Hi guys!
First of all thank you so much for an amazing work you’re doing, I’ve learned (Still am) so much from you.
I have a question about my mother. She’s 54 years old, obese with type 2 diabetes and back pain. I’m worried about her health so I wanted her to start lifting, taking care of her diet to lose some weight etc., but I wanted to consult it with you first. She had an x-ray (lumbar and cervical spine) done a few months ago and it said that she’s got a discal hernia/slipped disc (I’m hoping I’m using a correct translation) on her L3-L4-L5-S1 and C4-C5-C6-C7 in addition to osteophytes and degenerative changes in the intervertebral joints (Again I’m really sorry if I’m using the wrong terminology here). From a practical standpoint, she’s told me that she can’t walk or stand for a long period of time, also, she can’t lift any weights (She has to ask other to lift like a 3kg bags for her).
I was thinking to advise her on what foods to eat to achieve a calorie deficit and increase protein intake, introduce some cardio (bike so her back pain won’t stop her from doing it) and weights doing pain-free stuff. Obviously, I’d like her to do some compound movements but I think she can only do machine work at this moment, I’ll find out at the gym though.
My question is, can you give me any advice on what to do and not do? Also, how can I help her to manage pain?
Why did she have the X-ray done?
I agree with your approach to get her moving and exercising more, and there are no magical / “correct” or “incorrect” exercises here. It sounds like you can get your foot in the door w/ aerobic activities and machine work, which is a fine starting point. The long-term goal should be to get her doing movements / activities she currently feels she “can’t” do.
Things to do: provide education, set reasonable expectations, and try to accumulate small “wins” (in terms of progressing her level of function) over time.
Things NOT to do: perpetuate the harmful biomedical narratives she has been given (e.g., assuming she has a “bad” back, focusing on the X-ray findings, etc), focus on her pain as the target outcome measure (versus focusing on function and on the process), allow her to avoid activities she’s afraid of (as this perpetuates the fear-avoidance problem).
These can be very complex situations to manage, depending on the individual. If you would like guidance with the process, our rehab guys would be happy to help: Contact Us | Barbell Medicine
She’s been having problems with her back for a very long time and eventually went to a doctor who prescribed it. I think the psychological part can be a biggie here - I believe that she was told that she’ll end up in a wheelchair by some doctor around 30 years ago so her negative emotions could have accumulated in that time. Additionally, she hasn’t been physically active for many years (Mostly due to that pain) and her attitude hasn’t been the best either (“It’s too late for me” “I’m too old” “I can’t do anything due to my back” etc etc.).
Thank you so much for the tips. I’ll do some more reading before I meet her but I’ll try to apply (or avoid) everything you told me. I’ll see how the situation progresses, but I might need to consult it with Dr. Ray and Dr. Miles. I’m hoping that as she hasn’t done any physical activity or tried fixing her diet before, some small changes in these areas will bring about benefits anyway.