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Low Back Pain: Part Two

How to train for a pain-free back

In my last article I discussed what are main causes of low back pain, how to find your personal trigger and what can be done to (temporarily) take away your pain. Once you’ve found your pain trigger and positions of relief, it’s time for the next step: building up your back. A widespread misbelief regarding this very subject is that the core needs more strength. And every ‘professional’ has his or her favorite exercise for providing this. In this article I will debunk this core-strength myth, and provide you with a better method to build up the core muscles.

photo by @wearebru

Core strength vs. endurance vs. technique 

If we look at how to maintain that neutral position (discussed in my previous article) when we want to load the back, we need strength, control (technique) and endurance, where the first aspect is the least important. Say what?

Research has shown that the incidence of low back pain in people with a stronger core is actually higher compared with their less strong peers. And people with more core endurance seem to have less low back pain. This is because people with a strong core tend to lift more, but without the required endurance and technique to safely do so. As a result their backs suffer, especially when fatigued. You therefore need endurance to prevent your back's protective mechanisms from failing when you’re getting tired.

Core endurance training

So how do you increase your core endurance? Having a look at a regular gym, most people are applying bodybuilding rep schemes to their core work. The standard three sets of 12 reps or four sets of 10 reps will build muscle and strength, but not endurance. Other popular approaches - like doing an all out plank - will train some endurance, but most of the energy will still be provided anaerobically (like during a sprint). 

A better way to train core endurance is by stringing together intervals of 7-10 second static holds with short 2-3 second breaks in between (this will allow for fresh blood to flow into the muscle). After the first series, reduce the amount of intervals by two and repeat. Go for 3 series in total. When you get better, add more intervals, but keep the duration of the holds the same. Example:

Side bridges:

6 intervals x 7 seconds (3 second breaks in between)

repeat on other side

4 intervals x 7 seconds (3 second breaks in between)

repeat on other side

2 intervals x 7 seconds (3 second breaks in between)

repeat on other side

Technique matters

Anyone with a history of low back pain will acknowledge that a simple misstep or picking up your sock from the ground can already set off your pain. Where with a misstep or even just a forward bend the imposed load on the spine can already be high, some forms of low back pain are caused by micro-movements of the vertebrae. The problem with training with poor form is that those exceeding loads or micro-movements will be present and trigger your pain. In most cases the exercises are just too difficult, and too heavy. Starting with the basics, with 100% perfect technique, is therefore a way better approach.  

Make a choice

As with everything in a training program, everything should be there for a reason. Think about the risk vs. reward of your exercises. Know your pain triggers and find out which exercises are safe to start with. Be mindful of the impact and load that the exercises are imposing on your spine. 

And don't forget: what is your goal? Do you want to be a flexible yoga master, or strong as hell? Do you want to be a sprinter, or an endurance athlete? Going into one direction will in most cases be detrimental for the other. Don’t just go for the magic one-size-fits-all solution. Spend your time wisely.

Tom van Iersel

MSc. Human Movement Sciences, owner of Kettlebell Outdoor Amsterdam, and trainer at Vondelgym

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