This is a fascinating overview of the psycho social contribution to back pain
Month: April 2014
Overcoming mental blocks: value of conditioning and progression.
Just so you can get on board with the injustice of it all, in April 2013 I did my 1st ever unspotted back flick at the age of 52. It was clunky, legs bent etc, but it was a back flick. Throughout the rest of the year, while working on my Tucks and P bars and round off and muscle up and up rises ( the list is endless), and in between back injuries, Elbow tendonitis and adductor tear ( in both adductors at different times). My back flick slowly improved it, but became dependent on an emotional spot. I had to have my coach by me, to lightly touch my back before I “went”. There was no actual spotting, but my mental dependence grew and grew.
We started solving this last week: ie my coach started stepping back.
Boom!!
My form collapsed totally and my back flick, when I can pluck up courage to throw one, is now heavily twisted to one side or the other and is “dangerous”.
In catastrophe theory, I hit my bifurcation point. This is that teeny change that collapses the whole structure and from which there is no going back: imagine counting from 1 to 5. And you do it well.
“1.2.3.4.5”
Now your teacher say, ok this time count to 6… you go
“7, 2, sob, london , kitty cat”
So your teacher goes, ok, ignore the 6, lets stay with the 1-5. You go, great!
“ paris, 4, hiccup, moon beam”.
Hitting a bifurcation point, destroys everything you have built up, its not a question of taking one step back to where you were: everything gets demolished.
You can try charging at the back flick ( go to a pit and throw your self in, time and time again) but , bearing in mind that a back flick involves jumping backward upside down and landing on your hands and is 100% technique based, a temper based solution isn’t the way.
This brings me to some observations which is based on the Crossft London teaching method, some of Grigori Raiport’s work and gym bunny rumour.
An interesting bit of advice is to “keep your mind tight”. Everyone talks about abs and glutes: maybe you need to keep your mind focused too. Just throwing yourself backwards doesn’t work.
That said, what does that mean. I know many gym goers who pronounce the value of special thinking and of special mind techniques, but frankly they normally deal in simple moves.
I offer several approaches to solve and maybe avoid blocks
1) Practice the basics
Where possible, base your skill training on proven progressions, build these progression into your warm up. You never know when you will injure yourself or have a brain malfunction and need to retrace your steps
The moment you hit a (new) problem your brain goes into an emotional overdrive. Many solutions are quite basic, but in my opinion, panic, combined with laziness and a wish for drama makes finding the solution difficult.
I once (back in 1979) had a friend who was really nasty ( and abusive and violent) to his girlfriend. She eventually kicked him out. He decided to win her back. His strategies, as I recall, ranged from expensive romantic dinners, to getting a violinist to play while he begged under her bedroom window, I think he even thought of (a mock) sucide. “then she’ll be sorry…..”
Never did it occur to him to be truthful, loyal, loving, sober ,patient and kind.Basics!!!
2) Get your mind to control your body.
Its a bit of a negative view, but there are streams of thought that say, left to its own devises, you will be lazy. In short the body will get away with whatever it can if the mind lets it. If the mind gives up, or goes soft, the body wlll auto pilot for a while, then it will do what the hell it likes.
You must have been in one of those classes where you mucked around. You could sense the teacher wasn’t in control, and off you went.
So with these models in mind I re-looked at what happened running up to my failure.
I tore my left adductor about 12 weeks ago then, screwed my back in a deadlift workout, and then we had a lovely time in Madrid. I had planned a lull to write a bit more and over the last few weeks was able to stay in bed longer, ( certainly later) and stay up late. I was able to lounge around on a soft sofa. In short a long way away from my normal regime. In short I let everything go. My routine went, my focus and drive went with it.
My mind surrendered authority, my body lost strength.
So why the hell would any animal throw itself backwards ( upside down…onto its hoof presumably) for a lazy master.
Here then is the value of underpinning conditioning. No matter how good you do the big skills, do the progressions and your under pinning conditioning often and well because, not only are they useful rehearsal , but its is a message to your body that you, not it, is in charge.
3) that said, it takes a while to re establish control, so there’s nothing much wrong with laying off a hard skill for a short time, while you re-establish control
If its10 push ups, a run, or a WOD drive yourself to do it regularly,
Allegedly, repetition works
But, please stay in control
Specific Causes of Back pain
Specific causes of back pain: some ideas from European Guidelines for the management of Chronic non specific back pain (2004)
There is little relationship between low back pain symptoms, pathology and radiological findings.
In 85% of people (Deyo 1988), pain has no relationship to any time of physical abnormality.
*4% of people seen with low back pain in primary care have compression fractures
*1% have a neoplasm (Deyo et al 1992).
*5% develop at least one vertebral fracture in 4 years (Kado et al 2003).
Spondylarthropathies have been reported to occur at a rate of 0.8 to 1.9% of the general population (Saraux et al 1999).
Spinal infections are rare, and chronic spinal infections are particularly rare. Infectious diseases of the spine should be considered if the patient has fever, has had previous surgery, has a compromised immune system, or is a drug addict.
Spondylolysis and spondylolisthesis are often classified as non-specific low back pain because a considerable proportion of patients with such anatomic abnormalities are asymptomatic (Soler and Calderon 2000)
Back and leg pain after surgery represent a major problem addressed at specific conferences for failed back surgery.
Failure rates range from 5-50%. Based on a failure rate of 15%, it was estimated that 37500 new patients with failed back surgery syndrome would be generated annually in the US (Follet and Dirks 1993).
There is little relationship between low back pain symptoms, pathology and radiological findings.
In 85% of people (Deyo 1988), pain has no relationship to any time of physical abnormality.
*4% of people seen with low back pain in primary care have compression fractures
*1% have a neoplasm (Deyo et al 1992).
*5% develop at least one vertebral fracture in 4 years (Kado et al 2003).
Spondylarthropathies have been reported to occur at a rate of 0.8 to 1.9% of the general population (Saraux et al 1999).
Spinal infections are rare, and chronic spinal infections are particularly rare. Infectious diseases of the spine should be considered if the patient has fever, has had previous surgery, has a compromised immune system, or is a drug addict.
Spondylolysis and spondylolisthesis are often classified as non-specific low back pain because a considerable proportion of patients with such anatomic abnormalities are asymptomatic (Soler and Calderon 2000)
Back and leg pain after surgery represent a major problem addressed at specific conferences for failed back surgery.
Failure rates range from 5-50%. Based on a failure rate of 15%, it was estimated that 37500 new patients with failed back surgery syndrome would be generated annually in the US (Follet and Dirks 1993).
One of the causes that is consistently reported in the literature includes poor patient selection (Goupille 1996, Van Goethem et al 1997).
“This means that patients with non-specific back pain are operated on for radiologically diagnosed disc bulging, herniation or degeneration, which turn out not to be responsible for their pain.”
“This means that patients with non-specific back pain are operated on for radiologically diagnosed disc bulging, herniation or degeneration, which turn out not to be responsible for their pain.”
- References
1. Andersson HI, Ejlertsson G, Leden I, Rosenberg C (1993) Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain, 9(3): 174-82.
2. Balague F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk factors. Eur Spine J, 8(6): 429-38.
3. Barash HL, Galante JO, Lambert CN, Ray RD (1970) Spondylolisthesis and tight hamstrings. J Bone Joint Surg Am, 52(7): 1319-28.
4. Bressler HB, Keyes WJ, Rochon PA, Badley E (1999) The prevalence of low back pain in the elderly. A systematic review of the literature. Spine, 24(17): 1813-9.
5. Cassidy JD, Carroll LJ, Cote P (1998) The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine, 23(17): 1860-6; discussion 7.
6. Deyo RA (1988) Measuring the functional status of patients with low back pain. Arch Phys Med Rehabil, 69(12): 1044-53.
7. Deyo RA, Rainville J, Kent DL (1992) What can the history and physical examination tell us about low back pain? Jama, 268(6): 760-5.
8. Dickson RA, Stamper P, Sharp AM, Harker P (1980) School screening for scoliosis: cohort study of clinical course. Br Med J, 281(6235): 265-7.
9. Ebbehoj NE, Hansen FR, Harreby MS, Lassen CF (2002) [Low back pain in children and adolescents. Prevalence, risk factors and prevention]. Ugeskr Laeger, 164(6): 755-8.
10. Follet KA, Dirks BA (1993) Etiology and evaluation of the failed back surgery syndrome. Neurosurgery Quarterly, 3: 40-59.
11. Goupille P (1996) Causes of failed back surgery syndrome. Rev Rhum Engl Ed, 63(4): 235-9.
12. Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Low back pain: what is the long- term course? A review of studies of general patient populations. Eur Spine J, 12(2): 149-65.
Is an MRI for you
Clients with bad backs clutch onto their MRI scans . Often they are of no value. There is little correlation with disc degeneration and pain. Most people have a bit of disc degeneration.
MRI’s are often ordered by doctors for patients as placebo’s
But for those who want a bit more insight into MRI magic, here is the best lay persons description I can find. Focus on slides 61-63.
As this slide show says, “ask specific questions”
Experiment with Bracing?
One of the biggest confusions in “back pain” is the role of abdominal muscles.
For years hard working doctors and researchers have attempted to assess the role and value and ideal type of abdominal engagement and training methodology. At the same time fraudsters and charlatans have always sought to promote and mystify the actions of an obscure muscle
There are 3 things you can do with your abs if you are standing up in a neutral position ( we need to talk about this concept too!)
1) You can suck them in
2) You can “tighten” them where they are
3) You can “bear out”
Ill discuss these ideas in painful depth else where.
Andrew Stemler 