Last September, I received a call from a friend who was having back pain. He had recently returned from summer vacation and, after a week at the beach, he went straight to the gym and proceeded to work out as hard as possible in order to get back to his pre-vacation physique. In his rush to get back into shape, he made a common mistake of frequently doing too much in too short a period of time, leading to back pain. Getting to know your limits will allow you to identify warning signals from your nervous system that are telling you that something might happen if you do not slow down. At first, these warning signals can be felt as tightness or stiffness. If left unresolved, the signals can transform into cramping or sharp pain. It is advisable to consult a health care professional if you experience those signals.
Be mindful when you exercise – understand the purpose of the exercise you’re doing and how it benefits you. Exercise with good form and for a suitable duration, and use appropriate resistance. If you are part of an exercise class, the instructor will guide you to a certain extent. However, it is your duty to be aware of how your body is feeling at different points of the class. Never feel the need to keep up with the instructor if your body is sending you those warning signals. Rest or modify the exercise when needed.
It is also important to maintain flexible hips. Muscles located around your hips are designed to transfer forces from your lower body to your core and vice versa. If these forces are not well distributed, they create stress on several low back structures including ligaments, muscles and discs. These muscles will typically tighten if you have an office job and sit most of the day. The most important muscles to target are the hamstrings, hip flexors, buttocks and quadriceps.
Lastly, improve your control of the deeper core muscles. These muscles (transversus abdominis, multifidus, quadratus lumborum and pelvic floor) wrap around your torso and protect your lower back by stiffening the area in anticipation to movements like lifting, pushing or pulling. Proper core control is believed to play an important role both in the treatment of back pain and as prevention of back pain recurrence. A good way to improve deep core control is to learn abdominal bracing. Think about what you would do if you were to prepare yourself for someone to punch you in the gut. In abdominal bracing, you are simultaneously co-activating all layers of core muscles. This provides you with 360 degrees of spinal stability, making you injury resilient. Use abdominal bracing as an exercise on its own or as a support for your back while doing your exercises.
Put these concepts into practice to help keep your back healthy for years to come.
Hector Lozada is a doctor of physical therapy at the Spine Therapy Center at Hospital for Special Surgery. He has a Mastery Certification in Manual Therapy and is a Certified Stott Rehabilitation Pilates Instructor and Certified Kinesio Taping Practitioner.
