Taking a Back Seat
Eight out of ten Australians will experience a significant episode of lower back pain (LBP) at some stage of their adult life, with a further 25% experiencing chronic lower back pain (CLBP), which is pain that persists for three months or longer.
LBP can present with a vast range of causes, symptoms and associated limitations and disabilities. Loss of function, mobility, altered posture and secondary aches and pains, inability to work and changes in socialisation are just a few of the implications to consider in clients with LBP. The psychological consequences of chronic pain are equally significant, with implications on mood, motivation and attitudes to exercise.
Understanding LBP
LBP generally presents in two ways, as acute lower back pain versus chronic lower back pain (CLBP).
Acute lower back pain
Acute lower back pain can present with a range of symptoms centrally or to one side, and may also involve referred pain from nerve compression into the buttock, the groin or down the leg. Predisposing factors may include poor posture, repetitive activities, over use, excess load, or a previously asymptomatic condition such as spondylolisthesis, where one vertebrae can slip forward on another.
Chronic lower back pain
CLBP persists over an extended period of time and can be characterised by ongoing pain or recurring acute episodes. Several studies show that general exercise assists CLBP sufferers with others suggesting that exercises that specifically train the core and lumbar stabilising muscles offer benefits beyond that of general fitness activities.
Accredited Exercise Physiologist Molly Shevill explains that exercise is beneficial as an adjunct to other treatments in that it helps restore and maintain range of motion and provide additional mechanical support for the spine.
It is always wise to consider the lower back when designing an exercise program or class, even for those who are symptom free. Avoiding exercises that place undue stress on the lumbar spine via load, speed of movement, or compromised form is an important consideration when working with any client. Shevill says that where an exercise professional has the most relevance is in their capacity to prevent and protect against lower back pain, as any efforts to treat the condition fall outside their scope of practice.
Read the full article in the eJournal, POWERED by Fitness Australia at ejournal.fitness.org.au
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