As a personal trainer, your role in the overall health of your clients’ spine cannot be overlooked. Although many physicians will tell their patients that they have non-specific back pain, this is simply untrue.
Back pain comes from an internal issue, even if it’s a result of an external force.
Passive treatments like ultrasound and prescriptions for narcotics can be part of a broader approach, but without an actual plan to permanently stop the cause, these modalities rarely lead to a long-term solution. A thorough assessment pinpoints a client’s specific pain triggers. By identifying the pain mechanism, personal trainers create a targeted treatment plan.
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Types of Back Pain
Lumbosacral pain, non-specific back pain, and idiopathic pain are all terms physicians use to label back pain. In reality, these generic labels indicate that the patient hasn’t had a complete workup to diagnose the exact mechanism of their discomfort, and thus, they’re given a vague diagnosis.
Fortunately, trainers have the expertise to guide clients through a more in-depth assessment that can reveal their pain triggers. Many times, this type of approach introduces them to the first evaluation that accurately pinpoints the exact cause of pain.
By treating the client’s back pain, both trainers and their clients understand why one approach is more effective than another when trying to manage chronic back pain.
By utilizing data revealed during the assessment, they can:
- Create a stable foundation for a pain-free range of motion
- Remove pain triggers
For instance, when someone has a slipped disc, their range of motion is limited. They can only bend so far before it becomes painful. Pain sensitivity from bending is also influenced by hydration. If the discs are hydrated, the painful symptoms often encountered with bending are minimized.
Other variables that can affect a client’s pain threshold include how long they sit on a daily basis. Prolonged sitting causes an excessive amount of strain on the lower back, which can lead to pain upon standing and trying to bend forward.
Things to Consider
When working with a client who suffers from back pain, you should be familiar with:
Mechanism of Injury
Disc bulges do not just happen. They are a direct result of repeated flexion and bending when the spine is under load, such as someone sitting for prolonged periods of time, lifting something the wrong way, or squatting too deeply when their hips are stiff.
Disc tears can also occur from excessive twisting while under load. Twisting exercises like Russian twists may enhance your clients’ strength, but they can also cause delamination of the annulus, which leads to disc tears.
Identifying Training Goals
Every one of your clients should be able to answer the question, “What are your fitness goals?” Is it to increase flexibility and exercise tolerance levels? Is it to restore a loss of function? Write their goals down, and choose specific exercises that focus on achieving them. Exercises you recommend are tools to help them reach their goals, whatever they may be.
Creating a workout plan for a pain-free life is very different than creating one for a specific fitness goal. To reduce pain levels, we need to follow the principles that we created over the years to reduce specific injury mechanisms. If you only measure your client’s range of motion, you probably won’t have much success in pain reduction or increasing flexibility. Understanding their pain history will establish a baseline of their existing weak points.
With pain provocation testing, you can then reveal their pain triggers, such as offending postures and movements. Together, these will help you create an exercise plan that reduces your client’s symptomatology.
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When to Refer to a Pain Specialist
There will be times when the situation is beyond the scope of even the most experienced trainer. And when this occurs, it’s best to refer the client to a specialist. A qualified personal trainer will have a list of competent clinicians within their network.
If your client has not had a formal workup, they need to see their primary care physician immediately. But if they’ve had a complete evaluation without resolution of symptoms, they may need to see a pain specialist for further evaluation.
Training With Back Pain
Although it sounds counterintuitive, working around an issue to find a solution is sometimes the best approach. Clients suffering from back pain fall under this umbrella. And since approximately 80 percent of Americans will experience back pain at some point, it’s inevitable that you will encounter a client suffering from back pain.
Working around your client’s back pain is less about their back and more about the functionality of their body as a whole.
Creating a program that addresses core stability along with increased mobility of the hips will keep your client’s back healthy and will allow them to build their fitness levels safely.
Frequently Asked Questions About Back Pain
When should I see my doctor about back pain?
If your back pain persists or if your back pain is accompanied by sudden weight loss, numbness, or if you have difficulty urinating, it is best to see your doctor as soon as possible.
How do I know if I have a herniated disc?
Some herniated discs have no symptoms at all, while some cause pain or weakness. The best way to determine if you have a herniated disc is to see your doctor.
Will I need surgery to fix my back pain?
Surgery for back pain is rarely necessary. Your doctor will determine the cause of your back pain and will talk with you about your various treatment options.
Does yoga help back pain?
If your back pain is not severe, yoga may offer some relief. However, it is important not to engage in yoga that incorporates a lot of backbends or twisting when you are experiencing back pain.
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