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NIFS Healthy Living Blog

3 Simple Rules to Train When You Have Pain

GettyImages-1017760106How many people do you know who suffer from a form of back pain? I’d be willing to wager it’s at least one person, and perhaps that person is you. The prevalence of nonspecific lower-back pain alone is estimated at 60-70% throughout the lifespan of a citizen of the United States and other industrialized countries. If you fall into this category or know somebody who does, first direct them to my previous blog about warming up with back pain to get started. Once you’ve made your way through that, keep reading to find out how to design a great workout even if you’re in pain.

For some, the idea of working out with pain is strictly off limits for fear of further injury. For others, the workout must be completed as planned, no matter how intense the pain might be. As usual, the solution will likely require a balanced approach between these two ideals. Unless your pain is an emergency (and this article might give you an idea of whether or not it is), there is likely something productive you can achieve by not skipping your scheduled workout. For one, if one of your goals is to establish a new habit or routine, making it to the gym for some self-love might just keep you on track. Self-love can mean foam rolling or other soft-tissue work, properly prescribed corrective-based activities or stretching, walking, or virtually ANYTHING that helps you feel better. The bottom line is that it must provide a feeling of relief.

Great, so you’ve made it to the gym and you’re feeling better than when you walked in thanks to some well-thought-out pain-relief techniques, or maybe just 10 minutes in the sauna. In any case, you’re ready to sweat and help that heart of yours pump some blood. Before you get too carried away, there are some general rules I like to follow if I know somebody has a history of, or is presently experiencing, back pain symptoms.

1. If It Hurts, Don’t Do It

This one sounds too simple to be genuine advice, and I’ll admit I stole it straight from my own father’s dad-joke arsenal. I’d say, “Dad, it hurts when I do this,” and he’d invariably respond, “Then don’t do that.” Of course, the older I get, the more I realize how wise much of his advice was, especially that nugget. If there is a particular movement or activity that you know for a fact will reproduce your pain symptoms, simply avoid it, at least until your symptoms go away. You can almost always find an alternative exercise to accomplish what you wanted, especially with the staff here at NIFS ready to provide you with such options. Regardless, no exercise is worth potentially worsening your symptoms, causing an even greater setback, or worse, leading to yet another injury.

2. Keep the Weight Off Your Back

The last thing you want to do while experiencing back pain symptoms is to make it any worse, and I see the risk as far outweighing the reward in having a barbell or any other load compressing your spine directly. You’d also be wise to approach higher-impact activities such as running and jumping with a fair amount of caution. Although not directly loading the spine, the landing portion of these high-impact activities requires a fair amount of compression throughout the body, particularly through the spinal segments. If a contributing factor to your flare-up of pain was a lack of integrity in your core strength and control, these higher-impact activities become even more risky.

3. Use Perfect Form

This should be a no-brainer, even when you’re not in pain. However, it becomes vital when the fear of pain is on your mind. Use this time to make sure every aspect of your movement is as close to perfect quality as you can get it. When in doubt, refer back to Rule #1. A great way to monitor your form closely is by either performing each repetition with an extremely slow tempo, or doing some static holds (unless you have high blood pressure or higher risk for aneurysm), meaning holding still during the repetition. Performing your repetitions in this manner will also require you to use significantly less weight, therefore limiting another risk factor. Many of our members take advantage of completing a Functional Movement Screen, which allows one of our trained fitness professionals to analyze your movement on a fundamental level. This is included as part of your membership at no extra cost, and it can provide essential strategies for you to make sure you’re moving to the best of your body’s abilities.

You may have noticed this post is largely about what not to do instead what you should be doing. That’s because each presentation of pain is completely different from another, and should be approached individually, and with care. No two humans are the same, which is what makes us fascinating creatures, but it also provides a challenge of finding the proper activities for each unique case. This is true no matter what your current physical condition is, but requires special attention when you’re limited by increased symptoms of pain. Whatever the case, movement will almost always be the answer to returning to your “normal” self; it’s just a matter of what type and how much.

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This blog was written by David Schoch, CSCS, FMS, and Healthy Lifestyle Coordinator. To find out more about the NIFS bloggers, click here.

Topics: injury prevention pain lower back pain back pain

Warming Up with Back Pain

GettyImages-936117924How many times have you had every intention of heading to the gym either before or after work, only to be deterred by nagging back pain? Maybe you woke up feeling stiff and sore, or maybe you had a long day at work and had a flare-up of pain. Either way, you’re far less motivated to be active when in pain, which quickly turns into a slippery slope. Pain is often a signal that something is not right, and your body will likely encourage behaviors that relieve your pain or prevent it from worsening. If your pain increases with movement, the likelihood of you working out becomes very low. The less you move, the better you feel, and voila, your back pain “magically” goes away!

How long will that last, though, until yet another flare-up digs its claws painfully into your spine? Unfortunately, we have yet to discover a sensor for detecting such episodes, but in the meantime we can do everything possible to prevent it from happening. The first step has to incorporate some semblance of movement. I can’t tell you how many times I’ve had a client come to me with a flare-up of pain. Virtually every single time, there is a significant reduction in pain after simply taking some really good breaths and/or actively moving through a safe range of motion. “My back was really achy/stiff/tight/sore/etc. when I came in, but now it feels great!” Some version of this is music to my ears, because now that individual is likely to be far more motivated to complete the workout.

The How

To know exactly what movements or warm-up activities you should be doing, the first step should be to determine whether your pain is something that is chronic (more than a week or two), or extremely severe. In either case, you might need to seek a trusted physical therapist or other healthcare professional to dig a bit deeper into your pain. However, if you’re simply in need of a consistent routine to optimize your warm-up, there are three main activities that can benefit virtually any generally healthy gym-goer.

1. 90/90 Hip Lift (adapted from the Postural Restoration Institute)

  1. Lie on your back and place your feet flat on a wall, or place your heels on a box of appropriate height. Your knees and hips should be bent to 90 degrees, as pictured.
  2. Lift only your tailbone, keeping your back flat against the surface on which you’re laying. Visualize tucking your tail between your legs, as though you are a dog that just got in trouble. You should feel your glutes and hamstrings engage.
  3. Holding this position, fully exhale through your mouth so as to push your ribs down into your back. You might place your hands on your ribs to better feel them lowering as you exhale. You should feel a very strong contraction in your abdominals, especially on your sides.
  4. After a full exhale, lightly inhale through your nose, keeping your ribs in the “down” position that you achieved after your exhale. Your goal is to maintain the engagement in your abdominals as you breathe in through your nose.
  5. Repeat this for 4 to 5 full exhales, and do 2 to 3 sets overall.

KEY POINT: The first priority here is to be in the correct position. If the body parts aren’t aligned properly, the muscles you want to be working won’t have any leverage to work. Feeling your hamstrings and glutes engage along with your abdominals, particularly on your sides, is a good sign you’re in the right position. It’s also entirely possible that you could be in the correct position, but not “feel” either of those areas working. That’s okay, just keep practicing and you’ll start to feel it soon. It never hurts to take a video of yourself just to double-check.

2. Hands and Knees Rib Lift

  1. Start on your hands and knees, with your palms directly under your shoulders and your knees directly under your hips.
  2. Tuck your tailbone between your legs, as though you are a dog that just got into trouble.
  3. Push your palms through the floor or table to spread your shoulder blades, opening up some “space” in your upper back. Your spine will have a moderate curve to it, as pictured, and you should feel your abs around your ribs engage.
  4. Holding this position, exhale fully out of your mouth as though you are fogging up a mirror.
  5. Pause for a moment after you finish exhaling, note the activity in your abdominals, and inhale through your nose, keeping your abdominals engaged by pulling your ribs up into your spine.
  6. Repeat this for 4 to 5 full exhales, and do 2 to 3 sets overall.

KEY POINT: Avoid shrugging your shoulders toward your ears as you push your palms through the floor. You also want to make sure you’re not using those 6-pack abs (rectus abdominus) in this activity. You want to be focused more on the abs attached directly to the ribs, on the sides of your belly. There’s a time and a place for the 6-pack abs, but this is not one.

3. Spiderman Stretch with Rotation

  1. Start on hands and knees as in the Hands and Knees Rib Lift.
  2. Bring one foot forward and to the outside of your hand on the same side.
  3. Keep your forward foot flat, and take your hand on that same side up to the ceiling, reaching long through your fingertips.
  4. Fully exhale through your mouth as you reach up to the ceiling, inhale through your nose while reaching, then return to start.
  5. Repeat 8 to 10 times with each arm and leg.

KEY POINTS: Make sure you’re reaching straight up to the ceiling. Don’t rotate for the sake of rotation. Reach long through your fingertips as high as you can while you’re pushing away from the floor with your support arm.

Ask a Trainer

Try these out the next time you have some soreness or stiffness coming into the gym. Even if you don’t, these three activities will very much set the tone for your entire workout if performed properly. As always, if you’re unsure, just ask! Any one of our trainers will be happy to help you out, or find the person who can.

Happy moving!

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This blog was written by David Schoch, CSCS, FMS, and Healthy Lifestyle Coordinator. To find out more about the NIFS bloggers, click here.

 

Topics: stretching pain warmups back pain