One of the questions I ask during an initial consultation with prospective members for the studio is “Are you experiencing any pain or discomfort in your low back?” It’s commonplace for the response to be, “Yes or every once in a while”. Regarding training and loading the spine, I’ve come to a place where the more I learn, the more I realize I didn’t know. I lived during the era of the following “commonsense” recommendations:
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Bend the knees and keep the back straight to perform a lift.
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Take Yoga or Pilates classes.
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Reduce the load being handled to reduce the risk of back trouble.
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Stretch the hamstrings.
In the last thirty years of training people, I’ve recommended either one or more of the above remedies. In some situations, they worked, in others, it did not generate a positive response. The reality is that each situation is unique. Some people may have a structural problem such as a herniated disc or spinal stenosis. In other instances, the person may possess poor hip mobility which is creating stiffness in the trunk as a compensation. Poor muscle endurance within the core may be the source of the problem for someone else. And finally, some people have a combination of them all. What’s a trainer to do?
As the saying goes, if you’re a carpenter with a hammer, everything looks like a nail. I use movement and strength training as my tactic. I perform a movement assessment with everyone. In that assessment, you must put your spine in a flexed (child’s pose) and extended position (cobra). If either of those positions produces pain, I recommend you see your health care professional. The assessment allows me to proceed with someone without the risk of making them worse. If neither of those positions produces pain, I proceed to determine if they have movement competency.
Once we start their training, the introduction of tissue work such as foam rolling and mobility drills are a good starting place for most, especially for those who are sedentary. Improving the tissue quality of the glutes (both Gluteus maximus and Gluteus medius), hamstrings, and thoracic (upper back) spine area can make a difference in a short amount of time. I consider this low hanging fruit.
Along the members’ journey, I will address expectations. When I’m speaking with the 48 yr. old who hasn’t exercised on a consistent basis since they were in their early twenties, or half of their lifetime ago, I explain that they got to this state over a period of time. It’s going to take time to course correct. I wish I could say that foam rolling your glutes for 2-3 minutes three days a week will permanently rid you of the intermittent back pain you’ve had over the past 10 years, but it won’t. I can sympathize with people. When you have a headache, you don’t want to hear about meditation methods, you want an Advil.
The rate of improvement can be greatly affected if the source of the problem is not eliminated. You have a job which requires a moderate amount of sitting on most days of the week or you maintain positions of poor posture for extended periods of time. This can create the three steps forward and two steps backwards cycle. The good thing is that you will make progress.
In strength training, it’s key to determine the right effective dose. Too much can make things worse in a hurry, but not enough can be a waste of time. This is when the Goldilocks approach is best. Consider the deadlift exercise as an example. Having a 43 yr. old female perform deadlifts with two 16kg (thirty-six pounds) kettlebells initially may be too much to start. On the same spectrum, ten pounds in each hand may not impose a large enough demand to stimulate a positive training effect.
And what is the goal of the deadlift? There are a few. It’s a great hip hinge drill that teaches the user how to properly load the hips and the posterior kinetic chain. The second benefit of the exercise is that it strengthens the user’s ability to create spine “stiffness”. As stated by world-renowned lecturer and expert in spine function, injury prevention, and rehabilitation, Dr. Stuart McGill:
“Spine stiffness (and stability) is achieved by a complex interaction of stiffening structures along the spine and those forming the torso wall. Balancing stiffness on all sides of the spine is more critical to ensuring stability than having forces on a single side.”
The final piece of the puzzle is to increase muscular endurance of the core. It’s the inability to maintain strength over a duration of a time that ails many. This is when exercises such as farmer carries can be prescribed. Strengthen the body first and then proceed to increase its work capacity over time.
I wish I could say that it is a quick fix, but it’s not. The important thing is to have a strategy, and at the studio we do. If you’ve struggled with getting your core stronger in the past, please feel free to contact me at Doug@janddfitness.com at J and D Fitness Personal Training for a movement evaluation and allow us to help make you better.
I’ll see you at the studio.