It may come as some surprise to you that I have long suffered with lower back pain. It has taken me years to get to the bottom of it and although I still experience occasional flare ups I now have a good strategy for dealing with it and getting back to normality as quickly as possible.
Without boring you too much with lots of technical anatomy information let me just explain this. The joints in the body alternate between mobile and stable in an ideal world. The lower back, or lumbar, has a tremendous range of motion compared with other parts of the spine. 40-60˚of flexion 20-30˚ of extension, 15-20˚ of lateral flexion and 3-18˚ of rotation. Yet, the lumbar spine should be a stable joint and the problem for many people who develop chronic “non-specific” back pain is that their lumbar has become unstable. The reasons for this are many but if the hips and mid-spine, or thoracic, have become stiff and immobile the lumbar will compensate for much of that lost range.
If your lower back flares up and becomes painful, you would likely benefit more from doing some simple mobility exercises for the t-spine and hips and avoiding stretching the lower back completely.
If the lumbar has become unstable the pain is often due to muscular tension cause by the muscles which should be providing stability working to hard and too often to facilitate movement. To improve this, it is necessary to do some stability exercises. The primary role of the rectus abdominis (your six-pack abs) is not to flex the spine, as with ab crunches or sit-ups, but to decelerate extension of the lumbar. Therefore, exercises which provide a stimulus to ‘teach’ the muscles to resist the ranges of motion listed earlier are necessary. So, you are looking for anti-extension/flexion and anti-rotation/lateral flexion exercises.
Fortunately, we have the work of Dr Stu McGill to refer back to. Stu McGill is the world’s leading authority on spine biomechanics, he has published hundreds of studies on the spine and written numerous text books on the topic. The most informative and easiest to follow is Back Mechanic.
Stu has devised a simple three exercise routine which has been shown in research (1) to be more effective than traditional physical therapy at improving spine stability, increasing range of extension, spine function and reducing pain output.
You can see the simplicity of these exercises and the practicality of them requiring no equipment which means they can be done almost anywhere.
When performing these make sure that you first learn how to breath correctly. Yeah, I know, you already know how to breath otherwise you wouldn’t be reading this. But try this. Place one hand on your chest and one on your abdomen. Now inhale. Did the hand on your chest move? That’s wrong! When you inhale you should feel your abdomen expands, while expansion in the chest should occur you shouldn’t feel the chest rise. Practice pushing your tummy out as you breath in, inhale to the top of your head and draw the breath down through the diaphragm.
Now, that you have got the breathing right, when you do the exercises you should take a deep inhale, brace your abs, you can engage the pelvic floor too. Not sure what the pelvic floor is? Imagine that you are going for a pee and need to stop in mid flow – now you know what your pelvic floor is.
When you do the superman or bird-dog move, pull your shoulder blades down your back and squeeze your armpits like you are holding oranges there. Keep as much tension as you can in your torso throughout these exercises. It should feel like an effort and after a few reps you might even start to break into a sweat.
Do 3 reps of each exercise, each one is a ten second hold. And then see how your back reacts the next day, if your pain hasn’t increased then you are good to continue doing these daily. Use a descending pyramid of 3-2-1 and build that up to 5-3-1 over a matter of weeks.
This is just one method. It's not so much that is you aren't doing the McGill Big Three you won't get results, it's more that this is an example of three exercises you could do to strengthen and stabilise the right areas. Below you can see a slightly more advanced version. The key here is to realise that this is part of your rehab. After a few weeks of these exercises you should be feeling ready to move on to slightly more complex movements and progressive strength training. More about that in upcoming blogs.
When you couple this with some basic mobility exercises for the hips and mid-spine you should experience dramatic reductions in lower back pain. Of course, there is a lot more to back pain than just exercise. If you want to know more about these nuances read on: