When Low Back Pain Strikes Unexpectedly

Woah! I am starting off this blog with a biggie – low back pain! Yup – this is a huge issue. Just look at this quote from the NIH.  I am one of those 80% and this has been one of the biggest motivators in my search for a sustainable physical practice that will keep me active and happy through the end of my life. Figuring out how to keep my back happy was initially the reason I began practicing yoga, and many years later it was also the reason I left yoga. Curious? Read on, dear soul…

So, I am writing about this tonight, because yesterday I unexpectedly tweaked my low back. Opportunity! What better reason could there be for writing about an issue that is hugely important to me? This is the first time this has happened to me in years, which is a good sign that what I have learned has helped. Anyway, first I’m going to write about my history, so that you know where I am coming from. As we said at the beginning of this blog – history is important – we’re all different. You need to know what is behind my story. Then at the end of this post, if you’re still with me, I’ll get to what happened yesterday, how I managed it, and how it resolved!

My relationship with my low back goes all the way back to my early twenties. Yes, yes… we’ve been acquainted since I was born, but I didn’t really get to know my lower back until I began having low back pain in my third year of college. Until then, the only serious thought I’d given that part of my body was worrying about it getting sunburnt when I was biking. Now that I am in my 50’s, I have spent decades thinking about my low back and working on a physical practice that keeps it and me happy through my life. For the most part, I have been successful at this. At 52, I am still extremely physically active, and I rarely if ever have low back pain these days. This is the first time I’ve had a problem like this in several years. However… the unexpected happens occasionally, and it is a great opportunity to see how my practice is working.

First, a little about my history of physical practice / exercise. I was pretty active in high school and the first couple years of college. I cycled, learned kung fu, and lifted weights on occasion in high school. In college my activity level went down, I began having low back pain in my third year when I was studying architecture and spending a lot of time sitting at a drafting table – sometimes spending all day and night working hunched over on a short deadline. My back started really bothering me. I didn’t go to the health clinic, but on my own I decided to try spending time on the rowing machines at the gym as a way to strengthen my low back muscles. Amazingly, the problem up cleared up entirely in about a month. From that point on I became convinced that strength training can make an enormous difference in managing certain low back problems.

In the intervening 30 years I have gone through several stretches of time when I struggled with some low back pain. With a couple exceptions, most all of these seemed to be due to prolonged periods of inactivity or sitting. And most of these I have been able to manage with some sort of exercise routine. There were two major exceptions to inactivity as a cause of my back pain. One time I took a very long fall when I was leading a rock climb. I fell on a rope, but the total fall was probably over 30′. The more important episode was an an incident when I received a bad adjustment from a yoga teacher. At the time, I was learning an advanced Ashtanga yoga series with a traveling teacher. Ashtanga yoga is a very intense, gymnastic style yoga practice that is often popular with athletes. I was working on  an advanced back bend (“Kapotasana A” for those of you who are interested), and the teacher gave me an assist that stretched my back too deeply. I was practicing Ashtanga yoga very regularly, and I had a regular 2nd series practice. When the teacher suggested adjusting me, a little voice inside my head told me that I should not go deeper.  Unfortunately I listened to the teacher rather than my own intuition, and as a result had to take six months off any serious physical activity.

When I returned to Ashtanga yoga I continued to advance my practice and teach, but over the next decade I began to look more closely at what my body needed rather than what someone else said was good for it. I found that even after eleven years of very dedicated Ashtanga yoga practice my back would start bothering me if I even slacked off one week. I wanted my body to be sustainable for the long haul and resilient to injury, but this suggested to me that Ashtanga yoga was not supporting this goal. So I began the explorations to create my own practice.

Tweak! So, what happened yesterday? Admittedly I was doing something that is physically challenging. I was picking up my 8 1/2 year old step-daughter Isabel over my head – over and over. Right after one of the times I lifted her I felt a sharp pinch in my lower back. Over the next hour my back became progressively more painful. But… I do this regularly – literally several times a week. So why did my back suddenly start acting up this time? Have you ever had a situation like this, when you are doing something that you have done a million times before and suddenly it goes wrong? I have. (Please leave a comment below with your experiences)

Here is what I think happened. The day before the tweak I had done a very strenuous workout that included a lot of core work, a lot of exercises that work the low back muscles and some very deep stretching that included deep back bends. The park where I normally exercise (Barton Springs) had been closed for a month had re-opened. I was excited to be back, and I really wanted a good workout. It wasn’t way out of the ordinary for me, but it was more strenuous than I had been doing over the past month or so. Then yesterday, Rachel and I surprised our daughter, Isabel (aka Curly Girl) in summer camp at another pool during our lunch break. Isabel was happy, and I threw her around like I normally do. But here’s the thing… I had been sitting all morning, I hadn’t warmed up my muscles which were tired from the previous day, and the pool water is cold – 68 degrees. It was probably a quick, small compression injury that inflamed the lower back muscles. The inflammation pressed on some of the many nerves that radiate from the lower back, and Voila! Back pain! Ah… It’s been so long since we’ve met! I don’t miss you!

Recovery I feel strongly that there is no single prescription for dealing with injuries. The most important thing is to learn to listen to your body, and learn a variety of ways to handle different types of problems. In a nutshell, here is what I did to recover. This is a pretty standard routine I use whenever I have a sot tissue injury, and I have had many.

1) Reduce the inflammation with ice, an ice/heat combo or anti-inflammatories. This time I used anti-inflammatories (naproxen sodium or Aleve), because I didn’t have the option to easily ice my back after it happened. I prefer naproxen to ibuprofen because it lasts for up to 12 hours. Years ago a nurse friend told me that treating inflammation injuries quickly can make a difference in how long an injury lasts, because the inflammation itself can cause more injury, but these days there is a lot of controversy about them in the physical therapy world on whether they help or hinder healing. Here is a good article about the issue – read this review and decide for yourself. Perhaps the reason anti-inflammatories help is that they allow you to start moving again, and most recent research has supported the idea that rehab needs to start as soon as possible – this is true even with serious injuries like a broken hip.

2) Keep the area of injury in motion as much as possible. I reduced the intensity of my exercise the next day, but I still tried move the area – albeit gently – as much as possible. Later the same day, I did a set of gentle, dynamic recovery stretches and two short gentle swims, keeping an eye on how my back felt the entire time. I avoided intense back bending and anything that created additional pain. What i wanted to do was to make sure that I wasn’t letting the area remain still. Over the next week I kept assessing the feeling of my back while exercising, trying to work back to my normal state.

The end result… I am writing this paragraph a month later. I have had minor tweaks like this one in the past. I recognized the initial feeling of a sharp mildly painful pinch and the speed at which my back started to feel uncomfortable and then painful. After two days my back felt almost back to normal. Over the next week and a half I had a few setbacks, but by maybe ten days I felt completely strong and pain free again. Ten years ago this sort of minor injury would have stuck with me for several weeks. The worst injury I had like this knocked me out of commission for nearly a year, and for the first month it would take 15-20 mins after getting out of bed before I could stand up straight. I am really happy that I was able to work through this problem quickly.

At age 51, I feel that is a major success, and I feel as though the physical practice that I have developed is a major part of my recovery. I think a big reason I recovered so quickly is that I have spent much of the last decade strengthening the muscles that support the lower back, keeping those muscles and joints in regular motion and trying to maintain a moderate degree of flexibility. I believe that this combination builds a bulwark against chronic back injury. Much of what I am going to talk about in this blog will center around these sorts of exercises, and of course all the other varied things that make up my physical practice.

Keep moving and listen to your body. I believe this is the most important thing to know how to do. Keeping things in motion soon after an injury is important, but you must know how to listen to your body. Learn where the limits are, because you can set yourself back. I had some minor setbacks while healing this, but I listened and healed fast.

I plan to write more about injuries in general, and how I’ve dealt with them over the years. Injuries are inevitable if you are very active, and likely if you are moderately active. Learning how to recover from them is a huge part of creating a body that is sustainable and will allow you to stay active, happy and comfortable. Hope you’ll join me, and please share your own experiences in the comments below!