I was hiking a trail in Yosemite during Thanksgiving this year. As I walked along relishing the fresh air and the beauty around me, I soon became aware that navigating a rough trail is very different than walking on flat concrete. It’s more work. I realized that I had to use different muscles and expand more energy to walk than I do in civilization. I had to step over tree branches and put the weight of my feet on different angles to accommodate the rough terrain. It occurred to me that this is closer to how our bodies are designed to function. We are meant to be able to easily recruit different muscle groups in order to maintain our balance and to compensate for changes in the terrain as we walk. Walking on flat surfaces does not use these muscles.
I believe that this form of de-conditioning that we all so easily get into – thanks to civilization – is behind some of the injuries I encounter in practice. I’m thinking particularly of the small innocent movements that result in sudden low back pain or neck pain. The patient will come in and complain that all they did was bend down to perform some minor motion, they twisted a little, then felt a sharp sudden pain.
The problem is that so many of us are not used to using all those various muscles that help support the body. As a result, at certain critical times, those muscles don’t fire to support the body when they should and an injury occurs. For this purpose, I recommend certain exercises to strengthen the core musculature of the body, the postural muscles and to improve one’s balance or proprioception. Strengthening the core is a great beginning. It helps add strength to the spine and the entire body. Even better is to strengthen the core in such a way as to add instability to the exercise thus forcing the body to stabilize itself. A great way to do this is to perform core exercises with a Swiss ball. For example, if one exercises their low back in extension on a machine, which has a prescribed motion built into it, many of the postural muscles aren’t used. But if one bends their waist over a Swiss ball, feet supported against a wall, and extends their back so that their entire spine is straight, now they are using the same muscles to extend the spine plus all the other countless muscles needed to hold them steady on a relatively unstable surface.
After an injury, damaged ligaments tend to lose some of their ability to stabilize the body. This makes a re-injury more likely. Another great exercise is to work on one’s balance. The same idea applies – improving the body’s ability to recruit muscles and stabilize itself. Balance tends to get worse with age due to various reasons. For the elderly, a fall can be disastrous. A simple and effective way to improve balance is to simply stand on one foot facing a corner. If you start to fall, you can quickly put one hand on each wall and catch yourself. Try standing on each foot for a minute. It’s harder than it seems. When you get pretty good at that, try doing it for 30 seconds with your eyes closed. That’s a lot harder. Without the visual feedback, you have to rely purely on the messages coming from within your body. Balance is a skill that can be developed and, in doing so, can go a long way toward helping to prevent future injuries.