Back pain can range from being mildly uncomfortable to seriously debilitating and is incredibly common in the American population, with around 31 million people suffering from back pain at any given time.
One of the key factors in preventing back pain is strengthening and stabilizing the many different muscles of the core. However, often when people hear of their ‘core’, their minds instantly turn to images of ripped six-packs and strong abdominals.
Your abdominals actually play a leading role in supporting your spine. Ironically however, if you predominantly focus your attention on your rectus abdominus (abs) to the neglect of your other core muscles, you are likely to cause imbalance and weakness, putting your spine at risk.
For this reason many gym junkies or fitness fanatics, who are have not been properly guided in the do’s and don’ts of resistance training, often experience back pain, or worse end up doing some real damage.
So in today’s blog I would like to have a look at both understanding how to prevent back pain, and ways in which we can manage it.
Back Pain Prevention
When it comes to back pain prevention, in relation to resistance training, the key word here is ‘Balance’. Remember that even if aesthetics is your driving factor, strength, stability and balance should also be right up there on your list!
So firstly, let’s have a look at the back and the many different bones and muscles that comprise and support it:
The spinal column – This is made up of 33 vertebrae, 5 of which are fused and form the sacrum (S1-S5) at the base of your torso, and 4 that form the tailbone. 7 (C1-C7) more of these vertebrae are grouped together in a region known as the cervical vertebrae, which start from the base of the skull and move down. Then there are 12 (T1-T12) thoracic vertebrae, which is where the ribs are attached. Then there are the 5 (L1-L5) that make up the lumbar vertebrae, which form the lower back. Between each vertebrae is a cushioning disk that works to absorb any shock as well as keeping the spine flexible and limber. If these disks are put under too much pressure, from overloading or inappropriate movement, they can become injured. These injuries can range from mild to severe (such as disk herniation). When this happens the spinal cord, that runs internally through the spinal vertebrae, is at risk. These types of injuries can seriously impact on your mobility and independence.
Muscles of the core – The muscles of the core all work to provide stability, flexibility, strength and movement to your torso and spine. They are comprised of a combination of muscles found in both the abdomen and back, as well as including muscles of the hips, pelvis and neck. These core muscles can actually be divided into two main groups, those that are attached directly to the spine (the inner group) and work to support and stabilize its movement, and those that are attached to these stabilizing muscles (the outer group) and work to create your movement.
The major muscles of the inner group include:
- Transversus abdominus
- Internal obliques (fibres)
- Quadratus lumborum (fibres)
The major muscles of the outer group include:
- Rectus abdominus
- External obliques
- Quadratus lumborum
- Erector spinae
Even though the outer muscles are the ones that control the majority of your strength and movement (as well as the ones you can tone aesthetically), it is actually the inner group of muscles that need to be worked on to help prevent and manage back pain.
The reason for this comes back to what I mentioned previously; ‘balance’.
If your strength outweighs your ability to stabilize your core, then you are putting yourself at risk. You can look as strong as physically possible, however if you don’t cultivate balance into your workout, and strengthen these inner muscles that work to stabilize your spine during your movements, then you are likely to experience back pain or potentially do some serious damage.
This ‘balance’ also applies to the front, back and sides of your core. So when designing your workouts, make sure you don’t focus too heavily on one part (e.g. your abs) with the neglect of others (e.g. your obliques and lats).
This might sound like common sense, but I have actually spoken to many people who complain about experiencing back pain and find it hard to believe because they think that they keep their ‘core’ so strong. More often than not, this is simply because their focused workouts lack the appropriate balance needed for core stability and balance.
Ways in which to manage back pain
When it comes to managing back pain I’d like to firstly make it clear the importance of seeing an advanced practitioner who will give you a thorough orthopedic assessment (we have several advanced C.H.E.K practitioners here at Ascend) if you are experiencing any back pain that falls outside of general muscle soreness. As you may have noticed, your back is fairly integral to your wellbeing, so it is important that you look after yourself and not put your back at further risk.
From a physiological standpoint, the key to managing back pain is to get to the ‘core’ of the issue (please excuse the pun). By this I mean gradually working at both strengthening and stabilizing the muscles that support the spine.
In order to do this we need to focus our attention on the inner core muscles that are actually stabilizing the spinal column, as well as working at ‘balancing’ our outer core muscles.
The muscles that play the leading role in postural integrity are the internal and external obliques.
- The external obliques, located on either side of your abs, work to protect the lumbar spine against any rotations or twists. It is these movements that are most likely to cause damage to your spine.
- The internal obliques form the base support for the sacrum, as well as supporting the external obliques in protecting against rotations.
So which exercises are most effective at strengthening and stabilizing these muscles?
There are many exercises that have been devised by physiotherapists to specifically target the muscles required for spine stabilization, however you may be interested to learn that many of these exercises have actually been adopted from yoga.
In an interview between Ben Greenfield and the CEO and founder of Mindbodygreen.com, Jason Wachob, Jason actually talks about his struggles with being a 6”7 athlete with chronic back pain, and how yoga has not only helped him manage his back pain, but also eradicated the issue.
Another key component to reducing back pain and stabilizing the spine is reflecting on the way we breathe.
Poor breathing habits can actually contribute to a myriad of health condition including anxiety, heartburn, high blood pressure, digestive complaints and increased muscle tension.
Increased muscle tension in itself can contribute to poor posture and back ache, however it is the use of the diaphragm that plays a key role in both causing and helping manage back pain.
The diaphragm is a dome shaped muscle, positioned underneath your lungs and lower ribs, in the centre of your torso. Its is responsible for breathing, aids in digestion and is also the chief stabilizer of the lower back. It actually shares fibers and attachments with the lower ribs, and the deep stabilizing muscles of the lower back, as well as the serratus anterior (muscles of the shoulder).
When the diaphragm is being poorly activated, through bad breathing habits, the stability and support it offers the lower back and spine is lost. This can cause weakness and pain in these areas.
So what is proper breathing, you might ask?
From birth we breathe in a natural state, where the diaphragm pulls downwards, causing the belly to protrude slightly. The enables the oxygen to fill all the way down into the lower lobes of the lungs. This is called diaphragmatic breathing. We do this when we are in a relaxed state, such as when we are sleeping.
The problem is that the stresses and pressures of life has lead many of us to develop poor breathing habits that involve shorter and shallower breaths into our chest region, instead of deep into our belly.
This shallow breathing style can not only potentially cause problems with back pain, it actually tends to exacerbate the stress that causes us to breathe like that in the first place.
Ideally this style of diaphragmatic breathing should also be utilized during resistance training as much as possible. Instead of holding your breath during stabilization exercises, try to adopt a deeper version of diaphragmatic breathing.
So if you needed another reason to take some time out to internalize and relax.. Now you have one!