If there is ANY topic I am hyper sensitive to it is that of low back pain. I am sure if you have been following us for any period of time, you know my struggle with low back pain. That stems from a very aggressive spinal degenerative disease I have that basically is causing my spine to collapse. When I often share my story the first question I get is, “what did you do to have these problems.” The question is really intriguing to me because as a disease, it doesn’t infer that I really did anything especially when I tell people it is congenital and something I have been battling since I was 14. Yet, it is interesting because we think low back pain can be traced back to a singular instance.
Losing my ability to walk and having 6 spinal surgeries to being able to train doesn’t make me an expert, but does give me unique insight into what is happening and how we can make a positive impact upon people. I would say the results I get for others makes me more of an expert than what I do for myself.
Most times when people “blow” out their backs, that instance was just the “straw that broke the camel’s back” type of situation. That makes us think that low back pain can always be prevented. I find that we can’t always prevent low back injuries because there are elements at work more than just “making X strong.”
Thinking that way makes us believe that our fitness can solve all, but there are other issues that contribute to low back pain…
-What you do on a daily basis (does your work or life situation put you in a position to be more predisposed to low back issues)
-Sleep (when your body is run down you can be more prone to issues like low back pain)
-Nutrition (placing your body in constant inflammation can cause your body to experience low back issues since there are nerves that innervate your organs that can relate to muscular issues)
-Genetics (I for a long time dismissed this role as my family doesn’t like being physically active, therefore I attributed the high amount of low back pain in my family to just not being strong and fit. Having doctors look at bone and other structures in my body and show the genetic role, I do give it more credence however, that doesn’t mean you HAVE to have low back pain if it does run in your family).
Social Media & Low Back Pain
Talking about low back pain could be a whole course in of itself (sounds like something the physical therapists in our community are working on;), but I wanted to address some common issues. Largely I was inspired to do so because social media is full of random actions to take for low back pain and exercises that if you truly had low back pain would be absolutely impossible to perform.
Since low back pain is so prevalent in our society I wanted to give a more mindful approach to how to help low back pain in yourself or others. I will preface what I am going to discuss by saying that this is for general low back pain. Depending upon the cause of your low back pain certain exercises or ideas may be more relevant than others. While I don’t claim some universal exercise to solve all low back pain, I am going to share ideas that have helped many of my clients in 25 years of coaching and myself in 30 years of battling low back issues.
Should I Stretch?
Unlike many people today, I don’t try to be polarizing by taking an absolute in any form. So, instead of telling you stretching solves everything or is useless let me say this. Stretching can help give some relief to people with low back pain. Especially a focus on hamstrings, glutes, and hip flexors. However, at the same time, I often find stretching to be a band-aid in many cases. Meaning, it can give us some immediate relief if we are feeling really achy, but it is rarely fixing a problem.
I recommend stretching at the end of a workout (mostly to calm down your body and nervous system) or on off days, especially if you have been sitting for awhile. Where I like to spend way more time and where we see far better results is when we employ more “activation” drills. These are exercises that “wake up” many of the stabilizer muscles that get compromised either by sitting too much or when you have pain you often alter your posture. It is the use of activation drills that seem to have a much bigger impact upon how we move and a few reps done really well goes much further than trying to do a lot.
This makes such drills perfect for at home programs, or giving people “homework” for days they aren’t training. Here are a few great examples that have a big impact upon people with low back issues.
Strength Coach, Martin Adame shows not only great activation drills but the impact it has on our lower body mobility. Since “tightness” in the hips and hamstrings are issues for low back pain, having that big of an improvement after a few exercises tells us that we aren’t typically dealing with a muscular issue. That is why understanding the body makes such a difference in the results we can achieve. Remember “tightness” usually is the body’s way of trying to protect us when it doesn’t feel stable.
DVRT Master, Cory Cripe breaks down another way we use “activation” to help us build better mobility which leads to better movement and less issues potentially on the low back or letting the low back relax because the other structures are working more efficiently.
For people with low back pain, some of these activation drills may just be the workout depending upon their level of pain and what is causing it. In my case, post-surgery it was awhile till I was cleared to workout and even then I had a weight limit I could use. So, when I returned to training my body was weak both from what was done in the surgery and trying to heal. My point is that most trainers start people WAY too aggressively and too far ahead in the progressions. The goal with someone in low back pain should be to find what level of a movement can they perform well without causing pain.
That is why I broke down a familiar exercise in our dead bugs below, but in a very different way. You will see how foundational we have to get and patient as well. In an upcoming blog I’ll address how we layer more strengthening, but don’t overlook such activation drills as the foundation to strength!
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