Performance

Lower Back Pain Part I: Overview of the lower back anatomy and mechanics

Lower Back Pain Part I: Overview of the lower back anatomy and mechanics

One of my greatest fears in weightlifting is the development of chronic lower back pain. To me, developing chronic lower back pain would turn weightlifting into nearly a zero sum game. The vast majority of lifters need to stay healthy more than they need to increase in strength. Yet, athletes of all levels of competency develop lower back pain (LBP). The purpose of this four part series of articles is to discuss the causes, prevention, and self-care of LBP.

Part I: Overview of the lower back anatomy and mechanics

Part II: Causes and prevention of LBP in athletes weight training

Part III: Causes and prevention of LBP in sedentary people

Part IV: Self-care of LBP

Significance:

LBP ranks third in most burdensome causes of mortality and poor health (behind ischemic heart disease and chronic obstructive pulmonary disease from smoking) — over 25% of people have experienced it in the last three months (NIH LBP Fact Sheet). Most LBP is acute and typically a result of a mechanical problem, resolving itself in a few days. About 20% of people who suffer from acute LBP eventually suffer from chronic LBP lasting over 12 weeks. Furthermore, almost one-third of patients with chronic pain are clinically depressed (Watson, 2011). Staying away from LBP is critical to staying disability free and aging healthily as described in my last article (Paras, 2017).

General Anatomy:

The lumbar spine represents the lowest five unfused vertebrae of the spinal cord. The 121prevaillumbar vertebrae are the largest of the spinal column as they are built to carry the most weight while providing both stability and mobility (Davis, 2013). In between each vertebra there is a cushiony, spongy intervertebral disc that absorbs shocks to the spine. Notably, the spinal cord does not run through the lumbar spine. Instead, large nerves run through the lumbar spine and branch out in the sacrum. This includes the sciatic nerve, which has a larger diameter than most garden hoses (Eidelson, 2017)!

(figure source)

Torque and reasons the lumbar spine is vulnerable:

The lower back is surprisingly mobile considering it is a long stack of discs. It allows for forward and backward bends, twists, and movements in multiple planes simultaneously. However, this mobility comes at the cost of the stability necessary to maintaining proper posture. Common types of injuries are strains (e.g. muscle tearing, ligament tearing) and herniation (i.e. damage to a intervertebral disc).

The torque placed on the lower back is extremely high due to its long lever arm. The amount of force a muscle must produce to counterbalance a rotational force is proportional to the distance of the weight from the joint and the distance of the muscle’s attachment to the joint.The lower back is mechanically disadvantaged because a weight held at shoulder distance is very far away, while the lever formed by the muscle and joint is 12341prvailonly a few centimeters long. Therefore, the muscles of the lower back have to exert many times more force than the weight of any object it needs to support. For example, if a 180 pound person bends over 40 degrees to lift a 30 pound weight, the erector spinae muscles would need to generate 738 inch-pounds of force and experience a compressive force of 2214 inch-pounds just to maintain an isometric hold (Cornell University Ergonomics, n.d.). The massive torque placed on the lower back when lifting even light weights is one reason it is injury prone.

(Figure source)

Conclusion:

The lower back is a common injury site that can develop into a source of disability. It provides stability and mobility in multiple planes, but its multi-functionality makes it vulnerable to injury. Furthermore, the lower back is mechanically disadvantaged because weights are typically held far from the hip and thus, require many pounds of exertion for every pound carried.

Tune in next time for a discussion on the causes and prevention of lower back injuries in athletes!

12tylerTyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine

Tyler was born and raised in Santa Barbara, California and began training at Prevail in October 2016. He attended Westmont College and will be attending medical school this fall. While at Westmont he graduated summa cum laude, led a student-run homeless outreach program, and volunteered with medical clinics in Mexico and Bolivia.

After Tyler’s mother was diagnosed with rheumatoid arthritis (RA), he became interested in the cellular mechanisms behind the disease. He conducted his Major Honors project at Westmont on the role of the microbiome in inflammatory arthritis and conducted summers of research at Harvard Medical School studying the role of macrophages in RA. His research has resulted in seven presentations, three at national medical conferences.

Coach Eck’s Training Session 3/8/13

by Chris Ecklund, MA, CSCS, USAW
Quick Thoughts:
  1. Another quick sessions this morning between clients and my interns. 
  2. Turned out to be shorter than I would have like as I spent more time on soft tissue (much needed today). 
  3. Throughout this journey of the last month and tracking my workouts it has reinforced a truth to me that I encourage my clients and students toward: consistency is key. Time and time again I realize that consistency trumps intensity or volume in my training. While both intensity and volume are important, it’s much more important for me to maintain consistency in order to sustain a training effect (in all facets: smr, mobility/flexibility, stability, power, strength). In short, getting in something is always better than nothing.

Coach Eck’s Training Session 3/5/13

by Chris Ecklund, MA, CSCS, USAW

Quick Thoughts:

  1. Today was another extremely busy day that I didn’t think I was going to be able to fit training into. Luckily an hour opened up. 
  2. Although it’s already Tuesday, I’m feeling physically exhausted. Definitely unloading and trying to peak this week if I feel well enough each day.  Since I didn’t feel great today, I kept my loads about 10-20% lighter and tried to minimize my tempo. 
  3. Threw in a couple different variations today simply because I trained at Prevail and this is a training day I’ve been doing at UCSB over the last 2 months.

Coach Eck’s Training Session 2/27/13

by Chris Ecklund, MA, CSCS, USAW

Quick thoughts:

  1. Trained at UCSB today.  I must admit that is was humorous to watch people watch me do the BB Bent Leg Hip Extensions.  Though I have tried to encourage my classes to begin working on this lift…next to NO ONE at UCSB performs it.  Quite funny to watch their faces as it’s a pretty conspicuous exercise.  But…great glute/adductor exercise.
  2. Had more time today, got more work done.
  3. ESD and Core work still pathetic.  Not getting either done on a regular basis.  Painfully obvious that I need to do a better job with my consistency in these areas.

More Backing for Training to Run Instead of Running to Train

 
Train to Run Farther, Faster
Paul Robbins November 20, 2008

A training plan for the intermediate runner, this workout session will improve your movement efficiency and your time.

As an intermediate runner, the training sessions here will bolster your movement efficiency, meaning you’ll reduce wasted movement and use less energy to travel the same distance or speed. Think of it as upgrading to a more fuel-efficient engine. And by training common weak areas for runners, you’ll also become stronger and more resistant to pain and injury.

The Workout
You can consider yourself an intermediate-level runner if you’ve completed a 5K, 10K, or maybe even a marathon.

Directions: Rest at least a day between training sessions and vary your intensity. For example, you might run hard intervals on Monday followed by a day of rest on Tuesday, and then run at a medium intensity on Wednesday. Repeat this general training schedule,or get a customized program.

Intermediate Energy System Development
Warm up in what we call the “yellow zone” (65-75% of your maximum heart rate) for 5 minutes.
Run for 5 minutes in the “green zone” (80-87% of your maximum heart rate).
Run for 2 minutes in “yellow zone.”
Repeat steps 2 and 3 for duration of your 30- to 60-minute workout.
* If you don’t have a heart rate monitor, then correlate the “green zone” to a mile and the “yellow zone” to a ½ mile.

Trainer Workout 5/7/10

Here’s another one to enjoy.  Remember, always use loads, tempos and speeds you can maintain perfect technique with.  Poor movement with load = Pain.

Strength and Power
1a. Hang Clean 3×3-6
b.  Non Alt Bent Leg Quadruped Opposites w/MiniBand and Band Resistance 3×8 each, 30-60 seconds recovery

2a.  BB Dead Lift 3×8
b.  Push-ups on Bosu (with leg lifted) 3×10-40
c. Rotating Push-ups on Wobble Board Rotating 3×3-8 each
d.  Reverse Crunch on Bench with SB 3x 8-12, 30 seconds recovery

3a. Foot Elevated Split Squat SB – Foot Elevated Push Up 3×2/2 8-12 total
2. BB RDL – BB High Row 3×2/2 8-12 total, 30 seconds recovery

Metabolic Conditioning:
Each Station 30 secs

1. Mountain Climbers on slide
2. Jump rope
3. Cone Clock Drill
4. Box Jumps Up and Down
5. Sled pushes with 50lbs

One min rest. Repeat 2 more times.

Consult a physician prior to beginning any exercise program and stop at the onset of any pain or dizziness.

Today’s Workout…Brutal

Great workout today. Give it a shot. Quick warning…the rope climbs are incredibly demanding for forearms. If you’re forearm strength is low (like mine), you may need to add in greater recovery periods or have to rest between the climb and lowering phases.

Strength:
1a. BB Split Snatch 4×6
b. Valslide Handwalks Forward/Backward 4x15yds each 30 sec recovery
2a. Rope Climbs Hand over Hand (no feet) 4x8ft
b. Dips off Bench 4×20
c. Swiss Ball Oblique Crunches 4x7ew 30 second recovery
3a. Rope Climbs Parallel (no feet) 3x8ft
b. Swiss Ball Push Ups hands on 4×25
c. Sled Push @180lbs 4x30yds
d. Torso Trainer Russian Twists 4x3ew 60 second recovery

Metabolic Conditioning:
4 x 20 Seconds Heavy Rope Circuit
-10 Jumping Big Waves
-10 Big Circles outward
-20 Drums
30 seconds recovery

Great Job Wolfshorndl!

Santa Barbara High School Football Hell Weeks

This August I had the opportunity and pleasure of working with the Santa Barbara High School football program. I am truly pleased to say that my time with the SBHS coaching staff was probably the best experience I’ve had with a coaching staff from any sport at any level. The coaches were open and trusting to turn the reigns of all the Strength, Performance and Conditioning work over to my staff and me. Rare. Aside from that their communication with myself and coaching staff was excellent. Their desire to do what was best for their team(s) and begin the building process (during a rebuilding year for their program) of developing safe and efficacious training practices is truly admirable. I know that this season is going to be a long haul for them but am quite certain that with the desire and concern for doing what is best for their program, they will quickly be where they desire to be.

Hats off to Coaches Jaime Melgoza, Doug Caines, Sean Simms, Char Vandaele (ATC), and all of the other coaches whose names I’ve missed.

Below you’ll find some of the footage from the training we did on site:

Prevail Conditioning