The low back and low back pain is a hot topic these days among Strength Coaches, Trainers and exercise enthusiasts. As well it should be because low back pain is a huge problem that effects just about everybody at least one time in their life. That’s why I, like many other coaches, read as many books as I can on the subject of low back pain.
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One of the best books I’ve ever come across in regards to low back pain and research on low back pain is – Medical Management of Acute and Chronic Low Back Pain: Pain Research and Clinical Management Series, Volume 13 – By Nikolai Bogduk BSc(Med) MB BS MD PhD DSc DipAnat Dip PainMed FAFRM(RACP) FAFMM FFFPM(ANZCA).
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If you don’t know? – Nikolai Bogduk is the worlds number one Functional anatomist and has been since the early 90’s. You can view a list of all Bogduks books and research publications here at BioMedExperts.com.
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This book is unlike any book I’ve ever read and really is responsible for my current approach to training and my overall philosophies about science in general.
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In this book, Bogduk analyzes and compares 100s of research studies on low back pain. What he concludes with shocked me and will shock you too!
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In the first part of the book, Bogduk systematically invalidates and rules out many highly quoted research studies for one reason or the other. He then compares the findings of the “valid” research studies left to find commonalities in the findings about what causes low back pain, what are the best treatments for low back pain and what we should do to prevent low back pain.
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By the way, Bogduk defines back pain as pain arising from the tissues of the axial skeleton or body wall, “perceived in an area not more than a hand’s breadth either side of the lumbosacral vertebral column.” (Medical Journal of Australia, 3 Feb. 1992.)
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Interestingly enough, after over 250 pages of some seriously scientific bedtime reading, the Worlds #1 Anatomist concludes that because most of the current research on low back pain has drastically inconsistent findings – We really don’t know a damn thing about what causes low back pain or how to prevent it!
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Now, this book was published in 2002 so many may say it’s out of date. But, even after the eights years since his book was published, Bogduk still conveys the same message that much of what we believe about what causes and prevents Back pain is not trully evidence based.
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This is why I don’t just follow one researcher or the other. Nor do I ever just throw out stuff that I know works because one study says it maybe no good. Because another study will come out saying something completely different. This is what Bogduk found when he wrote this book and is still finding to this day – One researcher says this. But the other researcher says that! The science almost always conflicts itself. You read the research, you know what I’m talking about…
Some folks who have herniated discs get pain, but others do not! So, does a herniated disc cause back pain? Maybe? – Maybe not!
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Some folks with degenerative disc(s) have pain, but other do not! Does degenerative disc(s) cause back pain? Maybe? – Maybe not!
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Some folks with Spondy get pain, some have spondy and fell nothing! So, does having Spondy cause back pain? Maybe? – Maybe not!
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Some folks have tight hips flexors and get pain, others test tight but have zero pain. Do tight hip flexors cause low back pain? Sometimes yes and sometime no!
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Some folks who exercise get back pain but others who don’t regularly exercise get low back pain. So, is back pain caused by activity of lack there of?
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I could go on but I think you get my point! The truth is, after reading this book, it changed my outlook on everything thought I ‘knew”. I realized that I really had no right to argue or look down on anyone who does things different than me because everything I “knew” was really based on nothing more than my personal experiences, opinions and my own interpretation of research.
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My approach now is simple – I have a system that works for me. Sometimes I don’t know why it works, but I don’t really care because it works!
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