One question we often get is, “will getting stronger make me better?” I have a hunch this question comes up because there’s so much info, and sometimes, myths floating around about pain, especially dealing with lower back and neck issues. Some of these ideas come from both healthcare and fitness professionals. So let’s try to shed some light on how pain works and, hopefully, you can piece together your own answer.
Pain is essentially our nervous system’s distress signal that says, ‘something isn’t right here.’ This alarm can be activated by a myriad of factors, from an old ankle injury leading to lower back compensation, to immobility in your thoracic spine (mid-back) caused by a sedentary office job, resulting in your lower back picking up the slack.
In response to these discomfort triggers, your body adopts certain protective mechanisms. It might ‘brace’ or tense up muscles near the site of pain, a bit like a safeguard against further injury. It could also modify your movement patterns to evade pain aggravation, such as limping after an ankle sprain or hunching to guard a tender back spot.
Given these factors, it becomes apparent that lower back pain predominantly arises from structural overloading, not because your back or core is inherently weak – contrary to what Google might suggest! Understanding these instinctive reactions and modifications in our body plays a significant role in managing pain more effectively.
Now, let’s focus on the concept of strength, defined as the capacity to exert force to surmount resistance. While it indeed has a place within rehabilitation, it’s not the foundation stone of the recovery process. Strength training fails to directly address the underlying cause of pain, as it’s highly unlikely that lower back or core weakness is the root cause of your discomfort. Therefore, think of strengthening as the crowning touch to your rehabilitation journey, rather than its base. If strength was the ultimate remedy, we wouldn’t observe strong individuals in pain, and those neglecting strength work would constantly suffer, which certainly isn’t the case. To visualise this, refer to the pyramid diagram below.
Bypassing the pyramid’s formation and leaping straight to strength is a shortcut to re-routing yourself back to the base (pain and dysfunction), which we strive to avoid. You’re essentially overloading an area already under abnormal stress with powerful muscle contractions, so it’s no surprise when your brain sends out distress signals. This could be why lower back pain recurrence rates are so high – patients either sidestep crucial rehabilitation stages or fail to address the root cause of their injury, leading to persistent pain. It’s paramount to emphasise here the importance of gradual progress up the pyramid, respecting each stage, rather than opting for shortcuts in rehabilitation.
Hopefully, at this point, the pitfall of focusing solely on strength training becomes evident. A well-rounded approach to addressing your problem involves a careful evaluation and establishment of a solid foundation in mobility and stability, with strength training becoming relevant only if it aligns with your treatment objectives. If not, strength training is by no means a prerequisite for a pain-free life. To wrap up, strength isn’t inherently bad. Instead, it should form part of a comprehensive recovery process, with an emphasis on establishing and focusing on foundational aspects first.