‘Back to the Future’ Isn’t Just a Movie
Your lower back keeps you upright. It's the "hinge" in the middle of your body, allowing you to bend fully and stand with "good" posture. Throughout much of our childhood and teen years, we are painfully "unaware" of how much punishment our lower back goes through. It carries us through dance recitals, football practice, gymnastics events, jumping on trampolines and much more. We bend, twist, flex and extend to our hearts' content trusting our bodies will conform to our needs without as much as a peep or twinge of discomfort. Much of what is felt at these times is usually dismissed as growing pains or the normal bumps and bruises of childhood.
It's usually in our maturing that we get to taste a little of what is to come, lifting or carrying a little more than we are accustomed to, then we begin to understand that even our bodies have some limitations. By the time low back trauma is really adding up, we may take a rest, maybe a pain-relieving medication or put an ice pack on it (or, in my experience, ignore the problem altogether).
Usually, by the third or fourth decade of life, we can really get a wake-up call with the accumulation of repeated injuries or insults to the lower back can become more of a consistent presence in our lives. It's unfortunately also some of the busiest times in our lives with a lot of competing demands on our time, and the tendency to "put off" self-care is a great challenge.
The spine, muscles, nerves and connective tissue that make up the lower back are pretty injury resistant in most cases. There are a few areas of the lumbar region (lower back) that have great mobility and, thus, are more susceptible to injury. The lower back is also the main weight-bearing part of the spine. The most mobile areas are in the lower lumbar region (lumbar levels L3-4, L4-5 and L5-S1). These three levels account for nearly 50 degrees of normal movement in flexion and extension of the lumbar spine. With all that mobility comes a greater risk of injury or overload. One of the primary ways of protecting this area from injury is to build up muscle strength that supports the spine through this broad range of motion.
My approach is to promote a balance of muscular power and flexibility. Power will be needed to maintain proper alignment and provide a controlling factor in the body to reduce strain or overload of isolated muscles, nerves and connective tissue. Flexibility is important to allow natural elongation (stretch and shortening) of elastic tissue to ensure no area gets pulled beyond its natural length or shortened too much where it cannot provide support. I find it's best to examine patterns of human behavior, daily tendencies and a person's physical build. I use these to better understand the person's potential sources of injury or repeat injury.
At the DIY level – what YOU can do:
• Stay fit (exercise regularly, focusing on strength and flexibility at least 3-5x/week).
• Keep a healthy BMI (weight to body size ratio).
• Learn proper lifting techniques and use them!
• Keep postures symmetrical where possible; pay attention to work and leisure patterns that result in pain.
• Treat any sprains or strains quickly and support/restrengthen them as soon as the pain subsides.
• Don't ignore problems or try to just work through them; seek professional help.
At the professional level – see your physical therapist:
• Take an inventory of how many times you have been injured to the region(s) affected
• Look (again) at patterns of postures and behaviors with your therapist and come up with a plan.
• Examine your beliefs (some think surgery or chronic pain treatment are the only viable option). It's not!
• Build power and strength in isolation exercises.
• Regain flexibility to all areas contributing to the pain generating region(s).
• Look at a pain control plan and reduce the need for medication, injections and potential side-effects.
• Modify or stop activities that complicate recovery and improve return to normal behavior.
If your future plans include potential surgery or permanent alternatives to the above recommendations:
• Consider if you have fully pursued all the conservative options you are comfortable with.
• What will be the likelihood that surgery or permanent changes will provide you with long-term improvements?
• Speak with several (three or more) patients who have done the procedures you have considered to get a good postprocedure perspective.
Ultimately, your future is brightest when you keep your "eye on the prize," and don't lose your focus on taking care of yourself.
To get help with your back from Dr. Redmond and the rest of the team at Eberhardt Physical Therapy, Nutrition and Wellness Clinic, call 318-222-7442 or visit www.eberhardtpt.com.