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Archive for the ‘Low Back Reconditioning’ Category

When I conducted my EMG research, I was surprised to find that squats elicited more lumbar erector activity than deadlifts. Not surprising was that deadlifts elicit more thoracic erector activity than squats. In powerlifting competitions, you squat, then bench, then deadlift. Most recreational lifters always squat before they deadlift as they feel that squats “warm them up” for heavy deadlifting. This makes sense as many individuals hurt their low backs when deadlifting because they aren’t warmed up sufficiently. The squats also provide for more range of motion at the hip, knee, and ankle joints, so it makes perfect sense to squat prior to deadlifting rather than the other way around.

Many find that they are stronger at deadlifts when they squat first. Conversely, if they deadlift before they squat, they find that their squat is considerably weaker. So I feel that if you’re going to squat and deadlift, it makes more sense to squat first and deadlift second. I’ve always done it this way in my training and coaching.

Need more evidence? Click on this link.

It’s an abstract from a 2007 Journal of Strength and Conditioning study that shows that when using an 80% of 1RM load in the squat and deadlift, the squat activates 34.5% more lumbar erector activity than deadlifts while the deadlift activates 12.9% more thoracic erector activity than squats. Interestingly, this study showed that powerlifters were able to control the lumbar spine and prevent flexion in the squat but not the deadlift.

The kinematics of a squat and deadlift are very complex but if you squat and deadlift in a speedo your form will magically perfect itself!

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Puppies in Vices: The Deleterous Effects of Sitting
By Bret Contreras

Listen to this horrific story and decide whether you think this guy should be given the death penalty. A man was recently imprisoned for being convicted of cruelty to animals. He would take puppies and place them in vices.

He kept them in the vices for 8 hours per day. During this time, the puppies were not given any water or food. He would only clamp down on one side of the puppies’ bodies which caused the puppies’ internal organs to migrate toward one side of the body. Over time the consistent pressure caused some of the puppies’ internal organs to bulge against their abdominal cavities and even spill out of their bodies as the puppies’ protective tissues degenerated due to the extreme forces they received. The puppies’ bodies slowly started deteriorating as structures weakened and dysfunction creeped throughout their systems.

Does this man sound sick? Does he belong in an insane asylum? Or does he deserve the death penalty? You may want to be lenient on this man, because this man is you!!!

How This Relates to Your Back

In this egregious, overly-dramatic scenario, the puppies represent the intervertebral discs of your lumbar spine. The time spent in the vices represents the time you spend sitting. The migrating organs represents the nuclei of your lumbar discs. The spilling out of the organs represents the tearing of the wall of a disc and subsequent disc herniation. The fact that the puppies’ hydration and nourishment was neglected relates to the behavior of your dics while staying in one prolonged position throughout the day. The migrating bodily dysfunction is a cold reality in regards to adaptations imposed from sitting. I realize that the story mentioned above was a little over-the-top and scientifically-unrealistic but you must admit that I may have finally gotten you to pay attention to the consequences of your daily postural habits.

Although we’ve known since a study was published by Kelsey in 1975 that those who spend over half their day sitting experience higher incidences of herniated discs, time spent sitting continues to rise over the years. It’s a byproduct of the technological age and will most likely keep getting worse as time passes..

Devolution

Our species put forth a lot of time and effort toward promoting adaptations that allowed us to exhibit upright postures and use our glutei maximi to powerfully propel the hips rearward via hip extension. Although there are at least twelve distinct hypotheses as to why and how bipedalism evolved in humans (postural feeding hypothesis, provisioning model, threat display, vigilance against predators, sexual selection, male phallic display, thermoregulatory model, carrying models, wading models, changes in climate/habitat, etc.), suffice to say that bipedalism appears to be a critical component to our survival as a species.

According to Wikipedia, “Devolution”, “de-evolution”, or “backward evolution” is the notion that a species can change into a more “primitive” form. It is associated with the idea that evolution is supposed to make species more advanced, and that some modern species have lost functions or complexity and seem to be degenerate forms of their ancestors. This view is rejected by modern evolutionary theory, in which adaptation arises from natural selection of forms best suited to the environment, and so can lead to loss of features when these features are costly to maintain.

Devolution presumes that there is somehow a preferred hierarchy of structure and function, and that evolution must mean “progress” to “more advanced” organisms. For example, it could be said that “feet are better than hooves” or “lungs are better than gills”, so that change to the “less advanced” structure would be called “devolution”. A modern biologist sees all such changes as evolution, since for the organisms possessing the changed structures, each is a useful adaptation to their circumstances.

So even though there may be no such thing as “devolution,” it appears that we are indeed reverting back to our ancestral roots, as an upright posture may no longer be necessary in today’s sedentary world. Perhaps it’s too cost effective and we will continue evolving into creatures whose natural postures are more akin to the fetal position to allow for more efficiency in sitting. Unfortunately, until our skeletal structures adapt to these adaptations, our low backs pay a price for the alarming amounts of stooping, hunching over, and sitting that we undergo in today’s society.

Some Facts About Low Back Pain

• Back pain is the second most common reason for visits to the doctor’s office, second to upper respiratory infections

• Americans spend over $100 billion annually on medical bills, disability, and lost productivity related to lower back pain

• At least 85% of the American population will experience back pain at some point in their lives

• At least 85% of the American population will develop disc degeneration disease by the age of 50 years old

• At any given time, around 25% of the American population is experiencing low back pain

• Low back pain is the most common reason for lost playing time in sports

• Some evidence indicates that at least 94% of low back disorders is mechanical in nature (Waddell)

Now let’s break down the biomechanics and physiological repercussions of sitting

How Much are We Sitting and What are Some Physiological Concerns Associated With Too Much Sitting?

• A 2003 and 2004 U.S. Census showed that Americans spend an average of 56 hours per week sitting. This equates to half of one’s waking hours (8 hours per day). Another study showed that the British spend 15 hours per day sitting when totaling up the hours spent sitting at work, in transit, watching television, working on a computer, eating dinner, and reading. Finally, another study showed that Australians workers spend around 9.5 hours sitting. Researchers have dubbed this epidemic “The Sitting Disease.”

• When sitting, the large postural muscles of the back and legs are shut off which reduces fat-burning enzymes by 50%. Sitting also decreases the HDL:LDL cholesterol ratio, increases the risk of contracting diabetes by 7% for every 2 hours of sitting per day, increases the risk of heart disease, increases the incidents of depression, increases the risk of acquiring metabolic syndrome by 26% for every hour spent sitting irrespective of the quantity of moderate exercise performed (as shown by Australian researchers) and decreases lifespan (as shown by Canadian researchers involving a twelve-year, 17,000 person study as well as by Australian researchers involving a six-year, 8,800 person study). In addition, prolonged sitting increases incidences of discomfort (including back pain, muscle tenderness and aches, stiff necks, and numbness in the legs, chronic disorders, arthritis, inflamed tendons, chronic joint degeneration, impaired circulation, varicose veins, hypertension, obesity, cancer, high blood triglycerides, high blood sugar, osteoporosis, and herniated discs (Graf et al. 1993 and 1995, Grandjean 1987, Kelsey 1975).

• According to Missouri microbiologist Marc Hamilton, “If you’re standing around and puttering, you recruit specialized muscles designed for postural support that never tire. They’re unique in that the nervous system recruits them for low-intensity activity and they’re very rich in enzymes.” One enzyme, lipoprotein lipase, grabs fat and cholesterol from the blood, burning the fat into energy while shifting the cholesterol from LDL (the bad kind) to HDL (the healthy kind). When you sit, the muscles are relaxed, and enzyme activity drops by 90% to 95%, leaving fat to camp out in the bloodstream. Within a couple hours of sitting, healthy cholesterol plummets by 20%.”

• According to Galen Cranz, a professor at the University of California at Berkeley, “Short of sitting on a spike, you can’t do much worse than a standard office chair. The spine wasn’t meant to stay for long periods in a seated position. Generally speaking, the slight S-shape of the spine serves us well. “If you think about a heavy weight on a C or S, which is going to collapse more easily? The C,” she says. But when you sit, the lower lumbar curve collapses, turning the spine’s natural S-shape into a C, hampering the abdominal and back musculature that support the body. The body is left to slouch, and the lateral and oblique muscles grow weak and unable to support it.”

• Some researchers have created a new model or paradigm called “inactivity physiology”. It establishes that sitting and non-muscular activity may independently boost the risk of ill health, and that sedentary behavior is a separate class of behavior with specific consequences for ill health. These are different than those caused by taking too little exercise.

A Cascade of Biomechanical Repercussions from Sitting

• Sitting is static stretching for the back

• What gets stretched? All the soft tissue from the center of the discs to the back of the body. This means all of the muscle, fascia, tendons, ligaments, and disc material/cartilage that lies posterior to the center of the lumbar discs

• This leads to joint laxity and ligamentous instability of the lumbar spine as the ligaments are no longer taut enough to correctly perform their job

• This also causes the posterior wall (annulus) of the disc to stretch, thin, and weaken, in addition to causing the disc nuclei to migrate posteriorly and exert pressure upon the weakened annulus, which creates disc bulges and herniations that protrude into the spinal column and can ultimately lead to extreme levels of pain. Tears and herniations are almost always posterior-ipsilateral in nature

• Pain leads to muscular inhibition and altered motor programming

• Sitting can force the body’s natural posture to exhibit lumbar flexion and posterior pelvic tilt, which is akin to a constant flexion moment on the lumbar discs and constant strain on the soft-tissue at the back of the spinal column

• This posterior pelvic tilt is the number one cause of mechanical dysfunction in the lumbar spine

• What else shortens? The hip flexor and hamstring muscles. This is known as “Adaptive Shortening.” Shortened muscles become dominant muscles

• An overactive psoas creates strong compressive forces upon the lumbar spine every time it contracts

• A tight psoas leads to decreased hip extension range of motion and therefore decreased glute activation from a mechanical perspective

• A tight psoas leads to what’s known as “Reciprocal Inhibition” which leads to decreased glute activation from a neural perspective, which is pronounced by the inhibition due to low back pain

• Compression of the glutes incurred while sitting also inhibits the glutes

• Decreased glute activation leads to what’s been coined, “Gluteal Amnesia”

• Gluteal Amnesia leads to flat (atrophied) and weak buttocks

• Weak glutes lead to what’s known as “Synergistic Dominance.” Synergists are “helpers” of the glutes which include the erector spinae, hamstrings, quads, and adductors depending on the movement

• Since the glutes aren’t functioning optimally and the hips “lock up” due to tight muscles, movement patters erode – more forward knee bend and lumbar rounding and less hip extension during squatting and standing from a chair, less hip extension and glute “pushing” and more hamstring “pulling” during gait, more lumbar extension and less hip extension when picking something up from off the ground, doing yard work, and deadlifting, etc. The erector spinae become prime movers rather than stabilizers in most movement patterns

• Synergistic Dominance leads to “Pattern Overload” which creates more pain

• Pattern Overload leads to tissue trauma, inflammation, spasm, trigger points, adhesions, altered motor patterns, and more muscular imbalance

• Spasms, trigger points, and adhesions lead to less movement and more sitting

• More sitting and less activity leads to detrimental postural adaptations in the form of flattened lumbar curve, kyphosis, posterior pelvic tilt, forward head posture, diminished mobility at the ankles, hips, thoracic spine, and shoulders, inflexibility of the hamstrings, hip flexors, and hip rotators, and weak glutes and core musculature

• Any attempts to exercise with considerable intensity or duration in this state leads to pain and possibly injury, especially at the hamstrings, groin, low back, knees, and shoulders

• Problems in one area of the body lead to problems in other areas of the body. If a misalignment exists in one segment of the kinetic chain, predictable patterns of dysfunction known as “Serial Distortion Patterns” throughout the entire kinetic chain will ensue, which compromise the body’s structural integrity both above and below the misaligned segment. For example weak upper glutes cause knee pain due to their inability to control the femur from being pulled into valgus (inward) when squatting, climbing, and jumping

• Dormant and weak muscles atrophy, which decreases the metabolic rate

• Decreases in metabolism leads to increases in body weight and body fat, which puts more stress on the joints and leads to increased pain and muscular inhibition

• The cycle repeats itself and the individual’s physique, movement patterns, posture, and performance capabilities enter into a continuous downward spiral

• In short, sitting changes the way we move and changes the way our bodies function

The Lumbar Spine – The Ultimate Compensator

As alluded to earlier, the lumbar spine is an amazing segment. It can and will compensate for lack of mobility found in many of the body’s major joints including the ankles, hips, thoracic spine, scapulae, and shoulders.

Let’s look at the hip. If your hip flexors are too tight and you can’t extend your hips (think of gait, hip thrusts, or back extensions), don’t worry; the lumbar spine will extend to pick up the slack. If your hamstrings are too tight and you can’t flex the hips (think of bending over in a deadlift or back extension), don’t worry; the lumbar spine will flex to make up the difference. In fact, the lumbar spine will compensate for any of the six actions of the hip; extension, flexion, external rotation, internal rotation, abduction, and adduction. If you have poor hip rotation and you play golf, where do you think you’ll get the extra range of motion when you swing the club and your hip mobility “runs out”? You’ll get it from the lumbar spine!

At the ankle joint, inadequate ankle dorsiflexion (toe to shin mobility) causes excessive forward lean and low back rounding in a squat. At the thoracic spine, inadequate thoracic extension can force the low back to extend during any exercise where you have to “keep the chest up,” including bent over rows, deadlifts, good mornings, squats, front squats, and overhead squats. Poor upward rotation of the scapulae will cause the low back to extend during overhead pressing. Insufficient external rotation at the shoulder joint will cause the low back to extend while holding onto the bar during a squat. These are just some of the movements that are performed by the lumbar spine that should be performed by other joints. If you lack mobility in key joints, the lumbar spine will contort to get you from point A to point B.

It should be mentioned that the low back musculature including the erector spinae, quadratus lumborum, multifidi, as well as the lats, glutes, rectus abdominis, external and internal obliques, transverse abdominis, diaphragm, and pelvic floor muscles should contract to keep the core tight, produce intra-abdominal pressure (IAP), efficiently transfer energy from one half of the body to the other, and prevent energy leaks during strength training and high-velocity sporting movement. However, the core should usually be braced isometrically and should not move much concentrically or eccentrically in any direction (flexion, extension, lateral flexion, rotation, etc.). While a standard “arch” is a good thing during heavy compressive loading, there’s a fine line between arching and hyperextending the lumbar spine. Contracting the erector spinae is wise, but overarching is unwise as it places the posterior elements of the spine under too much stress and will likely lead to damage and injury over time.

So we know that inflexible muscles (which can be either short or stiff due to excessive tone) can cause the low back to come into play as a “substitute.” But weak muscles can also cause the low back to move, even in the presence of perfect flexibility and mobility. Weak glutes will force an individual to lift with their low back, run with their hamstrings, and squat with their quads. A weak core will cause the low back to collapse and “leak” energy.

What’s the big deal, you might say? Who cares how someone gets from point A to point B as long as they make it? Due to their larger structure and the fact that they support much of the body’s weight, they take a serious beating when they move around at high velocities, under high load, or for sustained periods of time. So you need substantial flexibility, mobility, stability, and strength at the hips in addition to adequate core stability in order to spare your lumbar spine.

In summary, healthy, mobile, and stabile joints spare the lumbar spine. But it takes more than just mechanical efficiency. You also need neural efficiency. Sometimes sparing the spine is a simple matter of motor reprogramming. Many individuals possess adequate joint mobility and stability, yet they still move too much in their lumbar spines and too little in their hips and thoracic spines. These folks need to be taught proper movement mechanics and exercise form.

After working with beginners for an entire session many times they can learn how to stabilize their spine through bracing and move solely at the hips during various exercises and movement patterns such as hip abduction and external rotation movements, quadruped hip extension movements, supine bridging movements, squatting movements, deadlifting movements, lunging movements, and back extension movements. Upon learning proper form many of these individuals will remark that they “finally feel the exercise working the right muscles.” The body wants to take the path of least resistance. It is more cost effective physiologically to stoop rather than squat (Garg and Herrin 1979). You must override your brain’s default signals and teach it to automatically resort to proper motor programs.

How to Reverse and Bulletproof Against the Negative Adaptations Imposed by Sitting

Stop Bad Adaptations

• Less sitting, more standing, more movement. Motion is good (Holm and Nachemson 1983). Sitting is evil (Videman et al. 1990). Sitting has been proven to increase intradiscal pressure over standing (Nachemson, 1966), increase posterior annulus strain (Pope et al. 1977), cause tissue creep in posterior passive structures which decreases anteroposterior stiffness and increases shearing movement (McGill and Brown 1992, Schultz et al. 1979), and cause a posterior migration of the mechanical fulcrum which reduces the mechanical advantage of the extensor muscles and increases compressive load (Wilder et al. 1988)

• Take mini-breaks from sitting, as sitting or stooping severely compromises lumbar stability (McGill 1999). Don’t set for more than 50 minutes at a time. Even standing for 10-20 seconds in a relaxed posture and then stretching overhead (lumbar extension) and then perhaps some neck rolls and windmills briefly and some walking helps a lot as it allows time for the disc nuclei to redistribute which reduces annular stress and to allow for some recovery of ligament stiffness. Athletes on the bench should sit on taller benches to reduce lumbar flexion, stand and pace every 20 minutes. If your work requires standing, dynamic effort, take frequent breaks to relax and possibly stretch. Too much of any single activity is undesirable and dangerous. Opposite loading is key (Krismer et al. 2001)

• Consider your spinal posture at all times (sitting, standing, sleeping, etc.) and know when you are extending, flexing, rotating, laterally flexing, and combining movements. Even pelvic tilting during sexual intercourse is associated with lumbar flexion! Learn the different spinal movements and how they feel. Knowledge is power (Preuss et al. 2005)

• Switch posture frequently to prevent tissue creep and injury (Liira et al. 1996, Callaghan and McGill 2001) and to avoid diminished disc nutrition which can lead to herniations (Buckwalter 1995). Don’t sit in one posture for more than 10 minutes at a time

• For the majority of time spent sitting (not all the time as it’s important to alter posture every so often), try to maintain a normal lordotic position since such a posture helps to balance the loads on various spinal structures. A good idea is to have 90 degree angles at the ankles, knees, and hips with an erect torso. A 1997 study by Hedman and Ferney subjected 12 lumbar spines to constant loading while in flexed and extended seated postures for 30 minutes with 500 N. Forces on the anterior column and the facets were measured. Forces on the posterior ligaments, the disc shear and the facet impingement forces were computed via a quasi-static analysis from the data. The authors of this study concluded that the “minimization of disc shear, tolerable levels of ligamentous tension, lower disc loads and a balancing of facet impingement and articular fact forces were found to be characteristics of prolonged erect sitting in this study. Based on these results, one would expect that the extended seated posture would reduce exasperation of tissues as compared to flexed postures.” They also concluded that the increased load on the tissues of the lumbar intervertebral joints in the flexed seated posture would likely result in increased degenerative changes. The results of this study were as follows:

1. Mean facet force in the L4/5 joints was greater in the extended seated posture (50.7 +/- 32.2 N) than in the flexed posture (5.6+/- 7.5N).
2. Mean anterior disc compressive force was greater in the flexed posture (165+/-133N) than in the extended posture 53.0+/-46.9N).
3. There was no significant difference between the two postures in posterior disc force (flexed=165 / extended=127N).
4. Vertical creep was increased in the extended posture (3.22mm) as compared with the flexed posture (2.11mm).
5. Disc shear and ligamental forces were higher in the flexed posture than in the extended posture.
6. Anterior column force increased 32% in the flexed posture and 28% in the extended posture over the 30 minute experiment.
7. An increase in facet force (65%) in the extended posture after 30 minutes was offset by a decrease in facet impingement force (27%) such that the net increase in facet force was only 1%.
8. The ligament tension in both postures increased substantially (183% in extension and 153% in flexion) due to creep loading. The posterior ligament force in the flexed posture, however, remained roughly 3 times the anterior ligament force in the extended posture over the period of the experiment.
9. Disc shear force increased 9% in the flexed posture and decreased 75% in the extended posture.

• Refrain from conducting any activities, exercises, or postures that cause low back pain to flare-up. If your low back acts up, cease the aggravating activity immediately

• Avoid prolonged stooping and deviated postures as they increase the risk of injury (Adams, Hutton, and Stout, 1980, Prunett et al. 1991, McGill and Brown, 1992, Marras et al. 1993, McGill 1997, Wilder et al. 1988)

• Avoid repetitive lumbar flexion as it has been shown to be the damaging mechanism leading to herniations as the nucleus inside the disc breaches the annulus layer by layer with progressive delamination of the layers (Callaghan and McGill 2001, McGill et al. 2007, Tampier 2007). In fact, McGill’s labs have repeatedly shown that under low compressive loading around 18,000 – 25,000 flexion/extension cycles usually lead to disc herniations (and 5,000 cycles with high loading)

• Avoid frequently bending and twisting the low back (U.S. Dept of Labor 1982, Andersson 1981, Marras et al. 1995, Punnet et a. 1991, Snook 1982, Aultman et al. 2004)

• Avoid stretching the low back; chances are it already has too much ROM and increased lumbar mobility puts people at greater risk for low back injury (Battie et al. 1990, Biering-Sorenson 1984, Burton, Tillotson, and Troup, 1989, Parks et al. 2003)

• Do not practice abdominal hollowing while lifting as it has been shown to reduce spinal stability (McGill 2009) and reduce training efficacy (Koumantakis 2005). Instead, learn the bracing technique

• Avoid lumbar hyperextension under high load or velocity as it may increase the incidents of damage to the posterior elements (pedicles, laminae, spinous processes, and facet joints) of the low back (Hardcastle et al. 1992, Bono 2004)

• Avoid round-back lifting, according to Zatsiorsky round-back deadlifting imposed 66% more compression than arched-back deadlifting. Learn to hinge at the hips. McGill has noted that weightlifters “lock up the lumbar spine close to neutral and rotate almost entirely about the hips,” whereas most normal people bend over by flexing a combination of their hips and low back. Lumbar flexion is most likely more dangerous when standing and bending forward as in a heavy deadlift than it is when lying supine and bending upward as in a crunch as there is a “flexion-relaxation phenomenon” that occurs when standing and bending over where the lumbar erectors shut down near full flexion. The erectors contract eccentrically to allow the bending and then relax completely at end-range flexion which shunts the load to the passive structures which includes the discs (although myoelectrically silent, the lumbar erectors still contribute some elastic stability through the stretching of their tissues according to McGill). Internal pressure on the lumbar discs is 15 psi when lying supine and 334 psi when lifting 20 kg with a rounded back (Wilke et al. 1999)

• Avoid combined spinal movements especially under load. Disc prolapses were produced in human cadaver lumbar spines by combining lumbar flexion and lateral bending with sudden compressive loading (White & Panjabi) as well as with lumbar flexion and torsion (Gordon et al. 1991). When just supporting in the extension axis, supporting 50 Nm was shown to impose 800 N of spinal compression. Supporting 50 Nm in the lateral bend axis was shown to impose 1,400 N of spinal compression. But supporting 50 Nm in the axial twist axis would impose over 3,000 N of spinal compression if induced while extending during lifting (McGill 1997). Since there are no muscles specifically designed for axial twisting, a bunch of muscles contract to help out which increases compression

• Don’t train in the early morning when discs are hyper-hydrated as disc bending stresses increase by 300% and ligaments by 80% due to the increased disc-height (Adams et al. 1987). After just 30 minutes of waking discs lose 54% of the loss of daily disc height/water content (Reilly et al. 1984) and 90% within the first hour. Early spinal motion is unsafe (Adams and Dolan 1995). Avoiding lumbar flexion in the morning has been shown to reduce back pain symptoms (Snook et al. 1998). Play it safe and train 2 hours after waking

• Make sure the abdominals and obliques are strong, not just the erector spinae. Imbalance is problematic (McGill et al. 2003)

• Learn how to breathe properly while stabilizing a load (McGill et al. 1995)

• When picking something up from off the ground, place the load as close to the body as possible to reduce the reaction moment, reduce the subsequent extensor forces and resultant compressive joint loading, and prevent entering into lumbar flexion/spinal buckling

• Learn how to brace the core, engage the inner core unit (transverse abdominis, multifidus, diaphragm, and pelvic floor) and outer core unit (glutes, lats, LDF, rectus abdominis, internal and external obliques, quadratus lumborum, etc.) via integrated movement, and properly develop intra-abdominal pressure (IAP). The beliefs regarding IAP are all over the place, with Zatsiorsky stating that IAP can reduce pressure on the discs by an average of 20% and up to 40% in extreme cases, McGill believing this data is greatly overexaggerated (although he sees merit in IAP for increased trunk stiffness, decreased tissue strain, and failure from buckling), and Bogduk stating that our beliefs about IAP are flawed as research shows that 1) IAP doesn’t correlate well with the magnitude of the load being lifted or the applied stress on the vertebral column as measured by intradiscal pressure, 2) The Valsalva maneuver has been shown to increase loading on the lumbar spine, as has raising IAP 3) Abdominal strength and IAP is poorly correlated, and 4) Strengthening of the abdominals has not shown to increase IAP during lifting. Although the research on IAP seems pretty dismal, Siff states that the lungs should be filled to about 75% of their maximum capacity for the interval when muscle tension is highest. This jives with what most powerlifters believe.

• Always use proper form! Failure to do so is not only dangerous but it reinforces bad technique (Cholewicki and McGill 1996). Practice doesn’t make perfect, it makes permanent. Learn to use the legs and hips while keeping the back stiff while lifting. Learn how to sit back and keep the knees out and chest up in a squat. Learn how to hinge at the hips while keeping the chest up in a deadlift. Learn how to take long strides while staying upright in a lunge. Learn how to move at the hips and not the lumbar spine in a hip thrust. Learn how to rotate at the thoracic spine and not the lumbar spine in a cable chop or lift. Get strong everywhere to eliminate energy links. According to Siff, “Spinal flexion during heavy lifts from the ground can damage the intervertebral discs, so competent lifters strive to diminish the flattening of the lumbar spine by actively concentration on increasing erector spinae tension. If this is overdone, the various spinal ligaments become slack and most of the load is borne by the muscles. Conversely, if the muscles are inadequately contracted, then excessive stress is placed on the ligaments. The skilled lifter is able to optimize the required balance between the spinal muscles and ligaments, thereby enhancing lifting efficiency and diminishing the likelihood of injury.”

Reverse Bad Adaptations

• A multi-pronged approach consisting of varying types of drills, stretches, and strengthening exercises is an effective route to improved back health (Saal and Saal 1989). Proper exercise selection is critical (Linton and van Tulder 2001)

• Get a FMS or similar evaluation – a Functional Movement Screen can identify asymmetries and limitations in fundamental movement patterns which can lead to a specialized corrective exercise plan tailored to the individual

• Engage in SMR or body work – this is important as it can reduce excessive tone, alleviate trigger points, break up adhesions, and reduce spasms

• Engage in static stretching for the hip, shoulder, and ankle musculature – this is important as it can prevent and reverse the effects of adaptive shortening. It is usually not necessary to stretch the spinal column which can sometimes do more harm than good as it can diminish the stretch reflex and lead to spasm (Solomonow et al. 2002)

• Engage in mobility drills for the ankle, hip, t-spine, shoulders, and scapulae – this is important as it can prevent losses in mobility and restore the body to it’s natural state of mobility

• Engage in activation work for the glutes, psoas, serratus anterior, and low traps – this is important as it can “wake-up” dormant muscles and teach them to contract more easily which can then be coordinated into more integrated movement

• Engage in core stability work – this has been shown to be more effective than traditional abdominal full range movement (Hides, Jull, Richardson 2001, Saal and Saal 1989, Koumantakis et al. 2005). Learn to stabilize the core from all directionl load vectors including axial, anteroposterior, mediolateral, torsional. Hernations occur at full end range-of-motion so it’s important to be able to prevent forces from taking you into those extreme ROM’s (Adams and Hutton, 1982). Muscles that attach to the spine are like guy-wires that form the rigging on a ship’s mast which brace the spine and prevent it from buckling, There are many torso and core muscles are well-suited for lumbar stabilization (Crisco and Panjabi 1990, Cholewicki and McGill 1996, Cholewicki, Juluru, and McGill 1999, Gardner-Morse, Stokes, and Laible 1995, Macintosh and Bogduk 1987, McGill and Norman 1987). Spine stability is greatly enhanced by co-contraction or co-activation of antagonistic trunk muscles (Cholewicki and McGill, 1996). Co-contractions increase spinal compressive load as much as 12–18% or 440 N, but they increase spinal stability even more by 36–64% or 2925 N (Granata and Marras, 2000)

• Learn to apply the appropriate level of bracing for the task at hand. For menial tasks, usually co-contraction in the amount of 5-10% of MVC for the supporting core musculature is sufficient in stabilizing the spine and enhancing spinal stiffness. Contracting too hard is unnecessary. Remember, contracting the core muscles via bracing imposes a penalty on the spine via increased compression. This penalty is worth it in order to resist buckling and prevent unstable behavior. The level of co-contraction depends on the task

• Look into the McKenzie method as it is possible to reverse some of the negative adaptations of sitting and to allow the discs’ nuclei to “equilibriate” (Scannell and McGill, 2005)

Bulletproof Against Bad Adaptations

• Increase back endurance; people with back pain have stronger than normal backs, but they need more back endurance (Biering-Sorenson 1984, Nicolaisen and Jorgenson 1985, Holmstrom and Moritz 1992, Alaranta et al. 1994, Luoto et al. 1995, McGill et al. 2003)

• Get strong glutes! It is this author’s opinion that if you get strong glutes, the body uses those glutes for lifting and the low back is used as a stiffened transducer to transfer energy. Strong, properly functioning glutes may be the most important facet of lower back health as the glutes are the ultimate sparers of the spine

• Get strong in a variety of load vectors. Wolff’s and Davis’ laws state that tissue conforms to the lines of stress it receives. We want our tissue to be strong and prepared for all directions of force. We know that bone (Carter 1985), ligament (Woo, Gomez, and Akeson 1985), disc (Porter 1992), and vertebrae (Brinckman, Biggemann, and Hilweg 1989) in addition to tendon and fascia remodel themselves according to the directions and magnitude of stress to which they’re subjected

• Lose bodyfat. Most people are muscularly-skinny and weak yet they are forced to carry around a giant sack of fat with them everywhere they go. This weighs them down, puts more pressure on their joints, and causes fatigue which leads to breakdowns in posture and mechanics. According to the CDC, 67% of Americans are either overweight or obese

• Master simple drills, postures, and exercises, then gradually progression to more advanced drill, postures, and exercises. This might mean to advance from static to dynamic, isolative to integrative, and bodyweight resistance to external resistance. Gradually increase range of motion, duration, number of repetitions, volume, intensity, loading, etc. Too much axial loading too quick can result in endplate fractures and damaged vertebrae. Too much anteroposterior loading too quickly can lead to damages in the posterior elements of the spine or endplate avulsion. Inability to prevent the spine from buckling during heavy lifting can result in damages to discs, ligaments, disc annulus, and disc nucleus

Stop the Madness!

Hopefully this article has inspired you to stop sitting so much, start moving more, and start engaging in back-friendly practices. And most important, hopefully you will stop torturing innocent little puppies!

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If you want to get “accepted” in the strength & conditioning industry, I’ll let you in on the secret. Just don’t rock the boat! Use the FMS, have your clients foam roll, do mobility drills, develop single leg stability and strength, follow the joint by joint approach, develop core stability, and utilize “accepted” equipment and exercises.

Although I’m in favor of the methods listed above, I’m not always in agreement with the mainstream especially as it pertains to “unsafe” exercises. What do you do when a new fad comes along that goes against what your past experience has taught you? Do you go with the flow in order to get interviewed on the popular podcasts, posted on the popular websites, or invited to speak at the popular seminars? Or, do you stand your ground knowing that it won’t win you any fans in the industry? I’m proud to say that I am the type of guy who stands his ground. I will not cave until I am completely convinced that I should change something, and there are certain trends in the industry that leave me unconvinced at the moment.

I must admit, sometimes I have a hard time taking certain individuals in the S&C community seriously. For instance, when I listen to some of them speak boldly about exercises or concepts in which they have limited or no experience, I realize that they’ve been brainwashed. Many are so wrapped up in theory that they become “addicted” to the science even if it doesn’t add up in the real-world. You see, I’m an advanced lifter who has been training for seventeen straight years and is still trying to increase his strength, muscle mass, and power. You can’t pull the wool over my eyes very easily.

Many strength coaches these days are anti-back extensions and reverse hypers. While I appreciate the logic behind these folks’ arguments, I am still a big supporter of these lifts. For the record, I have no problem with a strength coach who has years of experience with these exercises and arrives at the conclusion that these lifts are not worthwhile. I do, however, have a bit of a problem with rookie strength coaches who have never spent a significant amount of time with these apparatuses and simply regurgitate what they’ve heard from their mentors.

I also have a problem with guys who are so passionate about being “anti-back extensions and reverse hypers” to the point where they’re irrational and absurd. From listening to some of these guys speak you’d think that lifters’ discs would explode and squirt gel across the weightroom the second they performed a back extension or reverse hyper. Sometimes the mindset of today’s younger generation of strength coach ticks me off! In conversing with some members of this crowd I realize that they think I’m an absolute idiot for prescribing back extensions and reverse hypers, yet I’ve had my glute ham developer, 45 degree back extension, and reverse hyper for four years and have trained myself as well as hundreds of clients off of them while they’ve only seen pictures of them or read an article or two about them.

We often forget that the online S & C community is a small sample of the total S & C population and that just because one’s favorite gurus have iron-clad beliefs about a certain topic, it doesn’t mean that they are completely correct or that hundreds of strength coaches and trainers out there aren’t having great success with the very same methods that are being denounced by the online community of coaches. For example, I know of a handful of top sprint coaches who list the reverse hyper as one of their top five exercises for speed development. Unfortunately, their voices aren’t heard because they’re so busy training sprinters.

Moreover, I’m shocked at the number of younger strength coaches who will see a video clip of a coach prescribing a high-caliber athlete an exercise like a back extension or a sit up and will race to the forums to post something like, “Oh my God! Can you believe that (insert athlete)’s coach was having him do (insert bad exercise such as back extensions, reverse hypers, sit ups, bent over rows, good mornings, flies, pullovers, hanging leg raises, or leg presses)! He’s so behind the times. It’s a wonder that these (coaches/trainers) get hired with such a lack of knowledge!

If a coach is having great success with a particular lift, and it seems to be transferring over to his or her athletes’ sports performance without creating any perceivable harm to the athletes’ bodies, then why on God’s green earth would that coach abandon the exercise?

When we omit certain movements, we raise the risk of allowing our athletes to get weak in a particular movement pattern. I’ve witnessed plenty of strong athletes who can squat and deadlift a ton of weight yet struggle to execute twenty bodyweight back extensions or reverse hypers. What does this tell you? They’re weak and need more strength endurance in their posterior chains!

It is this coach’s belief that variety greatly reduces the need for strict periodization and that one should alternate accessory lifts frequently. Furthermore, there’s nothing wrong with having a huge pool of exercises from which to choose. I believe that strength coaches should have their handful of “money lifts” as well as a plethora of accessory movements on hand to slate into their athletes’ programs.

In this article I’m going to roll through some of the arguments in favor of and against back extensions and reverse hypers. I’d like for you to be the judge.

Arguments Against Back Extensions and Reverse Hypers

1. Deadlifts and especially trap bar deadlifts are a safer hip dominant lift
2. Most folks do them incorrectly and compensate with their lumbar spine
3. Repetitive flexion-extension wreaks havoc on the spine
4. They require adequate levels of hamstring flexibility, anti-flexion core stability, hip flexor flexibility, and glute activation
5. Deadlifts and squats are much more effective due to a more pronounced eccentric component, more total-body muscle activity, and increased testosterone-release
6. “Supported” lifts or lifts that support part of the body train muscles without improving upon integrated, coordinated movement
7. In sport-specific training the isolation of joint actions is not worthwhile
8. They lead to significant amounts of shear loading on the spine even if executed properly

Arguments in Favor of Back Extensions and Reverse Hypers

1. While deadlifts, good mornings, squats, and lunges have axial, vertical directional load vectors, back extensions have anteroposterior, horizontal directional load vectors and reverse hypers are one of the rare lifts that have cyclical, dynamic directional load vectors due to the pendulum reorienting itself throughout the lift
2. These lifts can be done properly with all hip extension and no lumbar extension, and if done properly this tells a lot about the athlete in terms of hamstring and hip flexor flexibility, core stability, and glute activation
3. Just like we “isolate” for core stability, it’s a good idea to “isolate” for hip strength…whether it be hip extension, hip flexion, hip abduction, hip external rotation, etc.
4. It’s never unwise to hammer the posterior-chain which is often a weak link among lifters and athletes
5. Reverse hypers are therapeutic for the low back
6. These lifts will improve squat and deadlift strength as well as sprinting speed
7. These lifts have impressive levels of hamstring and glute EMG activity
8. Anything that strengthens the posterior chain might lead to less low back pain and injury

Let’s take a closer look at the various arguments against straight leg hip extension exercises:

1. Deadlifts and especially trap bar deadlifts are a safer hip dominant lift

Anyone with any weightroom experience knows that deadlifts involve much higher incidents of acute injuries. In fact, I can’t think of one strong deadlifter who has never aggravated his or her low back at some point from heavy deadlifting.

The case could be made that back extensions and reverse hypers lead to higher incidents of chronic injuries but I don’t agree. More on that later.

2. Most folks do them incorrectly and compensate with their lumbar spine

I agree. Most folks do in fact perform these lifts incorrectly. However, most folks also perform squats, deadlifts, and lunges incorrectly. It’s our job as professionals to teach our clients and athletes how to perform lifts properly. Shouldn’t we exhibit high expectations for our clients and athletes and “expect” them to learn how to perform lifts correctly? Think about how many times you “coach” squats and deadlifts. If you apply this same amount of “coaching” to other lifts they will get it.

3. Repetitive flexion-extension wreaks havoc on the spine

I am a big fan of Stuart McGill. I believe he’s a great person, a passionate researcher, and an impactful presenter. The science behind his work makes perfect sense. Bend the spine back and forth enough times and the intervertebral discs will eventually rupture. However, I take his research with a grain of salt.

Considering that 80% of individuals suffer from low back pain at some point in their lives it is important that we figure out exactly what is causing this pain. Is it weak glutes? Weak core? Repetitive flexion-extension? Poor back endurance? Quad-dominance? Tight hip flexors and poor posture?

It is my opinion that a weak posterior chain and weak glutes in particular are largely responsible for the alarming number of low back pain in the U.S. The flexion-extension argument just doesn’t hold up in the real-world. There are many folks that perform crunches, sit ups, and back extensions their entire lives and never experience back pain. If there were indeed a “set number” of flexion-extension cycles, every single individual who performed crunches would have disc-related injuries. Although it’s not en-vogue these days to go against the great Dr. McGill, you can’t ignore this simple fact.

The world record for sit ups was set by a Brazilian gentleman named Edmar Freitas who did 133,986 sit ups in 30 hours. He’s also done 111,000 sit ups in 24 hours. If we were truly dealt a fixed number of flexion-extension cycles, Edmar would have likely used his up during his remarkable feats and would have herniated a disc on sight. He’d have been carried off the premises in a stretcher. All boxers, wresters, and bodybuilders would have herniated discs as well. Edmar has probably executed over a million sit ups in his life yet he’s still able to walk around with an intact spine.

What does this tell you? I’ll tell you what it tells me:

1) Clearly we don’t have a fixed number of flexion-extension cycles
2) Strong muscles and proper form can buttress against shear and compressive loads, and
3) The intervertebral discs can clearly regenerate themselves to a certain degree

At any rate, I have no problem with folks who decide to abandon more traditional ab exercises like crunches, sit ups, leg raises, and side bends, and instead concentrate on performing solely stability exercises like planks, side planks, Pallof presses, ab wheel rollouts, bodysaws, chops, lifts, and suitcase carries. While I still program straight leg sit ups and hanging leg raises, I’ve found myself programming core-stability exercises much more often and traditional ab exercises much less often. However, back extensions done properly do not involve spinal flexion or hyperextension!

You be the judge; does it look like my low back is going into unsafe levels of flexion or hyperextension? I should mention that the two videos below showcase subtle technique alterations from “standard form” that increase gluteal contribution and decrease erector contribution:

As you can see, my low back doesn’t flex or extend even when holding onto a 100 lb dumbbell and draping a miniband around my neck which probably offers another 50 lbs of resistance to the top of the lift.

What about reverse hypers? Here’s a video clip of Smitty from the Diesel Crew explaining how they perform their reverse hypers:

As you can see, it is possible to perform reverse hypers without flexing or extending the lumbar spine as well. If you tell me that this form is just too hard for people to master then I will think you’re a crappy trainer. Remember – high expectations and quality coaching!

4. They require adequate levels of hamstring flexibility, anti-flexion core stability, hip flexor flexibility, and glute activation

Proper squats require adequate levels of hip, thoracic spine, and ankle mobility; should we avoid them? Are you okay with your clients or athletes not being able to perform proper back extensions or reverse hypers? If they can’t do them right, it means that they either have crappy hamstring or hip flexor flexibility, poor levels of core stability, weak glutes, improper motor patterns, or simply an insufficient knowledge of form. Personally I’m not okay with my clients or athletes suffering from any of the aforementioned dysfunction and I intend to fix their movement patterns. If someone like me can do them correctly, then I surely expect them to do them correctly and will keep working with them until they get it right.

5. Deadlifts and squats are much more effective due to a more pronounced eccentric component, more total-body muscle activity, and increased testosterone release

I would actually agree with this statement. However, back extensions have an eccentric component that is more accentuated up top in the contracted position, while reverse hypers have an extreme eccentric component if you perform the exercise correctly and stop the pendulum from pulling your low back into flexion.

When you hold onto the handles in the case of the reverse hyper, you activate the forearms and lats and transfer energy from the hands down through the arms, back, and core. In fact, the process of holding onto the handles and adding a lot of weight to the pendulum makes the reverse hyper an excellent total body exercise. If you doubt me, I recommend palpating someone’s erector spinae all the way up and down the spinal column to see how hard they’re contracting during the lift.

The last thing I want to mention is that there have been a couple of studies that have come out in the past year or two showing that increased testosterone release from lower body exercise does not impact muscle protein synthesis in upper body muscles. This means that we may be wrong about “squats and deadlifts” causing upper-body growth due to increased testosterone release. Maybe the increased upper body growth from squats and deadlifts is simply due to the development of a strong set of erectors which allows for more weight to be lifted during upper body exercises like bent over rows, t-bar rows, bent over rear delt raises, and barbell curls.

6. “Supported” lifts or lifts that support part of the body train muscles without improving upon integrated, coordinated movement

At first thought I would tend to agree with this statement. However, upon further consideration one realizes that this is not in fact true. Since these lifts can hone in on muscular weak links and improve strength in the integrated, coordinated total-body lifts like squats and deadlifts, they lead to improved integration and coordination in a round-about manner. In other words, if you strengthen the hip extension pattern and the posterior chain in general, you’ll get stronger at squatting and deadlifting and more powerful in running and jumping.

Furthermore, is integrated, coordinated movement the sole objective of sport-specific training?

7. In sport-specific training the isolation of joint actions is not worthwhile

What happens when you get an athlete with virtually no glute development? Don’t you try to isolate the glutes with quadruped and bridging patterns in order to increase activation and hypertrophy? What if an athlete has weak hamstrings? Don’t you prescribe Russian leg curls or glute ham raises? The bottom line is that there are times when we need to increase the size of a certain muscle as well as times when we need to increase the muscular endurance of a muscle, both of which warrant isolation.

When you really think about it, nearly everything we do in sport-specific training is “isolation” work. In sports the body is all over the place. In the weightroom, we’re very controlled. Squats isolate double extension. Plyometrics isolate triple extension. Planks isolate core stabilization. Static stretching isolates muscles. So do mobility and activation drills. We foam roll individual muscles. When we bench press we isolate horizontal pressing. But in sports we combine several joint actions at once and usually move our upper and lower bodies simultaneously.

In sport-specific training we get individual parts strong so we can assemble them together on the field, court, or ring with the right timing patterns to create powerful movement. Although it’s wise to focus on “money exercises” that give you much bang for your buck, it is still okay to program some more isolated work as accessory movements. That said, I have a hard time seeing how anyone could really consider a hip extension movement “isolation training” when there are over 20 muscles involved in hip extension including large muscle groups such as the glutes, hamstrings, and adductors.

Here’s another way to think about it: Stronger deadlifts equal faster sprints. Reverse hypers equal stronger deadlifts. Therefore, reverse hypers equal faster sprints. In mathematics we call this the transitive property of equality. If stronger deadlifts truly lead to faster sprints, then anything that strengthens the deadlift therefore leads to faster sprints. In this manner a grip exercise could increase sprinting speed if it strengthens the grip which happens to be the limiting factor in one’s max deadlift.

Obviously if you’re limited on time, go with standing movements. Standing lower body movements like squats, deadlifts, lunges, and power cleans reign supreme for a variety of reasons, but supine, prone, and quadruped lower body movements can supplement standing lifts very well and lead to synergy in training adaptations. In other words, 2 plus 2 doesn’t equal 4; it equals 5.

8. They lead to significant amounts of shear loading on the spine even if executed properly

Deadlifts also lead to significant amounts of shear loading especially at the bottom of the lift when bent over and even more significantly when the lifter keeps his or her hips high when deadlifting. This technique is characteristic of taller lifters. When we pick up plates or dumbbells off the bottom rack, we experience large shearing forces on the spine. In fact, any supine, prone, or quadruped hip extension movement or standing hip extension movement that involves bending forward significantly is going to produce large shearing forces.

It is important to expose the body to forces from different directions as Davis’ law and Wolff’s law state that the body’s tissues can strengthen and restructure themselves to better prepare for the types of forces to which they’re regularly exposed. If we avoid certain directional loading patterns then injuries will arise in sporting situations as soon as the body is greeted with unfamiliar directions of force. With proper progression and mechanics, you can perform heavy back extensions and reverse hypers and not have to fear spinal injury, and you’ll even safeguard the body to prevent injuries in competition.

Summary of Arguments in Favor of Straight Leg Hip Extension Exercises

Back extensions and reverse hypers may be more “specific” to top-speed sprinting and may transfer better due to the more specific-nature of the directional loading pattern (horizontal vs. vertical) in comparison to squatting, lunging, and deadlifting patterns. Since the glutes contract very hard at the top of these movements at end-range hip extension, they may help add much needed power to that range of motion during athletics. This range of motion includes the critical stage of ground contact in sprinting.

When an athlete can demonstrate proficiency at heavy back extensions and reverse hypers, you know that he has adequate levels of hamstring and hip flexor flexibility, anti-flexion core stability, and glute activation. In other words, you can feel confident that their backs aren’t going to round forward or hyperextend very easily, their glutes are strong and can turn on when needed, their hamstrings are loose enough to allow for a healthy range of forward bending motion, and their hip flexors are loose enough to allow for full hip extension.

Strengthening the posterior chain in general may increase squat and deadlift strength in addition to staving off low back pain and injury. Many individuals have witnessed their back pain disappear once they started performing back extensions and reverse hypers. In fact, some experts argue that the reverse hyper is quite therapeutic for the low back as it rotates the sacrum and may “pump” fluid into the intervertebral discs. Although this sounds great in theory, it may or may not be true. Anecdotal evidence seems to support the notion.

In the clip below, I perform a heavy set of reverse hypers while allowing the sacrum to rotate. I have been performing reverse hypers for four years and am one of the individuals who feel that it’s benefited my back health tremendously.

As Dr. Stuart McGill has often mentioned, pain is very specific to the individual’s injury, dysfunction, or pain-mechanism. For example, a flexion-intolerant person better keep a strong arch while he performs back extensions or reverse hypers and avoid going too deep or he’ll certainly feel it the next day. Conversely, an extension-intolerant person better brace the core hard and avoid going up too high on back extensions or reverse hypers or he’ll certainly feel it the next day. I should mention that arching the low back slightly in comparison to flexing the low back helps buttress the spine and protect the low back from shear forces by 23-43% (McGill). As a matter of fact, simply bracing the spine and contracting the core musculature increases spinal compressive loading by 12-18%, yet the act simultaneously enhances spinal stability by 36-64% (Granata and Marras, 2000). Some individuals get an uncomfortable tingling sensation when they perform reverse hypers. This is usually due to tight hamstrings and glutes and clears up with stretching and continued use of the reverse hyper.

The last thing I want to mention is that many high-level coaches are in support of the reverse hyper including Louie Simmons, Dave Tate, Kelly Baggett, Joe DeFranco, Erik Minor, Christian Thibaudeau, Martin Rooney, James Smith, Jason Ferruggia, and Charlie Francis. You certainly cannot call this list of coaches a bunch of idiots as these folks are some of the top minds in the S & C industry.

How Do I Use Reverse Hypers in Training?

1. I prescribe bodyweight reverse hypers to beginner males and amateur women that I train
2. I prescribe heavy reverse hypers to all sprinters that I train
3. I prescribe them infrequently (maybe every other week) to most athletes that I train
4. I personally perform them when I notice that I have trouble getting the bar moving in the initial portion of a max deadlift

I hope that I’ve done a good job of trying to persuade strength coaches to being open-minded about back extensions and reverse hypers. Thanks for reading my article!

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At some point in time, 80% of people will suffer from low back pain (LBP). As a trained specialist who watches people move all day long, it is blatantly apparent why such a large percentage of people have low back pain: They don’t move correctly! The root of the problem is this:

People move with their low backs instead of their hips!

When the low back moves and the hips stay locked up, the gel inside of the lumbar discs propels toward the outside of the disc and can cause bulges or herniations. This is often the source of lower back pain.

The solution is not as simple as simply learning proper mechanics. Many people are unable to move with proper mechanics due to poor mobility and motor control. It takes some time to reprogram the body to move correctly.

In this blog I will teach you how to get rid of back pain by combining seven different strategies. Since this blog is intended for the common person, I will refrain from using too much technical terminology and try to keep it simple. In the interest of brevity, I will exclude specific exercises and drills, as this blog is intended to entice the reader to learn more about each strategy listed.

1. Improve Soft-Tissue Quality

Over the years people have built up adhesions and scar tissue that needs to be cleared. Furthermore, trigger points need to be desensitized. A muscle cannot function optimally if it has adhesions, scar tissue, and trigger points. By using self-myofascial release (SMR), which is simply a technical term for a “poor man’s massage,” you will restore optimal tissue quality and allow proper functioning of the muscle’s nerves and blood flow.

There are two ways you will address your soft-tissue quality. First, you will use a foam roller. You will roll out your entire back, including the erector spinae, lats, rhomboids, and traps. You will also roll out your glutes, hamstrings, calves, quads, IT band, hip flexors, adductors, and pecs. A simple Google search will allow you to find pictures and videos of foam roller drills for each muscle group.

And second, you will use a tennis ball or better-yet a lacrosse ball for more targeted therapy. You will use the ball to focus on the arches of the feet, the calves, the upper glutes, and the mid scapulae.

Although you can find many different drills on the internet for SMR, the best way to learn the correct application of the foam roller and lacrosse ball is to simply buy them, get on them, and start moving around. Your body will show you how to use them!

2. Improve Soft-Tissue Length

There are many different opinions in the fitness industry regarding the role of static stretching, but I believe it’s the best way to turn off inhibition and increase flexibility. Two main points to static stretching is to learn how to relax into the stretch and to combine rotational aspects into common stretches (PNF techniques) in order to kill two birds with one stone by stretching multiple muscles simultaneously. Never stretch so aggressively that you end up stretching ligaments! In particular, hamstring flexibility and hip flexor flexibility are critical components to minimizing low back stress.

3. Activate the Glutes

Many people have weak glutes. The glutes don’t like to contract unless need-be. They like to let other muscles such as the hamstrings and quads do a job and stay dormant unless you force them to contract. Years of inactivity and sitting (which shortens the hip flexors and causes more glute inhibition) cause the nervous system to literally forget how to use the glutes.

Use two different strategies to increase your mind-muscle connection for the glutes. First, incorporate loadless training into your arsenal, which is just a fancy term for “flexing your glutes.” Seriously, start squeezing your glutes as hard as possible every ten minutes or so throughout the day. Hold the contraction for around one second and then shut them off. Do this around three times during each “session.” This will equate to around 300 maximal isometric contractions per day and will go a long way toward increasing your glute activation.

Second, start doing low-load training which simply means start performing relatively simple glute exercises while focusing on high-quality glute contractions. Some good glute activation exercises include bodyweight glute bridges, quadruped hip extensions, side-lying abductions, side-lying clams, bird dogs, x-band walks, single leg glute bridges, and fire hydrants.

4. Increase Mobility and Stability in the Hips, Ankles, and Thoracic Spine

The best way to improve mobility is to add strength and therefore stability at new ranges of motion. By performing the right drills, you can simultaneously increase mobility and stability. Learn how to contract the muscles being stretched at the end range of a motion and pull the body into new ranges of motion with opposing muscles. There are many great mobility exercises that can easily be found online.

5. Learn How to Control the Core and Prevent Lumbar Movement

This could very well be the most important tip of all. Most people move by contorting their lumbar spines. Proper movement mechanics usually involves keeping the lower back locked into place (bracing) in neutral position while moving about other joints such as the thoracic spine and hips.

Even while exercising, most individuals have poor lumbar mechanics. They overarch (excessively extend) their low backs during squats, deadlifts, bridging, quadruped, lunging, and back extension movements, they round their lower backs (flexion) during deadlifts, bent over rows, good mornings, and reverse hyper movements, and they twist their lower backs during rotary movements. In all of these examples, this is improper mechanics.

Advanced lifters and high level trainers/coaches often have an insufficient understanding of lumbar mechanics. It takes much diligence to reach optimal core control but it is a critical component to moving, exercising, and eliminating back pain.

An excellent trick to learning core control is to perform anti-movement exercises. Anti-movement exercises teach the lower back how to brace heavily to resist movement and strengthen the core in a manner that uses all of the vital core muscles involved in bracing the core.

There are three types of anti-movement core exercises: 1) anti-extension, 2) anti-lateral flexion, and 3) anti-rotation.

Anti-extension exercises prevent lumbar arching and include front planks and ab wheel rollouts. Anti-lateral flexion exercises prevent lumbar side-flexion and include side planks and suitcase carries. Anti-rotation exercises prevent lumbar twisting and include Pallof presses.

Cable chops and lifts are valuable core exercises as well. These exercises should not be thought of as less difficult or challenging than traditional core exercises. If performed correctly, they are very hard.

6. Increase Hip and Leg Strength

Most people who suffer from back pain have strong backs, and that’s precisely why their backs hurt. They use their erector spinae musculature (back muscles) to lift things rather than relying on the glutes, hamstrings, and quadriceps. By strengthening the hip and leg muscles, the body will be encouraged to lift with the appropriate muscles. This doesn’t mean that the erector spinae will not be involved in lifting mechanics, as they will always contract heavily as stabilizers. However, the lumbar discs will be spared as the lower back will be stabilized to allow the muscles of the hips and legs to be prime movers.

It is imperative to start out with basic exercises and move up through the exercise progressions gradually. One must master bodyweight with a full range of motion before using extra load.

7. Learn How to Move Properly and Incorporate All of the Aforementioned Qualities Into Your Motor Patterns

Contrary to what is often said, one does not need to “lift with the legs.” The low back muscles are stabilizers, while the hips and thigh muscles are prime movers. It is perfectly fine to lift with the hips high as long as the lower back stays in neutral position. This simple act requires many of the qualities listed above, such as hamstring flexibility, glute activation, core control, and core/posterior chain strength. Learn proper movement mechanics and reinforce those movement patterns over and over until it becomes automatic. Finally, keep the load close to the body.

If people learn how to follow these steps, many lives could be improved dramatically. To give you a personal story, a 21-year old former client of mine (now he’s 23) was told by three different doctors that he needed to have surgery on his lower back. He was in and out of the emergency room and constantly taking pain killers. After three weeks of training with me, his lower back pain completely disappeared. Within two months he began performing loaded squats and deadlifts with 135 lbs. Within six months he was squatting 300 lbs and deadlifting 380 lbs. It is now two years later and he has never suffered a single bout of lower back pain despite lifting heavy week-in, week-out. While this story isn’t the norm, it clearly shows that low back pain can be alleviated and a LBP-free life is possible if the correct strategies are employed.

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