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!
It’s never nice when a client has to stop working with you for whatever reason it may be. Recently I found out that one of my long term clients, Russell P had to move to another city. I thought as a result I’d take the opportunity to write a quick tribute to him, because the way that he approached his training made my job really easy, but can also serve as an example to anyone out there who wants results on how to get them with some help from a trainer if you feel you need it.
Listen to and Trust your Trainer
When Russell and I met, he had been training for a marathon and managed to get Achilles Tendonitis. At the time I was working for a chain gym and he asked for someone with a running background and who knew about injuries. As luck would have it, I do well with both. At our first meeting Russell outlined his training program and one of the first things that I did was cut his mileage in half immediately. Now, Russell had eight weeks before running his first marathon so he thought I was crazy.
But, he listened. We strengthen and mobilized his ankle and got him back into a regular running rhythm and eight weeks later he completed his first marathon. It wasn’t fast, but it was done. Russell was simply trying to do too much too soon and his body was fighting back – quite common with runners.
Two years later running the same race (where he beat his old marathon best by over 30 minutes) we had a goal established that he probably could have tried to push more, but he chose to listen and just hit the numbers we had talked about, which is what brought him success.
Russell could have easily done something else or told me that he was doing what I asked and done something else, but that’s not like him. He has always trusted in the process. We do get input from each other, but the whole point of having a coach is to have them tell you what to do to succeed.
Just Show Up
I can probably count on one hand the amount of times Russell and I missed a session with a last minute cancellation. Even if he was hung over, tired or just generally stressed he still always showed up. Sometimes we wouldn’t get the best out of him that day, but what we did was always better than doing nothing. Once he committed to a race, it was there and 100% done. Before he decided to leave we had his goals planned out into 2016.
He was also excellent at following his programs without overdoing it or doing anything silly. If we had an off day planned, he took it – or if he had to make up for a run he missed he put it there. He never did too much again after that first injury.
Over time we even learned that we had to factor in two weeks after any major race in order to let his body rest and gave him time to recover and do nothing for a while. This should never be a problem for any coach because all you’re doing is giving the body what it needs after a big performance, which is recovery.
My point is that 98% of any success is just showing up. Many time it would have been easy for Russell to text me and say he couldn’t make it, but his training and progress were a priority that he made time for and as a coach this is something that makes it a lot easier to get results.
Any good coach will be able to plan out a schedule for a client, but Russell was especially good at thinking ahead and long term. Not only would he plan for what he was going to do workout wise when he was away, he made it a priority or scheduled workouts with friends while he was travelling. His family lives in England and even when he was over there for a week he still got his workouts is because he planned what days he was going to do them ahead of time.
We also planned his race schedule year to hear with one big goal (last year it was riding a bicycle from London to Paris, this year it was a ½ Ironman triathlon) and didn’t change it. He already has his priorities scheduled into 2015 and is committed to the process. There are little goals along the way, but the main focus can’t be month to month – it was to be one event and I always prefer if it is an annual goal, not a bunch of them (maybe twice a year at most).
Doing this ensures that your focus is always on the main event you have prioritized. It doesn’t mean that you can’t do a 10k race on your way to a marathon goal of course. And that brings me to my final point:
Roll With The Punches and Be Realistic
Sometimes life gets in the way. Russell and I at the beginning of the season had a ½ Ironman triathlon scheduled for the end of his race season (his first). However, the way that the summer fleshed out and with many work and life changes we both mutually agreed that it wasn’t a good idea to push for the distance when the training he was able to do would have resulted in a less than 100% result. He still completed his first Olympic distance triathlon with flying colours and hit all of his goals along the way.
Sometimes you need to assess if your life can really manage to get you the training that you need. I run into this quite often with fitness competitors who have jobs, families and lots of stress and have a hard time sticking to things. Health and well-being in my opinion should always be the top priority, and things like races and shows aren’t going anywhere any time soon. If you have to put a goal off temporarily due to something getting in the way – do it.
Want to do a ½ marathon but couldn’t get in your long runs? Try setting a PB at the 10k distance instead. You can still get a fantastic result and maintain your training and health, while also lowering your stress at the same time and taking pressure off so that the training that you can manage to get in isn’t wasted.
I hope that this brings some perspective into your own training. I’ll miss working with Russell on a regular basis a ton (we’re going to work together coaching virtually in the new year), not only because we have had a great relationship face to face but also because of all of the reasons labelled above that makes doing my job well so much easier. If you have a trainer take a look at the list and maybe there might be one thing that you could honestly say you can step up and improve a bit. I’m sure your coach will thank you for it and be able to get your results to you that much faster.
Also, if you’re reading this and are interested in coaching, my virtual services are available for the month of December at a 20% discount – five months for the price of four. Contact me for more details. Have a fit and healthy holiday season!
Often my first few encounters with people are met with trepidation and fear. These are people who are injured, and have been for a long time without getting any type of improvement or change in their condition and they are tired of it, or often have just resigned themselves to feeling a certain way for a very long time.
I’m of the opinion that if you do the right things to tissue, it is a living thing and it can change to adapt and get stronger given the right stimulus. I’ve managed to prove this to myself and my clients over and over again through the years by giving their tissue exactly what it needs – more capability to handle stress under load without overtaxing the nervous system and causing pain, which is more often than not a defense mechanism or warning sign that something isn’t quite right.
My most recent example happened just two weeks ago. I began working with a woman who has had what was diagnosed as “tennis elbow” (by a sport medicine doctor) over nine months ago and has been living with daily pain since. She’s been doing physio weekly and has had not one, but two trainers working with her as well. She was actually referred to me by a colleague in another city after moving to mine.
So I’m doing my assessment and taking a very careful look at her elbow and notice that there seems to be a lot more laxity in the joint than on the opposing side. Her shoulder, elbow and wrist were also quite weak and unstable (unable to hold force without deviation) on that side. So as a result I spent a lot of our first full session together increasing her elbows’ ability to hold position, and also did a movement designed to apply force directly through the radioulnar joint into the humerus. Isometric elbow extension, limited range elbow flexion, and finally a simple direct push isometric into the joint with a lot of force. Result? Immediately after a simple 20 second isometric application she stated that it felt “better – strangely better” as she proceeded to fully extend her elbow (which she couldn’t do 2 minutes previous). As we proceeded with the rest of the movements things continued to improve.
Three days later she said that she had slept through the night previous, something she hadn’t done in months due to pain, and suddenly her elbow was a lot stronger – strong enough to do weighted pulling movements, which is something else she hadn’t done in months. All from a very simple – but deliberate and intentional – application of force to an area.
Now two weeks later we can do upper body pulling movements with load – something she couldn’t do two weeks ago and was afraid of doing when she walked into my studio.
Here’s the thing – if a wall is falling down, do you let it fall part way, then stop it there and start repairing it? No. You shove it back into place and then put a bolt in it so that it doesn’t fall down again. That’s strength.
So many people have a misconception that strength means that they have to move a boulder or throw something over their head. That they will get big and huge overnight if they even look at a weight. To me, strength is the ability of the body to hold onto force through its’ varying joints without causing trauma that causes that tissue to degrade. If you can move a bit more force through that joint (picture your knee during a knee extension) without the joint being compromised and losing the ability to hold position – that’s strength. If you can run 500 meters further without causing your legs and back to degrade to the point that you slouch or start striking with the wrong part of your foot – that’s strength.
Stronger tissue also means shorter recovery times, meaning you can either train more or train harder. Stronger tissue means that simple everyday tasks don’t have to cause you pain due to a joint going way too far out of its’ appropriate range of motion. The great thing about your body is that if you stimulate it properly with just enough force, it will adapt. Every single time. And, it is so intelligent that it will learn how to deal with that level of force by laying down more tissue in order to deal with the requirements being put upon it.
The greatest thing about this concept is that you can literally apply it to anyone. Have an elderly relative who can’t lift a grocery bag? Find a way that they can lift one that’s half or quarter full, or weighs 3 pounds. Then, once they can do that, add a pound. On the flipside of that you might have an athlete who can perform explosive fast movements for 45 seconds, but needs to be able to do it for 60, or maintain strength after being on a basketball court for 35 minutes with little rest. Find out where their threshold is and take them just a little beyond (if they can handle it at the time) and then the body will do the rest.
And for pete’s sake – if you are dealing with a professional who isn’t working towards resolving the problem and still throwing money at them – stop it. There’s a thousand practitioners out there in my city alone. I’m not saying that I have all of the answers, but sometimes what is done to people in the name of “therapy” makes me shake my head. Here’s a very simple statement: If your practitioner can’t tell you what they are trying to do to make sure your problem resolves and doesn’t happen again – every time – then find someone else who can.
And the next time you’re in the gym, or on the field, think about what you did last time. Then do more.