Low back pain can be debilitating. In many chronic low back pain cases it starts with an occasional dull ache and before you know it you're suffering an acute episode, you're off work and you're struggling to sleep.
I've been there.
My chronic low back pain developed from driving up to 4 hours per day with my commute to work and it cost my company money, it's cost me sleep and discomfort on long journeys to see family, which should be joyful.
80% of working age Brits suffer with non specific low back pain at some point in their lives and once they've suffered with it once, they're 75% likely to get it again.
This means 60 people in 100 will have low back pain more than once.
That figure is astonishing, and many of us don't talk about it on a daily basis. But you might not be that person. What if you're the person who has had months off work, who finds it difficult to face the day, who has seen the physio for months and is now on strong painkillers like tramadol. What if, as a result of your chronic pain you now suffer with obesity, you're pre-diabetic, you are depressed and suffer with anxiety. How can you get out of that hole!?
It's not easy. But it is possible and there's so much support out there. Of course you're probably already talking to your GP and a therapist and or physiotherapist. Did you know you can go onto the Register of Exercise Professionals and look for exercise specialists that can help you?
Exercise is great because it helps your muscles to support the area in pain, sometimes relieving that pain; it makes you feel strong; it helps you keep your body weight down and it releases all the happy hormones. It's that first step that takes the most courage. Or even saying to your GP - this isn't enough.
You need to take ownership of the problem and do something for you, for your life, to help you live rather than exist. It's really tough and sometimes the last thing you want to do is even leave the house but as I say to my own sister there's always a way.
Throughout periods of acute pain, I have been able to life very heavy weights and this really helps me feel powerful and keeps my mind healthy. It also offers me a route to connect with others and I've been really surprised at how true the statistics are when I mention my back.
Take that first step today and be proud of yourself when you do.
Here's a great blog by my good friend Alice if you want to read more about chronic pain:
This question is one of the great personal trainer marketing conundrums.
Why do people come to the gym?
This is about why you might walk through our door in the first place.
And more importantly why do they stay?
The reasons are not really what you expect. As an exercise referral specialist I know that a lot of people are 'advised' or 'referred' to attend a gym. Through funded schemes this might only allow for 6 to 12 weeks. So someone is telling you that you need to go and giving you a period of time or number of sessions to attend. This isn't a solution. It's a start. So even when you're pushed in the door by a health professional it's really important to figure out how you can maintain what we call 'adherence' to a programme. Why you stay.
Why am I writing this on a blog?
Because if you know what makes you keep coming back, it will help you make the right choice in the first place, making it more likely that you will stick with it and incorporate exercise into your lifestyle.
Let's digress about habits for a moment.
The '21 day' habit forming period is bollocks. It's an urban legend. It's not true. At day 22, you're not going to automatically continue. It's not going to become suddenly easy. It wont suddenly click. It took me 2 years to get my exercise up to 5 days per week and to really commit to that time. I do 27 sessions a month now. You don't start by doing this! You start with one bootcamp and maybe a 2 mile jog and you build it up.
Why do you go to a gym in the first place?
You feel fat.
You feel unhealthy.
You feel old.
You feel sad.
You're not happy.
Something happens - a prompt.
(you come across an instagram account of a trainer; your friend mentions something about their gym; you spend a whole day trying not to cry; your GP puts you on beta blockers...it could be anything)
....and you decide to do something about it.
So how can you choose the right gym?
Google maps & photographs.
Start with google maps and search for 'gyms near me'
Then click on local gyms and look at the photographs. These show you what's available. What the people look like. What the environment is like. What he other clients are like. Do I like the look of it. Do I like the look of them?! It's much of a muchness but you need to like the general look. Might it suit you? Pick a few.
Google maps tells me how far I need to travel to get there. Time is a huge barrier but most people spend an hour at the gym, even after they've joined a gym AND if they think time is an issue. They still spend an hour there. Help this barrier by keeping the journey short but base the choice on photographs FIRST and distance SECOND. Then take up a free trial and see if you like it. Take up the free trials of 3 or 4 of the gyms you like the look of.
Then pick one. Just one. If you join more than one, you will have extra cost, timetable conflicts, and you probably wont commit because you can use 'going to the other later' as an excuse.
A digression on time
Time often isn't the issue. The real issue is that you're putting other people first. You feel guilty about spending time away from people or chores. You feel like you should be doing something 'more important.'
Nothing is more important than you. How can you best look after them if you aren't being your very best you?
You've started at a gym. Why do you stay?
A lot of people see changes to their body, but these eventually stop! These changes alone are unlikely to keep you going to the gym. Once you've achieved your goal weight you will probably find your attendance drops off again. No one recognises this fact when they first start exercising but it is important to start to develop 'adherence skills'. But what can you do?
Firstly, focus on how the gym makes you feel.
It should be FUN and if it is, you end up making excuses to others (I'm not drinking because I'm at the gym in the morning) rather than excuses not to go to the gym (I'll skip the gym that day because I've got a night out).
Here are a few ideas to help with commitment that don't involve how you look:
1) Make new friends. Attend classes and gym social events.
2) get an interesting AND fun workout. As the gym trainers for a workout, a refresher or to show you a new exercise.
3) introduce a challenge: your first press up; your first pull up; to deadlift your body weight. It might take a year but it's something you can be proud of.
4) attend classes and work out solo. Mix it up!
5) Use exercise as 'me time' - yoga and the treadmill are great for these.
6) Learn something new. Rowing is great but most people have never learned the skill - they just do it. Google it.
Have you made the gym lifestyle stick? I would love to hear how you did it. You can share with me (and everyone) on social media @lauramcnallypt or firstname.lastname@example.org and you never know - they might make an appearance on this blog so everyone else can benefit! #ShareSport
Why eat more carbs?
Muscles burn more energy than fat. So the more muscles you have, the higher your basic daily calorie burn will be. This is why a lot of trainers will tell you that resistance training (but not necessarily body building like the Hulk!) will help to burn fat.
If you don’t have enough carbohydrate in your system your body will look to breakdown muscles through a ‘catabolic reaction’ to use them for energy. So it’s important to eat enough carbs to maintain your muscles to ensure you keep your natural calorie burn rate as high as possible.
Eat Carbs for Brainpower!
Your brain uses about 20% of your calories every day. If you don’t feed it, you wont be able to think properly. Guess what fuel your brain uses? Yes, carbohydrates.
Carbs are only 4kcal per gram. Fats are 9kcal per gram. Don’t ban fats though! You need them in your diet for other reasons equally as important as I’ve described above. But filling up on carbs, by the gram, is lower calorie.
How much is ‘more’?
Carbohydrates should form about 30%+ of your meals. The less processed the better – I don’t like bread but it’s ok to eat it! Rice and brown pasta are the best.
But I’m eating a calorie deficit
If you have a calorie deficit, you will always lose weight, always. But that doesn’t mean you’re going to lose fat.
We use electric fat measurement devices and stomach to hip ratios to establish how much fat is sitting around your organs. This is called visceral fat and can increase health risks of many diseases including diabetes and coronary heart disease. Men are at slightly greater risk than women because women also store body fat around their hips and thighs, however this doesn’t let women off the hook!
There is also fat under your skin – this is called subcutaneous fat. This is what people try to lose to get their abs to pop. But a very low fat percentage isn’t good. In women the side effects of low body fat include amenorrhea which is a sign you should see your GP or perhaps a certified dietitian.
So how do carbs help?
Back to muscle loss and carbs though, if you eat fewer calories than your body needs, I mentioned already that you will lose weight. However, if that weight loss is muscle because you aren’t eating enough carbs, your basic calorie needs reduce (you have less muscle to burn calories). This means that when you come off the diet, if you start eating at the same levels you did before, you will put more weight on because you’re eating much higher than your body now needs. This then becomes yoyo dieting and you get bigger every time!
So how on earth do you lose weight?
Firstly, plan for the long game. It probably took you years to put on the weight. It is likely to take at least the same amount of time to get it off (if you want to keep it off). And with this in mind, it’s about changing your lifestyle not dieting.
Secondly, aim for only a small calorie deficit – around 300-500kcal.
Thirdly don’t add exercise calories to your calorie count. MyFitnessPal does this for you but you should ignore it. The level of activity you do already forms part of your daily calorie calculation so adding them again will increase your calorie intake.
Fourthly, watch your portion size. Everyone’s portions are different. Cup two hands together – use that as a guide. A whole meal should fit into your hands. Vegetables are not extra on top of that! Just under half of your meal should be some form of carbs. This could be potatoes (a great vitamin C source!), rice or pasta. This will help to burn the fat.
Lastly, ditch the scales. Since muscle weighs more than fat you might not feel that you're losing as much as you did when you last dieted. Pick a pair of trousers that are a bit tight around the waist (remember that visceral fat is around the organs so your tummy is important!) and measure your progress by how good you feel in them.