PainĀ FAQ
This video is my best advice on navigating pain with exercise. The topics below it contain my answers to more specific pain questions.
I feel pain/discomfort during the movement...
STEP 1. Listen to Your Body. This is a major theme of the program.
When doing any exercise, you are engaged in a 'constant dance' of listening to your body and adapting the intensity and amplitude of your movement to its communication. Since everyone's situation is unique, you are the only person qualified to do this for your body.
Pain is communication.
There are many types of pain/communication, and you are the ONLY ONE who can feel and interpret it. Not even the best doctor in the world can do it for you. Developing your skill of interpreting the type of pain/communication and responding appropriately is the MOST VALUABLE skill for getting out of pain.
Not all pain is bad. Think about getting out of the car after a long road trip... Those initial movements can be painful, but they're actually good for you. It's your job to determine if it's "good pain" (eg. stiffness from lack of movement) or "bad pain" (eg. intense, sharp, electrical). Your intuition is the greatest tool for this.
(Note: Your body communicates good feelings (relief), just like it communicates bad feelings (pain). These good feelings are equally as important, and should be interpreted as communication that what you're doing is working. Respond appropriately by doing MORE of what's working!)
STEP 2. Ask yourself: "What type of pain?"
1. Good pain. If it's dull, achy soreness/stiffness in your back muscles or tenderness on your rib cage, that's generally okay.
It may have been awhile since your muscles and joints moved this way, or even laid on a firm surface like the floor. Your body may need time to adapt to the firm surface or new movement, and tolerance will go up with practice. The soreness usually goes away after a couple sessions.
2. Bad pain. If it's sharp or intense, there are a few possibilities and I recommend reading further into the FAQs. With any bad pain, my recommendation is to back off to where it is comfortable and DO NOT push through it. Turn down the intensity and practice right below your pain threshold, where it's comfortable.
^^^^^^ This is an example of listening to your body - a guiding principle throughout this program. Only continue progressing through the movement if your body is communicating that it's ready.
(Note: Bad pain can become good pain, and vice versa, depending on how appropriately you are responding to your body's communication. That's why listening and adapting is a 'constant dance'.)
My BEST recommendation for pain...
Regardless of the type of pain, my recommendation is the same:
Until your body gets more comfortable with this activity, practice at a lower intensity.
Too much intensity is the most common reason for pain. Not only that, it bypasses the deep stability muscles (that we're trying to target) and engages the superficial power muscles (counterproductive to our goal) - reinforcing the root cause of the problem.
Because of the above, you get the MOST benefits at a low intensity in Modules 1 and 2.
I know you're excited to feel benefits and high intensity effort is a reflection of that, but this program is a long-term strategy to back pain. Turn it down. You must develop awareness of these muscles BEFORE you can build their strength. Trust in this process, and you'll have a lifetime to experience the benefits.
Pain with the Back Anchor Awareness/Progression...
The most important thing to keep in mind is that the Back Anchor position is safe and will not cause damage. Breathing and gently connecting your rib cage to the floor is a natural part of human development. With the floor supporting your spine underneath, it provides a barrier protecting you from unsafe positions.
If it's not just stiffness or tenderness from pressing into the firm floor, then your lower back may be communicating that it doesn't like the way you are performing this progression.
I see 3 possibilities for the cause:
1. Recent activity. The factors contributing to your lower back pain may involve excessive rounding of the lumbar spine. This could be from exercises, sitting posture, lifestyle or any other activities you've done recently. If they've involved repetitive forward bending, rounding, or posterior pelvic tilt, this exercise may aggravate you.
On its own, this exercise does not take the spine into a range of motion that would cause irritation. So it's a message to change something about your lifestyle (how you sit, maybe?). If you don't think it's your lifestyle or posture, then this factor is not relevant to you.
2. Your form. You may be flattening your lower back, posterior pelvic tilting, or pressing your lower back into the floor. Try switching your intention away from your lower back, and focus exclusively on pushing away from the Back Anchor. This area has much more bony support, making it more resilient as a support zone, and the lower back doesn't necessarily need to flatten into the floor to accomplish this. When combined with #3, this may be the solution for you whether or not #1 is the case.
3. Too much intensity. This is the most common reason for pain. Try turning down your intensity extremely low (between 1 - 10%). You'll still get the same benefits of core connection, without the downside. This is where breakthroughs regularly happen.
(Note: If your form and intensity are correct, and the Back Anchor exercises still don't feel GOOD, then this may be a sign of #1. In this case, the Front Anchors are probably the key to restoring your core balance. They are the opposite of the Back Anchor, and often provide students with significant relief.)
Live Stream Q&A's:
Q: When I go all the way down, it strains my back. Is it okay if I only go 20% of the way down?
A: https://www.youtube.com/watch?v=TO6nkewJRu0&t=5474s
Q: Is it normal to feel tired holding this position?
A: https://www.youtube.com/watch?v=TO6nkewJRu0&t=2489s
Q: As I started to lower my ribcage, a “problem spot” in my right mid-lower back flared up for a moment and then went away.
A: https://www.youtube.com/watch?v=hzDBWNWKAxQ&t=2779s
Q: Is it common to have soreness in the back after doing this? A few hours later now my back actually feels better than it did before the exercise.
A: https://www.youtube.com/watch?v=2CsBM5vsOSs&t=2788s
Q: Initially I had cramping in my hamstrings! Have to extend legs for a bit then resume posture. What's happening with the cramping?
What to do if you experience sharp or intense nerve/electrical pain...
Sharp or intense nerve pain is likely the exacerbation of an existing disc/nerve irritation, which can cause anything from tingling to shooting, or even burning. Maybe your disc is currently in a position where performing this movement presses on a nerve. This can change over time.
While movements in this program are very safe, your body is communicating that it doesn't like this right now... and that's okay. Most likely, you need to slow it down, lower your intensity, and treat this more like meditation than exercise.
My best advice is to back off to the point where the symptom doesn't occur. (applies to any exercise)
If you are in the middle of a flare up, you might need to give your body a day or two for things to calm down before trying again. In the meantime, focus on your breathing, do the things you can tolerate, and reflect on these questions:
"What can I learn from this experience that I can apply next time?"
"How intense was my effort when I exacerbated the pain?"
"What was the distance/amplitude of my movement?"
Your answers will give you a guideline for your current threshold of tolerance. You can progress your threshold of tolerance by working right below it. This is how to sharpen the skill of listening to your body.
Your goal is to build up your tolerance for more movement (gradually, over time), and you can do this by working right up to your edge (just before the pain occurs). Doing this (consistently, over time) pushes that edge out further, into more tolerance of that movement. This is a long term strategy that requires listening to your body, and going at your own pace through any new movement (throughout the program).
In conclusion, if you can't tolerate an exercise right now, it only means your body is not ready at the moment. Try again when you're ready, with more information from your reflection. Turn down the intensity to tolerable levels, and build up your tolerance over time.
Soreness across the sacrum/pelvis...
If you are having pain across the sacrum, there is a decent chance of SI joint involvement. This is not muscular pain but commonly ligament/joint pain from hyper-mobility, and it's very interconnected with lower back pain. You can stabilize this with the surrounding muscles over time (eg. glutes). The program will address this directly so I believe you're in the right place. Continue listening to your body, follow "My BEST recommendation for pain" and stay consistent with the daily routine. With this strategy, you'll make consistent, gradual progress, which is exactly what you want with SI joint pain. It's the most sustainable kind of progress.
I'm sore AFTER doing this... Have I overdone it?
(Note: I'm sharing this early on, in hopes that it prevents you from overdoing it.)
Possibly. Normally, I would expect you to feel better after doing any of the exercises in this program. However, this is not always the case.
There is a type of muscle soreness called DOMS (delayed onset muscle soreness) that occurs normally after a good workout and subsides over the next couple days. This is okay.
If your soreness is not DOMS, but is instead an exacerbation of something else (specific to your lower back, non-muscular or severe pain) then you should listen to this and adjust your approach.
The exercises in this program are inherently safe, but there are variables in your approach that can lead them to cause aggravation. These include your intensity, the frequency at which you perform them, and your method or technique. All of these should be reflected on, and considered to be adjusted.
As the Back Anchor progresses into performing the bridge, this comes with the responsibility to listen to your body. If you experience pain with the next step in any progression, the best thing you can do is back off. Your body's communication should be your #1 guide throughout this whole process.
Once you are confident with the movement, that's your cue to move forward.
If you performed an exercise that has caused you discomfort, it is not recommended that you continue performing it the same way. You must change something about your intensity, frequency, or even method. Your body is the guide and when it is sending you negative signals, they are not to be "pushed through". If you have gotten to the point where you are too sore to get off the couch, this is likely your body sending you an even stronger message.
When we push through pain we risk experiencing a setback, which is our body forcing us to stop.
The good thing is that setbacks are learning opportunities, and the most important thing about them is how you respond. With any setback, the best thing you can do is take some time to let your body recover and reflect on what led to this response. When you're ready, it's always best to go back to the basics (Back Anchor Awareness), applying what you learned from the setback.
"It doesn't matter how many times you fall - it matters how many times you get back up." - Lilly Singh
Wherever you're at in your back pain journey, the goal is to make slow, gradual progress over time. Even 1% improvements are significant over a long enough time span.
The way to progress towards your goal is to challenge your current tolerance/ability. If you can learn to enjoy this process, you will have already met your goal.
Stay connected,
Dr. Ryan Peebles, DPT