In any three-month period, about a quarter of American adults have at least one day of back pain, according to the National Institutes of Health. The first time often happens between ages 30 and 40 and, like all fun things, tends to become more common with age. “After the common cold, back pain is the most common reason adults seek physicians,” says physical therapist Eric Robertson, PT, DPT, OCS, a spokesperson for the American Physical Therapy Association.
Most cases aren’t serious and go away on their own—we’ll get to that later—but wouldn’t it be nice to avoid them entirely? Some simple changes to your daily routine might just do that, suggests Robertson. Some might be familiar, and we’ll go over a few basics, to get them right. But it may surprise you how many things you can do every day to protect your back.
You know about core strength—keeping your abdominal muscles strong to support your back. But hip muscles are equally important for preventing back problems, emphasizes Robertson. These are called the gluteal muscles, which include the muscles in your rear end, as well as those that wrap around the side of the hip. “One works to extend your hips, the other to move the hips out to the side,” explains Robertson.
One simple way to stretch your “glutes” is to lie on your back and pull your knees up to your chest. Hold for 15 to 30 seconds, and repeat two or three times. “This keeps the hips from getting stiff,” says Robertson. “The more you move your hips, the better off you are.”
You’ll want your glutes not just limber, but strong, too. Try a “mini-squat,” suggests Robertson. Stand about about six or seven inches away from a wall and squat—just a little. No need to make the top of your legs parallel to the floor—that’s a 90-degree angle that trainers often recommend. Instead, aim for about a 20-degree angle. “It’s a nice safe exercise to do.”
Another exercise: Stand up from a sitting position. Sit on the edge of a chair, and stand up without using your arms. “As simple as this sounds, if you do it 5 or 10 times, three times a day, you’ll get really strong.”
A third exercise: Balance on one leg. “Hold on to a counter that won’t move, and stand on one leg,” says Robertson. “Keep your pelvis level. This works on the gluteal muscles on the side, and improves balance.”
Here’s something you don’t have to fret about: Standing up straight. “There’s actually a poor correlation between posture and back pain,” says Robertson. “When we fix posture, we don’t see back pain get better. In any case, if you tell someone to stand up straight, they can only do that for a little while. But if you help them develop the muscles to stand up straight, they can do it all day long.”
Now that you’re practicing standing up from your chair, do it frequently! Sitting for long periods is bad for your back. It puts pressure on your disks, and it also relaxes your gluteal muscles too much. “Too long in a seated position, and these muscles that are important to stabilize the spine get into a more relaxed state than you want.”
Solution: Standing micro-breaks. “As soon as you stand up, you activate your gluteal muscles, your core, and your pelvic flood muscles,” says Robertson. His advice: Every 15 minutes or so, stand up, stretch your back, go for a tiny walk, and sit back down again. Every hour or so, if you can, get up and take a slightly longer walking break.
The standard advice on how to lift heavy objects—that’s your grandkids to you—is always important, according to the American Physical Therapy Association.
When lifting a child from the floor: stand close, keeping your back straight, and place one food slightly in front of the other. Bend your hips and knees to lower yourself onto one knee. Now grab your grandchild with both arms, hold him close to your body, tighten your stomach muscles, and push up with your legs so that you return to a standing position. Put him back down on the floor with the same maneuver in reverse. Whatever you’re lifting, “Lift with your legs, not your back,” says Robertson. “The stronger you keep your hip muscles, and the more limber, the more likely you will be to lift with your legs rather than your back.”
“Walking is absolutely the best exercise for your back,” says Robertson. For one, it’s the best position to reduce pressure on your spine. “You have the least amount of stress on your spine when you’re up and walking.” Standing is better than sitting, but standing for too long in one position is more stressful than gently moving along. “As you walk, you strengthen your hip muscles, and stabilize your spine and back.”
Bonus: If you do have back pain, regular walking may reduce it. This could be because when you exercise the body releases endogenous opiates or dopamine, both feel-good chemicals in the body. Whatever the reason, the evidence is clear that “walking reduces the perception of pain,” says Robertson.
There’s a reason why we’re warned against just picking up the snow shovel and having at it. One is the cardiovascular risk of going from inactivity to heavy exertion so quickly. But it’s a really good way to throw your back out. One reason: Water is heavy. Another is that the weight is so far from your body that you’re creating a lever to put extra pressure on your back muscles. “The further away from the axis, the more rotation force there is,” says Robertson, for all you Archimedes fans out there. “You’re guiding a shovel that’s four feet from your back, and you have to work hard to stabilize your back.” His advice: “Warm up, stretch your hips, don’t fill up the shovel, and take frequent breaks.”
Chronic stress not only tightens your muscles, which shortens them and makes it harder to support your back—but it also increases your sensitivity to pain. Anything you do to help you break the stress cycle—relaxation exercises, aerobics, meditation, yoga—can help. But if you get recurrent back pain, one stress you can work on is the fear of back pain itself.
“It’s very clear that the more stressed you are, the more likely you are to feel pain,” says Robertson. “You’ll have more trouble with any aches and pains that you have.” If you start to feel anxiety or fear about your pain, it can make the pain worse. “You feel fearful, and think your back pain will never go away.”
Stress and its affect on back pain is one reason why Robertson often emphasizes to his patients that the vast majority of back pain isn’t serious—and it goes away on its own. Certainly you should see your doctor if you have certain symptoms such as numbness or weakness, or a change in bowel or bladder function, which may indicate a medical condition. And see your doc if your back pain persists. “For a small proportion of the population, back pain is chronic,” admits Robertson. “But for most it’s self-limiting—it gets better with time.”
Just knowing that most back pain gets better over time can help you lower your stress level, which, in turn, can help you get over any back pain quicker. “Knowing it’s not really serious helps to reduce your fear. It goes a long way to helping people to continue to move when they have back pain.”
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