Since moving away from top level sport and taking a role working with people with more fundamental health issues (mainly heart disease), I have been lucky enough to see a large number of people and examine their bodies in readiness for an exercise programme. Most of them come with aches and pains. Number one complaint would be lower back pain, followed closely by the knees, shoulder and neck pain.
I frequently hear them say things like “it’s just an age thing,” “normal wear and tear” and “there’s nothing anyone can do.” We could go into the reasons why people adopt these attitudes, which sometimes have their foundations in the fact that a lot of people lack the will to search for or to do the thing that actually would solve or at least help the problem. When I examine these people with the usual problems they present, never in any case do I see a body that is in perfect balance. The back pain is always matched by a pattern which though sometimes subtle and takes some intricate thought, is always there.
Let’s focus on back pain.
As I’ve already said, it’s the most common injury I see and will probably have the most likelihood of being useful to someone who is reading this. Then let’s focus on the most common factor I see in people when they present with these lower back problems, an incorrect or imbalanced pelvic position. The pelvis can tilt forward and back, and one side can move independently to the other. In fact, it needs to be able to do this to allow a human being to move efficiently. What can happen over time though is that the pelvis is exposed to uneven forces, and it starts to adopt a position more one way, than the other.
In athletes, we tend to see what’s called an anterior pelvic tilt. This is a pulling down of the front of the pelvis and associated rising up of the back. This creates excessive arching of the lower back, increasing sheering forces and causing wear and tear to the discs and sometimes vertebrae. Tight hip flexors are the primary reason for this.
In general population, the opposite seems to be true. A posterior tilt is seen with rising up at the front and dropping down at the back of the pelvis. This creates a less than optimal straightening of the lower back. Vertical force that is imparted onto the spine is not dissipated and the lower back starts to feel stiff and achy. The hamstrings have become too tight in this instance.
What can I do?
So if you’re in category two, a non athlete with lower back pain and you present with the above set of circumstances what should you do? Well the body in simple terms has become weak in some areas and overly strong and tight in others. You simply need to undo these things. Imbalance has created the problem, so you need an imbalanced programme to correct the issue.
If you’ve had lower back pain for a while and nothing else has worked, try this workout for 4 weeks. The broad aim of it is to strengthen the quads and lower back, lengthen hamstrings and increase overall pelvic control.
A. DB Goblet Squat – 12 to 15 reps for 4 sets (30 seconds rest. Sit right back onto the bench on each rep).
B1. Single leg dumbbell squats – 8 to 10 reps for 3 sets (30 seconds rest).
B2. Bodyweight single leg Romanian deadlift – 10 to 12 for 3 sets (30 seconds rest).
C1. Reverse hyper machine or prone hyper extensions on floor – 15 to 20 for 3 sets (30 seconds rest).
C2. Standing knee drives with cable machine or rubber bands – 15 to 20 for 3 sets (30 seconds rest).
To read more about how you can reduce lower back pain and improve your posture check this earlier article