Mind your back: lose the weight, use a physio and close the fridge

Q To cut a long story short, I suffered from debilitating backache for years until I found out about anti-inflammatory foods – such as the arthritis diet, clean eating and so on – and almost overnight all my pain vanished.

But now, five years later, having taken up running and finding that I can run 20 or 25 minutes nonstop, I'm plagued with pain again. Sometimes it's in the lower back and sometimes it's in between the shoulders.

After Googling it, I think it's a combination of being overweight (I'm a late-night fridge raider) and having no core muscles to speak of.

That's another challenge, as I can't do sit-ups and stuff. In fact, I detest getting down on the floor for anything. It puts me off running a little. I won't stop yet, but is there light at the end of this road? Anon

A The first thing I recommend you do is to see a real doctor. Tell him or her everything you’ve told me. And while you are there, be sure to get weighed and have your BMI calculated so you know precisely how much excess weight your poor back is currently labouring under.

Providing the doctor rules out any serious health concerns, and diagnoses your back pain as “musculoskeletal disorder” (MSD), he or she will be confident in referring or recommending you to a physiotherapist: your new best friend for understanding and treating MSD.

This physio will be able to treat your back and advise you about appropriate exercises and pain relief. There’s nothing quite like swapping the Google doctor within for a real one in a surgery to get this properly sorted.

And here’s the gritty truth: Running is not always the answer, and certainly not the immediate answer in your case. There are infinitely more back-friendly cardio activities that will nurture and strengthen your back without putting it under the unnecessary strain that a high-impact activity such as running does. Pilates, swimming and yoga are obvious options that spring to mind. Talk these through with your GP and physio and choose one you know you can make friends with readily: if it’s simply walking regularly, great.

The Grit Doctor, who lies somewhere in between the Google doctor within and the real one at the surgery, can wholeheartedly recommend a lower-back strengthening exercise that every mother will embrace, as it’s the closest thing you ever get during the day to a rest.

The sit-up has to be the least friendly exercise for those of excess poundage and weakened core, let alone in pain; plus it’s one of the most difficult to perfect, so leave it aside for now and embrace instead the “knee roll”: a back-strengthening exercise that is tailor made for you.

Roll that last word round in your mouth and brain for a moment and appreciate how much less gritty than “sit-up” it sounds.

Here’s how: Have a gentle lie down, engage your core, and then bring your knees into your chest with your arms outstretched and roll your knees gently from side to side. Roll, baby, roll. And there are plenty of other back-strengthening exercises, equally relaxing and simple, that bear no relation to the sit-up and that your physio will point you towards and, most importantly, teach you to do correctly.

As for your weight, lugging around less of you means less back strain, no question, so let’s focus on this area. You say “clean eating” helped before, great: it’s time to clean up your eating again.

A lot of us are still eating dirty because some bad habits that embedded themselves over December are refusing to budge: sweetie/chocolate/nut bowl still knocking around, anybody? Begging to be eaten as we plough our way through another marathon Netflix session?

This sort of crappy eating habit must end: in fact, eating must end after dinner. Each and every night. Late-night snacking is a killer bad habit: so knock it on the head and fast. Eat your evening meal a little bit later if it helps, and when it’s done and cleared away turn off the kitchen lights, and that’s it: no re-entering the kitchen again until breakfast. And make this a habit.

Make sure you have a hearty, wholesome breakfast every day – don’t even think of skipping it – as those are the very calories that are coming to bite you in the face late at night because your body is just making good the calorie deficit when you are least in need of the energy (marathon sex sessions excepted, of course).

Let your back heal at its own pace with the help of your physio, and while that is ongoing, attack your spare tyre with the sort of zeal required for 100 sit-ups. When the time comes and your back no longer hurts, with luck it will be less prone to injury, with your leaner and stronger core supporting it. And you’ll be running like the wind.

Who’d have thought that you’d reach a stage in life when to be able to run regularly – pain free – was the reward you sought for your labour?

The Grit Doctor says

Well bloody done for trying to sort this out rather than resigning – as many do – to a lifetime of sofa surfing while complaining

loudly about a bad back.

Ruth Field is the author of Run Fat B!tchRun, Get your Sh*t Together and Cut the Crap.