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Dr. Arnan Sisson, PT / November 2, 2022
One of the most common questions I’ve gotten is, “I was told I should never lift more than 25 pounds again ever again or I might throw out my back. What can I do?”
And so here’s what happens all the time: people go to their MD, physical therapist, acupuncture, or chiropractor, etc., and that person tells you to stop doing the activity because it hurts. You should never do it again.
Maybe they don’t know to tell you to go see a back specialist, so they told you to stop, and you did. The other thing that happens is the patient, because of being rushed through the system, feels like they were told, “stop, never do the activity again”. When, the provider might’ve said, “stop doing that one thing, and figure out another way to do it.”
I don’t know why, but, this is the message that I get from my patients, “I was told never to lift 25 pounds ever again because my back hurts and I’m going to damage something, or throw out my back, or damage my back permanently.” That’s the message people have. The message is: never lift grandkids, reach into low cabinets, throw out heavy bags of trash, run vacuums for long periods, etc.
What they really mean is: don’t do that thing that’s aggravating your problem again until you find someone that can help you the problem. However, they’re not really saying it in those words, or maybe they don’t know exactly what those words are, and they don’t know that I (or other back specialists) exist.
So, I had my patient who was told they should never lift 25 pounds ever again. When I tested her and took her through a full on body evaluation and movement assessment, her back moved great, her back felt great. When I looked at her hips, her hips didn’t move the way they should have moved. Her hips were the problem. Her hips weren’t moving like they’re supposed to.
So, we retrained her hips. We did some therapy to help open up her hips, and I retrained her to move her hips better, and then her back felt better. By the third visit she was like, “My back’s not a problem. I can lift my 2 year old grandchild and lift my dog.”
I said, “Okay, great. What else is the problem?” I knew she had had migraines and neck issues, so then we had time to start working on some other areas of her body. It helped her improve her life even more.
One of the things we do is we don’t just treat where you hurt. We figure out where the problem is that’s causing the discomfort. Pain does not always equate to damage. One of the misconceptions that people have is that damage and pain go hand in hand. People can have pain without damage or damage without pain. And you can have both.
One of the other misconceptions is that people feel like they’ve tried physical therapy. And physical therapy doesn’t work. That’s just like saying I tried a restaurant, and I don’t like eating at any restaurants now because the food was bad at this one place. There are different types of physical therapy, there are different therapists who specialize in different things, physical therapy is a broad profession.
The other thing I want you to understand is that when someone says you might throw out your back, or your back might go out, or you might slip a disc; that your back is really strong, and it doesn’t really go out. There’s nothing that’s going out of place, even though it might feel like that.
It’s not like Lincoln logs or Legos that don’t quite fit together and they’ve shifted. It might feel like that because of a muscle spasm. But really what’s happening in nine out of 10 cases is a muscle is tightened up so much that you don’t feel quite right and it hurts. But when someone tells you like you’ve slipped something and something’s gone out of place, the visual is something that’s more scary than what’s actually is happening.
And that’s why it’s always good to work with a movement professional or a pain specialist, but pain specialists sometimes just do pain medicine. Whereas someone like me and our therapists that we’ve trained here, we specialize in movement and pain because my goal is to figure out the cause, not to fix your body and take the pain away, but figure out what you want to do and help you do it comfortably.
Or maybe pain-free. Maybe not, but you’re supposed to have pain because pain is feedback from your body. It’s like when you drive a car and you’ve got the check engine light, you’ve got to speedometer, you’ve got a fuel gauge. Pain is like the check engine light coming on. Breathing hard because I’m running fast is like the tank meter. It’s just feedback and telling me where I am, where I’m going.
So if you’ve been told you should never lift weight again because you might damage something or you should never run again because she might damage your knees or your knees might get blown out. Knees and backs don’t get blown out, unless they’re actually in an explosion.
Yes, there are times when there is damage, like your disks bulge or they rupture and that’s okay. It will generally heal just like a scab. It’s like a wrinkle on the inside and there are times when surgery is necessary and there are times when, yes, physical therapy isn’t the answer.
But physical therapy and working with one of our back pain specialists is the best first place to go before you decide to take any medications, get an injection, do an epidural, get an MRI or even undergo the knife and do surgery.