Back Pain 101
What is Back Pain?

Pain in the lower back or non-specific lower back pain is a common concern, affecting up to 90% of the population at some point in their lifetime. Up to 50% of those people will have more than one episode. Lower back pain is not a specific problem or disease, rather, it is a symptom that can occur as the result of a number of different processes.

What causes back pain?

The first is an obvious trauma to the lower back, a nerve impingement or a serious impact to the area, in these cases the cause or trigger is usually obvious. For most people however, lower back pain is a much more gradual process and the cause is typically the lower back being overloaded over time.

Nothing I've tried seems to work/last?

The conventional belief is still that if the lower back is sore, it needs to be strengthened. Unfortunately, the truth is that the lower back is overworked. Generally speaking, the reason the lower back becomes overworked, is because the muscles either above or below, simply aren’t doing their job properly. Therefore strengthening the lower back is not only unnecessary, but can often make the problem worse, (even though you may experience short-term relief in pain).

 

Stuart McGill the worlds number one authority on the treatment and prevention of back pain, states that he has almost never seen anyone with lower back pain, (that wasn’t the result of direct trauma), with healthy buttocks and upper backs. If those muscles aren’t switching on when they should, working the way they should, or they are simply not strong enough, then the lower back has to take up the slack. This in turn can leave it tight and inflamed and cause the nervous system to increase the amount of tension held in those muscles at rest.

Why should I roll?

As we age and become less active, or even more active in repetitive ways, the fibres of our muscles can start to move less efficiently due to the accumulation of 'fuzz'. Foam rolling can help restore movement within the muscle and potentially also prevent injuries if performed correctly.

For a better explanation of what 'fuzz' is, watch the video below by Dr Gill Hedley.

Here's another great video from Trigger Point themselves, which not only provides a simple insight into what foam rolling does, but also some good guides on how to do it.

How Do You Use It?

The use of foam rollers has progressed in many circles from an acupressure type approach to a self-massage approach. The roller is now used to apply longer more sweeping strokes to the long muscle groups like the calves, adductors and quadriceps and small directed force to areas like the TFL, hip rotators and glute medius.

Individuals are instructed to use the roller to search for tender areas or trigger point and to roll these areas to decrease density and over-activity. The major areas that respond well to the foam roller are:

Legs: Both the upper and lower legs respond incredibly well to foam rolling, although cheaper foam roller tend to deform with regular use when performing many of these techniques due to the weight of the individuals body bearing down on the roller.

Glutes: The largest muscle in the body and arguably one of the most abused by day to day life. Foam rollers can be effective in the short to mid-term, before the density of the muscle requires a firmer and more focussed approach.

Adductors: One of the most neglected areas of the lower body. Foam rolling these areas can improve posture, biomechanics and stability.

Beware

It is important to note that foam rolling can be hard work, particularly initially, as the arms are heavily involved in moving the body. In addition, foam rolling can border on painful. Foam rollers are available in a number of densities from relatively soft foam, slightly harder than a pool noodle, to newer high-density rollers with a much more solid feel. If using a foam roller unsupervised, it is important to gear the feel of the roller and the intensity of the self-massage work to your age, and fitness level. Good massage work, and correspondingly good self-massage work, may be uncomfortable much like stretching, so it is important to learn to distinguish between a moderate level of discomfort related to a trigger point and a potentially injurious situation. Foam rolling should be used with discretion by more slender individuals. Foam rolling should never cause bruising. Remember to stay at around a level 4 on the FACES pain scale shown below.

When to Roll

Rolling provides great benefit both before and after a workout. Foam rolling prior to a workout can help to decrease muscle density and allow for better warm-up. Rolling after a workout may help to aid in recovery from strenuous exercise. The nice thing about using the foam roller is that it appears it can be done on a daily basis. In fact, Clair and Amber Davies in the The Trigger Point Therapy Workbook actually recommend trigger point work up to 12 times a day in situations of acute pain.

How long an athlete or client rolls is also individual. We typically allow 5-10 minutes for soft tissue work at the beginning of the session prior to warm-up.

What version should I buy?

We’ve used a number of foam rollers over the years and our preferred model is The Grid by Trigger Point Therapy. We find that this is significantly more durable than most others (think 3 years plus in comparison to 3 weeks).  Not only that, but our clients have consistently acheive significantly better results with it in comparison to other rollers. Click here to purchase.

Although cheaper foam rollers do allow for a less painful introduction to foam rolling, we find their durability and thus cost effectiveness to be prohibitive. We’ve also found that good technique allows you to modify the intensity in the early stages, thereby negating the need for a softer roller.

As for the other cool tools available: Again, we like the TP Therapy products and recommend the Myofascial Compression Tools (MCT), but we'd always suggest starting with the Grid first, before moving on to these.