All too often, I hear from my athletes and yogis that they’ve got low back pain.
For some, it’s an acute issue: having sat too long in cars and airplanes and in front of a computer, and it’s gone in a few days. For others, it’s chronic: everytime they train abs, or when they run, or squat, or randomly-but-consistently, their low back gets tweaked or sore. And maybe it goes away on its own, or maybe it takes some intervention to address it.
And then there are the folks for whom it’s 24/7, and those for whom it’s a constant concern.
Which category are you in?
How do you train around back pain – how do you get fitter and healthier, even in spite of it? Naturally, it depends.
First, you need to build your pain narrative. How long have you had back pain? Is it consistent, or does it come and go? What makes it better or worse? How do you spend the majority of your time? Have you been to a specialist – what was their diagnosis, and what did they recommend? Did it make it better, worse, or no change? When working with a client with low back pain, building this narrative is always the first step – it allows us to have a shared understanding of the situation, and plan for ways to improve fitness without making things worse – and ideally, even making things better.
Second, identify your primary health and fitness goals. Regardless of your history with low back pain, there are ways you can train towards your goals – progress is almost always possible under the watchful eye of a coach. As a coach and a trainer, it’s not in my scope of practice to eliminate pain – that’s not something you should be promised by any personal trainer, coach, or yoga teacher; this is honestly the realm of physical therapists and physicians.
If a trainer can’t promise to get me out of pain, what can they do?
There’s a subtle difference between addressing pain and addressing conditions which may be causing pain. When it comes to the low back, this is particularly important. My goal is not to make your back feel better (even though that happens with some frequency). Rather, my goal is to help you to understand and address the underlying factors contributing to low back pain. Here are a few of the most likely and common culprits:
- Lack of flexibility in the hips
- Lack of flexibility in the upper back
- Excessive movement in the low back, especially under load
- Sitting for long periods
If you’ve got back pain, your trainer should be working with you to assess these things, and to help you address them.
And while they’re helping you with these things, you should never leave in more pain than when you arrived. The goal is to use the envelope of pain-free motion, however small it may be, and, over time, to expand that envelope to be larger and larger. For many clients, simply improving mobility of the hips and upper back, and a small dose of improving abdominal strength and endurance, can make a tremendous difference in the experience of low back pain.
Where do I start?
First, build your narrative. This should include your history of pain and diagnoses, an assessment of what movements make you feel better and worse, and a movement assessment to explore what you can do pain free, and to look for flexibility and control across the entire spine.
Second, unpack your goals. What do you want for your health and fitness? What does success look like? What do you wish you could do?
Finally, build a plan. Your plan needs to be unique to you; it needs to account for your narrative and your goals. It needs to never make you feel worse than when you started, and provide opportunities for success as you work through it.
Let’s get started, together.
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