Hey Team,
Back pain is a drag, but you’re not alone.
A reported 10-15% of the population has chronic back pain(1) and over 500,000 surgeries take place in the U.S. annually for the lumbar spine alone(2). Most of you have either had back pain at some point or just popped two anti-inflammatories to ease the ache as you settle into the heating pad for the night. I feel you.
While some conditions may ultimately end up needing surgical intervention, it should generally be viewed as a last resort. There are a few steps you can take that may lead to decreased pain and tension across the lumbar region. While there’s no magic remedy, we can turn our attention to two major areas in the body to find relief:
- Strengthen the Core: Cliché as it sounds, a strong core equates to a strong body, and it goes beyond a few crunches each day. Your core is more than the abdominal muscles. The major muscles of your core include your transverse abdominis (TA), multifidus, internal and external obliques, erector spinae, diaphragm, pelvic floor muscles, and yes, your abs, the rectus abdominis. Though not everyone realizes that it also includes your lats, traps, and even your glutes.
Building a strong core is imperative to support the movement required in both performance and everyday life, but plays a significant role in injury production. If the anterior (front) of the core is weak, the posterior (back) of the core is going to take on the brunt of the load, thus leading to the nagging tight and painful lumbar. Think of training your core 360º, hitting anterior, posterior and lateral angles (obliques).
Here’s a routine to get started with:
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Deadbugs: The perfect move to get started with for transverse abdominis strengthening, and can easily be progressed into expert mode. If you’re new to the move, start by laying on your back, knees bent in a 90º position, arms towards the sky. Drawing the belly button towards the floor to engage the core, begin to move your left arm back towards the floor while extending your right leg, then switch. Lifting the head and shoulders slightly off the floor can also help activate the TA.
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Birddogs: Let’s counteract deadbugs. Start on your hands and knees, head is looking towards the ground to ensure cervical alignment, and begin to extend opposite arm and opposite leg out, then back in to curl, meeting the knee and elbow for a “crunch”. Repeat multiple reps on the same side before switching.
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Modified Side Plank: Most who perform side planks in their weekly programming are often missing the optimal alignment to directly target the obliques, which is why it’s beneficial for everyone to include the modified version. Get started on your side with a bent elbow positioned directly under the shoulder joint. Bend both knees with the heels towards the glutes and hip joints serving as headlights facing the mirror or wall. Lift the bottom glute away from the floor to activate obliques.
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Forearm or High Plank: Here’s the thing about planks- you fully control how hard they can be. When done properly, you should be shaking within the first 10 seconds. Most feel a better core “burn” in forearm planks as the high plank (push up position) tends to target shoulders as well, but to each their own. When setting up the plank, think about recruiting every muscle group from head to toe. Squeeze the glutes, brace the core, imagine drawing your elbows to your toes and toes to elbows, creating friction in the midline. Breathe through the shake.
Remember, this is a starting block. When you master these movements, start adding in rotational patterns that can mimic what’s needed in your everyday life. I talk a bit about this in our podcast episode with Gabe Snow.
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Loosen the Hips: If you’ve worked with a physical therapist, they’ll often advise you to take inventory on the joints both above and below the area of pain. Oftentimes lower back pain can stem from tight hip joints.
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Hip 90/90’s: This is a goldmine for hip mobility as it’ll hit both internal and external rotation. Start by sitting on the floor, bend both knees with feet flat on the floor, allow the knees to fall to the right, then to the left, and repeat. Move slowly and intentionally between each side. Folding over with your spine might feel nice on the thoracic region as well.
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Supine Elevated Adduction: This is one you’ll want to get comfortable for. Lay flat on your back, place a yoga block under the bottom portion of your sacrum right above the glutes, bring the soles of your feet together and let your knees fall out. Take long, slow deep breaths and relax for a few minutes at a time. Your knees will get closer to the floor with consistent practice as the adductors loosen.
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Supine Figure Four Twist: Similar to the rotational concept of the core, your hips need to be worked outside of the sagittal plane (forward and backward). Show the largest joints of your body some love with this stretch. Lay on the floor with both knees bent and feet flat on the floor. Bring one ankle over the opposite bent knee, flex the toes towards your knee to protect the knee joint, arms are splayed out in a “T” shape and allow the knees to fall in the direction of the bent leg. Work your ways towards meeting the floor in time. Repeat on the other side.
Alleviating low back pain takes time and testing to determine what your body needs. Start with efforts to strengthen the core and loosen the hips to release tension from low back muscles such as the QL, erectors and lats. Application of heat therapy and daily stretching + strengthening can get you one step closer to the freedom you’re seeking.
Looking for more? Check out our Bespoke Physical Therapy playlist on BodyFit, where Doctor of Physical Therapy, Kristen Lettenberger, breaks down the core basics that everyone can apply to their routine.
Until next week. 👋
Danielle Bitts
VP of Brand, Bodybuilding.com
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