Prevent Low Back Pain & Build a Stronger Foundation With These Three Simple Exercises
By Justin Cronk, D.C.
Chances are, you’ve had some form of low back pain at some point in your life. I know I certainly have. You may even have low back pain right at this very moment. Maybe you’ve been having back pain for several months now, or even years. Well, guess what? You’re not alone, and I may have some of the answers you are looking for.
A study conducted by the UNC School of Medicine found that, “80 percent of Americans will experience an episode of low back pain at some time in their lives and that total costs of the condition are estimated at greater than $100 billion annually, with two-thirds of that due to decreased wages and productivity.”
That figure is astounding when you consider the many treatment options that currently exist – medication, surgery, massage, chiropractic, physical therapy, etc. Moreover, even if you get treatment and the treatment does help, quite often the relief is short lived and many (if not most) people will experience a reoccurrence of pain some time afterward.
The reason for this reoccurrence (in my humble opinion) is that quite often, people with chronic low back pain often have weakness and instability in their lumbar spine and therefore are susceptible to reinjury. I’ll even see this in elite athletes at times. They may seem powerful and athletic, but quite often they lack essential spinal stability and motor control. Or their programming doesn’t provide them with opportunities to create greater stability of the spine.
The lack of spinal stability and core strength is something I see a LOT in patients who present with low back pain. Many of these patients will come to the clinic with an MRI in hand, and when I look at cross-sections of their lumbar spine, I often see significant muscle atrophy and fatty infiltration which definitely points to chronic disuse atrophy of the musculature that should be supporting the spine, making these people vulnerable to disc herniations, bulges, nerve compression syndromes, and degenerative disc/joint disease.
At the beginning of my career, I’d like to think that I did an okay job treating patients with low back pain. However, over the years I have become much more successful at decreasing the frequency of exacerbations by adding rehabilitative exercises to their treatment plans. At first, the exercises are geared towards strengthening the deep spinal stabilizer muscles such as multifidus and transverse abdominis as well as exercises targeting the more superficial stabilizer muscles such as the spinal erectae muscles, quadratus lumborum, external obliques, etc.
In addition to the stabilization exercises as mentioned above, I utilize a whole arsenal of other exercises and activities in order to rehab patients who experience low back pain – everything from retraining gait biomechanics to goblet squats, to isometric holds, to deadlifts. However, no matter what your fitness level or athletic background, nearly every person must first learn the basics as they were taught to me by Stuart McGill, Ph.D. Basics he refers to as the Big Three.
Stuart McGill, Ph.D. is a professor of spine biomechanics at the University of Waterloo in Ontario. He’s been studying spinal biomechanics for nearly as long as I have been on this earth and he is subsequently the go-to guy when it comes to anything related to spinal movement and stability. ESPECIALLY regarding the low back since it’s dynamics make it one of the most complex regions of the body to treat. I utilize his Big Three protocol as a base in the clinic all the time.
What I like about these exercises, is the fact that they are extremely simple, and even after 30 years of studying spinal biomechanics, Stuart McGill still says these exercise must form the foundation of any good rehabilitation program. I only mention that fact for the sole purpose of ingraining in you an understanding of how vital and useful these exercises can be to increase stability and function of the lumbar spine. Which as a result, should decrease (and possibly eliminate) low back pain, and prevent any further injury from occurring.
So, without further adieu, here they are.
The Big Three
I want to preface this by saying that McGill suggests doing three sets of 5-3-1(first set has five reps, second has 3, you’ve got it from here), holding each rep for 8-10 seconds.
1. Bird dog: The lumbar and thoracic back extensors are challenged in this exercise. This exercise will enhance the stability and strength of the low back. See a video of it being performed below.
2. Curl Up: Not to be confused with the spine compromising sit-up or the crunch; the curl up is a simple movement that gives you a lot of bang for your buck. Its purpose is to strengthen the anterior abdominal muscles. See a video of it being performed here.
3. Side Plank: This exercise is intended to strengthen the lateral abdominal muscles such as the quadratus lumborum (QL) and the obliques. See a video of it being performed here.
It is essential to stay within the pain-free range when performing all of these exercises. If you have pain, modify your position or decrease the reps/time.
If you have any questions, please email me at firstname.lastname@example.org.
Justin Cronk, DC
Owner/co-found of TheChiroFix Sports Therapy Center
Carey, Timothy. “Chronic Low Back Pain on the Rise: UNC Study Finds ‘Alarming Increase’ in Prevalence.” Edited by Janet Freburger, Statistics – Center of Excellence for Eating Disorders, 24 Feb. 2011, www.med.unc.edu/www/newsarchive/2009/february/chronic-low-back-pain-on-the-rise-unc-study-finds-alarming-increase-in-prevalence.