Back pain as a diagnosis has an incredible effect on our economy by driving a large number of prescription medications and paid days off. It is often over-associated with the aging, overweight, or acutely injured, but the reality of lower back pain is that it can occur in people of any age or activity level, as it is caused by a very specific set of muscular imbalances.
Common, mysterious back pain happens when muscles in the core are too weak to support the lumbar spine at times of stress, or when the muscles in the front of the hips (hip flexors, quadriceps) are stronger than the muscles in the posterior chain (gluteal muscles, hamstrings).
The muscles that naturally work in tandem around the lower back and hips can become out of balance when a person overtrains, trains incorrectly (poor programming), or trains with poor form.
The problem can become compounded when there is slight inflammation or irritation that is ignored. Because the entire kinetic chain of the body is interconnected, a dysfunctional movement in one part of the body affects everything else.
For example, if the transverse abdominus muscles of the core are not strengthened regularly, other exercises such as push-ups or deadlifts can result in a back injury that is not severe enough for medical attention.
What often happens is that someone with a slight back injury will continue to exercise without addressing the underlying issue, thus compounding the problem until there is an acute injury that is incapacitating.
There are lifestyle modifications as well as exercise treatments that can improve and eliminate back pain, even if an acute injury has already occurred.
Tips for Lifestyle Changes
Eliminate the following exercises from your repertoire: touching your toes (standing or sitting), crunches, weighted side bends, and supine leg extensions. These exercises, although some are popular, can be disastrous for someone with an existing back inflammation issue or injury.
Unfortunately, some of these exercises are touted by well-meaning people as core-strengthening treatments for back pain, but the reality is that these moves put excessive pressure on the lumbar spine.
Good posture doesn’t just mean “sitting up straight.” Proper alignment of the body also involves keeping your abdominal muscles engaged and consciously changing the way you hold your hips when you are standing. Practice good posture in your daily life, including contracting your abdominal muscles .
Don’t focus too much on “flexibility.” What fitness culture glorifies as “flexibility” is often hyper-mobility or hyper-flexibility. Flexibility has nothing to do with being showy or overly bendy—it is about pain-free movement. Instead of trying to reach for your toes as a marker of flexibility, focus on self-myofascial release (foam-rolling) before and after exercise.
Tugging on stiff muscles through excessive stretching can sometimes result in more injury instead of more flexibility, and SMR helps to relax muscles effectively. Some people will never touch their toes because their bodies aren’t built that way, but everyone can live pain-free.
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