With Guest Blogger, Chris Schnare
In the third installment of our mini-series on the considerations for training with back pain, we will be giving you movement corrections and exercises that you can begin including in your daily life and exercise programming to help build a strong and stable foundation. This can help you to continue to do all the activities that you enjoy, without the back pain!
In case you missed it, in Part 1 and Part 2 we discussed some general guidelines for beginning on your road to recovery as well as the important role that your core plays in preventing and treating back pain. In part 3, we will now outline foundational movement corrections, strategies and base level exercises that will play a large role in the long-term management or resolution of back pain.
Small steps climb mountains over time. By making small, consistent changes, you can dramatically improve your chances of recovery and success.
MOVEMENT ERROR CORRECTIONS
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Replace bending over with the hip hinge
The hip hinge, pictured above, is a foundational movement that forms the primary mechanism of lower body exercises. Use your hinge for mundane tasks, such as loading and unloading plates. You would be surprised how many times you bend over to grab your water bottle, pick up a set of dumbbells or load weight plates on a barbell. These positions and loads can quickly add up, so work to move from the hips and preserve your back for your exercises.
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Replace higher compression exercises with more spine sparring alternatives.
Exercises such as the dumbbell bench press or one arm dumbbell row are great additions to a training program. However, in the early phases of back pain management, it is best to avoid these exercises. The stabilization that is required to get in and out of the proper position places unnecessary demand on your back structures.
Instead, use exercises such as the TRX row, push ups, and similar bodyweight exercises until the pain desensitizes and allows you to resume your normal training program and exercise selection.
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Replace dynamic spinal action exercises with anti-movement isometric exercises
Dynamic spinal action exercises include side bends, crunches, and leg raises. These exercises place demand on the back structures and should be avoided during your back-pain recovery process.
Anti-movement isometric exercises, on the other hand, provide a stimulus that challenges the core in a manner that it was designed for. The core is designed to stabilize and prevent movement, which then allows the limbs to carry out movements such as walking, lifting, throwing a ball, jumping, etc. These exercises strengthen the core to help you perform these basic tasks.
For the back pained individual, here are some of my top recommended exercises, as well as a sample workout that virtually anyone could begin including in their daily routine:
Modified curl up (aka. McGill curl up)
Lay on your back with one knee bent and one leg straight. Maintain the lumbar curve by placing your hands under your lower back. Lightly lift your elbows. Engage your trunk and squeeze your glutes. Lift your head and shoulder blades slightly off the ground. Ensure your neck remains neutral. Stabilize with active breathing.
Work up to a 1-minute active hold before progressing to more advanced variations.
Side plank
Lie on your side with your legs stacked on top of each other and your upper body propped up on your elbow and forearm. Engage your core, glutes, and quads as you drive your upper body away from the support arm. Stabilize with active breathing.
Work up to a 1-minute side plank before progressing to more advanced variations.
Bird dog
Begin on your hands and knees. Engage your core and squeeze your glutes as you begin the movement. Make a fist and reach your left arm forward, while also driving through your heel and pushing your right leg backwards. Hold this position. Ensure to stabilize with active breathing throughout the movement. Bring both your leg and arm back to the starting position. Repeat movement with the opposite arm and opposite leg.
Work up to a 1-minute active hold before progressing to front planks.
High tension plank
Place your forearms on the ground with your elbows aligned below your shoulders and arms parallel to your body. Engage your core, squeeze your glutes, and lift your body up so that you are balancing on your toes and your forearms. Hold this position and stabilize with active breathing.
Work up to a 1-minute active hold before progressing to stir the pot.
Stir the pot
Rest your elbows and forearms on a swiss ball and get into a plank position. Your arms should be bent at a 90-degree angle and your body should form a perfectly straight line from your head to your ankles. Engage your core, squeeze your glutes, and think about driving your upper back to the ceiling. Draw small circles on the ball with your elbows and shoulder blades creating the motion. Ensure to remain constant tension in your core and stabilize with active breathing throughout the movement.
Perform 2-4 sets of 8-10 reps per side.
For all the exercises listed above, there is no one size fits all approach. A great first step is to begin including the low-level core isometrics first (bird dog, modified curl-up, side plank), then progress to more challenging variations as your tolerance increases (high tension front plank, stir the pot).
I recommend you make these low-level exercises part of your daily routine, even outside of the gym. This will further speed up the increase in tissue tolerance and will pair well with your efforts to improve your daily movement patterns, such as the hip hinge.
Start including the appropriate level of these exercises, for the prescribed times, sets, and reps above and work towards steady progressions. Include them between main exercises, place them at the start of a training session, or use them as stand-alone mini workouts daily. It will all add up and get you closer to being back to your regular self and more than likely, with a lot more capacity to do the things you love pain free!
