How to Deal With Lower Back Injury by Andy Steinke University of Houston
Back injuries are probably the most common form of injury with many
varying degrees of pain and limitations incurred. I write not as a
doctor or expert, but I have had a back injury for almost five years
(from age 15 to the present) and write from personal experience.
First and foremost, nobody you talk to on the internet and nothing you
read in a book or magazine is a substitute for a doctor. If you get
injured, feel pain that is not muscle ache or standard fatigue and the
pain persists, see a doctor. Unless you have had success with
chiropractic care in the past, a chiropractor should NOT be your first
resort. Many of you are afraid of the "drug and rest" method that many
general practitioner doctors will prescribe. The key is to see an
orthopedic specialist or a sports medicine specialist. They are far
more in tune with athletic desires and how to not only heal you up, but
heal you up so you can get back to your activity as soon and as safely
as possible. If your insurance requires you to see a general
practitioner, ask to be referred to a specialist.
Chiropractic care is NOT the ideal first option, contrary to what many
in the iron game seem to believe, because there are some serious back
problems that will be further aggravated by spinal manipulation.
Unless you have had success with it before and pretty much know that
your back pain is fixable by chiropractic care, it does well to see a
specialist first to rule out other possibilities. As an example, a
chiropractor has no way of knowing if you have a crack in any of your
vertebrae but manipulation can further damage the bone. Small cracks
will not show up on x-rays-they require more expensive and accurate
testing such as CT scans and MRIs. Tendon and ligament tears also do
not benefit from spinal manipulation. It is imperative that you see a
specialist with a back injury, and not just your general practitioner,
so you can rule out injuries that could possibly be devastating if left
untreated. There are many ways to help an injured back, and
chiropractic care is just one important tool in the list of many. It is no doubt extremely effective for many people, but is not always the answer.
My own experience was with a crack in one of my vertebrae and torn
ligaments. I have experienced many forms of therapy throughout the
years, and unfortunately missed out on my last three years of high
school sports due to the injury and its initial misdiagnosis as being
wholly soft tissue in nature. If it is your first injury do NOT just
try to "be a man" and ignore pain. If it hurts, tell your specialist.
While procedures such as MRIs are expensive, it is far less expensive
than wasting years of your life in pain and misery. This is probably
the most difficult concept for many to handle--that this is not
something they can force their way through. I have avoided
surgery so far, and look to avoid it in the future.
In summation, when you encounter your first back injury you must get to
a back specialist or sports medicine doctor before anything else, and
rule out any really serious injury first. Chiropractic care can help,
but it is imperative to make sure that nothing underlying is going on
that chiropractic care can hurt. Chiropractors can perform miracle-like
feats, when the conditions are right for it. Do not think that you can just grin and bear it. Get yourself looked at first and determine if it is something fixable, or something you have to work around.
How to Deal With Lower Back Injuries Part II
Here we will concentrate more on actual methods, many of which can be
applied preventatively to the non-injured as well as the injured. We
will first focus on preventative and recuperative measures in training,
and expand it to principles you can apply to your daily life.
First of all, if you are worried about back injury or have suffered
one, unless your doctors and physical therapists (who have experience
training preferably) recommend it, do NOT wear a weight belt. I
currently go to the extreme that I don’t wear a belt for maximum
attempts even. Relying on a belt is a shortcut back to another injury,
and if used improperly can set you up for one. Obviously if you
compete or anything like that, a belt is going to be necessary, but
non-competitive trainees would be served best by staying away from that
kind of support. You may have to step back in a few exercises, but
instead of having a disparity of strength between your legs and torso,
your whole body will be a machine capable of moving the weight without
the external supports. It also translates a little more directly to
real life—how many times when you help your neighbor move his
refrigerator do you pause and go grab your lifting belt? Not wearing a
belt forces your back to adapt to the stress of the weights you are
using, and strengthens it. It will take longer to strengthen this way,
and you must be wary of overtraining. But ultimately, you will build a
body far more resistant to back injuries. In a book I once read,
entitled something like “How to Get Rid of Back Pain for Good”, there
was a story about American POWs in Japan doing forced labor. While
they were malnourished and overworked, none of the POWs complained of
back pain. Today most of us live rather sedentary lives—the only times
we are really working is when we are under the iron or pursuing other
athletic hobbies. Keeping our backs strong is the best preventative
measure against back pain and injury.
However, this does not mean go hog wild into rounded back and dangerous
lifts—we must work within the limits of our bodies and where we are
strongest. Generally, an arched back is key to maintaining tight form
on most exercises. It also helps on standing exercises to tense your
abs and hold them in slightly, especially on overhead pressing
movements and other standing movements. This creates a stability of
your whole torso, which serves to keep your spine in place. It also
helps to prevent you form forcing your stomach outward and training it
like that (some of you guys may have noticed from squatting, especially
if you ever did work with a belt that you push out with your stomach.
After awhile it actually does create a rather unsightly bulge—like any
true ironheads are concerned about it). This does take some getting
used to at first. The position can best be learned by practicing the
exercise described in Tony Friese’s ABSolutes article.
When first recovering from an injury, back raises can be beneficial,
but beware that the lower back does require time to recover and if you
combine back raises with deadlifts and squats, this could easily lead
to overtraining of the back. There are a few possible solutions. I
would cut either the squat or deadlift until you felt your lower back
was strong enough to institute them again, and then whenever you work
your abs (need I even mention this? Strong abs are CRITICAL to a
healthy back!) do a set of no weight back extensions just to get blood
flowing to the area and some movement. This helps you retain some
flexibility without seriously taxing your back. Eventually you should
be able to maintain lower back strength with your heavy lower body
movements, but if you feel like it is lagging or anything, do not
hesitate to do specific work for it—just factor it in to your recovery
time.
When I underwent physical therapy most recently, the buzzword they used
was “Neutral Spine Therapy”. It involved finding a neutral spine
position (again, I refer to Tony Friese’s ABSolutes article) and
training your body to automatically assume the neutral spine position
whenever you are working against resistance (bending over, lifting
something, basically anything which could stress your back). Some
training methods besides the “dead bug exercise” are doing your
exercises with little weight but concentrating on maintaining that
position. This is probably an ideal way to learn, as most of the
stress you put on your back will be in your training.
Along with neutral spine therapy goes a dose of common sense. Do not
just bend over to pick up things, no matter how trivial…bend at the
knees and deadlift the item, whether it is a paperclip or a couch.
Always maintain the neutral spine position when you do this. When you
sit in a chair, arch your back slightly, and stand up and stretch and
walk every half-hour or so. Maintain good posture with your shoulders
back and your midsection slightly tight. Always stretch after your
workouts, and realize a lot of back pain comes from hamstrings and
gluteal muscles being too tight, not the back muscles themselves. Make
sure to keep those muscles flexible and loose. Always practice the
utmost to keep good exercise form to avoid injuring or reinjuring
yourself.
Now before you get all paranoid, I am going to delve into a little
opinion here, which the more conservative among the medical profession
may disagree with. So far, the best thing for my back has been
progressively heavy trap bar deadlifting. In 6 months my back has
improved to the point where I don’t remember it ever feeling this good.
As soon as I have the opportunity, I plan on incorporating awkward
object lifting into my routine. I do standing military presses. And I
don’t wear a belt for anything. I am building my routine around heavy
lifts. Basically, I am saying progressively work into these things—
don’t jump in before you are ready, but when you are ready you had
better get into these. There are very few legitimate excuses for
someone to not be progressing in workouts, and few people can
legitimately use that excuse. If you can no-no-no deadlift or squat
500 pounds, or take some 200 pound rock from the ground and press it
over your head, you had better believe you have a strong back. A
strong back, in the general case, is a healthy back. So get out there
and (intelligently) heave some iron!
Chiropractic care is NOT the ideal first option, contrary to what many
in the iron game seem to believe, because there are some serious back
problems that will be further aggravated by spinal manipulation.
Unless you have had success with it before and pretty much know that
your back pain is fixable by chiropractic care, it does well to see a
specialist first to rule out other possibilities. As an example, a
chiropractor has no way of knowing if you have a crack in any of your
vertebrae but manipulation can further damage the bone. Small cracks
will not show up on x-rays-they require more expensive and accurate
testing such as CT scans and MRIs. Tendon and ligament tears also do
not benefit from spinal manipulation. It is imperative that you see a
specialist with a back injury, and not just your general practitioner,
so you can rule out injuries that could possibly be devastating if left
untreated. There are many ways to help an injured back, and
chiropractic care is just one important tool in the list of many. It is no doubt extremely effective for many people, but is not always the answer.
Here we will concentrate more on actual methods, many of which can be
applied preventatively to the non-injured as well as the injured. We
will first focus on preventative and recuperative measures in training,
and expand it to principles you can apply to your daily life.
