Your Daily Habits Are Causing Back Pain & what to do about it!

What if your back pain is being shaped by the movements you repeat every day? Welcome to Beyond Diagnosis. I'm Rita De Michele. This podcast is for people who believe there is more to health than managing symptoms. Through expert conversations and real-life experiences, we explore functional, holistic, and whole-person approaches to health, lifestyle, and living well again. Brought to you by the Beyond Diagnosis Collective, your connection to trusted holistic practitioners. Today we'll be talking about how persistent back pain can be connected to how we sit, stand, reach, turn, and use our bodies without thinking. My guest is Valentina Solovy, a physiotherapist with over 40 years experience and a Master of Applied Science in Physiotherapy and Orthopedics. Through her work with chronic back pain and functional scoliosis, Valentina has helped people understand how to relief with simple exercises. Welcome, Valentina.

Hello, Rita. How are you?

I'm good. And well, back pain, huge in the world, is it not? You can hardly find a person who can say they've never had back pain of some form. Do you find that scoliosis is on the rise? And how do you feel when someone has been told you just have to live with back pain?

Okay, in terms of frequency of back pain, the statistics say about 80% of the population, and this is pretty much around the world, at some point in their lives will experience pain. Some people will just come and go and that's it, they never have it again. Some, it's more chronic. I don't— I couldn't tell you whether scoliosis is on the rise. What I see in the clinic is that literally every person who comes in to see me with either back or neck pain has some degree of what is referred to as a functional scoliosis. Now, nothing saddens me more when someone comes in and they've been suffering with back pain or neck pain and they have been told exactly what you just said, that they're just going to have to live with it, there's nothing else that can be done. This is a simple approach and people pick it up very quickly and they get great results. So it always saddens me to hear that people are putting up with pain when they don't need to.

How is functional scoliosis different from structural scoliosis people are diagnosed with very young?

Structural scoliosis refers to the structure. So each individual vertebra should be a cube or a cube shape, and they stack nicely one on top of the other. But if you have one or maybe 2 that have developed into a wedge shape for whatever reason, That will start off a structural scoliosis. A functional scoliosis is one that develops over the course of our daily lives, and it's to do with function as opposed to structure. So it is how we use our bodies over the day. It is my theory, and I haven't researched it formally, though I am hoping to do some coming up soon, is that we turn to the left too much, either occupationally— people who work on 2 screens, for example, 3 screens Recreationally, people who play golf, cricket, tennis, basketball, netball right-handed, and/or in people who are dominantly right-handed and strongly so, or a combination of all 3. But that doesn't mean left-handers won't end up with this functional scoliosis. It's just that there may be something else in their life, either recreationally or occupationally, that may be adding To the problem. And don't forget, left-handers live in a right-handed world. 95% of us are right-handed, so things in this world are set up for right-handed people. For example, a lot of sinks in the kitchen are set up to work from right to left. The way certain doors are hung, they encourage you to turn to the left. So even left-handers will have to turn to the left sometime and/or use their right hand.

So So is— so you're saying it's predominantly just the movement to the left that will cause scoliosis, not the movement to the right?

No, over the 10, 15 years that I've been developing this protocol, and that is what I have narrowed it down to. It certainly was the issue for me. I have always been a strongly right-hand dominant person doing everything with my right hand, and I was first told that I had a scoliosis when I was a 19-year-old physiotherapy student because my right leg Was too long. Now I found I accepted that, but then I found as I was getting older that the degree of twist was getting better, and sometimes it got worse. So my leg wasn't getting longer and shorter. That couldn't have been the cause. There had to be something else, and I broke it down and worked it out that it was the repeated turning to the left. When you use your right hand, you can see already when I'm pushing, my torso's turning. To the left.

And then I, I looked into that more deeply, especially with our modern way of living, that our lives are busier but our bodies are now moving less. So what is the cost when we talk about this scoliosis and everything? What is the cost to all of this convenience?

The, the biggest thing of all is that a lot of us now work, um, on computer screens, so our work has become more sedentary. So already, if you look at it, working from 9 to 5, 5 days a week. That's a huge proportion of our waking hours. So when people sit for prolonged periods, if they're sitting facing front with no twisting, not as much of an issue, but your hip flexors will get tight. But if you work on 2 screens, maybe 3, you're sitting hard up against a wall on the right, you have to turn to the left to get out of the chair. Mary sits on the left over there. If you want to talk to Mary, you have to turn left. All these things will add up Over the day. Not only our working hours, but it's also that things are becoming automated. Siri, turn on the lights. Siri, change the channel. We're getting to the point where we're going to have driverless cars. We are becoming more— our lives are becoming more automated. We don't have to get up or move around as often. And one of the big things that is one of my bugbears is that back in the day, we, you know, we didn't have remote controls for TVs and we had ads. And so you'd come to an ad and you go, for goodness sake, I'll make a cup of tea, or I'll go and put— change the hose in the garden. Now we can, on our streaming services, we can watch 2, 3, maybe even 4 episodes in a row without a break. And next thing you know, 3, 4 hours have gone by and we're sitting on our soft cushiony couches with our legs up or twisted one way or the other, and we haven't moved for that time. It's very easily done. Because we're distracted, we're engaged with what we're watching, and we forget perhaps to move.

That makes sense, especially I've done that. I've sat there for several episodes.

I think we all have.

And then I've got wanted to I've got up and it's so true. It's like the hips hurt, and you can actually mistake that for am I starting to develop arthritis? Are we we tightening those muscles or are we loosening them by sitting?

When we sit for prolonged periods, we've got our hips roughly at 90 degrees. And so the hip flexor, which is a long muscle that works us all the way through our hip range, is in its half range for prolonged periods. So it will become short if it's always in a mid position and a shortened position. It will become shorter. The problem with that is that it becomes tight, and it not only minimizes the hip ability of movement, you also impact the ability to arch backwards. Your back becomes a bit. Differ as well. Plus the fact that a lot of things that people sit on, a lot of chairs and sofas and couches, are too low. So not just that they're at 90 degrees, your knees will be higher often than your backside, which makes your hip flexors even tighter. And so when you combine the tightness in and around those hip flexors with a functional scoliosis, that's when things really become uncomfortable for people's backs. The Tight hip flexors tend to reinforce it, if you like, or even lock in that functional scoliosis. So that is actually one of the exercises that I recommend to people, is lying on their stomach to stretch out their hip flexors.

Did you notice as you're getting older, you can't even touch your toes anymore?

That is also an issue. A lot of the time that comes, I have found, from a tight nervous system, that the nervous system cannot glide as freely as it would have done when we were younger, partially I believe because of this functional scoliosis. It has to travel further. So when we bend forwards, the brain detects, oh, the nervous system is tight, the sciatic nerves are tight, make the hamstrings tight to protect the nervous system. So people will come into me and they say, oh, my hamstrings are tight, my hamstrings are tight. I'm like, yes, but that's because they're doing their job. If you deal with the cause, which I believe is the inability of the nervous system to glide better, the hamstrings will get the message, oh, I can let go. And then if you decide to stretch your hamstrings as well, it will be more effective. But so many people tell me that they stretch their hamstrings, they're feeling great, and the next morning they're back to square one because you haven't dealt with the cause of why the hamstrings are tight.

Which is the nervous system, like you just said.

Yes, it should be gliding freely. It's designed to slide and glide in all directions. So it's one giant spiderweb, all interconnected. And it's supposed to slide easily so we can do any movements we like. Look at dancers, how beautifully they move and they go through their full range of movement. And our nervous system, yours, mine, everybody should be able to do that. If the nervous system has become— the gliding of the nervous system has become compromised, the brain goes into protection mode. It makes certain muscles tight, and then we tend to, oh, I'm uncomfortable, I'll move less. And you move— it can become a bit of a downward spiral.

I was talking to you before we pressed record, and I said to you just recently that I found out I have scoliosis. And I found out by accident by having an x-ray for something else, right?

Yeah.

Like I said to you, I've gone to osteopaths and chiropractors, which I think do a fantastic job. All my life, I've never been told that I've had— that I've got scoliosis. And they tend to treat my hips or the upper part of my— or my neck, but it has never resolved anything. So why is treating the whole spine more effective than focusing on one painful area or spot?

If you want to fix the Leaning Tower of Pisa, you have to look at the foundation. There's no point in trying to straighten it without looking at the foundation. So when patients come to me, I look at the whole lot. I start from the pelvis and then I work my way up and I have a look. And if there is asymmetry from side to side, it's telling me something. So to jump in on someone's neck or jump into someone's spine and to mobilize it without dealing with the foundation, which is the orientation of the pelvis, doesn't make sense to me. And I've done that in the past too. I've treated the neck and the upper back. Good results, but they— it would come back. Or you do the lower back without taking into account the upper back. So I've learned over the years, start from the bottom, work your way up, loosen. And you see a regular pattern with everyone. And you loosen those tight areas. So coming back to your not being told that you had a scoliosis, functional scoliosis, everybody who walks in the door comes to see me has some form of this, some more, some less. And I suspect we all, you know, the general public probably have it as well, but it doesn't necessarily reach a degree where it becomes an issue. But when people come to me, it can be so subtle. It's easy to miss. But if you know what to look for, then you can pick up. And you also look, of course, at the range of movement. It should be symmetrical from side to side rotation. If it's not symmetrical, again, it's telling you something. And some people are just so obvious that anyone can see they've got a scoliosis. And some people come to me and they have both. They have a structural scoliosis, but I look at them and I say, it's possible you have a functional one overlying that as well. I cannot fix your structural. I am not a surgeon. That's something I can't do. But let's see if changing your habits and doing these simple exercises may be enough to ease that functional scoliosis, and that too may still give you some relief. And I have several patients exactly like that who have been so pleased that having been told, as we discussed earlier, to live with it— you've just got a scoliosis— that they've been able to manage their own discomfort.

Now, what would you like to say to people who think, surely the way I reach or sit or carry my bag Can't matter that much.

Well, I think you've got to look at it from the point of view every movement you make over the day accumulates. And particularly, it's interesting when people come to me and they say— and they've gotten worse or their back has played up— and I ask them, was there something that happened? Something— did you do something differently? No, no, no, I didn't do anything different. But that, I think, is the point, is that we often do things in the same way. We have certain habits where we set things up. Where do we put our keys? Where do we put our phone? Where do we put our coffee when we're at work? Is it off to the left? Is it off to the right? Where do we put our computers? We tend to do things— we tend to be creatures of habit. And when you add those movements up over the day, over the week, over the month, it's not surprising. And as I said, if you tend to be right-handed and right-hand dominant, strongly so, it's not surprising that this can develop. Or people will pick up a hobby, they start playing golf where they tend to swing to the— mainly to the the left with power. Or they may end up— they've changed their house, they've moved somewhere else, and now the stove in relation to the kitchen bench is on the left. So they're turning to the left repeatedly. There will be always a reason for— I find— for them to be doing more turning to the left, which seems to correlate with back pain, the pain they have.

So it sounds like everything is like on autopilot. Like we just do things automatically, or we're just not even aware at all. So it's more about developing awareness.

Absolutely. I mean, this protocol I have is a 2-part protocol, and the first part is hopefully encouraging people to be more mindful of how they move. We are so busy. We are distracted by our phones, by notifications, by beeping on our smartwatches. We're busy, busy, busy, and we can get into Exactly as you say, automatic pilot, and it's time just to slow down a little and start being aware of how we move. Which way? Oh my gosh! I just turned left. I got to use my left hand. What I say to people: the exercises in this protocol are easy. Changing your habits takes a little longer. Maybe two weeks, maybe three weeks. You make mistakes. Oh yes, oh yes. But eventually, quite soon, you will actually find that you've developed. Better habits, and then you will find you don't have to think about it quite so much.

Let's think about something here. Someone who is sitting on their couch watching TV, or what about desk workers who sit for like 50% of the day? What would be the ideal position for their spine, for their hips and their legs? How would you like to see them? Describe how you would like to see them sit?

Okay, so I, I discourage people from sitting on couches. A lot of them are not designed to be supportive. I believe they're designed to be beautiful, to make your house look lovely, but they aren't always very supportive. However, if you like your couch and you want to sit, first things first, bottom right back up against the backrest. Number 2, if your knees are higher than your backside, please put a cushion under your hips to try and even it out, or you can even raise the couch a bit on, on bricks or on raisers. And then the last thing is, I would recommend, if there is no support in the natural arch of the back, in the natural low back, I would recommend maybe rolling up a little towel and into a cylindrical shape and resting it behind your back so that your spine is as close to vertical as possible. So that's sitting on the couch, and then I would make sure that the TV is in front of you, or preferably even maybe slightly off towards the right so that you're twisting a little bit to the right. At work, what you can do— the easiest thing is get yourself a standing desk. So people have said to me, but when I stand, my back hurts. Well, I recommend then start slowly, start maybe 5 minutes Every half an hour, raise it up. Make sure everything is is at your eye level. When you're actually sitting, the same principles apply: feet flat on the floor, bottom well back, good support in the small of the back, the top of the screen at your eye level, and your elbows bent to about ninety. I don't want hands outstretched. If you mix it up over the day and gradually increase your standing time so that on and off fifty percent of the day. sitting, 50% of the day standing. It will make a big difference.

Well, it definitely will to the pain in your hips. And I find that when I'm at the computer here, after a long period of time, it's not just my hips, my knees hurt, like the back of my knees hurt as well. So is that all connected through this function?

Look, it can be. I would have to have a look at your seat. Um, you ideally want a seat where the front of the seat drops down. That's called a waterfall rather than a hard edge, because that hard edge can dig into the backs of your knees or into the backs of your thighs. But same principle, any joint in the body likes to move, and when they don't move, they get grumpy. So whether it's your knees or your hips, but coming back to also your neck, a lot of people when they sit and they're working on their computer, it's very It's very easy to get dragged into the computer. We get, you know, really involved and engrossed with what we're doing.

For people who aren't watching, you moved your head forward, didn't you?

Yes, that's correct. Pushing it forward towards the screen. And that will set up increased tension in your neck, which can add to neck pain. If you try and do that when you're standing, you're going to fall over.

So already it will help to So after years in physiotherapy, what do you believe the body is capable of when we finally stop, like, fighting this pain and start to understand it?

I feel that if you give the spine and the body the best possible alignment, the body has an amazing capacity to heal itself. That doesn't mean, you know, this protocol is going to cure your arthritis or fix your bulging disc. We all wear and tear as time goes by, but I believe if you give the spine the best possible alignment, it gives it a chance to settle down. So for example, if you follow this protocol, you're feeling great, but you go out and do a whole day's hard paving, you will still be sore because of the wear and tear in your spine, the wear and tear in your joints. But a lot of people tell me the next day there's either minimal pain or the pain isn't Whereas in the past it may have lasted for days or maybe even weeks. So it's not a cure-all, it's not going to fix you and make you 20. As many of my patients who would like to be 20 ask me, I can't do that. But it will give you management. You can manage your condition. You know what's going on, you have a good idea of what is going on. And that in itself is a relief for a lot of people to have some insight into what their condition is and How to manage it. So you're upset, you're back, okay, you know what you've done, you've been able to analyze what you've done, but you also know what to do to get over it. And that, I think, is power. Knowledge is power.

So your method uses 4 simple exercises, but most importantly, habit change. What is one exercise you wish every person would leave this episode knowing?

Probably the simplest one is exercise 1 out of my 4. So what I recommend people do is they lie on the floor. Now, not everybody can get up and down off the floor safely. Even if you did it on the bed, that's better than not doing it at all. But eventually, I like people to do it on the floor. So lying on your back on either a yoga mat or on the carpet with a pillow under your head so that you've got your head supported. And then what you do is you bend your left knee, bring it up to your chest, put your left hand on your left knee. Pull it firmly diagonally to your opposite shoulder, straighten the knee so it's at 90, and then whilst keeping the diagonal firm, grab the ankle and pull the ankle around towards the right. And that will give you a good stretch in the piriformis muscle deep in the left hip. Hold for 5 seconds, 5 times. I usually say to people, just do the left side, but if you feel tightness When you do it on the right, by all means do it on the right, but it's the left side that needs it the most.

And you have these four exercises on your website as a video, I believe.

That's correct. And you also have them in your book, which is called Banishing Back Pain: Relief Is Within Reach. The video is on the website, but it's also available on YouTube if you just put in my name, Valentina. Solovey, the videos come up. And those 4 exercises, they're not direct— they're referred to in the book, but the actual exercises are on a video because if you draw them or you write a description, people invariably get it wrong. With the video, you can watch it, you can pause it, take a screenshot, write your own little notes, go to the next one, and you can watch it as many times as you like. It's freely available to everybody.

Fantastic. Thank you, Valentina, for sharing those fantastic points about scoliosis and back pain in general and how we should be sitting, because we do do everything, I guess, to create this functional, uh, scoliosis.

A lot of things, definitely. Yes.

Yeah. So go to the show notes. Valentina's details will be there, her socials, Her website, her book. Do, do go and, and get educated around this.

Thanks, Valentina, for coming on. Thank you.