“In the United Kingdom, low back pain was identified as the most common cause of disability in young adults: with more than 100 million work days lost per year.” – World Health Organisation
The first thing we want to point out here is that we are absolutely not trying to advise people on how to treat lower back pain - that is not the aim of this post.
If you are currently experiencing chronic lower back pain then seek out a reputable chiropractor or osteopath that can have a look at you and if needs be send you for an MRI scan to diagnose the issue.
It seems there are far too many personal trainers out there claiming to be able to alleviate back pain with a few stretches because of “lower crossed syndrome” or “anterior pelvic tilt”. There are sometimes underlying structural factors that lead to degenerative issues and chronic pain that are quite simply not within our scope.
The point of this post is to outline the ways to reduce the risk of aggravating/provoking issues and being able to train when experiencing lower back pain.
It is estimated that in the UK 2.5 million people are experiencing back pain on any given day of the year, which is astonishing. A lot of the time (this is anecdotal) movement is helpful for people experiencing low levels of back pain. At W10 we frequently deal with and work around a large number of spinal issues from fused spines to herniated disks to inflamed facet joints.
Here are a few things to consider if you’re currently experiencing low back pain and want to exercise:
(these are also things everyone should consider every time you exercise regardless of whether you have back pain or not).
1- Do not attempt aggressive rotation of the lower back
As tempting as it might seem, rotating a lot through the lower back is actually counterproductive and may create increased flare up. Your lower (lumbar) vertebrae are larger in size and are not designed to rotate as much as the upper (thoracic). Your lumbar spine is designed to withstand broadly 13 degrees of rotation each way; it is there for stability and not mobility.
The joints above and below are areas we need to get mobility from (thoracic spine and hips). When our thoracic spine and hips are tight we crank on the lower back to take up the slack.
2- Know what your range of motion allows
Anatomically we are all different. Not everyone should squat as low as possible, different bone lengths create different levers and everyone’s hip anatomy is different. Flexibility and torso length will also determine how low we should squat for example, as well as determine if we should be deadlifting from the floor or not.
Realise that SOMETIMES reducing range on certain movements is a good idea. If you cannot squat safely to parallel then a split squat is likely a better option. Single leg training is a very safe way to train the lower body when it comes to working around lower back issues.
3- Reduce axial loading
Axial loading means weights that are compressive on the spine (anything with a bar on your back for example). Barbells are not compulsory, they are great when used for the correct purpose in the right situation, but there are many ways to load an exercise and also progress an exercise. It doesn’t always have to mean putting a heavier weight on your back.
4- Learn when and how to breathe
Breathing well and correctly during exercise creates a bracing effect through your mid section. As a general rule you should forcefully exhale on the concentric (on the way up) portion of the lift.
To use a squat as an example you should take an inhale when at the top, hold the breath keeping tension as you descend, then forcefully exhale as you come up. A good way to think of this is imagine that your are stood in water up to your neck when squatting so as you go through the rep you are going under water.
5- Move through different planes of motion
A very high percentage of exercises that we do are in the “sagittal plane” which means moving forwards and backwards. Moving laterally and in rotation improve “movement vocabulary” which allows us to be more resilient to lower back pain.
6- Utilise total body exercises
Everyone agrees that you need a strong “core”. The point to be made here is that your core includes everything from your knees to your shoulders. We are absolutely not saying that direct core training isn’t necessary, because it is, but core stability is being able to perform movements without any un-necessary compensation through the spine.
7- Warm up properly
Mobilising the correct joints as well as performing a couple of sets to activate the muscles that we want to stabilise the lower back are both key when it comes to training with lower back pain. Our glutes and abs are notoriously lazy because of the percentage of our lives spent seated.
Waking these up before we train will go a long way to being active when experiencing low back pain. This is very often the part of everyone’s sessions that gets rushed or completely missed if we are rushed for time.
Everyone should take note of these 7 tips especially if you're already experiencing lower back pain. If you have any questions on the above and would like some further advice, don't hesitate to reach out - firstname.lastname@example.org