Relieve Low Back Pain | Reduce Low Back Pain | Canada's Leading Authority in Human Movement | Dev Chengkalath

As you all know, I’m a huge proponent for movement as a safe, effective and dangerous-side-effect-free “cure” for many of the health issues faced by a large percentage of the population. This includes relieving low back pain, treating diabetes, lowering cholesterol and conquering obesity and its related deadly disorders. 

In this post, I’m going to be switching gears a bit from discussing low back pain to discussing body fat.

Don’t get me wrong. The two are still intimately related and that’s why, if you’re carrying extra body fat, you need to get rid of it. 

Potentially Fatal Body Fat

 As I subscribe to dozens of physical therapy, health and fitness newsletters, I’m always looking to pass along information that will benefit you in relieving your low back pain or just getting you in the best shape possible (which is one of the best ways to avoid low back pain!). 

Here is one such newsletter I recently received that caught my attention:

[ Editor's Note:  Fitness author Jon Benson shared this letter with me and gave me permission to share it with you. ]

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I agree with Jon. You can keep waiting on the sidelines or you can suit up, take action and take charge of your health and fitness. 

Yours in movement.

Dev Chengkalath

the core?

In contrast to popular belief, the core not only encompasses the abdominals or the six-pack muscles on the front of the body, but also some smaller and larger muscles that are involved in stabilizing the lumbo-sacral-pelvic region, or as more commonly known, the torso (which includes the low back).

This includes muscles in the back, hips, pelvis and trunk. Furthermore, this includes the passive structures that help transmit or dampen forces such as fascia (connective tissue network), bones, tendons and ligaments.

Functional Core

And let’s not forget, all of these fall under the control of the nervous system. For our purposes here, this includes the brain, spinal cord and the nerves that activate those core muscles.

All of these systems must work together to form a fully functional core. 

And a fully functional core is what will protect you from low back pain and optimize your performance.

In my book, those are both worthy outcomes!

So to help you continue on your journey of back pain relief and optimal core performance, here is another short video clip.

This one shows the proper execution of the side plank, which will really hit the obliques (love handle area) while minimizing potentially dangerous compressive loading on the spine.

To your optimal core function and performance.

Dev Chengkalath

If you suffer from low back pain, I’m willing to bet that you’ve been told to “strengthen your core” from someone, somewhere, at some point. Maybe your doctor, maybe your physical therapist, or maybe even from Uncle Johnny or Auntie Suzy. 

While I do believe that having a strong core helps, I don’t believe it will protect you from low back injury or pain. Often, it won’t even help you relieve the pain you already have. And at worst, it could do you harm.

I’ve seen this first hand in my physiotherapy practice in Toronto. I’ve had clients come in who had taken this advice to heart, and for years, they had worked on their abs. This usually involved a whole routine of abdominal curls, crunches and twists, with hundreds or thousands of repetitions a week. Their abs did get strong, but they didn’t relieve their low back pain. Sometimes, they actually made it worse.

They went about it the wrong way.

So what should you do if you shouldn’t strengthen your core with curls, crunches and twists?

Improve your muscular endurance with stability exercises!

Dr. Stuart McGill, one of the world’s foremost spine researchers, discusses this concept in depth in his book Ultimate Back Fitness and Performance. He presents a strongly supported, evidence-based argument for the back-protective nature of improving muscular endurance as opposed to doing the same with muscular strength.

A must read for low back health.

So where does that leave you if you can’t get your daily fix of abdominal work?

Just give the following series of exercises a go to improve your core endurance and spinal stability. 

Yours in movement,

Dev Chengkalath

There are some people who are just NOT built for certain exercises. 

Not everyone should be squatting deep. 

Not everyone should be dead lifting.

Not everyone should be bench pressing. 

You get the point, right?

As I’m sure you’ve noticed, there are very few people whose bodies are built the same way, with the same shapes, sizes, limb lengths or proportions.

So if everyone is built a little differently, why would you have everyone do the same exercises?

This concept is even more important when you’re dealing with relieving low back pain or any other form of injury or trauma to the body.

She is definitely built a little differently.

One of my major tasks as a physical therapist is to assess my client’s biomechanics as well as their body structure. How does their body move? How do their limbs move in relation to the rest of their body? Do they have any compensations? Are they in control of their muscles and joints? Do they have body awareness? These are all very important considerations when designing and prescribing beneficial exercise.

Key word: beneficial. 

Anyone can make up an exercise program. Pretty much anyone can “train” someone hard. However, without having a defined structure or purpose behind it, does it actually help or does it put you at risk?

When looking at biomechanical faults, the biggest reason for disqualifying someone from an exercise is lack of motor control.

This pretty much means that the movement is too advanced for you at this point in time: you can’t move your limbs , joints and other tissues the right way. I’m not saying you can’t improve your control or body awareness, I’m just saying that at this instant in time, because of that motor control deficit, the risk outweighs the benefits. 

Using the same dead lift technique that was on the video clip in the previous blog post here, you can see that biomechanically, this young man should not be dead lifting. His spine crushing technique with severely rounded low back and poor posture will only end up creating the ideal environment for serious low back pain and pathology. That is, if he doesn’t already have it!

He just doesn’t have enough control over his muscles and joints to be dead lifting, therefore, he wouldn’t make the cut in my book.

Now on the other side of things there are structural faults.

When looking at structural faults that would disqualify someone from an exercise, it still comes down to biomechanics. Although this time, motor control may not be the issue.

Structural faults are simply acquired or adaptive changes in your body’s structure. These can include various bone related issues such as spinal curvatures (scoliosis), adaptively shortened muscles (contractures), or other changes in the actual structure of the body tissues.

These structural changes may then in turn cause biomechanical faults.

For example, someone with a significant leg length discrepancy (one leg shorter than the other), may have muscle contractures as an adaptation for this fault. This may change weight distribution patterns and shift weight to one side or the other. If we had this person squat, uneven loading may occur through the spine because of these shifts which would increase the risk, while decreasing the benefit of the exercise.

Unfortunately, with structural faults, improving motor control won’t solve the problem. Instead, alternative exercises will need to be found. 

So there you have it. Some of the physical therapy criteria I use to qualify my clients for certain exercises, especially as they relate to relieving low back pain. 

Yours in movement,

Dev Chengkalath

is to use poor technique when exercising.

How many of you have see someone doing an exercise at the gym or fitness centre that just made you cringe?

How many of you have wanted to go over and suggest a “safer” way of executing a certain movement?

Poor exercise technique (which includes poor exercise selection) is probably one of the most common exercise errors that causes or perpetuates low back pain. 

And it’s rampant!

Many people learn new exercises from books, magazines or on the internet. I know I’ve picked up a few that way. The problem with this type of “education” is that it isn’t always ideal. There is too much room for error. 

Three of the most common exercises prone to technique faults that put your low back at significant risk for injury include the squat, the dead lift and the common sit-up or crunch.

With the first two, most people are familiar with the risks as these have been embellished and extrapolated in gym lore, passed from generation to generation. Typically, excessive rounding of the lower back takes place, putting spinal structures at risk of failure. While the risks are real, the benefits from these exercises, for the properly qualified and instructed individual, far outweigh them. 

The last one, sit-ups or crunches (I’ll use the terms interchangeably) are a little more insidious. Many people are told by their physical therapists or trainers that they need to strengthen their core to relieve their low back pain. For many of these people, the first exercise that comes to mind are abdominal crunches. 

Unfortunately, this type of exercise is not only ineffective for core training, but it’s also potentially harmful. Having heard about the dangers of crunches, many people will then try another variation, under the assumption that this “different” version is somehow safer. It’s usually not. 

There are, however, many safe and efficient exercises out there for relieving low back pain. The key is to qualify yourself for the exercise while weighing the risk to the benefits. 

Yours in physical therapy,

Dev Chengkalath