326 | Our Tips to Avoid & Improve Low Back Pain

[00:00:00] Welcome to the Optimal Body Podcast.

[00:00:08] I'm Doc Jen.

[00:00:09] And I'm Dr. Dom.

[00:00:10] And we are doctors of physical therapy, bringing you the body tips and physical therapy pearls

[00:00:13] of wisdom to help you begin to understand your body, relieve your pains and restrictions,

[00:00:18] and answer your questions.

[00:00:19] Along with expert guests, our goal of the Optimal Body Podcast is really to help you

[00:00:24] discover what optimal means within your own body.

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[00:01:46] Today we're going to talkurring episode of low back pain. And this can range from you're waking up and you're like, what's that? To like, I can't even get out of bed, you know? So let's talk about optimizing that low back health. Yeah. It's something like 80 to 90% that have what would be classified as debilitating back pain.

[00:03:02] So more towards the, I can't even get out of bed kind of low back pain or I can't go

[00:03:06] to work kind of low back pain. a very stable yet mobile structure in the upper back. It is where our core is, it protects all those abdominal viscera and organs so that it needs to have some stability, but there aren't many bony structures that keep it stable other than those vertebrae. So it's just such a complex area of the body,

[00:04:21] which is why when it comes to low back pain,

[00:04:23] there's not ever like one magic fix for it.

[00:04:27] We're gonna talk about a lot of different components just controlling it from moving. And I think that's one of the main driving factors in what continues to drive pain is people get so afraid of moving. Yeah, fear avoidance behaviors is like one of the top risk factors for developing recurring or persistent low back pain. And that means like you have fear and so you avoid certain behaviors or

[00:05:42] certain movements. And I love that you bring up do for your low back. So when we're talking about it, again, we have to put in all aspects of the low back because yes, your spine moves in certain ways. We have muscles that help control and move the spine. We have certain structural issues

[00:07:00] that can pop up on MRI and show different things.

[00:07:04] And we have tissues that can create some damage because there's all sorts of other components at play, which there are, and there always will be. And the reason I just like talking about this one is because it makes it really simple for people cutting it down into these three buckets. Even though I think the psychological and social aspects have a lot of crossover, like feeling like you have enough support, how does that help emotionally and mentally support you?

[00:08:20] Feeling like you can go out to activities with your family

[00:08:24] and see your grandkids and play on the floor

[00:08:26] with your grandkids or your kids. that bio body type of pain, we're not just talking about the biomechanics and how we're moving. Like when we're talking about the body, let's look at the entire body. How much fluid intake am I getting? How much hydration am I getting throughout the day? How much sleep am I getting? How am I moving my body on a day-to-day basis?

[00:09:40] You know, all of these components,

[00:09:43] what nutrients am I taking in?

[00:09:44] What kind of foods am I eating?

[00:09:46] Like it all plays a role in what they feel within their body. Even just the subtle awareness to the things you don't even have to make any huge changes.

[00:11:01] Yeah.

[00:11:02] Like once you become aware of like,

[00:11:03] oh yeah, I'm sleeping like crap.

[00:11:05] I don't eat the greatest things. go very globally, then I can see, you know, the neck needs a little bit more stability. The upper back needs more mobility. Low back needs more stability, hips more mobility, knees more stability, ankles more mobility, foot more stability, toes more mobility. And so it goes mobility, stability, mobility, you know, and so that's why we start to say,

[00:12:23] oh, well, the low back needs stability.

[00:12:25] So I have to in the big areas as well first. Yeah, I'm a good example of this specifically when it comes to low back because I have a lot of stiffness and reduced mobility in my upper back, my thoracic spine specifically into extension. I don't get into much extension at all in my upper back and my hips. I do have some significant limitations internal rotation extension,

[00:13:44] which is getting better.

[00:14:43] where you can get internal and external rotation. And we're not gonna list all the examples of exercises.

[00:14:46] Because there's so much that you can do

[00:14:48] and a lot of it depends on where you have your own restrictions.

[00:14:52] That's where you're gonna wanna be working.

[00:14:54] Your restrictions aren't gonna be the same as mine

[00:14:56] or the next person.

[00:14:58] A lot of it has to do with self-assessing a little,

[00:15:01] finding the areas of restriction,

[00:15:02] whether it be ankles, hips, upper back, or all three like me.

[00:15:07] And then finding the areas that you need to work on is by gaining better awareness and control of our body. Right? And that's where we go into this integrated core next. Right? If I understand where I'm restricted and tight within my body and I can take pressure off of my low back, that's great. But now how do I start to build in this control through my body?

[00:16:20] And that's where we start to talk about this dynamic core.

[00:16:22] And we actually have a whole pelvic floor foundations course

[00:16:26] that is basically your entire core. And so when we started to talk about this dynamic core, it's how do I use my internal breath, my intra-abdominal pressure system to help create that control and power as I'm doing, whether it's more neutral-based movements, rotation, flexion, extension, any type of movement

[00:17:40] that I'm doing within my body.

[00:17:42] Yeah, I mean, and I love how you bring up that core

[00:17:44] is really anything from hips to shoulders.

[00:17:47] Yeah. transitioning that into movement. Because your breath is something you can always kind of come back to when you're in movement and owning your breath in a certain movement is therefore being able to own and control that movement. And that's where I think that starting just with basic breath exercises to feel that rib cage, to feel that pelvic

[00:19:01] floor and diaphragm move, and then pay it then do it again and pay attention

[00:20:21] to what your back does, right? Are we maintaining some integrity in that core

[00:20:26] as we do these other movements and that you try to keep your back when you're doing a hinge type movement like a deadlift or a squat, your

[00:21:41] low back is going to move. There is going to're just like, okay, if we can just get people loading it up, loading their system, the pain will go away, the body will get strong and, you know, they'll become more resilient people. I think every case is a little bit different. There are some people that might respond well to that type of a method.

[00:23:00] This is where we think, hey, much attention to how we're moving what we're doing.

[00:25:25] body, which is just so incredible, right? And I've had other people who are like, oh, my gosh, I did this mobility flow and my low back actually feels more tense. Oh, because you're moving into

[00:25:30] a new range that your body isn't used to. And this is where we talk about gaining that awareness

[00:25:35] first under control so that then when I start to put on different loads, pick up kids in different

[00:25:41] ways, reach in the back seat and twist my body know if it's just this scare tactic to get people to comply with what you are then recommending after that. I don like, yeah, great point to bring up. Don't let anyone tell you your back is bad or your back is broken. And then yes, don't tell yourself because those messages will just continue to play into that bio-cycle through those three plans, it'll take you seven months, eight months, depending on, I'm not sure how many phases are in low back and core. There are two in each of those. Two right now, but there's going to be three phases for everything. Those are seven months of content right there, and that's just three of the plans.

[00:29:40] I know. There's a lot.

[00:29:42] If you work through all of those over seven months, I'd be hard pressed if you weren up Andrew Dito Bach, we did a podcast with him on his experience. Matt Hall, who was a professional baseball player, also his experience with debilitating low back pain. And Stephie Cohen, who has set dozens of world records as being one of the strongest women in the world.

[00:31:00] And her experience with debilitating back pain. She was one of our very first interviews.