by Gil Magne
Here’s a story I hear from time to time from frustrated patients with persistent low back pain: “I don’t know why I have back pain, I have a strong core… I do crunches everyday!” OR “I’m able to lift heavy things but when I go to put on my socks or pick up something from the floor it just kills me!”
Some interesting studies have shown that people with persistent back pain, tend to have stronger backs than people without a history of back pain! This seemed to show that if you have back pain, you tend to overuse your back and hence why you could be having pain. Makes sense right? If you were to go and do 100x more reps of any particular exercise, the muscles that you are using will be where you are feeling the burn/pain, but will also get strong as a result of this extra work.
So what else might be going on with your back that is causing your pain even though you may be strong? Here are some factors we take into consideration when assessing you and your back to help zone in on your problem.
The way you move: Maybe you’re moving and using your back more than other joints and muscles that could be taking that stress better. Often when someone is overusing their back, they aren’t moving their hips well, or a stiffness in the foot/ankle, or upper back as a limiting factors., If you are having trouble with specific tasks such as lifting, or walking, etc a movement assessment would point us in the right direction for what would need to be corrected. This type of assessment allows us to see how you use your whole body in unison to complete the tasks of your daily life.
How much you move: Maybe you’re moving or in a posture in a way that is repetitively stressing your spine in one direction. The spine often gets irritated by repetitive movements and would have a hard time recovering if your are continuing to load it in the same way!, If my door swings open and hits the wall, it will leave a mark. I can fix the mark, but how long will that last? If I don’t fix the door hitting the wall, it will just continue to leave a mark on the wall! Sitting with poor slouched posture, standing with poor stability, leaning over to one side are all examples of what we see regularly that can contribute to repetitive stressors on the spine leading to aches and pains.
Your core endurance: Your core is likely strong enough, but has a lack of balanced endurance. Strength is an indicator of how much you can can move or lift, and endurance is how long or often you can do it. The way we should be using our core to limit the stress on the spine is steady and controlled over time. This core acts like a buffer and shock absorber for your spine, and if the endurance is lacking, then you may find that over time with repetitive tasks you start stressing and irritating your back because you are unable to keep up with the right way to move. If you are finding that you are OK if you do a handful of repetitions, but then seem to have trouble after a certain amount of time, this might be part of the problem. So testing your endurance and comparing left to right and front to back would help give us an idea.
In our future posts, we will go over each of these components to see what you can do to improve them. To find out what YOU need for YOUR back, we could figure it out by putting you through a movement, mechanical and endurance assessment at the clinic.