You ask and you shall receive…

From my experiences as a physiotherapist in Toronto, these are the top 5 things you do to your back that you should not do:

1. Abuse it: This is probably the most simple item on the list. Almost every one of my physical therapy clients, with a little bit of prodding, can tell me exactly what activity causes them back pain.

Yet they keep doing it.

If something hurts, stop doing it.

This likely leads to low back pain...

This includes exercises. Or body contortions as pictured above.

In most cases, pain is a signal from your body that something isn’t right. Usually it means that some sort of tissue is being damaged.

2. Prolonged Postures: The big culprit here is sitting. How many of you spend more than 15 minutes in the exact same position? How many of you spend an hour in the exact same position?

I’m willing to bet that there are quite a few of you who spend your days driving in a car, commuting, riding in airplanes, and more specifically sitting at a desk in front of a computer (usually for HOURS on end!).

Slouched Sitting Postures: Over time can lead to injury.

Then you get home and crash on the couch in front of the TV, or worse, lie down in bed in awkward postures, twisting your body to get a good view of the screen while “relaxing”.

By maintaining these postures for longer periods of time, you don’t let the tissues recover from the stresses that they face.

Think of this like an elastic band that you stretch and hold. Eventually, when you let go, it won’t spring back to the original length. The same thing happens to your body tissues.

As stated previously, the best postures are the ones that keep changing.

3. Repetitive Motions: Similar to prolonged postures, numerous repetitive motions have been shown to be the major factor in disc herniations with full lumbar flexion (rounding of the low back) being the major player.

What exactly are repetitive motions?

Think about bending a paperclip back and forth over and over again. Eventually, the paperclip will break.

To get an idea of some of the repetitive motions that we use regularly, just have a look at the previous post where I discussed the 3 worst core exercises for people with low back pain. Each of those exercises puts the lumbar spine through those exact repeating movements (flexion, extension or rotation) that can potentially lead to intervertebral disc injuries such as bulges.

4. Neglect it: According to Dr. Stuart McGill, and the study he cites by Luoto et al (1995), low back muscular endurance appears to have a greater protective effect against low back injury than does low back strength.

Ergo, make sure you work on your muscular endurance using exercises such as the Birddog and plank variations.

McGill also suggests that lower back exercises seem to have their greatest positive effect when executed daily, and not 2 or 3 times as week as most exercise sessions are set up.

So don’t neglect your back!

5. Ignore it: This is the most surprising item on the list, but the longer I’m in clinical practice the more often I see this.

People will live with their back pain for years without doing anything about it.

Or worse yet, they will ignore it and work through it. Sometimes they will even wait patiently for the latest excruciating episode to clear up. There are people out there who can help you.

Find them and let them help you fix yourself.

Yours in movement.

Dev Chengkalath

It has the ability to spread knowledge across the globe in real time. You have a problem, google it, and more than likely you’ll find a solution.

So what’s wrong with that?

As a physiotherapist in Toronto, these are the questions I ask myself: How good is the information you’re getting? Is it valid? Reliable? Can it be trusted? Will it help you? Or will it hurt you?

This holds even more weight when dealing with physical issues such as injuries or illness. Plug in your signs and symptoms and within seconds, hundreds, if not thousands of webpages will be returned for your perusal.

It’s no different with relieving low back pain. Plug in those search terms and instantly you’ll have at your disposal more information than you could possibly even use.

When looking at low back pain, a good portion of the information that’s returned discusses strengthening your abs to fix your back problems. At times, this is similar to the information many people are given by their medical and fitness professionals: “Build a strong core to protect your back”.

Unfortunately, abdominal training is typically considered the foundation of core training. In reality, abdominal training is only a small part of the bigger picture. And in some cases, poorly designed or applied abdominal training can actually be what’s keeping you in pain.

As I’ve already talked about six pack abs and low back pain, I’ll just stick to giving you some ideas on how to keep your back strong, safe and healthy. Without further ado, here’s my list of the 3 worst core exercises for people with low back pain:

The abdominal crunch or sit-up: These staples of most back rehab programs should be eliminated because of the tremendous compressive loading forces that they create through the discs of the spine. There are better ways to train the core!

Dr. Stuart McGill, one of the foremost spine researchers in the world, has measured compressive forces of approximately 3300N (730 lbs) in the spine with these types of exercises.

This is equal to the amount of force noted by some government health agencies as the amount of force needed to cause injury!

Abdominal machines (crunch and twist machines): So if crunches or sit-ups can cause as much damage to your spine, imagine what happens when you take the same exercise, restrict movement at certain joints, isolate movement at others (in this case the lumbar spine) and then add a load.

Doesn’t sound very good, does it?

Now take that same flexion movement add a loaded rotation component on the twisting abdominal machines and you’re well on your way to getting yourself sent off to the disabled list.

In fact, we’ve  dubbed these types of exercises “disc herniators” and inform our clients on continuing to do these only if they wish to help us finance our latest exotic car purchase.

www.madwhips.com

Take home message: save your spine and stop flexing and/or twisting through your low back!

Back Extension Machines: As described by Dr. McGill, the repeated spine flexion/extension movements used by these devices create the same conditions that were necessary in his lab to produce disc herniations.

Enough said.

Why would you want to do the same to your back at home?

So there you have it…The 3 worst core exercises for people with low back pain. If you love your back, stop doing them.

Let me know your thoughts. Do you agree? Disagree? Or just not care?

Yours in movement.

Dev Chengkalath

The only problem is that most often people will do the wrong kind of core training. In most cases, the type of training is flexion based (sit-ups, crunches, twists etc) and uses just a small component of the so-called core. 

In this short post, I just want to re-visit what is one of the best foundational core exercises that will also help protect your spine.

Since a picture is worth a thousand words, here is a short clip on the birddog exercise and its variations, popularized by Dr. Stuart McGill.

What are your thoughts on this type of core training? 

Yours in movement.

Dev Chengkalath