Why Your Back Injury Was the Last Straw, Not the Start of Something New
If you hurt your back, how likely are you to blame what you were doing at the time?
This often makes sense considering most don’t have back pain until we do, but it raises an interesting question.
Is the moment you hurt your back the start of something or the last straw?
Clinically, a little exploration often reveals hidden features that set them back up to fail over time. In short, most back injuries are the moment your tissue no longer tolerates a history of bad mechanics or poor loading.
Yes, accidents happen and bad luck exists, but there’s often far more going on in the lead up than we first realize.
We just need to know what to look for.
So let’s discuss why back pain is often the legacy of something else, and what you can do to get ahead of the curve.
The Last Straw
Once your back is sore, it’s really tricky to find perspective.
Initially, we’re often asking ourselves some important questions:
What have I done?
What impact will this have for me going forward?
What do I do now?
It’s often hard to remove yourself from the immediate whirlwind of emotions to consider what led you to this moment - often because there’s no obvious trail of evidence to follow.
For the most part, you had no back pain until you did. It wasn’t a problem until you woke up and got out of bed. Nor was it sore until part of the way through your run. It wasn’t even a thing until you coughed or sneezed and your back started to hurt.
This quick shift from no pain to pain can make a very compelling case for what you were doing at the time to be the cause of your back pain.
But again, a little perspective often reveals more than first thought.
The Body is Robust
Sometimes we don’t give the body enough credit.
Based on the sudden appearance of most pain and injury, it’s easy to imagine the body being fragile.
But it’s not.
The human body is an amazingly robust and adaptive piece of machinery. One that is designed to last us - in good health and function - for our entire lives. It’s a machine that thrives with movement and use.
Yet we are quick to blame these very things when they appear to cause our aches and pains.
For example,
If you’ve ever hurt yourself bending to pick something up, consider this:
It’s less likely one specific bend was the problem based on the body’s robustness and prerogative to move. It’s even less likely that you “moved the wrong way” - despite this being such a staple of our thinking.
Instead, hindsight often reveals a legacy of poor loading, poor spinal shapes and less than perfect mechanics. Things that have covertly built up over time and finally breaching your tissue’s ability to cope. Things that are almost impossible to notice unless you happen to be looking for them.
So it’s vital that we understand what to look for if we are to better prevent these issues from happening.
What Has Set You Up to Fail?
This is where things get interesting.
Clearly the build-up to most back pain and injury will differ based on the person and nature of the injury itself. But there are some tangible themes to consider.
Here are two very simple things that can set your back up to fail over time:
Stiff hips
Poor spinal postures and shapes
Stiff Hips
Stiff hips are a hugely underrated factor in back pain.
The message here is simple. Restricted hips ask more of your lower back when bending and moving.
Any movement that requires more hip range than you have available will increase the load through your lower back. It’ll also force a shift in the way you load your back.
This is unlikely to be a problem in the short-term thanks to your body’s ability to buffer poor loading. But we can leave ourselves vulnerable to dysfunction if this pattern exists over months and even years - which it unfortunately often does.
Poor Spinal Postures and Awareness
This won’t be news to many, but the positions and shapes you put your spine in to (and maintain) are vital.
The spine is at it’s athletic and functional best when in a neutral position. This is essentially a straight up and down shape. A neutral spine provides the best access to your diaphragm, pelvic floor, and core strength and lays the foundation for peak limb function.
Yet we currently live in a world that forces us to sit and slouch passively for hours a day, effectively short-circuiting these processes.
Whether it’s the couch, in the car, at work or up in bed, these static everyday positions tend to define our potential for back pain and injury. Interestingly, there’s little reliable evidence to suggest this is the case however clinically it’s paramount.
Passive, slouchy postures create a peak bend or “hinge” in the spine. This hinge is important as it becomes an area of peak tension. Over time, the body has to find a way to buffer this and the area stiffens and tightens as a result.
It may not come as a surprise to hear these very areas are often the ones that eventually become sore.
Accidents Do Happen
To round out this idea it’s important to acknowledge that accidents do happen. Despite the strong role of previously poor mechanics in developing pain and injury, there will always be a level of trauma to damage even the most robust human tissue.
Thankfully, car accidents, falls from a great height, etc, aren’t a common occurrence.
The best-prepared athlete may still have someone fall across their leg or receive a heavy knock. These things do unfortunately happen.
But what’s important to understand here is that the quality of your mechanics still count - even if it’s just a little.
The better your mechanics are going into an accident, the more likely you are to come away from it intact.
Perfect mechanics may not be enough to save you from the heaviest collision, but it may for everything else.
How to Decrease the Risk of Back Injury
There are a number of ways to regain control over the future health and function of your back. Here a few to consider.
Decrease the amount of time you spend sitting:
The less time we can devote to sitting, the less likely we are to accrue hip stiffness and default into bad spinal shapes for hours on end. The modern world doesn’t make this easy, but it’s something to strongly consider.
Free up your hips:
Things will naturally free up a little with less sitting, but it’s still important to do some hip stretches.
The Couch stretch is a highly useful stretch to open up the front of your hips. You can read about it here: https://www.lorpt.com/blog/couch-stretch
Similarly, make sure you’re taking care of the back of your hips as well.
Here are two simple stretches to free up your hips:
Hip Flexion Stretch:
Hip Rotation Stretch:
Keep Your Lower Back Supple:
Like the hips, it’s important to keep your lower back supple. Freeing up your spine often means undoing hours of less than perfect spinal shapes throughout your week. And doing so is simple.
Take a lacrosse ball, tennis, ball, baseball, foam roller or rolled-up towel and lie down. Let your tool of choice gently press into any areas of stiffness and tightness throughout your back. Stay there until you feel things release - anywhere from 1-10 minutes and then move on.
Conclusion
The next time your back hurts, try and put things into perspective. Know that your spinal kingdom was unlikely to crumble overnight. It’s far more likely to be a consequence of subtle dysfunction accrued and finally exposed over time. Dysfunction that you potentially have to power to prevent.
Preventing back pain can sometimes be as easy as monitoring your spinal shapes and keeping your hips and back relatively free from stiffness and tightness.
Ultimately it’s important to consider these ideas because you deserve to be pain-free.
If you’re struggling with back pain, please consider giving us a call on (949) 443-5442 and have one of our experienced Physical Therapists assess you. At the very least it’s important to know you have options.
It’s worth noting that we run a FREE low back pain workshop here at the clinic every second month. Head to our website at www.lorpt.com or find us on Facebook (facebook.com/lorphysicaltherapy/) for details. We’d love to have you!