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Relieve lower back pain by rehabilitating stabilisers | Tip Top Wellbeing

One of the biggest challenges for most people when they are returning to exercise from either a long term injury or just a sedentary life style, is lower back pain. We have to remember that if you spend all day sitting at a desk it is likely that you are sitting on your Sacrum (the slouch) with a posteriorly tilted pelvis instead of sitting on your Ischial Tuberosities the infamous sit bones. This will have the consequence of shortening your Hamstrings and weakening your Transverse Abdominis (TVA) which is a deep stabiliser muscles of the anterior and lateral (front and side) abdominal wall. Now this is quite an important muscle as the Transverse Abdominis helps to provide thoracic (mid back) and pelvic stability. Sitting can also weaken the Glutes (the bottom) specifically the Medius (side of the bottom) and last but not least the diaphragm.

So if your TVA has forgotten what it is there for (stability), the muscular tension from exercise will make its way to your already short hamstrings and tight lower back (ouch), resulting in tighter hamstrings, however much you try and stretch them and more weakness and pain in the lower back, until you finally give up disheartened.

Note:

Do not ever load a weak TVA with weights. If you don’t sort the TVA out then exercising will just show up your weaknesses and you will become injured.

Activate

So we need to get all these things activating and we do this by completing a series of  activation exercises or multi plane movements that warm up your core and stabilisers.  If you are having lower back pain and have not seen a doctor, don’t fall into the trap of stretching hamstrings within an inch of their life as there are some lower back conditions that can be aggravated by this type of stretch.   See your doctor or physio.

Find a good trainer and do the exercises you are told to do, there is no point paying for someone to train you if you don’t do them.  You’ll never be 100% fit if your TVA is not working correctly.

Exercises to avoid, until this has been corrected.

Plyometrics, weighted abdominal moves, unstable surface exercises, deadlift, clean and snatch.

You do not want to add tension, when muscles are not firing correctly.

Exercises you absolutely have to do.

Clam 

One of my favourites, as any of my clients will tell you. Important notes for the Clam.

Lie on your side with your head supported.
Pelvis in Neutral back is neither flexed nor extended.
Knees bent bottom and heels in line
Under your waist is a small chocolate you are saving, so hold your waist off it.
Engage your core.
Keeping your feet together, lift the top leg away from the bottom.

15-20 reps, change leg.

Plank

The basic plank trains your spine and the muscles around it to hold in proper form.

Lie on the floor
Tuck you toes under
Bring yourself up onto your elbows (sphinx like)
Keep your head in neutral so you are looking at the ground
Lift yourself off the ground
Don’t allow your hips to sag and don’t stick your bottom in the air.  If you have sharp pain stop.

Variations
Easy – on your knees
Intermediate – on your toes
Hard – on unstable surface.

For as long as you can.

Superman

 

This isometric hold assists the core hip and back to work together.

On all fours, knees under hip and hands under shoulders
(create a table top)
Keeping your spine and pelvis in a neutral position, hold your core and lift your left arm in front of you (aka superman) and your right leg out behind you (do not tilt the hip).
Hold for 5 seconds
Bring them back to the start position.
Do alternate side

10-15 reps on each side.

A strong stable and flexible core should be the basis of any fitness or sporting regime.

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