As you read this from your easy chair in the comfort of your home, your back is hurting, your shoulders are tight and rounded, and you continue to try everything including pilates, weight training, rehab and yoga to eliminate your discomfort. Even your best attempts at pain elimination doesn’t work. The more programs you throw at it, sometimes the worse it gets.
There is a very simple approach to finding the injury mechanism and eliminating the pain. The not so obvious first step is to go backwards and quit all activity. Often movement is better than rest, but sometimes the “something that is causing the pain” is a faulty movement practiced repeatedly or a soft tissue injury from trauma. How can you be certain what is causing your low back pain if you ski, lift weights, snowshoe and run on the treadmill all within the same time frame? Sometimes the best approach is to quit all activity and see if the pain subsides.
Once the pain resolves, slowly add one activity you were enjoying back into the training cycle and keep a good journal on how you feel. If you add running as your first reintroduced activity, and after a month your pain is still eliminated, then there is a good chance your back pain isn’t associated with running. If you re-incorporate weight training into your program and within a week the pain has re-surfaced, then clearly something in your weight training is irritating your back.
“First of all, you must remove the movement flaws that cause clients back pain throughout the day,” said Stuart McGill, Ph.D., professor of spine biomechanics and chair of the department of kinesiology at the University of Waterloo in Ontario. “Generally, statistics are compiled from epidemiological approaches, which ignore the large role of cumulative trauma. Despite a reporting system that tends to associate injuries with specific events, very few (back) injuries actually occur this way.”
The acute moment of injury was a long time coming. Bending over to pick up the pencil in the office wasn’t the culprit even though you felt the injury at that given time.
Given the example, if your back was aggravated once you reintroduced weight training, then the next reasonable step is to look at your program and hit a reset button; reintroduce one exercise in the strength program at a time. For example, let’s assume you originally performed a barbell full squat, chin-up, bench press, overhead lunge and planks in your program. A smart approach would reintroduce chin-ups only and see how you feel. If after a week or two, the pain is still absent, then chin-ups aren’t likely the culprit. Keep adding exercises slowly until the pain resurfaces, and you will find out which exercise you are either performing incorrectly or one in which your body mechanics doesn’t support. Whichever exercise is causing the problem, assuming it is the full squat, squatting was contributing small increments of cumulative trauma that gave way en route to the pencil on the ground.
The examples and logical progressions of pain elimination aren’t the only patterns and possibilities that are associated with pain or injury. Sometimes injuries or pain associations aren’t black and white. I am a fitness practitioner, not a licensed medical provider, therefore these professionals should always be sought out when the strategies I have suggested don’t work.
Ryan Richards has a B.S. from Ohio University and is a certified strength and conditioning specialist through the National Strength and Conditioning Association. He is the personal trainer at the Sonnenalp Golf Club and the owner of R2HP, an athlete consulting and personal training company. Richards’ passion comes from overcoming childhood obesity and a T1-L3 spinal fusion. Contact him at www.r2hp.com or 970-401-0720.