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This month we answer your questions about treating and avoiding back injuries.
Q: I occasionally throw my back out. What treatment provides the fastest recovery?
A: Nearly everyone experiences those oh-my-grab-the-ice wrenches in our backs. “Throwing out” your back is not a single medical condition; the stabbing pain can be caused by various things that can be difficult to diagnose. The most common culprits are a muscle pull or tear with subsequent swelling; muscle spasms; arthritis; and, less commonly, a “slipped” (herniated or ruptured) disc or bone fracture.
You probably can’t diagnose the cause by yourself, but you can act right away to minimize recovery time. After yelling, immediately apply ice for 20 minutes. Do the 20 minutes of icing for a total of four times per day if possible, but at least two times a day. After you remove the ice, blood flow will increase, relieving pain and removing the excess fluid caused by inflammation.
Follow the icing routine for 48 to 72 hours and then apply heat (a heating pad or sauna are two options). The heat promotes blood flow, which speeds healing. Be sure to use the heat treatment only 20 minutes at a time to avoid overheating your muscles or skin.
The next line of defense is medication. You can use ibuprofen, an over-the-counter anti-inflammatory drug (Advil is one brand), to decrease pain and inflammation. If you see your doctor, she might prescribe a local anesthetic or an anti-anxiety pill that relaxes your muscles as a side effect. Massage can help prevent muscle spasms.
Finally, stay active. It’s tempting to lie still in bed, but that’s the worst thing to do! Keeping active by walking and doing simple everyday chores (we’re not saying run a marathon or join a football team) will keep your muscles limber and stretched. Inactivity may leave you stiff and prone to re-injury.
To keep from throwing out your back in the future, do the core- and leg-strengthening exercises as directed in the answer to the next question. If you experience chronic strains even though you do everything right to prevent them, consult a specialist about possible physical therapy or visit a chiropractor. Acupuncture can help, too.
Q: What exercises will help me avoid back pain?
A: Because most back pain results from muscles that are too weak for strenuous motion or lifting, stronger core (abdominal) muscles are your best defense. Abdominal muscles oppose your back muscles to give you support, muscular strength and stamina, and better posture—reducing the chances of straining and injuring your back. Legs and butt come in second to aid in heavy lifting; you need to tighten your abs and feel how you can use those muscles to lift. We recommend these exercises:
¾ Push-ups: This is the most important of our five exercises. Get in a classic push-up position with your hands on the floor at shoulder-width apart, your back straight, and your toes or knees on the floor. Lower yourself until your chest nearly touches the ground and push back up; resist snapping your elbows in the up position (leave them slightly bent, in fact). Look 3 inches above your fingertips so you don’t overextend your neck. Do them until you can’t do any more.
If you’re not strong enough to start with standard push-ups, start with modified push-ups on your knees or even put your hands on a stair step and graduate to standard push-ups. When the push-ups become too easy, increase the number of repetitions and change the position of your hands by moving them closer together or farther apart.
¾ Tailbone lifts: While lying on your back, place your hands—with fingers laced—behind your head like a pillow. Lift your legs, keeping them as straight as you can, above your hips. While holding this position, lift your tailbone off the ground 1 inch and slowly lower it back down. Keep your chin a tennis ball’s distance from your chest; compressing your chin adds strain to your neck and back. Do this 25 times.
¾ Side crunches: Lie on your back and rest your head in your hands as before. Drop your bent knees down to the left, resting your right leg on your left. Next, crunch your upper body, keeping your chin a tennis ball’s distance from your chest. Focus on pulling your belly button toward your spine. Do 25 times on each side.
¾ Lunges: Stand with your feet a natural width apart, weight centered, with one foot in front of the other and both feet pointing directly forward. Keeping your spine erect, bend both knees and lower your back knee toward the floor, allowing the back heel to lift off the floor. Stop when your back knee is 1 to 2 inches from the floor and your front thigh is bent at a 90-degree angle and parallel to the floor. Keeping your weight centered, press back up to the starting position. Do a set of 12 with each leg.
As you become stronger, add hand weights; or if the sets are too easy from the get-go, start with equal weights on each arm until you can’t do more than 12 lunges with each leg.
¾ Squats: Stand with your feet about shoulder-width apart and your toes pointing forward or slightly out. Facing forward, with chest lifted, shoulder blades drawn together and down, a natural arch in your lower back, and your navel pulled in toward your spine, slowly bend your knees, taking your hips back toward the wall behind you and down toward the floor, until your thighs are almost parallel to the floor. Don’t let your knees extend farther in front of you than your toes. Slowly push back up to the starting position. Keep your upper torso lifted and do not lean forward excessively—this could strain your back! As with lunges, add equal hand weights as you get stronger. Do as many as you can within two minutes and without exhaustion.
If you don’t like to exercise by yourself, take a yoga or Pilates class. Both build core strength, balance and good posture.
Q: Whenever I buy something heavy at the home center, the cashier asks a guy wearing a weight belt to put it in my car. To prevent injuring myself, should I wear a weight belt when I unload the stuff at home?
A: Weight belts are designed to provide extra support for your waist when lifting heavy objects. But you have a natural weight belt: your abdominal muscles. If your abs are strong enough, they’ll provide you with enough back support for lifting heavy objects and avoiding injury.
Weight belts may actually train your back and abdominals to rely on the belts’ added support instead of your muscles. That leaves the muscles vulnerable when you call on them for protection if you’re not wearing a weight belt, such as when you slip on ice, twist in an unnatural way, or lift your child out of a grocery cart or car seat.
Do the core- and leg-strengthening exercises outlined in the previous answer to safeguard against back injuries during heavy lifting.