In my recent article about how manual handling instructions in the workplace may be contributing to back problems instead of correcting them I made a reference to an interesting book by Esther Gokhale called 8 steps to pain free back. In this book she provides some fascinating insights into how people in Africa and India move in daily life with much different posture in comparison to people in the Western world. She notes how these people are almost completely free of back pain and musculoskeletal problems that are rampant in modern industrialized society. These observations are the basis for her 8 steps in the book and provide some great ideas to treating back problems at the source. As opposed to most injury rehabilitation methods that focus mostly on the exercise corrections this method concentrates on adjusting the way we move with sitting, lying, walking, and bending. In this article, I discuss how this book helped me personally with a hip and back problem and the key parts that relate to all of us.
This article was inspired by conversations I held with several people over the last few months who came to see me for help with a chronic back problem that was hindering their job. During their assessment I could see in each case how poorly they would complete a bending action, also known as a Romanian Deadlift. This is not unusual and a very common problem to most back pain sufferers, especially those with a bulging disc. However, as I got to know these people I discovered this was not their natural way to move. They told me that they had spent considerable time learning how to lift a certain way at work where they use their knees and keep their back straight. It was this poor method that they had been taught that was to blame for their pain. Unfortunately, it was not a simple task to reset their movement to a more efficient and safer technique as their body had developed a lot of compensation and stiffness in the meantime. If they had been shown a better way in the beginning I believe they would have avoided a lot of pain and suffering.
There has been many times I have proven wrong or changed my mind about certain exercises over the last 18 years as a trainer, and recently I discussed a perfect example of this in great length in an article about the hip-thrust exercise for the glutes. I mentioned in that article how I was really struggling with various movements I would normally use in my workouts due to an auto-immune disease causing severe problems with my right hip and my sacroiliac joint. While I found the hip thrust helped me a lot to continue strengthening my hip without aggravating things I still needed something more to help me with the instability I could feel in my back. This is where you would often see the use of targeted core stability exercises but, once again my preferred choices of movement to do this were very difficult to do as I was so limited in my use of my hands and wrists. This led me to explore the use of the Pallof press which is quite a unique exercise for strengthening the core. And much to my pleasant surprise it really helped me to overcome some of the instability I was suffering with. In this article I will explain what this exercise is designed to do and the variations you can use to progress or regress the movement.