August 18, 2025 • 36 mins
Back pain touches almost everyone at some point, arriving either as a sudden jolt or a slow-burning ache that transforms how we move through our days. Whatever your experience, know this: you're far from alone. Nearly 80% of people will face back pain in their lifetime, with 1 in 13 adults currently experiencing limitations in their daily activities because of it.
This episode dives deep into the fascinating science behind back pain, challenging common misconceptions that might be holding you back from recovery. Did you know that pain doesn't always signal damage? Or that gentle, consistent movement often outperforms rest, medication, and many passive treatments? We explore how your nervous system, beliefs, and movement patterns all play crucial roles in your experience of pain and your path to feeling better.
The conversation moves beyond simplistic solutions like "strengthen your core" to examine how motor control—the way your nervous system coordinates your movements—influences back pain. When these patterns get disrupted, some muscles work too hard while others remain underactive, creating a cascade of compensations that can prolong discomfort.
Back pain isn't just a mechanical issue but a blend of biological, psychological, and social factors. This holistic perspective offers more entry points for healing than a purely physical approach.
Whether you're currently managing back pain or simply want to understand how to move well for the long term, you'll discover practical strategies for reclaiming your strength and mobility. Remember, you have more power over your recovery than you might think—and with patience, consistency, and the right approach to movement, you can find your way back to a life of greater freedom and joy in motion.
*This podcast episode includes information based on the latest research and international guidelines on back pain management, but always consult a qualified health professional for advice suited to your unique situation.
Lorimer Mosely TED Talk: Why Things Hurt (Explain Pain)
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Heart of Motion Podcast host Susannah Steers is a Pilates & Integrated Movement Specialist and owner of Moving Spirit Pilates in North Vancouver, BC. She is passionate about movement, about connections and about life.
Through movement teaching, speaking, and facilitating workshops, she supports people in creating movement practices that promote fitness from the inside out. She loves building community, and participating in multi-disciplinary collaborations.
Along with her friend and colleague Gillian McCormick, Susannah also co-hosts The Small Conversations for a Better World podcast – an interview based podcast dedicated to promoting the kind of conversations about health that can spark positive change in individuals, families, communities and across the globe.
Social Media Links:
Moving Spirit Pilates Instagram
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Susannah Steers (00:00):
Welcome to the Heart of Motion podcast.
I'm Susanna Steers and I'll beyour host as we explore the
heart, soul and science ofmovement as a pathway to more
active, vibrant and connectedliving.
Nothing happens until somethingmoves, so let's get started.
Hello and welcome.
Today I want to dive into atopic that touches so many of us
(00:21):
, literally to our core, andthat's back pain, how it affects
our lives, the truths and mythsthat swirl around it and, most
importantly, how intelligentmovement can help us return to a
life we love.
Maybe back pain landed in yourlife like a thunderbolt, a
sudden jolt that stopped youdead in your tracks, or maybe
(00:41):
it's a slow, burning ache, thatunwelcome shadow you carry from
the moment you get out of bed tothe minute you crawl back in.
However it shows up, back painis deeply personal and it can be
truly life-altering.
Pain can be isolating, butremember you're not alone.
(01:02):
Today I want to explore with youwhat the latest research and
years of teaching movement havetaught me about moving through
back pain and reclaiming yourstrength and vitality.
Like most good things, thatlast, it's not a quick fix, in
my mind, learning to move in away that not only improves your
situation, but likely alsocreates more capacity in ways
you didn't expect is a valuableway to spend your time.
(01:24):
Before I go any further, though,I want to remind you that I'm
not a medical professional.
Your first conversations aboutback pain will be with your
physician, but if you arecleared for exercise, let's
explore some choices you canmake that may lead to more
freedom in your movement andperhaps a change in your
experience of pain.
I simply want to share mythoughts and my experience on
(01:46):
this, after more than 30 yearsas a Pilates and integrated
movement specialist, teachingpeople experiencing all kinds of
different challenges to theirmovement.
Honestly, it's going to be lessabout what you're doing and
more about how you're doing it,and if you're up for that
conversation, let's go.
(02:06):
I want to talk about the bigpicture for a moment Back pain,
by the numbers, if youwill
.
Back pain is astoundingly common.
Did you know that nearly 80% ofpeople will experience it at
some point in their lives?
Right now, almost 1 in 13adults is living with back pain
that limits their daily activity.
Right now, almost 1 in 13adults is living with back pain
(02:27):
that limits their daily activity.
That means that the weekly golfgame is getting postponed.
Picking up the kids andemptying the dishwasher might be
tough, and maybe you can't sitat your desk long enough to get
any work done at all.
Sitting, standing, driving,lying down maybe even the
quality of your sleep isaffected.
Back pain is the leading causeof disability worldwide and in
(02:54):
Canada it's among the topreasons people under 60 see a
doctor, and the associated costsand lost productivity are
staggering.
It's not just your physical lifethat suffers either.
Enduring pain takes a lot outof you.
Your emotions might be lessstable and you might find
yourself in kind of a brain fogbecause you can't think as well
or as quickly as you'd like.
Pain can isolate you fromothers, affecting relationships
(03:15):
and families and even how youengage with your most important
communities.
When I said that back pain canbe life-altering, I wasn't
kidding.
Okay, so we know it's prevalentin the population and we know
it can really mess up our plansin life.
What actually causes back pain?
Let's get specific.
(03:35):
Back pain isn't just one thingand every case will not be
handled in the same way.
Recent research highlights many, many different, broad causes
of back pain.
As you might expect, somethinglike a traumatic event, like a
bad fall or a car accident, caninjure the spine in ways that
(03:56):
cause severe injury and pain.
Degenerative changes over timecan alter the shape of the bones
and the cartilage and theligaments and shift support
structures in a non-optimal way,placing load in places it might
not be equipped to handle itwell.
Inflammation, infections andeven metabolic issues can be
causes of back pain too.
Beyond that, there are posturalissues, referred pain patterns,
(04:20):
congenital issues and even painwith psychological origins.
In my experience, back pain isnot easily placed into tidy
boxes that we can check off andfind ourselves free of it,
understanding that there arelikely many different factors at
play and that diagnosis of theproblem and the treatment plan
and, when we're talking aboutexercise, the movement plan must
(04:42):
be highly individualized.
Whatever the source of the pain, it's always a good idea to
check with your healthcareprovider before starting a new
movement exercise plan,especially if you have warning
signs like unexplained weightloss fever or changes in bladder
or bowel function.
These things in particularshould prompt you to see your
(05:02):
doctor as soon as possible.
So those are not things youbrush off, but here's a ray of
hope.
The most common experience ofback pain is typically that
chronic, non-specific low backpain.
Basically, that means painlasting over 12 weeks where your
doctor can't really find anyclear, definite injury or
disease, and that's the kind ofback pain we're going to spend
(05:24):
some time talking about today.
It can be stubborn, but withtime, simple movement and with
mindful self-care, many peoplefind ways to manage or resolve
their back pain problems for thelong term, especially when it's
intense.
Back pain can bring up somereally primal survival instincts
.
Our ever-helpful back brainsimmediately jump in, because
(05:48):
when it hurts to move even alittle bit, how will we survive?
Many of us have beliefs aboutback pain that are not actually
supported by science and theyare not in our best interests
for recovery.
So I want to talk about a fewof these for recovery.
(06:08):
So I want to talk about a fewof these.
The first one is the idea thatback pain always equals back
damage.
Think about it you feel a twinkor a spasm of pain in your back
and if it doesn't resolvepretty quickly, you start
thinking that something isreally wrong.
And the more it hurts, the moreyou think you've damaged
yourself and that you're brokensomehow.
The more you think you'vedamaged yourself and that you're
broken somehow.
But here's the thing Pain doesnot necessarily indicate damage
to the structure.
(06:29):
That might sound surprising,but it's a truth shared by
doctors, scientists and painexperts all over the world.
In actual fact, most back painis not caused by serious injury
or ongoing damage.
Often it's your body's way oftelling you that some part of
your structure is irritated andunhappy and that you've moved in
an unfamiliar way or you're notsupporting some part of your
(06:51):
body well, or perhaps thatyou've just been still for too
darn long.
Think of this kind of back painas your body's early warning
system.
Your body, your brain and yournervous system just want to keep
you safe and they're lettingyou know that something is a
little hinky and you better payattention when something feels
(07:12):
off, even just something likeminor strain or tightness, your
nervous system can send painsignals even if there's no real
tissue harm or immediate threatof damage.
The soreness is not a sign ofserious injury and typically
these episodes resolverelatively quickly.
If it resolves well, but keepshappening, there may be movement
(07:32):
habits that need closerattention.
Stress, tension and bad posturecan tense up your muscles too,
making your back complain andlet you know it's not happy.
I see a lot of that in thePilates studio as people learn
to support themselves better,move more and balance their
stress.
They often experience less ofthis kind of pain and recover
(07:52):
more quickly when they do.
If you're someone who's been inpain for a while, your nerves
can become though sensitive.
They might react to normalmovements with pain signals,
even when your back is safe tomove again.
It's like the nerves havebecome hypervigilant and they
respond to even the slightesttrigger.
Time and gentle exploration ofa pain-free range is usually the
(08:15):
best way to build confidencethat it's safe to move again.
It's like retraining yournervous system and sometimes
it's like the volume dial onyour entire nervous system gets
turned up to 11.
Research shows that people canfeel quite a lot of pain even
when scans and tests show thattheir tissues are healed or
(08:36):
healthy.
In these cases, the work isn'tso much on the back itself,
where you feel pain, but onfinding ways to balance the
nervous system so it's notresponding at full volume every
time you make a move.
So you can see that back paindoesn't always equate to back
damage.
If your first thought when youexperience back pain is, oh no,
(08:59):
I'm broken, you're probably not.
It might feel that waytemporarily.
You can chalk it up to age andthrow a bunch of Robaxacet or
other drugs at the problem, andthat might provide temporary
relief.
If you've checked it out with adoc or your physio and you're
cleared to do more, get moving.
Once you can bring awareness towhat might be going on in your
(09:19):
own body and learn somestrategies for moving forward,
you'll be back in the driver'sseat in terms of your own
healing, and that can feelreally good.
Another myth we should bustright now is that rest is best.
It's tempting now, isn't it?
The last thing we usually wantto do when we're hurting is move
, but the research shows thatstaying active aids recovery,
(09:41):
bed rest can actually makethings worse.
You may have heard me say inthe past how you move matters.
Let's look at how it matterswhen it comes to chronic,
nonspecific low back pain.
Activity strengthens musclesthat support your spine,
especially in terms of your core, your hips and your lower back.
Stronger muscles mean morespinal stability and better
(10:04):
posture, which can directlyreduce pain in future episodes.
When you're hurting, though,we're not immediately talking
about building power.
We want to build robustconnections in your systems of
support.
First, we can add more loadonce we know all those are
working well and in anintegrated way.
Moving your body increases yourblood flow, bringing oxygen and
(10:26):
nutrients to soft tissues,helping them heal and flush away
waste products that contributeto stiffness and lingering pain.
Movement helps to restoremobility and range of motion.
Gentle stretching and movementcan help to combat stiffness,
improving flexibility in themuscles and the tendons and the
ligaments around the spine,creating greater ease in daily
(10:48):
activities and less risk ofre-injury.
When you've been in pain for awhile, you might start to be
afraid of moving in particularways, for fear of inducing more
pain or concern over creatingfurther harm.
Ironically, avoidance canincrease pain and disability
over time.
Instead, controlled, positivemovement experiences can help
(11:10):
you to retrain your brain andyour body to trust your motion,
breaking that cycle of fear andavoidance.
I get it.
It can feel like a giant leapsometimes, so it really helps to
be able to work with someoneyou trust to guide you in the
right direction.
Exercise really any kind ofexercise even walking, increases
(11:32):
your body's natural productionof endorphins, which are
pain-relieving chemicals thatlower your perception of
discomfort.
Movement helps you torecalibrate your nervous system,
making pain signals lessintense over time, and any kind
of moderate aerobic exercise hasbeen shown to decrease
inflammation in tissues,providing relief and preventing
(11:53):
a more chronic situation.
Now, having said all of that, itmay or may not be possible for
you to do all the things youlike to do.
When you're in the thick of apain episode, it might be hard
just to get out of bed.
But taking time to explore whatis possible for you right now,
then moving in whatever capacityyou can, will be beneficial for
(12:15):
you.
It's the start and we justbuild on that.
So you know, maybe it's justsimply walking a little bit and
some very gentle stretches.
Those are usually a safe placeto start
.
Remember, as you go to progressgradually.
You want to build up yourintensity and the variety of
your movement as your strengthand confidence grow.
That whole go big or go homething is not your best friend
(12:40):
here.
Try small, frequent doses ofmovement that feel manageable at
first, rather than going toohard too soon.
I think this is true all thetime, but in the case of back
pain or really for recovery ofany kind, consistency counts.
The benefits of movementaccumulate over weeks and months
(13:01):
, not just days.
Keep moving, but lose that bootcamp mentality.
You want to feel like you'rejust gently adding gains If we
go too hard too soon and youcan't do what you want to do for
a few days.
You've got a big gap there andyour body kind of backs up in
its capacity.
You want to be able to do alittle bit.
Really often those biginterruptions in our ability to
(13:24):
keep moving are just going toslow down the recovery in the
long run.
On the scientific front,clinical studies have shown
again and again that exerciseoutperforms rest medication
alone and many passivetreatments in improving pain
function and mental healthoutcomes for most people
managing back pain.
(13:44):
Over the years, one of the moststriking things I've noticed is
that movement consistentlygives people a sense of agency
over their own healing.
They recognize that they havethe power to affect positive
change in their own situation.
They're not just waiting for atherapist to fix something.
The movement they choose to doimproves the whole outlook for
(14:06):
their body, mind and spirit.
Now I hope you'll forgive mefor getting on my high horse for
a minute.
You know I do this sometimes.
A lot of the things I've justdescribed around the power of
movement for back pain couldeasily be true for injury
prevention and general fitnesstoo.
Movement matters for everysingle system in your body, not
(14:27):
just your muscles and your bones.
Consistent, mindful movement isa powerful tool on the pathway
to long-term health andwell-being.
The big fancy workouts are whatgets the airtime and the
attention on the socials.
It doesn't need to be flashy oreven wicked.
Just keep moving in as big arange as you can, as often as
you can, and give yourself timefor recovery too.
(14:49):
And give yourself time forrecovery too.
Movement heals.
It really really does.
Okay, let's get back to thetopic at hand.
Another common misconception isthat you need a super strong
core to prevent or fix back pain.
Yep, you heard it.
That's me, the Pilates teacher,telling you that core strength
(15:09):
isn't a panacea.
Early on in my career, thebelief was that core strength
was the solution to just abouteverything.
Ah, but we evolve and learnMore.
Recently, research has shownthat, while core muscle capacity
and function does matter,strengthening the deep core in
isolation isn't a magic bullet.
What matters is how all yourmuscles and systems work
(15:32):
together and how you move as awhole.
Integrated function is the keyfor robust physical health and
motion.
Now the integration part iswhere I get really excited.
It's something I've worked hardto learn about and spent years
exploring, and I can see thismost readily when I look at a
person's motor controlstrategies.
Broadly speaking, motor controlrefers to the way your nervous
(15:56):
system coordinates your posture,your movement, your muscle
activations to support andprotect your spine and other
parts of your body during dailyactivities.
In the case of chronic,nonspecific low back pain, these
patterns can get disrupted,which means that some muscles
may be working too hard andothers too little or at the
(16:17):
wrong time, and thisdisorganization can cause
overload or stiffness or havinga hard time stabilizing your
structure, perhaps prolongingyour pain and interfering with
your full recovery.
Now, if you've spent any timewith me at the Pilates studio,
whether you're in pain orworking at full capacity, you'll
(16:37):
know that I'm constantlylooking at your movement
patterns and your motor controlstrategies as I'm watching you
do the exercises in your program.
I'm less interested in thespecific choreography of an
exercise and a whole lot moreinterested in how you make a
movement happen.
Everybody has their own uniqueway of doing things.
Why do I care?
(16:57):
When underlying motor control isdisrupted somehow, it doesn't
matter what exercise protocolyou might be following to
improve your back pain.
Your access to integratedsupport will be elusive and you
may not get the results you want.
Integrated support will beelusive and you may not get the
results you want.
Here's what I mean.
People with chronic low backpain often show changes in how
their trunk muscles fire,especially those deep
(17:19):
stabilizing muscles.
You might have experienced thisyourself, like you've had the
core muscles working and thenall of a sudden you've got this
back pain and you just cannotconnect to your core.
Some muscles are gettingoverworked while others get a
little sleepy.
This alone can compromisespinal stability and efficient
movement.
So we got to address that.
(17:40):
In terms of efficient movement,disruption in motor control
leads to less coordinated,slower or more limited movements
.
Poor control makes everydaytasks feel harder and increases
the risk of ongoing discomfortand sometimes re-injury.
Inefficient movement means ittakes more energy to accomplish
(18:00):
less.
You're working harder for lessgains.
Usually the larger musclegroups find a way to compensate
for the deeper, smaller andsometimes harder to feel
stabilizing muscles, and it'simportant to rebalance those.
Some people adopt overprotectivebracing strategies, tensing
(18:22):
everything up to find somemeasure of control.
This has been my pattern,especially when I'm stressed
what can I hold on to Everything?
It would be funny if it didn'tmess with my movement so much.
Other people have loose,underactive patterns where
there's not enough tone orcapacity in the tissues to
stabilize appropriately for thetasks at hand.
These maladaptive strategiescan increase tissue strain or
(18:45):
limit normal, healthy movementand can get in the way of
healing.
So understanding yourstrategies of choice can go a
long way to understanding howyour body moves around in space,
and it might begin to give youa little bit of a window into
your pain patterns.
Identifying and improving lessefficient motor control
(19:06):
strategies is a way to improvethe integration of all the
tissues and systems of the bodyinto a comprehensive whole,
integrated whole body movementExercises with this in mind need
to be done mindfully andfrequently in order to make a
change.
Movements aimed at improvingmotor control won't likely bring
(19:27):
on a hard sweat and a burn.
Remember that we're working notjust with the muscles here, but
with the brain and the nervoussystem.
It might feel more like mentalgymnastics at first, but you're
building structural integritythat will improve your recovery
and prevent re-injury.
The good news on this is thatthis process ends up rewiring
(19:48):
pathways that leave you withaccess to more strength, better
patterns with less effort, soyour overall fitness may improve
too.
So is that it, then?
We improved some motor controland we're good to go.
Well, maybe and maybe not,science now understands that
(20:10):
back pain is not just amechanical issue like oh, my
back is out, but as a blend offactors Biology, yes, but also
your mood, your stress, yourbeliefs, your sleep patterns,
even your relationships and yoursocial supports.
If we define motor control as away your nervous system
(20:30):
organizes and activates things,if we define motor control as a
way your nervous systemorganizes and activates things,
then we have to understand thatthe state of your nervous system
is a powerful force when itcomes to recovery.
If the sympathetic nervoussystem, our fight, flight or
freeze response, is ramped wayup, it can be challenging for
deep system support to respondand come online as it should.
(20:50):
Naturally, if you're in thatheightened state and trying to
recruit your deep abdominalmuscles, for example, it might
feel almost impossible.
But breath work, release workand meditation are all great
ways to begin to balance thenervous system, bringing on the
parasympathetic or the rest anddigest, which are more
associated with your posturalmuscles, so that you can do
(21:12):
things differently, and inconjunction with a movement
practice, these tools can reallyhelp to improve both function
and pain.
Sometimes it's our beliefs thathold us back.
If we hold beliefs about whatis or isn't possible and we
can't imagine that somethingdifferent might be available for
us, we could limit our abilityto improve past a certain point.
(21:36):
And this is where I think thepower of community comes in.
If you've got a great coach orteacher working with you,
they'll probably hold a visionfor your progress that it's even
greater than you might imaginefor yourself.
They'll gently guide you intoplaces you might not have
thought possible, and if you canfind an environment where there
(21:57):
are people working together ina way that feels really good to
you, you may just find that thegroup elevates your sense of
what you can do too.
I love the small group classesat Moving Spirit for this very
reason.
People connect, they supporteach other, they motivate each
other and cheer each otheron as they work, learning about
themselves and their bodies anddedicating themselves to
(22:18):
consistent practice.
I have one client who actuallycalls moving spirit her oasis of
limitless possibilities.
I think I'd like to put that ona bumper sticker.
Our sense of safety is somethingthat we don't often talk about.
Right, we go into these placesand we just assume it's all fine
, but if we're in an environmentor in a circumstance where we
(22:38):
do not feel safe, for whateverreason.
We may experience movement,avoidance, tension, stiffness or
pain.
If you don't feel safe, respectthat you are the boss.
Find a way to shift thesituation.
Claim your space.
Change your environment.
Ask questions.
Change what you're doing sothat you do feel safe.
(23:00):
Have a conversation with yourteacher about what doesn't feel
right and, if your teacher orcoach is maybe the problem, find
someone else to work with.
If there is a constant,pervasive sense of unsafety,
exploring what that means andhow you can work through it in
multiple different ways can bevery helpful.
(23:22):
Trust your gut If you're notfeeling good.
Trust your gut.
Sometimes we're not even awarethat we don't feel safe If we've
gotten used to bracingourselves and pushing through
fear.
Bringing a gentle awareness towhat we feel as we move and any
thoughts or emotions that comeup along the way can help us
bring those thoughts andfeelings we've buried to light.
(23:44):
And sometimes those thoughtsand feelings show up as tension
in your body or areas where youfeel weak.
You don't know how to engagethe strength in that particular
path.
We can choose what we want todo with takeaways:
One (23:59):
and feelings we have in the moment, but becoming aware of
them is the first step toTwo: inviting some kind of
positive change.
We like to think that we canseparate the physical, the
Three (24:10):
mental, the emotional, all of that.
We like to think that we canseparate the physical, the
mental, the emotional, all ofthat.
Really, it's all happening inour bodies at the same time and
the same place, and the more wecan find ways to pull those
things together it's not to sayyou have to be a victim to your
emotions, but respect them, knowthat they're there
Four: Five (24:31):
with them rather than
trying to stuff them away.
I had a client years ago withpretty severe pack pain.
She had exhausted the medicalinterventions available to her,
but she still experiencedsignificant discomfort every day
.
She'd been in pain for a longtime and her nervous system was
in a state of realhypervigilance around any
movement that might cause hermore pain, real hypervigilance
(24:52):
around any movement that mightcause her more pain.
She was profoundly hesitant tomove At first.
Even the smallest movementswould cause her to say things
like oh, oh, I feel that, andshe would stop and tense up.
She wanted to just stop doingwhat we were doing and it took
us a little while to navigatethat.
I'll admit it was a littletough at first because she
didn't want to move in even thesmallest ways and I obviously
(25:13):
didn't want to cause her morepain, but we were really trying
to get some movement happening.
She'd been in pain for so longthat her entire system seemed to
interpret every sensation aspain.
I decided that perhaps we couldexplore and qualify her
sensations a little morespecifically, as she felt them,
(25:35):
to see whether we coulddetermine which sensations were
simply her brain becoming awareof something happening in her
body and which she couldactually classify as pain.
Was that pull she felt as sheextended one leg really pain, or
was it perhaps a sensation oflengthening tight tissues?
Was the shortening she felt inher side pain, or was it the
(25:57):
sensation of a musclecontracting?
As you can imagine, thisprocess took some time and
reclassification of hersensations in her experience
helped her find a way into agreater capacity for movement
and improve both her painsymptoms and her overall fitness
, and she was able to moreeasily find peace with her
(26:22):
movement.
It wasn't such a scary thinganymore.
So, regardless of where you'reat, if you're experiencing
chronic, non-specific back pain,I believe it's important to
take a wide view and incorporateall the possible areas where
you might make a difference.
Strengthening your core mightbe part of the solution, but
it's likely not the only one.
(26:42):
I've thrown a lot at you in thelast few minutes, so let's get
practical and lean into somequick, evidence-based takeaways.
One nearly all the majorguidelines now encourage staying
active as a first-line strategyfor back pain.
Two exercise helps.
Doesn't have to be Pilates,yoga, walking, strength training
(27:03):
.
All show benefits.
Three manual therapy, paineducation and a
multidisciplinary approach canhelp.
I am a firm believer inmultidisciplinary approaches.
Just don't do it all at once.
Start with one thing, see howyou respond.
Add another thing.
See how you respond.
Are you experiencing some levelof better?
(27:25):
A little at a time gives you achance to know which
interventions are the ones thatare really giving you the most
benefit.
Four imaging like x-rays andMRIs, is not always necessary
unless your doctor suspects aserious underlying cause.
Most people of a certain agewill show degenerative changes
(27:46):
on a scan, whether or not theyexperience any pain.
Sometimes a scan will show allkinds of crazy things going on
in somebody's spine and there'sno pain patterns, there's no
movement issues, so the scan isnot necessarily going to tell
you what you think it's going totell you Osteoarthritis or
spondylosis appearing on a scanmay or may not be the cause of
(28:09):
your pain.
It may give you a startingpoint, but what you do moving
forward will be more importantand more likely than not.
The advice will be to keepmoving.
Five importantly consistencyand individualization matter
much more than the specific typeof exercise you've chosen.
(28:30):
We know the research shows thatpretty much any movement is
beneficial.
But I want to zoom in on Pilatesfor a moment, because that's
what I do.
Research reviews show Pilatescan offer small to moderate
improvements in pain andfunction for chronic low back
pain, which is about the same asany other exercise approach.
(28:51):
But Pilates brings somethingspecial a focus on body
awareness, controlled movementand whole body integration.
That means you're not justgaining strength, you're
learning how your body works andhow it moves, so you can do
that with greater confidence andjoy.
So why, as an integratedmovement specialist, do I
(29:11):
believe so deeply in Pilates forback pain?
Well, I initially startedPilates for a pain problem in my
20s.
I had chronic and sometimessevere knee pain.
It took about a year ofconsistent practice, but Pilates
did what nothing else could and, believe me, I had tried
everything at that point.
Pilates got me out of pain andactually gave me more strength
(29:34):
and capacity than I had hadbefore.
I knew there was power in thiswork.
Over the years since then I'vewitnessed profound changes in
recovery and people managing awhole host of different kinds of
back pain and dysfunction.
What I see time and time againis this Pilates strengthens the
(29:54):
deep core system in harmony withthe breath, the pelvis, the
hips, the legs, the shouldersand the whole body.
It is the only form of exerciseI've found, when practiced and
taught well, that has aprofoundly integrating effect on
the body.
The exercises in Pilates helpto lengthen and decompress the
(30:15):
low back and the hips and thethorax, all important for
stability and freedom in thetrunk.
We build strategies for wholebody support, not just bracing
the spine.
With guided, positive movementexperiences, clients learn that
movement is safe, rewiring thosepatterns in the brain.
There is no one-size-fits-allsolution.
At Moving Spirit, for example,our approach is personalized.
(30:38):
Everyone's story is different.
Perhaps most crucially, pilatesinvites you to listen to your
body and become an activeparticipant in your own healing.
It's not just aboutbiomechanics.
There's an educational,empowering and psychological
support element, especiallyimportant when pain has eroded
(31:00):
your confidence.
So I'd want to give you somepractical tips for everyday life
when you're dealing with backpain.
Practical tips for everydaylife when you're dealing with
back pain.
I'd like to tell you to choosea skilled, compassionate Pilates
teacher or movementpractitioner who will listen to
your story.
Start with some privatesessions and a thorough
assessment tailored to you.
(31:21):
And here's the thing Commit toregular, mindful practice.
Movement is medicine, but onlyif you take the dose and it's
not just one and done.
You need to pay attention towhat you're doing, to feel it,
to recognize it, so that youtake it beyond the hour or two
(31:42):
or three that you spend with acoach or within a class and you
can recognize that and take itout into your world with you.
Look for small dailyimprovement, not instant
perfection.
Really feel what feels better.
Be open to new movementexperiences Like that's kind of
a be coachable moment rightImagery, new movement strategies
(32:05):
, mindfulness or even exploringhow play and maybe joy can sneak
back into your movement life.
That can help you reframe howyou're living and moving inside
your own body.
Maybe that sounds a little woo,I don't know, but I promise
it's true.
Support yourself outside yourmovement habits with good sleep,
manage your stress and find anurturing community.
(32:31):
I read an article once by awoman whose name I can't
remember right now, who wroteabout her experiences working
through back pain.
She described finding someoneshe worked with as a back
whisperer, and in that moment Iloved it.
She found someone who was ableto listen to her problem,
evaluate all the elements ofwhat was going on for her and
guide her toward a betterexperience over time.
(32:52):
That doesn't happen in threeeasy lessons with a few standard
protocol exercises.
It takes some time, but thething to remember is that it is
possible to feel better and thatthe real back whisperer is you.
All this being said, there aretimes when you must urgently see
your doctor.
If you notice sudden severepain, unexplained fever,
(33:17):
significant weakness or numbnessor issues with bladder or bowel
control, please seek medicalattention right away.
Don't mess around.
Back pain can feel utterlyoverwhelming, but you have more
power than you might think.
By staying engaged, listeningto your body and listening to
(33:38):
your pain, asking for help andmoving yes, moving you give
yourself thevery best chance of feeling
well again.
So move and move some more.
Walk, stretch, play, breathe.
Pilates can be a greatcompanion, but also let your
curiosity and a littleplayfulness lead the way.
Every little bitof movement you add gives you
(34:00):
more strength, resilience and,most importantly, freedom and
independence.
You are so much more than yourpain and you're worth investing
in.
I'd like to recommend a coupleof great resources talking about
pain that might be useful foryou if you're navigating a pain
problem of any kind.
One is a video by LauraMermosley called Explain Pain.
(34:21):
It's a great, really quickperspective on pain.
You'll understand itdifferently after you hear it.
Another is a book called whyThings Hurt by local
physiotherapist Brent Stevenson.
I'll slide some links to thosein the show notes.
They may help you refine yourperspective on your experience.
You might also be interested inan earlier episode of the Heart
(34:44):
of Motion, an interview that Idid with a dear friend and
colleague, amy Ruth.
It's episode eight of seasonone called Resilience, health
and Connection Through Somaticswith Amy Kiara Ruth.
Amy has some beautiful ways totalk about movement and pain and
I hope you'll check it out.
And haha, there's more.
I hope you'll join me next timewhen I'll be talking to Anthony
(35:08):
Abagnano, internationallyrenowned founder of the Alchemy
of Breath and author of the bookOuter Chaos, inner Calm, about
the power of breath work.
His insights in that interviewfeed beautifully into today's
conversation about back pain andto the choices.
We have to move throughchallenging situations.
Tune in to the next.
(35:29):
We have to move throughchallenging situations.
Tune in to the next episode forthat one.
Before we go, I just want toremind you that this podcast
episode includes informationbased on the latest research and
international guidelines onback pain management.
But always consult a qualifiedhealth professional for advice
suited to your unique situation.
Until next time.
You matter, so keep moving.
(35:51):
You got this.
I hope you enjoyed today'sepisode.
Subscribe and, if you love whatyou heard, leave a five-star
review and tell people what youenjoyed most.
Join me here again in a coupleof weeks.
For now, let's get moving.
Welcome to the Heart of Motion podcast.
I'm Susanna Steers and I'll beyour host as we explore the
heart, soul and science ofmovement as a pathway to more
active, vibrant and connectedliving.
Nothing happens until somethingmoves, so let's get started.
Hello and welcome.
Today I want to dive into atopic that touches so many of us
(00:21):
, literally to our core, andthat's back pain, how it affects
our lives, the truths and mythsthat swirl around it and, most
importantly, how intelligentmovement can help us return to a
life we love.
Maybe back pain landed in yourlife like a thunderbolt, a
sudden jolt that stopped youdead in your tracks, or maybe
(00:41):
it's a slow, burning ache, thatunwelcome shadow you carry from
the moment you get out of bed tothe minute you crawl back in.
However it shows up, back painis deeply personal and it can be
truly life-altering.
Pain can be isolating, butremember you're not alone.
(01:02):
Today I want to explore with youwhat the latest research and
years of teaching movement havetaught me about moving through
back pain and reclaiming yourstrength and vitality.
Like most good things, thatlast, it's not a quick fix, in
my mind, learning to move in away that not only improves your
situation, but likely alsocreates more capacity in ways
you didn't expect is a valuableway to spend your time.
(01:24):
Before I go any further, though,I want to remind you that I'm
not a medical professional.
Your first conversations aboutback pain will be with your
physician, but if you arecleared for exercise, let's
explore some choices you canmake that may lead to more
freedom in your movement andperhaps a change in your
experience of pain.
I simply want to share mythoughts and my experience on
(01:46):
this, after more than 30 yearsas a Pilates and integrated
movement specialist, teachingpeople experiencing all kinds of
different challenges to theirmovement.
Honestly, it's going to be lessabout what you're doing and
more about how you're doing it,and if you're up for that
conversation, let's go.
(02:06):
I want to talk about the bigpicture for a moment Back pain,
by the numbers, if youwill
.
Back pain is astoundingly common.
Did you know that nearly 80% ofpeople will experience it at
some point in their lives?
Right now, almost 1 in 13adults is living with back pain
that limits their daily activity.
Right now, almost 1 in 13adults is living with back pain
(02:27):
that limits their daily activity.
That means that the weekly golfgame is getting postponed.
Picking up the kids andemptying the dishwasher might be
tough, and maybe you can't sitat your desk long enough to get
any work done at all.
Sitting, standing, driving,lying down maybe even the
quality of your sleep isaffected.
Back pain is the leading causeof disability worldwide and in
(02:54):
Canada it's among the topreasons people under 60 see a
doctor, and the associated costsand lost productivity are
staggering.
It's not just your physical lifethat suffers either.
Enduring pain takes a lot outof you.
Your emotions might be lessstable and you might find
yourself in kind of a brain fogbecause you can't think as well
or as quickly as you'd like.
Pain can isolate you fromothers, affecting relationships
(03:15):
and families and even how youengage with your most important
communities.
When I said that back pain canbe life-altering, I wasn't
kidding.
Okay, so we know it's prevalentin the population and we know
it can really mess up our plansin life.
What actually causes back pain?
Let's get specific.
(03:35):
Back pain isn't just one thingand every case will not be
handled in the same way.
Recent research highlights many, many different, broad causes
of back pain.
As you might expect, somethinglike a traumatic event, like a
bad fall or a car accident, caninjure the spine in ways that
(03:56):
cause severe injury and pain.
Degenerative changes over timecan alter the shape of the bones
and the cartilage and theligaments and shift support
structures in a non-optimal way,placing load in places it might
not be equipped to handle itwell.
Inflammation, infections andeven metabolic issues can be
causes of back pain too.
Beyond that, there are posturalissues, referred pain patterns,
(04:20):
congenital issues and even painwith psychological origins.
In my experience, back pain isnot easily placed into tidy
boxes that we can check off andfind ourselves free of it,
understanding that there arelikely many different factors at
play and that diagnosis of theproblem and the treatment plan
and, when we're talking aboutexercise, the movement plan must
(04:42):
be highly individualized.
Whatever the source of the pain, it's always a good idea to
check with your healthcareprovider before starting a new
movement exercise plan,especially if you have warning
signs like unexplained weightloss fever or changes in bladder
or bowel function.
These things in particularshould prompt you to see your
(05:02):
doctor as soon as possible.
So those are not things youbrush off, but here's a ray of
hope.
The most common experience ofback pain is typically that
chronic, non-specific low backpain.
Basically, that means painlasting over 12 weeks where your
doctor can't really find anyclear, definite injury or
disease, and that's the kind ofback pain we're going to spend
(05:24):
some time talking about today.
It can be stubborn, but withtime, simple movement and with
mindful self-care, many peoplefind ways to manage or resolve
their back pain problems for thelong term, especially when it's
intense.
Back pain can bring up somereally primal survival instincts
.
Our ever-helpful back brainsimmediately jump in, because
(05:48):
when it hurts to move even alittle bit, how will we survive?
Many of us have beliefs aboutback pain that are not actually
supported by science and theyare not in our best interests
for recovery.
So I want to talk about a fewof these for recovery.
(06:08):
So I want to talk about a fewof these.
The first one is the idea thatback pain always equals back
damage.
Think about it you feel a twinkor a spasm of pain in your back
and if it doesn't resolvepretty quickly, you start
thinking that something isreally wrong.
And the more it hurts, the moreyou think you've damaged
yourself and that you're brokensomehow.
The more you think you'vedamaged yourself and that you're
broken somehow.
But here's the thing Pain doesnot necessarily indicate damage
to the structure.
(06:29):
That might sound surprising,but it's a truth shared by
doctors, scientists and painexperts all over the world.
In actual fact, most back painis not caused by serious injury
or ongoing damage.
Often it's your body's way oftelling you that some part of
your structure is irritated andunhappy and that you've moved in
an unfamiliar way or you're notsupporting some part of your
(06:51):
body well, or perhaps thatyou've just been still for too
darn long.
Think of this kind of back painas your body's early warning
system.
Your body, your brain and yournervous system just want to keep
you safe and they're lettingyou know that something is a
little hinky and you better payattention when something feels
(07:12):
off, even just something likeminor strain or tightness, your
nervous system can send painsignals even if there's no real
tissue harm or immediate threatof damage.
The soreness is not a sign ofserious injury and typically
these episodes resolverelatively quickly.
If it resolves well, but keepshappening, there may be movement
(07:32):
habits that need closerattention.
Stress, tension and bad posturecan tense up your muscles too,
making your back complain andlet you know it's not happy.
I see a lot of that in thePilates studio as people learn
to support themselves better,move more and balance their
stress.
They often experience less ofthis kind of pain and recover
(07:52):
more quickly when they do.
If you're someone who's been inpain for a while, your nerves
can become though sensitive.
They might react to normalmovements with pain signals,
even when your back is safe tomove again.
It's like the nerves havebecome hypervigilant and they
respond to even the slightesttrigger.
Time and gentle exploration ofa pain-free range is usually the
(08:15):
best way to build confidencethat it's safe to move again.
It's like retraining yournervous system and sometimes
it's like the volume dial onyour entire nervous system gets
turned up to 11.
Research shows that people canfeel quite a lot of pain even
when scans and tests show thattheir tissues are healed or
(08:36):
healthy.
In these cases, the work isn'tso much on the back itself,
where you feel pain, but onfinding ways to balance the
nervous system so it's notresponding at full volume every
time you make a move.
So you can see that back paindoesn't always equate to back
damage.
If your first thought when youexperience back pain is, oh no,
(08:59):
I'm broken, you're probably not.
It might feel that waytemporarily.
You can chalk it up to age andthrow a bunch of Robaxacet or
other drugs at the problem, andthat might provide temporary
relief.
If you've checked it out with adoc or your physio and you're
cleared to do more, get moving.
Once you can bring awareness towhat might be going on in your
(09:19):
own body and learn somestrategies for moving forward,
you'll be back in the driver'sseat in terms of your own
healing, and that can feelreally good.
Another myth we should bustright now is that rest is best.
It's tempting now, isn't it?
The last thing we usually wantto do when we're hurting is move
, but the research shows thatstaying active aids recovery,
(09:41):
bed rest can actually makethings worse.
You may have heard me say inthe past how you move matters.
Let's look at how it matterswhen it comes to chronic,
nonspecific low back pain.
Activity strengthens musclesthat support your spine,
especially in terms of your core, your hips and your lower back.
Stronger muscles mean morespinal stability and better
(10:04):
posture, which can directlyreduce pain in future episodes.
When you're hurting, though,we're not immediately talking
about building power.
We want to build robustconnections in your systems of
support.
First, we can add more loadonce we know all those are
working well and in anintegrated way.
Moving your body increases yourblood flow, bringing oxygen and
(10:26):
nutrients to soft tissues,helping them heal and flush away
waste products that contributeto stiffness and lingering pain.
Movement helps to restoremobility and range of motion.
Gentle stretching and movementcan help to combat stiffness,
improving flexibility in themuscles and the tendons and the
ligaments around the spine,creating greater ease in daily
(10:48):
activities and less risk ofre-injury.
When you've been in pain for awhile, you might start to be
afraid of moving in particularways, for fear of inducing more
pain or concern over creatingfurther harm.
Ironically, avoidance canincrease pain and disability
over time.
Instead, controlled, positivemovement experiences can help
(11:10):
you to retrain your brain andyour body to trust your motion,
breaking that cycle of fear andavoidance.
I get it.
It can feel like a giant leapsometimes, so it really helps to
be able to work with someoneyou trust to guide you in the
right direction.
Exercise really any kind ofexercise even walking, increases
(11:32):
your body's natural productionof endorphins, which are
pain-relieving chemicals thatlower your perception of
discomfort.
Movement helps you torecalibrate your nervous system,
making pain signals lessintense over time, and any kind
of moderate aerobic exercise hasbeen shown to decrease
inflammation in tissues,providing relief and preventing
(11:53):
a more chronic situation.
Now, having said all of that, itmay or may not be possible for
you to do all the things youlike to do.
When you're in the thick of apain episode, it might be hard
just to get out of bed.
But taking time to explore whatis possible for you right now,
then moving in whatever capacityyou can, will be beneficial for
(12:15):
you.
It's the start and we justbuild on that.
So you know, maybe it's justsimply walking a little bit and
some very gentle stretches.
Those are usually a safe placeto start
.
Remember, as you go to progressgradually.
You want to build up yourintensity and the variety of
your movement as your strengthand confidence grow.
That whole go big or go homething is not your best friend
(12:40):
here.
Try small, frequent doses ofmovement that feel manageable at
first, rather than going toohard too soon.
I think this is true all thetime, but in the case of back
pain or really for recovery ofany kind, consistency counts.
The benefits of movementaccumulate over weeks and months
(13:01):
, not just days.
Keep moving, but lose that bootcamp mentality.
You want to feel like you'rejust gently adding gains If we
go too hard too soon and youcan't do what you want to do for
a few days.
You've got a big gap there andyour body kind of backs up in
its capacity.
You want to be able to do alittle bit.
Really often those biginterruptions in our ability to
(13:24):
keep moving are just going toslow down the recovery in the
long run.
On the scientific front,clinical studies have shown
again and again that exerciseoutperforms rest medication
alone and many passivetreatments in improving pain
function and mental healthoutcomes for most people
managing back pain.
(13:44):
Over the years, one of the moststriking things I've noticed is
that movement consistentlygives people a sense of agency
over their own healing.
They recognize that they havethe power to affect positive
change in their own situation.
They're not just waiting for atherapist to fix something.
The movement they choose to doimproves the whole outlook for
(14:06):
their body, mind and spirit.
Now I hope you'll forgive mefor getting on my high horse for
a minute.
You know I do this sometimes.
A lot of the things I've justdescribed around the power of
movement for back pain couldeasily be true for injury
prevention and general fitnesstoo.
Movement matters for everysingle system in your body, not
(14:27):
just your muscles and your bones.
Consistent, mindful movement isa powerful tool on the pathway
to long-term health andwell-being.
The big fancy workouts are whatgets the airtime and the
attention on the socials.
It doesn't need to be flashy oreven wicked.
Just keep moving in as big arange as you can, as often as
you can, and give yourself timefor recovery too.
(14:49):
And give yourself time forrecovery too.
Movement heals.
It really really does.
Okay, let's get back to thetopic at hand.
Another common misconception isthat you need a super strong
core to prevent or fix back pain.
Yep, you heard it.
That's me, the Pilates teacher,telling you that core strength
(15:09):
isn't a panacea.
Early on in my career, thebelief was that core strength
was the solution to just abouteverything.
Ah, but we evolve and learnMore.
Recently, research has shownthat, while core muscle capacity
and function does matter,strengthening the deep core in
isolation isn't a magic bullet.
What matters is how all yourmuscles and systems work
(15:32):
together and how you move as awhole.
Integrated function is the keyfor robust physical health and
motion.
Now the integration part iswhere I get really excited.
It's something I've worked hardto learn about and spent years
exploring, and I can see thismost readily when I look at a
person's motor controlstrategies.
Broadly speaking, motor controlrefers to the way your nervous
(15:56):
system coordinates your posture,your movement, your muscle
activations to support andprotect your spine and other
parts of your body during dailyactivities.
In the case of chronic,nonspecific low back pain, these
patterns can get disrupted,which means that some muscles
may be working too hard andothers too little or at the
(16:17):
wrong time, and thisdisorganization can cause
overload or stiffness or havinga hard time stabilizing your
structure, perhaps prolongingyour pain and interfering with
your full recovery.
Now, if you've spent any timewith me at the Pilates studio,
whether you're in pain orworking at full capacity, you'll
(16:37):
know that I'm constantlylooking at your movement
patterns and your motor controlstrategies as I'm watching you
do the exercises in your program.
I'm less interested in thespecific choreography of an
exercise and a whole lot moreinterested in how you make a
movement happen.
Everybody has their own uniqueway of doing things.
Why do I care?
(16:57):
When underlying motor control isdisrupted somehow, it doesn't
matter what exercise protocolyou might be following to
improve your back pain.
Your access to integratedsupport will be elusive and you
may not get the results you want.
Integrated support will beelusive and you may not get the
results you want.
Here's what I mean.
People with chronic low backpain often show changes in how
their trunk muscles fire,especially those deep
(17:19):
stabilizing muscles.
You might have experienced thisyourself, like you've had the
core muscles working and thenall of a sudden you've got this
back pain and you just cannotconnect to your core.
Some muscles are gettingoverworked while others get a
little sleepy.
This alone can compromisespinal stability and efficient
movement.
So we got to address that.
(17:40):
In terms of efficient movement,disruption in motor control
leads to less coordinated,slower or more limited movements
.
Poor control makes everydaytasks feel harder and increases
the risk of ongoing discomfortand sometimes re-injury.
Inefficient movement means ittakes more energy to accomplish
(18:00):
less.
You're working harder for lessgains.
Usually the larger musclegroups find a way to compensate
for the deeper, smaller andsometimes harder to feel
stabilizing muscles, and it'simportant to rebalance those.
Some people adopt overprotectivebracing strategies, tensing
(18:22):
everything up to find somemeasure of control.
This has been my pattern,especially when I'm stressed
what can I hold on to Everything?
It would be funny if it didn'tmess with my movement so much.
Other people have loose,underactive patterns where
there's not enough tone orcapacity in the tissues to
stabilize appropriately for thetasks at hand.
These maladaptive strategiescan increase tissue strain or
(18:45):
limit normal, healthy movementand can get in the way of
healing.
So understanding yourstrategies of choice can go a
long way to understanding howyour body moves around in space,
and it might begin to give youa little bit of a window into
your pain patterns.
Identifying and improving lessefficient motor control
(19:06):
strategies is a way to improvethe integration of all the
tissues and systems of the bodyinto a comprehensive whole,
integrated whole body movementExercises with this in mind need
to be done mindfully andfrequently in order to make a
change.
Movements aimed at improvingmotor control won't likely bring
(19:27):
on a hard sweat and a burn.
Remember that we're working notjust with the muscles here, but
with the brain and the nervoussystem.
It might feel more like mentalgymnastics at first, but you're
building structural integritythat will improve your recovery
and prevent re-injury.
The good news on this is thatthis process ends up rewiring
(19:48):
pathways that leave you withaccess to more strength, better
patterns with less effort, soyour overall fitness may improve
too.
So is that it, then?
We improved some motor controland we're good to go.
Well, maybe and maybe not,science now understands that
(20:10):
back pain is not just amechanical issue like oh, my
back is out, but as a blend offactors Biology, yes, but also
your mood, your stress, yourbeliefs, your sleep patterns,
even your relationships and yoursocial supports.
If we define motor control as away your nervous system
(20:30):
organizes and activates things,if we define motor control as a
way your nervous systemorganizes and activates things,
then we have to understand thatthe state of your nervous system
is a powerful force when itcomes to recovery.
If the sympathetic nervoussystem, our fight, flight or
freeze response, is ramped wayup, it can be challenging for
deep system support to respondand come online as it should.
(20:50):
Naturally, if you're in thatheightened state and trying to
recruit your deep abdominalmuscles, for example, it might
feel almost impossible.
But breath work, release workand meditation are all great
ways to begin to balance thenervous system, bringing on the
parasympathetic or the rest anddigest, which are more
associated with your posturalmuscles, so that you can do
(21:12):
things differently, and inconjunction with a movement
practice, these tools can reallyhelp to improve both function
and pain.
Sometimes it's our beliefs thathold us back.
If we hold beliefs about whatis or isn't possible and we
can't imagine that somethingdifferent might be available for
us, we could limit our abilityto improve past a certain point.
(21:36):
And this is where I think thepower of community comes in.
If you've got a great coach orteacher working with you,
they'll probably hold a visionfor your progress that it's even
greater than you might imaginefor yourself.
They'll gently guide you intoplaces you might not have
thought possible, and if you canfind an environment where there
(21:57):
are people working together ina way that feels really good to
you, you may just find that thegroup elevates your sense of
what you can do too.
I love the small group classesat Moving Spirit for this very
reason.
People connect, they supporteach other, they motivate each
other and cheer each otheron as they work, learning about
themselves and their bodies anddedicating themselves to
(22:18):
consistent practice.
I have one client who actuallycalls moving spirit her oasis of
limitless possibilities.
I think I'd like to put that ona bumper sticker.
Our sense of safety is somethingthat we don't often talk about.
Right, we go into these placesand we just assume it's all fine
, but if we're in an environmentor in a circumstance where we
(22:38):
do not feel safe, for whateverreason.
We may experience movement,avoidance, tension, stiffness or
pain.
If you don't feel safe, respectthat you are the boss.
Find a way to shift thesituation.
Claim your space.
Change your environment.
Ask questions.
Change what you're doing sothat you do feel safe.
(23:00):
Have a conversation with yourteacher about what doesn't feel
right and, if your teacher orcoach is maybe the problem, find
someone else to work with.
If there is a constant,pervasive sense of unsafety,
exploring what that means andhow you can work through it in
multiple different ways can bevery helpful.
(23:22):
Trust your gut If you're notfeeling good.
Trust your gut.
Sometimes we're not even awarethat we don't feel safe If we've
gotten used to bracingourselves and pushing through
fear.
Bringing a gentle awareness towhat we feel as we move and any
thoughts or emotions that comeup along the way can help us
bring those thoughts andfeelings we've buried to light.
(23:44):
And sometimes those thoughtsand feelings show up as tension
in your body or areas where youfeel weak.
You don't know how to engagethe strength in that particular
path.
We can choose what we want todo with takeaways:
One (23:59):
and feelings we have in the moment, but becoming aware of
them is the first step toTwo: inviting some kind of
positive change.
We like to think that we canseparate the physical, the
Three (24:10):
mental, the emotional, all of that.
We like to think that we canseparate the physical, the
mental, the emotional, all ofthat.
Really, it's all happening inour bodies at the same time and
the same place, and the more wecan find ways to pull those
things together it's not to sayyou have to be a victim to your
emotions, but respect them, knowthat they're there
Four: Five (24:31):
with them rather than
trying to stuff them away.
I had a client years ago withpretty severe pack pain.
She had exhausted the medicalinterventions available to her,
but she still experiencedsignificant discomfort every day
.
She'd been in pain for a longtime and her nervous system was
in a state of realhypervigilance around any
movement that might cause hermore pain, real hypervigilance
(24:52):
around any movement that mightcause her more pain.
She was profoundly hesitant tomove At first.
Even the smallest movementswould cause her to say things
like oh, oh, I feel that, andshe would stop and tense up.
She wanted to just stop doingwhat we were doing and it took
us a little while to navigatethat.
I'll admit it was a littletough at first because she
didn't want to move in even thesmallest ways and I obviously
(25:13):
didn't want to cause her morepain, but we were really trying
to get some movement happening.
She'd been in pain for so longthat her entire system seemed to
interpret every sensation aspain.
I decided that perhaps we couldexplore and qualify her
sensations a little morespecifically, as she felt them,
(25:35):
to see whether we coulddetermine which sensations were
simply her brain becoming awareof something happening in her
body and which she couldactually classify as pain.
Was that pull she felt as sheextended one leg really pain, or
was it perhaps a sensation oflengthening tight tissues?
Was the shortening she felt inher side pain, or was it the
(25:57):
sensation of a musclecontracting?
As you can imagine, thisprocess took some time and
reclassification of hersensations in her experience
helped her find a way into agreater capacity for movement
and improve both her painsymptoms and her overall fitness
, and she was able to moreeasily find peace with her
(26:22):
movement.
It wasn't such a scary thinganymore.
So, regardless of where you'reat, if you're experiencing
chronic, non-specific back pain,I believe it's important to
take a wide view and incorporateall the possible areas where
you might make a difference.
Strengthening your core mightbe part of the solution, but
it's likely not the only one.
(26:42):
I've thrown a lot at you in thelast few minutes, so let's get
practical and lean into somequick, evidence-based takeaways.
One nearly all the majorguidelines now encourage staying
active as a first-line strategyfor back pain.
Two exercise helps.
Doesn't have to be Pilates,yoga, walking, strength training
(27:03):
.
All show benefits.
Three manual therapy, paineducation and a
multidisciplinary approach canhelp.
I am a firm believer inmultidisciplinary approaches.
Just don't do it all at once.
Start with one thing, see howyou respond.
Add another thing.
See how you respond.
Are you experiencing some levelof better?
(27:25):
A little at a time gives you achance to know which
interventions are the ones thatare really giving you the most
benefit.
Four imaging like x-rays andMRIs, is not always necessary
unless your doctor suspects aserious underlying cause.
Most people of a certain agewill show degenerative changes
(27:46):
on a scan, whether or not theyexperience any pain.
Sometimes a scan will show allkinds of crazy things going on
in somebody's spine and there'sno pain patterns, there's no
movement issues, so the scan isnot necessarily going to tell
you what you think it's going totell you Osteoarthritis or
spondylosis appearing on a scanmay or may not be the cause of
(28:09):
your pain.
It may give you a startingpoint, but what you do moving
forward will be more importantand more likely than not.
The advice will be to keepmoving.
Five importantly consistencyand individualization matter
much more than the specific typeof exercise you've chosen.
(28:30):
We know the research shows thatpretty much any movement is
beneficial.
But I want to zoom in on Pilatesfor a moment, because that's
what I do.
Research reviews show Pilatescan offer small to moderate
improvements in pain andfunction for chronic low back
pain, which is about the same asany other exercise approach.
(28:51):
But Pilates brings somethingspecial a focus on body
awareness, controlled movementand whole body integration.
That means you're not justgaining strength, you're
learning how your body works andhow it moves, so you can do
that with greater confidence andjoy.
So why, as an integratedmovement specialist, do I
(29:11):
believe so deeply in Pilates forback pain?
Well, I initially startedPilates for a pain problem in my
20s.
I had chronic and sometimessevere knee pain.
It took about a year ofconsistent practice, but Pilates
did what nothing else could and, believe me, I had tried
everything at that point.
Pilates got me out of pain andactually gave me more strength
(29:34):
and capacity than I had hadbefore.
I knew there was power in thiswork.
Over the years since then I'vewitnessed profound changes in
recovery and people managing awhole host of different kinds of
back pain and dysfunction.
What I see time and time againis this Pilates strengthens the
(29:54):
deep core system in harmony withthe breath, the pelvis, the
hips, the legs, the shouldersand the whole body.
It is the only form of exerciseI've found, when practiced and
taught well, that has aprofoundly integrating effect on
the body.
The exercises in Pilates helpto lengthen and decompress the
(30:15):
low back and the hips and thethorax, all important for
stability and freedom in thetrunk.
We build strategies for wholebody support, not just bracing
the spine.
With guided, positive movementexperiences, clients learn that
movement is safe, rewiring thosepatterns in the brain.
There is no one-size-fits-allsolution.
At Moving Spirit, for example,our approach is personalized.
(30:38):
Everyone's story is different.
Perhaps most crucially, pilatesinvites you to listen to your
body and become an activeparticipant in your own healing.
It's not just aboutbiomechanics.
There's an educational,empowering and psychological
support element, especiallyimportant when pain has eroded
(31:00):
your confidence.
So I'd want to give you somepractical tips for everyday life
when you're dealing with backpain.
Practical tips for everydaylife when you're dealing with
back pain.
I'd like to tell you to choosea skilled, compassionate Pilates
teacher or movementpractitioner who will listen to
your story.
Start with some privatesessions and a thorough
assessment tailored to you.
(31:21):
And here's the thing Commit toregular, mindful practice.
Movement is medicine, but onlyif you take the dose and it's
not just one and done.
You need to pay attention towhat you're doing, to feel it,
to recognize it, so that youtake it beyond the hour or two
(31:42):
or three that you spend with acoach or within a class and you
can recognize that and take itout into your world with you.
Look for small dailyimprovement, not instant
perfection.
Really feel what feels better.
Be open to new movementexperiences Like that's kind of
a be coachable moment rightImagery, new movement strategies
(32:05):
, mindfulness or even exploringhow play and maybe joy can sneak
back into your movement life.
That can help you reframe howyou're living and moving inside
your own body.
Maybe that sounds a little woo,I don't know, but I promise
it's true.
Support yourself outside yourmovement habits with good sleep,
manage your stress and find anurturing community.
(32:31):
I read an article once by awoman whose name I can't
remember right now, who wroteabout her experiences working
through back pain.
She described finding someoneshe worked with as a back
whisperer, and in that moment Iloved it.
She found someone who was ableto listen to her problem,
evaluate all the elements ofwhat was going on for her and
guide her toward a betterexperience over time.
(32:52):
That doesn't happen in threeeasy lessons with a few standard
protocol exercises.
It takes some time, but thething to remember is that it is
possible to feel better and thatthe real back whisperer is you.
All this being said, there aretimes when you must urgently see
your doctor.
If you notice sudden severepain, unexplained fever,
(33:17):
significant weakness or numbnessor issues with bladder or bowel
control, please seek medicalattention right away.
Don't mess around.
Back pain can feel utterlyoverwhelming, but you have more
power than you might think.
By staying engaged, listeningto your body and listening to
(33:38):
your pain, asking for help andmoving yes, moving you give
yourself thevery best chance of feeling
well again.
So move and move some more.
Walk, stretch, play, breathe.
Pilates can be a greatcompanion, but also let your
curiosity and a littleplayfulness lead the way.
Every little bitof movement you add gives you
(34:00):
more strength, resilience and,most importantly, freedom and
independence.
You are so much more than yourpain and you're worth investing
in.
I'd like to recommend a coupleof great resources talking about
pain that might be useful foryou if you're navigating a pain
problem of any kind.
One is a video by LauraMermosley called Explain Pain.
(34:21):
It's a great, really quickperspective on pain.
You'll understand itdifferently after you hear it.
Another is a book called whyThings Hurt by local
physiotherapist Brent Stevenson.
I'll slide some links to thosein the show notes.
They may help you refine yourperspective on your experience.
You might also be interested inan earlier episode of the Heart
(34:44):
of Motion, an interview that Idid with a dear friend and
colleague, amy Ruth.
It's episode eight of seasonone called Resilience, health
and Connection Through Somaticswith Amy Kiara Ruth.
Amy has some beautiful ways totalk about movement and pain and
I hope you'll check it out.
And haha, there's more.
I hope you'll join me next timewhen I'll be talking to Anthony
(35:08):
Abagnano, internationallyrenowned founder of the Alchemy
of Breath and author of the bookOuter Chaos, inner Calm, about
the power of breath work.
His insights in that interviewfeed beautifully into today's
conversation about back pain andto the choices.
We have to move throughchallenging situations.
Tune in to the next.
(35:29):
We have to move throughchallenging situations.
Tune in to the next episode forthat one.
Before we go, I just want toremind you that this podcast
episode includes informationbased on the latest research and
international guidelines onback pain management.
But always consult a qualifiedhealth professional for advice
suited to your unique situation.
Until next time.
You matter, so keep moving.
(35:51):
You got this.
I hope you enjoyed today'sepisode.
Subscribe and, if you love whatyou heard, leave a five-star
review and tell people what youenjoyed most.
Join me here again in a coupleof weeks.
For now, let's get moving.
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