HOW TO HANDLE A BAD BACKSep 05, 2019
This is a reprint, with permission, written by Phil Greenfield on his Facebook page. If we all approached our injuries in this manner, the outcomes would be very different.
You can keep up with Phil on his Facebook page by clicking here.
MY (GOOD) BAD BACK
There’s nothing so instructional for someone in my profession, than to have the occasional ‘bad back’ of my very own.
After a long day on Sunday of doing prolonged bending stuff to do with the car and the garden, a small shuffle/wrestle with a wayward shopping trolley Monday morning pulled me up short, and half an hour later I was walking like a saddle-sore cowboy, and my sacrum felt like it had a fist of steel wrapped around it.
Given that I rarely experience back pain, in the past I would have been freaked... all sorts of catastrophic stories would be running through my head. But in the light of what I’ve learned about pain over the last few years, I decided to offer some of the advice to myself that I regularly offer to clients who show up for help after finding themselves in a similar predicament.
1.) “It’s ‘normal’...”
Experiencing occasional episodes of back pain is a normal occurrence throughout life, just like the odd headache or cold.
2.) “There’s no damage...”
For all of the discomfort felt, this type of pain is not indicative of any tissue damage. Tissue damage generally needs a pretty severe impact to initiate it.
3.) “Understand what’s actually going on...”
I fatigued some muscles from prolonged ‘loaded’ positions (bending). My brain perceived this persistent loading as being somewhat dangerous, and decided in the light of all the evidence that some medium-term muscular ‘guarding’ in the over-loaded area might be a good protective strategy, and that a little pain might dissuade me from a repeat of yesterday’s behaviour.
4.) “Don’t catastrophise...”
It’ll go away soon. The evidence suggests that the majority of episodes of back pain of this type will resolve within a few days, so don't be making up any tales of doom!
5.) “Keep moving!”
It’s tempting, when experiencing scary pain and a pair of legs that feel like they’re going to give way under you, to want to stay very still and ‘cotton-wool’ yourself for fear of making a difficult situation worse. Up-to-date information on back pain suggests that I’d do well to go about my business as normal, whilst of course exercising a little caution as the problem improves.
6.) “Be OK with taking painkillers...”
The good thing about painkillers is that they kill pain. I used to think that was a terrible thing; painkillers “disguise the problem”... I’d say to people. Well, for this kind of acute episode, that’s actually not good advice... having less pain allows you to move more normally. Moving more normally sends information to the brain that all is (probably) well and it might be OK to turn down the smoke alarm a couple of notches.
7.) Causes, contributions and conditions 1: “Reflect on the previous few days...”
I knew when I set myself the challenge of the five minute two-arm half-snatch set with the kettlebells on Saturday, that I was pushing it. I’d never done that lift before, and I stubbornly wanted to get my entry in for an online competition before it closed.
8.) Causes, contributions and conditions 2: “Reflect on the recent medium-term levels of stress and fatigue...”
I’ve been real tired lately. I love lifting the bells, but I know from the feedback my body’s giving me that I’m pushing things a bit too quick. I’m keen, reasonably fit, but new to the sport and not as young as I was, and of course surrounded by fellow lifters banging out the big weights and numbers. This little episode gives me an opportunity to reflect on all of that.
9.) “Avoid ’body-blaming’ language...”
It’s not a ‘bad’ back. It’s doing the very best that it’s able under the circumstances, which is good. Good back.
... and by Day 4: (>90% improvement)
10.) “The time to be careful is when you feel better...”
With regard to everyday activities, no need to be over-cautious, but no harm in being extra-mindful when negotiating obstacles and loads, even small things like kerbs and saucepans.
Day 5: (>95% improvement)
11.) “Begin to get back into what you do...”
But first with mobility work and body weight drills, rather than using external loads. Be mindful. Expect to be a bit sore. Have little breaks to evaluate.
Day 6: (expecting 98% improvement)
12.) “Graded exposure...”
Start to work back up the weights in order to gain confidence that all is once again back to normal.