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Lower back pain is a real pain. Really, it's no fun and yet it is a common type of chronic pain experienced by all kinds of people, from athletes and fitness fanatics to sedentary America.
Most adults will deal with this kind of pain at some point, so what can you do about it as a trainer? While some cases of pain should be referred to a medical professional, in most cases simple changes to lifestyle and workouts will provide relief.
Exercises for low back pain, stretches, foam rolling, and a few other simple strategies may be all your clients need to have less pain. Teach them to do these exercises with good form and provide some other tips to help manage chronic pain.
Low back pain is not uncommon, but it is uncomfortable. There are many potential reasons that a client may be experiencing this pain, and many of them can be addressed with good training. Poor posture, aging and wear and tear, and sports related injuries are common culprits.
If your client has severe pain, if training doesn't help relieve it, or if there are other symptoms, make sure you encourage a doctor's visit. There are plenty of medical conditions that could be causing the pain, and getting it diagnosed and treated is essential.
Perhaps the biggest reason people end up with low back pain is poor posture. How you stand and sit throughout the day really impacts how you feel. Proper spinal alignment holds everything in balance, but many people lack adequate strength in the erector spinae muscles to be able to hold good posture for very long. Ultimately, what underlies poor posture is weak muscles, in the lower back, core, and glutes. However, overactive or tight muscles are just as problematic. For example, tight hip flexors can pull the top of the hips forward, creating tightness (rather than weakness) in the lower back.
Even people who train and work out, athletes too, can suffer the consequences of poor posture when inactive. Sitting a lot throughout the day can lead to imperfect posture, even in people who are strong and fit.
Of course, lower back pain can also be triggered by specific injuries. A muscle strain in the lower back caused by over-working it or a movement that causes it to stretch too far can lead to pain until it heals. Ligaments in the lower back can also become strained, usually from sudden movements, and cause issues.
Another issue is simple wear and tear. As we get older the deterioration in spinal discs and joints can cause pain. Aging can also naturally cause the muscles to weaken and the elasticity of ligaments to decrease. These changes can all trigger chronic pain in the lower back.
Stretching and rolling or a gentle massage are easy ways to start working on low back pain with your clients. Strengthening exercises will be essential in managing and preventing future pain, but don't forget the importance of these lower-intensity activities.
Rolling out tight muscles and connective tissue with a foam roller is another way to stretch and loosen areas that are causing or contributing to lower back pain. Show your clients how to effectively roll the glutes, hamstrings, hips, and calves. Actually rolling the lower back is not likely to be helpful and could cause more harm than good.
To learn more about relieving tight muscles in the back, neck, and shoulders, check out this ISSA blog post.
Gently stretching the lower back, hip flexors, and other areas of the body can loosen tight muscles, promote better postures and form when doing certain movements, and relieve pain:
Stretch the hamstrings to improve the position of the spine when bending over. When hamstrings are tight the spine tends to round, putting pressure on the lower back.
Tight hip flexors compound low back pain by pulling the pelvis forward. Kneeling or standing hip flexor stretches can help this. Clients will want to feel the stretch in their quads (rectus femoris, specifically) and deep in their torso (psoas).
To gently stretch the lower back the client can perform a child's pose, or lie supine and bring both knees into the chest.
The best medicine for lower back pain, unless of course there is a medical cause, is to strengthen key muscles. The erector spinae in the back, gluteals, and core muscles all contribute to holding your spine in a neutral, balanced position. When any of these are too weak, that alignment goes out of whack and the result is pain.
Help your clients build strength to prevent and manage back pain with these exercises. Show them good form and encourage them to do up to three sets of 10 to 15 reps, three times per week.
On hands and knees on the floor, lift the right arm and left leg. Stretch the arm forward and the leg back and hold for a few seconds as far as possible and feel the stretch in the back. Repeat with the left arm and right leg.
Hold a simple plank steadily increasing your time to 45 to 60 seconds. The body should be a straight line from feet to head with toes, elbows, forearms, and hands pressed into the ground and the neck relaxed. Do just three to five reps of this exercise to strengthen the core.
Lying on your stomach with hands pressed to the floor, directly under the shoulders. Point the toes away so the tops of your feet are on the floor. With hips pressed to the ground, lift the chest up and pull the shoulder blades back and together. Hold for a few seconds, and slowly lower back down.
Lie on your back with knees bent and feet hip-width apart. With feet planted firmly on the ground, lift the hips off the floor and squeeze the glutes.
Most people will find they can get some relief from lower back pain without turning to medication. Of course, if you have a client whose pain persists or gets worse, insist they see their doctor for some medical intervention.
Before that becomes necessary, though, the stretches and exercises that strengthen and relax lower back muscles should be a big help. There are other things you can recommend for your clients too:
Get more exercise generally. Being sedentary can contribute to pain. Poor posture also causes lower back pain and more time spent exercising and strengthening muscles supports a healthier posture.
But rest if necessary. If the pain is from over training or an injury, resting the muscles is important, as is avoiding sitting for too long, lifting heavy objects, and bending at the waist.
Change sleeping habits. Finding the right sleeping position can make a world of difference. First, the mattress should be firm and supportive and the pillow not too fluffy. Back sleepers should put a pillow under the knees, while side sleepers need something between the thighs or under the waist to provide the best alignment.
Work on posture. Being more aware of posture throughout the day can help reduce lower back pain over time. It's important when sitting and standing, and requires flexing those newly-strengthened back and core muscles.
Back pain can be very limiting. Pain in the lower back impacts mobility and overall well-being. In most cases it is caused by factors that can easily be fixed, and yet most adults live with some degree of low back pain.
As a trainer you have the ability to help more people live pain free. Improving posture, moving more and sitting less, stretching out tight muscles, and strengthening the muscles that are important for posture and alignment can relieve most cases of lower back pain.
With the right guidance and expertise, your clients can live with less pain.
To learn more about muscle imbalances and how to use exercise as part of a pain reduction or injury prevention program, look into becoming a Certified Corrective Exercise Specialist.
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