Tuesday, October 15, 2013

An Easy, Applicable Drill for Improving Low Back Pain and Core Stability

Back pain is a common problem among adults. With the onset of inactivity and obesity,  the extra weight in the gut coupled with poor posture throughout the day, can cause a host of problems for the lower back. These two factors are very common with most people with no accident-related back injuries and is what is becoming more prevalent in younger people. They eat too much and sit too much. Enter back pain. 

During a period of time, changes in the structure of the spine begin to occur at the aforementioned curves. These pronounced curves become exaggerated. Exaggerated in the sense that they alter the way the spine handles the gravitational load and the body’s center of gravity. The alteration in the facet joints creates pain with movement or static posture over a lengthy period of time.  Pain or discomfort can be experienced with simply tasks like bending over to pick up a pencil, playing a sport, sitting or standing for long periods. The curvatures of the spine change due to different muscular involvement during static posture. These changes in the spine structure are mechanically based.

Mechanical back pain is related to the muscular system. The postural muscles of the body, such as the erector spinea, quadratus lumboroum, hamstrings, piriformis and many more, tend to alter in length due to poor posture. Poor static posture promotes tightness or shortness in the tonic muscles (flexor muscles)—located mainly in the front of the body. Conversely, the phasic muscles (extensor muscles)—located mainly in the posterior aspect of the body become weak. 

This version of back pain can be remedied with a properly designed exercise approach. In simplistic terms, muscles that are tight can become lengthened. Muscles that are weak, can become strengthened. The key is to properly assess movement and functionality, and contrast those findings to a medical history evaluation. 

In most adults, low back pain is most often caused by a series of inappropriate movements and de-conditioning over time. 
In the weight-lifting genre of the population, many young, ego-driven exercisers will overly load exercises and use incorrect lifting form. This poor form usually is comprised of a kyphotic lower back (rounding out the natural lordotic curve) and using the back muscles to lift the load. 

Mechanically speaking, the pull of the posterior muscles is altered. Muscles that are designed to initially stabilize now become prime or associated movers. Muscles that are designed to lengthen during certain lifting movements, now contract against a limited range of motion that may promote injury. Performed repetitively, the central nervous system is “programmed” to memorize this movement pattern and translate it to everyday functionality.

This pattern of dysfunction leads to structural damage through a mechanical pathway. Meaning…it can be corrected with proper instruction of lifting technique and muscle usage. Re-learning proper movement patterns through exercise is the most effective remedy for this—but it takes a lengthy amount of time depending on the frequency of exercise

For youths or athletes, a stress fracture in the actual vertebrae may be the culprit to back pain. Abrupt falls, blunt force, or violent hits may cause a sudden altercation between disc and vertebrae, which may lead to disc herniation or tears. Facet joints can also fracture leaving bony fragments within the vertebral space affecting nerve function and spinal health.

Another dysfunction that impedes back health is limited range of motion (ROM) at the hip joint. Restricted hips are due to overly tight tonic muscles, inactive hip extensors, and overly used back muscles. The hip hinging exercise is one of the first movement pattern corrections that are in place for this. 

Core strengthening and stability greatly influence spinal health.
What you have been hearing for over a decade is true. Most of the literature from today’s leading back experts including Shirley Sahrmann and Stuart McGill confirm that core stability is important when it comes to back health. Muscles of the pelvic floor help stabilize the spine and promote healthy posture. Learning proper breathing techniques and core stabilization exercises creates “stiffness” within the core (center of body) which improves pelvic alignment. 

One such easy, applicable exercise that many of your clients can perform is the popular Dead Bug drill. However, I have found that an ordinary Dead Bug was challenging for people to initiate rigidness throughout the core. Remember, in order to move one muscle or muscles optimally, the opposite(s) must stay stiff (rigid)

Enter the Dead Bug with Band Resistance:

To perform: Lie on a mat holding a band or tubing. Place tubing around feet or ankles. Hold handles of band/tubing with your hands and lie back. While holding your body down on mat, hold arms overhead and hips flexed. This is a “deadbug” position. With tension mounting in band, slowly draw 1 arm back and 1 leg down to create an “X” pattern. Try to prevent any hyperextension in the lumbar spine.

Some important coaching cues:

  • Keep your torso tight. 
  • Breathe slowly and with shallow breaths. 
  • Keep your core braced throughout exercise. 
  • Hold elbows tight and extend the arms back as far as possible against the tension. At the bottom position, this is the bands strongest tension. 
  • Repeat on both sides.
  • Try 3 sets of 10 reps on both sides.
I've used this drill with many of my clients and it has really helped them understand the function of the pelvic musculature in relation to core stability. After a few training sessions, back pain was never mentioned again. Note: This exercise is by no means a "beginner" exercise. The client should be able to perfect a un-resisted Dead Bug drill with proper core stability. 

There is a new product that I've contributed to that includes the Dead Bug with Tubing Drill plus a dozen more back specific strengthening exercises. It is the latest product in a series of Fix My Back Pain which has been released this week.

Check out Fix My Back Pain and look for my Special Report!

Make sure you check out my report that can be optionally added to your purchase of the product called 
8 Weeks to an Indestructible Back!


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