This week I did not have to think at all about what I would write. Of course it would be on the back, after having written about stability in the last post, and backache being one of the foremost ailments generally experienced. Backache can be caused by a multitude of factors, which may range from habitual bad posture and movement patterns to trauma and injury with surgical component. Interestingly, as I am writing this post, I have come across an article in the Wall Street Journal regarding meditation as an option for pain relief in lieu of narcotic pain killers after a back surgery. In my opinion, pain killers overdose acts much in the same way as antibiotics overdose. That is, it eventually decreases in effectiveness.
I will keep this post simple- backache, as a result of poor postural habits and non-traumatic back pain, and an insight into its prevention.
At birth, the spine is c-shaped or “kyphotic.” After birth as the child lifts the head and starts walking, the “lordosis” (convex forward curve) in cervical and lumbar curves develop. The primary “kyphosis” (concave forward curve) is preserved in thoracic and sacral vertebrae. The sacral vertebrae are 5 in number, however they are fused into 1 bone, “the sacrum.” Pretty interesting? Moving on then, in an adult human being, the spine is made up of 33-35 vertebrae (7 cervical, 12 thoracic, 5-6 lumbar, 5 sacral, and 3-4 coccygeal). With all daily activities which have an impact, like walking, running, jumping, the spine must transmit forces multiple times that of the body weight. To absorb the magnitude of these forces there are the intervertebral discs or IVDs, which are made of cartilage and a soft gel-like center. The muscles and ligaments as well as the “taken for granted/forgotten” fascia allow a smooth movement during any activity. Fascia is the soft tissue that is semi- fluid and very forgiving, providing much needed flexibility, protection, and freedom of space to move to all structures like muscle, nerves, blood vessels, and even organs, which it completely surrounds.
Now with habitual poor postures (static posture), the soft tissue may shorten and tighten at certain places and stretch at others, straining nearby structures including ligaments and joints/bones, causing visible postural deviations. The adapted soft tissue alters the movement patterns (dynamic posture) in slow and steady progression (over months to years) and eventually, at a “critical point” the system fails and may be experienced as discomfort or pain, predisposing to further micro- injuries. Once injured, any healthy, soft and flexible tissue can be replaced with non-flexible, cord- like collagenous tissue. This continues and is cyclical, leading to recurrence of back pain. This then is the most prevalent and most benign form of chronic backache with episodes of acute exacerbations. The point I am making here is not to create fear, albeit amplify that, if alert (and there is plenty of time and opportunity to do so), this is totally preventable at any point in the cycle. The simple answer to that: “awareness and stability before mobility.” Sound familiar?
I will consider some examples here: this being the “Silicon Valley,” a large population is made of professionals spending majority of time on computers or at the desks, sitting with slumped posture. How about the students and children writing and involved in use of technological devices? How about impact caused by improperly done yoga or other popular fitness routines nowadays? Technology is not good or bad in itself, it is just a tool in our hands. Good posture lies not in the desk and chairs we use, but within us.
To keep your back healthy and strong:
*Be aware of the sensory signals that your back, the neck, legs, and hands/arms send to the brain.
*Listen to the body and make that important decision to stand and stretch frequently (every1-2 hours), keeping the muscles and ligaments supple, flexible, and happy.
*Proactively engage in spinal stabilization exercises maintaining a healthy back.
Recently there was a young girl who reached the finals in America’s Got Talent. The amazing flexibility she demonstrated was “beyond this world.” Bending backwards and folding in half, hanging onto a ring by the neck, shooting an arrow with amazing accuracy with the feet, and so on. One statement she made impressed me. She said “People often wonder does it hurt? No, it does not hurt at all.” One does not need to go to such lengths to prove anything. However, it is possible to do all this if it is our calling and train to be the masters of our bodies in our own way.
As contributing members in society, we each play a valuable role. Being healthy and to continue doing what each one of us does the best, it is important to not only to respect the body, which is one of the instruments along with our minds and hearts being the others, but also to keep it efficient to serve the best we can. There is a lot more awareness nowadays to stay “fit.” Popular fitness lays emphasis on movement mainly, undermining the stability aspect. Let us then bring our awareness to the important function of stability underlying all mobility/movement, and enjoy being ourselves. Our back has an important role to play here. So let us bring the “backbone to the forefront of our awareness.”
Ami Gandhi is a licensed physical therapist in the state of California. She is the owner of StableMovement Physical Therapy, a small boutique practice in San Jose that offers patient centered, one-on-one, hands-on physical therapy.