Chronic lower back pain is no joke. Yes, it’s physically painful but the mental aspects aren’t talked about enough.
No one wants to live their life with a pain that makes everyday tasks feel harder than they should be… it’s exhausting.
People who haven’t experienced prolonged periods of pain can’t understand just how debilitating it is to be in pain every second, while also worrying that the pain will get worse if you try to do anything out of the ordinary.
No one wants to feel weak in their own body.
I have a L4/L5 disc protrusion and a L5/S1 disc extrusion with nerve impingement and spent a year in agonising pain as I learned how to get out of it – and I count myself lucky! A year is not a long time compared to many others that I have worked with who have often been in 10-20+ years of pain.
Within that year I nearly lost my marriage, nearly gave up on everything that I enjoy, and nearly gave up my career as a coach.
In this blog I am going to cover the long game of recovery and the many ups and downs you’ll experience when you decide enough is enough.
Three key points you want to keep in mind:
· Moving more is key, not less, you don’t get pain free and stop
You Don’t Know What You Don’t Know
Before my injury and as I went through my recovery, I thought that discs could “slip” (they can’t, they’re stuck on pretty good trust me), I also believed that anyone with a disc injury had to stop moving & training or had to get surgery… I believed that there was no other option.
It took me so long to get my MRI scan that I was 100% pain free when I got it, yet it still showed my structural disc injuries – that’s when I realised what I did had worked and my body hadn’t just “healed”.
What I had done was to create a better, stronger, and more mobile support structure around my back, allowing it to work as normal without needing to take on the extra stress of tight hips and poor upper back movement which are major factors in disc injuries.
Did you know you should rotate your hips? Because I didn’t! and I also had NO IDEA how tight my right hip was compared to my left and even after £1000’s spent on treatments this was never pointed out to me.
Hips have such a big influence on your back that you’d probably be surprised how many people suffer chronic back pain without disc injuries. For many their spine is perfectly fine; their hip flexibility is just so awful that everything just hurts. This is why some people can appear to be strong and active and still have pain: because their body isn’t going through full joint range of motion regularly, causing tightness, compensations and stress in the wrong areas.
Hips can move in loads of different directions, and for healthy, happy hips you need to work on your:
- Flexion
- Extension
- Internal Rotation
- External Rotation
- Hip Elevation
- Adductor Strength
- Abductor Strength
- Single Leg Balance
We cover how to do this (except single leg balance, which is just as it sounds – practice standing on one leg!) in the video below. We cover the most common stretches recommended for back pain, why they won’t work to relieve you pain long term, and show you how to fill in the gaps with simple exercises:
To keep the lower back happy, the supporting structures of your hips & upper back need to be strong, stable and move well.
If your pain goes away and comes back, goes away, and comes back, and you feel stuck in a cycle then there is something amiss in what you’re doing regularly, and more often than not you’re missing one of the movements listed above. Just as same avoiding a diet means you don’t lose weight, not moving your joints the way they are designed to move means your body becomes stiff, sore, and over time you lose your spring in your step and confidence.
That being said, when you do start working to improve them it is totally normal to feel like you’re aggravating your pain further and your brain will do everything in its power to try to make you stop.
But think of pain as mixed-up signals: it’s a defence mechanism to stop you doing something stupid like picking up heavy weights or sprinting, however when it’s in such a sensitive state of chronic pain, your CNS can’t always tell the difference between beneficial movement and potentially dangerous movement. Remind yourself that you’re doing the right thing, take deep, slow breaths, and only go as far as you can tolerate (which may change day to day).
Learn how to improve your hips, spend time working on your them & your balance every day, and take some time to review your technique in any training you do – bad technique habits could have slipped in unnoticed! Learn proper bracing and how to keep a neutral spine when you need to, and how to use your glutes and hamstrings effectively – by the way, you do not need to walk around braced with a straight back all the time either, that’s another thing I believed for a while! You can be completely relaxed in whatever way you like BUT you need to learn how to switch your muscles on when you need them.
Setbacks Are Expected & Normal
The fun thing about disc issues (and many other long term structural injuries) is that you can still get flare ups, and it can feel like you’re back to square one each time.
Though the physical pain can be heart-breaking, it’s your mind you need to get under control:
Over my recovery I had 3 massive flare ups and thought I had injured the discs again or things were crumbling and all kinds of mad stuff, but each time it happened I kept moving and each time took me less and less time to get better, I could recover in a matter of minutes.