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Common cures for lower back pain
by Chris Kelly
In the gym, it is not uncommon to hear the wails and grunting of lifters hunched over machines and free weights jerking out reps-- attempting to exercise away their nagging back, neck and shoulder pain. Exercise can be the perfect cure for pain. But even stretching, followed by ab crunches usually lead to the massage table. And while the traditional workout routine may fill the pockets of your masseur, it is unlikely to bring you lasting relief. Lower back pain is the second most common cause of missed work days in the United States, yet 85% of cases remain unexplained.
"There is no such thing as generic pain" said Stuart McGill M.D., a professor of Spine biomechanics at the University of Waterloo. "Somewhere a weak link has been created and this link will eventually breakdown"
Over the last century, Americans have seen a marked rise in chronic lower back pain as heavy labor jobs have been replaced by occupations which require workers to remain sitting for long periods. McGill says that daily habits which lead to poor posture are often the source of chronic back pain (think leaning forward at the computer or twisting your torso while bending over). Some tell tale signs of bad posture are slouched shoulders and a rounded lower back.
"Leaning forward continually shifts pressure on to the back. Pulling back the shoulders back, and tucking in the chin can often bring immediate relief by taking significant load off the back" said McGill.
Do you take short steps and lean forward when you walk? Walking is one of many activities which can help or hurt the lower back. Common walking posture mistakes are leaning forward, leaning back, and failing to keep the head up and eyes forward. Simple corrections to your posture can help to relieve low back pain.
But regardless of posture, the source of back pain remains different for everyone. Factors such as the genetic, neurological factors and aging process play a key roles in determining your pain. And the cycle of injury can begin early in the morning. During sleep, the disks in your back act as packets which fill with water. But while this may make you feel taller, it also makes the back up to three times more likely to sustain injury in the morning.
Stretching in the morning is an example of something which most would assume would help to relieve pain. But bending over at a time when your disks are filled with fluid places extreme stress disks When it comes time to exercise, stretching can actually decrease performance by stiffening the muscle. As an alternative warm-up, McGill suggests exercises such as birddogs, side planks, wall squats, and dragon walks-- keep the spine in a neutral position while mobilizing the hips through a range of motion. The idea is to keep the muscle under load and motion during the mobilizing warm-up.
In the gym, effective lower back rehabilitation focuses on free weight exercises which work multiple joints to create stability such as squatting and dead lifts. But before progressing to strength training, it is important to address the underlying cause of back pain-- by correcting the source of your imbalance.
This process begins by strengthening weak gluteual (rear) muscles which provide stability to the pelvis and trunk. This can be done without weights, using exercises such as front, and side bridges which keep the spine in a neutral position. The next step is to create stability in the muscles around the back with exercises for the abdominal, oblique and back extensor muscles.
Once proper posture has been established, training with light weights can be safely resumed to build up muscular endurance. McGill says those experiencing common lower back pain should engage in weightless exercises for at least the first 3 weeks before weight training is resumed. Significant pain relief can be noticed in as little as 3 months, but whatever exercise you choose, it is best to stay away from lower body machines.
Lower body machines like leg press, and the roman chair shift additional load on to the back. Sitting down and pressing against the spine against the back pad of a machine a is a great way to re-aggravate your pain.
The jury is still out on the best workout program for lower back pain, but here are a few guidelines and exercises guaranteed to bring relief:
* Birddog: This exercise works the lower back. Start on all fours with hands under the shoulders and the knees directly under the hip. For the patient with the a stiff lower back, the first step is simply lifting a hand or knee off the floor. After you are able to raise your hand or knee without pain, progress to raising the opposite hand and knee together. The objective is to hold the limbs parallel off the floor for six to eight seconds. Good form includes a neutral spine and sucking in your gut.
* Bridges: This exercise is for the glutes and abdominals. Lie on the floor with your knees bent. Squeeze your glutes and then push your hips up until there is a straight line through knee and hip to upper body. Shoulders remain on the floor. Beware of raising too high or of flaring the ribs, which pushes the back into hyperextension. Hold this position for an increasing length of time up to a maximum of one minute. Perform two to three sets.
* Side bridges: This exercise strengthens the side obliques glutes, quads, and lats. Lie on side, support yourself on one elbow and stacked ankles. Lift midsection from the surface of the table. Maintain neutral to hold this position as long as possible, until you begin to lose neutral or note discomfort. Repeat this on the other side.
* Cat/Camel: This is an exercise for the neck. Kneeling down on all fours begin with your head looking down at the floor. Now, nod your head up and down in a continuous, rhythmic motion for 15-30 seconds at a time. Note that this exercise is performed with continuous motion.
* Abdominal bracing: Abdominal bracing is the act of "stiffening" or tightening the muscles of the midsection. An abdominal brace protects the spine by forming a brace of muscles around the spine. This stiffening of the core muscles should be done during all activities to protect the low back.
Exercise program progression:
1. Start with bridges and side bridges to strengthen the glutes. 2. Proceed to birddogs, and bridges for back stability. 3. Hold out repetitions in each exercise for no longer than 8 seconds. The goal is to build muscular endurance, by gradually increasing your repetitions.
Chris Kelly is a NASM Certified Fitness Trainer, nutritionist, and editor of the Spotter, a webzine devoted to becoming your personal trainer outside of the gym. For more easy to read articles on fitness, diet, health, and nutrition, visit http://www.thespotter.net
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