By Dawn Harris Sherling, M.D., F.A.C.P.
As Hurricane Dorian came barreling towards the coast in early September, Floridians braced for what could have been a category 5 storm. All across the state, we lugged pallets of water, hauled outdoor furniture in, and hoisted sheets of metal and wood onto windows to try to protect our homes. Ultimately and thankfully, Dorian did not bring destruction to our external structures.
Sadly, though, it may have to our internal ones. You, or perhaps your friends and neighbors, may be walking a little differently post-storm scare. It turns out that all of that lugging, hauling, and hammering wrought havoc on the backs of your fellow Floridians.
Back pain is one of the most common conditions for which people seek medical attention, and simple, unexpected movements can bring on painful strains. But like a hurricane, it is much wiser to prepare and protect ourselves before the event rather than trying to repair the damage afterwards. Just as we fortify our homes in advance of the storm, we need to strengthen our backs to hold steady when one of our most important structures is called upon to do tasks as mundane as lifting laundry baskets or as challenging as putting up shutters.
If you’ve ever had a bad back strain, odds are good that you were referred for physical therapy. And odds are also good that the physical therapy helped. Perhaps you sought alternative therapies for the back pain such as chiropractic care or acupuncture. In that case, the odds are equally good that these treatments helped too. In studies of therapies for acute back pain, it turns out massage, chiropractic, physical therapy, and acupuncture all provide relief for a few weeks to months. In severe cases, spinal injections may work well. And then they all seem to wear off. In one recent study, most of the participants were back (yes, I did that on purpose) to where they started after one year.
It is clearly better to not injure our backs in the first place. So, what can we do to protect ourselves? The answer is simple to suggest but harder to commit to—we need to strengthen our cores. Think of your core as the muscles around your middle. It’s your abdominal wall and also the lesser known muscles surrounding your spine. These need to be both strong like shutters and flexible like palm tree trunks. It means strengthening exercises like planks and lifting need to be accompanied by stretching exercises specifically targeted to the spine and its surrounding structures. Physical therapists routinely prescribe these exercises and personal trainers who have done extra study around caring for backs can be a great resource too. For the DIYers, the Mayo Clinic website offers a great series of exercises with step-by-step instructions and pictures.
The catch is, unlike hurricane preparation, there is no season for back building. Like brushing our teeth, the exercises are best done daily, or even twice a day (note: definitely brush your teeth at least twice a day). But also, unlike hurricane preparation, it need not take hours. Just five or ten minutes of core stretching and strengthening a day can mean reducing or eliminating days or weeks of future pain. If you wait until you’ve hurt yourself, it’s so much harder to bounce back (yup, I did it again).