Description
"Your back isn't broken. It's just loud."
That's usually the first thing I say to someone who walks in convinced their spine is falling apart.
MOST back pain isn't a structural failure.
It's a smoke detector...going off because the room filled with smoke...
Not necessarily because the house is burned down.
In the majority of cases, the biggest doors of opportunity aren't MRIs, surgery, or hyper specific therapy techniques.
They're sleep, stress management, nutrition, and general activity level.
Get those reasonably dialed in and consistent, and a huge percentage of back pain calms down on its own.
Here's where the "it depends" part comes in...
Movement quality, mobility, and strength absolutely matter ...
If the lifestyle variables represent the doorway, then mobility, movement competency, and treatment .... represent the small hinges that swing the door.
For athletes and active adults whose pain shows up around a specific movement or activity, that's exactly where I go deeper...
movement assessment, targeted mobility work, individualized programming.
Now, I assess movement for every client. Im always looking at the movement variables I can manipulate.
But if I see real gaps in the lifestyle foundation, I don't overcomplicate the program.
I simplify it and focus on habit stacking over weeks and months...
building a base of resilience before we ever talk about optimizing anything.
Back pain is a multivariable equation.
The dependent variable changes from person to person.
That's why the exact same exercise program can fix one person and do nothing for the next.
In an industry currently obsessed with "do less," I'm still committed to doing whatever a person actually needs...every case, every time.
It's interesting to see rehab pros world hell bent on "making things simpler", stripping a;l the nuance from the conversation..., yet, the best in the industry (in my mind anyways) still respect, and consider the complexity of the system before they do anything...
Do you think the "do less" mindset in rehab has been over-indexed?
I do, and I think the pendulum is swinging back to real, in person, hands on care, integrated with real coaching....