Relieve Low Back Pain | Reduce Low Back Pain | Canada's Leading Authority in Human Movement | Dev Chengkalath

If you want to relieve your low back pain, unload your spine.

As I’ve stated before, in my physical therapy practice in Toronto, I see a lot of bad backs. Many of these people have tried all sorts of “solutions” for their back pain, but none of them seem to work.

Usually, one of these solutions is exercise.

As I’m sure you can infer from my blog, I am a HUGE advocate for exercise in relieving low back pain. However, not all exercises are applicable in the treatment of this dysfunction for everyone. Doing any old exercise is not how you fix your bad back. 

Where do most people go wrong with their exercise choices?

Typically, as discussed in the previous post, a lot of people crank their training volume too high. To recap, doing too many exercises or too many repetitions can lead to form failure or sloppy technique, which only puts vulnerable tissues at greater risk to injury or irritation. 

Another major exercise error is overloading the spine. 

Spinal Loading Arnold Style

When certain tissues are injured, they don’t respond to being loaded (essentially, made to work) the same way that uninjured tissues do. 

So what’s the solution?

Unload.

This just means don’t lift as much, don’t push as much, don’t pull as much. Don’t do as much.

This does NOT mean do nothing. 

This just means you need to make sure that you are challenging your tissues, but not overdoing it.

You are stimulating them to repair, not breaking them down through excessive exercise.

The key is to work within your capacity, always maintaining neutral spine and making sure your form is bang on.

So spare your spine and unload.

Dev Chengkalath

In North America, and many other places across the globe, we equate value with volume.

When we go to restaurants, we want heaping servings and overflowing plates. We want non-stop soda-pop and endless French fries.

Would you like a heart attack with that?

We want massive volumes of food for the dollars we spend. This is what we take as value.

In the gym, we think pushing ourselves until we vomit is better for us. We think doing more reps, more sets and more exercises is our salvation. We take this “hard work” as being optimal for our health and fitness.

We have it ingrained into our minds that More is better. More is better. More is better.

More is not always better.

In my experience as a physical therapist and human movement specialist, this is especially true when relieving low back pain through exercise.

Training when you’re injured is not the same as training when you’re healthy.

Sure, some of the principles may be the same but the major aim of the intervention is different, the goals are different. Or they should be!

When exercising to relieve low back pain, high performance should not be your primary objective. Motor control and return to function should be. Once you have gained or regained control again, then you can switch focus back onto optimizing performance.

After an injury to your low back, your first steps should be to get out of pain and find the root causes.

Your next steps should be to re-learn how to move your body efficiently while protecting your back.  You need to be able to find that pain free zone and keep it.

The volume of your exercise program should always allow for perfect practice. Because perfect practice makes perfect. Practice just makes permanent.

Imperfection is not an option

If you’re cranking out set after set and rep after rep of an exercise, your odds of fatiguing and losing control of a movement are much higher. Your execution of a given exercise may get sloppy. Your movement patterns may get lazy. Your risk goes up. Your benefit goes down.

And in the end, a safe exercise could become a dangerous one. 

Train smart, not just hard.

Dev Chengkalath

In dealing with exercise errors and low back pain, poor warm-ups rank right up there as major contributors to either keeping you in pain, or getting you there. 

What do I mean by poor warm-ups?

Take a quick look around any of your neighbourhood gyms or fitness studios and you’ll see that most people walk out of the change rooms and straight to their favourite piece of equipment. They will then proceed to get on with their lifts or exercises without a care in the world. 

In many cases, poor warm-up actually means NO warm-up!

Sure, you may see a few obligatory static stretches thrown in after a few minutes on the treadmill, but you’ll seldom see a well designed or consistently applied dynamic warm-up which follows the principles I discussed in my free report (if you haven’t already done so, sign up for the free report at the end of this post. It’s FREE!). 

Why is that a problem?

Well, how many of those people have spent their day sitting at a desk? Or sitting in a car? Or slouched on the couch?

The point of the warm-up is to PRIME your body for optimal health and performance.

After a day of poor postures and bad habits, shouldn’t you get your body ready to face the rigours of your exercise program? And wouldn’t this seem even more important if you were trying to relieve your low back pain?

Basically, if your body isn’t warmed up properly, all the systems that come into play may not be functioning at the level they need to be working at to keep you healthy and pain free.

This takes us back to the risk/benefit ratio. 

By not warming up appropriately, your level of risk goes up, while your level of benefit goes down.

And for relieving low back pain, this is not the position you want to be in.

So reduce your risk. Use trojan.

And after that, reduce your risk some more by warming up properly.

Yours in movement.

Dev Chengkalath

P.S. Don’t forget to sign up below for my FREE report on Athletic Warm-Up for Optimal Performance

There are very few exercises that are inherently safe or inherently dangerous.

In the case of low back pain, what will push an exercise into either of the above two categories is the application of said exercise.

As a physical therapist in Toronto, I come across this situation often. This becomes a delicate balancing act between the risk and the benefit of a chosen exercise to that particular client with their particular brand of low back pain (basically, what is the “cause” of their problem).

In my experience, the following are the primary exercise errors that may increase your risk of acquiring or perpetuating a low back injury:

1. Poor warm-up
2. Too much volume
3. Too much load
4. Poor technique
5. Biomechanical fault (e.g. injury, body type etc)

Over the next few days, I’ll dig a bit deeper into each of these.

Yours in movement.

Dev Chengkalath

As a physical therapist in Toronto who treats a lot of low back pain, a significant part of my job is to educate my clients on how they can become their own healers.

My goal is to not only enable them to get themselves out of pain, but to keep them that way.

Permanently.

As part of my client education, I always define three words:

Cause. Source. Symptoms.

By defining these, my clients should have a better understanding of what it really takes to relieve their low back pain and get back to enjoying life. 

Enjoy your life, pain free.

The Cause: The producer of an effect.

For low back pain, the end effect is a negative one. The “cause” is what leads to the direct, or more often, indirect, production of the pain, pathology and dysfunction.  For example, in some low back pain cases, repeated lumbar spine flexion and rotation movements put excess pressure on the discs. The discs wear out and bulge. This bulge in turn puts pressure on a nerve root, which then leads to pain to shooting down the leg.

In other cases, the cause may be repeated poor postures (think slouching in front of a computer or TV) for hours on end. This then leads to stretching or trauma over time to certain tissues such as the ligaments. These tissues will then become injured and painful. 

Notice how the cause was the repeated movements or postures which then in turn injured the discs or ligaments.

The Source: The tissue that is irritated, injured or involved that directly leads to the production of pain.

In many low back cases this can be the facet joints, the vertebral discs, nerve roots or ligaments, to name a few.

Disc Bulge: Why did it happen?

Notice how if you were to only look at the source of the pain, you wouldn’t take into consideration the reason that the disc is bulged in the first place or the reason the ligament was stretched excessively.

The Symptom(s): This is what you feel as a low back pain sufferer.

remember him?

Keeping with the same examples, in the first case you would feel the shooting pain down your leg (aka sciatica). Maybe some numbness, tingling or muscle weakness as well. In the ligament sprain case, you may feel some tightness or protective muscle spasm in the area around the injured site with localized aches and pains.

Now if you were only dealing with the symptoms, you’d deal with less than if you were just looking for the source tissue and even less than if you were looking for the cause!

Basically, you’d deal exclusively with stopping that immediate pain.

You might use hot packs, cold packs, pain medication, muscle relaxants or other modalities such as interferential current. You may avoid painful movements and take plenty of rest. 

The easy stuff. 

Notice how if you were only to deal with the symptoms, you’d just mask the deeper underlying issues.

To recap, as a physical therapist who treats a lot of low back pain, my first priority is to educate my client, to empower them to become their own healer.

To do that, they must learn a very important lesson:

Separate the cause, the source and the symptoms so you don’t miss out on identifying and removing the real reasons that you are suffering from low back pain.   

Dev Chengkalath