H.E.A.T. Therapy Blog
In the Mind of Sudbury's #1 Osteopath
7 MYTHS ABOUT LOWER BACK PAIN YOU SHOULD KNOW!
Myth 1: Tight hamstrings are linked to back pain
Truth: Tight hamstrings can be a symptom, not a cause of back problems. As back pain subsides, tightness in the hamstrings decreases. However, if one hamstring is tighter than the other, this can have a mild effect on back pain, especially in athletes. However, even those with tight hamstrings will be able to do such activities without putting pressure on your back. For instance, many athletes who are highly explosive, such as jumpers, require tight hamstrings in order to store and recover energy. The hamstrings here are not stretched but "tuned".
Myth 2 - Lying down in bed is good for your back.
Truth: Excess periods of time lying down in bed can actually cause back pain. Let's look at this further. Unknown fact: We are actually all taller when we wake up in the morning compared to before we go to bed at night. It all comes down to the spinal discs. Our spinal discs are stuffed with highly concentrated protein chains that love water. This is scientifically called "hydrophilic". When we lie horizontally, our discs are filled with fluid. The fluid pushes the vertebrae apart, lengthening the spine. Our backs can become stiff when we wake up in the morning because the discs are full of fluid. It's like a water balloon ready to burst. Once our spines become vertical again when we rise in the morning, the fluid from the discs begins to seep out, and within an hour or so, we are back to normal height.
The natural ebb-and-flow of blood is good for health. It is also what gives the discs nutrition. However, problems can arise if the spine is in a horizontal position for too long. Although eight hours of sleep is considered healthy, it is best to avoid staying in bed for longer than eight hours per day consistently. "Too much of a good thing" lying down in bed for longer than eight hours per night for consecutive days, allows the spine to swell excessively and can cause disc pain.
In conclusion, limit your time in bed and select the right mattress for you.
Myth #3: I can get rid of my back pain by doing daily exercises at the gym
Truth is that the key to preserving your back, rather than destroying it, is to do the right exercises. Patients often find it difficult to understand why they aren't able to take care of their backs exercising at the gym regularly, while others who are not as fit, seem to have no problems.
It is a fact that if someone hits the gym without using spine-sparing techniques, they will cause cumulative trauma to their discs. You will speed up the "breaking down of your discs" through delamination of disc fibers, by repeatedly bending your back at the gym and then sitting for long periods at work.
Un-fit Joe, who sits all day doesn't feel the same strain as a gym star because they don't put the same amount of strain on their backs by causing disc injuries. Their spines are healthier in terms of pain! It is important to not stop working out, BUT, change your default movement patterns (ensure proper mechanics while at the gym training) to enjoy the benefits of exercise without compromising your back.
Myth #4: Yoga and Pilates can help relieve back pain
Truth: Although doctors and therapists may recommend this exercise to patients for its "therapeutic" benefits, research has shown that this is not the case. Although some movements and poses may feel beneficial, or make a patient feel better, there are elements of both systems that can cause back problems. It is impossible to find an exercise program that benefits all back pain sufferers. It is irresponsible to prescribe yoga or pilates to someone with undefined back pain. Each exercise should be justified, and then adjusted if necessary to fit the individual and their pain.
Pilates has a major problem. One of its core principles is to flatten your spine and "imprint" your lower back on the floor while you lie down. It is not healthy to try and move the spine away from its neutral position and "straighten up" one of its natural curves. This can cause pain sensitivity in someone already sensitive.
Because it stimulates the back's stretching receptors, some people feel false relief. This temporary relief is usually temporary and your pain symptoms will return due to the stress placed on your discs.
The "Rollup" movement, which is basically a sit-up, involves rolling each joint of your spine segmentally. The science behind the "Rollup" has shown that sitting-ups should be avoided as part of a routine to maintain a healthy spine.
You can bend a thin branch backwards and forwards without stress. If you try to bend a longer branch back and forth, it will break and crack because of the greater stress this type of structure cannot sustain. This is why thicker people can actually delaminate their disc fibers more than someone with a leaner more slender spine.
Training mobility also softens collagen matrix, which holds the fibers together. This reduces load-bearing capacity. Training strength reduces mobility by strengthening the collagen matrix. The adaptations are very specific. This means that one must choose between training spine mobility and spine strength with load-bearing ability. It is rare that people can do both.
The exaggerated style of the Pilates' rollup emphasizes moving through the spine, which puts unnecessary strain and load on the discs. Our goal should be to reduce spinal movement and instead make our hips the primary center of motion. This will help the back pain settle.
As we have discussed, it is important to recommend a therapeutic exercise that corresponds with the results from a thorough assessment. Many doctors will suggest Pilates/Yoga and believe that it is good for the back. This must stop. Don't get me wrong, many of the Yoga and Pilates instructors have a specialization in matching exercises to certain people and their pain issues. But the bottom line is, if the components of Yoga or Pilates are NOT chosen and modified to suit the individual doing them, they may do more harm than good. At the end of the day, neither Yoga or Pilates should be considered the "end-all be-all" for all back pain sufferers.
Myth 5: A stronger back will heal my pain
Truth: Therapists start strength training in early rehabilitation because strength is one of the easiest attributes for them to improve. And requires little expertise. They may have even chosen to use strength as a measure of disability. This is due to a legal process that seeks financial settlements based upon strength loss (or loss of motion).
Many patients are left stuck as "long-term" or "maintenance" clients, because they have failed to properly rehabilitate their backs. Their training methods need to be changed in many cases. You can think of strength as the body's horsepower. It's only a matter time before a 500-horsepower engine, stuffed into a simple, regular car that isn't in good condition, for it to breakdown as it's raced around the city at high speed. In other words, the car cannot handle the power of the engine.
A back patient with a high level of strength relative to their endurance can expect more injury. This has been proven time and again with strong back patients. A strong back is characterized by endurance and strength. Endurance training should be held with higher regard than strength when is comes to back pain.
Back injuries result from putting the spine under strain and then failing to maintain healthy movement patterns. Maintaining proper movement patterns requires endurance. When rehabilitating patients with spine conditions, endurance must be given priority over strength. Only when the back-pained person has improved their endurance for maintaining healthy movement patterns, can their stability and mobility move on to more intense strength training.
Myth 6: Back pain can be reduced by stretching
Truth: While stretching is widely considered to be beneficial for back pain sufferers in general, it is an outdated notion that should be challenged.
A stretch that works for one back pain sufferer, may not be effective for and patient with back pain. Every case of back pain is unique, so each stretch should be carefully chosen and customized to each patient. Too often, therapists will prescribe wrong stretches to patients with the goal of increasing mobility in the spine. However, they should be focusing more on gaining control of their back stability, not mobility because stretching can initiate a mechanism called, the "stretch reaction".
The "stretch reaction" is a neurological phenomenon that reduces pain sensation. It can be activated by pulling your knees towards your chest or similar stretches. It provides pain relief for about 15-20 minutes, so it is only temporary. You are actually aggravating your discs by putting your spine in this position. After you have experienced temporary relief, your pain will return and often be worse. This creates a vicious circle with a misinformed patient, who believes that the only way to relieve pain is to "stretch" it. However, this is actually contributing to their pain. Stop the cycle!
Instead of focusing on stretches that bend your spine, focus your energy instead on stabilizing and controlling it. You can modify your daily activities to ensure your spine is in a position that does not cause pain. Your mobility will improve as a result of this and your pain will diminish.
Myth 7: A strong back is ideal for protection for the spine
Truth: Power is the result of velocity and force. It is possible to generate high power by quickly bending the spine and exerting force. This is very dangerous to generate power in the spine as it can increase the risk of injury. Let's take a look at two examples to better explain this. Example One: In golf, the spine movement and bending must occur at high velocity. Therefore, the force applied must be kept lower to reduce the power exerted on the spine. Example Two: Alternately, while deadlifting the force placed on the spine is high, therefore velocity must be slow to prevent injury.