Cardiovascular demand and load on your body will stress joints and muscles, and training in this way is what people really mean when they think of the "no pain, no gain" expression.
If you are just training – whether it’s for aerobic fitness or anaerobically using weights to get stronger – it’s probably going to hurt. It’s impossible to say whether these strains are to the muscles, ligaments or other soft tissues, and as we said above, they are not likely to be be damaged as such. Rather, it is more likely to be excessive stresses and strains on the low back causing pain by placing too much load through the soft tissues and causing them to fire off nerve signals to the brain that are interpreted as pain. If you did have a simple soft tissue strain, then this would take a month or two to settle, yet in the clinic, treatment over a week or two can make significant improvements so it doesn’t fit that you’ve actually damaged some tissue. So, it can’t really be one simple act that has caused the problem, but rather that it is the last straw from all the times you have done movements that place strain or excessive load on your back, and now one of those tissues is crying out for help. Clearly, if tying our laces was so dangerous, we would all be forced to wear slip-ons.
I hear stories from patients of how their back "went out" when they bent down to tie their shoelaces or to pick up a pen. If you're wondering about it, we have a feature discussing ' can yoga fix your posture' too. Yes, the overlying muscles can then spasm as a result, but clinical experience suggests that the cause of most simple back pain is not muscular. This movement is actually loading the joints in the lower back – the facet joints – and it is most commonly produced in patients with simple back pain. In the doctor's office, an examination will most often produce the patient’s symptoms when they extend (arch) their back, where there is no load on the musculature. Often back pain is described as muscular or as a muscle strain, even by doctors, yet MRI scans never show this, and there is little or no evidence to say that there is actual damage to the soft tissues at all. The majority of back pain doctors see is either classed as non-specific or mechanical, but what does that really mean? These are genuine conditions of course, but sometimes back pain is not as serious or significant as that. You may have heard of people having a prolapsed or slipped disc in their back, or having degeneration / arthritis as a cause of their back pain. (Image credit: Getty) Is back pain muscular?
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