Guest Post by Jehan Yehia, MSc Sports Medicine, SRP, HPCP
This week in the news there was discussion around Low Back Pain. It is estimated that a huge number of us suffer from it and a recent study suggested that exercise outshone any other treatment. This included; pain killers, injections and surgery.
This is obviously great news because as a physiotherapist this is what I spend most of my day prescribing. But as I continued to listen to this researcher he did not give any ideas as to WHAT exercise we should be doing.
Now if you have ever had back pain, knowing what you can and can’t do can be quite tricky and every day I hear some one tell me that they tried to get back to exercising but it was just too painful.
So as happy as I am to hear research promoting exercise especially medical research, I still feel that ‘one size fits all’ attitude does not necessarily apply to us all.
So, what do we mean by exercise?
There are probably three different groups of patients with low back pain,
- you have those who exercise regularly and want to get back to their programmes (Group 1)
- you have the group who have stopped exercise (possibly since they injured their back) and have not returned to exercise for a while (Group 2)
- finally you have the group who don’t exercise at all (Group 3).
Exercise will look very different for each of these groups and the main aims of exercise are:
- Get active, cv work (increased HR, blood flow and general well-being)
- Get stronger, muscles that are stronger can cope with more demand
- Get your joints moving
- Get flexible
Each person from the Groups above will have to fit aspects of the above in their programmes. What is important though before you exercise is to make sure you are not doing anything that is currently aggravating your back.
For example, if you are an office worker and spend 4 hours a day sitting at a computer (badly) without a break and decide that you are going at add a walk, this may help with the symptoms because you are taking exercise but what would also help is coming off all that sitting. So, what ever you decide you need to make sure that you know your 24hour pattern (what your back is like throughout the day).
Group 1
Group 1 for those who regularly exercise the main things to consider are; how does your back feel during, after and the next morning? If you get any pain from your current exercise, then It’s worth taking at look at exactly what exercises you are doing.
It may be you need to have a week to settle things down and then start to slowly add exercises in.
It may also be worth looking at your technique with exercises, for example squats can often strain the back, overhead weights especially heavy can also overload the back. Sometimes running through technique can really help.
Group 2
For Group 2, this is a very common group and often they feel very frustrated and low about what they use to be able to do before they had their back pain. They may have gone a number of years without exercise so have become quite deconditioned.
n their heads though they should be able to do more but actually its always best to start slowly and gradually and then when we know that what you are doing has no ill effect during, after and the next morning then you can gradually increase the amounts. Its better to do less to start with and it not aggravate your back than to go crazy and spend the next week suffering.
Group 3
The final group will have to battle with the will power to start exercising if they have come to it out of needs rather than want. I can spend many hours discussing the benefits of exercise to people and know outright the feeling you get when things start to take shape but its very hard to sell that to some people.
I think if this is you then just try and add something like walking into your routine and maybe a 5minute stretch every day. Walking is great way to exercise and maybe even invest in a fit bit to motivate you.
How do we know we aren’t going to make our back pain worse?
If you follow the above rules, start slowly only do something once or twice a week to start. Start with 5-8 repetitions of an exercise and if its feels painful during, after or next morning then its probably not the right thing.
Its very hard to work out what you need to do and also how to train effectively.
So it’s always worth getting a 1:1 assessment.
What happens if I get a flare up?
Flare ups can happen and if they do you need a plan in place to settle down your pain quickly. Have a look at my blog on how to manage an acute flare up.
There should be a basic group of exercises you can do but you may probably have to reduce what you normally do but keep moving.
Exercise is the way forwards for low back pain and managing it and working out what we need to do can take some time and if you are unsure then come and talk to us because we are the experts at getting people back to exercise.
Contact Jehan's clinic JY Physiotherapy in Kingston Upon Thames: 0208 0909 330 or info@jyphysiotherapy.co.uk
