Back Pain Myth Busting 1 – Movement and exercise is bad

Back pain is an extremely common complaint. We frequently hear of back pain and injuries from our clients, and have found it to be a difficult hurdle to overcome despite its frequency.

We have enlisted the help of Physiotherapist and Exercise Physiologist, Phill Forostenko from Queen Street Physiotherapy in Brisbane for insight and expert advice on back pain management.

Phill has over 10 years’ experience as both owner and directing physiotherapist at Queen Street Physiotherapy. He has interests in sports and work related injuries including neck, shoulder and back pain. He is also highly experienced in managing mobility issues and post surgery rehabilitation.

We sat down with Phill earlier this month to break down some common myths around back pain.

Read on to see his insights and why movement is so important for a speedy recovery.

Click on the links to read the other articles in this series:

You often hear that exercise and movement is bad for recovery, is that the case?

Absolutely not. The right exercise has been shown hands down to be the best rehabilitation for just about any injury or niggle. The real question should be, ‘What is the RIGHT exercise?’ This is where things can get a little complicated and it’s like asking, ‘How deep’s a hole? Or how long is a piece of string?’ It really depends on you, your injury and your personal circumstances. At Queen Street Physiotherapy we can advise and guide you on the right types and amount of exercise.

But for a very basic baseline you want to exercise within a tolerable pain limit (i.e. it’s a bit sore but I can do the exercise without it getting worse) and you want to reach small milestones along the way. Typically that will reduce the swelling/inflammation, achieve pain free range of motion, gentle return to activity, then a full return to performance. And your activity or performance is very dependent on you. It might be rep level sport, or gasping for air in a PT circuit wishing it was time for that post workout cappuccino. 

Exercise vs. rest for back pain, what’s better?

To elaborate more on the above, exercise again…hands down. But backs are little more complex and require a bit more thinking on your physiotherapists behalf. However the principles are the same as above. Once you’ve gotten past the initial acute pain with your standard stretches and mobility, things can get confusing.

Do I do yoga? Pilates? Can I deadlift and squat again? I’m tipping the scales at 110kg but I love rollerblading…should I do it?

The bottom line, yes do it. Do what you enjoy and what doesn’t stir the back up.

If you are still unsure about what exercise is appropriate for you, please come and see one of our professionals at Queen Street Physiotherapy.

When should you rest, and how long for?

For most acute injuries, typically 48hrs, but the consensus is evolving.

The old acronym RICE (say it with me…rest, ice, compression, elevation) has now been given a shiny new upgrade to POLICE (protect, optimal loading, ice, compression, elevation). And it’s the optimal loading part that’s key.

Early movement, early rehab, early exercise equals faster and better recoveries. The best example of this is a knee replacement. The morning after you’ve been cut open, bones and joint removed replaced with titanium then stitched back together again, you’ll have a nasty physio like me getting you to stand up and walk around…while you’re still drugged up, in your flattering surgical nightie and connected to a bunch of drips and beeping machines.

Why? Because we know it’ll be that much better later down the track.

What simple exercises can you recommend to get someone back moving again?

In regards to getting back into exercise, whether you have been absent due to injury or you have just had a large break due to the hectic nature of life, the key is to take it slowly but keep it on a daily basis.

Generally we have all done some form of exercise at some point in our life, whether it was in a sporting team, a PE class at school, or a group fitness session.

The first place to start is by simply walking.  Increase your endurance and your physical capacities to handle 30 mins of brisk walking.  Stretches to your lower limbs should be performed prior & post walking that include stretches to your calves, hamstrings, quadriceps and gluteals.

If you are still unsure, the professional staff at Queen Street Physiotherapy can advise you on all your stretches or exercise program.

How can a physiotherapist help with back pain? 

Not all lower back injuries have a singular diagnosis and a sequential rehabilitation program. Lower back pain management strategies need to be designed specifically for your particular injury and lifestyle. First and foremost, a physiotherapist can reduce your immediate pain with treatment including manual therapy, massage therapy and strapping. Alleviation of pain will be your paramount concern and is an important first step in your rehabilitation.  Physiotherapists can advise you on the duration of your rehabilitation and treatment needs, which will vary for each individual and injury. It is also important to be aware of the correct techniques for activities and daily living to support your injury throughout the rehabilitation phase. A physiotherapist can advise you:

  • When to rest
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    When to start the right exercises - should you be strengthening muscles or stretching them?
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    Tips on getting to sleep and staying asleep with your back injury
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    How to lift objects correctly
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    Tips on getting in and out of bed without aggravating your pain
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    How to look after you back at work - is sitting or standing the best option for your lumbar injury?
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    How to manage your pain outside of your treatment session - should you be icing or heating when it's sore and for how long? Should you be taking anti-inflammatories?

Thanks Phill.

Stay tuned for Phill's next interview in December. 

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Phill and his team by visiting the Queen St Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.