The number one cause of back pain:

it's not posture.

it's not "bad form"

it's not "sleeping in the wrong position"

it's a self fulfilling cycle. 

and before you say "oh great, hannah's telling me my back pain is all my fault" - hear me out.

we've been told:

keep your back straight.

lift with your legs, not your back.

don't round. don't twist.

your spine is strongest in neutral.

we've basically been taught our entire lives: our spines need protecting. they are fragile.

and if you've had back pain or a back injury before, I'd bet you've also been avoiding loading your back even in neutral.

When you pick something off the floor, you squat, you don't bend over.

You avoid deadlifting because it's hurt your back before.

you don't back squat because you've heard it's bad for your spine.

you purposefully avoid rounding, and twisting, and bending...

and then life happens.

you need to move a couch.

do some manual labor.

pick up the dog food.

you hop in a new workout class with a ton of back and core movements.

something inevitably comes up where you're forced to round your spine, twist, or lift with your back.

and then your back hurts - for days. 

unfortunately, it reinforces the belief that you must have done something wrong.

but here's another way to look at it:

your back wasn't prepared for all of that.

not because you moved in the wrong way, or you have a "bad back" - but because you avoid loading it. because you don't train it. because you don't move it enough.

why don't we freak out when our biceps hurt??

when our glutes are sore after leg day, we feel good about it. dare I say we LOVE it. 

when our biceps are sore, we relishhhh the pump. 

when they're MORE than sore (ahem, Murph, anyone?), we think "well, maybe I did too much"

we don't panic. we don't swear off bicep curls forever. we don't rush to get imaging or injections or stay in bed for days.

but when our backs hurt...

we freak out. we assume something is wrong. we rest, we protect, we avoid.

and then we're surprised when our backs can't handle anything in life.

this is the self-fulfilling cycle I'm talking about - and most people are in it for YEARS without realizing it. 

This is exactly what happened to my patient.

(let's call him Sam)

Sam came in after a group fitness class "wrecked his back"

The workout was lots of twisting, bending, more back work than usual.

He woke up the next couple days barely able to move and was terrified something was seriously wrong. 

When we talked, I learned this wasn't new.

this had been going on for decades:

he goes to the chiropractor every couple of weeks, he can't sit on a plane/in a car for more than two hours, and he can't stand or walk around for long periods of time.

he thought it was normal. 

and he's chalked it all up to "having a bad back."

he had spent years learning how to avoid using his back. 

The problem with this -- what do you think would happen if you avoiding bicep curls for years? If you avoided bending your knees for years?

his back was extremely incapable, stiff, and weak. 

People think their bodies are like cars - that they need to save their joints, that we're going to "pay for it later" - that we have parts that need to be replaced because of too much "wear and tear"

and unfortunately, traditional PT/healthcare/fitness fosters this mentality.

a lot of people go to physical therapy and are taught to NOT use their back. They're taught "how to protect it"

as a PT, I see it all the time: people avoid movement out of fear. They brace. They stiffen. They do these things to "stay safe" 

but this leads to deconditioning, weakness, more fear, and more pain. 

Instead, I taught Sam how to make his back MORE prepared. How we needed to use his back and load it and stress it ~ in the right amounts ~ for it to become more capable. 

our spines are NOT fragile.

Our spines are literally designed for movement -- with 33 vertebrae and hundreds of joints, it's literally DESIGNED to move - to bend, twist, rotate, extend.

we have muscles specifically for each of those things.

why would we have them if we weren't meant to use them?

the problem isn't that your back is weak. the problem is that it's been undertrained - and now the demands of your life are more than it can handle.

and you've been taught to fear it - which makes pain worse. 

if you avoided loading your knees - no squatting, no lunging, no stairs - you'd lose the strength and ability to do those things. same exact thing happens with your back.

use it or lose it!

the fix isn't more rest.

it's not more protecting. it's building a back that can actually handle your life.

next week, I'll tell you exactly how to do that - the specific movements your spine was designed for and how to start training them so you can build a strong, capable spine.

see ya then :)