I’ve dealt with lower back pain on and off for some time and I’ve finally found resolution. For about the last 18 years I’ve had to be careful bending forward for fear my lower back would go into spasm - never knew when it would happen and when it did it usually took about 10 days for the spasm/tightness to resolve. Lost my bottom turn and feared cutbacks - not fun. Doctor said I had minor disc degeneration -nothing to be concerned about. So I started doing a lot of core work - it helped but still I had the occasional spasm - Read all I could find on the internet - virtually everything talked about sciatica but I’ve never had that kind of pain - didn’t make sense. In July, while bending over a bicycle to fix the chain, my lower back went into spasm big time - this time it took 2 months to undo. Back to the internet - finding the usual stuff until this:
What is the meaning of lumbar stabilization and why is it important?
It is important to have a stable lumbar spine (low back) in order to prevent low back pain, dysfunction and disease. The lumbar vertebrae need to stay in normal alignment. By this we mean not too much forward flexion, backward extension, side bending or rotation. This is sometimes referred to as a “neutral spine” position.
The position of the pelvis can influence the alignment of the lumbar spine and contribute greatly to itʼs stability. The pelvis and lumbar spine work together in conjuction. When the pelvis is unstable, the lumbar spine is unstable, when the pelvis is stable so is the lumbar spine.
What causes an unstable pelvis and lumbar spine? Trauma, pregnancy and delivery, or simple muscle imbalance. This unstable, misaligned pelvis and lumbar spine can not only cause low back pain, but causes a “non-physiological axis of motion” through the lumbar spine which contributes to structural damage and degeneration. What is a “nonphysiological axis of motion”? Think of this disrupted axis as a bent axil of a car. When the axil is bent it causes the tires (or discs) to wear out much faster than normal. Not only do the discs wear out much faster, but all of the structures in your lumbar spine will wear out faster, causing degenerative diseases like degenerative joint and disc disease, osteo arthritis contributing to stenosis, sciatica, scoliosis, etc.
The muscles that tend to get too tight, short and spasmed that contribute to an unstable pelvis and lumbar spine are the right iliopsoas and left quadratus lumborum muscles. The muscles that tend to become too weak and let the pelvis and lumbar spine become more unstable are the gluteus muscles, the abdominal muscles and the hip abductor muscles.
One needs to stretch the muscles that pull the pelvis and lumbar spine out of alignment (iliopsoas and quadratus lumborum) and strengthen the muscles that hold them in alignment (gluteus, abdominal and hip abductors). There are other muscles that become spasmed as a result of an unstable lumbar spine and pelvis, however they are usually compensating for the above.
Body mechanics that tend to create the above mentioned muscle imbalances are prolonged sitting, repeated forward bending, sit-ups, working the latissimus dorsi muscles (including swimming) and backward bending against resistance. Sitting on a wallet can also contribute to an unstable pelvis and lumbar spine
I read this article then this: Lower on the 2nd page they talk about surfing and lats - my lats are out of proportion to the rest of my body
LOWER BACK WORKOUTS
When working the lower back muscles we want to increase core strength and mobility without causing pain or dysfunction. So many of my patients come to me with low back and neck pain as a result of working out improperly in the gym, or doing yoga or pilates improperly.
Core strengthening is very important as it helps to keep the center of gravity stable and can also help to level the pelvis, the foundation of the spine. However, not all core strengthening is safe, depending on the muscle imbalance already present. Every lower back patient I have seen for the last 30 years has muscle imbalance which causes pelvic instability, pain and spinal dysfunction. This muscle imbalance then causes an unstable pelvis. When not corrected it then causes compensation throughout the rest of the spine and can result in problems like herniated discs, degenerative disc disease, osteoarthritis causing stenosis, scoliosis, sciatica, etc.
The muscle imbalance which is consistently seen to cause back pain is either a tight right iliopsoas muscle (which tends to get tighter when doing pilates), a tight left quadratus lumborum muscle, or both. Sometimes you will also see a tight piriformis muscle which frequently gets overused due to it compensating for an unstable pelvis. The twisted pelvis (and unleveled foundation) then causes abnormal side bending and rotation which causes the spinal joints to become dysfunctional. This joint dysfunction then causes muscle spasm and muscle weaknesses throughout the rest of the spine, potentially up to the neck. Even though we see muscle imbalance all the way up the spine, it is important to understand that the right iliopsoas and left quadratus lumborum muscles caused the original problem by causing the pelvis to go into an uneven, unstable position. The other muscle imbalances we see are usually compensations for the uneven pelvis.
There is one more muscle that I would like to talk about that can make an already unstable pelvis worse. It is the latissimus dorsi muscle (or lats, see above). If the core muscles are not strong and the pelvis is unstable using the lats can cause increased instability as they attach to the top of the pelvis (via the thoraco-lumbar fascia) and can pull the pelvis into a more uneven position. I have seen many patients cause their low back pain as a result of strengthening their lats.
So, what is the best lower back work outs?
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Strengthen the rectus and transverse abdominus, internal and external obliques (without shortening the iliopsoas), the hip abductors and adductors, and the three gluteus muscles.
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Stretch the right iliopsoas and left quadratus lumborum muscles. Sometimes the piriformis muscle also needs to be stretched, but only secondary to the above muscles.
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Stay away from using the latissimus dorsi muscles. If you need to use these muscles for activities of daily living and you have low back pain you will probably need to work with a physical therapist who understands pelvic dysfunctions well.
The latissimus dorsi muscles are used when you swim. SWIMMING IS CONTRAINDICATED IF YOU HAVE LOW BACK PAIN because it uses the lats which then pull the pelvis into a more unstable position. Other sports that use the lats are kayaking, surfing and mountain/rock climbing. The lats are also used when you do pull-ups/chin-ups, triceps dips, rowing and lat pull downs. One needs to avoid these exercises until you have stabilized your pelvis, strengthened your core and learned how to keep your pelvis stable.
One needs to strengthen the muscles that hold your spine in alignment and stretch the muscles that pull your spine out of alignment.
I ignored the part about stopping swimming etc. So I started doing these stretches http://www.youtube.com/watch?v=3NlugMEihG8 and also ( OOPS - having trouble getting some of this stuff up here - go to youtube and look up ililpsoas muscle and lat muscle stretches) In addition I hang from a chinning bar for about 30 seconds. So I’ve been stretching the iliopsoas, lats and quadratus lomborum muscles for a month now each morning and before and after I surf. I am astounded at the difference. My lower back feels like it did decades ago - I feel ‘normal’ none of the apprehension about bending over. I’ve also learned my lower back does not like hamstring stretches. I’m writing this hoping it’s helpful to others. It sure has helped me.
