backpain

This was the the subject line of an email I opened this morning from an athlete with whom I have consulted in the past.  I’m sure this is a question that many people have as it is a common misconception that back health is directly related to core strength.  It is not.

In the email he went on to share his numbers for the big lifts and mentioned that he foam rolled religiously as I recommended.  “Shouldn’t that be enough?”

Well, it is a start but in my experience both isometric and dynamic core strength has little to do with predicting low back pain.  Foam rolling may help to release tight tissues but there is a big chance that this in’t the underlying issue.  So much so that I have to turn this into a 2 or 3 part post.

I could write a book on the subject, er, well maybe I’m not quite there yet but some great books have been written on the topic of back rehab and performance.  If your interested (I know you are!) then I recommend checking out both Low Back Disorders and Ultimate Back Fitness and Performance by Dr. McGill.  For coaches who work with real people, this is a must!

What I have found to have a profound impact on backs is posture which is a combination of both muscle function and endurance as well as mobility in the hips and shoulders.  Programming for both rehabbing a bad back and prevention should include components of both.  I would even go as far as to say this type of programming should be included in anyone’s regimen that works at a desk.  Just sayin’.

*Please note that I did not mention back flexibility.  Did you make a note?  Ok, good.  Stop trying to stretch your back.  It typically makes things worse by temporarily masking pain.  

Function

Contrary to what most people believe, functional training is more than ‘doing what you do in real life’ and definitely not one-leg squatting on a balance board while pressing a 3lb dumbbell overhead with your eyes closed (don’t laugh, I have seen this done).  In general function refers to proper motor patterns (think computer hardware but in your nervous system).

For instance, many people with low back pain “forget” how to use their gluteal muscles.  All this means is they generally use their backs more and their hips less.  As simple as it sounds, this is common in anyone who sits at a desk all day and/or neglects properly using or training those muscles.

This is where most conventional training methods lack.  Here are 3 common exercise modalities that may contribute to your low back pain:

  1. Machines – If you look around the gym, most of the ‘functional’ training equipment requires you to sit.  Forget about dynamic stability, your glutes are taking a back seat.  The leg press machine may be one of the worst as it flexes your spine under load which can lead to even bigger problems!
  2. Ellipticals – These boast less pressure on your knees put most people in a position where they never really have to fully extend at the hip or knee.  I would argue that walking on a treadmill (although less intense) will go a much longer way to protecting your back muscles!
  3. Cycling or Spinning – I call this the silent ‘ass’assin (trade-marked) since most avid cyclists don’t realize the damage they are ultimately doing.  Not only is the back typically fully flexed but the hips are in chronic flexion as well which inhibits proper gluteal function.  What happens here is you have someone with piss poor glute function, overly dominant quads and hams and chronic back pain.

With the above examples, many of these people continue to train this way with no relief.  Don’t get me wrong, I’m all for doing something and I may get some hate-mail for bashing spinning (I really didn’t) so I want to let you know there IS a way to continue doing these things.  It is by doing other things!

Simply supplementing your training with extra glute work to ensure that those buns are firing on all cylinders.  It can be as easy as adding various glute bridge exercises to your warm-up and spending a day or two doing some actual strength work.  I am biased but deadlifts and squats always work here provided you are not dealing with any pain.

I will also recommend adding direct glute work such as barbell glute bridges and hip thrust variations to your strength training and preventative program.  Please not that these exercises should be used for strengthening and preventative measures and may aggravate an already bad back when done improperly.  Rehab first, train second.  That said, here are some great videos to get you started:

Single Leg Glute Bridge

Single Leg Hip Thrust

Barbell Glute Bridge

Barbell Hip Thrust

The other half of the functional equation is motor patterning.  As sexy as that sounds this is the basis of how we move whether it is doing a deadlift, picking up a penny off the ground or reaching for a glass.  Your body has patterns that sequence the muscles you use to perform these tasks.

For instance, lets take someone picking up a penny off the ground.  If their glutes aren’t firing properly they will probably bend from the back and use their hamstrings and sensitive back muscles to return to standing.  Someone who uses their glutes will sit back (maintaining a more neutral spine) and use their glutes, hams, and to a MUCH lesser extent their back.  This would be the basis of the deadlift pattern.  Now do you see why I promote a steady diet of deadlifts, meat and veggies?

The correct pattern would be this:

Not this:

That covers some of the basics of the functional side of preventative training for your back but remember that this is only part of the puzzle.  Stay tuned for parts 2 and 3 where I will go over mobility and posture to rehab and prevent back pain.


Written by Steve