Back Pain Essentials


 

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Back Pain Essentials

Back pain sufferers will typically present with poor stability/motor control at the pelvis and lumbar spine. In the clinic, I find most people improve greatly with time spent learning how to control segmental movement of the spine, brace the spine and correctly flex and extend their hips. I’ve had success incorporating this simple sequence of drills while rehabbing back pain sufferers and transitioning them into training programs.

Spinal Control: The segments from T12-S1 are often a proprioceptive “dead zone” for many due to injury, protective bracing and disuse. The lack of movement leads to a loss of neurological control and resulting stiffening of the spinal fascia. Practicing slow, controlled, segmental rolls of the pelvis and lumbar spine can improve motor control and fascial integrity. Move slowly, pairing exhalation with flexion and inhalation with extension. Be sure there is no pain while performing this drill.

Core Bracing: Basic hardstyle bracing progressions like bear holds and planks are essential to educate clients on how to properly create compression around the spine. The untrained client will often benefit greatly from training these basic isometric exercises to build fundamental core strength. Be sure to focus on breathing and creating full body tension throughout the entire drill.

Active Hip Extension: Educating clients how to properly extend their hips is an essential piece to any back rehab program. We should work to not only develop glute strength but to teach clients how to properly disassociate hip movement from spinal movement. Using the progression shown in the video can build hip extension strength while also teaching the client to maintain anterior abdominal tension.

Hip Hinging: You can tie all of the pieces together into an integrated drill using the hip hinge. For many this may simply serve as a motor control drill that bridges the gap to deadlifting and swinging but it may be used to develop fitness in an untrained population.

For the typical back sufferer the key is simplicity. Stick to basics, avoid painful patterns and work to restore normal function around the lumbar spine and pelvis.