Solving Lower Back Pain through Exercise

I’ve read that anywhere between 80% and 90% of us will experience back pain at some point in our lives. What makes this statistic even worse is that once the vast majority of people experience back pain for the first time, it never really goes away. Of even greater concern is that many causes of back pain remain unknown, and universally successful treatments have yet to be discovered. (1)

If you have back pain that is severe and reoccurring, you should consider seeking medical attention for your condition. Get second and third opinions. Try various options including chiropractic and massage for muscle spasms. Surgery is being recommended less and less, and medicating with pain killers is usually only a temporary solution. (2)

However, I'm writting this to advise you on the proper way to exercise in order to optimize back health. This knowledge is from years of studying all the available research on the topic (I myself herniated two disks when I was younger, and only through proper exercise do I now have the strong and healthy back I do today), as well as working with perhaps hundreds of individuals who suffered from back pain before training with me. Indeed, one of my clients said after only two months of training: “I’ve had trouble getting out of bed every day for years because of my back, and I just noticed the other day that I haven’t felt any pain in weeks. Do you think it has anything to do with our workouts?”

In fact, even clients who come to me with purely aesthetic goals will also benefit from improved back health and core muscle strength resulting from the personalized fitness plans we design here at Fitness Together.

First of all, it is important to be aware of the fact that your spine is supported by all the muscles in your midsection. To properly support your lower back throughout the course of normal day-to-day functions, the muscles of your lower back have to work in concert with your abs, oblique's, etc. Hence, I prefer to utilize exercises that transfer the load from the upper to lower body, or vise versa, in order to strengthen the core. I break these exercises down into two categories: 1) Heavy exercises that work on strengthening the core musculature with the spine in a straight (neutral) position, and 2) Light weight, high repetition exercises that work on muscular endurance and move the spine through a range of bending and twisting motions.

Your spine is in a “neutral” position when you are standing straight with good posture. In this position, your spine (with the help of the supporting musculature) is actually capable of withstanding incredibly high loads without damage. When you’re spine is in this position, you can work on strengthening the muscles of your lower back in a way that will improve your ability to lift heavy loads without injury. In fact, exercises like squats, deadlifts, rows, military presses, etc. will not only strengthen your lower back, but they will teach you to lift heavy objects with good form. These are compound, multi-joint exercises. Machines and single joint isolation exercises will NOT have the same benefits.

***One VERY important note*** These exercises MUST be done with proper form or you will risk back injury. This means keeping the back flat during the entire range of motion. It’s also important to brace your spine using your natural weight belt. This means you should tense the muscles around your waist similarly to the way a boxer braces for a punch to the stomach. Don’t suck it in, just tense it.

The midsection of your body is analogous to a suspension bridge. Your spine is the main structure of the bridge, and the muscles are the guide wires. Without the guide wires the bridge would collapse under its own weight, but with properly loaded guide wires connecting and supporting each section of the bridge, it’s able to support a load. But this system can only support heavy loads when the spine is aligned properly. Any bending or twisting of the spine throws this system off, and greatly reduces its load carrying capacity.

Stuart McGill, PhD (one of the worlds leading lower back authorities) once did a study on weightlifters doing deadlifts to determine how they were able to repeatedly lift such monstrously heavy loads without any long-term back problems. The lifters performed repeated deadlifts while the positions of their spines were recorded in real time with specialized equipment. By chance during one of the lifts, a lifter felt something go wrong and complained of lower back pain. Upon examining the video, it was found that for a brief moment during the lift, one of the lumbar joints went from a neutral to a flexed position for a brief instance. None of the other lifters complained of pain, and examination of all of their videos show no other instances of their spines losing their neutral position. (3)

To summarize the last couple of paragraphs: If you’re going to lift a heavy object, either in the gym, or in the real world, you MUST learn to bend at the hips so as to maintain a neutral spine position! If you learn one lesson from this article, this is probably the MOST important. At Fitness Together, we’ve found that perfecting the form on the Stiff Leg Deadlift is the best way to teach someone to lift properly. Once you mentally master this exercise, you will probably never hurt your lower back again!

The other types of exercises that will help the lower back are muscular endurance exercises, which involve a range of bending and twisting. When you are bent over or twisting, your spine is in a much compromised position. If you try to lift a heavy load with your back rounded, the chances of getting a herniated disk are upwards of 100 times greater than with a flat back. However, in the real world, much of what we do involves bending and twisting. Hence, it is still necessary to strengthen the core musculature through these motions.

Since we don’t want to put high loads on the spine in these compromised positions, we use lighter loads and higher repetitions to improve our muscular endurance. Since we shouldn’t ever be lifting heavy loads in these positions, working on muscular endurance will go a long way towards taking the loads off the spine while you bend and twist in everyday movements. Some of the exercises I prefer for high rep work are swiss ball crunches, unloaded hyperextensions, front and side planks and various theraband twisting exercises. These should be done with a load that you can do at least 20 reps with.

It is commonly believed that following the rehabilitation of a back injury one should start with the light weight, full range of motion exercises and progress to the more conventional lifts. However, it is best to limit the range of motion of the spine until injuries are fully healed. Remember, flexing will almost always be detrimental to a damaged spine. In fact, I’ve had clients who couldn’t do a single crunch without waking up in pain the next morning, and yet could do proper, stiff leg deadlifts without pain.

If you have been treated for a back injury, and your doctor has cleared you to start exercising again, the following is my preferred progression:

1. Start with a general-purpose, full body routine. All exercises should use lightweight to start, and meticulous attention should be paid to making sure the spine stays in a neutral position throughout. The only core exercises that should be performed at this point are static planks (front and side). A front plank is similar to a pushup off your elbows and toes, except that you just hold the position. Side planks are the same, except facing to the side. For cardio, do plenty of fast walking. Studies have shown walking fast (at a pace where the arms swing), is distinctly better for a recovering back than slow walking or running. Stop ANY exercise if pain is experienced. This is no Toughman competition, and pain is a warning sign that should not be ignored!

2. Build up the weight gradually. Realize you will have good days and bad days. Don’t force yourself to go heavier with each workout if you don’t feel up for it. Do not let anyone persuade you into doing balance or stability exercises at this point (exercises that require sitting or standing on an unsteady surface), as this is an easy way to accidentally put the spine into a compromised position where it could be reinjured. (4)

3. Once you have gone a month of so without any pain and your weights are back to normal, you can slowly reintegrate bending and twisting exercises. Start with small range of motion crunches on a padded floor, and work up from there. Again, if a particular exercise causes pain, stop immediately and go back a step.

4. Don’t be discouraged if it takes a long time to return to normal. Depending on the actual cause of the pain, certain parts of your back may take a long time to heal, even under the best conditions.

A couple of details: In the past, conventional wisdom was to stretch the back to help restore range of motion. This may feel good in the short term, but recent studies have show any stretching of an injured back will cause more damage than good Range of motion in the spine is actually not very important to overall back health. (5-8)

Another warning is in regards to bed rest. Although it might be recommended in some extreme cases, most studies have shown bed rest slows the healing process. Get up, move around, take a walk, get back into life. Just be careful of your activities until the pain subsides. (9)

So there you have some of my personal recommendations for your lower back. This is certainly not a complete report. I have left a lot of the small items out for the purpose of brevity.

Remember, I’m not a doctor. This information is based on the latest research in conjunction with my own personal experiences. Individual results may vary, and you should always consult your physician whenever in doubt. Good Luck!

(1-9) - References available upon request