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Back pain

As Amanda entered my office she looked liked she was walking on eggshells, clearly in great
pain. Aside from her obvious suffering and constricted movements, I noticed something else
I'd seen many times before with clients who had lower-back pain. Amanda was holding in her
belly real tight, and her breathing was very shallow. When I asked why she was doing this,
she explained that she'd been having low back pain for many years and had been told that
tightening her stomach muscles would help support her lower back and reduce the pain.
"However," she added, "the pain is as bad as ever." I gently told her, "This tightening might
be great if you were a table but we humans are built to move."
As Amanda told me about the different therapies and ways she tried to get rid of her pain, it
became clear to me that the most important part of her healing equation was missing--the
brain! When I told her this, she said, half-jokingly, "Are you telling me it's all in my head?"
"If you are asking me if I think your pain is all psychological, I can assure you that's not the
case," I said. She was relieved to hear this.
I continued to explain that all of our movements--from the movement of our bodies to the
movement of our thoughts and feelings--yes, even these are movements-- all are organized by
our brains.
For nearly 30 years I worked with professional musicians, various athletes, regular folks and
even small children who suffered from lower-back, shoulder, neck, hip and other kinds of
pain. I discovered that with Amanda, just as with most clients, the pain she experienced was
the result of the way she was moving her body--her movement patterns. And these movement
patterns issue from the brain!
The long-term solution is to be found not with the muscles and joints themselves, but by
changing the habitual pain-causing patterns the brain has learned. Amanda's present
movement patterns were creating stresses in her muscles and joints that caused her pain. The
good news is that our brains can change, as current research has confirmed. (1) As I
explained this to her, she seemed to relax. I told her that I would be guiding her through very
gentle movements that will give her brain the information needed to create new patterns;
these new brain patterns will organize her body to move in pain-free ways.
"These new movement patterns have many benefits," I told her. "They will not only eliminate
your pain, but you will be stronger, more flexible and will feel more vital and energetic
"You are saying the change has to first occur in the brain?"
"That's exactly right," I said.
The pain Amanda had suffered for nearly seven years began dissipating during our sessions
together as her brain began forming new patterns for moving her lower back and the rest of
her body. As with many of my clients I was inspired to observe Amanda's life gradually
opening up in magnificent ways, no longer constricted and defined by her pain. She was now
able to play freely with her children, enjoy long walks with her husband and find pleasure in
everyday activities that were once struggles for her.
Pulling the belly in and holding it tight to restrict movement in an effort to avoid pain in the
lower back is a natural reaction and a useful one for the short term. But if we are seeking
long-term, life-enhancing solutions, we need to understand that this pattern of restriction
changes the movement patterns in the brain, ultimately creating a host of new problems. We
not only immobilize our lower back by pulling in our belly, but we greatly restrict movement
in our pelvis, our back, our chest and even our neck will become tighter. (2)
The center of our body is the greatest source of our muscular power, coming not just from our
abdominal, but from all the muscles attached to our pelvis. When we immobilize this area by
tightening our bellies, we not only weaken ourselves greatly, but we also lose flexibility,
restrict our breathing, accelerate aging and we settle for a limited version of ourselves. And
we still have not solved our original back problem.
Brain research shows that we can change the movement patterns of our brains very quickly.
(3) Movement -- rich, varied, gentle movement done with lots of attention and awareness -- is
the language through which our brains wake up, gather new information and problem solve.
(4) Contrariwise, when we learn to restrict our movements to avoid pain, we deny ourselves
the opportunity for our brains to find better, more sophisticated, life giving, long-term
Applying This Information in Your Life
Movement With Attention: For the next two to three minutes, wherever you are -- perhaps
sitting at your computer -- turn your attention to how your shoulders are feeling at this
moment. Then scan your arms, your buttocks, your legs and the soles of your feet for what
you feel there. Notice how your neck feels, your upper back, your lower back. Each time you
move, for example as you reach for the computer mouse or an object on your desk, scan all
these parts of your self and pay attention to whatever you are feeling in those areas. After a
few moments, get up and briefly walk around. Are you aware feeling any differences?
Perhaps you feel a bit taller or shorter. Do your shoulders, arms, legs or lower back feel any
different? You do not have to do anything with whatever you notice. Your only objective is
to pay attention in the ways described.
Repeat this two to three minute movement with attention exercise during other activities in
your life, be it while you are dressing in the morning, while cooking your breakfast, getting
into your car, when talking with your spouse or kids, or during your exercise routine.
Bringing attention to your movements provides information for your brain to draw upon and
create alternative movement patterns, free of pain. Research shows that when we move
without attention there are practically no new connections formed in the brain. Through
adding attention to what you feel as you move, your brain grows millions upon millions of
new connections. (5)
If you do this simple exercise regularly you will begin noticing not only greater comfort in
your lower back but improvements in your mobility, your mood and your ability to
concentrate and problem solve. The regular practice of movement with attention is also a
powerful tool for preventing future back pain and injury.
Gentle Movement: Gentle movement means reducing the effort and intensity with which you
move. For example, next time you reach to pick up glass of water, close your car door or put
on your shirt, see if you can do it successfully with a lot less force. If you have exercises you
do for low back pain, reduce the effort and intensity with which you do them. Reduce it
greatly! Think gentle, easy, lazy and comfortable as you move. Doing this will increase your
ability to notice and become aware of how you presently move and give your brain the
opportunity to improve the way you move. You can never move too gently.
Remember, gentle movements provide your brain with new information to create pain-free
patterns. As you go through the day, performing thousands of different movements,
remember to occasionally apply gentle for a few minutes at a time. You will be amazed at
how much you will discover about yourself and the new options that will open up for you.
Over time you will also become more efficient and effective in whatever you do. Many
people report that after just a few weeks of gentle, tasks that were once difficult and
unpleasant become effortless and even pleasurable to do.
Varied Movement: Select any movement that you do on a regular basis, for example walking.
As you walk, slow down a bit and begin varying the ways you do it. For example, put your
head down and focus your eyes on the ground. After a few steps lift your head, look forward
and continue walking in this way. Now lift your right hand and place it on your left shoulder.
Walk like this for a minute or so. Drop your hand back to your side. Now, instead of walking
forward, step sideways, first to the right for a few steps, then to the left for a few steps.
Resume walking forward. Cross your arms over your chest as if to hug yourself. Then --
make sure you're in a safe area for this one -- walk backwards. As you walk, vary the speed
or the length of your step a bit, or raise your knees slightly higher than you usually do.
Resume walking normally and notice any differences in the way you feel.
When introducing variations you do not need to go to extremes. They can be subtle. The
number of possibilities is endless. Repeat your variation exercises in different situations a few
times a day. All you need is to take three to four minutes and be creative, experimenting with
five or so variations in the activity of your choice. Each time, as you finish your exercise,
take a moment to notice differences in the way you move and feel. Of course, notice if your
pain diminishes over time.
We are built biologically to always optimize ourselves -- do the best we can -- with the
information available to us. Your brain will work it out in your own unique way -- provided it
gets the new information it needs. Movement with attention, gentle movement and varied
movement are sources for that information.
For more about this process, and to try out our animated movement exercises for reducing
pain and optimizing your potentials, go to:

Notes and References

1. As science writer Sharon Begley recently stated "For decades the prevailing dogma in
neuroscience was that the adult human brain is essentially immutable, hardwired, fixed in
form and function, so that by the time we reach adulthood we are pretty much stuck with
what we have ... But research in the past few years has overthrown the dogma. In its place has
come the realization that the adult brain retains impressive powers of neuroplasticity --the
ability to change its structure and function in response to experience." S. Begley. 2007."How
the Brain Rewires Itself." Time, Jan 19.
It was only in 1999 that Torsten Wiesel, who won the nobel prize with David Hubel in 1981
for his studies of the development of the visual cortex, after much public denial, admitted in
print that adult neuroplasticity was a genuine phenomenon. T. N. Wiesel. 1999. Early
Explorations of the Development and Plasticity of the Visual Cortex: A Personal View.
Journal of Neurobiology. 41(1): pp 7-9.
2. "Core stability exercises (are) not superior to conventional physiotherapy exercises in
terms of reducing pain and disability" Muthukrishnan R, Shenoy SD, Jaspal SS, Nellikunja S,
Fernandes S. The differential effects of core stabilization exercise regime and conventional
physiotherapy regime on postural control parameters during perturbation in patients with
movement and control impairment chronic low back pain. Sports Medicine Arthroscopy
Rehabilitation Therapy and Technololgy. 2010 May 31;2:13.
"Despite the large variety of treatments which have been evaluated through randomized
controlled trials and meta-analyses, the effect sizes are often small, even for commonly used
treatments such as exercise for chronic low back pain." Hayden JA, van Tulder MW,
Malmivaara AV, Koes BW: Meta-analysis: exercise therapy for nonspecific low back pain.
Annals of Internal Medicine 2005 , 142(9):765-775.
3. At birth the brain contains in the region of 100 billion neurons each of which connects to
anywhere between a few thousand to 100,000 other neurons through specialized junctions
called synapses. A conservative estimate of the total number of synapses in the adult brain is
100,000,000,000,000_ or 100 trillion. The formation of synapses begins in the cerebral
cortex, for example, during the 7th week of gestation and continues well into childhood. It is
estimated that at its peak each neuron forms an average of 15,000 connections. This equates
to a rate of formation of 1.8 million synapses per second during the period from the second
month in utero until the child's second birthday. Not all of these synapses survive. See A.
Gopnik, A.N. Meltzoff, P.K. Kuhl, P.K. 1999. "The scientist in the crib: Minds, brains and
how children learn." New York: William Morrow. pp181-186;
4. "Movement is the language of your brain;" Nobel laureate Gerald M. Edelman states that,
"The brain's motor functions ... are ... critically important, not just for the regulation of
movement, but also for forming images and concepts." He says, "In the mammalian nervous
system, perceptual categorization is carried out by interactions between sensory and motor
systems...(we first) sample the world of signals by movement and attention and then
categorize these signals as coherent through ... synchronization of neuronal groups." G. M.
Edelman. 2005 "Wider than the sky." Yale University Press. pp23 and 49
5. "Experience coupled with attention leads to physical changes in the structure and
functioning of the nervous system." M. M. Merzenich and R.C. Decharms, "Neural
Representations, Experience and Change," in "The Mind-Brain Continuum," ed. R. Llinàs
and P. S. Churchland, (Boston, MIT Press, 1996), p77. G.H. Recanzone, M.M. Merzenich,
W.M. Jenkins, K.A. Grajski, H.R. Dinse (1992b) Topographic reorganization of the hand
representation in cortical area 3b of owl monkeys trained in a frequency discrimination task.
Journal of Neurophysiology. 67:1031-1056. RJ Nudo, GW Milliken, WM Jenkins and MM
Merzenich 1996 Use-dependent alterations of movement representations in primary motor
cortex of adult squirrel monkeys. Journal of Neuroscience. Vol 16, 785-807