6 Strategies for Maximizing Lower Back Health in Athletes
From superstar athletes to weekend warriors alike, the presence of lower back discomfort and injury can be debilitating, both physically and psychologically. Research shows that 80% of people/athletes will go through some sort of back pain or injury throughout their lifespan. When it comes to lower back health in athletes, there is no one size fits all approach. The complexity of lower back pain can go beyond the scope of many medical professionals, however, there are key principles that have stood the test of time and continue to produce positive outcomes from a pain and performance perspective.
The lower back is intricately intertwined with layers of muscle, fascial, and connective tissues. The underlying factor of lower back discomfort is often an asymmetry or previous injury of muscles that directly impact the pelvis. This isn't surprising considering it has 36 muscles that attach to it (hopefully the figures below can give you an appreciation of this). These muscles serve to protect, stabilize, and facilitate the transfer of energy between the lower & upper extremities. When chronic asymmetries at the hip, pelvis and lower back are left unaddressed, injury is often the outcome. Listed below are 6 strategies for maximizing lower back health.
Work in Ranges that Don’t Cause Discomfort.
At Instinct Performance, you'll often hear us checking in with our athletes during sessions; “where do you feel that?”, “what does it feel like?”, “What part of the movement do you feel the onset of discomfort?”. Depending on the response from the athlete, we will perform the exercise in an adapted range of motion or simply select a different exercise. If you know what a long season of playing sports is like (eg., 162 game MLB Season), you most likely understand the aches and pains that seem to have become “a part of life”. Our job as performance specialists is to put athletes in optimal positions where they experience the most success, safely.
2. Master Rib Cage & Pelvic Positioning, Especially Under Load.
Due to the human body being upright with vertebral columns stacked on top of each other, the spine is highly susceptible to compressive forces. Research consistently shows 85-90% of disc herniations occur at the L4 & L5, or L5, S1 vertebrae (1). Learning to master rib cage and pelvic positioning puts the musculature of the core, lower back, and hips in the most optimal position to rotate, transfer power, and protect the spine. This “stacking” during heavy resistance training also allows for intra abdominal pressure to be maintained and optimized because of the anatomical orientation of the diaphragm and pelvic floor (see figure below to get a visual of this).
As seen in the image below, athletes who experience chronic low back discomfort and injury often find themselves in an aggressive anterior pelvic tilt (ie., a tipping forward of the pelvis), along with extension of the lumbar spine. Not only does an extended low back and a pelvis that is dumped forward lead to higher rates of injury, it’s also mechanically less efficient (especially in rotation sports). The reverse is also true, a heavily flexed lumbar spine under load is highly susceptible to pathology (eg., disc herniations). The key? Learn how to maintain and build strength around a neutral spinal position.
3. Adapt Training Volume to Maximize Recovery and Avoid Training to Failure.
In an article written by Morán-Navarro and colleagues, they looked at the time course of recovery following a variety of training methods, one of which was training until failure (2). The results were as followed:
“Resistance training leading to failure considerably increases the time needed for the recovery of neuromuscular function and metabolic and hormonal homeostasis. Avoiding failure would allow athletes to be in better neuromuscular condition to undertake a new training session or competition in a shorter period ” (2).
Notice how the results never stated “don’t train hard”, they stated training until failure is suboptimal for neuromuscular and endocrine function and recovery time. Large amounts of training volume can have a profound residual effect on the body's ability to recover. A body that is constantly in a state of catabolism from playing, training, and long road trips is one that can’t optimally recover. This inability to recover may be a contributing factor to lower back health or lack thereof.
4. Train ALL functions of the core in Multiple Planes of Motion
As mentioned above, the core serves to protect, stabilize, and facilitate the transfer of energy between the lower and upper extremities in all planes of motion (eg., sagittal, frontal, & transverse). Dysfunction of the core may lead to a decrease in power output and an increased risk for injury. Below is a list of all the functions along with example exercises:
Flexion: McGill Curl-Up
Anti-Flexion: Deadlift
Extension: Prone Cobra
Anti-Extension: Deadbug’s
Lateral Flexion: Side Bridge + Hip Dip
Anti-Lateral Flexion: Single Arm Farmer’s Carry
Rotation: Landmine Rotations
Antirotation: Pallof Press
5. Be Diligent With Exercise Selection & Other Training Variables
Pathologies at the lumbar spine often arise from a combination of heavy compressive forces,
shearing forces, and continuous training in an overly flexed or extended posture. If an athlete comes to see us with heavy asymmetries we will often prescribe unilateral work in the early stages of training as we restore tissue function, quality, and range of motion (eg., lunges, step-ups, deficit lunges, sled pushes, lateral lunges, rear foot elevated split squats, single-leg deadlifts, single leg RDL’s, etc). As an example, one of my athletes experiences a ton of discomfort when performing axially loaded exercises (eg., barbell loaded squats, deadlifts, etc). As an adjustment to his program, we added heavy sled work and found other ways to stimulate adaptation (eg., tempo exercises, incorporate more kettlebell/dumbbell work, etc). The sky's the limit when it comes to exercise selection, I highly recommend you reach out to a qualified professional for guidance on the above variables.
6. Listen to the Subtle Hints your Body is Giving to You
As someone who has seen 15+ medical doctors, countless physiotherapists, chiropractors, and massage therapists for my lower back, one thing I wish I did was listen to my body when it was subtly hinting at me that something is wrong (eg., a huge decrease in performance (on the field and in the weight room), lack of muscular function, and pain). Pressure to perform and play at an elite level is a real challenge that often leaves athletes ignoring symptoms. Taking time off or investing in a healthcare professional that can help resolve and prevent future issues is critical.
Final Thoughts
Lower back pain can result in decreased power output, hindered mechanics, and ultimately a decrease in performance (not to mention the psychological effects of injury). A proactive approach to movement quality alongside a detailed strength training program are crucial components in the long-term development of athletes. Interested in training with us? Each athlete is taken through an extensive assessment process and screened for biomechanical flaws that increase injury rate and decrease performance.
References
Almond, L. M., Hamid, N. A., & Wasserberg, J. (2007). Thoracic intradural disc herniation. British journal of neurosurgery, 21(1), 32-34.
Morán-Navarro, R., Pérez, C. E., Mora-Rodríguez, R., de la Cruz-Sánchez, E., González-Badillo, J. J., Sanchez-Medina, L., & Pallarés, J. G. (2017). Time course of recovery following resistance training leading or not to failure. European journal of applied physiology, 117(12), 2387-2399.
