Back Pain… Let’s Identify Which Group You’re In – Part 2

By Nunzio Signore (BA, CPT, NASM, PES, FMS)

Back Pain Part 2 - Top ImagePlease note that this article is not from a medical standpoint.  It attempts to cover different reasons people experience back pain.  In Part 2 of this series, I will attempt to cover the potential sources of back pain.  In case you missed Part 1 please feel free to click here.

In my experience there are three different types of people with back pain, all needing a slightly different approach:

  1. Those with medical issues (genetics or trauma based),
  2. Those that are sedentary (tending to spend much time seated), and
  3. I will surprise you and say “those that are physically active”.

Often times my clients come to me with complaints about back pain and the majority has already sold themselves on “laying-off” from exercise for a while.  While that may solve or help alleviate back pain issues for some of those with medical issues or physically active clientele, it may actually be the source of the pain for many sedentary individuals.  Let’s deal with each of these categories separately.

1. Medical or Congenital Issues: In the case of those with medical issues stemming from genetics, trauma or degeneration (such as arthritis or herniated discs), my first recommendation is that you get clearance from a physician before you begin a training program. Getting an MRI can be helpful as to where the trauma resides, but they are by no means the “end all and be all”. The problem with an MRI is that they are images taken while you are lying perfectly still. So, if your pain is “movement based” it may not show up in the MRI. I have a client whose lower back is missing a vertebrate (L4) from birth. When he showed up he was in pain and had lost much of his mobility.  Although he still suffers from the occasional back pain, by following a strict program of mobility work and strength training (2-3x per week) over a four month period, we have been able to minimize the “bad days” considerably and replaced them with “good days”.

2. Sedentary Clientele: Let’s face it, as time goes by and “life happens”, it gets harder and harder to find time to get our workout in on a daily basis. Our bodies repay us for this negligence by gracing us with excess weight, lack of mobility and a general feeling of fatigue, all of which can wreak havoc on our spine. Many sedentary folks can solve much of their back pain issues by embarking on a well-balanced fitness program.  This would include first and foremost a thorough assessment, followed by a combination of mobility work and a well-rounded strength training program to help build muscular support around the spine and correct faulty movement patterns. Note: An assessment is similar to a map (click here for more info on this topic). It gives us a starting point as well as an idea of which roads to travel on and which to stay off of enroute to our desired destination. Remember, what may be a great exercise for one person may create problems for someone else.

businessman lost in field using a map

3. Physically Active Clientele: Just because you work out every day doesn’t mean you’re immune to back pain. Sometimes strong musculature can help “hold” a bad back in place and tolerate bad movement patterns for a longer period of time than someone who isn’t as physically strong. This will only last so long until it can’t hold out any longer.

Back Pain Part 2 - Bottom Image

This usually creates a much greater injury than the warning signs a less muscular person would get.  Being active in athletics, and quite frankly “over-doing it” with too much running (it used to be in style) and not enough recovery days when I was younger, got to me around age 40.  Consequently, I suffered two herniated discs.  On a positive note, however, working out every day and learning correct breathing and mobility work has helped me get back to working out with my 25 year old coaches.

Another thing I find more often than not is that many of our first time clients have been focusing solely on the muscles located in the front of the body (pressing and knee dominant exercises) and ignoring the muscles in the back (pulling and hip dominant exercises). This is an algorithm for back pain and should be addressed by any qualified coach or trainer.

If you find yourself in one of these three groups please feel free to give us a call.  I believe we can help.  In the meanwhile, please stay tuned for Part 3 of this series where we get into the nuts and bolts of what we can do about your back pain.