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

If you want to relieve your low back pain, unload your spine.

As I’ve stated before, in my physical therapy practice in Toronto, I see a lot of bad backs. Many of these people have tried all sorts of “solutions” for their back pain, but none of them seem to work.

Usually, one of these solutions is exercise.

As I’m sure you can infer from my blog, I am a HUGE advocate for exercise in relieving low back pain. However, not all exercises are applicable in the treatment of this dysfunction for everyone. Doing any old exercise is not how you fix your bad back. 

Where do most people go wrong with their exercise choices?

Typically, as discussed in the previous post, a lot of people crank their training volume too high. To recap, doing too many exercises or too many repetitions can lead to form failure or sloppy technique, which only puts vulnerable tissues at greater risk to injury or irritation. 

Another major exercise error is overloading the spine. 

Spinal Loading Arnold Style

When certain tissues are injured, they don’t respond to being loaded (essentially, made to work) the same way that uninjured tissues do. 

So what’s the solution?

Unload.

This just means don’t lift as much, don’t push as much, don’t pull as much. Don’t do as much.

This does NOT mean do nothing. 

This just means you need to make sure that you are challenging your tissues, but not overdoing it.

You are stimulating them to repair, not breaking them down through excessive exercise.

The key is to work within your capacity, always maintaining neutral spine and making sure your form is bang on.

So spare your spine and unload.

Dev Chengkalath

In North America, and many other places across the globe, we equate value with volume.

When we go to restaurants, we want heaping servings and overflowing plates. We want non-stop soda-pop and endless French fries.

Would you like a heart attack with that?

We want massive volumes of food for the dollars we spend. This is what we take as value.

In the gym, we think pushing ourselves until we vomit is better for us. We think doing more reps, more sets and more exercises is our salvation. We take this “hard work” as being optimal for our health and fitness.

We have it ingrained into our minds that More is better. More is better. More is better.

More is not always better.

In my experience as a physical therapist and human movement specialist, this is especially true when relieving low back pain through exercise.

Training when you’re injured is not the same as training when you’re healthy.

Sure, some of the principles may be the same but the major aim of the intervention is different, the goals are different. Or they should be!

When exercising to relieve low back pain, high performance should not be your primary objective. Motor control and return to function should be. Once you have gained or regained control again, then you can switch focus back onto optimizing performance.

After an injury to your low back, your first steps should be to get out of pain and find the root causes.

Your next steps should be to re-learn how to move your body efficiently while protecting your back.  You need to be able to find that pain free zone and keep it.

The volume of your exercise program should always allow for perfect practice. Because perfect practice makes perfect. Practice just makes permanent.

Imperfection is not an option

If you’re cranking out set after set and rep after rep of an exercise, your odds of fatiguing and losing control of a movement are much higher. Your execution of a given exercise may get sloppy. Your movement patterns may get lazy. Your risk goes up. Your benefit goes down.

And in the end, a safe exercise could become a dangerous one. 

Train smart, not just hard.

Dev Chengkalath

There are very few exercises that are inherently safe or inherently dangerous.

In the case of low back pain, what will push an exercise into either of the above two categories is the application of said exercise.

As a physical therapist in Toronto, I come across this situation often. This becomes a delicate balancing act between the risk and the benefit of a chosen exercise to that particular client with their particular brand of low back pain (basically, what is the “cause” of their problem).

In my experience, the following are the primary exercise errors that may increase your risk of acquiring or perpetuating a low back injury:

1. Poor warm-up
2. Too much volume
3. Too much load
4. Poor technique
5. Biomechanical fault (e.g. injury, body type etc)

Over the next few days, I’ll dig a bit deeper into each of these.

Yours in movement.

Dev Chengkalath