One Foot in the Grave?

Oh! My Aching Back!

By Tamia Nelson
tamia@paddling.net

February 6, 2007

Despite the uncharacteristically warm winter weather, it wasn't a promising day for a paddle. The put-in bay on The River was sheathed in new ice, and a stiff south wind drove lusty rollers down the open channel. It wasn't a good day for cycling, either. Even the state highway was a slurry of salty slush, and cars were sliding off the road with joyous abandon. But I needed some exercise. Badly. Holiday meals had taken their toll. My pants were uncomfortably snug, and my muscles felt squishy soft. So I bit the bullet and pulled on my wellies. Then I shouldered my rucksack, picked up my walking stick, and headed out the door for a brisk cross-country ramble. Swinging along at a lively pace felt great — or at least it did for about a hundred yards. That's when my back began to stiffen up. An hour (and about three miles) later, my springy bipedal stride had been reduced to an agonizing tripedal stagger. Still, it could have worse. Much worse. I was very glad I'd brought my stick. Without it, I'd have been crawling on all fours.

Sound familiar? I bet it does. Few of us make it out of our twenties without exclaiming "Oh! My aching back!" at least once. So what can we do about it? Well, first things first. The root causes of back trouble are more than skin deep, so let's begin by taking a quick peak…

Beneath the Skin

What we call the backbone isn't really a single bone, of course. If it were, we'd have trouble bending over to tie our shoes, let alone hefting a pack or swinging a paddle. Fortunately, our spines are built up from 25 interlocking vertebrae. Having grown up within sight of a railroad grade crossing, at a time when watching the trains pass by was the best free show in town, I can't help thinking that the vertebrae have a lot in common with the cars in a freight train. Like freight cars, our vertebrae need to hang onto each other. Or else. Couplings connect the cars in a train; facet joints and ligaments link each vertebra to its neighbors. Yet the individual vertebrae, like individual freight cars, also need to rock and pivot. If a little movement is a good and necessary thing, though, it doesn't follow that more is better. After all, our vertebrae don't just keep us from folding up like a jackknife with a broken spring, they also protect the most important bit of wiring in our bodies: the nerve bundle we call the spinal cord. This is where my freight train analogy breaks down. Trains don't often rear up on their hind legs, and on the rare occasions when they do upend, the results aren't pretty to look at. Our backbone has to stand and deliver all day long, however — a task it accomplishes only with the help of a complex support structure of muscles and ligaments. And that's the rub. While the manifold causes of back pain are still being hotly debated, it's a pretty safe bet that injuries to muscles, facet joints, and ligaments rank high on the list of culprits.

This is a good time for a few cautionary words: I'm a hack, not a physician, and I don't want to play doctor on the Internet. Yes, most back pain is just, well, a pain in the back. It may make it hard for you to get through your day — let alone wield a paddle, lift a kayak onto a car rack, or portage a canoe over a height of land — but it's not a harbinger of worse things to come. Sometimes, however, back pain is an early warning of serious disease, and occasionally it's nothing less than a medical emergency. This isn't a call you want to make on your own. Only your doctor can help you distinguish one from the other. So if your back is troubling you, see the doc, just to be on the safe side. And if the pain is severe, if it radiates down one or both legs, or if it's accompanied by weakness, tingling or numbness, or by disturbances in bowel, bladder or sexual function — don't waste time! There's not a moment to lose. Get to the doc ASAP. If that's not possible for some reason, head for an emergency room. Pronto. A few hours delay could mean a lifetime in a wheelchair. 'Nuff said?

Luckily, such emergencies are rare. But that doesn't mean that everyday back pain is fun to live with, does it? Certainly not. So let's explore some tested strategies for coping with a bad back. I'm going to use the case study approach here, and for the most part I'll play the part of the case. When I was in my early twenties I tried a dead lift of 300 pounds. I made the lift, but my back let me know right away that my form left a lot to be desired. Next day, I shambled into a doctor's office with my knuckles dragging on the ground. The doc's prescription? Two weeks' bed rest. I complied, but after two weeks in bed I felt worse than I had on Day One. So I embarked on my own course of treatment: pain management with over-the-counter medication and exercise. And wonder of wonders, it did the trick. It seems I was ahead of the curve. Nowadays, bed rest isn't often prescribed for back pain. Doctors are likely to recommend — you guessed it! — pain management and appropriate exercise. More often than not, this conservative approach works.

That said, it's much better to avoid injury in the first place. And exercise plays a key role in the prescription for prevention, too. But since "exercise" isn't everyone's idea of a good time, let's call it something else, something a little more upmarket, something like…

Physical Conditioning

Or maybe we ought to call it sweat equity. After all, it's an investment you make in your body. It doesn't have to be elaborate, time-consuming, or exhausting. But it does have to be regular. Exercise — sorry, conditioning — has to be part of your life. Take a week off and your back will know it. Take a month off, and you'll probably have to begin at the beginning again. The upshot? Get your doc's OK, and then get started. And once you've started, don't stop. Simple is good. I get by with pelvic tilts and curl-ups. Farwell prefers bent-leg sit-ups. We each do a few gentle stretching routines, as well, and we both try to get a daily dose of vigorous aerobic exercise. This can actually be therapeutic. Farwell, who's fallen victim to a common, if rather ominous-sounding, affliction called degenerative lumbar spinal stenosis, reached the point not long ago when walking more than a couple of hundred yards was agony. But he could ride his bike for hours without pain, and when he learned that stationary cycling was actually being prescribed for patients with this condition, he increased his time in the saddle. Guess what? Now he can walk for miles carrying a pack without so much as a twinge.

There's more good news for canoeists and kayakers. Vigorous paddling is a great conditioning exercise. Some lucky folks' doctors have even prescribed it. Of course, you still have to get in your boat, and that can be agonizing when back pain flairs up. Clearly, exercise alone isn't always enough. You also have to…

Adapt, or Else!

This can be as simple as avoiding activities that make the pain worse and substituting others. Or as complicated (and costly) as getting a sports medicine specialist to work with you to modify your stroke. Or it might mean that it's time to get a new boat. A kayak with a larger cockpit could be just what the doctor ordered. No go? Then how about a sit-on-top, or even an open canoe? You won't find any boats anywhere that have more capacious cockpits!

A little caution goes a long way, too. Think before you bend over, twist round, or lift. Smooth and steady are your watchwords. Don't bounce or jerk. There are proper and improper ways to hoist a heavy load. Learn the difference and do it right. Portages are the places where things most often go wrong. They test even the young and fit. The not-so-young (or not-so-fit) need all the help they can get, and the torture's just beginning when you get your load off the ground. One-shoulder carries are particularly trying. This isn't good news for kayakers and pack canoe owners, who may discover that their ultralight boats are almost as much of a pain to portage as a tandem all-rounder. Although going light is (almost) always right, it's not a panacea. What's the solution? Easy. Rig a portage yoke with your paddles, with or without a tumpline assist. Modify a packframe like the Camp Trails® Freighter to carry your kayak. Or — if regulations permit — use a wheeled cart.

Of course, back problems don't disappear at the take-out, where you face the job of loading your boat on your car. Luckily, you can purchase extension bars and rollers to make this chore easier. And if that's not enough, you can always buy or build a trailer, which will also double as a storage rack at home. Ah, yes. Home, sweet home. Home, safe home. Or not. It pays to remember that most injuries happen close to home, not on the trail or while under way. That's why it's a good idea to carry your back-safe habits over into your everyday life. Then you'll be ready to go paddling as soon as the ice melts and the rivers run free.

Back pain. It's easy to give in and let it run your life. But most paddlers would probably applaud the determination of the reader who wrote that he'd rather wear out than rust out. I'm no exception. Use it or lose it. That's my motto. It's a hackneyed phrase, but it's apt. And while I'm not about to give an unqualified endorsement to another overfamiliar saying — no pain, no gain — there's a bit of truth in it, too. So when your back troubles you, don't give up. Fight back, instead. Above all, have fun. Go paddling. Ride a bike. Take a hike. Or better yet, do all three. I can't think of a better prescription for an aching back, can you?

Copyright © 2007 by Verloren Hoop Productions. All rights reserved.