Understanding and Managing Low Back Pain in Functional Fitness

Explore a comprehensive guide on managing low back pain in functional fitness.
Written by
Sean Hiller
Published on
Jan 10, 2024

Low back pain is a hot-button topic in the world of functional fitness and sports medicine encompassing a large amount of the “workout” population who seek medical help. It is very common. Odds are, if you workout long enough, you will eventually run into some form of low back pain.

This article is meant to be a comprehensive guide to understanding the following common questions:

  1. How did I hurt my back?
  2. Did I injure a “disc” in my low back?
  3. Can I keep working out?
  4. How can I heal 100%?

How Did I Hurt My Back?

Obviously you are not standing in front of me right now but we know some of the most common causes of low back pain, and common means 90% of the time.

For the most part, low back injuries are are chronic in nature and develop over time. It is common to have acute low back pain but far more common to have the chronic version. For both of these however it is normally not some movement you did.

A common question we get is, “Did I do a movement wrong?” While that is possible, a certain movement is not likely the cause of your low back pain. The number one indicator of any injury is have you injured this area before? If the answer is no, then the next question is have you increased or decreased how much you exercise on a weekly basis? Workout volume changes, aside from previous injury, seem to be the greatest cause of injury.

Take-away: On the pre-emptive side of low back pain, to try and avoid it, steer clear of changes in the volume and intensity of your workouts by greater than 10%. That does not sound like much of a change, but we have good evidence that any change greater than 10% increases your risk of injury by 72%. This is known as the 10% rule.

Did I Injure a Disc?

Very loaded question, and again, you are not standing in front of me while I am evaluating you so I will keep this answer to something that would be good for most people in general. You very well could have injured a disc in your low back. These are known as vertebral discs and they are typically accompanied by referring or radicular low back pain in which the pain you have in your back spreads down your hip and leg or across the back.

This is a possibility. It could also be your SI joining (sacroiliac joint), a low back muscle strain, a hip issue. There are many possibilities here.

The interesting part of disc related issues is that the majority of disc injuries relate to the disc being herniated, meaning the disc is outside of its normal location and the vertebrates are impinging upon it. That is what your doctor would look for on an MRI, you have thrown a disc out of place. The kicker is that most herniated discs relocate to the correct area in about a month, but most people who seek medical help continue to have pain after the disc has “fixed itself.” Obviously, there is more going on here.

Can I Keep Working Out?

Quick Answer: YES! You have to find a way to continue to workout. Whenever someone stops working out due to an injury, depression rates rise drastically, anxiety rates rise even further and your risk for further injury increases. So keep moving and contracting tactfully

Finding a way to keep you working out is one of our first lines of business at Vulcan Performance in our process of healing low back pain BUT we have to be smart how we do it. Everyone asks, “can you just give me some exercises that will help me?” We can, but that could make things worse.

Commonly, someone with low back pain will have what we call a directional preference. Meaning I could give you some exercises without ever evaluating your specific case that put you in extended positions when you have an aversion to extension movements. This makes things worse, and sometimes, much worse.

My best answer, if you are able, come see us. After a thorough evaluation, we will be able to answer this question in great detail with much specificity.

If you are interested, click this link to come see us for a physical therapy evaluation at one of our two locations in Birmingham, Alabama.

How Can I Heal 100%?

So many things matter here - your nutrition, your sleep, your stress levels,  and YES, the quality of the physical therapy you receive all matter. A good physical therapist will address all of these.

BUT the answer is yes. Many of our low back pain clients set personal records on their fitness goals as we are wrapping up rehab, so getting back to 110% is possible. Why? In PT we will focus on everything. Your strength, movement quality, form, endurance, stamina, and the injured area in order to return you to full function. Many people NEVER look at all of these. So going through a structured program can make leaps and bounds for the injury as well as your overall fitness.

Conclusion

In conclusion, navigating low back pain in the realm of functional fitness requires a nuanced understanding of its origins and effective strategies for recovery. The prevalence of low back pain underscores its significance in the fitness community, often prompting individuals to seek medical guidance. This comprehensive guide addresses common questions, emphasizing the chronic nature of most injuries and the critical role that workout volume changes play in their occurrence. The 10% rule emerges as a key preventive measure, urging individuals to avoid abrupt alterations in exercise intensity. The imperative to continue working out, albeit with caution and strategic planning, is underscored as a vital component of both physical and mental well-being. Ultimately, the prospect of healing 100% from low back pain is a tangible outcome through a comprehensive and structured rehabilitation program.

If you are interested in dealing with your own back pain, click this link to set up a physical therapy evaluation through Vulcan Performance in Birmingham, Alabama.