Let’s begin with establishing some basic principles that help us navigate “Lumbar Hygiene.”
- Generally speaking, we desire STABILITY of the lumbar spine in the joint by joint approach.
- Being able to DISSOCIATE the lumbar spine from the pelvis is extremely important.
- We must be able to tolerate and express full range of motion of the lumbar spine.
Looking at the facts, we know that EIGHT out of TEN people will experience low back pain at some point in their life, that’s right, 80% of people will have low back pain! There HAS to be something we can do help bring this number down. If we look at the three principles established above, we can begin to have a framework for daily low back hygiene.
STABILITY OF THE LUMBAR SPINE
We must first bring back the concept of tone that we learned last week from the hip series. When we lack stability of the lumbar spine, we tend to see UP-REGULATED tone of the surrounding muscles, and consequently “tight” muscles of the low back and hips. We see it all the time in the clinic. An over spoken term is probably telling people they are “weak,” when it is probably more lacking of stability and motor control than a true “weakness.”
Folks who tend to disagree will often say that “stability” of the lumbar spine is an over simplification and that stability isn’t just this easy fix.
Well, here’s my counter argument to that: While it might not “fix” low back pathology, having the ability to fire your abdominal muscles in a 360 degree fashion is at the very least an important option to have in our index, and probably one that most folks lack. So while it might not be a guaranteed “fix,” I would make an argument that the majority of humans would benefit from owning this option of muscular control of these abdominal muscles.
Here are three SIMPLE, yet excellent exercises I prescribe on a daily basis that help promote gross lumbar stability: “The ANTI- Triplet.”
- Plank- Anti extension
- Suit case carry- Anti side bend
- Pallof Press- Anti rotation
This one really hits home for me. . . With 8/10 people experiencing low back pain at some point in their life, a mission of mine is to help bring that number DOWN. Besides for knowing how to move at the hips, understanding how and why we want lumbar stability is another crucial way to reduce our chances of experiencing low back pain AND chronic tightness. ••• Let’s see a show of hands 🙋for folks who consistently say, “Man…my back is always so tight!” You can try and stretch, and stretch, and stretch….but the tightness mysteriously remains… 🤔🤔🤔 . If we think back to last weeks hip post, we opened our minds to the fact that MOBILITY can be compromised by our lack of STABILITY. This could not be more true for the low back. We tend to see sloppiness in the lumbar spine, and consequently chronic “tight muscles.” ••• Now lets talk injury reduction: We understand from the research that REPETITIVE FLEXION under load is potential mechanism for injury to the low back. Now, I am not saying we need to move like robots, however, I would say a great deal of people know how to flex and extend the lumbar spine, but stabilizing it…not so much. We want options people! . However, if we can teach people how to properly stabilize their lumbar spine, we can hopefully give them another option in there index as well as begin to build capacity of the muscles that stabilize the low back which can also decrease "tightness" ••• Here are 3 SIMPLE, yet excellent exercises I prescribe on a daily basis: “The ANTI- Triplet.” I would argue that the majority of humans would benefit from all of these exercises, so long as there are no contraindications. See videos for demonstrations on form. . 1️⃣Plank- Anti extension 2️⃣Suit case carry- Anti side bend 3️⃣Paloff Press- Anti rotation #KineticHygiene @strong_by_science @joegambinodpt @strengthcoachtherapy ________________________________________________________ #simplestrengthphysio #physicaltherapy #PT #DPT #DPTstudent #physio #fitness #workout #health #training #exercise #crossfit #strength #sports #wellness #weightlifting #powerlifting #athlete #recovery #performance #movement #strengthtraining #athletes #mobility #healthandwellness
While stability is obviously desired when it comes to performance and daily life, we must also appreciate the fact that we are not robots. We do not want to advocate for “neutral stable spine” all day long. We must be able to express full range of motion of both our pelvis, as well as our lumbar spine.
***A quick note on lumbar flexion: We understand from the research that REPETITIVE FLEXION under load is potential mechanism for injury to the low back. Now, I am not saying we need to move like robots, however, I would say a great deal of people know how to flex and extend the lumbar spine, but stabilizing it…not so much. We want options people!*** (1,2)
That being said, especially before someone has an episode of low back pain, beginning to learn some of these patterns of dissociation can help establish a fantastic baseline of movement options!
Below, Joe goes over two excellent drills to train anterior pelvic tilt and posterior pelvic tilt as well as lumbar flexion and lumbar extension.
Kinetic Hygiene – Lumbar Spine Disassociation. __________________________________ When it comes to low back health, we know that stability is king. The cores job is to make sure that the spine can maintain its positioning in the presence of external loads. ••• But maintenance of neutral spine isn't the only thing that promotes back health. Without sufficient spinal motion into flexion and extension you won't be able to build stability. ••• The video on the left is pelvic tilts using a pole to prevent my shoulders and upper back from moving. . This will teach you how to bring your hips into full anterior pelvic tilt and posterior pelvic tilt in the hinge position. ••• On the right is pelvic tilting with a thoracic block. By rolling onto our head and rounding the upper back – we can take up motion here allowing for focuses movement from the low back. ••• Once you can do both variations with relative ease, you can start to take away the "training wheels." . By removing the pole from the hinge position, you will need to demonstrate better control and stability to not move other areas. . Once the lumbar spine is moving well in quadruped you can progress to cat/cow and work on multi segmental motion from there. ••• If you have any questions, comments, or concerns let us know 👇. . 👉 @simplestrengthphysio 👉 @strengthcoachtherapy 👉 @strong_by_science
Another dissociation to consider, is being able to “hip hinge” or, be able to flex your hips in a closed chain fashion while keeping a “neutral spine.” Tom Walters does a FANTASTIC job exploring this concept in his post below. Big takeaway, is that learning this movement pattern is an excellent movement option for folks who need to pick things up off the ground, but especially needs to be mastered for athletes and weight lifters.
Teddy does a great job of essentially combining all of these principles into one cohesive post on “maintenance” of the lumbar spine. He covers a series of exercise that establish lumbar stability, lumbar mobility, and pelvic mobility. See post below.
- It is never a bad idea to train stability of the lumbar spine through abdominal strengthening exercises.
- We want to be able to DISASSOCIATE between lumbar and pelvis.
- We want to express full range of motion of the lumbar spine and pelvis.
Questions, comments, concerns? Please post below. Thanks for reading!
McGill Flexion MOI study-
(1) Callaghan, J.P., and McGill, S.M. (2001) Intervertebral disc herniation: Studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin. Biom. 16(1): 28‐37.
(2) Childs, J.D., George, S.Z., Wright, A., Dugan, J.L., Benedict, T., Bush, J., Fortenberry, A., Preston, J., McQueen, R., Teyhen, D.S., (2009) The effects of traditional sit‐up training versus core stabilization exercises on sit‐up performance in US Army Soldiers: A cluster randomized trial, J. Orthop. Sports Phys. Ther., 39(1): A18.