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by on Oct 2, 2013 in Guides, Posture, Training | 1 comment

Reader Question of the Week: How to Fix Lower Back Pain


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Question: I’ve been trying to eradicate some mild but noticeable lower back pain over the past couple months. Nothing in my life health wise has changed. Still do my best to have a moderate to intense workout 3-5 days per week with a decent balance of lower, upper and core work. Almost always build in a row or run for 15 min. intervals. I stretch hamstrings, hip flexors, quads and groin after I get a sweat going; usually a mix of dynamic and static. 

From my research, it seems like my lower back pain could be from uneven lower body work (lots of quads and not enough glutes) OR poor hip mobility. 

Any thoughts? Totally not expecting a diagnosis, but if you know of best practices or common alleviating exercises/stretches for lower back, I’d love to read about ‘em.

- Max

My Answer: 

Hey Max,

Thanks for reaching out!

You ask a great question and I hope my answers will help to alleviate your back pain. It’s important for me to note, though, that it may be in your best interest to first get the opinion of a local physical therapist. While I can offer suggestions based on the current literature and my practical experiences, I’m not a physical therapist nor am I able to provide a diagnosis. That being the case, please use my recommendations with caution and consult a local physical therapist prior to beginning any exercise protocol.

With that disclaimer out of the way…let’s get to the good stuff, shall we?

How to Fix Lower Back Pain

First and foremost, your lower back pain could be caused by any number of issues including – but not limited to – the issues you mentioned.

If I had to guess, though, I’d assume your back pain stems from a combination of:

  • Insufficient hip mobility
  • Weak posterior chain (think glutes and hamstrings)
  • Weak abdominals
  • Tight hip flexors
  • Tight lower back
  • Excessive anterior pelvic tilt (APT)

While this certainly looks like a laundry list of issues, they’re all interrelated with one another and are extraordinarily common in young, athletic populations (re: you’re the perfect candidate).

I’d also note that there could be a variety of other issues at play here as well. For example, poor breathing patterns, lack of ankle mobility, insufficient knee stability…the possibilities are endless. That being said, I believe the above-listed issues are the most common and likely what you’re dealing with at the moment.

Below are my recommendations:

1) Get Out of Lumbar (Lower Back) Hyperextension!

Most extension-based atheltes (like yourself) find themselves in excessive lumbar hyperextension all the time. Whether they’re walking, running, weightlifting…even just standing around in what they consider to be “normal” posture. A hyperextended lower back is what feels natural to them which is why they keep reverting to it over, and over, and over again.

Unfortunately, chronically assuming this posture may exacerbate lower back pain and discomfort!

Now, there are a variety of ways to improve your posture and get out of excessive lumbar hyperextension – most of which will be discussed later on. In the remainder of this section, though, I want to emphasize the importance of self awareness; understanding your body and paying attention to the position that it’s in.

Realistically you can do all of the “right” work in the gym but if you don’t pay attention to your posture during the other 23hrs of the day you’ll never achieve the best results.

Pay attention to your standing and seated posture

posture through time

Plain and simple, you need to pay attention to how you’re standing and sitting.

You don’t need to do anything drastic or time consuming; simply be aware of how you’re standing and sitting – you can even look in the mirror for extra feedback – and adjust yourself to ensure that your lower back is flat instead of caving inward.

For more insight, take a look at this brief article which outlines 3 quick tips to improve seated posture.

Fix your sleeping position

"I just don't get why my back hurts!"

“I just don’t get why my back hurts!”

Individuals who sleep on their stomach often present with lower back pain.

While some professionals advocate changing their sleeping position altogether, the reality is that very few people are willing – or even able – to sleep in a different position than the one to which they’ve grown accustomed.

Fortunately, Bret Contreras wrote this informative article (with a great video demonstration) explaining how to sleep on your stomach without hurting your lower back. In short, by creating an exaggerated posterior pelvic tilt (PPT) prior to sleeping you’ll actually pull yourself closer to neutral and put less strain on the posterior elements of the spine.

Too geeky? I know.

Just click here to read Bret’s article and watch the video demonstration.

Strength train with a neutral spine

 

lumbar hyperextension

When training to fix lower back pain it’s necessary to maintain a neutral spine at all times.

It doesn’t matter if you’re performing Squats, Deadlifts, Push-Ups, Planks, Overhead Presses, etc, etc, etc.

You MUST maintain a neutral spine at all times!

As we can see in the picture above, this guy is finishing his Deadlift by extending his lower back. Needless to say, forcefully hyperextending the spine while holding onto a heavy external load definitely isn’t the best way to alleviate lower back pain.

While it’s easy to spot in this still picture, a preponderance of lifters make this exact mistake as it’s difficult to catch yourself doing it.

To ensure that you don’t make this same mistake, adhere to the following guidelines:

  1. When finishing the deadlift, squeeze your glutes as hard as you possibly can while maintaining a neutral spine.
  2. Drive through your heels, squeeze your lats, and force your rib cage down while maintaining a neutral spine.
  3. Record yourself (or have someone record you) lifting. Analyze the video’s and pause them at lockout to make sure you aren’t hyperextending the lower back.

Finally, at the risk of sounding like an old record, it’s important to remember that maintaining a neutral spine is of the utmost importance for all exercises!

2) Learn to Use Your Glutes

Glute-muscles

The glute complex comprises the largest muscle group in the entire body and has major implications in strength, performance, posture and – surprise, surprise – lower back health.

Without going into the nitty-gritty, individuals with back pack pain tend to have trouble firing the glutes and compensate by overusing the spinal erectors (lower back muscles).

To prevent this compensation pattern from occurring it’s necessary to “teach” our glutes how to fire effectively. This can be accomplished in a variety of ways so below I’ll provide a few my favorite recommendations:

Basic Glute Activation Exercises

Basic glute activation exercises are the foundation of our gluteal education. We can perform the big, bang-for-your-buck exercises (re: Squats, Deadlifts, etc) until the cows come home but without the necessary foundation it will all be for naught.

Several of my favorite basic glute activation drills are:

Glute Bridge

Single-Leg Glute Bridge

Glute Bridge with Postero-Lateral Reach

These drills can be performed every day of the week but – most importantly – should be included prior to training as part of a well designed warm-up routine.

Not sure what a proper warm-up looks like?

You can download my FREE e-book, The Syatt Fitness Guide to Warming Up for Optimal Performance, by signing up for my free newsletter at the bottom of this article.

Antero-posteriorly Loaded Glute Exercises

“Antero-posterior” is a fancy way of saying “front-to-back.”

In other words, antero-posteriorly loaded exercises simply denote that the resistance is applied front-to-back (think Glute Bridges) opposed to axially loaded exercises (think Squats and Deadlifts) in which the force is applied top-to-bottom.

Front-to-back loaded glute drills are extraordinarily useful in the process of fixing low-back pain as they limit forces placed on the spine, are relatively easy to perform, and are arguably the best exercises for improving overall glute strength.

Some of my favorite antero-posteriorly loaded glute exercises are:

Barbell Glute Bridge

Barbell Hip Thrust

Cable Pull Through

As a general recommendation, these drills can be performed 2-3x/week. Use moderate to heavy loads and perform anywhere between 3-5 sets of 5-12 repetitions per exercise.

3) Achieve Adequate Hip Mobility

o.k. that's a little too much...

o.k. that’s a little too much mobility…

Granted, we probably don’t need as much hip mobility as her…

…but it’s important to understand that a lack of hip mobility may drastically increase your chances of experiencing lower back pain.

As such, it’s of the utmost importance to achieve and maintain sufficient hip mobility to help us perform and function at our best.

Many professionals like to over-complicate the process and make improving hip mobility out to be some kind of voodoo magic…

Rest assured…it isn’t.

In fact, it’s honestly very simple.

With a few simple movements and the due diligence to consistently practice these movements, most of us can achieve more than sufficient hip mobility in a relatively short period of time.

Some of my favorite drills to improve hip mobility are:

Half-Kneeling Hip Flexor Mobilization

Rear Foot Elevated Hip Flexor Mobilization with Lat Stretch

Split Stance Adductor Mobilizations

Lateral Lunge with Overhead Reach

Walking Spiderman with Overhead Reach

Squat to Stand with Overhead Reach

These exercises can be performed every day as part of your standard daily routine or prior to strength training. Regardless of when you do them, performing roughly 1-3 sets of 8-12 repetitions per drill should be sufficient in a given day.

4) Maintain Proper Form and Technique!

oh. oh dear.

oh. oh dear.

This goes without saying but you better be lifting with proper technique.

Too often lifters get overzealous and compromise form to put more weight on the bar.

This is unacceptable!

If you’re serious about fixing your low back pain – and becoming a responsible lifter – then leave your ego at the door and start emphasizing technique over weight.

For a brief reminder on what constitutes proper technique, below I’ve provided several common movements that should be a staple within your training program:

How to Sumo Deadlift

How to Conventional Deadlift

How to Box Squat

How to Goodmorning

How to Do a Chin-Up

How to Do a Push-Up

How to Dumbbell Row

 

5) Stop Sprinting!

sprinting - fix lower back pain

Max, you mentioned that you regularly row and/or sprint for 15 minute intervals.

At the moment, I need you to stop!

Sprinting is unquestionably one of the best things an individual can do to improve overall health and performance.

Like everything, though, it has a time and a place and – in a program geared towards fixing back pain – it needs to be put on the back burner.

What many people don’t realize is that sprinting can cause ground reaction forces up to nearly 3x a person’s bodyweight! These ground reaction forces put the spine under a great deal of stress and can potentially exacerbate lower back pain.

Likewise, the demands of rowing put the lower back under a great deal of stress and can cause some serious pain-related symptoms.

While both sprinting and rowing are fantastic ways to improve overall health and performance, for the time being you’d likely be better off eliminating from your program. That doesn’t mean you can never do them again but wait until your back is strong and healthy enough to sustain such high demands.

6) Wrapping Up

Well, Max, I think that’s about it.

I’m sorry for going on such a long rant (I bet you didn’t expect such a long response, did ya?) but it truly is a great question and one that very few people have taken the time to answer.

I hope you enjoyed my ramblings and that the information provided helps you relieve your lower back pain.

As always, if you have any questions, comments, or suggestions you can leave them in the comments section below.

Never Minimal. Never Maximal. Always Optimal.

-J






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  • Noel

    Another problem could be a minor herniation due to improper posture. If your condition is aggravated by forward flexion (of the trunk), there is a possibility of an herniation. While for pain aggravated with extension would be of muscular fatigue, stenosis (narrowing of the passageways of nerves) in which would be solved using the above mentioned by Jordan.

    great article.