Tuesday, April 22, 2008

Low Back Pain in Disguise

Six weeks ago, I met Avery who is a 53 year old avid golfer. Avery was a pretty good golfer and in pretty good shape. His bodyfat level was low and his flexibility was decent. His goal was to put on a little more muscle mass and gain some strength. I developed a program for Avery that included some foam rolling and mobility exercises, then followed with a couple of circuits of loaded compound movements. Well, on our off days, I would see Avery come into the fitness center and perform the windshield wiper exercise (see pic) as part of his warm-up. As I worked with another client, I wondered, "hmmm...I didn't give Avery that exercise". However, I let it go for the time being.

One day, Avery said to me, "you know my back has been hurting lately". I ran him through a number of questions trying to figure out if it is a certain exercise in the program that I developed for him that may be causing him back pain. I then asked him how long has he been performing the "windshield wiper exercise"? He replied "...the last 4 years". He then followed that with, "...I have gotten really good with it". He also added that a golf professional taught him that exercise specifically for golf.

Well, I asked him to stop performing THAT exercise.

He replied "Why?"

I answered, "It looks good that you have exceptional flexibility in your lower body to be able to touch the floor with the sides of your thighs, but my concern is your lower back area being exposed to TOO MUCH rotation."

If you follow golf training, rotation and golf go hand in hand. But, after reading the current findings on excessive rotation in the lumbar spine, I felt that Avery's consistent performance of the "windshield wiper exercise" is causing too much instability in the lumbar spine.

According to physical therapist Shirley Sarhamann, "...Rotation of the lumbar spine is more dangerous than beneficial and rotation of the pelvis and lower extremities to one side while the trunk remain stable or is rotated to the other side is particularly dangerous." (Sahrmann, pg. 72)

Most of the time, these exercisers have weak abdominals and poor transverse abdominal activation which causes "core bracing" to be insufficient.

Sarhamann added, "During most activities, the primary role of the abdominal muscles is to provide isometric support and limit the degree of rotation of the trunk which, as discussed, is limited in the lumbar spine." (Sahrmann, p. 70)

Once I presented Avery with my explanation, he gave me his word he would cease using that exercise in his warm-up. Fast forward to 6 weeks later....his low back pain magically disappeared.

1 comment:

  1. John,
    First, it wasn't THIS golf professional that gave him that exercise. More importantly, what I as a coach look for is a restriction of the hip rotation to allow for greater separation of hips and shoulders in the backswing.

    If a student does need to release the lumbar spine I prefer "hip drops" to something so potentially dangerous as a straight leg exercise as he was doing.

    George Connor, PGA

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