Divers can avoid back pain by correcting bad standing, sitting and lifting habits, by performing the right exercise and by doing healthy stretches. In cases wherein the individual already suffers from back pain, treatment cannot be done until the cause of the pain is known.
Although back pain often comes on suddenly, the injury that causes pain is rarely a sudden event. It brews with years of abuse. Wear and tear from your body weight alone by poor sitting, standing and bending habits can injure your back over time as badly as a single accident. Main factors in back pain are lack of flexibility and strength of supporting muscles, common even if you work out regularly.
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Preventing Back Pain
The Red Cross estimates that 90 percent of all back pain is preventable. Exceptions are extremes of inherited disorders, infection, falls or other accidents. However, their severity can usually be reduced with good back habits. The tendency of arthritis, for example, increases with habits that contribute to wear and tear. Scoliosis may be aggravated by carrying shoulder bags or skipping exercises that strengthen muscles that support the spine.
You can easily reduce your chance of back pain or reduce existing back pain. You first need to identify and avoid things that chronically abuse your back. Then there are several easy exercises that make your back more injury resistant.
Avoid Bad Standing, Sitting And Lifting Habits
Do you sit, stand and bend with your lower back rounded outward rather than inward? That is the most common way to slowly ruin your back. Most chairs are made wrong. Their built-in concave back makes you sit with a rounded back. Watch for bad chair engineering in office, bus, train and plane seats. Other problem chairs are bench seats in restaurants and church pews. Dive boat benches may have no backs. Divers often sit with their backs curved forward, sometimes wearing heavy gear. Physical stress to the back may be made worse when pounding over waves. Bring a cushion and sit, keeping the normal inward curve of your lower back. Do you stand with your head forward? That’s a common source of back pain, particularly between the shoulders. Keep your ears over your shoulders, not in front of them. Do you stand with too much arch in your back? Abdominal exercises increase the forward pull that can prevent too much backward sway. Do you pick things up by bending at the waist with your legs straight or nearly so? Don’t do that. Keep your torso upright, not bent over, and bend your knees. Support your upper body weight with one hand on your knee or other support whenever possible. Don’t twist to one side during a lift or bend. Avoid things that throw your back into postures that cause it to strain muscles and push discs in unhealthy directions, such as beer guts and high heels.
Avoid Too Little Exercise
Without sufficient exercise, your back muscles easily become weak. Weak muscles can’t hold the good posture necessary for anatomic structures to fit together without strain and rubbing. In brief, muscles running along your back keep a certain amount of tension to keep you from slouching over forward. Abdominal muscles, which run from your ribs to your pelvic bones, work similarly to keep you from arching too far backward during normal standing and sitting. Weakness in either or both allows you to sit and stand in ways that slowly injure you without being aware of it or having the day-in day-out muscular endurance to stop it. For carrying around gear or walking to dive sites in full gear, muscular endurance of the back muscles can make the difference between an uneventful diving day and a tired, achy back that night.
Avoid Too Much Exercise Of The Wrong Kind
Many people mistakenly concentrate on abdominal exercises such as crunches, thinking it will make their backs injury free. Without also working back muscles, you can strengthen your abs until your relatively weaker back muscles can’t counter the pull from the front. The resulting forward slouch slowly injures. Abs create an important support structure for your torso but they are not the entire support.
Several exercises common at gyms and exercise studios cause more harm than good. A few bad exercises now and then usually do little damage – but give them a chance. Like smoking, the repeated forced nature of the exposure harms at a rate faster than your body can repair. Avoid repeated bouncing on toe touches, for example. Avoid dead lifting. There are much better exercises for your back, described below. Avoid situps and leg lifts unless you need them for activities requiring high hip flexor strength, such as ballet and martial arts. They are tough on the back. Avoid forced, repetitive back arching that, over the years, can irritate the section of each backbone where it joins the next. Examples are continuously swinging your leg backward in the air in an exercise called donkey kicks. With better fitness education, these problematic exercises are slowly being replaced with safer techniques but are still quite common.
Poor flexibility of back and leg muscles are common culprits in back pain. The range of motion required to strain tight back muscles is small, accounting for many painful backs after a day of diving. Hip flexors are the muscles that bend your leg forward at the hip. They start on your lower back bones and end at the top of your leg bone. Tight hip flexors, common in people who sit a lot, sometimes pull the pelvis forward. The shift in the normal tilt contributes to low back pain. Hamstrings are the triple set of muscles in the back of your thigh. They work to both bend your knee and also swing your leg in back of you. The hamstrings of each leg start at the bottoms of the hip bones, on the bony bumps you sit on called ischial tuberosities. Three hamstring muscles run down the back of each leg and cross the back of the knee, where you can feel their stringy tendons. Tight hamstrings are thought to influence the tilt of the pelvis to the back, which can contribute to back pain. What to do for better flexibility is described below.
Posture matters. Lift, stand and sit keeping the normal inward curve of your lower back.
Try a posture test. Stand normally with your back very close to a wall but not touching it. Now slowly, carefully back up so you contact the wall. Did your head, shoulders, back, behind, calves and heels all touch at once? Good posture. Did your behind touch first? You probably slouch forward. You need to concentrate on the back muscles that pull you upright toward the back. Did your shoulders touch first? You might be arching backward and need extra abdominal muscle work to keep them from being weak and overstretched. Did the back of your head never touch? You may have a forward head. If you habitually keep your head forward of your shoulders, pull your chin in and back, not just down. When you sit in a chair, keep a small rolled towel or commercially available lumbar roll between your lower back and the chair. It will support you in a healthy, inward curved lumbar posture and feel good at the same time. You don’t need to force your body into an unnaturally straight posture – just relax against the roll. Keep one in the car and one at your desk. Carry a roll in a bag for unexpected meetings or movies. If you find yourself without your lumbar roll, press a rolled towel, article of clothing or even your arm into service. Commercially available rolls are sometimes too fat. An easy solution for those made of foam is to cut them in half lengthwise, making two long rolls, each round on one surface and flat on the opposite. Put the flat part against the chair and the rounded side to the small of your back.
When working at a desk, remember to stand up every half hour or so and arch your back in the other direction. After bicycling, gardening, cleaning floors or any other activity where you lean forward for prolonged periods, try lying face down, propped up on your elbows so your back curves backward. When Larry Bird of the Celtics hurt his back he began lying on the sidelines in back extension rather than sit in flexion on the bench.
Safe Lifting Habits
Any time you bend over, whether for a drink of water, to wash your face or lift your gear, bend your knees. It’s not wimpy. It will save your back from cumulative abuse that it was not built to withstand. When lifting anything heavy or light, get close and face the weight, feet apart, bend your knees. Take a deep breath. Keep your torso upright and lift slowly. Think “I don’t want to hurt my back” before you just lean over and yank. Don’t bend over wearing a tank to pick up other gear. Instead, stoop down, bending your knees, and support yourself against tipping over with one or both hands, especially on a rocking boat. When lifting dumbbells for back strength, don’t bend over and lift. Lie on a flat or tilted bench face down and lift. If you choose to stand, support your weight with one hand on a bench or your knee.
Back pain is sometimes unfortunately regarded the way heart attack was years back – as a condition not an injury. Both were relegated to the “cardiac cripple” status of inactivity – never to exercise or lift the weights found in daily activities. In that way a tragic cycle of disuse and declining ability perpetuates.
Back muscles, like heart muscles, need exercise to strengthen in progressive sane ways until they meet the need. Increased endurance of posture muscles reduces back and knee pain. Increased strength reduces the chance of hurting your back, knees and shoulders from lifting gear.
Abdominal exercises like crunches are important for the musculature that supports your back from swaying backward. Other exercises that contract the back muscles are important to help complete the support your back needs to keep from slouching forward. These exercises are described below. For all exercises, see your physician first.
- Lie face down, hands at your sides but off the floor. Slowly lift your upper body a few inches. This action is called back extension. Then lower back to the floor – don’t force it. Start with one or two lifts and see how you feel the next day. If pain free, gradually increase to ten repetitions three times a week. To progress, add repetitions and move your arms from your sides to overhead.
- Lie face down, chin on hands. Lift one leg off the floor, hold and lower – easy does it. Then switch legs. To progress, lift both legs together. It’s great for your behind as well. These exercises are much better for your back than dead lifting.
- If you go to a gym that has weight machines, look for the back machine. You sit with a pad against your back and curl it backward. It should be next to the abdominal machine, where you sit with a pad against your abdomen and curl it forward. If there is an ab machine but no back machine, an unauthorized alternative is to sit in the ab machine backward.
A good range of motion in all the directions your back bends helps prevent back pain. Warm up before you stretch. Warm up means just what it sounds like – raise your body temperature. Slow jogging, bicycling or anything that gets you to break a light sweat will make stretching safer.
Leaning over at the waist for toe touches does stretch the back and hamstrings but is not the best stretch for regular use. Although it often feels good on tight muscles, it’s tough on your back in the long run. A safer back stretch is to lie on your back and bring your bent legs to your chest one at a time. A safer hamstring stretch is to stand with one heel propped up on a chair, keeping the inward curve of your lower back and sticking your behind out a little. Many exercise programs concentrate on bending forward, forward and more forward. For back health, add stretches in the other direction. Stand up with your hands on your behind. Lean back into an arch. Another variation is to lie face down. Slowly, gently press up into an arch. Try these two after bicycling, gardening, cleaning floors, sitting on dive boats or any activity where you lean forward for prolonged periods.
Lie face down while keeping one elbow bent on the floor. Press the other arm straight, twisting toward it – gently. Switch sides.
To avoid back pain avoid these:
- Continuous incorrect lifting, sitting and standing
- Sitting with your lower back rounded outward rather than keeping the normal inward curve
- Chronic bending at the waist and hip
- Twisting during a lift or bend
- Damaging exercises
- Beer guts
- High heels
- Lack of exercise
- Poor flexibility of back and hamstrings
- To avoid back pain practice these:
- Good posture – stand and sit keeping the normal inward curve of your lower back.
- Safe lifting habits
- Back exercises that include extension
- Any time you bend over, make sure your knees are bent
- Don’t bend over with tanks on, particularly not on a rocking boat.
- When lifting anything, get close and face the weight with your feet apart and your knees bent. Keep your torso upright. Lift slowly.
- Stand up after every half hour or so of sitting and stretch your back a little in the other direction.
Treating Back Pain
How do you treat back pain? Same way you treat a tummy ache. It depends what caused it. The key is not to treat until you know the cause. Get an accurate diagnosis from a physician specializing in orthopedics. The Greek word gnosis means “knowing or recognizing.” Dia is a word element that, in this context, means “completely.” It’s crucial to completely know. Getting rid of pain and the disability that goes with it means treating the cause. Don’t let any practitioner treat you without knowing what’s wrong first, particularly for severe pain. Because most ordinary back pain temporarily goes away by itself, confusion about what relieved it results. If you tried a home remedy, you think the remedy worked (however far-fetched) not rest and time.
Even though accurate diagnosis is so important, immediate treatment for most back pain is similar. Rest to let your back heal, reduce inflammation that causes pain by using anti-inflammatory medications and ice packs and relax muscular spasm with muscle relaxing medications and stretches. While you’re recovering from back pain, identify the things you do that contribute. Make easy modifications in your routine to avoid them in the future. Then, when pain subsides, begin a good back exercise program to increase injury resistance. Use ice after every workout and at the end of every long day.
Surgery for disc protrusions called herniations is rarely necessary. This happy discovery was made when disc patients were referred to physical therapy for back exercises to better condition them for the physical stress of surgery. By surgery time, many of the people didn’t need it.
Disc herniations usually result from chronic outward pressure on discs by bad posture and lifting habits. Often all it takes is a small provocation for the disc to finally protrude far enough for a sudden onset of disc pain. Then people attribute the disc injury to the one event that brought on the pain, never realizing it was brewing all the while. Small herniations will heal and go back into place if you let them – and this is a big if. Watch your posture while sitting and standing. When you sit use a lumbar roll. Extension exercises usually bring good results to reduce pain, slowly encourage the disc to return to place and strengthen muscles so you are less likely to slouch forward. Slouching forward is a major culprit in disc injury.
Disc pain is usually worst upon waking in the morning because discs swell overnight. When you wake up, turn face down and lie propped slightly on your elbows for a minute or so instead of sitting slumped in flexion at the edge of the bed. Lying prone reduces pain and pressure. (Just don’t fall back to sleep!) After the phase of acute pain is over, begin a good back exercise program to increase injury resistance.
This section only touched on the basics of back care. There are other conditions that contribute their share of back misery. But, the basics of safe back habits apply to most back pain. Back pain prevents diving and preventing back pain is easier than treating it. Practice “safe backs” to keep your back healthy for diving.