Most of us have suffered through at least one bout of low back pain in the course of our lifetime. The occurrence is alarmingly quite high, affecting approximately 60-80% of the adult population. In fact, physicians report that low back pain is so prevalent; it is second in medical visits to the common cold. In some societies, the financial drain of low back pain (LBP) exceeds that of coronary artery disease and diabetes combined.
The majority of LBP can be classified as mechanical; including problems affecting the many joints, discs, ligaments and muscles of the spine. Most risk factors related to muscle performance can be prevented by taking a proactive approach. By ensuring an exercise program has an adequate warm-up, muscular balance, core strength, a flexibility component, and is regularly performed, the risk of developing a lower back injury decreases substantially. In addition to this, overall body awareness is equally important as often times injuries occur when we least expect it.
Include a Proper Warm-up
The benefits of injecting a warm-up prior to engaging in vigorous exercise are numerous. This preparatory exercise or movement helps protect against injury by improving the flexibility of the muscles. Generally speaking, cold muscles have low blood flow to the area and are more susceptible to injury or damage than muscles at a higher temperature and blood saturation. In general, the warm-up activity should last approximately 5-15 minutes with the focus on raising the total body temperature, as well as temperature of the muscles, to prepare the body for the activity that is about to follow.
Create Muscle Balance
All major muscle groups in the body work in pairs as agonist and antagonist to coordinate and produce movement. Agonist muscles are primarily responsible for generating the movement, while antagonist muscles act in opposition to the movement generated by the agonist. An example of the agonist/antagonist muscle pair would be the rectus abdominus and erector spinae muscle group. When designing a weight lifting routine it is critical to balance these muscle pairs to avoid over development of one group compared to the other. Asymmetry can lead to muscle compensation and increase the risk of developing lower back injuries.
Build a Strong Core
There is an abundance of research to support the incorporation of a core specific program into a regular training regime in order to prevent lower back injuries. The core musculature can be defined as the 29 pairs of muscles that support the lumbo-pelvic-hip complex in order to stabilize the spine, pelvis and kinetic chain during functional movements (Faries, 2007). These muscles have further been classified as global and local spinal stabilizers. Global stabilizers are responsible for generating movement while the local stabilizers provide intersegmental stability. The local stabilizers include muscles with intervertebral attachments and are of primary concern when designing a core strengthening program. These muscles include; the multifidus, transverses abdominis, and internal obliques.
Exercises specifically designed to challenge and activate the local stabilizers as well as the spinal extensors (erector spinae) are critical in preventing episodes of lower back pain. To incorporate core exercises into a training program remember to optimize the function of the local system before emphasizing movements that utilize the global system. When implementing a core program, be mindful of the functional progression of the exercises to ensure optimal results.
Incorporate a Flexibility Program
Augmenting strength and conditioning programs with a flexibility program is an important step in preventing lower back injuries. Since all muscles are shortened with exercise, it is advantageous to return the muscle to the lengthened state upon completion of the exercise. In addition, chronically contracted muscles can cause an imbalance from front to back or from side to side. Choose stretches for all the major muscle groups and hold them for 20-30 seconds.
Body Awareness
Overall consciously being aware of the lower back and potential for injury during our daily activities will help reduce the occurrence. Taking the time to lift objects with the legs for example and not with the back and keeping the item close to the body is key. If sitting for prolonged periods is required for work, inject micro standing breaks to alleviate the stress on the back. Sleeping position is another area that needs close attention. Since we spend anywhere from 6-8 hours a night lying in bed, it is important that the position favours the lower back. The ideal sleeping position is lying on your back with a pillow under the knees.
Stay Active
Maintaining a regular fitness regime will help in the prevention of lower back injuries. As exercise will strengthen and balance the muscles that assist in maintaining upright posture, performing them regularly is essential. Complimenting this regular program with a flexibility component and core strength will not only enhance conditioning but will decrease the risk of developing injury.
Teresa Gillard for Shave Magazine