If you’re watching Flipping 50 TV (and if you’re not, why??), you know Sunday’s episode was all about preventing back pain. I’ve worked with thousands of men and women directly since 1984 and thousands more indirectly by training personal trainers. If it isn’t mentioned in the initial meeting, it almost ALWAYS comes up during the fist session.
“I’ve got back pain.”
Sometimes it’s due to scoliosis (oops, so often someone forgets to mention this: yes! it’s important), or vocation, or repetitive movements at work and leisure (golfing is about 200 strokes in one direction every 18 holes…IF you take a practice swing and you’re good and more if you’re not). Many times today it’s due too 1. too much sitting at work and 2. trying to overcompensate with too much exercise in the gym.
For me, it was being thrown off a horse. Maybe for you it was a fall, a car accident, a way too big a baby coming out of those hips (been there done that!). But regardless, 80% of us have back pain at some point. More than 80% of those who do get it back during the year. So reducing back pain frequency, intensity, or both are good goals. When you’re in pain, even of the smallest amount, there is a cascading effect. If it’s your back or your knee for that matter, the rest of your body is compromising. Something else is going to go wrong. So let’s not ignore it and let’s not ignore this ugly little fact:
the things that contribute to back pain don’t have to cause pain as the damage accumulates
Whether or not you and I “agree” that crunches and sit ups contribute to risk of injury, we have scientific evidence that they are. Repetitive forward flexion with resistance causes stress and strain to the discs in your lower back. Depending on the thickness of your spine your journey to injury is sooner or later. If you brag hundreds of sit ups a day, and a six-pack to show for it, you still are contributing to a future that has greater risk of back injury.
I know I know. I’m a buzz kill.
It isn’t about being “right.” It also isn’t about letting you get slack and soft. There are dozens of other things that you can do instead. They can actually help you more than these traditionally taught movements. Even the military, finally, recognized the correlation with back injuries and their old methods of conditioning and testing.
Good Morning, Bad Back?
Your best time to exercise may not be morning. The discs between vertebra essentially “plump” overnight. That added pressure makes you more prone to injury. Add exercise to the mix and you increase your risk dramatically. Activities like core exercise, boot camp, weight training, and yoga can be risky, but so can shoveling or running the vacuum.
Any movement that compresses, twists, or increases torque on the spine makes you more prone to injury any time, but first thing in the morning it’s worse. The increased fluid dissipates about 90% within about an hour after rising. You’re safe to begin exercise then. Just be up and gravity will take care of itself. You can take the dog for a walk, as you don’t have a 100lb dog that pulls.
Feels Good May Not Be Good
Pain is a message that’s easy to understand. What if what you’ve been doing feels good? If you’ve ever been told to stretch before you get out of bed, for example, or your back temporarily feels better while you’re doing crunches, understanding risk can be hard. Even hugging your knees to your chest creates forward undesired spinal flexion when your discs are expanded. What feels good temporarily can in fact be an insurance policy that you’ll feel the need to do it again tomorrow.
Even dropping the soap in the shower could be the perfect storm if you have a thicker spine and weak gluteal muscles. Fluke injuries to exercisers may not be such a fluke.
Suck your belly in, or draw your navel to your spine are common cues in core exercise classes. Newer science shows these actions actually make the core weaker. These techniques are not taught any more in fitness certifications but they linger on even in popular group fitness training settings. Instructors who once learned them may be still teaching them if they’re not keeping up with industry standards. I’ve had heated discussions with group fitness directors who were unwilling to examine the science and change what they were having instructors teach in 80+ classes a week. In my professional opinion, if there is a risk and there is an alternative and equally effective way without risk, that’s clearly the best way.
Seemingly “free” Youtube video workouts could end up costing you. They may be full of information that contributes to injury without you even realizing or feeling it at the time. Better training for core is bracing or stiffening the muscles, instead of hollowing the core by trying to draw in. The plank, for instance, is one example of bracing.
Rise Out Of Back Pain
People often fear weight training due to risk of injury. The weight room where you’re more conscious of form and technique is probably the least of your worries. Two risky movements you do without stopping to think about form are getting up from the floor and lifting.
To properly get up from the floor you want to keep the back straight and use the lower body. Try it.
- Get on all fours.
- Come to a kneeling position with one knee down the other foot forward.
- Keeping your back upright, press through your legs to rise up.
- Use a nearby chair or table if needed.
To lift heavy objects, keep them close to the body. If you must bend over to lift something, stagger your feet if possible instead of standing with them side by side.
Skip Forward Flexion All Day
Crunches and sit-ups are forward flexion exercises. They carry risk for everyone, but those people with a thicker spine with have more pressure during flexion. Doing the same routine as someone with a thinner spine they will be first to be injured. Both individuals are at risk, however. It’s just a matter of whether it will happen sooner or later. Your spine has only so many repetitions of forward flexion before an injury occurs.
On the floor, or over a ball, or using machine weights, the risk is still present.
If you feel uncomfortable doing crunches and sit-ups, leaving them out is no hardship. It’s harder to accept if you don’t feel pain. Whether you feel the pain or not forward flexion against force adds stress to the discs in the lower back. Repetitive movement is eventually going to cause problems. Even if you swear by these exercises, the damage is still accumulating.
Forward flexion is not always bad. You want a flexible spine. Cat and cow back stretches for instance, or rocking the pelvis can be appropriate. Removing the additional resistance removes risk.
Don’t Be So Pushy In The Morning
If movements like crunches and sit-ups are stressful actions, pushing a shovel, vacuum cleaner, or pulling a big dog around the block are stressful inactions for your spine. There is still an increased pressure on the discs by doing these things too close to your rise time in the morning. Save the big boot camp moves like flipping tires or pushing the weighted sled across the floor until later in the day.
Stir the Pot and Carry Your Weight
This article may in fact have stirred the pot if this is making you rethink your core exercises. What’s left to do? Several exercises are worthy substitutes for you if you’re looking for a challenge.
Use a stability, or Swiss, ball and set your forearms on it in a plank position. If you’re new to planks using the ball, allow yourself to adapt to this position first. To “stir the pot” you’ll move the ball in small circles clockwise and counter clockwise. The rest of you should be still.
Carries are simple enough exercises but they’re often not included in workouts. Carry a heavy dumbbell or kettle bell at your side as you walk across the room. Repeat on the other side. Your core muscles have to work to keep you balanced. Alternatively, you can bring the single weight up to chest height by bending your elbow at your side. As you raise the weight from hanging at your side to above your core, you’ll feel the core muscles engage more. You can do this walking or during squats or lunges if these exercises are appropriate for you.
Go Ahead, Repeat Yourself
Repeated crunches and sit-ups make it a matter of time before you’ll have lower back problems, but doing repeats of bracing exercises is recommended. Ignore the taunting online or in class to see who can hold a plank the longest. When you reach a point of fatigue you’re not doing more good. Turning on and off muscles has more benefit than long holds, especially if you’re beginning. This kind of rapid response is what you need your core to do all day.
If you’re starting your exercise program or returning to it and have low endurance in those core muscles, start with repeats of 10 seconds. Rest between. Perform 5-6 repetitions. Your total time will still be a minute and it may be much prettier than if you tried to hold for a minute. You can also repeat short core sessions throughout the day until you can do a single longer session. Morning, noon, and evening for instance, do six repeats of 10 seconds each. Next week do the same increasing to 15 or 20 seconds. Progress by doing 30-second holds twice a day.
Watch the Flipping 50 TV episode 15 on back pain. Then click over here for the show notes, where you can look at the exercises. Watch for the Exercise cards coming soon for Flipping 50 TV viewers to help you at home with images and descriptions of the exercises.
Got a back pain story? Share it! I’d love to hear from you.