5 Things I Know About Successfully Rehabilitating A Lower Back Injury.
It Depends…
Where is the best place to start? What should you be doing to strengthen the back? What should you be avoiding the let the back settle?
There is NO SINGLE BEST WAY to approach dealing with chronic back pain.
When you have a back injury, every man and his dog will have recommendations for you on what worked for them, a friend or co-worker. It is tempting, then, to take a shotgun style approach of trying to do everything which will, more often than not, just leave you even more confused.
Instead, the best place to start is by mechanically understanding any structural damage done (disc bulges, tears, bone damage), and which movements and habits have created the problem.
If certain discs are wearing out quicker than others, there are reasons for it.
Bulges and herniations for example, when understood in terms of their type and direction, will give you MASSIVE clues as to which movements and habits need to be changed to prevent further damage to the back. From this you will know what to avoid and have a starting point for the safest and most effective types of exercise to start on.
There are many similarities and common themes with back issues (disc bulges around L4/L5/S1 for example) but each case has its own unique characteristics that need to be taken into account.
Disc bulges and herniations will heal…
…provided you remove the movements and posture habits that created them.
Given time to settle, the body with harden and gristle disc injuries and then, over a few months, eat away at it.
It cannot, however, replace lost disc height. The best you can do here is to preserve what you have left by sparing the back.
It is not a death sentence for training and sport
Following on from point 1, it of course depends on what your sport and training is, but I think a worthy long-term goal is to build a more robust back that can tolerate the demands of the activities you enjoy doing.
Long-term success does not involve reducing yourself to just doing core exercises and stretches for the rest of your life.
An active back will heal quicker and be more robust than a sedentary one
Again it depends…on the activities you are trying to, but as a general rule I see far quicker and greater results in those who lead a more active life than those who don’t.
Part of it comes down to muscle tissue quality. Those that are more active have better muscle condition and hence will recover faster from the rehab work than those with poor condition.
The trick comes in keeping the back active while avoiding any movements that may aggravate it further.
Start with stability, then work on mobility
In a lot of cases of chronic back pain, certain muscles will tighten up (hamstrings are a prime example).
Stretching them can provide short-term relief and make the back feel better as the muscles relax, but you will the find problem will keep coming back, no matter how much you stretch.
Instead, try to approach it from an understanding that there must be a reason why they are tight, in most cases its because the body is using the hamstrings to create stability around the hips, which results in tight hips and hamstrings that don’t move well.
As with a lot of chronic muscular injuries and pain, you will be feeling the effects of a compensation, a muscle group doing more work than it should to make up for slack somewhere else. If you can identify and understand the underlying issue for the compensation (for hamstrings is is very commonly an issue with lateral stability and glute strength) and rectify it, you will have far greater long-term success.