We have all experienced it: the lower back “tweak”. My most recent injury occurred during a Brazilian Jiu-Jitsu training session. I was attempting to pull guard and fell on my lower back with the weight of my training partner on top of me. I felt a sharp pain and I knew it would quickly stiffen up so I started MOVING right away. This is key with most back injuries, especially when you go to lift something or bend over and feel that “tweak” in your lower back. It can be scary, and the common thought is to lie down and rest so you can recover. This is the opposite of what you want to do as being immobile will lead to an increase in pain, increased muscle guarding and longer recovery times. If you know the right movements to do you can speed up your recovery and significantly lower the pain right away.
First you want to maintain what mobility you have and decrease inflammation. You can do this by performing some light movements in a pain free range. When we stand up, we have the force of gravity/our weight plus force from the ground compressing our spines. This loading of the spine can make it painful to even just stand erect when you first tweak your lower back. So immediately after my injury I started moving my spine while lying on my back with my knee’s bent. You can do this in multiple different ways but start by squeezing your stomach to slowly flatten your back (called a posterior pelvic tilt) and then do the opposite motion by slowly arching your back (increasing space under your lower back). This will move your spine into both flexion (rounding) and extension (arching) without the added forces of gravity in standing. Another way to do this is on your hands/knee’s and performing what is commonly referred to as the cat/camel. Slowly move into a pain free range in each direction, even if it is very minimal. The purpose is to keep what mobility you can and not allow the back to stiffen up.
It is important to continue to MOVE. Even though it may be a little painful, try to keep walking. It will be more painful if you just lie down all day because when you get up you will be even more stiff and have difficulty walking. The spine will usually have what is called a directional preference. For example, I had more pain in sitting and more relief while standing. This tells me that my spine preferred to be more extended (standing up) versus flexed (rounded back while sitting down). So another movement that was very helpful was lying on my stomach and propping up on my elbows. That enabled me to relieve the pain and keep my spine moving. I then progressed to yoga stretches such as Cobra (prone press up) and Child’s Pose. All of these stretches/movements are good to start with because you can easily control the movement and these won’t cause more harm. Applying heat via a hot pack can also be a good way to decrease muscle tightness/pain and help you perform these exercises.
The key with an acute back injury is MOVEMENT. It certainly can make a huge difference when you know which movements to try. DISCLAIMER: this is not one size fits all as there can be serious back injuries that won’t improve without medical attention. If your pain gets worse or these movements do not help, come see us at Streamline Performance Physical Therapy or find a local provider near you.