Several years ago I hurt myself really bad while working out. Full disclosure: it was during a CrossFit class. I was really trying to push myself during this particular WOD (work out of the day) when I felt a sudden sharp pain in my low back. I laid down immediately due to the pain and realized that the pain started spreading down my hip and into my leg. The next morning I woke up and my right leg was all pins and needles. As a Physical Therapist I decided I would start slowly addressing my symptoms with the very information I use in the clinic. It took a solid 8 weeks for me to start returning to my normal activities. It was a slow road and it may not be for everyone but I outline my plan below. I hope you enjoy reading!
***To be upfront this is for ACUTE onsets of low back pain NOT chronic or long standing low back pain.
Step 1: First things first, do not freak out. Research shows us that acute episodes of low back pain happen all the time and typically resolve on their own in a few weeks to a few months.
Step 2: Keep moving! One of the worst things we can do is to STOP moving all together or to reside yourself to bed rest. Maintaining activity levels does a couple of things for us: first, it helps maintain our mentality and regulate our emotions around the episode of low back pain. Next, it helps us maintain our fitness level so we are not starting from 0 when we come back.
Activities that do not increase our pain or increase it only slightly are suggested here.
- Potentially
- Walking/running
- Elliptical
- Upper body lifting exercises
- Presses
- Rows
- Lower body exercises that limit increased pain
- Potentially we do the same exercises slower and with less weight.
- Could include: squats, bridging or hip thrusts, farmers carries (unilateral or bilateral carrying), & deadlifts
Step 3: Hopefully by now our symptoms are improving. If they are not, then we may want to consult a professional. Our bias is that early initiation of physical therapy or other conservative care can do wonders in reducing overall cost of care and reducing time to return to activity.
- If our symptoms are improving then we want to SLOWLY start reintegrating our normal activities.
- In this phase, we want a systematic return to our pre-injury level.
- We advise a scaled approach where you start much lower than you think and work up to a weight/resistance that is comfortable or potentially only increases your pain minimally. (See our other Blog post on acceptable pain when working out)
- This may take a couple of days or even weeks before you feel “back to normal.”
- In this phase we may not be jumping back into our full work out.
- Cross fitters: talk honestly with your coach about how to scale your workouts and respect your body.
- Weightlifters: The goal is working out for a lifetime not lifting your 1 rep max today. Respect the healing process and don’t push through pain in hopes it will go away.
- Gardeners: do not try to weed the whole yard on day one of returning. Set up a schedule to work your way back in and consider getting help to jumpstart the process.
Step 4: By now hopefully our pain is minimal and we are progressing slowly back into the activities that contributed to our painful episode.
- Always remember the goal is to train throughout the lifespan, assess your REAL goals and determine if your workout regimen is appropriate for you.
KEY TAKEAWAYS:
- It is so incredibly important to remember that just because you got hurt on a specific activity does NOT mean that activity is not a good activity. More than likely it was a variety of factors that led to your current injury. Perhaps too much load too quickly was the issue or too much volume was the issue.
- We hear all the time in the clinic that deadlifting (bending over and picking something up) is BAD for you and that’s just is not the case. An appropriately loaded deadlift may be a great activity for you. If you’re not comfortable doing deadlifts then maybe they are not for you. IT DEPENDS. Our argument is that, functionally, they are a very appropriate exercise to be performing both inside and outside of the clinic.
- Trying to simply push through pain may not be the best way to handle your current issue. At REV Physical Therapy we like to educate clients on finding an appropriate threshold for them. Maybe that’s avoiding one specific activity while still maintaining other systems. Possibly, we simply lower the resistance for a period of time to a point that is tolerable, then slowly build back up.
*** Remember this approach focused on a recent onset of low back pain!
I hope this was helpful and please stay tuned for future BLOG posts at REV Physical Therapy!
If you feel lost following an injury to your back please give us a call, our therapists in DeLand and Pierson Florida can help you build a plan to return to sport! (386) 738-3456
