Stuart McGill, a professor at the University of Waterloo and Chief Scientific Officer at Backfitpro, gives us an in-depth look at the trainer’s role with clients who suffer from back pain and discusses the causes of back pain and disorders.
Most back-pained patients who are referred to me have symptoms caused by trainers and clinicians. Now I have your attention! So, I will also acknowledge that the trainer can be the most effective professional in reducing back pain. I hope that the story that follows will empower both you and your clients to reduce pain and enjoy the pleasure that comes from disciplined and competent movement.
Let’s be clear, there is no such thing as non-specific back pain. There is always a cause. Nearly always, the pain is worsened by specific motions, postures and loads, and yet may also be relieved with specific motions, postures and loads. Trainers who work within this reality create able-bodied, robust clients.
The medical system is woefully inadequate for dealing with back pain. Most patients rarely receive the most important part of the prescription to get rid of back pain from their doctor — the knowledge and understanding of their condition required to become their own best advocate.
Typically, they receive a ten or 15-minute appointment that simply is not sufficient to diagnose back pain. The person remains clueless and frustrated, left in the dark about what behaviors must be stopped to alleviate the cause of their pain. And they have no guidance as to what is required to build a foundation for pain-free movement.
Simply getting passive treatments such as prescriptions for pain medication, or a modality such as ultrasound, without a plan to stop the cause itself rarely creates a long-term solution. While medication may be a part of a broader approach, a thorough assessment of an individual’s specific pain triggers will identify a pain mechanism and guide a targeted treatment plan. Performing the exam to find the pain triggers is not difficult. I will coach you through the process.
There are several popular myths about back pain that can thwart recovery. “Non-specific back pain”, “Idiopathic back pain” and “Lumbosacral strain” are terms used to label patients with back pain. These non-specific diagnoses indicate that the patient has not had a competent assessment of their pain mechanism.
Yet another popular diagnosis is degenerative disc disease. I am so disheartened when a distraught patient expresses their fears to me regarding this supposedly progressive disease. When I tell them that in actuality they have no such disease, their reactions vary from relief to anger towards the person who mislabeled their condition.
A degenerative disc disease diagnosis is the equivalent of telling your wrinkled mother-in-law that she has degenerative face disease. Surprisingly, many people can be guided through a more thorough self-assessment, assisted by their trainer or clinician that will reveal their precise pain triggers. This approach often introduces patients to the first accurate assessment of their unique causes of pain that they’ve ever received.
Based on the pain triggers, the next step is to guide movement strategies that allow motion while avoiding the triggers. By treating patients as individuals, they are able to understand why one approach may be very effective to remove pain for one patient but may hurt the other. Using the knowledge gained from their assessment they can both remove the pain triggers and create the foundation for pain-free movement.
Read the full article at Strength Matters