Acute Low Back Pain – How & Why to Get Moving Following Injury.
Acute back pain is the most common presentation to our physiotherapy clinic and one of the most unpleasant experiences some people will encounter in their life.
If you sprained your ankle, twisted your knee or tore a muscle in your arm. The expectation is for pain, limited mobility, a limp or a loss of function for a period of time. Most people will think I need to get moving and some exercises so I can get better quicker.
But when it comes to the back, a lot of people freak out. Think they should not move, “what if it is a disc bulge?” and many other scary things.
Remember the low back is like any other area of your body, It gets hurt and will get better to.
Following up from previous blogs, this one will dive into one of the most important aspects of acute lower back pain management. The how and why it is important to return to movement and normal activities post back injury.
Early return to movement
One of the most important things when experiencing low back pain is to keep moving. Its ok to sit down if its comfortable, it’s ok to lay down, but try not to stay there for too long.
Changing positions from lying or sitting to standing is useful, go for a short walk around the house, around work or down the street.
Please do not lie in bed for a whole day or week. Keep yourself moving, remain active, but allow periods of relative rest.
Relative Rest
To put it simply, long periods of rest isn’t a solution to lower back pain. So… What’s relative rest?
Relative rest is modification of your normal activity to allow periods of rest between activity and limiting aggravating your lower back pain.
This allows the body to heel its tissues, but still providing some appropriate loads in our tissues to keep strength, reduce muscle wasting (atrophy) occurring and keep the rest of our body moving so not to become deconditioned.
Some examples of relative rest:
- I’m sore from lifting at work, solution = temporary change in roles that avoids lifting, but allows periods of sitting, standing and walking.
- My job requires me to sit. for long periods and this aggravates my back, solution = chat with the boss, explain your situation and schedule in regular short walks, a sit to stand desk, a. 5 minute stretch every 30-60 minutes of work and a few movement breaks. A good tip here is to point out the office smoker and their breaks, but your will be a healthy one!
- Running hurts my low back and I need to stay fit, solution = change to swimming, cycling or another form of exercise to stimulate your cardiovascular system.
Return to Normal Activities
It is common for people who have just experienced low back pain to be cautious about returning to their usual activities of gardening, lifting, carry the kids, golf, tennis, or gym.
It is important not to avoid or prolong a return to activity in fear of “doing more damage”.
Returning to regular activities is safe and you should feel comfortable to return to things like. work or sporting activities.
If you are worried, scared or fearful of doing more damage then it is best to be assessed by a professional and seek an active treatment plan.
However, If you feel confident, focus on a graded return to activity. You need to build up a tolerance to movement and activities through starting small and building up gradually over time.
Remember our backs are designed to move, bend, twist, turn, stretch and lift.
So if you want it to function normally, you have to allow it to do it, learn movement again and build the capacity to do more of it over time.
Exercise helps to reduce pain and prevent future low back pain!!
Exercise is fantastic for acute low back pain, this includes any form of exercise.
The best type of exercise is the one that an individual likes to do and feels most comfortable with.
There is no one best. Exercise, just the best one for you at the time.
This can be yoga, walking, swimming, cycling, pilates and even weight training.
Wait… Did you just say weight training and acute low back pain in the same sentence??
YES you can still get in the gym, but remember what I said earlier. You will need to modify, adjust or change the type, reps, sets, or exercise selection for a period of time while heeling occurs.
Being active early also reduces the risk of and future episodes of low back pain.
What can I do NOW!
At Fighting Fit we love to get our lower back pain patients moving early, teaching them about relative rest and assisting in developing strategies for immediate management of their lower back pain
Some great starting exercises for your low back pain are:
CHILDS POSE
On all fours, start with knees under hips and hands under shoulders.
Take your bottom back slowly while keeping the natural curve of your back.
Hold your stretch as you take 5 relaxed breaths then return to the start position.
You can repeat 6-8 times, if it feels relieving then do it often.
KNEE ROCKS
Lie on your back with feet closer to yourself.
From here we you will gently rock both knees from left to right within the limits of your pain.
Relax your breathing to reduce muscle tone and guarding.
Repeat 15-20 times
SINGLE KNEE TO CHEST STRETCH
Lie on your back with both legs straight.
Gently bring one knee up toward your torso and pull toward your chest using your hands.
Again relax your breathing during movement.
Return the leg to straight and switch to the other leg.
Repeat 8-10 times or try holding for 15-20 seconds. Which ever works best for you!
MACKENZIE EXTENSIONS
While on your stomach with your hands positioned beside your shoulders.
Keeping the back nice and relaxed push up through your hands while keeping your hips in contact with the ground.
You can also do this exercise on your elbows if on hands is too much to begin with.
Repeat 4-6 times with hold times of 30 seconds or until pain eases.
LUMBAR ROTATIONS
Lie on your back with your leg bent up and foot on the floor.
Use your opposite hand to pull your knee across your body while rotating your trunk.
Repeat on the other side, try for reps or hold times. Which ever feels good for you.
NOTE: No one back is the same, like no two people are. Some of these may help, some may not. It is important that you don’t push into pain. If you are unsure how to perform any of there exercises, contact us a Fighting Fit and well tell you if these exercise are the right ones or not and show you how its done properly.
Should I be doing strength work too? Or just stretch and mobilise?
I am glad you asked.
Here at Fighting Fit we like all forms of exercise, but our favourite is resistance-based exercise.
An individually tailored and graded strength program is a great way to start.
Strengthening exercises for low back pain can start easy, then build up to more advanced ones as you heel, move better and pain settles.
Strength exercise is fantastic because with an experienced practitioner/coach any exercise can be regressed or progressed with the right skills and knowledge.
If you start the right exercise early, you will avoid weakness, deconditioning, altered movement patterns and an array of other stuff.
Get moving, strengthening and exercising correctly as you heel will not only give you pain relief, but will set you up to prevent any future low back issues.
If you wait and hope it gets better it will bite you long term by hurting more, for longer and requiring far more therapy to get you better.
The best treatment for low back pain is an individualised and consistent one!
At Fighting Fit we will work with you to reduce your pain, improve your movement and help you build a strong and resilient back so you can do whatever you want to do.
It all starts with making an appointment, getting informed and a tailored low back treatment plan specific to you!
Kyle Wells is a Physiotherapist at Fighting Fit Physio.
He has a special interest in arthritis, neck pain and tendinopathy. Just to name a few.
Kyle loves cross fit and has an exceptional eye for technique and performing exercise correctly.
He use exercise to improve patient results and get them moving better for the long term.