In part 1, I discussed how back pain is the number two reason for doctor visits and the number one reason people leave work on disability. I talked about what the core is and what it's job is. If you didn't read part 1, you can read it here.
The purpose of the core is to protect the spine during movement. It does this by creating stiffness. Stiffness means that your muscles tighten to keep the spine stable during movement. Most people who have back pain don't have core muscles that are strong enough to stiffen during movement, which allows the spine to move when it should not. This is why the need to strengthen the core is so great.
When we hear we must strengthen our core, we immediately think of doing crunches, rotation exercises (i.e. russian twist, cable twists), and back extensions. These exercises are not the most effective when you have back issues as they can cause even more issues.
Most back pain can be classified as either flexion or extension intolerant. In other words, you may have more pain when you flex your back (hunch over), or more pain when you extend your back (arch). To find out if you are flexion or extension intolerant, you can perform a simple test:
Flexion Intolerance Test
- Get into a quadruped position.
- Sit your butt back onto your heels.
- Extend your arms out in front of you.
- If you feel pain, congratulations! You are flexion intolerant.
Extension Intolerance Test
- Lay down on your belly, eyes to the floor.
- Bring your hands to the sides just under your armpits.
- Push up onto your hands, extending your elbows, and leaving your hips on the ground.
- If you feel pain, congrats! You are extension intolerant.
When it comes to rotation exercises, I explain it like this: If you sometimes get back pain when you try to pick something up from the floor or turn to grab that paper off the desk, then your core muscles are too loosey goosey to perform rotation exercises. Your muscles don't know how to stiffen to support the spine.
So if crunches, back extensions, and twists are out, what in the world is left to do?
There are a multitude of anti-flexion (including anti-lateral flexion = trying not to bend to the side), anti-extension, and anti-rotation exercises you can do to teach those core muscles to work. AND we can't forget those glute exercises! We need to wake up those muscles so they can do their job and give the lumbar spine a well deserved rest.
I've picked a few exercises for each category (anti-flexion, anti-rotation, and glute):
1. GLUTE BRIDGE
3. GLUTE KICKBACKS
1. DEAD BUG
2. HOLLOW BODY
3. PHYSIOBALL ROLLOUTS
ANTI-FLEXION & ANTI-LATERAL FLEXION EXERCISES
- Lay on your belly, arms out to the sides with thumbs up.
- Keeping your head in line with your spine, lift your shoulders and chest off the ground, while squeezing your shoulder blades together, and squeezing your butt.
- Hold for a couple of seconds then return to the original position.
2. Farmer Walks/Hold
1. Pallof Press Iso-Hold
2. Anti-Rotation Band Chop
- Stand so that the band has some tension, feet wide.
- Pull the band in front of your body to the other side.
- Keep your hips and torso facing forward.
- Try not to allow hips and torso to twist as you pull the band from one side of your body to the other.
If you are feeling a bit lost or confused, come join us StrongGirl Revolution! We provide the guidance and support to make you stronger, healthier, and help you move better. Feel free to contact me at firstname.lastname@example.org if you have any questions about our program.