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It's All Relative
People often ask me things like,
“What are the best exercises for back pain?
“Is this movement bad?”
“Should I just avoid doing that?”
And while the answers that I give vary depending on the individual, they all have the same core principle: It’s all relative.*
What does that mean?
Relativity in general means that there is an absence of standards of absolute and universal application.
Put even more simply, relativity means that things must be considered in relation or proportion to something else.
Part of the difficulty in providing the answers people want and expect (answers shorter than blog-post-length) is simply that each person is unique.
And because each person is unique…
The most helpful things for one person to do for their back pain may be entirely different from that of another person who is experiencing back pain
A movement that may make one person’s symptoms worse may be the very thing that should be repeated to help another person move forward
The requirements to do a certain activity may be reasonable for one person, but unattainable or undesirable for another
So to answer these common questions about the relative safety and helpfulness of exercises, movements, or activities truthfully, we must consider them in relation or proportion to something else.
But what is this “something else” that I speak of?
To determine the best exercises for you to do, the movements that are good or bad for you, and what you should avoid or repeat, we must consider at least 3 things:
Where you are now
Where you want to go
What’s holding you back
1. Where you are now
Where you are now from a movement or activity standpoint has to do with your body’s stress tolerance.
Stress tolerance means how much stress your body can handle before triggering pain or other symptoms. This is relevant to movement because every movement places certain stressors on our bodies.
When the stress tolerance of our bodies is on the lower end of the spectrum, it’s easy to make things worse, so movements that make things worse should generally be (temporarily) avoided, and we should be paying close attention to the effects of movement on the symptoms.
On the other hand, when our bodies’ stress tolerance is on the higher end of the spectrum, it’s much more difficult to make things worse, so we can (and perhaps should, depending on where we want to go) push things harder.
This has everything to do with the stages of Simple Pain Management outlined in my article on The Pain Spectrum.
Identifying where you are now with regard to stress tolerance and stage will give you insight into how much you should do. How much movement or activity, how vigorously or intensely you should be doing it, and what to look for to make sure it’s not too much (or too little).
Next, we will discuss what we should (or should not) be doing.
2. Where you want to go
Determining the best exercises for you, the movements that are good or bad for you, and what you should avoid or repeat also has to do with what you want to be able to do in the future—ie, where you want to go.
Do you want to be able to walk? Run? Swim? Pick up your kid or grandkid? Toss them in the air 4 feet above you and catch them? All of these are great goals but will lead you in different directions when it comes to training your body to perform these activities.
This is because different activities come with different types of stress. The stresses on our bodies from running, swimming, and lifting are all different. So the right type of stress to move toward these distinct goals should be different, too.
In the earlier stages, when our bodies’ stress tolerance is lower, the focus is simply on doing things that help and avoiding things that make it worse. This often involves very simple movements and activities in supportive positions like lying down, hands and knees, or sitting.
As the stress tolerance increases, though, and you move on to the rebuilding stage, the focus shifts to building back up to your desired movements and activities. So if walking is your main goal, gradually building back up your walking distance/duration is the best thing for you to do. If picking up your kid or grandkid is your goal, gradually increasing your body’s tolerance to bending and lifting is the best thing for you to do.
This all must be done with the awareness of how your body is responding to what you’re doing. Each of the stages build on one another and should be incorporated into the next phase.
We’ve talked about how much to do and what to do. Next, we will talk about the why.
3. What’s holding you back
What’s holding you back has a lot to do with the big question of why?
Why are you having pain in the first place? This can be a complex question, as pain is a protective experience that arises from multiple causes and conditions.
Sometimes it’s simple: We trip, twist our ankle, and it hurts. Other times it’s not so simple: a pain that showed up one day for no apparent reason, or a pain that came on gradually and didn’t go away or got progressively worse.
A related (and more answerable) question is:
What factors appear to be causing or contributing to your problem?
The more that we discover and learn about these related factors, the more clear the answers become.
For example,
Maybe you notice a pattern in which the pain is worse on the days following a poor night’s sleep
Maybe you notice that when you move a certain way the pain is worse, and when you move another way it’s better
Maybe you notice that the pain gets worse after you eat certain foods
Maybe you notice that a certain part of your body feels particularly stiff or weak
Maybe you notice that the pain gets worse when stress levels are high
Each factor that you notice gives you some insight into what you can do to change it. It gives you a jumping-off point to learn more and begin experimenting so that you can influence it.
For example:
If you notice a pattern in which the pain is worse on the days following a poor night’s sleep, you can investigate your sleep habits and experiment with altering them.
If you notice that when you move a certain way the pain is worse, and when you move another way it is better, you can dig deeper into your movement habits and experiment with other movement options.
If you notice that the pain gets worse after you eat certain foods, you can experiment with cutting these foods out and noticing the effects.
If you notice that a certain part of your body feels particularly stiff or weak, you can get more specific with exactly what area feels stiff or weak, and experiment with moving it in the way(s) it feels stiff or weak.
If you notice that the pain gets worse when stress levels are high, you can get specific about areas in your life that are causing stress, and experiment with giving yourself what you need.
When we clear away what’s holding us back, changes abound, and we effortlessly move toward that which we desire.
Back to the questions
So what are the best exercises for back pain?
The best exercises for back pain are ones that:
Match your current level of stress tolerance
Have some specificity to—or possess some components of—your goal(s)
Help to clear away the factor(s) holding you back
Are certain movements bad?
The only bad movements are the ones that:
Far exceed your current level of stress tolerance
Have no specificity to your goal(s), and are things that you don’t enjoy doing at all (though these would be more irrelevant than bad)
Exacerbate any factors holding you back
For more on this, check out the movement resource.
Are there certain things that should be avoided?
Certainly. If your goal movement or activity far exceeds your current level of stress tolerance, it should be temporarily avoided until your stress tolerance improves sufficiently, or it should be reduced in intensity or complexity until it falls within your current zone of tolerance (i.e. The Goldilocks Zone).
It’s all relative
As much as we may want there to be, there are simply no absolutes when it comes to movement, pain, and the body.
This is only true because of the highly adaptable nature of our bodies. Without this adaptability, things wouldn’t be able to change, we wouldn’t heal, and life would be much more bleak and boring.
Fortunately for us, our bodies are in a constant state of change, adapting to the present circumstances with incredible flexibility and wisdom. And because of this…
It’s all relative, baby.
Good luck out there,
Andrew
Footnotes
*This whole principle of relativity is only true because of the fact that stress (of any kind) is not a categorically good or bad thing; it entirely depends on the type and amount of stress. Simply put, the right stress provided at the right time produces positive change. For more on this, check out Stress is the Medicine.
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