Updated: May 10, 2021
When addressing low back pain, the idea of strengthening the back is true. But commonly misunderstood, is that strength for movement of the low back does little to reduce back pain. What is more effective, is stiffness of the low back.
We know that the low back, or lumbar spine, functions best as a stable joint group. The area above, the thoracic spine, and the area below, the hips, are meant for mobility. As we know that stability joints and mobility joints alternate, we know that the most efficient function of the lumbar spine is to provide stability, and that stability comes from stiffness provided by the supporting musculature. The muscles that support the lumbar spine work best to limit excessive motion, rather than creating motion.
To create muscle stiffness for stability, the best way to train the lumbar spine is with isometrics to build muscle endurance and coordination. Isometrics are when muscles activate, but no joint movement happens.
Focusing on one specific muscle is not effective or efficient, so learning to stabilize all the supporting musculature is the best way to create spinal stiffness, which is resistant to excessive motion and injury.
With extensive research and publications, the following three exercises have been found to be highly effective at improving spinal stability, while also not resulting in excessive strain to irritated areas.
As with any condition, each individual case and response is unique. These exercises may not be what each person needs, but they are a good way to introduce spinal stability safely in many cases. Any introduction of new skills is best completed under the supervision of a qualified provider.
Exercise # 1 - Modified Curl Up
Lie on your back with one knee bent and the other leg down flat. If you have a painful side, make that the straight leg. Place your hands under the small of your back to help maintain and support the slight arch off the ground
Pick your head up slightly off the ground, like you were taking the weight off a pillow. You don't need to lift your head high, and your back should not move. If you lift your head too high, you will create low back movement that may be irritating.
Aim for a 10 second hold, but start where you need to. If you can only do 3 seconds, do 3 seconds. Do whatever you can as long as your low back doesn't move and you are able to complete them pain free. Start with a set of 6 repetitions, then rest a full minute. Do 4 repetitions the next round, rest a minute, then 2 repetitions the final round. Work up to a 10 second hold in which you can do 10 repetitions, rest a minute, 8 repetitions, rest a minute, 6 repetitions. Use the descending number of sets to combat fatigue which could exacerbate pain.
Exercise # 2 - Side Plank
Start laying on your side with your legs stacked and knees bent. Prop your upper body onto your bottom elbow, and place your top hand onto the bottom shoulder.
Raise your hips off the ground so you are supported by your knees and your elbow.
Again, aim for a 10 second hold, but start where you can. Do one set of 6 repetitions, then switch to the opposite side. After, return to the original side for 4 repetitions, then 4 repetitions on the other side, then 2 repetitions on each side.
Exercise # 3 - Bird Dog
Start on hands and knees. You can be on your fists if needed. Maintain a neutral low back, which is a slight arch and not completely flat.
Straighten one leg back while reaching the opposite arm forward. Your back should not move during this movement. Think about reaching your leg and arm long, rather than reaching up. You can do the exercise with only the leg reaching back if needed.
Hold this position up to 10 seconds. If the time needs to be shorter, than 10 seconds is a goal to work toward. Complete 6 repetitions with one arm and the opposite leg, then switch pairs and continue with 6 more repetition. Follow with sets of 4 repetitions on each pair, then sets of 2 repetitions on each pair.
With all these exercises, multiple variations can be progressed to increase the difficulty. However, starting with the basics is necessary to move forward. #snowbeastperformance