The past few years haven’t been kind to my lower back. Amidst the burdens of pregnancy, parenting, and working from home, I frequently experience stiffness and pain in my lower spine. I am not alone: It is estimated that up to 80% of Americans will experience lower back pain throughout their lives, with 15 to 20 percent of adults reporting it in an average year.
Can exercise prevent some of this pain? The short answer is maybe. A consistent combination of cardio and specialized exercise can help. However, exercise alone does not guarantee pain relief, as there are a number of mistakes many of us, even experienced athletes, can make.
The spine is prone to pain when the core muscles are weak.
“The lower back is the central point of our entire body,” says Dr. Krishna Shah, a pain intervention specialist at Baylor College of Medicine. The spine must be mobile, able to bend and twist in many directions, and at the same time bear the weight of our body.
Surrounding the spine are core muscles. While we tend to place our center of gravity on our abs, it also includes the deep back, as well as the hip, quadriceps, and hamstrings, which support our spine and pelvis.
The core muscles act similarly to a back brace, keeping the midsection stable and upright. That’s why wearing a brace provides short-term pain relief for patients with lower back pain, but relying on a brace too much can weaken their core muscles. Instead, the goal should be to strengthen those muscles enough to do the brace’s job.
“If you could develop your own internal brace, that would be more effective,” says Dr. Sean Barber, a neurosurgeon and spine specialist at Houston Methodist Hospital.
Acute back pain is often the result of pulling or straining a muscle while trying to perform a movement that requires the muscle to become weak or stiff. If this muscle cannot provide the required force, then pressure is transferred to the spine in a way that leads to pain.
Developing core strength, flexibility, and muscle control can help you avoid these pulled or stretched muscles.
Exercise strengthens the spine.
The simplest way to strengthen your spine is to exercise regularly throughout the day, whatever capacity works for you. This means increasing your daily step count, taking a short walk during the work day, or prioritizing a slightly longer walk in the morning or evening.
People who are physically active tend to have lower rates of back pain, and recently meta-analysis of 25 studies found that the most effective way to prevent low back pain from recurring is to exercise regularlypreferably combined with some form of physical education.
“Exercise doesn’t cure everyone, but on average, it’s a measure,” said Mark Hancock, professor of physical therapy at Macquarie University and one of the study’s authors. effective intervention. There is no one type of exercise that has been proven to work, he says. “If you’re doing a lot of different exercises, then you’re likely getting all of the things you need,” he says, adding, “It’s kind of like your diet.”
Physical activity also strengthens the bones and cartilage of the spine, protects against age-related degeneration and increases blood flow to the cartilage discs in the spine that don’t receive as much blood, says Dr. Shah.
Exercise the deep inner muscles that are neglected.
Working your core is important to avoid future back pain, but that doesn’t mean you have to trim your abs to look like Chris Hemsworth. Popular core-strengthening exercises, such as crunches or sit-ups, primarily work the larger outer muscles, while ignoring the deeper muscles.
For example, the transverse abdominis is a deep, thin sheet-like muscle that wraps the midsection like a corset. There is also the multifidus, a muscle that contours the spine, with several extensions that wrap each individual vertebra, similar to how a bicycle chain wraps a sprocket.
“It doesn’t take a lot of work to activate these deep muscles, but they’re neglected because you can’t see them,” says Femi Betiku, a physical therapist at the New Jersey Physical Therapy Center. specializes in the treatment of low back pain. He adds, people with six pack bodies can still experience back pain if they just work out stronger outer muscles.
The muscles work deeper in movements that require more control than raw strength. One way to activate your deep core muscles is by practicing plankwhether it’s a regular plankOne side plank or some other variation.
If a regular plank isn’t comfortable, start with your knees on the ground, then work your way up to balancing on your toes.
There are also athletic activities that require a slight contraction of the core, such as kayaking, cycling, dancing, barre classes, boxing, rock climbing, and swimming. Any activity that requires a certain degree of control over the midsection helps activate and engage those deeper muscles.
Work to control the spine.
In addition to strengthening exercises, new research shows it’s important to develop muscle coordination and spinal control. The same is true for athletes, who focus on performance and sometimes neglect exercises aimed at controlling the spine and pelvis.
In one Research 2018, the researchers compared elite athletes with a population of moderately active people. Half of each group had lower back pain.
To the researchers’ surprise, both elite athletes and regular low back pain sufferers present similar stiffness and lack of spinal control, which is indicative of a similar pattern of impairment. in their back muscles.
“The key factor is how well you can control your muscles,” said Mariá Moreno Catalá, a researcher at Humboldt University Berlin and lead author of the study.
To combat this, Dr. Betiku recommends Pilates because, in addition to strengthening the deeper core muscles, the exercises also promote muscle control. For some exercises, the spine either remains stable or moves very slowly, which develops the ability to control the muscle along the spine as it is in different positions.
Incorporating Pilates into your exercise routine can be as simple as making short workout videos, many of which require little or no equipment, two to three times a week.
Incorporate an element of instability into your workout
The slow, controlled movements in exercises like Pilates teach your muscles to move your spine efficiently. The next step is to begin exercising in a more variable environment where more coordination and control are developed.
In another studyDr. Moreno Catalá and her colleagues found that adding stability to exercises – like balancing on uneven surfaces or even working out in noisy environments – was effective in lower back pain relief.
Moreno Catalá says it’s not about the amount of muscle strength and more about the fine control over the activation and deactivation of all the muscles that stabilize the spine.
“We think muscle size is the most important quality, but activation quality is also important,” she says.
Choosing sports with a reactive element, whether it’s hiking on rocky surfaces or reacting to a sudden tennis volley, can lead to similar levels of muscle development and control. . Bodyweight exercises, such as push-ups, pull-ups, sit-ups, and squats, are also helpful, as they require whole-body coordination, rather than the individual movements of lifting weights.
Like many people, I make the mistake of working the outer muscles while ignoring the deeper muscles. But over the past few weeks, I’ve started doing a number of short Pilates videos, 10 to 20 minutes each, focusing on slow, controlled movements. Two weeks later, the stiffness in my back began to subside, disappearing for hours. Turns out, all my lower back really needed was to develop a little more coordination and control.
Rachel Fairbank is a freelance science writer living in Texas.
https://www.nytimes.com/2022/02/25/well/move/back-pain-exercises.html The best exercises to prevent lower back pain