Tips (and products) to avoid dreaded lower back injuries

Warning: this article was written from bed. Don’t try it at home.

There is a certain chapter Malcolm in the middle, the iconic turn-of-the-millennium television series, in which Louis, the controlling and angry mother, watches Reese, her rowdy son, enter the house on roller skates and soil the carpet with a suspicious, smelly brown substance. “What did you step on?! “, she asks in shock, on the verge of a crisis. Reese, completely ignoring her, sits down in an armchair and takes the end of the coffee table to clean the debris stuck between the wheels.

The scene ends just before Louis expels all the air he has been carrying in his lungs. Immediately afterwards, the mother appears in bed, complaining of pain. Hal, the distracted and awkward father, laughs heartily as he sets up a communicator on the bedside table. “You have to admit it’s still funny yelling so hard that you hurt your back.” If looks could kill, Hal would have been shot on the spot.

Although there are no statistics on the number of people who have injured their backs by shouting too loudly, it is likely that many fathers and mothers have suffered similar episodes. Especially in the last two years, amid the tension of confinement and telecommuting.

Traumatologists, kinesiologists and other specialists assure that consultations for lumbar discomfort have so far increased during the pandemic. One of the causes, they say, has to do with psychological and emotional discomfort. “Generalized stress, uncertainty and anxiety undoubtedly have an impact on certain pains, allowing the appearance and exacerbation of its symptoms”, explains Rodolfo Hidalgo, kinesiologist and master in health and sports sciences. .

It’s not that low back pain is something new to the world population. Some studies indicate that about 80% of people in western countries suffer from a lower spine injury throughout their lives. The World Health Organization (WHO) ensures that it is the first cause of sick leave and the second reason for medical consultation after the common cold.

“Its societal impact in terms of direct healthcare costs and indirect costs (i.e. work absenteeism or lost productivity) is enormous,” indicates the site of the international organization in this regard .

With the pandemic, yes, no new injuries have appeared: “they are basically the same”, specifies Hidalgo. The main one is lumbago, which, as Sebastián López, traumatologist at Clínica Bupa Santiago and Bupa Sport explains, “is a pain located between the ribs and the buttocks, on the back, which does not radiate to a distance”. And this, in general, “is produced by flexing the spine.”

What happened, says Hidalgo, is that new cases of cervical and lumbo-pelvic pathologies increased, as well as the “acute events” of patients who already suffered from this type of pathology.

What are the reasons for these ailments? The psychological factor has already been mentioned, which would have a particular impact on the permanence and the chronification of the lesions. Another is the sedentary lifestyle that much of Chile’s population fell into once the pandemic hit. “Many stopped doing their usual physical activity, like weekend soccer or another sport, or they weren’t going to the gym anymore,” says López.

In fact, Chile leads the ranking of countries that have dropped their sporting activity the most during the pandemic, according to IPSOS . A survey that the international consultancy published in January 2021 indicates that 33% of those surveyed said they had decreased exercise since March 2020, ten points above the global average.

What we made work hard was the jaw: the same study indicates that 51% of Chileans gained weight, exceeding the world average by 20 points. After Brazil, we are the second country that recognizes having gained the most kilos.

Hidalgo asserts that the lack of caloric intake control “has further aggravated the prevalence of overweight and obesity, which are relevant factors in the onset of lumbar pathologies, as they increase the load on the spine”. The last National Health Survey, published three years before the pandemic, already established that 31% of people over the age of 15 are obese and 40% are overweight.

A sedentary lifestyle, explains Sebastián López, leads to a decrease in muscle mass, “and once normal activities resume, overwork is generated that turns into mechanical lumbago”.

A third cause behind lower back injuries appears from telecommuting and telematics study. The modality -highly desired by some, less by others- forced a large part of the population to improvise their work, using the dining room table as a desk or even their thighs if “the chair” consisted of an armchair or, even worse—and as it was in this case—the bed.

Dining chairs don’t help much either. In fact, sitting doesn’t help at all. Fitness expert and model Roger Frampton put it plainly and simply in a popular TED talk: “sitting destroys you.” In his presentation, he demonstrates that even when keeping our backs straight and supported by the backrest, the posture we use to sit distorts our spines, turning them from a natural “J” shape to an “S” shape. “.

If you don’t believe Frampton much, you could take the words of the medical director of the Center for Spine Care at Baptist Center for Health Neurosciences (of the United States), Ronald Tolchin.

“My patients sit for long periods of time, and we know that sitting for more than five hours a day really increases the risk of low back pain,” he says on the institution’s website. The specialist also argues that sitting too long increases the risk of developing obesity, diabetes and heart disease. “People now spend more time sitting down and they don’t get up like they would at work, moving around the office. So they sit for even more hours.

It is advisable to have an ergonomic chair, that is, a chair that bases its design on the interaction it has with the human body, in addition to the movements that the person performs while seated.

On the other hand, Rodolfo Hidalgo suggests contacting a risk prevention specialist to carry out “a complete analysis of the jobs” that take place in the home. This, says the kinesiologist, “would help a lot in detecting risk factors and preventing lower back injuries”.

In any case, bad habits and postures do not only apply when sitting. Postural vices occur during static positions and increase during movement, Hidalgo points out. And among the statics, there are the postures we adopt to sleep. The facing down position generally generates “a greater load on the lower back, unlike the fetal position, for example”. The improper use of pillows and cushions at the cervical level, and the fact that they are made of unsuitable materials, also does not help to have a healthy and undamaged spine.

In this sense, the sports specialist recommends buying memory pillows and mattresses, which are made with polyurethane foam, called visco or memory foam, whose properties allow it to return to its original shape after use. In this way, whoever uses it will feel the comfort of the mattress and/or pillow as if sleeping together for the first time every night. Grr.

Do you remember the first pichanguita you played after the long period of confinement? How nice it was to get back on the courts, catch up with friends, hit the ball and feel the endorphins running through your veins! It wasn’t so nice the next day, when the whole body recognized the downtime: all the muscles tensed by lactic acid, the legs on the verge of cramps and what about the back pain… that the pain in the lower area is a small announcement that age no longer accompanies sport without proper preparation.

Yes: age is a relevant factor in injuries of all kinds, including low back, since the quality of our tissues decreases over time. “In particular, the intervertebral discs lose water and other components, which alters their structure and indirectly their function in the spine, which is mainly to cushion and distribute loads”, explains Rodolfo Hidalgo.

This leads to an increase in the weight that other bone and joint structures have to bear, which, in turn, have also lost quality. Incidentally, we ask more of the muscles, which no longer have the same capacity as before.

Juan José Zamorano, a traumatologist at Clínica Alemana Sport, comments that many of his patients arrived shortly after the mobility restrictions established due to the pandemic were relaxed. “They have resumed physical activity, in some cases without adequate preparation, so the pain trigger has changed, and low back pain consultations are now more frequent in relation to specific physical exertion or activity.”

A key advice is given by Sebastián López: when low back pain radiates to other areas, especially to the lower limbs, and is associated with weight loss, fever or lasts longer than six weeks, a specialist should be consulted . These symptoms are the “red flags” of low back pain.

Failure to treat these injuries in time can lead to a series of risks, such as the evolution towards more complex states, compromising the functionality of the body and thus limiting the activities that can be carried out. In this way, you can join the restricted group of 4% of patients suffering from lumbar diseases who must undergo surgical treatments, as mentioned by the WHO.

“Prevention is better than cure,” sang Topo Gigio. Guillermo Hidalgo does not sing but he assures that a healthy life, maintaining the weight that corresponds, with good postural hygiene and “good management” of stress, is going on the right track. For physical activity, she recommends undergoing a kinesthetic assessment, “addressed beforehand by a medical specialist”, from which an exercise prescription can be obtained.

Juan José Zamorano offers exercises to strengthen the trunk, abdominal and lumbar muscles. The plates, specifies the traumatologist, are the most supported by science, since they allow “to activate the entire abdominal belt, without bending or lengthening the trunk, thus avoiding overloads in the various components of the spine”.

The important thing, adds Sebastián López, is that the return to physical activity is gradual and progressive. It is also advised not to follow social media trainers as they are unaware of your specific needs. You were warned. You’re not going to end up like Louis.

*Prices for products in this item are updated as of April 22, 2022. Values ​​and availability may change.