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

Let’s face it.

Back Pain Sucks.

And it really does get in the way of life.

But it doesn’t have to!

Over the past few years in my physiotherapy practice I’ve had the pleasure of working with some wise and insightful clients on their journey towards a back pain free life.

For some of these individuals, the constant irritating pain has been a loyal companion over long stretches. At times abating to a dull nagging “friend” that tags along for the ride. And at other times rushing to the forefront of their awareness in crushing, life-altering waves of excruciating spasms.

Through their pain, suffering and journey towards salvation, each of these clients has taught me something new about living life with back pain.

Without further ado, here are the top 5 things that my clients have taught me about back pain:

1. You can do something about it: You don’t need to live with the pain. There are solutions out there. You may just need to dig a little deeper and search a littler harder. Ask around. Find out what others you know who have had back pain have done. This doesn’t mean their solutions will work for you, but at least it’ll give you someplace to start.

2. Keep moving: Exercise almost always helps. In most cases of low back pain, appropriate movement will help. It will keep joints lubricated, muscles working and mental outlook up. If you’re carrying a few extra pounds, losing those will ease the load on your spine and other joints. Even dropping 10 lbs will significantly decrease the wear and tear on your body. Getting in shape will dramatically improve your capacity to tolerate various stresses, mental and physical.

3. Empower yourself: Be your own best advocate. Only you truly know how your back pain impacts you. Only you are the “expert” on your own life. It’s easy for someone else to sit across a desk from you and say “stop doing ____.” They aren’t the ones living your life. It’s much better if the people who are supposed to help you, work with you, to generate workable solutions that can be implemented in your “real world” and not in some imaginary or unattainable “ideal world”.

4. Consistency is key: Stay on track and keep at it. Don’t give up. Be relentless. There will be peaks and valleys on your journey towards relieving low back pain but in the end, you will find a solution that works for you, a solution that will let you get back to the business of enjoying life.

5.  Know and respect your body’s limits. The body is capable of some pretty amazing feats. It can heal and repair itself from some pretty incredible situations if given the opportunity. This does not mean you can’t push the limits or even reset them. By all means, this should be the goal when looking at reaching new heights of human movement and performance. Just do so safely within the tolerances of your body structures.

If you have any insights on relieving low back pain, I’d be interested in hearing about them. Drop me a comment and let me know.

Yours in movement.

Dev Chengkalath

It seems to me that people like lists.

They’re short. Concise. And should be to the point.

And if created correctly, they’re pretty easy for most people to remember.

So here goes…

This is my list of the five worst things you’ve done to you low back today:

1. You’ve flexed through your lumbar spine on fully hydrated intervertebral discs (yup, these are the same discs involved in those famous disc herniations or “slipped discs”). In fact, this was probably the first thing you did this morning upon awakening from your more than likely short and insufficient sleep.

• Sitting bent forward on the edge of your bed in that sleep induced haze right after you wake up.
• Sitting in that same bent forward and flexed position on the toilet.
• Brushing your teeth, washing your face, and maybe even standing slouched in the shower.
• Hunched over the breakfast table (you SHOULD be eating breakfast!).

2. You’ve spent more than 30 minutes (this being a fairly conservative guess) in a static and continuous slouched posture.

• Collapsed on yourself with your ribs resting on your pelvis during your commute to work (this includes planes, trains and various forms of automobiles).
• In your standard computer posture in front of that technological wonder that was designed to make your life easier and more manageable. This position likely has you with your head protruding and your shoulders rounded forward for extended periods of time.
• On the couch watching your favourite television programming (typically for a few hours) after a long, grueling and tiring day at the office.

Slouched Sitting Postures: Over time can lead to injury.

3. You sit. And sit. And sit. Enough said. Follow the link if you need more info on the dangers of sitting.

4. You wear high heels. This one is mostly for the women out there, although, who am I to judge? This piece of fashion will confer the wearer with an instant and noticeable alteration of lower limb appearance. But at what cost?

• Centre of gravity shifts with resultant changes in weight bearing
• Increase in lumbar spine curvature (increased lordosis, possibly excessive)
• Altered muscle recruitment patterns, biomechanics and gait patterns

5. You decided that you were too tired to exercise today. This follows along with number 2. And number 3. I think everyone is aware that exercise is good for you so there’s no need to belabor that point. It’s just a matter of prioritizing it to get it done.

Yours in movement.

Dev Chengkalath

It seems as though my  Toronto physiotherapy practice doors act as some sort of magical entrance to the land of body awareness.

For the brief period of time that they’re with me, my clients allow themselves to be aware of what’s going on with their bodies.

For those brief moments, they reconnect with how their bodies function.

For that period of time, they are in control of their pain.

It’s true.

The number of times I have seen my clients turn their pain on and off in my treatment room is astounding.

While I don’t believe in physiotherapy miracles, I would even go so far as to say it’s almost magical.

And what’s more amazing about this pain control is that it’s done without powerful drugs, fancy high tech machinery, or, in most cases, any equipment at all.

There are almost no adverse reactions.

Contraindications are almost non-existent.

And the time investment, surprisingly, is just a few seconds at a time.

So at this point, you’re probably wondering what this panacea for pain relief really is.

It’s movement.

Don’t be confused.

It’s not just any movement, but movement with a purpose.

The simple act of moving your body in a precise fashion to retrain your tissues to respond in a specific way.

It’s movement designed to unload certain irritated joints and tissues, while activating inhibited ones.

It’s movement designed to improve your motor control and put you back in the driver’s seat of your body.

The Movements:

Over the last couple weeks I’ve had great success addressing a variety of aches, pains and dysfunctions with the following two motor control movements.

The first one, a forward wall slide, is fantastic for dealing with tight, painful shoulders and upper backs.

And the following video clip of quadruped rocking is extremely helpful in addressing hip and low back issues.

So if you’ve got some of those aches and pains, give these movements a try.

But remember, it’s not just about doing the movement for the sake of doing it, it’s about doing them with purpose. It’s about feeling what your body is doing. It’s about breathing. It’s about taking control of your body back.

Yours in movement.

Dev Chengkalath

The second point brought up in the previous couple posts relates to the risks of too much sitting and limiting everyday, non-exercise activity.

I’ve already spoken about the dangers of sitting in a quite a few of my previous physiotherapy blog posts, so I won’t belabour that point.

What I will say is that even for those who are fairly physically active, prolonged sitting will still cause problems, the same as it will for those who are more sedentary.

This is where NEPA comes into play.

NEPA or Non-Exercise Physical Activity (I’ve talked about it as NEAT or non-exercise activity thermogenesis previously) is all the other movement you do during your day that doesn’t count as exercise. The “everyday life activity”. This is where that leisurely stroll, the housework, and yes, even the fidgeting comes in to play.

Why is NEPA important?

Think of it this way…It’s a lot easier to get a few minutes of NEPA frequently throughout the day than it would be to set up an intense exercise activity regularly and consistently through your day.

If you can increase your non-exercise physical activity by 15-20 minutes a day in spurts of 1-2 minutes at a time, over the course of your week you will have added around 2 hours of increased movement. And most of you won’t even notice the added bouts of 1 minute movement.

It won’t interrupt your day.

It won’t cost you much in terms of time to take the stairs instead of the elevator, but the health benefits multiplied over a long period of time can be significant.

This takes me back to an article I was emailed some time ago.

According to that article, in the past 150 years non-exercise related calorie burning has dropped by about 2000 calories a day.

Yup.

2000.

That’s the same number that is used as the baseline total daily calories for calculating percentage of daily values for nutrient requirements in American food labeling.

150 years ago, we used to burn more calories with non-exercise related activities than we are supposed to take in daily today.

Now that’s something to think about.

Yours in movement.

Dev Chengkalath

In my humble opinion and using my knowledge as a physiotherapist, the solution to the above noted problem is quite simple.

But as I’ve stated many times before, simple does NOT mean easy.

To recap the previous blog post, there are two behaviours and their resulting effects that need to be addressed to stave off the dangers of prolonged sitting.

These are:

1. The benefits of regular moderate to vigorous intensity physical exercise

2. The risks of too much sitting and limited non-exercise everyday life activity

In today’s post, I’ll take a deeper look at the first point and offer what I believe are realistic actions you and any other reader of my blog can take immediately and without significant changes to your life.

It’s been proven over and over again that regular physical activity, typically undertaken at a moderate to vigorous intensity, as noted above, has numerous health benefits to the various body systems including the cardiovascular system, the neuromusculoskeletal system, the endocrine system, the neurological system etc.

Intense Physical Activity

Key words: moderate to vigorous intensity.

So taking a leisurely stroll around the block, walking to the corner store, going up some stairs, doing housework…just won’t cut it as exercise. These are typically not intense enough and don’t last long enough to stimulate the body the way a more focused exercise regimen would.

The thing with exercise is that you have to do it to get the benefits and you have to keep doing it to keep the benefits.

The other thing with exercise is that most people do it in one big burst (e.g. early morning before heading off to work) and then remain sedentary the rest of the day.

A better option may be to do smaller bursts of higher intensity physical activity, frequently throughout the day.

Here are some options of how you might be able to fit in multiple bouts of exercise-based physical activity:

-Early morning high intensity interval program combining resistance training and cardiovascular training for 30-45 minutes.

-Lunchtime body-weight workout for 15-20 minutes just doing lunges, squats, push ups, burpees or other equipment free movements.

-Post work exercise class for 30-45 minutes – just find one you enjoy!

-Join a recreational or competitive sports team for an activity that you love.

-Take your kids out to the park and play those games you used to love to play, have races, climb and jump around.

-Schedule it and respect it like you would any other appointment.

As you can see, with a little imagination, the physical activity possibilities are endless!

The objections:

I know many people will tell me that they don’t have time for the above amount of exercise in their day.

I don’t buy it.

It’s not that they don’t have time, it’s that they haven’t prioritized their health.

Cut out 1 or 2 television shows and you’ve just gifted yourself an extra half hour to an hour of exercise time. Or if you just can’t give up on the reality TV shows, do some exercise during the commercial breaks.

Want to find some more time in the morning? Stop pressing snooze 3 or 4 times in the morning and you’ve got another 15-20 minutes.

If you have kids and you take them to their various extra-curricular activities, use the time that you’re there to do some quick exercise. While watching little Timmy’s hockey practice, why not use that time to lunge around the rink?

It may look strange, but you’ll be the one improving your health. Plus that will probably also get you away from the pop and chips from the concession stand.

While this is by no means an exhaustive list of how you can find exercise time during your day, it should give you a place to start.

If you have any other ideas on how to fit in exercise drop a comment and let me know.

Yours in movement.

Dev Chengkalath