How To Fix Low Back Pain
Hey everyone. This is another article in our pain series, which corresponds to The Ready State Fix Yourself programs of the same name. We’ve developed these programs over years of clinical experience to help you, for lack of better words, fix yourself.
In this article, we cover our most well developed pain protocol yet: The Low Back Pain Protocol. These articles can be considered primers, something to get you started and show you the truth that pain is not permanent. When you’re ready, if you’re already convinced, or if you have a significant pain problem to address, I always recommend taking a look at the full protocol. Here at The Ready State, we’ve poured our hearts and souls into these programs and I know they can help you.
Introduction – How to Fix Low Back Pain
I am especially excited to be writing this article for you. The Low Back Pain Protocol exists as the result of 15 years of clinical experience. It’s near and dear to my heart and a personal journey as well.
What I’ve seen is that developing low back pain is a very common experience of being a human being. When we get clients coming into our clinic, whether they be Olympic athletes or elite military personnel or whoever else, we always start with what you are about to read in this low back pain protocol. This is not a watered down or a “made-for-the-internet” version. This is the best clinical program we’ve made to date.
This is because when you tweak your back, we understand that it is serious. The spine is so integral that even if you don’t yet have “injury,” that pain can be changing your life. And so, the tools in this protocol are designed to shift loci of control back to you. What can you control? How are we going to desensitize this problem, and interrupt this relationship between your brain signaling pain in your body? How can we restore your positions and mechanics, upregulate your function around your hips and your spine, and then what can we do to prevent this thing from happening again.
Let Go of The Three Untruths
Now, before we start we like to address three beliefs identified by our good friend Byron Katy. We want you to confront these three truths before you even begin learning how to fix low back pain, and that is:
Untruth #1: This is bad but it may get worse
The belief that it may get worse drives a lot of unrealistic fear expectations. You have some agency and control in making yourself feel better.
Untruth #2: This will never change
The body is a miraculous healing machine, and we’ve seen that even discs always heal. You’re not fragile. This notion that you’ll never get better is simply an untruth. It can be serious and it can be a gigantic pain, but I guarantee you we will see improvement over the long haul.
Untruth #3: You can’t take it
The feeling that you can’t take this is very real, I’m not denying that. However I want you to understand that if we shift that loci of control, things will change positively and you can handle it.
When To See a Medical Professional and How to Fix Low Back Pain
Now, if you think you should see a medical professional, do it. Green light. Start at go. I want you to understand that this protocol can be done in conjunction with working with a medical professional. Not sure if you should be?
Do you experience night sweats, changes in bladder and bowel function, or feel tingling in the saddle area? Is your pain an 8 out of 10 and are you struggling with major sleep disturbance? If the answer to any of these questions is yes, maybe recruit your doctor and your physical therapist. Just know this program is complementary to professional help.
Pain is highly subjective
Before we move on, I just want to remind you that pain is highly subjective. Your brain is the most complex structure I’m the known universe, and the spine may be the most beautiful system. If anyone ever told you “the spine is a bad design,” no, it’s not. We have friends that lift thousands, no hyperbole, thousands of pounds for multiple reps. Skiers who perform multiple backflips off a cliff at 50 miles per hour. All you have to do to understand the true beauty and capability of the spine is drop into a professional ballet.
We’re not going to get into modern pain science, but I want you to understand that you are not fragile and neither is your spine. We can improve your pain and function, and you can be free of this issue.
A Systems Approach on How to Fix Low Back Pain
One of the things that separates our protocol for how to fix low back pain is that we take a systems approach. Usually when one of us has back pain, we Google on the internet or think there’s a specific problem area or reason we can identify and then address.
Instead what we’re going to do is take a more holistic view. Typically we think about how the body moves in a big picture way.
First, is this an environment problem? Can we address issues of sleep quality and non-exercise activity like walking? How can I improve the robustness of my environmental conditions to make me a little less sensitive to what’s going on with my body?
Just like when you get really stressed you can get a cold, the same thing can happen with how your brain perceives pain in your low back.
Second is movement. Your body is robust and anti fragile and very tolerant in a wide variety of positions. It’s just that for some reason, something has caused your brain to perceive one of these movements as a problem. We tend to think it must be a certain muscle or tissue, but remember our brains are wired for movement.
By thinking about what shapes allow us to get in better positions, and what movements allow us to reclaim better function, we change the brain’s map of what’s going on.
Then we can move into the rest of the systems. For example, we might ask if we can improve joint function. If I’m stiff in my upper back that might affect my lumbar spine. If my hips are really stiff, that’s certainly going to be a factor in the way I feel. The tail might be wagging the dog when I hinge or sit. One of the ways I can improve pain is by improving the way my tissues work at the joint level.
Next we can ask “is this a muscle related problem?” Our muscles can get stiff, not function very well or just not be well connected to our brains. Tight, dysfunctional, or ischemic (not getting enough blood flow) muscles might be sending a message to my brain.
Lastly we look at sliding surfaces. My body should be like layers of warm silk sliding over steel springs, but that’s often not what happens. If I have areas that are no longer dynamic and robust, tissues can become tacked down at the myofascial level. Addressing myofascial systems is another way we can get non threatening input into the body.
Changing one of these systems may very well get me relief, but if I improve them all as a whole, what we see is an upregulation of the whole system.
Remember, the main point of this is not just to get relief for your low back today, but how to fix low back pain forever.
Mobility Tools: Rollers, Balls, Bands and More
Without mobility tools, we are restricted to a small number of solutions for how to fix low back pain. We can actively work on our position, alter our environment, and use dynamic stretching, but we are severely limited. Mobility tools allow us to address sliding surface mechanics, increase and improve blood flow to the tissues, desensitize rapidly, and change our brain’s perception of our pain.
You don’t need all of these. In fact, you can get away with as little as a lacrosse ball and a gym membership, but more tools means more options and more options means less pain.
We utilize the following tools in our low back pain protocol.
Balls: Lacrosse ball, The Ready State Supernova and The Supernovito
Balls are tied with foam rollers as our foundational mobility tools, and their incredible portability makes them awesome for on the go MOBs as well. Everyone should have a few lacrosse balls lying around, and I suggest adding in a larger ball like The Ready State Supernova when you can. For an upgrade to the lacrosse ball, we also have the “Supernovito,” A hard textured ball of the same design as the supernova, but the size of a lacrosse ball.
We use balls for pinpoint pressure on tissues. Many of the tissue mashing techniques in this protocol utilize these tools for tissue mashing areas we can’t always easily address using foam rollers. The traps, for example, are difficult to tissue mash with a foam roller but we can get deep into these tissues with a small or large ball.
As a bonus, another way we use balls is in what we call a peanut. Taping two lacrosse balls together, or using The Ready State Gemini creates a new device that can be used to great effect on the tissues around your spine such as the neck and scapula.
After balls, foam rollers are our next tool. If you haven’t been living under a rock, you’ve probably seen these tools appear in every gym you can find. Most of the foam rollers at the gym are quite soft and flimsy, and while these can still be used, we prefer more versatile devices. Our foam roller has a harder, textured exterior more well suited to improving sliding surface mechanics. Another staple of my toolset is The Rumble Roller Gator.
A textured roller like the aforementioned is crucial for tissue scrubbing techniques like the lat scrub. You can find The Ready State Rumble Roller here, our textured “leopard” roller here, and the rumble roller gator here.
Our third tool is loop resistance bands. In case you haven’t been following us, I’m not a fan of “stretching.” Stretching a muscle in the traditional sense is like pulling on a rope. The rope gets longer, but also weaker as the fibers draw thin.
At The Ready State, I promote an alternative known as PNF stretching which involves contracting your muscle and then relaxing into the stretch at intervals. For example, when touching your toes to stretch your hamstrings, you would flex your hamstrings and quads for 4 seconds, then relax and reach further into the stretch for 4 to 8 seconds.
We also refer to this as Contract-Relax, which is a technique we employ in tissue mashing too. Just another great tool for how to fix low back pain.
Where resistance bands come in is something we call banded distractions. By using a resistance band we can create an alternative vector for stretching. Looping a band around our foot for hamstring lockouts or the hip joint for our hip capsule mob are two ways bands increase our options for tissue mobilization.
Neuromuscular Electrical Stimulation (NMES) Therapy
Finally, we have NMES therapy. NMES devices use electrical currents to provide relief for painful tissues. While this may not be practical for everyone, we use this tool all the time in our clinic and I would be remiss not to discuss it. These kinds of devices allow us to have lots and lots of non-fatiguing muscle contraction. This allows us to create a lot of motion without having to exercise the muscle.
Basically, I’m getting movement in the tissues, but I can get upwards of 20 hours a day.
We favor the H-Wave OTC Muscle Rehabilitation Device for these purposes.
The Treatment Model: Desensitize, Restore, and Prevent
Our treatment model is organized around a few key concepts for how to fix low back pain.
How can we influence the environment around the site of our pain? Are there methods with which we can DESENSITIZE the pain signaling in the back in a way that doesn’t slow or limit tissue healing? Can we remove congestion and swelling in the tissues that may be slowing healing time and contributing to your symptoms when you use your back?
Can we RESTORE the normal function and movement to your back? Rarely do we see mechanical based pain that isn’t also associated with some kind of tissue restriction in the back. Improving global functional capacity of your back may potentially unload an aspect of your sensitized low back.
Are there particular shapes and positions that support better functioning of your back day-to-day that might unload the tissue while it normalizes and heals? How can we PREVENT future injury by changing your movement patterns and better preparing your body for the rigors of dynamic movement?
To see the best results while working through this protocol:
- Expect to spend 10 mins per day DESENSITIZING with breath work
- Expect to spend 10 mins per day (no more than 20min) RESTORING TISSUES with mobilization work
- Expect to spend 30 mins per day WALKING (this can be split into smaller sessions, but the goal is to accumulate 30 mins per day)
- Expect to work on controlling your SLEEP QUALITY and QUANTITY every day
- Expect to work through this protocol in 12 days, and then continue by revisiting 1-2 mobilization techniques per day that you found most helpful until your symptoms feel better
Breathing To Desensitize Threat
When we are experiencing low back pain, we tend to not want to move at all. But we know that the best way in, is through pain-free motion. Here we talk about how to use breathing techniques to change how the brain perceives the spine as a threat.
Rx: Spend 10 mins per day doing breath work
This simple technique enables us to get the musculature turned back on and used to being pushed and pulled.
Rx: When in pain, 2-3x per day
When people experience low back pain, the first thing that gets tossed out is movement. Our goal is to get as much non-threatening movement back into the body to tell the system that everything is ok.
Rx: Walk 30 mins per day (can be split into shorter sessions, but the goal is to accumulate 30 mins each day)
The next level of decongestion might include the use of neuromuscular-electrical-stimulation or “NMES.” While this technology is advanced and may not be practical for everyone, it is a cutting edge technology that we would be remiss in not explaining.
As we noted in the introduction, the next phase of our protocol is designed to restore and improve the soft tissue function of your low back. Unlike many common “internet solutions” that don’t work very well, you won’t see lots of traditional back “stretches” in this protocol. Your Low Back Pain Protocol contains the most clinically advanced thinking around movements and mobilizations today. We can divide this section up into two different kinds of interventions. The first are what we call “position transfer exercises” or “mobilizations”. These interventions are designed to restore your body’s ability to do what it is supposed to do. The second category of interventions can be thought of as skill or technique-based interventions.
We’ve organized these interventions into stand-alone sessions. It is critical that you accumulate many short sessions over the course of the week, rather than only a few longer sessions. We recommend that you work through these techniques in order, spending 10 minutes every day (and no more than 20 minutes per day). Once you have worked through each technique, continue working the techniques you found most helpful, 1-2 per day, until your symptoms feel better. These are ideal approaches for how to fix low back pain.
Tools: Roller or Ball
Time: 5-10 mins Total
Tools: Band, Belt or T-Shirt
Time: 4-5 mins per leg
Tools: Lacrosse Ball
Time: 4-5 mins per side
Couch Stretch Mobilization
Tools: Couch or Wall
Time: 2 mins per side
When we find our lives and activities suddenly limited by a painful condition, our gut instinct is to correctly solve that pain problem first. Unfortunately, the immediacy of our pain needs often override our long-term planning and behavior modification needs. When our athletes and patients present with a problem, we always want to try and discover “why” and if there were contributing factors like stress, changes in volume, or new running shoes for example.
Our back is some pretty extraordinary engineering. When a problem pops up, we believe that you should know how to put out the flames, develop an understanding for potentially why those tissues became sensitized and painful in the first place, and an action plan to keep it from happening again. One of the first things we always look at is sleep because the quality and quantity of your sleep has such a direct impact on your body’s ability to recover. We will also take you through what we call our “After Action Report.” This is an exercise we work through with our athletes and clients to help them discover potential behaviors that may have contributed to their dysfunction.
Rx: Work on controlling your sleep quality and quantity every day
Rx: Work on controlling your sleep quality and quantity every day
The Full Low Back Pain Protocol – How to Fix Low Back Pain for good!
Here you’ve had a taste of our most clinically tested protocol yet. My hope is that the tools here can help you realize that you are not your pain, nor are you bound to it. It is not permanent, you can handle it, and you can heal.
With that said, this article is only an intro. If you’re experiencing lower back pain, I strongly recommend checking out the full Low Back Pain Protocol.
Here you’ll find 24 videos ranging from additional mobs to deeper dives on the topic of low back pain and it’s causes, after action reports, and much, much more. Whether you’re experiencing minor aches, or major injury, I’m certain our protocol can help you massively improve your Ready State.
Resources & Links
- The Ready State Fix Yourself Programs – https://thereadystate.com/product-category/trainings/fix-yourself/
- The Ready State Low Back Pain Protocol – https://thereadystate.com/product/low-back-pain-protocol/
- The Ready State Home Page – https://thereadystate.com/
- The Ready State Lacrosse Ball – https://thereadystate.com/product/trs-lacrosse-ball/
- The Ready State Supernova – https://thereadystate.com/product/supernova-2-0-large-120mm/
- The Ready State Supernovito – https://thereadystate.com/product/supernova-small-80-mm/
- The Ready State Gemini – https://thereadystate.com/product/gemini/
- The Rumble Roller Gator – https://www.rumbleroller.com/products/rumbleroller-gator
- The Ready State Rumble Roller – https://thereadystate.com/product/trs-rumble-roller/
- The Ready State Leopard Roller – https://thereadystate.com/product/trs-leopard-roller/
- The Ready State Resistant Bands – https://thereadystate.com/product/trs-resistance-stretch-band/
- H-Wave OTC Muscle Rehabilitation Device – https://thereadystate.com/product/h-wave-otc/