Prevention is better than cure!
We know that you want to prevent back pain so in today’s article we will give you, 7 things that you can do the prevent lower back pain. 80% of people will suffer with back pain in their lives so it is a huge problem and one best avoided if you can. But what can you do to try to minimise the chance of getting a bad back?
1. Exercise more!
Do you find yourself saying this, “I can’t exercise due to back pain” and do you often avoid exercise for fear of causing a back pain flare up? The evidence shows that, in fact, you may be making things worse with this approach because exercise, particularly frequently taken exercise, is great for both prevention and treatment of back pain. This has been backed up by masses of studies and reviews along with expert opinion.
Contrary to popular belief there is no one, particular exercise, that is best for everyone. My advice is to try different exercise types to see what suits you. You should pick something that you enjoy and can do regularly. The next thing that you should do, is to start slow and steady. For example, if you were going to try yoga, then don’t just go to a class. First try a few poses at home, you can get some good yoga videos on YouTube. Keep the stretch to a minimum, don’t try to copy what you see to the letter. Check that you feel no worse during, after and the next day. If this goes well then add a few more poses until you have built up to the quantity of a full class. This is the time when you can go along to a class, but remember that the frequency of exercise is the most important aspect of general exercise for back pain so you would be better doing a few poses every day, than a class once per week.
2. Get stronger legs!
The body works as one synchronised unit, so any areas of weakness in the chain will cause other areas to overcompensate. If you think logically, if you have weak legs then you will naturally bend at your middle, making you do too much in your back. Now don’t get me wrong here, bending the back is not bad, it is just the amount of it that you do and having weak legs will make you bend in your back all the time.
So exercises to improve strength in your legs can be things like squats, lunges etc.
Now just like your approach to tip 1, you need to start light or with no weight at all, and you may even need to start with a smaller range of movement. The basic approach is to work between 6-10 repetitions and do these between 3-5 sets with 3 minutes rests between sets. You should perform these 2-3 times per week and look to build up slowly through the rep and sets ranges and look to increase your range of motion and weight as you are able. However, it is vital to check that you feel no worse, during, after and the next day, and this means you are not overworking you back. The only thing that you may experience is delayed onset muscle soreness in the muscles mainly in the legs but this will occur the next day and last only a couple of days. It will also get easier session to session and is a normal response to new exercise, so is therefore nothing to worry about.
Now for a long time, this has been preached to everyone but it is not quite as you may have been led to believe. Firstly, there is no such thing as good or bad posture. Either way the body is designed to move and be in a variety of positions. So certain phrases have been coined in recent years:
“Motion is lotion” & “Your best posture is your next posture”
So if you spend hours and hours not moving, even in a good posture, then this is likely to increase the risk of getting back pain. This being said, it still makes common sense that spending just as long in a “bad” posture may be worse but the jury is out on this one, because it depends.
4. A strong core!
Here is another contentious one. When I say a strong core, I mean strength and I mean in functional context. What I don’t mean is “Core stability” Pilates type exercise. Although nothing is wrong with this, it isn’t strengthening! Another misconception of a strong core is thinking about just muscle. It is more than muscle strength, it is strength of all tissues in the area, as they all adapt to loading. However, the most important adaptation is to the nervous system. Basically you are trying to build a less sensitised sympathetic nervous system, which is your fight or flight nervous system. This part of your nervous system can turn up or even turn down pain sensitivity. So if you build tolerance to more and more load within movements that you do on a daily basis then your nervous system will turn down the sensitivity making it harder to cause pain in these exact functional movements.
So examples of “core strengthening” are things like Deadlifts, Good mornings, Romanian Deadlifts and Jefferson curls for example. The key is to focus on good core control and awareness throughout each exercise and these can definitely help you to prevent back pain!
Now just like your approach to tip 1 and 2, you need to start light or with no weight at all, and you may even need to start with a smaller range of movement. The basic approach is to work between 6-10 repetitions and do these between 3-5 sets with 3 minutes rests between sets. You should perform these 1-3 times per week and look to build up slowly through the rep and sets ranges and look to increase your range of motion and weight as you are able. However, it is vital to check that you feel no worse, during, after and the next day, and this means you are not overworking you back. The only thing that you may experience is delayed onset muscle soreness in the muscles in the legs and back. You will need to work out that it is just normal delayed onset muscle soreness and not actual back pain. Delayed onset muscle soreness will occur the next day and last only a couple of days. It will also get easier session to session and is a normal response to new exercise, so is therefore nothing to worry about.
5. Correct Movement patterns!
This essentially means moving as we were designed to, with variety. For example somebody who can’t squat, can’t move properly and somebody who has a lot of inward knee motion in walking will cause abnormal repetitive forces to be placed in various parts of the body. Having poor hip extension mobility will make the back have to arch more. etc. etc.
Obviously this one is harder to just implement yourself because you would need to be assessed for your movement, flexibility and strength in functional context. From this you would then need work on any of the faults found to target and learn new motor pathways or skills in the brain. Overall this would make you have access and have control of your own body, making it harder to injure anywhere in your body including your back.
This is both flexibility in your back but also in the areas above and below it. If your back has limited range of motion that you are repetitively trying to access, then this can cause you pain. Imagine bending your finger back to it’s limit, all day, every day, it would hurt! This is true of anywhere in your body. So if your back has limited extension (arching) then even walking could cumulatively cause you pain. Another example is, shortening of muscles, for example your hip flexors. If these are shortened then you will have more anterior pelvic tilt and limited hip extension. These will transfer movement and force into your back. Now stretching is not for everyone, so you should only stretch where you need to because you can be too flexible. If you have short hip flexors and are looking for a hip flexor stretch then here is one:
7. Biomechanical leg length inequality!
We appreciate that this something that you may not have heard of before, but put simply, having one leg longer than the other is very common but that doesn’t make it okay. If we still walked on soft ground then the floor would compensate for us but obviously in modern society we walk on concrete and tarmac etc. So this means that we have to compensate in our bodies. Now other things are factors here too, mainly our ability or lack of, to compensate. So somebody with the same leg length difference as another person may be weaker and less flexible and this all in combination makes their ability to tolerate their difference harder. Now you won’t just know if you have a difference but a biomechanical assessment can examine your pelvic symmetry, look at your foot position, knee position and looks to correct these problems with exercises and orthotics (insoles).
Now this is no means an exhaustive list but just covers 7 of many factors to prevent back pain. If you are curious, then stress, nutrition, psychology and more can also affect back pain but this can be for another blog post.
The content in this blog article is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.