Prevention: Preparing For the Inevitable
As mentioned before 80% of Americans will suffer backpain before they die. Given the age of the baby boomer generation and the way in which lifestyle conspires with work habits to generate back problems, I see little realistic potential for shunting aside what is certainly now and will continue to be an epidemic. The thing to do is become informed sufficiently that once the back does give out, the bad results are minimized and the rehab period shortened. The Updates section quotes a formal study which corroborates this.
I think as individuals we can minimize risk and probably avert individual cases to some degree, but an epidemiological response is needed to affect society as a whole for this thing to change. Given the current trend to established capitation rates for doctors, coupled with fee-for-service agendas within "managed care" settings in health, there appears little incentive within the health area for things to change.
Things you can do as individuals are listed below.
Work on those abs. Aim for a bloody "six-pack" and back damage, when it occurs will almost certainly be minimized. Do separate sets for the uppers, the lowers and the obliques. Keep in mind there are at least sixteen muscle groups for the stomach area alone.
Age: Caution Beginning At Thirty-five
As noted we have a "baby boomer" phenomenon which is generating a whole raft of societal issues. I have noticed a trend in persons remaining active for longer periods in their lives -- actually a resurgance from times prior to 1930 in America, when the lack of retirement benefits forced Americans to remain in the workforce. Still, this current active trend features all sorts of physically demanding stuff that the middle-aged corpus sometimes can no longer handle as well, especially in those who have done nothing to maintain conditioning. As a martial artist I used to experience all kinds of incidental injuries in my twenties that now, twenty years further down the road would take much longer to heal. And most Americans are, quite frankly, not in very good shape such that, yes, even a quick game of hoops is nothing they can do anymore without a warmup.
The re-evaluation of personal health past thirty may be the single-most important thing you do to prevent back pain. The other sounds almost like a contradiction: Donít just lay off exercise because of wanting to "act your age." Thatís a cop out and a surrender to the insidious pressures in society to conform to external modes of behavior. One of the greatest joys in life is breaking the mold cast for you by society. I will always remember with pleasure my encounter with the Kentucky Septuagenarian's Touring Motorcycle Club.
When I say, use caution, I mean employ careful warmup and stretching with as much seriousness as directed at the main activity.
Ergonomics Of Lift
I originally did a bunch of mechanical drawings and laid out the math for how the body works like a crane during lifting, but things got a little lost in the math. Thanks to the Liftech engineers for the calculus anyway.
The human spine works well as long as the vertical axis remains neutral. All the vertebrae stack on one another and all the muscles line up perfectly with no stress. The instant a force pulls the body off axis, the stresses multiply the weight of the load by the angle the body is off the perpendicular. Hence, a person with a backpack is tugged backwards off axis until the person compensates by leaning forward and using a walking stick to ease the load. Same principle applies with a load carried in front, such as your Uncle Ralph's beer gut. A big belly pulls the body forward off axis continually, placing stress on the lower back.
Put simply, the back acts similar to the arm of a crane: when you bend to lift, the point of the fulcrum being right there in the hollows of lower back. Because you are lifting not only the object, say a 12 pound child, but ALSO the combined weight of your arms, your head and your torso, the actual mass being shifted is considerably more. But the real stress is a function of the distance from the fulcrum of the hips to the second hinge in the back and then along the arm of the crane (your torso to your shoulders) combined with the angle of lift and inertia. That is to say the weight of that small child, your beer belly, or computer monitor is multiplied by the angle of the body bent over the object in effort required to lift 100x and MORE. So a 12 pound child then will need about TWO TONS of force to move. Ever watch experienced day care operators lift a kid? They squat to eye level with the tyke and lift with the torso fully erect.
The only alternative is to use a counterweight to balance the vectored forces. Which is what golfers do each time they set the tee. Over goes the back and up goes the hind leg to balance the weight of the torso.
No you were not "just picking up a pencil", when your back went out. You were lifting much more.
Ergonomics @ Work
This is a tough one to control. But some variables are within your control, such as brief rest periods, varied motion, stretching, etc. But you can put aside those stylish pumps and loafers and get some decent shoes with arch supports. Remember Steve Martin's routine about the salesman who sold "cruel shoes?" Enough has been written on workplace sitting posture and repetitive motion to avoid going into all that here. Let me just add that those 14 hour days may be exhausting the muscles to the point that chance of injury increases. Now, some of you can do nothing about the hours you have to put in, but you can keep in mind that age and other circumstances put you at risk. It is when you are tired that you will lift that briefcase, that UPS, that ream of paper in such a way as to tweak those muscles. Putting in a long day means following up with a restful sauna, NOT a two hour session of squash.
This is a good moment to bring up the issue of time of day. It is much more easy to injure an area when the surrounding muscles are fatigued.
I once watched an 120 pound woman load up two trucks worth of 100 pound haybales (that's about three tons)-- alone and with only two grappling hooks as tools. She did not bend over more than 10 degrees at any one time. She manipulated the bales so that the weight swung over the point of her hip and slid into place like a judoka executing a throw. She also took the time to reposition the trucks and the loading ramp so that she never had to extend her torso. The point here is that we must work smarter, not harder.
Join A Combined Health Program
It is safe to say that ANY attention paid to health will reap benefits ten-fold. Pick a gym activity, any activity, and you will find that an entire constellation of health issues revolves around it, including attention to footwear, clothing, posture, diet, supplements, joint care, stretching, etc. Put it all together and live your life outside of the gym with focus on what you do inside.
The stages I mentioned begin with that barely memorable "tweak" followed by stiffness. You have to know your body and the difference between morning kinks and a stiffness that reduces mobility. Visit a chiropractor or massage therapist. Often these two work in tandem and will make referrals if necessary. It is safe to say, given the state of things, if you have never seen a chiropractor, you probably should soon to be "adjusted" and appraised of risk. This business of paying attention is really the most important thing you can do, as all sorts of nasty things can happen to the back which are a lot more serious than lumbar strain. One case study discovered that his pain was caused by a tumor growing right on the spinal cord, and by the time he had it removed it had grown to the size of a golf ball.
Sauna, Spa, Gym
You are past thirty? Go to the sauna. Do not stop to collect $200.00, do not go to jai. Better to cut short your regular workout and do a sauna than go for the burn and leave cold. Relaxed muscles are far less likely to injure themselves. Look at what young boxers at the pinnacle of human fitness do after workouts - sauna and whirlpool. At the gym, follow a program administered by a certified personal trainer. You can't learn fitness training from a book. Be smart in doing workouts using equipment. Use weight belts with back support. Put a rolled-up towel on the bench under the small of the back. Use a lot of care when doing exercises that compress the spine under load, such as squats, military press, standing arm curls. In fact, I have heard some trainers claim the standing arm curl should be done with the back leaning against a wall to avoid "throwing" the weight upwards.
Work the lower and upper back with as much attention as you would apply to biceps and pecs.
S t r e t c h
I know: I sound like that guy giving the commencement speech to the class of 1999. But do this everyday, even on days when you do not workout. Get a book. Get a video. Do it with your friend, your colleagues, your lovers or your cat. Just do it.
WHAT THE CHIROPRACTORS SAY ON WORK-RELATED BACKPAIN
From a reader we obtained this link to a chiropractor-approved set of sites that assist with information on research, prevention, diagnosis, treatment and more.
VISIT CHIROPRACTOR PRO-ACTIVELY This is so important I mention it twice.
Living With Back Pain © 2000 -