Johnston-Ruyer back therapy is suitable for ordinary [[back pain]] such as lower back pain, and is particularly suitable for recurrent bouts of muscles spasms. However anyone experiencing back pain should consult a physician, as in unusual cases, such pain is not ordinary, and may reflect a serious underlying medical condition.
The fundamentals of Johnston-Ruyer back therapy are simple and can be learned and applied by individuals without instruction courses, but some of the movements are a bit unusual and must be followed quite closely to be most effective in relieving everyday stress on the back muscles. All exercises can be applied in some form even when in pain, since, properly performed, they can provide immediate relief by helping the patient to use their back muscles much less while they are performing ordinary activities. The most effective proof of the method often comes when patients in great pain find they can move, for example rising up from a chair, without pain if they follow the prescribed movements for doing so very precisely.
Evolution is usually a very gradual process but human evolution, while taking millions of years, has been very rapid on an Evolutionary scale. This quick change to an upright stance, unlike other mammals and almost all other anthropoids has health consequences because that process of evolution is incomplete - principally, hernias (tears in the abdominal wall which is now under much greater stress), fallen arches and back muscles spasms. All are direct consequences of the change to bipedal motion. Even so, we are well adapted to an upright stance (just not yet perfectly adapted.) Back problems would be much rarer if we lived our lives in aboriginal conditions, being active, using our legs a great deal and not using chairs - or even if we were only a little less sedentary than modern humans have now become.
This rehabilitation plan assumes that a sedentary lifestyle and/or poor motion-posture is the root of most back problems, since during a period of comparative inactivity, our back muscles remain strong or at least active - even while sitting we use our back muscles to adjust ourselves, lean and reach - but the rest of our musculature, including our legs, become relatively weak. In contrast, our legs aren't doing much while we sit. Our tendency then, is to constantly overuse our back muscles, particularly lower back muscles, to substitute for other muscles, especially leg muscles. It's natural that this should happen, since we're still used to using our back muscles all the time, and these remain relatively strong. Paradoxically, back problems don't occur because of a "weak back", although it feels that way when they're hurting. According to the Johnston-Ruyer approach, back problems usually occur because the back muscles are the only muscles left that are fairly strong and which the sufferer is still used to using. Therefore, these muscles are overused, and used inappropriately to compensate for other weaker and less used muscles. Eventually the extra burden on the back causes muscle spasms, a typical sort of athletic injury for any overused muscle, which we experience as nagging back pain, or as a severe episode of pain that puts us "flat on our backs."
Standard sorts of leg exercises are part of the program, including lots of running and walking (taking care not to employ back muscles to help swing the legs.) Maintaining a specific sort of balance while moving, especially when sitting down or getting up from a chair is the other half of the therapy. Both parts require relearning our unthinking patterns of motion, in simple but precise ways that let all our other muscles do more of the work, and our backs, less. Exercises to strengthen the back itself are regarded as inessential, since the principle of the method is to strengthen and ready for use the rest of the musculature, such as the legs.
While this therapy can be used as an adjunct for atypical back pain resulting from unusual medical conditions, it is principally designed for the standard case, of a no longer young or no longer athletic person experiencing episodes of back pain (lower or upper.)
There was a time, only a few years ago, when physicians uniformly prescribed bed rest for backaches. Scientific studies then showed that this actually aggravated the problem by further weakening muscles, and that getting active again as quickly as possible strongly aided patient's recovery. This change of treatment has boosted Johnston-Ruyer therapy, because it helps patients get moving even while still in pain, and begin the process of recovery as soon as possible. At the same time, it's very specific changes to the way in which we move, such as when raising or lowering our body weight, form habits which relieve the back of much of the burden it has been under while at the same time strengthening other muscles so that they can resume a more normal, active role.
Believe it or not, the best time to exercise and learn how to use your muscles in ways that will cause your back less pain is when your back hurts the most - because this is when even the smallest deviations from good posture-in-motion will show up. This, after all, is one of the evolutionary purposes of such pain - to illustrate and enforce the more efficient use of our muscles, and retrain us in these better habits - not to keep us wholly inactive while we slowly starve.
Using the legs more, and the back muscles less is central to most approaches to back pain. Johnston-Ruyer holds that overuse of the back muscles occurs when we lose track of where our center of gravity is; or more particularly, where the centers of gravity of each of our three main body segments are with relation to each other. It says that back muscles are usually strained or overused when they are attempting to balance us and keep us upright while the centers of gravity of these main body segments are eccentric from a straight vertical line through the body. The three segments of our body mass are held to be: toes to knees, knees to hips, and hips to the top of the head. Even sitting up from a chair, down badly, can thus cause unusual strain.
Aside from general exercises to strengthen the legs, the most important, and central exercise is therefore to learn to sit down and get up from a chair. We all do this constantly, and usually simply but awkwardly, straining our back muscles with unnecessary work, whether we realize it or not, because it's not an exercise we were evolved to perform, and a special technique is required to sit down in or rise from a chair while keeping the centers of gravity of the three segments of our body mass precisely "stacked on top of one another". This series of movements is much more complex than what we usually do when standing up, and more precise.
The critical idea is to keep these three separate centers of gravity all lined up vertically, perfectly when raising and lowering oneself, reaching, and lifting. Re-learning the process of sitting in, and standing up from a chair, takes center stage in this therapeutic approach.
All of which could be taken to mean that the vast majority of back problems are not a hardware error - not a problem disks or muscles or anything else physical. They could be said to be a software error, instead. The way our brains tell the muscles to move, particularly if we've become used to being sedentary, causes the problems. A positive feedback cycle easily sets in - a vicious cycle of pain and behavior can too easily form in which most muscles are allowed to weaken, and because they are weak, are used still less. Meanwhile the back muscles, because they have remained relatively strong, are used more. Then one of two things happens: when an unusual stress or heavy lift occurs, the habit of overusing the back muscles really hits home as the large back muscles go into spasm, or poor motion-posture habits become so ingrained that nearly all movements are causing the back muscles to do too much work, resulting in constant back pain from even ordinary activities, that just never seems to leave.
Learning different ways of using the body that keep those centers of gravity on top of one another at all times, and exercising and strengthening our other muscles, breaks the cycle, and allows a pain-free, strain-free life to resume.
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