Many people injure their back multiple times over the years before ever seeing a physical therapist. I’ve heard it over and over again while interviewing my patients. They usually describe several previous low back injuries that “resolved” on their own. They also commonly describe each successive injury as more severe than the previous episode by remarking that each was more painful and / or took longer to subside.
So why does this occur? Several reasons could be to blame, but one common cause is easily fixable. This occurs when patients don’t properly (or fully) rehab their injury. For example, research indicates that the most important core muscles don’t always resume their proper firing patterns after the pain from a back injury subsides (Hides and Richardson).
Furthermore, if this occurs, these muscles are likely to remain inhibited unless the nervous system is re-educated. Re-education is needed to re-establish the connection between the brain and the muscles. This allows for proper initiation and utilization. Since using these muscles correctly is important to be able to stabilize and protect the spine, failure to do so sets the stage for re-injury to occur.
Strengthening exercises are often used for low back pain. However, simply performing bracing exercises and / or machine strengthening may fail to correct the problem. In fact, these exercises can allow the same faulty substitution patterns to persist. Just because someone can perform a given exercise does not mean that they can do it with the proper sequencing and timing. Consequently, these exercises may actually be reinforcing poor habit patterns. Nevertheless, one of the most effective ways to re-educate these muscles, in order to correct the issue, is through the hands of a physical therapist.
Skilled application of HANDS ON resistance techniques known as PNF, allows these important muscles to “wake back up”. This, in turn, creates proper muscle function. Now these important muscles are available to do their job.
Once the proper recruitment patterns are re-established, motor control training is utilized to improve strength and endurance. Finally, these new patterns are integrated into activities of daily living with the goal being protection from re-injury.
In closing, if your back pain reoccurs, try some hands on exercises delivered by a physical therapist who has advanced training in PNF.