Finding Fitness With Lower Back Pain
The number of USA emergency room visits, pain medication orders, injections, imaging studies, and surgical interventions directed at lower back pain continue to rise. I frequently meet people who report their fitness efforts have been hampered by low back pain. I have five recommendations that can help fitness clients with lower back pain have more success in the gym.
#1 Do not exercise first thing in the morning: Ergonomic experts have found that many more industrial lower back injuries happen in the morning. The theory is that the discs in the lower back imbibe or gain fluid overnight and are more likely to deform with a physical challenge. Give your lower back one or two hours of walking around time before starting an exercise session.
#2 Isometric strengthening of the spinal stabilizers: The function of your “core” muscles is to limit movement of the lumbar spine and pelvis. Stop all crunches, toes to bar, sidebends, sit ups, seated twisting, and learn how to perform bird dogs, side hovers, Pallof press, planks, and carries. Compliance with this single hint would reduce USA expenditures on lower back pain dramatically.
#3 Enhance the function of your hip flexors and gluteal muscles: Please cease all the forward spine flexion, toe touching, spine twisting activities. Greater lumbar spine range of motion is associated with more–not less, lower back pain problems. Learn how to foam roll and mobilize the hip flexors and gluteal muscles. Prolonged sitting and most popular “cardio training” deadens these muscles. Properly functioning hip flexors and gluteal muscles keep the pelvis stable and take stress off the lower back. Reawakening dormant gluteals and hip flexors is the magic that resolves long term lower back pain.
#4 Focus on single leg strength training: Ditch the front loaded hip hinges–deadlifts, cleans, snatch, and drop the loaded squats. Swear off the lower lumbar deranging leg press. Reduce spinal compression and train the legs, one at a time. Single leg training reveals the right / left side movement asymmetries that drive lower back pain. Resolving these asymmetries and sparing the spine goes a long way to abolishing back pain. You will need some guidance on exercise selection and execution- this brings me to #5.
#5 Get some help: Exercise is the most powerful medication on the planet. Nothing else comes close. Take the proper dose of appropriate training and the results will be amazing. Take the wrong dose of an inappropriate activity and the results can be devastating. This is especially true for people with a history of lower back pain. Find a qualified physical therapist to guide you through your fitness journey. One way or the other, you are going to spend time and money on your health. Proactive spending is always cheaper and more beneficial than reactive spending.
Michael S. O’Hara, PT, OCS, CSCS
Fitness Success Secrets
WSJ and My Fitness Success Suggestions
A member at the gym brought in this *article from the May 20, 2017 issue of the Wall Street Journal. The article had some good tips on exercise compliance but fell short in other areas. Take the time to read my suggestions. These habits have been time tested, proven winners in multiple studies on real world people who were successful in making fitness a lifelong habit.
Get Some Help.
Numerous studies have shown that individuals that seek the assistance of a personal trainer or fitness coach are more successful in long term exercises compliance. The guidance from a fitness expert improves motivation, goal attainment and is more time efficient. Scientific understanding of fitness and the best training practices have changed dramatically in the last fifteen years, and your knowledge is probably behind the times. A good coach will temper your “beginner’s enthusiasm” and make it less likely you will over train and/or injure yourself. A professional helps you reach goals despite physical limitations or prior fitness challenges.
Personal Performance Evaluations.
In school, you have tests to see if you are gaining knowledge and ready to advance in a specific subject. The same should be true of your training program. The minimal requirement is a Functional Movement Screen. This simple test can prevent 90% of the fitness related injuries we see in the physical therapy clinic. Keep a record of relevant performance evaluations—a good trainer can help you with this. Your initial successes with exercise will come in the form of better strength, mobility, and work capacity. An ongoing record of “fitness victories” strongly reinforces the exercise habit.
Have Reasonable Goals.
The infomercials for fitness products promise big changes in extremely short periods of time. Television shows document massive fat loss in a single month. The healthiest changes in body composition occur slowly and steadily. Make those body composition goals, but also make performance goals such as being able to perform a pullup, twenty lunges, or a full pain free squat. I can think of no better goals than being able to eliminate blood pressure medication, normalize blood sugar levels, or decrease the use of anti-inflammatory medications.
Place Your Exercise Session At the Beginning Of the Day.
The University of Michigan department of psychology found that individuals that are successful with long-term exercise compliance train in the morning before other aspects of life have a chance to interfere. Consistency is King–an exercise plan will never work if you are not able to maintain a schedule. The most consistent attendance happens when gym members train in the mornings.
Michael S. O’Hara, PT, OCS, CSCS
*Wall Street Journal, May 20, 2017, Rachel Bachman, Five Secrets for Steadier Workouts