Do I Exercise When My Back Hurts?
I’ve just had an interesting conversation with Taryn Goodman of Sea Point Pilates Studio about exercising with back pain. My general rule is to avoid exercise if pain is acute or muscles are in spasm, but she has a different take.*
Although she bills herself as a Pilates instructor, Taryn is instinctively a healer. She’s driven to improve her skills, increase her knowledge and learn from others. She reads widely, attends courses and loves to connect with instructors who have new skills that she can learn from. So when she presents a different point of view, I’m pleased to hear it…
When a client messages to cancel a session because their back is sore, Taryn generally tells them to come in anyway. They’re often uncomfortable with the advice. They wonder if they should be moving. What if they hurt themselves even more? Taryn’s view is that movement is essential, even if it’s tiny little movements. Being afraid to move and cocooning yourself is often the worst thing you can do to an unhappy body.
That makes sense. As we get to understand more about how the fascia works and how movement maintains the sliding surfaces between muscles to keep us flexible and mobile, so we get to realise that prolonged periods of doing nothing are actually damaging and should be actively avoided.
Let’s take a Science break and talk fascia…
If you have a strong stomach and can handle an autopsy situation, watch Gil Hedley’s ‘The Fuzz Speech’ on YouTube.
It’s the best explanation of how fascia enables movement that I’ve seen. Made in 2005, it’s a bit dated as science has made huge strides in this area but there are update notes.
Briefly, Hedley explains that limiting movement allows ‘fuzz’ to build up in the fascia between our muscles, so they don’t glide along one another and enable smooth movements. Prolonged lack of movement allows the fuzz to become like fibres in the layers between our muscles which inhibit movement more permanently. As ‘fuzz’ builds up and fibres develop, it feels as though our body is solidifying, particularly in areas where we may avoid movement in order to protect an injury.
Back to Taryn…
When a client has back pain, Taryn’s exercise prescription is to start with very basic, gentle movements and increase the level of difficulty very gradually. Her aim is to move her client’s body from a sympathetic nervous state to a parasympathetic nervous state.
Another Science break…
The autonomic nervous system (ANS) regulates the functions of internal organs such as the heart, stomach and intestines and has control over some muscles within the body. The functions of the ANS (such as the beating of the heart and contraction of blood vessels) are involuntary so we aren’t aware of them most of the time. It has two ‘modes’: the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS).
The PNS controls the “rest and digest” functions of the body – the functions that maintain our equilibrium. It’s what our default mode should be – when our body is running smoothly and calmly, with controlled heart beat and relaxed muscles.
The SNS controls the body’s “fight or flight” responses, or how the body reacts to danger or stress. Pain is stressful.
When the body is stressed and controlled by the sympathetic nervous system, it speeds up, tenses up and becomes more alert.
Back to Taryn…
At the start of a session with a client with back pain, she gets them to do seated roll downs, gently flexing through the spine from the head, through the neck and only as far down the spine as is comfortable. This is definitely NOT a ‘no pain, no gain’ scenario. ‘If a movement hurts, don’t do it’ is the abiding rule.
Having done a gentle warm up on the spine, Taryn goes onto basic mat exercises.
She starts off with imprinting and releasing the small of the back (the lumbar spine) into the mat, making small rocking movements, forward and back, side to side, using the breathe to soften and release. This subtle imprinting and releasing movement is borrowed from the Body Sensing method, and is sometimes called skin sliding. The purpose is to get fascia moving in a soft, gentle way.
When the client is comfortable with imprinting and releasing, she selects exercises from the Pilates repertoire that are suitable, such as small pelvic tilts, maybe progressing to full pelvic curl; gentle chest lifts; arms open and close without weights…
There’s homework too, to be done in bed. She suggests that clients with sore backs should do the gentle exercises of imprinting the spine and moving the pelvis, rocking it gently and mindfully, and get the body to soften and relax before getting up in the morning or going to sleep at night.
She thinks the mindfulness element is important and suggests that the small movements can become part of a meditation to help the body move from a tense, pain-filled sympathetic nervous system to the calmer, healing parasympathetic nervous system.
She asks her clients to imagine that rhythmic imprinting and releasing are like waves washing up a beach, then retreating back to the sea. When the wave rushes back into the sea, she suggests they visualise giving away something negative in their life – an emotion, a feeling, a thought – and imagine it floating far away into the ocean, never to return.
As a new wave washes up the beach, they can imagine it bringing a new and positive thought or emotion that they want to welcome into their life and body.
It’s a strategy that’s working for Taryn’s clients and allowing them to unlock their pain and return to normal sooner than they expected.
Isn’t it great how science and the power of the mind can combine to help us heal ourselves.
* If your back pain is severe or you have recently suffered injury, surgery or illness, consult your doctor, surgeon or physiotherapist before exercising. Pilates instructors do not hold medical qualifications and cannot advise on serious illness or injury
