Washington Post Article That Back Pain Sufferers Should Exercise…
Hey, it may not be much, but its about time people REALIZE exercise for back pain relief is ESSENTIAL!
Welcome back!
Exactly HOW Fast Should Back Pain Relief Happen?
This is a bit of a tricky question. It can refer to the amount of relief you have after a therapy directed at relieving back pain, OR long term relief.
You may have been told that back pain relief takes time, perhaps weeks or even months. While this may be true for decreasing back pain as the “big picture”, it certainly does not refer to how fast immediate relief can be achieved.
For example, one of my outcomes in working with back pain sufferers who have not received relief from previous therapies is either:
- Reduce the INTENSITY of the pain: Say, for example, on a 1 to 10 scale, with 10 being the worst, your pain is an 8 when you walk in my office. Our outcome would be to bring it down to anything lower, such as a 7,6 or better. That would represent a reduction in pain intensity.
- Reduce the FREQUENCY of the pain: This refers to how often you experience back pain. If you have back pain everyday, then a decrease in frequency might mean that you had 2 “good days” of minimal back pain during the following week after the therapy session.
Each session of therapy, which may include any number of approaches, from corrective exercise, corrective stretching, neuromuscular therapy, and even relaxation training, should progress in its effectiveness as each session passes.
I see it as sort of a “mathematical formula”. Meaning, when a certain sequence of movements and interventions are used, it equates to a certain level of pain relief, thus decreasing the intensity or frequency of your back pain.
Each session should focus on improving upon that formula, and results should ideally improve as the formula gets more and more directed toward your unique situation.
If, after 3-5 sessions of any therapy, you are not seeing improvement in either intensity or frequency of your lower back pain, something is wrong. You may not be performing the therapy correctly, OR that therapy is not effective enough to continue using.
-Sam Visnic
The MOST Common Back Pain Symptoms Are…
Back problems need to be separated into two groups:
Back Pain….and….Spinal Conditions!
These are actually 2 different issues, and must be addressed as such. The trick is being able to figure out the difference between them. Symptoms can vary widely with lower back pain, for example, here are just a few:
- Numbness in the legs
- Tingling in the legs
- Pain in the legs without associated pain in the actual lower back
- Pain which occurs with specific postures or positions
- Different sensations of pain such as stabbing, throbbing, heat, shooting, dull ache
- Pain that tends to move in location
Neuromuscular Therapist
The Case Against Crunches For Back Pain Relief
Its a common belief that weakness in the abdominal muscles can cause lower back pain. I agree with this statement, however, the general recommendations for strengthening your abs when you have back pain are most likely to make you hurt more!
There are 4 muscles in the abdominal wall that are important here:
1. The Rectus Abdominus: This muscle is the “six pack” muscle. Its primary job is to flex the spine, meaning, to flatten the lower back. The best exercise for this muscle is a crunch.
2 and 3. The Internal and External Obliques: These 2 muscles work together in both rotating the spine, as well as side bending it. They also assist in posterior pelvic tilt, which, when both sides activate, will flatten the lower back.
4. The Transverse Abdominus: This muscle is the deepest muscle in the abdominal wall. Its job is to pull inward, protect the internal organs, assist in respiration, and stabilize the spine and sacroiliac joints.
Typically, the common recommendation to strengthen your abdominals when you have back pain is to do crunches, however, this movement does not produce the desired outcome when it come to pain relief. Instead, if you have attempted to do this when your back hurts, it usually makes you feel worse.
The most effective way to train the abdominal muscles lies in not using your abs in the “crunch” movement, but instead using them to create posterior pelvic tilt. This reversed muscle action involves the obliques to a much greater degree.
A video on this is coming up soon!
–Sam Visnic
3 Lower Back Pain Fighting Strategies
Lower back pain is now affecting about 90 % of the population with at least one “episode”, and the occurrence of chronic back pain is rising. Of the many strategies to helping heal this health malady, four have really stood the test of time. Here they are.
- Stretching: Stretches for lower back pain are very effective at improving blood flow, loosening tight muscles, and promoting overall muscle and postural balance. It is highly suggested that you only stretch the muscles that are tight for your unique body, while avoiding the muscles that are already weakened or need exercises.
- Rest: Getting off your feet when you have back pain is effective, but only short term. If you are not getting relief within 36-48 hours of being off your feet, then experience shows that back pain may get worse as a result of lack of movement and blood flow. It may be more effective to have “active rest” in which light movements and stretches are alternated with complete relaxation of the involved muscles, which usually means lying on your back with pillows under your lower back.
- Ice or Heat: The age old debate is whether to use ice or heat. Ice should be used for acute injuries or immediate inflammation, such as a back strain that just occurred. Once back pain becomes chronic, heat may be more effective because it improves blood flow to muscles that have tightened due to the condition.
–Sam Visnic
To “Draw-in” Or To “Brace”….What is the answer?
The transverse abdominus (TVA for short) is the deepest layer of muscle in your abdominal wall. Its primary job is to act like a “corset” to the core region of your body.
Now, there has been a RAGING debate lately as to the validity of focusing on this muscle for the purpose of stabilizing the spine. Some say “Suck your abs in when you lift things”, while others say “Brace your abs as if performing a crunch when lifting things”. That’s not the exact argument, but for the purpose of this blog post, it’ll do!
So, what is a back pain sufferer to do??
I have always been a proponent of doing what works. I’ll use damn near any approach that is useful in some way, particularly when it comes to working with people in chronic pain. I’ve personally used both of these versions of abdominal stability, and can say for sure….
BOTH of them work.
However, they both work for DIFFERENT tasks. The larger “global” muscles, such as the obliques (love handle muscles), and rectus abdominus (six pack muscles) are normally used for larger tasks, such as big movements of your spine. It makes sense to use these muscles, and with more activation when you have back pain. However, you should NOT need to use them while performing tasks such as picking up your newspaper in the morning. If so, then you REALLY have issues in your lower back.
The problem with overuse of the “bracing” technique lies in the long term shortening and tightening of the superficial abdominal muscles. The rectus abdominus DEPRESS the sternum. For example, if you think about what the end of an ab crunch looks like, and imagine doing that in a standing position, you will see how most people stand.
A sunken chest, rounded shoulders, etc…
Too much tension in these abdominal muscles overtime leads to all issues that can be associated to excessive thoracic kyphosis (rounded mid-back), particularly if not countered by good strength in the mid-back muscles. Imbalances in the respiratory system are one of my major concerns.
–Sam Visnic
Massage Therapy…Relax Your Way To Relief!
One of the back pain relief methods that I subscribe to most is definitely massage therapy. Massage has a very nice list of benefits to your back, including:
1. Improving circulation throughout your body.
Massage can reduce ishemia (lack of blow flow), which improves the endurance of your muscles, and thus their job of stabilizing your lower back. Move blood flow and endurance equals less pain!
2. Reducing or eliminating adhesions and scar tissue.
Both adhesions and scar tissue in muscles cause decreased blood flow and decreases strength. Massage therapy is an effective method for reducing these that may be found in your back muscles.
3. Improving muscle imbalances.
Massage therapy, when applied to your unique muscle balance, is very effective. When you relax your “tight” muscles, such as the psoas (hip flexor) and quadriceps (front of thigh) can reduce anterior pelvic tilt.
Bottom line…..Massage Therapy = Less back pain!
–Sam Visnic
How to Instantly Strengthen Your Abs And Correct Pelvic Tilt
How To Measure Anterior Pelvic Tilt and Posterior Pelvic Tilt
Psoas Stretch
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"Having someone like Sam to refer my patients to who is as comprehensive, brilliant and caring as he is makes my job so much easier!! I feel assured that my patients are in good hands and are going to get the results they so desperately want. I highly recommend Sam to anyone who is looking to resolve their back pain easily and effectively!”
-Dr. Holly Lucille N.D., R.N. -
“I've used Sam on more than one occasion to help me with back pain issues. As a full time web designer I often spent too many hours sitting behind the pc which led to chronic back pain. I started working with Sam a few years ago and his knowledge and insight helped me to alleviate my back pain issues and even improve my posture. Whenever I start to have back pain issues I just re-implement the tools and techniques he showed to me and in no time my back pain goes away. He really is the back pain specialist!”
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Owner, Stellar Media Group -
“Sam is an excellent mind/body fitness coach & trainer. When it comes to eliminating complex back problems, Sam's your man. He is passionate about his work and dedicated to healing his clients. I highly recommend his services.”
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Author, "Manage Your Mind, Master Your Life" -
“In my experience it is rare to find a health practitioner who consistently cures the underlying issues, and successfully drives to total wellness. Sam has become our trusted family 'health support system' because he is one of those rare people. He has successfully helped my mother in law, sister, wife, daughter, and myself cure what western medicine has been unable to. We highly recommend Sam ... plus he's a cool guy !”
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-Dr. Matt Costantino
HealthSource Chiropractic and Progressive Rehab