Understanding the mechanics

For decades, the standard medical advice for lower back pain was simple: lie down and rest until it hurts less. Today, clinical research points us in the exact opposite direction.

Understanding the Mechanics of Lower Back Pain The lumbar spine is an incredible feat of biological engineering, designed to support the upper body’s weight while allowing for significant flexibility. However, this complex network of bones, discs, nerves, and muscles is highly susceptible to strain. When injury occurs, the surrounding muscles often spasm to protect the area, leading to the acute pain many of us are unfortunately familiar with.

Historically, total bed rest was prescribed. The logic seemed sound: don’t move the injured part.
However, we now understand that prolonged inactivity actually exacerbates the problem.

The myth of total rest

Immobilization quickly leads to muscle atrophy and stiffness. In the lower back, this means the very structures meant to support the spine weaken, increasing the load on the injured discs or ligaments. Furthermore, blood flow decreases when we are sedentary.

“Movement is medicine. Healing structures in the lower back require the increased circulation that only mild, controlled activity can provide. Resting too long is often the primary barrier to recovery.”

Dr. Sarah Jenkins, PT, DPT

Effective active recovery strategies

Active recovery doesn’t mean hitting the gym for heavy deadlifts immediately after a strain. It involves specific, guided movements designed to promote blood flow without overloading compromised tissues. Key components include:

Walking: Short, frequent walks on level ground are often the best starting point.
Pelvic Tilts: Gentle core engagement helps stabilize the lumbar region.
Cat-Cow Stretches: Promotes spinal mobility in a low-load, quadruped position.
Aquatic Therapy: The buoyancy of water unloads the spine while providing gentle resistance for movement.

Setting realistic timelines

Recovery is rarely linear. It’s crucial to work with a licensed physical therapist to develop a progressive loading program. What starts as gentle stretches will eventually evolve into strengthening exercises tailored to prevent future injury.

After a hip replacement at 72, Arthur set one goal for his rehab: play a full 18 holes again by the start of spring.

Where Arthur started

In his first session Arthur could walk about ten minutes before the hip began to ache. Getting in and out of a golf cart was the hardest part of his day, and a full swing was out of the question.

“I did not expect to feel stronger than before the surgery. The team kept every exercise tied to my game, and that kept me going.”

Arthur, patient at Metro Physical Therapy

Building strength step by step

His plan started with hip abductor work, balance drills and short walks on uneven ground. Around week six his therapist added rotational core exercises that mimic the golf swing without the impact.

Back on the course

Four months after surgery Arthur played nine holes with his son. Two weeks later he walked all 18. He still comes in once a month to keep his mobility where he wants it.

Morning stiffness is common, and five minutes of gentle stretching can make a noticeable difference in how the rest of your day feels.

Why stiffness builds overnight

During sleep, joints stay in one position for hours and the fluid that lubricates them moves less. Gentle movement right after waking helps restore that circulation.

The five exercises

Knee to chest: Hold each side for 20 seconds.
Seated spinal twist: Rotate slowly, three times per side.
Cat-cow: Ten slow repetitions.
Standing calf stretch: 30 seconds per leg against a wall.
Overhead reach: Five deep breaths with arms raised.

When to talk to a therapist

If stiffness lasts longer than an hour each morning, or comes with swelling or warmth in a joint, book an evaluation so we can look at the cause.

Metro Physical Therapy is adding aquatic therapy sessions at three more clinic locations this fall.

What is changing

Each new location will offer morning and evening pool sessions led by licensed physical therapists with aquatic therapy training.

Who it helps

Water supports body weight, which makes it easier for patients with arthritis, post-surgical restrictions or chronic back pain to move through a full range of motion.

How to book

Current patients can ask their therapist about adding aquatic sessions to their plan. New patients can request an evaluation at any location.

Getting back to running after a knee injury takes patience. Rushing the first few weeks is the most common reason runners end up back on the table.

Check your readiness

Before your first run you should be able to hop on the injured leg ten times without pain and hold a single-leg squat for 30 seconds.

Use a walk-run plan

Start with one minute of running and two minutes of walking, repeated eight times. Add a minute of running each week as long as the knee stays quiet the next day.

Keep strength work going

Keep doing your quad, hamstring and hip exercises two to three times a week. Strength work protects the knee as mileage goes up.

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Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since 1966, when designers at Letraset and James Mosley, the librarian at St Bride Printing Library in London, took a 1914 Cicero translation and scrambled it to make dummy text for Letraset’s Body Type sheets. It has survived not only many decades, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised thanks to these sheets and more recently with desktop publishing software like Aldus PageMaker and Microsoft Word including versions of Lorem Ipsum.

Why do we use it?

It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).