Tag Archives: Bridge

Low back pain: why and what to do about it

by Thommy Chui, PT, OCS, CSCS, TPI CGFI MP2

What does it mean when someone says I threw my back out? Was it spring cleaning and this person decided, I  don’t want it anymore?

As a Physical therapist, all too often I hear the phrase” I threw my back out”, followed by… “all I’ve done for the last week is lie down, take pain medication, and rest.  I didn’t want to make it worse.”

Our human anatomy and physiology was developed to move, however our increasingly sedentary work duties and lifestyles have done quite the opposite. Whether it’s sitting watching TV, sitting in front of a computer station for hours without breaks, sitting in meetings , or traveling by car or airplane to then sit in meetings, we just aren’t moving as much anymore.

Studies have shown that prolonged sitting can contribute to decreased disc height in our lower back.  Additionally, extensive sitting produces overly tight hip muscles and weakness in the low back and gluteal muscles.   The result is an imbalance in our core stability.

The most common non-traumatic ways in which people injure their lower back is by bending, standing from a chair, turning or twisting. This is when we “throw our backs out.” What does this mean? It means that since we have an imbalance in our core stabilization, our muscles are not working in harmony. Specific muscles around our spine end up compensating and can progressively become overworked, setting the stage for injury.  The pain we feel initially is usually  tension or spasms of these overworked muscles.  Remember the root of the problem is weakness and inadequate stability caused by not moving enough.—so the last thing you should to do when your back is sore or in pain is lie down and not move!

Research shows that continued mobility in pain free ranges in combination with modification of activities helps decrease pain significantly.

Below are some recommendations for strength and mobility exercises along with safe techniques for getting in/out of bed and standing up from chairs without exacerbating your back pain. Try these the next time you have back pain and it may help avoid a trip to your doctor’s office.

LOG ROLL (4 steps):

log roll 1 crop

log roll 2 crop

log roll 3 crop

log roll 4 crop

HIP HINGE

hip hinge crop

SIT-STAND (SQUAT)

squat crop

LUMBAR ROTATION, TRUNK ROTATION

LTR 1 crop

LTR 2 crop

FRONT PLANK

front plank crop

SIDE PLANK

side plank crop

BRIDGE

bridge crop

References:

–          O’sullivan, K et al. “Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.” Ergonomics. 2012;55(12):1586-95. doi: 10.1080/00140139.2012.721521. Epub 2012 Sep 25.

–          Zemp, RIn vivo spinal posture during upright and reclined sitting in an office chair.” Biomed Res Int. 2013;2013:916045. doi: 10.1155/2013/916045. Epub 2013 Sep 24.

–          Lee SH, et al “The change of whole lumbar segmental motion according to the mobility of degenerated disc in the lower lumbar spine: a kinetic MRI study.” Eur Spine J. 2014 Mar 28.

–          Kline JB et al. “Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in pre-professional ballet dancers: a case series.”J Dance Med Sci. 2013;17(1):24-33.

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Ski/Board Strong, All Day Long: Week 4

Hooray for SNOW!!!  Welcome back to the fourth week of the Ski and Snowboard Series.  This is a progressive strength and conditioning program specific to snow sports injury prevention and performance enhancement.  By now you should have a good base strength to protect you from injuring yourself the first day out on the slopes.  Also by now, hopefully you have made it to the slopes!  The previous weeks direct you in beginning hip, core, and balance exercises.

Week 1:  Glut med and balance progressions

Week 2: Front plank and squat progressions

Week 3:  Clams and side plank progressions

Now, we are going to work on power development:

Bridge Progression – Week 4

If there was a single exercise we’d perform on a deserted island, it’d be an exercise called bridging, or just, the bridge.  The bridge reverses so many deficits that can be detrimental to our level of conditioning.  The bridge will strengthen your core, gluteals, hamstrings, and stretch the hip flexors.  This exercise progression is great for prepping for the slopes and can be a lifelong injury prevention exercise.

Start: Double or single leg bridge.  Perform 2 sets of 10-20 repetitions or to fatigue.  Make sure your lumbar spine and pelvis is neutral and that you engage your lower abdominals.  During the single leg bridge keep your pelvis flat like a table top.

Progress:  Perform the progression above on a physio ball

Hip Power Progression – Week 4

Last week, we introduced the clamshell exercise to help stabilize the hip joint and ligaments during movements requiring change of direction.  The large outer layer of the hip musculature (the gluteus maximus) along with the hamstrings are responsible for large bursts of power.  The squat below will help develop this movement, and work on upper body muscle imbalances at the same time.  To work on hip extensors, power, AND balance, perform the RDL progression.

Start: Overhead squat.  Make sure to keep your elbows locked and arms right overhead.  Squat down as far as you can before your arms start migrating forward or your heels start leaving the ground.  Perform 2 sets of 10-20 or to fatigue.

Progress: Single leg Romanian dead lift (RDL).  Perform 3 sets of 10-20 reps or to fatigue on each side.

Still not motivated or don’t have enough time to practice every day?  Come to Total Body Fitness every Tuesday and Saturday where we will feature specific exercises geared towards snow sports fitness.

Check back for next week’s installment of the ski and snowboard series!

Ski and Snowboard Series – Week 4

Hooray for SNOW!!!  Welcome back to the fourth week of the Ski and Snowboard Series.  This is a progressive strength and conditioning program specific to snow sports injury prevention and performance enhancement.  By now you should have a good base strength to protect you from injuring yourself the first day out on the slopes.  Also by now, hopefully you have made it to the slopes!  The previous weeks direct you in beginning hip, core, and balance exercises.

Week 1:  Glut med and balance progressions

Week 2: Front plank and squat progressions

Week 3:  Clams and side plank progressions

Now, we are going to work on power development:

Bridge Progression – Week 4

I always tell my patients that if I was stuck on a deserted island and I could only choose one exercise, it would be the bridge.  The bridge reverses so many deficits that can be detrimental to our level of conditioning.  The bridge will strengthen your core, gluteals, hamstrings, and stretch the hip flexors.  This exercise progression is great for prepping for the slopes and can be a lifelong injury prevention exercise.

Start: Double or single leg bridge.  Perform 2 sets of 10-20 repetitions or to fatigue.  Make sure your lumbar spine and pelvis is neutral and that you engage your lower abdominals.  During the single leg bridge keep your pelvis flat like a table top.

Progress:  Perform the progression above on a physio ball

Hip Power Progression – Week 4

Last week, we introduced the clamshell exercise to help stabilize the hip joint and ligaments during movements requiring change of direction.  The large outer layer of the hip musculature (the gluteus maximus) along with the hamstrings are responsible for large bursts of power.  The squat below will help develop this movement, and work on upper body muscle imbalances at the same time.  To work on hip extensors, power, AND balance, perform the RDL progression.

Start: Overhead squat.  Make sure to keep your elbows locked and arms right overhead.  Squat down as far as you can before your arms start migrating forward or your heels start leaving the ground.  Perform 2 sets of 10-20 or to fatigue.

Progress: Single leg Romanian dead lift (RDL).  Perform 3 sets of 10-20 reps or to fatigue on each side.

Still not motivated or don’t have enough time to practice every day?  Come to Total Body Fitness every Tuesday and Saturday where we will feature specific exercises geared towards snow sports fitness.  There will be no class Sat Dec. 25th or Sat Jan. 1st.  In the meantime, keep working hard!

Last minute shopping:  Give the gift of fitness with CPMC Sports Wellness holiday specials.

Happy Holidays!