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-   -   Anything actually work for low back pain? (http://tt.tennis-warehouse.com/showthread.php?t=455115)

heycal 02-18-2013 06:20 AM

Anything actually work for low back pain?
 
I've had lower back pain for about a year. MRI's show not unusual damage for a 50 year old in terms of disc and arthritis stuff. I've tried various strengthening and stretching exercises, but nothing helps. I continue to do all recreational activities and weight training I've always done, since they don't seem to aggravate the problem. (Sitting and lying down are the bigger problems.)

Anyone here have any experience with any treatments that actually greatly helped their long term-ish low back pain? (I never did have much success trying to treat my neck for similar issues. The pain just gradually turned into a chronic stiffness.)

I'm worried that the only thing that's going to help -- if anything does -- is time. Anyone beg to differ?

OHBH 02-18-2013 07:14 AM

Because the back is so integral to everyday movement it is very difficult to give it proper rest. You need to do lots of core strengthening exercises and wear a brace or back support most of the day so that you can relax it more during the day.

ollinger 02-18-2013 07:33 AM

"Time" doesn't help arthritis -- usually makes it worse. Spinal arthritis usually demands less physical activity. It's different from other joints in that the arthritic changes in the facets doesn't remodel or improve with moderate activity.

heycal 02-18-2013 02:37 PM

Quote:

Originally Posted by OHBH (Post 7222271)
Because the back is so integral to everyday movement it is very difficult to give it proper rest. You need to do lots of core strengthening exercises and wear a a brace or back support most of the day so that you it can relax more during the day.

Back brace, huh? Hmm. One of the docs actually suggested this, but since he didn't seem very pumped about it, and since I was a bit skeptical, I never got around to it. Maybe I should.

I've already done -- and still do -- a fair amount of core stuff. Doesn't help much.


Quote:

Originally Posted by ollinger (Post 7222316)
"Time" doesn't help arthritis -- usually makes it worse. Spinal arthritis usually demands less physical activity. It's different from other joints in that the arthritic changes in the facets doesn't remodel or improve with moderate activity.

But we do know that there are people who suffer less from arthritis than they used to for one reason or another, yes? I actually have a friend who was told his arthritis would only get worse a few years back, but he actually says he feels better now. I think all he did was a few back exercises here and there. (And I only need look at myself for confirmation of this: my neck bothers me less than it did 2 years ago.)

I'd have to say the only times my back doesn't bother are when walking, or doing a specific stretch for it. Tennis and other more strenuous activities can leave it a little sore, but not much.

For those who know about such things, here is the summary of my MRI (my cervical and thoracic are similar or worse I believe.) I welcome any input or explanation of this:

MRI OF THE LUMBAR SPINE

Spondylitic changes L5-S1, with a left paracentral annular tear and small associated posterocentral disc herniation. Mild diffuse degenerative facet hypertrophy. No stenosis demonstrated.

OHBH 02-18-2013 09:45 PM

Quote:

Originally Posted by heycal (Post 7223202)
Back brace, huh? Hmm. One of the docs actually suggested this, but since he didn't seem very pumped about it, and since I was a bit skeptical, I never got around to it. Maybe I should..[/b]

I injured my back 3 years ago doing too much deadlifts. Made it impossible to do a proper serve. But I played wearing a brace just like this one http://www.amazon.com/McDavid-493R-B...=cm_lmf_tit_10 hit only patty cake serves and did abdominal workouts. In 3 months I was 100 percent. A little different at your age but I still think it help me recover a lot more quickly and I didn't have to stop playing tennis.

Bobby Jr 02-19-2013 01:43 AM

One of the best alleviators of lower back pain is walking. The cadence relaxes the hips and spine area somewhat (assuming you can walk fine).

I've also had many troubles with lower back issues over the years and found doing the yoga child pose very helpful. Tight quads and hamstrings especially are also known to contribute to back issues.

So far as core exercises go - they can help but many people end up worse off because the sort that help your lower back need to be done with ruthless adherence to form otherwise they'll be counter-productive and probably make the pain worse.

One good one is the leg lift - where you lie on your back with your legs straight and lift one/both up and then and then back down to almost touching the floor.... Everyone has seen this exercise but the majority of people with sore back will make it worse doing it. Instead do it one leg at time with the other leg bent at the knee with the foot pressing on the floor near your buttock. You should also do it with the small of your back pressed onto the floor. So, hold you hands palm down with the fingers wedged in under the small of your back instead of having them simply on the floor by your side. You should be able to do the exercise with your hands being pressed down by your back - if not, you're not holding your core straight enough and probably wasting your effort with regards to addressing the back pain.

Don't do: sit-ups, crunches or double leg lifts. No amount of doing these will alleviate lower back pain and will usually make it worse.

morten 02-19-2013 02:41 AM

core training never helped my lower back, a myth and marketing hype my doctor said.. my back is better now, took me seven years...

Thepowerofchoice 02-19-2013 03:32 AM

I had lower back pain which started last year for the first time in my life and it scares the crap out of me (I'm 44). The pain was shooting down my butt for several days and back up to my lower back. This went on for several months.

My friend gave me this book and swears by it.
http://foundationtraining.com/home/

His wife had lower-back pain for more than 20 years and this book saved her from constant nagging back pain after a few short weeks following these tough but simple exercises.

After first week of this program and already feeling 80% better but not just my lower back. I just feel better in overall. Its hard to explain but feel more efficient on the court and almost pain free. I still do this as a warm up before my fitness routine as a warm up.

I have many arthritis but after changing my diet to "gluten free"...I'm now pain free and feeling like I'm back in my 20's. Just my 2 cents.

wallabeechamp 02-19-2013 04:51 AM

Mckenzie Stretch/Technique

http://www.amazon.com/Treat-Your-Bac.../dp/0959774661

http://www.youtube.com/watch?v=tIZppe-RB0g

heycal 02-19-2013 06:37 AM

Quote:

Originally Posted by Bobby Jr (Post 7223850)
One of the best alleviators of lower back pain is walking. The cadence relaxes the hips and spine area somewhat (assuming you can walk fine).

I've also had many troubles with lower back issues over the years and found doing the yoga child pose very helpful. Tight quads and hamstrings especially are also known to contribute to back issues.

So far as core exercises go - they can help but many people end up worse off because the sort that help your lower back need to be done with ruthless adherence to form otherwise they'll be counter-productive and probably make the pain worse.

One good one is the leg lift - where you lie on your back with your legs straight and lift one/both up and then and then back down to almost touching the floor.... Everyone has seen this exercise but the majority of people with sore back will make it worse doing it. Instead do it one leg at time with the other leg bent at the knee with the foot pressing on the floor near your buttock. You should also do it with the small of your back pressed onto the floor. So, hold you hands palm down with the fingers wedged in under the small of your back instead of having them simply on the floor by your side. You should be able to do the exercise with your hands being pressed down by your back - if not, you're not holding your core straight enough and probably wasting your effort with regards to addressing the back pain.

Don't do: sit-ups, crunches or double leg lifts. No amount of doing these will alleviate lower back pain and will usually make it worse.

Good post. Thanks.

I do like to walk because it doesn't hurt and also burns a few calories.

The rest of your post terrifies though. I've never been one to have perfect form on exercises, and of course, people often disagree on what correct form is.

This single leg left thing you mention is interesting. Just had a session with some trainer who suggested both legs at a time to help the lower back. So either he is right, you are right, you both are wrong, or it doesn't matter if you use one or both legs. Hmm.

What other exercises do you like or not like for low back issues?

Quote:

Originally Posted by Thepowerofchoice (Post 7223922)

I have many arthritis but after changing my diet to "gluten free"...I'm now pain free and feeling like I'm back in my 20's. Just my 2 cents.

I've heard this can help, and the book "Wheat Belly" contains all sorts of stories like this.

but I'm afraid to contemplate such a thing. Gluten free? I'm not sure which is worse: back pain or giving up the main reason I like being alive: eating bread and bread type products.

Quote:

Originally Posted by wallabeechamp (Post 7223979)

Did it religiously for a month. Nothin'. I was even a supposedly perfect candidate for it based on their symptom checklist in the book.

heycal 02-19-2013 06:42 AM

Quote:

Originally Posted by morten (Post 7223891)
core training never helped my lower back, a myth and marketing hype my doctor said.. my back is better now, took me seven years...

All hype, huh? Interesting but disturbing. I can believe it though....

What did work for you, if anything?

charliefedererer 02-19-2013 06:54 AM

Quote:

Originally Posted by heycal (Post 7223202)
Back brace, huh? Hmm. One of the docs actually suggested this, but since he didn't seem very pumped about it, and since I was a bit skeptical, I never got around to it. Maybe I should.

I've already done -- and still do -- a fair amount of core stuff. Doesn't help much.




But we do know that there are people who suffer less from arthritis than they used to for one reason or another, yes? I actually have a friend who was told his arthritis would only get worse a few years back, but he actually says he feels better now. I think all he did was a few back exercises here and there. (And I only need look at myself for confirmation of this: my neck bothers me less than it did 2 years ago.)

I'd have to say the only times my back doesn't bother are when walking, or doing a specific stretch for it. Tennis and other more strenuous activities can leave it a little sore, but not much.

For those who know about such things, here is the summary of my MRI (my cervical and thoracic are similar or worse I believe.) I welcome any input or explanation of this:

MRI OF THE LUMBAR SPINE

Spondylitic changes L5-S1, with a left paracentral annular tear and small associated posterocentral disc herniation. Mild diffuse degenerative facet hypertrophy. No stenosis demonstrated.

The MRI results show some "chronic changes" and don't offer a real insight into your problem.
Many with no back pain would have some similar MRI's.


Several have been kind enough to post potential back exercise programs for you to consider:
- yoga
- leg lift
- foundation training [the videos are in fact worth watching]
- Mckenzie stretch technique

PostureGuy, who frequently posts here, likely would also recommend Egoscue exercises, illustrated in the book Pain Free.



I would have you keep an open mind about any of these "therapies" that have as their central tenet hyperextension exercises of the back.




AAAAGGGGHHHH!!! you must be thinking looking at that horrible form in Djoker's serve photo above.

But even in a conditioned athlete like you doing properly executed squats and deadlifts to maintain a great core and back, there can build up "tightness" that tends to keep the back in relative flexion during the course of our day.
Or even during our tennis or weightlifting.

The extra hyperextension exercises of the back just [i]might/I] be the recipe of success for relieving the tendency for your back muscles to remain tight in an flexed posture.


"Founder exercise" of foundation training


"cats and dogs" exercise as demonstrated by Suzanna McGee aka "sixftlion", an exercise recommended by her http://www.tennisfitnesslove.com/201.../#.USOfX6WsiSo and also by Pete Egoscue in Pain Free


- yoga back exericises

morten 02-19-2013 07:02 AM

Quote:

Originally Posted by heycal (Post 7224133)
All hype, huh? Interesting but disturbing. I can believe it though....

What did work for you, if anything?

nothing lol, just wait and while still do sports at a lower level, sitting for longer times, especially high barstools etc, made it worse, tried chiropractors, naprapathy, fysiotherapy.. They all said different things btw, some said run, others no no, some said ride a bike others the opposite.. Excercise made it worse, even very light excercises

heycal 02-19-2013 07:10 AM

Quote:

Originally Posted by charliefedererer (Post 7224150)
The MRI results show some "chronic changes" and don't offer a real insight into your problem.
Many with no back pain would have some similar MRI's.


Several have been kind enough to post potential back exercise programs for you to consider:
- yoga
- leg lift
- foundation training [the videos are in fact worth watching]
- Mckenzie stretch technique

PostureGuy, who frequently posts here, likely would also recommend Egoscue exercises, illustrated in the book Pain Free.



I would have you keep an open mind about any of these "therapies" that have as their central tenet hyperextension exercises of the back.




AAAAGGGGHHHH!!! you must be thinking looking at that horrible form in Djoker's serve photo above.

But even in a conditioned athlete like you doing properly executed squats and deadlifts to maintain a great core and back, there can build up "tightness" that tends to keep the back in relative flexion during the course of our day.
Or even during our tennis or weightlifting.

The extra hyperextension exercises of the back just [i]might/I] be the recipe of success for relieving the tendency for your back muscles to remain tight in an flexed posture.


"Founder exercise" of foundation training


"cats and dogs" exercise as demonstrated by Suzanna McGee aka "sixftlion", an exercise recommended by her http://www.tennisfitnesslove.com/201.../#.USOfX6WsiSo and also by Pete Egoscue in Pain Free


- yoga back exericises

Thanks, Charlie. I appreciate the input. I actually already do many of these exercises and stretches several times a day. Lot of extensions as per McKenzie. Many do feel good to do and help for a short period of time, but it doesn't last long.

Quote:

Originally Posted by morten (Post 7224168)
nothing lol, just wait and while still do sports at a lower level, sitting for longer times, especially high barstools etc, made it worse, tried chiropractors, naprapathy, fysiotherapy.. They all said different things btw, some said run, others no no, some said ride a bike others the opposite..

This is scary, but very believable unfortunately: different people suggesting different things, and nothing really working but time itself.

I just went through this with my neck. Hurt for well over a year, but now just feels stiff all the time, an improvement I'm happy with. I can't recall anything specific helping, and I did the shots, PT, stretching, accupuncture, etc routine.

morten 02-19-2013 07:32 AM

good luck heycal! it could be over in a few weeks or a couple of months too..

heycal 02-19-2013 07:46 AM

Quote:

Originally Posted by morten (Post 7224248)
good luck heycal! it could be over in a few weeks or a couple of months too..

Thanks, Morten. We shall see....

When you said your doctor said all that core stuff was a myth, what DID he think would work if anything?

heycal 02-19-2013 07:55 AM

Anyone else want to weigh in on the double vs. single leg lifts, and why one might be better or more harmful than the other? Curious about that one.

morten 02-19-2013 07:58 AM

Quote:

Originally Posted by heycal (Post 7224280)
Thanks, Morten. We shall see....

When you said your doctor said all that core stuff was a myth, what DID he think would work if anything?

time or surgery, i could do surgery but did not dare.... there seems to be a lot of different reasons, treatments and symptoms of lower back pain, you and me probably have different pain.. the so called experts say different things and and "guess" things imo. some even say it`s mental, well it became mental that`s for sure lol... :) I went from competitive nationally ranked both tennis and squash, to dropping a couple of levels :( lost interrest in competing, as i said it is better now, but stiffer than before. I got my pain from sitting a lot in front of the computer. I think core excercises are good for preventing pain, but once you get it i don`t know... now i have some foot bain, inside side of the ankle, a torn tendon, have not played for months :( but that`s a different story..

heycal 02-19-2013 09:41 AM

Quote:

Originally Posted by morten (Post 7224300)
time or surgery, i could do surgery but did not dare.... there seems to be a lot of different reasons, treatments and symptoms of lower back pain, you and me probably have different pain.. the so called experts say different things and and "guess" things imo. some even say it`s mental, well it became mental that`s for sure lol... :) I went from competitive nationally ranked both tennis and squash, to dropping a couple of levels :( lost interrest in competing, as i said it is better now, but stiffer than before. I got my pain from sitting a lot in front of the computer..

I think sitting at a computer and elsewhere and doing most everything else with bad posture for decades was a big cause of mine too.

Bobby Jr 02-19-2013 12:01 PM

Quote:

Originally Posted by heycal (Post 7224126)
Good post. Thanks.

I do like to walk because it doesn't hurt and also burns a few calories.

The rest of your post terrifies though. I've never been one to have perfect form on exercises, and of course, people often disagree on what correct form is.

This single leg left thing you mention is interesting. Just had a session with some trainer who suggested both legs at a time to help the lower back...

What other exercises do you like or not like for low back issues?

Good stuff re: the walking.

My experience started when I played squash years ago. I saw the person who was then the Aussie Olympic doctor. He thought surgery was an option - although my issue was confined to L5 and L4 so not quite as extensive as you. We opted to try mild therapy and a few set exercises and, surprisingly, I got to a level I could live with relatively quickly. I've had flare-ups, especially when I spend a lot of time sitting at a desk or do something like kayaking but can get back to manageable levels within a short period.

One thing I most definitely do not agree with re: your trainer is the double leg lift. He is dead wrong and every time you do it you're probably making your back worse - fyi this is straight from the mouth of a Dr who treated many dozens of gold medal winning athletes.

There is simply no way - unless done with solid form - for it not to cause additional stresses on the lower back. Think about it - when you lift your legs all the pressure and weight of your legs gets focussed into the pivot point, which presses your hips into the floor as the load increases. To compensate for the weight as you raise/lower your legs your back will naturally arch (unless you have super light legs :p ). This massively increases the force on the bones in the lower back. Hence the one leg idea - you use the other leg to brace properly and reduce the weight by half. But, keeping the small of your back as flat on the floor as much as possible is key.

I'm very surprised your PT hasn't explained this (or has he?). Without keeping your lumbar region as flat on the floor as you can manage this exercise is 100% pointless.

A note on this: start this exercise is with the leg skywards, not on the floor. It means you can focus on the flat back thing better and then lower your leg. Doing it from the floor up you start at the point of highest weight/pressure so will be harder to find good form initially.

Someone else posted some other exercises - cats & dog and the pic of the yoga exercises. I do a few of them daily and they seem to be good for easing annoying muscle tension and strengthening without loading up the lower back as many normal core exercises do. That is what you're trying to achieve.

It's worth considering that the bottom of the spine has all of the weight of the body above it pushing down on it. Most of the pain (assuming it's not skeletal injury) will be down to chronically tight or inflamed muscles and connective tissue - not lack of strength. So, on one hand you're trying to find a way to ease the load on the back by improving the torso muscles, but you also need to ease all the tight muscles/connective tissues around the spine/hips which are likely giving you the pain - not making them tighter by overworking them more, especially with poor form. When you have a sore back they're in an almost constant state of tension and mild probably inflammation too. If you find yourself at your desk holding your abs tight to alleviate your lower back pain then this is a good demonstration of it - even sitting or lying down they can be overworked.


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