My Back Pain is Interfering with my Training:
Three simple strategies to understand, beat, and prevent back pain.
Do you feel pain at the bottom of your squat? Does your back “blow up” with high-rep dumbbell snatches? Do you do deadlifts and have a tight back for the next three days? Does your job demand a lot of sitting or driving, leaving you feeling stiff and achy when it’s time to hit the gym?
If any of these things resonate with you, you are not alone. In our sports medicine and therapy practice, Love Health (lovehealth.live), low back pain makes up about 25% of all of the injuries we see and treat. The other 75% is comprised of any other symptom or pain in extremities ranging from ankle pain, to wrist and elbow pain to knee and shoulder pain, or headaches.
Low back pain is so prevalent and is such a literal pain because it’s in the center of our body and requires a focus on stability to stay healthy. Since the low back is in our veritable core, there are two major truths to consider:
TRUTH 1: All movement starts at the core and all power is generated from the core.
When you’re performing a dynamic movement in strength and conditioning, like a clean, you start with your body folded into the starting position. The “folding” that creates the starting positon puts us into a state of trunk flexion. This flexed trunk position allows us to store potential energy through our posterior chain. In this position, we are coiled liked an explosive spring so that when we start to stand up in that first pull and uncoil our lower limbs and trunks we create a huge explosive moment of hip extension. THIS is the physics of what creates the weightlessness of the bar in the lift and allows us the time to drop underneath the weight to receive it.
And, guess what’s in the middle of all that action? Your core.
If in that complex symphony of muscle contractions, timing, and explosiveness, the core is weak or underactive, your back will bear the load.
And the main components of the core are:
- a roof (your diaphragm),
- a foundation (your pelvic floor and gluteus maximus),
- and walls (internal obliques, external obliques, the transverse abdominus, and multifidus)
Activation and coordination of these muscles allows for a healthy and stable core that can strongly bear the demands of our lifestyles and sports.
TRUTH 2: We are extremely crafty and compensatory creatures.
It is fact our bodies are super-compensatory monsters. Given any opportunity to rob Peter to pay Paul with what muscles we choose to move and use, our bodies will.
We now know that core muscle integrity is needed for a healthy back. If the core is underperforming in a clean, a squat, or even when we are standing up and walking for long periods, our bodies will go to using the second-string stabilizers. In this scenario, we start to do this lovely concept I call “hangin’ on the meat” and we use our paraspinal muscles (the big ones that run up the center of our back like ropes), the Quadratus lumborum, the hamstring and inner thigh muscles, and so on, to manufacture the stability our core isn’t giving us.
And do you know what this ends up causing? Often times, it’s pain.
Alright, cool. Perhaps you now learned a little more as to why back pain could show up in the performance athlete, but now let’s take it to the next level to see what you can learn about how to beat and prevent low back pain.
So, without further ado, here are the three steps to beat and prevent back pain:
1. Determine if you tend to have one of the following issues: shortened muscle tissue length, joint mobility restriction, or a muscle-firing motor control issue.
So, the truth is, you’re a unique snowflake, and your movement is governed by the relationship of how compliant your tissues are, how full your joint mobility is and how on-point your muscle firing patterns are. And the pattern of which this shows up is completely and utterly yours.
If you have back pain from performing you certainly would have a combo of snafus in these three categories: eg, functionally short hamstrings, tight hip joint external rotation, and underperforming psoas and glute max.
This is a typical pattern we see at Love Health when an athlete presents with back pain. So, if this hits home, find a forward-thinking clinician, like a physical therapist, an acupuncturist, a chiropractor, or a coach who understands this type of assessment and can help you understand which of these apply to you.
2. Firing, → stability → strength
So, ok, super. Now if you suspect you have a disruption to your core causing your back pain, where do you start?
I can’t articulate enough how important it is to slow down before you can speed up. Take your pain as a lesson that there’s something to work on. Even if you’re the strongest person in your gym, this applies to you. This same principle applies to little old ladies and elite muscley athletes alike.
First, you must learn how to fire the and activate the muscles of interest. I mean, literally learning how to fire our butt muscles when laying down is where we start in our clinic.
Then, after these tissues experience the on-switch of contracting, they’re ready to be stabilized, and work with some time under tension so we can build up these small, vital muscles’ capacities for the demands we put on them when we impose intensity on load through a 15 minute AMRAP.
Then, finally, is the last step is when you earn the privilege to strengthen this newly grooved pattern. Now you’ve fired and stabilized, you can get strong by going, ham at 80% of your max squat.
3. Brace, breathe, bridge (and beyond)
So, now, I leave you with a challenge, when you would normally mindlessly plop down and pseudo foam roll in the pre-wod social time, throw in 3 minutes of this muscle-firing drill.
Lay flat on the floor, take that foam roller and put it between your knees. Then put your feet flat on the floor. Roll into a “posterior pelvic tilt” by bringing your ribs down and your belt buckle up so that your low back would be almost flat on the floor. No sunshine should get under your back in this position.
Now, slightly squeeze the foam roller between your knees and do what would be like a kegel exercise, and squeeze your pelvic floor or “pee muscles.”
Put your hands on those booty cheeks and with everything else in position, give those bad boys a light squeeze to start. I want you to feel them tension in your hands.
Now, from here, let’s start with the breath. Take a breath in, expanding through your lower ribs for a four second count. Your lower ribs should expend in a 360 degree fashion before your chest rises. Then, hold this breath gently for four seconds, slowly let the air out for four seconds and then hold the exhale for four seconds. All of this should be done with your core muscles braced as described above. This is called “box breathing” and was made famous by SealFit’s Mark Divine.
Repeat this box breath for four cycles, and then use the remaining time in your 3 minutes to perform the most perfect glute bridges you have ever done.
This is your core’s neuromuscular wake-up call so it’ll be prepared for what’s to come in your workout.
Give this a whirl for a few weeks, and then we will build from here in a future post.
If you have any questions about this content or your specific condition, don’t hesitate to reach out to me directly at firstname.lastname@example.org.
Love you. Be well.
Abby Perone, DC, CES