The Body Keeps Score, Part 1: My Back Has Opinions

I want to tell you about the morning everything changed, and I want to be accurate about how undramatic it was.

Ellie was two. It was a Tuesday. I bent down to pick up her shoes — small shoes, canvas, perhaps 400 grams — and something in my lower back produced a sensation I can only describe as a reminder. Not pain exactly. A communication. We are here. We have opinions about this. Proceed carefully.

I stood up very slowly, the way you stand up when you are 43 and something has just reminded you that you are 43, and I thought: right. Here we are.

The accumulation problem

The back does not give way dramatically in most cases. It accumulates. Twenty years at a desk. A decade of carrying things badly — laptops, boxes, children, shopping bags in configurations that a physiotherapist would describe as "suboptimal." A series of gym phases that began with good intentions and ended with something pulled, followed by a period of doing nothing to compensate.

The lower back is a load-bearing structure that was designed for a species that moved continuously throughout the day, that crouched and walked and climbed and did not spend eight hours a day shaped like a question mark over a keyboard. What we ask it to do — sit still for extended periods, then suddenly pick up a small child from a low surface, then sit still again — is not what it was engineered for.

I did not think about any of this until the Tuesday with the shoes.

What I did about it

The first thing I did was nothing, because I assumed it would resolve. It mostly resolved. Then it came back after I carried Sam up the stairs with bad posture. Then it mostly resolved again. This cycle — discomfort, recovery, discomfort — continued for about four months before I accepted that the pattern was not going to interrupt itself.

I saw a physiotherapist. This is the correct answer and I should have done it immediately, but I am a man in my forties and there is a particular stubbornness in this demographic about treating physical problems as things that will simply get better if given enough time and sufficient ignoring.

The physiotherapist assessed me and said several things that were useful:

First: my hip flexors were short from sitting. Short hip flexors pull the pelvis forward and compress the lumbar spine. The back pain was not, primarily, a back problem. It was a sitting problem presenting as a back problem.

Second: my glutes were weak. This is, apparently, extremely common in people who sit for a living. The muscles that should stabilise the pelvis during movement had, through disuse, largely excused themselves from the arrangement. My hamstrings were compensating. The hamstrings were not happy about this.

Third: the way I was picking things up from the floor was contributing significantly. The casual single-spine-flex to retrieve a small shoe is fine at 25. At 43, with compromised hip flexors and underperforming glutes, it is a compressed disc waiting to express itself.

The exercises nobody tells you about

The programme she gave me takes twelve minutes. I do it six mornings a week, before the kettlebell session, before the coffee. It contains:

Hip flexor stretches. Three sets, ninety seconds each side, in a kneeling lunge position. Initially this felt like nothing. After a week I realised the absence of "nothing" was because the hip flexors had been so tight that normal extension felt like the neutral position. Then I started feeling the stretch.

Glute bridges. Lying on your back, feet flat, pushing your hips toward the ceiling and holding. Three sets of fifteen. This is an exercise that looks like very little from the outside and is, in practice, doing significant work on the structures that had been politely opting out.

Dead bugs. On your back, opposite arm and leg extending simultaneously, slow and controlled. The name is accurate. You look like a dead bug. They are excellent for the core stabilisers that protect the spine during the lifting of small shoes.

The standing desk intervention. I bought a standing desk converter. It cost £85. I alternate between sitting and standing throughout the working day. The back has mostly stopped filing formal communications.

The thing worth knowing

I want to say this clearly because it is the thing I wish someone had said to me before the Tuesday with the shoes: the back problems that accumulate in your forties are almost entirely preventable and largely reversible, and they are not a sign that your body is failing. They are a sign that the body is doing what the body does when it is asked to sit still for extended periods without countermeasure.

The countermeasure is twelve minutes in the morning and a slightly ridiculous purchase of a standing desk converter. The countermeasure is cheaper than a physiotherapist and considerably cheaper than the ongoing cost of being in pain while trying to be present with two small children.

I pick up small shoes now with a slight squat, knees bent, load distributed. It looks faintly ceremonial. The back is quiet.

I count this as a win.