Physiotherapists Get Back Pain Too
My name is Steph, I am a physiotherapist, and I have had acute back pain.
It started last week.
It's still here this week.
And it's not even the first time it's happened.
You might think that, as a physiotherapist, I'd have all the tools and tricks to prevent a debilitating episode of back pain, but there's no vaccine for injury. You might think that, as a yoga teacher, I'm bendy and bendy people shouldn't get back pain. I did, and now I'm here to share my experience in hope that it will help you.
Last week I was strength training, something that I love to do, and incorporate into my training several times per week. I've recently started working on lowering the depth of my banded box squats, adding more weight to the bar, and maintaining control and awareness. I've had a history of low back injuries, but it's been much better since I've increased strength training, last week I had more than my body weight on the bar, which I've done successfully before, when I hurt myself.
Maybe my form broke for a second, maybe I was overtired that day, maybe it was too much weight for how low the box was, maybe it was just dumb luck. I can't tell you exactly what caused my back pain, but I can tell you that it was a quick "pop," sharp pain, and immediately I knew I had gone too far. I had difficulty with any movement through my back, I had trouble weight-bearing on my left leg, I couldn't take a full stride, and I certainly couldn't tie my shoes. I don't write this to make you feel bad for me, I write it because as I was having difficulty with even these basic tasks, I was immediately reminded of what so many patients had told me about their back pain.
I want to share my experience with you, and what I did about it. As I sit here, almost two weeks since my initial injury, I'm moving much easier, I'm starting back into modified exercise, I'm doing all my normal activities and chores, and I might even be able to play hockey this weekend. I still have some symptoms, but they're controlled, and in another week I'll be 95% better (barring anything crazy happening!). Not all back pain is created equally, and this is general advice for how to move through the most acute stages of back pain. We always recommend going through this journey with the help of a medical professional, but for those DIY'ers out there, this is for you.
Keep reading for 5 lessons on how to treat your back pain, plus a 15-minute yoga flow that I used multiple times each day to help me get moving sooner.
So, You've Hurt Your Back. Now What?
As muscles begin to spasm and pain settles in, the best thing you can do is keep moving, gentle walking, gentle movements, anything at all to keep moving. The most important thing to remember is that you're EXTREMELY unlikely to be doing further damage to yourself simply by moving. Pain is your nervous system being... well... nervous, and often times gentle movements help calm down the system. Figure out what you can do, and do a little more moving each day. Wondering what pain is okay pain? Check out our blog post with a simple stoplight system that you can use today to help guide your movements.
Everyone's first tendency when they're in pain is to bare down, hold tight, brace, and avoid any movement that might make things "worse." Here's the thing, that squeeze may actually make things worse. So how can you deal with this? Find a comfortable position, whether it's sitting, lying down, or simply standing with your hands on a counter. Once you're there, take a deep breath in through your belly. As you inhale, concentrate on letting everything go. You might think about melting into the floor if you're lying down, getting swallowed up by the couch or chair if you're sitting, or letting gravity pull all your tight muscles downwards if you're standing up. Whatever cue you need, practice this for a minute and see how you feel.
ACTIVE REST AND MODIFIED MOVEMENTS
Remember that stoplight? Listen to it (or read the post here). Change your movements within your regular workouts (as you get back to them) to match activities that are less aggravating for your back. This might mean doing a kettlebell deadlift or sumo deadlift instead of a squat or conventional deadlift, biking instead of rowing or running to warm up, bench press instead of push ups, or seated press instead of standing. The important thing to remember is that "no pain, no gain" isn't an optimal strategy. Build in more rest as you need it, and you may have to, at least in the beginning, switch your workout modality all together (hence, the yoga video at the end of this post!).
Early stages of an injury are where you shouldn't be afraid to support your healing. That might mean taking Tylenol for pain, even when you're a dedicated pill-avoider. Heat and cold are another helpful strategy. You can alternate hot and cold packs, or alternate hot and cold in the shower to ease tight muscles. If you have a preference for one or the other, use the one you like most. Try an epsom salt bath if you're able to get up and down from the tub. Use muscle rubs or creams that you've had luck with in the past. Whatever you need to do to help yourself move better during the day, and sleep better at night is on the table.
Rome wasn't built in a day, and the back pain that came with building it didn't resolve overnight. Statistically, 80% of back pain cases have resolved completely in six weeks. That number jumps to 98% after twelve weeks. That doesn't mean you feel the way you're feeling right now for twelve weeks, it just means you might get reminders over that time. Either way, the vast majority of cases are going to go away. Getting help from a registered health professional like ours at CONNECT can help expedite that process, but it's important to remember that you ARE going to get better.
Now, How Do I Start Moving Again?
This is a gentle yoga sequence that I started doing shortly after I hurt my back. I did what I could to start, spent more time on comfortable poses and built up each day to spend more time on the challenging ones. Scroll down for a description of the sequence, and feel free to mix and match the poses to whatever best serves your back pain!
As I write this, my back pain has improved drastically. I'm moving faster, I'm lifting weights, I'm participating fully in the yoga classes that I teach, and I'm only occasionally reminded of the pain I had last week. My back is strong. My back is resilient. I'll be back to lifting heavier again soon because I know that, even though they are how I hurt my back this time, they do a lot to prevent the episodes I've had in the past.
Staying strong and active during and after an injury, rather than avoiding things because they might hurt is what we call the "try anything once" approach at CONNECT. The next time your back hurts, or if you just want to get ahead of a problem, consider tackling it with the help of our CONNECT team.
Start on your back
Single Knee To Chest
Bring one leg up toward you, keeping the other knee bent or straight out in front of you. Switch sides. Hold for a few breaths and repeat as you wish.
Double Knee To Chest
Bring both knees up toward you, add a little gentle rocking if that would feel good, or just relax into the stretch.
Take your feet down to the mat and the soles of your feet together, allow your knees to fall out to the sides, press your feet into each other and then relax. Allow your knees to come back up and and down as many times as feel good.
Knee/Low Back Sways
Take your feet back to hip width apart and start swaying your knees back and forth, moving with your breath and pausing at either side if it feels good to stay there.
Press your feet into the ground, inhale first, and then on the exhale lift your hips up, squeezing your glutes and trying to keep your pelvic/low back still. Repeat a few times inhaling down, and exhaling back up.
Next, roll to your side and slowly push up coming to your hands and knees in table
Start to round and arch your back, rounding up, dropping your head, tucking under your tailbone, and then arching up, lifting your head and sticking out your tailbone. Gently move back forth.
Calf And Side Bend Stretch
Take one leg out behind you, landing on your toes, and stretching through your calf, trying to keep a neutral spine. Then take your foot up and over to the other side of your body stretching through your side. If it feels ok look back over your shoulder at your foot. Breathe into your side, holding for a few breaths. Repeat on the opposite side.
Come back into hands and knees and find your breath. On a slow exhale take weight through your hands and toes, and lift your knees up off the mat about 1 inch. Pause and then lower back down. You can start to hold the lift for a couple breaths, or just with 1 breath.
As a progression if the knee hovers are feeling ok, lift the hips up into downward dog, keeping the knees a little bent and aiming for a flat back with head in between the arms
Use a table or a block for your hands, and step a foot forward into a knee down lunge. Keeping your hands on your knee or blocks rock a little bit back and forth getting movement through the hips and pelvis. Switch sides.
Next either stand up from kneeling or slowly through a forward bend.
From standing, hinge at the hips, walking your hands down your thighs until you feel a nice stretch, pause and then walk your hands back up. Repeat this a few times.
Shift your weight to one foot, lifting the other foot to the inside of your ankle or leg, balance on one side taking nice breaths. Repeat on the other side.
Feel free to share this video with someone you know who might benefit from a little bit of gentle movement to ease and get them through their back pain.
Stephanie Sollazzo is a Registered Physiotherapist, wife, mother, yoga teacher, and self-professed lover of homemade Italian food (especially when her sons make the noodles). She is passionate about helping moms return to activity after pregnancy, and working with children of all ability levels. If you can't find Steph at CONNECT, the only place to look for her is on a beach. To book an appointment with Stephanie, click here