Why you still have low back pain

We have all been there. Go to lift something off the floor, and then wham, the sensation of having done something terrible to your back starts to set in. According to the World Health Organization, lower back pain is the leading cause of disability worldwide. It is estimated 90% of reported lower back pain is non-specific, meaning there is no structural damage or disease from which the pain could have been caused. Our life expectancy is higher than ever before in human history, but I would argue that our quality of life is deteriorating rapidly. Reported lower back pain as of 2020 was at 619 million affected; estimated by 2050, that number could be over 800 million. Okay, enough fear-mongering and let's dive into ways to make ourselves more resilient to the growing problem of lower back pain.

Our life expectancy is higher than ever before in human history, but I would argue that our quality of life is deteriorating rapidly.

Okay, so I have a confession to make. I recently tweaked my lower back doing something dumb. I tried to broad jump as far as possible without a warmup. If you don't know what a broad jump is, it is when you try to jump as far as you can and then try sticking the landing. I was pretty happy I could jump 9 feet without a warmup but only to realize a bit of low back stiffness afterward, which eventually turned to low back pain. After I injured my lower back, I did several things that helped alleviate the pain. Two days later, I was back exercising and moving as usual, so I figured my success was worth sharing.

A quick disclaimer, this is not medical advice, and if your doctor has not cleared you for exercise, I highly recommend you do that before applying some of the things I talk about here.

Number one reason you still have low back pain: You keep trying to stretch it out. Even google doctor recommends it.

Stretching can be beneficial, but one phrase that drives me crazy is when I hear someone experiencing tension and tightness in the body say, "I need to do more yoga." To be clear, I have nothing against yoga and believe it can be beneficial, but to view it as the panacea to all muscle tightness can steer someone into more issues. Let's get back to the person experiencing low back pain and who decides to take up a stretching routine. Often, the hamstrings get tight when low back pain flares up, and mind you, it will probably feel good initially to stretch tight hamstrings, but in the long run, you are just extending your time with back pain. Let me explain.

The highlighted muscles in the photo above are the hamstrings. The hamstrings originate at the hips and insert at the knee further down near the bottom of the image. Now, if the low back is tight or has been injured, it makes sense that your body will want to limit movement at your hips to keep the low back from moving into a painful position. Guess what? The hamstrings, or AKA Hamhocks, are connected to the hips. So now you are starting to see why hamstrings get tight and how they protect the low back by providing stability at the hips. Okay, maybe you already knew that but are still wondering what you can do instead of stretching to relieve low back pain.

Provide more stability using Stuart McGill's big three, including the modified curl-up, the bird dog and the bent knee side plank—an excellent explanation of the three exercises in the video below. If you want to understand low back pain on a deeper level than I can do here in this blog, buy "The Back Mechanic" by Stuart McGill: https://www.backfitpro.com/books/back-mechanic-the-mcgill-method-to-fix-back-pain/

The goal with the big three is to provide your body with strategies to stabilize the torso or spine while moving the head and limbs. Additions I will add to your stability routine are progressions to the big three, where you can develop strategies to stabilize the spine while moving on your feet. They are Standing cross-body limb fight, single leg deadlift with opposite hand overhead reach, and chaos suitcase march. Keep scrolling through if you'd like to check out the additional spine stability exercises. I recommend starting with Stuart McGill's big three first for at least a couple of sessions or until low back pain improves. Consistency with your chosen stability practice is essential to alleviating low back pain. Even if that means you only do the cross-body limb fight once daily for 10 seconds per side. Stick to it for at least a week before adding something different.

Consistency with your chosen stability practice is essential to alleviating low back pain.

Standing cross-body limb fight:

Single leg deadlift with opposite hand overhead reach:

Chaos suitcase marches:

Number two reason you still have low back pain: not enough walking.

My dog Hendrix is the most handsome boy.

I love having Hendrix for several reasons, but the number one reason is the time we spend together going on walks. I firmly believe in the power of walking and how restorative it is for us bipeds. Walking should be one of those activities we do without effort, and we can go for hours without significant issues. Okay, you have probably heard ten thousand times how important it is to get ten thousand steps a day, so I won't throw that down here as a challenge to you; what I will challenge you to is feeling your body when you walk. I challenge you to see how little effort you can use when you flow from right to left. There is magic in the gait patterns like crawling, skipping, walking, rolling and running. When was the last time you got down on the ground and crawled? Or went for a skip like you did when you were ten years old, playing outside with your friends? The fact that we can move in all these ways is a miracle, and not regularly engaging in the advantage of our movement capabilities is why so many are living in physical pain. Go for a walk in nature every day for a year, and you will undoubtedly come out of that experience a more vital version of yourself.

I believe that just as we were designed to sleep, we are also designed to walk daily. We know the answers to our pain and suffering in this life, and most of the solutions are almost too simple that we do not take them seriously enough to do them consistently to sustain vitality for the rest of our days. Get to stepping regularly to help alleviate low back pain.

Number three reason you still have low back pain: not enough conscious breathing.

Breathing is autonomic and happens without us having to spend any mental energy to make it happen. The downside is that we can default to breathing patterns that no longer mimic the type of breathing pattern that communicates to the brain, "I am safe." Two subdivisions of the body's autonomic nervous system are parasympathetic (rest and digest) and the sympathetic nervous system (go mode or fight-flight). You have probably heard of the studies surrounding how little we breathe when reading an email versus how we breathe when fully relaxed. When reading a work email about the project review, your body goes into go mode. When in go mode, our bodies will breathe more shallowly because there is no time for long, drawn-out inhales and exhales. Go mode is about mobilizing energy quickly and taking action. Whether being fired from your job or chased by a mountain lion, the body does not know the difference. Both events will alter your natural breathing pattern and shift you into go mode.

Just think, if your body is perpetually screaming danger by being in go mode, do you think that will promote recovery of your low back pain? To rest and repair fully, we must shift into a parasympathetic state. There are a few ways to do this. I mentioned one of them earlier, which is going for a walk. You can supercharge that walk by moving slowly and breathing through the nose exclusively. The other thing worth trying is to place your tongue on the roof of your mouth while walking and breathing through the nose. The diaphragm can function optimally by having the tongue on the roof of the mouth. The diaphragm provides stability for the spine, and when functioning optimally, it helps all the other spinal stabilizers, like the pelvic floor, transverse abdominis, the psoas, and the multifidi, do their thing in making the body strong.

To rest and repair fully, we must shift into a parasympathetic state. There are a few ways to do this.

Not breathing optimally is probably the number one reason people suffer from low back pain because how you breathe affects everything about you, from heart rate, emotions, digestion, hormones, thoughts, muscle tone, and so forth. I decided to put this one last for this blog to leave a lasting impression on the importance of occasionally paying attention to your breath. I want you to feel safe in your body. I want you to feel strong and empowered in your body. The breath is the gateway to being in your most optimal state.

Want to know more about how breathing can help lower back pain? Check out the study below.

Ki, C., Heo, M., Kim, Y., & Kim, J. (2016). The effects of forced breathing exercise on the lumbar stabilization in chronic low back pain patients. Journal of Physical Therapy Science, 28(12), 3380-3383. https://doi.org/10.1589/jpts.28.3380

Wrap up:

The quick takeaway; stabilize the spine with proper breathing first, add trunk stability exercises like the big three and then cap it off with a walk.

There is so much more I have to say about this topic, and I can almost guarantee there will be a part two. For now, I hope this finds you before you start stretching your hamstrings. The quick takeaway; stabilize the spine with proper breathing first, add trunk stability exercises like the big three and then cap it off with a walk. Do that consistently, and be patient with yourself. Pain is information your body is communicating to your brain, and that message could have been brewing for months or years, and now it has shown up. There are no overnight solutions, but there are certainly things you can start doing today to inch closer to being in a pain-free body.