This article addresses Lower Back Pain (LBP) which is typically muscular. The other cause of LBP will either be due to a nerve/nerve root or disk pain. The reader is encouraged to get any ongoing LBP checked out by a health professional first.
Anatomy of Back Pain
A sudden movement may cause a tiny tear in an annulus. Nearby ligaments may stretch.
Contained herniated disk
As a disk wears out, the nucleus may bulge into the annulus and press on nerves.
Extruded herniated disk
When a disk ruptures, its nucleus can squeeze out and irritate a nerve.
As disks wear out over time, bone spurs form. These growths can irritate nerves and inflame facets.
This is a condition in which one vertebra has moved forward or backward, in relation to the one above or below it. This causes a crack (stress fracture) in the areas that link the vertebrae together. This may put pressure on the annulus, stretch the disk, and irritate nerves.
Most of the time, LBP is related to muscular issues. There are lots of muscles in the back, deep and superficial layers, and all get tight due two typical reasons:
1. Most symptoms of LBP come from underneath that area (issues go from bottom up in the kinetic chain). So the first issue is usually due to lack of mobility in the hip. It’s a ball and socket joint so should have a lot of mobility. If we don’t have mobility there then we look for mobility somewhere else. The next station up the kinetic chain is the lumbar spine. This is NOT a good place to seek mobility – the role of the lumbar region to be strong and stable, not to be mobile! That area provides support to the body and is not a primary mover muscle region.
Mobility should come from below the lumbar spine (hip complex) and above (thoracic spine). If the lower back muscles are called upon to compensate for a lack of mobility, they react by seeking to control that mobility (as that area strives to be stable!) and they get tight and can spasm. This causes discomfort. We want to make sure the lower back is strong and stable.
2. The second main reason we experience LBP is due to a lack of muscular strength around that region. Again, looking directly underneath the lumbar spine first, if the muscles around and underneath the hips are weak (glutes, hamstrings) then the lower back is trying to do the work of those areas. This should be avoided.
Example corrective exercise:
Reverse Hyper Extension. 12 quality reps per day or do for 45 seconds. Respecting that strength is built bottom up in the kinetic chain, engage the glutes first then finish the extension of the legs by using the muscles of the lower back. This will ensure the glute muscles are strong enough to take the load they should support enabling the lower back to focus on its supporting role. Most LBP issues will generally go away when
muscular weakness is resolved.
Reverse Hyper Extension (weighted shown). A staple of Gravity calisthenics classes.
To ensure mobility and build strength to allow the lumbar spine to focus on its stabilization role, the following mobility and strengthening exercises are recommended as part of a strength training or rehabilitation centric session. These often form part of an extended warm-up and mobility section of a workout as is common in our calisthenics classes.
Warm & Mobility – Dynamic
Payer Squat with knee drops
Kneeling Lunge, T-rotation then sit back on heel
90/90 External/Internal Rotations – can sit on a block
90/90 External/Internal Rotations with kneeling thrust (and optional lunge)
Frog – rock back and forth with alternating leg rotation
Pidgeon Pose with circles
Kneeling Hands on heels (or lower back support) dynamic arches
Standing (pole) or quadruped hip rotations
90/90 Flying Hip Rotations (Kim)
Back Hyper Extension and/or Reverse Hyper Extension
Lateral Leg Raises
Hollow Body/Dead Bug Extensions
Single Leg Bridge – 5 sec each leg – 10x
Angel/Y to W Angel
Kneeling Lunge (optional quad stretch)
Pidgeon/Thread the needle
Seated Hamstring/Seated Glute/Piriformis then Figure 4 Twist
3-way stretch (hamstring, over mid line, outside and up)
How to fix a bulging disk (no surgery)
Firstly, terminology. Bulging, protruding and or herniated disc are synonymous for the purposes of this article and we use the collective term ‘herniated disc’ going forward. A ruptured disc is different and you should seek assistance from a health practitioner where that condition is suspected.
Second, a disc problem is very common. Almost all of us at some stage would present a herniated disc on an MRI. It’s only where the disc is in contact with a nerve root however that pain would be triggered. So often, we have a herniated disc without knowing it.
In the event you do have a herniated disc that is causing you pain (i.e. In contact with nerve root), the following three steps will resolve the issue 98% of the time. But first, a common misunderstanding, back flexion – typically via stretches such as knees to chest from a supine position on the floor – would not resolve a herniated disc and, in fact, can only serve to worsen the situation as flexion will not help re center the disc – extension is required for that.
Step 1 – decompress spine (not flexion – so no stretching).
Hang from bar or rings but let toes touch the ground (if we hang in the air, some muscle tension in hip flexors /abs will result and not allow the spine to decompress!). We need to create some space in the spine to allow the nerve to be clear of the herniated disc. 3 sets of 10-20 seconds (or as long as is comfortable).
Step 2 – fix any list.
Find yourself leaning away from the side with the pain, then we need to fix that first. Using a wall and assuming pain on back left side, stand parallel to wall and put right shoulder on wall. Move feet approx 9-12 inch away from wall and slowly push your left hip towards the wall with your left hand. Do about 10 reps, 2-3 s per rep driving hip into wall. The aim is to get hips and shoulders to be level again. This will also centralize the disc with the issue ready for step 3.
Step 3 – Extension.
Lie face down on ground, hands under shoulders, feet together. Squeeze the glutes and slowly push into the hands extending the spine. Hips stay on ground (otherwise may over extend). Just push up as high as you can comfortably go. Hold for 15-20 seconds. Go back down. Re-contract glutes and extend the spine again by pushing up through the hands. Keep hips on ground. Might get a little higher each rep. Do 3-5 sets daily. 98% of time, disc will recentralize in the spine and get off the nerve root. You can then get back to your normal training schedule including lifting.