One of us had a completely new insight after visiting a physiotherapist specialised in recovery. It turns out that it is possible to stand up without backpain.

She asked me:“Show me how you stand up from a sitting position”.
Oh My God, why had no one asked me that before? I did it all wrong

“Why had no therapist looked at that before? Why did I not think about that before? I did it all wrong. It is hard to explain how I used to stand up but I basically tried so hard not to burden my back while standing up, that I actually put all the load on it. And even worse, I had no idea on how to do it differently.”

The way to stand up from a chair properly

This is what we were taught, and is now second nature:

    1. Sit up straight, on the tip of the chair/couch/sofa
    2. Gently engage* your abs, and keep them engaged
    3. Use your leg muscles to lift your butt just above the chair
    4. Push from the heels of your feet to and rotate my pelvis forwards while standing up(think Austin Powers! We have found that in the early stages we had to overdo it to get it right, but we’ve been told it doesn’t look strange)

Once we got it (it took a day or so of practice), it was incredible how easy it was to stand up without backpain, or any strain on the back at all.

Comment from the therapist

Note that we’re talking about engaging the abs, and not “flexing” them. When we asked the physio to review the steps above, she had some very important observations about the act of “engaging abs”. If you’re considering trying this out and stand up without backpain, please do read her comments here.

“FLEX or BRACE are no no’s for this.  A big part of the problem with a large population of back pain patients is that they do exactly that.  Therefore their muscles become tired and aching and tight from being held in a rigid tight position for a prolonged period of time.  They then stiffen the joints of the vertebrae which feeds into the pain.  Then these two things combined prevent normal movement..thus leading to us observing abnormal movement. 

If you think you actually learnt to relax into your sitting bones, and GENTLY ENGAGE your deep layer of abdominal muscles to then support your spine as you stood up, bent forward etc.  

Use words such as ENGAGE or GENTLY DRAW IN your abs.  It would also be worth stating that there are three layers of abs – your six pack muscles on the outside will not help with stabilising or supporting your spine, but will only feed into that fixed rigid pattern of abnormal movement.  

Learning to understand pain and therefore feel empowered is very important.  Use language such as this when explaining the importance of learning to use your abs.  Its not simply about whether you engage a muscle or not, but the timing of when you switch that muscle on vs when its OK to let it relax, and the degree of intensity to which you switch that muscle on.  The core needs to be gentle, its not for power but to help control your spine.  This is VERY important to note.

More?

Interested to read more about the other parts of the complete strategy to lower backpain relief? Read about self medication and nerve blocks to kill lower backpain, and about a two minute exercise to increase your mobility .