“Why me?” – A common question for those with Back Pain.

Back pain is the most common injury or problem that people deal with in the therapy world. 85% of us will experience back pain in their lives, you are not alone, it is inevitable! You or someone you know will get back pain! So why you??

Truthfully, there’s a whole host of reasons why. The important point to get across is, it is rarely one movement or action that caused the pain. It is usually a combination or culmination of events that lead to the problem (pain is also an hugely interesting topic of which you can read more about here). This culmination of events potentially puts you on a path to one day asking just one too many things of your back. The (literal) straw that breaks the camel’s back (sorry to sound doom and gloom!)

So it wasn’t that one time I bent over funny or when I sneezed, so what could have caused it?!

The ‘causes’ of back pain are hugely varying and controversial so I will summarize a couple of the main ones below, but they are not limited to just these;

• Injury
• Stress
• Occupation
• Exceeding load bearing abilities
• Incidents (car crashes etc.)
• Repetitive strain
• Over reliance on the back
• Smoking
• Weak core and/or Hamstrings
• Poor diet
• Lack of good quality sleep

It is very normal and highly likely for you to have a combination of these. It is rare to have an over reliance on the back without the compensatory weakness of the core and hamstrings which can cause this over reliance. The stress from your occupation which may cause you to smoke or to be stuck in the same position all day long. Or, physical stress from over training in the gym or in sport. These things are not necessarily your ‘fault’ but they contribute to the greater picture of back pain and problems. It is also worth noting that these things sound fairly innocuous on their own, which makes it amazing how they can cause you so much discomfort! The biggest problem we see, is not what you could have from the list above, but what are you doing to combat these things? You answer this question and you will find the only way to cure your back problems.

I’ll give you a minute to read that again. Yes I’m telling you despite the underlying typical issues people identify, the most important one is what are you doing to combat or offset them? If you are doing the right things, despite the things above you will see an improvement in your mobility and a reduction in your pain. This is because sometimes, these things are unavoidable due to external circumstances, but that shouldn’t mean all hope is lost. The key is manipulating what we can to your advantage and start getting some little wins that will get you going in the right, pain-free direction.

So, let’s use the example of having an over-reliance on the back muscles. This is the most common issue we see at Tier1 Northampton. Backs are hugely strong and dominant. They are very very very rarely ‘weak’. However a typical rehabilitation programme would tell you to target a ‘weakness’ and make it stronger. But for the back, it doesn’t necessarily work like this. By making the back stronger, you are adding work, on top of work, on top of work and could make the issue worse.

Let’s look at this in a hypothetical office. If we assign you to be the ‘back’, a colleague (lets call them Jack) to be the ‘core and hamstrings’ and the Boss to be the ‘brain’. In this scenario, you (the back) are doing all of the work in a job that should be split between yourself and Jack. However, they are sat on the other side of the office doing very little, which means that you are having to over work and tire yourself out whilst they sit pretty not doing a lot. The work is getting done, but not to the best standard or in the most efficient way. I don’t know about you, but if I was being asked to do more and more work from my boss whilst I can see my colleague across the hall doing nothing, eventually I’m gonna tell my boss (the brain) they aren’t pulling their weight and kick up a fuss.

“Get me some help over here! Jack across the office isn’t doing anything to help me!”

When the boss takes action and gives Jack the kick up the arse to help you, all of a sudden your workload decreases. You are both doing an equal amount of work and you can actually function better than you could before. You become better at your job when you are provided that time to focus on it and not have to worry about what is going on across the other side of the office! Not only that that work you are producing as a team improves, plus it is being done to the best standards and in the most efficient way. It is now how it should be!

This in essence is what happens in your body. Your back (you) will tell your brain (the boss), that Jack (the core and hamstrings) is not doing their job properly. So when you are made aware of this via pain (which is sent via the brain), you should start taking the right steps to correct this. Once you are able to utilise your core and hamstrings again you can provide your back the well needed rest it deserves to start focusing on its job again! You will become more efficient and pain-free as a consequence!

This is what we aim to do in our rehabilitation programmes. We insist on true core and hamstring training – by true we mean we ensure you are not using your back. Buy your back some well needed time off and your pain will decrease as a result. Again I would refer you to our ‘what is pain’ blog to help understand the principles behind it and how it is effectively an alarm system.

In a nutshell, the reason why you are suffering from back pain is not always just what you are doing, it is often what you are not doing that causes it. There is no evil reason behind ‘why me’.

Funnily enough, this is what we do. We find the reason for your pain and then provide you with the skills and exercises to combat it and get on top of it. We provide you with the map, you just have to follow it. You can learn more about the back on our website and even download our FREE lower back pain guide ‘Back on Track’ here.

Thank you for reading, until next time,

Oliver Attoe

Sports therapist