I was working with a client this week who had hurt her lower back. As is usually the case, she could not remember exactly how she did it, though it was likely she did it lifting her young son. (Those of you who are parents know exactly what she is going through- raising young children can be surprisingly tough on the body). During the course of the session, she asked if the problem was going to go away.
“Of course”, I responded. “This is a simple strain. You have some joints that are not moving properly, some muscle guarding, a bit of trunk weakness, and a bit of hip stiffness that likely predisposed you to the strain in the first place. You’ll be up and running in 2 weeks or so. “
“No”, she asked, “I mean will this ever be GONE?” She was asking if her back was ever going to get to the point where she never had to think about it. She had had back trouble before that went away, but it usually came back. “Can anything CURE this?”
I paused for a moment before answering. I was certain that she would be markedly better in 2 weeks, and virtually asymptomatic in less than 4 weeks. She would not be experiencing any physical limitations. If she had the world’s most involved medical workup in 6 weeks, there would be no evidence that she was ever in the clinic. (Except for the copious notes PT sessions generate…) But I was equally certain that there was no way she would ever be “cured”.
“Well”, I answered, “it depends on what you mean by cure. This condition is a bit like having a heart attack. (OK, a bit of a stretch here given the relative severity of each condition, but bear with me.) If you have a heart attack and survive, it’s possible to regain all of your heart function, unclog your arteries, change your diet, lose 40 pounds, stop smoking, and live for another 40 years, never having heart trouble again. But you are going to have to work at it. If, instead, you continue to smoke, eat crap, and gain weight, you are certain to have another heart attack. You can manage heart disease, but not cure it.”
The same is true for a back strain. With proper care, you can live the rest of your life without having any substantial back problems ever again. But, if you put your back in the same environment that got you hurt in the first place, (bad sitting posture, poor trunk muscle tone, tight hip muscles, sitting way to long and exercising way too little), your symptoms will come back within 12 weeks. I’ll bet my house on it.
My client was a bit disappointed, until I reminded her that her treatment program would probably take her 15 minutes a day, 5 days a week. Not technically “cured”, but still pretty darn good.
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