Hi Friend!
I hope your day is starting great. I was a bit hoarse yesterday, so I came home early and shut it down to recover faster. When I woke, I decided to work on CEU's (continuing education units). I purchased a couple of interesting courses, one on the core (Complete Core) and one on conditioning (Complete Sports Conditioning). I'm pumped to learn and get credit for them.
The inspiration for this email is from this recent learning, but most of the
content presented is from my experience and education as an Certified
Athletic Trainer, Licensed Athletic Trainer and Strength & Conditioning Coach.
Two Types of Back Pain The title is misleading. There are a number of different back pains, but the author, Mike Boyle, one of my early mentors and a fellow Springfield College grad, put most of them into two main categories.
1. Extension Based 2. Flexion Based
Extension related pain is common to people with anterior pelvic tilts, big bellies and stomach sleepers. Pregnant moms, people whose stomachs are larger than their waists, people with rib flare, butts out and chins protruding upward. Gymnasts, divers and weight lifters are common athletes with this posture and pain.
Flexion related pain is common to people with posterior pelvic tilts, rounded postures, fetal position sleepers and sitting. This is more of an age related pain.
Two Problems:
1. The problem with extension related pain is when Lumbar extension is substituted for hip extension because of weak glutes. Either because of biomechanic positioning or simply a weak glute, if you can't extend your hip when walking, sprinting, jumping, standing from a hinge (dead lift or swing) or standing from a squat or hold pelvic neutral when overhead pressing, you compensate by extending your lumbar spine to decrease the range of motion needed to finish the task.
2. The problem with flexion related pain is when Lumbar flexion is substituted for hip flexion because of a weak or inhibited psoas. This means you round or crunch your trunk forward when pulling up your knees vs standing tall while pulling up your knees. Your psoas muscle does hip flexion from 90 degrees and up. When we do marching in class or high knee runs or high knee skips, its easy to get your knee above your hip (90 degrees) with momentum, but if we do it slowly and controlled, if your psoas is weak, you'll round your trunk forward to compensate. This exposes your low back and contributes to disk related pain.
Two Solutions 1. Extension related pain.
- Foam Roll Hip Flexors, Quads, Lats & Low Back x5-10 rolls per spot
- Diaphramatic Breathing 1-3 breaths (inhale-nose, 5ct exhale-pursed lips).
- Front Foot Elevated Hip Flexor Stretch 1-3 x 30s / side (continue breaths)
- Front Foot Elevated Cross body Hip Flexor Stretch 1-3 x 30s / side (continue breaths)
- Front Plank 1-3 x 10-30s
- Glute Bridges 1-3 x 8-12 reps
- 1-Leg Bridges 1-3 x 3 breaths (3:6:1)
- Mini Band Hip External Rotation from 45 Degree Squat 1-3 x 8 reps / side
2. Flexion related pain.
- Lax Ball - abs, chest x5-10 rolls / spot
- Foam Roll - hip flexors & quads x5-10 rolls / spot
- Diaphramatic Breathing 1-3 breaths (long slow inhales - nose, exhales through nose).
- Front Foot Elevated Hip Flexor Stretch 1-3 x 30s / side
- Front Foot Elevated Cross Body Hip Flexor Stretch 1-3 x/ 30s / side
- TRX Deep Squat with Palms Up and Internal + External Hip Rotation 1-3 x 30s
- Hands Behind Head Psoas Marches from Front Foot Elevated Above 90 degrees - Psoas Marches 1-3 x 8 reps / side
- Quadruped T-Spine Rotation 1-3 x 8 reps / side
- Quadruped Opposites 1-3 x 8 reps / side
- Floor Slides 1-3 x 8 reps
The more I think about it, there's so much you / I could do to address this. Lifestyle changes would be more long term and these exercises would be both a short term relief and corrective strategy to get you started. This isn't an exhaustive list, but a good, start with the first strategy. See how you feel. Go to the next one. Once you feel like your pain is diminished to zero or reduced enough to train, get going.
Excited to learn more,
Coach Mike
p.s. if I can help you, reply and let me know.
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