MotoPT: IMPROVE YOUR MOVE Do You Have Low Back Pain? Just Walk it Off! Hello FTR Family. Let’s start this month’s column by discussing something that 80% of us will deal with at some point in our lifetime, low back pain (LBP). LBP was the number one reason for missed work days in the United States. More work days were missed for LBP than for any other condition, including the common cold.1 I am sure you can imagine in the pandemic world we now live in, LBP is now the number two reason for missed days of work in this country. I need to define the type of LBP we will discuss today: non-specific LBP. This means the LBP is not attributed to a known pathology such as infection, fracture, or nerve root compression. Non-specific back pain is located below your ribs and above your pelvis without radiating nerve symptoms that go down your leg. The anatomy of the lumbar spine consists of five lumbar vertebrae (L1L5) that interact with one another as adjacent motion segments. Between the central portion of each lumbar vertebrae is the intervertebral disc. We consider two adjacent vertebrae and the disc in between them to make up a complete lumbar spine motion segment. For example, L4-L5 and the disc between those vertebrae would be named the L4-L5 motion segment. Each motion segment has an individual synovial
joint, one for each side. These synovial joints are similar to most joints in your body (elbow, knee, etc.). The joints in your lumbar spine are the type that slides on one another or gap/compress. They don’t bend like most synovial joints, such as your knee, for example.
sistently study the benefits of medication versus physical activity and other non-medication type treatments such as pain education and physical therapy for LBP.2 When you look at the multitude of studies, you can draw several conclusions about the long-term management of LBP.
With the multitude of joints in your spinal column, the gliding (sliding) of all these joints cumulatively causes movement in the four cardinal planes or rotation if the joints are compressing on one side and gapping on the other. It’s easiest to put your hands upright in a football field goal position and move your body to mimic the biomechanics of how your lumbar spine moves. For example, if you hold your arms in the field goal position and rotate to the left you will notice that your left forearm goes straight backward (gaps), and your right forearm goes forward (compresses). If you bend directly sideways to the left, you will notice that your left forearm dips downward toward the ground (downslide), and your right forearm slides upward towards the ceiling (upside). These motions occur at multiple motion segments in your lumbar spine each time you move. When you consider the robust anatomy and structure of the lumbar spine, you can see our spines were built to absorb forces and move with the rest of our body. Movement is the best medicine for your lumbar spine. Researchers con-
The first and most crucial lesson is that movement is medicine for our spine. We have learned that the type of movement or activity matters less than we used to think. Still, when you consider movement or exercise type approaches against other medical approaches, exercise is usually the long-term winner for non-specific LBP. I meant what I said in the title, if your back hurts, walk it off, and keep walking daily. Start going for daily walks, and work from a low time of 10 minutes up to 30-minute walks. Even a generic group exercise program can benefit you tremendously if you have chronic LBP.3 There are so many benefits that a simple exercise like walking provides us if we have LBP, it would be difficult to do them all justice in the space of this magazine. And suppose you maintain moderate or vigorous exercise as part of your healthy lifestyle. In that case, you are significantly less likely to experience LBP again for the next four or more years.4 Trust me, exercise works!
FLORIDA TRAIL RIDERS
When should you not walk it off or perform some other type of physi-
