Back Pain Mismanagement and Misconceptions
80% of the general population will, at some point in their lifetime, experience some level of low back pain. The cost to the Australian economy? $9.17 billion. You want to know what makes that figure even scarier? Those figures are from 2001!
There are so many instances in my experience unfortunately, where a client might come in and describe their back pain to me in such a way that you can tell that they have been mismanaged in the past.
What do I mean by that? Rather than simply telling you about some different examples I have heard personally - I present to you my case study for the day:
Tiger Woods' Career Has Been Derailed By Back Injuries
If you know me, you may be familiar with the idea that Tiger Woods is one of my (sporting) heroes (the less said about his personal life the better!). 14 majors, holding the record for the youngest major winner at 21 and winning his last major whilst having a broken leg - the guy is a machine.
Unfortunately, since 2012 in particular his physical ability has been devastated through a series of injuries, along with 4 surgeries on his lower back.
As incredible as his playing career is, his understanding of his back pain and the issues that he needs to address are somewhat below average - and that's being VERY nice about it. Here are a collection of quotes that help my case:
"My sacrum went out... once it went back in it was all good"
To help my point, have a quick look at the picture below of the sacrum - pay particular attention to the ligaments (white on the picture):
Ligaments attach from bone to bone, and their roles in the body is to provide structural stability to a joint. Looking at the picture above, I'm sure you can appreciate how stable your sacrum, your pelvis and your hips are. Short of a high-speed car-accident, your pelvis is completely stable and is certainly not "going out" anytime soon!
"I need to strengthen my core to get back to golf pain-free again"
Core stability is such a big area in rehab in this day and age. The point I want to make is not to criticise core exercises becuase they absolutely have their place when appropriate. When are they probably least appropriate? Following disc surgery in the lower back!
Core exercises increase pressure on the lumbar discs - if you are trying to decrease the irritability to these discs, the last thing you want to be doing is compressing them further!
"My glutes are just shutting off, then they don't activate and then, hence, it goes into my lower back."
...I'm not sure how to approach this quote. It's so incorrect I wouldn't know where to begin! Our take-home message from this quote is that the glutes shutting off are not a thing!
So Tiger's Wrong, Who Cares?
You might think that just because Tiger has been fed some poor information, does not mean that his back would be any different even if he HAD been given the right information. Consider this though:
If you walked around thinking that your sacrum could pop in or out at any given moment, that your glutes were having a 'bad activation day' or that your core muscles were weak, would your mindset towards your back pain be affected?
I know mine would.
This type of thinking is referred to as catastrophising - the thinking that your back pain is more serious or more imminent than it actually is. There is a wealth of research in this area that shows that poor beliefs about your back pain can delay recovery and even make the pain worse!
Our roles at physios is to treat the physical issues that may be causing the pain you're experiencing, while at the same time addressing the thoughts and beliefs which might otherwise hold back your recovery.
Unfortunately, Tiger's medical team does not come off looking great in his case.