Below is an email exchange with a client on his back pain.
At the time he was unable to to come and see me at the clinic, but the advice I've given him is likely to be of use to some individuals that suffer from 'posture based' back pain.
Initial client email
Hey Alex,
Long time.
Just wanted to ask a question about back pain.
I've had back pain for last couple years and it seems like I've been doing everything right.
What should I do next? What type of person should I look to visit in Southampton?
Thanks...
Additional details
I then asked him for a few additional details so I could give him better interim advice. We exchanged a couple emails. Alongside other things he informed me of the following details:
- No acute incident caused his pain, his discomfort has built in over time.
- He's had lots of Sports Massage / Chiropractic adjustment on his back and neck.
- He's in his early 20's.
- He's a writer / Blogger so spends ALOT of time at the computer.
- The main advice he's had from the Physio / Chiro has been to improve his posture and strength his back.
- He is seeing a personal trainer twice a week and has been working on the strength in his back.
My email response
Hi *********,
No worries.
On the face of it, it does sound largely that you have been doing all the right things - which I understand will be frustrating!
From what you have described is sounds alot like you have some postural issues through the spine / upper trunk. Which is likely to be causing the pain. Obviously I'm making a few assumptions here.
The symptoms you have described all for into the category of poor work (or other) posture. A good clue to this is that after improving your desk set up things have improved, if only slightly.
The type of issue you have described falls very much into 'upper cross syndrome' (Google it!). Again I'm sure you know this is the issue already.
In basic terms you need to STRENGTHEN up your weak / lengthened back muscles (which you're doing) and STRETCH your chest / biceps / anterior deltiod muscles (which you may also be doing).
The problem I find with this sort of issue is that many people, on the face of it, are doing the right things to improve the problem. However they are doing nowhere near enough volume of the rehab exercises to improve the problem.
Bear in mind if you are spending 8 hours+ per day with poor postureworking, then only doing 3x one hour in the gym per week and 10 mins stretching per day is not going to make enough of a difference.
If you want to fix this you will need to really put some time into it.
These are some of the things I would recommend:
1) In the gym, for the short term, minimise pressing movements (e.g. Over head press, bench press etc). Maximise Pulling movements (E.g. Bent over rows, seated rows etc). Focus on retracting the scapula with the pulling movements, as if you're trying to trap a pen between them. This will help address the imbalance between chest / back muscle groups
2) Do face pulls every time you're in the gym: http://www.youtube.com/watch?v=uQS-tXL1CLg
3) Do YTWLs every time you're in the gym: http://www.youtube.com/watch?v=Jj3NdjH1NSk / http://www.youtube.com/watch?v=hjIHVuV673k
4) Foam roll the back every day (10-15mins min) - looking to create extension in the thoracic spine / stretch the chest + shoulders. See pdf attached.
5) Stretch your chest / deltoids as often as possible. Long 30sec holds needed! See pdf attached.
6) Be truly aware of your posture while at your desk - you've got to work at breaking poor posture. This will take a bit of time.
Try these for 4 weeks and really work hard at them. Show the exercises to your trainer so he can go over them with you to make sure you do them with good form.
If you work really hard at these for 4 weeks and it doesn't make any change you can come down and see me and we can go through a proper consultation to get to the bottom of it.
I hope this helps.
Let me know if you want anything clarified.
Catch up soon.
Summary
The type of problem discussed here is something I see over and over again if you suffer from this type of problem have a detailed read over the post as some of the tips and exercises are likely to help you!
As always email me directly if you need any further advice.
