When we hurt our backs, our first instinct is to rest, grab a heating pad, and ask our friend Google for answers. Usually, this feeds our fear and avoidance of movement. “Anytime I move this way, I’ll injure my back.” Or, “Google says this is probably a herniated disc, which could affect me for the rest of my life.”
These thoughts spiral into worst-case scenarios, which turn up the volume on the signals going to our nervous system.
Pain is a protector, not a damage meter
Pain is your nervous system’s alarm. Its job is to protect you, and it takes in far more than tissue health: stress, poor sleep, fear, past experiences, and what you’ve read online all feed into it. That’s why two people with the same scan findings can have very different levels of pain, and why many people with disc bulges or “degeneration” on imaging have no pain at all.
When we avoid movement out of fear, the alarm gets more sensitive. Muscles guard, motions feel riskier, and a back that was healing normally starts to feel fragile. Understanding this is often the first step in getting better.
Healing happens in three stages: reset, restore, and rebuild
1. Reset. In the first couple of weeks after an injury, the body is managing inflammation, and that process deserves respect. But respecting it doesn’t mean total rest. The most effective approach is gentle movement that resets your nervous system, reduces fear, and retrains our thoughts around movement. This looks like short, easy walks throughout the day, breathwork and diaphragm control to settle the nervous system, pelvic tilts to ease tension, gentle stretching with easy trunk rotations and side bends, and low-effort core stabilization to support your spine. Heat can be a helpful comfort tool here. Just let it support your movement rather than replace it.
2. Restore. Next, we bring back the movement patterns of daily life: hinging, bending, and squatting. These are all motions your spine is fully capable of performing, and this phase is about rebuilding trust in your body, little by little. We practice hinging at the hips, bending to pick things up, and squatting, starting with sit-to-stands and progressing to lower surfaces. From there, we add other functional patterns like stepping, reaching, carrying, and getting down to and up from the floor, so you can return to laundry, gardening, or playing with your kids. If a movement is uncomfortable, we don’t avoid it forever. We find a version you can tolerate and gradually build from there.
3. Rebuild. Finally, the rebuilding phase begins. Tissues adapt to the demands we place on them, so we progressively load them, build power, and train the specific movements your life and activities require. This is the phase people skip most often, and it’s a big reason back pain keeps coming back. Feeling better isn’t the same as being ready for your workouts, your sport, or your hobbies. We gradually increase weight, volume, and intensity so your muscles, tendons, and spine become more resilient. We build power, the ability to produce force quickly, and add jumping and landing as your body tolerates it. Your PT will guide when and how to add impact. Then we practice what you actually do, whether that’s running, pickleball, lifting, hiking, or a day of yard work, and we build a plan for flare-ups so you know how to adjust, rather than stop, when your back acts up.
Back pain and women: what’s often overlooked
Women’s bodies go through changes that can affect the back, and too often the message is that pain is just part of the deal. It isn’t. Here are some of the most common things I see.
Pregnancy and postpartum. A growing belly shifts your center of gravity, and hormones soften the ligaments that support the pelvis and spine. After baby arrives, the work changes: hours of lifting, carrying, feeding, and bending over a crib or car seat. Many women are told “it’s normal” and never get help.
The core and pelvic floor connection. Your deep core, diaphragm, and pelvic floor work as a team to support your spine. When that team isn’t coordinating well, after pregnancy, surgery, or periods of high stress, the back often takes on extra work. Leaking, pelvic heaviness, or pain with intimacy alongside back pain are worth mentioning to a PT, because they’re often related and very treatable.
Perimenopause and menopause. Hormonal shifts can affect sleep, muscle mass, joint comfort, and bone density. All of these influence how the back feels and how well it recovers. Strength training becomes one of the most powerful tools we have during this season.
The caregiver load. Many women are lifting toddlers, hauling laundry, and helping aging parents, often on little sleep and with little time for themselves. Back pain gets pushed to the bottom of the list until it can’t be ignored.
Long days of sitting or standing. Desk jobs, school pickup lines, and hours on your feet at work all add up, especially when stress keeps the body in a tense, guarded state.
The same principles apply: stay gently active, rebuild confidence in your movement, and get stronger. But your plan should fit your season of life. What helps a new mom is different from what helps a woman in perimenopause, and that’s why individualized care matters.
Why a full, individualized assessment matters
“Back pain” is a symptom, not a diagnosis. Two people can have the same pain in the same spot for completely different reasons: one has a stiff, underused hip, another has a core that isn’t sharing the load, and another is guarding because of fear and stress. A generic list of stretches or a program from the internet can’t tell the difference, and the wrong exercise at the wrong time can leave you frustrated, or worse, convinced your back is fragile.
A physical therapist looks at the whole picture. At Rooted, that starts with a 60-minute, one-on-one session with someone who will listen to your concerns and take the time to understand what’s going on. We talk through your story: when it started, what makes it better or worse, past injuries, sleep, stress, and what you’re afraid to do right now. We look at how you move, including bending, squatting, rotating, walking, and getting up from a chair, because patterns matter more than any single test. We assess your strength, mobility, and control to see what’s tight, what’s weak, and what’s working overtime to compensate. We screen for red flags so nothing that needs a physician gets missed. If you ever notice numbness in the groin or inner thighs, new trouble controlling your bladder or bowels, significant or worsening leg weakness, fever, or sudden severe pain after a fall or minor event like a cough or sneeze, don’t wait. Get checked right away. And we get clear on your goals, the lifting, caregiving, workouts, and activities your program actually has to fit.
From there, we build a step-by-step plan to address your goals. It meets you at the right stage (reset, restore, or rebuild), progresses as you improve, and adjusts when your body or your life changes. You leave knowing what you’re doing and why, which is what keeps the pain from coming back.
You don’t have to guess, and you don’t have to live around your pain. You deserve a plan built for your body.
Why I started Rooted
That belief is why I built Rooted around one-on-one care. I started Rooted to educate women about their bodies, provide high-quality 1:1 physical therapy, and build a community of active women who know they don’t have to be limited by pain.
If back pain is holding you back, I’d love to help you move with confidence again.
Book your 60-minute evaluation
Not sure where to start? Reach out at taylor@rootedhomept.com or 419-569-9762.