How To Cure Lower Back Pain Without Seeing A Physio
This article is something I wish I had read 5 years ago. It's written for people too stubborn to see a physiotherapist. Men with the 'I can do it myself' attitude.
Men like me.
I want to show you how you can self-solve your lower back troubles in 5 steps.
1. Increase core endurance through low-load exercises.
2. Learn to move sparing the lower back.
3. Increase mobility through the hips and upper back.
4. Walk with a purpose every day.
5. Decrease any aggravating activities.
By the end of this article, you will master each of these and be able to start your self-curing journey today.
Straight away I'll precursor this article by saying; this is not medical advice. This is purely anecdotal and backed up by some research. I am not saying you shouldn't see a physiotherapist. I'm only offering some things which may help you as an alternative.
We cool? Alright, moving on.
The air was thick with tension. It was roughly five years ago and I was going for a big squat record. Rage Against the Machine blasting into my ears. I wanted three reps and unless the devil himself came out and struck me down, I was going to get three reps.
Rep 1 was good. Solid form. Happy Michael.
Rep 2. Harder. Got it up. Good.
Rep 3. The bottom of the squat almost swallowed me up. Veins like a roadmap pulsed on my forehead. I kept pushing up with everything I had.
Something went. I could barely breath. There was excruciating pain in my lower back. I was done for.
It was a long process to come back from my lower back injury. Partly because I did it solo. I read everything on the topic and tried everything under the sun. Eventually, it did get better.
There was a positive to my stubbornness. I learned a hell of a lot about lower back pain. The type of useful information that can actually help people. As a trainer, I've been blessed to be able to put this knowledge to use and help many others rehab their own pain. Through rehabbing my own back and helping many others, I've picked up on some key insights. Each being as important as the next.
Here are 5 ways to self-cure your lower back pain.
1. Increase core endurance through low-load, neutral exercises.
When you have lower back pain, you know you need to do something for your core. But what?
Sit-ups? Hell no.
Planks? Too much load.
Crunches? Please don't.
Then WHAT!? Read on, friend.
The core is primarily made up of a bunch of stabilising muscles. They form a network across your torso. Imagine it as guy wires attaching to a tower.
If these wires are lost your lower back needs to get stability from other muscles. These muscles have other jobs. They don't like to help. And if they are called upon, they will retaliate by getting tight.
The most important thing is to never need the other muscles in the first place. Your core should have enough endurance to always be in control. Most people with lower back pain have poor core endurance.
But, you can't just go and do a bunch of sit-ups and expect to feel better.
The goal is to increase core endurance through low-load exercises. These are exercises which don't put strain on the supporting structures and don't rely on you flexing and extending your lower back.
This means most of the exercises are done in the neutral position.
Neutral is a position where there is a natural curve in your lower back. It is not overly arched or flattened out. This position is where your lower back is happiest, so it makes sense to do your core training from this position.
How to train core endurance, in neutral, without loading your spine.
Dr. Stuart McGill (world's leading lower back pain expert) has his 'big three', which are the best three exercises to train core endurance with minimal loading on the spine.
One is the curl-up (it's not a crunch).
The next one is the superman (or bird-dog).
And finally, he finds the side plank an invaluable exercise for lower back rehab.
These three exercises should be your bread-and-butter. He prescribes some particular set and rep schemes. To save this article going out on a tangent, click here to see them. CLICK ME FOR BACKSAVERS.
For further insight into how these three exercises can cure your lower back, check out this article on the 'big three'.
Who wants to do only three exercises? Not me...
We can take these three exercises and use them as the core of your routine. Then, add in a few more for some flavour. Still keeping the load low and neutral position, these five exercises will further improve your core endurance.
Core endurance is incredibly important for lower back pain rehabilitation. The problem is, many people aren't aware of how to train their core for endurance in a safe manner. Hopefully this step gave you some ideas to get started.
2. Learn how to move sparing the lower back.
The primary solution to lower back pain comes from fixing the movement patterns which caused it to start hurting in the first place. This ensures that your won't hurt it again after you fix it.
You want to be moving through your hips and upper back.
Moving through these joints allows your lower back to always be in a stable position. You want to be proficient in the movement patterns which allow you to move freely (like bend, squat, lunge, rotate). Doing them in a lower back sparing manner is the key to solving your pains for good.
Learn the hip hinge.
This single movement is also known as the 'lower back saver' and 'humping the air'. Whatever you choose to call it, it works.
The hip hinge is a way of bending over using your hip joint (rather than lower back). It is supported by the muscles of the hamstrings and glutes (rather than the lower back muscles). We are clearly avoiding use of the lower back.
Learning the hip hinge gives you the ability to bend over without snapping your spine in half.
Here's how you can start air-humping, I mean hip hinging... You only need a wall.
Sneaky tricks of the trade for lifting objects pain-free.
Lift with your legs.
The warning on those big cardboard boxes were right. If the object is the right size, squat with your legs to pick it up. Don't bend over.
Keep objects close to your body.
Imagine holding a baby on your chest. Not too bad. Imagine that same baby just spewed and you're now holding it at arms length. It's a lot harder to maintain this position. Your shoulders begin to ache and back will soon give out.
The closer and object is to your body, the better. If you are carrying an object, always have it touching your body. If you have to pick something up, get as close as possible to it first. No reaching.
Use the golfer's pick-up.
A pro golfer's livelihood is in his back. He know's he needs to minimise any risk. The golfer's pick up is a technique to pick up smaller, lighter objects in a safe manner.
Two things you NEVER want to do.
Your spine is made up of bones stacked on top of each other. Between the bones are discs. These discs are filled with fluid. You want, with all your heart, for this fluid to stay in the disc and for the discs to stay between the bones. There are two movements which put these discs in their most vulnerable position, and they are primarily how people injure their lower backs.
1. Loaded flexion.
Loaded flexion happens when you are bent over, in a poor position, and pick something up. When you curve your spine, think about how the vertebrae bones look.
Loading the spine in this position is asking for trouble. You can see in the picture how the disc almost has to come out of the back. It's being pushed out. This position must never, ever happen.
2. The reach and rotate.
Similarly to the loaded flexion, you are bending forward, but this time you are reaching with one hand and rotating at your lower back. This also can put the discs in a very awkward position and makes it easy for them to slip out of position (or burst). Never over reach for something.
3. Increase mobility through the hips and upper back.
The previous point I made was to use your hips and upper back to move. This allows your lower back to always be in a strong, stable position.
The problem is, many people are Incredibly stiff. Their hips and upper back have terrible mobility. This is often how lower back pain comes on in the first place.
Imagine a pole with three joints. The top joint being your upper back, middle being your lower back and bottom being your hips.
If they all move through a full range, the middle joint can stay still and you can still move it freely.
If either the top of bottom joint is stiff, the middle joint (lower back) will have to move around a little to compensate. It doesn't like this.
If both the top and bottom joints are stiff, the middle joint will have to do most of the moving. It can't be stable. It must provide range of motion so the pole can move.
You are the pole and if you have a tight upper back or lack hip mobility, your lower back hates you.
Without mobility in those areas, your lower back must provide movement. The area that likes to be stable now has to flex and extend all day to compensate for your lack of mobility. Muscles get overworked and tight. The pain receptors get sensitive. You get lower back pain.
The easiest way to fix this is to improve your upper back and hip mobility. This will reduce how reliant you are on your lower back for movement. Let's run through some drills for each area.
Open the book
Foam roller extensions
Hip flexor stretch
Supported deep squat
One final point before we move on is as follows:
Do not do any movement drills right out of bed. Wait 15-30 minutes.
When you sleep, you are laying down (usually). The effects of gravity aren't causing any compression on your spine as it would if you were standing. Therefore, water can seep into the discs between your vertebrae. Over the night, they become engorged with water and unstable. It's normal, don't worry.
When you wake up, they are still unstable. Standing upright begins the process of dehydration. During this period of instability, its a good idea not to bend your lower back in any direction or put any load through it. Instead, walk around, stand while the kettle boils, have a shower. Try to remember your back is at it's most sensitive and most vulnerable point during this time.
Give your lower back 15-30 minutes to 'wake up'.
4. Walk with a purpose every day.
Walking is the single best thing you can do for your back. There are a few reasons for this.
Number one is lubrication.
Movement! Your body loves you for it. Muscles release tension as they get to naturally flex and stretch they were made to. Walking is the simplest low-load movement you can do. As your torso and hips slightly rotate with each stride, you gently lubricate your spine and give the surrounding muscles some love.
The second is pain management.
Walking is generally a pain-free activity. Any exercise you can do which is pain-free is good for you. Over time, this sensation of being able to move around without pain will extend to other activities. The pain becomes less noticeable as you become fitter.
And the final reason is progression.
Walking is easy to progress. You can easily monitor how far you have walked, then next time build upon that.
You walked for 15-minutes today. Tomorrow, try and walk for 20-minutes.
You walked around the block once today. Tomorrow, walk around it twice.
Having something which allows you to visually see your progress is great. With lower back pain, it is notoriously hard to monitor improvements. Walking allows you to step away from the pain-scale and see progress elsewhere (which will inherently help your back).
How to walk.
I assume only adults read my articles, so I know you know how to walk.
But there's 'walking' and then there's 'walking'.
The walking we want (the style which reduces lower back pain) is one of purpose. A gentle hand swing with comfortably long steps and a slight rotation of the torso as the hands swing back and forth. Nothing special.
Mainly, what we don't want is your phone in your hand. This means your neck will be cranked downwards, one arm won't be swinging (no lubrication) and yu will have slow, shuffling steps. That won't help.
Walk with a purpose.
5. Decrease any aggravating activities.
There's a bandwidth of tolerance your lower back can handle.
Sensitive to begin. Allow pain to subside.
You probably already know the activities that hurt your lower back.
STOP DOING THESE.
I shouldn't have to say that, but I've seen things...
Right now, you have a pain threshold. Things will feel fine on the lower back, then suddenly, you reach the threshold and things become a little uncomfortable.
The threshold is your lower backs tolerance. It refers to how sensitive the nerves are around the area. If you have low tolerance, the nerves are very sensitive and anything can set them off, sending pain signals to your brain
The best way to increase tolerance is to not stimulate the nerves. Stop doing anything which causes pain. Allow them to subside and stop being so sensitive.
This requires you to be careful. One wrong move and you're back to square one. You have to always be aware of your lower back and never put it in a position which could cause pain (at least until the nerves chill out).
Lower back pain tends to be an injury which sticks around for life. This is because your lower back is used in a lot of movements. People with pain never give the lower back a chance to recover.
Take responsibility for your lower back. It can be fixed, but you have to chip away at it consistently. No slip ups.
If these steps aren't your cup of tea, I have one more solution for you to try before you throw in the towel.
Play the surgery game.
Pretend you just had lower back surgery to cure your pain. Yep, you went under the knife of a surgeon in a hospital and he cut you up. He fixed you. Now, go through the full rehabilitation protocol. This includes a huge amount of rest.
Interestingly enough, McGill has tried this with many of his patients who were in agonising pain, and it has worked. They simply needed to take a step back and rest. I mean, really rest!
Avoiding surgery at all costs is good advice. Once the knife goes in you will always be hindered in some way. If there's a way to get around that, use it.
The five ways to self-cure your lower back pain feed off of each other.
They work in perfect harmony. If you neglect one area, the whole song will be out of tune. And your back won't feel any better.
If you want my advice on exactly what to do next; here's what I recommend:
1. Make your own routine from the exercises and mobility drills provided. 10-15 minutes worth of core endurance and hip/upper back mobilisations. Begin doing this twice a day, every day.
2. Start a habit of walking daily. For your first walk, make it super easy, such as walking around the block. Then next time, walk around the block twice. Build your own progression up to two 30-minute walks a day. No rush to get there though, take it slow.
3. Become super aware of how you move. Always be cautious of loading your spine in any way. This includes picking up a sock off the floor. Think of ways you can make movements easier of your back. If you need to, ask someone to help.
Your lower back is the most precious thing for long-term health. Take care of it and it will support you for your whole life. Disregard it, and it will haunt you.
Before you go and drop-kick lower back pain out of your life, know this.
Not all back pain is the same.
There are various things that could be causing your trouble. This article is a good guideline for 'most' to follow, but does not replace seeing a professional in person.
Alright, that's enough from me.
I know this article was a lot to take in, so, as always, please feel free to message me here with any questions. I'd like to support you in any way possible.
All the best on your self-curing adventures!