Listen to Your Body
Make no mistake about it, your body does not want to be in pain. If you are suffering in pain, it is nearly always because you are doing something that your body does not like and therefore it is giving you pain as its way of asking you to stop doing it.
The human body has an innate desire to heal itself of any injury it encounters 24 hours a day, 7 days per week. Whether you have a simple paper cut a broken bone or low back pain and sciatica, your body will always strive to repair itself.
So where does the body go wrong with low back pain and sciatica?
The truth is, it doesn’t go wrong, it is just we do not always give it the best conditions for it to work. I get very frustrated with the mystique often created with regard to low back pain or sciatica. Ultimately, it is the same as any other injury… if you provide your body with the correct conditions to heal itself, heal itself it will.
What are the correct conditions for our body to heal itself then?
Well, that’s an impossible question for me to answer on an individual basis, simply because your low back pain or sciatica will be different from the next person who is suffering with low back pain or sciatica. However, you can answer the question for yourself by quite simply listening to what your body is telling you.
If you are suffering with low back pain or sciatica and you perform a certain activity or get yourself in a specific posture which increases your level of pain, then you are doing something which your body does not like and therefore you are interfering with your body’s natural desire to heal itself. Alternatively, if you are performing a certain activity or in a specific posture and your levels of pain decrease or go completely, then without doubt your body likes what it is doing and therefore it is healing itself to the best of its ability.
Although I appreciate it is not always practical, adopting postures and performing activities which your body likes, along with avoiding or modifying those activities and posture that it does not like (those which increase your levels of low back pain and sciatica) is something that you should aim for 24 hours a day… I guarantee you it will go a long way to resolving your pain!
Isn’t that just like a Tommy cooper gag though?
I went to the doctor the other day, I said “Doctor, it hurts when I do this”. He said “well don’t do it then”
Funny, yes (well, for those older one’s like myself!) but also very true.
Believe me, your body does not want to give you pain just for the sake of it. If you are feeling pain, it is because you are creating inappropriate stresses across the structures responsible for your pain. In turn, these inappropriate stresses are interfering with your body’s desire to heal yourself of the low back pain or sciatica you are suffering with. Consequently, your pain is not going to get better, or at best, take longer to get better than it should do.
It’s like having a cut across your elbow, or any joint for that matter. Due to the natural movement that occurs at a joint you will keep on interfering with the healing trying to take place for that cut. Therefore it is highly likely, due to this interference, that this cut will take longer to heal than if it were just on your forearm say.
Anything you do which interferes with the healing process trying to take place for your low back pain or sciatica, I can almost guarantee you will increase your levels of pain, so why keep on doing it? Whereas if you are doing something which is not interfering with the healing process, your level of pain will at worst not increase, although more than likely it will decrease or go away.
Is that all I have to do then for my low back pain or sciatica to get better then?
I’m afraid not, although it is without doubt an integral part of resolving your pain. Ultimately, you need to address the cause of your low back pain or sciatica, which in my opinion is a combination of incorrect postures and movements, along with muscle imbalance (tight and/or weak muscles). However, if you do not stop aggravating your pain, it will not matter how much you do to address the cause of your problem, you will always be fighting a bit of a battle due to you interfering with your own body’s natural desire to heal itself. Therefore always try your best to…
avoid or modify the things which aggravate your pain and encourage those that ease it.
If you take this little saying onboard and put it into practice as much as often as you can throughout the day, you will be on the right road to begin healing your pain. As I mentioned above, more will be needed with regards to getting to the cause of your problem, but if I can offer one single piece of advice for you to put into practice, this would be it.
It’s only what the professional do anyway…
Just before I go, I know there may well be some people thinking that not doing things that increase your levels of pain is stating the obvious. Well firstly, you will be surprised at the number of people who do not listen to their body. For example, I have treated many people who know that sitting in a certain chair aggravates your pain and walking around a little eases their pain.
However, when I discuss this matter further with them, it transpires they still spend much of the evening sat in that same chair, not even thinking to get up and walk around a bit! The best they muster is to ‘fidget around’ in the chair, even though this only gives them temporary relief at best. They are then surprised that they find it difficult to get to sleep because their low back pain or sciatica is worse when they finally do get up to go to bed!
I would suggest for this type of problem (it may well be one you recognise) that the individual concerned only sits for about 15-20 minutes and then stands up and has a little walk around the living room for a minute or two. It is amazing the difference a small change like this can make, not just to the pain being suffered while sitting, but also to the pain that is preventing them from getting to sleep.
Another suggestion is obviously with regard to the chair, maybe a firmer one should be used, or at least a rolled up towel, or something similar, should be placed in the small of the back.
Anyway, I am really digressing now! Back on to my point with regard to those who think it is stating the obvious, or even just burying your head in the sand by avoiding things that aggravate your pain, have a think about what professional athletes do during the rehabilitation of an injury…
If there was a professional sprinter who tore his hamstring, do you think he would keep on trying to run on it? Of course he wouldn’t. Why not? Because he knows that if he were to do that, the tear would just get worse and therefore take longer to heal.
It is more likely the first thing he would do is rest it, maybe only walking but potentially using crutches if the tear was severe enough. As the body began healing itself, he may take up some brisk walking, but he would still avoid doing any more than that for fear of re-injury or simply it taking longer to heal. As time passed this athlete would begin gentle jogging (but no more at this stage) and then slowly but surely progress to full jogging, running and then finally sprinting.
This would all be a very gradual process though, where he would be constantly listening to what his body (his hamstrings in this case) was telling him. If at any stage while exercising pain was felt from the site of injury, he would ease off straight away and not perform that exercise (at that intensity anyway) until enough healing had taken place to allow him to perform it pain free.
If we think about it, what this athlete is doing (and what any athlete does for that matter) is listening to his body and avoiding the activities that aggravate his injury while encouraging those he can do pain free… exactly the approach I would want you to take when suffering with low back pain or sciatica. This approach, along with an appropriate exercise programme to address the cause of the problem, will soon see you free of the pain you are suffering with.
Many thanks for taking the time to read this article. Please accept my apologies for it being a bit of a lengthy one, but hopefully you have enjoyed it and gained a good insight into the best way of curing the pain you are currently suffering with.
As always, feel free to leave an comments, or suggestions for future blogs, below.
Paul, a fantastic article. As I always say to my participants, “it’s not rocket science” but common sense. I spend an enormous amount of time trying to educate my participants so that they can help themselves – even to the point of setting weekly challenges. Those who take this on board are amazed with the benefits they derive. I have a lady who attends my classes twice per week (during the summer months) and does well in class stating her sciatica decreases and she gets great relief for some time after class. When I suggested it may be something she does on a regular basis outside class that exacerbates sciatica she was puzzled. I know she has spent a fortune on “finding the magic cure”. I suggested purchasing your book and there was a sharp intake of breath at the price! My response…….”What price, free of pain?” I will ask her tomorrow if she “invested in herself”
Hi there Mary and thanks for the post and positive comments, much appreciated.
Yep, you’re right, it is common sense, but sometimes it only makes sense when it’s pointed out and that’s where the likes of yourself and myself come in.
As for your lady who feels better when attending your classes, it is likely not only to be something outside the classes that is aggravating her pain, but also what she is doing in the classes that are easing her pain. Therefore I’d suggest she really thinks about any particular exercises she performs in the class which ‘feel like they help’ and then encourage her to do these one or two exercises once or twice a day, every day… I’d like to think that will help her pain further (by the way, I am sue there are more than one or two of your exercises that help, but it would probably be a bit unrealistic to ask her to perform your whole class twice a day!)
If this lady is unsure of getting my book, let her know you have posted here and tell her that I will personally guarantee she will gain some benefit from it or I’ll refund her the money! I’ll also answer any questions she may have.
Anyway, must shoot, keep up the good work and thanks for replying to my blog.
If you, or anyone who attends your classes, have any suggestions for future blogs, just post back and I’ll do my best to get something up.
Cheers again,
Paul.
Hi Paul
Very interesting article. My work as an Alexander Technique teacher concurs with the idea that it’s how we do things that causes us either pain or freedom of movement. For instance if we use our hip joints instead of our spines to bend forwards we are likely to move with greater ease.
But the tight/weak muscles idea needs perhaps a little unpicking. Our muscles work by messages from the brain via the nerves to the muscle motor end plates. So if our muscles are tight it’s because we are sending the messages to contract that muscle 24hrs a day 7 days a week. If we stopped that message the muscle would relax. The corresponding muscle that ‘seems’ weak would then be seen to be working fine. I have seen this happen time and time again in my students as I work with their ideas and thinking and do hands on work. They let go of tight muscles and go instantly back towards balance. To stay that way they have to train their thinking – not the easiest of asks or a quick fix but a gradual re-education of the mind.
I know this idea is contrary to what you have been taught but I thought you might be interested in it anyway!
Best wishes
Veronica
Hi there Veronica and thanks for the post, I am familiar with what you have to say and this is an approach that a lot of physiotherapists (myself included) have been taught.
but I believe these people are in the minority. The majority still may need a bit of ‘re-training’ but they are more than capable of sorting that out themselves.
)
HOWEVER, my approach aims to overcome what I see as a big problem we have as health professionals and that is we over complicate things, especially with regards to low back pain and sciatica.
My approach, and more so my book, is about handing the initiative and control back to those who are suffering with low back pain and sciatica. I know it is not quite as straight forward as this, but in a nutshell:
• If a muscle is tight, it will need stretching.
• If a muscle is weak it will need strengthening.
With my approach I encourage the stretching of tight muscles, the strengthening of weak muscles and equally important, the promotion of normal movement.
If people have tight muscles they will become more supple with stretching. Will they want to tighten up again if there are other issues going on, yes they certainly will, but nevertheless stretching will help them loosen up. My approach would address these other potential issues as well, but it would also look to stretch the muscles out.
If people have weak muscles, will they get stronger if the start to work/strengthen them? Yes they will. Once again, will they be reluctant to strengthen/work better if there are other issues? Yes, but nevertheless strengthening will help them and also once again, my approach would address these other issues.
I will elaborate a bit more on this in a minute, but first I am going to go back to my point above where I say I believe as health professionals we over complicate things, and I mention this in my book about a kind of mystique which has been built up over the years that low back pain and sciatica is different to any other kind of injury in that it needs health professional intervention in order to resolve it… more often than not it does not.
I do not profess to be any kind of expert on The Alexander Technique, far from it, but the little I do know I like. I know it is not quite as straight forward as this (and what I am about to say may be the typical lay persons view of The Alexander Technique that you do not like, if so I apologise) but I see it as a technique which promotes normal postures and movement with kind of minimal energy expenditure. Believe me, I am all for that (like I said, if my view is an incorrect one, please reply back and educate me)
However, getting back to my point I suppose, nearly everyone who suffers with non-specific low back pain and sciatica, do so because of the things they are doing from day-to-day. They are not moving how their body would like them to and consequently inappropriate stresses are being placed upon certain structures of their lower back and sciatic nerve.
In addition to this, these incorrect movements and postures are causing certain muscles to tighten and others to potentially weaken… once again placing inappropriate stresses across the lower back and sciatica nerve. Finally, pain typically results, which itself can cause muscles to tighten and others to weaken, which will then lead to inappropriate stresses across the structures concerned and therefore potential pain and so on…
I do not know how clear I have been with that last paragraph and apologies if it is not clear at all, but my point is there can be a lot going on, all leading to a big pot of issues which can be causing the pain… so what is the real cause. In my opinion, we do not always know. It is a kind of ‘chicken and egg’ scenario…
• Is it the pain that is causing the tightness and therefore the tightness then exacerbating the pain?
• Is it the tightness which is causing the incorrect movement patterns and therefore this is causing the pain?
• Or could it be the incorrect movement patterns are leading to the muscles to become tight and weak and therefore this leading to pain?
My opinion is a lot of the time it is difficult to tell.
What we do know though is that there could be tight muscles, weak muscles and incorrect postures and movement patterns all present… is it really necessary to pick the bones out of it all and work out what one is specifically the culprit before we begin to address the cause? More to the point does it really matter?
The most important thing is that there is a vicious cycle being created and that needs to be broken into, so let’s just do it!
For example, if the incorrect postures and movement patterns were the cause of muscles being tight or weak and we targeted that as a problem, we would be addressing this cause and therefore the muscles would also begin to loosen up and strengthen. However, if it was just tight muscles that were an issue, then we would be addressing this cause also and they would become more supple with the stretching. This would take stress from the structures responsible for the pain and therefore the pain will begin to resolve. In addition to this though, with the muscles no longer being tight, normal movement will be that much easier to perform and therefore this would help set up an environment conducive to being pain free.
To save repeating myself again, if we address weak muscles the same result will apply.
The issues above that I have said would be addressed would not be so ‘willy-nilly’ in the sense of just stretch or strengthen it just in case, no way. Rather the individual concerned is encouraged to check to see if particular muscles are tight or weak, and if so they would be shown how to stretch or strengthen accordingly.
Likewise, they would be encouraged to think about their day-to-day activities re posture and movement and once again address this if necessary.
My whole approach, as I mentioned above, is about giving the control back to the person suffering with low back pain and sciatic. Far too many people live with low back pain and sciatica when they do not have to. They have the misconception that nothing can be done (incorrectly), they may not be able to afford to see someone privately (be that a Physio such as myself, an Alexander Technique practitioner such as yourself, an Osteopath, Chiropractor etc) or they are on a long waiting list to see a Physio or Consultant which, in the mean time, means things are getting worse.
A lot of low back pain and sciatica is not that difficult to treat. The individual concerned does not always need to see someone such as myself or yourself to get better, because more often than not it is just a few basic changes that are needed to their day-to-day activities, maybe with a couple of stretching and strengthening exercises, in order to resolve their pain. Not just that, but the cause of the pain will be addressed therefore meaning that the chances of the pain returning are greatly reduced.
Once again, I believe that as health professionals we are guilty of creating a belief that if you suffer with low back pain or sciatica you need to go and see someone to get it better, otherwise you will always suffer. Even worse, when you pain is better, you need to keep on coming back otherwise the pain will return… I could not disagree more.
I think this view is very patronising. Nearly everyone out there who suffers with non-specific low back pain and sciatica is more than capable of addressing the cause of their problem and therefore resolving the pain they are suffering themselves… as long as they know what to do, and it is not rocket science either.
OK, there maybe a few people who do need a little bit of guidance or professional input, but these are the minority. With those that may need to see someone such as myself or yourself, there may also be a need to look a little more specifically at their movement. We may also need to encourage them to think a bit more about how they are moving or using their muscles and encourage them to do so a little differently (re-training I suppose
There will also, unfortunately, be those whose pain does not get better, a very small handful, but nevertheless they are out there.
I just know, from my experience as a Physiotherapist, that I have treated many, many people who needed to make just a few simple changes and perform a few simple exercises and there pain was gone, and some of these individuals had been suffering for a long, long time. In truth they did not need to see me, it just needed to be explained to them what the problem was, they did the rest themselves… my book gives that explanation.
There have been some people who have read my book that have had surgery and treatment from many different health professionals to no avail, yet by putting the simple principles into practice which I recommend, there pain has gone.
Is that because I am some kind of super human physiotherapist who has written an absolute masterpiece of a book… of course not. It’s because my book explains the basics of listening to your body and promoting normal movement. That, along with appropriate stretching and strengthening is enough for most people to resolve their pain.
WOW, have I gone on
Feel free to reply to this post, I welcome your views, and please do not think that any of the general accusations I have made above are pointed in your direction at all, they are not. I just think that in general as health professionals we can all be a bit guilty of them, I am just trying to address that.
As an Alexander Technique practitioner, I value your knowledge and approach and I do not doubt that your approach helps many people get over any pain they may be suffering with. My one issue I would have is that I would try not to complicate things by speaking about motor end plates and re-training the brain.
I do encourage normal movement (which does re-train the brain and also therefore re-trains how and when those nerves transmit impulses to the motor end plates) but I try to keep it nice and simple. Not because people would not understand otherwise, as that would be patronising, but simply because keeping it simple is enough, so why try and complicate it (unless we are just trying to justify ourselves as being a health professional and that we are something special… now there’s another story
If you were to read my book, you will see it is nigh on 100% free of medical jargon. I am just trying to provide information to those suffering with low back pain and sciatica that not only do they not have to live with their pain, but also that they do not have to make an appointment to see people such as ourselves, they really can cure the pain themselves, as long as they know what to do, my book just explains to them what they need to do.
Apologies again for going on a bit and thank you very much for your post, I am grateful.
Also, keep up your good work with The Alexander Technique, as I mentioned above, the little I do know about your approach I like and can see how it would benefit people suffering with low back pain and sciatica.
Cheers,
Paul.
Hi Paul
Huge long reply and thanks.
In my practice the most common cause of tight muscles is ideas! Imagine a 12 year old girl who is taller than her friends. What is the most likely thing she will do to be like the others? Yes she will stoop or squash herself down. Using her muscles and keeping them on. She may grow up to be an average height but her way of using herself may stay and those muscle will be tight because she is sending the messages to her muscles 24/7. She doesn’t know she is doing this because it is below the level of her awareness and more importantly it ‘feels right’. Stretching a muscle may temporarily loosen it. But if the thinking stays the same, the muscle will just be tightened up again. Because our muscles are under the control of our thinking even though it may be subconscious thinking. So the Alexander Technique as I teach it is about getting people to change their thinking so that they can change the way they move and let go of their debilitating ideas. The body cannot retrain the brain! The brain is in charge. Planning, moving , feeling. You cannot have a movement unless there was a thought that preceded it.
And I agree wholeheartedly with you that people can help themselves. That’s what I teach. Carry on your good work! Here’s my website if you are interested in finding out more…www.veronicapollard.co.uk
Best wishes
Veronica
Hi again Veronica and thanks again for your post.
I hope you do not mind me saying this, but your post tends to show me that you have not read my book or learnt about my approach.
I state that I believe nearly all non-specific low back pain and sciatica is a result of incorrect postures and movement patterns along with muscle imbalance. These tend to create a vicious cycle where incorrect postures and movement patterns lead to muscle imbalance and vice versa.
Now using your 12 year old girls as an example, if she was very tall at the age of 12 and therefore begun to stoop, she would be adopting an incorrect posture (just what I state is a classic cause of low back pain and sciatica) as a consequence of this stooping, you rightly predict that tight muscle are likely to result. These tight muscles would then make it difficult for her to readily hold a good posture and therefore the stooping posture is likely to be the easier posture to hold. This would probably mean that she would still consciously hold this stooped posture, but it would also start to become a habit (sub-conscious posture). As the years pass, this habit could become quite deep seated and therefore if she did turn out to be of average height, she may still possess the stooped posture she had learnt from her younger years. Up until this point I am pretty sure we both agree more or less on this pattern.
Where we differ (well in actual fact, I do not think we do differ, it is just I believe you are complicating things) is how we treat this. First things first, if there are tight muscles there, they will need stretching. HOWEVER, we need to get to the cause of the problem which was the ‘stooped posture’ otherwise you correctly say state that the muscles would just tighten up again (and I whole heartedly agree). The difference we have is in how we would go about it…
The whole aim of my approach (and it is one of the (many) reasons why I developed it and consequently quote my book) is to simplify things. As I believe, and I mentioned this in my earlier post, that as health professionals we can be guilty of over complicating the treatment of low back pain and sciatica.
Now correct me if I am wrong, but am I right in saying your approach would be to encourage the client to send the appropriate messages from their brain, down the nerve to the motor end plates in the muscles, therefore, working the correct muscles and relaxing others.
My argument to this (although I agree with it in principle) is the best way to send the correct messages to the appropriate muscles would be to show her how to adopt the correct/a better posture. I appreciate this may not be easy at first, especially if she has been holding herself with an incorrect posture for many years, but ultimately this is the aim. Therefore my belief is that we do practice a similar approach, but maybe go about it differently.
Muscles, as I am sure you are aware, are very activity/posture specific. That is why an athlete may be extraordinarily fit for his own personal discipline, yet if he was to try a different one he would appear relatively unfit. This is because he has trained his muscle specifically for his discipline and not the other.
My point being, I believe the best way for a person to train the correct muscles to adopt a good posture… is to adopt a good posture.
I have had many patients ask me questions such as “What is the best exercise I can do to encourage me to sit straight?” I am sure you know what my answer pretty much is… “The best exercise you can do for that is the ‘sitting up straight’ exercise!”
While I appreciate it is not quite as black and white as this (and not always as straight forward either) ultimately, in my opinion, it is the nuts and bolt of it.
My approach does not involve people just stretching or strengthening, far from it. My approach addresses the person’s whole lifestyle, from the way they sit, walk, run, and sleep (and anything else they do as part of their day-to-day activities). This is because it is almost certainly their day-to-day lifestyle which has led to them developing pain and therefore it is this they need to address (and the consequences of it e.g. tight and weak muscles) in order to resolve themselves of that pain.
Therefore, if they stretch and strengthen the appropriate muscles, and then modify the day-to-day activities which have likely led to them being in pain (using your example, the stooped posture) the correct and new postures will be exercising and strengthening the muscles that need strengthening and taking some of the stress away from the tight muscles, therefore encouraging them to relax. This in turn will ultimately lead to them being able hold a good posture with relative ease which, with practice, will mean they perform it regularly and the good posture will become a habit. Therefore, in effect they have ‘trained’ their brain to work certain muscles and relax others without the need of over complicating things.
I am sure I may well have been able to word this a bit better and apologise if I have not made myself clear. I also gladly welcome further comments from yourself.
If I can just say one thing, I am not being critical of your approach as an Alexander Trainer, as I am pretty sure I said in my earlier post, I value your opinion and respect the Alexander Technique. I have no doubt many of your clients benefit from your approach and I believe (from the limited knowledge I have of AT) that there are similarities between our lines of thought.
Anyway, that’s more than enough from me again
Please feel free to reply and comment further, I enjoy your posts and they are very thought provoking which is good.
Take care for now,
Paul.