Chiropractic

Lower Back Savers III: Bulletproof That Back

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Sooner or later, you’re going to tweak your back, and there’s nothing you’ll ever experience, perhaps shy of limb dismemberment, that’ll put a stop to your training as cruelly or effectively. Of course, if you’ve already had some back problems, you know what we’re talking about. Either way we recommend you bone up on the back. It’s one complex little beastie.

It’s time for Round 3 of my Lower Back Savers. If you missed Parts 1 and 2, check them out, respectively.

This time around, we’ve got fewer bullet points and plenty of videos.

15 – Reevaluate Use of Unstable Surfaces

I’ve spent a good chunk of the last five years studying unstable surface training (UST). In fact, the results of my master’s thesis were published in the Journal of Strength and Conditioning Research in 2007, and I’ve written an entire e-book about the topic.

My main impression that’s come about from all this research and experimentation is that UST is like the food guide pyramid of the exercise world. There are certain people in certain scenarios (e.g., ankle sprain rehabilitation, upper extremity proprioception drills) who need to use it, whereas it’s remarkably inappropriate for others. Standing on an unstable surface is different than sitting on an unstable surface, which is also different than doing a push-up on an unstable surface.

I could go in a hundred different directions with this, but for the sake of brevity β€” and to avoid the guaranteed Internet pissing match that would ensue β€” I’ll simply highlight one obvious perspective and back it up with a bit of research. Classic β€œcore” work on unstable surfaces doesn’t really carry over to anything.

Stability balls might increase fiber recruitment on these exercises (and double the spine load, according to Dr. McGill, but that’s another story). The bigger issue is that the core stability improvements may not carry over to functional tasks.

A 2004 study from Stanton et al. is a great example of the divide between testing proficiency and performance. Researchers found that six weeks of stability ball training improved core stability in young athletes β€” as it was measured (in a manner consistent with the training itself).(1)

In other words, this is like saying that bench press training will make you better at bench pressing. Well, duh! The more important question, though, is whether or not that bench press performance will carry over to athletic performance.

While their measure of β€œcore stability” improved, it did not effect favorable changes in running economy or running posture, or modify EMG activity of the abdominal or erector spinae muscles. In other words, it didn’t carry over.

A comparable result was seen in a 2005 study from Tse et al. After eight weeks of stability ball training in collegiate rowers, while β€œcore stability” (as they tested it) improved, the experimental (core training) group showed no performance improvements over those who did ZERO core training during this time.

And, the researchers tested several measures: β€œvertical jump, broad jump, shuttle run, 40-m sprint, overhead medicine ball throw, 2,000-m maximal rowing ergometer test.”(2)

So, I guess the question is why bother doing this stuff if there really isn’t any evidence to suggest that it directly improves performance? I could take the β€œit may lead to injury” perspective, but I think that the β€œwhy waste your time?” mindset is far superior.

Of course, if you’re training with unstable surfaces just for comedic value, carry on.

16 – Appreciate the Role Thoracic Erectors in Protecting the Lumbar Spine

Take a look at any high-level Olympic lifter or powerlifter, and you’ll see some monster thoracic erectors. Why? They subconsciously know to avoid motion in those segments most predisposed to injury, and the extra meat a bit higher up works to buttress the shearing stress that may come from any flexion that might occur higher up on the spine.

Novice lifters, on the other hand, tend to get flexion at those segments β€” L5-S1, L4-L5, L3-L4, L2-L3 β€” where you want to avoid flexion at all costs. Show me a lifter with crazy hypertrophy in the lumbar erectors, and I’ll show you a guy who probably has a history of back pain. Our body is great at adapting to protect itself β€” especially as we become better athletes and can impose that much more loading on our bodies.

Here’s the issue, though: you’ve got to take care of your thoracic erectors or else they won’t perform up to par. Tissue quality is incredibly important, and since regular massages aren’t always feasible, we utilize two β€œhome versions” with our athletes.

First, you’ve got the more diffuse approach with the foam roller.

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17 – Consider Different Classes of β€œCore Training”

There’s been a pretty solid back-and-forth jabbing here at T Nation over the past few years about whether or not specific β€œcore” work is overrated. Some say that squats and deadlifts are enough, while others insist that you’ve got to train the core directly. Who’s right? As usual, my answer is β€œit depends.”

Would a powerlifter and other breed of athlete β€” whether it’s hockey, soccer, baseball, football, or whatever β€” have different demands? Yep!

Now, how about an athlete who played baseball when he was younger and then took up powerlifting after a collegiate baseball career? Wouldn’t he have a unique set of a) weaknesses and b) functional demands? Of course!

Next, how about a 38-year-old guy who a) chases his two kids around, b) sits at a desk eight hours a day for work and then in the car for another hour to commute, c) lifts heavy stuff three days a week, d) does interval training twice a week, d) does yard work, and e) plays on a beer-league softball team once a week? Think his core might have different functional demands?

Different people, different needs, limited training time and energy. What do you do?

If you’re me, you categorize your core exercises in one of the following four disciplines (although there may be some overlap):

  1. Anti-Flexion
  2. Anti-Extension
  3. Anti-Rotation

I look at both squats and deadlifts as anti-flexion. Your goal is to maintain your neutral spine in scenarios where the load is positioned in front of your center of gravity. Honestly, if you are regularly doing squats and deadlifts (and their derivatives), I don’t think you need to add in extra anti-flexion exercises.

Working with predominantly athletes, though, anti-extension and anti-rotation exercises are of paramount importance. As the majority of athletic lower back injuries involve uncontrolled extension or rotation in either an acute or chronic sense.

With anti-extension exercises, we’re generally setting up in a position where gravity makes our job tougher. Examples include regular ol’ prone bridge variations.

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Professional Scope of Practice *

The information herein on "Lower Back Savers III: Bulletproof That Back" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

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Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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