“My doctor always tells me to go and exercise; lose weight and your back pain will go away.”
The last thing you want to do when your back pain is bad is go out and exercise or go for a long walk. We mentioned earlier that going for a small walk or moving around the house is good when you have a back spasm, as the blood will flow more effectively to the back muscles and provide oxygen to reduce the spasm and take away the inflammation.
So which exercise should I be doing? Well, if you have had an acute back episode, then I would do as above, just gentle movement around the house, try lying on the floor and gently moving the knees from side to side or gentle rocking. You don’t want to be moving too much when your back ‘goes’, the reason it has gone in to spasm is to keep everything in place.
What should I do with a back spasm?
Once the back spasm has reduced, then we can look at beginning to exercise again. To start with and to keep it as simple as possible, we want to start with anything low impact. The reason being that high impact activities like running or jumping will cause more shock and load to go through the joints and the back, when they aren’t strong enough to be taking up this load. A gentle walk is the best place to start, even if it is just five minutes around the block. We can always build on this. Rome wasn’t built in a day, and this is exactly the same concept that the ‘couch to 5k’ programme was built on. Small and achievable steps over a longer period of time rather than jumping up and going straight to the end. If you go to step 10 with your back straight away, you will end up on the floor again. It’s so important to listen to your body when recovering from a back injury. Even when you feel ok, it’s key to remember where you were, as when the pain disappears there is still an issue there. We often see clients coming back two months later saying, “I did a half marathon this weekend” or “that gardening that needed doing, I couldn’t resist, but feel it’s put me back a few weeks.”
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Make sure when walking that you are wearing supportive footwear. High heels don’t count (don’t get me started on highheels). Trainers with a cushion on the bottom are good, a pair of running shoes like Asics work wonders. You don’t need to break the bank; you can pick up a decent pair for around £50.
The important thing about the shoe is that it cushions when the heel touches the floor when walking so the back
doesn’t take up all the absorption of the strike. This is why a lot of people are wearing those ‘minimal’ or ‘barefoot’ shoes when running, as it forces you to land on your forefoot and minimises the load going through your spine. It’s a great idea if people didn’t think that completely changing their running and walking cycle would cause problems elsewhere, like shin splints, knee issues and strained calves. So it’s really important to build it up super slowly if you do use something like that. Start small and build gradually, pick a landmark like a pub or shop and factor this into your day, every day. Do it on the way to work or on a lunch break. Gradually, as your back begins to get used to this movement, we can then increase the length of the walk.
When can I run again? Usually at least a month after the last symptomatic episode. The reason being that there is
no point going back to it when you are going to cause more damage. I’m writing this book at the time of the Covid-19 outbreak, and sorry to reference this, but it’s a nice comparison.
If we release the lockdown too early, there will be a surge in the number of cases, and we may have to go back into lockdown (according to the government). Same thing with physical activity, if we go back in, we may go back to square one.
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Can I go to the gym if I have back pain?
The gym is a great place to build strength and core stability, but it’s important to be doing the
right things. We have some great links with personal trainers in the area who help our clients build long-term strength and prevent recurrence of their back pain. Email me on firstname.lastname@example.org, and I can send you their details.
With the gym, you don’t want to be doing anything that causes your back to be painful. An ache or muscle soreness
the day after is different. I’m talking sharp pain that feels different to the ‘gym ache’. Weightlifting when done correctly will support the back.
I would not do any complex Olympic lifting without the supervision of an expert trainer. I’m also not a fan of the deadlift. Reason being the margin for error isn’t worth it. The benefit of extra strength in the low back and hips is far outweighed by the damage it can do to your back. If you are just 1mm out or something is off when doing a deadlift, it can cause huge pressure through the disc. There are many other ways to build strength in the back that don’t compromise it. We will touch on these further on. Anything overhead, so overhead squatting, standing shoulder press and shoulder jerks should be avoided, as it’s a quick movement that can put pressure on the low back.
If just starting out in the gym I would stick to machines. They give you a predictability of load and direction. Then, as
you become more confident, move on to the free weights. These give a better recruitment and activation of different
muscles around the joint. But be slow and controlled when doing them to activate the muscles properly.
What about swimming with back pain?
Swimming is brilliant for backs and necks. It is nonload bearing, meaning there is minimal load going through
the joints. You get in the water and feel weightless. This is great as it means your back discs and joints can rest whilst
the muscles are worked and lubricated through a full range of movement.
It’s not all that simple though (it never is unfortunately). It’s important to be careful if you have any underlying
knee or hip issues when kicking, particularly with breaststroke. It can put excess pressure on the hip, which can
cause pain in the back as well. I recommend front crawl legs with breaststroke arms, to make things really confusing. But it’s the best stroke, and also the one that will cause the least damage. Front crawl is also good, but the torsion through the upper back when breathing can cause issues with neck pain. So just take care if recovering from neck pain with this one
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