Crooked Thumb

Featured Photo: The origin of my lower back pain: backcountry telemark skiing. Berthoud Pass, CO 1979. Credit Dale Anderson

It’s 5:30 AM. Turning off the shower, I grab the squeegee to clean the glass door. Lifting it over my head, I feel a twinge in my lower back— red light. My lower back muscles spasm. Moments later, my back already stiffening from the muscle trauma, I painfully bend over to put on my gym shorts, socks; and tie my shoes. I have to be at work in 45 min and on my feet for the next 6 hours. It’s going to be a tough day.

I have been dealing with lower back pain for over 40 years. Over the last 10 years, as a personal trainer, I have been helping clients manage their lower back issues. Lower back pain (LBP) describes pain between the lower edge of the ribs and the buttock. It can last for a short time (acute) or a long time (chronic). LBP makes it hard to move and can affect quality of life and mental well-being.

In this edition of What I learned this Week, I explore the causes and symptoms of lower back pain. I also offer what I have learned over the years to manage lower back pain; and improve lower back strength, mobility and flexibility.

Causes of Lower Back Pain

First a disclaimer: I am not an orthopedic surgeon, doctor, or licensed physical therapist. I am a certified personal trainer. My knowledge is self-taught through articles, books and real life experience.

Lower back pain affects the lumbar region of your spine or back. It can result from many different injuries and conditions. A partial list includes:

• Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. For people in poor physical condition, constant strain on the back can cause painful muscle spasms. For those in good physical condition, repeated stress on the lower back, poor posture, inadequate hydration, suboptimal diet combined with hard workouts and a lack of adequate recovery can result in muscle spasms.  
• Bulging or ruptured disks. Disks act as cushions between the bones in the spine. The soft material inside a disk can bulge or rupture and press on a nerve. While a bulging or ruptured disk might not cause back pain per se, it stresses the lower back muscles causing micro-tears, inflammation and pain. In more severe cases, herniated disks put pressure on nerves and can cause a variety of nerve pain including sciatica.  
• Arthritis. Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.

Photo: Bob McCord on wood three pin skis looking at a bad landing. Before he passed away in 2016, Bob dealt with chronic lower back pain. Telluride, CO 1974. Credit Steve Markusen.

Symptoms of Lower Back Pain

Nearly everyone experiences lower back pain at some point in their lives. The pain can range from mild to severe. For most, it’s temporary. But long-lasting chronic lower back pain is also common — up to 23% of adults worldwide have chronic lower back pain.

Symptoms include:

• Stiffness: It may be tough to move or straighten your back. Getting up from a seated position takes time. You feel like you need to walk or stretch to loosen up. Over time, you experience a decrease in range of motion.

• Posture problems: Many people with back pain find it hard to stand up straight. You may stand “crooked” or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
• Muscle spasms: A spasm is when your muscles suddenly, and against your will, painfully twinge, seize or contract. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.

Photo: Dick Irish dropping off the edge of the world. Telluride, Co 1974. Credit Steve Markusen

My Experience with Lower Back Pain

I backed up my skis from the edge of the cliff, firmly planted my poles, took a deep breath… and launched. Twenty vertical feet and two seconds later, I landed at the base of the cliff in powder snow. Oh, that hurt. No worries, my buddies and I are twenty years old and indestructible. Skiing groomed runs was not enough for us. We had to throw ourselves down steep mogul runs at high speed. Skiing the ski areas got boring. We had to explore the backcountry on our skinny skis and leather boots; fling ourselves off cliffs and drop off cornices. Never did we think of the long-term consequences.   

Over the next twenty years in addition to extreme skiing and climbing, I added competitive handball, tennis and cycling. By the time I was in my forties, I suffered from chronic lower back pain. With regular frequency, bending over to tie my shoes, my lower back muscles would spasm. The next several days were spent in bed or on the couch.

In the mid-90s I visited the Mayo clinic. I sat in a spartan office smelling of antiseptic with the spine doctor reviewing my x Rays: two herniated disks between the L5 and L4 vertebrae.  I said no thanks to surgery. The Mayo PT gave me a booklet of exercises. For the last 35 years, I have avoided the surgeon’s scalpel and kept my back strong enough to remain an elite (for my age) skier, climber, backpacker and cyclist.

Photo: Dick Irish launching on Trucker BCPs with Ramer bindings. Baldy Mountain (Sun Valley) in the background. 1977. Credit Bob McCord.

Managing Lower Back Pain

In my personal training practice, I have a number of clients with a wide range of lower back problems. I help them manage the pain it so they continue doing the activities they love.

If you have nerve pain from herniated disks or spinal stenosis, go see a doctor. If your back is sore or you are prone to muscle spasms you need to take action. If I can be of help please reach out to me at steve.crookedthumb@gmail.com.

My lower back stabilization program includes:

Strength training: by strengthening your core and glutes with squats, RDLs, deadlifts, lunges and core exercises you provide the foundation for a stronger back. I still use the floor exercises that Mayo taught me 25 years ago. Make sure you allow adequate recovery between workouts. Recovery: The 50+ Athletes Secret Weapon

Aerobic and HIIT training: include in your training program aerobic workouts. Use HIIT and interval training to improve your body’s ability to handle stress. Gaining Fitness, Losing Weight and Slowing Aging with Interval Training

Improve mobility: Using your muscles under load over their full range of motion will help prevent lower back problems. I use exercises like dumbbell twists, cross body raise and wood chops to improve lower back mobility.  Balancing Act: Common Overuse Injuries and Muscle Imbalance

Stay flexible: I use a number of stretching exercises both static and dynamic that target the lower back. Some of these would be familiar to those of you practicing yoga.  Pain: The Body’s Call to Action

Improve your diet: Stay hydrated. Keep away from processed, high salt, fatty foods. Eat regular meals. If you intermittent fast, make sure you eat something before a hard workout. Fasting: Critical for Weight Los

Control your weight: Maintain a body weight that is appropriate for your height, build and age.  Weight Loss: Changing Your Body Set Weight

Photo: Pat Kent on 205 cm Splitkein wood skis dropping the mother cornice. Galena Pass, ID 1977. Credit Bob McCord

Afterword   

I am writing this in real time. If I had these back spasms twenty years ago, I would be in bed or on the couch. Instead, I trained all my clients, did my scheduled workout with my client who is an elite triathlete and Nordic skier. We did 100 squats, 50 RDLs and 40 deadlifts; then 15 minutes of core exercises— I stayed with super lightweight, but I got it done. Then I sat on my stability ball at the computer for three hours and wrote this blog.

At age 70, my back is in better shape than it was 20 years ago. I get occasional muscle spasm, but they are less severe and frequent. I tell my clients the herniated disks will never heal; the pain and stiffness will never go away. But we can learn to manage the problems and live an active lifestyle.  Please email mailto:steve.crookedthumb@gmail.com if I can help you. Thanks for reading!      

Photo: Still at it after 55 years. Triple Direct, Teton Pass, WY. 2019. Credit Max Markusen.