We know how much you love to get outside on a good, long hike. We also know how much back pain that incredible trail can spur. Here are six tips on preventing back pain on outdoor adventures.

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When it comes to back pain, there’s as much misinformation out there as there is facts.

Such as: “I slipped a disc.”

Fact: Discs don’t “slip.”

Or, “My glutes are shut off.”

“If your glutes were actually shut off, you probably wouldn’t be able to stand or walk,” explained Stephanie Clark.

“There may be asymmetries and compensatory muscle recruitment patterns, but your glutes are most definitely working,” she added.

Another myth Clark said she often hears from patients at her physiotherapy clinic in Coquitlam is the age-old belief that if they’re experiencing back pain, they should stay in bed and remain horizontal all day.

“This is the worst thing for back pain,” Clark said. “Discs fill with fluid when we lie horizontally and can actually place more pressure on sensitized nerve roots if in bed too long. … Get up and move.”

There are even myths when it comes to MRI diagnosis, Clark warned. For example, a patient might find out in an MRI, for example, that he/she has a L5S1 disc bulge or “degenerative disc disease.” Clark cautions not to get too tied up with these findings.

“These findings are often normal and not attributed to the patient’s subjective pain,” Clark explained. In fact, multiple studies suggest sometimes these are normal age-related changes that occur in your back, shoulder, or even knees or hips.

“Often, when people focus on their diagnosis, their fear and worry increase, and therefore, so does their pain,” Clark said.

One of her tasks as a physiotherapist at Coquitlam Wellness is to help her patients gain strength and mobility so they can rehabilitate injuries and experience less pain. Often back pain.

Never is this truer than when it comes to avid hikers, who are notoriously prone to back pain.

Here are six tips to help alleviate current back pain and prevent future back pain, if you’re someone who likes to put your body through short or long, casual or gruelling, hikes of all kinds.

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1. Build your core strength

One of the biggest keys to preventing back pain when you’re hiking, or doing other activities, is developing a strong and stable core. This movement education, so to speak, will help your body become strong and stable enough to reduce or avoid finding yourself in painful or compromised positions that often cause back pain, Clark explained.

When people think about their core, they often think about just their abdominal muscles, however, your core is a lot more encompassing than just the six-pack and oblique muscles we all want so badly. The core actually consists of the muscles in almost half of your body, muscles in the pelvis, the spine and your bum. When you walk, run, jump, bend over, twist and, of course, hike, these muscles work together.

Major muscles of the core include:

  • Trapezius muscle, which connects your spine to your shoulder blades
  • Gluteus maximus and gluteus medius (essentially your bum)
  • Hip adductors, which attach to the inside of your pelvis
  • Quadratus lumborum, located in your lower back (this is where many hikers often feel pain and tightness)
  • Spinal Erectors, which run along the spine from your glutes to your head

At our clinic, we recommend spending some time every single day working on your core.

Here are four exercises with accompanying videos that you can do as a warm-up right before a big hike that will not only strengthen your core, but will also ensure the right muscles are activated and firing as you head up a big mountain.

3 sets of:

  • 25 Glute Bridges

  • 20 Bird Dogs (10 on each side)

  • 1 minute of a Deadbug variation

  • 30 seconds planks in three position (front and both sides)

 

2. Avoid painful triggers

Though prevention is the best medicine, avoiding painful triggers when you do experience pain is also a form of preventing future back pain, explained Clark.

“Flawed movement patterns hypersensitive the injured structures,” Clark explained. For example, if you’re extension intolerant, meaning you have pain when you arch your back, or flexion intolerant, meaning you have pain when you bend forward and touch your toes, then it’s best not to aggravate your body by putting it into those positions and putting yourself in pain unnecessarily.

“Muscles and joints are loaded with sensors that include sensors to pain, forces, chemicals and pressure. Simply put, this sensory information is perceived by our brain as either good (pain free) or bad (pain). We want to flush our central nervous system with good sensory input by decreasing the painful stimuli,” Clark said.

If this means changing your workout routine to avoid flexion or extension of the spine, make the necessary adjustments. Your back will thank you for it.

Clark added that experiencing less pain even has a mental component to it. When you start avoiding painful triggers, this can also increase your confidence and ultimately help your start building a more resilient back.

 

3. Get the right backpack

This is a simple, practical, maybe even obvious tip, but if you’re into long or overnight hikes and bring a large backpack with you, spend the money on getting the right one, as it can make a big difference in your back pain.

Clark recommends a backpack with two straps: one to go around the chest and one to go around the hips. This reduces the compression forces that get placed on the spine as you hike.

Also, make sure you get the right size backpack for your body. This means it needs to be the right size for your torso length, your hip width, as well as your bodyweight.

 

4. Use trekking poles

This isn’t a solution for everyone, but many people find using hiking poles helps their back pain. Research has also shown that using poles helps alleviate the pressure placed on your joints, specifically your back.

Like a backpack, get poles that work for your body. This means your arms should be able to bend to 90 degrees while you’re holding the poles. Get poles you can adjust for incline and decline parts of the hike.

 

5. Invest in a good sleeping pad

If you’re an overnight hiker, often your back and neck pain get aggravated from sleeping on a poor quality sleeping pad (or the ground if you’re really hardcore). If you don't have a decent sleeping pad, consider investing in a quality camping air mattress.  

It also helps to put a pillow under your knees both when you’re sleeping on your back and your stomach, and a pillow between your legs if you’re sleeping on your side. While you might not have the same great quality sleep at the top of a mountain in a tent than in your $2,000 mattress, it’s worth taking the time to make that sleep as comfortable as possible on the trail so you don’t wake up with back or neck pain before your morning hike even starts.

Another thing to consider is sleep in general. Sleeping injures are real, and can be aggravated by sleeping in bad positions or with bad pillows. In terms of pillows, it’s important to pick the right pillow, based on whether you’re a back, stomach or side sleeper.

Generally speaking, if you sleep on your back, you should strive for a thinner pillow so you don’t throw your head too far forward. If you’re a stomach sleeper, a thinner pillow is also best, even a totally flat pillow or no pillow at all if you can swing it. Meanwhile, if you sleep on your slide, a larger, firmer pillow is helpful to fill the distance between your ear and shoulder.

 

6. Improve your posture

Improving your day-to-day posture will help you maintain good posture as you hike. When you’re in a solid anatomical position, you’re more likely to remain pain-free.

If you’re thinking, ‘How am I going to just ‘fix my posture?’ It’s how I have been standing my entire life,’ here are four practical tips that you can consciously focus on to get you moving in the right direction:

  • If you’re around other people, try to stand taller than everyone else. A perfect time to play this game is if you’re standing in line at the grocery store.
  • Adjust your rear view mirror in your car by placing it a bit higher than normal so it tricks you into sitting a bit taller when you’re driving. Each time you look at your mirror, it will remind you to get taller.
  • Consciously focus on squeezing your butt cheeks together to help you keep a neutral spine. If nothing else, this drill will get you thinking about developing a perfect booty in time for the summer.
  • Avoid sitting cross-legged, and when you’re sitting at a computer, place your feet flat on the floor.

Happy hiking!

 

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