Category: Blog

The ‘big three’ misdiagnoses haunting back pain sufferers

The only thing worse than back pain is prolonging it with incorrect misdiagnosis. Yet this is a common reason why regular back pain progresses to Chronic Back Pain.

Too many people self-diagnose their pain or, even worse, make an Internet diagnosis. They then become attached to the diagnosis.
They often fail to get a second opinion when treatment isn’t helping, and become resigned to their fate.
But it all starts with misdiagnosis, and the ‘big three’ misdiagnoses which mislead back pain sufferers are:

Believing it’s a disc problem:
Around seven out of 10 people, if put under an MRI, would show some kind of disc issue. Our bodies aren’t perfect. For example disc bulges are incredibly common yet don’t necessarily cause pain or discomfort.
Debilitating disc problems are less common than people think. People are too quick to believe it’s a disc. With proper analysis they often find it’s something completely different, such as gluteal tightness, nerve spasm, lower spine joint tightness or even stress.

Sciatica:
People often assume a shooting ‘nerve-like’ pain emanating from the back is sciatica – it’s a favourite of the ‘self-diagnosed’ – but nine times out of 10 sciatica is not the issue.
Problems which can masquerade as sciatica include lower back biomechanical issues, hip pain and even knee issues. None will improve while you wrongly mistake these complications for sciatica.

Stress fractures:
Stress fractures can be debilitating and commonly impact sportspeople and those performing physical manual labour. But a funny thing happens to people who suffer from stress fractures – they then fall into the easy routine of blaming any other body issues on the stress fractures, even after it has healed. Meanwhile, they are missing other issues such as shoulder pain, knee problems or neck pain.
Believing that a healed injury is still troubling you is a common trap. It’s almost always something else, even if it appears to be mimicking that old familiar pain of a previous injury.

Five fitness secrets we all can learn from elite athletes

You don’t have to be an elite performer to benefit from Olympic training secrets.
Weekend cyclists, runners, triathletes and golfers can all improve performance and cut down on injury time by emulating some of the principles driving elite athletes.
Years of working with elite athlete have taught me there are five simple things athletes do which the rest of us don’t:

1. Not trying to ‘ride out’ injuries: Athletes are great at listening to their bodies and will seek an expert quickly if they have an injury. Sure, we all know inspirational stories where athletes pushed through incredible pain and adversity. When a medal or a ranking is on the line they can do amazing things. But they are way more in-tune with their limits and capabilities than we are. When something goes wrong they do not push their luck – they don’t try to ‘ride it out’. By contrast, weekend warriors in their thousands make small problems much worse by being macho or refusing to give in and betting that ‘riding it out’ is the only way.

2. Rehab exercises are also preventative: Athletes take rehab very seriously, but the rest of us tend to skimp on rehab exercises once the pain goes away. The secret athletes know is that rehab exercises are also preventative exercises. Even if your body is feeling better you may continue to enjoy significant benefit from those rehab exercises.

3. Recovery is essential: We may think of recovery as a beer and a sit down, but even a short recovery routine can help. You may not need the ice baths favoured by elite athletes, but anyone can benefit from using the correct warm-down recovery routine after training and playing.

4. Change a treatment if it’s not working: Too many people continue getting the same treatment when there is no change. Elite athletes expect results quickly, and so should we. You should see a change in three sessions or less. That’s how quickly athletes expect a response and it is a good rule of thumb for anyone. Seek a second opinion if there is no positive change after three sessions.

5. Sleep: Just ensuring regular sleep may make a big difference. Elite athletes are serious about sleep because it’s so important both for mental and physical recovery. You won’t find them rushing to join the ‘sleepless elite’; the famous world leaders and captains of industry who supposedly only need a few hours. An improvement in sleep often has tangible benefits in performance, but again it’s important to have an awareness of your body.

Have you returned to work with ‘holiday back’?

Many people come back from holiday feeling worse than when they left, because they have developed back pain.
The biggest culprits are sleeping in different beds and over-exercising.
Sleeping in a bad bed can cause issues such as low back pain, upper spinal discomfort, neck strains and even headaches. A different pillow can also cause these problems.
Running on the beach is the other big issue. Even regular runners develop problems due to poor footwear support and running too far.
If you have holiday back pain, try the following (if the pain is debilitating or not improving then it’s best to seek out physio treatment):

So how can you lessen your chances of picking up a ‘holiday back’ in the first place?

1. Mobility: Back pain can make you feel seized up and stop you moving. But mobility is the single most important thing for beating back pain.
Be careful not to sit down for too long at a time. Get up at least once an hour. Ensure you do some walking on holiday and generally maintain a good degree of mobility.
2. The 20% rule: Holidays allow more exercise time, tempting us to over-do it and leading to injury. But it’s best to restrict that exercise to only 20 per cent extra on what your body is used to.
It’s ok to do extra exercise, but the body responds to gradual change, such as the 20 per cent rule.
3. Realistic New Year’s resolutions: People often set the bar too high on New Year’s resolutions, which means the resolution either ends up abandoned or causing injury. Fitness resolutions should be realistic, such as considering a three minute high intensity training regime. Anyone can do these exercises at their own level and it will make a positive difference.
4. Keep the beach running casual: Beach running can be one of the joys of summer, but needs to be moderate. Running bare feet on sand is hard on the body, and we see ailments caused by beach running every year. Take it easy and save your serious running for good running tracks and proper footwear.
5. Get a second opinion if treatment isn’t working: The last thing we need is holiday injuries to trouble us into March and April. If a back problem isn’t showing improvement within three physio treatments it’s time for a second opinion.

Kusal Goonewardena
Elite Athlete Sports Physiotherapist
Melbourne University Olympic and Winter Olympic Team

The 3:21 Workout

The 3:21 Workout Three minutes a day, for 21 days. This is the routine that was created for those who are super busy.

You may not have enough time to commit to exercise.
You may not have the correct equipment.
You may not know where to start.
This routine is simple, to the point and you do not need any equipment. You can do it at home, or you can do in a hotel room, or you can do it where ever you please.

How can it benefit you?
It will help improve arm strength, it will help you improve leg strength, it will help condition your body to anticipate more exercise (so the body isn’t shocked if you start doing other forms of high intensity exercise over long periods of time), core control, fitness and help your cardio vascular health.

What do you have to do?
You will do six exercises for 30 seconds each. You will push yourself to 85% with each exercise. You will NOT push into pain during the 3:21 Workout. And if an exercise is not tolerable you will not persevere through it… You will change it slightly so you can tolerate it and still continue at 85%. Three minutes a day for 21 days straight.

Why 21 Days?
For best results we recommend you do this routine for 21 days straight. The old adage is true – it takes 21 days to break a habit…We are instilling a nice habit to help you body be healthier.

So what are the 6 six exercises?

Sit ups | Push ups | Squat jumps | Star jumps | High knee running on the spot | Shadow boxing

You can change the order of the routine depending on what you want to address:

Upper body strength
Shadow boxing
Push ups
Star jumps
Sit ups
Squat jumps
High knee running on the spot

Lower body strength
Squat jumps
High knee running on the spot
Star jumps
Shadow boxing
Push ups
Sit ups

Good luck & keep healthy!

Kusal Goonewardena
Elite Athlete Sports Physiotherapist
Melbourne University Olympic and Winter Olympic Team