It happened. You joined the 80% of American’s who suffer from an episode of back pain (1). The first few weeks are scary. You wonder, “Why did this happen to me? When can I get back to normal? Will this pain ever go away?” You take the proper action by seeing your doctor and rehabbing with physical therapy. After weeks or months of therapy, you have returned to your daily activities, hobbies, and work without pain. So time to forget all about the whole injury, right?
I hope (after all of the teaching you received from your physical therapist) you are shaking your head, “no.” Unfortunately, once suffering from a back injury the chance of a re-occurrence within a year can range anywhere from 10% to 56% (1). Lifetime re-occurrence is over 50% (1). What can you do to avoid another injury, and not join the majority of Americans? Each back injury is different, therefore the exercises and special instructions you receive from your physical therapist will be different. However, there are common themes which are part of all back patients therapy instructions: Exercise, posture, and body mechanics.
Early in the rehab process you have a constant reminder (pain) to do your exercises. However, once you start feeling better, it becomes easier to make excuses or forget about the exercises. I get it, I am guilty of this myself. Ideally, the exercises are not aimed to be a lifetime chore. While the exercises may not be on your mind every day, they should remain in your tool box for when you need a tune up.
You received exercises throughout your rehab process specifically targeting your “problem areas.” Early on in treatment, it is likely you had several exercises to be completed multiple times a day, aimed at reducing pain and promoting proper spinal movement. As you progressed, your therapist introduced proper flexibility and strengthening exercises to get you ready for your hobbies and chores. Making those early exercises a staple in your daily routine will keep your spine healthy and avoid future injury. Making the strengthening and flexibility exercises part of your normal exercise regimen is an excellent way to stay out of our office!
Proper posture is key for pain free living. Think of your posture as your base, or starting position. In order to have proper movement, it all starts with a proper set up. Let’s review what proper posture looks like.
These rules apply while you are standing and moving as well. Standing upright with shoulders and chest back will allow your hips and abdominals to work optimally, protecting your spine.
One of my favorite sayings in the office is “Half of rehab is doing the right things, the other half is avoiding the wrong things.” This is where proper body mechanics (lifting, bending, and twisting) is SO VERY important for back patients. Our spine is only designed to flex (bend forward) 60 degrees, and twist 20 degrees (2). That’s not a lot of motion, is it? Over the years, our body tends to form habits of bending and twisting through the spine versus with our hips and knees, leading to wear and tear on your back. Using the techniques your therapist taught you to bend and twist with your hips can avoid excessive movement at the spine. To review proper lifting and bending mechanics check out this article.
Once you are discharged from therapy, our goal is that you have the knowledge and tools to prevent further injury and continue to improve your function. Once you have suffered a back injury, you may have to manage it throughout your lifetime. Remembering what you learned through your rehab process will help you manage more successfully (and without pain)!
1. Hoy, D., et al. The epidemiology of low back pain. 2010; 24 (6); 769-781.
2. O’Sullivan, Susan B., and Raymond Siegelman. National Physical Therapy Examination Review and Study Guide. Evanston, ILL: International Educational Resources., n.d. Prin