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How many of the following situations have you experienced?

Back Breaking Situations
Have you:
* Been crammed into a car that's too small for a long journey?
* Had to carry and lift heavy bags/boxes?
* Spent long hours being squashed in the middle seat on the plane?
* Taken a cross-Atlantic flight with departure delays and waited for hours in airports?
* Sat for extended time in heavy traffic?
* Woken up with a stiff neck or back due to a too soft or hard mattress or pillow?
* Noticed that your back is sore or stiff when you change court surfaces?
* Been told by your physiotherapist or doctor that you need to work on your Core Stability or flexibility?
* Felt stress in your neck or back after sitting at the computer or watching TV?
* Stretched for an object and felt a pull or a pain in your back or neck?

If you answered "YES" to any of these questions, YOU may be at risk of suffering back or neck pain.

What Causes Back Pain?
Muscle guarding and spasm - A muscle spasm is when the muscles tighten around the spine to limit movement and protect strained or sensitive areas from further damage.
* Muscle spasms often occur after an injury or when the spine is repeatedly in poor postural alignment. A spasm can be quite painful. The muscle may continue to spasm even after the underlying problem is gone, or remain "twitchy" - easily returning to spasm - for a long period.

Muscle Strain - Muscles are highly elastic and can absorb a lot of force without tearing completely.
* Sudden over-stretching or over-loading of muscle can tear and damage the fibers within the muscle, called a "strain". Rarely, there may be a rupture (a complete tear where all the muscle fibers are torn). "Back strain" may also refer to a pulling injury of the tendon, the
fibrous band that attaches the muscle to the vertebrae (the bones of the spine).

Ligament Sprain - Ligaments, unlike muscles, are not very elastic, and only stretch about 25% of their length.
* If stretched beyond that point, they may tear and result in an unstable joint. Ligament sprains are most common in other joints, such as the knee and ankle; it is rare that there is enough force to directly cause a sprain in the back.
* Usually, prolonged over-stretching from poor posture and/or incorrect lifting techniques causes ligament damage in the spine over time.

Loss of facet joint or sacroiliac joint mobility - Facet joints and sacroiliac (SI) joints are structures in the spine and pelvis.
* Loss of mobility in these areas can cause pain and loss of function and can also refer pain into the arm or leg.

Disc strain, bulge or herniation - There are various stages of disc displacement:
* The first stage of disc displacement is the weakening of the fibrous outer layers of the disc (annulus) through years of poor posture and improper lifting and twisting
* Once these outer layers begin to give way, a bulge forms as the inside (nucleus) is pushed through the weakened fibers
* Finally, the disc wall may tear, or rupture, allowing material to escape. A bulging disc can put pressure on the adjacent nerve root, causing pain into the arm or leg.

Healthy Back-Care Habits
* If possible, avoid heavy lifting immediately after a long drive or flight. Ask for help from the hotel bellman, airport porter or the car driver if you are struggling to lift heavy bags.

Good Lifting
When picking up heavy items, remember to use proper technique:
* Keep your legs shoulder width apart
* Tighten your abdominal muscles (core stabilizers)
* Bend your knees
* Keep the item you are lifting close to your body
* Keep a slight arch in your low back
* If possible, avoid heavy lifting immediately after a long drive or flight.

Move It!
* During long hours of travel or work, interrupt sitting with standing, walking up and down the plane aisles, stretching or simply shift your weight to change positions frequently.
* Sitting for long periods of time can increase disc pressure, stretch ligaments and place static loads on the muscles.

Pillow Talk
* Make sure you have a firm and supportive mattress and pillow to sleep on at night.
* Make a cervical roll to improve the neck support in the pillow (roll up a towel and put it inside the pillowcase).
* Try traveling with one of the great cervical pillows available that fit in your suitcase.
* Sleep on your side or back using a supportive pillow. Sleeping on your stomach increases pressure on your neck and back.

Practice Good Posture
* Whether you sit at a computer, on an airplane, or in a car, it is important to support your low back.
* Most car and airplane seats provide little back or neck support and the constant vibration puts extra stress on your spine as it attempts to absorb the force.
* Travel with an inflatable back and/or neck support or improvise and use a carefully rolled towel, sweater or jacket for support. On an airplane, use pillows or blankets to support your back and neck.

Take the Core Challenge
* Do you know whether you have good deep abdominal and lower back muscle strength? This is not related to how many sit-ups you can do!
* Having a strong core will not only help you to protect your lower back but it will help you to generate more power and help you use your shoulder, arm and leg muscles more efficiently and reduce your risk of injury. Keep up with your exercises!

Seek Advice and Help
* See your physiotherapist if you have any symptoms like pain, stiffness or problems moving.
* The physiotherapist will evaluate your spine and then work with you to develop the most appropriate treatment plan.
* There are many options available: manual therapy, exercise therapy to increase stability and flexibility, hot/cold packs, electrotherapy modalities, postural re-education and advice on practicing good body mechanics.

DISCLAIMER: The contents of the Game, Set, Health site, are for informational purposes only and should not be treated as medical, psychiatric, psychological, health care or health management advice. The materials herein are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. Reliance on any information provided herein is solely at your own risk.

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