Article Rundown

• How back pain develops
• What is ‘bleeding capacity’?
• The injury cascade
• Stop the ‘bleeding’

How Back Pain Develops Over Time

In this video and accompanying article, I will discuss the concept of “bleeding capacity” and how it relates to back pain. Specifically, I’ll address whether your back is “bleeding” and if you are unaware of the process. This idea, which I have coined, is not directly associated with Dr. McGill’s terminology, although his work may touch on similar concepts. My perspective stems from my own experiences and observations with clients, particularly those whose intake forms reveal recurring back pain that escalates over time.

What is ‘Bleeding Capacity’? 

“Bleeding capacity” refers to the gradual, often unnoticed, worsening of back pain that results from repeated stress and injuries to the spine and surrounding tissues. Initially, back pain can arise from an acute trauma, which is typically manageable. The pain may subside over the course of weeks, months, or even years, only to resurface later—often unexpectedly and in a different form.

At first, the pain may present itself during specific activities such as squatting, bench pressing, or deadlifting. These flare-ups might only occur under heavy load, and you may be able to live without pain during most of your day. However, as time progresses, the pain may resurface more frequently, even with lighter loads. Eventually, you might find that you can no longer perform squats without pain, yet other exercises or daily activities remain unaffected. This is the beginning of the injury cascade.

As the pain persists, it may start to radiate or become sharper and more intense, even during exercises that were once pain-free. The discomfort that initially appeared only in specific movements like squatting may eventually appear during exercises such as leg extensions, leg curls, or hack squats. This progression of symptoms signifies the ongoing damage to the spine and tissues. What was once tightness may evolve into sharper pain that radiates to the legs, for instance.

Over time, the pain may no longer be confined to exercise. It can start affecting even the simplest daily activities—getting out of bed, filling your dog’s water bowl, sitting down, or standing up. Eventually, you might wake up in pain and begin to feel overwhelmed, wondering if you’ll ever be pain-free again. What began as isolated discomfort during one exercise has now transformed into persistent pain in nearly every aspect of your life. This is what I refer to as “bleeding capacity”—the gradual loss of your ability to handle normal, everyday movements due to repeated injury and insufficient healing.

The Injury Cascade

The key to preventing the “bleeding” of your back’s capacity is stopping the cascade of damage before it escalates. The injury process typically starts with tightness, then discomfort, and eventually pain. Once pain develops, the tissues may be undergoing significant damage, progressing from micro-injuries to more severe, macro-level damage. The more you load these damaged tissues, the more sensitized and vulnerable they become. This is when pain begins to interfere with even the simplest activities, which once caused no issues at all.

STOP the Bleeding: Taking Control of your Recovery

To avoid further damage, it’s essential to identify and eliminate the actions that are causing repeated injury to your back. While this may sound like a simple solution, it is an important first step. If this resonates with you, consider reducing the intensity of your physical activities and allowing your tissues to heal. The healing process for back injuries can take months, or even years, depending on the severity.

In my own experience, it took me 18 months to recover enough to be platform-ready, as I discuss in my book Gift of Injury. I highly recommend reading both Gift of Injury and Back Mechanic—two books that have the potential to change your life and eliminate your pain if applied properly. Many individuals can resolve their pain on their own by following the strategies outlined in these books without needing additional consultations.

It’s important to note that recovery times vary significantly from person to person. While some workers’ compensation and healthcare guidelines may suggest a general timeframe for recovery, they often fail to specify which tissues are damaged or the degree of that damage. While some injuries might heal in a couple of months, others could take years. This variability is one reason why generalized recovery guidelines are often ineffective for most cases of chronic back pain.

Conclusion 

In conclusion, “Bleeding capacity” refers to the gradual decline in your ability to tolerate normal movement due to repeated strain on your back. Initially, you may be able to manage pain from an acute injury, but over time, the damage accumulates, eventually causing pain in everyday activities. The key to preventing this downward spiral is to identify and address the underlying causes of pain before they worsen. While recovery may take time, and no one can magically fix your pain, you are ultimately responsible for your healing process. If you are struggling to identify the source of your pain or need guidance on how to proceed, I am here to help. Click [HERE] to schedule a consultation and begin working toward a pain-free future.

BRIAN DOES ONLINE AND IN-PERSON COACHING!

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