I was on the mat doing warm ups before class and I heard one of the other students telling someone “Well, my mom and grandma both had back pain, so my back pain is inherited. There’s not much I can do about it”.
I have heard this sentiment over and over throughout my life. I used to want to intervene (but honestly, now I know better!)
The way in which we move is socialized- we move like our parents, and they in turn move like our grandparents. There can be genetic conditions which pre-determine that we have a set up that may make back issues more likely, but largely, how we move through our life determines spinal health and function.
Over the course of our lifetime, most of us (American adults) will experience back pain at some point.
The pain may have many different sources (ranging in etiology from intervertebral disc herniations to arthritis) and some of us will experience this pain chronically.
And yet much of the western medical information about how to protect your spine and create longevity is not being practiced by those of us who are suffering, not taught by our friends teaching our fitness classes and not discussed with us by our physicians.
In a world that is so spine impoverished, why is the rich flow of education to help us maintain spinal health not getting to us?
What if you could learn a couple of basic principles to help your decision making around spinal integrity and exercise to help you preserve spinal health and longevity?
You’d love to? I’ve been waiting my whole career to write this, so let’s go!
Let’s focus on four ideas we can embody, to become proficient in learning to work with spinal health.
1) Our spine is the most susceptible to injury where we move and load with gravity the most (given this, how much stretching do we need?)
2) Sensory discrimination is very poor in the back
3) Disc herniations heal
4) We influence bone growth and health in our spine with our posture and movement (this has a huge impact on arthritis or stenosis and bone density)
In short, your spinal health (barring any systemic disease process) is largely within your hands.
The concepts we will be exploring in this month are based on a biomechanical and anatomical/ physiological science. These are not the only lenses to apply when working with your health. However, understanding the science of the spine is an important primer for working with our backs to promote longevity.
We will look into the movement/ injury relationship of our spines in our next post.
This week, let’s get familiar with the different tissues of the spine:
1) Muscles: muscles are perhaps most familiar to us. Skeletal muscles are elastic and are excitable and when stimulated by a motor nerve, they can contract (shorten) to create stability or movement. Muscles create or stabilize movement of the bones.
2) Tendons: tendons are a chemically stiffer version of muscle. They exist at the transition point where muscle attaches onto bony surfaces. Tendons assist muscle in creating or stabilizing movement.
3) Ligaments: very little elastic, firm and dense connective tissue. Ligaments bind bone to other bone and create specialized joint capsules (mentioned previously here). Ligaments limit motion.
4) Intervertebral discs: the specialized cartilage that exists between the intervertebral (bone) bodies of the spine. The discs have a very firm cartilage inner (the nucleus propulsus) and a very firm and fibrous outer casing (the annulus). Cartilage is without blood and nerve supply- it cannot regrow. The annulus does have some blood supply and can knit back together after an injury. Discs (and all cartilage) allow for movement of the spine in all planes of motion, cushion loading forces.
5) Vertebral bodies: these are the dense, compact bones of the spinal column. We are focusing on the moveable segments (we have fused segments near the tailbone and pelvis). Bone provides structure and protection for the spinal cord and peripheral nerves.
It is important to note that something called 2 point discrimination, the ability to sense the distance between 2 points (usually tested with 2 fine points pressed into the skin), is very poor in the back. Given our slightly limited sensory capacity here, how do we suss out if sensitivity or pain we are feeling is coming from the disc, ligament or nerve when these structures co-exist in very small spaces together?
This is really important, we cannot.
We truly need a physical therapist or non-surgical orthopedic consult to help us determine sources of discomfort.
I hope this has been a helpful reminder for you about the tissues we will be looking into as we learn the possibility of safety and longevity in working with our spines.