Leslie Fishbein, a community leader and business owner here in Denver, died about a year ago due to complications from a cortizone injection  she received  from a physician to relieve chronic back pain.

Recently Rodger MacFarlane, ex-director of The Gill Foundation, took his life due in part to debilitating back pain and a heart condition which did not allow him to enjoy his life.

We’ve all read the statistics that 8 out of 10 Americans will suffer from back pain in their lifetime or that currently more than 65 million Americans suffer from back pain. But the tragic stories above emphasize that, unlike a broken arm that eventually mends, back pain affects more than the tissues it irritates. It casts a cloud over most of the activities that give us joy and therefore can lead to depression and hopelessness if it is not solved. No one is immune from the potentially devastating effects of chronic pain.

I feel for all people who suffer from chronic pain. Each person has a story—often a fine line between managing pain and life-changing suffering. My experience has taught me however, that most chronic pain need not be chronic. It can be cured by correcting the underlying factors causing it. Yes it can be a mystery but not an unsolvable one.

As a physical therapist and author of several books for self-treatment of chronic pain conditions, I’ve seen many people with chronic pain become significantly better if not completely pain free by addressing the anatomy, biomechanics, and daily habits that contribute to their pain.

Don’t give up on the idea that your body is not meant to be in chronic pain. There are answers and I hope you will discover that they are contained in you.

It’s a beautiful sunny morning and you’ve arrived a half hour early for your tee off. Great time to get in some putting practice before your game right? Well, maybe not. According to a recent study¹ 40 minutes of putting practice significantly affects swing kinematics in professional and elite golfers (those with a handicap of 0-8). The study reports that trunk extensor muscles fatigued, peak club head speeds decreased, swing duration increased and movement coordination was affected.

What’s more is that golfers with a higher body mass index (BMI) experienced fewer effects than those with a lower BMI (generally heavier people have higher BMI’s than thinner people). This resulted in more complaints of low back pain (LBP) in golfers with a low BMI. LBP is ubiquitous in golf however this need not be the case. Even changing how you practice can affect your pain.

Prolonged putting affects the trunk extensors which are active during the backswing and downswing (trunk extensor muscles are found on either side of the spine). Elite golfers rely on a stretch-shorten cycle of the extensor muscles to generate club head speed during these phases of swing. By assuming more of a flexed trunk position during putting, trunk extensor muscles are stretched which removes a key element of this cycle.

What to do? Based on this study, putting practice should be either shortened or more rest taken before tee off. Exercising the trunk extensor muscles and leg muscles to improve endurance would also be a good solution depending on the source of your back pain. This together with a good strengthening, stretching and endurance program could do wonders for your game and your pain!

1. Evans K, Refshauge K, Adams R, Barrett R. Swing Kinematics in Skilled Male Golfers Following Putting Practice. JOSPT. 2008;38:425

My first marathon is coming up in just over a month. I’m finding the most difficult part of the training is changing my lifestyle habits surrounding my training goals. In other words I’m having a hard time committing to the process of training.

Committing to the process is about identifying and altering the secondary aspects of meeting a goal in addition to meeting the primary requirements. Primary requirements in this case are completing the runs. The secondary aspects of the training are changing my diet to keep my glycogen levels adequate, hydrating more thoroughly throughout the week, getting more rest and staying on top of  minor aches and pains.

I must admit, I’ve been slacking on the fuel and hydrating parts of the goal. I haven’t taken it seriously enough and I’ve paid the price on a couple of longer runs where I’ve hit the wall way too soon. From now on, I’m embracing the process and changing my habits!

This closely parallels the process of injury recovery. Yes, you can perform the prescribed rehabilitative exercises x times a day but are you really embracing the secondary aspects of your healing? Have you taken the time to identify the habits, activities, and general attitudes that may be prolonging your recovery? If not, it’s time to begin! I’ll be doing it for my marathon and you should do it for your injuries (or whatever you are trying to achieve). Let’s commit to it for one month and see how it goes!