Back pain? What does it mean for you and what it can mean.

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Over the last few years I’ve spent a lot of time studying pain. I have never written about it, because I am not a doctor or physio. Recently though, I had a new client contact me for a consultation — his primary concern was chronic back pain. I always love these types of clients. Whenever a client comes to me with a pain issue I’m never intimidated by it, but rather, excited. I have worked with clients who have had knee, shoulder, back, elbow and ankle pain, and unless the pain is resulting from a trauma I am confident that I will help them.

However, there was something about this consultation that got me thinking a lot about how we conceive and deal with pain. As I spoke on the phone with this guy, I began to imagine someone who was immobile and downtrodden, but when I actually met him he moved very well. He could hang, balance, crawl, roll, squat, push and pull. He could do it all gracefully and with ease. Even more than that, it was all pain free. I instantly said, “Lets not concentrate on the pain at all. Let's not even talk about it anymore. Don’t give it the time of day. Instead, let's concentrate on maximizing your strength and movement potential.”

This little interaction reminded me of a study that I read in The Lancet. The study explored the widening gap between the research and the treatment and prevention of back pain.

The reality is that millions of people suffer from back pain every year. That number is increasing despite the fact research has also grown. The reasons for back pain are not the basis for this article, but the method for treating it. Guidelines and research suggests the education and advice on staying active should be the go to approach. The authors of the paper advocate for non-pharmacological treatment in the form of advice, reassurance and activity as an initial treatment option for non-specific lower back pain. Professor Helen Stokes-Lamperd, chair of the Royal College of GP’s has said that the myths must be dispelled. “Rest, for example, is one of the worst approaches.”

Despite the advice of many at the top of their field, research in the U.S. and Australia suggests that medication and rest is the most prescribed treatment option. It’s clearly not working, but no guesses why it’s the most popular (cough, big pharma, cough, cough). I don’t want to be too conspiracy theory-esque, or get bogged down in all of the whys. I want to look at a mental shift on the hows.

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At Hanuman Health Club, we have helped numerous clients with varying degrees of back pain. How? We do it with extremely attentive coaching that involves knowing every single client and giving them the confidence to move again. We want our clients to take ownership of their bodies. We empower them to say, “What can I do”, rather than limiting themselves by saying, “I can’t do that. I have a sore this, that, or the other.” It’s not about what you can’t do. So many times I’ve had clients who told me on day one, “My doctor said I can’t ever squat again, because I have bad knees.” I ask them if he said they where ever allowed to sit down again, walk up the stairs, or ride a bike. They always say, “Of course not, that's stupid!” So then…let's look at what all of those movements involve. Hip and knee flexion. What does a squat involve? Bingo, you guessed it: hip and knee flexion. So now, instead of saying “I can’t”, lets find the end range of what you can do so you’re empowered to do more. Then that end range will grow and get bigger. You can move, you are not in body cast, but if you let pain or what you think pain is dictate all of your actions, then you are dead certain to lose your ability to move pretty quickly. It’s a vicious circle. Break it by saying "I can” instead of “I can’t”.

A more practical piece of advice: I always say move to where the pain is, but don’t force your way through it. A discomfort level of 4 out 10 on your subjective pain index is a good place to think, “Ok, I am close to my end range”. That range will get bigger over time. Trust me and trust yourself.

So there you have it! Don’t be a victim to words you are told. No one knows your body like you do. Get connected to yourself again, so you can have a true conversation about what you can and can’t do. Don’t blindly accept what someone tells you you’re not allowed do. HOWEVER — Move slowly. This is not a recommendation to go from 0 to 100 in your next training session. It is an invitation to start really feeling your body and getting to know it so that you know what is right and wrong.

Now happy moving all.

Oh PS — In case you were wondering, that guy started training consistently with me and has since climbed Denali, swam from Cuba to Florida and all the while trained for and won World’s Strongest Man. Oh I almost forgot the circus show too — he is an acrobat now. All obvious conclusions of trusting yourself and your training.

-Eoghan O’Kelly