Acute Lower Back Injury
Mar 30, 2024
And now, here is a guest article from a friend, OS Clinician, and Instructor, Dr. Kurt Brooks.
Oh! The Agony!
Today, while squatting 205#, I heard a pop in my lower back, followed immediately by quite a bit of pain and muscle spasms. Luckily, being a Physical Therapist and an Original Strength Certified Clinician, I knew what to do.
Injury comes with pain and often localized swelling (and occasionally bleeding). Being an injury around the spine, I knew I would be experiencing localized spasms (to protect the injured tissues) as well. The inflammatory response (swelling) after injury is a complex series of chemical reactions governed by the immune system. This occurs in response to overstretching of soft tissues (sprains, strains, tears, etc.).
The first thing I did was stop the workout, of course! Then I laid down on a mat and started Pressing RESET: Diaphragmatic breathing, Shin box rotations, dead bug holds, gentle rocking, speed skaters, and Chinese planks (a plank… but lying on your back). Later, after going home and taking some anti-inflammatory and pain medications, I did some more RESETS. I added forward and backward baby crawling, head nods, and rotations while on my hands and knees.
Why did I choose those things to help mitigate the inflammation, reduce the spasms and speed along the healing process? I’m glad you asked! Let me explain.
We all know the typical fight-or-flight response to an injury: pain, spasms, holding your breath, clenching your teeth or making a fist, and moving slowly and stiffly. With all of that comes the psychological or emotional response: fear.
So, where does Pressing RESET come in? Pressing RESET helps to limit the body's Fight-or-Flight response (the Sympathetic Nervous System) by stimulating the Parasympathetic Nervous System (PNS). The PNS decreases pain, spasms, heart rate, and blood pressure. The PNS, though, enhances the inflammatory process, thus causing a short-term increase in swelling. But this also speeds along the whole inflammatory process and aids in tissue repair and regeneration!
To address the short-term increase in swelling, I took an anti-inflammatory medication and kept the tissues moving. Shin box rotations, rocking on hands and knees, head nods, and rotations all help to pump along any swelling that was coming into the hurt area. Dead bug holds, speed skaters, and Chinese planks were all used to keep the spasms and muscle guarding to a minimum by forcing them to work as normal (and not shut down or overwork).
That covers the mechanical and chemical responses to the injury. Then there is the emotional response… sometimes the hardest to overcome! When the tissues heal, should I avoid heavy squats again? What about deadlifts? Heavy pushing or pulling? Of course not! Injuries will inevitably occur when we exercise or play a sport and constantly try to push ourselves. This is no different than biting your lip. We may chew our food funny for a few days, but eventually, we get back to eating our food normally. Too many times, we let injuries get inside our head, and we spend the rest of our lives avoiding that movement or situation that led to the original injury. This often happens because we let our Fight or Flight System get out of control when the injury first occurs, and we lose the ability to regulate it. It then dominates our lives – making us fear reinjury. We start avoiding certain activities and movements. Eventually, we create the very thing we were afraid of: a back (knee, hip, etc.) that is weak, fragile, and likely to get hurt when we have to lift something heavy.
So, my first reaction, even before lying down to work on gentle RESETS, was to focus on diaphragmatic breathing and tell myself that it would be okay and that I would be back as soon as I could. When that day comes, I will modify my routine as needed, not to reinjure the tissue, but I will be back! If you’ve read or seen the movie Dune, you may remember the phrase, “Fear is the mind-killer.” It can also be the body killer and life killer if you let it. Don’t let your memory of injury, or fear of injury, stop you from pushing yourself and living your best life. Injuries are a normal part of living. But if you are stronger, more mobile… more resilient… they are only bumps in the road.
Keep moving! And keep Pressing RESET!
If you are local to F-V, NC, and struggling with an acute or nagging injury and need some help or guidance, feel free to contact me at drkurt@os-institute.com or schedule an appointment at Physical Therapy | Original Strength Institute. Or if fear of injury or reinjury limits you, get in touch.
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