Look after yourself in the garden
Though it may seem an unusual combination, we get plenty of keen gardeners in the clinic each week, and especially during spring and summer, predominantly wanting help with their low back pain. Read on to learn a little more about what causes gardening-related back pain, and what can be done to help.
Let us first begin by stressing... GARDENING IS GOOD FOR YOU!!!
Gardening has a raft of health benefits, which are particularly beneficial as we age. These include:
Improved general mobility and strength
Improved hand and grip strength
Burns calories, so assists with maintaining heathy body mass index (BMI)
Sunshine provides a dose of vitamin D, which is not only great for mood, but great for bone health
Increased sense of purpose
Growing your own food is a healthy alternative
It is no secret that the keenest of recreational gardeners are usually retirees; those with the most time to dedicate to the cause. As we also know, the prevalence of low back pain usually increases with age. This does not always mean "arthritis" is the cause of back pain, though it can be a contributing factor. Let us explain.... 'Mechanical' back pain makes up 95% of all cases of low back pain. This refers to pain caused by stiffness, lack of stability and/or movement dysfunction. It is pertinent to note that the prevalence of "age related changes" found on x-rays or scans is the same among symptomatic people and asymptomatic people. Chances are that most 70+ year old’s absolutely will not have a pristine lumbar spine x-ray report, and that in itself is normal. Given that "age related changes" are fairly standard in a retired population, it this does not necessarily mean arthritis is the cause of your pain.
The main issue with gardening is that it calls for increased time, or repeated bouts of the same posture – bending forwards. Bending forwards, like any other activity, is not inherently bad for your back. Let us repeat that; bending forward is not bad for your back. Where it is likely to become in issue, is the amount or dosage. This not only refers to the amount of bending in one particular bout or afternoon in the garden, but also the amount accumulated over a week. The amount of rain we have had here in the last couple of days in The Hills District means that weeds will grow like crazy. With that, will come a huge increase in the amount of people coming into physio as a result of overdoing things in the garden.
Given that plants grow in soil, the bending component is unavoidable. A few tips we give people to get around this include:
Break up prolonged or repeated bending as often as possible - have mini 30 second breaks with some simple straightening up, bending backwards, twisting from side to side. Little and often is the key here. Some people will need to do this more frequently than others, i.e. you may only tolerate bending for 5 minutes while your neighbour might cope for 30 minutes. Everyone is different!
Change your position often; vary between bending, sitting, kneeling, squatting. Kneeling on one knee, then the other knee etc. The more frequently we change position, the less likely our back is to get stiff. No one position is ideal or perfect; too long in any one position will result in stiffness. Motion is the lotion!
Build up slowly - your body doesn't like surprises!
Break up tasks and chores to ensure variety e.g. some pruning at high level, mixed up with some digging at low level.
Working with pots or raised garden beds can also help with providing different levels to work at.
Break up tasks across several days. Your back will cope better with 1 hour of weeding across 5 days than it will cope with 5 hours of weeding across 1 day.
Preventing major flare ups is key. All too often we see gardeners overdo things in one day, then need an extended period of rest to recover. In this extended period they get down and frustrated, and then feel guilty about how 'behind' they're getting. This can then result in them overdoing things once they feel better, and the vicious cycle continues. Try not to fall victim to this boom-bust cycle by knowing your limits, and building up slowly.
Another common recommendation we often make to gardeners is to work on some exercises to improve general strength. While gardening is great for strength, some specific exercises to strengthen core, upper body and legs can work wonders for improving tolerance to activity, and improving lifting tolerance. Simple exercises include squats, wall push ups, step ups and glute bridges. Again, there is no one-size-fits-all, so best to speak to one of our physios if you are after exercises tailored specifically to your needs.
It may seem like common sense, but another well-known 'danger' of gardening is succumbing to a lifting injury. Again, lifting is good exercise and done well, should actually assist in improving your strength. Adhering to all of the above can greatly reduce your risk of a lifting injury. Knowing your limits, and having a good foundation of strength are both key. Otherwise, using a bag of mulch for an example, lifting injuries can be minimised by:
Assessing the weight and size of the bag; is the mulch spread out evenly, or is it likely to move as you lift?
Starting square-on to the bag, with your feet forming a good, wide base of support
Bending from the knees and hips, keeping the back neutral (and not 'rounding' out through the back)
Lifting slowly, being careful to avoid twisting as you lift. If you need to place the bag at your side, move your feet so that you are square-on again to avoid twisting.
Lowering the bag down slowly, again using the hips and knees and keeping the back neutral.
“The key take-home message here is this... do not be afraid of gardening or be reluctant to get into it if you have a bad back."
The potential health benefits far outweigh the risks! However, do be aware of strategies to help reduce your risk of developing back pain, including frequent positional changes, lifting with good technique and knowing your limits while building up gradually. As always, for any specific or tailored advice, have a chat to one of our physios.
We love helping people get back to the activities they love doing!