Back Pain: The Bank Account Analogy Revisited

Back Pain and Bank Account…

After the principle of “It depends…” this is the next most important, useful and powerful concept to understand.

The “bank account” is the amount of stress/workload your spine will tolerate in any given day.

Just as with your regular bank account, it is in a state of constant flux with deposits and withdrawals being made into and upon it.

Your aggravators/pain triggers are the withdrawals.

These are specific to you and your injury and why a THOROUGH initial assessment is a MUST to clarify them.

But let’s say for an easy example you are flexion intolerant…so every time you slip into lumbar flexion you make a withdrawal on the bank account.

This could be a single movement (putting on your shoes, doing up your laces) or it could be prolonged postures (slumping in the office chair or car seat, technique breakdown in a lift, etc), all will make withdrawals on the account. The size of which depends upon the amount of flexion, the load and the timescale/number of repetitions.

As you make more withdrawals and bank account gets lower, the chance of injury (or re-injury) increases.

Some pain in the back may occur as the account gets low and muscular inhibition starts to set in (particularly in the glutes) as that workload then has to be taken up by the back.

If you don’t take head of this initial increase in pain/sensitivity, the bank account will continue to drain until we get low enough to start causing tissue damage.

For those who are flexion intolerant this could be a refresh of a disc bulge or herniation.

Which means we get even more pain and then a diminished bank account for the next day.

Long-term, continuously draining this bank account “picks at the scab” and so prevents the disc from healing.

If we want success with our bank injury we MUST manage our bank account wisely and actively stop poking the goddam bear! 😎


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