The Misconception About Low Back Pain

We live in a world where low back pain is a very common issue.  We all know people who have back pain or who’ve had hernias or hurt there back playing sports, training or sometimes just picking up grocery bags off the floor.  I read a statistic somewhere that stated that 80% of the population will, at some point in their life, suffer from back pain.  That is A LOT!  And the truth is that low back problems are still very misunderstood.  Even in the research world, we seem to have a better understanding of the injury mechanisms of the lower back, thanks to great researchers like Stuart McGill, but there are still some gray areas.  There seem to be much more that we need to learn.

But as I just mentioned, there is definitely a better understanding of the injury mechanisms of the lower back.  According to McGill’s research there are different movement patterns that cause low back problems.  Hernias and other back problem are usually a result of one of the following:

  • repetitive and/or excessive flexion at the lumbar spine
  • repetitive and /or excessive extension of the lumbar spine
  • repetitive and/or excessive rotation at the lumbar spine
  • a combination of flexion and rotation
  • a combination of extension and rotation

Most back problems originate from one of these mechanisms.  There are different reasons why these injury mechanisms develop.  Lack of hip mobility, lack of thoracic spine mobility, muscle imbalances and compensation patterns in the hips and core, poor posture, and sitting too much are all reasons why back pain these injury mechanisms can end up causing back pain.

One thing that is really important to understand with back problems is that they do go away.  Having back pain at some point in your life doesn’t mean you have to be stuck with this pain all your life.  Even serious back problems such as hernias don’t last forever.  If it needs surgery, you obviously need to get it.  If you don’t need it (which is often the case with low back hernias), according to McGill, the disk will go back in place by itself if you allow it some recovery time.

If the pain persists or come back, it probably means that the source of the pain hasn’t been addressed (note that I said the source, not the symptoms).  As mentioned above, the injury mechanisms that I outlined that are at the source of most back problems need to be addressed.  That might mean to learn to bend over the right way and learning a good hip hinge (e.g. let the hips move and do the work while keeping the spine in a neutral position).  It could also mean learning to get more hip extension when you run instead of having the lumbar spine compensate and extend too much.  There are also many daily behaviors that will need modifications in order to avoid the faulty movement occurring at the spine.

The bottom line is that you need to re-train your body to move the right way.  If you don’t, the pain will keep coming back because the injury mechanism is still there.  There is also usually a big mental component to any back problem, and understandably.  Folks who suffer from back pain often apprehend the pain coming back, whether it’s when they train or just in their daily activities.  Part of the re-training process in teaching good movement patterns and teaching back pain clients to move better is going to be mental and making sure they understand that they are not stuck with that pain their whole life.

It’s THAT important that you explain all of that as well as possible before you drop the word ‘Deadlift’ in front of them.  The deadlift is not only a safe tool, but an essential part of their rehab.  Most of them will associate deadlift with back injury, or think of it as a dangerous exercise for their back.  This couldn’t be any further form the truth.  And obviously deadlift doesn’t mean ‘heavy’ or ‘full range of motion’ right from day 1.  But there is a very under-appreciated rehab component to the deadlift for clients who’ve had back pain.  The deadlift is probably THE best way to teach someone how to hinge at the hips, while keeping their spine in a neutral alignment.  By reinforcing this movement pattern you will help your clients reduce their risk of re-injuring their back.  A very careful approach must be taken though, and no flaws should be allowed in their form before any type of loading is even considered.  The deadlift is really just a hip hinge and everyone should own that movement, whether you lift weights or not.  It’s just a back saver to know how to deadlift the right way.

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