The 5 Steps to Reversing Chronic Back PainApr 12, 2020
Written by Dr. Ryan Peebles, DPT
Step 0 – Believe
Biggest mindset component: You will get better and you must know it to be true. It’s a prerequisite.
Step 1 – Mindset Shift – Adopt a “Whole Body” Perspective.
Look at your body as a whole unit. You may feel that something is wrong with your “back”, but you must begin to understand that this is not entirely accurate. Your back is just taking the biggest hit for something that’s going wrong on a broader level.
Your back is at your core. Literally, your lumbar spine is inside your core. It is central to your entire body. What better place to manifest pain when there is an imbalance in your body? Change your perspective about what your back pain represents. You don’t have a “bad back”. Your core is out of balance.
Further, when you have back pain, you don’t just have an injury to a joint (like an ankle injury), you have an injury to the core of who you are. And it reveals itself that way in your life. It affects your mind. It affects your psychology. So you need to make changes, not only to physical components, but also to mindset components. Look at it from a holistic perspective. This is a whole-body, whole-self mission.
Step 2 – Learn Yourself.
You don’t have to get a doctorate in physical therapy like I did. Learn some basic concepts about the body in which you live. In order to reverse your back pain, you need to understand what’s happening in your body that’s causing it. Otherwise you depend on your faith in other people and their interventions to fix your problem. With a little knowledge of what’s happening and how to reverse it, you empower yourself to take things into your own hands. Learn about muscle imbalances, and how they are the underlying causes of back pain. Learn some basic concepts about training to reverse them with therapeutic exercise.
Step 3 – Become Aware of Your Core.
What is your core? What does it feel like to use not just your abdominals, but your entire core synergistically? Before you can learn how to use your core, you must become aware of it. What does it feel like to connect with your anchor zones? People with back pain likely have decreased connections to their core.
During my years of struggling with back pain, I compensated for my underactive core by overusing my arms and legs. I’d get up or down from a chair using my arms and legs heavily with my core largely not participating. This is called “limb dominance”. My core was dormant and I didn’t even know it. We need to become aware of this pattern, reverse it, and work towards what I call “Core Dominance”.
First, you need to reactivate your core because it has gone dormant. We have terms for this in the industry: Deep Core Amnesia, Gluteal Amnesia. Yes, the glutes are part of the core. Reawaken your connection with your core, then strengthen the connections.
How do you increase the connection to your core? A guitar player has highly developed neuronal connections to the fingertips in his hand. Was he born with this? No. He acquired it through training. There are specific exercises you can do to re-awaken and re-connect with your core.
Step 4 – Balance Your Core.
In a nutshell, the muscles that make up your core tend to get out of balance with each other. Their tone, or resting length, increases or decreases in relation to each other. This is called a muscle imbalance. It happens to virtually everyone to various degrees and is a predictable pattern. This pulls your body out of alignment and leads to things like increased compression, friction, and ultimately pain. Like guitar strings that get out of tune, you can tune your muscles back into balance through therapeutic exercise.
Step 5 – Move With Your Core.
Once your core is in balance, you can start moving in a healthier way. Final guitar reference: skipping to this step is like trying to make an out-of-tune guitar sound right by practicing more or playing better. You must tune the guitar first to make it function properly. In the same sense, your body will not function properly until the muscles are in balance with each other.
Learn how to use your core as a foundation to perform basic movements, functional movement training. It’s easier than it sounds when your core is activated. You will naturally start to move in a healthier way as your core becomes balanced.
You can do this by going through life with a little bit of a core mindset. Stay conscious of your core as you take your body though the normal movements of life. Reaching in the cupboard, picking something off the floor, sweeping, playing sports, literally anything. Simply living life can have a huge impact on maintaining your core by using it regularly.
Finally, do an exercise every once in a while to stay in balance. This is especially important if you sit a lot, drive a lot, work at a desk, lift heavy things, or your back injury is such that you need to maintain it. Just listen to what your body needs. It communicates to you regularly.
Personally, I just do one exercise regularly and that’s the bridge. But largely, the rest of the time you’re able to just live a normal life. You don’t need to become a gym rat. It takes 2-5 minutes a day, just like brushing your teeth. And it’s not a problem if you skip a day here and there.
Pain-Free is Inevitable
Put all this together and you have a package for an aware person, who knows how to move healthily, who knows how to take care of their body. And the knowledge is yours for life. This is Empowering.