Oh, my aching back! Ways to beat back pain
Like Chip Schwartz in the accompanying article, aging athletes often give up the rigors of softball and basketball, turning to less punishing activities like, swimming, walking or golf. But as the Baby Boomers hit the links more than 75 percent will experience at least one injury, most often to the back.
Back
Oh, the pain in the back! You wake stiff as a board, slide off the bed and shuffle across the room wondering what happened to the Golden Years. Back pain is frustrating to fix and painful to endure. Even with a professional diagnosis, it's not always clear what's wrong and harder yet to find treatment that relieves the pain. What works for one back, may have little effect on another.
For golfers, or even gardeners who want to stay active, specialists in the community can provide a wealth of information. No one promises a life free of pain. But as you take responsibility to manage your own pain, you'll see a difference in how you feel. Don't forget to always consult your own physician before beginning any exercise, treatment or supplement program.
Physical therapy
"So often I see the 'grip it and rip it' philosophy," says Curt Brown, physical therapist and site coordinator for HealthSouth Rehabilitation Center of Brainerd. "Weekend warriors step off the street and tackle 18 holes of golf without any kind of a stabilization program." That, he says, is asking for back trouble.
After 17 years as a physical therapist, Brown has seen a lot of aching backs -- people with a vague, chronic pain in the small of the back or even a sharp, shooting pain down the side of the leg. "I hate to tell you this, but degeneration (to the body) begins at age 2," says Brown. By the time you're 30, for active types, discs can tear, the facet joint in the spine can begin to degenerate and inflammation and pain in the back is not far behind.
Specialists sometimes recommend giving up a favorite sport, and in some cases that may be the best advice. But Brown says that for many a back stabilization program and lessons from a pro on technique, can get you back on the golf course (or in the garden).
Brown's Back Basics
1. Key to stabilization for the lower back is keeping the spine in a neutral position.
Think of the spine as a tower made out of building blocks, says Brown. The tower is most stable when one block is directly on top of the other. If the blocks aren't aligned, they become unstable and vulnerable. The same is true for your back, says Brown, who teaches all his clients the back neutral position as the first rule of back health.
2. Muscle Strength and Flexibility.
Large red, yellow and blue balls decorate the therapy room at HealthSouth, like a kindergarten classroom. For the past eight years, Brown has taught clients exercises using these colorful gymnic balls to strengthen the lower, middle and upper back. There are a variety of programs out there, from the more sophisticated Pilates program to balls you can buy at Target. Muscle strength needs to be balanced by flexibility he says, recommending simple exercises that can be done in 10 minutes. "Showing up before tee time and taking a few swings is not warming up," says Brown.
This low back stretch, grasping both knees and slowly pulling them toward the chest, is a good warm up before golf or any exercise.
3. Swing technique
So how does the golfer learn to swing the club without injuring his back? Who doesn't want to be like Tiger? Be careful trying to swing like Tiger, warns Brown. Tiger uses "segmental rotation of the trunk at high velocity, which is very stressful to the lower back." Already Tiger's experienced some low back pain, which will no doubt intensify as he ages. Nor does Brown recommend the "reverse C." Some golfers, like Jack Nicklaus, made a career out of this swing, says Brown, but it's harmful to the back, and generates less power to the ball.
Brown advocates the athletic swing, "using the large trunk muscles to provide the needed power and speed while supporting the lumbar spine in a relatively neutral position." Talk to a golf pro, recommends Brown. He or she can teach the technique.
Brown's Back Tips
It's not always your swing. Some injuries occur before you even step on the golf course.
* Use a golf bag with a double back strap. Easier on your back than slinging a strap over your shoulder.
* Bend your knees, not at the waist when putting your golf bag into or out of the trunk. Use two hands and the bumper for more control.
* When putting the golf ball on the tee, either squat down, or bend down on one knee, and use the golf club for support. Never bend at the waist.
* Retrieve the ball from the cup using the motion above. Never bend at the waist.
Chiropractic and
medical care
John Redebaugh, doctor of chiropractic for Redebaugh Chiropractic PA, Nisswa, has been practicing sports medicine for 24 years, providing chiropractic care to many area college and high school student athletes. Approximately 10-20 percent of his clients are athletes in the senior age bracket.
"Typically, senior athletes get in trouble when they're sedentary during the long winter months, not keeping up with an exercise program," says Redebaugh. Muscle tone, circulation, all the systems lose their edge, without the benefit of so much as a daily walk.
When spring comes, the urge is to get out on the golf course without stretching or even swinging a club. This is particularly irritating to the lower back, says Redebaugh, with its "bending, lifting and twisting and often results in strained ligaments, tendons or joints."
Compound that pain with degenerative arthritis, or osteoarthritis, says Redebaugh. By the time we're seniors, all of us have it, he laughs, 'it's just a matter of how much wear and tear you've put your body through."
Osteoarthritis (OA) affects approximately 20.7 million Americans, most of them over the age of 45. Physicians or chiropractic doctors can diagnose OA through a physical history, X-ray, or CT scan. Medications recommended by the medical community to control pain include a variety of NSAIDS and sometimes cortisone injected into the joints. Surgery is often viewed as the choice of last resort.
For many, chiropractic care relieves back pain. When joints are out of alignment, there's more stress on the lower back and more pain, explains Redebaugh. When the spine is realigned through manipulation therapy that takes pressure off nerve endings and reduces pain.
Alternative Therapies
The growing popularity of the nutritional supplement, glucosamine sulfate/chondroitin has put the spotlight on alternative therapies. Some studies, not to mention word of mouth, tout the effectiveness of glucosamine sulfate/chondroitin as a pain reliever and anti-inflammatory, suggesting it may encourage the regeneration of joint cartilage. The medical community has been slower to embrace the supplement, waiting for studies to substantiate the claims.
Kandy Leige, for 17 years an owner of LifePreserver Natural Foods, Inc., now located in Baxter, has a B.S. degree in nutrition and thinks vitamins, minerals and supplements play a role in the relief of back pain. Sometimes, she says, as prevention, others time in conjunction with other therapies.
"Everyone's body chemistry is different," says Leige. He recommends trial and error to find what fits for you. "Give it time," she cautions when trying an herb, vitamin, or supplement. "We're so conditioned to want an instant fix that we don't wait long enough." As alternative therapies for back pain, Leige also recommends yoga, massage therapy and acupuncture.
Leige's List of pain relievers (Taken from "Doctor's Guide to Natural Medicine" by Paul Barney, M.D.)
Herbs: Ginger, tumeric, devil's claw, yucca, willow bark, rosemary, feverfew
Nutritional Supplements: Glucosamine Sulfate/Chondroitin
Minerals: calcium/magnesium, silicon, phosphorous, boron
Vitamins: D and K.
Dietary Guidelines
Eat a diet that emphasizes whole grains, fresh fruits and vegetables rather than animal protein. Include servings of collard greens, almonds, sunflower seeds, chick peas and endive. Drink 6-8 glasses of water a day.
Home Remedies
Ice or heat pack in short intervals. Some swear by one, some the other. Try both to find what works best or first the ice, followed by the heat
Pillows in the small of the back when you sit
Arch supports for your shoes (from the drug store) help keep the back aligned
Jacuzzi, Hot Tub or a soaking, hot tub
A firm mattress
Websites on osteoarthritis
The Arthritis Foundation puts out a glossy periodical, Arthritis, with current information on OA and treatments