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Back Pain Myths

As I spend more and more time treating patients from all sorts of backgrounds with “lower back pain”, there are a few common beliefs about back pain people have. At the end of the day, who know where this information comes from – the internet, a friend who told a friend who told another friend, who told you, another practitioner? In this day and age there is SO MUCH information out there it can be daunting to try and figure out what is truth and what is just down right false. However, that is just science. It is constantly changing and adapting with research and trial and error. Remember when smoking was a thing?? And people thought it was actually GOOD for you? Obviously, we know a little better now. Here are a couple myths I would like to discuss:

Myth 1: Back pain is due to my tight hamstrings

Research has found that in most cases, tight hamstrings are a secondary cause of lower back issues rather than a primary cause. As I have seen, hamstrings often decrease in tightness as lower back pain decreases. Whoa! Everything is connected?!

With that being said, when one hamstring is tighter than the other, it causes an asymmetry. This imbalance is what can have an influence on back pain.

At the same time, TIGHT does NOT mean OVERACTIVE. I find allllll the time people are stretching, rolling, and/or massaging their hamstrings! What if you actually had WEAK hamstrings? Then why would you continue to stretch and release them?

Myth 2: Resting will fix my back pain

Actually, being static (no movement) for extended periods actually causes lower back pain.

Did you know that we are all actually taller first thing in the morning than we are before we go to bed at night. Did you also know that we shrink as we age? I’m assuming your 95 year old grandmother was not always THAT much shorter than you. This comes down to one thing: inter-vertebral discs. The discs in between each of our vertebrae are packed with water loving proteins.

When we lie in bed, the discs fill with water and gently push the vertebrae away from one another, lengthening the spine. The reason our backs are often stiff in the morning is that the discs are so full of water, they become much harder to move. When we get up in the morning and our spine becomes vertical, gravity can now work and the fluid in the discs begins to move out. You may feel after an hour or two, you are back to normal and the stiffness has dissipated.

Myth 3: Yoga and Pilates will help my back problems

At the end of the day, I love movement! Anything that you enjoy that gets you moving is always better than the alternative: doing jack squat.

However, when you are in pain and dealing with an injury, these exercises may just not be the best “fit” for you at the end of the day. While some poses and movements may “feel good” at the time, there are components of both exercises that can irritate an individual with back pain. There is no such thing as a one size fits all program that can help everyone who sufferers with back pain. Therefore, to recommend yoga or Pilates to a patient with lower back pain without doing some type of exam/ movement screen, is not doing that patient justice.

Every single exercise should specifically tailored to that individual.

One of the specific movements in Pilates that may be some what irritating to a patient with lower back pain is the “sucking in” and/or flattening of the spine. We all have a natural curve aka a lordosis. It is there for a reason. To have someone who is already in pain due to their increased sensitivity, the action of “straightening” out the curve just isn’t the most efficient movement for THEM. At the same time, people tend to also “suck in” their diaphragm. The diaphragm is our primary muscle of respiration, its meant to expand 360 degrees with each breath. Sucking in tends to prevent that motion from occurring. This is just perpetuating the inefficient breath pattern – breathing vertically versus horizontally.

The overall real goal for lower back pain sufferers should be to minimize spinal movement and instead create movement from a stable, neutral spine as our center of motion.

Myth 4: Stretching will fix my back!

How many times have you heard or thought this?? You just need to stretch more. There is no such thing as a stretch that is good for everybody. At the same time, there is no singular cause of pain. Each back pain story is different, and as such each movement (whether stretch, release, technique, and/or activation/exercises) needs to be specific to that story. Again, tightness does NOT always mean it is overactive. Sometimes, believe it or not, tightness can mean the opposite – WEAK. Why would you continue to stretch, roll out, and/or foam roll something that is weak? That is literally sending the wrong signals to your motor control centers. The reason stretching feels good because it activates our stretch receptors, which in turn become desensitized. Less sensitivity leads to less pain. This is very short term relief. However, people that repeat this process over and over and over again fall into a vicious cycle. Each time those stretch receptors get activated more and more, the weaker and weaker those muscles become. Think about a rubber band that has been used over and over again. At some point, that initial elasticity is gone.

So, what do we do instead? Concentrate on stabilizing and controlling your spine. Keeping your spine neutral will help reduce triggering positions and in turn gives your discs less strain, which leads to a decrease in pain.


Bottom Line:

At the end of the day, everyone’s back pain story is different. We forget how many other factors can play into pain: diet, emotional stresses, belief systems, anxiety, work stress, lack of social support, and so forth. Therefore, everyone’s path to recovery will be quite different. There is no one size fits all fix.

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