CHOOSE WISELY While swimming can be relaxing for the whole body and your back in particular, thrashing about and trying not to drown isn’t much fun.
Back pain, exercise and what’s right for you
Questions, questions. We are all constantly asking and answering questions. From ‘Why is the sky blue?’ to ‘Would you like chips with that?’, there is at least one question in even the briefest of conversations.
On an average workday, I talk to a different person every half an hour or so. If the person in front of me is a new client, I ask everything from their date of birth to what medication they are on. I ask where it hurts, when it hurts, what makes it worse and what makes it better. I ask what they can do and what they currently can’t do; if this has happened before and if this time is better or worse than last time. Oh, and then I ask them to do certain movements so that I can see for myself how well or otherwise they can move.
Once I have finished with my interrogation, the tables are turned. What is wrong with me? Will I get better? How long will it take to get better? What can I do? What shouldn’t I do? Did I do something wrong to cause this?
Given that the most common reason for people attending a physio is back pain, then all these questions and more have to be answered through that lens. The most asked question, bar none, is ‘What is the best exercise for back pain?’
According to research, exercise is useful in both relieving and protecting against back pain, the old saying that motion is lotion rings very true for back pain. By getting your back moving, you can get some relief from pain, and keeping your back moving reduces the risk of that pain coming back – or possibly even appearing in the first place.
But when it comes to answering the ‘what is the best’ question, as is so often the case, the best answer is: ‘it depends’. In the early stages of acute back pain, gentle, easy and short tend to be the best options. Initially your exercise might involve nothing more than lying on your back and rolling your knees from side to side for a minute or two at a time. As the pain eases and movement improves, then exercise intensity and duration can increase gradually back to normal levels.
As to which specific exercise type or regime is best, well the answer is the same. It depends. Because research would suggest that there isn’t a universal best exercise any more than there is a universal best diet. In fact, the research says that the best exercise is the one you enjoy and actually do with some consistency. Which means that one man’s go to exercise is another woman’s worst nightmare.
Some people love yoga, others go to Pilates while yet more lift heavy weights. My dad swears by his daily walk, I prefer a run. I’m often asked if swimming is good for the back. My stock answer: only if you can swim. While swimming can be relaxing for the whole body and back in particular, thrashing about and trying not to drown isn’t much fun, and if you do survive, you’re not likely to go back, thus ruining the enjoyment and consistency.
I had a patient once who had suffered a serious disc injury in his lower back, causing him severe back pain with a burning sensation running all the way down his leg. This chap couldn’t walk across a room without excruciating pain. One day, out of boredom and frustration, he decided to mow the lawn. He figured it was a tractor mower, so at least he wouldn’t get sore from walking, and he could be outside for a while.
The shaking and bouncing of the mower seemed to relieve his pain; so much so that he felt like he could run. So, in an Irish version of Forrest Gump, he got off the mower and sprinted across the lawn. His pain had disappeared and he felt great. Then he tried to walk back to the mower and his pain returned immediately. He repeated the test several times and each time sprinting eased his pain, while walking aggravated it. His new rehab programme? Run Forrest, run.
Which brings us back to more questions, things to ask yourself. What exercise do you enjoy? Do you do it regularly? Could you do it more regularly? If it hurts, could you somehow modify your exercise, so that you can keep doing something? If not, should I look up the number of that bloke who writes in The Mayo News?
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.