Back Injury: Why Building Tolerance Is So Important To Overcoming Low Back Injury

Listen To The Episode Below

Welcome to the Back Pain Solutions Podcast – Back Injury: Why Building Tolerance Is So Important To Overcoming Low Back Injury

Click here to subscribe via iTunes

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 Injury: Why Building Tolerance Is So Important To Overcoming Low Back Injury

When we are injured, we are often blinded from the pain and disability which leads us to do things that are not good for our recovery. Oftentimes we are desperate and through frustration we end up taking the wrong approach. This often leads to the injury not getting better and, in many cases, becoming a chronic issue. When this happens, we lose confidence in our bodies and start accepting that it will not get better again. This downward spiral ends up being our life or rather our life becomes dictated by this downward spiral. This is a place we don’t want to find ourselves in. In this series of four episodes we will explain how to build tolerance through desensitisation, spinal hygiene and stabilisation techniques/training.

In this first episode we introduce the concept of how to approach your injury through the lens of building tolerance, which sets you on the path to recovery. Being aware of these principles will provide the key to optimal recovery and like with many things in life provides the start of a plan for successful rehabilitation. You need a strategy and here we explain what is needed to consider in your personalised strategy.

Some of the things you’ll discover…

Why not to stretch your lower back injury
Why too much exercise for your injury is holding you back from recovery
The importance of adequate rest for your healing potential
Understanding compression of the spine and how much is needed
Why we need to desensitise first
Quality movement is essential to allow the injury to heal
Why we need to avoid the pain trigger(s)

Show Highlights

Like with any rehabilitation plan you need to take a systematic approach and the low back is no different. Unfortunately, all too often, the approach that is undertaken is wrong, or key principles are overlooked which results in negative outcomes, frustration, and ultimately chronic pain. Learning how to desensitise is a fundamental principle in low back pain recovery and done the right way results in more successful outcomes.

Interview Transcription

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 back 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.

Jacob Steyn 0:28
Welcome back to the back pain solutions podcast everybody. I’m here alone today and not with my good friend and co host Ben James. So I’ll be doing a solo today. And I’m going to be talking about building tolerance. So we’re going to specifically like always, or generally focus and talk about the low back. So especially focusing on low back injuries, chronic or acute and we’re going to explore the idea of building tolerance. And why it is important to back health, what it means to build tolerance, and why it is so relevant to activities of daily living. So, when we think of tolerance, we could really apply to any structure or any piece of material, whether you’re an architect or an engineer, we generally have to know the tolerance of tissue or certain materials before we use it to build something or put it to the test in an application. So, I think we can in a similar way, think about the low back and when we think of the low back we have to be a little bit more systematic or we have to look at the structures of the low back and we have to then apply this tolerance concept to certain structures of The low back. So, we from the research we typically know that generally, mostly the structures that get damaged with especially chronic low back injury in other words where we have a part of the low back tissue that becomes irritated and then becomes or leads to a chronic problem ends up being most likely the disc and so we often get this cold irritation and that leads to aberrant movement or unwanted pressures or dysfunction in terms of stabilization. Or we might go and do silly things like trying to alleviate the pain with with with maximal effort stretches or These sorts of sometimes we can even call it therapeutic ideas. What happens is this tissue becomes irritated, and it leads to a dysfunction. In other words, it may then lead to problems with the small joints in the lower back called the facet joints, where they become irritated as a secondary result of the disco irritation. And so you have to imagine yourself having that injury and if you’ve had it long enough, you started having a lot of muscle tension in the low back and quite often patients will ask me well, is that a problem of the joints or is it a problem of the muscles, my muscles? Why are they so stiff? And my answers generally, well, it’s not the muscles nor the joints. It’s all of them together. And we have to go back to the brain. So we have to look at the computer system. In other words, what causes the muscles to contract, what causes them to be stiff and tight. And so they’re actually being told to cramp up to be stiff. And generally, the reason is to protect the low back. So the brain actually tells the muscles to cramp up and stay cramped up. And that is because the brain knows that it’s not going well, at the spine. It feels and interprets that there’s too much unwanted pressure, whether it’s a problem with tolerance. So normal pressure is already too much. Or it’s a situation where you are constantly putting yourself in a posture or a position at work, which irritates that damaged tissue in the low back. And so that will then lead to the brain reacting to it, trying to stabilize or do its best To make the most out of a bad situation in terms of getting the muscles to cramp up and to protect the low back. So, we have to think tolerance. And that’s where we quite often miss the point. And we start doing all sorts of interesting things to alleviate the back pain, whether it’s therapeutic from a therapist who thinks that they’re really that they might think that they know what they’re doing. But in general, what I see a lot of people coming to me is actually their therapists who are treating people before they these people or patients come to me is that they’re really just trying things out. They’re trying dry needling or they’re trying deep tissue massage, or they’re trying specific exercises, you know, and that’s, that’s like throwing a dart. You know, to try and hit the bullseye with your eyes closed. You In my opinion, so sometimes you’ll hit it quite often you won’t hit it. And when you hit it, you’ll think, Oh, it’s what I did. In other words, the dry needling helped or the deep tissue massage helped. But quite often, it isn’t even that that got the patient better. So, when we look at tolerance, we have to understand that a tissue, injured tissue body part will obviously have if we think about it a lowered tolerance. And a lower tolerance means that it can have or handle handle less than average or less than what I’d handled before in a normal average state. And so when we have an injured body part, we really want to back off we want to take a step back and we want to limit the forces Going through that tissue, so that we can enable that tissue to heal. And so the question is, how do we do that, we cannot just lie on the couch all day and hope that it will get better. We, we have to be active, we may have children, we may have to go and do the shopping. We may even still have to go to work. In most cases we do. And, you know, you have to take care of yourself. So, we have to make all these movements throughout the day, we were definitely going to have some unwanted forces going through the joint complex, in other words, the actual disc, which finds itself between two vertebrae. And so we have to then think of a few things to increase our tolerance by decreasing the load. So the first thing we want to do is understand our environment so that we can desensitize the tissue, we want to understand our environment in terms of what will cause me more pain, because of my lower tolerance. So if I would Hoover the floor, or I would use a broom and I would sweep the floor or a mop, that might be a movement where I’m going to twist with my shoulders on my hips. And this is going to provoke that or trigger that that the pain that I don’t want to feel when I do that, I actually just irritate the tissue even more. So, movements like this or picking things up where you know, okay, oh, no, that feels really bad, is the first things you want to start to avoid doing until you’ve learned how to protect the lower back and enable yourself with a protected brace or a way of tightening the muscles in the correct way. So that we can now isolate the low back and isolate that injured part, which will allow us to not move through the spine, but move through the hips or through the shoulders. And so that’s how we start desensitizing that area. First, acknowledging what will trigger the pain, what will make it worse, try to avoid it. If not, we have to learn or find a strategy where we’re going to protect our low back, which then enables us to do things with an isolated injury. So we don’t move through the injury, we don’t look up that pain trigger. Otherwise, we’re just picking the scab and we’re throwing ourselves back and we’re going to have to pick it up again and then becomes a chronic situation, which is something we want to avoid. But if you already find yourself in that chronic situation, it’s something that we obviously want to get out of So the second thing we need to think of as the first thing was to desensitize. The second thing would be something we call spinal hygiene. And so spinal hygiene is the awareness of how to while I just mentioned how to isolate a lock up the injured body part, in this case, the low back and understanding what is meant with a neutral spine. So the neutral spine is where we, we have that shallow hollowing in the low back, which feels comfortable. Generally, it’s just the position you will assume when you’re relaxed, and so we’re not rounding the low back, we’re not over arching the low back we have a neutral pelvic stance, and then we have the low, low back in a shallow hollowing position. We’re standing a little bit proud with our chest in other words, we don’t over exaggerate a problem. position, but we just raised the chest bone one centimeter so we have a neutral spine which is made up of and shallow hollowing in the low back, and a shallowing generally a shallowing, shallow rounding in the upper back. So we want to learn how to first find this position. And then we want to learn to hinge or bend through the hips or twist through a hip so we twist through the hips, like a boxer, twisting through the hips when he makes a punch, instead of twisting through the spine, when we open a heavy door, for example, or we push a chair over underneath the table. So that’s the second thing we want to do is learn what is meant with spinal hygiene is finding the neutral spine and moving through the ball socket joints, the shoulders, but more especially the hips, so we don’t move through this Mind, we want to learn what we have to do with spinal hygiene, the correct movement, so we can give the low back a break, we want to give it a break because we wanted to heal. If we keep hammering the low back with unwanted movement, flexing through the low back or twisting or rotating through the low back or bending to the side, we will keep picking the scab and we keep throwing ourselves back. Because we have to allow we have to allow ourselves to get through that phase of recovery. In other words, we have to allow ourselves to get through the inflammation face. But the third thing we have to focus on and it’s something we will already start doing almost from the start depending on your level of tolerance is to stabilize the spine. Because why do we want to stabilize the spine and not stretch the low back A lot of people do when they feel something in the lower back. stabilizing the spine means that we’re gonna create a stabilizing effect from the brain towards the muscles, which then protects the low back or that injury site. So stabilization. We also want to be aware and know what is meant with the neutral spine. So when we have the neutral spine in position, we now want to lock the shoulders on the hips. Similar to the spinal hygiene, we want to understand how to move through the hip and not through the spine and as we do with specific exercises, which will focus on strengthening, especially the glutes, the ball and socket joints, otherwise, we’re going to find it very difficult to move through the hips. If these muscles have been on holiday for a long time, they might not want to take the job. And so we’ll give the job back to The low back muscles and we end up moving through the spine again. So spinal hygiene. And then the next thing would be stabilization. And these stabilization exercises will be exercises like the bird dog or the clam shells to activate the glutes. You know, we’ll build it up to planks, side planks, and we’ll increase the intensity to doing the stir the pot. And eventually we’ll be on two feet where we might be lifting weight, but all with stabilizing and conscious effort to protect the low back. So I hope you understand the idea of building tolerance from the short podcast. And in the next episode, I’m going to go deeper into how to approach that first phase when you have acute pain or you’ve been in long term Chronic pain that doesn’t go away the desensitizing face and how to approach it, how to look at it, and what you can do to initiate the healing process. So thank you for listening to the podcast and like always head over to iTunes, give us a rating, or head over to the website and have a look at our free ebook. Thank you very much.

Transcribed by https://otter.ai

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