My Back

I mentioned in a post a long time ago that I have “a bad back”. I have been prone to bad backs in the past, usually caused by me overdoing exercise, such as running 10km straight away from doing nothing other than a bit of 5-a-side. But this time last year I was in the best shape I’ve ever been in. I had certain goals I was looking to achieve with one of them being to look better, to get stronger to help my posture and also a vague idea about the minimum amount of functional strength I wanted which I won’t go too much in to on a family blog!

Then, at the beginning of January this year, I missed the bottom step of my staircase and fell on 3 of my all fours whilst protecting my breakfast with the other one and felt a twinge in my back.

Although I’ve tried to do bits and bobs of exercise, I’ve been lacking the confidence to push it. This is mainly because the second bad episode of back pain I had this year was after playing football for 90 minutes, although the third episode (and by the far the worst) came the day after I simply felt a bit of tightness in my back. On that occasion, I was unable to move my legs even a little bit without some of the worst pain I’ve ever had, and couldn’t support my own body weight while on my hands and knees.

Unfortunately by the time I’ve been able to get further than my GP to understand what is causing the issue, the main symptoms have cleared and I’m in little pain even if something as simple as putting a cup of coffee on a table can cause a temporary sharp pain from my back in to my legs.

I went to see the first person in the physio department who told me I had a lack of core strength so she would refer me for further physio sessions. My appointment took so long to come through that when it said “We’re really busy, let us know if we can cancel” I said that they could. Three days later, I had that worst episode yet.

I demonstrated to my Dad that the pain was relieved by rolling my knees causing two cracks in my back and he suggested I go back to the GP to get a referral for imaging. So off I went, got the referral and a heavy dose of embarrassment (“is that all?!” when she tested my flexibility). I turned up at the hospital to be greeted by “Alan” who also said I had a lack of core strength and that he’d book me in for physio appointments again.

Now, I’m still to this day not happy with the “core strength” diagnosis. I rang my private health care in the hope of finally getting the imaging my GP wanted, but was again referred to a physio who said my condition was classic for someone who had been “inactive and sedentary for years” and was a result of a lack of core strength.

Before the first episode I was able to squat 125% my body weight and deadlift more than that, inhibited more by equipment than my strength. I know those aren’t power lifting figures, but I’d bet that they’re higher than a good percentage of the population. Add to that a regular core circuit that I did, including planks, rotations, leg raises and next to zero crunches, I struggle to believe that a lack of core strength was a contributing factor to the start of this, albeit I am now in worse condition than I was at the beginning of the year. I also wonder if core strength is fashionable and easy, with my inner cynic seeing as fueling an industry. There is a body of research suggesting it is a myth, with certain practitioners advocating core strength exercises that in no way mimic functional movement in “healthy” people. The second point supporting the idea of core strength treatment as maybe not right is that too much core strength could actually compress a route cause injury and make it worse. In truth, I think the answer lies somewhere in between, but probably fall closer to the side that core strength can mask the true injury. This is what my body is telling me anyway. For example, when trying to accelerate on a slippery surface playing football, I get a twinge in my back. Greater core strength could stop that, but without knowing what is causing the twinge, would it fix that particular injury? It’s like putting a sticking plaster over a cut.

Buy anyway… Yesterday I had my first private physio appointment. I’ve had 5 approved by my insurance company, and the first ones will be loosening me up before the later ones are increasing strength. He did a lot of what felt like kneading the muscles in my back to each side and then moved on to manipulating the sarcoiliac joints in my hips. Apparently you should have about 4 degrees of movement in each and it’s rare for people to get issues with both. I have no movement in either. I left feeling pretty battered and not any better than when I entered the room, although I understand this is all a process and didn’t expect immediate results. I’m not sleeping great at the moment anyway, and it was worse last night because I was sore.

I did my prescribed stretches this morning and I went to my NHS physio appointment. She took a history and did an examination. She has declared me to have the tightest hamstrings she’s ever seen! She noted the fact the my left knee doesn’t point forward and said that that would be my hip, which is interesting after what happened yesterday. The most interesting thing that this morning’s physio said though was that she thinks I have a very strong back and the issue is just flexibility. This is the first time that one has not ventured the “core strength” diagnosis.

So I’m going to run the two physios side by side for a while. I’m having one session a week privately and my next NHS appointment is in three weeks. They have both prescribed hamstring stretches and both said that it will be a long journey to loosen those up. The private one has shown me some stretches for the sacroiliac joints, while the NHS physio has shown me some stretches and exercises (which I think include the Cobra from Pilates?) to mobilise the lower 5 vertebrae in my back. That Pilates exercise has got me nervous cause it does get a little pinchy if I go too far.

I want to see whether the two physios converge on anything common other than my hamstrings. We’ll see how it goes.

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