There are few things more jarring to your every day than severe back pain. Particularly when it comes out of nowhere and you're a particularly physical person.

For years we were told bed rest was the best thing, but over time the practice of physiotherapy has evolved.

We spoke to Michael Boutros who runs Next Move Physical Therapy near the M50/N2 Junction on the North Side of Dublin. He is a registered physical therapist with the Irish Association of Physical Therapists.

Michael works with the MMA athletes at SBG Charlestown as well as taking patients in a private capacity.

What is the most common ailment you find with the people you treat?

I see a bit of everything to be honest. A common thread can be pushing too hard, too soon. I’ve been guilty of this myself and it resulted in me hearing the dreaded phrase "that’s actually common for your age" from a surgeon. That hurt about as much as the injury, I would really recommend avoiding that. Pace yourself, particularly once you hit your late twenties. We can all be guilty of having this physical image of our younger, windswept and more interesting selves who could go out until the small hours and still get up the next day and do things without consequence. When I say pace yourself I mean let your body adjust to what you’re trying to do, let it get stronger in steps, in the manner you want to use it and it won’t disappoint. A small bit of patience at the start will really pay off long term. I would apply that to getting back into any exercise or changing your routine, particularly with explosive or dynamic work. Talking to your coaches and trainers helps, they should have an exercise variation or adjustment that will help with anything you’re having difficulty with.

How much does the treatment vary from person to person?

Everyone’s different really and it's one of the things I like the most about this job. I’m lucky to see all sorts, the driven, athletic individual to the person who just wants the pain to stop. Each has their own set of challenges and things they love to do that the injury has taken from them. "I can't train" or "I can’t pick up or play with my kids". To me these as things that are really beneficial to that individual’s long-term health and happiness, so the focus tends towards getting that important thing back in their lives.

Thankfully there’s a lot of research now of proven methods on how to recover from pretty much everything. Some of it has been surprising, especially with lower backs. Not so long ago it was all about bed rest, discs being all over the place and unintentionally creating an environment where the unfortunate individual was terrified to move. Now, for therapists, it’s about being vigilant about the scary stuff - fractures, cancer, the neural disorders etc and encouraging pain-free movement as soon as possible and building from there.

Keep a constant eye on the scary stuff, keep moving, get a bit stronger - Physical Therapy 101!

How to get that message across convincingly to that person is the real variable I suppose.

Is it an on-going thing or can the majority of cases be treated over the course of a few visits?

Honestly, I would be disappointed in myself if I had someone coming to me repeatedly for the same injury every week, provided it wasn’t the early stages of a traumatic injury. I wouldn’t feel that I was helping them and I presume they would feel the same, very justifiably.
You end up getting to know the person you’re working with, (in most cases!) you end up wanting the best for them. I think it's a matter of sharing what you know, then working together to figure out what will work for that individual. And then in the end I would hope they know a way to deal with that particular issue.

Long story short - a few visits should sort most injuries. There's no magic number, unfortunately.

Is it true that an exercise ball at work is better for your back than an actual chair?

What I would say is, it depends on the person and it depends on what the person was trying to achieve. There’s no doubt the ball is more unstable and you tend to work that little bit harder and it’s easier to challenge yourself by lifting one foot up etc all while in work. It definitely works you more than a regular chair and that can help some people.

Pregnant women can find them really good, at least, my partner did (Hey J-Wag, hi kids!), particularly in the later stages or if sitting becomes uncomfortable. Both at home and in the office.

For most people a good quality chair set up right, so that you can sit properly and relaxed in it, should be fine once you remember to get up and move around every so often. From experience, I know they aren’t always available in every office but there is usually a procedure to get a better chair if you need it.

What is the question you get asked the most by your clients?

Most people want to know how soon they can get back to doing their particular thing (training). Then it’s about managing expectations and trying to get them back as soon but safely as possible.

The more random questions are by far the most interesting!

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