Lower back pain is a broad and vast condition that can be caused by a multitude of conditions and situations. General thoracic tightness to the thoracic region to muscles within the pelvis or hips has the ability for a cascade effect to occur leading to lower back pain.
This can include tight hamstrings, hip flexors such as psoas major and even latissimus dorsi, just to name a few. This doesn't even to start to cover the injuries that the lower back can sustain, let alone the type of conditions that can have an affect on the discomfort some might feel in the lower back region. One thing that they all have in common is the the mobility and range of motion (ROM) that a person with lower back pain has, is diminished or limited due to either their condition or the activity and control around the area
After some investigation upon updated articles and research on lower back pain and effective treatment plans there are three main areas of exercise prescription that were highlighted. Increasing proprioception and mobility through different forms of Pilates was a repeated success from a few studies such as Patti et al., 2016)and Wells, Kolt, Marshall, Hill & Bialocerkowski, 2014, showing that this type of exercise can help in lower back pain prevention.
Pilates looks specifically into breathing, pelvic and abdominal control while trying to increase endurance and strength within the areas and demonstrated to be a better intervention then general pain reducing exercise prescription in the gym.
The second is an underlying principle from the same and further studies that also show an improvement in lower back pain. This is the increase of length in muscles and the control or stabilization of the surrounding muscles which comes after the increased awareness or activation of the muscles as suggested in the first area of research (Kim, Kim, Chang & Lee, 2018).
Being able to increase muscle length of corresponding muscles such as the Iliopsoas, Quadratus lumborum and the Erector Spinae muscles may lead towards the increased range of motion in the lumbar region of the spine. Focusing on all planes of motion for control and lengthening of the muscular control instead of simple flexion/extension is the best holistic version of prescription for increasing muscle lengthen and stabilisation within the area.
Compounding upon the first two areas, properly demonstrated and executed dynamic exercises such as:
- Glute Ham Developer (GHD)
- Hip extensions
- Kettlebell swings
once lower back pain has reduced to an insignificant amount has shown to significantly increase the range of motion and strength within the spine when compared to general exercising within the gym (Yaprak, 2013) .
This type of training might help to prevent any further decrease in lower back range of motion in clients with existing lower back pain so that a healthy and active lifestyle may be further embraced without the constant fear of flare ups.
A good long term approach to our clients condition and is the best way to help a client, so that they can always see the next step in the process and that it’s not just waiting for the pain to diminish or go away. Being able to definitively tell a client what they have next after achieving either their range of motion, increased control or decrease in pain will always help keep them looking forwards and have trust that everything is being done to help them.
Kim, Y., Kim, N., Chang, W., & Lee, S. (2018). Comparison of the Therapeutic Effects of a Sling Exercise and a Traditional Stabilizing Exercise for Clinical Lumbar Spinal Instability. Journal Of Sport Rehabilitation, 27(1), 47-54. doi: 10.1123/jsr.2016-0083
Patti, A., Bianco, A., Paoli, A., Messina, G., Montalto, M., & Bellafiore, M. et al. (2016). Pain Perception and Stabilometric Parameters in People With Chronic Low Back Pain After a Pilates Exercise Program. Medicine, 95(2), e2414. doi: 10.1097/md.0000000000002414
Wells, C., Kolt, G., Marshall, P., Hill, B., & Bialocerkowski, A. (2014). The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review. Plos ONE, 9(7), e100402. doi: 10.1371/journal.pone.0100402
Yaprak, Y. (2013). THE EFFECTS OF BACK EXTENSION TRAINING ON BACK MUSCLE STRENGTH AND SPINAL RANGE OF MOTION IN YOUNG FEMALES. Biology Of Sport, 30(3), 0-0. doi: 10.5604/20831862.1047500
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