Lower Back Pain: 8 Step Checklist to Eliminate Pain When You Are Training

Breath

The way you breathe is the single most important aspect to understanding lower back pain, movement mechanics, and rehabilitation.

It starts with being still. Through stillness, you will find the breath. The breath has two major roles in eliminating lower back pain: down regulation and core stability.

You have heard of the “Fight or Flight” response. This is the body’s natural reaction to stress — controlled by the sympathetic nervous system. Any time you feel stress, this system is working overtime. Emotional, mental, and physical stress are stored in the body’s tissues leading to tight muscles, decreased ROM, and tension in the connective tissues.

The opposite of “Fight or Flight” is “Rest and Digest.” “Rest and Digest” is the body’s down regulatory system, the parasympathetic nervous system. This system is responsible for flushing stress out of the body.

The breath gives your brain the chance to stop processing external threats, restore function, and heal itself.

The Stress Breathing Checklist

1. Take a deep breath, did your belly rise before your chest? Yes / No
2. Take a deep breath, was your mouth open? Yes / No

Your thoracic spine is protected and supported by a massive bone structure, the rib cage. Below the ribs, however, in your lumbar spine, there is no such structure. Instead, you have to create this structure, using your core to stabilize your lower spine.

Turns out, the six abs you work so hard on are the least important muscles in your body when it comes to low back health. The multifidus is the deepest core muscle. Attached to the spine, the multifidus assists in vertebral stability and function. The transverse abdominis, responsible for lateral expansion of rib, provides stability to the spine by connecting the rib cage to the pelvis.

The only way to train these deep core muscles is through diaphragmatic breathing, deep into the belly.

A post shared by Dr. Theresa Larson (@theresalarson) on May 12, 2016 at 8:28pm PDT

Core Stability Checklist

1. With straight legs, can you bend over to touch your toes? Yes / No
2. Can you rotate and look behind you, pain free, with equal rotation on each side? Yes / No

Balance

It is ok to admit your life is stressful. From the time you wake up you are rushed, stuck at a stressful workplace, and bookend your day sitting in rush hour traffic. The first time you think about quality movement is walking into the gym. Sitting in traffic and meetings all day is not the ideal way to prepare for a workout with 45 deadlifts and pull ups for time.   Balance is divided into two categories, “global” and “local.”   On a global level, analyzing general stress brings awareness to the energy you are bringing into the gym. Sleeping 6 hours, multiple deadlines at work, plus a long commute is the triple threat of general, long duration stress on your body. Throwing in a high intensity workout does nothing but compound the stress and fatigue your body is combatting.   This stress is stored in the tissues and nervous system. Despite your intuition, you do not need to stretch your hamstrings. General, long duration stress creates inflammation in the body. This inflammation is stored in the tissues. The brain communicates with the body through a complex system of nerves passing over and through joints. Increased inflammation in the tissue compresses these nerves and signals to the brain that there is a problem. The tension you feel in your hamstrings has nothing to do with the length of the tissues. What you feel is adverse neural tension that cannot be stretched, foam rolled, or mashed with a barbell. It can only be fixed by reducing stress and inflammation in the body through the breath.

Global Balance Checklist

1. Did you get 8 hours of sleep? Yes / No
2. Was your total work day (including commute) less than 10 hours? Yes / No

Local balance references the asymmetries you have developed through poor movement mechanics and lifestyle choices. When you squat, your right leg is a little stronger and at higher percentages you start to develop a tiny hip shift. Setting PR’s is great, you earned it, but you also are earning the pelvic imbalances that lead to lower back pain.   Your body loves these asymmetries. Your brain does not know back squatting is cool. It recognizes a gigantic weight on your back that is about to crush you. Your brain is going to use every resource and advantage it has to stand that weight up. Your strong leg is going to bear the brunt of that load because your brain knows your weak leg is going to fail.   Over time, asymmetries develop, imbalances shift your pelvis effecting the way you walk, sit, and train leading to chronic pain.

A post shared by Dr. Theresa Larson (@theresalarson) on Jul 29, 2016 at 11:38am PDT

Local Balance Checklist

1. Can you stand on one leg for 30 seconds? Yes / No
2. Can you stand on one leg with your eyes closed for 30 seconds? Yes / No