From Rehab to Recovery: An Athletic Trainer’s Approach to Lower Back Injuries
4 minute Read time
Low back pain (LBP) is the leading cause of disability worldwide! Over 80% of the population will experience LBP at some point during their lives. Over 26% of the population at any given time is suffering from LBP! With these types of numbers there are about 2 billion people with LBP at any given time world wide and 86 million just in the US! Are you one of them?
If so, Certified Athletic Trainers (ATCs) are one of the best suited professionals to help guide your recovery. With their extensive training in injury assessment and rehabilitation, ATCs can help you determine whether you need further imaging, like an MRI, or if mobility, strength work, and soft tissue therapy can get you back to feeling your best.
Initial Assessment: Understanding Your Pain
During your Initial Assessment your practitioner will take a thorough history, what is going on now, and what has happened in the past (it all matters!) Together, you’ll outline your goals, ensuring the treatment plan is aligned with what you hope to achieve.
Then the physical assessment will be performed. This is a mixture of active (you doing) and passive (practitioner moves you) so he/she can get a sense of what is the source of your LBP. The source can be anything from compensation from and old ankle injury that has over time changed your gait, to irritable bowel and stomach issues and the internal inflammation causing internal stress to your low back.
Some other special tests may also be performed such as the LTAP. This is the Locator Test Assessment Protocol developed by Anna Hartmant @MovementRev. This helps guide the practitioner to where treatment should be started (it’s not always the site of pain) (See also my Blogs “Hierarchy of Protection” and “What is Visceral Manipulation?”
Treatment: Moving Toward Pain-Free Living
Now with an idea of the root cause and where to start the Athletic Trainer can begin to use modalities ranging from hands on soft tissue mobilization, to cupping to movement therapies to help reduce your LBP. As your pain decreases he/she can also assist in modifying your activity to continue to reduce your pain. Contrary to popular belief, recovery from LBP doesn’t usually involve lying on the couch for weeks. Movement is medicine, and the sooner you can incorporate pain-free movement, the faster your recovery will be.
For example, just this week I had someone come in with acute LBP. He could barely hold himself upright and had pain while walking. Lifting his knee just a couple inches off the table aggravated his pain.
After the assessment, I started to move each of his legs passively in a pain free range of motion. This communicated to his brain that these movements were safe! After I finished he was then able to raise his knee without pain in the same range that earlier caused pain!
Movement around the area helps with the inflammatory process as well….something we actually want to facilitate instead of inhibit with anti-inflammatories and such! Movement increases the blood flow to and from the area bringing in the key components to help clean up the damaged tissue and then carry it away, instead of allowing it to build up and get stagnant in the area (swelling).
Strengthening and Returning to Activities
As pain free range of motions increase this is the time to address possible movement patterns that may need to be adjusted as well and low level strength work (also called corrective exercises) This includes everything from stretches to squats (I know you think you shouldn’t be doing those….but you should!) And can be anything from standing on a ball to stretch the inner muscles of your feet out, to twisting and picking up objects while balancing on one foot. These are the things that will get you back to your regular activities. Once all of these are done pain free, then you can start to load (add weight) to strengthen to prevent further injury! The brain when it feels unsafe makes things tight. For the brain to feel safe we need to be strong, thus releasing the tightness and granting back our pain free range of motion.
At this stage, returning to your usual activities starts. Runners will begin jogging, cyclists will get back on their bikes, and tennis players will return to the court—all while monitoring how your body responds and adjusting the program as needed.
Long-Term Maintenance
As you return to your activities your ATC may recommend a maintenance program for you to follow. This should not be a life sentence of everytime you want to participate in an activity you need to go through an hour of stretching and activation just to go play. But initially you should probably do some prep work before and after your activities just to make sure everything is feeling good. This usually gets cut down to 2-3 days per week just so you are now aware of how/what your body feels like and what it needs in order to maintain a pain free low back.
Maintaining a relationship with your ATC allows for you to seek out maintenance and progressions with your programs for a professional that now knows and understands your body! Think of these as monthly car maintenance sessions.
Ready to Start Your Journey to Pain-Free Movement?
Though having LBP can be scary and painful there are many skilled professionals out there who are ready to help you out of pain and back to moving better and feeling better! The Certified Athletic Trainer is one of the best at this due to their varied skill sets from assessment to manual skills to programming you back to activities. By using a truly holistic approach you will get individualized programming and get you moving as soon as possible.
If you are currently suffering from Low Back Pain and want to start your journey back to pain free movement click below to schedule a free phone call so we can chat and see how I can help you!