Overcoming chronic and/or acute back pain:
Over the past two years, I have helped many PCF athletes with low back issues. These athletes asked that I put something together for all to read. The following information covers three important and what I see as interdependent topics:
â€¢ Causes of low back pain
â€¢ Proactive recovery techniques
Understanding these three areas can help prevent future injuries and allow athletes to resume training at a higher intensity.
The below information combines my personal experience with the advice of physical therapists, orthopedic surgeons, and neurosurgeons.
Additionally, I included tips from published articles in The Crossfit Journal and The National Strength and Conditioning Journal.
Causes of Low Back Pain
How many of you have said this before? â€œIt feels like my back â€˜goes outâ€™ every six months or so.â€
Doctors, regardless of their specialty, would probably argue that most low back pain is muscular in nature, likely temporary, and can be avoided. The basic prescription is rest, anti-inflammatory medication, muscle relaxers,and physical therapy. Doctors prescribe physical therapy to strengthen the muscles around the low back to regain full mobility. Emphasis, however, is not always placed on proper form when doing these movements.
You, as the patient, may feel like you are being shrugged off. Trust me, I know where you are coming from. Doctors take this approach because, unless you have experienced blunt force trauma to the low back, your body will typically heal itself without much intervention. Sometimes it takes years, and sometimes it takes months, weeks, or days, but if you stop doing movements that hurt you, you will heal, and return to a â€œnew normalâ€.
Instead of stopping a desired exercise routine completely, the goal is to take as much pressure off the low back muscles as possible during a workout. One accomplishes this by opening up the hips, strengthening the core, and lifting with proper technique. Most recurring acute low back issues are caused by tiny micro-tears of muscles around the spine.
Micro-tears can be just as bad, if not worse, as slipping a disc. Those tiny muscles are directly surrounding the spine and used in nearly every movement you make. Hereâ€™s how I recovered from a discectomy of the L5-S1 and frequent muscle strains, without changing Crossfit training as my main source of fitness.
Itâ€™s important to understand that any type of back strain will require modification and scaling of many movements. Although muscles heal, they will always be slightly different than they were before. Embrace the change, and stop comparing yourself to what you could do before. You are working with a â€œnew normal.â€
First and foremost, warming-up before a WOD is essential. Stretching and rolling-out in between and after a WOD is also very important.
I recommend stretching in this order to maximize the effects of your workout. Think of your anterior and posterior chains as a lever system. If the anterior chain is tight and shortened, then your posterior chain is also tight but elongated. The intent of stretching the anterior chain first is to give you some slack in the posterior chain so that you can make the stretch more effective:
â€¢ Quads (wall stretch) http://www.youtube.com/watch?v=gUUWeZtRklY
â€¢ Psoas stretch: http://www.youtube.com/watch?v=yfswfLuW_tI The psoas is right next the lower abs. It is just as important to stretch this out as it is the quad. These two stretches usually help open up your hips to take pressure off your back.Hamstrings (hurdler stretch or with a band)
â€¢ Back Stretch: http://www.youtube.com/watch?v=14CyUzNOtQo This is great to open up the spine
â€¢ Figure-4 (with or without a strap)
*I would stretch, at a minimum, before and after every WOD. If you can find a few minutes to stretch first thing in the morning and at night, that helps a lot too!
Rolling out (same anterior and posterior theory applies):
â€¢ Great link with explanation and videos http://smr.networkfitness.com/smr-categories/
â€¢ IT Band
â€¢ Thoracic Spine
â€¢ Bottoms of your feet http://www.youtube.com/watch?v=q09syIQHvUM (52 seconds in)
â€¢ Ice your lower lumbar region after workouts. This cannot be stressed enough. Twenty minutes, twice a day after workouts, will stop inflammation and allow you to maintain consistency in your workouts.
â€¢ Slow down your intensity during workouts from 5th gear to about 3rd gear so that you can move properly with an engaged core.
â€¢ Supermans are great too as long as you do them correctly. http://www.youtube.com/watch?v=bF-FCOrAXMc (do about 2-3 sets of 10 each side)
â€¢ Try to stay off your stomach while sleeping. Sleep on your side with a pillow between your legs or sleep on your back with a pillow under your legs on a firm mattress.
â€¢ Nerve flossing is another good technique: http://www.youtube.com/watch?v=UoUqfOGuEOU
Proactive recovery techniques
– Limit heavy squat snatch or squat cleans, and focus on the power positions.
– No max weight on back/front squats and snatch balance, instead do more reps with less weight. Focus on form!
– Deadlift and OHS as normal but exercise caution with heavy weight. Focus on form, err on the side of caution, and do not overload the weight. The same applies to WODs with running and box jumps. Slow it down and try step-ups to avoid any jarring motion to the back.
1. Planks (front and side) (Try and get to 1 minute on front and 30 seconds on each side)
2. Bird-Dogs (10-20 each side) http://www.youtube.com/watch?v=3KiN9CAqvFY
3. Cat Exercise (5-15 Reps) http://www.youtube.com/watch?v=zzNJP_SgHRc
4. Bridges (5-15) http://www.youtube.com/watch?v=yOPkM2pzznc
5. Lateral walk on treadmill (work up to 3 min each side whenever you can on a treadmill) http://www.youtube.com/watch?v=hpBubdBn68w
If you do these movements once a day before working out or at home, you should be on your way to a strong low back. Muscle fatigue, whether under heavy load or just bodyweight, is what ultimately contributes to poor form, leading to injury. So, if you are trying to find that “safe” training zone for the next month or so, target those stabilizer muscles in order to maintain good strength and form in your movements. From there, you will want to continue with the lighter weights and work towards higher intensity.
Next delivery day to Potomac CrossFit from Heritage Hollow Farms (formerly Mount Vernon Farms) is Thursday. Orders need to be in NLT 1pm on Tuesday. .
Warmup: EMOTM 8 Min
3 Snatch Balance
3 Situp to Straddle
Alt: 3 Ring Row Drill/3 Divebomber
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