A Pilot’s Guide to Self-Managing Back Pain – Core Strength & Flexibility

“It’s not the job of sports medicine professionals to look after your tissues and joints, whether you hydrate or whether you actively work toward improving and maintaining healthy positions and range of movement throughout the day. It’s up to you. Spend 10 minutes minimum per day. No days off. No excuses.”

– Dr. Kelly Starrett, READY TO RUN

In my attempts to nurse my back to full strength, I have spent a great deal of time researching how to manage my pain, while also looking at the best home remedies/exercises to help fix my injury and prevent similar ones from happening again in the future.

As a result I have decided to compile my research into this comprehensive guide regarding all the things I’ve found particularly useful for managing my back pain day to day, including some important what-not-to-dos!

Following on from my previous post – Sitting, Standing, Swimming – this post will explore core strengthening and flexibility. The following post will look at lifestyle tips and how to sleep properly. A final post will look at the use of drugs/other treatments plus some final thoughts.

It goes without saying I’m not a medical professional in any way, shape or form, so please, please, don’t take what I’m saying as gospel. I’m simply relaying what has helped me in managing my pain. 

Back pain is a complex issue that I believe requires a complex approach from a number of different angles. Trial and error is necessary in figuring out what works best for you and your condition. 

Hopefully this guide will help you as well in some way, shape or form. As always seek advice from a professional (added advice – seek more than one opinion) and do your own research.

I’ve left links to a number of articles throughout that I found useful/helped support my own findings. I should add I am in no way affiliated with any of the organisations mentioned or products that I recommend. 


CORE STRENGTH AND FLEXIBILITY ARE KEY

CORE STRENGTHENING aND FLEXIBILITY EXERCISES NEED TO be a top priority, not only to aid in recovery, but crucially prevent further injury down the line!

YOGA is an obvious go-to that COMBINES BOTH FLEXIBILITY AND STRENGTH well. It’s also easy to modify, as needed, depending on your pain/condition.

PILATES ALSO COMES HIGHLY RECOMMENDED by many health care professionals in aiding lower back pain.

Before you jump down to do 100 sit-ups there are a few things worth knowing.

NOT ALL CORE STRENGTHENING OR STRETCHING EXERCISES ARE GOOD FOR YOUR BACK. Sit ups, for example, put a lot of pressure on the discs in your spine and are best avoided. Other stretches such as forward bends can be equally bad for those who suffer from lower back issues.

I’ve found the following TO BE problematic TO SOME DEGREE:

SIT UPS – BICYCLE CRUNCHES – RUSSIAN TWISTS – BOAT POSE – DOUBLE LEG LIFTS – TOE TOUCHES/FORWARD BENDS – DOWNWARD DOG – HAMSTRING STRETCHES

This list is not exhaustive – just off the top of my head. That said, I have been able to modify a few of these exercises/stretches to work for me – Hamstring stretches on my back for example – as opposed to bending from sitting or standing – doesn’t cause me pain unless I over do it!

It goes without saying but EXPERIMENT TO FIND WHAT WORKS FOR YOU and as always use pain as your guide. IF IT HURTS BACK OFF (more on this below!).

With that in mind here are a few tips I’ve found useful.

A key aspect for most core exercises is KEEPING YOUR TAILBONE TUCKED AND ENGAGING YOUR CORE AND GLUTES.

Similarly when performing ab exercises from your back you want to KEEP YOUR LOWER BACK GLUED TO THE FLOOR (imagine drawing your navel towards your spine).

Strengthening and improving flexibility both upstream and downstream of the problem area is also important. For your LOWER back this means your glutes, quads, hip flexors, HAMSTRINGS, upper back and chest, as well AS your core.

Below are a list of exercises & stretcheS that I’ve found work well without aggravating my pain. As always these are exercises I’ve found work for me. That might not be the case for you. Be cautions and let pain be your guide.

Rather than bore you with a description I’ll leave it up to you to look them up and choose which ones you would prefer to incorporate into your daily routine.

FYI there are a million and one great workout videos you can follow on YouTube or other such media platforms. Simply Google exercise videos for lower back pain and away you go. I often follow fitness blender workouts when on a layover in my hotel room.

On your front:

PLANK

BIRD DOG

PIGEON POSE

CAT 🐈 COW 🐄 

CHILD POSE

SPHINX/COBRA POSE

SUPERMAN 

On your back/side:

SIDE PLANK

BRIDGE

PELVIC TILT

PARTIAL CRUNCH 

WINDSHIELD WIPERS

GLUTE STRETCH 

HAMSTRING STRETCH

HAPPY BABY

From standing:

WALL SIT

FORWARD/REVERSE LUNGE

QUAD STRETCH

SQUATS

https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265?s=3

https://www.everydayhealth.com/back-pain-pictures/the-best-and-worst-exercises-for-back-pain.aspx

https://www.webmd.com/back-pain/ss/slideshow-exercises

https://www.self.com/gallery/core-exercises-for-lower-back-pain-relief/amp

https://www.self.com/story/the-abs-exercises-you-should-skip-if-you-have-lower-back-pain

https://www.healthline.com/health/fitness-exercise/anterior-pelvic-tilt-exercises


LISTEN TO YOUR BODY BUT DON’T STOP MOVING

For the vast majority of injuries there is almost always a healthy and safe way to modify your exercise routines. Sure it might mean you have to stop running for a while or playing tennis (or whatever that sport you love may be) but it certainly doesn’t mean you should stop altogether. It’s not a death sentence.

I would argue NOT MOVING MIGHT BE THE WORST THING YOU CAN DO. I’ve certainly found this to be the case with regards to back pain. Remaining sedentary or trying to do nothing certainly hasn’t worked for me.

You need to move, stretch and strengthen everyday. You do, however, need to be smart about it. By this what I really mean is, LEAVE YOUR EGO AT THE DOOR!

It was leading up to a weight training session that I felt a small twinge in the back of my lower back. The alarm bells were there. It didn’t feel like much so I pressed ahead determined to ‘get ripped’ like a jackass. The result? I put my back out doing deadlifts…

LISTEN TO YOUR BODY. ONE MISSED WORKOUT IS ALWAYS WORTH IT TO AVOID INJURY. I’ll say again, if your body is trying to tell you something, listen. The same applies post injury too (something I’m also well versed in).

It might seem obvious but YOU SHOULD NEVER BE STRETCHING OR TRAINING TO OR BEYOND THE POINT WHERE YOU FEEL PAIN. .

When lifting weights you have to BE VERY CAREFUL NOT TO OVER DO IT. Once again leaving your ego at home is highly recommended! Start small and build slowly. Never ever sacrifice your form for amount of weight.

Equally important to consider is the type of lifting exercises – which matter greatly depending on the particular condition and severity of your back injury/pain. IF YOUR COMING BACK FROM INJURY GO SLOW!!

When testing the waters with weights last week, despite lifting only a small amount, my back decided to complain considerably the next day. It was too soon. Until you’re back to full strength, AVOIDING IMPACT FROM BELOW AND WEIGHTS FROM ABOVE ARE GOOD RULES OF THUMB to follow! My weights remain firmly in the closet for now. I’ve already done a fine job prolonging injuries over the years. This time my ego will have to wait. 


Mission ImBACKible – How do you fix chronic back pain and what if you can’t?

My mother has suffered with chronic back pain and sciatica for many years now. Sadly she still does.  

Her story is very similar to countless others. A story of multiple misdiagnoses and scans which showed little, if nothing, out of the ordinary. 

Ultimately the frustration over many years led her down the path of trusting a surgeon to remove one of her discs and then fuse two vertebra together.

It didn’t work.

In fact, it made matters worse. 

Forgetting the fat cheque that private surgeon took home, or the many painful and frustrating nights that followed, the happy ending to the story is this. 

My mum can do more or less everything she wants. She can stand. She can sit (although not for too long). She can walk. Her overall range of motion is good. She can pick up and hold her grandson. She can play with and read to him while sat in her lap. And she can do all of this without too much pain.

BUT.

She still suffers from chronic back pain.

She manages her pain by doing a number of daily mobility exercises, walking often and sitting less. When she does sit she uses a pillow for support (to watch tv or have dinner) and stands regularly to stretch. On top of this she occasionally goes swimming or attends a pilates class. She also takes pain killers to help her sleep through at night. All of this means she can still have a decent quality of life.

The main point is this though:

SHE MANAGES HER PAIN. Her pain has not been cured, but SHE HAS MADE PEACE WITH IT. She doesn’t complain about it or let it detract from her day. She simply gets on with life. 

Her acceptance, despite many years of fighting this frustrating, heart-breaking battle, is truly inspirational.

It’s an important lesson I mean to take with me as I attempt to solve/manage my own issues with back pain. 


A WORD OF WARNING ⚠️ 

(I should say, for those who are considering back surgery as an option to help cure their own back pain, proceed with caution!! Surgery should be the absolute last call of action and even then, you better be damn sure you have an accurate diagnosis. 

Peter Ullrich, an orthopaedic surgeon, has this to say,

“The number one determining factor whether or not a fusion surgery will deliver the desired reduction in pain is an accurate preoperative diagnosis, meaning a diagnosis that clearly identifies the underlying cause of the patient’s pain.

Identifying degeneration of other changes in the spine is not sufficient—the diagnosis needs to identify that those changes in the spine are actually causing the patient’s pain. Many people have a bulging disc, herniated disc, stenosis, and other issues with their spine, but no pain.

I can’t stress this point enough.”

If you’d like to know more please have a read of this article).


So what’s wrong with me?

A lot of things but let’s stick to the topic of my back for now. 

I injured my back early on while training for the London marathon in 2014. Instead of backing off though, I ran through it, repeatedly… Stupid, I know. 

Following that I attempted to run a half marathon in new shoes, a month out from the main event, during which something in the back of my right knee gave way… Stupid, I know.

I limped home and didn’t train again till I ran the actual thing. 

On race day I wore a compression top for my back and had both knees strapped. Despite feeling pain in both, I felt committed (having asked so many people to sponsor my brother and I), so I ran the London marathon anyway… Stupid, I know. 

(Side note: I should write a piece on how not to run a marathon). 

I finished in what was probably a record slow time for my age, but I finished! It was an unforgettable day and one that I cherish.

BUT.

It came at a price. 

The long term result is, I’ve suffered on and off with a variety of different issues related to the back and neck ever since. While it’s clearly been nothing serious, as multiple MRI scans have shown, my back has never truly healed either. 

More recently (a few weeks back to be exact), I managed to put my back out lifting weights, bringing on a fresh wave of lower back pain and sciatica that has, quite frankly, scared the shit out of me. 

What if it’s something serious? 

What if I never can never lift weights again? 

What if I have chronic back pain for life? 

What if, what if…. I, I, I… Me, me, me….

STOP!

Take a breath. 

Observe. 

Proceed.

After a long period of catastrophizing and feeling sorry for myself, its clear I’m in a dangerous position of falling down the rabbit hole again.

I need a plan.

So, here it is…

1) Start treatment with my PHYSIO. (I know a lot of people who swear physio off as inconsequential, but I think it has its place. I can’t say it’s ever been a cure to my problems but I have responded positively to it, feeling better after – if only for a day or two. Nonetheless I believe it’s better than not having it, so I plan to continue)

2) Start treatment with an OSTEOPATH. I’ve had success with Osteopathy before, so I’m going to start here before considering other forms of treatment. (Those that I want to have look at include Acupuncture &/or Acupressure, Active Release Technique (ART), Biopuncture and Dynamic Neuromuscular Stabilisation (DNS) should the physio and osteopath not prove affective).  

3) In the interim I’m going to get an MRI SCAN to help see exactly what is or isn’t going on in my lower back – hopefully ruling out some more nasty possibilities as a result. 

4) Following that I’m going to take MRI results to an ORTHOPAEDIC specialist for advice on the problem.

5) Research/test out the best WAYS TO MANAGE MY BACK PAIN AT HOME AND AT WORK including the BEST STRETCHING AND STRENGTH EXERCISES plus HOW TO SIT, STAND AND WALK properly. Also what not to do and what other things or tools (shoes etc.) one can use to help (A pilots guide to managing back pain – my next blog post will be a result of this particular research). 

6) Follow up with my results later this year, looking into HOW I CAN PREVENT SIMILAR INJURIES GOING FORWARD and to make sure I have a healthy back well into my old age. I also want to look at HOW TO IDENTIFY AND CORRECT IMBALANCES WITHIN THE BODY (One thing I want to look into is Functional Movement Screening (FMS)). 

7) Regardless of whether I find myself back to full back health or not, I want to look into the IMPLICATIONS OF PERMANENT CHRONIC BACK PAIN. How to manage that going forward? What are the best coping mechanisms people who are in this situation use? (Aside from what pain killers one might use I really want to explore the best PSYCHOLOGICAL TREATMENTS for coping with chronic pain including Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT)).