Joint-by-joint: low back pain
This is the fourth post in a series about ways to identify and correct movement imbalances. Foam Rolling, Joint-by-Joint, and Core should be read or skimmed prior to reading this post.
Following the joint-by-joint approach for low pack pain, it points us to two specific areas: the hips and the thoracic spine (upper back). With the hips, they could need stability OR mobility (or both) but the thoracic spine most likely needs mobility.
Also, it can’t hurt to have a stronger core.
HIP MOBILITY.
Hips are a more complex joint than say, the knee. We really only need the knee to move in one direction (flex and extend). Hips can and should internally rotate, externally rotate, flex, extend, abduct, and adduct. We want to be able to move in all those ways with control. To improve hip mobility we need a combination of soft tissue work and mobilizations (videos at bottom of post).
HIP STABILITY.
I loooooove mini bands. If you’ve ever trained with me or watched me train someone, you know this. They are so versatile and give a tactile cue for abduction, especially when squatting. You can use them to train and strengthen abductors and external rotators, as well as hip flexors. Glute bridges, wall sits, squats, and deadlifts are other ways to build strength for extension and adduction. Anytime we can perform a movement on a single leg (unilaterally) we should incorporate this, too.
THORACIC MOBILITY.
I have several mobilizations I like and use for increasing mobility in the t-spine. The t-spine can flex and extend, can rotate, and can flex laterally. Coupled with soft tissue therapy, the mobilizations below will help increase mobility in the thoracic spine.
When the thoracic spine lacks mobility, the low back (lumbar spine) will compensate, causing undue friction and eventually, inflammation. Same goes for the hips; if our hips are immobile, our bodies will find a way to get what needs to get done, done. On the flip side, if our core and/or hips lack stability, we will overuse our lumbar spine and/or spinal stabilizers. This will cause pain and sometimes muscle spasms (throwing your back out).
THE FIX.
Identify what area or areas need help (mobility, stability, or a combination). You may require professional assistance. Then, on your own or with a coach, come up with a training schedule. Sometimes results take longer than you’d like… if you’re 40 years old, chances are these imbalances have been around for a while. They won’t change overnight. They will take time and attention, not just during training sessions but also when you’re slouching at work or your kid’s soccer game. The good news is none of these mobilizations or stability exercises should take very long and can be done while watching TV at night. Whenever you can sneak 5 minutes for your own wellness, you should. You only get one body.
Hip mobilizations:
Thoracic mobilizations: