“The spine is considered to be a strong structure and pain is seldom a sign of injury or disease caused by strain, but rather a functional disturbance” (Ree et al 2016). This Norwegian study found that this “Non-injury Model” of patient education resulted in significantly less sick leave days in their participant groups at both the 3 and 6 month follow ups. This is in contrast to the “Injury Focused Model” of care that the medical system and many practitioners emphasize.
The main message here is to educate people that their body and spine are strong and need to move. Too many people are taught terms such as: your back is ‘unstable’, your pelvis/hip/back/ or neck have ‘gone out’. No wonder people are scared to move when they are hurt or in pain!
In 2004, Rob McKenzie (1931-2013) was voted the most influential and distinguished physical therapist in the field of orthopaedic physical therapy. He published and wrote many articles and books over the years such as “Treat your own Back” and “Treat your own Neck”. His philosophy was that you needed to move and find directions of movements that gradually eased your pain. This was indeed a new way of thinking in the 1980’s! When our body signals to us that there is a problem by sending pain messages, this means that some structures are being stressed and have become sensitized (hypersensitive). The right movements can help to unload mechanical stresses and help to desensitize certain structures (joints, ligaments, nerve tissue, muscles). It is our goal to empower patients to learn pain free, or less aggravating positions, to move in order to desensitize the nervous system.
When we assume prolonged static postures, these postures can become an aggravating factor for someone with spinal pain. Over time, the spine will become sensitized (hypersensitive). It is recommended to frequently change your posture at least every hour! This doesn’t have to mean getting up out of your chair and becoming less productive. Dr. Bahram Jam, a Canadian physical therapist and founder of the Advanced Physical Therapy Education Institute (APTEI) outlines some effective desensitization exercises for people with spinal pain…all while still sitting.
For the lower back, he refers to this exercise as “pelvic pumps”. In a sitting position, round your back into a fully flexed (bent forward) position. Then slowly roll your pelvis forward so that your lower back moves into an extended (arched) position. Continue this movement in a rhythmical fashion 5-10x every hour.
A commonly stiff but less symptomatic area is our mid back, the thoracic spine. To self-mobilize this area in a seated position, simply lift your arms and reach up overhead. If it’s comfortable for your neck, look up towards the ceiling as well. Continue to raise and lower your arms while following your hands with your eyes. Perform this motion in a controlled manner 5-10x every 1-2 hours.
The neck undergoes a lot of time in a flexed position while reading, using the keyboard, and looking at an iPhone. Reach your hands to the back of your neck with your fingertips pointing downwards towards your shoulder blades. As you slowly look upwards to a comfortable degree, gently press your fingertips in a downward glide motion over the centre of your spine (the bony ridges). Repeat 5-10x every hour of uninterrupted sitting. Never move into a position that causes pain or aggravates your symptoms. Movement is healthy, movement is necessary and the correct movements can help unload sensitive structures and desensitize our nervous system!
If you are experiencing back pain and are unsure of how to move properly to help alleviate your symptoms, we would love to help you out.
Jennifer Gordon (BSc.PT, CGIMS, AFCI)