Most common causes of back pain & changes you can make to ease that pain



In industrial nations, it is estimated that up to 75% of the population will experience low back pain. Causes of low back pain are variable from excessive weight, strenuous exercise or lifting to stress and anxiety. With multiple possible contributing factors, there appears to be a common denominator amongst many of them, poor posture. Rounded shoulders, forward head, the pelvis tucked under or pushed back leading to low back being too arched or flattened results in impaired spinal loading, muscular activation and length and impaired pressure regulation through the core. Teaching postural alignment is typically the first step to achieving less pain. The subsequent steps involve strengthening the muscles of the core and upper and lower body. For the purposes of the blog, the core will be activating the pelvic floor muscles, the transverse abdominals, and the deep spinal extensors in coordination with the breath, as the diaphragm is a major pressure regulator and activator of the core. Within this workout, the goal will be to activate the core enough to meet the demand of the exercise. In the beginning you may be activating the muscles as hard as you can, but as you learn the exercises lessen the amount of activation. Why? Because you want to teach the core to activate at varying intensities, versus all or none, thus improving the core endurance and versatility needed for ideal postural alignment and less low back pain.

The below routine is designed to prime the core then challenged it while incorporating lower and upper body movements, as well as, stretch the body all of which will improve your posture, range of motion, and strength needed to decrease low back pain. As with any new exercise you may experience some discomfort not pain. If any of the movements are painful, then modify or stop. Perform each movement for 30-60 seconds for 1-3 sets at least 3-4 times a week.

Position and Movement

Accessory and Total Gym Incline

Movement/ Cue

Progression/Regression

 

Seated forward: Core Activation Awareness

 

Incline middle1/3

 

 

Pelvic floor: hold back passing urine and gas.

 

Transverse Abdominals: pull navel to spine.

 

Deep Spinal Muscles: growing tall, string on tailbone.

Legs can be straight or can be straddling on the glideboard with feet on the floor.

Seated Forward: Roll back and up

 

Incline middle 1/3

 

 

Feet on rails, reach the arms to shoulder level. Slowly rolling back all the way onto the back focusing on moving through each segment of the spine.   Reaching the arms at shoulder level slowly curl the body up to roll the body all the way up and forward reaching for the toes. Roll through the spine up to the sitting position.

 

Modify by rolling partially back onto the low back.

 

Ensure to initiate via curling the tailbone versus hinging straight back.

 

Incorporate reaching the arms overhead.

 

Bend the knees or straddle the glideboard to assist with stability, flexibility and/or strength.

 

 Seated Forward

Lateral leaning

Incline middle 1/3

Sitting tall, reach one arm overhead and lean to the side. Example reach the right arm up to the sky, then lean the body to the left.

 

 

One arm progress to reaching both arms overhead.

 

Focus on anchoring the hip onto the glideboard.

 

Avoid pushing the lower ribs out.

 

Bend the knees or straddle the glideboard to assist with stability, flexibility and/or strength.

 

 

 

Supine Squatting Series- Core focus

 

Squat Bilateral

 

Squat alternating legs

 

Static equilibrium

 

Squat varying ranges

 

Incline middle 1/3

 

 

Bend and straighten the knees gradually start to alternate lifting a leg and transition into alternating the legs fast enough to where the glideboard stays still, i.e. fast feet.

 

Incorporate an abdominal crunch to assist with core activation and awareness of pushing the abdominals or ribs out versus maintaining them engaged pulling in.

Supine: Bridging series

 

Rolling up and down

 

Bridge squat

 

Low squat stretch

 

Hip lift with squatting

 

Incline middle 1/3

 

 

Bridge: Slowly roll the hips up and down focusing on rolling through the pelvis, low to mid back.

 

Bridge Squat: Lift the hips up into a full bridge and bend and straighten the knees.

 

Low Squat Stretch: With hips flat, enter a low squat.

 

Hip Lift: Lift the hips 2” off the glideboard, maintain this position and bend and straighten the knees.

 

Glide board can be at the bottom or open with rolling through bridging.

 

Press through the heels.

 

Visualize reaching knees over the toes to avoid placing excessive pressure on the neck.

 

Incorporate pulling the arms apart from one another to help increase activation of the back muscles. Use a towel or band.

Prone/On your belly head toward the tower:

 

Lat Pull Down with arm pulleys

 

Shoulder Adduction with thoracic lift

 

 

Incline Lower to Middle 1/3

 

Arm Pulley

 

 

With arms reaching overhead, bend the elbows into the sides and hands to shoulders.

 

With arms out to the sides like a “T”, pull the hands down to the sides of the body.

 

Focus on sliding the shoulders away from the ears throughout the range of motion.

 

Focus on maintaining the navel away from the glideboard throughout the glideboard.

 

Incorporate upper back extension/lift.

 

Sitting facing tower to Inverted Supine

 

½ Roll Back to reaching forward

 

Inverted supine abdominal series with or without arm pulley:

 

Ab Crunch

Marching

Toe Taps

Bicycle

 

 

 

Incline Lower to Middle 1/3

 

Arm Pulley

 

 

 

Slowly roll back into an inverted supine position with or without the arm cables then roll forward reaching for the toes then roll up in sitting upright.

 

Abdominal Series with or without Arm Pulley:

Ab Crunch: Lift the upper body up into an abdominal crunch. Focus on abdominals pulling in and avoid tucking the pelvis under.

 

Marching: Alternating lifting and lowering of the leg

 

Toe Taps: legs 90-90 at hip and knee and tap one foot down toward the glideboard then back to 90-90

 

Bicycle: Reach one leg toward the tower and back. The other leg can be bent supported on glideboard or 90-90.

 

Focus on shoulders sliding away from the ears and feeling the movement of the pelvis and spine.

 

Watch the abdominals to ensure you are pulling in and not pushing out.

 

 

The feet can be on the rails to allow the body to be fully supported when rolling back.  Since the glideboard moves ensure the feet are far enough away.

 

With abdominal series, head may be lifted or supported.

 

Focus on reaching the shoulders away from the ears.

 

 

Quadruped: Hands and knees Series

 

Hip extension

 

Shoulder extension

 

Bird Dog: Opposite arm and leg reach

 

Child’s pose with and without rotation

 

Incline Lower to Middle 1/3

 

Arm Pulley

 

Holding cables in each hand, anchor the hands on the board and enter hands and knees position.

 

Hip Extension: Straight one leg straight back

 

Shoulder Extension: Pull one arm straight back.

 

Bird Dog: Reach the opposite arm and leg straight back.

 

Child’s Pose with and without rotation: Sit back onto the heels with arms outstretched and breathe. Then reach one arm under the torso and rotate the chest.

 

Focus on hips staying steady. When reaching the right leg back, the right hip will want to move to the side. Cue the body to move slightly to the left or place a little more pressure through the inside part of the left knee.

 

Ensure the spine remains in neutral to avoid tucking the hips under.

 

Focus on pulling the shoulders away from the ears.

 

 

Optional Bird Dog Variation maintain the arm or leg reaching while the opposite arm/leg moves.

 

To assist with stability, perform without the arm cable.

 

To allow for more range of motion, place the body toward the side to allow the moving leg to come off the board to touch the floor.

 

Seated facing tower series:

 

Reverse Shoulder Fly: Shoulder horizontal Abduction

 

Shoulder External Rotation

 

Incline Lower to Middle 1/3

 

Arm Pulley

 

 

 

Reverse Fly: Reaching the arms toward the tower and to each other, pull the arms out to the side like a “T”.

 

Shoulder External Rotation: Keeping the elbows bent 90 degrees at shoulder height, pull the forearms back.  

 

Maintain the shoulders pulling away from the ears.

 

Visualize sitting tall and lightly.

 

To challenge balance, stability and strength, perform with legs out straight or low kneeling.

Squat Series: Strength Focus

 

Bilateral Squat

 

One Legged Squat with Toe Touch

 

Plie Squat

 

One Legged Plie Squat with Toe Touch

Incline Upper 1/3

Bilateral Squat:

Bend and straighten the knees.

 

One Legged Squat with Toe Touch: Focus on pressing through one leg while the other leg is toe touching on the squat stand.

 

Plie Squat: Legs are turned to turn out, bend and straighten the knees.

 

One Legged Plie Squat with Toe Touch: Legs are in turn out with one leg toe touching, focus on bending and straightening one leg.

 

Ensure the knee is tracking along the 2nd and 3rd toes.

 

Press through the entire foot.

 

Initiate by tightening the leg and pressing through the foot to avoid the tendency to pressing the low back into the glide board to start the movement.

 

Optional Plie Squat Variation: Perform on the balls of the feet.

 

 

 

Push Up Series

 

Plank hold with shifting forward and back, side to side and/or rotation.

 

Down Dog to Plank – optional push up

 

Down Dog to piriformis stretches

 

 

Incline Upper to Middle 1/3

Hands on the glideboard, focus on moving the body forward and backward then rotate or shift hips side to side.

 

Push back into a down dog positions with hands on glideboard and body in an inverted V position. Push glideboard up entering a plank position then add an optional push up then return to down dog.

 

Starting in down dog position, push out glideboard up the rails while bringing the knee into the chest. Rest the leg on the glideboard and feel the stretch about the outer hip.

 

Can also be performed on forearms.  

 

Modified plank with knees on the board is an option. Move the hands up the board to start.  

 

Press through the toes visualizing yourself in one straight line while in plank.

 

In plank, maintain a soft bend in the elbow.

 

 

 

 

Hip Stretching

Hip Flexor

Hamstring

Adductor

Incline Lower to Middle 1/3

 

 

 

Hip Flexor:

Standing facing away from or to the tower, place one knee bent on the glideboard while the other is bent and supported on the floor (split lunge position) facing forward.

 

Hip Adductor: Standing facing away from or to the tower, place one knee bent on the glideboard while the other is bent and supported on the floor (split lunge position) facing to the side.

 

Hamstring/Calf: Standing facing away from or to the tower, place one knee bent on the glideboard while the other is straight with toes pulled up.

 

 

 

Can use squat stand or chair for balance.

 

Incorporate arm reaches for hip flexor and adductor stretch:

Overhead

Side to side

Rotational

 

Hamstring/Calf Stretching: Turn toes in, up to the sky and out to the side.

 

Ensure the knee is straight not locked out. If needed maintain a slight bend.

Elizabeth Leeds, DPT

Elizabeth Leeds, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training, and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues.Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.

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