https://www.girlsgonestrong.com/

Hi Ann,

I have nagging lower back pain that flares up from time to time. Last week I was lifting bags of mulch and threw my back out. I was in so much pain for a few days, and now it still hurts. What can I do about this?

Jenny

Hi Jenny,

Thanks for writing in with your question about low back pain. I would like to provide both education and encouragement to help you get back to feeling your best.

Low back pain is the most common complaint of patients seeking help from physical therapists and chiropractors, and is the second leading cause of consultation with a primary care physician. Up to 85% of people will experience an episode of low back pain in their lives. The good news is that even though it may be worrisome and uncomfortable, low back pain is rarely serious.

Although it is common for people to describe their pain as their back “going out” or their SI joint “going out,” this is not an accurate term for what is actually occurring. The spine is actually very stable, and bones and discs don’t just slip out of place.

Let’s discuss the anatomy of the low back first.

The lumbar spine consists of five vertebrae, which are larger than the vertebrae in the cervical (neck) and thoracic (mid back) regions, due to their function of carrying more of the body’s weight. The vertebrae are separated by intervertebral discs, which provide shock absorption for the spine. The spinal cord runs from the head down to the low back through the space in the middle of each stacked vertebrae.

Nerve roots exit the spinal cord at each level through spaces in the bones, and carry messages from the brain to the muscles. The spinal cord ends at about the level of the first and second lumbar vertebrae and continues as a bundle of nerve roots called the cauda equina. Some of these nerve roots form the sciatic nerve, which continues down the leg. The entire spine is supported by strong muscles and ligaments.

The low back gains stability from the deep central stability system of the diaphragm, pelvic floor, deep abdominal muscles (transversus abdominus) and the spinal stabilizing muscles (the multifidus). In a properly functioning system, the ribs are aligned over the pelvis to take advantage of the piston-like relationship between the diaphragm and the pelvic floor. When we coordinate our breathing with our deep central stability system, our spine has additional protection when we lift heavy objects (like your bags of mulch!) I wrote much more about this system here.

When we experience some sort of trauma to the muscles and nerves around the low back, it sets off a cascade of events. This cascade of events is part of the “pain cycle.” When we lift the heavy bag of mulch, our tissues send a message to the brain through the spinal cord that something is going on. Pain occurs when the brain perceives that there is damage or the threat of damage to the body, and the brain wants action (think about when you hold your hand too close to a flame – the brain wants the hand to pull back).

Pain is meant to motivate action to protect the body. With trauma, pain tells us that there is a problem, but pain is not good at telling us where the problem is or how severe it is. In acute injuries, pain is important in that it allows for protection of the area (we stop lifting the heavy mulch) and healing of the area (we get in a comfortable position and let the injured tissues heal).

Sometimes pain persists, even after tissues are healed, and sometimes the protective mechanisms persist as well (we stay rigid to protect our low back and we are afraid to move it). Your brain is constantly evaluating the severity of the threat in order to allow you to function; the brain considers the input from your body, your beliefs, your context, your emotions, and your pain history.

In effect, our brain and nervous system “remember” pain, and our system can become more sensitive to pain, even long after tissue damage has healed. For more information about pain and how it affects us, please see this excellent booklet by Greg Lehman, a physiotherapist and chiropractor.

Treatment of low back pain (and any other type of chronic pain) is largely about convincing your brain that you are strong and you no longer need protection. Initially it might make sense to rest, use heat or ice to your back, and try to make yourself comfortable. But very shortly after an acute injury, treatment should be aimed at learning how to move your body in pain-free ways again. This helps to decrease the protective response (spasm and tightness in muscles) and encourages natural movement again.

Research shows that early access to physical therapy improves outcomes and saves money downstream. When you consult with your physical therapist early in the treatment process, we provide a thorough evaluation which assists in the diagnosis of the issue. Then we work with you to develop a treatment plan to get you moving again. We can help you examine the triggers for your pain, and develop a graded movement program to help you move without fear of pain.

Early consultation with a physical therapist may help you avoid unnecessary medications and diagnostic tests such as X rays and MRI, which we know from research are often poorly correlated with pain (many people with no pain have MRI’s which show herniated discs and other issues). Your physical therapist will treat you, and not your MRI.

Complete treatment of low back pain involves partnering with your therapist to develop a specific exercise plan to allow you to move without pain, manual therapy to promote joint movement and desensitize your nervous system, education about your individual pain triggers, and lifestyle recommendations to improve your supportive environment for healing.

Most of all, we will help your brain begin to trust that you are strong and capable, and can move well without pain. If you are experiencing acute or chronic low back pain, you can find a physical therapist near you here.

Originally posted at: http://www.nerdfitness.com/

Like most people, I started working out because I wanted to look better and feel better about myself. 

I was 16, had just spent four years with braces, had plenty of acne, and recently got cut from the basketball team. Let’s just say I didn’t feel comfortable in my own skin, and my confidence was certainly lacking.

So, I figured if I could build some muscle and get stronger, it would be an opportunity to change how I was viewed by others. I saw stronger, bigger people who had the confidence and charisma I lacked, and set my sights on becoming them through exercise. This is what got me started, and kept me going for years. 

Now, over my dozen years or so learning about health and fitness, and now 6+ years of building Nerd Fitness, it’s been a personal odyssey to learn what truly creates lasting healthiness, self-confidence, and happiness.

To say I’ve learned a lot would be an understatement. 

Just as you can be in poor shape and lack confidence, so too can you be in incredible shape and still be miserable and lack confidence.

Molly Galbraith, co-founder of Girls Gone Strong and one of our interviewees in the Nerd Fitness Academy, wrote a fantastic article about her experiences as a fitness model and how it didn’t result in the happiness she expected.

In interacting with thousands upon thousands of people through Nerd Fitness, I’ve realized we don’t strive to look a certain way just for the sake of the look. Instead, we also want achieve a certain status in our social groups, be seen as attractive, or sometimes just fit in. Feeling out of place or at the bottom of the totem pole isn’t very fun.

Although I started out aiming for a certain look, what I was REALLY after was happiness, confidence, and self-respect. 

Wanting to look good can be a strong and positive force in getting us started and keeping us moving forward. It was for me. And I’m sure it is for MANY Nerd Fitness Rebels. 

Even today, I do still focus on taking pride in my appearance and wanting to look the part of a guy who owns a fitness company! However, it has taken a back seat to the joy I get from exercise and the excitement I feel from making strength gains and continually leveling up in the gym.

Along with having fun and seeing progress, it’s helped build a level of self-confidence (and inner strength) I had always lacked.

As Henry Rollins said: “I have never met a truly strong person who didn’t have self-confidence.”

All of that to say, I don’t care what helps you get started with exercise, even if it’s a purely physical goal of wanting to look better.

However, if we’re not careful when using JUST external appearance as a singular goal all of the time, things can go too far down the path to the dark side. One day, we could wake up and realize that we’ve pushed the whole “confidence and happiness” thing to the side in favor of unhealthy and unsustainable behavior all for the sake of a smaller waistline. D’oh!

The line between confidence and obsession

If you’re familiar with BroScience, you know it’s a parody account of a gym meathead who tells us what life is like as a superficial bro.

In the following video, he cracks an all-too-real joke: “the day you start lifting is the day you become forever small.”

If you’re easily offended (a poor allocation of resources), fair warning on bad language:

When your goals are 100% focused on appearance, there’s a very real possibility you can take things too far down the other end of the spectrum. Instead of seeing the improvements you’ve made and being excited about progress, you instead start to notice each and every imperfection.

Before NF Team Member Staci became a deadlifting superhero, she lost a tremendous amount of weight the wrong way and almost did serious damage to her body. Because her focus was COMPLETELY on her aesthetics, she was willing to sacrifice her personal health to get there. It didn’t matter how much weight she lost; she was never satisfied, because there was always something else to “fix.” 

It’s no surprise body image posts like this are so popular on Reddit  – so many of us are insecure about our appearance, and are striving for the perfect body. Just like money can’t really buy you happiness, a perfect body won’t buy you happiness either!

If you’re getting in shape because you hope it will solve all of your problems of low-self worth or unhealthy comparisons, you’re setting yourself up to be disappointed or putting your health in danger:

• If only I had a six pack, then I’d be happy.
• If only I could fit into these pants, then I’d be happy.
• If only I looked like that person, I’d be happy.

Because we tie our happiness to the appearance we don’t have, we are never satisfied while chasing the unattainable: We all harbor these unrealistic expectations for ourselves and for others, thanks to the wonders of the internet. We see perfectly framed (and photoshopped) magazine ads, or instagram photos, or “Famous Celebrity” in “Big Action Movie” and we become disappointed with our reality. This can lead to us seeking shortcuts or unhealthy fixes (steroids, eating disorders, body dysmorphia, diet pills, etc.).

Thus, we need to be constantly vigilant in battling down these conventional-wisdom, empire-created illusions! Wherever we are, we wish we looked like the bigger guy or skinnier girl next to us at the gym, and they in turn wish they looked like the person next to them. And that person wants to look like somebody on Instagram.

After all, most of what we deem attractive are just social constructs. We made this point strongly in our article on body image, and what is ” beautiful” seemingly changes by the decade!

Finding the Right Balance

So with all of these things luring us into not being good enough, how can we avoid focusing on our imperfections, while still wanting to improve ourselves? 

Sixteen-year-old Steve assumed how he looked physically changed how people viewed him, which in turn would in change how he viewed himself.  

He had it backwards.

I’ve since come to realize that how strong and happy I became changed how I viewed myself, and how I carried myself and interacted with others, which in turn changed how people viewed me.

If you want to use external appearance as a source of motivation, and that’s what got you started, go for it! Just don’t lose focus on the two major goals:

• Healthy – You get a clean bill of health from your doctor and no issues physically.You are transforming in a healthy, sustainable way. 
• Happy – You can do the activities you want to do without your body holding you back. You feel confident in your own skin. Whatever “look good naked” or “look good in a bathing suit” means to you. Bulky, thin, orange, green, whatever! Male or female, you get to determine what your personal ‘look’ is.

That means it’s okay to feel confident in your skin – RIGHT NOW! Make sure you understand this isn’t just about your body fat percentage or bicep size or thigh gap.

Yes, it can be great to use others as a source of inspiration or motivation, and it’s okay to hold yourself to higher standards, but know you are not them and not in their situation and do not have their genes. But if you’re building long-term habits, try to put your focus on the process – find a way to exercise you can fall in love with (and how it makes you feel).

No matter what, know that YOU need to set your standards for what you expect of yourself. If you’re a new parent, or a busy single mom of three, your expectations will most likely be different from a supermodel or fitness professional – and that’s okay!

As long as you understand what a healthy goal is for you, leveling up your body is great (that most likely will not be 5% body fat and chiseled abs year round)! Regardless of who you are and what you do, remember: Haters gonna hate.

Healthy and Happy

This is a huge topic almost everyone has struggled with; we’re hardwired to compare ourselves to others.

Wanting to look better can be an awesome motivator – helping people shed hundreds of pounds and transform their lives. When used properly, it can be a fantastic tool to get us started and keep us on track.

But when this source of motivation grows beyond our control, it can poison our self-esteem and self-worth, no matter if you have six pack abs or are 100 lbs overweight. In the process, we can find ourselves pulled down even further than where we began. 

We plan to dive into this topic a bit more over the coming months, and would love to hear what you think: 

How do you hold yourself to a higher standard without setting it impossibly high?

Have you found a way to improve yourself without nitpicking your flaws or comparing yourself to the person next to you?

Let’s hear it in the comments!

-Steve

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photo source: Joseph Jansenn: runner, Phil Gradwell: measuring tape male, Charlotte Astrid: measuring tape female