Why wont my nagging back injury clear up?

Back pain

So according to government statistics, a fairly sizable proportion of the country either suffers or has suffered with some kind of back pain. That’s probably not news to you I would imagine that if, like me you have had a back issue then you know how debilitating and frustrating it can be.

 

An issue in the back can take years to manifest itself as pain and become a problem, assuming that it’s not a contact injury like getting kneed in the back playing rugby. More often that not in athletes and clients I have worked with (myself included) the actual injury, be it a disc herniation, stress fracture etc. is the result of poor biomechanics (movement) somewhere above or below the joint and or improper volume and intensity of work being done. This ‘work’ does not necessarily mean work in the gym, it can mean way too much time sat at a desk causing spinal ligaments to ‘work’ in a compromised position for hours on end or repetitive lifting of awkward furniture or kids!

 

One of the world authorities on low back pain is Dr Stuart McGill. He describes how every human being only has so much ‘capacity’ for work. This capacity is degraded every time we do something beyond the tolerance of our bodies’ capabilities. Using this idea it is easy to understand how it can take years of poor mechanics for a back injury to actually manifest itself. We can be happily picking things up with a horribly rounded back position for years with no issue what so ever the BANG! Herniated disc! That’s more than enough on how and why we get hurt… Key point, do as much as you can to move well in EVERYTHING you do.

 

Now, once we have these lower back issues they tend to last for a long time right? Correct, but they really don’t have to in the vast majority of cases.

 

When the body suffers pain the brain sends a message for everything around the area to either lock up or shut down to protect it from ‘harmful’ forces. In the early stages this helps us to prevent further injury, providing we listen to our bodies and off load (rest). However, once the initial injury phase has finished the pathways between brain and muscles/tissues surrounding the injury site are not as clear as they once were. For example, when we have lower back pain the muscles around the spine generally lock up initially. Following this locking up and probably after some massage and a hot bath or two they will loosen off and feel better. At this point the individual will probably assume everything is ok and return to full training.

 

THIS IS A BIG MISTAKE…

 

The pathways between brain and the muscles that stabilize the spine have been disturbed and going back to running and jumping around like a nutter isn’t going to help them. Time must now be spent re-grooving these pathways and ‘switching on’ the stabilizing muscles/tissues to provide stability for the more fun stuff.

 

 

How much, how often?

Improving what’s known as ‘motor control’ is key to regaining trunk integrity and requires more than a 3 days a week approach. This approach works perfectly well for improving things such as muscle size (hypertrophy) and strength. Regaining control and activation of the muscles proving stability to the spine requires (initially) very frequent doses of low volume (number of) and intensity exercises. This will sound scary and you will be thinking can I fit it in to my day? The answer is yes. I did and I know many others who have as well. 3-5 minutes of specific trunk (core) stability exercises 3-5 times per day can have a huge effect on motor control and reduce re-injury rates massively.  The bottom line is if it is affecting your life you will find the 10-15 minutes per day!

 

Of course these exercises need to be appropriate to the kind of pain/injury you have and this is by no means me saying ‘I can 100% cure your back pain’! However in many cases of people with nagging back pain the message from me is clear. YOU ARE PROBABLY NOT DOING ENOUGH REHAB WORK This will sound brash but it is almost always true and implementing this little and often, low fatiguing stability work can help a person regain the necessary control in as little as a week. This will allow them to build a foundation of trunk strength and stability to help reduce the chances of re-injury.

 

Take homes.

  1. Prevention is better than cure. Nail your technique in whatever you do and don’t stress the bodies’ systems unnecessarily through excess sitting, bad lifting etc.
  1. If you have pain… De-load the area and wait for pain to subside
  1. Get checked by a physio, chiropractor etc.
  1. Once cleared to return to activity perform small doses of low fatiguing trunk and glute stability (as directed by a professional) work multiple times a day.
  1. Give it a couple of weeks to work. Be patient.
  1. If you don’t see an improvement there may be something more serious underlying.
  1. If you do, happy days… Ideally keep up a very small maintenance dose (1-2 minutes per day of a specific exercise)
  1. Re-build slowly (depending on severity on injury and time away from full training)

 

Good luck!

 

Mark

 

By Mark Taylor