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Top 5 Exercises Making Your Back Pain Worse

by Dr RJ Burr(more info)

listed in exercise and fitness, originally published in issue 253 - April 2019

 

What if I told you the exercises you’re doing for health, fitness and to even strengthen your low back are doing more harm than good?

You’ve dedicated yourself to a healthier lifestyle: eating better, moving your body more frequently, got yourself a convertible standing desk, taking the stairs even though that people-container-on-a-cable and elevating stairs are daring you to take the easy way out, yet you still have frustrating back pain.

It may be surprising to know some of the most popular, conventional ‘core’ exercises performed in gyms and home living rooms across the globe are a cock up – you’re burning calories but at the cost of increased injury risk.

Good News: there is a Better Way!

For up-front clarity, no movement is inherently bad. Shoot, if people would simply move their bodies more often, they would have significantly less physical health woes.

Movement is medicine, motion is lotion. However, regarding body mechanics, it’s imperative to familiarize with how we carry ourselves all day, then assess whether what we’re doing the gym is truly helping. If you’re going to expend energy to exercise (you should), would it not make sense to spend your valuable time getting better opposed to tending to disheartening setbacks?

 

Feed-Forward-Stabilization-Mechanism-Exercises-that-cause-back-pain

 

Back Pain and Body Mechanics

To why most popular ‘core’ exercises, like sit-ups and crunches, are more risk than reward, we need to understand core and lumbar spine (low back) mechanics – how they function in a real-world application.

The skeleton is held up by muscles and has been described as floating within our musculature – it cannot hold itself up on its own.

The Core is our anchor for all movement – it’s the center or fixed point to grant the arms and legs the ability to produce movement.

The Core is a transmission of forces, not an engine generating force. It’s meant to reflexively resist movement or ‘anti-move’ rather than generate movement. Though Core mechanics are based on the scientific principles of Physics it, unfortunately, doesn’t align with how conventional wisdom trains the core.

To dive deeper into the Core, it’s mechanics, and how to ideally train it, check out this Core Breathing series.

Top 5 Exercises Making Your Back Pain Worse

 crnches

1. Sit-ups/Crunches

Sit-ups and crunches – the quintessential core exercise, right? Crunches/sit-ups are the typical exercises you think of when ‘abs’ and ‘exercise’ are used in the same sentence. It makes sense as you most certainly feel your abs while doing it!

What if I told you sit-ups and crunches can not only cause or make a back problem worse but doesn’t even train your core the way it’s meant to function?

Blimey, as this is the first time you’ve heard crunches aren’t a good core exercise?

Relieved, because crunches are not your cup of tea anyway? I couldn’t agree more.

Gutted? Don’t fret, because I’ve got some alternatives to train the Core the way it’s meant to function whilst offering the core-burn feel you’re accustomed to.

Unless you’ve committed to being more active on the job or invest in a standing desk, you’re likely sitting all day, every work day.

Let’s look at a typical work day: Wake up; eat breakfast, sit; commute to work, sit; working at work, sit; take lunch, sit; back to work, sit; commute back home, sit; watching the tele to relax, sit; dinner...You get the point!

Prolonged sitting, especially without support, tends to perpetuate a forward, slumped posture which drives our low back into a sustained imbalanced position of forward flexion (extension is backward; the opposite).

Let’s say you’ve been slumped sitting on-and-off for eight hours at work, which is not unusual. Does it make sense to go to the gym to do numerous sit-ups which is repetitively forward flexing? It’s driving the imbalance even further, which can cause mechanical low back pain.

To understand mechanical low back pain, grab your finger then bend it back until you feel a stretch. Bend it back even further, further, further. You let it go (please, tell me you did) because it hurts, right? 

Notice how your finger felt a bit stiff and achy upon the initial release but quickly returned back to normal?

Is your finger damaged or broken? No.

The ‘stretchy’ pain you experienced is mechanical pain and is the same type of pain we feel in our backs from prolonged poor postures and positions.

Not only can crunches perpetuate back pain, but it doesn’t train the core the way it’s meant to function – it’s rubbish. Ponder it: when in daily living is flexing your midsection required? Walking, running, pushing, pulling, lifting, throwing, jumping, bog snorkeling – never!

The abs are meant to do the opposite of crunching: keep your ribs and pelvis (midsection) connected to anti-extend so we don’t crush our spine.

But what about that fit 6-pack of ‘abs’? If you want washboard abs, diet and nutrition is key, not crunching!

What to do Instead

Work your abs in the anti-crunch approach with exercises such as a plank roll-out, proper positioning of planks and pushups, and a triceps exercise turned anti-abs.

 

Roman-Chair-Back-Extensions-Top-5-Exercises-Making-Your-Back-Pain-Worse.

 

2. Roman Chair Back Extensions

Take what we discussed regarding sit-ups and crunches (flexion) then flip it and reverse it: what sense does it make to repeatedly bend backward (extension) to train our “back abs”?

But isn’t this doing the opposite of my sitting posture, which would balance it out?

Great question. In theory, yes; in practice, no. Why? You’re 2-for-2 with great questions!

Remember the ‘bent finger’ example? Would it make sense to jam forward that bent finger in the opposite direction? Going from one extreme to the other is a recipe for disaster.

Your fingers operate the best in a middle range between endpoints of the finger joints – same with your core and all the other joints in your body. Performing Roman Chair Back Extensions  ‘strengthen’ a group of back muscles collectively called your erector spinae muscles or ‘paraspinals’. The paraspinals constitute only one part of your core canister.

The core functions as a whole and not as a sum of its individual parts.

Exercising your paraspinals performing back extensions in a Roman Chair feeds an ‘Abnormal model’ of spinal stabilization (first image below) described as an ‘open-scissors’ position (look for the scissors icon).

Abnormal-Models-Exercises-that-cause-back-pain

 

Optimal-Model-Exercises-that-cause-back-pain

In the ‘Abnormal models’  image, notice how the back muscles are enlarged and the red in the white spaces between the bones of the spine compared to the ‘Optimal model’? Back extension exercises in repetition feed this type of pattern, subjecting excessive strain on the low back structures, leading to problems in other remote areas of the body, e.g., knees, hips, shoulders, neck, etc.

What to do Instead

Don’t crank down on your back muscles, train all your core muscles in unison – the way they’re meant to function – with exercises such as the Dead Bug with heel taps, a Dead Bug with shoulders loading, and variations in the Bear position.

Reverse-Hypers-Exercises-that-cause-back-pain

3. Reverse Hypers

Reverse Hypers is a perfect transition from the Roman Chair as they’re an extension of, well, extensions!

If you’re unfamiliar, a Reverse Hyper is essentially a Roman Chair back extension where the torso is fixed to the machine while the legs ‘pendulum’ up and down. Typically, people are executing the exercise with too much weight on the pipes and using momentum to whip their legs back and forth. The exercise and associated equipment are sourced from a popular powerlifting group as an accessory posterior chain, i.e. muscles of the back of the trunk and legs, strengthening exercise. 

What’s the problem? Compare the two pictures of the lady’s back position at the waistline via red lines.

Here’s a phenomenal idea: how about we hop on the meathead swing set where we willy-nilly flex and extend our spines back and forth a bunch of times per our legs locked into a weight stack – you’ve got to be off your trolley!

What you’re seeing is cyclic open-to-closed scissors repetition. And better yet, with weighted resistance thrown in the mix. Luckily, this gal isn’t off her trolley hasn’t loaded on the plates.

Cyclic forward and back bending of Reverse Hypers is like bending a paperclip back and forth – the paperclip will eventually break (injury).

The founder states in a demonstration video, “full flexion and extension of the spine,” and, “it will cure a bulging disc.” He makes a stonking claim which is anecdotal at best, especially since there’s evidence of cyclic spinal flexion and extension increasing the risk of disc problems.

Yes, there is a way to execute this exercise well: slowly drive upward motion from the hips, don’t overextend the spine in an attempt to get the ankles parallel with the torso, and slowly control the downward descent back to starting position. However, it’s difficult to execute given the pendular nature of the machine, and there are more productive ways to spend your time.

There may be a viable argument for a strength athlete to integrate the Reverse Hyper into their programming, but for the general population, there’s greater risk than reward.

Just because ‘everybody’s doing it’ doesn’t mean you should too.

What to do Instead

If you’ve heard of this machine you’re likely inundated to weightlifting. Instead of causing a back problem, focus on the fundamentals of the basic lifts, e.g. deadlift, barbell squat variations, with emphasis on understanding the mechanics of “neutral spine,” better positioning, and better lifting.

Burpees-Exercises-that-cause-back-pain

4. Burpees

Ugh, Burpees – every gym-goer, cross trainer, and boot camper’s favorite love/hate, get-tired-quick, exercise.

Burpees are nothing new but its recent acclaim can be attributed to the rise cross-training and military-style workouts. The Burpee is a full-body exercise that gets your heart pumping, requires no equipment, and you can do it anywhere.

What could conceivably be wrong with an exercise that feels so right?

Have you caught on the trend? It’s the repetitive spinal bending.

Recall the paper clip example?

Bending the paper clip back and forth over and over is like what we are doing with our spine during the traditional burpee.

Your hips can only extend (backward) and flex (forward) so far until the range of motion is exhausted. To get your knees into your chest in full burpee style, you have to flex your spine to get your legs to where your hips cannot do alone. In other words, your hips can only move so far. To get your knees-to-chest your spine has to contribute – hips cannot do it alone.

Imagine the whole Burpee dance over and over again while you’re fatigued, thus peeling yourself up off the ground after every repetition — this is when back injuries occur.

The Burpee is not complete rubbish – it has its place. But if your coach or trainer programs Burpees into your program, get a new trainer. Burpees are mindless. If you’re paying a ‘professional’ for quality coaching, brains are a must and they need to know how not to use them.

What to do Instead

There are many ways to modify a Burpee. The best way is to get the feet wide into a ‘sumo’ stance, then assuming a ‘bear’ position at the bottom opposed to pulling the knees to chest. The Sumo-Bear modification significantly reduces the amount of spinal flexion needed to perform the burpee.

Check out the burpee modifications in this video.

Oblique-Side-Bends-Exercises-that-cause-back-pain

5. ‘Obliques’ Side Bends

So, Sidebends. Let’s be blunt, we’re (figuratively) beating a dead horse here.

‘Working the obliques’ is the side-bending cousin of crunches and back extensions. Whether you do it as a twisting crunch, standing side bend with weight in the other hand, or side-lying ‘v-up’, they all consist of repetitive spinal bending and don’t train the core the way it functions in real-life.

What to do Instead

The Suitcase Carry functionally trains your obliques by challenging anti-bending while walking. Modify your plank to induce greater challenge to the obliques. To train the obliques functionally while reaping the benefits for rotational sports such as golf and throwing sports, the Chop/Lift is your ace.

Conclusion

Though seemingly sensible, the most popular core exercises may be strengthening core muscles but at the cost you were not intending – causing back pain opposed to curbing it.

Back pain doesn’t have to be complicated.

If strengthening was the holy grail of fixing back pain, then high-level athletes built like brick houses would never have it, yet they do. Our daily postural habits and behaviors are a stronger predictor of back pain than abs and back muscles strength.

Let’s be clear, training the exercises criticized in this article are not a death sentence – not guaranteed to cause injury. You may very well be able to do all the exercises every day for the rest of your life without ever having an issue. However, the risk is greater than the potential reward. I’d bet it would eventually catch up to you, but I digress.

The take-home point is there are better ways to train your core; specifically, in the way it’s intended to function.

Let’s be intelligent and deliberate of how we train our bodies.

What are your goals? Do your goals align with your training regime? Why train like a professional athlete when your goal is to be lifestyle fit and healthy?

Don’t fall victim to risk outweighing the reward because of social influence.

Let’s stick to the basics: pressing, pulling, carrying, climbing, squatting, lifting from the ground.

Please, no BOSU balls and circus tricks.

The deadlift is one of the greatest core exercises out there, yet the mainstream does not perceive it as a core exercise because it doesn’t look like a crunches, et al. Furthermore, a deadlift has carryover to other aspects of life outside of the gym. Whether you’re lifting a barbell or a laundry basket, you’re using the same muscles in unison!

Sit less, move more often, and avoid the foolish fluff. I promise you’ll be just fine.

Actually, you’ll be more than fine, you’ll be living without physical compromise.

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About Dr RJ Burr

Dr RJ Burr DC Cert MDT CSCS as the founder of  Reach Rehab + Chiropractic Performance Center and founding partner of Start Standing, RJ works according to his belief that for you to have a healthy, pain-free lifestyle, you must be responsible for your health by eating well, moving well, and moving often. RJ received his Doctor of Chiropractic Degree from the National University of Health Sciences (NUHS) and has accrued more than 700 hours of post-graduate work with an emphasis on manual therapy, rehabilitation, biomechanics, nutrition and movement restoration. He’s earned certifications in Active Release Techniques (ART) and Titleist Performance Institute (TPI) medical track, and can sit for the American Chiropractic Rehab Board Diplomate (DACRB) and Certification in Mechanical Diagnosis & Therapy (McKenzie). He also continually treats recreational and professional athletes at races, tournaments, and other competitions. Dr Burr may be contacted via Reach Rehab and Chiropractic on Tel: +1 (734) 335-0212;  https://reachchiro.com/

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