V”, “Monster”. You cannot squeeze blood from a stone and when your body is tired it is tired. It requires adequate nutrition and rest so that it can recover. People should learn to listen to their body. Pick-me-ups are only ever warranted for very short spells when there is absolutely no other option. When there is constantly no other option then lifestyle changes should be considered because to continue in such a fashion can only end in tears. This modern living can produce dire results by destroying our organic functionality. Result = completely sapped energy and dwindling resource to do anything about it. We are trying to do more work with less energy. Something’s gotta give, and usually one of the first things to go is the discipline required to rest, exercise, and care appropriately for our posture.

Remedies: When you have suffered severe acute back pain for long enough you will eventually be forced to take stock of your life and make some lifestyle changes (probably involving diet and/or exercise).

Inadequate strength

Causes: Later we will mention habits, but for now let’s just say that the way we live every day has resulted in the lives we have. How many people reading this have a favourite side to sleep on? If you do then you could be introducing physical imbalance into your life.

The problem is that you may not create inadequate strength as much as the lack of strength to work throughout the entire range of motion of a joint. In a gym sense this is the result of poor form. Without the gym (in general life) this is failing to exercise and allowing life’s imbalances to dictate your physical condition.

Ever wonder why they have all those mirrors in the gym? It’s so all the buff guys can love themselves, right? WRONG!!!

Yes the buff guys do watch themselves in the mirror but they are not marvelling at how great they look (not all the time anyway). (Mostly) they are checking to ensure correct form. It is critical they do!

How many people have you seen do 10 (or any) chin ups but only come half way down? Those people are going to develop incredible strength but only through a partial range of motion. At full extension they will be weak (because they have not been training to full extension). This will destroy functionality because not only is the strength not throughout the full range of motion but opposing muscle groups (which may be strong throughout a greater range of motion) will represent strength imbalances. What does that mean? Have you ever seen a muscle bound gym bunny strutting down the street, body twisted, one shoulder riding higher than the other, their gait uneven, looking kind of ape-like as they drag and scrape their knuckles along the ground? Bad posture like that is a sure sign of muscle strength imbalance throughout the full range of motion.

By the way it is not just buff guys who suffer from this. Every day I see people who don’t ever work out that have developed forward sloping shoulders which tends to indicate weak back muscles and weak but tight anterior (frontal) musculature. Their chin juts forward and the head is angled down, creating a problematic forward pointing curve to the neck. Folks, the neck is supposed to hold the head up so you can look forward whilst maintaining the “arc of life” at the top of the spine!

Remedies: Always pay attention to technique whenever training. If you don’t know what correct technique is you need to find someone who can show you, and find them quick!

If you don’t work out then check out your posture or find someone in a good gym to check it for you. Whether you are a fitness freak or not good posture in critical to making the most of your life. You don’t have to be a body builder or spend hours in the gym pumping weights but you do need to protect your ability to stand upright. 20-40 minutes, 3 times per week is all you need if you don’t want to produce big muscles but you just want to be able to continue to function. If you don’t you are virtually guaranteed problems sooner or later (and probably sooner).

Inadequate flexibility

Causes: Lack of stretching or working a joint throughout its full range of motion. Everything we do such as driving a car, working at a desk, or watching television, reduces flexibility and weakens muscles that will lead to a bad back

Remedies: Ordinarily your average gym instructor will prescribe isolation stretching exercises. These are better than nothing, but I want to explain more on this whole subject as part of addressing “Lack of Balance”

Lack of balance in these things across muscle groups responsible for controlling the movement of any joint

Causes: Unbalanced strength and flexibility. We have mentioned strength and flexibility but we just don’t want to randomly strengthen and stretch muscles. I cannot remember how many guys I have seen spending countless hours doing arm curls because they want big biceps. Firstly, this won’t work because 2/3rds of the upper arm’s mass is the biceps opposing muscle (called “triceps”). Secondly, this won’t work because the strength and flexibility developed between these opposing muscles with such a method will create imbalances that decrease the effective range of motion. The muscles that control flexion and extension of the elbow joint are weak when they need to be strong and tight when they need to be supple. I call it screwing your body up in knots. Now, imagine the same brand of ignorance inflicted on the far more complicated musculature that supports the skeletal architecture of the lower spine and hips.

Remedies: We want to build up to doing what I like to call “Compound Stretching”, which is when you stretch muscle groups in a way that improves functionality through increased joint range of motion. Let me be as clear as possible. I am not talking about stretching a sore calf or a tight hamstring. I am talking about stretching muscles that work together whilst simultaneously placing the requirement for opposing muscles to contract, as well as maintaining correct form when training. That way you get strength and flexibility that allows opposing muscles to co-operate properly throughout the entire range of motion of a joint.

Habits

Sleeping: If you have an un-supportive bed or constantly sleep in the same position you could be asking for trouble. I have prescribed a complete bed change (as a part solution) for people with back pain in the past and it has helped immensely.

Sitting/Working: I used to design ergonomic work stations. One thing I noticed is that when something looks supremely comfortable it kind of looks like the human form, and it never is supportive. Yet when something ergonomically designed looks like the opposite of the human form, and it seems it will be uncomfortable to sit on, it is commonly very comfortable. Some of the most confortable workplace seating I have prescribed for people to great positive effect has appeared (at first glance) to “look” like it would be insanely uncomfortable! Other times complete replacement of seating or desking can be avoided simply by correct adjustment.

I have often walked into a living room to help a person with a bad back and have been able to identify immediately where they sit to watch television every night. The seat always looks like the most comfortable but has all the hallmarks of a back-killer. Usually the seat is too low, long, and soft. There is no way the lower back can be supported when someone is sitting in it.

Over-reliance on the provision of support: When the body is tired and you have to keep going it needs support. If at all possible the real priority should be rest and recovery (supported by adequate nutrition). The remainder of the time fitness should be such that your body can function throughout appropriate levels of stress/work without support. Anything less is tantamount to lack of balance and lifestyle choices should be re-evaluated.

Ceasing to move: When the body is in pain it is sending a signal to stop everything and rest up, right? That is “listening to your body”, isn’t it? Well… depends. The bottom line is you need to protect, support, and maintain range of motion for all joints. As long the level of swelling and pain are appropriately handled then the sooner you can get joints moving throughout maximum range of motion the sooner the problem will go away. Therefore, under the correct guidance, movement is often the answer (and not necessarily the enemy).

This article is merely a brief summary of my back care experience. More information is available from www.managing-back-pain.webs.com Alternatively you are welcome to visit one of our Open Days at the gym (dates to follow) or contact me at Freedom Fitness PLUS any time to discuss your particular situation with me: