Saturday, March 12, 2011

Working out with back pain

This may be one of my most important posts date on FitandWise and here is why. Back pain is a major health and socio-economic problem in modern societies. The lifetime prevalence of back pain has been estimated at anything between 59% to 90%.
In other words, the vast majority of us will have back pain at some point in our life. And being over 40 does not help in that respect.

MY OLD PERSONAL NEMESIS
I think that my own personal experience with back pain is worth telling. I first encountered problems with my back in my early 30's as I started working behind a screen for several hours every day. As a matter of fact this risk factor has only worsened since with the emergence of the Internet. I remember my first visit to
a chiropractor in Paris at about 33. This definitely helped (I have been using the services of a chiropractor ever since). In spite of
that, my condition worsened until I had a herniated disk in 2003 after heaving a heavy piece of furniture during a move. This was really a difficult period in my life as I could not work out for 6 months and was in constant pain until I got an epidural cortisone shot at a local hospital. I remember my chiropractor telling me that I should give up working out altogether.  Needless to say I was not ready to accept this fact. Gradually I resumed going to the gym while adapting my routine to new situation.

THE 5 COMMANDMENTS OF BACK SUFFERERS WHO WORK OUT
Here are the principles I sucessfully applied to my new routine:
  • No asymmetrical movements (for example: one arm dumbbell bent rows)
  • No movement requiring a forward leaning posture like the barbell power clean. Need I mention NO MORE SQUATS? see my prior post on the subject)
  • Only abs exercises that do not involve twisting the spine or extending legs out (thus putting too much pressure on the lumbars)
  • Always keep good form in every exercise instead of trying to put on as much weight as possible (a typical example of that would be: never arch the back when doing bench presses in order to gain an extra 20 lbs)
  • At any rate, immediately stop any exercise as soon as you experience back pain (no pain, no gain does NOT apply here)
By applying these principles and going through much trial-and-error iterations, I ended up being able to recover 90% of my abilities before my injuries.

A BACK INJURY DOES NOT USUALLY MEAN GIVING UP ON YOUR WORKOUT
I therefore believe that it is possible in most cases for somebody with a serious back injury (a herniated disk is an irreversible condition) to resume an exercise routine with a satisfying intensity level provided he adapts it to his new limitations. Pretending that nothing happened would in most cases turn out to be a fatal mistake.
I must mention here that I am not a physician and that anybody, especially over the age of 40 should consult with an orthopedist before resuming physical exercise after a serious back injury.

WHY PAINKILLERS ARE A BAD IDEA FOR BACK PAIN
Today the only thing I have to do to control my condition is going to the chiropractor on a regular basis. I never took and probably will never take pain-killers. The reason for it is not that I am a hardcore believer in alternative medicine. But taking pain killers for back pain is a very dangerous proposition because it deprives you of a critical signal used by your body to avoid harmful movements and postures. By suppressing the symptoms, chances are your back problem will become  worse dragging your body into a downward spiral: more painkillers, further damages to your spine etc.

LIFE IS MOVEMENT
Two more important pieces of advice to close the subject. The first is pretty obvious: most orthopedists agree today that you should try to resume a normal routine (including walking) as soon as possible after most back injuries (remember that 20 years ago the same doctors would have advised bed rest for a week!).

THERE IS MORE TO ABS THAN GOOD LOOKS
The second recommendation is to reinforce your abs and lower back muscles. This is common sense even for non-back sufferers. This may still sound paradoxical as doing abs may cause further back pain. Then again, you should act with moderation by very gradually resuming an abs routine making sure that you do not experience back pain while exercising. Regular crunches for example are not recommended in that respect. More on that in a later post.

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