WRITTEN BY RICHARD SEVEN

	COURTESY OF "THE PILATES PRESCRIPTION FOR BACK PAIN"
	Using a scarf to do a straight-leg-raise test can help you determine if your hamstrings are too short. When the hamstrings (a group of three muscles that flex and bend the knee) are too short, your flexibility is restricted and you are at greater risk of injuring the lumbar spine in everyday bending or sports activities.

The pain can be acute or chronic or both. It can come in tweaks and jolts from well-meaning physical fitness, that new movement or everyday life, like gardening or driving long-distance. I once became bed-ridden for five days (on the first day of a weeklong vacation!) when I bent down to tie my son's shoes.

Some get back pain from traumatic injury, say a car accident, and some acquire lingering back pain that creeps up on them after years of slumping as they sit, walking less than upright and forgetting about the importance of core strength.

Most of us understand the vicious cycle. A bad back stops you from exercising, and while rest is a critical short-term treatment, resting can become habitual and lead to more back problems. You begin moving differently to protect your aching back, only to start more problems.

What kind of pain do you have? How can you rehabilitate? And how do you prevent reoccurrence?

There is no shortage of options: physical therapy, surgery, massage, smart "core training," chiropractic treatment and acupuncture, to name just a few. Many gadgets are designed to stretch, support and massage it.
 

COURTESY OF "THE PILATES PRESCRIPTION FOR BACK PAIN"
Proper posture is key to avoiding or alleviating back pain. Ideally, if we ran a plumb line along our profile, all the joints would be aligned from head to heels, with the pelvis in a neutral position and the spine retaining its natural curve. These diagrams show three common types of misalignment in which our upper or lower back is curved out of line and our heads are too far forward.

I decided to look into the gentle, focused arts of yoga and Pilates.

I ran across Dr. Karen Sherman, a researcher for the Center for Health Studies at Group Health Cooperative, who is finishing a study of yoga's effect on back pain. She is tallying data from the study, funded by the National Institutes of Health. Some of the patients participated in a series of gentle, back-focused classes, while some took on other exercise programs. Sherman says early anecdotal information is encouraging.

What surprised her as she prepared her study proposal was that, despite the videos and books espousing the wonders of yoga on back pain, she could find no research-based literature showing the benefits of yoga for back problems.

She teamed up with yoga therapist Robin Rothenberg, who owns the Yoga Barn in Issaquah and Fall City. Rothenberg has been teaching gentle yoga for more than 16 years, and gave a talk about back pain to yoga instructors last year. She was surprised by how many of them had back pain.

At her Fall City studio a few weeks ago, I went through a series of poses with her. I promptly put a disgusted look on her face as I began a leap from my back toward my feet. Gentle, she implored.

We worked a long time on proper breathing, designed to relax, focus and energize. To help me learn how to deepen and focus my exhale, she put a 10-pound bag of rice on my stomach so I'd start from there and squeeze my breath upward. I did several poses while on my back and then on all fours — each designed to stretch, strengthen and then stretch again my back. Each movement was slow and timed to the rhythm of the breath.

That was just lesson No. 1. Participants in the study moved on to hamstrings, flexors, quads and all the other body parts that need to work in sync.

Pilates shares much of the same principles.

I found the book "The Pilates Prescription for Back Pain" especially helpful. The book is chock full of exercises, but I was particularly impressed by one of its early scolds (which I heard in some form from Rothenberg) to stop waiting for people to fix you. "No one can follow you around reminding you to sit up tall! It is time for us to take responsibility for our own bodies."

The book describes in depth how our movements affect the spine and how stabilizing and mobilizing muscles must work in concert. It speaks of posture and how we become "knowing victims" by letting everything from fashion to stress to slouching shape us.

Consider standing. You know how to do that, right? But do you do it right? You should be aligned from heels to head with the pelvis in a natural, neutral position and the spine retaining its natural curve. Yet many of us let our upper or lower back sway or curve backward or walk with our heads leading the way.

A key message of the book, Rothenberg's yoga therapy and many other experts ultimately comes down to this: If you really want to solve and prevent back pain, you have to pay attention. Not just to the back, but to all the mistakes it is carrying.

Richard Seven is a Pacific Northwest magazine staff writer. He can be reached at rseven@seattletimes.com.

More On Fitness columns