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Hurt doesn’t mean harm

Nurturing

SCARED STIFF?  Stiffness from doing an activity you’re not used to, like dancing or painting, does not necessarily mean injury.

Physio focus

Andrew O'Brien

A couple of days ago, I woke up feeling stiff and sore in my lower back. Now there’s irony for you! Like anyone, my first instinct was to worry what I had done to myself. Is it a disc? Have I torn something?
But then reason kicked in: I had spent most of the previous two days painting the office, bending down to point around the skirting and reaching overhead to get the top of the walls – actions that are not in my normal daily routine. I was stiff from doing something different, not because I’d done something bad.
That’s the thing with pain, it’s not always because you’ve done damage. It’s amazing though how quickly we all jump to that conclusion. Which reminds me of a short video that has been circulating on social media of late called ’10 Facts About Exercise and Back Pain’. In summary, exercise has been shown to be a good way to relieve back pain, and also to protect against recurrence, while bed rest and avoiding activity are likely to increase pain levels and lead to a poorer recovery.
An interesting point raised in the video, and one that I tell all my clients regardless of their injury, is that the best exercise is the one that you enjoy doing and actually do occasionally.
An extension of this, is that no single type of exercise has been proven to be any better than any other for back pain. If you enjoy yoga or Pilates, go for it. If on the other hand you prefer gardening, that’s fine too. Twisting and turning might annoy your back from time to time, but that doesn’t make them inherently dangerous movements.
People often ask me if swimming would be good for their back, a question that’s worth answering with another question: ‘Can you swim?’.  If you can’t swim, but get into deep water, it’s often referred to as drowning and will get rid of your back pain, permanently!
Should you take painkillers? Maybe. For some people in severe pain, medication might help, but for plenty of others, movement has been shown to be more effective. Similarly, surgery is beneficial to a small cohort of people as a last resort, but the reality is that even with a bulging disc and neurological signs, most back pain will improve with conservative management – that is, time, treatment and exercise.
Like all forms of treatment, dosage is important, but the thing with exercise is that not getting enough is better than not getting any. Yes, the usual recommendations are to get half an hour of exercise each day, but that doesn’t have to be all in one go. Going for a two minute walk fifteen times a day is the same as going for a fifteen minute walk twice. In fact, some studies suggest that more frequent short bursts of movement are better on numerous health markers than one long effort.
When you have a sore back, any movement can be sore, making us fearful of movement. A normal enough phenomenon: it hurts, so you avoid it. But if you keep avoiding, it will keep hurting, possibly even hurt more. Thus, it’s important to move as normally as possible from the outset, without worrying excessively about posture.
Without wishing to open an enormous can of worms, being obsessive about ‘good’ posture might be no better than having ‘bad’ posture – now there’s something you don’t hear from your physiotherapist every day! The reason I’m saying it? We are made up of an awful lot of moving parts and trying to restrict those moving parts to only a defined ‘good’ pattern of movement may well cause other problems. Added to which, moving carefully requires more effort than just moving, adding tension to an already tense system.
Lastly, sometimes exercise hurts. Not because it’s bad, but because it’s different. The first game of tennis in a while will result in a slightly sore shoulder. So can painting, as it turns out.

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.

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