Sit, Stand, Bend, Lift, or Twist

I’ve come across a concerning trend in my practice lately…. that is, patients assuming that all low-back pain is the same, and therefore all low-back pain solutions are the same.

Low back pain (LBP) is most definitely the number one condition that walks into my office, even though we offer a full-body approach; from necks to toes and everything in between.  But here’s my concern: please don’t assume that your low back pain is the same as your friend’s low back pain.  Just as you wouldn’t take a friend’s prescribed medication, be wary of taking a friend’s prescribed rehabilitation exercises.  I hear this all the time:  “My friend told me to do ____ for their back pain.”  “I saw this stretch on Google.”  “My sister had back pain and she still did 100 sit-ups a day.”

Please, no.  (And also, please, please, please, NO sit-ups.  Ever.  We can talk about this later.  Email me.)

Don’t assume that your back pain is the “same” as your friend’s/neighbour’s/Uncle’s/dog’s.  There are many causes of low back pain, and it’s my job to figure out what is causing yours specifically, and give you the appropriate rehab to support that.  In certain cases, forward fold stretches can be helpful.  In certain cases, they can be harmful.  The same can be said for extension exercises, and mobility drills, and activity limitations.  Each has their time and their place, and one size does not fit all.

Low back pain is a widespread condition; in fact, up to 85% of working Canadians can expect to experience LBP in their lifetime.  And if we all work together, from practitioners to researchers to personal trainers to patients, I think we can dramatically lower that statistic.

There is one hard and fast rule that everyone can safely adhere to: a neutral spine is always the most preferred, protective posture for your spine.  Keep that in mind the next time you sit, stand, bend, lift, or twist.


Happy Tuesday.

Straw. Camel’s back.

In my practice, I often ask the question, “Was there an incident that started your pain?  Or did it just creep up on you?”  The answer is very often, “Well, it could be (insert activity here), but I’ve been doing that for years, so I don’t think that’s it.”  But, perhaps, that’s exactly it.

Tissues have a certain amount of force they can withstand before they become injured/dysfunctional/irritated.  This is called tissue tolerance.  The end result of too much force is usually pain.  You see, pain is often the last symptom to appear, not the first.  So, prior to your experience of pain, damage has been done behind-the-scenes for awhile.  If you are body-aware, you may have already noticed this in yourself; perhaps your first perception of a symptom was tightness or decreased strength or lack of range of motion.  But the pain didn’t follow until later.

This process gives us some valuable insights into treatment.  At least, that’s how I see it, and that’s how I treat it.

First, pre-pain symptoms (the above-mentioned tightness, strength, and range of motion) should be watched for and can be used as warning signs to prevent further injury.  Maybe these pre-injury symptoms can be used as healthy reminders to improve your mobility, add in some recovery time, or focus on your nutrition.  Maybe they cause you to re-check your workplace ergonomics or your sleeping positions or your form in the gym.  Maybe they are a signal that your body needs some hands-on treatment.  Listen to those signals, and heed their warnings.

It is much easier to prevent an injury than it is to fix an injury.

Second, just because the pain has disappeared, doesn’t mean that the affected tissues are back to their normal pre-injury state.  This helps to guide my decisions for a patient’s return to activity and give appropriate movement guidelines.  So when I tell you to stop box jumps for the time being, or to raise your computer screen, there’s a method to my madness and science in my reasoning.

The bottom line is this: if you’ve been dead-lifting with a rounded spine for months, or you’ve been sitting at a desk job for years, or you’ve been hunched on your couch with your iPad and “it’s never bothered you before,” doesn’t mean that it won’t bother you now.

Straw.  Camel’s back.  Remember?


“When Should I get Treatment?”

“When should I get treatment?”

I get asked this question a lot, most often by people who are nursing an injury, hoping that I’ll tell them to just wait it out.  And the truth is, for most injuries, waiting it out will ease your symptoms.  Nature will take its course, your body will know what to do, and your pain will subside.  But is that really the best option?

blank-muscle-anatomyYou see, our bodies are very, very smart.  They know what to do to fix things, far better than I claim to know.  But the thing is, our bodies don’t take compensation injuries into account.  A rob-Peter-to-pay-Paul situation often develops.  And let’s not forget the time factor; manual therapy can speed up healing rates.

Take the common example of knee pain.  Your knee hurts.  So you take some time off from the gym, modify your daily activities, and utilize home remedies like stretching and Voltarin and hot tubs and ice.  You feel better, so you return to the gym and the physical rigors of daily life.  But your knee pain starts to creep back in, although milder than before, and now it’s accompanied by lower back pain.  Why?  Well, the cause of your knee pain was never really addressed with all of your stretching and Voltarin-ing and hot tubbing and icing, so when you resume activity, it comes back.  And your body has done such a excellent job of compensating (gait changes, postural changes, biomechanical changes) that your lower back worked extra hard and is now paying the price via a secondary injury.  And you forgot to maintain your core strength while you did all that laying around nursing your knee pain.  Sigh.

“When should I get treatment?”

You should get treatment if home remedies aren’t working effectively.

You should get treatment if you want to get back in the game faster.

You should get treatment if you want to be proactive and preventative with your health.

“When should I get treatment?”


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