I recently received a lengthy email from someone filling me in on their back problems going back eight years.

He had a disc problem in his lower back that called for surgery. He was looking for a therapist who would take someone on with chronic back issues. 

Past therapies he endured included passive modalities such as TENS and ultrasound. He said he has an exercise routine but isn’t consistent with it. When he exercises, his back flares up.

WHERE TO START?

During a typical physiotherapy assessment, I start by looking at the alignment of the body. Is the pelvis resting properly, and what is the mid- to upper-back doing? The muscles of our bodies are both short (cross only one joint) and long (cross more than one joint). In our backs we have muscles that cross several spinal segments.

What is happening at the hips and mid-back? Even our shoulder can effect what’s going on in our lower back.

The lower back is not meant to twist. Twisting comes from the hips and mid-back. If these are tight, twisting happens in the lower back. The result then is a breakdown of the joint stabilizing system and discs. 

BALANCING THE MUSCLES

The best treatment technique I have come across for releasing tight muscles is Intramuscular Stimulation (IMS www.istop.org). If there are tissue adhesions and fascial tightness in conjunction with tight, ropy, reactive, shortened bands of muscles, then the addition of massage therapy techniques, with stretching is hugely beneficial.

MOBLIZING THE JOINTS

If there’s a joint that’s stiff or stuck (not moving or hypomobile), mobilization and/or manipulative techniques are useful to get it unstuck. 

RETRAINING THE SYSTEM

Once the system/body is properly aligned with more normal muscle tension (not over-reacting to all your movements and activities) then I look at re-training the system (re-programming) it to work at its best.

DID YOU KNOW?

We tend to run on autopilot most of the time? We only use about five per cent of our conscious brain throughout the day. Most of what we do runs off of our subconscious programming. 

Re-training your muscles takes concentration and repetition (in other words time and dedication). 

It’s like when you first get behind the wheel of a car. You need to focus on what you’re doing at all times and thinking about every move. 

It’s like learning to walk again after a brain injury or stroke. It can be done but you have to do the work. 

It’s not just about going back to the gym, starting back into running or taking up boot camp. You will just run those old, automatic brain patterns when you do these activities. 

NANCY MCNEIL is a local personal trainer (www.forever-fit.ca) who runs a back fit class that was developed in conjunction with me. The focus is on re-training the core from the inside out. You start by finding your inner core muscles, then progressively work on more challenging core exercises. The goal is to be able to engage the inner core muscles while doing certain movements without the compensatory muscles kicking in. 

I also refer my clients to Pilates instructors or a Somatics group (www.appliedsomatics.com)  in town to help with supervised muscle re-training exercises.

SELF CARE

When it comes to care of the body, it does not matter whether it’s the back, shoulder, knee, hip, elbow or neck, it requires work on your part. The therapist is there to assist while you release certain muscles or joints that need releasing. A client (you) can take a pro-active approach and do self release or massage techniques and stretching. The therapist can show you exercises that will be most beneficial for re-training and strengthening, but we can’t do them for you. 

We can advise you what activities you should avoid and when, but we can’t keep tabs on you at all times.

It’s your body and the only one you get in this lifetime. Help it last a lifetime by giving it the maintenance it needs. 

Give it a rest when it needs it and fuel so it can function optimally and heal well.

IF YOU’RE MOTIVATED:

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