Training and Lower Back Health

The second most commonly injured joint in the gym next to
the shoulder is the lower back. The World Health Organisation has stated that
“the lifetime prevalence of non-specific (common) low back pain is estimated at
60% to 70% in industrialized countries” as of 1997 (Taimela, Kujala, Salminen
& Viljanen, 1997); meaning you are more likely than not to experience lower
back issues at some point in your life.

If you read our post on shoulder injury prevention / treatment, you will remember that there are three main factors for preventing injuries to joints: stability, mobility and strength. Whilst the shoulder is an incredibly mobile joint, and stability is most often prioritised; the lower back is arguably more complex.

A fairly common cause of back pain and injury occurs as a result of poor hip mobility. The body compensates by increasing mobility in the lumbar spine. However, this is a joint that wants to be stable. When high compressive or shear force is placed on the lower back (such as at the bottom of a squat or deadlift), the joint is compromised in its ability to retain its ideal positioning, and an injury is more likely to occur. The body will then react by tightening the surrounding muscles to prevent further unwanted movement. A common mistake by the athlete is to then focus on improving mobility in the lumbar spine (where it hurts) as opposed to the hips. Relief from the symptom of pain in the lower back can be gained by relaxing the muscles through myofascial release or deep heat gel, but does nothing to improve the condition long term.

One of the most prominent and influential researchers in the field of lower back pain is Dr Stuart Mcgill, whose credentials include publishing several textbooks and being featured on literally hundreds of published peer-reviewed articles.

Points he commonly repeats for spine health and optimal
performance include eliminating the sit up entirely from one’s training; developing
proximal stiffness for distal explosive power; and athletes recognising the
need to train the spine for either mobility or stability, but not both.

The sit up involves spinal compression and repeated bending
to improve one’s ability to flex the torso. As an Iron Edge customer, hopefully
I do not have to expound in great detail why sit ups are outdated, not only in
terms of safety but also effectiveness. The spine is most at risk of damage
when flexed and loaded with high compression (ie, the sit up) and when it
extends while still under high compression.

For proximal stiffness, an analogy I frequently used with clients would be to imagine a cannonball being shot out of a canoe versus a battleship. Same cannon, but which shot is more powerful? The idea behind developing proximal stiffness is to prevent energy leaks throughout the body, so that the athlete can express as much of their power as possible.  This coincides with keeping the spine healthy, we want the shoulders and hips to be the mobile joints where our movement comes from as opposed to the stabilising framework of the spine. 

All joints need a blend of mobility and stability, depending not only on which joint but also the demands placed upon it. Shoulder mobility is important for most athletes, sure, but when does a rower for example use overhead movement? If we compare the spines of a powerlifter and a gymnast, they have totally different requirements and different adaptations. Imagine the spine as either a tower or a straw; a large weight on top will crush the straw but cause no issue to a (properly loaded) tower. Bend that tower though, and it crumbles; whereas the straw can go back and forth to its heart’s content.

The spine is tricky, and popular treatments are full of
contradicting theories, hence I am loath to provide cookie-cutter approaches to
spinal health. However, I hope this has given you some food for thought for
your programming and training.

For further reading on Dr Stuart McGill’s methodology, check
out the below 2-part interview:

https://www.t-nation.com/training/interview-with-dr-stuart-mcgill-part-1

References

1. Taimela S, Kujala UM, Salminen JJ & Viljanen
   T. The prevalence of low back pain among children and adolescents: a nationwide,
   cohort-based questionnaire survey in Finland. Spine, 1997, 22: 1132–1136.