• Emily Drakes

Future proofing your back


Following on from what to do with back pain, I've put together some practical tips on how to prevent back pain starting in the first place. I've broken this down into the areas I think you should focus on to have a future proof back...

Move!

One of the biggest thing people are worried about with their backs is posture. Whilst there are some bad postures there is no proven link between posture and pain. Even if you're sat in a perfectly aligned position, if you sit for 8 hours a day you will be straining your back. There is a phrase that 'your best posture is your next posture' highlighting the need to move regularly. It's the sustained part of posture that is the problem. If you've sat on the train to work, sat at work for 8-10 hours then sit when you get home you probably haven't moved your back in many directions at all leading to the same parts being loaded and same few muscles having to work. I know it's unrealistic for a lot of job roles to have a couple of minute walk every 20-30mins but just standing up rotating you back and stretching will help get things freed up.

Pictures like this crop up a lot, both suck! The second one is worse to be fair but the first lady will also be at risk of pain if she stays there too long.

The abdominals

One of the obvious things that people think of with back pain is 'core training'. It gets talked about in many forms but generally people think of ab work. The six pack is generally not what we're thinking of, it's the deeper layers (as seen in the pic above) that you target which acts like a corset. The 'core' really encompasses the abdominals, spinal muscles and pelvic floor. It's good to spend some time on these within your programme even if it's part of your warm up as they won't necessarily get strong with general exercise. I've seen plenty of people who train regularly with a nicely developed six pack but terrible stability and control. Core stability is basically your ability to transmit the forces from your arms and legs with control so doing exercises to condition this are key rather than sit ups. Some ideas are:

Bird dog - This is a nice start point to see how balanced you feel, as in the pic you want to try to keep the spine level and the hips from swaying so it is just the arm and leg moving.

Asymmetrical lunge - Doing a lunge with a single arm overhead makes it a lot harder to stabilise = core work ++ having something like a kettlebell upside down makes this even tougher!

Paloff press - in a similar way to the lunge having to control your trunk against a force but this time it's rotation so it challenges the obliques (waist). You can do it kneeling or standing and the aim is to keep the arms on track whilst the cable or band is trying to pull you sideways.

The upper back

A lot of people are surprised at how much the upper back impacts the lower back. With the amount of time we generally spend sitting still or hunched over our phones, stiffness here can cause the lower back to be overloaded. So keeping your upper back mobile is a good idea to allow the whole spine to share the load and transmit the forces through your back. Some of my favourite exercises:

Foam rolling - the upper back only (from bra strap to the base of the neck). This can be painful and click and cracks are normal but it's a nice way to massage the area.

Wall stretch - The key here is keeping the lower back flat to the wall then you'll see how much it contributes to your movement! This can be quite intense if you're stiff, if you can't get the arms flat to the wall it doesn't matter just move them up and down to mobilise the upper back.

Thoracic twists - This is a nice one to do and you'll find you can get further after a few reps towards the floor. Make sure you turn your head and chest with the arm.

Leg work

Another area that is often forgotten are your legs and glutes (butt!). As the spine sits on top of the legs they are the platform for the back to work from, so if you are not strong in your legs you are leaving the lower back to do more work. Physio's are a little bit obsessed with the glutes as they are one of the biggest muscle groups that get under active. Even if you think you're working on them sometimes they won't actually be kicking in so it's making sure your technique is good i.e. squatting like the me on the left not on the right where you'll be overloading your knees and not using your glutes properly.

Maintain form

This is the best way to avoid injuries during exercise. I cannot tell you how many times I've winced at the gym watching people with terrible form putting all the strain through the back. Keeping a 'neutral' spine (where it's straight) is key to allow the force to transmit evenly, if you break this position you will take the load into the spine. It's always good to keep an eye on form if you have a mirror nearby when your exercising if possible or film your first set. This is a good warm up drill to check you can maintain it:

Hip hinge - Grab a dowel bar or mop!Place it against your head, upper back and bottom and try to bend forwards without the bar coming away. It is harder than it looks but a good way to check you are maintaining your form throughout a movement.

Summary

As discussed in the back pain article the majority of us will experience back pain at some point, however by including these tips in your training you can go a long way to avoiding problems and giving yourself a better starting point should pain arise.

References

  1. Faries, M. D., & Greenwood, M. (2007). Core Training: Stabilizing the Confusion. Strength and Conditioning Journal, 29(2), 10. http://doi.org/10.1519/1533-4295(2007)29[10:CTSTC]2.0.CO;2

  2. Goodman, B. P. J., Tracy, B., Handzel, M., & Haff, B. G. G. (2003). Core Training. NSCA’s Performance Training Journal, 2(6), 1–30.

  3. Huxel Bliven, K. C., & Anderson, B. E. (2013). Core stability training for injury prevention. Sports Health, 5(6), 514–22. http://doi.org/10.1177/1941738113481200

  4. Lederman (2010) The fall of the postural–structural–biomechanical model in manual and physical therapies: Exemplified by lower back pain. CPDO Online Journal (2010), March, p1-14

  5. Lee, B. C. Y., & McGill, S. M. (2015). Effect of Long-Term Isometric Training on Core/Torso Stiffness. Journal of Strength and Conditioning Research, 29(6), 1515–1526. http://doi.org/10.1519/JSC.0000000000000740

  6. McGill, S. (2010). Core Training: Evidence Translating to Better Performance and Injury Prevention. Strength and Conditioning Journal, 32(3), 33–46. http://doi.org/10.1519/SSC.0b013e3181df4521

#physio #pain #back #strengthening #posture #prevention #injuries

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