Table of contents |
2 Using Other Muscles More 3 The Basic Program 4 The Stages of Rising From a Chair 5 Other Exercises |
Evolution is usually a very gradual process but human evolution, while taking millions of years, has been very rapid on an Evolutionary scale. This quick change to an upright stance, unlike other mammals and almost all other anthropoids has health consequences because that process of evolution is incomplete - principally, hernias (tears in the abdominal wall which is now under much greater stress), fallen arches and back muscles spasms. All are direct consequences of the change to bipedal motion. Even so, we are pretty well adapted to an upright stance (just not yet perfectly adapted.) Back problems would be much rarer if we lived our lives in aboriginal conditions, being active, using our legs a great deal and not using chairs - or even if we were only a little less sedentary than modern humans have now become.
This rehabilitation plan assumes that a sedentary lifestyle and/or poor motion-posture is the root of most back problems, since during a period of comparative inactivity, our back muscles remain strong or at least active - even while sitting we use our back muscles to adjust ourselves, lean and reach - but the rest of our musculature, including our legs, become relatively weak. In contrast, our legs aren't doing much while we sit. Our tendency then, is to constantly overuse our back muscles, particularly lower back muscles, to substitute for other muscles, especially leg muscles. It's natural that this should happen, since we're still used to using our back muscles all the time, and these remain relatively strong. Paradoxically, back problems don't occur because of a "weak back", although it feels that way when they're hurting. According to the Johnston-Ruyer approach, back problems usually occur because the back muscles are the only muscles left that are fairly strong and which the sufferer is still used to using. Therefore, these muscles are overused, and used inappropriately to compensate for other weaker and less used muscles. Eventually the extra burden on the back causes muscle spasms, a typical sort of athletic injury for any overused muscle, which we experience as nagging back pain or as a severe episode of pain that puts us "flat on our backs."
Standard sorts of leg exercises are part of the program, if possible including lots of running and walking (taking care not to employ back muscles to help swing the legs.) Maintaining a specific sort of balance while moving, especially when sitting down or getting up from a chair is the other half of the therapy. Both parts require relearning our unthinking patterns of motion, in simple but precise ways that let all our other muscles do more of the work, and our backs, less. Exercises to strengthen the back itself are regarded as inessential, since the principle of the method is to strengthen and ready for use the rest of the musculature, such as the legs. Yes, it is possible that your back muscles are not in great condition, but it's very probable that other muscles, such as the legs, are even weaker.
While this therapy can be used as an adjunct for atypical back pain resulting from unusual medical conditions, it is principally designed for the standard case, of a no longer young or no longer athletic person experiencing episodes of back pain (lower or upper.)
There was a time, only a few years ago, when physicians uniformly prescribed bed rest for backaches. Scientific studies then showed that this actually aggravated the problem by further weakening muscles, and that getting active again as quickly as possible strongly aided patient's recovery. This change of treatment has boosted Johnston-Ruyer therapy, because it helps patients get moving even while still in pain, and begin the process of recovery as soon as possible. At the same time, it's very specific changes to the way in which we move, such as when raising or lowering our body weight, form habits which relieve the back of much of the burden it has been under while at the same time strengthening other muscles so that they can resume a more normal, active role.
Believe it or not, the best time to exercise and learn how to use your muscles in ways that will cause your back less pain is when your back is hurting - because this is when even the smallest deviations from good posture-in-motion will show up. This, after all, is one of the evolutionary purposes of such pain - to illustrate and enforce the more efficient use of our muscles, and retrain us in these better habits - not to keep us wholly inactive while we slowly starve. (Remember, you've already consulted a physician and can reasonably assume that your back pain is the usual kind, not caused by an unusual injury or disease.)
Using the legs more, and the back muscles less is central to most approaches to back pain. Johnston-Ruyer holds that overuse of the back muscles occurs when we lose track of where our center of gravity is; or more particularly, *where the centers of gravity of each of our three main body segments are with relation to each other.* It holds that back muscles are usually strained or overused when they are attempting to balance us and keep us upright while the centers of gravity of these main body segments are eccentric from a straight vertical line through the body. The three segments of our body mass are held to be: 1) toes to knees ("upper body"), 2) knees to hips ("upper legs"), and 3) hips to the top of the head ("lower legs"). Even sitting up from a chair, or sitting down badly with the centers of gravity of these segments out of line, can cause very considerable strain to our back muscles.
Aside from general exercises to strengthen the legs, the most important, and central exercise is therefore to learn to sit down and get up from a chair. We all do this constantly, and usually in a simple but awkward way that strains our back muscles with work they needn't be doing, whether we feel that or not. It isn't an exercise we were evolved to perform, and a special technique is required to sit down in or rise from a chair while keeping the centers of gravity of the three segments of our body mass precisely "stacked on top of one another". This series of movements is more complex than what we usually do when standing up, or sitting down, and more precise.
The same principle, of keeping these three separate centers of gravity all lined up vertically, perfectly, can then be extended to other activities: when raising and lowering oneself, reaching, lifting, using stairs and running. But a good place to begin is with the process of sitting in, and standing up from a chair, because most people do it so awkwardly.
In summary, one could say that the vast majority of back problems are not a hardware error - not originally a problem with disks or muscles or anything else physical. They could be characterized instead, as a software error. The way our brains tell the muscles to move, particularly if we've become used to being sedentary, causes the problems. A positive feedback cycle easily sets in - a vicious cycle of pain and behavior can easily form in which most muscles are allowed to weaken, and because they are weak, are used still less. Meanwhile the back muscles, because they remain relatively strong, are used more and more. Then one of two things happens: when an unusual stress or heavy lift occurs, the habit of overusing the back muscles may really hit home and the large back muscles will begin to spasm or seize up causing acute pain, or, poor motion-posture habits become so ingrained that nearly all movements are causing the back muscles to do too much work, resulting in constant nagging back pain from even ordinary activities, pain that just never seems to leave. It won't leave until other muscles are strengthened and our posture-in-motion changes.
Learning different ways of using the body that keep those centers of gravity on top of one another at all times, and exercising and strengthening our other muscles, breaks the cycle, and can allow a pain-free life to resume, in which we aren't straining our back.
Note that to keep the centers of gravity of our three body segments stacked exactly on top of one another, in a straight line to the ground, each section has to pivot and tilt. If you've ever seen an aboriginal dancer, dancing largely in a crouch, you've a very good idea of what that means - aboriginal dancing is strenuous and keeps going for a while. If their posture-in-motion isn't very good, the dancer will surely feel that later. So their body segments are exactly stacked and each segment tilts and pivots as necessary to maintain that rule of posture throughout the dance, setting all of us a good example.
Similarly, rising from a chair, say, we want to pivot and tilt each body-section as if it were independent, to keep those centers of gravity lined up as well as we can. (Starting by leaning far forward and tucking our feet a bit under the chair, before we begin to rise.)
As was said earlier, our bodies didn't evolve for use with chairs. So it shouldn't be surprising that chairs can force stereotyped motions that isolate and overuse just a few muscles, and that they often force us to move a bit awkwardly, with our body segments out of line. So therapy often centers on relearning this common motion, in detailed steps or stages. With luck, you'll be in at least some pain when learning the exercise, since your discomfort will punish any deviations from good practice, and be a very accurate teacher. If doing this exercise leads to substantially more pain, you are doing it accurately, or have a problem other than normal back pain from overuse and deconditioning. Stop, and consult a physician.Evolution and our back
Using Other Muscles More
The Basic Program