SYDNEY — The last few years have not been kind to my lower back. Between the physical stresses of pregnancy, parenthood, and working from home, I have a constant feeling of stiffness and pain in my lower spine. I’m not alone: It’s estimated that up to 80 percent of Americans will develop low back pain in their lifetime, with 15 to 20 percent of adults reporting it in an average year.
Could exercise prevent some of this pain? The short answer is maybe. A consistent mix of cardio and dedicated core work can help. However, exercise alone is not a guarantee of pain relief, as there are a number of mistakes that many of us, even experienced athletes, can make.
The spine is susceptible to pain when the core muscles are weak.
“The lower back is the center point of our entire body,” said Dr. Krishna Shah, an interventional pain specialist at Baylor College of Medicine. The spine has to be mobile, capable of bending and twisting in multiple directions, while also supporting the weight of our body.
Surrounding the spine are the core muscles. Although we tend to think of our core as the abdominals, it also includes the deep muscles of the back, as well as the muscles of the hips, quads, and hamstrings, which support the spine and pelvis.
Your core muscles work similar to a back brace, keeping your midsection stable and upright. That’s why wearing a brace provides short-term pain relief for low back pain patients, but relying too much on one can weaken your core muscles. Instead, the goal should be to strengthen those muscles enough to do the job of the brace.
“If you can build your own internal brace, that’s more effective,” said Dr. Sean Barber, a neurosurgeon and spine specialist at Houston Methodist Hospital.
Acute back pain is often the result of pulling or straining a muscle while attempting a movement that requires a muscle that has become weak or stiff. If this muscle cannot provide the necessary force, then the pressure is transferred to the spine in a way that causes pain.
Building core strength, flexibility, and muscle control can help you avoid these pulled or strained muscles.
EXERCISE STRENGTHENS THE SPINE
The easiest way to strengthen your spine is to move regularly throughout the day, in whatever capacity works for you. This might mean increasing your daily steps, taking short walks during the workday, or prioritizing a slightly longer morning or evening walk.
People who are physically active tend to have lower rates of back pain, and a recent meta-analysis of 25 studies found that the most effective way to prevent recurrence of low back pain was regular exercise, preferably combined with some form of exercise. physical education.
“Exercise doesn’t cure everyone, but on average it is an effective intervention,” said Dr. Mark Hancock, a professor of physical therapy at Macquarie University and one of the study’s authors. There is no single type of exercise that has been shown to be effective, he said. “If you’re doing a variety of exercises, you’re likely to get everything you need,” he said, adding, “It’s like your diet.”
Physical activity also strengthens the bones and cartilage in the spine, protecting them against age-related degeneration, and increases blood flow to cartilage discs in the spine that don’t get much of a blood supply, Dr. Shah said. .
If you have time, try brisk walking or jogging. Several studies suggest that runners have thicker, healthier cartilage discs in their spines than people who are not active.
WORK NEGLECTED DEEP CORE MUSCLES
Working your core is crucial to avoiding future back pain, but that doesn’t mean shredding your abs to look like Chris Hemsworth. Popular exercises to strengthen the core, such as sit-ups or sit-ups, primarily work the larger outer muscles, while neglecting the deeper muscles.
For example, the transversus abdominis is a deep, delicate muscle that wraps around the midsection like a corset. There’s also the multifidus, a muscle that lines the spine, with a series of extensions wrapping around each individual vertebra, similar to how a bicycle chain wraps around a sprocket.
“It doesn’t take a lot of effort to activate these deep muscles, but they get neglected because you can’t see them” when you’re at the beach, said Mr. Femi Betiku, a physical therapist at the New Jersey Physical Therapy Center. that she specializes in treating low back pain. People with ripped abs can still have lower back pain, she added, if only the strongest outer muscles work.
The deeper muscles are engaged during movements that require more control than raw power. One way to activate your deep core muscles is by doing planks, whether it’s a regular plank, a side plank, or one of many other variations.
If holding a regular board is uncomfortable, start with your knees on the ground and then progress to balancing on your toes.
Dr. Shah also suggested squats, pushups, and bridges. To build and maintain core strength, he recommends two to three sessions of dedicated core work per week. “This is a lifestyle change,” he said.
There are also sports and physical activities that require a slight core contraction, such as kayaking, cycling, dancing, pole classes, boxing, rock climbing, and swimming. Any activity that requires a certain level of control over your midsection will help activate and engage those deeper muscles.
WORK ON SPINE CONTROL
In addition to strengthening exercises, emerging research suggests that developing muscle coordination and spinal control is important. This is equally true for athletes, who focus on performance and sometimes neglect exercises aimed at controlling the spine and pelvis.
In a 2018 study, researchers compared elite athletes to a population of moderately active people. Half of each group had lower back pain.
To the surprise of the researchers, both elite athletes and normal people with low back pain had similar stiffness and lack of control over the spine, which is indicative of a similar pattern of weakness in the back muscles.
“The key factor is how capable you are of controlling your muscles,” said Dr. Mariá Moreno Catalá, a researcher at Humboldt University Berlin and lead author of the study.
To combat this, Mr. Betiku recommends Pilates because, in addition to strengthening the deeper core muscles, the exercises promote muscle control. For a series of exercises, the spine remains stable or moves very slowly, which develops muscular control throughout the spine when in different positions.
Incorporating Pilates into your exercise routine can be as simple as making short exercise videos, many of which require little or no equipment, two or three times a week.
ADD AN ELEMENT OF INSTABILITY TO YOUR TRAINING
The slow, controlled movements in exercises like Pilates teach your muscles to move your spine efficiently. The next step is to begin exercising in a more variable environment, which further develops coordination and control.
In another study, Dr. Moreno Catalá and her colleagues found that adding instability to exercises, such as balancing on an uneven surface or even exercising in a noisy environment, was effective in relieving low back pain.
Dr. Moreno Catalá said it’s less about the amount of muscular strength and more about the ability to precisely control the activation and deactivation of all the muscles that stabilize the spine.
“We think the size of the muscle is the most important quality, but the quality of activation is also important,” he said.
Choosing sports that include an element of reactivity, whether it’s walking on a rocky surface or reacting to a sudden tennis volley, can result in a similar level of muscular development and control. Bodyweight exercises like push-ups, pull-ups, burpees, and squats also help, as they require full-body coordination, rather than the isolated motion of lifting weights.
Like many, I am guilty of working the outer core muscles while neglecting the deeper ones. But over the last few weeks, I’ve started making some short Pilates videos, 10-20 minutes each, focusing on slow, controlled movements. Two weeks later, the stiff feeling in my back began to fade, disappearing for hours. As it turned out, all my lower back really needed was to develop a little more coordination and control.
This article originally appeared on The New York Times.
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