Why do so many people suffer low back pain?
Every client I see is different but there are recurrent themes that appear time and time again. One of these is the difficulty we have in understanding which muscles engage for which task, and which muscles are stronger and should be used to take on heavier tasks.
Frequently clients with back pain have an incorrect pattern of muscle engagement. They show poor activation in the gluteus (butt) area, the abdominals which provide support (transverse/internal obliques) and the multifidus (muscles linking into each vertebrae). The rectus abdominal (used in situps) and hamstrings are often over working. This pattern of muscle activation alters the loading through the spine, sacrum and pelvis, doesn’t give efficient support and, as a result, will often lead to back pain.
In a group session I am keen to see the correct muscles activating. This is something that clients can practice at home and, in time, see benefit from in day to day life. If the stabilising abdominals are taught to activate along with the gluteus and multifidus there is a good chance of giving the spine and pelvis the support it needs. This is harder than it may sound as the brain has to learn new patterns and retain the knowledge to use in everyday life.
The basic pattern of engagement is this:
Tighten or brace the abdominal area (transverse abdominal) without incurring any movement. Engage the muscles which run in a strip each side of the spine (multifidus), and engage the butt (gluteus) muscle without tilting the pelvis. Once achieved, release and re-engage. With repetition this encourages the brain to understand the pattern of activation which is required. It can be practiced standing, sitting or lying.
Most people find initially that every muscle in the body tightens – especially the neck and shoulders – but the muscles you want to engage have still not activated. Once all the correct muscles activate without affecting the whole body, additional work can be added. This will strengthen these muscles but mastering the correct activation pattern is essential for long term benefit. To achieve any of this without professional instruction is difficult. A bio mechanic coach or low back pain specialist will be able to help you achieve the correct muscle activation pattern as well as performing other tests for muscle spasm and imbalance which may contribute to back pain.
Please be aware that the information in this article assumes that there is no disc damage, scoliosis, degeneration, arthritis or nerve pain. This is a personal opinion based on my experience with clients suffering back pain. Bear in mind that there are other considerations including the angle of tilt of the pelvis, as well as foot and knee positioning. Consult your GP before starting an exercise plan if you have any concerns about your health.