It has been over a week since our towns of western Nevada County experienced snowmageddon. Residents are STILL without power, propane tanks empty, and generators running out of gas. This storm has created the most significant amount of grief, anguish, fear, and some well-needed cheer of a winter wonderland, “sort of,” on Christmas or boxing day. What is boxing day anyways? Please don’t answer, I know.
Mother Nature did not disappoint. Over the Christmas weekend, there were over 20 inches of snow in Grass Valley, 20-25 inches of snow in Nevada City, and over 36 inches of snow in Truckee. The December storms have given us more than ten feet of snow. Penn Valley, well, you guys got some rain and won’t have to read the rest of this article because you didn’t shovel any snow, and I am sure your back is feeling fine. LUCKY (as said in my best Napoleon Dynamite accent). With all that snow, eventually comes snow removal. Since most of us don’t own a snowplow or even a teenager that needs extra cash, we are the snow removal team. With our warm clothes and boots on, we grabbed that snow shovel, our version of the snowplow, and ventured out onto the carport and entryway to clear the path. You did well, you removed, you cleaned, you conquered, and now, a week later, you still have that nagging backache. At about one to two weeks out, you think, Oh My God, my back is still quite painful. Many questions arise, like:
• Could it be just a muscle strain, or is something wrong?
• Did I herniate a disc?
• Did I tear a muscle or ligament?
• How do I know what I did without seeing a professional?
Facts about Back Pain and the Research
According to the American Association of Neurological Surgeons, 75 – 85 percent of Americans experience back pain at some point in their lives. We also know that more than 85 percent of patients that experience back pain will become pain-free within 6-8 weeks. So, if we experience back pain often and it resolves quickly for most of us, how can you tell if you are on the healing trajectory or the path that will need conservative treatment to get well?
What are the causes of back pain?
A muscle or soft tissue strain is a common cause of back pain and happens when you injure the muscle, tendons, or ligaments of the spine when overusing or misusing your back muscles. Maybe one hour of shoveling snow in one direction only without proper warm-up or training can be the cause of a muscle strain. Anyone can “pull” a muscle. Here are a few factors that can contribute to a strained /pulled muscle.
• Aging, lack of exercise, or not warming up before exercise. Did you do 5-10 minutes of warm-up before shoveling snow last week? Of course not. That’s why you still hurt today.
• Being overweight
• Frequently sitting for long periods.
• If you already have certain medical conditions such as a previously herniated disc, degenerative disc disease with complications, osteoporosis, and autoimmune and inflammatory diseases.
Back Pain Symptoms from a muscle strain
This recent injury will be familiar if you have been active most of your life and strained a muscle. However, when we strain a back muscle, we all tend to get worried about the signs and symptoms. If you “keep it simple” and think about treating your sprained back muscles the same as your calf or hamstring muscle, I am sure you will come out of this issue without a glitch. Most important concept of treating a back strain is to keep it moving as you would with that ankle sprain. Do not treat the back with bed rest. Peer-reviewed evidence demonstrates that immediate gentle motion progresses to more activity as pain eases.
Common symptoms of a back muscle strain include
• Pain worsens when you move, especially when bending forwards with or without load.
• Difficulty standing up straight
• Swelling with or without bruising in the sore muscle
• Pain that is sharp at times and aches most of the time
• Spams/cramps in the muscles
Now we need to talk about the more serious back injuries. If you experience any of the following signs and symptoms, you need to see your primary care provider (PCP) immediately.
• Fever, chills, or night sweats
• Unexplained weight loss
• New bowel or bladder problems
• Pain that spreads down the legs
• Pain that lasts more than a few weeks and is getting worse
• Severe pain that is not relieved by rest
• Weakness, numbness, or tingling in one or both legs
How to Prevent a Back Strain
Prevention is the key to most problems and is the same for straining a back muscle. So, in the future, since this is just two weeks into Winter, let’s say that you didn’t injure your back and are ready to prevent a muscle strain in the future. In order of importance, here is a list of things you need to do:
• Maintain a flexible spine so that any bending and twisting of the spine needed for shoveling is well within the available range of your spine. As Joseph Pilates stated back in the day, “If you are 30 and have a stiff spine, you are old. If you are 60 and have a flexible spine, you are young.” The back, hips, and knees need to have such excellent mobility that doing an essential chore like shoveling snow is not challenging any tissue adversely.
• Maintain a strong core (back and abdominal muscles) to provide your spine with the strength that it needs to do heavy work like shoveling in the next storm
• When bending and twisting to push/pull anything repeatedly you need to use your legs and back together. Old-school PT stated that you need to keep your back straight and only use your legs to pick up or push heavy objects. We now know from countless research that it is false. You need to use your back and the hips, knees, and ankles to push and pull heavy objects. The research has demonstrated that you need use everything to lift heavy objects with the most efficiency.
Now that it is genuinely Winter and the snow is still on the ground, trees are down and need to be chain sawed into rounds, and hopefully, more snow is on the way. Stay safe by getting in shape for shoveling. Stretch, strengthen, and keep moving even if you still hurt a bit.
John Seivert is a doctor of physical therapy and he has been practicing for 34 years. He opened Body Logic Physical Therapy in Grass Valley in 2001. He has been educating physical therapists since 1986. Contact him at [email protected] yahoo.com