There are many opinions on how to prevent back pain and what to do when we have it. A huge industry has developed around back pain, selling treatments and products, promising to prevent or cure it. Most of this has no research backing, so success is more about luck than judgement. The costs of treating back pain in financial and disability terms are spiralling out of control, despite increasing intervention with surgery, injections, therapy and drugs.
The good news is there’s an alternative.
One of the biggest myths around back pain is that bending your spine (spinal flexion) is bad for it.
Lower Back Pain When Bending Forward
We often hear that bending our back is dangerous and should be avoided. And that keeping your back straight is a good way to steer clear of back pain. This simply isn’t true. Bending is great for your back but often we do it in a way that causes pain. We then assume it’s the bending that’s bad and not the way we’ve been encouraged do it.
This is like driving your car with the handbrake on and when your car complains you blame the car and assume it’s faulty. The car’s not faulty, you’re just using it incorrectly.
We’ve developed a fear of pain and a belief it indicates damage so should be avoided. We then protect our spines for fear that further pain will result in further damage. The simple fact is that pain and damage are not the same. Sometimes headaches can be really unpleasant. The cause could be as simple as dehydration or tiredness, but not damage.
Standing on a Lego block can be horribly painful and make you swear out loud, but you’re unlikely to have damaged your foot. Interestingly, if you deliberately stand on a Lego block you will get a very different pain response than if happens accidentally in the dead of night when you’re not expecting it. This is despite the forces involved being the same. The idea that pain equals damage is flawed yet it drives our behaviour and how we manage our spines.
Many of the commonly practised methods of back care cause the problems we’re trying to avoid. As we get worse, we try harder, using the same methods, and guess what? Because we’re using the wrong solution the problem gets worse.
We’re told to exercise and use our bodies to get fitter and stronger. Muscles, ligaments, bones, tendons all get stronger if we train our bodies. So why do we avoid bending and loading our backs for fear of damage or pain? If we load our back steadily over time, why wouldn’t it get stronger like the rest of the body?
The spine is an incredible piece of engineering and inherently strong. It’s designed to bend forwards more readily than bending backwards – after all we can get much closer to the ground by bending forwards than by bending backwards. So why is bending so bad?
Normal movement is thoughtless, fluid and relaxed. We allow movements to happen and our system just gets on with it, without fear creating tension or guarding. Our muscles are designed to switch on and switch off. If this doesn’t happen, muscles may remain contracted or tight when they should be relaxing and resting. After a while they get fatigued and painful and, if you practise it often enough, tension becomes your new normal This can put your joints under constant load, even at rest. Everyone needs a rest and if we don’t get one, we start to hurt
Our brains are really clever! They know what needs to happen and when it needs to happen for safe, confident, strong and pain-free movements to take place. Getting in the way of our natural movement patterns only confuses the system and leads to problems.
We believe there is a right way of doing things and that if we get it right, we will avoid injury and pain. Whether we are sitting, lifting, squatting standing or walking. As a result, we’ve become obsessed with technique in a misguided attempt to avert pain and prevent injury. The reality is that there is no correct way of doing things as we’re all individuals with unique methods.
Spines are strong and stable and unless we have a medical condition or a history of severe trauma, the pain we get is not related to instability or weakness. This idea is supported by research. But our treatments are based on pain meaning damage, and on instability. Many treatments try to increase stability by increasing stiffness and reducing movement. If you have an engine running and you gradually increase the resistance, it will eventually complain. The same thing happens with the human body. Stability is not the same as stiffness. The suspension on a car is very stable yet it isn’t stiff. It’s constantly moving and if it doesn’t move freely the performance of the car is affected. So why should the body need to be stiffer?
Lower Back Pain Made Worse by Sitting
We’re told to engage and train our core to strengthen and stabilise the spine and to prevent pain. This is aimed at avoiding injury and pain during physical tasks. You may get back pain if you lift something that’s too heavy or you have been sat for too long. Perhaps you’re not yet capable of lifting that weight or you’ve been immobile for too long. That’s not a fault of our spines but rather how we use them.
It could be the same with your arm or shoulder, but we tend not to protect them in the same way as we do our spines. Training would fix this as the more we use our bodies the stronger they get. Instead we’re encouraged to avoid using our spines normally and to protect them. Avoidance means we become physically weaker, so normal everyday tasks gradually cause more pain. It becomes a self-fulfilling prophecy.
In the ‘90’s when core stability was proposed, its popularity took off rapidly to become the “gold standard” of performance and status in fitness terms. Yet there was never any research to back it up. We’re prescribed planks, abdominal tucks, spine stacking…in the belief that a tense and engaged core is better. But people who bend less have more back pain, not less, and people who have back pain have an overactive core, not an underactive core.
Sit up straight to keep a healthy posture! A whole industry has developed, selling special chairs and gadgets to protect your back, to stop it from bending and being damaged doing normal stuff. We’re told sitting is evil and that it causes damage. Slumping is regarded as bad but the amount of bend in your back when you slump is small compared to what the back is capable of. Slump sitting is just a relaxed position with the chair doing the work. Why should it be bad? It’s not!
Should we sit on the edge of our seats, on a gym ball or a chair made into half a gym ball, just to work our core harder? We can’t maintain this for the long periods without tiring. If you’ve ever had cramp in your calves because of fatigue, you’ll know how painful that is. The solution is to move, stretch it out and then rest to recover. You wouldn’t choose to maintain a clenched fist for long and expect it to be comfortable. Why would we expect a different result with our backs?
We’re told to lift with a straight back and brace during the task. This is unnatural and causes increased load and strain. Research shows that backs are at their most powerful in lifting with a natural forward bend. We only adopt these techniques because we’ve been taught to, believe we’re vulnerable and told to fear our backs. This all serves to increase tension.
The human body is designed to work and rest, work and rest. Move, remain still, move, remain still. If we do this, the body maintains itself and gradually gets fitter and stronger. Too much load or too much rest may bring on pain or stiffness, but these are both normal responses and don’t mean the body is damaged or faulty. It’s just that we have taken the wrong approach. If we train and rest appropriately, all our body tissues become stronger and more capable, including our discs, cartilage and joints.
I can speak from personal and professional experience. I had consistent pain from when I was 15 to 35 years old although I did all the right things I’d been told to do by any number of healthcare professionals. During the time I played professional sport, some days I had mild grumpy backache and other days I had pain that stopped me getting out of bed. I was never without some level of back pain.
I had been told to:
- Keep my back straight
- Strengthen my core
- Engage my core more often
- Protect my back by avoiding using it as much
- Wear a weight-lifters belt to support my back
Not only did it get me nowhere, it actually made me worse!
We use our body automatically but sometimes we may cause pain without realising it. I was unaware of doing anything wrong so didn’t know I should change. I was doing unhelpful things and getting the same repeated complaints from my system. I was then introduced to an alternative way, I stopped doing the unhelpful stuff, replaced it with the helpful stuff and my pain disappeared. There was no change of structure in my back and no healing took place.
Guess what the foundation of this new remarkable treatment was that cured me of my 23 years of back pain?
BENDING MY BACK.
Yes, that’s it. I re-learned how to do forward bends. Not in a way that was thoughtful, considered, fearful, guarded or protected. Not by engaging my core and keeping my back straight and thinking about technique. I re-learned to bend my back as I did before I had back pain. In a way that was automatic, confident and psychologically and biomechanically normal.
I won’t lie to you. Other aspects of my behaviour influenced my pain and I go into them in my other articles. But they were the cherries on top. It was the new bending method that was the bedrock of my success.
When we bend our backs in a relaxed, confident, normal way, several remarkable things happen;
- We get fitter and stronger
- We relax
- We get less pain
All these responses are normal if we allow the body to respond normally without interfering.
Well, there you have it. The great secret is out!
I thought it was too good to be true when I first encountered it. My attitude was I was bored with being in pain, I hadn’t improved with the other stuff and this different approach made logical sense. So I went with it and very quickly saw the benefit.
Now, just because you have the secret, you may not be able to use it successfully in curing your pain. I needed some coaching to re-learn the helpful stuff that I was born with and I was a physio at the time. So, if I needed coaching there’s a good chance you’ll need some guidance as well. It took a little time and input from others.
If you’d like to re-discover normal pain-free movement and life, call me on 01392 949032 and start your journey of recovery.