Finally the finishing touches to my back pain series.  This was prompted by the epidemic of back issues that have been posted all over my social media lately.  It seems that this winter many people have decided to “throw out” their backs.  And this is something that is completely avoidable.  The problem lies in that you’ve already likely done it to yourself.  Now we have to make sure that it doesn’t happen again.

In July I wrote two articles on back pain.  The first one which you can find here was about identifying what and why back pain typically occurs.  The second one, which you can find here was about movements you can use when you’re feeling stiff or sore to help provide relief for general stiffness and soreness.

This part is about the exercises.  Now, most therapists and trainers would identify that you need “more core strength”.  What does that actually mean?  Many people will think that yoga, pilates or even just simple crunches will do the trick.  As I said in Part Two, the “core” is a very complex thing and can’t be isolated into one or two muscles.  You have to strengthen the entire complex, and this stretches from the pelvis all the way up to the shoulders and even down into the legs.

So how do you begin?  Well, a good place to start is by working on movements that you have to perform daily anyway.

My number one exercise to develop and improve back strength and resolve symptoms of back pain:  The Deadlift.  

In fact, if you were only allowed to do one exercise for the rest of your life, this would probably be my first recommendation.

Pretty simple, right?  Picking something up and putting it down.  This is not actually true. There is a lot of proper technique and intention behind this movement and I strongly suggest you have a competent coach (not your “brother-in-law who lifts”) teach you the movement and all of its’ parts.  It includes the ability to squat, hip hinge and also keep your spine engaged throughout the movement, all individual components that you need to be aware of.

The good thing about this exercise is that it can be regressed so that my 103 year gold Grammie can do it, or progressed to an Olympic lifting level.  It is very versatile and hits most of the muscles in your body in a very good way.  One of my goals with any of my clients (even those with compromised backs) is a good solid deadlift.

My second choice for back strength actually involves the hips more than anything.  Strong hips (and you can feel free to think “glutes” here) are essential for spinal integrity.  Therefore my number two is:  Hip Thrusters.

Now, this can be an uncomfortable position for many so I typically suggest starting this movement on the floor, then progressing to a Swiss Ball for mild loads, then a bench or modified floor position for heavier ones.  You also need to make sure that your legs are in the proper position and you can actually hinge at the hips before you can do this properly.  Again, please consult a professional coach to help give you the right technique.

Easy regression is an isometric hold in the up position (on the floor or a mat) for 15-20 seconds to start.  Focus on pushing through the heels and pretending you’re holding a pencil between your butt cheeks and not letting it go.

Now, we also need a movement that takes place in the frontal plane – which means up and down if you’re standing up.  This makes sure that the spine is being trained with forces that it will experience frequently.  One way that people frequently hurt their backs is by extending a load over their heads they have no business lifting.

Most people also have very little upper body strength in relation to their lower body or vice versa.  Men are horrible at this because they want to have a big upper body and never make their legs strong so their poor spine is like a pipe cleaner balanced with a big rock on top of it – and easily collapsed.

Therefore my next exercise for proper back health is very simple: The Pull-Up.

I realize that most people can’t do one full pull-up properly.  Therefore I’ve given you two pictures that show easy ways to do these assisted in a gym or at home.  If you need more ideas feel free to email me or google it and you’ll find a few more.  I have at home clients do this with a bed sheet and a door frame sitting on the ground.

This movement not only is great for loading your spine in a frontal plane, it also hits those often neglected upper body pulling muscles that don’t get a lot of use.  I encourage all of my clients to get to the stage where they can do pull-ups without much assistance.  There are also a variety of choices in terms of grips and adjustments to enhance the strength in your shoulders without wrecking them.  Please be careful and progress things appropriately.

Oh, and yes there is some debate over whether this is a frontal or sagittal plane movement.  I believe it is a frontal plane movement.  If you want to debate it, feel free to call me out.

There is a long list of complimentary exercises that I would add to this list.  Some of them include:

• Overhead Pressing
• Romanian Deadlifts
• Back Extensions and Reverse Back Extensions
• Loaded Planking with movement
• Lateral Side Flexion
• Loaded Trunk Rotation
• Split Squats

And the list can go on.  However, if you want to get started on the path to good spinal strength, these three are your first and best bet towards good spinal strength.

You might also notice that none of these first three exercises are traditional “core” exercises.  However, all of them load your spine quite nicely and give you the benefit of adding strength in a bunch of other places as well.  This is essential for total body health.

All of these exercises can be progressed and regressed by a competent coach.  Always remember that exercise is tailored to the individual, and a good coach will adjust your program based on need and result (and goal).

I’m planning on putting together a proper E-Book on Back Strength coming soon.  If you would like a free copy, feel free to subscribe to my site by adding yourself to the list at the side, or follow me on Twitter at @strengthottawa, Instagram at @strengthrehabottawa and on Facebook at Strength Rehabilitation Institute of Ottawa.  I’m also always interested in your thoughts and feedback, so feel free to Share this as well on any social media.

Take care of your backs!