I’m sure all of us at one time have made the comments, “I threw my back out” or “it’s literally a pain in the #@&*!” Injury to the lower back resulting in pain and a decrease in mobility and function may strike the sedentary and active alike. The resultant nuisance may often leave you wondering how it happened and make you realize how you took the health of your back for granted. We’ll explore some of the basic causes of lower back pain, the common symptoms, and most importantly, what can be done to avoid chronic problems and prevent initial injury to the back.
Before analyzing the causes, let’s take a look at the importance of the back with regard to the rest of the body and why its function is so important in our daily as well as athletic activities. The lower back muscles, along with the hips and abdominals, function as the central hub ? or core ? where all forces converge and are controlled. It is a crucial area because it supports the structural integrity of the body and plays a key role in maintaining overall posture and balance. So when we care for the injured back, it’s important not to neglect these other muscles and simply just focus on the muscles that are hurting.
There are numerous types of back disorders one can incur in a lifetime, however, I’d like to focus on the more common lower back dysfunction you or I are likely to experience. Approximately 85 to 90 percent of all lower back pain arises from muscle tightness or imbalance between one or more of the core muscle groups. This is usually precipitated by a specific injury such as a strain caused by poor posture, poor flexibility, weak abdominal muscles or improper lifting techniques. It is of utmost importance to care for the injured back in a timely fashion before your symptoms exacerbate and possibly cause multiple injuries.
Following initial trauma to the back, you may experience significant pain, muscle spasm, difficulty breathing or simply finding a comfortable position in which to sit, stand or lie. Proper treatment in this acute stage includes ice to the back, preferably with a moist towel over the skin, since this is a pretty sensitive area to ice. Frozen vegetables such as peas or corn also work well if you’re short on ice. Anti-inflammatory medication such as Advil or Aleve can reduce pain and swelling. Avoid twisting and bending activities, which may have lead to the initial injury. Taking pressure off the lower back when sleeping may be accomplished by putting pillows under your legs if you sleep on your back, between your knees if you lie on your side or under your hips if you are a stomach sleeper.
Static stretching of the lower back is recommended to help reduce spasm and lengthen those muscles that have instinctively become tight. A good place to start is by simply lying on your back and grasping your knee and pulling it toward your chest until a gentle pain-free stretch is felt in your lower back. The hamstrings, believe it or not, attach in your lower back region, so if they are tight, it may have a negative impact on your back. An often overlooked muscle in the lower back is called the quadratus lumborum which may be tight on one or both sides of your spine. Tightness of this muscle may also cause one leg to be shorter than the other. This muscle can be easily stretched by laying on your back, crossing one leg over the other with knees bent and pulling downward with the knee that is on top. Whatever crossed knee is on top, you will pull downward to that side until a gentle stretch is felt in the opposite side lower back ? see picture. Like the hamstrings this stretch should be performed two to three times per day, twice on each side for a 30 second hold. In addition, remember not to neglect stretching out the muscles of the hips and abdominals as they originate and branch out from the lower spine and pelvis.
Another major contributor to lower back pain is weakness of the abdominal muscles in relation to the lower back muscles. One of the many misconceptions made over the years is that doing ab crunches will take pressure off the lower back. Crunches primarily work the rectus abdominal muscles that you can visually see but fails to get at the transverse abdominus muscle group, which lies underneath. The transverse abdominus attaches directly to the spine and is usually the first muscle to act in almost any movement. Rather than flexing or extending the spine, its function is to stabilize and rotate the spine. When this muscle gets weak or “shut off,” others have to take over to compensate and the end result is overworked muscles and back pain. To strengthen the transverse abdominus, one can start by lying on their back in a sit up position. Instead of performing a crunch, concentrate on drawing in your belly button toward the floor and flattening your back. This can also be performed by sitting on a Swiss ball and sucking in your belly button in and holding for five seconds.
A couple of good analogies to get the hang of this exercise ? pretend you’re in the world’s tightest pants, or tightly squeezing past the turnstile sideways as you enter Goergen when you don’t have your UR ID card.
The bottom line in all of this is that the lower back does not simply function to bend and extend the trunk. It also stabilizes and rotates the trunkl. It is near the center of gravity, so when developing certain forces to produce movement throughout your body and extremities, your back and surrounding muscles are always working in some fashion. Therefore it should not be neglected when training other body regions and especially paid attention to when it is sending pain signals.
Next week we’ll continue to focus on the importance of the “core” and look at some fun and simple exercises to train and strengthen this region of the body.
Steckley is a certified UR athletic trainer.
