Monday, January 13, 2020

Dorian Yates And His Christmas Tree Back

Dorian Yates
As a teenager, I used to go to Times bookstore, Kinokuniya and Borders especially, browsing books and magazines. Other than the cycling, running and triathlon magazines, I used to be fascinated by the bodybuilding magazines. That's when I first learnt about Dorian Yates and his Christmas tree back. I was truly amazed with the definition and shape of his back. (Arnold Schwarzenegger had retired from competitions by then).
Arnold Schwarzenegger's back
Talking about backs, I never really had any low back pain (LBP) before I broke my back. Now it aches from time to time, especially if I see too many patients in a row or sit still for too long.

Many of the patients we see in our clinics have LBP too. LBP is the leading cause of disability worldwide and often associated with ineffective and costly care. Myths about LBP often causes disability, time off from work, taking too much medication and pain. These unhelpful beliefs are often reinforced by the media, health industry groups and well meaning clinicians.

Due to unhealthy beliefs, people with LBP may avoid slouching, bending, physical activities and other activities that load the spine. Meaningful activities and activities of daily living and work are affected.

This may lead to unhelpful protective behaviors such as muscle guarding, bracing 'core' muscles, slow and cautious movement.

Subsequently, this may lead to the patient opting for other medical and/or invasive interventions to ease symptoms (taking medication, injections) to 'fix' postural faults or allegedly damaged structures through surgery.

Here are 10 common unhelpful beliefs about LBP which are culturally endorsed and not supported by evidence (O' Sullivan et al, 2019).

Myth 1 : LBP is usually a serious condition.

Myth 2 : LBP will become persistent and deteriorate in later life.

Myth 3 : Persistent LBP is always related to tissue damage.

Myth 4 : Scans are always needed to detect the cause of LBP.

Myth 5 : Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity.

Myth 6 : LBP is caused by poor posture when sitting, standing and lifting.

Myth 7 : LBP is caused by weak 'core' muscles and having a strong core protects against future LBP.

Myth 8 : Repeated spinal loading results in 'wear and tear' and tissue damage.

Myth 9 : Pain flare-ups are a sign of tissue damage and require rest.

Myth 10 : Treatments such as strong medications, injections and surgery are effective, and necessary, to treat LBP.

All the above factors can cause stress, anxiety and depression.

I will write about the 10 actual real facts about LBP in the next post. Stay tuned.


O' Sullivan PB, Caneiro JP et al (2019). Back To Basics: 10 Facts Every Person Should Know About Back Pain. BJSM. DOI: 10.1136/bjsports-2019-101611.

Another look at Arnie's back - not in competition

1 comment:

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