Say ''No'' To Back Pain! Bullet Proof Your Lower Back

With back pain affecting 80% of the population at some stage of their life and 49% of the UK population experiencing back pain that lasted for at least 24 hours at some point in the year the need for better understanding and treatment of back pain is essential (1, 2).  Between 2003-2004 nearly 5 million working days were lost as a result of back pain which equated to 1% of the working population on any one day took sickness leave due to a back problem (5).  This places back pain as the number 2 reason for long term sickness in the UK (6).

It is interesting to note that in 85% of back pain sufferers that no clear pathology could be identified (4).  However, certain factors are commonly associated with back pain including:

•    Having back pain in the past (2)
•    Obesity (2)
•    Smoking (2)
•    Physical work such as frequent bending, twisting, lifting, pulling, pushing, repetitive work, posture and vibrations (3)
•    Psychological factors such as stress, anxiety, depression, depression and mental stress (2, 4)

Therefore building a strong and healthy back is essential for reducing pain in both sedentary and exercise environments. By keeping good mobility through the lower extremities, hips and upper body will help to avoid using compensations such as overly flexing and extending the spine. This will help to reduce the tissue loads and muscle challenge.  By also activating and strengthening muscles which are commonly under active and weak can help to improve posture and to move more efficiently.

The beginner and intermediate mobility and activation programs below will help to increase range of motion and reduce muscle compensation.  This will ensure more effective training by recruiting the correct muscles and when used with a balanced training program should help to prevent future back problems.

Beginner

Every Session:

A.    Foam Roll:
Upper Back
Glutes
Quadriceps/Hip Flexors
Hamstrings

B.    Mobility:
Cat Camel Stretch x 8
Thoracic Extensions x 8
Seated Glute Stretch (90:90) x 60 seconds each side
Half Kneeling Hip Flexor Stretch x 60 seconds each side

Week 1 & 2:
Session A    Session B
A1. Glute Bridge
3 x 12 reps
Flatten back to floor, brace abdominals and squeeze glutes.    A1. Single leg Hip Extension From knees
3 x 12 reps each side
From all-fours extend leg back and up whilst maintaining bend at knee.
A2. Bird Dog with Leg Point
3 x 6 reps each leg
From all-fours extend one leg at a time whilst keeping torso square to floor.    A2. McGill Curl Up with Elbows Down
3 x 8 reps
Keep neck from bending by looking up to ceiling. Brace abdominals when pausing at top of movement.
A3. Scapular Push Ups from knees
3 x 12 reps
From all-fours draw shoulder blades together and then pull wide apart across back, keep arms straight.    A3. Band Pull Apart
3 x 15 reps
Pull band apart until contact made with mid chest. Don’t allow ribs to flare.

Week 3 & 4:
Session A    Session B
A1. Glute Bridge Shoulders Elevated
3 x 12 reps
Extend hips until level with knees and shoulders.    A1. Side Lying Clams
3 x 15 each side
Keep feet clamped together, emphasise control.
A2. Bird Dog with Arm/Leg Point Hold
3 x 15 seconds each side
From all-fours extend opposite arm and leg until horizontal, emphasis is on slow and controlled movement.    A2. McGill Curl Up with Elbows Up
3 x 8 reps with pause at top
Keep neck from bending by looking up to ceiling. Brace abdominals when pausing at top of movement.
A3. Seated Retraction and Row with Band
3 x 15 reps
Draw shoulder blades together and lead the pulling movement with elbows whilst keeping proud chest.    A3. Band Face Pull
3 x 15 reps
Retract shoulder blades and lead pulling movement with elbows.

Advanced

Every Session:

A.    Foam Roll:
Upper Back
Quadriceps/Hip Flexors
Hamstrings
Piriformis release with hard ball

B.    Mobility:
Cat Camel Stretch x 8
Lying Glute Stretch (90:90) x 60 seconds each side
Spiderman Lunges x 8 each side
Side Lying Windmills x 8 each side
Half Kneeling Hip Flexor Stretch x 60 seconds each side

Week 1 & 2:
Session A    Session B
A1. Single Leg Glute Bridge
3 x 12 each leg
Be careful not to hyper-extend during the exercise and arch into lower back.    A1. Side Lying Clam with Band
3 x 15 each side
Keep feet clamped together, emphasise control.
A2. Side Plank
3 x 30 seconds each side
Ensure elbow is directly under shoulder. Squeeze glutes.    A2. Bird Dog with Elbow/Knee Touches
3 x 6 each side
From all-fours extend opposite arm and leg until horizontal, then draw elbow and knee towards each other, touch and extend again.
A3. Band Resisted Wall Angel
3 x 15 reps
Pull shoulder blades back and down whilst drawing elbows into sides.    A3. Prone I Cobra (arms by sides)
3 x 8 reps
Focus on squeezing glutes, pinching shoulder blades together whilst lifting chest off floor. Feet remain in contact with floor.

Week 3 & 4:
Session A    Session B
A1. Single Leg Bridge with Leg Extended
3 x 12 each leg
Non bridging leg must be extended, brace core as hips lifted.    A1. Monster Walks
3 x 15 shuffles each way
Maintain slight bend at hips and knees. Emphasis should be on controlled movement.
A2. Side Plank with Oblique Twist
3 x 6 each side
Focus on rotating the hips towards the floor.    A2. Dead Bugs
3 x 6 each side
Focus on engaging abdominals by keeping lower back pressed into floor.
A3. Prone T Cobra
3 x 8 reps
Focus on squeezing glutes, pinching shoulder blades together whilst lifting chest off floor. Feet remain in contact with floor.    A3. Supine Band External Rotation
3 x 15 reps
Ensure lower back and elbows remain in contact with ground.

REFERENCES

1.    Palmer KT, Walsh K, et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000;320:1577-1578.
2.    Burton AK, Balague F, et al. European guidelines for prevention in low back pain. Eur Spine J 2006:15(suppl 2):S136- S168
3.    Andersson GBJ. The epidemiology of spinal disorders. In: Frymoyer JW (eds) The adult spine: Principles and practice.
4.    Philadelphia: Liipincott-Raven, 1997.
5.    Neck and back pain: The scientific evidence of causes, diagnosis and treatment. Philadelphia: Lippencott, Williams & Wilkins, 2000.
6.    Van Tulder M. Chapter 1: Introduction. Eur Spine J 2006;15(suppl 2):S134-S135.

About the Author

Post a Comment

Please wait...