I’ve been in the physical fitness industry for over fifteen years and dealing with injuries and special conditions for most of that time. I’ve dealt with some of the most extreme cases you can think of and wanted to put together some comprehensive answers for people who need help figuring out how to help themselves with injuries.
Over the years the case I see most often is lower back pain. This can manifest itself in various different ways for different people. The typical stages of this type of injury are:
- General stiffness, usually upon waking up where it feels like you need to move around a bit in order to get blood moving again. This might also happen during the day at work or after driving in your car for a period of time. I call this Stage 1. Think of this as a check engine light coming on in your car.
- Constant stiffness and losing the ability to move quickly without a sudden jolt of pain. Often this is the stage where people start to seek help from some form of practitioner. There may be occasional sciatic pain down one leg or positions that cause discomfort, especially lying down. Sleeping may be difficult some nights. This is Stage 2. This is where you really need to start paying attention, although you really should have at Stage 1.
- Pain when moving. Typically this is sciatic referral pain (ie numbness or tingling down one leg or both) or sometimes SI Joint pain (beside the tailbone near the pelvis) and the whole joint area in the hip and lower back is stiff and sore constantly. Sometimes this can mean a disc herniation or bulge or an SI Joint displacement. This is Stage 3 and can render you unable to move properly at all, sit for periods of time and you will be in pain and likely have to resort to pain drugs to function.
This article is a series for letting you know why this pain happens, what you can do about it yourself without having to spend tons of money on physiotherapy, and how to prevent it in the future.
So to begin with, why does this pain happen?
Pain is a signal from your body telling you that something is either out of place or unable to support what it needs to. I wrote a previous article about pain and your body here if you would like to read about the concept of pain as a signal.
We spend hours each day in positions where our spine has to bend in ways that it is unsupported and doesn’t like to sit for periods of time. The most typical place for this is work – sitting in a desk chair hunched over a computer. As you sit forward, your lower spine and pelvis rotate and flex into the opposite position that they should be.
Basically when you’re standing your lower back has a curve (like it is supposed to), and when you sit it doesn’t – which puts pressure on and between the discs. It also means that some muscles have to work more to maintain the position and get tired, while others don’t do much work at all. Imagine at work you had two employees who did all the work, and two who showed up but never did anything. The two who did all the work would eventually get either burned out or pissed off. Muscles like to work together.
Stiffness is your body’s way of saying either “I don’t want to move” or “I can’t move well” – either way it isn’t a good thing. This can be muscular and can also be fascial restriction as well. It is a good idea to address both because without a very experienced imagining tech you’re not going to know for sure which one is the problem, and it is easy to address both issues.
What eventually happens when your joints and muscles tire and your fascia doesn’t allow movement is pain. Remember always that this is a warning signal and therefore should be looked at when it happens, not ignored like many of us tend to do.
So if I am starting to get these warning signs and have entered Stage 1 of the process, what should I do?
Awareness here is key. There are multiple avenues for relief at this stage, which is a good thing. In my next blog post I’m going to outline the best stretches and movements that you can use in order to bring relief to this area but for now let’s work on the immediate things.
However, in the meantime what you can do immediately is assess your position when doing things like sitting, moving around and even simply relaxing on the couch. Are you in a compromised spinal position? This means that something is usually twisted, flexed or positioned in a way that isn’t optimally aligned and eventually will cause a problem.
Example: recently I worked with an anesthesiologist who stood on the same side of his patients and bent and rotated to do his job – every day for hours. He didn’t realize that his spine was literally starting to twist into a new position. Bringing awareness to this and asking him to simply move to the other side of the table half the time brought him instant relief.
If you are a desk worker this can be as simple as moving your work station to a better position. It can also mean getting up frequently throughout the day and getting out of a bad position. I tell my clients to set a timer and stand up ideally at least every 30 minutes, and more often if they can. Walk in a circle or visit a colleague, do a lap around the floor or whatever you can do for a minute or two.
When standing, figure out if you’re always putting weight on one leg. Public transit riding is terrible for this. So is standing for long periods of time cooking, or doing any other type of work where you stand for periods of time. This shift onto one side creates a slight tilt in the pelvis and more load onto one hip, resulting in fatigue on one side. If you are, simply focus on shifting onto the other side once in a while.
If you’re driving long distances and have back pain when driving, try reclining your seat a bit more to open up your hip angle and decrease your lumbar spine flexion. It’s not a solution, but it can help with symptoms.
If necessary, even keep a log, writing down when you feel stiff. Is it after every day at work? Is it when you wake up or lie down? Is it after you have done three hours of gardening (which is probably normal)? Again, the awareness is important, especially if you want to figure out the source of the issue.
I’m always telling my clients to be more proactive and invest in their bodies. It really doesn’t take that much to be aware of when and why things are happening.
If you are already in Stage 2 or 3 then you need help. Go ahead and invest your time and consult a competent physiotherapist (sports therapists are generally best), chiropractor (ideally not a back cracker but a good ART specialist) or a good rehabilitative strength trainer (with credentials and education) like myself. Almost every day I help people reduce and eliminate back pain in a short period of time with simple solutions that you can perform on yourself with minimal time investment. However, you need to do the first steps first.
In my next article I’ll discuss the mechanics of back pain and your “core” and some simple movements and solutions to help you if you’re still experiencing problems. Feel free to like this article, subscribe to my site on the main page and follow me at @paradigmottawa on Twitter or Paradigm Personal Training on Facebook. And, of course if you have any questions I’m only an email away at firstname.lastname@example.org. See you next time!