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
Health and Ergonomic Assist Gift That Get Used
I have some fitness and health promoting ergonomic gift recommendations for the 2016 holiday season. I have used all of these products and have been happy with the results. Most can be purchased on line and this allows you to devote more time to a fitness program. In the tradition of all great holiday shoppers, I like to get one for me and another to give.
Giving a healthy holiday gift is easy at Fenton Fitness and Athletic Center. Our Christmas gift certificates can be used for any of the training programs at the club. Team training classes and personal training packages make great gifts. Numerous studies have shown that individuals who utilize professional guidance are more successful in reaching fitness goals. No one performs exercises correctly after only one training session. You need ongoing evaluation and progression on proper exercise performance. Older and physically limited individuals need the assistance of a trainer more than any other group. Our team of trainers and physical therapists can help everyone reach their fitness goals.
Jungle Gym XT Suspension Trainer
The creation of user-friendly suspension trainers set off a mini revolution in fitness. If you go into a fitness center and they do not have multiple suspension trainers readily available, you need to find a new gym. The Lifeline Jungle Gym XT is an elegantly simple and extremely versatile device that should be a part of every home gym. Suspension trainer exercises can be scaled to any level of fitness and are a valuable weapon in our fight against age, injury, and occupational stress. At $90.00, the Jungle Gym XT wins the price war and, in my experience, it has worked well in both commercial and clinical conditions.
Aerocart by Worx
Gardening and landscaping activities are responsible for many of the referrals to physical therapy. The afflicted gardener has tweaked a lower back or strained a knee after hoisting a heavy object or spending too much time slumped over the flowerbeds. A single ergonomic tool can help remedy both of those problems. The Aerocart from Worx is a gardener’s Swiss Army Knife. It functions as a lightweight wheelbarrow, handcart, rock lifter, snow plow, pull wagon, and gardening stool. The Aerocart costs $140 and you can get a snow plow- my favorite- and the wagon attachments for another $100. I have used this tool to push snow, haul firewood, rearrange rocks, and move soil. The fact that the bucket does not hold mega volume prevents a user from overloading his spine. This device will extend the gardening career of the avid weed puller on your Christmas list.
All Purpose Bands From Perform Better
One of the best strength training devices is a set of the All Purpose Bands. These bands are sturdy dipped latex products made by Lifeline. They have two handles on one end and a loop system that makes them easy to anchor in either a closed door or around a stable upright device. All Purpose Bands can be used in a home gym set up, but my suggestion is that you anchor a set in a door at work and fight off the debilitating stress of all day sitting with some daily rowing, hip hinging, and scapula retraction exercises. A set of All Purpose Bands costs $25.00, and as your strength improves, you can purchase the next level of resistance in the series (light—purple, pink, orange, yellow, blue, black—strong) from performbetter.com.
Varidesk Conversion Desk
Human physiology was designed to function under the physical demands of standing and walking. Much of the now rampant obesity, heart disease, diabetes, and metabolic syndrome can be linked to our species’ sudden fall into sustained sitting. The health statistics on the damaging effects of sustained sitting are distressing.
I can think of no better health-promoting gift for a loved one than a sit to stand conversion desk. The product I have the most experience with is the Varidesk. It comes pre-assembled and has functioned flawlessly. It allows the user to sit for some portion of the day and gradually transition to greater time in the standing position. The Varidesk comes in a variety of sizes / set ups and costs $375 to $550.
My First Stand Up from Jaswig
The New York Times recently reprinted an article by Jane Brody, “Posture Affects Standing, and Not Just the Physical Kind.” In the article, Ms. Brody talks about how poor posture creates problems across multiple areas of physical and mental well-being. The respiratory, digestive, emotional, and neurological systems are all impacted by postural restrictions. You are even more likely to be a victim of crime if you have a slumped over posture. So how do you develop better posture?
My suggestion is to start with early intervention in the form of a standing workstation. The Belgian company Jaswig, has produced a standing desk for children. As the child grows, this adjustable wood desk travels with him. In our physical therapy clinics, we are seeing younger people with head, neck, and upper back pain problems related to poor posture. Mobile phones, laptops, tablets, and all the other “devices” are being used at earlier ages leading to the postural breakdown that usually occurs in later years of life. The My First Stand Up workstation from Jaswig (cost $379) is the early intervention answer.
PowerBlock Adjustable Dumbbell Set
Dumbbell training is one of the most effective forms of exercise. The big limitation of dumbbell training is the cost of buying a series of varying dumbbell weights and the space required to store 10 – 15 sets. The PowerBlock company has solved this problem. A set of PowerBlocks occupies less than three square feet of your home and, depending on the size you purchase, replaces 10 – 25 pairs of traditional dumbbells. I have put some heavy use on a set of PowerBlocks that I purchased in 1992. They have functioned flawlessly and show minimal wear. A beginner set of PowerBlocks (5-40 pounds) costs from $300 – $330 and you can add expansion sets as you get stronger. My thirteen-year old self would have loved to get a set of PowerBlocks for Christmas.
Most people have busy lives and limited time to devote to fitness. They want to get stronger, improve mobility, and maintain some degree of conditioning with minimal time commitment. For those people, I have a suggestion: Buy a Hyper Vest Pro and get to work.
I have used the Hyper Vest Pro for many years and can vouch for its durability. The comfort and overall function of the Hyper Vest Pro is impressive. The side lacing system makes the fit superior to other weight vest products. The individual weights are small and spread evenly over the front and back of the vest. Ten pounds of small steel plates are standard with the Hyper Vest Pro. I have found fitness clients do well with vest loads between five and twelve pounds. At $160, the Hyper Vest Pro is more expensive than other products, but the first rate fit and comfort make it worth the money. It is a great holiday present for the fitness fanatic on your shopping list.
If you consistently exercise, one of the best things you can do to enhance recovery between sessions is perform foam rolling soft tissue work. Combining foam roll work with mobility drills is the secret fitness ingredient that makes chronically tight individuals more flexible. The older you are, the harder you work, and the more frequently you train, the more you will benefit from the foam roll. I like the roller made by Trigger-Point (tptherapy.com). They come as a short, 13 inch version for $40.00 or the longer, 26 inch roller for $65.00.
-Michael S. O’Hara, P.T., OCS, CSCS