Trent and Coach D return for round 4 of the series on lower back pain, wrapping up the topic with a meaty discussion about exercise for treating chronic low back pain as well as acute pain from injury.
As mentioned in previous episodes, it's very important to first get an accurate diagnosis to understand what you're dealing with before getting back to training. Hard neuro symptoms such as loss of motor function, drop foot, etc. are more serious and may require a different approach to treatment than chronic sciatica, for instance. The diagnosis helps identify the source of the pain, and provides some idea of the likely healing time of the tissues affected (muscle, tendons, bone).
Once an accurate diagnosis has been made, treatment should -- in most cases -- begin immediately. Rarely is rest the right answer, unless the athlete is dealing with a severe injury. At this point, the coach or medical provider should begin educating the athlete about the nature of their injury and some of the things they may experience during the rehab process, being careful not to catastrophize the injury. Sometimes they are going to experience pain during their workouts, but using the exposure without danger principle discussed in Part 3 will help rewire their pain response while giving the tissue the best environment to heal.
From here, Coach D likes to break down the exercise progression into several steps, with pain and knowledge of the injury and the typical healing times for different types of tissue serving as the guide.
The Exercise Prescription
At first the athlete should be doing these movements every day. Once compound loading begins, as the loads climb they can start tapering their workouts from every day to every other day, eventually back to their original workout schedule, such as 3 times per week.
The key thing when dealing with pain is motion is lotion, and movement as soon as possible after an injury is the best way to promote healing in the damage tissues. For those suffering from chronic pain and not necessarily an injury, movement is still the answer! Progressing to compound movements with load:
Further Reading on Back Pain, Pain Science, and Exercise Intervention for Pain
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