Research continues to show that exercise is the best “treatment” for back pain. But what to do if exercise hurts your back instead of helping?
This is one of the most common frustrations I hear. The doctor looks at her back and takes an x-ray. He or she just sees something like arthritis or degenerative disc disease. An operation makes no sense – therefore the advice is to do sport – and specifically to strengthen the core muscles. But if it doesn’t work, they are at a loss.
Why should exercise hurt your back when the research overwhelmingly shows it is supposed to help? Here are five reasons why …
It’s the wrong kind of exercise
While the research on exercise and back pain is not wrong, it does not always reveal the specifics of the types of exercises being performed. For example, walking is considered one of the best activities for back pain sufferers, and for most it will help significantly. But I also have customers who feel worse when they go to their mailbox at the end of the driveway. What the research really says is that exercise – not necessarily “exercise” – is really good for back pain – even for acute back pain. However, you need to make sure that it is the correct type of exercise for YOUR specific type of back pain. Getting the type of exercise or movement wrong makes you feel worse – and that’s one reason why exercising sometimes hurts your back instead of helping.
Stability training is introduced too early
Stability training is an important part of back pain healing – but I often see it introduced too soon. Mobility is something you always want to look at first. If your spine isn’t fully mobile, there’s a reason. You want to make sure that you fully explore this and move the spine as it should be before you start stabilizing or strengthening it. Every now and then I stabilize first, but that’s rare. I often see people with longstanding back pain suffering from a movement problem that has been overlooked. When your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to become irritated. You’ll want to find that out first before you move on to stability training your core and spine.
You are not activating your core
Knowing how to properly activate your core is different from having a good core power. You can have the strongest abs in the world – but if you don’t use them when they count, your 6-packs are useless. Knowing how to properly activate your core is important when exercising, but especially when it comes to back pain. Failure to properly activate your core when lifting weights or performing complicated movements that require good coordination will prepare you for injury. The ability to properly activate your core is developed through motor control training. Here we are teaching your mind how to recognize and activate certain muscles during certain activities so that they eventually become a habit. Pilates (when done correctly and with a well-trained instructor) can do this pretty well. If your back pain is constant every time you exercise or try to strengthen your core, you may not be able to activate it when it counts.
You are not breathing properly
Failure to breathe properly – or not breathe at all – can seriously affect the effectiveness of your exercise program and prevent you from doing an exercise properly. As mentioned earlier, knowing how to activate your core is crucial in exercising, and in order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abs, your deep back muscles, your pelvic floor, and your diaphragm. Your diaphragm controls your breathing. Let’s say you hold your breath while exercising. When this happens, it means that your diaphragm is not expanding or contracting as much as is necessary for your deep core to function fully. When your diaphragm is not working as it should, your back muscles are putting unnecessary strain and strain on your back muscles. This is one reason you may not be able to properly activate your core – and why exercise can hurt your back.
You are using the wrong form
The final, and most common, reason exercise can hurt your back is because you’re not getting it right. There are a lot of people out there who think that posture and shape don’t really matter. But they do. When you lift weights – especially if it’s frequent and repetitive – you want your spine to be well aligned. It may not hurt the first time you work out with the wrong form, but it will hurt when you hit your 100th rep. The same applies to body weight exercises. Just because you’re not putting any strain on your spine doesn’t mean you can’t make it worse by doing something in bad shape over and over again. That’s really where people get into trouble. If you want to exercise – and you want to exercise daily – do so with the correct form and posture or it will catch up with you and cause you unnecessary back pain.
If exercising is currently hurting your back, it could be one of these 5 things. Get expert help figuring out which it could be – because at the end of the day, exercise is good for your back. Maybe you just need some help getting there first.
Dr. Carrie Jose, physical therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch with her or to get a place in her Pilates 101: Get it [Your] Back on the health program, email her at firstname.lastname@example.org or call 603-380-7902.