I recently met “Maureen,” who has been coping with low back pain and tingling in her calf for over a year.
After a good physical therapy program, her pain had lessened. But, when she went back to the boot camp-style workouts that she enjoyed so much, the pain returned. Being a female warrior at heart, she decided not to go through physical therapy again.
Instead, she opted to just “gut it out” and rejoined her boot-camp class with a few modified exercises. Without fail, about halfway through her workout, she felt that familiar nagging pain in her back and tingle in her calf which would eventually degrade to outright numbness.
After another excruciating 2 months went by, she noticed the numbness was coming on sooner and lasting longer. To make matters worse, now her left hip was starting to hurt. But that’s all part of getting older, right? Shouldn’t she just keep “gutting it out”?
Working out through worsening pain—especially “nervy” pain that includes numbness or tingling is a mistake.
As I told Maureen, I have heard stories like hers before, and several of them ended with an emergency back surgery due to a ruptured disc. Pain is an important signal that something is wrong, and until your medical provider as has ruled out a structural problem like disc injury, it’s wise to put your workouts on hold.
Sometimes, symptoms like Maureen’s are actually coming from poor mechanics or a soft tissue injury. If that is the case, medical exercise may be useful in reducing the pain and improving the movements that provoke the symptoms.
We can only know for sure if she goes to her doctor for a full work-up, which may include imaging like X-rays or MRI. As I wrote in my article Hope for Low Back Pain, MRI is a great way to rule-out structural causes of pain such as disc injury or spinal stenosis, but it can otherwise be a poor tool for definitive diagnosis.
In the event that Maureen’s pain is not coming from a disc injury or any other structural cause, the fact remains that vigorous workouts, like those in a boot camp setting, will likely continue to provoke her pain and her situation will get worse, not better.
“But I don’t want to stop! How am I supposed to stay in shape?” Maureen asked.
This is the hard truth: attempting to push through fitness activities when your body is in pain is a mistake.
The result is not fitness, but more pain, and likely—more injury. If Maureen didn’t have a structural problem now, she would drive herself right into one if she continued.
The reason is in the absence of a structural cause, her symptoms must be coming from a mechanical one. Meaning, something in her movement is off. It’s inefficient, and may be causing additional compression, friction, or shear in her back. Over time, it will cause an injury.
The good news was after a thorough assessment, we determined that the use of medical exercise could reactivate Maureen’s deep stabilizing system, effectively re-teaching her body to move in a pain-free way. The toughest part for Maureen however, was letting go of the “gladiator” mindset. Meaning, exercise is an all-out effort with heart-pounding reps which ends with her in a collapsed pile of utter exhaustion. Instead, medical exercise requires the complete opposite mindset—less is more. It involves extreme mental focus and very subtle movement patterns which are employed to improve her body’s natural ability to stabilize her spine.
“Will I ever be able to go back to my boot camps?” she asked.
“Of course,” I told her. “Over time, which could be weeks or maybe months, we can chart your improvement and progress you back to pain-free, healthy movement. From there, we can add some boot-camp exercises back in to be sure you’re ready. You may need to keep a few of our exercises in your daily routine to maintain your body, but you will go back!”
Pain is complicated, sometimes it’s hard to know how to interpret it. “No pain, no gain” is an antiquated motto, and has gotten many a warrior in trouble. It’s always better to check with your doctor about your pain. Although she may not be able to give you a definitive diagnosis, she can at least rule out anything structural. (Which may require more medical intervention.) Once a structural problem is ruled out, exercise could be the best intervention, but only if it’s the right kind of exercise that addresses the root cause of the pain and helps you correct it.
If you are struggling with pain and your doctor has discovered it’s not structural, contact us or give us a call. We can schedule a 30-minute complimentary screening to determine if medical exercise is right for you. We’ll have you suiting back up in no time!