Lower back pain… There, that got your attention! Didn’t it? You see, I bet everyone has had a spell of lower back pain in their lives. The spine is literally the centrepiece of our skeleton and we cannot function well without a strong and mobile spine. If you injure a hand or foot, there’s a high probability that you can work around it and continue with your normal routine. However, damage the muscles/tissue surrounding the spine and it’s a different story. The body will literally lock down to protect it from further damage.

If you have suffered trauma to your back or suffer from unexplained chronic lower back pain then please go and see a clinical specialist (such as an osteopath) to get it checked out. Lower back pain is a generic condition, but a clinical professional will be able to provide an early diagnosis and intervention.

The reality is that many people’s back pain is a result of their postural habits, a sedentary lifestyle or imbalances in the body – and this is where an experienced Personal Trainer might be able to help. In these cases, lower back pain is often a symptom but not the cause.

Pain Science 

I thought I should throw this one in here just to challenge your perception of pain. Pain comes from the brain, not from the injury. it is something we should always pay attention to. Think of it like an alarm – stop what you are doing and have a think about what might be wrong. Yet pain doesn’t always mean that there is something wrong. 20 to 40% of people with herniated discs report no pain. Conversely, people can report chronic back pain for years despite an injury being completely healed (due to increased sensitivity). The take-home point is that pain is not always indicative of an injury and vice versa. A positive attitude goes a long way in recovery.

Causes of Lower Back Pain (AND HOW TO FIX THEM!!) 

It is important to know the history of your back pain – this is neatly covered by the  4 W’s and 1 H. When? Where? What? Why? And How?

This should provide enough information to signpost the nature of someone’s back pain. I won’t elaborate on this here but if you asked how the pain was caused, then you are going to treat “I fell off of a ladder on to my head” very differently from “It gets sore after driving for 6 hours”. In case you are confused, in the first instance you should be rushing to get yourself scanned!

1) Posture and Movement 

If you are stuck in an awkward position all day then your body will adapt to the position. Essentially, this position becomes the norm. A sedentary lifestyle involves a high degree of sitting and inactivity. This typically results in tight hip flexors and weak glutes. This is a recipe for back pain – why?

Because when muscles are not utilised correctly they are likely to become short and weak (causing reduced mobility). This is known as adaptive shortening. The iliopsoas is a small group of hip flexing muscles that connect the thigh to the lumbar region. When these muscles are tight, they directly tug on the lower back. Ouch! If you have other bad habits like slouching then guess what, the burden of your protracted shoulders is going to eventually cascade down to your lower back. Don’t be lazy, get your shoulders back! Always strive for good posture and to keep on moving.

Here are some excellent stretches to help straighten you out:

2) Imbalances 

I will bang on about this until I’m blue in the face (at the moment, I’m mostly pale). Balance is the key to strength and good movement. If you are imbalanced then you are far more likely to get injured. If a body part is not robust then the burden of responsibility will be passed on to another muscle or joint. Guess what, when the task becomes too much then you will break. Most people have weak lower backs. This can cause a dull ache or nagging pain. Many people don’t train their lower backs because they fear that training the lower back will injure it, but this couldn’t be further from the truth. Strengthen it and it will be able to endure far more work (though this doesn’t negate the need for good posture and technique).

When you are in the gym don’t just focus on the mirror muscles, but add plenty of rowing exercises into the mix too. If you love running, then you are overworking those hips, so do something to strengthen the glutes. Think of everything as an opposite. If you work the front then work the back, if you work your quads then train the hammies as well. Strength training is key, don’t be frightened of deadlifts and squatting either. If you are able to perform these lifts with technical expertise then these Big Bang for your buck exercises will build huge amounts of strength in your body and improve your lower back health too.

If you like rules to follow then remember this:

  • If it’s weak then strengthen it (Just strengthen it anyway….Push, Pull, Hinge, Squat and Lunge).
  • If it’s tight then stretch it.
  • If it hurts then rest it

Now get to work!

3) Glutes

Glutes get a section all of their own. Why? Because they help everything. You might know them as Gluteus Maximus, Gluteus Minimus and Gluteus Medius aka the 3 Musketeers. These muscles are so pivotal in hip health and sports performance that they cannot be overlooked. They provide the propulsion in running and jumping, they maintain stability in your pelvis, they prevent your knees from collapsing when you squat and more importantly, strong glutes take away the donkey work from your lower back (those poor QL muscles). In short, a strong set of glutes will give your lower back less responsibility, as well as counteract tight hips. So what’s the problem? The problem is that most people have a pancake butt and rarely engage their glutes – this means their glutes are not getting involved. Not only this but prolonged periods of sitting or driving have shortened peoples glutes. This can refer pain to the lower back. (*are you starting to take note – sitting down too much is not good for us).

The piriformis deserves a special mention. It is a little muscle deep in your butt and it can be a real pain in your butt too. When it gets tight it can compress your sciatic nerve causing shooting pain into both the lower leg or lower back. If you have these symptoms, you drive or sit down for extended periods, then stretch your glutes and piriformis (see pigeon stretch) – you might be surprised how quickly your lower back pain can disappear. Another clue to a dysfunctional piriformis is noting that your foot is excessively externally rotated.

If you are not sure how to train the glutes then get in touch, but for now, try and include an exercise for each of these

– Abduction (e.g lateral band walks)

– External rotation (e.g banded clamshells)

– A thrust (e.g. a weighted hip thrust)

That should cover your bases.

4) The Core 

Last but by no means least. The core is everything that attaches to your pelvis, not just your 6 pack. A weak anterior core often goes hand in hand with tight hips. Think back to the example of someone who sits in an office all day. If their hips are tight and the anterior core is weak, then the core will not be able to resist the pull of tight hip flexors. The result of this will be an anteriorly tilted pelvis (APT) and lower back pain. APT pulls the lower back into hyperextension which causes further lower back pain.

The solution to this is to build a solid core – this includes your anterior core, your lower back and your obliques. If you have been following our series of articles on Graspp you will see that Coach Fletch did a brilliant explanation of McGill’s Big Three for maintenance of your core and spinal health. Have a look at that and you won’t go far wrong from building a strong, healthy core and a solution to APT. Other exercises to consider include dead bugs and glute focussed hyperextensions.

I hope you found this article information

Be bulletproof,

Coach Craig.

Author - Craig Peterson - Personal Trainer & Mentor

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