Back Brace – Should You Consider One?

Listen To The Episode Below

Welcome to the Back Pain Solutions Podcast – Back Brace – Should You Consider One?

If you like the show, we would be grateful if you would consider leaving the show a review on iTunes as well as Stitcher Radio. A couple minutes of your time can help the show immensely! Thank YOU!

Introducing Back Brace – Should You Consider One?

We often see the back brace, and other back support products, promoted to provide support for people suffering from lower back pain. But does a back brace help? Should you be considering a lower back brace, or belt, for the management of your back injury? And if so when should you consider wearing a back brace?

In this episode we discuss the use of the back brace, and more specifically here, the back back belt, in support of lower back pain. We discuss some of the evidence around the use of back belts, and highlight when they could be considered but importantly those people that should avoid them altogether. We discuss the use of back belts in the gym and how they can alter lifting mechanics which could negatively impact performance as well as increase the severity of injury. More than that, we discuss a better approach to the management of lower back pain.

Show Highlights for Back Brace – Should You Consider One?

If you have never suffered an episode of back pain then the evidence suggests that you increase your risk of injury if you choose to use a back back, or lower back support brace. Some evidence suggests that the use of a back belt can support return to work where the work environment may be more demanding. However, these patients, who have suffered an episode of lower back pain and choose to use a back belt to support their return to work, should rely upon it in isolation. As always a structured rehabilitation programme is fundamentally important in the successful resolution of lower back pain.

Interview Transcription for Back Brace – Should You Consider One?

Unknown Speaker 0:00

When we’re young, we move with freedom and confidence with a great resilience to injury. But somewhere along the line we develop poor habits and become more vulnerable to back pain. Back Pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better black health through movement. So join us as we demystify some of the commonly held beliefs about back pain and build your confidence to a stronger back the smart way.

Ben James 0:28

Morning everybody. Welcome back to the back pain solutions podcast with me Ben James. And as always, my good friend and co hosts Jacob stay morning Jacob. Good morning. So today we’re talking back supports back belts back brace is essentially products designed to provide support to the low back specifically the back belts and maybe we’ll do an episode later on with other products or the kind of gimmicks that that are out there to support back health are designed and commercially promoted to support back health. But today, we’re Looking back braces? And do they help? Should you wear them? Should you wear them in the gym returning to work? These are questions that we’re going to answer today, on this episode of the back pain solutions, podcast. So Jacob, when I go to the gym, very rarely do I see someone lifting or do an exercise of some kind, particularly when they’re squatting or, or lifting dead weights and things when they’re wearing a black belt. Do you see the same over and over in Holland there?

Jacob Steyn 1:30

In the CrossFit gym, we not very often but every now and then we’ll have somebody who lives with with a belt. Yeah.

Ben James 1:37

And that’s so they’re less so because you do a lot of the kind of pre work in terms of the onboarding with regards to core and importance and stability. So I’m guessing that’s why you don’t see as much use over there.

Jacob Steyn 1:53

I think so. Yeah, I think so. It’s fair to say because we we have a big emphasis on learning how to read Route your core in a natural way. And I think also because our CrossFit gym is not we’re not competing. We’re not at a level where we’re competing as much as other CrossFit gyms we we cater more for the, the, you know young young professionals who do this as something on the side to their professional job.

Ben James 2:25

Sure. And the people that are the people that are using them then are they kind of just not following the advice they think they know better or do you think they’ve been advised to use them by a healthcare professional? Because that’s my big question when I see people in the gym, because I haven’t come across many people that use them. Just day to day, you know, maybe some for for particular work tasks or duties, but I haven’t really come across anyone that I’ve noticed walking down the road with a backpack, you know,

Jacob Steyn 2:55

Yeah, I think the mostly guys sometimes a girl here You’re in there, wearing them in the gym. It’s more experimental. I think it’s more a case of, you know, someone starts lifting and they eventually want to try the belt because they love so much. They’re curious to know what it would do or how it will help. And so I think it’s more I can’t imagine anybody has been advised to do it. We don’t have very high level powerlifting coaches. So I think it’s more on own initiative and experimental and, and, you know, yeah, don’t wear them all the time. It’s just from time to time.

Ben James 3:39

No. And again, I’m not aware of any chiropractors, osteopaths, physios that recommend these things. Or maybe maybe they do as a passing comment if you because you know, you’ll get that patient that says, I should consider wearing a black belt in the gym. Would that help and maybe someone that’s not really thinking about what they’re saying is, throw a comment is Yeah, give it a go. You know, maybe that’s the Yeah, the way it starts.

Jacob Steyn 4:04

I think you’d agree with me, Ben, that we if you haven’t if you have an injury, we definitely don’t want to just rely on something else to give you the support that your body’s supposed to provide you with. True, right.

Ben James 4:19

Yeah. And yet, the natural thing for people to do is to reach for the drugs for pain effectively.

Jacob Steyn 4:32

Yeah pain relief, or you’re in the same way grab for grab, grab a belt that’s going to relieve or support or alleviate.

Ben James 4:40

Sure. Yeah. So maybe it is a natural reaction for people to say, Well, I’m just going to grab that belt because I’m in pain or I’m suffering from a back issue. And therefore, surely that’s a good thing because commercially these products on No one’s going to promote a black belt and sale you know, maybe you should get this this this In this advice, you know, when I’ve had a look on the internet and some of these products, there’s no real advice around them. It’s just, it’s there for you to buy, if that makes sense. It’s just available without really any support.

Jacob Steyn 5:11

And I can understand why people do want to make use of these things, you know, if they, if you have a chronic back problem, and then you’ve had it for a few years, and you’ve been maybe to a couple of therapists, and it’s just, it keeps returning and you have a physical job, for example. So I can I can imagine you’re going to have one on your car, and you’re going to pop it on when you want to lift or do stuff.

Ben James 5:34

Yeah, yeah, exactly. Yes. Just a natural kind of response that and maybe then it becomes a habit. And I think that’s one of the key. I think there’s a good distinction there. Because if you’re a real high level, and we’re talking high level lifter, then the evidence the research seems to suggest it could be some, you know, benefit from that. That backbone, but really we’re talking high level.

Jacob Steyn 5:58

Exactly. It’s good to the between those two groups, right? Yeah, somebody who works in, in a factory where he’s got to lift a lot of stuff for a big part of his working day, compared to your high level lifter, who’s training a few hours very specifically, you know, taking care of his body, hopefully, and noticing what his body’s telling him or his spine in this case, and and obviously also taking the rest to, to grow and recover from his training.

Ben James 6:32

Yes, yeah. And I think the other distinction there is, these guys that are using them at a real high level, won’t have been using them throughout their training throughout their progression to that level. Yes, because I think that’s something that is important for people listening to understand is that actually some of the evidence suggests that a black belt can change the way that you lift. So actually change lifting technique, which means that your or potentially, the muscles are less active. Now that we’ve done a number of episodes talking about core strength and building the, the belt of muscles around the spine that support the spine. So clearly, if those muscles are recruited differently or less active when you’re wearing a belt, then that’s a problem.

Jacob Steyn 7:24

Yeah, exactly. Because the idea is, at least what people are thinking is the belt is giving you support. So it’s doing some of the work of your muscles, right? Yes. And so in that way, it’s protecting your spine and it’s giving you the support this this added support. But in fact, actually the the evidence shows quite the opposite.

Ben James 7:47

Exactly. And also, I think the other element to that is when we talk about work, a black belt doesn’t change the work environment. So if you’re proud Problem was caused by repetitive work, whether that’s, you know, lifting boxes off a production line, for example, a back belt isn’t going to change that work environment. And so how’s it going to be of benefit if you go back to repeating those aggravating factors without trying to improve that work environment to decrease your risk?

Jacob Steyn 8:24

Exactly. Yeah. The research also shows that it’s, it’s not really providing you any support. When you look at the the the range of motion in terms of flexion. So bending forward, is not going to be alleviated if you have a back problem when you were about.

Ben James 8:44

Sure. Yeah. And in turn, where is the support considered to be because rotation as well is not going to be supported you would assume from a back belt

Jacob Steyn 8:55

Supports more when you’ve been to the side. You’re so lateral kind of thing. lateral bending, but I mean, I think it’s you can say that if somebody has a back problem and they’re lifting stuff, they’re probably already going to avoid bending to the side because they have back pain.

Ben James 9:14

Yeah, so the bat belt van isn’t actually going to prevent them doing the actions that are aggravating because you would assume that naturally, you’re gonna avoid those anyway.

Jacob Steyn 9:22

Yes. But so what does the back belt do ben?

Ben James 9:26

Well, theres the question isn’t it? What does the back belt do?! I mean, I think, you know, there’s the perception again, back to the gym goer, and I appreciate what kind of talking gym goers and and the kind of layman that doesn’t go to the gym, maybe considering it for work. There’s a perception that that black belt helps people lift more, which probably it does, but again, we’re saying that it, it doesn’t recruit the muscles necessarily and therefore you’re probably lifting more than you should and therefore you’re at risk. That’s, you know, take home message number three for as it were. The actually wearing a black belt, if you’re not injured already increases your risk of a worse injury. So, to repeat, if you do something without that belt and cause an injury and you do something with a background and cause an injury, then the injury can actually be worse by using a backdrop. So, again, that’s something important to consider a backbone isn’t a preventative measure to, to back injury for sure. Good movement, and recruitment of the right muscles is is your way to prevent injury. So that’s something that people need to, to really consider. So back to your point, well, what, what does a back belt do? Because people are naturally going to assume well, I’m just going to use this and it’s going to protect my back, because, again, the commercial messages around that don’t seem to specifically highlight or explain how it should help. And that’s the same with a lot of supports. We just assume that designed to protect the back but we don’t actually know how they’re meant to do that.

Jacob Steyn 11:02

Exactly. If you look, if you look from outside you, you see a structure, you know, the the, the the abdomen and you you imagine, okay, that belt going around and it’s going to, it’s going to provide support and protection, which makes a lot of sense. Yeah. If you look at it from the outside, or when you understand the mechanism, then you realize that no, hold on. Let’s look at the mechanism. Well, let’s, let’s talk about that, shall we?

Ben James 11:31

Yeah. Go for it.

Jacob Steyn 11:32

So the, so the main thing that the belt does is it actually increases the, what is called intra abdominal pressure. So that’s when you would, for example, put your thumb in your mouth and you breathe hard against your thumb, not actually blowing air out but creating a lot of tension in your abdomen.

Ben James 11:54

Sure, so the brace that we’ve talked about previously.

Jacob Steyn 11:56

Exactly, that’s the bracing technique. So then when you have the belt on. And you do this you’re pushing against the belt. So you’re increasing that intra abdominal pressure that brace. But there’s something that goes along with the brace. And that’s the harder you brace, the more compressive load you get on the spine. Yeah, so if so if you would have a disk irritation or injury, the advice is not to brace as hard as you can for a prolonged period of the day. Advice actually to unload the spine. And that’s exactly what the back support isn’t doing doesn’t unload the spine, it actually loads the spine. Yeah. So it increases that compressive load.

Ben James 12:42

Sure. And the longer you keep it on the more sustained that that compression is going to be. Yes. Yeah, that’s a very good point. So therefore, again, another another kind of risk factor for assuming that about could be beneficial, particularly in an acute phase because you can just start stain that pressure on those discs, which we want to avoid. And we’ve said before bracing is so important to be able to learn and, and execute effectively. But we’re never saying brace all day throughout the day be a hell of an achievement if you actually could, but there’s going to be a lot of pressure on the, on the desks by doing say,

Jacob Steyn 13:21

And the bracing technique that we spoke of, in earlier episodes is of course, an essential essential way to protect your spine really, when you lift stuff, I mean, we should all master this technique. But too much of a good thing is a bad thing. So, you know, we we also work with and we have to think of the the the physiological response of the tissues. If we if we loaded too much, we have a chance of damaging it.

Ben James 13:52

Yes, absolutely. So I guess the question therefore is when is a blackbelt good. Is it good? Or should it just be avoided for most people? If not all?

Jacob Steyn 14:06

I think I think if you have an injury and you want to isolate the movement or you want to use it as a reminder, then in very special cases, it might be a good thing. Initially.

Ben James 14:22

Yeah, and I think there’s another distinction to make there. We made the distinction between high level performers, in weightlifting and a non lifters as it were. But the other distinction there I think, which is important and back to a point we mentioned earlier, is injured versus non injured. If you’ve never had a back injury, even if you are lifting at the gym, unless you’re really high level. And you’ve been given that advice. And you’ve you’re wearing that belt at a certain point and we’re really talking very niche individuals there. Then black belts For people that are not injured and going to the gym should be a No, no, because the risk of worse injury increases. So, if you’re not an injured already, back pain sufferer and you’re listening to the show, just for advice around prevention or general backhaul, then the advice really is avoid a back belt or a back support support. But when you’re you have suffered an injury like you say, maybe there are some benefits, but probably more specific to the type of work you do. And helping you return to work as a test.

Jacob Steyn 15:38

Yes. As part of a stretch as part of having the strategy to regain the independent function of your core, so you can rely on that instead of the belt.

Ben James 15:50

Yeah, and I think that’s got to be the key point here is that that, that training that rehab that advice is followed first. Rather than Right, I’m going to try and return to work. I haven’t really solved the movement patterns, the core strength, the bracing those foundations ready for a healthy spine and sorted them first I’m going to try and return to work soon can use a black belt. That’s not what we’re saying what we’re saying is maybe at some stage that that poll will support that return to work. But you have to lay those foundations first, because you’re just going to increase your risk of sustained injury or repetitive injury because you’re going to potentially rely on that belt.

Jacob Steyn 16:34

And like you said earlier, the idea that because especially when we have a back injury, we have the extensor muscles, so the back muscles cramping up. And there’s this idea that if we use the back belt, we relieve these muscles, they relax more, and there’s been a very interesting study done quite a while ago actually where they took a few men and they made them lift. A lot of things for four hours twice a week. And they they checked the extensor muscle function with and without the belt and it actually showed that there was no difference using the belt at all came back to Okay, you’re actually increasing the intra abdominal pressure. So you’re actually increasing the muscle function. So you’re not you’re not relaxing these muscles. And so that’s, that’s a big, big thing to keep in mind when you’re actually when you’re actually using a belt.

Ben James 17:28

No, absolutely. I think, you know, it’s a really valid point. And I think, you know, the take home message is there for people are, you know, if you’re not a high performer, and in terms of lifting and you’ve never experienced any injury to your back, then don’t be looking at using a back belt for prevention or just to help you lift more, because yes, it may help you lift more, but you’re not truly recruiting the muscles that you want to recruit that will support that spine and allow you to To lift that, you know truly from your technique and strength, so avoid a bat belt. If you’ve never suffered an injury, if you have suffered an injury as that problem, then unless you’re returning to work doing something repetitive and lightly manual, then the benefit of that belt is likely to be very limited. But there may be some instances where it can be a support once you’ve laid those foundations of good spine health, good movement and recruitment of those muscles. Remember, that back belts in non injured individuals can increase your risk of a worse injury than not using about important message and also a back belt. Put sustained pressure on those discs that intra abdominal pressure was discussed. And we don’t want that consistently. So that backbone if it’s helping you return to work shouldn’t be used all Every day, it should be used for key movements and key activities rather than it being a sustained support because again, that’s not going to allow you to learn to recruit those muscles effectively. And I think… sorry Jacob, you were gonna say.

Jacob Steyn 19:15

Yeah I just I’ll let you finish but I want to say a few things on weightlifting belts when you when you’ve done that,

Ben James 19:21

I was just going to make an another additional distinction there are some belts the sacroiliac belt for example that that again, is aside from this work in lower back supports specifically in this case, nothing so important take home messages for four people around back support and and support in back pain and recovery. And to really take home from from this episode.

Jacob Steyn 19:49

Yeah, I’ll finish off with the weightlifting. Well, so I’ve got a few points here. Because it’s an interesting one, it’s it’s, you know, a little bit controversial, but I think there’s no real need for it. To be controversial, because generally we talk about Healthy Athletes. We’re not talking about injured people. And there is no clear cut rule on weightlifting belt. It always depends, but I think the main points to think of and to keep in mind is that, you know, if you’re a power lifter or just a normal gym goer, but you know a crossfitter before wearing a belt, first become a competent lifter. And really master the bracing technique, you know, be be a well established lifter, before you start putting on a belt because just going straight for the belt is going to interfere with your process of becoming very good with that bracing technique, you know, so that’s, that’s an important point and then I have a couple more. The belt probably increases the output by about five to 10%. Only when you’re on that level of You know, having a very good technique? Sure. So it’s not by much. That’s why it’s only really recommended for competition lifters or if or if it’s a real, really big hobby of yours, you know what, you know, you know what you’re doing. And then the other recommendation for weightlifting belts is that you only really use it once you go above lifting weight of your one rep max. Okay, so you’re, you’re on that level of lifting such or so much weight that you need. You need it in order to lift that weight so it’s going to assess the heavy lift. And then the last rules actually not lifting or not not using it during the offseason. You know lead, especially during your offseason your lifters want to arrest you want to you know not put too much intra abdominal pressure and disk compression through the spine. So you want to recover, you want to work on technique. And so in the offseason, you’re probably not going to lift as heavy. And then you know, the best, the best thing is just to, to stay away from the belt and leave it to when you when you pick up lifting heavy again.

Ben James 22:14

Yeah, great point. And I think that again, is, is back to what we said even with those people that may try it for return to work. It’s not to be used consistently every day all day. And I think back to your point there, it’s, it’s use it at specific times, and even when you’re when lifting at that level. So it’s a great point. So I think, you know, great place to end the episode, you know, does a back brace help? Should I use a back brace? Well, the likely answer is for most people listening. No. You know, there may be some instances if you’re manual, and you’re it’s helping you return to work. But as always, we’ve got to lay those foundations, we’ve got to build that core strength. And that is ultimately those muscles around in the spine. Do that. Learn to move well, and you can be in a farm. better position than you are just trying to rely on a black belt for that support. It may take some more patience in order to return to work quicker or as quickly as you’d like, or to get out of pain, but certainly a black belt is not the solution or answer for your back health. So as always, thanks, Jacob. Thanks everyone for listening. You know, do us a favor, go over to iTunes, give us a rating, any ratings that we can get for the show help to promote and get other listeners listening and we can help more people and always get over to the website smartstrong.co.uk we’ve got a free book there to really help you start to take back control if your back health within seven days really start to take ownership and control of that back health so you can get back to the activities you love. Once again, Jacob thanks very much. And we’ll speak to you again guys in the next episode.

Share This Episode

Share on facebook
Facebook
Share on google
Google+
Share on twitter
Twitter
Share on linkedin
LinkedIn
Share on pinterest
Pinterest
Share on whatsapp
WhatsApp

WHAT ARE YOU WAITING FOR?

Start Your Journey to a Better Back Today