Low Back Pain - The Core is not the problem, the core is not the solution! - Fighting Fit Physiotherapy Nerang Gold Coast

Low Back Pain is something that burdens many of us on a day to day basis.

Most of us just get on with it, however as we age our ability to ‘just get on with it’ can decline.

Flare up’s will often knock around for a week or two on a yearly basis. With pain becoming more frequent, and longer in duration each year. Year upon year we try to get on with it, but after 5, 10 or 15 years of this it begins to get the better of us.

If you are experiencing this, likelihood is you are suffering with ‘episodic’ Chronic Low Back Pain.

“Chronic” sounds scary, and it is scary if you don’t address the root cause early on, as it is likely, that over time it can lead to more persistent pain and lost time doing the things you love.

Chronic Pain is pain that persists longer then 3-months or is episodic/ reoccurring in nature. Even if these episodes are months to years apart, it is still deemed chronic in nature.

The reason the pain needs to be labeled as chronic is to ensure the correct treatment approach is considered. When pain persists for these prolonged periods of time we know that the contributing factors that make up our pain experience can start to significantly change. No longer is it purely about structural, tissue damage or acute trauma. It now encompasses things like; motor control, emotions, sleep, neural sensitization and beliefs around the condition.

For this reason, the wait and see method aka the ‘just get on with it’ approach will eventually get you nowhere. To avoid back pain becoming a burden, you need clear and specific guidance from someone that knows what they are doing, or can at least put you in-front of someone that knows what they are doing.

In this short but sweet blog I intend to discuss two common patterns you may be experiencing with your back pain, and help clear the air around what you should or shouldn’t be doing to try and manage your pain. Also why doing countless sit-ups, planks and core exercises is not helping your situation.

A common term thrown around by Physiotherapists, Exercise Physiologists, and Personal Trainers is ‘Core Stability Exercises’.

“You need to work on your core stability” and “ensure you always lift with proper technique and a straight back”

At surface level this is not awful advice, but without additional education this belief could land you in more trouble than you think. When you first hurt your back a common experience is the muscles tightening up and your back “seizing up”. Unable to move with pain.

In an acute injury this pain and muscle guarding is purposeful, it reduces the amount of movement at the lumbar spine to decrease the likelihood of pain or any potential comprise of the tissues to any further harm and damage. This is a useful short term strategy to a short term situation.

However, once that initial acute pain has settled and tissue healing is occurring in the body we need to normalise movement patterns to ensure normal function is restored.

Core is not the problem, Core is not the solution!

‘Movement Control’ is what you need. This is the ability to consciously and subconsciously control the moving parts of the lumbar spine. Whether at rest or when completing a high level lifting task. It is the ability to not only move the spine in all directions but control it as needed for your daily tasks. To activate when needed, and relax when it is not.

With pain, the longer it lasts, the longer we activate to guard when we should be relaxed and moving.

When pain becomes chronic, learning to control movement, when to relax and when to activate, our pain experience will change drastically.

Being rigid and over protective of your back will see you develop poor movement patterns, reduce functional range of motion, loose mass in specific stabilizing muscles, and have decreased strength through ranges of motion.

We all know that one person that trains at the gym religiously and is extremely strong, bends over at work to pick up a pen and BANG……. their back pain is worse than ever. I don’t know about you but that does not sound very functional or ideal to me.

It is essential to train the lower back to have complete control of movement and be resilient in all positions.

That leads us to our next part of the blog…

Two patterns of chronic back pain that we see on a daily basis here at Fighting Fit Physio.

Note: If these resonate with you – get yourself down to the clinic for a proper assessment and individualised plan!

‘Tight Control’

This is often seen in people that have been struggling with low back pain for a long time and have taken that ‘core stability’ progrram to the next level.

Sometimes a friend or even health professional has told them the importance of strict lifting form and holding sustained positions like planks to stabilize their core.

These individual often have extremely tight muscles up either side of their spine and will never pick anything up without a “straight back and bending at the knees”. This pattern stems from using that muscle guarding strategy and never letting it go.

As a result the muscles are tight and fatigued, no longer able to manage load through a lengthened position (bent back) and thus have lost functional strength. This continuous sustained position causes reduced range of motion and the feeling of instability or fear when lifting outside this position. They believe this strategy will protect them, until life throws a curve ball and they have to quickly lift something from a bent position… bang …… and back in severe pain again.

These individuals benefit greatly from lumbar pelvic motor control re-training.

It teaches them to move and control the spine in all positions, allowing them to relax and activate at the right times to build the functional strength for day to day activities.

Often manual therapy will be used to reduce tone (tightness) and relax the affected muscles and then begin movement pattern retaining to expose the spine to it’s full range of motion.

Done well this type of treatment has great affect. You will be feeling more free and more confident with whatever life throws at you.

‘Loose Control’

This refers to people that go in the opposite direction. These individuals will move more freely through the lumbar spine whilst lacking the control and strength to manage the loads imposed on it.

This is equally detrimental and can be a source of pain just as much as the tight control pattern. In these individuals they are often truly tight in the both the glute and hamstring muscles. When they bend forward they will have minimal hip hinging and the movement will come entirely from the lumber spine.

Due to the reduced range in the hip, the lumbar spine is being over loaded in excessive ranges relying on the passive structures (bone, ligaments, discs) to bare the greater load rather than using the surrounding muscles. The repetitive movements and loading of these structures significantly increases symptoms and the pain experience.

Over time the muscles that are not being used appropriately begin to weaken more and more, snowballing the issues to get worse again as more load is placed on the spine.

These individuals benefit greatly from mastering basic motor control through exercises and cueing from the physiotherapist. Then once mastered this control can be implemented with heavy lifting and high level activity. This allows them to feel strong in all positions and load the whole system from legs to back, rather than the spine itself.

In Conclusion

The human body is an amazing thing, and the low back is designed to be strong and capable. To ensure we keep a happy and healthy back we need to have complete control over it and use it in a myriad of ways.

We need to be strong when we have a ‘straight’ back, a ‘bent’ back, a ‘twisted back’ or when quickly doing an unexpected tasks in all kinds of positions.

The low back should be adaptive and resilient, not fragile and ready to break as soon as we do something out of the ordinary. Thus, to achieve this we must train the back in many different ways and under many different loads. Teaching the whole body to work together to optimize performance.

That is why you need us!

At Fighting Fit we will assess your current function, patterns, and needs. We will then provide a detailed and individualised plan to suit your needs.

We will guide you every step of the way with the most up-to-date practice and technology to ensure you get the results you want. Allowing you to put that back pain to rest and get on with having an enjoyable life.

Ready to end the cycle of low back pain? Book a consultation with us today!

Dean Phelps

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

Andrea Bell

05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

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