Low Back 2015
Snow season is upon Iowa. Soon enough everyone with spinal issues and back pain is going to spend a moment appreciating the view of snow falling and follow that with the dread of how their back is going to feel for a few days after shoveling.
Really back pain prevents much more than something we didn’t want to do in the first place. Even though pain is a very important function that stops us from doing more damage to the body, it is still a signal something is wrong. Really, back pain or not, everyone just wants to be able to experience life the way they want to live it, and pain definitely prevents being able to do what you love most.
Back pain is frustrating, it's disabling, IT SUCKS. I know, I've been there. My spine issues started when I was a kid and no one could really give any solutions that worked. So, I went out and solved it myself. Only took about 15years and a few hundred books to really resolve the issue but in retrospect, it gives me a great perspective to the people walking into Grit with back pain.
Actually, one of the big errors people make is the thought that someone else can solve the problem. No one can solve a spine issue but the person with the issue. We can help, we can guide, but ultimately you have to do the work. I wish we could but we don't get to. Only you get to do that. It's a 24/7 obstacle and takes a lot of discipline.
Success in the spine health game really does depend on the circumstances but there are certain pieces of the plan that generally assist all of us.
1. Rotation is NOT your friend. And that’s not as simple as quitting golf for a few days.
The 3pt Row (left) is an example of a rotational exercise. No you shouldn't be moving at the spine during this exercise, however the body has to hold position against a rotational stress.
Where as, the Inverted Row (right) requires ample stiffening through the lower back while working the upper back+arms. This creates a sort of "connect the dots" stimulus, helping the body learn to work in a way that supports spine health.
2. Crunches are your enemy.
Most of us do not have spines that tolerate repeated flexion. Besides we sit too much anyway.
Think of bending a credit card back-and-forth. Eventually the credit card is going to bust, which could happen on the 12th bend or on the 12,000th. But eventually it's going to break. In this case the credit card is your spine.
It’s has been proven over and over again that spinal flexion causes disc herniations. And although approximately 87% of us have some type of spine issue and most of those are not a problem unless symptomatic...well, ALL DISC HERNIATIONS ARE BAD. Interestingly enough, the way we create disc herniations in cadaver spines for research is by repeatedly putting it through the same motion as the crunch exercise. If it's the most efficient way to create a disc herniation....why would anyone use it as an exercise?
There is a plethora of other+better ways to train the trunk, let’s use those. At this point research has made it conclusive enough to be able to say that crunches are to low backs what smoking tobacco is to lungs.
The dead bug (pictured above) is a much more appropriate exercise.
3. Stretching the low back = bad, Stretching the hips = probably good.
The spine very rarely needs to be stretched. So rarely that, in my opinion, it's not even worth talking about. Most back pain can be resolved by improving function at the hips while BUILDING STABILITY IN THE TRUNK. When the hips function well, the spine is spared. When the low back gets stretched, it loses stability. Stretching the low back is probably exacerbating the problem. Yes, stretching the back feels good and provides short-term relief, but it is probably causing increased long-term damage and decreasing the body’s ability to maintain the position that protects the spine.
The 2 left pictures are the most common and worst low back stretches I see, even if one of them does look like a pretty sweet dance move.
4. Everyone has to do their OWN job. Trunk stability PLUS hip mobility
Although this is touched on above, it is important to note that the function of the trunk is to RESIST movement and not produce movement. We want THE HIPS TO CREATE MOVEMENT while the spine holds position. And it needs to happen simultaneously.
A birddog (pictured above) is many times an appropriate starting point. Holding the spine in position while the upper and lower appendages have to move in opposing directions. It's another of those...connecting the dots maneuvers.
5. Daily care tactics.
The one magically correct posture while sitting is bogus. There are multiple ways you can sit for a healthy spine. You just need to change it every 20 minutes.
Breathe Deep. The diaphragm is THE MOST SIGNIFICANT Core muscle. You can do all the planks and corrective patterns that you want but until the diaphragm drops to pull air in to the lungs, everything else will have a subpar affect. Standing like Kim Kardashian isn’t helping anyone’s spine or anyone’s love life. If you want a booty, do the work.
Tying shoes: Bring foot to hands, not hands to foot.
Think of all this from a conceptual standpoint. Don't detail it to death. Accumulative affect of days and years of poor movement isn't going to be solved in one workout, one visit with the PT, or any magic pill. It's going to take guidance, mindfulness, and commitment to the plan. Then you can start experiencing life without pain. About the shoveling this winter, just like anyone who has lost the ability to perform a task, it’s not a burden after experiencing how much can be taken away. With a healthy spine you can run and jump around with your kids and/or grandkids. You can exercise. You can do…whatever. I don't know how anyone could put a value on being able to do what you love most in life but take it away and the value becomes very clear.