Introduction
Who among us hasn’t experienced some form of back pain? As riders we ask a lot of our bodies. My journey through disabling back pain began my journey from angsty, injured teenage competitive rider into a career that helped me understand my own pain, and my clients pain in a whole new light. Like any sport riding comes with the risk of bodily complaints, though who ever said that those aches and pains had to be permanent? Yet, rider’s are left on the back burner so often when it comes to appropriate assessment and rehabilitation of their pain. Often told to “just stop riding" if it hurts (as if that’s an option!) or going through rehab programs that have next to no function for what we need in the tack, only to not really get much relief.
Low back pain is a chronic complaint world wide, among riders and everyday people. In many global stats it accounts for upwards of 80% of reasons for doctor’s visits and while many acute cases of back pain don’t last much longer than a few weeks, many of those acute cases turn into chronic ongoing issues. 1
The reasons behind back pain can be just as diverse as those suffering from it. A study done in 2009 out of the UK stated that 88% of riders, across all disciplines, have chronic low back pain. Low back pain can be caused by many factors. In us riders it can stem from a combination of imbalances in our horses, ill fitting tack, stirrup length or tack style, and likely the biggest of all: imbalances in our body. 2 Yet it’s equally as important to realize that no one factor is usually the cause of back pain. As we will explore in this book, back pain is often non-specific to any one physical root cause, and a manifestation of many potential contributing factors from biomechanics, trauma, mind body miscommunication and personality traits.
Many have gone through the gambit of treatments, therapies, and tools to alleviate their pain, only to have it be a recurring problem. Physicians and experts in physical medicine struggle to counter the epidemic that low back pain (and pain in general) has become in our society, and riders are often left in limbo when it comes to functional care and rehabilitation. When I began specializing my practice to riders in 2015, back pain was one of the most frequent complaints from my clients. From recreational to professional, riders were being limited in their enjoyment and performance on horseback by often resolvable back pain.
Contrary to popular belief; low back pain does not have to be a life sentence. Nor is it necessarily related to age, activity levels, weight, or horse’s movement ability. To correct it requires appropriate body and self awareness, postural re-education, sometimes manual therapy tools to assist in breaking the pain cycle, and mindful awareness of ourselves. This book is dedicated to sharing my top solutions for back pain in a simple and easy to take home way.
Whether in equestrians or others- solving the low back pain issue can be simple, and it doesn't it need to be expensive; though it will mean investing some time and effort into yourself.
Part 1: Why
Part 1: Why
Trauma
Of course as equestrians we participate in higher risk activities than the everyday person. As riders we assume risk of injury every time we spend time on or around our horses. There’s a lot that can go wrong in riding to cause injury, low back pain included.
Many riders who see me about their back pain relay grand tales of falls that began it all, with the residual back pain ebbing and flowing in severity over the months and years that followed the original accident. This is actually where my own personal journey began with back pain. At the age of 16 while riding a young horse. The girth had loosened a bit through the warm up and while the saddle began to slip slightly to the side this young mare took off bucking. I was thrown into the arena wall before hitting the ground. While I walked away from this event, I spent the next few days stuck to a couch due to severe hip and low back pain and ceasing.
Being young this event didn’t keep me still for long, but over the next six to seven years I was routinely dysfunctional because of severe back pain- at one time diagnosed as a disc protrusion between lumbar vertebrae four and five. I remember receiving this diagnosis after years of seeing various doctors, physios, and chiropractors. It seemed like a permanent reality. I was both relieved that I knew why my back hurt and why riding was routinely painful, while also now feeling like my world was being dictated by the pain and the impact it was having on my performance as a rider.
For some time after this I became frustrated and depressed. The professionals that were supposed to be helping me were only giving me non-helpful words. Physio wasn’t working, the doctors just told me I “needed to strengthen more”, sending me home with no other guidance outside of suggesting I ride less, and the chiropractors simply suggested I return every couple weeks for a tune up. I hadn’t even turned twenty and my body had failed me.
I continued training and competing, both in riding and other sports. I became hardheaded and my story revolved around me being a victim of my pain. I championed myself for pushing through regardless, following the storyline of so many other high performing riders I admired: Pain is inherent to the sport. In order to be great, you must also suffer.
As I moved on to University I sought treatment at the University’s Athletic Therapy centre. This is where I met my first Athletic Therapist; this is also where my story changed. Over the next year I was offered true guidance in movement, strength training and education around WHY my back pain was actually continuously a problem. This is the year I also began consulting a sport psychologist. Between the two therapists, both of who over time became mentors as I began training in the profession of sport medicine, I began to understand my pain and my body. As I understood all the reasons behind my back pain I also began to understand how to train my body to function better in the saddle. My riding improved, my confidence improved, and my pain decreased.
It still took a couple years for my back pain to decrease from a flare up every few months, to maybe once a year, to only after a fall or other trauma, to very rarely at all. At the same time every time I did have a flare up it became a less and less significant part of my life. As I progressed through my own formal education and became a practicing therapist in my own right, my relationship with pain shifted. I still experienced pain, injuries, and set backs. I still experienced emotional upsets related to the physical aspects of injuries and pain. After a fall that fractured my leg and caused nerve damage that followed me for years - I once again went through the dark side of injury healing, relationships with pain, and communicating with the body and mind.
Pain, especially low back pain, takes a toll on us. Those I meet who have dealt with it for years can see it as part of their identity. I know I did, for a time. When something because a core part of our stories in life, it can add to the complexity of resolving the issue. Just because something is obviously uncomfortable to us doesn’t mean that it hasn’t become a comfort zone.
One of the things that became apparent to me during my sport psychology sessions while I was rehabbing my own chronic back pain was how it tended to appear most significantly when I was in emotionally heightened states. This is why it tended to show up right in the middle of an important competition. My performance anxiety didn’t show up for me in the stereotypical ways.. instead of butterflies in my stomach before a course, I would feel my back go out or my hips tighten.
Now, in reflection, I had been told this before. Yet the communication from doctors and physiotherapists prior had translated in my mind to something along the lines of “it’s all in your head, there’s nothing physically wrong with you”. Hearing or interpreting statements in that light as a person in real pain rarely translates well. Though as I progressed with my sport psych and later in my practice working with chronic pain clients, I began to understand that of course pain is influenced by the nervous system- which is highly connected to my psycho-emotional states. The pain wasn’t “all in my head” but it also wasn’t
