Body Talk: Back Talk, Part I

Since so many of you have asked what you can do for specific back problems, let's talk about backs! First, I'd like you to appreciate how essential it is to maintain a healthy back, and to understand how much your back is involved in everything you do. The back is truly the fortress of the whole body, worthy of protection from the troops. Even our language reflects the importance of the back as an essential foundation physically, mentally and emotionally. The 'backbone of society' points to a strong cultural platform or base. And someone lacking in solid character and courage may be referred to as 'spineless.'

Establishing a strong foundation built around the back is key when it comes to maintaining total-body integrity. Everything we do should come from a position of sound spinal alignment and posture. In order to know how to go about building a better base, we must first analyze the causes of back breakdown and pain.

It's important to understand that contact sports and heavy lifting are not the only culprits when it comes to back injuries. The back is very sensitive to wear and tear, and anything from repetitious or one-sided movements to emotional stress or doing the wrong kinds of exercise can throw it out of alignment, making it vulnerable to injury. Just as we learned how to manage our energy in the last two articles, I'd like you now to think about a lifetime of back maintenance. You may even find the rating scale from the last article to be helpful if you have a back problem. Tuning in and giving yourself a daily rating will serve as a guide, insuring that you stay within your limits.

Since 80% of the population will have a back issue at some point, it is necessary to take a look at the many ways in which we set ourselves up for back problems, not only from the standpoint of prevention, but from that of problem-solving. Let's begin by looking at the basic design of the spine, its shape and function, and how people typically hurt themselves by being out of balance.

The spine is a very delicate structure shaped a little like a backward 'S'. The spinal cord itself is encased in the curve of bony vertebrae. Alternating with the vertebrae are spongy discs that provide a cushion between the bones above and below. The discs are there to help with shock absorption, but can get scrunched together, compressed by too much pressure. Imagine the whole spine as something that looks and moves a little like an accordion. It can compress and extend and bend and twist. But despite the spine's flexibility, it has definite limits. If we compress or twist it too far beyond the limits, we can strain or damage the muscles, ligaments or discs.

Our spines are more vulnerable than those of many of our animal friends, since the impact going through their bodies is distributed among four feet, not just two. This means that in addition to improving our alignment and posture through proper exercise, it's particularly important to have supportive, shock-absorbing shoes, and to change them at regular intervals as they wear down. If you regularly walk or jog, you might need new shoes two to three a year or more Also, beware of high heels! They can actually alter your center of gravity, putting stress on your back and your knees.

It's so easy, in day-to-day living, to overwork our back muscles without even being aware we're doing it. Think about all the ways in which we create one-sided imbalances through daily motions, activities or sports. For example, how about the check-out person at the grocery store, pulling the items from one side to the other all day long, day after day. She's bound to have some muscular imbalances. Carrying children on one hip all the time can lead to lower back strain, as can that purse or gym bag slung over the same shoulder day after day. I'm sure you're getting the picture by now.

Once we become aware of the events in our lives that might lead to imbalances, we can then assess and make up for them with proper stretches and exercises. Getting an evaluation by a physical therapist or a qualified trainer is a good thing to do, especially if you have an injury. But even if you don't have any symptoms or pain, you may have subtle imbalances. Knowing what they are can help you design a more personalized and meaningful exercise program. (I generally advise my clients to get a musculoskeletal screening once a year that assesses the strength and flexibility in all of their muscles and joints.)

It's especially disturbing to think about the throngs of people who, without any previous conditioning, go out and suddenly rake leaves or shovel snow. Not only is it a one-sided activity (unless you're conscientious enough to switch sides periodically), it's something we should actually build up to…not just run out and do!

Other aspects of our lives that can set us up for back strain and pain may include excessive driving, sitting for long periods of time without maintaining good alignment, lifting heavy equipment without using correct lifting techniques and high impact activities (running, jumping), especially on hard surfaces. Anything that causes a lot of compression can wear down the space between the vertebrae or sometimes even cause the disc material to bulge out or break through altogether. And prolonged poor posture can add to muscular tension and weakness, setting us up for a strain even as we do something simple, like bending down to pick up a pencil from the floor.

Some solutions may be very manageable, helping you avoid an injury or re-injury to your back. Try using a lumbar support pillow if you have to drive long distances or commute to work. If you have to sit a lot, get up frequently and stretch your legs and back to break the pattern of muscle tension. Don't lift more than you can handle with good form (keeping your back 'neutral' and using your legs to lift). If you're a runner, try running on trails, asphalt or even a treadmill. Avoid concrete, because it has no give. If you play basketball or volleyball on a concrete court, try a wood floor or the beach (for volleyball). The impact of jumping may still be too much, but it may be worth testing out different surfaces.

Back care, just like overall fitness, is something we have to keep up on a daily basis. We need to avoid those activities and positions that contribute to our back problems, and find back-healthy solutions. Next, we need to know our own imbalances. As I've said before, 'You're only as strong as your weakest link'. Working out imbalances is just like working out weak links.

The next aspect of this topic on back care, the treatment, will be vastly different for each of you depending upon your individual back problem. Some of you may need to see your doctor and possibly get physical therapy for a while. Many may need a series of massages to help break the cycle of muscle tension. Others may be at a point where gentle stretches and strengthening exercises are appropriate.

In the next installment of Back Talk, I'll show you some of the options for improving circulation using slow range of motion, as well as a few key stretches and exercises. Until then, take the first step towards a healthier back: increasing your awareness of how your daily activities may be adding to your back issues.