Back Pain and More with Tommy Brennan

Renowned physical therapist Tommy Brennan recently joined ABC’s Noel Flynn to discuss exercise, back pain and its link to some of our recent lifestyle changes. 

Tommy is a physical therapist and owner of Pain and Performance Clinic. He started out as a primary school teacher and trained as a high-level athlete at the same time. Throughout his twenties Tommy experienced a large number of injuries, his growing frustration with these injuries coupled with his passion for sports performance led him to study and become a qualified physical therapist. He changed career to follow his passion and with over ten years’ experience is now the owner of three clinics based in Fonthill, Leixlip and Celbridge.

Through his practice, Tommy approaches injuries with a positive focus and an aim of getting clients back to doing the exercise they love as quickly as possible.

The company name – ‘Pain and Performance’ was developed to reflect the type of clients that Tommy Brennan works with. He has treated both athletes looking to improve their performance and clients who have suffered chronic pain – two ends of the population spectrum and   everyone in between, Athletes to Chronic injuries

Key Topics Discussed

  • Back Pain, and pain and it’s link to changes in lifestyle and stress
  • Differentiating between pain and damage
  • Contributors to pain
  • Dosage of exercise

Following feedback and queries from ABC member’s along with his own experiences with pain, exercise and managing stress in the current climate, Noel led a comprehensive interview that can be viewed on our Online Community Facebook page. This article provides an overview of the details discussed.

1. Why are so many experiencing increased Lower Back Pain at the moment?

  There are two general causes of lower back pain:

  • Increased daily movement – For example; lifting and bending more throughout the day 
  • Significant decrease in activity levels – For example; a teacher used to being on your feet all day and now you are working seated at a desk all-day

‘’Changes in our lifestyle similar the above mentioned will have an impact on our body and can lead to quite severe pain. Sometimes we can think that this pain is due to something more sinister than it is especially if using Google and online forums to search our symptoms. It is important to understand and learn the cause and mechanism of pain in order to deal with it correctly.’’

‘’Pain can feel quite severe yet there still may not be any damage done. If you think there is damage, this can lead to bracing your posture and muscles in a certain way which in turn may lead to further pain and stiffness. It is important to understand what it is that is resulting in the pain and then change our habits and movement accordingly. There are no quick fixes, the solution is a shift in mindset and an awareness of the reason for pain.’’

It is important to remember that we don’t damage our backs unless we do something very severe, but we can have severe pain without damage. 

  • We are not that fragile
  • Sore not Sinister (know the difference)

    2. What do you suggest we do to fix this lower back pain?

‘’Change what you are doing. Movement helps, Move more!’’

Try to think about what am I not doing now that I was doing prior to self-isolation. Even simply implement a ten minute morning routine to help introduce some movements and stretches.

“There is no such thing as bad posture, just one that you spend too much time in’’

Tommy explained to us that often there is a belief of a ‘good posture’. This can lead to people holding themselves in a rigid upright position. However, it is important to keep moving and changing position or posture in order to maintain mobility and decreased tension.

3. A phrase that is often heard in clinics, gyms and general populations: ’’My back just went doing an activity I’ve always done’’, for example. A business owner who is more anxious and uptight due to recent closures bends to pick up their child and hurts their back. What is the connection between this type of injury and a person’s stress levels?

‘’Logically you would think that you have injured your back but that is not necessarily what has happened. High stress caused by many factors such a work, finance or homelife may place you in a new environment and this can affect your sleep, stress and anxiety levels. Pain is more about what is going on in a person’s life. When there is a change there can be an increase in pain and niggles – this is related to sensitivity levels which are influencing many factors such as sleep quality, stress, nutrition or lack of movement. Usually, we can cope with all of that if we have an outlet for our stress or a routine – at the moment we don’t have that same outlet.’’

An example of this would be; If you know you have a lot of work to get done but you are minding your kids you can subconsciously experience a build-up of tension. Over time, working under more tension the muscles will become achy, sore and tired. A build-up of stresses in the background can cause tension resulting in pain that can be sharp and severe. Pain may be felt in the lower back, but it may be caused by overall tension in the body.

4. Traditionally, we ice, rest, massage or use pain relief to relieve pain – is this correct?

‘’We should take more of an approach of learning the causes and making changes to help relieve and cope with the pain. If you have a horrendous sharp pain it will cause the surrounding muscles to become tense. We need to get the muscles to relax, they won’t relax if you think you have done severe damage to the muscle. We need to realise the area is sore rather than sinister. Breathing exercises can help to take the tension out of the muscle, relaxing the muscle will allow it to move more freely. Choose heat rather than ice to get warmth into the muscle and move as far as the mid-range movement of the muscle.’’ (Exercises that can help lower back pain)

5. Movement is medicine – but is this always the case?

At ABC we know the clients and how they move from before the closures and so are able to tailor specific workouts to them. What are your thoughts on the safety of people performing random workouts from trainers across the globe that are published on social media channels? 

‘’At the moment some people may find they have more time to do more exercises. There can be different sources for these workouts or increasing running and walking. There is no right or wrong exercises – the key is dosage. If you think of exercise in terms of medication – the doctor prescribes one tablet per day which will make you better, if you take four per day you will feel ill. Similarly, if you do too much exercise or at too high an intensity for your ability then it may do more harm than good.

Whatever exercise you are doing, ease into it. We can become deconditioned quite quickly so stripping back exercises to using only bodyweight can actually be a lot more difficult than anticipated. There is no point in doing a workout that leaves you sore and unable to exercise for four to five days. A slight ache is ok but about 24 hours after your session all aches and pains should be almost returned to pre-exercise levels. You can then be confident that this is the correct level of intensity for you and repeat it and gradually increase duration or intensity. 

  • If you perform too much too soon and you are unable to exercise for 5 to 6 days, your overall exercise volume for the week will be low.
  • Dip your toe in – do a little bit, see how your body reacts and then go again, doing a little bit a few times a week. Even two, fifteen-minute sessions every day may be more beneficial than a one-hour long session a couple of times a week. Over the week the energy expenditure may be greater for the person doing the short sessions. Dosage is very individual.

Changes in any programme can have a physical impact (for example switching from the gym to online)

Home exercises can be much tougher than you think. If you are slow and achy after the sessions, then be more active but at a lower level such as walking (30% effort). This will get the blood pumping around the body and help recovery processes.’’

6. Walking and Running – a lot of people have taken up or increased their running or walking recently, do you have any general advice?

‘’The mental health benefit of fresh air is huge. The quantity and intensity of the exercise goes back to the earlier point on dosage. Be vigilant and learn from mistakes and previous sessions. There may be a need to taper back your run to a mix of walking and running at a pace that can be completed every day rather than a hard run that leaves you too sore to complete your next running session.’’

Key Learning Points:

  • The importance of differentiating between sore and sinister pain.
  • There is no such thing as bad posture, just one that you spend too much time in. 
  • Pain may be felt in the lower back, but it may be caused by overall tension in the body.
  • There are no right or wrong exercises – the key is dosage. Dosage is very individual
  • Movement helps, Move more!

Pain and Performance are currently doing online consultations for anyone that does need more specific advice or consultations.

Contact Tommy Brennan: 
P: 0876529287