Dealing with back pain and confused about what to do at the gym about it? When dealing with back pain, many say that you should strengthen your back and core. But, what are the best ways and are there some things you should avoid? There are often many machines or equipment at the gym or sold that say they “strengthen” the low back. But, often when dealing with back pain, strengthening probably should not be your first option as many feel weak as a result of their back pain and are not in pain as a result of weakness. The main thing to focus on early on in your back pain is to, you guessed it, to get rid of the pain. While how to do that is the topic of other posts, as a Physio, I’ve noticed that when you take care of the pain first, a good amount of the strength returns without ever having done a “strengthening exercise”. But, let’s say that you are now out of pain and are wanting to strengthen, what should you do? What should you avoid? So, here are your 4 gym machines to avoid when dealing with back pain along with some options to do instead to strengthen your core and low back.
First, what are the muscles we are actually targeting? What is your core?
Like it sounds, your core is at the center or you. If you think of it like a box, it has your diaphragm or breathing muscle at its top, your back muscles as its back, your oblique muscles(muscles on the side of your stomach) as its sides, your “6 pack” at the front along with your and your pelvic floor connecting your tailbone to your pubic bone and supporting you from below along with the core muscle everybody forgets-the glutes. Deep to all these is another muscle that acts like your internal back brace, the transversus abdominis. All of these muscles work together to brace and control the spine and give it what it just one of the things that it needs, stability. The logic goes that if you can just stabilize your spine you will be pain free but that often is not the case(because stability is just one of the things that the low back and spine needs.
How to think about core exercises
So, what do those core muscles do anyway? Well-their first job is to resist movement. Before gyms, everybody got strong cores not by laying on the ground and reaching for their toes, holding a position for minutes on end, or by using a machine. They did it through lifting things, moving things, and by daily chores. Their core got stronger by resisting twisting, bending, or by pulling on things. So we can think of our cores as “anti-” muscles. So how can you mimic some of those tried and true ways of getting a stronger core and using those muscles how they were meant to be used?
Avoid: 45 degree Low Back Bench/Roman Chair and any Low Back Machine Risk level Moderate Benefit Level Low
Why? Often these benches and machines rarely if ever actually isolate the low back muscles. Of all the low back machines I’ve ever worked with patients and clients on in the past 19 years, only the Lumbar MedX was actually designed to isolate the low back. Everything else mostly has you pushing with your legs. Second, these machines and the 45 degree low back bench actually take your back into a position that is most likely to cause a low back injury. In other words, when you have the most load on your spine on either the machine or the bench, your spine is in a forward bent position. Now, if you’ve been dealing with back pain, not only are you in a position that most likely triggers your pain(forward bent), but the muscles that are supposed to be protecting your back are not working like they used to so now all that force goes to the disc and facets of the spine.
What to do instead: Before we get to 3 options for strengthening your back, first we need to look at what the job of the muscles of the spine actually is. To start with, the main job of the spine muscles, aka your core, is to stabilize and resist motion. This makes for a stable platform for you to do basic things like roll out of bed or get out of a chair pain free all the way up to giving you a stable platform to run, jump, and lift. This means that your obliques job is to resist rotation, your abs to resist extension, and your low back muscles like your spinal erectors or quadratus lumborum’s job is to resist forward bending. Once they’re able to stabilize your spine in neutral, then they can be counted on to bend and twist while making a stable platform.
What to do instead: Cook Hip Lift: Risk Low, Benefit, High -Isolate the glutes to create a stable base
Anti-Rotation Press: Risk Low, Benefit High Train the obliques for stabilization of the spine
Skydiver: Risk Low, Benefit High
Avoid: Leg Press-Sled or 45 degree(but especially 45 degree leg press)
Risk Level High Benefit Low/Moderate: Scores moderate for benefit mainly for bigger leg muscles but minimal benefit for the low back, functional strength(very few activities have you pushing your legs up off your back or on a sled), and no benefit for stabilization or balance.
Similar to the back machine, the leg press has the highest stress to your back when your back is in the most vulnerable position. In this case, when the knees are fully bent, often the hips roll up off the pad shearing the bottom part of the spine.
Do this instead:
Rear Leg Elevated Split Squat/Bulgarian Split Squat
Risk Low for low back, with knee pain, it may be bothered. Benefit High for balance, low back, and hips
Avoid: Smith Machine Squats or Lunges: Risk: High Benefit: Low
Like the above machines, the smith machine leaves your back in a bad position just when the load is highest on it. In addition, it provides the stabilization instead of your core and doesn't help with improving functional strength.
Do this instead: Goblet Squats or Goblet Lunge
Risk: Low Benefit: High
The goblet squat or lunge engages your core before you ever enter the movement making sure your low back muscles, glutes, and abs are engaged.
Because the weight is held higher, it makes sure you are not able to go beyond what you can control and if there any problems in the lift, you are not stuck with a bar on your back.
Please make sure it is safe for you to try any of the exercises in this post. Often we find that when we make some of the changes, like improving our posture or getting stronger core muscles at the gym don't take away the pain or we find that we reaggravate our issue. Why? Often because some of the underlying causes remain untreated. Often our nervous system becomes so sensitive that these fixes only partly calm down our nerves, ease our stiff backs or loosen tight muscles. Sometimes we try stretches or exercises that only aggravate our spine, muscles, or pinch nerves that then send sciatica pain down the leg or make our muscles spasm. Often there are other natural solutions to fix low back pain. That’s why we offer free consultations to get to the root cause of your sciatica, low back pain, or just to make sure your back isn’t the cause of hip, knee, or even foot pain.
During one of our free consultations, the Total Body Diagnostic, we offer expert advice about the worry and frustration of life-changing aches and pains – for FREE, in under 30 minutes.
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