Pain affects more Americans than diabetes, coronary artery disease, stroke, and cancer. According to the American Pain Foundation, low back pain accounts for 27% of symptoms, ahead of migraines and neck pain. Low back pain is experienced by 8 out of 10 individuals, compared to the 56% of us who engage in social media. These numbers are why low back pain is the 2nd most common reason for doctor’s visits, 3rd most common reason for surgery and 5th most common reason for hospitalization. Unfortunately there is not yet a cure to these startling statistics, but there may be some preventative actions to reduce the risk of experiencing low back pain.
21st century antics are a major contributor to the prevalence of low back pain:
Working sedentary 40+ hours a weeks
Traffic and driving 3+ hours a day,
The influence of DVR and Netflix creating couch potatoes
Uncomfortable, yet “stylish” shoes
Improper weight lifting technique at the gym
The results of these 21st century routines are a numerous amount of muscle imbalances, which, coincidentally, is the leading cause of back pain.
Overusing the same muscles, whether from repetitive motion or simply holding a static position for a long period of time can cause muscle strain. The body is made to move. When one position is held too long, muscles get fatigued and strained. Switching positions shift the workload to another group of muscles, preventing one muscle group from becoming fatigued.
Inhibition and delayed activation of the gluteal muscles compromises pelvic stability. This can result in compensation by the lower back and more altered muscular firing patterns and function. Poor posture also causes the muscles to have to work harder to support the spine, which leads to fatigue, strain, and back pain. When strengthening the muscles in the lower back focus on good isometric endurance versus strength, in other words, an ability of the low-back muscles to maintain moderate levels of force for prolonged periods of time without significant fatigue.
The “core” is comprised of several groups of muscles including the transversus abdominus, multifidus, quadratus lumborum and diaphragm. Our deep core muscles are the main structures that support, control and move the lower spine and pelvis. They are also the most energy efficient and ideally located muscles to do the job for 24 hours a day. However, when experiencing back pain these deep stabilizers turn off. The aim of core stabilization exercises is to restore normal function of the muscles and enhance spinal stability to decrease pain and dysfunction.
Exercises For Core Stability and Endurance
Stability Ball Core Bridge:
Lying flat on the back on a hard, comfortable surface, extend the legs straight out with the lower leg (calfs) resting on top of the stability ball. Cross the arms across the chest, engage the abdomen and lift the hips off the ground. There needs to be a straight line from the shoulders, spine, and hips; there should be no exaggerated curve, or favoring to one side. The stability is an unstable surface, use the core to keep the spine, hips and legs still. Hold for 5 seconds and release hips back to the ground.
*Increase difficulty: Try the exercise single leg with the opposing leg straight up in the air.
Band Pallof Press:
Anchor a resistance band in line with the mid-torso. Grab band with overlapped hands and step away from the anchor point to create a desired level of tension. The tension is too difficult if the band cannot be maintained in line with the mid-torso. In an athletic stance: feet shoulder-width apart, chest out, shoulders back; Extend the arms completely out in front, pause for a 5-second count; then return to the starting position. To repeat on the other side, stand the other way and change the inside leg.
* Increase difficulty: After the first repetition, take a step further away from the anchor point. Continue to take a step after each repetition until the resistance is too great, and work back towards the anchor point.
Isometric Back Extension:
Heels against a wall, lie belly down on a hard, comfortable surface. Engage the glutes by forcing the heels into the wall, and lift the chest until the chest, lower abdominals and pelvis are slightly raised off the ground. Be sure the back is flat, and there is no exaggerated curve. Hold position for 30 seconds.
*Increase difficulty: Try holding this position on a stability ball.
Find a sturdy, flat surface to lay belly down with arms shoulder width apart and legs hip width apart. Keeping the pelvis and spine neutral, prop up on the elbows and toes and keep abdominals engaged. Hold this plank position for 30 seconds.
*Increase difficulty: Once in this planked position, lift the right leg without compensating any weight to the left side ( ie, hips don’t move). Hold for 3 seconds and return to neutral. Repeat process with left leg, alternating between both legs
It would be a perfect world if there were a few simple exercises to heal the epidemic of low back pain. The reality is that there are numerous ways to prevent pain, but we are all at a great predisposition to experience low back pain at least once in our lifetime. A healthy lifestyle of at least 30 minutes of activity a day, plenty of fluids and a colorful diet keeps the body mobile and properly nourished. Exercising the core and low back muscles to maintain strength and endurance is a great stride in preventing low back pain, and reduces the risks of becoming another low back pain statistic.
Janaye Dzikewich, MS Exercise Physiologist