THE SPINE IS THE TREE OF LIFE. RESPECT IT.
The Spine is the Tree of Life. Respect It.
— Lizl Kotz
If you have ever suffered from back pain this quote will resonate with you. Dysfunction in the spine causes both physical pain and a feeling of emotional disparity. My hope is to convince back pain sufferers that if we take a little time everyday to care for our spine, our backbone will support the loads life brings our way.
When the spine is in neutral with it’s three natural curves, it is most capable of supporting movement of our limbs. We can think of this position as our home-base. Stability or muscle stiffness becomes crucial when we maintain one posture for a long time such as sitting or standing. Abdominal bracing provides this stiffness needed to protect the spine when we push, pull or lift. Many back pain sufferers spend time in yoga classes to increase the mobility of their spine. While yoga has numerous benefits, many painful spines need stiffness and stability over increasing mobility. Rotational torso motion must originate from the hips and shoulders and NOT come about through rotation and flexion of the spine. It is thus wise to spend time increasing mobility in the hips and shoulders and work on strengthening the small stabilizing muscles in the torso.
Our body has amazing healing capabilities if we allow it. First identify and then remove painful postures and movement from your day to allow for healing. Some offending postures need to be eliminated completely (forward head posture) and some movement patterns (golf swing) need to be removed temporarily. Similar to a cut to the finger, our backs are constantly trying to heal. By continuing harmful patterns we get stuck in a pain-sensitive phase. Having a specific diagnosis may feel good but is often not as helpful as identifying your pain triggers.
Many perfectionist personalities magnify their pain unintentionally by being hyper-focused on an imperfect body. Obsessing over the ache will not make your recovery productive. Acknowledge your pain but then quickly stomp your fears and worries with recovery tactics.
Don’t believe any clinician who promises a quick fix. Back pain can be complicated and often times has to be managed for life. Be patient as your body heals and look for a positive slope in symptom reduction.
Find a good clinician who focuses care on the root cause of your back pain. Once the root is determined you are on your way to recovery. A clinician should work on teaching you how to manage your own back pain. Beware of clinicians who only offer passive treatments such as massage, e-stim and require numerous return visits.
With the help of a good clinician work hard to identify asymmetries between the left and the right side of the body and then establish a daily exercise program that focuses on mobility in the hips and stability in the trunk muscles.
The following four movements are important to learn and will spare your spine.
The Abdominal Brace
Ask your clinician to help you learn the abdominal brace. Sometimes the brace muscles are weak or inhibited due to pain and it can take a time to dial in to these core stabilizing muscles. In Standing, activate your stomach muscles as though you are preparing to be punched. Do not suck in or push your stomach out, simply activate a mild contraction. If you place your fingers 4-6 inches lateral to the navel you should feel these muscles gently stiffen.
You will use the basic squat or hip-hinge to lift objects. You will also use this to rise up out of a chair or toilet. Keep your back straight as you lead with you butt downwards and backwards as if sitting down on a low camp stool. The key is to keep the spine stiff and hinge at the hips. If your knees move ahead of the toes it sometimes is an indicator of weak glut muscles being overpowered by the quadricep muscles.
This movement is used to transition from standing to sidelying or supine without twisting the spine. Take a large step forwards and drop the back knee straight down. From here, one can transition to tall kneeling or all fours and then to sidelying.
Similar to the squat this movement is used to pick a small object off the floor. Stand on one leg and bend at the hip. Bend your torso forwards and down reaching back with the non-stance leg and using that same hand to reach towards the floor. All of this while maintaining a straight spine.
Additional Movement Tips
Vacuuming - hold the vacuum with both hands and close to your navel in order to generate force from the core with no rotation.
Walking a dog who pulls - turn on your abdominal brace and hold the leash close to the navel and preferably with both hands.
Standing - do not allow your chin to poke forwards as this forces the back muscles to activate. Instead tuck the chin back almost giving yourself a double chin; you will feel the back muscles relax.
Walking - often times slow walking or strolling will aggravate the low back because it statically loads the spine and places the spine in slight flexion. Instead, walk briskly leading with the chest to unload the spine.
Flying - always travel with a small lumbar pillow. Airline seats are designed with a hollow in the lumbar region-the opposite of lumbar support.
Sleeping - if you awake with stiffness and pain, it is likely that your mattress and or sleeping position could be contributing to your pain. There have been studies to suggest that people with a flat lumbar spine do better with a very firm mattress whereas people with a large lordosis do well with a firm mattress along with a cushioned top.
Returning to exercise - start slow and for short increments. It is best to test your body by doing 3 ten minute bouts of exercise spread out throughout the day. Once this is tolerated, you can increase your exercise time slowly to once a day.
Author’s note: Much of the information in this article is a compilation of many articles and books on the spine as well as my own experience with back injury.