After lasts weeks email about ways to improve your posture whilst sitting, I received quite a few emails from my other “email subscribers”.

Read on for two of the more thought provoking questions I received.


“Nick… How do you continue to try and stay fit (gym, work, golf etc…) when a long standing, persistent back injury keeps recurring? It seems that during the course of Physio things are fine, but often, my lower back problems return later down the track. I know the obvious answer is come back to physio, but I am wondering if there is something else I should be doing?

Jim, Hurstville.


– AND –


“Because of lower back problems I have been unable to do any exercise and have consequently put on weight which I struggle to get off.

I have a quite healthy diet but really could do with some exercise. I’m sure the extra weight I carry isn’t helping my back problem. In fairness, the weight gain wasn’t due to inactivity but a thyroid problem. Any thoughts?

– Frances, Mascot.


…So, let me try and answer both of these similar questions which, in a roundabout way, I hear a lot of.

And I’ll start with Jim’s concern about why his back problems keep happening.

First things first, Jim, Physiotherapy is not always going to be a 100% cure where you’re not going to suffer again.

(Very rarely).

Sure, it makes a HUGE difference to the quality of your life and can help you steer clear of pain and stiffness for significant periods…

It lowers the risk, and gives you a better shot at avoiding things like too early arthritis, but unless you combine it with lifestyle changes, quite commonly, you will feel some stiffness start to creep back in.

It’s a bit like cleaning your teeth…

You do it twice per day and you even visit the dentist every six months to get them checked, but I bet you still get tooth pain now and again, right?

And that’s because it’s just normal for mechanical things like teeth (and lower backs) to suffer everyday “wear and tear” as a consequence of “living”.

But hold on for a minute – how many people actually see the dentist that often? I often tell my patients, you clean your teeth twice per day to take care of them, but what do you do to take care of your backs on a daily basis?

Now, physio, like the dentist, does a great job of keeping you on the right track — meaning less time in pain, more time out of pain.

But the real long term success at fighting things like back pain is in what YOU do.

As in, the lifestyle changes you make, the exercise classes you attend (…or set up in your home), the type of exercise that you do or don’t do, right down to the length of time you spend sitting (even how you do it).

Jim has previously told me that he is a teacher…

Now I bet that his day is consumed with a lot of sitting at a desk or in important meetings etc.

And that means chronic back pain is more likely because “backs” aren’t made to sit.

(It’s true… sitting is the chief cause of most chronic back pain)

The long term solution?

Regular posture style exercises to INCREASE muscle control AND mixed with lots of stretching style exercises to make the muscles and joints more supple and flexible.

One thing I must point out – “exercising” (running, swimming, golf etc) rarely makes backs stronger… and there is a HUGE difference between exercising and doing exercises.

(Like Pilates and Yoga — which are exercises that get you in good enough shape to be able to “exercise”)

Pilates style exercises are also perfect for “Frances” (who asked the second question), and she is right… back pain is made worse by the amount of weight any lower back has to carry.

But the issue is the same…

Constant pressure added to the lower back… which makes it even MORE vital to do strength and control exercises to support her back on a DAILY basis.

(The same as brushing your teeth…)

Physio works perfect on lower back problems to help get you out of pain by loosening the joints and relaxing the tight muscles… then it’s over to the long term exercises to help keep it that way.

And is that a guarantee of staying 100% fixed?

Absolutely NOT!…


It gives you a great shot at being active and healthy for a LOT longer than had you chose not to do those exercises.

So, the answer to both of these questions is to be found in LONG term, regular commitment and discipline to doing the right exercises.