How Physiotherapy Helped a Young Man Overcome Recurrent Lower Back Pain Through Movement Retraining

Introduction
Recurrent low back pain is one of the most common — and often misunderstood — conditions physiotherapists see. Many patients suffer for years, falling into cycles of spasm, fear of movement, and inactivity. In this case study, we’ll show how McFerran Physio helped a young man break the cycle of pain and fear by retraining healthy movement and restoring his confidence.

Patient Background
Our client, a 25-year-old male, had been experiencing intermittent lower back pain for 2–3 years. His episodes followed a clear pattern:

• Sudden onset of severe lower back spasm.
• 1–2 weeks of functional limitation and significant pain.
• Gradual improvement with self-management (rest, medication).
• Symptom-free for several weeks… then another flare-up.

This pattern had begun to affect him not only physically, but also mentally — creating fear and anxiety around movement and exercise.

Assessment & Diagnosis

Step 1: Ruling Out Serious Pathology

As always at McFerran Physio, our first priority was to rule out red flags:

• No signs of inflammatory back pain.
• No nerve involvement (no radiating leg pain, no weakness).
• No symptoms of cauda equina syndrome.
• Clear neurological assessment.

The patient was otherwise fit, healthy, and had no significant medical history.

Step 2: Objective Assessment

Key findings during physical assessment:

• Range of motion: severely restricted lumbar flexion.
• During forward bending, he demonstrated hip hinging with a rigid lumbar spine.
• He had learned to “lock” his lower back in extension, avoiding normal spinal flexion.
• Fear and movement avoidance were driving this abnormal pattern.

Movement Dysfunction Identified:

The patient had developed a strong fear of bending his lower back, believing it was unsafe or would trigger pain — despite the lumbar spine being designed for movement and flexibility.

Treatment Approach

The goal was clear:
Restore normal movement, break down fear-avoidant behavior, and rebuild strength.

Phase 1: Movement Re-education

• Education & reassurance: bending your back is normal, healthy, and safe.
• Simple lumbar flexion drills:
  • Seated forward bends (progressively deeper). Sitting forward hang stretch
  • Incorporating spinal flexion into daily tasks (putting on shoes, picking up objects).
• Functional movement coaching: encouraging relaxed spinal movement during everyday bending.

Phase 2: Building Strength & Confidence

Once the patient began moving more naturally, we progressed to strength-based work:

• Hip hinge pattern training
• Reverse planks (Chinese planks)
• Bent-over rows
• Banded good mornings
• Romanian deadlifts:
  • Initially using a light kettlebell
  • Progressing to barbell
  • Gradually increasing load as confidence and form improved

Integration of Mobility & Strength

• Ensured lumbar mobility drills continued alongside strength work to maintain a balanced, functional spine.

Patient Outcome

After just a few weeks:

• The patient regained normal, relaxed spinal flexion
• Returned to the gym, performing Romanian deadlifts, squats, and lunges with excellent form and no pain
• Resumed full participation in football and other activities
• Has remained pain-free with no recurrences

Perhaps most importantly, he now has a healthy understanding of spinal movement and frequently shares this knowledge with others:
“Bending your back is good!”

Conclusion

This case illustrates a key principle at McFerran Physio:
Movement matters.
Pain often leads to fear, which in turn creates maladaptive movement patterns that can prolong or worsen symptoms. By identifying these patterns and restoring confident movement, patients can break the cycle of chronic pain.

If you’re experiencing recurrent back pain or fear certain movements, McFerran Physio can help with:

• Expert assessment
• Movement re-education
• Strength training
• Long-term strategies to stay pain-free

Contact us today to start your recovery.