By Phillip Snell, DC
Creator of FixYourOwnBack.com
On occasion, I refer to a formative patient I had in my chiropractic practice many years ago. I call him Carl. Carl was a big strong guy that had lifted heavy and played hard for most of his life. While his prior activity was apparent in his physical frame as he sat in front of me, it was juxtaposed by his emotional state. Carl was crying…and not just a trace tear on the cheek, either. This grown ass man was sobbing and fortunately for me, it was tears of joy. He had suffered a disc injury while lifting, and subsequently re-‐injured it several times. He’d seen a handful of chiropractors who painfully bounced on him to try to get some magic crack which made him feel worse about as often as it had made him feel better. He’d had more needles stuck into him than his mother’s pin cushion. He’d seen many physicians and surgeons who had all given some sort of advice that resembled “Stop lifting” or “These opioids should take the edge off” or “We can cut you open and snip that out”. He’d heard about poor surgical outcomes and was leery of going that route. His fear of surgery was rivaled by his fear of lifting which had now generalized to include lifting his child, lifting the garbage and lifting his socks from the floor. Carl didn’t know when the other shoe was going to drop and he was incredibly frustrated that his source of solace-‐lifting-‐could have seemingly turned on him like a traitorous friend. But he wept at the moment because of what we had just done in the clinic.
We had lifted a bit of weight, only 35# or so, but the importance of it rivaled his 3X BW deadlift he had been proud of. He had lifted the weight a bit differently than he had lifted before, and he lifted it over and over, and the pain in his back was totally absent. First, the fear with the movement fell from his shoulders and then the happiness gave way to the tears of joy. He looked at me and said the words that aimed me in the direction that places the readers of this article and I in proximity to each other. He said “Where in the hell was I supposed to have learned this?”
Recently I presented at University of Western States Chiropractic College on the topic of the bench press. I often get questions from the clinical community about the bench press. The deadlift and squat are discussed quite frequently as functional and corrective movement patterns, but the bench press is the dirty little step child that never gets covered in these environment, making it the most asked topic from this community. If it is covered, the posturally correct flat back or “sternal crunch” bench press is considered the most functional and preferred pattern.
Yet the question always remains: why can you bench more with an arch then? Correct patterns on the squat and deadlift help you lift more but the bench does not. Additionally, it’s easy to observe more shoulder deviation and control of shoulder centration/position with the flat back bench than an arched bench. Often times, people with lack of control of shoulder position can be corrected almost immediately by placing them into an arch. This is counter to what one would expect if you’re moving from a correct/functional position to an incorrect.
March 10, 2016 Stuart McGill, University of Waterloo and Backfitpro Inc. Most patients rarely receive the most important part of the prescription to get rid of back pain from their doctor – the knowledge and understanding of their condition required to become their own best advocate. They remain clueless and frustrated, left in the dark about what behaviors must be stopped in order to alleviate the cause of their pain. As well they need guidance as what is required to build a pain-free foundation that will allow them to get back to enjoying all their usual activities.
Getting “passive” treatments such as prescriptions for pain medication without a plan to stop the cause itself rarely creates a long-term solution. While medication may be a part of a broader approach, a thorough assessment of an individual’s specific pain triggers will identify a pain mechanism that will guide a targeted treatment plan.