Banish Back PainSusannah Kent February 1, 2010
Simple Strategies to Keep Your Spine Strong, Healthy and Pain-Free
“Oh my aching back,” are words that will cross the lips of four out of five people at least once in their lifetime. Other than cold and flu, back pain is the reason most cited for missed work and or visits to a health care practitioner. Back pain can disrupt every aspect of life, restricting activity and wreaking havoc on not only physical well-being, but emotional as well. Fortunately there are numerous simple, safe and smart preventive measures that anyone can use to avoid hurting their back.
Practising correct posture is crucial to maintaining a strong, healthy back and preventing back pain. Understanding what good posture entails is the first step. Our spines have three natural curves: the neck (cervical spine) curves inward, the mid back (thoracic spine) curves outward, and the low back (lumbar spine) curves inward. Ideally, we want to try and keep the three curves of our spine in natural balanced alignment. A neutral spine position is the one which provides the best balance and causes the least amount of stress and pain to the joints, ligaments, and muscles. You can bring balance back to your posture when sitting, standing or lying down by adopting some of the following habits.
When you sit, don’t hunch over with your back compressed and your shoulders curved forward. Even though this position may seem normal and comfortable, eventually it will take its toll. What you want to achieve is sitting up straight with your pelvis in a neutral position, maintaining the natural inward curve at the base of your spine. If your chair does not have sufficient support, try using a lumbar cushion, pillow or rolled towel at the small of your back. Knees should be positioned just below hip level, and feet should be supported – either flat on the floor, or if that is not possible, use a block to elevate them to the proper height. Try not to cross your legs when sitting as this puts your spine and pelvis out of balance. And avoid sitting curled up on the couch or armchair with legs tucked underneath you. This position will force your spine into an unnaturally sharp curve. Remember that even if you have the best chair in the world, and adopt the perfect sitting posture, there are still risks to sitting for prolonged periods of time. Take short breaks to stand and stretch.
When standing, do so with feet shoulder width apart and weight evenly distributed over your heel and ball of your foot. Stand with your head, neck and shoulders relaxed and your knees soft, not locked. Your ears, shoulders and hips should be in alignment. If work requires you to stand for long periods of time, keep your work close to you and at a comfortable height so that you do not have to reach, twist, or stretch too far. As with extended periods of sitting, standing too long in one position tires back muscles causing them to sag, which stresses the spine. Take breaks and walk around or shift frequently at your post. To give your spine more support, you should wear comfortable, low-heeled shoes with good arch support.
Sleeping right can prevent back pain, as well. In general, it is best to sleep with the hips and knees bent with a pillow between your knees, and a flat pillow under your head. If you lie on your back, put one or two pillows beneath your knees. To get out of bed safely, roll onto your side, let your legs drop off the bed, and push up with your arms. A good mattress (not too hard or too soft, with a box spring that does not sag) will also help avoid back problems that can be attributed to poor sleep posture.
Moving the wrong way when we lift, carry, bend and twist can hurt. As with poor posture, inappropriate body mechanics when moving often puts our backs at risk. Practising the following techniques will help you move safely.
To keep unnecessary pressure off your back, choose squatting, kneeling or sitting instead of bending to a task. To lift and carry, bend the knees, not the back. Keep the back straight with the feet hip distance apart for better balance. Try to ensure the bent knees do not extend beyond the toes. The object to be lifted should be kept close to the body – waist or pelvis level, no higher. Use both hands to distribute the weight evenly. And pay attention to your own physical limitations – some things are just too heavy for one individual to lift or carry safely.
Correct posture and form when performing everyday tasks and functions will go a long way toward preventing the straining of the muscles surrounding the spine – the most common cause of back pain.
MOVEMENT THERAPY TO ALLEVIATE BACK PAIN
Building flexible strength – through a variety of physical activities and movement therapies – is central to beating back pain. Specific exercises to strengthen and stretch the back, abdominal, buttocks and thigh muscles (which help support and maintain alignment of the spine, ribs and pelvis, whether static or moving), will address the issues of tight, weak and shortened muscles – often the main culprits contributing to back pain.
There are numerous stretches which will help prevent and ease back pain, but my favourite is the knee to chest. Just lie on your back with your knees bent and feet flat on the floor. Clasp your hands below the knee cap and draw the knee towards your chest, hold for a few seconds and switch sides. Breathe slowly and deeply throughout. This is a nice relaxing stretch for the low back and buttocks.
A program of back strengthening exercises should consist of ones that help build all the muscles of the core and include both flexion – pulling the back forward and down – and extension – lifting the trunk upright. The lying back extension exercise is very effective for building up the back extensor muscles and improving posture. Lie on your stomach with your head facing down, legs straight and arms extended in front of you. Using your back muscles slowly lift your arms and legs off the floor about one to two inches. Try holding for about three to five seconds, release and repeat five to 10 times. Excellent examples of flexion exercises to support the back and spine are the traditional abdominal curl, and the oblique or cross-over curl.
Some forms of exercise that help to build a strong, healthy back and can contribute greatly to the avoidance of back pain are yoga, Pilates and Tai Chi. Many of the postures in yoga gently strengthen back and abdominal muscles, helping the body maintain proper upright posture and movement. Pilates exercises foster awareness of neutral alignment of the spine, and strengthen the deep postural muscles that support this alignment. Tai Chi, with its slow, fluid movement, focused breathing and meditative state of mind puts an emphasis on improved posture, balance and alignment.
Instilling awareness of how the body moves as an integrated unit is another shared feature of yoga, Pilates and Tai Chi – and body awareness is a key element in learning to move in ways that protect your back. Unfortunately, most of us have no idea how we move, let alone how such movement patterns put wear and tear not only on our backs, but our whole system. The Alexander Technique and the Feldenkrais Method® expertly address the issues of movement education and awareness.
The object of Alexander Technique lessons (developed by Shakespearean actor Frederick Matthias Alexander, 1869-1955) is to learn how to perform an activity without interfering with natural coordination (your head, poised at the top of your spine, moves first). Over time, and with much observation and experimentation, Alexander discovered that once you allow the neck muscles to release rather than tighten, your head will naturally move forward and up instead of back and down. And as the head moves forward and up, the tension in the torso releases, the back lengthens and widens, and the legs and arms release out. The end result is the letting go of movement patterns that cause pain.
Until I had some Alexander Technique lessons myself with Toronto area teacher Graeme Lynn, I had no idea that when I sit down my head draws down into my neck, and my shoulders push up toward my ears. This constant pulling, pushing and inevitable tightening could very well be the cause of a whole array of muscle imbalances contributing to a number of painful back, neck and shoulder episodes that I experienced over the years.
The Feldenkrais Method® (formulated by Dr. Moshe Feldenkrais, an engineer, physicist, inventor, martial artist and student of human development, 1904-1984) is somewhat similar to the Alexander Technique in that it focuses on educating your mind to change and improve the way you move. I have been to a number of lessons and workshops over the years taught by Feldenkrais Centre Director, Marion Harris (a Feldenkrais practitioner for more than 26 years). Every time I am exposed to the Method, I make new discoveries about easier and more efficient ways to sit, stand and walk.
And recently, thanks to the Feldenkrais Method, I have discovered how to move with greater ease and no discomfort through some yoga postures that had always given me problems.
During Marion Harris’s “Feldenkrais for Yoga – Taming the Cobra” workshop, I rolled and twisted, lifted and rocked my body. Some moves were very familiar, others quite strange, even uncomfortable at first. But as the movements evolved into greater range and complexity, I began to feel my hips opening, my rib cage expanding, my shoulder blades sliding more easily downward, and the whole length of my spine moving, curving and lengthening with less effort. Unlike at the beginning of this workshop, I am now able to do forward bends and back bending (as in Cobra) with much less effort and no pain.
While back pain affects millions of people, it has become clear to me that by exercising to keep your body strong and flexible, using correct posture and good form for everyday tasks and functions, and learning to move more mindfully, you can create a pathway to safe, fluid, adaptable movement. It is this simple but priceless ingredient that will keep your back strong, healthy and pain-free.
· See pages 112, 113 in the print edition for a comprehensive view of upcoming yoga classes and workshops
· Marion Harris, The Feldenkrais Centre, www.feldenkraiscentre.com
· Graeme Lynn, www.intelligence-in-action.ca
· Carole Bodger, Smart Guide to Healing Back Pain, John Wiley & Sons, Inc., Toronto, 1999.
· Loren Fishman, MD and Carol Ardman, Relief is in the Stretch, W.W. Norton & Company, New York, 2005.
· Pat Manocchia, Anatomy of Exercise, Firefly Books, Richmond Hill, 2009
· Joan Sauers with Peter Edwards, DO, Quick Fixes for Everyday Back Pain, Marlowe & Company, New York, 2004.