Back Pain Back?
As Physiotherapists, one question that we often hear “why is my back pain back?”. Recent research from the University of Queensland may hold some answers to this common question. The researchers say that 34% of people with low back pain will have another bout of back pain at some time.
Changes in muscle behaviour may be why some people are more prone to returning pain. People who have had repeated bouts of low back pain were found to have delayed activation of the deep back muscles (multifidus muscles).
Interestingly, the volunteers involved in the research did not have back pain at the time of the study. This new information suggests that even when the pain goes away, changes in back muscle activity can remain and may cause some people to be more susceptible to further bouts of back pain. This supports previous research which shows that rehabilitation of certain back muscles can reduce recurrence of low back pain.
Posture - what’s all the fuss?
Most people got sick of being nagged about posture by their mothers and have not given it much thought since they were at primary school.
Preliminary research suggests that your postural habit can give an indication about what kind of low back pain you might experience. Interestingly men and women seem to adopt different postural habits.
Men have a greater tendency to slump causing low back pain through over stretching the tissues of the low back. Women seem more inclined not to use the backs of their chairs and sit too tall, leading to low back pain due to overuse of the low back muscles.
Research suggests that good posture is also essential for performance in sports such as golf and cycling. The more we learn about posture we realise that mum was right, ‘good posture is important’. Well ....... she was half right. Though appropriate sitting posture is important, sitting up tall like mum used to nag us to do will often lead to incorrect posture. Research continues in this area but we do know that, in people with spinal pain, good sitting should be taught by an experienced professional.
Muscle of the Moment: Multifidus
The multifidus muscles are positioned directly on top of your lumbar vertebrae. They are inter-segmental muscles, meaning that they connect one vertebra to the next and can control the motion between two vertebrae.
Multifidus’s primary role is to control lumbar rotation and flexion movements. It is packed with tiny nerve endings which detect joint motion. With sitting and bending forward, multifidus helps hold the curve in your low back. It is thought that sometimes this muscle loses some of its control, endurance and sensory ability after back injury.
If you experience recurrent back strains or an ongoing ache in the low back with sustained postures, your Multifidus Muscles may need rehabilitation.
When can I go back to sport?
When treating sport-related injuries this is usually one of the first questions that a Physiotherapist will hear from their newly injured patient.
Usually we base our recommendation on a combination of clinical experience and known tissue healing times. As a rough guide, muscles take 6-8 weeks to heal, ligaments take 6-10 weeks, and bone healing time varies depending on the size of the bone and its blood supply. Soft tissue injury severity is usually graded from 1 (mild) to 3 (severe). The severity of the tissue damage will make a difference to healing times as will the number of different structures injured.
Physiotherapy works to optimise these healing times by reducing the amount of complications along the way, such as unnecessary swelling. The exercises that we provide act to reduce the amount of de-conditioning that you develop in the surrounding muscles. Even when timeframes suggest that the tissues are completely healed you may be given restrictions when returning to sport. This is because you may lack reaction time or fitness for sport which can cause re-injury.
By accessing good Physiotherapy treatment from the start you can minimise the amount of time you have off, and with good preparation you will return to sport safely and prevent re-injury.
APMA would like to thank the Fortus Health for permission to reprint this information.