Lower Back Pain

One-Off

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The fact that you get sore in the same place every time is more a matter of hysteresis than an underlying physiological problem - your brain has simply learned how to produce that response possibly due to an acute injury earlier which might've come from a gradually-learned movement pattern from the past. The pain is a learned response your brain is good at. You have to approach chronic pain like this:

Stiff muscles are sore muscles. Chronically-tight muscles hurt. The key is to mobilize them in a way that doesn't threaten your nervous system. Somatics are best for this, or its predecessor Feldenkrais, Somatics being the more-formalized, easily-accessible version. So far, no one on here has tried this.


Yeah, I just had a bout of hip pain for about six hours. I had gone to some training that required a lot of breakfalling, I was worried about layoffs, my wife brought me some other bad news, and I had to travel the next day.

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Ok first off, yesterday's surf was fun. Small, but kind of a nice break from the past week's poundings. After all the rain, our local beaches have sand bars again.:waving: :applause2:

I read the article/blog. My first reaction was- she looks to be in her thirties. I'm in my 60's. Our "issues" might be a little different. A second, totally irrelevant observation, is that she is not an especially good writer, in technical terms (needs a proof reader).

The crux of her rambling, IMHO, was this-

"There is a buffer zone that exists between the protect by pain line and the tissue tolerance line and in chronic pain that buffer grows. To recover you need to find that line and know that you are safe because that buffer is so big that hurting doesn’t mean you are harming yourself. In order to recovery we need to find ways of knowing this line, not boom-busting in and out of it, and to do this you need skills to cope."

"Graded exposure." I guess my skill is to do exactly what provoked my pain response in the first place- surf. I had to google "somatics" and found an article which states that dance, yoga, pilates and aikido can be considered somatic movement. So I guess surfing can be too.

You also state- "The key is to mobilize them in a way that doesn't threaten your nervous system." I do a 15-20 minute daily stretching routine (mobilize) and a bodyweight strength routine that I developed that specifically targets positions I assume while surfing. For example, a recent addition to my routine are jefferson curls, to load the back in flexion. Similarly I do "tube squats" where I go up and down into as small a crouch as possible, which accesses a back flexion and knee valgus position that normal exercises would probably advise against.

The second part of the article/blog, the SIMs, I would summarize as "wishful thinking," or maybe in a less dismissive sounding term, "the power of positive thinking." And I do not mean to dismiss the idea. I remember in the lower back pain thread, when Von Meister basically said the pain was subconscious, I said something like, "I need to figure out how to tell my subconscious that there is no pain/danger," and he said, "Picking something heavy off the floor tells my subconscious my back is OK."

The writer listed her SIMs. I think mine right now might be- I just surfed everything mother nature could throw at me this winter and am OK. And- I can step out the door right now and run 26 miles with no problems (well, maybe a blister). And I can pick a heavy thing off the floor (not as heavy as VM, but heavy for a toddler), repeatedly, with no ill effects.

However for the final piece of the puzzle- rest/sleep- I might have to kill our cat. I'm kind of conflicted about that...:roflmao:
 
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Autoprax

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I'm surprised he could have advanced lung cancer and not have noticed something amiss during his jogs?

ps googled it and found it is very possible to have stage 4 lung cancer with no symptoms.



The diagnosis given to me by a pain specialist MD (and was seconded by Von Meister) is that I had some kind of pathology (VM called it a "soft tissure event", MD called it "non specific lower back injury") but that in the majority of cases the pain is a kind of over reaction to the novel input and can be attentuated by a process of "acclimitization" (my term)- a gradual exposure to movement which resets the response. With a case of "Disc bulges" or "degenerative disc desease" fixing the physical problem is not always necessary and the attempt to fix the pathology (surgery) doesn't always fix the pain.

Then, as Autoprax can attest to, and like you say, sometimes the neural danger signal is appropriate. I am sure there are lots of people whose patholgy is bad enough to warrant drastic intervention.

Even though my problem was not that serious, I still recognize that there is a pathology. My back still hurts while and after surfing, but I have not had a serious, incapacitating spasm in a couple years, despite the activity. However, I know there is a root physiological cause because when my back gets sore it's in a specific location (lower lumbar, right side). It's only "non specific" because no imaging was done to specify what it is.
You ever try working the tissue in front of. the spine?

I would say psoas but really there is a bunch of stuff there that can be signaling pain.

 
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Mr J

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Ok first off, yesterday's surf was fun. Small, but kind of a nice break from the past week's poundings. After all the rain, our local beaches have sand bars again.:waving: :applause2:

I read the article/blog. My first reaction was- she looks to be in her thirties. I'm in my 60's. Our "issues" might be a little different. A second, totally irrelevant observation, is that she is not an especially good writer, in technical terms (needs a proof reader).

The crux of her rambling, IMHO, was this-

"There is a buffer zone that exists between the protect by pain line and the tissue tolerance line and in chronic pain that buffer grows. To recover you need to find that line and know that you are safe because that buffer is so big that hurting doesn’t mean you are harming yourself. In order to recovery we need to find ways of knowing this line, not boom-busting in and out of it, and to do this you need skills to cope."

"Graded exposure." I guess my skill is to do exactly what provoked my pain response in the first place- surf. I had to google "somatics" and found an article which states that dance, yoga, pilates and aikido can be considered somatic movement. So I guess surfing can be too.

You also state- "The key is to mobilize them in a way that doesn't threaten your nervous system." I do a 15-20 minute daily stretching routine (mobilize) and a bodyweight strength routine that I developed that specifically targets positions I assume while surfing. For example, a recent addition to my routine are jefferson curls, to load the back in flexion. Similarly I do "tube squats" where I go up and down into as small a crouch as possible, which accesses a back flexion and knee valgus position that normal exercises would probably advise against.

The second part of the article/blog, the SIMs, I would summarize as "wishful thinking," or maybe in a less dismissive sounding term, "the power of positive thinking." And I do not mean to dismiss the idea. I remember in the lower back pain thread, when Von Meister basically said the pain was subconscious, I said something like, "I need to figure out how to tell my subconscious that there is no pain/danger," and he said, "Picking something heavy off the floor tells my subconscious my back is OK."

The writer listed her SIMs. I think mine right now might be- I just surfed everything mother nature could throw at me this winter and am OK. And- I can step out the door right now and run 26 miles with no problems (well, maybe a blister). And I can pick a heavy thing off the floor (not as heavy as VM, but heavy for a toddler), repeatedly, with no ill effects.

However for the final piece of the puzzle- rest/sleep- I might have to kill our cat. I'm kind of conflicted about that...:roflmao:
I think you are right to be critical about how useful that article is for you. I read it yesterday and wanted to see what you thought before offering my opinion.

Her case absolutely does not sound like the hyperalgesia radio program I listened to. She specifically says she does not have Complex Regional Pain Syndrome (CRPS) of which hyperalgesia is a component, nor fibromalgia or any phantom pain problem. She had an acute hip injury from snowboarding, has a labral tear (which hasn't gone away - they don't normally heal themselves apparently), has bone bruising in the hip socket (oedema) - I have had acute oedema in my shoulder joint from dislocations, but unlike hers they resolved. On top of that she has congenital hip dysplasia - socket deformity which gives inadequate socket coverage of the ball and socket joint which isn't going to go away. So ongoing problems which explain the pain.

Her rehab and return to fuller activity does not sound like it was all about getting the nervous system and psychology retrained either. Seems a lot to do with straightforward ball and socket joint rehab to me (which unfortunately I have some experience of). So its been explained to me that muscles can get "inhibited" in response to an injury. This is the term my physio has used. If the inhibited muscle is part of the group of muscles that keep force on a ball and socket joint in place then the ball gets pushed to one side of the socket because the other ones will overpower it. If the socket is further destabilised by labrum tears or shape deformities then this can exacerbate the ball not articulating properly in socket. Surprisingly my shoulder dislocations appear to have left my labrum intact (at least that's what the MRIs say although there is no guarantee that they are perfectly intact I'm told), so I don't have any experience of torn labrum symptoms, but apparently they can be painful. So shoulder gets into a state of aggravating the tears/defects, causes pain, causes inhibition which feeds back into making things worse.

She specifically says that pushing through the pain during the acute and flair up stage was a mistake. Things got better when she stopped aggravating it - swimming and yoga. Neither of these did much for rehab, then she got onto some standard elastic band hip stuff eg external rotation, single leg balancing which is a way of getting muscles "firing" again. Thats when things improved and by chance discovered the bike didn't aggravate, but was good for some real hip strength building.

My physio said they don't always repair labrums (was talking about shoulder, but I'm guessing could apply to hip), instead the physio can get those stabiliser muscles working well enough so that the ball gets pressed firmly into the centre of the socket thus putting less stress on the torn bit of the labrum. Sounds like that's what she did to me.
 
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Mr J

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I do a 15-20 minute daily stretching routine (mobilize) and a bodyweight strength routine that I developed that specifically targets positions I assume while surfing. For example, a recent addition to my routine are jefferson curls, to load the back in flexion. Similarly I do "tube squats" where I go up and down into as small a crouch as possible, which accesses a back flexion and knee valgus position that normal exercises would probably advise against.
...
Sounds great. I'm a bit frustrated at the moment with my arm in a sling. I've been allowed to do some things after week 1, such as stationary bike (which I don't have and would bore me) and my elastic band exercises for my other shoulder and legs, but I've only restarted them recently because I wanted to be extra careful about not accidentally activating the operated shoulder. I'm now 3 1/2 weeks post surgery. So I've been doing jefferson curls with a light weight in one hand and what you call tube squats. Just out of curiosity, I can get my butt within 2 or 3 inches of the floor with my feet flat on the ground, how about yourself?

I don't call them tube squats though. I had a bad experience in a tube so have been avoiding getting into that part of the wave. Just prior to my surgery I was getting in the water as much as I could so was doing a number sessions of standup boog in little waves or reform high tide waves. The boog requires a lot of that squat right down stance, so thought it was a good idea to make sure I could handle that. I did some this morning with just a few kilos of weight in one hand. I've got a slightly different take on them to you though - with good hip flexibility and glute strength the back doesn't need to go into much flexion and this is why they are good - it trains the body not to put a load on the back in awkward positions. A massage therapist told me that strong glutes protect the back.

I'm also doing a lot of brisk walking and a one armed yoga triangle and reverse triangle for the core - I'd rather be going surfing like you though!
 
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One-Off

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Sounds great. I'm a bit frustrated at the moment with my arm in a sling. I've been allowed to do some things after week 1, such as stationary bike (which I don't have and would bore me) and my elastic band exercises for my other shoulder and legs, but I've only restarted them recently because I wanted to be extra careful about not accidentally activating the operated shoulder. I'm now 3 1/2 weeks post surgery. So I've been doing jefferson curls with a light weight in one hand and what you call tube squats. Just out of curiosity, I can get my butt within 2 or 3 inches of the floor with my feet flat on the ground, how about yourself?

I don't call them tube squats though. I had a bad experience in a tube so have been avoiding getting into that part of the wave. Just prior to my surgery I was getting in the water as much as I could so was doing a number sessions of standup boog in little waves or reform high tide waves. The boog requires a lot of that squat right down stance, so thought it was a good idea to make sure I could handle that. I did some this morning with just a few kilos of weight in one hand. I've got a slightly different take on them to you though - with good hip flexibility and glute strength the back doesn't need to go into much flexion and this is why they are good - it trains the body not to put a load on the back in awkward positions. A massage therapist told me that strong glutes protect the back.

I'm also doing a lot of brisk walking and a one armed yoga triangle and reverse triangle for the core - I'd rather be going surfing like you though!
I can also get about 3” from the ground in a squat. Unlike you I’ve had good experiences in tubes and want to maintain the ability to get into them, even when the waves are small.

Here‘s a story about hips and pain I heard just a few days ago. There‘s a guy who shows up at my local on a 14’ foot Bark ”Adventure Board.” Sometimes he paddles over from the beach a few miles to the north. Sometimes he comes by boat, anchors just outside the line up and paddles in. He’s there on the biggest days. Well, I finally heard his story. It seems he was the rescue boat driver for the Harbor Patrol/Lifeguards. He said nine years ago they were effecting a rescue in really big surf. The boat almost got caught inside one wave and then a second, even bigger wave came. He gunned the boat to get over the wave and the boat “….caught air and came down really hard…” and, he said, “ I thought, ‘That wasn’t good.’ “ He was so focused on the rescue, he kept working. The next day the pain was so bad he went to the ER and discovered the hard landing shattered both his hip sockets (he’s a big guy…I’d estimate at least 200 lbs). Took him a year to walk and still can’t walk far. The trail down to the spot (about 1/2 mile ) is much too far for him and hat’s why he boats or paddles to the spot. After hearing his story I have much more respect for him.

 
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Mr J

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I can also get about 3” from the ground in a squat. Unlike you I’ve had good experiences in tubes and want to maintain the ability to get into them, even when the waves are small.
... .

Yes I know its your speciality and what you suspect triggered your back problems - a several days run of little tubes. I remember the pic of yourself slotted into one on the other back thread.

So a squat several inches off the ground doesn't seem to put much rounding/flexion on my back at all I'm guessing tis the same for you - practising it makes it less tiring though and keeps up the hip mobility.

I have a similar take on the jefferson curl - done with legs locked out and a reasonable length of hamstrings that doesn't round my back much either - your hamstrings reasonably long, or are they tight?

We should be thankful we don't have hip socket problems after hearing the story about the Bark Adventure board rescue chap. I've got shoulder socket problems, but I am optimistic about recovering from that. Just over 2 more weeks in a sling and then I will be feeling better about it. Kelly Slater had a major reconstruction on his hip involving a donor grafted labrum, then 2 months later he was surfing his Dubai wave pool for the opening. I don't know how he did it!
 
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Random Guy

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So after my back getting 100% back to normal, yesterday morning, the right side of my lower back was all fucked up again
today it was even worse
did a deep tissue massage and got stretched and twisted this morning and felt 90%ish better
i know it’s all stress, anger and rage, but having it manifest like this is also making me angry
until it’s better, and I’m snowboar like I never had a problem, and then im amused as hell
 

Mr J

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So after my back getting 100% back to normal, yesterday morning, the right side of my lower back was all fucked up again
today it was even worse
did a deep tissue massage and got stretched and twisted this morning and felt 90%ish better
i know it’s all stress, anger and rage, but having it manifest like this is also making me angry
until it’s better, and I’m snowboar like I never had a problem, and then im amused as hell
I was in a similar cycle of back pain and recovery to you. I did break the cycle. Instead of considering the problem to be a result of stress and anger I went on a program of trying to correct physical things. It was such an extensive program that it did require a fair bit of belief to remain committed, so that part is in common to your approach. I don't actually know which of the following had the most/any part in recovering. This is what I did.

- Deep tissue massage once a week. Idea was relieve those muscle knots which stop our biomechanics from working freely.
- Massage done immediately before a chiropractic adjustment at the same clinic. There were 2 chiro adjustment sessions a week for 12 weeks. After that once every 3 weeks.
- Various stretching exercise all prescribed by the chiro and told to stop all other stretches I was doing. A number of those stretching exercises were for lower back done with body weight supported, not standing.
- posture exercises.
- getting keyboard, chair, desk heights and sitting posture perfect according to an instruction sheet. No slumping in the chair - I ceased using the chair back.
- Sticking to approved posture techniques for things like washing the dishes, vacuuming the floor, getting in and out of bed or off the floor.
- Assessment of sleeping position.
- core strength exercises
- fish oil for anti inflammatory diet.
- no surfing for 3 months. I was able to keep on skateboarding with no rotational tricks.
- continuous attention to posture when standing, walking, sitting.

Those acute bad back events ceased at the start of this program, although getting the back feeling stronger and healthier without any aches/pains/twinges was something that gradually improved over many months.
 

Mr J

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addendum to above - there was even an approved way of putting on shoes, the worst way of putting on shoes is to sit on a chair and bend over to tie laces, second worst way standing and bending over with the foot on the floor - this was to be avoided. The program was centred around avoiding all forward bending over for the first few months to reduce the chance of a back incident, then after that just posture maintenance and all the other stuff. Jefferson curls would have been out of the question during that initial period, but fine for me to do now.

Some of the stretches prescribed came direct from the massage therapists - some of the value was not so much the actual releasing of tight muscles, but identifying where I was tight. I don't have hip pain, but bits of my hip get really tight and that can't be a good thing - one massage therapist identified it as the top of the gluteus minimus - so I knew what stretch to do. Another massage therapist spotted (just from probing my lower back muscles) that I was over extending (arching) my back - this must have been from paddling, so I always paddled with my belly off the board or just lightly touching the deck - never resting full torso weight on it and the massage therapist reckoned I had rectified the problem.
 

Mr J

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A good way to put on/take off shoes or socks is to balance on one leg and lift the foot up to your hands. If for some reason that is difficult then rest the foot on something of sufficient height. If for some reason it is necessary to be sitting down, then bring the foot up onto the seat with knee to the chest.

Approved way of getting out of bed or off the floor is to roll onto one side and push up sideways - avoid doing a sit up.
 

slipped_disc

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@One-Off how are the Jefferson curls going?

I threw my back out experimenting with QL work (sidebend-like movements). The majority of times that I try to push my back with a new movement, it explodes. I need to take it slower I suspect. In rest and recuperate mode for a bit.
 

One-Off

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@One-Off how are the Jefferson curls going?

I threw my back out experimenting with QL work (sidebend-like movements). The majority of times that I try to push my back with a new movement, it explodes. I need to take it slower I suspect. In rest and recuperate mode for a bit.
I was OK with them but only using 8lb dumbbells (3 sets of 10). It felt too easy so I was thinking of going to my next weight up which would be an empty Olympic bar (45lbs). Kind of a big jump, but I don’t have anything in between. I was doing them on my body weight day (Wednesday) but then started doing a long run on Tuesdays. I have a scheduling opportunity that puts me close to the mountains and am planning on running a marathon (26 miles) every week, slow , zone 2, with a decent climb (3600 feet) for 3 months unless I sense the stress on the body is too much…or if the surf is good (but spring is often crap surf in LA). I’ll move body weight day to Monday…if it doesn’t fuk with the long run too much.

Between surfing, running and resistance training I feel like I’m doing a sh!t ton of exercise . I need to figure out how to get more protein.

All that said my back is feeling pretty good. I’m back to surfing a short board (6-1 x 20-1/4 x 2-5/8). So all the work has been paying off.
 

Mr J

Michael Peterson status
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@One-Off how are the Jefferson curls going?

I threw my back out experimenting with QL work (sidebend-like movements). The majority of times that I try to push my back with a new movement, it explodes. I need to take it slower I suspect. In rest and recuperate mode for a bit.
I had to look up QL - its an abbreviation for a pair of back muscles. I looked up a QL bend and saw a youtube of someone standing with a dumbell in one hand and bending sideways.

I discovered that I have inadvertently been exercising the QL muscles - the yoga triangle pose. A difference between the triangle and the dumbell QL bend I saw on youtube is that the triangle puts sideways load with a much straighter spine - the leg with the foot that points outwards lowers that side of the body and there is a lot of stretch on outer hip of the other leg. So the triangle is an isometric exercise where the sideways bend is taken up with the leg and hips. Same with the reverse triangle, at a glance it might look like twisting the spine, but its mainly the hips that twist. I do quite a lot of these, it might sound a bit pissweak, but my guess is that most people who aren't used it would find it difficult to hold say 30 seconds of good form triangle and reverse triangle.

I did some jefferson curls this morning - one 4kg dumbell in one hand and just 0,5 kg in the hand on which I had shoulder surgery! I only got out of the sling 4 days ago after 6 weeks in the sling. This is where OneOff and myself have slightly different ideas, certainly I can see his logic of training the back to handle loaded rounded back position, but my approach is to let the hamstrings an rear pelvis stretch and take the strain. I don't know which is right, I'm just saying this is what I do. I've never been encouraged by my chiro to bend or twist my spine when loaded. My chiro quite rightfully thought that surfing would place a fair bit of rotational torque on the spine and I was told to rotate from the shoulders rather than the waist and tense the core.

Some people say the cobra position has helped them, but I don't like it and I was never prescribed that. There is one arched back and two rounded back exercises stretches that I was prescribed and all done unloaded not standing with load - lie on back, pull feet in and flat on the floor so knees bent and pointing to the ceiling, arch the back gently and also go the other way - push the lower back into the floor and try and lift the pelvis off the floor, Also on all fours (on hands and knees) do a similar thing both directions. Just passing this on as information, I don't know how good or suitable these exercises are.
 

One-Off

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I had to look up QL - its an abbreviation for a pair of back muscles. I looked up a QL bend and saw a youtube of someone standing with a dumbell in one hand and bending sideways.

I discovered that I have inadvertently been exercising the QL muscles - the yoga triangle pose. A difference between the triangle and the dumbell QL bend I saw on youtube is that the triangle puts sideways load with a much straighter spine - the leg with the foot that points outwards lowers that side of the body and there is a lot of stretch on outer hip of the other leg. So the triangle is an isometric exercise where the sideways bend is taken up with the leg and hips. Same with the reverse triangle, at a glance it might look like twisting the spine, but its mainly the hips that twist. I do quite a lot of these, it might sound a bit pissweak, but my guess is that most people who aren't used it would find it difficult to hold say 30 seconds of good form triangle and reverse triangle.

I did some jefferson curls this morning - one 4kg dumbell in one hand and just 0,5 kg in the hand on which I had shoulder surgery! I only got out of the sling 4 days ago after 6 weeks in the sling. This is where OneOff and myself have slightly different ideas, certainly I can see his logic of training the back to handle loaded rounded back position, but my approach is to let the hamstrings an rear pelvis stretch and take the strain. I don't know which is right, I'm just saying this is what I do. I've never been encouraged by my chiro to bend or twist my spine when loaded. My chiro quite rightfully thought that surfing would place a fair bit of rotational torque on the spine and I was told to rotate from the shoulders rather than the waist and tense the core.

Some people say the cobra position has helped them, but I don't like it and I was never prescribed that. There is one arched back and two rounded back exercises stretches that I was prescribed and all done unloaded not standing with load - lie on back, pull feet in and flat on the floor so knees bent and pointing to the ceiling, arch the back gently and also go the other way - push the lower back into the floor and try and lift the pelvis off the floor, Also on all fours (on hands and knees) do a similar thing both directions. Just passing this on as information, I don't know how good or suitable these exercises are.
Aren’t the last two exercises very similar the the bridge and the cat/cow?

I do a hip flexor stretch with QL stretch thrown in.
 
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