Part 5: Rewiring Movement - A Tailored Rehab Plan for Chronic Low Back Pain

If you’ve been following this series, you know chronic somatic low back pain isn’t just about your back—it’s about your brain’s protective habits, wired through neuroplasticity. Those stiff, guarded movements—like tensing up to stand or barely bending to pick something up—become your default. But here’s the good news: we can shift them. As a physiotherapist, I’ve seen how a tailored movement, activation, and strength program can nudge that overprotective system forward, restoring normal patterns and strength. It’s not generic; it’s personal. Think of it like building a house: you need a solid plan, a strong foundation, and patience to get it right.

First, the plan. Generic exercise sheets won’t cut it—your back pain isn’t one-size-fits-all, so your rehab shouldn’t be either. We start by assessing your movement patterns: where you’re stiff, what’s overworked (those splinting muscles), and what’s weakened (often the glutes or deep core). The goal? Gently challenge the brain’s “danger” alarm without tripping it into full lockdown. It’s a slow, steady nudge—think coaxing, not forcing. For example, we might begin with small, safe hip hinges to wake up underused muscles, keeping the spine relaxed instead of braced.

This builds the foundation: correct activation and movement patterns. Before we pile on strength, we reteach your body how to move naturally—undoing those protective habits wired by peripheral and central sensitisation. Maybe it’s activating your glutes to support your back during a sit-to-stand, or easing into a spinal twist without that old “splint” kicking in. Education is key here. Learning that pain isn’t always damage—and that your brain can overreact—can feel strange or even challenging. It flips old beliefs upside down, but understanding this empowers you to trust the process.

Only then do we build the house: life-specific strength and conditioning. Once your foundation’s solid, we add load tailored to your goals—whether it’s lifting kids or hiking trails. But here’s the catch: objective wins, like better range of motion or stronger glutes, often show up before pain drops significantly. That’s normal. Your brain needs time to catch up, to trust that these new patterns are safe. Rushing it risks tripping the protective system backward.

Slow and steady wins this race. A tailored program isn’t flashy—it’s precise, thoughtful, and built for you. With education woven in, you’re not just rehabbing your back—you’re rewiring your relationship with movement. Ready to lay that first brick? Let’s talk.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com

Bookings also available on our website for:

• Dietitian - weight-loss or to optimise your training nutrition / fueling

• VO2 Max testing - to discover more effective ways to train efficiently

• Strength & Conditioning Programs - contact us via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tightness from chronic pain or from training that could lead to injury.