Once upon a time, if you had a bad back you were told to rest. However, we now know that, in the majority of cases, rest is most definitely not the best thing for your back, in fact it could make your condition worse. When you rest you tend to seize up and it can take as little as a week for the muscles of the body to weaken.
The NHS website recommends “if you have back pain, you should try to remain as active as possible and continue with your daily activities. In the past, doctors recommended rest for back pain, but most experts now agree that being inactive for long periods is bad for your back. Moderate activity, such as walking or doing everyday tasks, will help your recovery.”
But if you’re in constant pain, the thought of exercising may seem counterproductive and even frightening because the last thing you want to do is make your back pain worse than it already is.
The first thing to do is to assess whether or not your chosen activity or exercise is appropriate for you at this particular time. Most back pain stems from accumulative injury, built up over time through repetition, so it’s very possible that your golf swing, hours spent digging the garden or poor posture while sitting at your desk have played a part in the pain you are feeling now. This doesn’t mean that you have to stop these activities but it could be that you need to swap a few hours on the fairway for some corrective exercise sessions to help rectify some muscle imbalances.
There are a few myths surrounding the best kind of exercise for back pain and you may have already had some of these recommended to you;
“You should perform sit-ups or crunches to strengthen your abs”
There is some logic behind this thinking. The abdominals form part of your ‘core’ so it makes sense that a strong core will help protect the spine and eliminate back pain. However, sit ups place a HUGE compressive force on the lower back and are a big “no no” for people who suffer with lower back pain.
Instead you should focus on creating stability and then building up the endurance of your core muscles.
“You should strengthen your lower back”
Again, this seems logical because if your lower back hurts it must be because it’s weak, right? Wrong!! If you suffer from low back pain it’s more than likely that your back muscles are already doing too much work. If you attempt to strengthen them even further you will put even more load on that area and possibly make your condition even worse.
A healthy back is correlated with stability and endurance, not strength. Instead you should focus on strengthening your glutes (buttocks). Because we spend so much of our time sitting down our glutes switch off. This means that when we attempt to move the hip or leg backwards, the low back gets compressed. If you get your glutes working properly again then this excess load is taken off the lower back.
“You should stretch your hamstrings”
This is pretty much universal advice when it comes to helping with back pain and it’s true that tight hamstrings can cause lower back pain. It’s also true that stretching your hamstrings can feel really good but this is only because you’re stimulating a stretch in your lower back. If you have a forward tilted pelvis then your hamstrings are already long enough, they only feel tight because your tilted pelvis is putting them on stretch. If you stretch them further then the pelvis will rotate forward even more and result in more compression in the lower back.
So what can you do to stay active and help alleviate your back pain?
Walking
Walking is probably the most underrated form of exercise yet it’s incredibly good for you whether you have a bad back or not! Make sure you wear comfortable, supportive shoes and focus on maintaining a good posture as you walk. Start with just 10 minutes a day and then gradually build up – half an hour a day is ideal.
Pilates
Pilates is often recommended by osteopaths and physios for people who suffer with back pain because it helps to strengthen all the core muscles whilst also helping you maintain and improve flexibility and mobility. You should always make your teacher aware of your back problems so that they can offer you exercise modifications where necessary.
Yoga
There are many forms of Yoga and some will be more suitable than others so always speak to the teacher first. Make them aware of your back injury – you need to be confident that they can adapt the exercises to suit your individual needs.
Corrective Exercises
A well planned programme will aim to address the factors that have contributed to your back pain, eliminate the pain and then have you follow a maintenance programme that prevents the pain from returning. This should be done following a detailed assessment of your posture, lifestyle and movement patterns.
Massage
Whilst massage won’t magically ‘cure’ your back pain, it can help to ease the discomfort and, when combined with corrective exercises, will speed up the recovery process.
If you do suffer with chronic back pain it’s really important that you stay active. Get up out of your chair and move more – your back will thank you for it!
Need more advice? You can contact me directly: sharon@corepilates.org.uk.
