A major study* shows that at least 44% of people with back pain can 'centralise' their back pain. If they are guided through a specific process that I'll describe in this post ...
... which is why it might just be one of the most important posts you read about the fitness of your back! This could enable you to continue with your Strength, Brazilian Jiu-Jitsu or CrossFit training. Or whatever quirky activity you are in to that requires peak performance.
I use what I'm about to teach you. While I can't guarantee it will work for you as I don't know you yet. It will help if you are one of the 44% of back pain sufferers proven to benefit from it.
As an Osteopath, I was stuck with my own back pain. After heaps of different treatments, I found a way to eliminate my own back pain. I couldn’t quite believe it when I discovered how simple it was.
I’m going to share exactly what I do, and how you can find out if this will work for you (which I hope it does).
Let’s get straight into it.
The process I discovered is called ‘Centralisation’. I learned it from Dr Nic Lucas when I did my post grad training in Osteopathy. It only works in certain people and will definitely not work in others. Dr Nic Lucas was delivering information to us he found during his doctorate studies. His doctorate included mechanical pain and diagnosis among other things. More than qualified to comment and deliver evidence based therapy.
It’s easy enough to perform, so that’s not a barrier. The only thing you need to figure out is if you are a candidate for this technique. I’ll help you with that in this post, but you must read my disclaimer first. Deal?
Anyway ... that is my recommendation. And I'm sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this post. I don't know your medical history, I don't know how you use your body ... and by reading this post you agree with this. Done deal?
What is 'centralisation'?
Centralisation is when the pain you feel in your back becomes centred in ONLY your back … it might even get stronger to begin with … and then it fades, and fades, until it fades away.
And I can tell you that it is awesome when it happens. But there’s quite a bit more to it.
Some people have back pain that they feel more on the right or the left.
Some others have pain they feel spreading into their glutes (buttocks) or down into their leg.
Centralisation can still work the same way in these people too. The pain ‘retreats’ back up the leg. Retreats away from the glutes, and into the centre of the low back. You might feel it stronger in the back … before it fades, fades some more, and eventually (and hopefully), fades away altogether.
You’ll know if your pain ‘centralises’ because that’s how it will be for you too. The pain moves to the centre of your back before fading … even if the pain starts out in your bum or leg.
Is 'Centralisation' Scientific? The answer is YES.
Scientists have been studying 'centralisation' for a few decades. It is important for you to know if YOUR back pain will centralise. Because if it does, you might have just discovered a method for managing or even eliminating your back pain.
Many doctors and health professionals don't know about this ... which is why I'm writing this for you.
If you want to read the highly technical stuff ... here's a systematic review for you to wrap your head around. It is summarised in this post instead anyway.
Geek Speak: * May S, Aina A. Centralization and Directional Preference: A Systematic Review. Manual Therapy, 2012; 17: 497-506.
So how do we make it ‘centralise’?
We use repetitive movements of your back in a specific direction. Officially, these are called ‘dynamic end-range movements’ or DERMS for short.
Let’s use me as a real example to explain what has to happen.
What was the problem?
I had pain in my back that spread as a constant strong ache all the way down to my left buttock.
So, how do I fix it?
I lie on my front, and with my hands placed next to my shoulders, I do a pushup while keeping my pelvis on the ground. (Just like in the picture below.)
This creates ‘extension’ in my lower back, and I repeat this movement at least 10 times in a slow steady manner.
Sounds simple enough, right?
Almost … but there are some important things you have to do to see if it will work.
And, if you don’t do these things, you might make the mistake of deciding that it doesn’t work. Not because your pain won’t ‘centralise’, but because you’re doing it wrong. Fair enough?
So, how do you do it ‘right’?
First, this is not the same as the movement you might have learned at Yoga. It’s similar, but it’s not the same.
Second, you might feel pain during this movement.
As I wrote earlier, during the centralisation process your pain might become stronger in the centre of your back before it fades. So, you have to be aware of this. If you bail at the first sign of pain in your back, then you’ll never know if your pain will centralise.
This is why it’s best to do this with expert guidance … but once you know how to do it yourself, you can do it yourself!
I’ll give further instructions … but again I strongly advise you to do this under expert supervision. I’m just describing it here so you know what to ask for, and what to expect.
1. Lie on your front, relax and then notice where you feel the pain.
If it’s just in the centre of your back, then you just stay lying straight. If the pain is to the right, or in your right glutes or leg, then shift your pelvis away from the pain (e.g. shift it to the left). If the pain is to the left, or in your left glutes or leg, then you shift your pelvis away from the pain (e.g. to the right).
2. Place your hands in front of you and just outside your shoulder width. Keep your back, glutes and legs RELAXED the WHOLE time.
3. Gently begin to push up while allowing your pelvis and legs to stay on the ground. The general aim is to fully extend your arms while your pelvis stays on the ground.
NOTE: You might not be able to do this … you might be too stiff, or you might feel pain. And this is where people ‘give up’ if they try it by themselves … again a great reason to have an expert guide you through it.
What if you’re too stiff and your pelvis starts lifting up off the ground as you push up?
You can just continue to see if will work, or, if you’ve got an expert guiding you, they can apply pressure down on your pelvis or spine to keep it on the ground. That way, you’re pushing up against their resistance.
A NOTE FOR THE DIY COWBOYS
For those cowboys who want to try this on their own ... just don't (you know who you are). Invest in yourself. Go and get the expert guidance to do it right the first time. Ever seen someone try to snatch 80KG without any training? Yeah ... well this is the same. Get help.
What if you’ve got pain as you push up?
You probably WILL have pain. So, here’s the rule. Follow this rule and 99/100 you’ll be OK.
If the pain gets WORSE in your glutes, your leg or to the right or left of your spine ... then stop and reassess.
If the pain gets STRONGER in the center of your back, and it’s tolerable, then keep proceeding with caution and confidence. Remember, before the pain fades, it often gets stronger in the center of your back.
So, once you’ve done your first pushup … and dealt with any stiffness or pain that crops up, you just lower yourself back to the ground … slowly. No need to rush this.
It’s not an AMRAP and it's not for time.
Push up again … go as far as you can go … and then lower yourself back down to the ground. Keep your back, glutes, and legs relaxed (you’ll find they tend to tense up … an expert will help you to do this).
Push up again … and down … and up … and down … and repeat this at least 10 times … unless what?
Unless the pain is getting WORSE in your glutes or leg/s. If this happens you stop.
If your pain centralises, here’s what you’ll find happens.
As you begin, you might feel stiff and have pain in the center of your back. But the more you repeat this movement, the less pain there is … even though at first, it might be stronger in the center of your back.
You might find that at the end of these 10 DERMS (dynamic end range movements), that lying there your pain has vanished. Amazing.
But what if this DOES NOT happen? Does it mean this won’t work for you?
Not necessarily. It would be unwise to give up so soon. Here’s what your expert guide should do …
1. Get you to repeat this another 10 times … if there is any noticeable reduction in your pain, then this is a positive sign.
Perhaps your pain will not completely fade in the first session … or the second or third. But the REASON you would keep trying is that:
(A) your pain is not getting worse, and
(B) your pain is actually getting better and you NOTICE that it gets better by doing this movement.
That is the easy criteria to go by.
2. Modify your position on the ground. Perhaps your pain was not exactly in the centre and you needed to shift your pelvis slightly to the right or left. You’ll know exactly what I mean when you do this. A small shift of your pelvis to the left or right will feel very different when you push up.
3. Apply pressure down against your spine as you pushup. This is difficult to do by yourself of course and yet it can make ALL the difference. Another reason you need expert guidance with this. In my experience … the amount of pressure and the exact location of that pressure can also make ALL the difference.
I haven’t covered it here … but there are other repetitive movements that can centralise pain, and this is why your expert is there to help.
If none of this works, then that’s just how it is. Your pain doesn’t centralise and you need to find another solution … and I would insist on finding that solution.
But imagine if you didn’t go through this process?
Imagine if you gave up too soon?
Imagine if your back pain could be centralised with this simple approach?
Quick. Easy. Empowering. Cost effective.
You could centralise your back pain right there on the CrossFit floor or before a roll at Jiu-Jitsu. Just like I do if I happen to have back pain.
I sometimes get a mild ache if I’ve been sitting at my mac for too long. Centralisation by dynamic end range movements deals with it immediately.
Even when I’ve had a very bad flare up, I’ve been able to centralise my pain and resolve it … e.g. I had to do that consistently after that life changing lower back pain I blogged about here (READ IT HERE).
This process of using Dynamic End Range Movements is only ONE approach, one solution. It only works for the people it’s going to work for, this is based on the source of the pain.
But there are other active ways to resolve your pain. If you’d like a better understanding, download the Athlete's Guide to Osteopathy. In this free guide, you’ll learn:
How athletic training and Osteopathy share very similar aims
How Strength and Conditioning can work together with Osteopathy to help you optimise your health and fitness
How an athletes strength training, CrossFit and Osteopathy should be wholistic from a scientific point of view
How Osteopathy can help people who train improve their functional movement
and more …
CLICK HERE TO GET YOUR FREE COPY OF THIS EBOOK!
A bit extra about me.
I consult as an osteopath. I have been a clinical educator. I am currently a tutor in the Masters of Osteopathy program at Southern Cross University. I am obsessed with helping people thrive in all areas of their life. My wife and I own and operate a thriving Osteopathic clinic here on the Gold Coast and we have two vibrant kids.
I have played sport at elite levels, I train every week. I chase down my goals. I get excited seeing people smash their own goals. It's even better when I get to share in part of that journey with them. As an Osteopath I get to empower people in their movement and performance. It is the idea of pain-free form and function of human movement that still drives me in my daily work.
At our clinic we have 4 osteopaths and our sports remedial therapist. All who chase and achieve sporting goals in their own private lives. If you feel you need guidance into discovering a potential solution for your back pain, book online here and come and get to know us.
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