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This article is a transcribed edited summary of a video Bob and Brad recorded in October of 2023. For the original video go to https://youtu.be/V2HfsDpLmxk
Brad: Oh, how do you stop nagging back pain? Ah!
Mike: Well, the first thing you need to do is stop performing activities that are causing your back pain.
Brad: For example, the first thing you need to do is look at how you get out of bed in the morning and that can start the pain cycle right there. A big mistake is when people go from lying on their back or their side to the seated position can really stress the back.
Brad: We get twisting and all kinds of stress on the back that'll irritate it, so the first thing you'll want to do is bring up your knees. We call this hook lying. At that point, we want to tighten the abdominal muscles. Mike, can you explain how you're going to do that?
Mike: So you're kind of inhaling and tightening up your abdominal muscles. When you inhale, don't expand your chest, this is not what we want. We want to inhale and expand out the stomach. This will help keep the back muscles around your spine stable, not causing back pain.
Brad: Right, it acts like a back brace. At that point, while you're maintaining those tight muscles in the abdomen, you're going to roll.
Brad: Now, when you get to this point, if you still feel some back pain, we're going to actually increase that back brace for the whole trunk, and you're going to tighten up the chest and the lats and by doing that, you're going to depress the shoulders, tighten everything up, and just feel that complete brace around your trunk, supporting your back, so you can do that rolling. We call that log rolling in the therapy world, at that point, bring the feet off the bed and maintain that tight trunk. Push with the elbow and the hand. Keep everything straight. I've always told my patients, to imagine you have a two-by-four along the back of your spine that's maintaining and stabilizing a nice strong spine.
Mike: Now, to get back in bed when you're having back pain, you just have to reverse this order. So when you are seated at the edge of your bed, start by bracing your core again. Slowly try to drop down onto the elbow and lift your legs up. You're going to get in this hook-lying or log-rolling position. Once you're here, try to roll onto your back, you can use your arm to push, and you should be okay from here. Now, if you sleep on your side to begin with, you're already halfway there.
Mike: The next common problem people have is getting in and out of a chair incorrectly. Now, this is going to vary from person to person how you're going to do it, but the start and the ending are all the same. When you're starting, you're going to try to slide your butt forward, my back is still supported. You can brace here if you need to like we were doing in bed. Once you're here, find the position that feels good for your spine. If it feels better to be more flexed, that is okay. If it's better to be straight up and down, that's fine too. Somewhere in between works. Once you find that comfortable position, then you start standing up. Make sure to push with your arms and then straighten up if you can, if that feels good.
Mike: When you're going back down, find the position again in your spine that feels good, reach back with your arms and sit slow and controlled, and then slide your butt back and get comfortable.
Brad: Right, I think the big thing is, you take your time with it. Everybody's back pain is a little different. That's why Mike is saying to adjust your back to the pain-free position, or as pain-free as possible, and work with it and continue that as a habit. Alright, the next big aggravator of back pain can be sitting in your seated posture. Supporting the back properly is very critical and what we have found is nice, you can use a pillow that you sleep with as a back support. Now, it's going to vary on the type of chair you have, but in a firm chair like this, we find, take a pillow, put it vertically on the back so it supports from the back from where the belt line is all the way up to the shoulder blades, adjust yourself so it feels good and supported, and how do you feel, Mike?
Mike: I feel good! So this allows your spinal muscles to relax more and not be so engaged. Often, if people aren't sitting with enough support, they might be overarching their back, which can fatigue it or cause your back pain to flare up as well. Now, if you're on a couch or recliner that's super cushiony, maybe a small pillow will suffice. Just try which one works for you.
Brad: Alright, now the next thing is, if you have spinal stenosis, which is more common with people 50, 55, and older, and then you have back pain associated with walking longer distances. Now, Stuart McGill came up with this stretch to help stretch out the nerves in the back, if you will, I'm not going to get into detail. We're going to show you two ways here, you can do this on your knees, and we'll also show it in a chair so it's more comfortable for some people. Now you put your elbows on the side of a cupboard, you could use a bed possibly. This is a little bit low for me. I would use a cupboard at home. You could put a pillow for your elbows to be comfortable. Hands out on your head just above your ears, relax and stretch. Mike, can you show them the stretches between the shoulder blades and down towards the back? Relax and stretch and hold it. I like to do pressure on, pressure off. I will hold up to 10 or 15 seconds. You can go longer if it feels good.
Brad: Now, the seated version, you don't need a rolling stool, just any chair that you have, and then we stretch, and I just going to lean forward, and I'm just stretching, arching the back. It's probably a little harder to see in the seated position. You do get a little bit better stretch when you're lower or if this is higher. You'll have to see what works for you at home.
Mike: Now, the fifth tip is for if you're out walking and you're experiencing back pain. Sometimes, just getting some type of decompression relief in the spine can allow you to walk maybe up to an hour longer. So what you can do is find some type of rails, or even a park bench, whatever you have available to you, and there are a couple of ways you can do this. Do which way is easiest for you to perform and decreases your back pain the most. So I'm going to be facing away from the railings, my hands are going to be facing this way as well, and I'm going to try to unload my spine by pressing through my arms and straightening out. This will have a little decompression feeling in my feet. You'll notice in my back, notice my feet are popping off the ground in the heels here. This adds a decompressive force. Now, this is a little tall for me, I'd probably do something a little bit shorter, but this is a way you can get relief, and Brad will show a different way.
Brad: Yeah, if you happen to have a park bench or something very solid, actually, this chair wouldn't work because it's wobbly, so Mike's going to put his foot on there as if it's a concrete bench or something very solid. Hands can go here. Now, you may find it more comfortable for your hands to be forward or the other way around, do what works best for you, but if you can lock your elbows, I'm up on my tippy toes now, lock my elbows, and now, I'm dropping the weight of my legs, and there's very little weight through my toes right now. The weight is mostly going through my arms, and I'm relaxing my core muscles around my stomach, and that's allowing decompression through the spine, letting it relax. You should feel relief while you do this, and you may want to stop, and give your arms a break. Do it two or three times, and then continue walking until you find the next park bench.
Mike: Just do what time duration your body allows. You may not be able to hold up super long, so there's not a set time for this.
Brad: That's right. Now, these are five tips and habits we've gotten from the expert in the back pain field as well as from our experience. I'm sure you're going to have some success, maybe not with all of them, but some will work. What else do you have to say, Mike?
Mike: If you want to check out other videos on back pain, this one includes exercises and stretches you can try at home, "Only 1 In 5000 Know This About Treating Sciatica."
Brad: Excellent.
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