In our last post, I shared 5 of my favorite stretches for lower back pain. Most often a combination of bodywork (heat, massage, manipulations, cupping, dry needling, etc) and stretching is the ideal point to start when you are dealing with low back pain. So if you have not read our previous article, make sure to go back and take a read, as they most likely will nicely compliment the strengthening exercises. (Click here to see Top 5 Stretches for Lower Back Pain)
Low back pain is the most common orthopedic complaint and impacts 1 in 10 adults at any point in time. Over 95% of the population will experience low back pain at some point in their life (okay, seriously... who are those 5% and why do they enjoy fibbing so much???). Fortunately, our bodies are incredibly resilient and, almost always, that low back pain will resolve on its own within 1-2 weeks. However, sometimes our bodies have a different idea and decide that the pain needs to linger on... In this case, it is time to show your body who is in charge by quite literally "flexing."
The retro train of thought was that for those experiencing low back pain, bed rest was the best course of action. I wish I could honestly, and honorably, prescribe you a 2-week Netflix binge in your bed, but the dang science just doesn't want to support that... Not at all in fact! With chronic pain and the opioid epidemic, research into the area of pain has skyrocketed, and all evidence is pointing towards the importance of getting up off the ground, dusting yourself off, putting one foot in front of the other, and putting some stress through your spine and core.
Most of you reading this article probably agree that movement can be one of the best, if not the best, medicines for many ailments we face or want to avoid. Well, low back pain is no different. So, without further ado, here is a list of 5 of my favorite exercises to share with those experiencing low back pain:
1) Deadbugs
The first 3 exercises on this list are part of what are called the "Big 3." When we move our bodies, there are 3 primary "planes of movement" that we can move through; forward/backward, side to side, and rotation. Each of the these exercises addresses "core stability" in one of these planes of movement. The operative word "stability" here is key, as it is the ability of our core to resist movement in any of these planes of motion. With our first exercise, Deadbugs, we are working on core stability in the forward/backward (sagittal) plane of movement. The key to this exercises is keeping the flat of your back imprinted (to steal a word from Pilates), into the ground throughout, while your arms and legs move. By keeping your low back on the ground, you are asking for your core to "stabilize" while other parts of your body move. Often times I will cue for this workout that the whole point of the exercise is to keep your back down on the ground, while the arms and legs moving are just a distraction attempting to get your back to lift up and off the ground. Don't let them win! Having trouble with keeping your low back on the ground with this one?? Modify it by keeping one foot resting on the floor at all times, while the opposite one kicks out.
10-20 reaches each side. 3-5x/wk.
2) Side Plank
The second exercise is again part of the "big 3" for core stability. In this situation, we are addressing core stability in the side-to-side (frontal) plane. As you are in the plank your hips and trunk are going to be tempted to sag down towards the ground, but you need to resist that by using your core (which includes both your stomach, butt, and thigh muscles). A modification for this one is to bend your bottom knee and let it rest on the ground. Need it to be a little harder? Try to lift the top leg up and hold.
20-60 seconds each side. 3-5x/wk.
3) Bird Dog
The final exercise in the "big 3" is to address core stability in the rotational plane. That is, while doing this exercise, your core (again, think mid back, stomach, butt), are going to want to rotate, but you are going to use your core muscles to keep that from happening. An excellent modification for this exercise is to alternate reaches with only your arms OR with only your legs. Want an easy way to know if you are stabilizing and avoiding rotation? Place a foam roller or dowel on the low of your back while doing this exercise, and don't let it fall off.
10-20 reaches each side. 3-5x/wk.
4) Deadlifts
Alright, admittedly, the first 3 definitely have a "rehab" feel and look to them. Don't get me wrong... you test those 3 out and they can be quite humbling, but ultimately they are just a foundation. I use the word "just" lightly in this case, as your ability stabilize in each of the 3 planes of movement is truly foundational, and without a solid foundation you are building up a house that has a good chance of crumbling down. Now, this is another area that has seen quite a chance in the past decade, as the old adage was to avoid lifting things if you were experiencing low back pain. Again, thanks to some inquisitive individuals, more and more research continues to come out in support of "loading" your spine as a key to addressing low back pain. Now when we talk about loading here, we are not talking about going for your all out 1 rep max while you are experiencing low back pain, but rather using a tolerable load that you gradually and systematically increase over the course of weeks and months. The picture below shows the deadlift being performed with a kettlebell, but can also be performed with a barbell, dumbbells, sandbags, or really anything that you can pick up from the ground (e.g., laundry basket or a backpack with stuff in it). As with any exercise, technique is paramount to your ability to get out of the exercise what you intend. In this situation, your intent is to address your low back pain. Without good technique, you might be hindering progress towards that goal... So make sure to have a coach and/or physical therapist well versed in deadlifts help you out if needed.
3 sets of 5-10 reps. 2-3x/wk.
5) Pallof Presses
And last but not least, one of my favorite exercises for those who are experiencing low back pain is one called the Pallof Press. It is similar to the bird dog, as it is asking to stabilize your core while an object (in this case the band) is trying to rotate you. While performing this exercise, make sure to squeeze and tighten your "butts, guts, and quads." Variations of this exercise can be done in kneeling, balancing on one leg, in the bottom of a lunge, etc...
3 sets of 5-10 reps. 2-3x/wk.
Wrap Up:
In review, for those experiencing low back pain, oftentimes the best place to start is by utilizing heat, bodywork (e.g., massage, foam roller, Theragun, etc), and stretching; however, these modalities should be followed up with strengthening to truly resolve the issue and ideally to limit the chances of the symptoms coming back over and over. The 5 exercises above are only 5 of my "go-to's," but of course there are hundreds of other options and variations. Give these 5 a shot and see how your back begins to feel. If you are unsure of the technique for these exercises or just have any questions in general about your low back pain, feel free to reach out to us by email or phone.
Email: matt@thrive-mn.com
Phone: 651-383-2626 (call or text)
Otherwise, we wish you the best as you go about getting your abs of steal!!!
Keep Thriving,
Dr. Matt
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